Midterm Cards Flashcards
Laws
Body of rules that govern professionals.
Ethical Codes
Guidelines for professional standards and practices.
Confidentiality
Client’s right to have communication kept within the bounds of professional relationship.
Privilege
Client’s right to prevent MH professional from revealing confidential communications in a legal proceeding.
Main Purpose of Ethical Codes & Laws
To protect the safety and welfare of clients and consumers.
Goals for Professionals?
- To practice safely and legally
- To provide a high quality of service
- To develop professional judgment and decision-making skills
- To identify personal values and ethics which may impact professional work
- To feel confident in professional decisions and choices
Things to Remember?
- Watch out for the slippery slope
- It depends
- Practice defensively and be protected
- Write it down
- Consult when necessary
- Focus on the welfare of the client
- Trust your judgment and training
Transference
Refers to redirection of a patient’s feelings, emotions for a significant person to the therapist.
Countertransference
Projections by therapists that distort how they view or react to the client.
Must Maintain Confidentiality EXCEPT when?
- The client has waived their right to confidentiality
- The client’s identity can be adequately disguised or removed.
- A breach of confidentiality is required or permitted by the law.
Stress in the Helping Professions
Sources of stress for professionals
Counselor impairment
Burnout
Self Care is Critical for
counselors and helpers
Three Legal Elements of Informed Consent?
- CAPACITY
- COMPREHENSION OF INFORMATION
- VOLUNTAIRNESS
What is one of the main causes of successful law suits?
Failure to obtain informed consent.
What should an informed consent include?
All info. necessary to help people make an informed choice about services.
People must be able to read, understand and sign that they agree to these policies.
Elements of Informed Consent? (1)
- What will transpire in the counseling process
- Costs and benefits of counseling
- Fees prior to the onset of service- THIS IS A LEGAL REQUIREMENT
- Estimated length of treatment
- Tape recording or video taping- requires a specific signed consent
- Office policies- cancellations, emergency policies and emergency access
When it comes to informed consent, what is a legal requirement?
Fees prior to the onset of service.
Elements of Informed Consent? (2)
- Intern, student, trainee status
- Consultation with supervisors
- Interruptions to treatment- alternate plans
- Client’s right to access their files (if appropriate)
- Rights pertaining to dx, confidentiality and limits of third party payers
Elements of Informed Consent? (3)
- Alternatives to therapy
2. Nature and purpose of confidentiality; exceptions to confidentiality
If it isn’t ____, it didn’t ____.
documented ; happen
Record Keeping
- If it isn’t documented, it didn’t happen
- Write it down
- Keep an accurate, complete clinical record
- Maintain the safety and confidentiality of all records
- Know who does and does not have access to records
In California, there are 3 criteria for involuntary commitment, what are they?
- Danger to Self
- Danger to Others
- Grave Disability
Welfare and Institutions Code 5150
Authorizes a qualified officer or clinician to INVOLUNTARY confine a person suspected to have a mental disorder that makes them a danger to themselves, a danger to others, and/or gravely disabled.
There are 6 types of situations that could result in malpractice, what are they?
- A procedure outside accepted practices.
- A technique the counselor was not trained to use.
- A procedure that would have been helpful was not used.
- Therapist failed to warn and protect others from a dangerous client.
- Informed consent was not obtained.
- the consequences of treatment were not explained.
______ is the _______ of a trust-based helping relationship
Confidentiality ; foundation
Confidentiality establishes a ____ for people to discuss their concerns or situation.
“safe place”
The ___ and ____ of the individual is always the foremost concern for professionals
safety; welfare
Privileged Communication
- This ONLY applies to MFT’s, trainees and interns, social workers, psychologists and
psychiatrists - It’s based on the patient- psychotherapist relationship.
What are the exceptions to confidentiality?
- Imminent danger to self
- Imminent danger to others
- Mandated reporting situations
- Child abuse reporting
- Elder abuse reporting
- Dependent adult reporting
Duty to Warn
refers to the responsibility of a counselor or therapist to inform third parties or authorities if a client poses a threat to himself or herself or another identifiable individual. It is one of a just a few instances where a therapist can breach client confidentiality.
Tarasoff Rule
When a therapist determines, or pursuant to the standards of his profession, should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger.
Ewing v. Goldstein Case
In this case, the patient did not tell his therapist of intent to harm himself and a former girlfriend’s new boyfriend but did communicate this to his father. The father in turn told the therapist of his conversation and the therapist encouraged the father to have his son hospitalized. The inpatient psychiatrist discharged the patient over the therapist’s objection by telephone and the patient then killed the boyfriend and himself. (The therapist did not see the patient after the father called and never was advised by the patient of his intent to harm the victim.) The parents of the victim sued the therapist for failure to warn.
Tarasoff v. Regents of U.C.
Duty to Warn
Tarasoff decision:
“when a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim.”
“the protective privilege ends where the public peril begins”
Mandated to disclose
Ewing v. Goldstein Case Implication
This case created a clear distinction between the duty to protect and the subordinate duty to warn and made communications by a third party indicating threatening statements EQUIVALENT to statements made directly by that person.
Duty to Protect Suicidal Clients
- Professionals have an obligation to act if a client is a danger to themselves
- Confidentiality may be broken to prevent suicide or self harm
- Evidence Code 1024 provides for this (protects therapist if confidentiality is broken)
- The protection of individuals who pose self-harm is an ethical responsibility
There are ___ legal mandates re: self-harm; counselors ___ break confidentiality in this case, but are ___ required to do so
No; May; Not
Evidence Code 1024
Patient dangerous to self or thers
Confidentiality MUST Be Breached in the Following Situations:
- When a cliet conmmunicates a serious threat of physical violence against a reasonably identifiable victim.
- Therapist knows or reasonably suspects a child is being abused or has been abused.
- Therapist suspects physical abuse, abandonment, isolation, financial abuse, or neglect of an elder or dependent adult.
- When the client request it or the court compels you.
Subpoenas
Therapist asserts the privilege and refuses to release records. NEED client’s permission.
Evidence Code 1024 is legally ___, but not legally ______.
Permitted and Mandated
Evidence Code 1024 conditions:
- Person must be dangerous to himself or the person or property of another.
- Disclosure of the communication is necessary to prevent the threatened danger.
Evidence Code 1024 MANDATE to?
take reasonable steps to prevent the suicide of a client.
Involuntary hospitalization lasts for?
72 Hours
Which child abuse reports are due and with in what time?
Telephone and written within 36hours
People legally authorized to involuntary confine an individual?
- Police Officers
2. County Authorized Staff (PET Team)
Categories of Child Abuse?
Physical, sexual, severe and general neglect, willful cruelty and unjustifiable punishment, corporal punishment, and injury in out-of-home care.
Questions to Ask To Determine Suicide Potential
Is there a plan?
Does the person have the means to follow through?
What is the level of the intent?
What alternatives does the person see?
Has the person seriously thought about death?
Have they tried it before?
Progress Notes
Means of documenting aspects of a client’s treatment and are kept in a client’s clinical record. May be used to document significant issues or concern related to a client’s treatment.
Process (psychotherapy) Notes
Deal with client reactions such as transference and the therapist’s subjective impressions of a client. E.g. details about client’s personal life, details of dreams, therapist’s thoughts, feelings and reactions to clients.
Keeping records is no longer a _____ task; it is now an ____, ___., and _____ requirement.
voluntary; ethical; clinical; legal
Malpractice
The failure to render professional services or to exercise the degree of skill that is ordinarily expect of other professionals in a similar situation.
Termination
The ethically and clinically appropriate process by which a professional relationship is ended.
Abondonment
The failure of the clinician to take the clinically indicated and ethically appropriate steps to terminate a professional relationship.
Privacy
Constitutional right of individuals to be left alone and to control their personal information.
The major types of elder abuse are?
- Physical
- Sexual
- Psychological
- Neglect
- Abandonment
- Financial/Material exploitation
Four Core Virtues
- Prudence
2 Integrity - Respectfulness
- Benevolence
Nonmaleficence
Avoiding doing harm, which includes refraining from actions that risk hurting clients.
Beneficenece
Doing good for others and to promoting the well-being of clients.
