Issues and Ethics in the Helping Professions 9

Issues and Ethics in the Helping Professions, 9 th Edition by Gerald Corey, Marianne Schneider Corey, Cindy Corey, and Patrick Callanan with Michelle Muratori, Johns Hopkins University © 2015. Cengage Learning. All rights reserved.

Chapter 5 CLIENT RIGHTS AND COUNSELOR RESPONSIBILITIES © 2015. Cengage Learning. All rights reserved.

Informed Consent Involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it A powerful clinical, legal, and ethical tool © 2015. Cengage Learning. All rights reserved.

Informed Consent Requires that the client understands the information presented, gives consent voluntarily, and is competent to give consent to treatment A process that continues for the duration of the professional relationship © 2015. Cengage Learning. All rights reserved.

Content of Informed Consent The following information should be provided in writing and discussed: – The therapeutic process (including assessment) – Background of therapist – Costs involved in therapy – The length of therapy and termination – Consultation with colleagues – Interruptions in therapy © 2015. Cengage Learning. All rights reserved.

Content of Informed Consent The following information should be provided in writing and discussed: – Clients’ right of access to their files – Rights pertaining to diagnostic labeling – The nature and purpose of confidentiality – Benefits and risks of treatment – Alternatives to traditional therapy – Tape-recording or videotaping sessions © 2015. Cengage Learning. All rights reserved.

Record Keeping From a clinical perspective: – Record keeping provides a history that a therapist can use in reviewing the course of treatment. From an ethical perspective: – Records can assist practitioners in providing quality care to their clients. © 2015. Cengage Learning. All rights reserved.

Record Keeping From a legal perspective: – State or federal law may require keeping a record. – Many practitioners believe that accurate and detailed clinical records can provide an excellent defense against malpractice claims. From a risk management perspective: – Keeping adequate records is the standard of care. © 2015. Cengage Learning. All rights reserved.

Record Keeping Counselors have the responsibility for storing client records in a secure place and exercising care when sending records to others by mail or through electronic means. Helping professionals who utilize the “cloud” as an off-site storage tool may be exposing themselves and their clients to unforeseen risks. © 2015. Cengage Learning. All rights reserved.

Content for Inclusion in Records Identifying data Fees and billing information Documentation of informed consent Documentation of waivers of confidentiality Presenting complaint and diagnosis Plan for services Client reactions to professional interventions © 2015. Cengage Learning. All rights reserved.

Content for Inclusion in Records Current risk factors pertaining to danger to self or others Plans for future interventions Assessment or summary information Consultations with or referrals to other professionals Relevant cultural and sociopolitical factors © 2015. Cengage Learning. All rights reserved.

Ethical Issues in Online Counseling It is the counselor’s responsibility to examine the ethical, legal, and clinical issues related to online counseling. Basic issues such as self-disclosure, confidentiality, boundaries, and dual relationships can take on unexpected shapes in online counseling. © 2015. Cengage Learning. All rights reserved.

Ethical Issues in Online Counseling Potential legal issues include: – Competence of practitioner in providing online counseling – Informing client of limits and expectations of the relationship – Developing a plan for how emergencies can be addressed © 2015. Cengage Learning. All rights reserved.

Some Advantages of Online Counseling Reaching clients who are reluctant to participate in face-to-face therapy as well as those who have certain disabilities or chronic illnesses that render them immobile Improving client access in rural areas The potential for greater numbers of people to receive services © 2015. Cengage Learning. All rights reserved.

Some Disadvantages of Online Counseling Danger of making an inaccurate diagnosis Compromising confidentiality and privacy Difficulty in being able to protect clients in crisis situations Absence of traditional client-therapist relationship and challenges of working through transference and countertransference © 2015. Cengage Learning. All rights reserved.

Some Disadvantages of Online Counseling Inability to address more complex psychological problems Lack of competence in providing online services and danger of the misrepresentation of a counselor’s qualifications © 2015. Cengage Learning. All rights reserved.

Some Disadvantages of Online Counseling Danger of clients misrepresenting themselves or minors masquerading as adults seeking treatment Danger of individuals other than the client logging on as if they were the client © 2015. Cengage Learning. All rights reserved.

Suggestions for Online Counseling Before offering distance counseling, acquire the appropriate competencies related to this evolving specialty. Learn how to adapt traditional methods for effective application to distance counseling. © 2015. Cengage Learning. All rights reserved.

Suggestions for Online Counseling Screen clients for suitability with specific services you are considering using. Gain deeper understanding of how clients use and experience social networking sites. As a part of informed consent, educate your clients about the difficult situations that may occur during distance counseling. © 2015. Cengage Learning. All rights reserved.

Suggestions for Online Counseling Familiarize yourself with the ethical guidelines that have been developed to inform your specific scope of practice. Be aware of the legal issues and state licensure board regulatory policies that govern your specific practices when delivering online counseling. © 2015. Cengage Learning. All rights reserved.

Working With Children and Adolescents Important issues to consider: – Minors’ rights regarding informed consent – Parental rights to information about a minor’s treatment – Minors’ assent versus consent – Involving parents in the counseling process with minors © 2015. Cengage Learning. All rights reserved.

Working With Children and Adolescents Important issues to consider: – Limits to confidentiality – Dealing with reluctance – Need for supervised clinical experience in play therapy, art and music therapy, and recreational therapy © 2015. Cengage Learning. All rights reserved.

Unethical Behavior of Colleagues Ignoring evidence of peer misconduct is an ethical violation in itself. – Many helping professionals are reluctant to address such problems. Informal peer monitoring provides an opportunity for corrective interventions to ethically questionable acts. © 2015. Cengage Learning. All rights reserved.

Unethical Behavior of Colleagues If informal measures are not enough, reporting a colleague to a professional board is one of several options open to you. © 2015. Cengage Learning. All rights reserved.

Elements of Malpractice To succeed in a malpractice claim, four elements must be present: 1. A professional relationship between therapist and the client must have existed 2. The therapist must have acted in a negligent or improper manner, or have deviated from the “standard of care” by not providing services that are considered “standard practice in the community” © 2015. Cengage Learning. All rights reserved.

Elements of Malpractice To succeed in a malpractice claim, four elements must be present: 3. The client must have suffered harm or injury, which must be verified 4. There must be a legally demonstrated causal relationship between the practitioner’s negligence or breach of duty and the damage or injury claimed by the client © 2015. Cengage Learning. All rights reserved.

Reasons for Malpractice Suits Failure to obtain or document informed consent Refusal to counsel clients due to value differences Client abandonment or premature termination Marked departures from established therapeutic practices © 2015. Cengage Learning. All rights reserved.

Reasons for Malpractice Suits Sexual misconduct with a client Practicing beyond the scope of competency Negligent assessment or misdiagnosis Repressed or false memory Unhealthy transference relationships Failure to assess and manage a dangerous client © 2015. Cengage Learning. All rights reserved.

Risk Management The practice of focusing on the identification, evaluation, and treatment of problems that may injure clients and lead to filing an ethics complaint or a malpractice action One of the best precautions against malpractice is personal and professional honesty and openness with clients. © 2015. Cengage Learning. All rights reserved.

Risk Management Know your limitations and seek consultation in difficult cases. Remain alert for possible misunderstandings that, if not recognized or poorly handled, could lead to a therapeutic break or premature termination of therapy. © 2015. Cengage Learning. All rights reserved.