IC&RC Domain IV: Professional and Ethical Responsibility (2023/2024) Already Passed

IC&RC Domain IV: Professional and Ethical Responsibility (2023/2024) Already Passed Ethics: A set of principles that guide our actions Ethics are not... rules The most important ethical principles: +Do no harm +Informed consent +Self-discosure +Professional competence +No dual relationships +Confidentiality Do No Harm: Decisions are made in order to avoid any harm to the client or cause the least amount of harm to the client or others Informed Consent: Counselor must inform client about the risks and benefits of treatment; and afterwards, client must give consent Self- Disclosure: In general, counselors should reveal as little about themselves that is necessary to help the client (i.e. discussing personal issues or revealing personal information) Professional Competence: Counselor must continuously maintain self-awareness and seek training No Dual Relationships- list: +Acting on romantic or sexual feelings +Sponsoring a client or former client in a 12-Step program +Counseling a client with whom you've had a current or prior personal relationship +Socializing with clients or former clients +Having a business relationship or giving/receiving personal favors/gifts +Giving clients phone numbers or having contact outside the scope of the professional relationship (unless required by one's job) Transference: The client's projections of feelings onto the counselor or other group members Countertransference: The counselor's projections of feelings onto the client. If you experience countertransference, get clinical supervision and make colleagues aware of the situation. Problems with boundary violations usually occur when... the counselor gets their personal needs met from professional relationships The MOST important issue for a counselor to consider when a client invites them to dinner is... the impact on the therapeutic alliance Confidentiality: Counselor must keep client information confidential, unless an exception applies. Confidentiality exceptions: Mandated reporting +Child abuse +Elder abuse +Dependent adult abuse +Imminent danger to self or others Medical Emergencies Crime at rehabilitation center Qualified Service Organization Agreement (data processing) Written Consent (HIPAA Changes) Internal Communications No Patient Identifying Information Third Party Payers Audit Court Order (not subpoenas) Court Order Crime at Program/Against Program Personnel Research Audit and Evaluation (HIPAA Changes) QSOA/BAA (HIPAA Changes) +Qualified Service Organization Agreement +Breaking Addiction Act A client discloses that her husband is abusing her three year old daughter. Jurisdictional law mandates the abuse must be reported, however, previous experiences with child protective services have been ineffective. The counselor fears if the abuse is reported it will escalate as child protective services will investigate the matter but take no further action. The counselor's BEST course of action is to a. consult with their immediate supervisor and follow the supervisor's directives on whether or not to report the abuse b. >>>>adhere to reporting protocols and determine if and if and when the client should be informed of the report. c. develop a plan with the client to remove her and her daughter from the abusive situation and then report the abuse to appropriate authorities d. document as much detail as possible regarding the abuse and continue to monitor the situation until the counselor can make a clear decision about what is in the client's best interest. Administrative supervision provides an opportunity to... address program policies and standards. Even though supervision is similar to therapy in some ways, there are important differences. Supervision sessions should not evolve into personal therapy sessions. While confidentiality is an ethical guideline there are two specific laws that govern confidentiality: 42CFR, Part 2 & HIPAA HIPAA Health Insurance Portability & Accountability Act In general, requires the protection and confidential handling of all protected health information. Provides minimum restriction. 42 CFR Part 2 CFR = Code of Federal Regulations The regulations are the federal confidentiality laws that specifically pertain to alcohol & drug health information concerning services and clients. Supersedes HIPAA Confidential Information: Any information about the person which includes name or identifying information A proper consent form must be in writing and must contain each of the following items: The name or general designation of the program(s) making the disclosure The name of the individual or organization that will receive the disclosure The name of the patientresident who is the subject of the disclosure; The purpose or need for the disclosure; How much and what kind of information will be disclosed; A statement that patientresident may revoke the consent in writing at any time, except to the extent that the program has already acted in reliance on it; The Program's ability to condition treatment, payment, enrollment or eligibility of benefits on the patient's agreeing to sign the consent, by stating either that the program may not condition these services on the patient signing the consent, or the consequences for the patient refusing to sign the consent The date, event or condition upon which the consent expires if not previously noted The signature of the patientresident (and or authorized person) The date on which the consent form is signed. Each state also has laws pertaining to the Emergency Detention of those who present an imminent danger of harm to self or others. In California this is called a "5150", which allows for a person to be hospitalized involuntarily for a period of up to 72 hours in order to be evaluated. Marginalized populations face the most challenges in entering into and remaining in treatment for the following reasons: Lack of money, skills, and language to negotiate the treatment system. High tolerance for pain and suffering. Illegal status. Negative experiences in other service systems (courts, child welfare, schools). Cultural or religious beliefs that conflict with mainstream treatment centers. Fear of "losing face" or bringing shame on the family by disclosing personal problems.