Midterm Prep Flashcards
What is informed consent?
A document to define boundaries and clarify the nature of the counseling relationship between therapist and client
What are the main points included in an informed consent document?
- Purpose of treatment
- Risks and benefits
- Alternatives available
- Voluntary participation
- Confidentiality and limits of confidentiality
- Fees
When should the informed consent document be delivered?
As early as feasibly possible, leaving room for discussion
What are progress notes?
A means of documenting aspects of a client’s treatment kept in a client’s clinical record
What do progress notes typically contain?
- Diagnosis
- Functional status
- Symptoms
- Treatment plan
- Prognosis
- Client progress
What are process notes?
Notes that deal with client reactions such as transference and the therapist’s subjective impressions of a client
What is a mistake of omission?
An error caused by neglecting or forgetting to do something rather than doing something incorrectly
What is a mistake of commission?
An error that occurs when someone takes an action, but it is the wrong action
What are some examples of mistakes of omission in online services?
- Failing to obtain clients’ full informed consent
- Limiting clients’ access to personal information on social networking sites
- Failing to comply with HIPAA regarding electronic communications
What is the definition of a minor in the context of counseling?
Varies from state to state, typically 18-21; some states authorize 16-year-olds to consent to their own health care in specific circumstances
What is necessary for a minor to enter into a counseling relationship in most states?
Informed parental/guardian consent or court order
What are some exceptions where parental/guardian consent may not be required?
- Addictions to dangerous drugs
- STIs
- Pregnancy/Birth control
- Examination following sexual assault of a minor over 12 years old
What is the duty to warn?
Obligation of a therapist to notify an identifiable potential victim if a client poses a credible threat to their safety
What is the duty to protect?
Broader obligation that includes notifying law enforcement and initiating involuntary hospitalization if necessary
What landmark case established a therapist’s duty to protect potential victims?
Tarasoff case
What does ethical bracketing refer to?
Intentional setting aside of the counselor’s personal values to provide ethical and appropriate counseling
What are the 3 Cs in maintaining ethical boundaries?
- Confidentiality
- Consent
- Competence
What is HIPAA?
Health Insurance Portability and Accountability Act of 1996, a federal law to protect sensitive patient health information
What does the HIPAA Privacy Rule regulate?
The use of Protected Health Information (PHI) and requires safeguards to protect health information
What are HIPAA covered entities?
- Healthcare Providers
- Health plans
- Healthcare Clearing Houses
What is the legal concept of privileged communication?
Generally bars the disclosure of confidential communications made to a psychotherapist from judicial proceedings
What is the counselor’s ethical duty regarding confidentiality?
To protect private client communication
What are some limits to confidentiality?
- Suspicion of child abuse
- Suspicion of elder abuse
- Credible and imminent threat to self or others
- Court orders
What should therapists do if a client poses a credible threat to themselves or others?
Evaluate and manage suicidal risk, inform clients of limits of confidentiality, and document threats
What should be included in the assessment of suicidal behavior?
- Evaluating depression
- Suicide ideation
- Suicide intention
- Risk factors associated with suicide
What are some danger signs to watch out for in assessing suicide risk?
- Direct verbal warnings
- Previous suicide attempts
- Feelings of hopelessness
- Access to lethal means
What does the term ‘values imposition’ refer to?
When a counselor attempts to influence a client to adopt their values, attitudes, beliefs, or behaviors
What is the purpose of defensive record keeping?
To document sessions and protect the therapist from legal liability
What should a therapist do if a client reveals intent to commit suicide?
Mandatory reporting is required if the disclosure of intent, a plan, and the means to carry out the plan are present
What should be removed from the home to reduce suicide risk?
Lethal means
Work with family members to remove lethal means from the home.
What is a key factor that can contribute to suicidal ideation?
Lack of a support system
How should counselors assess suicidal ideation?
By asking if the client wants to die or if they want the pain to end
What should counselors with limited experience in suicide assessment do?
Seek supervision and/or consultation with experienced professionals
What must counselors document regarding suicidal clients?
All assessments, interventions, consultations, and treatment decisions comprehensively
What is essential for professional preparedness in suicide prevention?
Ongoing education and training
What should a supportive environment for a client include?
A written safety plan with emergency contacts
How can counselors manage client risk effectively?
Increase session frequency as needed and secure dangerous items through third parties
What role does collaboration play in counseling suicidal clients?
Involves consulting with colleagues and involving family and support networks
What should counselors communicate regarding their availability?
Emergency contact procedures
What is a key component of a personalized safety plan?
Client lists their reasons for living
What may indicate a need for a higher level of care in a safety plan?
Inability to list reasons for living or identify contacts for assistance
What is cultural racism?
The belief that one group’s history and traditions are superior to others
What does social justice work in counseling involve?
Empowerment of individuals and advocacy for addressing injustices
Define multicultural counseling.
The working alliance between counselor and client considering personal and cultural dynamics
What assumption do many mental health professionals have about self-actualization?
It is a fundamental goal for individuals
What should counselors consider when building rapport with clients?
The client’s cultural background and how trust is established from their perspective
What is a balanced approach to self-actualization in therapy?
Integrating self-actualization with responsibility to the group
What is the counselor’s responsibility regarding cultural differences?
To initiate conversations about culture and acknowledge differences with respect
