Ethics Final_McKinney

Question 1

What is Professional Competence in Counseling?

Answer 1

Relates to the skills and training required to effectively and appropriately treat clients in a specific area of practice.
ETHICALLY: competence is based on the principles of beneficence and non-maleficence - to protect and serve the clients.

LEGALLY: if we are incompetent (working grossly outside our scope) we are vulnerable to legal implications.

Question 2

What makes a competent counselor?

ACA Codes on Ethical Competence

Answer 2

ACA: A.11.a - avoid entering or continuing counseling relationships if counselors lack competence to assist clients.

C.2.a. - Counselors practice only within the boundaries of their competence based on their EDUCATION, TRAINING, SUPERVISED EXPERIENCE, STATE and NATIONAL professional credentials, and appropriate professional experience.

Question 3

CACREP

Council on Accreditation of Counseling and Related Educational Programs

Answer 3

8 common core areas:

1. professional counseling orientation and ethical practice
2. social and cultural diversity
3. human growth and development
4. career development
5. counseling and helping relationships
6. group counseling and group work
7. assessment and testing
8. research and program evaluation

Question 4

Gatekeeping with STUDENTS

Answer 4

Definition: the protection of consumers by identifying and intervening with graduate students who exhibit problematic behaviors or who give evidence of performance problems.

• Critical BEFORE entering a program
• Critical DURING a program
• Not just problematic behaviors (i.e. plagiarism), but general life concerns

Question 5

Ethics codes: Competence with Cultures

Answer 5

C.2.a. multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a cultural competent counselor in working with a diverse client population.

Question 6

Ethical codes: Competence with Referrals

Answer 6

A.10.a. Counselors working in an organization (school, agency, institution) that provides counseling services do not refer clients to their private practice unless the policies permit doing so. In such situations, clients must be informed of other counseling options.
A.11.a. If counselors lack competence, they avoid entering or continuing counseling relationships. Counselors are knowledgable and make suggestions about culturally and clinically appropriate referral resource.
A.11.b. Counselors refrain from referring clients based on counselor’s values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when their values are inconsistent with those of the client, or are discriminatory.

Question 7

Assessing Competence - how do we know when one is competent/becoming more competent?

Answer 7

Formative assessment: information provided during one’s training and throughout one’s professional career.

Summative assessment: an end point evaluation typically completed at the end of a professional program or applying for licensure.

Both of these can highlight one’s strengths and areas of growth.

Question 8

Lifelong goal of competence

Answer 8

Competence is a MAJOR CONCERN for counselors and is a lifelong endeavor. We are called to devote the entire span of careers to developing, achieving, maintaining and enhancing our competence.

Question 9

Competence with NEW COUNSELORS

Answer 9

one must be able to make an honest and objective assessment of how far you can safely go with clients, recognizing when to refer or when to seek consultation.

Question 10

Ethics Code re: Competence with NEW COUNSELORS

Answer 10

ethics code:
C.2.b. while developing skills in the new specialty areas, counselors take steps to ensure the competence of their work and protect others from possible harm.

Question 11

How to Develop Competence with NEW COUNSELORS

Answer 11

Work to the edge of your competence. 
Increase competence by:
*reading scholarly material
*attending events - conferences, workshops, CEU
*professional engagement (CSI)
*community engagement

Question 12

SUPERVISION (qualities of supervisors)

Answer 12

Effective supervisors have/are:

• expertise
• trustworthiness
• great facilitative qualities - empathy, genuineness and positive regard
• understanding of qualities of effective counselors
• effective teachers and mentors
• gatekeepers

Question 13

Kinds of supervisors

Answer 13

Administrative:

• directions given by direct-line administrators to their employees
• purpose - see that counselors who are employed are doing their jobs

Clinical:
overseeing the professional work of counseling

Question 14

GOALS of CLINICAL supervisors

Answer 14

1. protect the welfare of CLIENTS (F.1.a.)
2. Monitor supervisee performance (gatekeeping) F.6.b.
3. Promote supervisee growth and development
4. empower supervisee to self-supervise - be independent

Question 15

Roles of SUPERVISEES

Answer 15

• come prepared for each supervision session
• be an active participant, collaborative in supervision
• address areas of concern in supervision
• ask for feedback (strengths, areas of growth)
• work between session - research, reading - to support the session
• follow through with supervisor’s recommendations

Question 16

Methods and Models of Supervision (3)

Answer 16

Developmental models
Social Role Models
Psychotherapy-based models

Question 17

Developmental models of supervisions

Answer 17

• supervisees are continually growing
• considers supervisee’s experience, values, previous training, and predisposition
• six phases

Question 18

Six phases of Developmental Models

Answer 18

1. lay helper - ready to assist individual with problem
2. beginning student - vulnerable, dependent, needing encouragement and support
3. advanced student - functioning at a basic professional level
4. novice professional - integrate personality into treatment
5. experienced professional - authentically integrates values and personality into therapeutic relationship
6. senior professional - very individualized and authentic approaches

Question 19

SOCIAL ROLE Model of supervision

Answer 19

Focus is on the roles the supervisor assumes
Discrimination model intended to train counselors in a systematic manner:

Roles: Teacher Counselor Consultant
Functions: intervention skills, conceptualization skills, personalization skills

Question 20

Psychotherapy-Based Model

Answer 20

Solution-Focused Supervision

• assists counselors towards focusing on counseling strategies which would be successful while helping them avoid ineffective strategies
• techniques: scaling, presupposition language, the “miracle question”, etc.

Question 21

Codes of Ethics re: supervision Section F

Answer 21

Intro to Section F (supervision, training, and teaching)
counselors supervisors, trainers and educators aim to foster meaningful and respectful professional relationships and maintain appropriate boundaries with supervisees and students, face-to-face and electronically. Have theoretical and pedagogical foundations, have knowledge of supervision models, aim to be fair, accurate, honest in their assessments of counselors, students, and supervisees.

Question 22

Codes of Ethics re: supervision - client welfare

Answer 22

F.1.a Client Welfare
Supervisors obliged to monitor the services provided by supervisees. Supervisors monitor client welfare and supervisee performance and professional development. supervisors meet regularly with supervisees to review work and help them become prepared to serve a range of diverse clients. Supervisees responsible for understanding ACA Code of Ethics.

Question 23

Supervisor-Supervisee Relationships

Answer 23

F.2a. Extending supervisory relationships
supervisors clearly define and maintain ethical professional, personal, and social relationships with their supervisees. Supervisors consider the risks and benefits of extending.
F.3.b. Sexual or romantic interactions or relationships with supervisees are prohibited.

Question 24

Supervisor Responsibilities - informed consent and emergencies/absences

Answer 24

F.4.a Informed consent for supervision
supervisors are responsible for incorporating into their supervision the principles or informed consent into participation.
Supervision contract - an explicit agreement between supervisor and supervisee that explains what will happen in supervision.

F.4.b. Emergencies and absences
supervisors establish and communicate supervisors or, in their absence, alternative on-call supervisors to assist in handling crises.

Question 25

Ethical Issues in Practice

Answer 25

Working within all the ACA Ethics Codes: A - Counseling relationship B - Confidentiality and Privacy C - Professional Responsibility D - Relationships with Other Professionals E - Evaluations, Assessment and Interpretation F - Supervision, Training and Teaching G - Research and publication H - Distance counseling, technology and social media I- resolving ethical issues

Question 26

Ethical Issues in Practice

Answer 26

Working within all the IAMFC Ethics Codes: The Counseling Relationship and Client Welfare Confidentiality and Privacy Competence and Professional Responsibilities Collaboration and Professional relationships Assessment and Evaluation Counselor Education and Supervision Research and Publication Ethical Decision-Making and Resolution Technology Assisted Couples and Family Counseling Diversity and Advocacy

Question 27

Ethical practice: Asking questions about the reasons behind your practices

Answer 27

what do you do during a client's first session? what is the rationale behind the interventions used? what do you want to accomplish in the first session? second session? within six sessions? can you communicate your profession, responsibilities, and rights of the clients in a straightforward way? what helps you stand out in a sea of professionals?

Question 28

Ethical practice: Reasons behind practices with families and couples?

Answer 28

* who is the client? * how do you try to ensure confidentiality? * what do you want to accomplish with your family? specific theoretical orientation? * do all family members need to attend every time?

Question 29

Ethical practice - Reflect on your own:

Answer 29

* own counseling experience? * what would I talk about in session today if I went? * How would I feel about sharing some of these concerns? * what perspectives on family, culture and gender I grew up with? * how many kinds of families/cultural perspectives have I been exposed to? * what experiences have a I had of discrimination or oppression?

Question 30

Ethical practice: How are goals determined with clients?

Answer 30

* how effective is counseling without goals? * who establishes these goals? - counselor - client - collaboratively * how specific can I be with these goals - specific = success * how might culture effect these goals?

Question 31

SMART goals

Answer 31

``` S - specific M- measurable A- Achievable R - realistic T- timely ```

Question 32

Ethics codes re: goals

Answer 32

A.2.b. Goal creations should be discussed with clients during informed consent process A.4.b. My personal values and beliefs should not get in the way of the client's created goals A.11.b. If my values and beliefs are inconsistent with the client's goals, I simply can not refer them or terminate counseling.

Question 33

Factors in goal-making

Answer 33

Assessment - evaluating relevant factors in client's life to identify themes for further exploration Diagnosis - Identifying a specific mental disorder based on a pattern of symptoms according to DSM-5 Differential diagnosis - process of distinguishing one form of mental disorder from another

Question 34

Legal Concerns

Answer 34

Fraudulent Practices (Insurance) * incorrectly reporting of diagnoses procedures * billing for services not rendered * misrepresenting dates of service, locations of service, and provider of service * overutilization of services * corruption (kickbacks and bribery)

Question 35

What are your theoretical underpinnings?

Answer 35

``` psychoanalytic adlerian existential person-centered gestalt CBT reality feminist SFBT/Narrative Systems - view problems as arising from within one's present environment and intergenerational family systme ```

Question 36

Ethical considerations, cont. "the best" care

Answer 36

evidence-based practice: integration of - the best available research with clinical expertise related to the client's characteristics, culture and preferences empirically supported treatments: each form of counseling needs to be tested in carefully controlled experimental research contexts to scientifically ground the practice.

Question 37

Ethical Issues in Group Work

Answer 37

Before beginning group; * where and when is group being held? * who is in the group? * what is the group on? * what is your role in the group? * what is the intended outcome? * is the group open or closed? * How long is group to run?

Question 38

Before beginning group

Answer 38

Leadership: - are you leading the group alone? - do you have a co-leader/facilitator? Benefits to more than one leader: - more insight and feedback - complement and provide a balanced view - shared responsibility Disadvantages: - professional differences and communication

Question 39

Screening participants in Group Counseling

Answer 39

- A.9.a: counselors screen prospective group participants, and select members whose needs and goals are compatible with goals of the group, and who will not impede the group process - is it appropriate for this person to become a participant of this group at this time?

Question 40

Screening, cont.

Answer 40

Not everyone will benefit from a counseling group experience, such as: - someone who has intense needs (active psychotic episode) - immediate crisis (suicidal) - detract from goup's goals Yalom: - screen for questions about personal relationships - screen for how process of screening was for the individual

Question 41

Screening, cont. Yalom quote.

Answer 41

Group cannot move much faster than its slowest members. -Yalom

Question 42

Starting a group

Answer 42

``` Informed Consent: * present basic information about group treatment to potential members to help them decide on participating - written and verbal - ongoing process - allows them to be aware of rights: ~to leave group ~right to confidentiality (and its limits) ~right to know risks of group counseling ```

Question 43

Running a Group: confidentiality

Answer 43

Confidentiality: it is the responsibility of the counselor to address this in group counseling *need to educate members, how easy it is to break, and the implications of breaking it *B.4.a. In group work, counselors clearly explain the importance and parameters of confidentiality for the specific group. Counselors cannot prevent other members from disclosing personal information about individuals in the group Reminders along the way are very helpful!

Question 44

Running a group: counselor's behavior

Answer 44

Counselor Behavior: * non-judgmental stance towards members * avoiding responding to sarcastic remarks with sarcasm * being honest with members rather than harboring hidden agendas/feelings * avoiding judgments and labeling members, and instead describing the behavior of the member * stating observations and hunches in a tentative way * letting members who are difficult know how the are affecting others in a non-blaming way * detecting their own countertransference and managing these reactions * avoiding misuse of power * providing both supportive and caring confrontations * avoiding meeting their own needs at the expense of members

Question 45

Terminating Group

Answer 45

Be Mindful * make sure members know it is coming * use the time to consolidate learning that has occurred * allow members time to reflect and share what group has meant to them * explore current feelings