Breaking Barriers and Blurred Boundaries: Ethical Challenges in Marginalized Spaces

This ethnographic study of clinical trauma therapy with Central American refugees introduces ethical and legal issues encountered while working in an under-resourced, marginalized host community organization. Some ethical and legal challenges that arose in the setting involved confidentiality, privacy, record keeping, assessment, competence, technology, supervision, screening, and the role of interpreters. The ethical and legal challenges discussed in this presentation are illustrated with case scenarios of culture “clashes” arising when traditional clinical trauma counseling practice standards differed from host culture organization norms and expectations. To break down barriers between people from privileged majority cultures and people in underserved marginalized spaces, actions consisted of: 1) exploring ethnocentrism and increasing cultural self-awareness and cultural humility; 2) immersion in multicultural counseling research literature, 3) consulting with multicultural experts, and 4) deferring aspects of one’s expertise to host organization values and norms. In addition, Carl Rogers’ client-centered attitudes and his views about resolving conflicts were relied upon to cultivate respect for differences and to encourage openness by holding less stubbornly to one’s own point of view. The ethical and legal cases presented in this study illustrate how blurred boundaries may produce role strain, but may be necessary to break barriers as they cause the professional to reassess the significance and application of longstanding privileged population beliefs and practices.