PSYC 514: Ethics and Professional Issues in Counseling

Question 1

Assent vs. Consent to Treatment

Answer 1

Assent refers to when a person unable to give formal consent, due to age or disability, gives agreement to engage in treatment. Consent is an ethical term that refers to a continuous process that involves legal permission to participate in psychotherapy (while having full knowledge about the treatment’s potential risks and benefits).

Question 2

Bartering of Clinical Services

Answer 2

When a clinician accepts payment for their services that is nonmonetary. Bartering of clinical services is not looked on favorable but technically can be done if it’s not clinically contradicted. If a clinician does engage in bartering, the terms need to be clearly outlined in a written contract.

Question 3

Basic Purpose of Ethical Practice

Answer 3

The basic purpose of ethical practice to keep the client protected. The guiding principles of autonomy, beneficence, nonmaleficence, and justice must be adhered to. The code of ethics can also provide guidance for clinicians and be a mechanism for professional accountability.

Question 4

Certification

Answer 4

A statement/acknowledgement that a person has met certain qualifications to perform a certain job/task. Certification indicates that a person possesses a certain set of knowledge, skills, and abilities in order to effectively practice under that certifications. Certifications, unlike licensure, are not monitored by any sort of board.

Question 5

Confidentiality

Answer 5

The responsibility of a clinician to not reveal anything about a client (including their identity) without the explicit written permission of a client (typically via a “Release of Information.”) The clinician can only break confidentiality if the client threatens harm to themselves or specific others, reveals abuse of a vulnerable population, or receives a court order signed by a judge. Breaching confidentiality without probable cause may lead to a lawsuit or suspension/loss of licensure.

Question 6

Confidentiality in Group/Marital Counseling

Answer 6

In a group or marital counseling setting, the clinician is required to information participants of confidentiality and ask that they respect it outside the session time. While the clinician must legally maintain confidentiality, there is no guarantee that other members in the session will do the same.

Question 7

Counselor Competency

Answer 7

A term that refers to a counselor’s knowledge base and ability to practice well. This refers to their ability to practice physically, mentally, and emotionally. Practicing without competency or not within one’s scope of practice is considered unethical.

Question 8

Direct Liability

Answer 8

This refers to when a person who committed an unethical act is held accountable both professionally and potentially legally. The burden of responsibility lands on the clinician themselves.

Question 9

Dual/Multiple Relationships

Answer 9

This refers to when a clinician has another type of relationship beyond a therapeutic relationship with a client. The therapist is either concurrently in another relationship with the client, with a close relation/friend, or promises to enter into a relationship in the future. It is considered best practice to avoid multiple relationships when possible.

Question 10

Duty to Warn/Protect

Answer 10

The obligation of mental health professionals to warn and/or protect third parties whom their client intends to harm or who might be able to protect a suicidal client from self-harm. The duty to warn/protect came about from the Tarasoff Case.

Question 11

Empirically Supported Treatments

Answer 11

Empirically support treatments (ESTs) have evidence in favor of treatment from at least 2 well-designed randomly controlled trials, several single-case experimental designs, or a meta-analysis. ESTs are used by clinicians utilizing evidence-based practice.

Question 12

Ethics

Answer 12

Set of standards which govern the conduct of members of a given profession. APA provides guidance for psychologists. Practice ethically by having consultation and formal documentation.

Question 13

Ethical Boundaries in Clinical Practice

Answer 13

Guidelines that are put in place to make the therapeutic relationship distinct from personal, intimate, and business relationships. These boundaries are in place to protect the client’s wellbeing. Crossing a boundary may not be innately harmful, but it removes the clinician from a neutral position. A boundary violation causes harm to the client.

Question 14

Ethnic-Sensitive Practice

Answer 14

Practice in which the counselor is aware of their client’s culture and ways in which their culture may affect their worldview and/or presentation of symptoms. Ethnic-sensitive practice involves a conscious effort by the clinician to grow their multicultural competence.

Question 15

HIPAA Compliance

Answer 15

This occurs when the therapist upholds the client’s privacy rights and protection of the client’s health information. HIPAA compliance is done by maintaining confidentiality of the client’s identity as well as the content of their session(s).

Question 16

Legal Aspects of Informed Consent

Answer 16

The three legal elements that must be included in informed consent include the limits of confidentiality, the nature of therapy, and the fees of treatment. The client must have the capacity to understand these aspects prior to their voluntarily consent of treatment.

Question 17

Licensure vs. Certification

Answer 17

Licensure is mandated and regulated by a government-controlled board. Licensure is required by law in order to practice. Certification means the clinician has completed appropriate course content and/or training on a specific topic – certifications are not regulated by a board.

Question 18

Malpractice

Answer 18

This refers to professional misconduct or negligent behavior on the part of the clinician. Malpractice can lead to legal action in which the person claimed to be injured needs to prove four things: 1) the clinician had a duty to the injured person; 2) the clinician deviated from the standard of care; 3) the individual claiming malpractice has been injured; 4) there was a direct link between the damage sustained and the professional’s deviation.

Question 19

Morality

Answer 19

A system of beliefs of a set of values relating to appropriate conduct, against which a behavior is judged to be acceptable or unacceptable. This is typically an internal value system and the clinician must be mindful of not imposing their own morals on their clients.

Question 20

Peer Consultation

Answer 20

This occurs when a clinician seeks out other mental health professionals to provide critical and supportive feedback about professional issues in practice. Peer consultation is essential in a risk management model and allows them to maintain objectivity.

Question 21

Privileged Communication

Answer 21

This refers to confidential information that may not be divulged to a third party without the knowledge and consent of the individual whose information is being shared. Privileged communication typically occurs in a professional relationship. Clinicians hold the privilege of client records, though clients may access their record at any time with the understanding of risk associated.

Question 22

Pro Bono Service

Answer 22

These are therapeutic services that are offered at no charge. Pro bono services are not ethically required but strongly encouraged as a means to break barriers to care.

Question 23

Professionalism

Answer 23

This refers to the competency of the clinician to perform the skills expected by their chosen profession. A clinician should uphold professional standards in and outside of the therapy sessions.

Question 24

Reporting Child Abuse

Answer 24

Clinicians are required to report child abuse to appropriate authorities. Clinicians should not however investigate the claims as an improper investigation can lead to reasonable doubt, which in turn may hurt rather than help the child’s case. Must be documented.

Question 25

SAD PERSONS

Answer 25

A mnemonic used to assess an individual’s level of suicidality and their corresponding risk/need for a higher level of care. S = Sex, A = Age, D = Depression, P = Prior psychiatric history, E = Excessive substance use, R = Rational thought loss, S = Separated/divorced/widowed, O = Organized/serious attempt, N = No social supports, S = Stated future intent

Question 26

Self-Monitoring of Ethical Practice

Answer 26

This is done via adequate self-care to ensure that you, as the clinician, are able to be a competent provider. All clinicians must know when they need to take a step back. Clinicians should not rely solely on self-monitoring, but rather incorporate the use of peer consultation when necessary.

Question 27

Sexual Intimacies with Former Clients

Answer 27

“Once a client, always a client.” Though the ethical codes say that sexual contact is okay 5 or 7 years after termination (depending on which code you are viewing), it is best practice to NEVER engage in any sort of sexual intimacy with former clients.

Question 28

Tarasoff Case

Answer 28

A 1976 Supreme Court decision which placed limits on a client’s right to confidentiality. This ruling stated that mental health practitioners, who knew or reasonably believed that a client posed a threat to another person, are obligated to protect the identifiable victim from danger.

Question 29

Treatment of Minors

Answer 29

Parental consent is required for treatment of clients under legal age, with the exception of crisis situations. The biological parents have rights to the child’s record and the record should be given to each parent (if applicable) if one requests the record. The clinician must consider this limited confidentiality, consent vs. assent, and their scope of practice to work with minors.

Question 30

Values in Counseling

Answer 30

Values are beliefs and attitudes that provide direction for everyday living. Clinicians need to be mindful of not imposing their own values on their clients, especially if said values do not align. If client values do differ from clinician, the clinician must be empathetic and nonjudgmental about these differences.

Question 31

Vicarious Liability

Answer 31

A term meaning that the clinician is responsible for and the actions of anyone working under their license. The licensed clinician is vicariously liable and legally responsible for those working under them (i.e. supervisees, office staff, etc.)