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chapter5.pptx

chapter5.pptx

Issues and Ethics in the Helping Professions

Tenth Edition

Chapter 5

Client Rights and Counselor Responsibilities

Learning Objectives (1 of 2)

5-1 Explain what is involved in the informed consent process.

5-2 Describe the basic content of an informed consent document.

5-3 Understand a counselor’s responsibility in record keeping.

5-4 Explore ethical issues related to online counseling.

5-5 Identify some legal issues and risk management strategies for providing online counseling.

Learning Objectives (2 of 2)

5-6 Discuss ethical issues in working with minors.

5-7 Address issues regarding suspected unethical behavior of colleagues.

5-8 Clarify what is involved in the concept of malpractice.

5-9 Examine the basis for malpractice liability in the therapy profession.

5-10 Delineate practical strategies for risk management.

5-11 Understand an appropriate course of action in dealing with a malpractice complaint.

Informed Consent

Involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it

Both an ethical and a legal obligation of the clinician

Not only meets legal and ethical standards but represents excellent clinical care as well

Requires that the client understands the information presented, gives consent voluntarily, and is competent to give consent to treatment

A process that continues for the duration of the professional relationship

Content of Informed Consent (1 of 2)

The following information should be provided in writing and discussed:

The therapeutic process (including assessment)

Background of therapist

Costs involved in therapy

The length of therapy and termination

Consultation with colleagues

Interruptions in therapy

Benefits and risks of treatment

Using telecommunication technology

Content of Informed Consent (2 of 2)

Alternatives to traditional therapy

Tape-recording or videotaping sessions

Clients’ right of access to their files

Rights pertaining to diagnostic classifying

The nature and purpose of confidentiality

Record-Keeping (1 of 2)

From a clinical perspective:

Record-keeping provides a history that a therapist can use in reviewing the course of treatment.

From an ethical perspective:

Records can assist practitioners in providing quality care to their clients.

Record-Keeping (2 of 2)

From a legal perspective:

State or federal law may require keeping a record.

Many practitioners believe that accurate and detailed clinical records can provide an excellent defense against malpractice claims.

From a risk management perspective:

Keeping adequate records is the standard of care.

Content for Inclusion in Records (1 of 2)

Client-identifying data

Client’s chief complaints

Physical exam objective findings

Intake sheet

Documentation of referrals and informed consent

Findings from consultations, referrals, diagnostic procedures and tests

Diagnosis and prognosis

Treatment plan

Content for Inclusion in Records (2 of 2)

Signed and dated progress notes

Appointment dates, times, and types of services

Termination and discharge summary

Release of information

Securing Records

Counselors have the responsibility for storing client records in a secure place and exercising care when sending records to others by mail or through electronic means.

Helping professionals who utilize the “cloud” as an off-site storage tool may be exposing themselves and their clients to unforeseen risks.

Ethical Issues in Online Counseling

It is the counselor’s responsibility to examine the ethical, legal, and clinical issues related to online counseling.

Basic issues such as self-disclosure, confidentiality, boundaries, and dual relationships can take on unexpected shapes in online counseling.

Mistakes of Omission in Online Counseling (1 of 2)

Obtain informed consent prior to services

Limit access to personal information

Obtain a clinical license to practice in the state in which the client resides

Comply with HIPAA confidentiality requirements

Respond in a timely manner

Mistakes of Omission in Online Counseling (2 of 2)

Terminating online services to clients abruptly

Claiming expertise in providing online services outside the scope of one’s education and training

Providing online services to clients whose clinical needs are so severe that they require in-person services

Some Advantages of Online Counseling

Reaching clients who are reluctant to participate in face-to-face therapy as well as those who have certain disabilities or chronic illnesses that render them immobile

Improving client access in rural areas

The potential for greater numbers of people to receive services

Some Disadvantages of Online Counseling

Danger of making an inaccurate diagnosis

Compromising confidentiality and privacy

Difficulty in protecting clients in crisis

Challenges of working through transference and countertransference

Lack of competence and danger of the misrepresentation of a counselor’s qualifications

Legal Issues and Regulation of Online Counseling (1 of 2)

A clinician’s license is intended for practice in the state where he or she is licensed to practice.

Counselors need to stay current regarding the changing laws pertaining to counseling across states.

Malpractice insurance carrier may not plan to cover out-of-state counseling.

Licensing boards have a legal mandate to protect consumers who live in their state; they do not have an obligation to consumers who do not reside in their state.

Legal Issues and Regulation of Online Counseling (2 of 2)

If a California consumer is traveling to another state and wants to participate in counseling via telephone (or online) the California-licensed therapists must receive permission from the temporary location.

Working With Children and Adolescents

Important issues to consider:

Minors’ rights regarding informed consent

Parental rights to information about a minor’s treatment

Minors’ assent versus consent

Involving parents in the counseling process with minors

Important issues to consider:

Limits to confidentiality

Dealing with reluctance

Need for supervised clinical experience in play therapy, art and music therapy, and recreational therapy

Unethical Behavior of Colleagues

Ignoring evidence of peer misconduct is an ethical violation in itself.

Many helping professionals are reluctant to address such problems.

Informal peer monitoring provides an opportunity for corrective interventions to ethically questionable acts.

If informal measures are not enough, reporting a colleague to a professional board is one of several options open to you.

Malpractice Liability

Malpractice means “bad practice.”

the failure to render professional services or to exercise the degree of skill that is ordinarily expected of other professionals in a similar situation

Professional negligence can result from unjustified departure from usual practice or from failing to exercise proper care in fulfilling one’s responsibilities.

Standard of care: Standards that are commonly accepted by the profession and are considered as the acceptable standard of practice in the community.

Elements of Malpractice

To succeed in a malpractice claim, four elements must be present:

A professional relationship between the therapist and the client must have existed.

The therapist must have acted in a negligent or improper manner, or have deviated from the “standard of care” by not providing services that are considered “standard practice in the community.”

The client must have suffered harm or injury, which must be verified.

There must be a legally demonstrated causal relationship between the practitioner’s negligence or breach of duty and the damage or injury claimed by the client.

Reasons for Malpractice Suits

Failure to obtain or document informed consent

Refusal to counsel clients due to value differences

Client abandonment or premature termination

Marked departures from established therapeutic practices

Sexual misconduct with a client

Practicing beyond the scope of competency

Negligent assessment or misdiagnosis

Repressed or false memory

Unhealthy transference relationships

Failure to assess and manage a dangerous client

Risk Management

The practice of focusing on the identification, evaluation, and treatment of problems that may injure clients and lead to filing an ethics complaint or a malpractice action.

One of the best precautions against malpractice is personal and professional honesty and openness with clients.

Know your limitations and seek consultation in difficult cases.

Remain alert for possible misunderstandings that, if not recognized or poorly handled, could lead to a therapeutic break or premature termination of therapy.

Course of Action in a Malpractice Suit (1 of 2)

Treat the lawsuit seriously.

Do not attempt to resolve the matter with the client directly.

Contact the ethics and risk management services of your professional associations.

Become familiar with your liability policy, including limits of coverage, and contact insurance company immediately.

Never destroy or alter files or reports pertinent to the client’s case.

Course of Action in a Malpractice Suit (2 of 2)

Do not discuss the case with anyone other than your attorney.

Determine support available to you from professional associations.

Do not continue a professional relationship with a client who is bringing a suit against you.

image1.png

chapter5.pptx

Issues and Ethics in the Helping Professions

Tenth Edition

Chapter 5

Client Rights and Counselor Responsibilities

Learning Objectives (1 of 2)

5-1 Explain what is involved in the informed consent process.

5-2 Describe the basic content of an informed consent document.

5-3 Understand a counselor’s responsibility in record keeping.

5-4 Explore ethical issues related to online counseling.

5-5 Identify some legal issues and risk management strategies for providing online counseling.

Learning Objectives (2 of 2)

5-6 Discuss ethical issues in working with minors.

5-7 Address issues regarding suspected unethical behavior of colleagues.

5-8 Clarify what is involved in the concept of malpractice.

5-9 Examine the basis for malpractice liability in the therapy profession.

5-10 Delineate practical strategies for risk management.

5-11 Understand an appropriate course of action in dealing with a malpractice complaint.

Informed Consent

Involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it

Both an ethical and a legal obligation of the clinician

Not only meets legal and ethical standards but represents excellent clinical care as well

Requires that the client understands the information presented, gives consent voluntarily, and is competent to give consent to treatment

A process that continues for the duration of the professional relationship

Content of Informed Consent (1 of 2)

The following information should be provided in writing and discussed:

The therapeutic process (including assessment)

Background of therapist

Costs involved in therapy

The length of therapy and termination

Consultation with colleagues

Interruptions in therapy

Benefits and risks of treatment

Using telecommunication technology

Content of Informed Consent (2 of 2)

Alternatives to traditional therapy

Tape-recording or videotaping sessions

Clients’ right of access to their files

Rights pertaining to diagnostic classifying

The nature and purpose of confidentiality

Record-Keeping (1 of 2)

From a clinical perspective:

Record-keeping provides a history that a therapist can use in reviewing the course of treatment.

From an ethical perspective:

Records can assist practitioners in providing quality care to their clients.

Record-Keeping (2 of 2)

From a legal perspective:

State or federal law may require keeping a record.

Many practitioners believe that accurate and detailed clinical records can provide an excellent defense against malpractice claims.

From a risk management perspective:

Keeping adequate records is the standard of care.

Content for Inclusion in Records (1 of 2)

Client-identifying data

Client’s chief complaints

Physical exam objective findings

Intake sheet

Documentation of referrals and informed consent

Findings from consultations, referrals, diagnostic procedures and tests

Diagnosis and prognosis

Treatment plan

Content for Inclusion in Records (2 of 2)

Signed and dated progress notes

Appointment dates, times, and types of services

Termination and discharge summary

Release of information

Securing Records

Counselors have the responsibility for storing client records in a secure place and exercising care when sending records to others by mail or through electronic means.

Helping professionals who utilize the “cloud” as an off-site storage tool may be exposing themselves and their clients to unforeseen risks.

Ethical Issues in Online Counseling

It is the counselor’s responsibility to examine the ethical, legal, and clinical issues related to online counseling.

Basic issues such as self-disclosure, confidentiality, boundaries, and dual relationships can take on unexpected shapes in online counseling.

Mistakes of Omission in Online Counseling (1 of 2)

Obtain informed consent prior to services

Limit access to personal information

Obtain a clinical license to practice in the state in which the client resides

Comply with HIPAA confidentiality requirements

Respond in a timely manner

Mistakes of Omission in Online Counseling (2 of 2)

Terminating online services to clients abruptly

Claiming expertise in providing online services outside the scope of one’s education and training

Providing online services to clients whose clinical needs are so severe that they require in-person services

Some Advantages of Online Counseling

Reaching clients who are reluctant to participate in face-to-face therapy as well as those who have certain disabilities or chronic illnesses that render them immobile

Improving client access in rural areas

The potential for greater numbers of people to receive services

Some Disadvantages of Online Counseling

Danger of making an inaccurate diagnosis

Compromising confidentiality and privacy

Difficulty in protecting clients in crisis

Challenges of working through transference and countertransference

Lack of competence and danger of the misrepresentation of a counselor’s qualifications

Legal Issues and Regulation of Online Counseling (1 of 2)

A clinician’s license is intended for practice in the state where he or she is licensed to practice.

Counselors need to stay current regarding the changing laws pertaining to counseling across states.

Malpractice insurance carrier may not plan to cover out-of-state counseling.

Licensing boards have a legal mandate to protect consumers who live in their state; they do not have an obligation to consumers who do not reside in their state.

Legal Issues and Regulation of Online Counseling (2 of 2)

Working With Children and Adolescents

Important issues to consider:

Minors’ rights regarding informed consent

Parental rights to information about a minor’s treatment

Minors’ assent versus consent

Involving parents in the counseling process with minors

Important issues to consider:

Limits to confidentiality

Dealing with reluctance

Need for supervised clinical experience in play therapy, art and music therapy, and recreational therapy

Unethical Behavior of Colleagues

Ignoring evidence of peer misconduct is an ethical violation in itself.

Many helping professionals are reluctant to address such problems.

Informal peer monitoring provides an opportunity for corrective interventions to ethically questionable acts.

If informal measures are not enough, reporting a colleague to a professional board is one of several options open to you.

Malpractice Liability

Malpractice means “bad practice.”

the failure to render professional services or to exercise the degree of skill that is ordinarily expected of other professionals in a similar situation

Professional negligence can result from unjustified departure from usual practice or from failing to exercise proper care in fulfilling one’s responsibilities.

Standard of care: Standards that are commonly accepted by the profession and are considered as the acceptable standard of practice in the community.

Elements of Malpractice

To succeed in a malpractice claim, four elements must be present:

A professional relationship between the therapist and the client must have existed.

The client must have suffered harm or injury, which must be verified.

There must be a legally demonstrated causal relationship between the practitioner’s negligence or breach of duty and the damage or injury claimed by the client.

Reasons for Malpractice Suits

Failure to obtain or document informed consent

Refusal to counsel clients due to value differences

Client abandonment or premature termination

Marked departures from established therapeutic practices

Sexual misconduct with a client

Practicing beyond the scope of competency

Negligent assessment or misdiagnosis

Repressed or false memory

Unhealthy transference relationships

Failure to assess and manage a dangerous client

Risk Management

The practice of focusing on the identification, evaluation, and treatment of problems that may injure clients and lead to filing an ethics complaint or a malpractice action.

One of the best precautions against malpractice is personal and professional honesty and openness with clients.

Know your limitations and seek consultation in difficult cases.

Remain alert for possible misunderstandings that, if not recognized or poorly handled, could lead to a therapeutic break or premature termination of therapy.

Course of Action in a Malpractice Suit (1 of 2)

Treat the lawsuit seriously.

Do not attempt to resolve the matter with the client directly.

Contact the ethics and risk management services of your professional associations.

Become familiar with your liability policy, including limits of coverage, and contact insurance company immediately.

Never destroy or alter files or reports pertinent to the client’s case.

Course of Action in a Malpractice Suit (2 of 2)

Do not discuss the case with anyone other than your attorney.

Determine support available to you from professional associations.

Do not continue a professional relationship with a client who is bringing a suit against you.

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