Client Rights and Counselor Responsibilities Record Keeping and Fees Flashcards
3.10 Informed Consent
Involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it.
*Both an ethical and a legal obligation of the clinician.
*Not only meets legal and ethical standards but represents excellent clinical care . *
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 therapist
*Costs involved in therapy
*The length of therapy and termination
*Consultation with colleagues
*Interruptions in therapy
*Benefits and risks of treatment
*Using telecommunication technology
*Alternatives to traditional therapy
*Tape-recording or videotaping sessions
*Clients’ right of access to their files
*Rights pertaining to diagnostic classifying
*The nature and purpose of confidentiality
Working With Children and Adolescents
*Minors’ rights regarding informed consent
*Parental rights to information about a minor’s treatment
*Minors’ assent versus consent
*Involving parents in the counseling process with minors
*Limits to confidentiality
*Dealing with reluctance
*Need for supervised clinical experience in play therapy, art and music therapy, and recreational therapy
Ethical Issues in Online Counseling
- Responsibility to examine the ethical, legal, and clinical issues related to online counseling.
- Self-disclosure, confidentiality, boundaries, and dual relationships can take on unexpected shapes in online counseling.
Issues in Online Counseling
(Legal Issues)
*Competence of practitioner in providing online counseling
*Informing client of limits and expectations of the relationship
*Developing a plan for how emergencies can be addressed
Mistakes of Omission in Online Counseling
*Obtain informed consent prior to services
*Limit access to personal information
*Obtain a clinical license to practice in the state in which the client resides
*Comply with HIPAA confidentiality requirements
*Respond in a timely manner
*Terminating online services to clients abruptly
*Claiming expertise in providing online services outside the scope of one’s education and training
*Providing online services to clients whose clinical needs are so severe that they require in-person services
Some Advantages of Online Counseling
*Reaching clients who are reluctant to participate in face-to-face therapy
*Certain disabilities or chronic illnesses that render them immobile
*Improving client access in rural areas
*The potential for greater numbers of people to receive services
Disadvantages of Online Counseling
*Danger of making an inaccurate **diagnosis **
*Compromising confidentiality and privacy
*Difficulty in being able to **protect clients in crisis situations **
*Absence of traditional client-therapist relationship and challenges of working through transference and countertransference
**Inability to address more complex psychological problems
**Lack of competence in providing online services and danger of the misrepresentation of a counselor’s qualifications
*Danger of clients misrepresenting themselves or minors masquerading as adults seeking treatment
*Danger of individuals other than the client logging on as if they were the client
Legal Issues and Regulation of Online Counseling
*A clinician’s license is intended for practice in the state where he or she is licensed to practice.
*Counselors need to stay current regarding the changing laws pertaining to counseling across states.
*Malpractice insurance carrier may not plan to cover out-of-state counseling.
*Licensing boards have a legal mandate to protect consumers who live in their state; they do not have an obligation to consumers who do not reside in their state.
*If a California consumer is traveling to another state and wants to participate in counseling via telephone (or online) the California-licensed therapists must receive permission from the temporary location.
Unethical Behavior of Colleagues
Ignoring evidence of peer misconduct is an ethical violation in itself.
Many helping professionals are reluctant to address such problems.
Informal peer monitoring provides an opportunity for corrective interventions to ethically questionable acts.
If informal measures are not enough, reporting a colleague to a professional board is one of several options open to you.
Malpractice Liability
Malpractice means “bad practice.” *the failure to render professional services or to exercise the degree of skill that is ordinarily expected of other professionals in a similar situation
Professional negligence can result from unjustified departure from usual practice or from failing to exercise proper care in fulfilling one’s responsibilities.
Standard of care: Standards that are commonly accepted by the profession and are considered as the acceptable standard of practice in the community.
Elements of Malpractice
1.A professional relationship between the therapist and the client must have existed.
2.The therapist must have acted in a negligent or improper manner, or have deviated from the “standard of care” by not providing services that are considered “standard practice in the community”.
3.The client must have suffered harm or injury, which must be verified.
4. There must be a legally demonstrated causal relationship between the practitioner’s negligence or breach of duty and the damage or injury claimed by the client.
Reasons for Malpractice Suits
*Failure to obtain or document informed consent
*Refusal to counsel clients due to value differences
*Client abandonment or premature termination
*Marked departures from established therapeutic practices
*Sexual misconduct with a client *Practicing beyond the scope of competency
*Negligent assessment or misdiagnosis
*Repressed or false memory *Unhealthy transference relationships *Failure to assess and manage a dangerous client
Risk Management
*The practice of focusing on the identification, evaluation, and treatment of problems that may injure clients and lead to filing an ethics complaint or a malpractice action
*One of the best precautions against malpractice is personal and professional honesty and openness with clients.
*Know your limitations and seek consultation in difficult cases.
*Remain alert for possible misunderstandings that, if not recognized or poorly handled, could lead to a therapeutic break or premature termination of therapy.
Course of Action in a Malpractice Suit
Treat the lawsuit seriously
Do not attempt to resolve the matter with the client directly.
Contact the ethics and risk management services of your professional associations.
Become familiar with your liability policy, including limits of coverage, and contact insurance company immediately.
Never destroy or alter files or reports pertinent to the client’s case.
