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There are three (3) Case Studies that make up this Signature Assignment.  In each case, use the Welfel (2016) ethical decision-making model to address the situation to come up with a plan/solution. Make sure that you review the following references while writing up the ppr. Each case study is to be completed individually as one ppr each. Please refer to these sources only:

American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author.  

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Welfel, E.R. (2016). A Model for Ethical Practice: Using Resources to Enhance Individual Judgment and  Ethical Resolve.

Additional Details

  • Ethical Decision-Making Model
  • Suggested Format of Ppr (APA)

Please refer to the attachment for details of case studies #1, #2, and #3

FO611 Ethics and Professional Issues

Page 1 of 6

Signature Assignment Details

Signature Assignment Information A signature assignment is an assignment, task, activity, project, or exam used to collect evidence of student learning for a specific program learning outcome(s). The PLO rubric is used to assess the signature assignment and the cumulative results are used as part of a program’s reporting on student learning in the annual report or self-study. Other coursework can build toward the signature assignment, meaning that the signature assignment integrates cumulative knowledge of what the student learned in a particular course or set of courses for a particular program learning outcome(s). Like other assignments, a signature assignment is graded numerically to be factored into the final course grade.

FO611 Ethics and Professional Issues For the signature assignment for this course, students will apply an ethical decision-making model to each of the three cases below. The paper should be an integrative, critical review of each case while integrating the most current version of the American Counseling Association (ACA) Code of Ethics as a primary resource. Students may integrate additional materials such as additional ethical codes or laws pertaining to the cases, however the ACA Code should be the primary reference in the paper. The additional codes should be discussed with the instructor prior to adding them to the paper. Below is the ethical decision-making model that students must use for each case. Students are to produce one paper that separates each of the three vignettes and uses the ten (10) steps of the Welfel (2016) decision making model to resolve the dilemma. In each step, students should write in a clear, logical manner while including references as needed in order to thoroughly address each step. Students should not merely state that a step was complete without discussing all relevant aspects of that step. Each case will be approximately 4-6 pages long not including title page or references. This means that your paper will end up being approximately 14- 20 pages including title page and references in APA style format. Please read the chapter associated with the Welfel model for ethical decision making as this will assist how you address each step. Ethical Decision-Making Model Welfel, E.R. (2016). A Model for Ethical Practice: Using Resources to Enhance Individual Judgment and Ethical Resolve.

Step 1: Develop ethical sensitivity, integrating personal and professional values. Step 2: Clarify facts, stakeholders, and the sociocultural context of the case. Step 3: Define the central issues and the available options. Step 4: Refer to professional standards, guidelines, and relevant law/regulations. Step 5: Search out ethics scholarship. Step 6: Apply ethical principles to the situation. Step 7: Consult with supervisor and respected colleagues. Step 8: Deliberate and decide. Step 9: Inform supervisor, implement and document decision-making process and actions. Step 10: Reflect on the experience.

Suggested Format of Paper (APA Style)

I. Title Page II. Case #1: Ethical Decision-Making Model Analysis

a. Review steps 1-10, while incorporating relevant diversity variables and ethical and professional codes/standards and necessary details from the Welfel model.

III. Case #2: Ethical Decision-Making Model Analysis a. Review steps 1-10, while incorporating relevant diversity variables and ethical and professional codes/standards

and necessary details from the Welfel model. IV. Case #3: Ethical Decision-Making Model Analysis

a. Review steps 1-10, while incorporating relevant diversity variables and ethical and professional codes/standards and necessary details from the Welfel model.

V. Reference Page

FO611 Ethics and Professional Issues

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CASES In each of the following dilemmas, use the Welfel (2016) ethical decision-making model to address the situation to come up with a plan. Make sure that you review the following references while writing up the paper. Mandatory references

• American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author. https://www.counseling.org/resources/aca-code-of-ethics.pdf

• Welfel, E.R. (2016). A Model for Ethical Practice: Using Resources to Enhance Individual Judgment and Ethical Resolve. Please discuss supplemental references (additional codes, laws, book chapters, etc.) with your instructor prior to including in your paper.

Case #1: You are an intern at an outpatient center where juveniles have been mandated by court to receive your services, which include psycho-education on anger and stress management to clients from diverse backgrounds and socioeconomic status. You have employed all of the strategies that you were taught in graduate school, researched the topics, and tried to consult with your supervisor regularly. However, your supervisor always tells you that you are doing fine and supervision is not needed because you are doing such a good job. Your supervisor does not even listen to you when you have questions and does not appear to be monitoring the client’s progress. You are not licensed as a counselor, but want to be licensed in your state, so you need the appropriate forms signed by your supervisor, which indicate that you completed your hours and required supervision. You have questions about what you are doing, especially since your clients have world views different than yourself.

Case #2: Your adult client has been arrested on several occasions, which resulted in your client having a long criminal record, being on probation, and being incarcerated on a number of occasions. The client was arrested and convicted for selling controlled substances. You were asked to visit the client to complete a current mental status and provide recommendations to the court. The client’s mental status exam did not yield any clinically significant issues. The client reported having positive thoughts about going home. The client has stated that they have learned a life lesson and will “never do anything against the law again.” The client denied having any distressing dreams, hallucinations, no manic or depressive episodes, and no problems with sleeping. The client reported no concerns about appetite and had no changes in the last few weeks. The client agreed that the medications were working well for diagnosed Bipolar I Disorder. Upon questioning about the client’s children, the client said the children have visited about four times since this last incarceration, and the client was happy about those visits. During your evaluation, you notice that you have started to have romantic feelings toward the client because the client seems like a nice person. You have decided that the client was in the wrong place at the wrong time and had to do what was needed to in order to survive. You have never felt this strongly about a client in the past.

Case #3: You are working with a client who is from a different religion than you and has strong beliefs about religion. You know very little about the religion or the religious practices so you have some reservations working with the client due to your lack of knowledge and how your lack of knowledge could negatively affect your therapeutic relationship. The client does not always answer your questions, is somewhat evasive, and insists on taking breaks to pray or meditate during the evaluation process. You know you are not supposed to cause harm to clients but are feeling hesitant to continue the evaluation process due to your lack of knowledge and familiarity with the client’s diverse background. You also think that the client may not open up to you due to your differences. You want to refer the client to someone else but are not sure if that is appropriate. You are receiving supervision in the process and your supervisor thinks that you are able to handle this case competently.

The grading rubrics for each case are below, totaling 300 points (100 points for each case).https://www.counseling.org/resources/aca-code-of-ethics.pdf

FO611 Ethics and Professional Issues

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CASE 1 RUBRIC

Points Student’s

Score Does Not Meet Criteria Somewhat Lacking Meets Criteria

Case #1: (100 points)

Review of Ethical Decision Making Model and Ethical Codes (____ of 80 points total)

Welfel (2016) Model There are ethical decision- making model steps missing, or review of all steps was poorly integrated and/or there are 4+ missing elements. No ethical and professional codes are discussed, or they are irrelevant. Information is unclear throughout. Complete absence of analytic and critical thinking skills. There is a poor discussion of the subject matter, and absence of analytic and critical thinking skills. (0-64)

Welfel (2016) Model All ethical decision-making model steps are reviewed, however, not thoroughly and missing 1-3 crucial elements. Only one ethical and professional code, standard, guideline, and/or law is discussed, or peripheral codes or guidelines are mentioned. Information is not thorough, may be unclear/vague during some sections and difficult to understand or follow. There is some difficulty with analytic and critical thinking and writing skills. Information presented has some inaccuracies and/or irrelevancies. (64.5-72)

Welfel (2016) Model All ethical decision-making model steps are reviewed thoroughly. At least two ethical and professional codes, standards, guidelines, and/or laws related to the topic are discussed. Information is presented clearly, completely, and across all sections of the paper. The subject matter is clearly discussed. Information presented is accurate and relevant to the field of forensic psychology and/or counseling in general and case facts in particular. Analytic and critical thinking skills are demonstrated throughout. (72.5-80)

Diversity Variables

(____ of 10 points total)

Diversity Variables No diversity variables are discussed, or they are irrelevant. (0-7.5)

Diversity Variables Only one diversity variable is discussed, or peripheral diversity variables are mentioned. (8-8.5)

Diversity Variables At least two diversity variables related to the topic are discussed. (9-10)

Grammar/ Organization (____ of 10

points)

There are at least 6 violations of APA rules and at least 3 or more missing or incorrect citations and references. Organization is unclear in at least 3 sections. There are no headers. Multiple spelling (5+) or grammatical errors are made. (0-7.5)

There are less than 5 APA rule violations and/or 3-5 missing or incorrect citations and references. Organization is unclear in 1-2 sections (unfocused paragraphs, poor topic sentences, poor transitions). Several (1-4) spelling or grammatical errors are made. (8-8.5)

All APA rules are followed for citations, quotes, references, etc. Paragraphs, topic sentences, and transitions aid in understanding main points. Information is presented logically. No spelling or grammatical errors are made. (9-10)

Case #1: POINTS

POSSIBLE (100)

(_______ of 100 points)

Case 2 Rubric on next page.

FO611 Ethics and Professional Issues

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CASE 2 RUBRIC

Points Student’s

Score Does Not Meet Criteria Somewhat Lacking Meets Criteria

Case #2: (100 points)

Review of Ethical Decision Making Model and Ethical Codes (____ of 80 points total)

Welfel (2016) Model There are ethical decision- making model steps missing, or review of all steps was poorly integrated and/or there are 4+ missing elements. No ethical and professional codes are discussed, or they are irrelevant. Information is unclear throughout. Complete absence of analytic and critical thinking skills. There is a poor discussion of the subject matter, and absence of analytic and critical thinking skills. (0-64)

Welfel (2016) Model All ethical decision-making model steps are reviewed, however, not thoroughly and missing 1-3 crucial elements. Only one ethical and professional code, standard, guideline, and/or law is discussed, or peripheral codes or guidelines are mentioned. Information is not thorough, may be unclear/vague during some sections and difficult to understand or follow. There is some difficulty with analytic and critical thinking and writing skills. Information presented has some inaccuracies and/or irrelevancies. (64.5-72)

Welfel (2016) Model All ethical decision-making model steps are reviewed thoroughly. At least two ethical and professional codes, standards, guidelines, and/or laws related to the topic are discussed. Information is presented clearly, completely, and across all sections of the paper. The subject matter is clearly discussed. Information presented is accurate and relevant to the field of forensic psychology and/or counseling in general and case facts in particular. Analytic and critical thinking skills are demonstrated throughout. (72.5-80)

Diversity Variables (____ of 10 points total)

Diversity Variables No diversity variables are discussed, or they are irrelevant. (0-7.5)

Diversity Variables Only one diversity variable is discussed, or peripheral diversity variables are mentioned. (8-8.5)

Diversity Variables At least two diversity variables related to the topic are discussed. (9-10)

Grammar/ Organization (____ of 10 points)

There are at least 6 violations of APA rules and at least 3 or more missing or incorrect citations and references. Organization is unclear in at least 3 sections. There are no headers. Multiple spelling (5+) or grammatical errors are made. (0-7.5)

There are less than 5 APA rule violations and/or 3-5 missing or incorrect citations and references. Organization is unclear in 1-2 sections (unfocused paragraphs, poor topic sentences, poor transitions). Several (1-4) spelling or grammatical errors are made. (8-8.5)

All APA rules are followed for citations, quotes, references, etc. Paragraphs, topic sentences, and transitions aid in understanding main points. Information is presented logically. No spelling or grammatical errors are made. (9-10)

Case #2: POINTS

POSSIBLE (100)

(_______ of 100 points)

Case 3 rubric on next page.

FO611 Ethics and Professional Issues

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CASE 3 RUBRIC

Points Student’s Score

Does Not Meet Criteria Somewhat Lacking Meets Criteria

Case #3: (100 points)

Review of Ethical Decision Making Model and Ethical Codes (____ of 80 points total)

Welfel (2016) Model There are ethical decision- making model steps missing, or review of all steps was poorly integrated and/or there are 4+ missing elements. No ethical and professional codes are discussed, or they are irrelevant. Information is unclear throughout. Complete absence of analytic and critical thinking skills. There is a poor discussion of the subject matter, and absence of analytic and critical thinking skills. (0-64)

Welfel (2016) Model All ethical decision-making model steps are reviewed, however, not thoroughly and missing 1-3 crucial elements. Only one ethical and professional code, standard, guideline, and/or law is discussed, or peripheral codes or guidelines are mentioned. Information is not thorough, may be unclear/vague during some sections and difficult to understand or follow. There is some difficulty with analytic and critical thinking and writing skills. Information presented has some inaccuracies and/or irrelevancies. (64.5-72)

Welfel (2016) Model All ethical decision-making model steps are reviewed thoroughly. At least two ethical and professional codes, standards, guidelines, and/or laws related to the topic are discussed. Information is presented clearly, completely, and across all sections of the paper. The subject matter is clearly discussed. Information presented is accurate and relevant to the field of forensic psychology and/or counseling in general and case facts in particular. Analytic and critical thinking skills are demonstrated throughout. (72.5-80)

Diversity Variables (____ of 10 points total)

Diversity Variables No diversity variables are discussed, or they are irrelevant. (0-7.5)

Diversity Variables Only one diversity variable is discussed, or peripheral diversity variables are mentioned. (8-8.5)

Diversity Variables At least two diversity variables related to the topic are discussed. (9-10)

Grammar/ Organization (____ of 10 points)

There are at least 6 violations of APA rules and at least 3 or more missing or incorrect citations and references. Organization is unclear in at least 3 sections. There are no headers. Multiple spelling (5+) or grammatical errors are made. (0-7.5)

There are less than 5 APA rule violations and/or 3-5 missing or incorrect citations and references. Organization is unclear in 1-2 sections (unfocused paragraphs, poor topic sentences, poor transitions). Several (1-4) spelling or grammatical errors are made. (8-8.5)

All APA rules are followed for citations, quotes, references, etc. Paragraphs, topic sentences, and transitions aid in understanding main points. Information is presented logically. No spelling or grammatical errors are made. (9-10)

Case #3: POINTS

POSSIBLE (100)

(_______ of 100 points)

Total for all 3 Cases

TOTAL POINTS POSSIBLE (300)

(_______ of 300 points)

Program Learning Outcomes Rubric on next page

FO611 Ethics and Professional Issues

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Program Learning Outcome Rubric The Program Learning Outcome (PLO) Rubric will be utilized to assess the student’s level of performance for the PLO associated with

this course: Ethics. In addition to receiving a numerical grade for this assignment, students will also receive a rating along a scale of 1

(Novice Level Performance) to 4 (Graduate Level Performance) for the PLO.

Program Learning Outcome (PLO)

Performance Level 1 (Novice)

Performance Level 2 (Internship)

Performance Level 3 (Entry-level)

Performance Level 4 (Graduate)

Ethics: Students will be able to organize professional activities by ethical and professional codes, standards, and guidelines; statutes, rules, and regulations; and relevant case law.

Student’s integration of ethical and professional codes is minimal to none. There is not a commitment to identify relevant codes. Student leaves 2+ pertinent codes out of the analysis and/or discusses codes in a vague or tangential manner. Student does not display ethical values and/or does not recognize own moral attitudes. Student does not demonstrate knowledge on identifying and applying an ethical decision-making model effectively and needs significant direction from supervisor/ instructor (tutoring on 3+ occasions). Student manifests little to no understanding of the relationship between laws, standards, and professional activities. Student needs moderate to significant direction to appreciate and resolve ethical conflict between codes and laws.

Student integrates ethical and professional codes, standards, and regulations into professional practice, however code sections are not relevant or pertinent to the issues. Student omits at least 1 pertinent code section. Student does not fully recognize own moral attitudes. Student demonstrates knowledge on identifying and applying an ethical decision-making model, however not effectively and needs moderate direction from supervisor/ instructor (tutoring on 2+ occasions). Student manifests adequate understanding of the relationship between laws, standards, and professional activities. Student needs minimal to moderate direction to appreciate and resolve ethical conflict between codes and laws.

Student is committed to integrating ethical and professional codes, standards, and regulations into professional practice. Student may leave one peripheral code section out but displays ethical values and recognizes own moral attitudes. Student demonstrates knowledge on identifying and effectively applying an ethical decision-making model. Student manifests good understanding of the relationship between laws, standards, and professional activities. Student is able to appreciate and resolve ethical conflict between codes and laws satisfactorily.

Student is committed to integrating ethical and professional codes, standards, and regulations into professional practice. Student recognizes own moral attitudes, such as accepting opposing viewpoints as valid despite disagreement. Student spontaneously identifies, internalizes, and effectively applies an ethical decision- making model. Student manifests in- depth understanding of the relationship between laws, standards, and professional activities. Student is able to appreciate and resolve ethical conflict between codes and laws at the advanced level.

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ETHICS IN COUNSELING  AND PSYCHOTHERAPY:  STANDARDS, RESEARCH  AND EMERGING ISSUES

6th edition 

Elizabeth Reynolds Welfel, Ph.D.

©2016. Cengage Learning. All rights  reserved.

Chapter 1

Introduction to Professional Ethics A Psychology and Philosophy for Ethical Practice

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Counseling and psychotherapy are effective  methods for relieving distress: 80% of those  who receive services are better off than those  who do not attend (Wampold, 2010).

Still, some services are harmful, at least 5% of  clients deteriorate (Lambert 2010).

Much of that deterioration is related to  unethical and incompetent practice

©2016. Cengage Learning. All rights  reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Dimensions of professional ethics

• Having sufficient knowledge, skill, and judgment to  use efficacious interventions

• Respecting the human dignity and freedom of the  client(s)

• Using the power inherent in the professional’s role  responsibly

• Acting in ways that promote public confidence in the  profession

• Placing the welfare of the client(s) as the  professional’s highest priority

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Resource 1: Developmental psychology 

Rest’s model of moral development applied to  ethical practice

• Ethical Sensitivity

• Ethical Reasoning

• Ethical Motivation

• Ethical Character ©2016. Cengage Learning. All rights 

reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Resource 2: Codes of Ethics

American Counseling Association: Code  of Ethics and  Standards of Practice (2014)

American Psychological Association: Ethical Principles and  Code of Conduct for Psychologists (2010)

American School Counselor Association: Ethical Standards  for School Counselors (2010)

Association of Marriage and Family Therapists: Code of  Ethics(2012)

National Association of Social Workers: Code of Ethics  (2008)

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

These codes represent the official statements of  the professions about what is expected of  members, and all members are held  accountable for actions that violate the code. 

©2016. Cengage Learning. All rights  reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Advantages of Codes

• They support the professional faced with an  ethical question

• They demonstrate that mental health  professionals take seriously their responsibility to  protect the public welfare

• They furnish members with a definition of what  their colleagues consider the fundamental ethical  values 

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Limitations of a code

• Application to any one setting is limited.  • Codes do not uniformly address cutting‐edge  issues 

• Codes sometimes represent what the board of  directors can agree to, rather an ethical ideal

• Codes of ethics are not cookbooks for responsible  behavior and do not always offer specific  guidance

©2016. Cengage Learning. All rights  reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Resource 3:  Literature from Philosophy

This scholarship defines the ethical principles,  virtues, and theories that form the rationale  for the specific statements in the codes. 

It clarifies the values and virtues underlying the  actions of responsible professionals and  highlights that ethical practice always requires  value judgments 

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Ethical principles: respect for autonomy,  beneficence (the obligation to do good),  nonmaleficence (the avoidance of harm), fidelity  to promises made, and justice.

Ethical theories: the most fundamental definitions  of what defines ethical behavior

Virtue ethics: integrity, prudence, trustworthiness,  compassion, respectfulness, conscientiousness,  discernment ©2016. Cengage Learning. All rights 

reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Feminist theory: emphasizes systemic variables such as  the power of the participants within the system and  the impact of race, class, and oppression 

Social constructivist model of ethical decision making:  an  ethical choice is viewed as primarily a socially  interactive process

Positive ethics perspective: an approach to ethics that  encourages practitioners to frame ethical action  according to ethical ideals 

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Resource 4: Literature from Neuroscience

This research offers some intriguing and  controversial findings; it suggests that moral  functioning may be affected by changes in the  brain caused by early experience, and it supports  the deep connection between emotions and  moral judgments. 

It also highlights the relationship between some  forms of brain damage and misbehavior,  especially damage to the prefrontal cortex  (Damasio, 2007). 

©2016. Cengage Learning. All rights  reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Research Findings on Professional Ethics

Sexual contact with clients is a frequent violation  for which counselors and psychologists are  disciplined. More males than females are in this  category

Other kinds of multiple relationships that  compromise objectivity occur repeatedly.  Incompetent practice, violations of  confidentiality, negligent responses to suicidal  clients, and inappropriate fees are recurrent  problems. 

©2016. Cengage Learning. All rights  reserved.

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Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Law and Ethics

Codes of ethics and laws related overlap  substantially, but some conflicts arise. Laws seek  to eliminate problematic behaviors, whereas  codes also define good and desirable behaviors. 

Professionals should focus on ethics not avoiding  lawsuits or discipline as the best form of risk  management

©2016. Cengage Learning. All rights  reserved.

Chapter 1: A Framework for Understanding  Professional Ethical Values and Standards

Creating a Positive Ethical Identity:

Professional ethics is not a matter of minimal  compliance with codes and laws; it represents  a deep personal commitment o be a virtuous  clinician who strives for the ethical ideal.

The task is to integrate the values of the  profession into one’s personal values

©2016. Cengage Learning. All rights  reserved.

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Chapter 2

A Model for Ethical Practice Using Resources to Enhance Individual Judgment and Ethical Resolve

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

Chapter 2: A Model for Ethical Practice

Why a model is important

• Useful when ethical questions arise  • Has substantial value in identifying the  broader ethical issues 

• Can identify likely issues to emerge in a setting  before they happen

• Use is required by ACA and strongly  recommended by APA and licensing boards

©2016. Cengage Learning. All rights  reserved.

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Chapter 2: A Model for Ethical Practice

Forms of Ethical Reasoning (Kitchener, 1984)

Intuitive judgments:  spontaneous ethical  judgments motivated by emotion or by a person’s  ordinary moral sense. 

Critical evaluative judgments:  a deliberate process  in which professionals justify ethical decisions  based on consideration of the facts involved, and  consistency with professional values, virtues, and  accepted standards for practice

©2016. Cengage Learning. All rights  reserved.

Chapter 2: A Model for Ethical Practice

Welfel’s 10‐Step Model of Ethical Decision Making

Step 1: Becoming sensitive to the moral  dimensions of practice

Step 2: Identify all the relevant facts,  sociocultural context, and stakeholders

Step 3: Define the central issues in the dilemma  and the available options 

©2016. Cengage Learning. All rights  reserved.

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Chapter 2: A Model for Ethical Practice

Welfel’s 10‐Step Model of Ethical Decision Making 

Step 4: Refer to professional ethical standards  and relevant laws and regulations 

Step 5: Search out the relevant ethics literature

Step 6: Apply fundamental ethical principles and  theories to the situation

©2016. Cengage Learning. All rights  reserved.

Chapter 2: A Model for Ethical Practice

Welfel’s 10‐Step Model of Ethical Decision Making 

Step 7: Consult with colleagues about the  dilemma

Step 8: Deliberate independently and decide

Step 9: Inform appropriate people and  implement the decision

Step 10:  Reflect on the actions taken

©2016. Cengage Learning. All rights  reserved.

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Chapter 2: A Model for Ethical Practice

Notes on the model

• Not all issues require all 10 steps

• Some are resolved with reference to codes  and guidelines

• Prior experience with an issue can quicken the  analysis

©2016. Cengage Learning. All rights  reserved.

Chapter 3

Ethical Practice in a Multicultural Society The Promise of Justice

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Introduction

American society has never been culturally  homogeneous, but changes in population  demographics will render it truly heterogeneous.

In fact, by middle of the twenty‐first century, ethnic  groups that have long been labeled minorities will  collectively outnumber the majority population.  This has already occurred in many states in the  US.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Attention to diversity has become so intense that some  have called this movement psychology’s “fourth force”  (Pedersen, 1991a)

These changes mean that mental health professionals will  need multicultural competencies that equip them for  providing effective service to diverse clients. 

Competencies include  (1) self‐awareness , understanding of  one’s own cultural heritage and the impact of racism and  discrimination on self and others (2) knowledge of other  cultures and the impact of culture on human behavior,  (3)  skills in transcultural interventions  and in adapting  counseling interventions to meet the needs of a diverse  clientele. 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Ethics Codes and Multiculturalism

• Codes place extensive emphasis on cultural  competence. 

• Other guidelines enhance responsible practice  with diverse clients (e.g., the APA’s Guidelines on  Multicultural Education, Training, Research,  Practice, and Organizational Change for  Psychologists (2003); the Guidelines for  Assessment and Intervention with Persons with  Disabilities (2010); and ACA’s Competencies for  Counseling Transgender Clients (2009) .

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Language of Multiculturalism

Culture is the “set of shared meanings that make social  life possible” (Fowers & Richardson, 1996, p. 610). 

Ethnicity is a shared identity derived from shared  ancestry, nationality, religion, and race (Lum, 1992). 

Multiculturalism is a “social‐intellectual movement that  promotes the value of diversity as a core principle  and insists that all cultural groups be treated with  respect and as equals” (Fowers & richardson, 1996,  p. 609). ©2016. Cengage Learning. All rights reserved.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Language of Multiculturalism

Culture‐centered practice is a term endorsed by  psychology to refer to the “cultural lens”  psychologists should use as a central focus in their  work.

A minority has long been identified as a group that has  suffered discrimination or been oppressed.

Culturally diverse clients are clients from any group that  is represented in the preceding definition of minority  or are otherwise of a different cultural tradition from  the professional or from those who hold a more  dominant position in society.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Language of Multiculturalism

Multicultural counseling or multicultural  psychotherapy is any service in which the cultures  of the client and the professional differ in ways  that are likely to influence communication and  therapeutic content and progress.

Prejudice is “the positive or negative evaluation of  social groups and their members” (Sherman,  Stroessner, Conrey, & Azam, 2005, p. 1)

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

The Foundation of Ethical Practice in a Diverse Society

Empathy is not possible without awareness of  the sociocultural context in which a client is  describing the reasons for seeking help. 

Gallardo, “…to be culturally responsive is not a  concept at which one arrives, but more a  process that is life‐long and ever evolving”  (2009, p. 428). 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

The Context of the Current Ethical Standards

Professionals are not immune from the  prejudicial attitudes and can inadvertently  perpetuate oppression and discrimination  even if they want to practice sensitively. 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Sue, Bucceri, Lin, Nadal, and Torino (2007) refer to  acts that are unintentionally prejudicial as racial  microaggressions and define them as “brief and  commonplace daily verbal, behavioral, and  environmental indignities … that communicate  hostile, derogatory, or negative racial slights and  insults to the target person or group” (p. 72).

Two subtypes of this phenomenon are termed  microinsults and microinvalidations (Sue etal.,  2007).

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Codes of ethics include both aspirational principles and specific standards related to  responsible practice in a diverse society  throughout the codes, all emphasizing  competent, respectful, and adaptive services.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Sue and Sue (2007) laid out three components  of multicultural competency: (1) self‐ awareness of one’s values, biases, personal  beliefs, and assumptions about human nature;  (2) an understanding without negative  judgments of the worldviews and assumptions  of culturally diverse clients; and (3) skill in  using and developing counseling interventions  appropriate with diverse clients.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Multicultural Counseling Competencies and Standards (Arrendondo et. al., 1996). 

4 components:

1. Awareness of the influence of one’s own cultural  heritage on his or her experiences, attitudes, values,  and behaviors and the ways in which that culture limits  or enhances effectiveness with diverse clients. 

2. Comfort with cultural differences and with clients from  diverse cultures, and an attitude that values and  appreciates cultural difference. 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Multicultural Counseling Competencies and  Standards (Arrendondo et. al., 1996). 

3. Honesty negative emotional reactions and  preconceived notions about other cultures,  recognition of their harmful effects on clients,  and commitment to changing such attitudes. 

4. Respect and appreciation for culturally  different beliefs and attitudes.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

APA’s Guidelines on Multicultural Education,  Training, Research, Practice, and  Organizational Change for Psychologists (2003b) echo the same themes, with greater  emphasis on the impact of bias on diagnosis  and assessment. 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Measures to help professionals assess their level  of multicultural competency

Multicultural Counseling Inventory by Sodowsky,  Taffe, Gutlin, and Wise (1994)

See Hays (2008), Pope‐Davis and Coleman  (1998), or Suzuki, Ponterotto, and Miller  (2008) for additional measures

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Research findings

Recent research on the beliefs of professionals  about the importance of  multicultural  competencies of mental health professionals  show promising results: professionals perceive  themselves as competent and view multicultural  competency as important

Negative results: professionals believe themselves  more competent than they seem to be

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

A critique of the ethics codes

• The ethical principles that underlie their tenets  are not universally endorsed by all cultures. 

• The emphasis on respect for individual autonomy  in Western societies and in the codes is much less  dominant in some Eastern and African cultures. 

• Some claim they fail to help practitioners deal  responsibly with cultural conflicts in fundamental  ethical values. 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

A critique of the ethics codes

• LaFromboise, Foster, and James (1996) suggest  that professionals must avoid both ethical  absolutism (a rigid, dogmatic adherence to a  particular set of ethical values) and ethical  relativism (an equal acceptance of all ethical  values). 

• Fischer, Jome, and Atkinson (1998) echo discuss  multicultural counseling as a “universal healing  process that takes place in a culturally sensitive  context” (p. 525). 

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Other Recommendations

James and Foster (2006) encourage mental  health professionals to be aware of the  difference between rights‐oriented societies  and duty‐oriented societies. They recommend  that professionals develop what Aristotle  referred to as practical wisdom, which is the  capacity to use rules, norms, and standards in  a contextual way.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Misinterpretations of Multicultural Competence

1. Failure to take culture into account in the therapeutic  process. 

2. Failure to acknowledge intra‐cultural variations and  individual differences. 

3. Failure to see overlap in cultural groups

4. Failure to remember each interpersonal encounter is a  multicultural encounter (Pedersen, 1991) 

5. Thinking that attention to issues of cultural diversity is  limited to professionals from European backgrounds or  others in privileged groups

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

When Clients Express Prejudicial Ideas

Professionals must be respectful but cannot  endorse actions in direct opposition to  professional values and standards.  They must  not impose their values, but must stand by  them.

Sometimes educating clients can be useful, if  done respectfully.

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Chapter 3: ETHICAL PRACTICE IN A MULTICULTURAL SOCIETY

Fundamental attitudes and background

• Openness • Inclusive Cultural Empathy • Specific Cultural Knowledge • Openness to Involvement of Support of Members  of the Client Community

• Willingness to Adapt Interventions to the  Individual

• Tolerance for Ambiguity

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Chapter 4

Competence to Practice Building and Maintaining a Foundation for Doing Good and Avoiding Harm

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

Chapter 4: Competence to Practice

Essential Components:

Knowledge: Comprehension of a body of  information about theory and research in the  field, the judgment to make an informed  choice about what knowledge and  interventions apply in a given situation, and a  set of objective criteria for evaluating new  theory and research (Spruill et al., 2004). 

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Chapter 4: Competence to Practice

Components of Competent Practice

Skill: Successfully applying interventions with  clients. Norman (1985) and Overholser and Fine  (1990) divide this component into two kinds of  skills: Clinical skill is the competent use of basic  interviewing skills, and technical skill concerns  effective use of specific therapeutic interventions  in an evidence‐based context. 

Scope of Practice: The boundaries of competent  practice within which a professional must  operate.

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Chapter 4: Competence to Practice

Components of Competent Practice

Diligence: Consistent attentiveness to the client’s  needs that takes priority over other concerns,  including appropriate assessment and  intervention for a client’s problem and  maintenance of that care until services are  completed. Diligence also encompasses  emotional competence, the capacity of the  individual “for self awareness and respect for  ourselves as unique, fallible human beings” (Pope  & Vasquez, 2010, p. 62).

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Chapter 4: Competence to Practice

Achievement of Competence

One is competent when one’s knowledge and skills  are as well developed as those of other  professionals previously demonstrated to be  competent in the specified area. In other words,  if, after education and supervised practice, one  can carry out an intervention at least as well as  supervisors or colleagues. 

Also measured by attainment of the standards  established by a professional association for a  particular type of practice. 

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Chapter 4: Competence to Practice

Performance not Capacity as Central Feature

One may have the ability (i.e. capacity) to perform  competently, but competence is judged in the  performance of the task itself (Jensen, 1979). 

Environmental circumstances, unpredictable  events, mental health problems, or personal  distress can compromise competent performance  in someone with the capacity to be competent.

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Chapter 4: Competence to Practice

Competent performance probably varies from  client to client and day to day. A realistic  standard is a set threshold level for competent  practice, which is not crossed. This threshold  level should be defined as service that  provides the client with the likelihood of  benefit.

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Chapter 4: Competence to Practice

Codes on Competence

ACA and APA and ASCA codes all identify  extensive criteria for professional competence  and for education of students and  supervisees. 

Licensing boards have similar standards to  obtain a license and usually to renew one.

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Chapter 4: Competence to Practice

Advanced Credentials

Professional organizations have been formed to  provide more stringent measures of competence  and more direct assessment of therapeutic  judgment and skills. 

One organization is the American Board of  Professional Psychology (ABPP). Practitioners may  apply to this body to be certified as “diplomats”  in their field. 

The National Board of Certified Counselors (NBCC)  provides the same service for counselors.

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Chapter 4: Competence to Practice

Other Credentials

Woody (1997) describes dubious and bogus”  credentials that have emerged because of  increased competition in the marketplace for  clients and reimbursement (p. 337). Practitioners  “earn” these credentials when they pay the  requisite fees and are often required to provide  little additional verification of their training or  qualifications.

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Chapter 4: Competence to Practice

Procedures for Developing New Areas of  Competence

1. Obtain formal training of a length and depth  needed for the activity

2. Engage in supervised experience

3. Demonstrate competence equal to  professional standards for that activity

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Chapter 4: Competence to Practice

Continuing Education: Criteria for Identifying  Acceptable Training 

The proposed training (1) is based on scientific  evidence, objectively obtained; (2) includes  sufficient classroom time to absorb the new  material; (3) is offered by a professional with  expertise in the area, and (4) provides  opportunities for supervised practice and/or  recommendations for obtaining additional  supervised experience.

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Chapter 4: Competence to Practice

Competence with New Populations

Professionals need to evaluate readiness to  work with different populations if training and  experience in an intervention has been limited  to another population.

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Chapter 4: Competence to Practice

Competence in Rural Settings and Small  Communities

Limiting scope of practice is difficult for these  practitioners, given limited alternative access to  care.

Practitioners should consider: risk of harm to client,  opportunity to help, difficulty of access to  alternative care, availability of supervision when  needed, and willingness to monitor client  progress very carefully when working with clients  at the boundaries of their competence.

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Chapter 4: Competence to Practice

Other Criteria for Evaluating Competence:

1. Am I emotionally able to help? Also referred  to as emotional competence (Pope and  Vasquez, 2010).

2. Could you justify your decision to take on a  client to a group of your peers?  This is the  “clean well‐lit room standard” Haas and  Malouf (2005).

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Chapter 4: Competence to Practice

Distress, Burnout, and other Problems of  Competence

Given the emotional and cognitive demands of  the profession, counselors and therapists must  carefully monitor their ability to provide  competent service, especially in setting where  caseloads are high or financial pressures are  great.

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Chapter 4: Competence to Practice

Distress, Burnout, and other Problems of  Competence

Components of Burnout:

• Emotional Exhaustion (most common)

• Loss of a Sense of Accomplishment

• Depersonalization

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Chapter 4: Competence to Practice

Stress in Crisis Counseling

Crisis work carries additional risks of emotional  distress termed compassion fatigue or vicarious  traumatization.

The primary manifestations of compassion fatigue  include withdrawal and isolation from others,  inappropriate emotionality, loss of pleasure, loss  of boundaries with the client, and a sense of  being overwhelmed or pressured.

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Avoiding Harm to Clients from Distress and Emotional Exhaustion

1. Recognize risks of mental health practice and celebrate its  rewards.

2. Set clear limits about how much help you can humanly give. 3. Use  the advice you give clients about self‐care. 4. Recognize your vulnerability and seek support when 

overwhelmed. 5. Consider counseling or psychotherapy for personal problems, 

even if not overwhelmed by them. 6. Prepare for possible symptoms of secondary post‐traumatic stress 

when crisis intervention is predominant mode of service and take  full advantage of support services.

7. Work to develop quality assurance programs in your work setting  to reduce errors and thereby improve overall effectiveness of  service.

Chapter 4: Competence to Practice

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Chapter 4: Competence to Practice

Good news about work stress

No counselor is doomed to experience any of these  problems with appropriate self care, consultation,  supervision, and professional networking.

Most therapists see their work as a healing  environment not only for their clients but for  themselves when they relieve the distress of their  clients.

Professional associations and state boards often  provide colleague assistance services.

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Chapter 4: Competence to Practice

Legal Ramifications of Incompetent Practice

4 Conditions for a successful liability action:

1. Existing professional relationship – duty to client

2. Substandard practice – breach of the duty

3. Harm to the client must have occurred

4. Therapist’s actions must have caused the harm

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Chapter 5

Confidentiality Supporting the Client’s Dignity and Right to Privacy

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

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Chapter 5: Confidentiality

Confidentiality in the Professional Relationship: A Sacred  Covenant (Driscoll, 1992)

Distinguished from personal confidences: • Very high client expectations of confidentiality • Clients’ statements are often even secret from 

family/friends • Both content and contact with client are confidential • Professional faces real penalties for violation of 

confidentiality • Even death does not release the professional from 

confidentiality

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Chapter 5: Confidentiality

Ethical Principles Underlying Confidentiality

• Respect for Autonomy.  Newton (1989) argues  that privacy is an essential component of  individuality and selfhood

• Fidelity to promises made

• Beneficence

• Nonmaleficence

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Chapter 5: Confidentiality

Virtues Underlying Confidentiality

• Integrity

• Trustworthiness

• Respectfulness

• Compassion

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Codes of Ethics

• All professionals codes highlight the  importance of client confidentiality and the  need for clear communication to clients about  it and its limitation

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Chapter 5: Confidentiality

Interprofessional Communication

• Sharing client information with other  professionals can be valuable and is  sometimes essential, but clients must  understand that their disclosures will be  shared and consent to that communication if  identifying information is revealed.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Office Staff and Confidentiality

• Office staff who need access to client data  must agree to confidentiality and must be  appropriately trained and monitored.

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Chapter 5: Confidentiality

Sharing client data with loved ones:

Simply put: prohibited unless information is so  vague that there is no possibility that any  individual client could be identified.

This standard is commonly violated.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Confidentiality and Privilege

Confidentiality refers to an ethical duty to keep  client identity and disclosures secret and a  legal duty to honor the fiduciary relationship  with the client.

It is primarily a moral obligation rooted in the  ethics code, the ethical principles, and the  virtues that the profession attempts to foster. 

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Chapter 5: Confidentiality

Confidentiality and Privilege

The legal term privileged communication refers  to the client’s right to prevent a court from  demanding that a mental health professional  reveal material disclosed in a confidential  professional relationship (Younggren & Harris,  2008) as part of evidence in a legal  proceeding. 

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Confidentiality and Privilege

Confidentiality deals with the prevention of  voluntary disclosure of inappropriate material by  mental health professionals, the term privilege refers to the rules for preventing involuntary  disclosures requested by parties in a legal action  (Roback, Ochoa, Bloch, & Purdon, 1992). Privilege  belongs to the client, not the professional.

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Chapter 5: Confidentiality

Subpoenas and Court Orders

• Subpoena, a legal demand to appear in court to  give testimony. 

• Subpoena duces tecum, a command to appear in  court and bring along specific documents. 

• A court order , a demand to provide either  documents or testimony, or both. In contrast to a  subpoena, a court order is issued by a judge who  has evaluated the legal merits of the demand and  has ruled that it is properly executed and  consistent with current law. 

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

In states where privileged communication statutes  have been passed, counselors, social workers,  and psychologists may not disclose material even if subpoenaed by an attorney unless they have  client authorization to release that information. 

APA has published Strategies for Private Practitioners Coping with Subpoenas or Compelled Testimony for Client Records or Test Data (APA, 2006). 

©2016. Cengage Learning. All rights  reserved.

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Chapter 5: Confidentiality

9 Limits of Confidentiality

1. Client requests to release information to a third  party – most common when clients ask for  insurance reimbursement for services

2. Court Orders for confidential information – most  famous court case:  Jaffee v. Redmond, U.S.  Supreme Court,  1996 extended privilege to  Federal Courts for psychotherapists but with  exceptions

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Limits of Confidentiality

3. Litigation against mental health professionals  by clients releases the professional from  confidentiality regarding the matter brought  to court.

4. Litigation in which the client voluntarily  discloses mental health treatment as part of  the case also limits confidentiality.

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Chapter 5: Confidentiality

Limitations of Confidentiality

5. Mandated reporting required by Federal and  state statues 

• Child abuse and neglect

• Elder abuse and neglect (in most jurisdictions)

• Vulnerable adult abuse and neglect (in most  jurisdictions)

• Therapist sexual misconduct in a few states ©2016. Cengage Learning. All rights 

reserved.

Chapter 5: Confidentiality

Limitations of Confidentiality

6. Clients dangerous to others: In many states  (but not all) mental health professionals have  a duty to protect or warn a third party at risk  of serious harm from a client. Laws vary  greatly so knowledge of statutes and case law  in each jurisdiction is crucial.

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Chapter 5: Confidentiality

Limitations of Confidentiality

7. In some jurisdictions if a client is planning a  future crime a mental health professional may be  required to respond to police questioning about a  client.

8. When clients with HIV spectrum disorders  maliciously intend to infect others, that may be a  limit.  Otherwise, disclosure of client HIV status  by mental health professionals is probably not  allowed in most jurisdictions.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Limitations of Confidentiality

9.  When clients with terminal illnesses are  seriously considering hastening their death,  confidentiality may be limited by law and is  limited when the person is simultaneously  diagnosable with a mental illness or has  cognitive impairments.

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Chapter 5: Confidentiality

Confidentiality with Children and Adolescents

Codes offer general guidance but few specifics, so  professionals must also rely on fundamental  principles and virtues and legal requirements.

Unless otherwise specified by law, minors have no  rights to secrets from parents/guardians, but  some laws have given minors this right.

Whether minors can be granted any confidentiality  in therapy also depends on their age and  maturity level.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality Confidentiality with Children and Adolescents

• Fundudis (2003) identifies four factors to  determine a minor’s competence: 1. Chronological age (including developmental history 

and maturational progress)

2. Cognitive level (including language, memory,  reasoning ability and logic)

3. Emotional maturity (including temperament, stability  of mood, attachment, educational adjustment, and  attitudinal style)

4. Socio‐cultural factors such as family values and  religious beliefs

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Chapter 5: Confidentiality

Confidentiality with Children and Adolescents

Laws typically specify 4 exceptions to parents’  rights to consent to minors’ care

1. Mature minor

2. Emancipated minor

3. Emergency treatment

4. Court orders

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Confidentiality with Children and Adolescents

Specific state and federal statutes allow for  minors to consent to treatment in many cases  for:

• Short term psychological care

• Some types of medical care, especially  reproductive health care

• Substance abuse evaluation and treatment ©2016. Cengage Learning. All rights 

reserved.

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Chapter 5: Confidentiality

Confidentiality with Children and Adolescents

Important, regardless of law, to attempt to  involve parents in care as they have  responsibility for minors.  At the same time,  the best interest of the minor takes priority  over parental involvement.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Group and Family Counseling

Responsibility is to encourage members to keep  disclosures confidential, to discuss limits with  them at the initiation of treatment, and to  monitor members’ compliance.

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Chapter 5: Confidentiality

Confidentiality and Diverse Populations

Cultural norms regarding individual rights to  privacy from loved ones vary significantly and  professionals need to be sensitive to cultural  issues when discussing confidentiality with  clients.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Confidentiality and Managed Care

Most clients are in managed care plans so to obtain  payment for services requires disclosure of  confidential information re diagnosis and  treatment and preauthorization of services.  Insurers may also reserve the right to audit  records. 

Clients must be informed of these disclosures and  alternative forms of payment available.

©2016. Cengage Learning. All rights  reserved.

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Chapter 5: Confidentiality

Technology and Client Records

When keeping records on a computer, tablet, or other  mobile devices they must be kept secure during both  storage and transmittal to another professional or third  party payor. Theft or damage to mobile devices is  common and back up for these records should also be  a routine practice.

The responsibility lies with the professional to ensure that  faxes, text messages, data stored on tablets, laptops,  home computers, and other media are kept secure and  not put at risk of hackers or of theft.

©2016. Cengage Learning. All rights  reserved.

Chapter 5: Confidentiality

Technology and Online Client Contact

Ethical issues: Highlighted in ACA Code Section  A. 12

Promising but innovative form of service

Client rights and privacy must be protected and  clients must be informed of the limits of  technology, confidentiality and issues related  to informed consent

©2016. Cengage Learning. All rights  reserved.

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Chapter 5: Confidentiality

Threats of Suicide‐Homicide

A rare but possible event especially when there  is a history of domestic violence, when an  older adult caregiver is depressed. Workplace  violence happens also but it is the least  common type.

Clients at risk tend to look depressed and not  have a history of violence or acting out.

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Rationale for its importance: 

Clients have no other way to gain information  about the service.

Consent expresses respect for client and can  facilitate client engagement in the process.

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Chapter 6

Informed Consent Affirming the Client’s Freedom of Choice

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Components of Informed Consent

1. Disclosure of relevant information the client  needs to make a reasoned decision about  whether to participate.

2. Free consent which means that the decision  to engage in an activity is made without  coercion or undue pressure.

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Chapter 6: Informed Consent

History of Informed Consent as a legal duty

First major case: Schloendorff v. Society of New York  Hospital ruled that “every human being of adult years  and sound mind has a right to determine what shall be  done with his own body “(p. 93). 

Second case: Canterbury v. Spence (1972, p. 783)  concluded that, “The duty to disclose is more than a  call to speak merely on the patient’s request, or merely  to answer the patient’s questions; it is the duty to  volunteer, if necessary, information a patient needs for  an intelligent decision.” 

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Truman v. Thomas (1980) initiated the duty  regarding informed refusal of care

Natanson v. Kline (1960) clarified that disclosure  should include the nature of the illness, the  treatment(s) available, their risks and the  probability of their success, and alternatives to  treatment and their risks

Osheroff v. Chestnut Lodge (1990) required  disclosure of alternatives to proposed treatment

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Chapter 6: Informed Consent

Underlying Ethical Principles

• Respect for autonomy and the client’s right to self  determination

• Nonmaleficence so that clients know risks • Justice so that clients (or their adult guardians) are 

treated as equals

Nagy (2000) recommends that clinicians “consider telling  [clients] what you would want a good friend to know …  if he or she were consulting a psychologist for the first  time” (p. 89). 

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Codes of Ethics on Informed Consent

Codes of Ethics have codified the requirement of  truly informed consent in language that clients  can understand and with some direct  discussion of services by the professional – not all of consent can be delegated to  subordinates.

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Chapter 6: Informed Consent

In addition scholars also recommend disclosure of:

• Logistics of counseling/psychotherapy • Discussion of release of information to third party  payors

• Indirect effects of therapy • Alternatives to therapy • Risks and uncertainties of innovative forms of  care

• Options for filing grievances

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Explicit consent for recording of sessions is  required by codes.

All standards for informed consent apply to all  media in which counseling is conducted – phone, electronic, as well as face to face.

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Chapter 6: Informed Consent

HIPAA Requirements

This federal law covers any professional who  uses any type of electronic communication in  relation to their work.

Gives clients control of who has access to their  private health information.

Includes both civil and criminal penalties for  violation.

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

HIPAA’s Notice of Privacy Practices document   allows for transmission of information to obtain  payment from third parties, to provide treatment,  and to keep the ordinary operations of the  practice, agency, or institution proceeding in an  orderly fashion.  HIPAA requires all community‐ based mental health professionals to have clients  read and sign the Notice of Privacy Practices so  that clients understand what information will be  released without explicit consent. 

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Chapter 6: Informed Consent

Approaches to Informed Consent

Codes require BOTH written and oral review of  consent issues.

Verbal discussion allows personalization of consent  and avoids some of the bureaucracy.

Written documents give clients a chance to review  consent components whenever they wish.

Important that documents be at a reading level  clients can understand.

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Formats for consent documents:

• Client information brochure • Frequently asked questions list • Declaration of client rights • Counseling/psychotherapy contract • Consent to treatment form • Web based materials, videos, etc.

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Chapter 6: Informed Consent

Consent is a process, not an event, an activity  for client benefit, not therapist protection, or  a formality.  Counselors must keep this frame  of reference in order to conduct consent  responsibly.

Counselors must adapt process to crisis  situations, must take into account social and  cultural variables.

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

When serving adults not competent to consent  (either temporarily or permanently)  professionals must obtain substitute consent  from a guardian or have legal authority to  treat without consent.

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Chapter 6: Informed Consent

Consent with Minors

In most situations a parent or guardian must  consent.  However, client assent to services is  also essential for treatment to be effective.

In some states teens as young as 12 are allowed  by law to consent for short term services and  parents need not be informed.

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Court Mandated Counseling

Typically consent involves 3 conditions: 1. Voluntariness: Free consent

2. Capacity: Fundamental ability to understand

3. Comprehension: Ability to comprehend the language  in which consent is discussed

In mandated counseling voluntariness comes into  question.

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Chapter 6: Informed Consent

Court Mandated Counseling

The task is to weigh the deficiency in consent against the  possible good that counseling might do for a particular  person. 

In essence, one engages in a kind of risk–benefit analysis,  asking oneself, Would service without free consent be  likely to do harm? Would the failure to provide  treatment, even under these compromised  circumstances, be likely to cause more harm than  providing it? Do I have the skills, compassion, and  attitude to help the client overcome the distrust  inherent in mandated services? 

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Informed Consent to Assessment

All the legal duties and responsibilities for  consent to therapy apply to testing and other  assessment tools.

©2016. Cengage Learning. All rights  reserved.

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Chapter 6: Informed Consent

Research Findings

Clients who have experienced a responsible informed consent  process view self‐disclosure more positively and have more  optimistic expectations for counseling outcome (Goodyear,  Coleman, & Brunson, 1986). 

Also, evidence suggests that adult clients view therapists who  carefully develop informed consent as more trustworthy  and expert than those who do not (Sullivan, Martin, &  Handelsman, 1993). 

Similarly, parents of children appreciate informed consent  information (Jensen, McNamara, & Gustafson, 1991) and  expect that mental health professionals will provide that  information to them. 

©2016. Cengage Learning. All rights  reserved.

Chapter 6: Informed Consent

Compliance with ethical standards and licensing  board rules for consent is inconsistent in both  face to face and electronic services.  

Claiborn et al. (1994) found that only 6% of the  clients surveyed indicated that their therapists  had given them information on the limits of  confidentiality. 

Especially problematic is waiting to disclose what  cannot be held as confidential after the client  reveals such information.

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Chapter 6: Informed Consent

Informed consent and social networking

Is it ethical for therapists to view clients’  Facebook pages without their consent?  

Most scholars suggest that it is not consistent  with standards or with ethical principles,  unless there is a compelling risk of harm.

©2016. Cengage Learning. All rights  reserved.

Chapter 7

Sexualized Relationships with Clients,  Students, Supervisees, and Research Participants: Violations of Power and Trust

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

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Chapter 7: Sexual Misconduct

A Universal Prohibition

All health care professions explicitly and  categorically state that sexual contact with  current clients is unethical.

All licensing boards have the same standards.

Some states have criminalized sexual contact  with clients.

©2016. Cengage Learning. All rights  reserved.

Chapter 7: Sexual Misconduct

Still, the behavior continues at a slightly lower rate  than previously, but has not been eliminated.

Why? • Intimacy of the counseling interaction • Mental health or character flaws in the  professional

• Client misunderstanding of the nature of the  therapeutic relationship that sets the stage for  exploitation by someone they regard as an expert  helper whom they need

©2016. Cengage Learning. All rights  reserved.

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Chapter 7: Sexual Misconduct

History of the problem

For decades client claims of sexual exploitation  were viewed as fantasies of mentally ill  women, but that changed with of Roy v.  Hartogs (1975).  Currently, such allegations  are taken very seriously. False claims happen,  but are rare.

©2016. Cengage Learning. All rights  reserved.

Chapter 7: Sexual Misconduct

When counselors make sexual overtures clients  typically feel trapped, too dependent on the  therapist to refuse.  

Sometimes, they confuse the therapist’s kind  empathic approach for interest in a personal  relationship. 

At other times they have a history of exploitation by  those claiming to help, so they mistakenly think  this is the price they must pay for help.

©2016. Cengage Learning. All rights  reserved.

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Chapter 7: Sexual Misconduct 

• Damage from sexual misconduct is extensive. Pope and  Vasquez (2010) list 10 categories of distress:

1. Ambivalence 2. Guilt  3. A sense of emptiness and isolation 4. Sexual confusion  5. Impaired ability to trust 6. Confused roles and boundaries, 7. Emotional liability 8. Suppressed rage 9. Increased suicidal risk 10. Cognitive dysfunction

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Chapter 7: Sexual Misconduct 

Effects on the Professional and the Profession

Professionals often lose licenses, pay high  malpractice claims, receive public as well as  professional censure, and experience loss of their  profession. Sometimes criminal charges ensue.

Since sexual exploitation is not the only ethical  problem, they face other ethics charges.

The reputation of the profession is also damaged by  such behavior.

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Chapter 7: Sexual Misconduct 

Research on the Scope of the Problem

No age limit to client abuse exists either for clients or  therapists

Male therapists and female clients are most commonly  involved

No other demographic or professional competency  correlate exists

More common in supervisory and teaching relationships  than in therapy relationships but up to 5% of  professional relationships may be involved sometimes

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Chapter 7: Sexual Misconduct 

Sexual Contact with Former Clients

Usually unethical or in violation of regulations,  but is allowed under rare circumstances, after  5 years (for counselors) and 2 years for  psychologists. Consultation with peers is  crucial even when the time constraints have  been reached.

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Chapter 7: Sexual Misconduct 

Sexual Contact in Online, Educational, Consultation,  and Employment Settings

The ACA and APA standards extend the prohibition  of sexual intimacies with current clients to people  in other kinds of professional relationships  including students, supervisees and indicate that  exploitation of anyone over whom the  professional has authority is prohibited.

©2016. Cengage Learning. All rights  reserved.

Chapter 7: Sexual Misconduct 

Sexual Attraction vs. Sexual Misconduct

Most therapists sometimes feel attraction – a  normal human response.  Feeling attraction is  not unethical, but acting on it is.

Most scholars also agree that disclosing  attraction to clients is irresponsible.

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Chapter 7: Sexual Misconduct 

The Place of Nonerotic Touch

The question of when a hug or a touch on the  shoulder is ethical in the absence of any sexual  intent depends on several variables: • Theoretical orientation of the therapist • Client culture and religious identification • Client history and diagnosis • Client transference and attraction to therapist  or  therapist attraction to client

©2016. Cengage Learning. All rights  reserved.

Chapter 7: Sexual Misconduct 

Providing Subsequent Therapy for Clients  Victimized by other Therapists

Important  to believe the client, not minimize  the seriousness, explain client rights to file a  complaint, assist with the complaint process  as needed, keep client disclosures confidential  unless a mandated reporting law exists (rare  event).

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Chapter 8

Nonsexual Multiple Relationships  and Boundary Issues Risking Objectivity and Client Welfare

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

CHAPTER 8: BOUNDARY ISSUES

Counselors usually maintain clear boundaries  around a professional relationship to maintain  objectivity and avoid exploitation. Boundaries  around non sexual contacts need not always  be rigid and extending them can sometimes  be therapeutically beneficial.

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CHAPTER 8: BOUNDARY ISSUES

Definition of Terms

• Multiple relationship or boundary extension: A  connection with a client beyond the professional  relationship, e.g., buying groceries at a market where a  client works. Formerly called dual relationships.

• Boundary crossing: an acceptable additional client  contact.

• Boundary violation or boundary break: an unethical  additional client contact, e.g., hiring a client as a office  manager.

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CHAPTER 8: BOUNDARY ISSUES

Types of Multiple Relationships

Circumstantial:  e.g., Buying gasoline at a service  station and seeing a client doing the same

Concurrent: Providing therapy to a neighbor 

Consecutive: Providing services either before or  after another connection with a client, e.g.,  treating someone with whom the therapist  had served on the PTA board

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CHAPTER 8: BOUNDARY ISSUES

Scholars and ethics standards disagree on what  constitutes an ethical or unethical boundary  crossing

Some worry about a slippery slope to  exploitation

Others argue that crossings can confuse clients

Others argue that they compromise objectivity  in ways therapists do not always realize

©2016. Cengage Learning. All rights  reserved.

CHAPTER 8: BOUNDARY ISSUES

Kitchener refers to the question of ethics of  boundaries as an issue of social roles. The  greater the divergence between roles, the  greater is the risk of an unsatisfactory  therapeutic outcome. 

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CHAPTER 8: BOUNDARY ISSUES

Culture and boundaries

Client cultural background influences decision  making. Not all groups appreciate or accept  the fine distinctions Westerners make  between professional and personal  relationships.

©2016. Cengage Learning. All rights  reserved.

CHAPTER 8: BOUNDARY ISSUES

Benefit vs. Risk

ACA emphasizes potential benefit as a major  consideration in evaluating ethics. 

APA emphasizes objectivity and avoidance of the  risk of exploitation in their codes. 

Neither code provides a blueprint for practice, so  the burden of assessing the ethics of any given  prospective multiple relationship falls largely on  the individual practitioner.

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CHAPTER 8: BOUNDARY ISSUES

Sonne (1994) advises professionals to take a  risk‐preventive stance neither code provides a  blueprint for practice, so the burden of  assessing the ethics of any given prospective  multiple relationship falls largely on the  individual practitioner.

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CHAPTER 8: BOUNDARY ISSUES

Application to other professional relationships

Not limited to counseling/therapy relationships

Apply also the supervisory, employment, and  teaching relationships

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CHAPTER 8: BOUNDARY ISSUES

Underlying Dynamics

1. Fiduciary relationship between professional and  client. This means that the professional’s primary  obligation is to promote the client’s well‐being. 

2. Duty to abstinence from gratifying self interest

3. Duty to neutrality to enhance client autonomy  and independence

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CHAPTER 8: BOUNDARY ISSUES

Additional dynamics

Client emotional involvement with the therapist.  The therapist becomes an important person in  the life of the client, at least during their  professional contact. When a professional has  another role in a client’s life, trust may be  endangered, the rules for interaction may be  obscured, and expectations may diverge.

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CHAPTER 8: BOUNDARY ISSUES

Additional dynamics

Multiple roles may make the client unsure about  when therapy begins and ends and what kinds of  conversation are appropriate in which setting. 

The third dynamic, the power differential between  professional and client, may make clients  acquiesce to the therapist’s wishes or suggestions  even when doing so is at odds with their own  desires. 

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CHAPTER 8: BOUNDARY ISSUES

Final dynamic

The confidentiality of services may be  endangered by accidental disclosures by the  therapists in the other contact.

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CHAPTER 8: BOUNDARY ISSUES

Questions to consider in decision making about  boundary crossings:

1. How divergent are the 2 counselor roles?

2. Is promoting the client’s welfare the exclusive  motivation of the professional?

3. Does the sociocultural context of the client  make the boundary crossing more important  to therapeutic process?

©2016. Cengage Learning. All rights  reserved.

CHAPTER 8: BOUNDARY ISSUES

Questions to consider in decision making about  boundary crossings:

4. Can the professional attain the same degree of  objectivity and competent practice as is achieved  in other professional relationships?

5. Is misuse of the professional’s power a plausible  occurrence?

6. Is the professional reasonably certain that the  crossing will not negatively affect the client’s  emotional involvement or capacity to achieve the  therapeutic goal?

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CHAPTER 8: BOUNDARY ISSUES

Questions to consider in decision making about  boundary crossings:

7. Is the multiple relationship truly unavoidable?

8. Has an informed consent procedure been  undertaken so that the client understands the  its risks and the necessary arrangements?

9. Have both parties evaluated the changes that  may result in their other relationships because  of the professional contact?

©2016. Cengage Learning. All rights  reserved.

CHAPTER 8: BOUNDARY ISSUES

Questions to consider in decision making about  boundary crossings:

10. If the decision were presented to the  practitioner’s colleagues (using the clear‐ light‐of‐day standard), is it likely that they  would support the decision?

11. Is the professional willing to document the  nonprofessional contact in case notes?

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CHAPTER 8: BOUNDARY ISSUES

Questions to consider in decision making about  boundary crossings:

12. Have provisions been made for consultation  and/or supervision  to monitor risks

13. Have the client and professional developed  an alternative plan 

14. Is the professional committed to diligently  following up

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CHAPTER 8: BOUNDARY ISSUES

Practitioner views

Because of the changes in standards regarding  boundaries and the role of individual  judgment professionals have not generally  agreed on what is ethical and unethical and  have not always followed professional  standards.

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CHAPTER 8: BOUNDARY ISSUES

Gifts in Therapy

What is a professional’s responsibility when a  client offers a gift?

Codes do not prohibit gifts; ethics of accepting  depends on the circumstances under which it  was offered.

©2016. Cengage Learning. All rights  reserved.

CHAPTER 8: BOUNDARY ISSUES

Gifts in Therapy

Professionals should take into account:

• Cultural factors

• Monetary value

• Nature and status of the professional relationship  – is this a token of gratitude at the end of service  or a recurring event during treatment

• Potential impact on future sessions ©2016. Cengage Learning. All rights 

reserved.

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CHAPTER 8: BOUNDARY ISSUES

Other considerations in accepting gifts

• It promotes rather than endangers the client’s  welfare

• It does not compromise the therapist’s objectivity  or capacity to provide competent service in the  future

• It is a token of appreciation consistent with the  client’s cultural norms and with a small monetary  value

• It is a rare event  ©2016. Cengage Learning. All rights 

reserved.

CHAPTER 8: BOUNDARY ISSUES

Boundary Considerations in Rural Settings and  Small and Shared Communities

Client access to alternative services is limited

Therapists are more likely to know potential  clients or their family members

Cultural norms in rural communities are more  accepting of multiple relationships and  circumstantial contacts are more frequent

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CHAPTER 8: BOUNDARY ISSUES

Recommendations for Small Community  Practitioners

• Careful informed consent and ongoing  monitoring of possible complications from a  boundary crossing

• Frequent consultation/supervision • Keeping client welfare as highest priority • Keeping limits to boundary crossings – rural  settings to not automatically justify them

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CHAPTER 8: BOUNDARY ISSUES

Bartering for services

A rare event, not prohibited by the code, but  one that should be used cautiously to avoid  client exploitation.

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Chapter 9

Interventions with Groups,  Couples, and Families Unique Ethical Responsibilities

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

Chapter 9: Group and Family Services

In addition to ethical responsibilities already  mentioned, multiple person therapies  involved unique responsibilities in regard to:

• Confidentiality

• Privilege

• Consent

• Competence

• Boundaries

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Chapter 9: Group and Family Services

Competence

Therapist power is increased in multiple person  settings – training and supervision to learn  group leadership skills is essential

Client vulnerability is greater, so screening of  clients before group is also essential

©2016. Cengage Learning. All rights  reserved.

Chapter 9: Group and Family Services

Confidentiality is limited because no legal  sanctions exist for group or family members  who violate it.  Encouraging member  commitment to confidentiality and monitoring  it throughout group/family is an ethical duty.

Privilege may also be limited for the professional  depending on state law.

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Chapter 9: Group and Family Services

Informed consent also involves:

• Disclosure of the limits of confidentiality and  privilege

• Discussion of the power of multiple person  therapies 

• Disclosure of the “ownership” of the records of  multiple person therapies

• Disclosure of policies regarding drop‐outs and/or  non‐participation of family members

©2016. Cengage Learning. All rights  reserved.

Chapter 9: Group and Family Services

Compliance with consent standards is uneven  and many therapists fail to discuss unique  limits of confidentiality in groups.  Such  omissions can have serious implications.

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Chapter 9: Group and Family Services

Groups with Minors and in the Schools

An effective and efficient mode of intervention,  but more attention to confidentiality issues is  needed because of the developmental levels  of participants

Parental consent is also needed in most cases

©2016. Cengage Learning. All rights  reserved.

Chapter 9: Group and Family Services

Boundary Issues

All the same duties apply in group and family

Concurrent Group/family and individual counseling  – not unethical but tricky and can cause problems  with group cohesion and confidentiality.  Material  disclosed in individual sessions cannot be  disclosed in group or family without explicit  permission.

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Chapter 9: Group and Family Services

Involuntary Group Participation

Those mandated to groups have the same rights  as those mandated to individual therapy.

Professionals have the same informed consent  responsibilities.

©2016. Cengage Learning. All rights  reserved.

Chapter 9: Group and Family Services

Multicultural Issues

Most groups are multicultural.  Professionals  leading groups need to be sensitive not only  to their own cultural awareness but also to  that of the group members.

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Chapter 9: Group and Family Services

Families and Couples

Therapist values play  a more central role in  family therapy – because families come in  many varieties, professionals need to be  aware of their own beliefs about the definition  of a healthy family and good parenting. 

Insensitivity to cultural differences serious  compromises quality and effectiveness.

©2016. Cengage Learning. All rights  reserved.

Chapter 10

The Ethics of Assessment Using Fair Procedures in Responsible Ways

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

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Chapter 10: The Ethics of Assessment

Clients seek the professional help of counselors  and therapists with two major goals in mind— (1) to find solutions to their problems and (2)  to gain a better understanding of themselves.

The procedures that professionals use to  achieve the first goal are collectively called  assessment.  The first step in helping is to  accurately diagnose the problems and  personal psychosocial resources of the client.

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Assessment is conducted as a collaborative  process between a professional and a client.

Competent assessments include judgments  about client prognosis, strengths, and social  supports along with determinations of the  scope and severity of problems.

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Chapter 10: The Ethics of Assessment

Two aspects of assessment are especially  vulnerable to abuse— (1) the use of diagnostic  categories to describe client problems and (2)  the use of psychological and educational tests. 

To diagnose means to define in professional  terms the nature, limits, and intensity of a  problem a client brings to counseling (Welfel  & Patterson, 2004). 

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Because of its association with naming and  specifying problems, diagnosis has been  pejoratively called “labeling” by some  professionals.

Reliance on the DSM with its overlapping  categories and issues with reliability in some  diagnoses adds to the distrust of a medical  approach to diagnosis.

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Chapter 10: The Ethics of Assessment

The limits of the DSM do not mean that  diagnosis is inherently unethical or  problematic if:

Professionals use this or any other system  diligently and with training. Accurate diagnosis  of a problem leads to more effective  treatment and more hope for clients.

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Power of Diagnosis

Diagnosis with a mental illness can limit some  job options, life insurance options, and new  self‐definitions, even if accurate, but it is  necessary to be helpful ultimately.

Inaccurate diagnosis leads to improper  treatment, client distress, and other problems.

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Chapter 10: The Ethics of Assessment

Problematic influences on diagnosis

• Method of payment – when insurance covers  only certain diagnoses practitioners are more  likely to use them even when not fully accurate

• Pressure to diagnose quickly • Confirmation biases and other heuristics misused  by professionals

• Client reluctance to fully disclose symptoms in a  new therapeutic relationship

• Stereotyping and insensitivity to diversity issues ©2016. Cengage Learning. All rights 

reserved.

Chapter 10: The Ethics of Assessment

Ethics of Testing

Two groups with ethical duties: 

• Test developers and marketers

• Test users who have responsibilities to  developers and test‐takers

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Chapter 10: The Ethics of Assessment

Ethics for Test Developers

The fundamental ethical directives for test  developers are (a) to prepare instruments  with substantial evidence to support their  validity and reliability, with appropriate test  norms, and with a comprehensive (and up‐do‐ date) test manual; and (b) to keep the welfare  of the consumer as a higher priority than  profit. 

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Ethics for Test Developers

Developers must truthfully represent the test  and restrict sales to professionals who can  show they are qualified users. Most test  developers require that users disclose their  degrees, licenses, graduate courses, and  training in psychological testing.

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Chapter 10: The Ethics of Assessment

Ethics for Test Users

1. To maintain test security to protect the rights  of test publishers and the future usefulness  of the measure 

2. To use only tests for which they have been  trained and deemed competent to  administer independently and use them with  sensitivity to sociocultural factors

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Ethics for Test Users

3. To protect the rights of test takers, using only  measures with appropriate psychometric  properties in controlled conditions 

4. To select and interpret results accurately and  in context

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Chapter 10: The Ethics of Assessment

Legal obligations of test users

Test Takers have rights to see their results, to  have their results explained, and usually to  have copies of test reports under HIPAA.  

Test takers may have access to test data but not  to the test materials, those materials that are  copyrighted by the publisher.

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Definition of Qualified Test User

Differs from state to state, but is fundamentally  governed by competence to understand when to  use a test and how to interpret it accurately.

Tests should be relevant to the client, should be  used as part of multiple criteria for decision  making about diagnosis and treatment , and the  inferences derived should be limited. 

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Chapter 10: The Ethics of Assessment

Client rights in testing

• Understandable explanation of the reasons for  testing 

• Feedback about results in understandable  language

• Confidentiality of results • Clear and comprehensive informed consent  prior to testing

©2016. Cengage Learning. All rights  reserved.

Chapter 10: The Ethics of Assessment

Characteristics of sufficient feedback

• The client’s satisfaction that he or she  understands the meaning and implications of the  test results

• The professional’s assessment that the feedback  has clarified any confusion in the test findings

• Their agreement about the ways in which test  results should influence treatment planning

• The implications of the release of these findings  to others if the client agreed to the release prior  to the testing

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Chapter 10: The Ethics of Assessment

Other ethical duties

Test data becomes obsolete – it is the duty of the  professional not to use obsolete data

Test interpretation services should be used as a  second opinion, not a substitute for competence

Be alert to the ways in which gender, age, race,  ethnicity, national origin, religion, sexual  orientation, disability, language, or  socioeconomic status may affect the appropriate  administration or interpretation of assessment  tools.

©2016. Cengage Learning. All rights  reserved.

Chapter 11

Maximizing the Opportunity to  Prevent Misconduct and Minimizing  the Damage when Prevention Fails

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

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Chapter 11: When Prevention Fails

Clients frequently tell their counselors and  therapists about unethical behaviors by other  mental health professionals. 

According to Pope (1994), approximately half of  all American mental health professionals have  had at least one client who revealed sexual  involvement with a prior therapist.

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

Information about ethics violations also may  come from co‐workers and from one’s own  observations of others’ behavior in the  workplace. 

Reports from practicing professionals show that  between 15 and 28% of practicing  psychologists had personal knowledge of an  incompetent or unethical colleague (Floyd,  Myszka, & Orr, 1999).

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Chapter 11: When Prevention Fails

When professionals act unethically, they may be  disciplined by employers, the state or provincial  licensing boards, and all national and state  professional associations to which they belong.  Interstate communication among licensing  boards also occurs through the National  Practitioner Data Bank. 

Counselors and therapists who violate standards  are also accountable to the courts in civil lawsuits  for negligence, malpractice, or breach of contract,  or in criminal court.

©2016. Cengage Learning. All rights  reserved.

Counselors can utilize a model like Crowley and  Gottlieb’s (2012) primary risk‐management  model for more resources and for higher  probability of responsible action.

The fundamental value of a model for primary  prevention of ethical misconduct is that it  attends to the practitioner and focuses on  ways in which the “non‐rational” factors can  affect ethical decision making.

Chapter 11: When Prevention Fails

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Crowley and Gottlieb’s (2012) model contains  five stages:

1. Resource accumulation

2. Attention and detection of risk

3. Initial appraisal of potential risk

4. Preliminary risk management efforts

5. Elicitation and use of feedback

Chapter 11: When Prevention Fails

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

Procedures for dealing with unethical behavior  by professionals

• Informal remedies  recommended between  colleagues for minor violations as a first step  in most jurisdictions and in the ethics code.   Some jurisdictions for some professions  mandate reporting all violations to a licensing  board.

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Chapter 11: When Prevention Fails

Formal Remedies

• Employer Complaint • Licensing Board Complaint • Professional Ethics Committee Complaint • Negligence/Malpractice Claim

All REQUIRE client agreement to release  information related to any client interaction.  Without client release, the suspected violation  must be kept confidential.

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

If a complaint is received with proper releases,  Boards and Ethics Committees first determine  whether they have jurisdiction, then begin an  investigation.  Due process rights of the  professional and the person filing the  complaint are protected in the process.

If found guilty, professionals are sanctioned at  different levels depending on the seriousness  of the violation.

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Chapter 11: When Prevention Fails

Supporting the client through the complaint  process

Professionals need to: • Avoid minimizing the suspected violation a client  reports

• Explain complaint procedures and lengthiness of  the process and give client full autonomy

• Explore client’s emotional reaction to filing a  complaint and dealing with the process

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

Responding to an ethics complaint if filed  against you

The risk of an ethics complaint happening to an  individual counselor or therapist is extremely  low (Van Horne, 2004). In 2009 complaints  were received by APA for only .07% of the  membership (APA, 2010). 

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Chapter 11: When Prevention Fails

Responding to an ethics complaint if filed against  you

Professionals need to: • Cooperate with formal requests • Get legal and emotional support • Avoid personal contact with the person filing the  complaint

• Admit wrongdoing if it occurred, show the  context, and demonstrate remorse and a plan for  change

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

Self‐Monitoring: Taking responsibility for ethical  missteps in the absence of any outside complaint

The typical mental health professional spends 30 to  40 years in practice. In that span of time ethical  mistakes of varying seriousness will almost  certainly occur. Many mental health practitioners  admit both intentional and unintentional  violations of ethical standards (Pope et al., 1987).   Most never get reported or identified by others.

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Chapter 11: When Prevention Fails

Professionals who fail to acknowledge their  vulnerability to misconduct are naive at best,  and frightening at worst. One of the truest  tests of a professional’s commitment to ethical  practice is the way that person reacts when he  or she deviates from ethical path and when  colleagues, clients or disciplinary bodies are  not likely to discover that deviation. 

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

A Three Step Model of Recovery

Step 1: Acknowledging the violation

• The first task in self‐monitoring is to fully  acknowledge the ethical lapse and understand its  nature and scope without catastrophizing about  it. This task requires careful reflection and  tolerance for the emotional discomfort  accompanying such reflection and is grounded in  ethical sensitivity.

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Chapter 11: When Prevention Fails

A Three Step Model of Recovery

Step 2: Addressing and Responding to the Damage • Assessing harm to the client is the top priority,  followed by damage to colleagues, others in the  community, and to the reputation of the  profession. Consulting with a trusted colleague  who is objective, knowledgeable, and able to  identify unconscious biases is often helpful. Then  the professional should develop a strategy that  will ameliorate that harm.

©2016. Cengage Learning. All rights  reserved.

Chapter 11: When Prevention Fails

A Three Step Model of Recovery

Step 3: Rehabilitating the Professional

• A professional who has erred begins the process  of recovery with an honest self‐evaluation that  unflinchingly recognizes the mistakes made and  seeks out the causes so that they will be less  likely to recur. The goal here is not to engender  guilt or shame, but rather to gather energy for  the process of change. 

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Chapter 11: When Prevention Fails

Compassion and Empathy

Personal accountability also involves  compassion. 

It reminds professionals that we are all  vulnerable to ethical missteps and deters us  from adopting an attitude of moral superiority  toward professionals who have been accused  of misconduct. 

©2016. Cengage Learning. All rights  reserved.

Chapter 12

Ethics in Community, College,  Addiction, and Forensic Settings Avoiding Conflicts of Interest

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐Based  Settings

Primary Ethical Issue: Conflict of Interest

Professionals must balance their own right to a fair  profit from their work against clients’ rights to  services and their roles as professional helpers. In  addition, outside parties, especially those who  provide payment for professional services, often  affect the relationship between counselor and  client. ©2016. Cengage Learning. All rights 

reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐ Based Settings

Responsibility 1:

• To set fair, clearly communicated fees sensitive  to the financial status of the client.  Professionals have a right to a fair income, but  they are not allowed to place their own  financial gain ahead of the welfare of clients.

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐Based  Settings

Responsibility 2:

• if service must be interrupted, mental health  professionals ought to have in place mechanisms  for alternate care so that clients’ therapeutic  progress will be minimally disrupted by the  interruption. If a referral is needed, specific and  multiple options must be provided to the client.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐Based  Settings

Responsibility 3: • Records of services must be up‐to‐date, accurate,  and confidential so that competent service can be  provided and privacy can be protected. Records  should be maintained for sufficient time for  follow‐up care to be provided, and disposed of in  ways that guarantee client privacy and follow the  law.

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐ Based Settings

Responsibility 4: 

• To recruit clients with fair, complete, and  honest descriptions of their capabilities and  credentials and to avoid direct solicitation of  potential clients.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐Based  Settings

Responsibility 5: 

• To interact ethically and responsibly with the  media or when asked to give public testimony  about matters before the legislature or to  comment about social problems. Conducted  ethically, such interactions educate the public and  bring credit to the profession.

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Counseling and Psychotherapy in Community‐ Based Settings

Responsibility 6:

• If clients need to be hospitalized against their  wishes, the procedures used should be  respectful to clients and minimally restrict  their freedom.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethical Relationships with Colleagues

Relationships with colleagues in the community are  built on respect, honesty, and fairness. Turf wars,  private judgments about competencies, and  disagreements among professional disciplines  ought not to be carried into the consulting room.

Financial arrangements between colleagues should  be open to client inspection and free from fee  splitting or other forms of kickbacks.

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Dealing with Outside Payors

Professionals must advocate for their clients for  needed services and for limited intrusion into  their clients’ privacy.  

They must assess appropriate diagnosis and  treatment separately from insurance and  financial considerations (i.e., avoid “upcoding”).

The frustrations with insurers that mental health  professionals commonly experience do not  excuse misrepresentations in diagnosis and  treatment to those payors.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics in College Counseling

Not just developmental issues:

In a 2013 survey of 97,000 college students, American  College Health Association found that 11% of students  reported a depressive disorder, 12.9% reported anxiety  problems, 1.8% identified a substance abuse problem,  and 6% listed experiences of panic attacks. Nearly one  third (31.3%) reported feeling so depressed it was  difficult to function at times, and 7.4% indicated that  they had seriously considered suicide in the last 12  months.

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics in College Counseling

College mental health professionals are also  affected by increasing concerns about liability for  student suicides and acts of violence.  

They are part of the threat assessment team and  have a role to play. However, they are still bound  by confidentiality standards and privilege laws  and are obliged to honor regulations governing  their duties with clients at risk for violence to  others in their jurisdictions.  

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics in College Counseling

College mental health professionals need to keep  abreast of laws in their state or province regarding  privilege and the duty to protect and to fully explain  the limits of confidentiality that apply to their clients. 

They also have a responsibility to collaborate with  college administrators to develop policies regarding  threat assessment that protect student privacy as  much as possible. 

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics in College Counseling

Finally, professionals need to familiarize  themselves with recent federal legislation,  including clarification of FERPA applications to  college students, the application of the  Americans with Disabilities Act, and the Clery Act.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Addiction Counseling

Addiction counseling requires professionals  who  are competent, who use power responsibly, and  who honor boundaries. 

Competence is crucial since abuse of substances is  one of the most common problems clients  experience and it occurs in conjunction with  other mental health, social, and employment  problems. 

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Chapter 12: Community, College,  Addiction, and Forensic

Ethics of Addiction Counseling

Training in substance abuse treatment is uneven  and general mental health training does not  necessarily imply competence with this  population. Ethical practice requires some  training and supervision do competently do  this work.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Addiction Counseling

Since substance abuse clients are typically reluctant  or mandated clients, one ethical issues in working  with these clients is the degree to which there is  some voluntary component to their presence in  treatment. 

Counselors have an ethical responsibility to use  their power wisely and not manipulate or coerce  clients, but to educate them about the  consequences of their substance use. 

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Addiction Counseling

The third major ethical issue relates to the  appropriate management of professional  boundaries since many of those who work with  substance abusing clients have a history of abuse  themselves. 

The final important ethical issue is the tendency for  clinicians’ to hold negative biases towards clients  with substance use problems.

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Coaching

Coaching as a practice activity for mental health  professionals emerged fairly recently, but it  has grown dramatically in this brief period.

According to Whybrow (2008) it is an activity in  which thousands of mental health  practitioners now engage. 

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Coaching

Definitions of what constitutes good training,  and competent practice are emerging and the  research base on effectiveness is limited.

The central ethical issues in coaching parallel in  many ways the ethical issues in counseling – confidentiality, consent, conflict of interest,  and boundaries (Brennan & Wildflower, 2010). 

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Coaching

In spite of these advances, it is important to note  that no state licenses individuals for the practice  of coaching or has requirements for such practice  in their jurisdictions. 

Consequently, if a person is offering services as a  personal coach without reference to his or her  credentials as a mental health professional, it is  unclear whether a client who feels the coach  acted negligently has any legal recourse. 

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Forensic Activities

The term “forensic mental health work” refers to  those professional activities of a psychologist,  counselor, or social worker that involve courts of  law. 

These include activities such as conducting child  custody evaluations, assessing a person’s  competence to stand trial or acting as an expert  witness in a legal case. 

©2016. Cengage Learning. All rights  reserved.

Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Forensic Activities

When conducted with allegiance to high ethical  standards, such activities can bring credit to the  profession and can improve the likelihood that  the court will make a fair and reasoned  evaluation of the questions before it.

Central ethical issues parallel other forms of  practice: competence, consent, confidentiality,  conflict of interest, boundaries, and power.

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Chapter 12: Community, College,  Addiction, and Forensic Settings

Ethics of Forensic Activities

Professionals engaged in child custody  evaluations or who are asked to give  testimony in such a proceeding should be sure  to respect the rights of both parents, be clear  about one’s role in the court, and limit  comments to direct experience.

©2016. Cengage Learning. All rights  reserved.

Chapter 13

The Professional School Counselor Applying Professional Standards to the Educational Culture

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

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Chapter 13: Ethics in School Counseling

Ethical Issues Unique to School Counseling

1. The conflict between the open communication norms  among educators and the confidentiality norm of the  counseling profession. • Response needed – education of other school personnel.

2. The obligation to assist students experiencing personal  and social difficulties and the potential for parents and  community standards to conflict with students’ needs. • Response: Sensitivity to community standards, parental 

contact and communication, and allegiance to student rights.  Huss, Bryant, and Mullet (2008) advise written policies on  confidentiality and written referral procedures which have  school board approval. 

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Ethical Issues Unique to School Counseling

3. The responsibility of the schools related to  cyberbullying and other harassing online behaviors.  Between 12 and 43% of middle and high school  students report that they have been victimized by  cyberbullying, typically via email, chat rooms, social  networking sites, and instant messaging (Dehue,  Bolman, & Vollink, 2008). • Response: School counselors can educate parents and 

children about the resources they have available to  respond and about the serious implications cyberbullying can have on those who perpetrate it. 

Chapter 13: Ethics in School Counseling

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Ethical Issues Unique to School Counseling

4. The confusing state and federal laws about parental  rights to educational information about their children. • Response:  Learn about applicable laws, especially FERPA  and share knowledge with colleagues, students, and  parents.

5. The obligations of school counselors with suicidal  students. • Response: Counselors must understand suicide risk 

assessment, must intervene when risk is high to get the  student help and must notify parents.

Chapter 13: Ethics in School Counseling

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Ethical Issues Unique to School Counseling

6. The complications of group counseling in  schools • Response: Educate participants to confidentiality and 

group process, inform parents about student  participation (usually), and monitor student  compliance.

7. The ethical challenges in post‐secondary planning • Response: Avoid practices that suggest compromises  in objectivity and protect student privacy.

Chapter 13: Ethics in School Counseling

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Ethical Issues Unique to School Counseling

8.  The ethics of peer counseling and peer  mediation with minors.

• Response: Limit peer assistance programs to  educational content, select, monitor and  supervise carefully.

Chapter 13: Ethics in School Counseling

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Chapter 14

The Ethics of Supervision and  Consultation Modeling Responsible Behavior

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

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Fundamental Ethical Issues in Supervision

Competence in supervision is distinct from  competence as a therapist. Education in  models of supervision and research findings  complimented by supervised experience in  supervision is essential.

Chapter 14: Supervision and Consultation

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Fundamental Ethical Issues in Supervision

Commitment to respect the rights of the supervisee:  (1) provide appropriate educational experiences  and informed consent to supervision, (2) give   feedback on supervisee work based on  observation or review of recordings of supervisee  activity, (3) provide remediation experiences as  needed, (4) keep supervision separate from  therapy, and (5) respect boundaries to avoid  misuse of supervisor power.

Chapter 14: Supervision and Consultation

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Fundamental Ethical Issues in Supervision

Commitment to respect the rights of the  supervisee:

Supervisors must keep written records of  supervision and of any evaluative feedback or  remediation plan.

Chapter 14: Supervision and Consultation

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Fundamental Ethical Issues in Supervision

Appreciation of the need to be sensitive to multicultural issues  in supervision.

Supervisors must reject the “myth of sameness” and  acknowledge the reality and contributions of cultural  diversity.

Supervisors must understand that their own views of the  world may not be shared by their supervisees and that this  difference does not represent a deficiency in anyone.

Supervisors are encouraged to devote the same energy to  appreciating cultural diversity in supervision as they may  use in understanding how cultural diversity affects therapy  relationships.

Chapter 14: Supervision and Consultation

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Fundamental Ethical Issues in Supervision

Appreciation of responsibility to clients served by the  supervisee.

Clients have a right to competent service even when  counseled by a trainee. 

Supervisors are responsible to monitor care, and  intervene if a client is receiving substandard service.

Clients also have a right to know they are being served by  a trainee and to consent to any supervision or  recording.

Chapter 14: Supervision and Consultation

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Legal Issues in Supervision

Direct Liability: Supervisors can be held liable to any  failure to carry out their duties

Vicarious Liability:  Supervisors can be held liable  for any negligence of their supervisees even if  carrying out their own responsibilities in  accordance with professional standards

These realities highlight the importance of  competent and diligent supervision.

Chapter 14: Supervision and Consultation

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Work Supervision 

Work supervisors are responsible to ensure that clients  receive competent care and employees are given  appropriate rights and responsibilities.  

One challenge is monitoring the work of those whom they  oversee when the needs of the organization exert pressure  to provide services. Another is managing boundaries  effectively since co‐workers can often become friends.  

The ethical duties of professionals in these positions parallel  those of training supervisors in many ways.  They must  ensure that clients receive competent care and employees  are given appropriate rights and responsibilities.  Ethics  standards apply here as well as in training supervision.

Chapter 14: Supervision and Consultation

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Mandated Supervision

Mandated supervision occurs when a licensing  board, employer, or ethics committee of a  professional association requires   professionals to have all or some portion of  their work supervised because of a violation.   Its goal is to ensure that the violation does not  recur and to rehabilitate the professional. 

Chapter 14: Supervision and Consultation

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Mandated Supervision

The supervisor not only has responsibilities to the clients  of the disciplined professionals and to the professional,  but also to the board or organization that arranged for  the supervision. 

It requires substantial skill as a supervisor in order to  establish a productive supervisory alliance with the  professional that also allows for communication with  third parties, set reasonable goals and methods of  evaluation of the professional’s work, and be  committed to the protection of clients. 

Chapter 14: Supervision and Consultation

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Consultation

Divided into clinical consultation with peers and  organizational consultation

Clinical consultation can be an ongoing process in  which the professionals meet regularly or it can  be a event that happens only when an urgent  client issue emerges

What distinguishes consultation from supervision is  the equality of the participants in the process.

Chapter 14: Supervision and Consultation

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Organizational consultation relationships are triadic  rather than dyadic (Brown, Pryzwansky, &  Schulte, 2011) and include the consultant, the  consultee, and the client. 

Newman (1993) cautions consultants to stay aware  of all three participant groups in consultation, to  be sensitive to the effects of their work on all  parties, and to avoid situations in which their  work may be used to the detriment of the client  system.

Chapter 14: Supervision and Consultation

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Chapter 14: Supervision and Consultation

Managing confidentiality, consent, conflict of  interest issues and boundaries is complicated  in organizational consulting and to some  extent in clinical consulting.

Consultants should have training in the mode of  service and comply with their responsibilities  to all parties involved.

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Chapter 15

Counselors and Therapists as  Teachers and Researchers Integrity, Science, and Care

Welfel, E. R. (2014). Ethics in counseling and psychotherapy: Standards,  research and emerging Issues (6th ed.).

©2016. Cengage Learning. All rights  reserved.

Central ethical issues embedded in activities of  teaching and science mirror those of direct  service:

• Competence

• Responsible use of power

• Promotion of welfare of those in care

Chapter 15: Teachers and Researchers

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Chapter 15: Teachers and Researchers

Ethics of Teaching

Competence to teach • Knowledgeable about subject matter, prepared for  work, and committed to facilitate student learning

Responsible use of power • Abuse of power can include sexual harassment or  exploitation, indiscriminant evaluation of student  performance, exploiting student labor for personal  gain, or neglecting responsibilities

©2016. Cengage Learning. All rights  reserved.

Chapter 15: Teachers and Researchers

Ethics of Teaching

Management of multiple, and sometimes conflicting, role obligations • Distinguish between mentoring and problematic dual relationships; 

pay attention to power imbalance inherent in teacher‐student  relationship

Duties to profession, students, and public • Educators have a duty to ensure students have emotional stability 

and temperament for the profession and that personal issues that  may impede their effectiveness are identified and resolved

• Counseling and psychology educators ought not to sacrifice  competent and caring teaching to attend to other responsibilities

• Need for professional relationships of trust and personal  responsibility for a psychologist’s actions

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Chapter 15: Teachers and Researchers

Ethics of Research

Responsibilities of researcher:

1. To develop scientifically acceptable research protocols  that are worth participants’ time and have reasonable  chance of yielding meaningful findings • Poorly designed and executed research is unethical even 

if participants are not at risk for harm or discomfort  (Rosenthal, 1994)

• Good science assumes sensitivity to issues of diversity  (Fisher & Vacanti‐Shova, 2012; Scott‐Jones, 2000)

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Chapter 15: Teachers and Researchers

Ethics of Research

Responsibilities of researcher: 2. Protect the rights and safety of research 

participants (both human and animal) • Institutional review boards (IRBs) approve and 

oversee conduct of any research that involves risk of  harming human subjects.

• Be aware of ethical guidelines for research with  animals, e.g., APA’s Guidelines for Ethical Conduct in  the Care and Use of Nonhuman Animals (2012).

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Chapter 15: Teachers and Researchers

Ethics of Research

Responsibilities of researcher:

3. To report results fairly and accurately

• Most basic obligation is not to misrepresent  results in any publication or communication of  them to participants or colleagues.

©2016. Cengage Learning. All rights  reserved.

Chapter 15: Teachers and Researchers

Ethics of Research

Responsibilities of researcher: 4. To cooperate with colleagues and share research 

data • Ultimate goal of clinical research is to add to  profession’s and public’s understanding of human  behavior.

• Research is cooperative endeavor in which findings  are shared with colleagues and peer criticism is  conducted in educative rather than punitive fashion.

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Chapter 15: Teachers and Researchers

Special Ethical Concerns for Counseling and  Therapy Researchers

1. Experimental design

2. Impact of treatments on participants

3. Accessibility of written information about  clients and need for client consent to such  activities

4. Provision of feedback

©2016. Cengage Learning. All rights  reserved.

Case Study #1

You are an intern at an outpatient center where juveniles have been mandated by court to receive your services, which include psycho-education on anger and stress management to clients from diverse backgrounds and socioeconomic status.

You have employed all of the strategies that you were taught in graduate school, researched the topics, and tried to consult with your supervisor regularly. However, your supervisor always tells you that you are doing fine and supervision is not needed because you are doing such a good job. Your supervisor does not even listen to you when you have questions and does not appear to be monitoring the client’s progress.

You are not licensed as a counselor, but want to be licensed in your state, so you need the appropriate forms signed by your supervisor, which indicate that you completed your hours and required supervision. You have questions about what you are doing, especially since your clients have world views different than yourself.

Case Study #2

Your adult client has been arrested on several occasions, which resulted in your client having a long criminal record, being on probation, and being incarcerated on a number of occasions. The client was arrested and convicted for selling controlled substances. You were asked to visit the client to complete a current mental status and provide recommendations to the court.

The client’s mental status exam did not yield any clinically significant issues. The client reported having positive thoughts about going home. The client has stated that they have learned a life lesson and will “never do anything against the law again.” The client denied having any distressing dreams, hallucinations, no manic or depressive episodes, and no problems with sleeping. The client reported no concerns about appetite and had no changes in the last few weeks. The client agreed that the medications were working well for diagnosed Bipolar I Disorder.

Upon questioning about the client’s children, the client said the children have visited about four times since this last incarceration, and the client was happy about those visits. During your evaluation, you notice that you have started to have romantic feelings toward the client because the client seems like a nice person.

You have decided that the client was in the wrong place at the wrong time and had to do what was needed to in order to survive. You have never felt this strongly about a client in the past.

Case Study #3

You are working with a client who is from a different religion than you and has strong beliefs about religion. You know very little about the religion or the religious practices so you have some reservations working with the client due to your lack of knowledge and how your lack of knowledge could negatively affect your therapeutic relationship.

The client does not always answer your questions, is somewhat evasive, and insists on taking breaks to pray or meditate during the evaluation process. You know you are not supposed to cause harm to clients but are feeling hesitant to continue the evaluation process due to your lack of knowledge and familiarity with the client’s diverse background. You also think that the client may not open up to you due to your differences.

You want to refer the client to someone else but are not sure if that is appropriate. You are receiving supervision in the process and your supervisor thinks that you are able to handle this case competently.

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