ACA Ethical Decision Making Model

Educational guidance for US mental-health clinicians. Not legal advice, not a board ruling, and not a copy of the ACA documents linked below.

Priya is an LPC in a solo office. It is 6:12 p.m. Her 5:00 client, Marcus, is still in the parking lot. He wants a letter by morning that says he attended every week this quarter. The chart shows four missed sessions. The sentence he wants is half typed.

That is not a second role with him, and it is not a decision about telling him something from her own life. It is a request to write a fact the chart does not support. The sheet at the top of this page is the ACA ethical decision making model for that hour. She fills the lines for this case. She does not recite a poster from memory and call that a decision.

Use the ACA ethical decision making model on the case in front of you

The association already states the steps. Holly Forester-Miller and Thomas E. Davis wrote them in Practitioner’s Guide to Ethical Decision Making, a 2016 revision published by the American Counseling Association. The guide’s own citation line names that revision. The “at a glance” list on the guide’s fifth page is:

1. Identify the problem.
2. Apply the ACA Code of Ethics.
3. Determine the nature and dimensions of the dilemma.
4. Generate potential courses of action.
5. Consider the potential consequences of all options and determine a course of action.
6. Evaluate the selected course of action.
7. Implement the course of action.

Read that list in the guide. This page does not replace it. What you can fill at 6:12 p.m., while Marcus is still in the parking lot, is the blank at the top. ACA also publishes a one-page ethical dilemma poster of the same sequence, the five principles, and the three tests. The poster is a reminder. It does not give you a line for Marcus’s letter. The sheet does.

The guide’s step 5 holds both the weighing and the choice. This sheet splits them, so the choice is not hiding inside the list you just cut. The guide’s steps 6 and 7, evaluate and then implement, share the last line. A test you do not act on is a note, not a decision.

Stop when the code already answers it

Standard I.1.b of the 2014 ACA Code of Ethics says: “When counselors are faced with an ethical dilemma, they use and document, as appropriate, an ethical decision-making model that may include, but is not limited to, consultation; consideration of relevant ethical standards, principles, and laws; generation of potential courses of action; deliberation of risks and benefits; and selection of an objective decision based on the circumstances and welfare of all involved.”

Two limits sit in that sentence. “As appropriate” means the model is not a ritual you perform on every awkward email. “May include, but is not limited to” means the code does not lock you to these seven titles. The practitioner’s guide is one model the association publishes. It is the model this sheet is built for. It is not a claim that a licensing board has adopted it, and it is not a claim that another model is forbidden.

The guide is sharper about the stop. After you apply the code, it says: “If there is an applicable standard or several standards and they are specific and clear, following the course of action indicated should lead to a resolution of the problem.” The next paragraph says that if the problem is not resolved by reviewing the code, then you have a complex ethical dilemma and you continue. Priya’s first job is that fork, not a performance of all seven lines.

She opens the code before she finishes the sentence. If a standard she actually reads forbids stating attendance the chart does not show, she writes the standard number on line 2, follows it, and does not send the letter. She does not invent a section number to sound finished. If she cannot find a standard that settles it, she marks “not resolved” and keeps going. Guessing a citation is worse than a blank line.

If ethics and law seem to conflict, do not let this sheet outrun standard I.1.c in the same code. That standard is the conflict path. This page does not quote it as your outcome. Open it.

What each line is for

Line 1 of the ACA ethical decision making model is facts. The guide tells you to gather information, be specific, and separate facts from innuendo, assumptions, hypotheses, or suspicions. It also asks whether the problem is ethical, legal, professional, clinical, or more than one of those, and it says to seek legal advice if a legal question exists. Priya’s facts are short. Marcus asked for a letter stating weekly attendance. The chart shows four missed sessions. The letter is not sent. Anything about his motive is a guess until he says it. Guesses go in a separate clause, or they do not go on the line.

Line 2 is the code you opened, not the code you meant to open later. Write the ACA standard number and what it requires in this fact pattern. Standard I.1.b, quoted above, also names consideration of relevant ethical standards, principles, and laws. If you opened a state board rule, an employer policy, or another credential’s code, write what you opened. If you did not open it, do not write it. This sheet does not decide which of those apply to you. A blog summary of the code does not count. If line 2 resolves it, stop. That is the guide’s rule, repeated here so the blank has a place to record the stop.

Line 3 is the conflict the code did not settle. The guide says to examine implications for autonomy, justice, beneficence, nonmaleficence, and fidelity, and then this: “In theory, each principle is of equal value, which means that you will need to use your professional judgment to determine the priorities when two or more of them are in conflict.” Name the two that fight. Name which one leads here, and why. The guide also tells you to review current literature, consult a colleague who abides by the ACA Code of Ethics, and ask a professional association if you need help. A consultation you did not make is not a consultation. Write “not consulted” if that is the truth.

The guide and the poster already define the five principles. Use those definitions. Do not borrow a textbook paragraph and call it line 3.

Line 4 is a list you are not allowed to edit yet. The guide says to brainstorm, include options you are not sure will work, and not judge them in this phase. It also says to consult at least one colleague who subscribes to the code, when you can. Priya’s list might include: decline the letter, offer a letter that matches the chart, call the recipient with Marcus on the line, ask what the letter is for before deciding, or wait until morning and talk to a colleague. “Wait” is an option. It is not a free pass if the morning send is already promised.

Line 5 is where cutting starts. The guide says to assess consequences for all parties, ponder implications for the client, for others, and for yourself, and eliminate options that do not give the desired results or that cause a worse problem. Write who is harmed by each remaining option. A letter that invents attendance harms the recipient and Priya’s record. A refusal may harm Marcus’s goal. Both can be true. Line 5 is the place that stays true.

Line 6 is the choice, pulled out of the guide’s step 5 so it cannot hide. One option, or a combination. “I will think about it” is not a choice unless the sheet says what you will do at a named time.

Line 7 is the guide’s evaluation, then the implementation the guide puts last. Do the three tests before you send anything. Then write what you did.

Document the path in the client file

The guide’s evaluation step says to apply three tests associated with Stadler (1986): justice, publicity, and universality. The guide states them this way.

Test	Question the guide gives you
Justice	Would you treat others the same in this situation
Publicity	Would you want this behavior reported in the press
Universality	Would you recommend the same course to another counselor in this situation

No cell above is your answer. Your answer is yes or no, written on line 7, for this case. The guide says that if the selected course causes any new ethical issues, you go back to the beginning. It also says that if you can answer in the affirmative to each test and you are satisfied, you are ready to implement. A failed test is not a vibe. It is a reason to return to line 1.

Implementation, in the guide, is two moves. Strengthen your resolve, because the right decision may still be hard. After you act, follow up to see whether your actions had the anticipated effect. The last blank on the sheet is that follow-up: what you did, the date, and when you will look back.

The guide’s conclusion says there is rarely one right answer to a complex ethical dilemma, and that different professionals may choose different courses for the same situation. It also says you should document the decision-making process in the client file. Standard I.1.b already said “use and document, as appropriate.” The chart line is how Priya does that without pasting the whole guide into the note.

A usable line looks like this. Brackets are hers.

6:24 p.m. Client asked for a letter stating weekly attendance this quarter. Chart shows four missed sessions. Letter not sent. Opened the 2014 ACA Code of Ethics, standard [number]. Clear standard found: [yes, followed, stopped / no, continued]. Principles in conflict: [names]. Colleague: [name, or not consulted]. Choice: [decline / letter that matches the chart / other]. Tests: justice [yes/no], publicity [yes/no], universality [yes/no]. Action taken: [what]. Review on: [date].

That line is the record. It is not a legal conclusion, and it is not “I followed the model” with nothing under it.

Sort a dual relationship or a self-disclosure on its own page

A dual relationship is a different job. If the dilemma is a second role, a barter, a social contact, or a referral that benefits you, sort it on the dual relationships in therapy page first. That page asks whether the relationship is prohibited, avoidable, or managed. Make that sort there. If the sort leaves you with a real choice, bring the facts back here and fill the seven lines. Do not talk yourself into a relationship the other page already marks prohibited.

Self-disclosure is also a different job. If the dilemma is whether to say something about your own life, use the therapist self-disclosure page and its stop rule before you speak. Fill these seven lines when the stop rule does not settle it, or when the disclosure is tangled with another problem, such as a letter, a gift, or a request to bend a record. Speaking first and documenting later is not line 7.

Both of those pages can send you here. Sort a dual relationship or a self-disclosure on those pages. Use those pages for that job. The compliance guides are the wider map: consent, privacy, reporting, and the paperwork around a decision like Priya’s. Use the seven lines as one tool on that map.

Print the consent form when you are writing the agreement. Print the dual-relationship card or the self-disclosure card when that is the dilemma. Use the page-6 sheet if you want paper. The lines are the same job.

Questions to take to your board or a lawyer

Look up your state’s licensing rule in the board’s own rules. Standard I.1.b is an ethics standard for counselors using that code. Whether your board has adopted the 2014 code, an older code, or a different one is that lookup. Make the lookup yourself. Do not treat the seven lines as satisfying a complaint.

If the question is legal, take it to a lawyer. The guide says to seek legal advice. A blank line that says “legal question, advice not yet obtained” is an honest line. A finished-looking choice that skipped the lawyer is not.

Keep the client’s name off a worksheet you might leave on the desk. The dilemma line asks for one sentence and no name. The chart holds the name. Write the path on the worksheet.

The guide says there is rarely one right answer. Priya can decline the letter and still offer a letter that matches the chart. Another counselor might decline both until morning. Either path can be documented. An undocumented path cannot be explained later as professional judgment, because judgment you cannot reconstruct is a memory.

If you want that seven-line path in the same chart as the session, rather than on a sheet you will lose, you can keep the note in Emosapien. The code lookup still happens in the ACA documents. The note has to hold what you opened, what you chose, and when you will look back. The security page is the product-side limit on that record: write the decision once, in the chart, and do not leave a second copy in a channel the client can forward with the letter.

Fill line 1 of the ACA ethical decision making model before you finish the sentence he asked for. If line 2 settles it, stop. If it does not, the other five lines are the work, and you document that path in the client file.