The two professional organizations design for counselors:
ACA- 18 divisions
APA- 17 divisions
The ethical practice of counseling can occur on two levels
Mandatory ethics:
Focuses on compliance with minimal standards of Laws and ethical codes. Counselors who focus only on mandatory ethics may be vulnerable to denial, distortion, discounting, or dismissing of ethical questions and issues.
Aspirational ethics:
When counselors practice aspirational ethics, they practiced the highest standards of conduct and demonstrate an understanding of the spirit behind the code.
The ethical standards of the association or present in two separate documents:
Standard of practice
Brief and focus on the minimal behavior required by professional counselors (mandatory ethics)
Code of ethics
More details; ideal of the profession.
(Aspirational ethics)
Scope of practice
Recognized areas of proficiency or competent gain through appropriate education and experience.
Scope of practice concept suggest the counselors should only practice using techniques for which they have been trained.
Professional ethics
Agreed-upon standards that define what is “good” as well as the “ideal” practice of the profession
Laws
Are distinguished from ethics in that laws dictate minimum standards of behavior, rather than ideal standards
Competence
Is both and ethical in a legal concept in that counselors need to meet the minimum standard of performance in order to practice in a given state (legal concept) as well as Strive for maximum levels of knowledge and skills.
Confidentiality
The obligation of professionals to respect the privacy of clients and the information they provide
Limit of confidentiality
Child abuse
Intent to do harm
Information related to counseling of a minor
Counselors under supervision
Court ordered
When the client consents to disclosure
Clients file a complaint against their counselor
In regards to group counseling
ACA code of ethics does not guarantee confidentiality
Family counseling
Counselors should not disclose information about one family member to another unless consent is given
Duty to warn and to protect
Identifying those clients who are likely to do physical harm to third party.
Protecting third parties from client
Treating those clients who are dangerous
Continuing education
Counselors “should recognize the need for continuing education “ to maintain a reasonable level of competence in the field
Dual relationships
ACA warns counselors to avoid those dual relationships “that could impaired judgment or increase the risk of harm to the client”
Sexual intimacy with current clients are always on unethical and unethical with former clients 2 to 5 years after termination
Informed consents
Contractual document that addresses:
Therapeutic process Background of counselor Cost of the treatment Length of treatment Benefits and risk of treatment Nature and purpose of confidentiality
Informed consent has three levels with ethical and legal implications
Possess The ability to make a rational decision.
Has sufficient information and be able to understand the information.
Be acting freely in the decision-making process
Record keeping
Information in the clients record belongs to the client.
Maintenance of actual records is the responsibility of the counselor
Sausages keeping records for 7 to 15 years after termination
Family educational rights and privacy act of 1974
FERPA
Give parents of minors as well as students 18 years old or older the right to:
Access to educational records.
Protection of the institution for releasing information to a third-party without written consent
Malpractice
Failure to render professional services
Legal concept involving negligence that results in injury or loss to the client
Negligence
Occurs when the counselor departs from ordinary practice or fails to exercise due care.
The most frequent allegations of malpractice involves:
Violation of confidentiality
Sexual misconduct
Failure to prevent suicide
Other allegations of incompetent treatment
Privacy
Keep certain information concealed Disposal of records Video /audio recording Not being identified in waiting rooms Credit card information Use of computer scoring services
Privilege communication
Is a legal concept
Laws protects clients from having confidential information disclosed in a court of law without their permission
Subpoenas
Produce copies of records
Appear for a disposition, court hearing, or trial.
Appears and bring their records with them.
Don’t ignore subpoena
All legal attempt should be made to protect clients info
Tort
Pay damages
Intentionally torts includes battery, defamation, invasion of privacy, and infliction of mental distress
Six moral principles upon which ethical codes are established and involved in ethical decision-making:
Autonomy: clients right to make their own choices.
Beneficence: pursues what is good and helpful for their client.
Nonmaleficence: do no harm
Justice: equal treatment
Fidelity: counseling relationships is based on trust.
Veracity: obligated to deal truthfully and honesty with cLients
Counseling became popular after the 1931 publication of
Workbook in vocations by Proctor, Benefield, and Wrenn.
Group movement
Began in the late 1960s
Forms of managed care
Health maintenance organization (HMOs) which use a restricted group of providers to provide specific services at a fixed cost.
Preferred provider organization (PPO). Which purchase services from specific providers at a reduced rate.
Independent practice association (IPAs) which allows consumers to choose independent practitioners and see them in their office rather than in an HMO facility.
Advantages and disadvantage of managed care
Advantages:
Limited cost of services compared to traditional health insurance.
Increase access to mental health services
No exclusion due to pre- existing condition
Increased referral rate
Disadvantages:
Limited choice in providers
Inability to consult a specialist directly
Reduction in the variety of services available
Potential overuse of medication
Limited treatment duration
Various ethical issues
A temptation exists in a managed care environment to “upcode” a client diagnosed, or assign a more serious diagnosis in order to obtain more counseling sessions.
The counselor must resist the temptation to “downcode” a client diagnosis to one for which the managed care company will reimburse.
Direct liability and vicarious liability
Direct liability: refers to an action or inaction by the supervisor that causes harm to a client, such as failing to address the suicidal ideation of supervisee’ client.
Vicarious liability: occurs when the supervisor is held liable for the behavior of the supervise even though the supervisor may be unaware of the behavior.
The type of mental health services provided to the client is coded via
The AMAs Current Procedural terminology (e.g. CPT 90844)
