Ethics and Counseling Regulations for Marriage and Family Therapists, Exams of Public Health

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Ethics Final Exam Study Guide

Questions And Answers.

AAMFT -

\American Association of Marriage and Family Therapists CAPS - \Christian Association for Psychological Studies NCC - \National Certified Counselors NBCC - \National Board of Certified Counselors NCE - \National Counselor Exam NCMHCE - \National Clinical Mental Health Counseling Exam ACA - \American counseling association AACC - \American Association for Christian Counseling MHSP - \Mental Health Service Provider How are registries different from certification and licensure and which organizations are registries? - \registries are membership lists of certain groups and agencies that provide a benefit to the community. -Examples include: ACA - American Counseling Association AACC - American Association of Christian Counselors CAPS - Christian Association for Psychological Studies How is certification different from registries and licensure and which organizations are certification bodies? - - Voluntary attempt by a group to promote professional identity

• Attempts to verify qualifications

• Sets minimum standards
• Does not assure quality practice -Certification is a process whereby an agency, which may be either governmental or private, attests or affirms that an individual counselor has met the minimum qualifications established by the agency. -The primary advantage of any certification lies in the prestige associated with it. Some states use certification bodies credentials as part of establishing licensure Examples:
• NBCC - National Board of Certified Counselors
• AAMFT - American Association for Marriage and Family Therapists -Credentials Currently Offered by NBCC -National Certified Counselor - (NCC) -School counseling - The National Certified School Counselor (NCSC) -Clinical mental health counseling - The Certified Clinical Mental Health Counselor (CCMHC) -Addictions counseling - The Master Addictions Counselor (MAC) -NBCC Approved Clinical Supervisor (ACS) (now managed by CCE) How is licensure different from registries and certification? - - Governs professional practice
• Highlights uniqueness of an occupation
• Restricts both use of title and practice of occupation
• As distinct from certification, licensure processes are stipulated in law, implemented at the state level, legally constituted as stipulated by law, and geographically restricted in authority
• The primary advantage of licensure, as opposed to certification, is that licensure permits counselors to do certain types of counseling and restricts the use of the title "licensed." current requirements for licensure in Tennessee as an LPC with Mental Health Service Provider designation - \Get your MA degree at Richmont After graduation complete 2 years of clinical experience under supervision 3000 hrs - 1500 direct; 1500, indirect; 150 hours of supervision Pass the NCE Pass the NCMHCE Pass the TN Jurisprudence Exam current requirements for licensure in Tennessee as an LMFT with Mental Health Service Provider designation - \Master's or doctoral degree in MFT or equivalent from a regionally accredited institution Two years of post master experience consisting of not less than 10 hours per week of counseling and approximately 100 hours of supervision per year 1000 hours of direct clinical experience under supervision 200 hours of supervision required of which 100 may be group supervision. Supervisor must meet AAMFT standards for supervisor

Tennessee has adopted the Professional Examination Service (PES), The National Marital and Family Therapy Examination, published Examination as developed by AAMFT. MFT Jurisprudence exam over code of ethics and practice related content and possibly MFT rules Rights of supervisees - -supervisory sessions free from distractions -to be fully informed of supervisor's approach -confidentiality with regard to supervisee's disclosure and with regard to clients except as mandated by law

• continual access to records maintained during supervision
• to provide feedback to supervisors concerning supervision experience
• to seek consultation from other professionals as necessary Methods of supervision - -Self-report (most widely used, but likely the least useful and least accurate) -process notes (build on self report by adding a written record explaining the content of the session and interactional process) -Audio recording -Video recording Legal considerations in supervision - \1. informed consent

2. confidentiality and its limits
3. liability- direct liability: incurred when the actions of supervisors are the cause for harm Vicarious liability: pertains to the responsibilities supervisors have to oversee the actions of their supervisees Questions to evaluate your own counseling theory - -Where did you acquire your theory? -Does your theory evolve and change as you gain clinical experience with a variety of clients? -Do you embrace a particular theory because it is a justification of your own experience and values? -To what degree does your theory challenge your own previous frame of reference? -Do you have a responsibility to know many theories and techniques to serve diverse clients? -Is your theory a dogma or is it the way you work best and have best results? -Do your own life experiences influence your counseling approach? Assessment and Diagnosis and types of diagnosis - \Medical diagnosis: is the process of examining physical symptoms, inferring causes of physical disorders or diseases & providing a diagnosis Psychodiagnosis (psychological diagnosis): a general term covering the process of identifying an emotional or behavioral problem and making a statement about the

current status of the client. It also includes identification of possible causes of the problems Differential diagnosis: the process of distinguishing one form of disease or psychological disorder from another by determining which of the two (or more) diseases or disorders with similar symptoms the person is suffering from. Arguments for and against psychodiagnosis - \For: -No third party reimbursement w/o acceptable diagnosis -Difficult to formulate treatment plan w/o defining problem -Provides team members w/ a common frame of reference -Allows therapists to rule out medical conditions -Used to assess whether clients pose danger to self or others -Provides framework for research -May be a minimum standard of care for some licensed professionals -May seldom have a choice about diagnosis -May be critical to determine therapeutic success -Helps to normalize a client's situation Against: -Emphasis of DSM is on pathology -Can minimize uniqueness of client -Ignores natural capacities for self-healing -Can lead people to accept self-fulfilling prophecies -Assumes that distress in family is result of individual pathology -Many therapists are not competent to use DSM diagnosis properly -DSM has been criticized (reliability & validity question, failure to predict treatment outcomes) 2 reasons why you should use tests in counseling (specifically as given in notes) - -to confirm a diagnosis if necessary -to provide a baseline to measure progress Guidelines for using tests in counseling - -Be familiar w/ tests being used and take tests themselves -Recognize limits of competence to use and interpret tests -Know reasons why a particular test is being used -Make clients aware that tests are merely tools that can provide useful information -Select tests appropriate for client given their unique cultural, social, and cognitive factors -Give test results, not simply test scores -Be sensitive to ways clients respond to results -Assure clients that test results will not be used against them -Assure confidentiality unless consent is given -Know the limitations of tests being used Ethical issues in research ( - know basics of informed consent for research) -

-Fair and understandable explanation of the activity and its purpose -Explanation of the discomforts or risks that may be reasonably expected to occur -Explanation of benefits that may be reasonably expected to occur -Disclosure of alternative procedures (where relevant) -Willingness to answer all questions -Freedom to withdraw consent and participation at any time Informed consent in couples and family therapy - - purpose of therapy

• typical procedures
• risks of negative outcomes
• possible benefits of therapy
• the fee structure
• limits of confidentiality (including how secrets are handled) -rights and responsibilities of clients
• the option that a family member can withdraw at any time
• what can be expected from the therapist exceptions to confidentiality in couples and family therapy - -when mandated by law -when it is necessary to protect clients from harm to self or others -when the family therapist is a defendant in a civil, criminal, or disciplinary action arising from therapy -when a waiver has been previously obtained in writing from each individual competent to execute a waiver -a release of information Adjunct training helpful for group leaders - -personal psychotherapy
• self-exploration and experiential groups
• participates in training and supervisory groups Advantages of co-leadership - \modeling for members, sharing responsibilities, and providing mutual support Those NOT suited for groups - \clients with brain injury, paranoia, hypochondriasis, addictions, psychosis, cluster B personality disorders Those suited for groups - \those who struggle with loneliness, inability to make or maintain intimate contacts, feelings of unlovability, fear of being assertive, dependency Open group - \groups in which participants may join at any point

Closed groups - \groups in which, after a preset number of sessions, no one else may join the group Issues regarding freedom to leave group - -procedures for leaving a group must be explained during the initial session

• clients have a responsibility to leaders and other members to explain why they want to leave reasons why clients should explain to others why they wish to leave - - clients need to discuss what they find threatening or negative about the experience
• termination can be harmful to group cohesion and therapeutic value for those who remain Psychological risks of group work - -the major disruption in their lives
• privacy may be invaded
• group pressure- a participant's right not to explore issues or participate in exercises should be respected
• scapegoating -confrontation can be used or misused
• there is no guarantee that all members will respect confidentiality Confidentiality in groups - -the concept of privileged communication does not apply unless there has been an exception in individual state law Community Agency - \any institution, public or private, nonprofit or for profit, designed to provide a wide range of social and psychological services to the community Four facets of comprehensive community counseling - -Direct client services: focuses on outreach activities -Indirect client services: client advocacy -Direct community service: preventive education -Indirect community service: influencing policymakers Alternative counselor roles - -advocate -change agent -consultant -adviser
• facilitator of indigenous support systems -facilitator of indigenous healing systems Tasks of community counseling (in general - NOT memorized) - - Ability to support community needs

• Develop partnerships in creation and delivery of services -Promote community organization and development of activities -Outreach
• Develop strategies to empower the community -Influence policymakers -Consult with community agencies -Evaluate human services programs -Advocate and assist with initiatives -Develop and build community assets Licensed workers - \have a graduate degree and may assume roles of practitioners, supervisors and consultants Non-licensed workers - \may have any type of degree from a graduate degree to just a certificate or training. Philosophy of case management - \to enable clients to achieve economic and personal independence and self-sufficiency