1. Client Rights and Counselor Responsibilities
Chapter 5
Client Rights and Counselor Responsibilities
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

2. Client’s Right to Informed Consent
involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it
a shared decision-making process
a powerful clinical, legal, and ethical tool
requires that the client understands the information presented, gives consent voluntarily, and is competent to give consent to treatment
a process that continues for the duration of the professional relationship as issues and questions arise
Issues and Ethics - Chapter 5 (1)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

3. Content of Informed Consent
When educating clients about informed consent, the following information should be provided in writing and discussed:
The therapeutic process
Background of therapist
Costs involved in therapy
The length of therapy and termination
Consultation with colleagues
Interruptions in therapy
Issues and Ethics - Chapter 5 (2)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

4. Content of Informed Consent
Clients’ right of access to their files Rights pertaining to diagnostic labeling The nature and purpose of confidentiality Benefits and risks of treatment Alternatives to traditional therapy Tape-recording or videotaping sessions
Issues and Ethics - Chapter 5 (3)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

5. Record Keeping
From a clinical perspective, record keeping provides a history that a therapist can use in reviewing the course of treatment.
From an ethical perspective, records can assist practitioners in providing quality care to their clients.
From a legal perspective, state or federal law may require keeping a record, and many practitioners believe that accurate and detailed clinical records can provide an excellent defense against malpractice claims.
From a risk management perspective, keeping adequate records is the standard of care.
Issues and Ethics - Chapter 5 (4)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

6. Content for Inclusion in Records
Identifying data Fees and billing information Documentation of informed consent Documentation of waivers of confidentiality Presenting complaint and diagnosis Plan for services
Issues and Ethics - Chapter 5 (5)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

7. Content for Inclusion in Records
Client reactions to professional interventions Current risk factors pertaining to danger to self or others Plans for future interventions Assessment or summary information Consultations with or referrals to other professionals Relevant cultural and sociopolitical factors
Issues and Ethics - Chapter 5 (6)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

8. Ethical Issues in Online Counseling
It is the counselor’s responsibility to examine the ethical, legal, and clinical issues related to online counseling.
Providing counseling services online is controversial.
There are potential legal issues that must be addressed, a few of which include:
Competence of practitioner in providing online counseling
Informing client of limits and expectations of the relationship
Developing a plan for how emergencies can be addressed
Issues and Ethics - Chapter 5 (7)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

9. Advantages of Online Counseling
Reaching clients who may not participate face-to-face Improving client access in rural areas Increasing flexibility in scheduling Facilitating assigning and completing of client homework Augmenting a problem-solving approach Improving an orientation to the counseling process Enhancing the provision of referral services
Issues and Ethics - Chapter 5 (8)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

10. Disadvantages – Online Counseling
Danger of making an inaccurate diagnosis Compromising of confidentiality and privacy Problems involved in being able to protect suicidal clients Difficulties in attending to clients who are in crisis situations Absence of traditional client-therapist relationship Inability to address a range of more complex psychological problems Inability to deal with interpersonal concerns in the therapy process
Issues and Ethics - Chapter 5 (9)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

11. Suggestions for Online Counseling
Here are some suggestions for counselors considering online counseling:
Before offering distance counseling, acquire the appropriate competencies related to this evolving specialty.
Learn how to adapt traditional methods for effective application to distance counseling.
Screen clients for suitability with respect to the specific distance services you are considering using.
Issues and Ethics - Chapter 5 (10)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

12. Suggestions for Online Counseling
As a part of informed consent, educate your clients about the difficult situations that may occur during distance counseling.
Familiarize yourself with the ethical guidelines that have been developed to inform your specific scope of practice.
Be aware of the legal issues and state licensure board regulatory policies that govern your specific practices when delivering online counseling.
Issues and Ethics - Chapter 5 (11)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

13. Working With Children and Adolescents
Important issues to consider:
Minors’ rights regarding informed consent
Parental rights to information about a minor’s treatment
Minors’ assent versus consent
Involving parents in the counseling process with minors
Limits to confidentiality
Dealing with reluctance
Need for supervised clinical experience in play therapy, art and music therapy, and recreational therapy
Issues and Ethics - Chapter 5 (12)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

14. Elements of Malpractice
To succeed in a malpractice claim:
(1) a professional relationship between the therapist and the client must have existed;
(2) the therapist must have acted in a negligent or improper manner, or have deviated from the “standard of care” by not providing services that are considered “standard practice in the community”;
(3) the client must have suffered harm or injury, which must be verified; and
(4) there must be a legally demonstrated causal relationship between the practitioner’s negligence or breach of duty and the damage or injury claimed by the client
Issues and Ethics - Chapter 5 (13)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

15. Reasons for Malpractice Suits
Failure to obtain or document informed consent Client abandonment or premature termination Marked departures from established therapeutic practices Practicing beyond the scope of competency Misdiagnosis Crisis intervention
Issues and Ethics - Chapter 5 (14)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

16. Reasons for Malpractice Suits
Repressed or false memory Unhealthy transference relationships Sexual misconduct with a client Failure to control a dangerous client Managed care and malpractice
Issues and Ethics - Chapter 5 (15)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning

17. Risk Management
The practice of focusing on the identification, evaluation, and treatment of problems that may injure clients and lead to filing an ethics complaint or a malpractice action.
One of the best precautions against malpractice is personal and professional honesty and openness with clients.
Know your limitations and remain open to seeking consultation in difficult cases.
Remain alert for possible misunderstandings that, if not recognized or poorly handled, could lead to a therapeutic break or premature termination of therapy.
Issues and Ethics - Chapter 5 (16)
Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning