Informed Consent
Involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it
A powerful clinical, legal and ethical tool
Informed Consent
Requires that the client understands the information presented, gives consent voluntarily, and is competent to give consent to treatment
A process that continues for the duration of the professional relationship
Content of Informed Consent
- the therapeutic process(including assessment)
- background of the therapist
- costs involved in therapy
- length of therapy and termination
- consultation with colleagues
- interruptions in therapy
Content of Informed Consent
the following information should be provided in writing and discussed
- client’s rights to access their files
- right to pertaining to diagnostic labeling
- nature and purpose of confidentiality
- benefits and risks of treatments
- alternatives to traditional therapy
- tape recording or videoing sessions
Record Keeping
clinical perspective-provides a history that the therapist can use in reviewing the course of treatment
ethical perspective-can assists therapists in providing quality care for their patients
legal perspective-state or federal law may require keeping a record, many therapists believe proper record keeping is an excellent defense against malpractice claims
risk management-keeping records are the standard of care
Record Keeping
- therapist have the responsibility for storing client’s records in a secure place and exercise care when sending records to others by mail or electronic means
- storing clients info in the “cloud” may expose themselves and clients to unforeseen risk
Content for Inclusion in Records
- identifying data
- fee billing info
- documentation of informed consent
- documentation of waivers of confidentiality
- presenting complaint and diagnosis
- plan for services
- client reaction to professional interventions
- current risk factors pertaining to danger for themselves or others
- plans for future interventions
- assessment or summary information
- consultations with or referrals to other professionals
- relevant cultural factors
Ethical Issues in Online Counseling
issues such as self-disclosure confidentiality, boundaries, dual relationships can take on unexpected shapes in online counseling
Ethical Issues in Online Counseling
Potential Legal Issues
- competence of practitioner in providing online counseling
- informing clients of limits and expectations of the relationship
- developing a plan for how emergencies can be addressed
Advantages of Online Counseling of Online Counseling
- reaching clients who are reluctant to participate in face to face therapy as well as those with disabilities or illness
- improving client access
- greater number of people able to receive services
Disadvantages of Online Counseling
-absence of traditional client-therapist relationships and challenges of working through transference and countertransference
Children and Adolescents
- minors and consent form
- parent’s rights to information about minors treatments
- involving parents in the counseling process with Minor
- limits to confidentiality
- dealing with reluctance
- need for supervised clinical experience in play therapy art music therapy and recreational therapy
Unethical behavior of colleagues
- ignoring evidence of peer misconduct is an ethical violation in itself
- informal peer monitoring provides an opportunity for corrective interventions to ethically questionable acts
- you can report a colleague to a professional board
Elements of Malpractice 4 elements must be Present
- a professional relationship between the client and the therapist must have existed
- therapist must have acted in a negligent or improper manner or not provided standard care
- client must have suffered harm or injury which must be verified
- must be a legally demonstrated casual relationship between the therapist’s negligence or breach of duty and the damage or injury claimed by the client
Reasons for Malpractice Suit
- failure to obtain or document informed consent
- refusal to counsel clients due to value differences
- client abandonment or premature terminations
- marked departures from established therapeutic practices
- sexual misconduct
- practice beyond your scope of competence
- misdiagnosis
- repressed or false memory
- failure to assess and manage a dangerous client
Risk Management
- best precautions against malpractice are personal and professional honesty and openness with clients
- know your limitations consult in difficult cases
- remain alert for possible misunderstandings that could lead to a therapeutic break or premature termination
