Ethics in Mental Health Counseling, Exams of Nursing

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Ethics Final for Colorado Mental Health

Jurisprudence latest 2024

Licensed Psychologist (LP) - CORRECT ANSWER-10 yrs Doctoral Degree: PhD or PsyD in clinical psychology. Must pass the EPPP national exam Minimum of 2,000 hours of post-PhD supervised practice hours Psychiatrist - CORRECT ANSWER-12 yrs Medical Doctor (MD, DO) Must pass the USMLE National Exam supervised client-contact hours: included in degree in professional orientation- "rotation" Professional Counselors - CORRECT ANSWER-Time investment: 6 yrs License/Certifications: LPC, LAC, LCSW, LMHC, LFMT, etc. GRE/MCAT Education: Master's Degree: MS/ M.Ed. in Counseling/Addiction Counseling/Marriage and Family Therapy. MSW: Masters in Social Work Tests: NCC National Exam for LPC. MAC National Exam for LAC CO Jurisprudence Exam Supervised client-contact hours: Minimum: 2 yrs/2000 hrs in Colorado post-degree (for LPC). 3,000 hours for LAC (hours can be accrued during grad school) Certified Addiction Counselor (CAC III) Registered Psychotherapist - CORRECT ANSWER-Post secondary time investment: 4 years Education: Bachelor's Degree: BS in Counseling, Psychology, Psychology, Bachelor of Social Work Exams: State certified CAC Classes, CO Jurisprudence Exam Client-contact hours: Minimum: 5000 hours for CAC III Certified Addiction Counselor (CAC I or II) - CORRECT ANSWER-Post-secondary time investment: 2 yrs. Education: Associate's Degree. AA, AS, AGS or High School Equivalency/GED Exams: State certified CAC Classes. CO Jurisprudence Exam Client-contact hours: Minimum 1000 hrs Pro Bono Services - CORRECT ANSWER-ACA Code C.6.e. Contributing to the Public Good

Counselors make a reasonable effort to provide services to the public for which there is little or no financial return (e.g., speaking to groups, sharing professional information, offering reduced fees) Confidentiality - CORRECT ANSWER-Rooted in a client's right to privacy. The counselor's ethical duty to protect private client communication. Privileged Communication - CORRECT ANSWER-a legal concept that generally bars the disclosure of confidential communications made to a psychotherapist from any judicial proceedings or court of law. All states have enacted into law some form of psychotherapist-client privilege, but the specifics of this privilege vary from state to state. Limits to Confidentiality - CORRECT ANSWER-When there is serious and foreseeable danger to an individual or society (harm to self or others) (i.e. child/elder abuse, threats of suicide) when the client requests a release of information when reimbursement or other legal rules require disclosure when clerical assistants handle confidential information, as in managed care when the counselor consults with experts or peers when the counselor is working under supervision when other mental health professionals request information and the client has given consent to share when other professionals are involved in a treatment team and coordinate care of a client Exceptions to Confidentiality and Privileged Communication - CORRECT ANSWER-* Disclosure of confidential information is ordered by a court

• Client waiver of the privilege
• Clients file complaints and litigation against their counselors
• Clients claim psychological damage in a lawsuit
• Statutes involving child abuse or elder abuse
• Clients pose a danger to others or to themselves The Tarasoff Case - CORRECT ANSWER-Prosenjit Poddar was a voluntary outpatient at the student health service at UC Berkeley in 1969. He threatened to kill Tara Tarasoff in his session with his counselor, Moore. Moore called the police and told them about the death threat. The police took Poddar into custody for questioning but released him because he promised to stay away from Tarasoff. Tarasoff and her family were never made aware of the death threat. When Tarasoff returned from her trip, Poddar killed her. Her parents filed suit against the Board of Regents and the employees of the University for failing to notify the victim of the threat. The CA supreme court ruled in favor of the parents, holding that a failure to warn an intended victim was professionally irresponsible. The court's rulings requires that therapists breach confidentiality in cases where the general welfare and safety of others is involved. The lower court cited a duty to warn.

duty to warn- when a therapist determines that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger duty to protect- "duty to exercise reasonable care to protect the forseeable victim" "you do not have to be perfect in predicting what will happen; you just have to be reasonably competent in assessing for what could happen" Mandated Reporters - CORRECT ANSWER-(a) Physician or surgeon, including a physician in training; (b) Child health associate; (c) Medical examiner or coroner; (d) Dentist; (e) Osteopath; (f) Optometrist; (g) Chiropractor; (h) Podiatrist; (i) Registered nurse or licensed practical nurse; (j) Hospital personnel engaged in the admission, care, or treatment of patients; (k) Christian science practitioner; (l) Publicor private school official or employee; (m) Social worker or worker in any facility or agency that is licensed or certified pursuant to part 1 of article 6 of title 26, C.R.S.; (n) Mental health professional; (o) Dental hygienist; (p) Psychologist; (q) Physical therapist; (r) Veterinarian; (s) Peace officer as described in section 16-2.5-101, C.R.S.;

(t) Pharmacist; (u) Commercial film and photographic print processor as provided in subsection (2.5) of this section; (v) Firefighter as defined in section 18- 3 - 201 (1.5), C.R.S.; (w) Victim's advocate, as defined in section 13- 90 - 107 (1)(k)(II), C.R.S.; (x) Licensed professional counselors; (y) Licensed marriage and family therapists; (z) Registered psychotherapists; Parental Right to Info About a Minor's Treatment - CORRECT ANSWER-In most states, for a minor to enter into a counseling relationship, it is necessary to have informed parental or guardian consent or for counseling to be court ordered. Parents/guardians generally have the legal right to know the contents of counseling sessions with their children. Informed consent of parents/guardians may not be legally required when a minor is seeking counseling for addictions to drugs, for STD's, for pregnancy and BC, or for an examination following alleged sexual assault of a minor over 12. It is important that you check with your state regarding the laws about informed consent. Assent - CORRECT ANSWER-Assent to treatment implies that counselors involve minors in decisions about their own care, and that to the greatest extent possible they agree to participate in the counseling process. Minors cannot give informed consent to treatment, but they can give assent Consent/Informed Consent - CORRECT ANSWER-involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it. Informed consent is a shared decision-making process in which a practitioner provides adequate information so that a potential client can make an informed decision about participating in the professional relationship Informed Consent Process - CORRECT ANSWER-Involves a process of reaching an agreement to work collaboratively rather than simply having an informed consent form signed. Informed Consent Document - CORRECT ANSWER-Therapists are required by their ethics codes to disclose to clients the risks, benefits and alternatives to proposed treatment. The intent of this document is to define boundaries and clarify the nature of the basic counseling relationship. Protects clients' rights.

Client Rights - CORRECT ANSWER-The right to have treatment explained to them The right to terminate counseling at any time The right to seek a second opinion The right to file a grievance The right to request and view records The right to be treated fairly Sexual Intimacy with Clients - CORRECT ANSWER-Illegal to sleep with current clients. Must wait 5 years (legally) but ethically it is not recommended. ACA: "Sexual intimacy with current clients or with known members of the client's family system is prohibited" (1.4) ACA: "sexual/romantic counselor-client interactions or relationships with former clients...are prohibited for...5 years following the last professional contact. This prohibition applies to both in-person and electronic interactions. Counselors, before engaging in sexual/romantic interactions... with former clients...demonstrate forethought and document (in written form) whether the interaction or relationship can be viewed as exploitive in any way and/or whether there is still potential to harm the former client; in cases of potential exploitation and/or harm, the counselor avoids entering such an interaction or relationship" (A.5.c) Multiple relationships - CORRECT ANSWER-Multiple relationships (dual relationships and nonprofessional relationships) occur when professionals assume two or more roles at the same time or sequentially with a client. Mental health professionals must learn how to effectively and ethically manage multiple relationships, including dealing with the power differential that is a part of most professional relationships, managing boundary issues, and striving to avoid the misuse of power. Good judgement, the willingness to reflect on one's practices, and being aware of one's motivations are critical dimensions of an ethical practitioner. Ethically not advised for current clients. "once a client always a client" - future clients Boundary Crossing - CORRECT ANSWER-a departure from commonly accepted practices that could potentially benefit clients boundary violations - CORRECT ANSWER-a serious breach that results in harm to clients and is therefore unethical Bartering - CORRECT ANSWER-ACA Code A.10.e. counselors may barter only if the bartering does not result in exploitation or harm, if the client requests it, and if such arrangements are an accepted practice among professionals in the community. Counselors consider the cultural implications of bartering and discuss relevant concerns with clients and document such agreements in a clear written contract.

Receiving Gifts - CORRECT ANSWER-ACA: counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and gratitude. When determining whether to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, the client's motivation for giving the gift, and the counselor's motivation for wanting to accept or decline the gift (A.10.f) Touching - CORRECT ANSWER-It is important to consider whose needs are being met when it comes to touching. If it comes from the therapist alone, and not from the context of the therapeutic relationship, it should be avoided. A touch that is not genuine will most likely be detected by clients and could erode trust in the relationship Autonomy - CORRECT ANSWER-The principle that addresses the respect for independence and self determination. The essence of this principle is allowing an individual the freedom of choice and action Justice - CORRECT ANSWER-Treating equals equally and unequals unequally, but in proportion to their relevant differences Beneficience - CORRECT ANSWER-contributing to the welfare of the client Nonmaleficence - CORRECT ANSWER-do no harm Fidelity - CORRECT ANSWER-faithfulness; loyalty veracity - CORRECT ANSWER-truthfulness: involves the practitioner's obligation to deal honestly with clients self-care - CORRECT ANSWER-taking adequate care of ourselves so that we can implement the moral principles and virtues that are fundamental ethical concepts Social Constructionist Model - CORRECT ANSWER-Focuses primarily on the social aspects of decision making in counseling Redefines the ethical decision-making process as an interactive rather than an individual or intrapsychic process and places the decision in the social context itself, not in the mind of the person making the decision Transcultural Integrative Model - CORRECT ANSWER-addresses the need for including cultural factors in the process of resolving ethical dilemmas Corey's ethical decision making model - CORRECT ANSWER-Includes aspects of the feminist model of ethical decision making, waldens views on including client's voice in ethical concerns, a social constructionist approach to ethics, and a transcultural integrative model of ethical decision making Steps:

1. identify the problem or dilemma
2. identify the potential issues involved
3. review the relevant ethics codes
4. know the applicable laws and regulations
5. obtain consultation
6. consider possible/probable courses of action
7. enumerate and consider the possible consequences of various decisions
8. choose what appears to be the best course of action the Practitioner's guide to ethical decision making - CORRECT ANSWER-Forrester- Miller & Davis
9. identify the problem
10. apply the ACA code of ethics
11. determine the nature and dimensions of the dilemma
12. generate potential courses of action
13. consider the potential consequences of all options and determine a course of action
14. evaluate the selected course of action
15. implement the course of action Disclosure Statement requirements - CORRECT ANSWER-1. [Name, business address, business telephone number of licensee, registrant, or certificate holder.]
16. [An explanation of the levels of regulation applicable to mental health professionals under the Mental Health Practice Act and the differences between licensure, registration, and certification, including the educational, experience, and training requirements applicable to the particular level of regulation.]
17. A Licensed Addiction Counselor must have a clinical master's degree, meet the CAC III requirements, and pass a national exam.
18. A Licensed Professional Counselor must hold a master's or doctoral degree in professional counseling, have at least two years post-master's or one year postdoctoral practice, and pass an exam in in professional counseling.
19. [A listing of any degrees, credentials, certifications, registrations, and licenses held or obtained by the licensee, registrant, or certificate holder, including the education, experience, and training the licensee, registrant, or certificate holder was required to satisfy in order to obtain the degree, credentials, certifications, registrations, or licenses.]
20. [A statement indicating that the practice of licensed or registered persons in the field of psychotherapy is regulated by the division, and an address and telephone number for the board that regulates the licensee, registrant, or certificate holder.]
21. [A statement indicating that a client is entitled to receive information about the methods of therapy, the techniques used, the duration of therapy, if known, and the fee structure.]
22. [A statement indicating that the client may seek a second opinion from another therapist or may terminate therapy at any time.]

9. [A statement indicating that, in a professional relationship, sexual intimacy is never appropriate and should be reported to the board th Multicultural Ethics - CORRECT ANSWER-ACA Code C.5. Nondiscrimination Counselors do not condone or engage in discrimination against prospective or current clients, students, employees, supervisees, or research participants based on age, culture, disability, ethnicity, race, religion/spirituality, gender, gender, identity, sexual orientation, marital/partnership status, language preference, socioeconomic status, immigration status, or any basis proscribed by law. E.8. Multicultural Issues/Diversity in Assessment Counselors select and use with caution assessment techniques normed on populations other than that of the client. Counselors recognize the effects of age, color, culture, disability, ethnic group, gender, race, language preference, religion, spirituality, sexual orientation, and socioeconomic status on test administration and interpretation, and they place test results in proper perspective with other relevant factors. Multicultura/Diversity Considerations: Counselors maintain awareness and sensitivity regarding cultural meanings of confidentiality and privacy. Counselors respect different views on disclosure of information. Counselors hold ongoing conversations with clients as to how, when and with whom information is to be shared (B.1.a.) Ethics of Psychological Diagnosis - CORRECT ANSWER-ACA Code E.5.d. Refraining From Diagnosis Counselors may refrain from making and/or reporting a diagnosis if they believe that it would cause harm to the client or others. Counselors carefully consider both the positive and negative implications of a diagnosis. Grievance - CORRECT ANSWER-complaint. Most common types of grievances: confidentiality Malpractice lawsuit - CORRECT ANSWER-A case arising from an incident where a client or client's family perceives a dereliction of professional duty or a failure to exercise an ordinary degree of professional skill or learning on the part of a clinician, which results in harm to the client. most common types: sexual transgressions transference - CORRECT ANSWER-process by which clients project their past feelings or attitudes they had towards their caregivers/significant others onto their therapist countertransference - CORRECT ANSWER-occurs when the therapist displaces onto the client attitudes or feelings from his or her past; process that can occur when the therapist responds to the client based on personal, unconscious needs and conflicts.

1. being overprotective with a client
2. treating clients in benign ways (superficial, bland)
3. rejecting a client
4. needing constant reinforcement and approval
5. seeing yourself in your clients
6. developing sexual/romantic feelings towards clients 7.giving advice
7. developing a social relationship advice giving - CORRECT ANSWER-form of countertransferrence giving advice as a regular intervention can be counterproductive. even if a client is asking for advice there is every reason to question whose needs are being served when a therapist falls into advice giving. advice giving places therapists into a superior position, and they may delude themselves into thinking they do have the answers for their clients Self-Care - CORRECT ANSWER-positive actions that promote wellness and effective coping. Includes routine positive practices and mindful attention to one's physical, emotional, relational, and spiritual selves in the context of one's personal and professional lives Ethics of Supervision - CORRECT ANSWER-* informed consent in supervision- the standard of practice to incorporate clear informed consent material for supervisees, both orally & in writing. Also, it is the responsibility of the supervisor to ensure that supervisees carry out an informed consent process with their clients prior to beginning a counseling relationship *engage in sound informed consent practices for the duration of the relationship *create a collaborative, egletarian supervisory working alliance Ethical Concerns with Colleagues - CORRECT ANSWER-