ETHICS FINAL YEAR 1
CH 3 Multicultural considerations were not given extensive attention in the ACA Code of Ethics until:
the fifth version adopted in 1995
Reversibility test
the golden rule, would you have made the same choice if you were in the clients shoes?
The umbrella of confidentiality can be extended to
-Assistants (Remember counselors are responsible for any breach of confidentiality by someone who assists them) -Consultation with colleagues or experts -Counselors working under supervision Other professionals (coordinating client care)
Boundary violation that are discouraged
-Bartering - not prohibited but discouraged -Post-counseling relationship - not spoken to in ACA -Accepting gifts - ACA says counselor considers client's motivation, monetary value -Self-disclosure - ethically unethical when they meet counselor's needs, otherwise OK
Confidentiality is not absolute. Counselors inform clients of the limits of confidentiality Exceptions to confidentiality:
-Client is a danger to self or others -Suspicion of child, elder, or dependent adult abuse -Client has directed counselor to share info -Counselor receives a qualifying court order Subpoenas are official court orders (obtain legal advice before responding to a subpoena)
A client might have the basis for a lawsuit against a counselor if the client believed, for some reason, that the counselor had done any of the following:
-Failed to include required HIPAA elements. -Guaranteed an outcome as a result of counseling. -Guaranteed privacy with no exceptions. -Agreed to fee arrangements different from what was intended. -Touched without implied or actual permission. Misrepresented credentials. -Failed to communicate the nature of counseling. -Neglected to warn client about possible stigma.
Purpose of records:
-Provide the best quality of services to clients -For counselors own self-protection -Refresh memory for next session -Review progress toward goals -Document actions and decisions
According to the ACA Code, A.1.b. Records & Documentation, Counselors should:
1. Create, safeguard, and maintain documentation necessary for rendering professional services. 2. Include sufficient and timely documentation to facilitate the delivery and continuity of services (regardless of the medium). 3. Take reasonable steps to ensure that documentation accurately reflects client progress and services provided. If amendments are made to records and documentation, counselors take steps to properly note the amendments according to agency or institutional policies.
The following are core professional values of the counseling profession:
1. enhancing human development throughout the life span; 2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts; 3. promoting social justice; 4. safeguarding the integrity of the counselor-client relationship; and 5. practicing in a competent and ethical manner.
Clinical case notes: notes that counselors keep regarding their sessions with clients
2 basic reasons to keep case notes: -provide quality counseling services to clients and to document decisions made and actions taken -Counselors must assume case notes will be read. -Counselors document as much as possible (date, time, important information, and within a timely manner)
guardian ad litem
a person appointed by courts to determine the best interests of a child related to privilege
ACA Code of Ethics: When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decision-making process, consulting available resources as needed. Counselors acknowledge that resolving ethical issues is a process; ethical reasoning includes consideration of professional val
True
CH 4 With respect to a client's right to choose the time and means of their death, the ACA Code of Ethics allows counselors the option to maintain confidentiality depending upon applicable laws and the specific circumstances of the situation after seeking consultation or supervision from appropriate professional and legal parties.
True
CH. 1 Law and ethics differ from one another in that laws dictate minimum standards of behavior that society will tolerate, whereas ethics represent the ideal standards expected by the profession.
True
Turf Issue
Accusing counselors of practicing outside their scope of authority when dx'ng mental and emotional disorders.
CASE STUDY: Carole is a master's student in counseling who is enrolled in her practicum course and has begun to work under supervision with her first clients. Carole self-identifies as mixed-race Hispanic; her father is White, and her mother emigrated from a country in Central America. Carole grew up hearing stories of the oppression and violence her mother had experienced in her home country before coming to the United States, and she has been saddened and angered to see the prejudice that her mother continues to encounter as a Hispanic American. Now in her sixth week of practicum, Carole has received positive feedback about her work with clients. Today, however, she had a new client named Frank who sought counseling for depression that he believes is caused by his inability to find a job. During the session, Frank spoke at length and with bitterness about immigrants from Mexico and Central American countries who "
Although Carole's emotional reaction to the client's prejudice toward people who share her heritage is understandable, she must learn to bracket or set aside her personal values within her counseling sessions. Her supervisor will work with her to help her process her reaction and learn to effectively counsel clients who "push her personal buttons." Actually, Carole is fortunate to have encountered a client like Frank while she is in her practicum and can receive the assistance she needs to become competent to work with such clients. Her supervisor will make it clear that referring Frank to a different counselor is not the solution to her difficulties and that Carole is expected to develop the competence to work with clients who evoke uncomfortable personal reactions. Ethics is a discipline within philosophy that is concerned with human conduct and moral decision making. Certainly, you have developed your own individual ethical stance that guides you in the ways you treat others, expect them to treat you, and make decisions about what behaviors are good or right for you. In this text, however, we think of ethics as it relates to the profession of counseling; that is, ethics refers to conduct judged as good or right for counselors as a professional group. When your fellow professionals have come to sufficient consensus about right behaviors, these behaviors have been codified and have become the ethical standards to which you are expected to adhere in your professional life (ACA, 2014). Therefore, think about ethics as referring to your professional behavior and interactions. Keep in mind that ethics must prevail over your personal values when value conflicts arise within a counseling relationship. Because the counseling relationship exists to benefit the client, you must avoid imposing your own values on your clients.
CH. 6 When counselor trainees make audiotapes or videotapes of counseling sessions for supervision purposes:
Answer: D - ALL OF THE ABOVE A. supervisors must handle the tapes appropriately during the time the tapes are in the supervisors' possession. . B. supervisors should return tapes to trainees after the tapes have been reviewed. C. trainees must retrieve the tapes after the supervisors have reviewed them and then erase the tapes. D. all of the above. E. the tapes should be labeled simply, in a manner that does not bring attention to the fact that the tapes are confidential records.
The Informed Consent documents that clients sign before counseling sessions begin:
Are a good way to inform clients of their rights and responsibilities and are required by some federal rules and state laws
Section B in the ACA Code of Ethics is
Confidentiality and Privacy
CH. 5 It is best practice that when counselors share confidential client information with other professionals involved in a client's care, the counselors should first obtain client permission to share the information.
True
Bruff vs North Mississippi Health services (2001)
Counselor (Bruff) refused to help a LGBTQ client due to counselors religious beliefs. They referred the client to another counselor and the company tried to accommodate the counselors religious beliefs but determined it would make things too difficult for Bruff's coworkers. Bruff was terminated from her job and sued her company. Eventually the 5th district court of appeals ruled against Bruff. Determined that Bruff's inflexible position caused undue hardship to her fellow EAP counselors.
CH. 6 When documenting for self-protection purposes, a counselor should include as much detail as possible (e.g., dates, times of events, and exact words spoken) in the documentation process.
True
Ch.1: Counselors believe that most of the problems people encounter are _____ in nature and therefor are natural and normal
Developmental
2-2 The Case of Kevin Kevin earned his master's degree in counseling 8 years ago and has been working as a staff counselor in a psychiatric hospital since he graduated. In addition to this employment, he opened a part-time private practice when he became licensed as a professional counselor. Kevin recently completed his doctorate in health care administration from a non-traditional distance learning university in California. He is now focused on his goals of moving into an administrative position within the hospital as well as building up his private practice in case an administrative job opportunity does not occur. He has decided to update the business cards and brochures he uses in his private practice, and he has changed the wording to present himself as "Kevin Smith, PhD, MS, LPC, Professional Member of the American Counseling Association." Do you see anything wrong with the wording on Kevin's cards? Do you belie
Discussion: All of Kevin's credentials on his card are directly related to counseling except perhaps his PhD, which is in health care administration. If his doctorate was earned from a university that was not accredited by one of the regional accrediting bodies, then the legitimacy of his degree would be questionable. He must be careful not to mislead the public into believing that he has a legitimate counseling doctoral degree. Whether the university from which he earned his degree is accredited by a regional accrediting body is not known. Many non-traditional distance learning universities do hold regional body accreditation. According to the ACA Code of Ethics (2014), "Counselors do not imply doctoral-level competence when possessing a master's degree in counseling or a related field by referring to themselves as Dr. in a counseling context when their doctorate is not in counseling or a related field" (§C.4.d.). There are arguments for and against recognizing a PhD in health care administration as a doctorate in a field closely related to counseling. On one hand, counseling is a form of health care, and a specialty within health care could easily be mental health care administration. On the other hand, general health care administration is not a mental health field. Perhaps the best way for Kevin to ensure that he is acting ethically, even though it might be a bit awkward, would be for him to specify on his business cards that his PhD degree is in health care administration and his MS degree is in counseling. Basically, advertising must be accurate and must not be false, misleading, deceptive, or fraudulent (ACA, 2014, §C.3.a.). When you become aware of any misrepresentation of your credentials that might be made by others, you are responsible for making reasonable efforts to correct the misinformation (§C.3.c.).
1-3 The Case of Edward Edward is a high school counselor. His administrative supervisor is the school principal, Ms. Wilcox. Although Ms. Wilcox has no training as a counselor, she generally has been supportive of the counselors on her staff. She asks Edward to provide, for her eyes only, a list of his clients and presenting concerns. Edward trusts the supervisor to be responsible and refrain from sharing the list with others. Nonetheless, Edward believes it would be wrong to produce the list because it would violate his clients' right to confidentiality. At the same time, he realizes he could be at risk for disciplinary action for refusing to produce the list. He thinks that no real harm would be likely to result from giving it to Ms. Wilcox. He is also concerned that a refusal could negatively affect Ms. Wilcox's supportive attitude toward the counselors. What should Edward do? Do you believe the principle of confi
Discussion: If Edward reasons that the ethical principle is most important, he would be committing himself to uphold the moral principle of fidelity. Fidelity refers to fulfilling a responsibility of trust in the counseling relationship: Counselors strive to be faithful to the promises they make, such as keeping clients' disclosures confidential. If Edward adheres to this line of reasoning, he could be said to be thinking as an ethical absolutist—that the principle always applies, regardless of the situation. He would also be thinking as a deontologist, by deciding that keeping the students' confidentiality is the right thing to do, regardless of the consequences. In addition, he might be relying on altruism, in that he believes that his actions must uphold client welfare rather than serve his own interests. If Edward decides to produce the list for Ms. Wilcox, he might be motivated by egoism, or a focus on protecting himself and his fellow counselors from negative repercussions. He could be using utilitarian reasoning as suggested by Mill, that because no harm is likely to come to the students, his decision will do the greatest good for the greatest number of people—not only himself and his fellow counselors but also the students who would be better served by having a supportive school administration. We believe the best course of action in this situation would be for Edward to have an open discussion with his principal and explain his concerns about providing her with the list of students he has seen in counseling. Hopefully, his principal will either understand his concern and withdraw her request or convince Edward of a need for the list that would override his ethical concerns about the privacy of his students.
3-2 The Case of Jack Jack, a counselor intern, is working in a college counseling center. Mai-Ling, a freshman who came to the United States from mainland China with her parents 8 years ago, has come for her first session with Jack and has agreed to let him audiotape the session for his supervisor. Mai-Ling states that she has come for help in deciding whether to continue in her 2-year associate degree program in computer operations or switch to a baccalaureate program in computer science. Jack, very much aware that his supervisor will be listening for reflections of feelings and other attending skills, asks Mai-Ling how she feels about being confronted with this decision. She responds by simply restating her problem. The session continues in this fashion, with Jack probing for the client's feelings and the client responding in a cognitive, content-oriented manner. After the session ends, Jack determines to ask his s
Discussion: If Jack had known that many Asian clients are very uncomfortable with the idea of discussing their feelings with a stranger, he might not have perceived his client as difficult. His lack of understanding led him to make an error that is common among counselors who lack knowledge of different cultures—he blamed the client for his failure to establish a therapeutic alliance. A variety of avenues are available for gaining and increasing knowledge of different cultures. A number of excellent texts are available that address multicultural counseling in general or that focus on specific groups such as lesbian, gay, bisexual, and transgender (LGBT) clients, African American youth, and older individuals, to cite just a few examples. Specialized training is readily available through workshops and seminars, online courses, journal articles, and other resources. Many articles are available that assist counselors in understanding and counseling clients who belong to specific populations, including sexual minority groups (Abreu, McEachern, & Kenny, 2017; Byrd & Hays, 2012; Harris, Roberston, Jones, & Prado, 2017; Kull, Kosciw, & Greytak, 2017; Kurt, 2017; McCullough et al., 2017; Simons, Hutchison, & Bahr, 2017; Singh & Kosciw, 2017); African Americans (Adkison-Johnson, 2015; Washington, 2018); Latinos (Parker & Ray, 2017); and immigrants (Roxas, Gabriel, & Becker, 2017). There is a limit, however, to what can be learned through reading and taking courses and seminars. Experiential learning can be powerful. As you begin to practice, the most important resource for your continued learning will be your clients. They are the most expert source of knowledge about their own cultural values, beliefs, customs, and behaviors, and they are often willing to teach their counselors.
3-4 The Case of Mary Jo Mary Jo, aged 78, comes to see Roberta, a counselor at a community mental health center. When Roberta asks Mary Jo what brings her to counseling, Mary Jo replies, "I really don't know why I'm here. My daughters pretty much insisted that I see a counselor, and I got tired of their nagging so here I am." Further exploration elicits the information that Mary Jo's daughters are concerned that she isn't planning for retirement and that they believe that their mom "should retire and enjoy life while she still can." Mary Jo explains that she has no thoughts of retiring, she loves her work and finds it to be a source of meaning in her life, and her employer wants her to stay on. As Roberta listens, she thinks that perhaps she should inquire more deeply into the sense of meaning that work provides for Mary Jo. Yet Roberta, who is 28 years old, also finds herself thinking it might be more important to e
Discussion: Roberta seems to be unaware of the differences in perspective when age 78 is viewed through the lens of a 28-year-old versus the lens of someone who has reached that age. Her lack of awareness of possible age bias may lead her to align with Mary Jo's daughters rather than with her client. This could happen if she focuses on retirement planning rather than the reason Mary Jo has come for counseling, which is that her daughters have insisted and she is feeling nagged. Roberta might be more effective in working with Mary Jo if she were to stay in the present moment with her client and attend to what Mary Jo has stated, rather than think ahead to what she believes Mary Jo needs to do at this point in her life. Older adults tend to underutilize mental health services, perhaps partly because of the stigma they attach to seeking psychological services. Counselors need to be prepared to address the reluctance of some older clients to enter into counseling relationships. Counselors should be alert to signs of possible elder abuse or neglect (see Chapter 11 for a further discussion of this topic). As advocates, counselors are uniquely positioned to assist older individuals because our developmental perspective recognizes and supports the possibility of positive growth across the life span (Myers, 2007). Working both with and on behalf of older individuals, counselors can strive to effect changes in laws, policies, and organizations.
3-3 The Case of Theo Tameika, a 28-year-old African American woman, comes to the community mental health center seeking counseling. During her initial session with Theo, a novice counselor who is White, Tameika reports several symptoms suggestive of depression, including disturbance in her sleep patterns, loss of appetite, general fatigue, and unexplained weeping spells. Theo inquires as to whether she has experienced any losses or significant life changes recently. She replies, "Not really. I just keep trying to keep it all together. And it's hard when I earn a minimum wage and so much of it goes for child care for my two little ones. Some months I can't afford both to feed my kids and pay the utility bills. I can't see how it's going to get any better." Theo suggests that she might get some short-term relief by taking an antidepressant medication and offers to refer her to the mental health center's consulting psyc
Discussion: In this case, the counselor would have been more effective had he taken more of a systemic approach to helping Tameika. Rather than focus on her intrapsychic dynamics and her depression, he might have explored with her whether there were any social support systems available in her community. He might have discovered, for instance, that her religious faith was an important source of strength for her and, he could have helped her connect with a church in her neighborhood that offers free or reduced-fee child care for its members. He might have helped her contact social services agencies such as Aid to Families With Dependent Children or a community organization that could help her manage her financial problems. His failure to implement any such culturally appropriate strategies could have been a major factor in Tameika's failure to return to the center.
4-1 The Case of Lynn Lynn has been counseling Elaine, a 30-year-old client. During this session, Elaine states that she wishes she could just walk away from her marriage, but she can't do it because it would traumatize the children. Lynn, herself a child of divorce whose father abandoned the family, further explores Elaine's fears for the children. At one point Lynn says to her client, "Well, yes, the statistics do show that a lot of kids lose touch with their fathers after a divorce. It would be really hard for them if that happened. It could even have repercussions well into their adult years." What do you think motivated Lynn to respond the way she did? Do you see any problem with Lynn's response?
Discussion: It appears that the counselor, Lynn, is interjecting her own feelings about paternal abandonment into the session. Lynn is focusing on her own feelings rather than trying to help Elaine clarify her own feelings about the issue. By focusing on the client's children rather than the client herself, Lynn is discounting the client's feelings and imposing her own values about the effects of divorce on children onto the client. This case example illustrates that, if counselors lack self-awareness of their unfinished business, areas of vulnerability, and defenses, there is a risk that they will inadvertently be working on their own issues in the counseling relationship rather than the client's issues. As Corey, Corey, and Corey (2019) have noted, counselors who are unaware of their own issues are in a poor position to recognize the ways in which their personal lives are influencing their interactions with clients. This is particularly true when the client's problems or issues are similar to the unresolved issues of the counselor. We are not suggesting that counselors do not have their own needs or that it is unethical to get some of these needs met by choosing counseling as a profession. In fact, most counselors would probably say that they get a real sense of satisfaction or fulfillment from their work and from knowing that they have made a difference in the lives of others. Still, it is important for you to explore your own answers to the questions "What motivates me to choose the counseling profession?" and "What do I get out of being a counselor?" and "What needs of mine am I getting met?" Knowing your own needs will help you identify potential areas of vulnerability and sources of therapeutic error. For example, if you have a strong need to nurture others, you may be tempted to encourage client dependency. You
1-5 The Case of Fatima Fatima is a counselor in a university counseling center who is in the process of planning for a month-long vacation. She will be leaving in 2 months. She has been having a series of conversations with her supervisor and several of her colleagues at the center about the proper way to handle her existing clients: when to tell them she is leaving; whether to refer them permanently to other counselors; whether to refer them temporarily to other counselors and take them back when she returns; whether to terminate with those who are nearing readiness; and what to do about those clients who have been at risk for suicide in the recent past. At the staff meeting today, the counseling center director announced that he had talked to the university attorney about the situation and her advice was just to tell all of Fatima's clients that she will be gone for a month and to let them decide what to do in the
Discussion: It is good for counselors to get advice from attorneys regarding their legal obligations. However, a counselor's ethical obligations may go beyond what is required legally. Fatima will want to be careful not to offend the director, so perhaps she could thank the director for obtaining legal advice. Later and in private, she might share the ACA Code of Ethics with the director and point out some of the ethical obligations she wants to meet. She could continue by suggesting that a good goal for the center would be to follow ethical and best practice guidelines, in addition to legal obligations, in order to provide the best possible service to clients. When counselors face issues that require them to exercise their clinical judgment, particularly where there are no clear right or wrong responses, it is essential to consult with colleagues to the extent possible. In some situations, consultation might be impossible, such as when emergencies arise. When time does allow, however, consulting about clients provides a substantial protection to counselors whose clinical decisions are later challenged. The legal standard of care for counselors is that counselors must practice in a manner consistent with the way in which a reasonable, similarly educated counselor would practice under the same set of circumstances. By consulting with others, counselors can prove later that they indeed met the standard of care by doing what other, presumably reasonable, counselors advised or agreed on. If experts are available for consultation, it is wise to talk with them as well. Experts might include former university professors, counselors who are known for their expertise in a particular area, or counselors with extensive clinical experience. It is impossible for counselors to know for certain whether they are making decisions that
2-1 The Case of Rebekah Rebekah is a third-grade teacher who recently completed her master's degree in counseling. Because her school district employs counselors only at the high school level, she has assumed that she will have to move to another district to fulfill her goal of being an elementary school counselor. She is very excited when her principal calls to tell her that the school board is going to consider hiring either counselors or school social workers for the elementary schools. The principal asks her to attend the next school board meeting and speak about what an elementary school counselor does and how counselors differ from social workers. Rebekah wants to give a very persuasive talk so that the board will decide to hire counselors and, she hopes, offer her one of the new positions. She asks you for advice on what to say and how to say it. What advice would you give Rebekah, in terms of the information
Discussion: Rebekah might gather all the information available from the American School Counselor Association (ASCA; www.schoolcounselor.org) regarding the unique role of school counselors in elementary schools. She should summarize this information for the school board members. She should also be prepared to explain the differences between the roles of school social workers and school counselors at the elementary school level. The most influential information Rebekah could present would be data showing that elementary school counselors make a difference in schools in terms of students' academic achievement; satisfaction of parents with the school; and satisfaction of parents, teachers, and administrators with elementary school counseling programs. Providing testimonials from students, parents, teachers, and principals in schools that have effective elementary school counseling programs might also be very effective. We hope this chapter helps you clarify your professional identity as a counselor and helps you tell others about the profession of counseling. It also is intended to help you understand and appreciate the history of the counseling profession, the professional associations that serve counselors, graduate program accreditation, and the credentials available to counselors.
3-1 The Case of Marlene Marlene, a White high school counselor, is conducting a group for non-college-bound senior girls. The topic of this session is "preparing for life after graduation." The nine-member group is composed of equal numbers of African American and Euro-American girls, and one Hispanic American girl. The discussion has turned to a consideration of the advantages and disadvantages of continuing to live at home with parents for a while versus moving into an apartment with friends as soon as one finds a job. Marlene notices that the Hispanic American group member has remained silent for the past several minutes. In an effort to draw her in, Marlene asks her, "Consuela, isn't it more of an expectation among Hispanic families that girls will continue to live at home until they marry?" What do you think of the question that Marlene posed to Consuela? What are some other ways Marlene might have used to draw
Discussion: The case of Marlene illustrates how lack of awareness of one's own assumptions can be manifested in a counseling situation. Marlene had good intentions when she asked Consuela the question to draw her into the group. However, she failed to consider how Consuela may have felt about being asked to speak for all Hispanic families. It hardly seems likely that Marlene would have asked a similar question of one of the White students. In fact, being able to count on not being asked to speak for all members of one's racial or ethnic group is an element of White privilege. Had Marlene examined her unconscious assumptions that may have originated in her own status of White privilege, she would not have used this particular strategy to draw Consuela into the discussion.
1-2 The Case of Alicia Alicia will be seeing a 16-year-old minor for his first counseling session. Alicia knows that legally and ethically she must have one of his parents sign an agreement for her to disclose information regarding his sessions to his parent's health insurance company so that the parent will be reimbursed partially for the cost of her counseling services. Alicia also is aware that, according to the ACA Code of Ethics (2014), she may include parents in the counseling process, as appropriate (§A.2.d.; §B.5.b). However, she realizes how important confidentiality is to adolescents, and she wants to provide services to this minor in a way that would meet best practice standards. What are some of the things Alicia might do in this situation to go beyond what is minimally required by law or the code of ethics? How will Alicia know if what she finally decides to do is best practice?
Discussion: You will have the information you need to answer these questions after you have read material on ethical decision making, informed consent, confidentiality, and counseling minor clients, all presented later in the text. For now, a brief answer is that Alicia would be well advised to hold a conversation with both the client and his parent(s) present, in which she discusses confidentiality and its limits (including the information she would share with the insurance company). Including the client in the decision-making process is good practice, and Alicia can ask the client to sign the agreement to signify his assent, in addition to having the parents sign to give legal consent. Best practice for Alicia will mean keeping a careful balance, honoring both her minor client's right to privacy and his parents' rights to information about their son, and working to establish and maintain a cooperative relationship with all parties.
Section H of the ACA Code of Ethics
Distance Counseling, Technology, and Social Media
What duty did the Tarasoff case create for counselors?
Duty to warn persons who are foreseeably endangered by a clients conduct.
Agreed upon rules that set forth principles that allow people to live together in society. Dictate minimal standards of behavior
Laws
Allison v. Patel ,1993 & Anno v. Mcintosh, 1994:
Ethical guidelines in the ACA Code of Ethics and legal decisions related to physicians prohibit counselors from abandoning their clients. Also, judge or jury would not support a counselor who abandoned their client during a crisis.
Refers to professional behaviors. prescribes both minimal professional behaviors and deal or aspirational behaviors
Ethics
Section E of the ACA Code of Ethics is
Evaluation, Assessment, and Interpretation
ACA Code A.2.a.: Clients do NOT have the freedom to choose whether to enter into or remain in a counseling relationship and need adequate information about the counseling process and the counselor. Counselors do NOT have an obligation to review in writing and verbally with clients the rights and responsibilities of both counselors and clients. Informed consent is NOT an ongoing part of the counseling process, and counselors appropriately document discussions of informed consent throughout the counseling relationship.
False
CH. 2 Counselors who practice from a developmental perspective believe that all stages of life traumatize clients and, thus, the counselor's role is to treat the trauma their clients have experienced.
False
CH. 7 Licensure ensures that counseling practitioners are competent to do what their licenses permit them to do.
False
CASE STUDY: Monica is a new counselor at a community mental health center . She has taken this position as her first job after completing her masters degree in counseling. Ashley is a 15-year-old client with whom Monica has had two counseling sessions. Ashley's mother drives her to counseling sessions and waits for her until the sessions are over and then drives her home. Ashley told Monica in their first session that she sometimes cuts herself with small incisions above her ankle and below her knee. Ashley assured Monica that the cuts were never deep, rarely produced any blood, and were not in any way dangerous. In that first session, Monica talked with Ashley about self-injury and what is known about such behaviors. She asked Ashley questions about what precipitates her cutting behaviors; what her feelings are before, during, and after cutting; and what her thoughts were about cutting. In the second session, Ashley
First, Monica should ask Ashley to give her more information about the cutting behaviors. Monica should ask Ashley if she actually has cut herself so deeply that she has bled substantially. Monica needs to determine whether Ashley is fearful of cutting herself too deeply in the future, or if perhaps she has already done that in the past, and if she has cut herself deeply in the past, how many times. If Monica determines that Ashley is involved only in surface cutting and has not put herself in danger, but is only concerned about perhaps doing that in the future, Monica could determine that Ashley is not currently a danger to herself and could continue her counseling sessions with Ashley. Monica would want to closely monitor Ashley's cutting behaviors from week to week. If Monica makes the determination that Ashley is not currently a danger to herself, she should consult with her supervisor at the agency, give her supervisor complete information about Ashley, and then follow the directives of her supervisor regarding how to proceed in her counseling sessions with Ashley. If, after questioning Ashley thoroughly about her cutting behavior, Monica determines that Ashley might be engaged in cutting behaviors that might constitute a danger to herself, then Monica should consult with her supervisor immediately. Monica may decide to bring Ashley's mother into the session. Monica can either convince Ashley to tell her mother, or tell Ashley's mother herself what Ashley told her. Monica should advise Ashley's mother to have Ashley evaluated by a physician to determine if her cutting behaviors constitute a danger to her health.
Diminished Capacity:
Keep in mind that diminished capacity is not the same as an absence of capacity. Counselors have an ethical obligation to discuss consent with these clients in a manner that they can understand and to obtain their assent to services even though their agreement may not be legally recognized
Keeton Vs Augusta State University (2011)
Keeton dismissed from masters program due to her stance on counseling LGBTQ clients. She was asked to separate her beliefs from her work in counseling clients
Refers to personal beliefs and how these beliefs affect your conduct
Morality
Section D of the ACA Code of Ethics is
Relationship with Other Professionals
Informed consent to counsel a minor should be obtained from the ___________. As an ethical matter, the child client should be actively involved in giving consent and determining treatment goals and strategies.
Parents
Minor clients have an ethical right to privacy and confidently in the counseling relationship, but the __________ of minors belong to their parents.
Privacy Rights
Section C of the ACA Code of Ethics is
Professional Responsibility
Section G of the ACA Code of Ethics is
Research and Publication
Section I of the ACA Code of Ethics
Resolving Ethical Issues
Section F of the ACA Code of Ethics is
Supervision, Training, and Teaching
What is the purpose(s) of the ACA Code of Ethics?
The Code has 6 main purposes: 1. The Code sets forth the ethical obligations of ACA members and provides guidance intended to inform the ethical practice of professional counselors. 2. The Code identifies ethical considerations relevant to professional counselors and counselors-in-training. 3. The Code enables the association to clarify for current and prospective members, and for those served by members, the nature of the ethical responsibilities held in common by its members. 4. The Code serves as an ethical guide designed to assist members in constructing a course of action that best serves those utilizing counseling services and establishes expectations of conduct with a primary emphasis on the role of the professional counselor. 5. The Code helps to support the mission of ACA. 6. The standards contained in this Code serve as the basis for processing inquiries and ethics complaints concerning ACA members.
Section A of the ACA Code of Ethics is
The Counseling Relationship
Section A of the ACA Code of Ethics is related to
The Counseling Relationship
ACA Code A.12: Counselors do not abandon or neglect clients in counseling. Counselors assist in making appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacations, illness, and following termination
True
ACA Code A.5.a.: Sexual and/or romantic counselor- client interactions or relationships with current clients, their romantic partners, or their family members are prohibited. This prohibition applies to both in person and electronic interactions or relationships. The Code also has guidance for situations of previous sexual relationships (prior to being a client) and former sexual relationships (post-counseling clients).
True
ACA Code 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. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population.
True
The ACA Code of Ethics contains 9 main sections that address the following areas: Section A: The Counseling Relationship; Section B: Confidentiality and Privacy; Section C: Professional Responsibility; Section D: Relationships With Other Professionals; Section E: Evaluation, Assessment, and Interpretation; Section F: Supervision, Training, and Teaching; Section G: Research and Publication; Section H: Distance Counseling, Technology, and Social Media; and Section I: Resolving Ethical Issues.
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ACA Code: In the Preamble of the Code, you will find:
Two numbered lists - the core professional values of the counseling profession & the fundamental principles of professional ethical behavior
impaired
Unable to go beyond periods of stress, skills have diminished or deteriorated. Med Prof says - "The inability to deliver competent patient care."
FERPA (1974) Family Educational Rights and Privacy Act
affects all educational institutions -Says that minor students' parents (and students in college) have 2 rights -1-to inspect and review their educational records to ensure the records are not inaccurate -2-to have their written authorization obtained before copies of their educational records can be transmitted to a 3rd party ---->Thus: school counselors should keep their case notes separate from other school records, clinical case notes do not have to be shown to students or parents under FERPA
CH. 5 Disclosure of confidential information is acceptable under all of the following conditions EXCEPT:
an attorney sends a counselor a subpoena
Walden vs Center for disease control and prevention (2010)
an employee at the CDC sought counseling for help with their same sex relationship. Was turned away due to the counselors religious beliefs(Walden) and referred to another counselor. The client later brought suit, stating that she felt judged and condemned. Walden was laid off and she later filed suit against her company and lost due to her rigid position regarding referrals.
CH. 2 The most significant problem within the counseling profession today, according to the authors of the text, appears to be:
becoming a united and societally-recognized profession
Certified
certification law is what is known as a title law which means that a person must be certified to use the title of certified professional but that the practice of that profession is not regulated by the state
Confidentiality
is primarily an ethical concept that refers to the counselor's obligation to respect the client's privacy and the promise to clients that the information they reveal during counseling will be protected from disclosure without their consent
CH. 6 Which of the following statements is most appropriate regarding clinical case notes?
counselors should take the clinical notes they need in order to function effectively as professionals.
Reparations
duty to make up for a wrong
(Chapter 7 Competence, Assessment & Dx (diagnosis)): Preparation is explained as
education, training, supervised experience, state and national professional credentialing & appropriate professional experience, gain knowledge, personal awareness, sensitivity, dispositions & skills to be culturally competent. Ethical obligation to protect the public by acting as gatekeepers. *
CH. 7 The primary purpose of diagnosis is to:
facilitate effective treatment
CH. 3 According to Ridley, examples of unintentional racism included all of the following EXCEPT:
facilitating co-dependency relationships with ethnic clients out of a need to be accepted
What is best practice?
goes beyond what is minimally required by law or codes of ethics and is the very best a counselor would expect to do
Moral traces
identify lingering feelings of doubt, discomfort, or uncertainty present, especially when expediency, politics, or self-interest have influenced the decision.
Cynthia b. V New Rochelle Hospital
if the client waives the right to privileged communication...the client rather than the health professional has the responsibility for any embarrassment or inconvenience that resulted from the disclosure of privileged mental health information -Client can implicitly waive the right to privilege by filing a lawsuit against a mental health professional -Counselors my reveal confidential information when it is necessary to defend themselves against charges brought brought by clients
Foreseeability
important to be able to determine proximate cause - whether the professional knew or should have known that the professional's actions would result in a specific outcome.
External forces that can support counselors in their efforts to practice ethically include all of the following EXCEPT:
intentionality
Privileged communication
is the narrowest of the three terms and is a legal concept. Privileged communication laws protect clients from having confidential communications with their counselors disclosed in a court of law without their permission (Garner, 2014). For a communication to be privileged, a statute must have been enacted that grants privilege to a category of professionals and to those whom they serve.
Goal of counseling
is to empower clients to problem-solve independently
CH 4. In two recent court cases, students in counseling master's degree programs were dismissed from their training programs because they failed to:
learn to counsel LGBTQIQ clients effectively
Licensed
licensure law is referred to as a practice law which means the professional must be licensed to practice that profession in that state
CH. 5 In order to get a privileged communication statute passed that protects the privacy of clients who are in professional relationships with counselors, legislators must be convinced that:
making an exception to the general rule that all evidence must be presented in court is vital to the well-being of society.
CH. 1 At their most fundamental level, Codes of Ethics serve to:
protect and promote the welfare of the client.
Nonmalefcence
or avoiding actions that cause harm;
veracity
or dealing truthfully with individuals with whom counselors come into professional contact
Autonomy
or fostering the right to control the direction of one's life;
fidelity
or honoring commitments and keeping promises, including fulflling one's responsibilities of trust in professional relationships
Justice
or treating individuals equitably and fostering fairness and equality
beneficence
or working for the good of the individual and society by promoting mental health and well-being
CH. 2 A core belief that members of the counseling profession hold concerning helping others with their mental health concerns is
prevention and early intervention are the most appropriate means to deal with emotional and personal problems.
Interdependence with the community
realize that values cannot be espoused without awareness of context, connected with and understand the expectations and values of their communities.
privacy
refers to the right of persons to decide what information about themselves will be shared with or withheld from others.
Registered
registration law was intended to mean that a professional had to register with the state but that no credentials would be required for registration
Torts law
relates to the principle that individuals will be held responsible for any harm they cause to other members of society.
Freedom of choice legislation
requires health care providers to give access to licensed counselors for mental health care if they give access to other health care providers such as psychologists or social workers
CH. 7 When a counselor determines that a client may be at risk for harming self or others, the counselor must ALWAYS:
take the steps necessary to prevent harm.
Counselors have a fiduciary relationship with their clients, which means
that they have a legal obligation to protect their clients' best interests and to avoid interactions that benefit themselves.
Logistics of Counseling Process
the counseling process, such as length and frequency of sessions, procedures for making and canceling appointments, policies regarding telephone contact between sessions, and how to reach the counselor or an alternative service in an emergency.
Universality publicity -
would you recommend the course of action to other counselors in similar situations?