My Account



by Sally Sutton, MA, MSSW

Sally Sutton, MA, MSSW, is a Senior Policy Analyst at the Institute for Health Policy, Muskie School of Public Service, University of Southern Maine. Ms. Sutton completed her graduate work in social work and public policy and administration at the University of Wisconsin-Madison. In addition to over 25 years work as a social justice advocate, managing nonprofits and being involved in the debate on many public policy issues impacting social workers and their clients, Ms. Sutton has taught graduate level courses in legal and ethical issues in social work, provided continuing education workshops on the same topics, and currently serves as an officer on the board of the state chapter of the NASW as well as on that group’s ethics committee.

This course is the copyrighted property of and may not be copied in part or in entirety without the express written permission of For information on how to secure permission to use this course or any part of this course, contact us at:


The objective of this course is to instruct mental health clinicians in the use of the best practice ethical decision making models for addressing complex ethical dilemmas. When the trainee completes this course, he or she will:

1) Grasp the most important models for addressing and resolving ethical dilemmas
2) Understand factors that may impact the use of the best practices approaches
3) Learn the special complications created by ethical practice with clients from non-majority cultures
4) Comprehend the factors involved in cultural competency
5) Know the model for addressing ethical decision making in cross-cultural counseling

This course is designed for mental health clinicians in the early to intermediate stage of their career, or for clinicians seeking review in this area.

Course length:
3 contact hours: Ethics

Section I: Introduction
Section II: Best Practice Models of Ethical Decision Making
Section III: A Six-Stage Model for Ethical Decision Making
Section IV: Business Approaches to Ethical Decision Making
Section V: Models for Cultural Diversity
Section VI: Applications of an Ethical Decision Making Model
References and Test


Section I: Introduction

Please note the following three paragraphs from the preamble to the codes of ethics for, respectively, social workers, counselors and marriage and family therapists:

NASW code: This code offers a set of values, principles, and standards to guide decision making and conduct when ethical issues arise. It does not provide a set of rules that prescribe how social workers should act in all situations. Specific applications of the code must take into account the context in which it is being considered and the possibility of conflicts among the code’s values, principles, and standards. Ethical responsibilities flow from all human relationships, from the personal and familial to the social and professional.

ACA Code: When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decision-making process. Reasonable differences of opinion can and do exist among counselors with respect to the ways in which values, ethical principles and ethical standards would be applied when they conflict. While there is no ethical decision-making model that is most effective, counselors are expected to be familiar with a credible model of decision making that can bear public scrutiny and its application.

AAMFT code: The absence of an explicit reference to a specific behavior or situation in the Code does not mean that the behavior is ethical or unethical. The standards are not exhaustive. Marriage and family therapists who are uncertain about the ethics of a particular course of action are encouraged to seek counsel from consultants, attorneys, supervisors, colleagues, or other appropriate authorities.

Each of these statements speaks to the complex relationship between the codes of ethics and responsible ethical decision making. Mental health clinicians in each of the three major counseling disciplines are expected to thoroughly understand their code of ethics and use their code as a starting point for guiding their decision making in situations of ethical conflict.

However, each code states, in essence, that the code - by itself - is insufficient to resolve all ethical dilemmas. In order to practice ethically, each mental health clinician ultimately must develop their ethical understanding to the point where good ethical decision making is almost second nature, incorporating a thorough knowledge of ethical decision making approaches into a systematic and thorough model for identifying ethical violations and resolving ethical dilemmas.

To help the trainee to expand their knowledge of ethical decision making, this course will present a number of best practice models or approaches that can be used for resolving ethical dilemmas. While there is a great deal of overlap between many of these models, each one presents somewhat different aspects of the ethical decision making process. Taken together, they form a solid foundation for understanding how to approach complex ethical dilemmas.

To take this knowledge one step further, the course will also present a discussion of some factors that will influence the successful application of any decision making model, such as the need to be culturally competent or aware of your own values, or how to be an ethics advocate.

Integrating the Codes of Ethics with Best Practices Models

While the code of ethics for each profession is not sufficient by itself to resolve all ethical dilemmas, knowledge of the code is a key component of good ethical decision making. For trainees who are interested in expanding their knowledge of the code of ethics, offers an alternative five-hour introductory course on ethical decision making that includes both the ethical decision making models covered in this course and a detailed overview of the codes of ethics. This course is entitled: Using Best Practice Ethical Decision Making Models and the Code of Ethics: A Guide for Mental Health Clinicians.

It is our hope and expectation that each mental health clinician has read the code of ethics for their profession and keeps on hand at all times a copy of the code for easy reference. It may be useful for trainees to have available their code of ethics as they take this course. In this way, it will be easier to integrate the guidelines presented in the code with the ethical decision making models. For convenience sake, we have provided below an easy link to the three main codes of ethics for mental health clinicians.

You do not need to disconnect from this course in order to print out these codes. You should be able to return easily to the course by clicking the return, or back, arrow at the top left of your web browser once you have finished printing the code. You will not need to log back in.

(If you prefer not to print the code, but wish to have the code available as you read through this course, you can minimize this screen by clicking on the minimization box at the top right of this page. This will keep the course open while you navigate elsewhere on your computer. Leaving the course minimized, re-open your web browser application, and enter the URL address as shown below to take you to the code of ethics. When both windows are open, you can go back and forth between this course and the code.)

Connect to the Appropriate Code of Ethics

NASW Code of Ethics

American Association for Marriage and Family Therapists

American Counseling Association