ch 4 Flashcards
client rights and counselor responsibilities
fiduciary relationships
the counselor promises to act in the best interests of the client, and the client accepts that trust
counselor responsibilities
be aware of their own needs and motivations
avoid fostering dependent relationships, use appropriate counseling techniques, and manage any interruptions that might occur in the counseling process
terminate counseling relationship in an appropriate manner
countertransference
when counselors project their emotions into a client and the counselors own needs become entangled in the therapeutic relationship
involuntary client
a client who chooses to enter into counseling rather than accept an alternative or an unwanted consequence
usually required to sign a waiver of their privacy rights
must be informed that reports must be made and understand the types of information that will be included in reports
ACA code of ethics around involuntary clients
states that counselors are accurate, honest, and objective in reporting their professional activities and judgements to third parties, including courts or those who receive evaluation reports
counselors and evaluation
most do not perform them but some do.
when they do, they can not evaluate a past client, and must emphasize that this is to gather information for an evaluation and not a counseling session
must be unbiased
no confidentiality
role changes
counselors must obtain the clients informed consent for the change and explain the clients right to refuse services related to the change
when selecting techniques
use ones that are grounded in theory
if using an unusual one, must warn client of the dangers/possible benefits, and be done cautiously (also should be adequately trained)
techniques should be chosen based on…
theoretical orientation, your training
tailored to specific needs to client
any techniques used cannot cause potential harm to client (like conversion therapy)
interruptions in services
counselors must plan ahead for emergency absences by developing procedures to safeguard their clients welfare
give clients adequate notice and ensure the clients know whom to contact in a crisis or emergency
termination
an intentional process that occurs over time when a client has achieved most of the treatment goals, and it provides opportunities for consolidating, making plans for maintaining, and generalizing client gains made in counseling
effective ones model how healthy relationships should end and provide clients with opportunities to work through their feelings
converts caring and helps to prevent harm (discussed way before actual termination)
times counselors can terminate prematurely that is ethical
it is apparent that the client no longer needs assistance, is not likely to benefit, or is being harmed by continued counseling
clients do not pay the fees as agreed upon
the counselor is in jeopardy of being harmed by the client or someone with whom the client has a relationship
must give adequate notice and give time to client to find another therapist or suggest a referral
utilization review
when managed care plans give only the services that they deem to be necessary and appropriate for the client
(counselors should try to appeal when possible) `
when a client is terminating/canceling
counselors ethical obligation in these situations is to attempt to communicate a willingness to continue to meet with the client, either to continue counseling or to summarize and end treatment, or to refer the client to another mental heath professional
abandonment
considered a form of inappropriate termination and can occur when the clients counseling needs are not adequately addressed by the counselor, either when treatment ends or during the course of treatment due to counselor unavailability
prohibited
guidelines to terminating clients
honestly discuss with the client your intention to terminate and specify the reason
give written notice to the client that the relationship will be terminated
offer the client one to three termination sessions
give your client up to three good referrals
give your client places to contact in the event of emergencies
place a summary of your interactions with the client related to the termination issues in the clients file. do not transfer that document to another individual or entity without an express written request from the client
give the client plenty of time to find another mental health professional. of more time is requested, allow it
transfer records to the new mental health professional promptly
informed consent
clients have a right to know what they are getting into when they come for counseling
respects clients autonomy and self-determination and is integral in the formation of an effective therapeutic alliance
contract law
technical principles are offer, acceptance and consideration
relationships with professionals who provide services are contractual by nature
salgo v Leland standford jr
provided the essential elements that physicians must give to their patients
disclosure od the nature of the ailment, the nature of the proposed treatment, the probability of success, and possible alternative treatments
two elements to the informed consent legal standard
the professional element
materiality
professional element
defined as information that a reasonable physician would have provided to a patient in similar circumstances
materiality
defined as the amount of information that the average patient would consider adequate in deciding whether to accept treatment
HIPPA
requires all health care providers who transmit records electronically to comply with procedures to endure consumer privacy and records
written disclosure statements
written contracts for informed consent
disclose to clients that nature of the counseling relationship
are legal contracts
elements that need to be included in disclosure statements
the purposes, goals, techniques, procedures, limitations, potential risks, and benefits of services
the counselors qualifications, including relevant degrees held, licenses and certification, areas of specialization, experience, and approach to counseling
arrangements for continuation of services if the counselor dies or becomes incapacitated
the role of technology
the implications of diagnosis and the intended use of tests and reports
fees and billing information, including procedures for nonpayment fees
confidentiality and its limitations
clients rights to obtain information about their records and to participated in ongoing counseling plans
clients rights to refuse any recommended services or modality change and be advised of the consequences of refusal
client might have a basis for a lawsuit against the counselor if the client believed the counselor had…
- failed to include HIPPA 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
the two most common problems for private practitioners concern…
fees and billing
late cancellations or no shows
benefits of informed consent
clients want information about their prospective counselors
that they perceive counselors who provide informed consent information as being more expert and trustworthy
that clients who have received appropriate information are more likely to follow their treatment plans, to recover more quickly, to be less anxious, and to be more alert to possible negative consequences
