Ch 8

Question 1

malpractice

Answer 1

involves professional misconduct or unreasonable lack of skill and has been defined as the failure to render professional services to the level expected in a particular community by a prudent member of the profession with the result that a recipient of services is harmed
includes intentional wrongdoing, incompetency, or unintentional wrongdoing of the professional involved
type of civil lawsuit

Question 2

incompetent

Answer 2

professional misconduct
evil practice
illegal or immoral conduct

Question 3

following elements to prevail in a malpractice suit as a professional

Answer 3

1. the counselor had a duty to the client to use reasonable care in providing counseling services
2. the counselor failed to conform to the required duty of care
3. the client was injured
4. there was a reasonable close casual connection between the conduct of the counselor and the resulting injury (aka proximity cause)
5. the client suffered an actual loss or was damaged

Question 4

actual cause

Answer 4

means that a person actually caused the injury of another person

Question 5

proximate cause

Answer 5

has to do with whether the individual would not have been injured had it been for the action or inaction of the other person

Question 6

foreseeability

Answer 6

has to do with whether the professional knew or should have known that the professionals actions would result in a specific outcome
important in proximate cause

Question 7

statistics regarding malpractice suits

Answer 7

p 184

Question 8

insurance: how to avoid malpractice claims

Answer 8

1. always maintain strong personal boundaries
2. educate yourself on standards of care for counselors set by your state licensure board and make sure you always follow them
3. make sure your clients have realistic expectations for the services you are providing them and get an agreement in writing
4. keep notes and records that are thorough and accurate
5. terminate services to clients who attempt to initiate any inappropriate relationships with you, and facilitate their transfer to another counselor
6. refer clients to specialists when they have issues outside your areas of expertise

Question 9

suicidal clients

Answer 9

an ethical duty arises to protect the client from harm to self
confidentiality waived when disclosure is necessary to protect clients from serious and foreseeable harm
begin with a thorough risk assessment and then, depending on level of danger, might include involving the clients family or significant others, working with the client to arrange for voluntary hospitalization, or even initiating the process that leads to an involuntary commitment of the client

Question 10

how to handle deficit in handling crises

Answer 10

independent reading
workshop attendance
post-masters degree course completion
supervised practice

Question 11

how should a determination be made as to whether a client is suicidal?

Answer 11

1. know the warning signs that a particular person is at risk for committing suicide
2. must know how to make assessments of a clients risk for suicide and must be able to defend their decisions at a later time

Question 12

nonsuicidal self-injury

Answer 12

behaviors that involve intentional bodily harm that cause tissue damage without an individual having the intent to die, and for purposes that are not socially sanctioned
EX: cutting, burning, self-bruising, breaking bones, carving of the skin, subnormal tissue scratching, banging or punching objects or oneself, embedding objects under the skin, subnormal tissue scratching, banging or punching oneself, and excoriation (skin-picking)

Question 13

common risk factors for both suicide and self-injury include

Answer 13

substance misuse, low self-esteem, suicidal ideation, disordered eating, and non-heterosexual identity

Question 14

self-injury risk factors include factors that are not predictive of suicide

Answer 14

history of abuse or current abuse
eating disorders
early first sexual encounter
low socio-economic status

Question 15

suicide risk factors that do not predict self-injury include

Answer 15

broken homes
mental illness in self or family members
female behavioral problems

Question 16

individuals who self-injure and have addictive qualities are…

Answer 16

more at risk for unintentioanal severe harm than those who self-injure who do not have addictive qualities

Question 17

bullying

Answer 17

an intentional behavior that hurts, harms, or humiliates a student, either physically or emotionally, and can happen while at school, in the community, or online
bullies have more social or physical power
the bullied should be assessed for suicidal ideation

Question 18

essential items to include in your suicidal documentation notes

Answer 18

1. what precipitated your concern about the client (referral by another person, something client said or did)
2. questions you asked the client and his or her responses
3. individuals you consulted regarding the situation, what you said to them, and how they responded
4. interactions you had with any other persons regarding the situation, from the time you became concerned until you completed your work for the time being regarding the situation

Question 19

action plan to follow for suicidal assessment/client

Answer 19

figure 8-1 p 190-191

Question 20

key therapeutic processes that helped clients overcome suicidal ideation and behaviors

Answer 20

1. experiencing an affirming and validating relationship as means of reconnection with others
2. dealing with the intense emotions surrounding suicidal behavior
3. confronting and discarding negative patterns while establishing new, more positive behaviors

Question 21

following situations in suicide malpractice cases make it more difficult to win cases against mental health professionals

Answer 21

1. when the client who committed suiced had suffered from chronic depression and had resisted treatment
2. when the client had not expressed an actual suicidal plan to the mental health professional
3. when the client who has been on steady doses of anti depressant medications or is not being medicated commits suicide
4. when a client who commits suidice has not attempted suicide in the past

Question 22

steps to prevent harm

Answer 22

warning intended victims
consult with other professionals

Question 23

how to predict if a person is going to harm someone else

Answer 23

1. learn as much as you can about the warning signs of persons who commit violent acts against others EX: past violent behavior
2. once a client is deemed dangerous, the law requires that you take whatever steps are necessary to prevent the harm and, further, that the steps you take be the least disruptive
   EX: least intrusive action: obtaining a promise from your client not to harm anyone most intrusive (psych hospital)
   other things you can do: notifying the clients family members and getting one to take responsibility for keeping the client under control, persuading the client to be voluntarily committed to a residential facility, notifying the police, or calling client periodically

Question 24

Clients with HIV

Answer 24

when clients disclose they have a disease commonly know to be both communicable and life-threatening, counselors may be justified in disclosing information to identifiable third parties, if the parties are known to be at serious and foreseeable risk of contracting the disease
you assess the intent of clients to inform the third parties about their disease or to engage in any behaviors that may be harmful to an identifiable third party
counselors are justified in disclosing, but are not necessarily required to disclose

Question 25

responding to accusations of unethical or illegal behavior

Answer 25

report to immediate administrative supervisor and professional liability insurance carrier figure 8-2 p. 205

Question 26

justice obsession syndrome

Answer 26

describes individuals who believe that the most important thing in life is to get justice in a personal situation where they believe that an injustice has occurred

Question 27

general process that boards and committees use in processing complaints...

Answer 27

p 203 & 204

Question 28

recommended necessary conditions for reporting a colleague for unethical behavior

Answer 28

figure 8-3 p.207

Question 29

complaints may be filed at the same time with all of the following entities

Answer 29

1. all state licensure boards that have licensed the counselor 2. all national certification boards that have certified the counselor 3. ethics committees that accept complaints of all professional counseling associations in which the counselor holds active membership 4. the counselors employer

Question 30

guidelines for avoiding problems

Answer 30

p. 211 & 212

Question 31

keys to professional behavior

Answer 31

authentic caring willingness to examine our own motivations willingness to tell the truth to ourselves, our peers, and our clients willingness to ask for help and to learn