Class Terms/Concepts (Midterm)

Question 1

mandatory ethics

Answer 1

what you are required to do (e.g., informed consent) or are NOT supposed to (e.g., have sex with clients)

Question 2

aspirational ethics

Answer 2

not required to do, but expected to do

e.g., pro-Bono work, social justice embedded in practice

Question 3

duty to protect

Answer 3

the obligation of therapists to break confidentiality if they have reason to believe their client presents a serious danger or threat to a third party and protect that third party from potentially being harmed

Question 4

duty to warn

Answer 4

the obligation of therapists to warn third parties/identifiable victims, therefore breaking confidentiality, regarding the potential harm or danger that may be inflicted by their client

Question 5

standard of care

Answer 5

refers to the usual and customary practices within the field

Question 6

reasonable person standard

Answer 6

acting with care as the average person would have in those circumstances

Question 7

ethical dilemma

Answer 7

conflict between law, ethics, and values

Question 8

scope of practice

Answer 8

establishes guidelines for boundaries of practice within a license; delineates what can be performed and what is limited or prohibited

-regulated by the state agency (BBS)
-applies to all licensees/registrants

Question 9

scope of competence

Answer 9

defines and limits what an individual within the profession may or may not do

-determined by education, training, supervised experience
-requires continuing education

Question 10

autonomy

Answer 10

one of the fundamental ethical principles of the ACA Code

fostering the right to self-determination (controlling the direction of one’s life)

e.g., clients determine goals in therapy, how long they are in therapy, and when/if they attend therapy

Question 11

nonmaleficence

Answer 11

one of the fundamental ethical principles of the ACA Code

avoiding actions that cause harm; duty to “do no harm”; supersedes all other principles

e.g., client with anorexia asking therapist for ways to lose weight –> clearly unethical but obviously this would be doing harm (supersedes autonomy)

Question 12

beneficence

Answer 12

one of the fundamental ethical principles of the ACA Code

promoting health and well-being; not only about doing harm and reducing symptoms, but it is about actively working with clients to promote growth

e.g., helping client suffering from DV coping skills/ways to deal with the conflict

Question 13

justice

Answer 13

one of the fundamental ethical principles of the ACA Code

treating individuals equitably; fostering fairness

-removing barriers to access to therapy as best as possible
-not about having identical policies for everyone, but it is about having policies that are aware of the different circumstances of others
-need to know when to be flexible and when to have stronger boundaries with policies

e.g., having a policy that requires a doctor’s note for canceling session - not equitable because presumes that everyone has insurance/access to healthcare

Question 14

fidelity

Answer 14

one of the fundamental ethical principles of the ACA Code

honoring commitments; trustworthiness

-this is the foundation of a therapeutic relationship
-you gain trust with clients by being clear in expectations and responsibilities

e.g., explaining to the client that therapy is generally confidential, but there are certain instances where you would have to breach confidentiality

Question 15

veracity

Answer 15

one of the fundamental ethical principles of the ACA Code

TRUTHFULNESS

-can be thought of as truthfulness in terms of marketing/advertising

e.g., not marketing yourself as a licensed therapist when you are not one

Question 16

ACA Ethical Decision-Making Model

Answer 16

1. Identify the problem (What type of conflict is this? Legal, ethical, professional, or clinical?).
2. Apply the 2014 ACA Code of Ethics.
3. Determine the nature and dimensions of the dilemma (Consider implications for each foundational ethical principle, review the relevant professional literature, consult other professional counselors, & consult state & national professional associations).
4. Generate potential courses of actions (identify THREE options that must be mutually exclusive/distinct).
5. Consider the potential consequences of each course of action for all parties involved (apply ACA principles to each option, discuss risks/benefits of each alternative, and use guiding ethical principles as framework to evaluate).
6. Evaluate the selected course of action (test of justice - is it fair and does it apply to all cases, test of publicity - would you stand by your decision in court, on social media, etc, and test of universality - would you give the same decision to a colleague if they were to ask for advice about what to do in that same situation?)
7. Implement your course of action.

Question 17

Frame and Williams (2005) Ethical Decision-Making Model (Steps 2 and 3)

Answer 17

2) Explore/acknowledge the context of power and the reality of white privilege: the social context of power not only affects decision-making but also shapes the nature of the therapeutic relationship and course of therapy. Additionally, counselors have failed to incorporate culturally diverse views and practices because they are hampered by their own Eurocentric and monocultural positions . . . they underestimate the power of white privilege, resulting in unintentional racism in the therapeutic setting.
3) Assess the level of the client’s acculturation and racial identity development: conduct a brief assessment of 3 key acculturation variables: generation, preferred language, and social interactions with members of one’s own racial/ethnic group compared with interactions with members of other groups.

Question 18

Herlihy and Corey (2015) Ethical Decision-Making and Multiple Relationships

Answer 18

1) Avoidable
-Assess Risks and Benefits
-Benefits outweigh risks –> Proceed with
unavoidable decision-making model
-Risks outweigh benefits –> Referral or Decline dual
relationship
-Documentation of the above
2) Unavoidable or Benefits > Risks
-Secure informed consent –> seek consultation –> ongoing discussion with client –> supervision (if problematic)
-Documentation of the above

Question 19

Dimensions of Risk Assessment (Gottlieb, 1986; 1993)

Answer 19

1) Power differential: 1) lower risk: no/little relationship; mutually identified as peers 2) intermediate risk: power differential; relationship is clearly bounded, circumscribed 3) higher risk: clear power differential with profound influence

2) Duration of Relationship: 1) lower risk: brief: single/few contacts over a short period of time 2) intermediate risk: regular contact over a limited period of time 3) higher risk: continuous or episodic contact over a long period of time

3) Clarity of termination: the likelihood that the therapist and client will have additional contact [1) lower risk: relationship is limited by time (externally imposed or prior agreement), unlikely to see again 2) intermediate risk: professional function is complete but further contact is not ruled out 3) higher risk: no agreement regarding when or if termination is taking place].

Question 20

boundary crossing

Answer 20

departures from standard practice

-not necessarily a problem
-has the potential to be therapeutic
-may provide greater equity (e.g., extending regular working hours for clients who can’t take time off during the workday)
-there are many scenarios in which you do not want to have such rigid views because you have to consider the cultural context

Question 21

role blending

Answer 21

the therapist has two professional roles that overlap

-slightly more vulnerable than a boundary-crossing because of the power differential
-e.g., being both a faculty supervisor and site supervisor (should not happen)

Question 22

boundary violation

Answer 22

exploitative behaviors more in the therapist’s interest than the client’s interest that does clear harm to the client

Question 23

examples of multiple relationships

Answer 23

-counselors in small, rural communities
-therapy with known professional contacts, acquaintances (e.g., realize your client is your accountant’s assistant)
-entering social or professional relationships post-therapy (e.g., becoming friends with your client’s friend)
-social relationships with family members, close relations (e.g., becoming friends with client’s spouse, begin dating client’s dad accidentally)
-interacting with clients outside of session (ceremonies, rituals; e.g., at a funeral)

Question 24

Use of Touch: Stenzel and Ruppert (2004)

Answer 24

main takeaways:
-Therapists cautious of touch in therapy due to fear of it being misconstrued and therefore avoid it
-Overwhelming majority of therapists who do use nonsexual touch in therapy do not discuss benefits or risks with the client or process it in therapy
-Smith’s model/taxonomy, 3 considerations:
–>Scope of competence with use of touch
–> Congruent with therapist as a person
–> Whether touch meets needs of client
-Gender and touch: most common use of touch is female therapist and female client dyad
-Handshakes most common use of touch
-Humanistic therapists most likely to use touch in therapy, psychodynamic less likely

Question 25

Use of Touch: McNeil-Haber (2004)

Answer 25

main takeaways:
-Child-initiated touch: 1.) Inappropriate touch – aggressive or sexual or 2.) Appropriate touch – effort of the child to communicate or express certain emotions
-Must consider cultural implications of touch and the context of the client (e.g., whether the client was previously sexually abused, child may come from a culture where physical touch is perceived differently, perception of touch by therapist can vary based on the gender of the child)
-Benefits to incorporating touch: 1) a way of addressing boundaries with children and asserting their own boundaries (like being able to say no to touch), 2) a way to educate children how to express positive emotions, 3) touch can be both a powerful reinforcer for children and an effective means for comfort.

Question 26

Use of Touch: Phelan (2009)

Answer 26

main takeaways:
-types of touch: 1) touch as comfort, 2) touch to explore contact - therapist may ask client to allow him to put his hand on his as a way to evoke or to stay with his feelings, 3) touch as amplification - help client focus and bring attention to body sensations, 4) touch as provocation - form of pressure on muscles to provoke discharge, & 5) touch as skilled intervention - enacting of a particular paradigm
-within humanistic psychotherapy, touch is acceptable while in psychoanalytic, it is considered a taboo
-one of the key factors identified in assessing whether to use touch or not is a careful consideration of need – whether it came from the therapist or the client
-the use of touch with a client was a psychotherapeutic procedure only if the client needed it and the therapist was willing to offer it.