Term
| CLTS RIGHTS & CLR RESPONSIBILITIES: Introduction |
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Definition
- clrs right to put the clts' welfare first except when the benefit to others outweigh the benefit to a clt
- clrs have a fiduciary relationship with their clts-one of trust & confidence;
- clts believe clr will act in their best interests
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Term
| COUNSELOR RESPONSIBILITIES |
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Definition
- clrs responsibilities in safeguarding the clts welfare
- honoring diversity
- being aware of one's own needs & values
- avoiding clt dependency
- respecting the involuntary or mandated clits rights
- using appropriate clg techniques
- managing interruptions & termination of services
- avoiding abandonmt of clts
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Term
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Definition
- clrs has to know their needs system - what will prevent them from becoming effective clrs or by knowing will aid them in identifying potential areas of vulnerability
- if you recognize your potential problem areas, clr will be better able to keep the best interests of his clts foremost & less likely to intrude into his work with clts
- ACA code A.4.b clr know thyself & do not impose your values unto the clts.
- clr may influence the clg process & outcomes in many ways: desired goals, clt dx, which clt issues will become the focus in therapy, & theory utilized.
- if clts & clr values are incompatible, it may cause potential problems in clg relationship
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Term
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Definition
- clr has to clarify their own morality position & values regarding abortion prior to facing a clt with this issue
- clr must know state laws & ethical standards regarding abortion
- clr may be sued for negligence under tort law if they do not act with skill, withhold info, provide false info, fail to refer
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Definition
- ACA signed off on an americus brief giving clr support in RTD cases
- ACA Codes standard A9 support clrs dealing with these ethical dilemmas
- if clr is in conflict on the issue of RTD, he should refer the pt or keep the case
- be careful not to impose your own values on living/dying and/or religion/spirituality
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Term
| RESOLVING VALUE CONFLICTS |
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Definition
- some clr may disclose their values with inform consent or at times when their are conflicting values
- clr might share their belief system as a part of the learning experience
- clr must address their conflicting issues/values directly this may prove enriching to both clt & clr-broaching openly discussing the viewpts
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Term
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Definition
- value conflicts can be seen as differing worldviews
- a person's worldview is influenced by culture & is the source of his/her values, beliefs, assumptions
- worldviews affect how people think, make decisions, act, interpret events
- when clr & clt have differing worldviews, it can lead to misinterpretations, misunderstanding & early clg termination
- clr should develop cultural empathy in order to effectively counsel diverse clts. It is having empathy skills & skills to be able to decode cultural messages
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Term
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Definition
- express lack of knowledge.awareness of clt's cultural experience
- communicating an interest in learning more about the clt's culture
- convey a genuine appreciation for cultural differences
- acquiring knowledge about clt's culture hx & sociopolitical background
- being sensitive to oppression. marginalization, discrimination that clts may encounter daily
- clarifying language & other modes of communication
- incorporating culturally appropriate strategies, tx goals, interventions in clg process
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Term
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Definition
- clr must avoid fostering dependent clg relationships with clts - the goal is increase autonomy & independence
- in clg clt learn new skills for living including the ability to make decisions without the clr's aid.
- clr may have their reasons for fostering dependency as well as clts - needto nurture
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Term
| DIVERSITY CONSIDERATIONS on dependency |
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Definition
- encouraging autonomy is highly individualistic & may isolate many clients whose cultural context includes their family, group, community
- clr could also incorporate knowledge of family-oriented Asian culture by acknowledging & communicating cultural empathy toward the clt's family & by including family in tx.
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Term
| INVOLUNTARY OR MANDATED CLIENTS |
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Definition
- are given a choice of clg or other alternatives
- they have to sign a waiver of their privacy rights when begin clg relationship
- ACA code of ethics address this issue in standard C.6.b on reporting
- clr must info clt of his/her role, purpose, reporting, privacy waiver, role change in accordance with ACA code of ethics A.5.a
- clr has to engage the clt but if not working, clr must terminate clg
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Term
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Definition
- in promoting the clt's welfare, clrs are obligated to select the appropriate clg strategies or techniques that is empirically supported
- clr selection of techniques must be tailored to specific needs of the clt, based on theory & training, fit your clg style,
- do not use txs that are unproven- ACA codes C.6e - inform the clt should clr decide otherwise of potential risks & benefits & get inform consent
- clr should not use txs if research has proven them to be harmful to clts ex. conversion therapy
- ACA codes A.1.c clr to work jointly with clts
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Term
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Definition
- ACA codes A.11.c clr to conduct pretermination session with clts prior to terminating the clg relationship - this allows time to plan for clt's transition to functioning w/o the clr
- clr makes the decision to terminate or end clg
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Term
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Definition
- clrs must plan ahead in event of sudden emergencies, vacations, etc
- they should plan who will notify clts, who has access to clt records, how the transfer clts to another clr will be handled
- clr must give adequate notice & ensure clts know who to contact in event of emergencies
- ACA codes standard A.11.a - clr required to make appropriate arrangemts for cont'd tx during interruptions of services
- clrs who have at risk clts must be assigned to another professional who will accept responsibility for their care
- ensure that their clts will be able to tolerate the clr's absence for a time.
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Term
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Definition
- ACA codes A.11.c allows clrs to end clg abruptly or when needed: clt no longer need services, clr is at risk for harm, clt is not paying the fees, clt is not benefiting from clg, or clr is at risk for harm
- when deciding to terminate, clr must give adequate notice,
- allow clt to time to secure another provider;
- clr to suggest another referral, & assist with transition of clt & records
- if its about pymt, clr should refer to an affordable clr or free services or sliding scale fee provider;
- if clt refuse referral clr is not obligated to provide free services A.11.b
- clt refuse to continue, fail to show for appts, do not call-clr is ethically responsible to reach out to clt, communicate a willingness to continue clg or summarize & end tx or refer clt.
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Term
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Definition
- can be considered inappropriate termination & occur when clt's clg needs are not being addressed by the clr-when tx ends or during tx due to clr not being available
- ACA code A.11.a clr cannot end relationship if it will put the clt at risk
- if clr gave ample time & clt refuse referral-clr to document the notice given, any assistance to find a new clr, & time given to facilitate the process
- attorney advise not to terminate when clt is angry or in crisis-could lead to lawsuit
- if clt is at risk for self-harm or to others, clrs can refer to psychiatrist or healthcare facility who monitors suicide pts
- clr will work collaboratively with new clr & referred clt. when referral is made, clr should inform all parties whether its a transfer or referral
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Term
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Definition
- honestly discuss with clt intent to terminate & reasons for clr decision
- give clt opportunity to make changes & continue clg
- give written termination notice to clt
- offer clt 1-3 termination sessions
- give clt up to 3 good referrals
- give clt places to contact in event of emergencies
- document interaction & place summary in clt's record
- do not transfer w/o written/verbal permission from the clt
- give clt plenty of time to find another clr
- transfer records promptly to new clr
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Term
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Definition
- clr to communicate clt's role in making tx decisions;
- best practice - to obtain an inform consent from clts prior to beginning clg-ethical way to proceed
- some laws require licensed clrs provide written documents to prospective clts -these constitute inform consent that will enable clts to make wise choices
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Term
| Health Insurance Portability & Accountability Act HIPAA 2003 |
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Definition
- federal law requires all healthcare providers who transmit records electronically to comply with procedures to ensure consumer privacy.
- they should explain to their pts in detail the pts rights to privacy & records; also pts have to sign a document that they have been informed of their rights
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Term
| WRITTEN DISCLOSURE STATEMENTS |
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Definition
- written contracts for informed consent are disclosure statemts; they are signed by both parties
- ACA codes A.2.b specifies the essential elements need in inform consent:
- purposes, goals, techniques, procedures, limitations, potential risks, benefits of proposed clg services
- the clr's qualifications, degrees held, licenses, certifications, area of specialization, experience
- arrangemts for continued services, if clr dies, incapacitated
- dx implications, intended use of tests, assessmts, reports
- fees, billing info
- confidentiality & its limitations
- clts rights to obtain info about their records, to participate in ongoing clg plans
- clts rights to refuse any recommended services change, be advised of the consequences of refusal
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Term
| Additional "essential elements" for written disclosure statemts |
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Definition
- clr's theoretical orientation
- logistics -length, frequency of sessions,procedures for make/cancel appts, policies regarding phone contact, how to reach clr,or alternative service in an emergency
- insurance reimbursement
- info about alternatives to clg - other support services or self-help products
- statemt about sessions being videotaped or audiotaped
- clt's options if dissatisfied with the services-names, contact info for Supervisors, addresses, phone#s of licensing boards, & professional organizations
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Term
| Problematic Areas that may lead to Lawsuits 3 |
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Definition
- Guaranteed privacy with no exceptions- a new clt expresses concern to clr that others might find out what he tells the clr in sessions. To reduce the clt's anxiety, clr explains her ethical & legal responsibilities to protect his privacy. He believe the clr told him she would never in any circumstances reveal to anyone esle info given to her in clg. Clr reported to his wife about his suicidal ideas & that he should be evaluated to determine risk. Clt sued for breach of contract, malpractice, intentional infliction of emotional distress
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Term
| Problematic Areas that may lead to Lawsuits 4-5 |
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Definition
- Agreed to fee arrangemts different from what was intended - A clr begins a clg therapy charging clt $75/hr. After 3mths, he informs clt his fees will increase in 1mth to $90/hr. Clt objects saying its too high. Clr states he will not provide further clg unless clt agrees to pay new rate. Clt sues for breach of contract & abandonmt
- Touched without implied or actual permission- in group clts were blindfolded & asked to fall back into another members arms as a demonstration of trust. A female clt reluctantly participates, she leaves, visible shaken, & upset. She sued for breach of contract, breach of fiduciary duty, assault, battery, & sexual assault.
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Term
| Problematic Areas that may lead to Lawsuits 6 |
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Definition
- Misrepresented credentials - Clt began clg with a Master's level licensed clr. Clt told others he is seeing a psychologist for clg, he e notes the paymt made for psychological services. He address her as Dr and she made the correct. Clt asked you are a psychologist, aren't you? Clt sued for breach of contract, & fraudulent misrepresentation
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Term
| Problematic Areas that may lead to Lawsuits 7 |
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Definition
- Failed to communicate the nature of clg - clt has new job which has her speaking before groups. she sought out clg.Clr believes her anxiety is due to low-self-esteem & focus on positive reinforcements of clt's positive attributes. after 5 sessions, clt complained she still feels anxious. She felt the clr would have given her books to read, or told her how to give presentations w/o being anxious. Clt sued for breach of contract & malpractice
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Term
| Problematic Areas that may lead to Lawsuits 8 |
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Definition
- Neglect to warn clt about possible stigma - After 1st session, clr complete insurance form at clt's request. Clr indicated clt had a signle episode of depression & assigned DSM dx. Clr treated clt for 10 sessions & terminated when clt moves to a new city far away. 2yrs later the clt contacts clr & complains that he has been denied a security clearance for a job he has applied for b/c sh dx him without his knowledge or agreemt with a mental disorder. He sued clr for breach of contract, malpractice, & defamation.
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Term
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Definition
- disclosure statemts can be used to clarify any misunderstanding on clts' part before clg begins
- written disclosure statemts provide the detail info
- info should be communicated in a way that the clt will understand ACA codes A.2.c
- clr will obtain inform consent from legal guardians if clts are PWDs. clr will communicate & obtain assent from the clts & engage them in tx process-ACA code A.2.d
- clrs should provide not only a disclosure statemt but a written statemt of clts rights & responsibilities
- ACA code A.2.a states inform consent is an ongoing process
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