First, decisions about what is in the best interests of the client are entrusted to the client unless either she is unable to exercise that responsibility or proposes to exercise that responsibility in ways which seriously threaten other people's autonomy, perhaps by putting them at risk of serious physical harm. Fortunately these exceptions are rare. Therefore usual practice is for the counsellor to take responsibility for managing the counselling process but not for the way the client applies the counselling to hersel or to its outcome. To do otherwise would be to undermine the general aim of counselling which is to facilitate the client taking greater control of her life when she considers this is possible, or alternatively making appropriate personal adjustments when it is not, such as coping with loss. The priority of respect for client autonomy is not only an ethical imperative but a practical necessity.
Counselling requires the active participation of the client throughout the process.
It cannot work on the basis of the client giving informed consent and then passively entrusting herself to the counsellor. Therefore, from the outset, it is important that the client is a volunteer, and is actively involved in negotiations about significant aspects of the relationship with the counsellor, e.g. method of working, confidentiality etc. Counsellors will also generally avoid giving advice or acting on behalf of the client as the aim is to help the client make her own decisions and act for herself. Any reduction in the level of confidentiality offered to clients often inhibits the growth of trust and what the client is willing to discuss. The counsellor's management of confidentiality is also closely related to the ethical priority of respect for his client's autonomy.