Finding A Client’s Autonomy

Autonomy has been a word that has come up in my practice quite frequently in the past few months. Currently I am assisting in a research study that involves assessing client autonomy with music therapy interventions. Also, I am taking a graduate course called “Ethics in the Counseling Profession” and within the first ten pages autonomy is listed.

I am so glad this word has entered my vocabulary because it’s something that I have felt is important through my music therapy experience, but I didn’t have to word to label it. Often, I would call it “intrinsic motivation” but it never really felt right.

Autonomy, as defined in “Issues and Ethics in the Helping Profession” by Corey, Corey, & Corey, is:

“…promotion of self-determination, or the freedom of clients to be self-governing within their social and cultural framework. Respect for autonomy entails acknowledging the right of another to choose and act in accordance with his or her wishes and values, and the professional behaves in a way that enables this right of another person” (p. 16).

After working in school systems, where there was constant pressure to have a student complete X,Y and Z to learn socially acceptable behaviors, I often found myself struggling with wether or not the client wanted to do the task or not.

For instance, let’s take greetings. Working with children with autism, this can be a hard skill to learn. Drilling this with a student would give us the result we want, but it would not give the student the competence over the skill. Then if motivation isn’t there, instead it becomes more like “checking off the boxes” so a client can move on and get to the next thing.

So, how can we make sure that we are acting ethically in that we are doing our best to access the client’s autonomy as much as possible within session? Can this translate to situations where our client is self-injuring? What would this look like for you? Have you taken any time to think about what your agenda is versus the client’s autonomy? How do we maximize this within our sessions?