Ethics Flashcards

1. Consider the client’s best interest and potential impact of any of the counselor’s actions
2. Use the counselor/client relationship to model healthy interactions
3. Treat clients with respect
4. Earn trust by protecting privacy
5. Consider the role and impact of personal beliefs and values
6. Consider the role of diversity
7. Attempt to give time for pro bono work

the primary responsibility of the counselor. In order to keep client dignity at the forefront, the counselor needs to keep the client’s interest in focus

1. The counselor focusing on their own needs and interests at the expense of the client
2. Temptation to disrespect the client when facing a tense or argumentative situation
3. Lack of attention to the client’s background or cultural diversity

1. Consider the impact of client interactions
2. Communicate respectfully at all times
3. Double check all your actions to ensure that they are consistent with best practices
4. Communicate with the client on their terms

• key to safeguarding confidentiality and maintaining integrity in the relationship, accurately reflecting treatment and process.
• Accurate record keeping allows the counselor to abide by appropriate laws, keep the process going seamlessly, communicate with colleagues, smooth re-entry for a returning client, and facilitating a transfer of a client.

1. Temptation to delay documentation, letting memories fade
2. Failure to anticipate the multiple uses of records
3. Adding notes that were not part of session, failing to stick only to the facts
4. Disposing of records prematurely

1. Create, keep, and protect records at all time
2. Consider all potential uses
3. Pay close attention to confidentiality issues
4. Note the process clearly without additions or omissions (if amendments must be made to a record, these must be made in accordance with agency or institutional policy)
5. Include the rationale for treatment

1. Failure to assess the client’s needs, strengths, and goals
2. Setting unreasonable goals
3. Selecting goals and developing a plan without involving the client
4. Failure to reassess and update the plan

1. Goals should be thoroughly assessed at the beginning of the relationship and be constantly re-evaluated
2. Plans should be constantly re-assessed, working with both the counselor’s and the client’s needs and strengths into account
3. Developing a plan should be a collaborative process that takes the client’s and the counselor’s wishes into account
4. Constantly attend to factors that may affect the process, including motivation, level of support, and financial factors

Involving the client's support network can make or break the treatment process. When possible the counselor should enlist aid from the client’s network, facilitating the building of relationships.

1. Assuming the counseling relationship is all that the client needs
2. Failure to help clients reach out for other support
3. The temptation to assume how the relationships in a client’s life will affect them
4. Becoming defensive about the involvement of other relationships

1. Consider the support network as a means for buffering the counseling relationship
2. Openly discuss resources and how to enlist help from others
3. Monitor the effectiveness and value of the support network
4. Only contact support with the client’s permission

• gives clients the freedom to choose throughout the counseling process. It is the counselor’s job to make sure the client has accurate information and documentation throughout the process.
• a continuous process and lets clients make decisions with all the information in front of them.

1. Having the client sign forms without discussing and explaining
2. Viewing the client's questions as intrusive
3. Seeing informed consent as a burden
4. Taking an authoritarian approach may make the client feel like they have less freedom to make their own choices

1. Recognize the importance of informed consent
2. Make sure that consent is freely given
3. Ensure that clients have all the information needed to make a decision
4. Share information verbally and in writing
5. Update on a continuous basis

• purposes, goals, techniques, procedures, limitations, risks, and benefits. It also includes the counselor’s credentials, experience, approach, backup plans, and any other pertinent information. It also includes billing information and arrangements. All of this information must be shared freely and explicitly.

• look into the ethics of getting consent from an incapacitated adult or from a child.
• Even if a client is not capable of giving consent they should still be informed of their situation and their rights. Counselors should always be up to date on current laws about consent and incapacity.

1. - Sharing information only with guardians
2. Failure to involve clients in the decision-making process
3. Confusion about who the actual client is

1. Clarify each person’s legal rights
2. Include each client in the process as much as possible
3. Make sure voluntary consent is given before the counseling process starts

1. Mandated clients may not care about the process
2. Clients may not understand the confidentiality rules
3. Clients may not know they can refuse to participate
4. Counselors may assume they need to persuade clients to participate
5. The counselors might attempt to persuade the client to accept for their own financial gain

1. Be extra mindful of the need for informed consent
2. Take extra care at the beginning of the process to make sure the client understands all the details of the process
3. Make sure that clients understand their right to decline to be involved in the process

1. - Lack of awareness of personal values
2. Failure to think about the impact of statements on the client
3. Holding strong values that could adversely affect the client
4. Forgetting that trainees and interns require the same sensitivity as clients

1. Consider the impact of any action on others before taking it
2. Take part in ongoing self-reflection
3. When personal values conflict with the client’s be very mindful about sharing them
4. Be careful about doing anything in conflict with the pre-set treatment goals
5. Be respectful of diversity

1. Having sexual relationships with current clients or from accepting a client with whom they have previously had a sexual relationship.

2. Having a sexual relationship with former clients for at least 5 years after the counseling process has concluded; there must be a written agreement demonstrating that the relationship is non-exploitative.

3. Having relationships with friends and family members if there is an inability to remain objective.

4. Having personal virtual relationships with current clients.

1. Keep healthy boundaries and self-care
2. Always think about how entering a relationship will affect client care
3. Keep appropriate boundaries with the client’s support network
4. Realize that commitment to the client’s well-being does not end when the professional relationship ends
5. Pay attention to warning signs
6. Refer friends and family to professional help when necessary
7. Ensure that new clients are informed about professional communication and relationships
8. Seek colleague consultation if you are struggling with romantic feelings about a client

1. It is tempting to try to help a former acquaintance
2. Refusing to avoid a counseling relationship with anyone the counselor has ever known previously

1. Carefully consider taking any client which you have previously known
2. Weigh the potential risks and benefits
3. Carefully discuss the pros and cons with the potential client
4. If unsure, consult colleagues or other professionals

• such as attending weddings and funerals of clients and their network (secondary relationships).
• Sometimes these extensions of boundaries are necessary and helpful. These extensions should be carefully documented and take into account state laws.

1. Failing to consider the potential impact of these relationships could result in damaging relationships with clients
2. Desire to keep relationships secret
3. Placing counselor needs about client needs
4. Counselors living in remote areas are more likely to engage in secondary relationships

1. Only enter a secondary relationship if it is advisable and there are no laws or policies against it
2. Use a thoughtful decision making process
3. When unsure about appropriateness, consult colleagues
4. Document the rationale and decision making process

• takes place the counselor must update informed consent with the client. This role change may include change between individual or family counseling, changing from evaluation to therapy, or changing from a counselor to a mediator.
• Any role change must be to the benefit of the client.

1. Shifting roles without discussing with the client
2. Failure to consider the potential impact
3. Changing roles without careful consideration of incompatibility with other roles
4. Forgetting to maintain professional boundaries

1. Consider the client’s best interests
2. Engage in informed consent processes before any changes are made
3. Provide adequate information to the client
4. If the client’s needs go beyond your ability, refer them to another professional
5. Never change roles for personal benefit
6. Steer clear of nonprofessional interactions

1. Failure to see opportunities for client advocacy by placing yourself in a limited role
2. Being overzealous in advocacy may undermine the client’s autonomy

1. Honor overarching obligation to society as a whole
2. Only engage in advocacy with the client’s informed consent
3. Advocacy should be motivated by the client’s needs, not the counselor’s personal needs

• Sometimes counselors provide care to clients who are in a relationship. In this case it is important for roles and relationships to be made clear.
• All professional roles should be clarified from the beginning of the relationship.

1. Overlooking the potential for lack of objectivity
2. Failure to openly talk about the roles of all affected clients

1. Careful consideration of the needs of the multiple client as individuals and in their relationships
2. Closely and continuously monitor the impact of the process on all clients
3. When concerns come up, openly discuss them with all clients
4. Before counseling begins, consider all options

1. Attending to the needs of the group may cause a counselor to overlook the individual
2. Challenge of overlooking the potential harm of group work

1. Ensure competency in group work
2. Carefully screen clients
3. Attend to informed consent
4. Be clear about expectations and confidentiality
5. Take active precautions to minimize harm

1. Address all fees and payment issues in the informed consent process
2. Consider community standards for reasonable fees
3. Maintain a list of other professionals to give the client options

1. may only take place if it does not result in harm to the client. It should only take place with a clear and written contract
2. Remain open to the possibility that bartering may be the only option for some
3. Reach an agreement in advance
4. Monitor the impact on the client
5. Be sure the client’s best interests are met
6. Periodically revisit the agreement
7. Seek the opinion of a colleague

1. Never suggest gift giving
2. Explore the meaning of the gift
3. Consider whose needs are being served and make decisions based on the needs of the client
4. Be mindful of client vulnerabilities
5. Do not suggest that gifts are expected
6. Consider cultural factors
7. Consider whether the gift will impair your judgment
8. consider cultural and personal implications as well as personal motivation from both the counselor and the client.

1. The client no longer needs counseling
2. The client is no longer benefiting from counseling
3. The client may be harmed if counseling continues
4. The client no longer pays the agreed upon fees
5. The client or someone with whom the client has a relationship poses a threat to the counselor

• These may include the client meeting his/or her goals, running out of insurance benefits, financial limitations, a move from the area, a decision to transfer to a new counselor, or just deciding to stop the counseling process.

• lack of competence, lack of client progress, boundary or relationship issues, conflicts or threats from the client, lack of availability to meet your client’s growing needs, illness, disability, death, or retirement. It might also be the end of a training experience.

Planning for and openly discussing the end of the relationship with a client is a critical part of the counseling process. These are a few recommendations:

1. Openly discuss termination with clients: allow enough time for planning and processing, allowing clients to move forward in life
   
2. Never abandon a client: do not stop service abruptly; keep clients thoroughly informed of procedures
3. Cooperate fully in the client transfer process: if the client is changing counselors, help by recommending other professionals and keep open communication, including transferring records or other requested information
4. Address insurance coverage issues up front: make sure the client knows limitations at the beginning of therapy
5. Carefully manage abrupt endings: if the client ends things abruptly, try to create a smooth transition; if the client is a high risk for harm or suicide, follow up with ethical obligations

1. Termination or referral must include informed consent
2. Be sensitive to feelings of abandonment
3. Be knowledgeable about community resources
4. Make appropriate coverage arrangements during an absence
5. Seek additional training

gender, age, race, depression, alcohol, impulsivity, history of attempts, family history, chronic illness, hopelessness, helplessness, loss, psychosis, lack of social support, and having a plan and the means to carry it out.

talking about suicide, verbal cues, self-neglect, worsening mood, sudden loss, sudden changes in mood, suicidal planning, withdrawal, preparations, and saying goodbye.

• refers to the variety of insurance companies that help facilitate health care.
• Insurance approves care based on several factors and is often a major factor in a client's decision to take on counseling.
• Managed care can be essential for allowing a client to enter counseling, but it also presents challenges to counselors in a number of forms.

• a client’s mental health records (also called progress notes) and psychotherapy notes (also called process or private notes).
• progress notes, include information regarding assessment results, treatment plan, symptoms, and a summary of the client’s progress in therapy. The client has a legal right to access progress notes.
• Psychotherapy notes, on the other hand, include the therapist’s observations as well as thoughts and feelings related to the session. These are the therapist’s personal notes and they get special protection under the HIPAA Privacy Rule because they often contain sensitive information. On a federal level, the client does not have a legal right to access psychotherapy notes.

- Name
- Contact information, including emergency contact
- Fees and billing
- Informed consent documentation
- Releases of information
- Mandated disclosures (ex. child abuse report, court ordered releases)
- Reason for service (presenting issue, diagnosis)
- Treatment plan
- Certain history, such as medical, family, or developmental

Each time you are in contact with the client:

Date of service and length of session
- Type of service (assessment, treatment, consultation, etc.)
- Type of professional contact (treatment modality - individual/group/family/couples, referral, letter, e-mail, etc.)
- Client’s current mental status