chp 5 and 6 Flashcards
Informed Consent
“the client’s right to agree to participate in counseling,
assessment, or other procedures or services after such services are fully explained and understood”
(Cottone & Taryadas, 2007, p. 40).
Two main components: Disclosure and Free Consent.
ACA Code of Ethics on Informed Consent (ACA, 2014, A.2.a., P. 4)
“Clients have the freedom to choose whether to enter into or
remain in a counseling relationship and need adequate
information about the counseling process and the counselor.
Counselors have an obligation to review in writing and verbally
with clients the rights and responsibilities of both counselors
and clients. Informed consent is an ongoing part of the
counseling process, and counselors appropriately document
discussions of informed consent throughout the counseling
relationship. “ (ACA, 2014, A.2.a., P. 4).
ACA Code of Ethics on Informed Consent Continued
“Counselors explicitly explain to clients the nature of all
services provided. They inform clients about issues such as
but not limited to the following:
The purposes, goals, techniques, procedures, limitations,
potential risks, and benefits of services;
The counselor’s qualifications, credentials, relevant
experience, and approach to counseling;
Continuation of services upon the incapacitation or death of
the counselor; the role of technology;
And other pertinent information.”
Inform clients about fees and billing, including procedures for
nonpayment.
Clients have the right to confidentiality and to be provided
with an explanation of its limits (including supervision and/or
interdisciplinary teamwork).
Obtain clear information about their records and referral.
Who can give consent?
A mentally competent person 18 years or older.
Parent or legal guardian of a minor child.
A.2.c. Developmental and cultural sensitivity counselors
A.2.e. Mandated Clients
A.3. Clients Served by others
A.4. Avoiding harm and Imposing Values: A.4.a Avoiding harm,
A4.b. Personal values counselors
Types of informed consent
Individual
Group
Relational and family
An informed consent should…
Clearly state the purpose, goals, theoretical orientation, techniques, procedures, limitations and potential risks, and benefits of counseling.
Plainly define confidentiality and specifically state limits of and exceptions to confidentiality.
Provide your qualifications, education, licenses and certifications, experience, and professional training.
State arrangements for continuation of services if the counselors dies or becomes
incapacitated.
Describe the implications of diagnosis and the intended use of texts and reports.
State clients’ rights to obtain information about their records and document storage policy.
Describe fees, billing, terminations, scheduling, and cancellation policy
State clients’’ right to participate in ongoing counseling and rights to refuse any recommend services or modality change and be advised of the consequences of refusal.
You should go over consent verbally with the client and then
have the client read it.
You should ask the client if they understand the contents and
if they have any questions!
Then ask them to sign.
If it is not in writing, it did not happen!
Assent
to demonstrate agreement when a student is not competent to give informed consent to counseling or other services the school counselor is providing.
- Autonomy: Client has the right to know who has information.
- Fidelity: Counselor (for the most part) ensures not to disclose information.
- Beneficence: Responsibility to do good with confidentiality
- Nonmaleficence: Do no harm and don’t compromise confidentiality.
- Justice: Act fairly to client.
Exceptions in confidentiality
- Client has the right to choose to release information.
- Obtain written permission.
- Release to “legitimate” third parties.
- Only release “relevant’ information.
- Discuss all negative aspects with client!!
- Document!!
- Seek supervision!!
Exceptions Court/order legal action
- Court order: subpoena or subpoena duces tecum
- Do not ignore!!
- Legal action against a counselor: Confidentiality is waived if action is
brought against the counselor.
EXCEPTIONS
SUICIDE/HOMICIDE/ABUSE/NEGLECT
- Follow risk assessment protocols for school or agency
- Tarasoff v. regents of the University of California, 1974, 1976
- Must be diligent! Should have known? Did you act reasonably?
- Seek supervision!
What does SD law say? (elder/disabled abuse)
- 22-46-9: “Mandatory reporting of abuse or neglect to states attorney…
violation as misdemeanor. Any person who is a…licensed mental health professional, or counselor engaged in professional counseling who knows, or has reasonable cause to suspect, that an elder or disabled
adult has been or is being abused or neglected, shall, within twenty-
four hours, report such knowledge or suspicion orally or in writing to
the state’s attorney of the county in which the elder or disabled adult
resides or is present, to the department of social services, or to a law enforcement officer. Any person who knowingly fails to make the
required report is guilty of a class 1 misdemeanor.
What does SD law say? (child abuse/neglect)
- 26-8A-7: “Child abuse or neglect reports by school personnel failure as
misdemeanor-written policy required. Any person who has contact with a child through the performance of services in any public or private school, whether accredited or unaccredited, as a teacher, school nurse, school counselor, school official, or administrator, or any person providing services pursuant to 13-27-3 shall notify the school principal or school superintendent or designee of suspected abuse or
neglect….each district shall have a policy an anyone knowingly who
fails to report will be guilty of a class one misdemeanor.
Exceptions to privileged information
- Privileged communication may be broken if:
- There is written consent of the person or someone else is the legal
beneficiary. - The licensed professional counselor is not required to treat a confidential
communication that reveals the contemplation of the commission of a crime or a harmful act. - If the person is a minor and the minor indicates they are a victim of subject of a crime
- Or if the person waives the privilege by bringing charges against the LPC.
Minor children and confidentiality
- Counselors have an ethical obligation to the children and a legal
obligation to the parents or guardian (Schmidt, 2003). - Consider the following:
- Age of child
- Cognitive level
- Emotional maturity
- Socio-cultural factors
- Level of severity of the information the minor is providing
Minor children and the ACA code of ethics
- ‘When counseling minor clients…counselors protect the confidentiality of information received in the counseling relationship as specified by federal and state laws, written policies, and applicable ethical standards”
- “Counselors inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship. Counselors are sensitive to the cultural diversity of families and respect the inherent rights and responsibilities of parents/guardians over the welfare of heir children/changes according to law. Counselors work to establish, as
appropriate, collaborative relationships with parents/guardians to best serve
clients” (B. 5.b).
Minor children and SD law: confidentiality
- 25-5-7.3: Parents have equal access to records pertaining to child-
Name address or both parents to be listed. Access to records and
information pertaining to a minor child, including, but not limited to,
medical, dental, orthodontia…school records shall be made equally
available to both parents/guardians. Counseling…and other records
subject to confidentiality or privilege shall only be released in
accordance with state and federal law; but, if available to one parent,
shall be available to both.
Counselor communication with significant others
- “Achilles heel of the profession” (Woody, 1999, p. 608)
- Conversation with significant others-Don’t ask
- Rough Day…
- Seek supervision
- Colleague support* Professional colleagues who uphold their ethics,
won’t care who but can support you with the “what”
