• clrs need to have extensive knowledge about the core areas of study. competence defined as knowledge, skills, diligence
• they must have skills in basic interviewing & interventions acquired thru internships, practicum, fieldwork, etc
• they must be diligent - having a consistent attentiveness to clt's needs means putting clt's welfare first A1a code ex. extra reading, research, training, consultation, f/u with clts to ensure effective services
• clrs must accept job positions they qualify for - ACA code C2c

• NBCC certify clrs who have distinguished themselves beyond the minimum in the field
• clrs can violate nonmaleficence- by causing harm to clts if they are incompetent-lack knowledge,skills
• ACA code C2a clrs should practice within their limits
• clts can sue for malpractice if clr incompetent

• clrs personal characteristics openness to new ideas, flexibility, cooperativeness, being open to feedback, awareness of 1's impact on others, ability to deal with conflict, to express feelings, to accept personal responsibility - to be effective clrs
• clrs credentialing is important-they must earn their degree from an accredited program CACREP OR CORE.code C4e
• much depend on clg students motivation, ability to learn, quality of instruction, faculty competencies, supervised experience rec'd

• method of identifying individuals by occupational group

Licensure

• govt regulation only those who are licensed may practice the clg profession in a state Amer Clg Assoc but practice og clg is not restricted to those who are licensed
• legislators agree to license a professional group only when it can be shown that the public do not have the ability to determine who is competent to practice a profession & could be harmed by incompetent practitioners
• when state legislators determine that the public best interests are best served by creating a license to practice-they pass statues or amendmts -they specify minimum standards for practicing profession
• US constitution requires that individuals who already are practicing clg in a state when a licensure statue is passed be automatically licensed-grandparenting

Certification

• competence thru certification -when a title is can be used only by those who are certified
• when clr has specialized in a particular field, they seek certification of NBCC.
• code C2b reinforces practicing with area of studies

• after graduation, clrs are responsible for monitoring their effectiveness code C2d

• C.2.f. Continuing Education

  Counselors recognize the need for continuing education to acquire and maintain a reasonable level of awareness of current scientific and professional information in their fields of activity. They take steps to maintain competence in the skills they use, are open to new procedures, and keep current with the diverse populations and specific populations with whom they work.

• upgrading skills, reading articles, etc, keeping up with new developmts in field

Peer review

• a system where clrs assess each other thru consultation, supervision
• this enhance self-awareness, deeper understanding, mutual support, objective feedback, info on therapeutic techniques, new research, referral services, aid in dealing with difficult cases review c2d code

Info technologies

• clrs can access libries of clt problems & clg techniques & collaborate/consult with clrs int'lly.new technologies  provide new opportunities. clrs can even clg on internet review code A12

Making referrals

• A.11.b. Inability to Assist Clients

  If counselors determine an inability to be of professional assistance to clients, they avoid entering or continuing counseling relationships. Counselors are knowledgeable about culturally and clinically appropriate referral resources and suggest these  alternatives. If clients decline the suggested referrals, counselors should discontinue the relationship.

• clrs can extend their competence by reading, participating in workshops, other professional developmt opportunities, consult with colleagues, co-consult, work under supervision

Diversity considerations in clg competence

• Counselors actively attempt to understand the diverse cultural backgrounds of the clients they serve. Counselors also explore their own cultural identities and how these affect their values and beliefs about the counseling process.

• C.5. Nondiscrimination

  Counselors do not condone or engage in discrimination based on age, culture, disability, ethnicity, race, religion/spirituality, gender, gender identity, sexual orientation, marital status/partnership, language preference, socioeconomic status, or any basis proscribed by law. Counselors do not discriminate against clients, students, employees, supervisees, or research participants in a manner that has a negative impact on these persons.

• clrs are encourage to read many articles on multiculturalism & volunteer in areas with clts who are culturally different & taking online classes, distance supervision

   

• impairmt is often associated with alcohol, drug abuse, bslippery slope, blurred boundaries in clg that can lead to exploiting clts
• clr may experience death in family, divorce, desertion, rape, severe physical illness family member, personal trauma-these can unbalance clrs emotional equilibrium
• human-based tragedies: hurricane victims, war victims, terrorist victims, events can put clrs at risk for vicarious traumatization also known as compassion fatigue or secondary traumatic stress disorder
• if not recognized, clrs will become less emotional, skilled to deal with clts-clrs have ethical obligation to know these hazards in advance & be prepared to deal with them

• preexisting conditions may put clrs at risk. some clrs enter profession in order to work thru their own unresolved problems
• personal difficulties that led clrs in clg may exacerbate by clg experiences. the practice can reactivate early experiences, open old wounds, reawaken unsolved issues
• this makes them vulnerable to drug abuse, depression, suicide
• personal characteristics also makes clrs vulnerable to impairmt -parentification a willingness to take responsibility for others, perfectionism, imposter feelings, self-doubt, audience sensitivity strong awareness of others feelings, responsiveness to them

• certain clt problems & clts can promote clr distress. suicidal clts takes an emotional toll,high relapse rate among clts with addictive problems can lead to clr cynicism, discouragemt
• certain clts characteristics-lack of empathy for others, manipulative behavior/nature, refusal to take responsibility for 1's actions/behaviors-these can exacerbate the stress levels in clrs & preachers
• clrs working with trauma victims are at risk for developing secondary PTS symptoms
• dealing with managed care & their demands for short term results, burdensome paperwork can put clrs at risk for emotional exhaustion

C.2.g. Impairment

• Counselors are alert to the signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when such impairment is likely to harm a client or others.
• They seek assistance for problems that reach the level of professional impairment, and, if necessary, they limit, suspend, or terminate their professional responsibilities until such time it is determined that they may safely resume their work.
• Counselors assist colleagues or supervisors in recognizing their own professional impairment and provide consultation and assistance when warranted with colleagues or supervisors showing signs of impairment and intervene as appropriate to prevent imminent harm to clients. (See A.11.b., F.8.b.)

1. deteriorated in personal relationships, including marital problems & family dysfunction
2. becoming isolated & withdrawn from others
3. feelings of disillusionment with the profession
4. emotional distancing during clg sessions
5. alcohol & drug abuse
6. changes in work habits such as increased tardiness & absenteeism
7. moodiness, depression, symptoms of anxiety
8. procedural errors & sloppy record keeping

• there are numerous indications of impairmt, the quality of her clg services may decline she may develop
• suggestion to find partners in clg services, join a supervisory support group or seek clg for possible burnout
• clrs should acquire self-monitoring skills & seek out the resources available:
• clg, supervision, take a break, vacation; join a peer group; exercise, meditate, hobbies, seek family/friends support

• involves professional misconduct or unreasonable lack of skill or fidelity in professional or fiduciary duties, evil practice, illegal, immoral conduct
• Malpractice refers to Negligence or misconduct by a professional person, such as a lawyer, a doctor, a dentist, or an accountant. The failure to meet a standard of care or standard of conduct that is recognized by a profession reaches the level of malpractice when a client or patient is injured or damaged because of error.
• 1. Improper or negligent treatment of a patient, as by a physician, resulting in injury, damage, or loss.
  2. Improper or unethical conduct by the holder of a professional or official position.
  3. The act or an instance of improper practice.

• civil lawsuit can be filed against professionals, clts are compensated financially for their injuries; clrs who are sued must defend themselves before a judge or both
• clts must prove: a. clr had a duty to use reasonable care in providing clg services, b. clr failed to conform to required duty of care, c. clt was injured,
• d. there was reasonable close causal connection betw the conduct of clr & resulting injury, e. clt suffered an actual loss or damaged
• proximate cause -whether individual would have been injured had it not been for the actions or inaction of the other person
• forseeability whether the professional knew  or should have known that the professional's actions would result in a specific outcome.

• clr's determination of a clt's level of risk must be based on clinical observations
• clrs can also be accused of wrongdoing if they overreact & take actions that violate a clt's privacy or freedom when there is no basis for doing so
• as a result clrs have a legal duty to evaluate accurately a clt's potential for suicide
• code C2e dvised clrs to consult when they have questions regarding their ethical obligations or professional practice
• clrs refer suicidal clts for evaluation from a more experienced clr

• consult with other professionals

B.2.a. Danger and Legal Requirements

• The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed.
• Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues. (See A.9.c.)
• first learn as much as you can about the warning signs of person who commit violent acts against others
• then take steps necessary if clt is found to be at risk-get a written commitmt that he may not harm others-least intrusice action or have clt committed to psychiatric facilty
• notify clt's family & potential victims, the police & have the clt's parents take responsibility for keeping clt under control

• Tarasoff v. Regents of the University of California, 17 Cal. 3d 425, 551 P.2d 334, 131 Cal. Rptr. 14 (Cal. 1976), was a case in which the Supreme Court of California held that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient. The original 1974 decision mandated warning the threatened individual, but a 1976 rehearing of the case by the California Supreme Court called for a "duty to protect" the intended victim. The professional may discharge the duty in several ways, including notifying police, warning the intended victim, and/or taking other reasonable steps to protect the threatened individual
• The Court also referenced the 1980 Nebraska case of Lipari v. Sears, Roebuck & Company that involved a mental patient who had been committed to and had been receiving psychiatric care from the Veterans Administration. After his discharge the patient purchased a shotgun and resumed psychiatric day care treatment from the V.A. for about a month. The patient then stopped the treatment and a month later walked into a nightclub and shot one person to death and seriously wounded another. While the subsequent lawsuit was a claim for failure to detain the patient by seeking commitment, the Kansas court recognized that the duty imposed by the Nebraska Court required the taking of an affirmative action for the protection of a third party

• B.2.b. Contagious, Life-Threatening Diseases

  When clients disclose that they have a disease commonly known to be both communicable and life threatening, counselors may be justified in disclosing information to identifiable third parties, if they are known to be at demonstrable and high risk of contracting the disease.

• Prior to making a disclosure, counselors confirm that there is such a diagnosis and assess the intent of clients to inform the third parties about their disease or to engage in any behaviors that may be harmful to an identifiable third party.

• clrs should consult the clt's physician to confirm diagnosis-its physician responsibility to warn but if not available speak with clt about informing his partners & work with them to or involve partner in the clg process