Psychotherapy chapter 3

What steps can therapists take to minimize the risk of dual relationships in their professional lives? (p. 50 -51)

1. set healthy boundaries early in the theraputic relationship and inform consent is essential from the beginning and throughout the therapy process 2. involve clients in ongoing discussions and the decision making process, and document your discussions. Discuss with your client what you expect of them and what they can expect of you. 3. Consult with fellow professionals as a way to maintain objectivity and identify unanticipated difficulties. Realize that you don't need to make a decision alone 4. When multiple relationships are potentially problematic, or when the risk for harm is high, it is always wise to work under supervision. Document the nature of your supervision and document any actions you take 5. Self monitoring is critical throughout the therapeutic process. ask yourself whose needs are being met and examine your motivations for considering becoming involved in a dual or multiple relationship

Why is it important for counselors to consider the client's needs before their own when making ethical decisions? What are some of the ramifications of failing to do this? (p. 38 -39)

It's important because it avoids legal trouble, the ramifications are legal trouble

Additional relationships with clients other than sexual ones.

Nonprofessional interactions

Describe the dimensions of confidentiality in the therapeutic relationship. Be sure to clearly define the difference between Confidentiality and Privileged Communication. (p. 42)

-danger to self or others, elder/dependent adult abuse, child abuse, hospitalized, court subpoena, client signs release of information -confidentiality is an ethical concept to not disclose info about the client -privileged communication is a legal concept that prevents disclosure of confidential communication in legal proceeding (does not apply to group, couples, family, or child/adolescent)

What does the informed consent process involve? What information must be presented to clients? Why is this important in counseling? (p. 41 - 42)

1. clients need enough information about the counseling process to make informed choices 2. educate clients about their rights and responsibilities 3. address privacy issues with clients, including the implications of using technology to communicate 4. informed consent empowers clients and helps to build trust with them should include: 1.therapeutic procedures and goals 2. approx. length of treatment 3. risks/benefits and alternatives to treatment 4. the right to withdraw from treatment 5. cost or fees 6. the counselor's use of supervision 7. the limits of confidentiality you establish the consent form so they know what boundaries not to cross and to have full knowledge on what will be covered of each session

What are some steps in making ethical decisions? Is it always appropriate to strictly follow ethics codes? (p. 40)

1. identify the problem 2. review relevant codes and laws 3. seek consultation 4. brainstorm 5. list consequences 6. decide and document the reasons of your actions - yes it is important

Define Evidence-Based Practice. What are the advantages and disadvantages of this treatment model? (p. 48)

Advantages: 1. treatments have been validated by empirical research 2. treatments are usually brief and standardized 3. are preferred by many insurance companies 4. calls for accountability among mental health providers to use effective treatment approaches Disadvantages: 1. insensitive to individual differences 2. not well suited for working with existential concerns 3. difficult to measure both relational and technical aspects of treatment 4. can be misused as a method of cost containment for insurance companies rather than as a way of improving the quality of services

A higher level of ethical practice that addresses doing what is in the best interests of clients

Aspirational ethics

Evaluating the relevant factors in a client's life to identify themes for further exploration in the counseling process.

Assessment

What is the function of Assessment and Diagnosis in counseling?

Assessment is an ongoing process designed to help the counselor evaluate key elements of a client's psychological functioning Diagnosis is the process of identifying a pattern of symptoms which fit the criteria for a specific mental disorder defined in the dsm 5

A departure from a commonly accepted practice that could potentially benefit a client (for example, attending a client's wedding)

Boundary crossing

What is the difference between Boundary Crossings and Boundary Violations? What can therapists do to establish appropriate boundaries with their clients? (p. 51 - 52)

Boundary crossings is a departure from a commonly accepted practice that can potentially benefit a client Boundary violation is a serious breach that harms a client and is therefore unethical Make sure everything is listed on the consent form to establish boundaries

A boundary crossing that takes the practitioner out of the professional role, which generally involves exploitation. It is a serious breach that harms the client and is therefore unethical.

Boundary violation

This is an ethical concept, and in most states therapists also have a legal duty not to disclose information about a client.

Confidentiality

What is the classic book for guiding practitioners in making diagnostic assessments? (p. 46)

DSM 5

The analysis and explanation of a client's problems. It may include an explanation of the causes of the client's difficulties, an account of how these problems developed over time, a classification of any disorders, a specification of preferred treatment procedure, and an estimate of the chances for a successful resolution.

Diagnosis

A counselor assumes two (or more) roles simultaneously or sequentially with a client. This may involve assuming more than one professional role or combining professional and nonprofessional roles

Dual or multiple relationships

Be familiar with the ethical issues associated with dual and multiple relationships in counseling. (p. 49)

Dual relationships are not inherently unethical b/c sometimes they are unavoidable

Describe boundary issues that may occur when using social media. (p. 52)

Dual relationships, confidentiality, and privacy

To make ethical decisions, consult with colleagues, keep yourself informed about laws affecting your practice, keep up to date in your specialty field, stay abreast of developments in ethical practice, reflect on the impact your values have on your practice, and be willing to engage in honest self- examination.

Ethical decisions

Psychotherapists are required to base their practice on techniques that have empirical evidence to support their efficacy.

Evidence-based practice (EBP)

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

Informed consent

The view of ethical practice that deals with the minimum level of professional practice

Mandatory ethics

What are the differences between Mandatory Ethics and Aspirational Ethics? (p. 38)

Mandatory ethics are the bare minimum for ethical practice (basic thinking) Aspirational ethics are living an ethical professional and personal life (critical thinking)

An approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble.

Positive ethics

A legal concept that generally bars the disclosure of confidential communications in a legal proceeding. Clients are protected from having their confidential communications revealed in court without their permission.

Privileged communication

Are there limits? If so, when do these apply? Why are these limits in place? (p. 43)

Yes the exceptions are 1. client poses a danger to self or others 2. clients who are children/minors, dependent adults, or older adults are victims of abuse 3. client needs to be hospitalized 4. info is made an issue in a court action 5. client requests a release of record

What, if any, ethical issues arise when providing assessment and diagnosis in psychotherapy? (p. 47)

ethical issues: diagnosis may place negative stereotype on the client, assessment may feel mechanistic and not personal

What is the purpose of having a professional code of ethics? (p. 39)

ethics codes are best used as guidelines to formulate sound reasoning and serve practitioners in making the best judgement possible