extended answers questions 2

Competence

· Performing effective counseling techniques as well as other skilled professionals and according to accepted criteria

· Competence has three primary components:

· Knowledge

· Skill

· Diligence

· Competence is distinguished from perfection, because universal competence is unattainable

· Competence should be thought of as spanning a continuum from incompetent to exceptionally competent. A mental health professional should always aim for higher levels of competence. Because of the evolving nature of knowledge and practice, competencies must be maintained through continuing education and consultation. If not, competencies become obsolete because of the changing nature of the profession

· Ethics codes of Competence:

· APA (Standard 2.01): Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence based on their education, training, supervised experience, consultation, study or professional experience.

· ACA (Section 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.

· AAMFT (Principle 3.0): Marriage and family therapists maintain high standards of professional competence and integrity.

Limits of Competence

· Ethics codes demand professionals practice within the limits of their competence. To determine whether a particular activity is within an existing skill or developing a new skill, clinicians must evaluate:

· Level of formal training: These can include university or college level courses, certification programs, continuing education credits and courses

· Supervised practice: The include supervised practicum, internship or supervision at employment site

1. NOTE: Both formal training and supervised practice are prerequisites for competence

· If skills are inadequate for a client’s needs, client should be referred to a competent colleague

· Counselors and therapists in rural areas or in other small and specialized communities have special concerns about the limits of competence, because referral sources are scarce and the pressures on them to act as generalists are great

· Purpose of competence: Avoid harm to client

· Ethical issue in competence: Capacity to assist the client while avoiding harm

· Professionals need to take developmental and cultural issues into account when evaluating their competencies. NO INTERVENTION has been demonstrated effective across all ages or cultures

Stress Management & Burnout

· At times the stress of this occupation becomes overwhelming. Practitioners are constantly exposed to traumatic situations, stress of managing patients & ethics/laws, reporting abuse, etc. When this happens, competent performance is threatened and a formerly competent practitioner may provide inadequate service. Burnout caused by occupational stress, and distress caused by emotional, relationship, or substance abuse problems, are the most common reasons for this kind of incompetent service.

· Ethics codes place the RESPONSIBILITY for self-monitoring stress ON THE PROFESSIONAL.

· Ethics codes also mandate that practitioners limit or interrupt their practices under these circumstances, if necessary, to avoid harm to clients

· Most common reasons for incompetent services:

· Burnout caused by occupational stress

· Distress caused by emotional, relationship, or substance abuse problems

· Ethics codes on impairment of competence:

· APA (Standard 2.06): Psychologists refrain from initiating any activity when they know or should know that there is a substantial liklihood that their

· personal problems will prevent them from performing their work-related activities in a competent manner.

· ACA (Standard C.2.g): Counselors are alert to the signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when such impairment is likely to harm a client or others.

· AAMFT (Principle 3.4): Marriage and family therapists do not provide services that create a conflict of interest that may impair work performance or clinical judgment.

Vicarious Traumatization

· A set of emotional/psychological reactions often experienced by someone who witnesses (directly or indirectly) any traumatic event or series of events

· Particular risk factor for those professionals who work with clients in crisis or victims of violence

· Factors that can affect likelihood of being vicariously traumatized include:

· Proximity to the situation

· Relationship with the person(s) involved

· Element of surprise or shock

· Presence of interpersonal violence vs. an illness/injury not deliberately caused

· Having experienced similar traumas or losses in the past

· Traumatic stress responses can appear soon after an incident occurs or can be triggered at some later time by any reminder of the traumatic experience

· Symptoms are almost identical to Post Traumatic Stress Disorder:

· Nightmares, “flashbacks”, or recurring memories/images.

· Numbing and avoidance responses

· Increased arousal and hypervigilence

· Feelings of shock and disbelief

· Feelings of (irrational) guilt and self-blame

· Irrational fear for the safety of oneself and loved ones

· Poor concentration due to anxiety, depression, or preoccupation with the traumatic event

· Feeling isolated and misunderstood

Professional Error vs. Negligence

· When professionals practice outside the boundaries of their competence or provide incompetent service, they are at risk for a civil suit against them in addition to an ethics complaint. While lawsuits are relatively uncommon, it is important to understand and be aware of one’s scope of practice legally.

· Professionals need to understand that negligence is not identical with professional error.

· Negligence can be proven only if:

· A demonstrable professional relationship with the client has been established

· If the practitioner made a mistake that showed substandard care

· If the client suffered an injury

· The injury was directly caused by the professional’s actions

· Professional error is considered if: " Practitioner made an error

· Client may or may not be harmed

· Intent was not to harm

· Key difference is the INTENT: Acting with a “good faith effort” towards the client vs. knowingly causing harm to client