Professional Orientation and Ethical Practice

Key Points of HIPAA

All patients must be given a copy of the HIPAA privacy policy, which outlines their rights; with whom their protected health information (PHI)—that is, individually identifiable health information—might be used or shared; and the procedures for requesting that their information not be released to certain parties. In essence, patients have a right to control who sees their identifiable health record. HIPAA applies to doctors, nurses, hospitals, clinics, insurance companies, health maintenance organizations (HMOs), Medicare, Medicaid, mental health professionals, and a variety of other health care providers. Patients have a right to obtain a copy of their medical record usually within 30 days. Patients have a right to request changes to adjust inaccurate health information in their record. Should there be a disagreement by the health organization about making such changes, the disagreement must be noted in the file. Health organizations are to honor reasonable requests to contact patients in different locations or by different methods. A counselor following HIPAA must allow clients to view their records and petition for changes to the counselor's notes if they believe any information is false or inaccurate.

Key points of Advocacy Counseling

Counselors are expected to be advocates not only for their profession but also for their clients, and to help clients overcome any barrier that is preventing them from making progress. The ACA Code of Ethics (2014, A.7.a.) demands that counselors empower clients to advocate for themselves when needed or that counselors advocate on their clients' behalf (with client consent) when clients are unable to do so for themselves.

Liability Insurance

In the event that professional counselors find themselves in a legal dispute or the subject of a complaint, having liability insurance can be instrumental in the protection of their assets and also greatly reduces the financial burden they may face if found guilty of malpractice or negligence.

Accreditation and the Council for Accreditation of Counseling and Related Educational Programs (CACREP)

the association in charge of the accreditation for the majority of counseling and counseling-related programs.CACREP was established in 1981 to promote excellence in counseling and counseling-related educational programs. CACREP has developed and revised educational standards over the years that institutions must meet to gain the organization's accreditation approval

U.S. Rehabilitation Act of 1973 (Section 504)

a civil rights act, protects individuals with disabilities from being discriminated against or denied equal access to services and opportunities because of their disability. Section 504 applies not only to educational institutions receiving federal funds but also to any organization or employer in the United States receiving federal funds.

A mental health practitioner

a person trained to treat individuals with mental health issues and mental illnesses.

Accreditation

a process that eligible educational institutions and organizations can elect to undergo (i.e., it is voluntary) to demonstrate that the institution meets set standards.

Psychiatric Nurses

a specialization within the nursing profession. Psychiatric nurses are trained to deliver counseling services to patients with severe psychological disorders, develop nursing care programs, and, in many states, prescribe medication. Individuals can pursue psychiatric nursing at the bachelor's, master's, and doctoral levels.

Health Maintenance Organizations (HMO)

also known as a managed care organization, is a health care organization that allows members to access health and mental health services at a lower cost than many standard health insurance plans.

Marriage and Family Therapists

approaches working with individuals, couples, and families from a systems theory perspective, helping clients to develop more effective patterns of interaction with significant others and family members. To become a marriage and family therapist, individuals must earn at least a master's degree in marriage and family therapy.

ethics

are developed by associations to help members practice in a reputable manner

laws

are included in the penal code and often carry more serious consequences

Key Points of FERPA

created to specify the rights of parents (if the child is a minor) and nonminor students to access and examine the educational record, petition to have incorrect information found in the record amended and ensure that certain information is not released to outside agencies without permission. Parents have the right to access their children's educational information until the child is 18 years old or begins college. Educational institutions are required to obtain written permission before releasing any information in a student's educational record however schools have the ability to give out directory information without consent. Professional counselors' personal notes on students, considered an expansion of the counselor's memory that are kept separate from the educational record in a secure location, are considered confidential (Hall & Ratliff, 2017; Stone, 2013). Students and parents do not have the right to access counselors' personal notes.

Psychologists

diagnoses and treats psychological, learning, and behavioral disorders in a variety of settings, including clinics, schools, hospitals, counseling centers, and private and group practice. Psychologists use interviewing and psychological testing when assessing and diagnosing client issues. To obtain licensure in most states, individuals must earn a doctoral degree in psychology.

Theory-based models of supervision

extend the basic counseling theories to the supervisory relationship. For example, a counselor who uses a cognitive-behavioral supervision approach would concentrate on teaching new skills to counselor-trainees, encouraging them to practice their skills and working with them to help improve particular areas of weakness.

Mental health counselors

first surfaced in the 1940s and 1950s but did not benefit from formal training or employment in significant numbers until the passing of the Community Mental Health Act of 1963, which provided funding for the establishment of mental health centers across the United States to provide greater access to mental health care services.

College admissions counseling

focuses on helping students maneuver through the college admissions process to select and, ideally, to secure entry into suitable postsecondary educational institutions.

Psychoanalysts

helps clients resolve psychological issues through psychoanalysis—an intervention developed by Sigmund Freud—a long-term process that attempts to help clients remedy and alleviate their symptoms through exploring their unconscious conflicts. To become a psychoanalyst, individuals are usually required to earn a terminal degree in the mental health field, train at a psychoanalysis institute, and engage in personal psychoanalysis by a trained psychoanalyst.

directory information

includes the student's name, address, telephone number, date of birth, place of birth, honors or awards, and dates of attendance at the school

Key points of HMO

A benefit for mental health providers who are part of an HMO is that they are given a stable influx of clients and are ensured payment if they follow the organization's regulations. However, a criticism of HMOs is that mental health providers must give the organization a diagnosis and detailed history of each client before the HMO will approve and pay for the treatment, perhaps infringing on the client's confidentiality. Mental health professionals also are often limited in how much time they have to treat clients, and they are usually required to follow specific guidelines or treatment modalities in working with their clients.

Licensure Portability

Although professional counselors can secure national certification, to enhance their professional credibility, through the NBCC, currently there is no nationally recognized licensure. • In 2017, representatives of the AASCB, the Association for Counselor Education and Supervision, the American Mental Health Counselors Association (AMHCA), and the National Board of Certified Counselors (NBCC) served on a portability task force to recommend the minimum licensure requirements needed to allow for licensure portability. These recommendations are referred to as the National Counselor Licensure Endorsement Process. The process would allow any counselor currently licensed at the highest level of licensure of independent practice within his or her state to also be licensed in any other state or territory, provided that he or she (a) has engaged in ethical practice with no disciplinary sanctions within the previous five years; (b) has possessed the license for at least three years; (c) has completed a comprehensive exam if required by the state regulatory body; and (d) meets all supervised experienced standards of the state, holds the National Certified Counselor (NCC) credential, in good standing, from the NBCC, or holds a graduate-level degree from a CACREP-accredited program.

Key points of licensure

Although the requirements for obtaining licensure vary from state to state, most states require individuals to achieve at least a master's degree from an approved institution (thereby fulfilling specific coursework requirements), accrue a certain number of years or hours of supervised clinical experience, and pass an examination, such as the NCE. • Licensure differs from certification: licensure is sanctioned and regulated by a state or territory. Virginia was the first state to license professional counselors (in 1976).

Key Points of CAPTA

Any counselor who suspects child abuse or neglect is required by law to report the suspicion to the local child protective services (CPS) agency within 72 hours from the time of first awareness of the potentially abusive or neglectful event (Hall & Ratliff, 2017; Stone, 2013). Counselors also must submit a written report to CPS after submitting the initial account. Anyone who reports suspected abuse or neglect will not be held liable, even if CPS fails to find any evidence supporting the claim during the investigation (Stone, 2013), unless a false report was filed with malicious intent. The ACA Code of Ethics (2014, B.2.a.) upholds this legal duty, allowing counselors to ethically break confidentiality to protect a client from a potentially dangerous situation.

Key points of the NBCC

Certification with NBCC is voluntary, but counselors who obtain certification strengthen their professional reputation. In some cases, the certification has made counselors eligible for salary increases. The NCC is NBCC's general-practice credential. To be eligible for the NCC, the candidate must meet one of the following educational requirements: (1) be a current student in a counseling program that participates in the Graduate Student Application process; (2) have earned at least a master's degree from a CACREP-accredited program; (3) have earned at least a master's degree in a counseling field and have taken courses in the following areas: human growth and development, social/cultural foundations, helping relationships, group work, career and lifestyle development, assessment, research and program evaluation, and professional orientation and ethical practice, and have been employed in the counseling profession under supervision for two or more years; or (4) hold a counseling license conferred by the candidate's state board and possess at least a master's degree in a mental health field.

Key Points of IDEA

Children are eligible to receive services under IDEA from birth until the age of 21 years. To qualify for eligibility under IDEA, a student must have a documented disability in at least one of the following areas: intellectual disability, hearing impairment (including deafness), speech or language impairment, visual impairment (including blindness), serious emotional disturbance, orthopedic impairment, autism, traumatic brain injury, other health impairment, or specific learning disability. In addition, the student must need special education services as a result of a disability. Every student who is eligible to receive special education services under IDEA must have an individualized education plan (IEP) on file. Each student's IEP ensure that the child receive the benefits of education in the least restrictive environment (LRE).

LCMHC

Licensed Clinical Mental Health Counselor

LCPC

Licensed Clinical Professional Counselor

Elder Abuse

Elder abuse typically involves three different forms of maltreatment toward a vulnerable or incapacitated older adult: physical, sexual, or verbal abuse; financial exploitation; and neglect of a caregiver to provide proper care.

Key Points of Section 504

Eligible individuals must have a physical or psychological impairment that substantially limits at least one major life activity. These major life activities include walking, seeing, hearing, speaking, breathing, working, performing manual tasks, learning, and caring for oneself. To receive consideration, individuals must also be viewed as having the disability or have documentation of the disability, and it must interfere with their ability to meet their needs. In a school setting, when a student indicates a need, a multidisciplinary team meets to assess the student's eligibility under Section 504. If the student is eligible, a 504 plan is constructed, which dictates the accommodations or other special considerations the student is entitled to receive.

Family Educational Rights and Privacy Act (FERPA)

Enacted in 1974, also known as the Buckley Amendment, is a federal law that affects any counselor who works in an educational setting that receives funding from the U.S. Department of Education.

LMHC

Licensed Mental Health Counselor

LPC

Licensed Professional Counselor

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is a federal law, passed in 1996, to protect the privacy of individuals' medical and mental health records. Health organizations were to be compliant with this law by 2003. Under HIPAA, patients are given rights to control who can view their health records as well as the ability to inspect their own medical record and request that changes be incorporated.

Key Points of Elder Abuse

Range from 2% to 10% depending on type, definition, and degree of reporting. Perpetrators of elder abuse are generally male and can include family members, paid caregivers, or fellow residents in a care facility. Elder abuse is a criminal offense in all 50 states, with a majority of states having mandatory reporting laws .In cases where an older adult is neglecting him- or herself in some manner, some states allow law enforcement to intervene when these individuals refuse services. Older Americans Act was passed in 1965 by Congress to increase social and nutrition services for older persons and was most recently reauthorized in 2016. Two specific pieces of this legislation, Title II—Elder Abuse Prevention and Services and Title VII—Vulnerable Elder Rights Protection, are particularly salient to the topic of elder abuse. The AoA (Administration of Aging) was developed as part of the Older Americans Act and oversees major grant programs and other initiatives related to this legislation.

Examples of advocacy counseling

Teaching clients to self-advocate, being involved in changes in public policy, writing to or meeting with policymakers about bills that affect counselors and clients, or backing licensure laws. Educating people about the counseling profession, providing leadership and advocacy training, networking with the media to have important issues covered, and working with community organizations to meet the needs of clients.

Key Points of the ACA

The ACA mandates coverage of preventive health services such as depression, substance use, and HIV screenings; smoking cessation screenings; obesity screening and counseling, domestic violence screening and counseling; and behavioral assessments. Health insurance companies, with the exception of grandfathered plans, cannot deny or charge more to individuals due to a pre-existing health condition (USDHHS, 2017c). For insurance plans that cover dependents, children can be covered under their parent or guardian′s plan until the age of 26 years. Lifetime and annual dollar limits on insurance benefits are not allowed for any insurance policy.

Key Points of the MHPAEA

The MHPAEA was developed to protect consumers directly from large group insurance plans, preventing annual and lifetime benefit limits for those receiving mental health and/or substance use services.

Mental Health Parity and Addiction Equity Act

The Mental Health Parity and Addiction Equity Act (MHPAEA) was signed into law in 2008. It requires insurance companies offering coverage for mental health and substance use related services to make that coverage comparable to general medical coverage.

Patient Protection and Affordable Care Act of 2010

The Patient Protection and Affordable Care Act of 2010, commonly referred to as the Affordable Care Act (ACA), provides health care to Americans and includes consumer protections from private health insurance companies and limits long-term health care expenses.

Child Abuse and Neglect

The federal Child Abuse Prevention and Treatment Act (CAPTA) defines child abuse and neglect as "Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or, an act or failure to act which presents an imminent risk of serious harm"

Key points of accreditation

The purpose of accreditation for educational institutions is to signify to the public that the accredited program's educators and curriculum adhere to specific standards of quality; only those institutions that meet the specified criteria become accredited (CACREP, 2016).

Key points of licensure

The underlying purpose of state licensure is to protect the public by ensuring that only qualified professionals, granted a license from the state, can legally render certain counseling services.

Counseling Minors

When counseling minors, particularly in a nonschool setting, it is crucial for counselors to obtain informed consent from the parents or legal guardian and assent, or agreement, of minors before any counseling begins.

Social Workers

characterized by his or her commitment to pursuing social reform, social justice, and affecting public policy. The social worker's role is one of counselor, case manager, and change agent, which is accomplished through delivering therapeutic treatments to clients, connecting clients with valuable community resources, advocating to fix societal conflicts, working with communities to develop programs to meet the needs of citizens, conducting research, and teaching. Educational requirements for social workers include a minimum of a bachelor's degree in social work.

Licensure

emerged in the 1970s in an effort to validate the counseling profession by passing state laws controlling who could legally practice counseling.

Developmental supervision approaches

emphasize counselor-trainees' progress through a series of stages as they become more experienced, competent, and independent. To meet the needs of the trainee at each stage, supervisors must adjust and adapt their supervisory style.

Counselor supervisors

experienced professionals who train new counselors and help them in the development and improvement of their clinical skills.

Individuals with Disabilities Education Improvement Act (IDEA)

is a civil rights law passed to guarantee that students with disabilities receive the services they need to gain the benefits of education.

Psychiatrists

is a medical doctor who works with clients with severe psychological disorders. Psychiatrists provide psychotherapy, prescribe medications, perform physical examinations, and order laboratory testing for clients. To become a psychiatrist, individuals must earn a medical degree, participate in a residency program, and pass licensure examinations

Advocacy Counseling

is concerned with supporting and promoting the needs of clients (e.g., individuals, groups, and communities) and the counseling profession at all levels (local, state, regional, and national).

.Certification

is determined by a particular trade and thus is not governed by a state.

discrimination model

requires the supervisor to be aware of the supervisee's intervention, conceptualization, and personalization skills and address supervisee needs by adopting the role of either teacher, counselor, or consultant as needed.

The National Board for Certified Counselors

the chief credentialing organization in the United States for professional counselors seeking certification. Founded in 1982 as the result of an ACA committee recommendation, NBCC is a nonprofit organization that certifies counselors who have met its criteria for education and training and have passed the National Counselor Examination (NCE). The mission of NBCC is to promote and recognize counselors who meet established standards of quality in delivering counseling services.

mandatory ethics

rules they must follow

aspirational ethics

rules they should follow if they want to meet the highest standards of professional practice and conduct

certified rehabilitation counselor (CRC)

seeks to help individuals with disabilities work through personal and vocational issues they may encounter as a result of their impairment. • To become a CRC, individuals must be granted certification from the CRCC.

live observation

sit in during a supervisee session with a client

College Counseling

work in counseling centers on college campuses to support students who have mental health and educational concerns that are negatively affecting their personal, social, and academic endeavors

Professional school counselors

work in elementary, middle, and high schools to serve the personal-social, career, and academic needs of the school's students.

Key Points of Informed Consent

• During the informed consent and assent process, minors and their parents must receive details on what they can expect from counseling, limitations to confidentiality, and their right to withdraw from treatment at any time. Informed consent should be given in writing to parents and explained by the counselor to minors in age-appropriate language. Some minor children, because of substantial disability (e.g., intellectual disability) or age, are unable to give assent for counseling. The child (if under the age of 18 years) should be able to expect confidentiality, parents still retain the legal right to know what their child discusses in counseling sessions should they choose to exercise that right. Minor consent laws vary among states. Most professional school counselors are not required to obtain parental consent before delivering counseling services to students.