Law & Ethics

Question 1

How many years must therapist wait after the counselor-client relationship has ended before engaging in any romantic or sexual relations with a client, a client’s family members, or a client’s romantic partner?

Answer 1

5 years

Question 2

Difference between progress note and psychotherapy note.

Answer 2

Progress notes include information regarding assessment results, treatment plan, symptoms, and a summary of the client’s progress in therapy. The client has a legal right to access progress notes.

Psychotherapy notes include the therapist’s observations as well as thoughts and feelings related to the session. These are the therapist’s personal notes and they get special protection under the HIPAA Privacy Rule because they often contain sensitive information. On a federal level, the client does not have a legal right to access psychotherapy notes.

Question 3

When can a subpoena compel release of information?

Answer 3

Obtain signed informed consent from the client if he or she wishes information to be released.

If client does not want it, request that the attorney file a motion to quash, which allows the counselor not to comply with the subpoena. „

If both a subpoena and a court order are received, the counselor must release the information with or without the client’s consent. Failure to do so may result in the counselor being held in contempt of court.

Question 4

For clients under 18, who holds LEGAL rights to confidentiality?

Answer 4

Clients under 18 years have an ethical right to confidentiality, but the legal rights belong to their parent or guardian

Question 5

What are the 10 limits to confidentiality?

Answer 5

1. Duty to warn
2. Mandatory Reporting
3. Subordinates (e.g. scheduling secretary)
4. Treatment teams
5. Consultation
6. Group and family counseling
7. Third-party payers
8. Minors
9. Contagious, life-threatening diseases
10. Court-ordered disclosure

Question 6

What are minor consent laws?

Answer 6

Minor consent laws allow certain minors to seek treatment for certain conditions without parental consent or notification, usually involving substance abuse, mental
health, and some reproductive health areas.

In California, minors 12 or other can self-consent to receive therapy without parent knowledge.

Question 7

Are personal notes shared with clients?

Answer 7

No.

Must remain in the sole possession of the maker and is only shared with a new therapist who takes over the client’s therapy.

Question 8

What is included with Informed Consent?

Answer 8

• Nature and course of treatment.
• Therapist credentials.
• Client’s right to refuse or terminate counseling.
• Treatment fees.
• Limits of confidentiality.
• Inform of any 3rd parties involved (e.g. clinical supervisor, treatment team, etc.)
• Expectations for virtual therapy (if applicable)

Question 9

If a client refuses to sign my treatment contract, can I then provide services to that individual?

Answer 9

No.

Question 10

What must happen to make the informed consent valid?

Answer 10

• Consent must be given voluntarily.
• The client must be competent (legally as well as cognitively/emotionally) to give consent.
• We must actively ensure the client’s understanding of what she or he is agreeing to.
• The information shared and all that is agreed to must be documented.

Question 11

How does one receive informed consent in mandated counseling situations (court-ordered, prison, etc.)?

Answer 11

In these situations we must obtain their assent from the client while obtaining consent from the appropriate third party.

If the client’s capacity to provide informed consent changes over time, then their consent for further participation (or for refusal to continue) in treatment should be obtained at that time.