Counselor Ethics and Responsibilities Paper

Counselor Ethics and Responsibilities

Grand Canyon University: PCN 505

Dr

November 15, 2017

Counselor Ethics and Responsibilities

To be a successful counselor and abide within the ethical and legal guidelines, counselors must take into consideration what is involved in providing sound and ethical judgements. Being a counselor should not be taken lightly, someone is trusting us to provide them with the best care possible and assist in finding solutions that will possibly work for the betterment of their livelihood. Counselors must ensure that their clients confidentiality will not be misused and counselor’s guarantee that appropriate measures are in place to provide a professional, safe, nonjudgmental environment.

Client Rights

Principles of Ethical Practice

There are five key principles of ethical practices, and Davis and Miller (2014), references Kitchener (2000) models on the following five principles:

a.) Autonomy addresses the concept of independence. Counselors should make sure they are not pushing their own values and beliefs onto clients, but rather encourage them to make their own decisions and act within their values. He/She would ensure clients fully understand how their differences may affect others whether positive or negative. He/She would also ensure they are competent to understand the choices they are making are theirs without any other influences. Clients who are children or persons with mental limitations, he/she need to make sure they have a well-informed, competent adult making decisions in their best interest.

b.) Nonmaleficence is the concept of not causing harm to others. Professionals should ensure clients are positively engaged during sessions and are not misconstruing information given to them.

c.) Beneficence shows the responsibility of the counselor contributing to the safety of the client. Incorporate positive outlooks and thinking in sessions. Periodically asking clients about their feelings, depending on the circumstances to make sure they have no intentions on harming themselves and be proactive when necessary.

d.) Justice in counseling means “treating equals equally and unequals unequally” (Davis & Walker, 2016). If I am providing services to two clients who are depressed. One is depressed and suicidal and the other client is not, more attention would be devoted to the client who is suicidal, and the proper steps would be taken to ensure the client does no harm to himself.

e.) Fidelity includes being, loyal, faithful and committed. Maintaining and having trust within the client-counselor relationship is crucial to successful progress, once that trust is broken, the client may leave and seek treatment elsewhere, or worse harm themselves or others. Clients need to be able to talk to about their feelings no matter how bad they think their situation is.

(Davis & Miller, 2016).

Informed Consent Process

Informed consent process involves the clients right to informed about their therapy to make decisions pertaining to it (Corey, Corey, Corey & Callahan 2015 p.154). clients must give consent to have information released pertaining to treatment and it must be presented concisely for the client to fully understand (2015).

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a.) Billing at the beginning of treatment provides the client with an idea of the cost of treatment, how many sessions insurance will cover and how reimbursement will work. They are aware of what information will be shared to insurance companies and how their information will be used (Corey, Corey, Corey and Callahan 2015, p.161). An example of this would be a time when me and my husband attended a counseling session, we were not informed about how insurance reimbursement would work and what they would cover, we went back and forth to get the situation resolved and eventually left the practice. ACA ethics code B.1.b-c states informed consent documents should include the route counselors should take for nonpayment of fee’s if the counselor plans to use outside agencies to collect fees (2014). According to Cantor,

clients have the right to not disclose the relationship with their mental health and substance abuse professional, unless laws state otherwise. Counselors are only allowed to disclose information concerning the client, such as treatment and length of time it may be needed, diagnosis and prognosis (1998).

b.) The Health and Insurance Portability and Accountability Act (HIPPA) provides consumers the rights to privacy and protection in regard to their health information and how it is being used (U.S Department of Health and Human Services, 2016). Compliance comes into play allowing the provider to communicate with relatives or other persons directly involved in the patients care. Provider’s can discuss an adult patient’s information with their parent’s or other family members as long as the patient allows (2016). Under certain circumstances, information may be disclosed about the patient’s condition if they are not in the mental state to make sound judgements. The treating clinician may provide disclosure to those involved in the patient’s care (U.S. Department of Health and Human Services, 2016).

c.) Clinicians are to have in place informed consent practices to ensure clients are aware of their rights. Informed consent involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it (Corey, Corey, Corey & Callahan 2015, p.154). The informed consent document defines boundaries and clarify the nature of the basic counseling relationship between the counselor and the client. Information presented to the client by the counselor should be conveyed in a way that clients understand. Clients should be made aware that counselors who work in a managed care system should be informed how their information could affect them before agreeing to treatment. These process gives clients a chance to ask questions and understand what is allowed pertaining to their treatment (pp. 155-157).

Responsibility to Warn and Protect

Mental health professionals have an obligation to ensure clients are protected from harming themselves or others, known as duty to protect and duty to warn (Corey, Corey, Corey & Callahan 2015, p. 221). Duty to protect and warn emerged from the Tarasoff v. Board of Regents of the University of California in 1974 in which Tatiana Tarasoff was killed by another student who relayed to his psychotherapist that he would kill her when she returned to school. The school was sued by her parent’s and it was ruled that the psychotherapist was negligent in warning the victim (Ivers & Perry, 2014). Factors indicating when there is a duty to warn and protect includes a threat or risk of death or physical harm is displayed (2014). When determining whether a duty to warn or protect exists, it is identified as mandatory or permissive.

Mandatory states that human service professional must take steps required under the statue whereas Permissive states a human service professional may decide to breach the client’s confidentiality and notify a third party, but legally have no obligation to do so (Ivers & Perry, 2014).

South Carolina code of law Section 42-22-90 states the laws are permissive when it comes to fulfilling the duty to warn or protect (SC Code of Law, 1991).

Client Record Keeping

The way in which counselors maintain records are set forth by regulatory bodies, depending on the setting and the therapist’s settings determines how detailed clients record will be. Adequate record keeping is essential to lowering the risk of malpractice suits and if done correctly, allows the counselors to respond to the licensing board in a successful manner (Corey, Corey, Corey, & Callahan 2015 p. 171). The ACA Section B.6.a. “state counselors create and maintain records and documentation necessary for rendering services”. Section B.6.b “ensures that counselors records and documentation kept in any medium are secure and only authorized persons have access” (ACA, 2014 pp.8-9). Clients have the right to know and understand what is in their file pertaining to the treatment they are receiving. Section B.6.e. states when asked to see their file, counselors are to assist the client in helping them understand and interpret records. Section B.6.f. “Reasonable access is granted if the client is competent, but they are also limited to what they have access to when there is compelling evidence it could cause harm” (ACA, 2014 p8). “A client’s clinical record is not a place for the counselor to document personal opinions or reactions about the client” (Corey, Corey, Corey & Callahan 2015, p.168).

Self-Care

The counseling profession is one with high demands, outside of counseling others, we have our own lives and family to take care of. Taking care of ourselves is beneficial to not only us, but our clients as well. We become exhausted and this does more harm than good and at some we are stretched thin. Being competent in this profession allows us to be fully aware of what we are relaying to clients. Section C, Professional Responsibility in the ACA code of ethics, states counselors should monitor how effective they are and take steps to improve when necessary. We should also seek consultation from other colleagues to get tips on how effective we have been as counselors. If we feel ourselves become impaired for whatever reason that may not allow us to perform to the standards set forth by code of ethics, counselors should seek assistance and not resume their duties until they feel competent enough to do so (2014). I plan to maintain a healthy balance by keeping my work separate from my personal life. This may be difficult to do since there may be clients that we simply are not able to forget. I know many professionals who bring their work home and eventually it can be detrimental to our health with the constant reminders of what was said to us by clients. I would set goals for things I would want to do after work such as family date nights or going to the gym. Some self-care activities I have engaged in the past and continue today are journal writing, enjoying a good book, Birkham yoga and massages. I would love to do acupuncture, I have read of the many great benefits and have friends who have recommended it. I have considered cooking classes as a fun way to hang out with my husband or participating in “sip and paint”. Ballroom dancing is something I would love to try, but nervous about doing so. To avoid impairment, if I feel myself becoming overwhelmed, exhausted or not wanting to report to work, I would seek advice from another colleague and possibly take a few days off if permitted. As always, I would take the steps to make sure my clients are not at risk of being abandoned. I personally believe it should be a requirement for counselors to be counseled. This would be a way we can deal with what happens on a daily basis, on issues we encounter in therapy. It would allow us to get things off our chest before it builds up and become problematic.

Advocacy

The American Counseling Association (ACA) has ways that members can get involved. There are several bills being introduced into Congress that potentially will have an impact on both providers and clients. Members can email their senator or congressman expressing their concerns and telling them why they should vote against or for a bill. This allows the member to not only be active but rather proactive in the decision-making process with legislations. This process includes a way for professional counselors to be heard and make the senate aware they all stand together and will advocate for the rights of their clients.

Counselor Values

Two of the issues I feel strongest about are Assisted Suicide and Extramarital Affairs. Assisted Suicide is a topic that many have conflicting views about. Having several friends and family members who have passed away or dealt with the pain of cancer. I can understand how a person may no longer want to continue through the agony if doctor’s have done everything they could. It sounds like her mind is made up with wants she wants to do regardless of the circumstances. I understand her being torn between telling or not telling her family. Depending on the state, assisted suicide maybe either legal or illegal. I would be uncomfortable assisting her because this is a sensitive topic. Section I.1.b. states

when faced with an ethical dilemma, counselors document, as appropriate, an ethical decision-making model that includes consultation, relevant ethical standards, principles and laws, generation of potential courses of action, deliberation of risks and benefits and selection of an objective decision based on the circumstances and welfare of all involved (ACA, 2014).

I would inform my client that is not my area of expertise concerning assisted suicide and I would feel comfortable referring her to someone who may be better to assist her.

Marriage is a commitment that involves hard work and dedication to each other. I would make sure to not impose on them my views of marriage values and beliefs as stated in Section A.4.b. (ACA, 2014). I would have them work on other areas in their marriage and focus on topics such as love, time, communication, and listening.

In conclusion, the counseling profession is not for everyone, you must have a desire to help those during their most challenging times. Not everyone we encounter are going through something traumatic, then there are those that just need a little help getting through life. We must also remember there are some people who we would not be able to get through too and may need additional help or services. If we choose to provide to services to a client in an area we have no experience in, it does more harm than good and will eventually damage the relationship. Continuing to educate ourselves and becoming competent in an area in which we desire is beneficial to not only us, but future clients as well. We must remember to take care of ourselves in the process and know when to scale back and focus on our own problems.

References

American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author Retrieved from https://www.counseling.org/resources/aca-code-of-ethics.pdf

Corey, C., Corey, G., Corey, M. & Callahan, P. (2015). Client Rights and Counselor Responsibilities. Issues and Ethics In The Helping Professions (9). Stamford, CT: Cengage Learning.

Corey, C., Corey, G., Corey, M. & Callahan, P. (2015). Confidentiality: Ethical and Legal Issues. Issues and Ethics In The Helping Professions (9). Stamford, CT: Cengage Learning.

Cantor, D. (1998). Achieving a Mental Health Bill of Rights. Professional Psychology: Research and Practice (29) 4 http://dx.doi.org.lopes.idm.oclc.org/10.1037/0735-7028.29.4.315

Davis, T., & Miller, H.F. (2016). A Practitioner’s Guide to Ethical Decision Making. (revised edition) Retrieved from https://www.counseling.org/docs/default-source/ethics/practioner's-guide-to-ethical-decision-making.pdf?sfvrsn=0

Ivers, N.N. & Perry, R.L. (2014). A Time to Tell? Legal Issues Regarding the Duty to Warn and Protect. Journal of Human Services, (1) 70 Retrieved from https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsgao&AN=edsgcl.418846148&site=eds-live&scope=site

Kitchener, K.S. (2000). Foundations of Ethical Practice, Research and Teaching in Psychology. Retrieved on November 13, 2017 https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=24269&site=ehost-live&scope=site&ebv=EB&ppid=pp_22

South Carolina Legislature (1991). Rights of Mental Health Patients. South Carolina Code of Laws. Retrieved on November 13, 2018 from http://www.scstatehouse.gov/code/t44c022.php

U.S. Department of Health and Human Services (2016). Health Information and Privacy. Retrieved from https://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/