Ch 5 legal and ethical issues in clinical setting

Question 1

the code you adhere depends on

Answer 1

the type of license and the state which it is held at

Question 2

six core principles of the ACA code of ethics

Answer 2

autonomy
nonmaleficence
beneficence
justice
fidelity
veracity

Question 3

autonomy

Answer 3

based on ones basic right to control the direction of ones life and counselor must both respect and support this

Question 4

nonmaleficence

Answer 4

speaks to the counselors responsibility to avoid harming the client in any way

Question 5

beneficence

Answer 5

based on the counselors responsibility to work for the good of the individual and society by promoting mental health and well-being

Question 6

justice

Answer 6

involves engaging clients equitably and fostering fairness and equality

Question 7

fidelity

Answer 7

relates to the counselors responsibility to be true to our word, uphold our commitments and promises, and be trustworthy in our actions

Question 8

veracity

Answer 8

requires that professional counselors remain truthful and honest in all professional interactions
related to honor and integrity

Question 9

nine sections of ACA code of ethics (first eight address professional practice issues, last one discussing steps for resolving ethical matters)

Answer 9

1. counseling relationship
2. confidentiality and privacy
3. professional responsibility
4. relationships with other professionals
5. evaluation, assessment, and interpretation
6. supervision, training, and teaching
7. research and publication
8. distance counseling, technology, and social media
9. ethical decision making model???

Question 10

spirit of the codes

Answer 10

upholding the six fundamental principles and the values inherent to counseling for which they stand

Question 11

ethical decision making model

Answer 11

provides a series of necessary steps that can help counselors make thoughtful and informed decisions

Question 12

ethical decision making model steps

Answer 12

1. clearly identify the problem and the multiple dimensions of it that influence the decision making process
2. identify the relevant ethics codes as they apply to the unique situation
3. **identify the relevant state and federal laws
4. involves brainstorming multiple course of action and outlining the probable consequences for each course of action
5. identifying the most appropriate course of action that upholds ethical codes
   ***should use supervision and consultation throughout process

Question 13

professional-personal boundary conflicts

Answer 13

new counselors should set early conditions under which it would be appropriate multiple relationships

Question 14

questions to consider for multiple relationships

Answer 14

1. what are you soft spots/ times you may push boundaries?
2. what happens when you cannot avoid a multiple relationship with client?

Question 15

ACA codes extending counseling boundaries and documenting boundary extensions

Answer 15

discuss the blurring of professional counseling boundaries and the counselors responsibilities related to considering risks and commenting decision making process

Question 16

process to determine ethical of multiple relationships

Answer 16

seeking supervision or consultation
talk openly with client about risks and concerns
appropriately documenting the ethical decision making process

Question 17

9 steps to take when trying to determine whether a boundary extension would be harmful or hurtful to client

Answer 17

1. consider the best possible outcome and the worst possible outcome
2. review the literature base on the topic
3. refer to ethical codes, professional conduct rules and relevant laws
4. seek supervision or consultation
5. notice and analyze your thoughts and feelings about the situation
6. practice informed consent with client
7. refer clients when appropriate
8. don’t overlook blind spots in boundary extensions
9. document your rationale and behaviors related to boundary extension

Question 18

confidentiality and privileged communication

Answer 18

foundational aspects of effective counseling
provides a framework for how to handle collecting and storing client information but also discusses possible exceptions to protecting that info

Question 19

questions to ask when confidentiality concerns arise

Answer 19

1. have I addressed this situation in my informed consent
2. how does the ACA code of ethics guide response to situation
3. how does state law guide?
4. who does confidentiality belong to (parent or child)
5. do I have sufficient indication of risk to breach confidentiality
6. what are the risks of not breaching confidentiality
7. what are the risks to breaking confidentiality
8. are there ways to resolve the situation that do not require breach of confidentiality

Question 20

seven subsections to section B: confidentiality and privacy

Answer 20

1. respecting clients rights
   2.exceptions
   3.information shared with others
   4.groups and families
   5..clients lacking the ability to give informed consent
   6.records and documentation
   7.case consultation

Question 21

exceptions to confidentiality

Answer 21

1. law supersedes ethics (court ordered, end of life decisions/foreseeable harm to self or others)
2. parents involved in regard to child (must receive assent from child though)

Question 22

confidentiality vs privileged communication

Answer 22

confidentiality: ethical obligation to protect client info
privileged communication: legally protected information and privacy is a basic human right for individual to control how/what is shared

Question 23

limitations of confidentially

Answer 23

counseling groups
counseling minors
protecting someone from danger
obey court orders

Question 24

three sections to consider when using social media in counseling

Answer 24

informed consent
confidentiality
professional boundaries
**establish a level of competency in using technology through training
**educate yourself on the legality of using social media and technology-based communication

Question 25

self-injury

Answer 25

the direct and deliberate bodily harm in absence of suicidal intent
reasons: way of coping

Question 26

how to treat/deal with SI

Answer 26

use assessment procedures that can improve treatment and clinical decision-making
can break confidentiality when there is an imminent threat to self

Question 27

the deliberate self-harm inventory

Answer 27

17- item self report questionnaire
screens for presence of SI, age of onset, duration, frequency, and severity of SI

Question 28

factors that may raise suicide risk of people who SI

Answer 28

repeated SI
use of multiple SI methods
use websites that encourage SI
history of alcohol use, alongside current depression
hopelessness
critical self-talk
distorted self-image
childhood sexual abuse
for adolescents, peer victimization

Question 29

four established suicide risk assessment instruments

Answer 29

the suicide probability scale
beck scale for suicide ideation
the suicidal behavior questionnaire-revised
Columbia suicide severity rating scale

Question 30

interventions for suicide risk

Answer 30

develop safety plan
counseling loved ones on access to lethal means
increase frequency of clinical sessions
voluntary hospital admission
involuntary hospital admission