CEFS501: Ethical and Legal Issues in Counseling Professor Linda Simon Module 1 Introduction to Ethics and Professional Identity Overview This module will provide you with an introduction to professional counseling ethics and its relationship to the law. You will become familiar with an ethical decision-making model and the six moral principles that guide ethical decision-making. Learning Outcomes Upon successful completion of this module, you will be able to: - Describe the purpose and use of a professional ethics code and its relationship to state and federal law. - Describe the six moral principles that guide ethical decision-making in counseling. - Define academic honesty and identify various type of plagiarism. - Identify the steps of an ethical decision-making model. Quiz: Professional Values 1. A master’s level counseling student is feeling overwhelmed due to having a major paper. She has worked overtime for the past two weeks, and her oldest child has a stomach virus, limiting the time she has to spend on researching and writing the paper. In a panic, she goes online and finds an online service that, for a small fee, will provide her sections of the paper, guaranteeing the information will not be detectable by any plagiarism program. She decides to use the service for the paper. a. Veracity

2. A counselor at a community mental health center has been seeing a client for 4 months. The client initially presented with substance abuse concerns but has not been complying with treatment goals for reducing substance abuse. The counselor’s supervisor suggests to the counselor that the client needs to enter a structured treatment program. At the client’s next appointment, the counselor tells the client that arrangements for the client to participate in the agency’s intensive outpatient program have been made for “her own good.” The client is upset and states she does not want to be in the program. The counselor tells the client, “Too bad, you’re already enrolled.” a. Beneficence 3. A marriage counselor has been working with a couple for the past six months. The couple started counseling to decide whether they wanted to continue in the marriage or divorce. The counselor believes that marriage should be for life. He has helped the couple see the roots of their unhappiness in the marriage, as well as, the benefits and consequences of remaining married or divorcing. One day the couple walks in and tells the counselor they have decided to move forward with a divorce. The counselor begins to tell the couple all the reasons they should not divorce and how their choice is wrong. a. Autonomy 4. An experienced career counselor works for a community agency that covers a broad range of services to clients. Two clients come in to see the counselor. The first client is a respected member of the community and is a department head in the local government. The second client is a part time employee at a factory who has had several arrests and is well known in the community for being intoxicated in public. Both clients come to the counselor wanting career counseling. The counselor recommends a full career

assessment, that involves four separate career tests, for the first client. The counselor does not administer any career tests to the second client because she knows they are expensive, time consuming, and “a waste of time” for someone with an “addiction problem.” a. Justice 5. A client initially comes into counseling worried that she might be bipolar like her mother and states several times that, “If I am bipolar, it will ruin my life!” The counselor assesses the client and administers a test that also assesses for bipolar. Both the counselor’s assessment and the results show that the client is bipolar. Four weeks later, the client requests to see the results of her assessment. The counselor refuses to release the results telling the client the results were not conclusive. a. Veracity 6. Two clients have been referred to a counselor who only has one available spot. The counselor looks over the referral information of both clients. The first client has insurance that is known for paying promptly and without requiring detailed documentation. The second client has insurance as well. But his insurance is always slow at reimbursement for services and requires a detailed treatment plan and weekly phone consultations. The counselor decides to take the first client but tells the second client there is no available appointment time for at least 4 weeks. a. Justice 7. A college student comes in with an eating disorder. The client is assigned to a counselor who has experience working with college students but not eating disorders. The counselor is aware that she lacks the knowledge and skills to work effectively with a client with an eating disorder but does not inform the client that she has no experience.

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a. Veracity 8. A counseling intern at a community agency has six new clients assigned to her caseload. Per her supervisor’s instruction, the student schedules to see the clients one time a week for 55 minutes. The student also works a full-time job, is taking two additional courses, and is a single mother of two children under the age of five. In the first two months, the student cancelled around 30% of her client’s appointments due to other obligations and a general sense of being overwhelmed. a. Fidelity 9. A counselor is leaving her employment at a community mental health clinic to take another job. In preparation for leaving, she tells all her clients that she will be leaving and her last date at the agency will be May 1. Two weeks before her May 1 date of departure, the counselor becomes angry at the agency and just quits, walking out, not informing her clients. a. Fidelity 10. A counselor at a community agency decides to start a group for women recovering from sexual abuse. On the first group meeting, the counselor hands out the informed consent form but rushes the members to sign the form without reviewing. The counselor reviews the benefits of group but worries reviewing risks will cause the members to feel anxious or frightened and drop out of group before they experience the benefits. She plans to review the risks on the third session. a. Veracity \ Quiz: Introduction

1. While principle ethics asks the question “What should I do?,” virtue ethics asks the question: a. “Who should I be?” 2. At their most fundamental level, codes of ethics serve to: a. Protect and promote the welfare of the client 3. When attempting to make an ethical decision, it is recommended that counselors take all of the following steps EXCEPT: a. Consult with an attorney 4. Law and ethics differ from one another in that: a. Laws dictate minimum standards of behavior that society will tolerate, whereas ethics represent the ideal standards expected by the profession 5. The ACA Code of Ethics: a. Helps to stabilize the profession 6. Counselors who function according to mandatory ethics: a. Believe that their duty is to comply with basic “must” and “must not” statements in codes of ethics, and nothing more 7. The best statement about the nature of professional ethics in counseling is that: a. Because there are few absolute right answers to ethical practice questions, consultation with lawyers is very important when making ethical decisions. 8. The personal values of counselors: a. Are influenced by their families of origin and their cultures, among other factors

9. From the perspective of principle ethics, a counselor who is counseling a client planning a violent act against another person, and who intervenes to notify the client’s family members is: a. Sacrificing client autonomy in order to prevent harm and to do good 10. Virtue ethicists believe that: a. That moral choices cannot be made by rule; what is needed instead is good judgement Quiz: Academic Honesty and Plagiarism 1. If it is considered common knowledge, it does not have to be cited. a. True 2. Jane had to withdraw from a course mid semester due to an illness in the family. When she retakes the course, she submits her first two papers again after doing some minor editing. She does not site herself in either paper. Jane has not committed an act of Academic Dishonesty. a. False 3. Jane is working on her essay, where she has to identify the themes of two different theories in a video. She watches the video twice and identifies one theme but is not sure about the second theme. She decides to go to a well know web site where students post past work for others to view. She finds where a past student posted their essay and verifies her two themes. She does not copy the essay word for word, but does use the previously submitted work to guide her own answer. Jane committed an act of Academic Dishonesty? a. True

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4. Jane is in a hurry this week and does not have the time to read her assigned chapters. She looks on a web site and finds a copy of the quiz for her class. She reads the questions, answers, closes the web site and then takes the quiz. Jane did not commit and act of Academic Dishonesty. a. False 5. Jane thinks she might like to access a sample paper from a web site that allows students to submit their previous work and in return access other students work. Jane submits three papers she completed last semester for future access to the web sites resources. Jane committed and act of Academic Dishonesty. a. True 6. Paraphrasing and direct quotes are cited in the exact same way in APA. a. False 7. There is no way for a student to know if they are plagiarizing. a. False 8. Counselors who plagiarize can be held responsible legally. a. True 9. The American Counseling Association has ethical guidelines that address plagiarism. a. True 10. Small and unintentional instances of plagiarism are not a big problem and should be ignored. a. False 11. In academic writing paraphrasing is considered more valuable than using direct quotes. a. True 12. You want to use an author’s writing in your paper. What do you need to do? a. Paraphrase, cite the author, and include a reference 13. Falsification includes:

a. All of the above 14. Knowingly assisting in any form of academic dishonesty (including selling or giving any kind of coursework to any other individual, company, or website) will result in you being held responsible along with the one who received the assistance. a. True 15. Academic Dishonesty does not include: a. None of the above 16. According to the video “Avoiding Plagiarism”, which of the following is not a possible consequence of plagiarism: a. Immediate removal from the program 17. Self-plagiarism is not a form of academic dishonesty. a. False 18. The following are forms of self-plagiarism: a. A (Re-submitting previously submitted course work) & B (Re-using part of previously submitted work without citing self) 19. It is considered plagiarism if I have someone revise my work who is not a professor or a trained tutor from the academic success center. a. True 20. Which of the following is a form of plagiarism: a. A (Omitting quotations marks when using words from any source) B (Accidentally forgetting to cite paraphrased information) & C (Replicating another student’s work in part or in whole) Quiz: Professional Identity of Counselors

1. A fundamental tenet of the wellness model is that: a. Mental health exists along a continuum 2. A core belief that members of the counseling profession hold concerning helping others with their mental health concerns is: a. Prevention and early intervention are the most appropriate means to deal with emotional and personal problems 3. Counseling aims to help clients: a. Be empowered to problem-solve independently 4. All of the following are steps toward professionalization EXCEPT: a. Offering services that are identical to services offered by other similar professions 5. The school counseling movement in the United States resulted as a consequence of which major event? a. The Russians launching Sputnik 6. Counselors who practice from a developmental perspective: a. View most problems people encounter as natural and normal because all developmental stages of life bring challenges 7. The most significant problem within the counseling profession today, according to the authors of the text, appears to be: a. Becoming a united and societally recognized profession 8. Counselors with a strong professional identity are able to do all of the following EXCEPT:

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a. Demonstrate that they hold a master’s degree from a CACREP accredited program 9. Within the counseling profession, the primary goal of counseling is to: a. Help clients achieve wellness 10. Professionalism in counseling includes all of the following EXCEPT: a. Taking pride in one’s profession Module 2 Multicultural Competence, Social Justice, and Ethics Overview This module will provide an introduction to personal values and cultural beliefs and the impact they can have on the counseling relationship. You will learn about the importance of social justice and social advocacy. You will also learn how to apply counseling ethics to writing, publishing, and research. Learning Outcomes Upon successful completion of this module, you will be able to: - Analyze the impact of your personal cultural values, beliefs, and assumptions as a counselor. - Apply ethical codes that pertain to multicultural awareness. - Identify the role of the counselor as an advocate. - Identify the importance of social justie. - Identify ACA Ethics Codes that relate to writing, publishing, and research. REMLEY & HERLIHY: CHAPTER 3

REMLEY & HERLIHY: CHAPTER 16 DANIEL: CHAPTERS 1 & 2 ADDRESSING VALUE-BASED CONFLICTS WITHIN THE COUNSELING RELATIONSHIP: A DECISION-MAKING MODEL NEW RESPONSIBILITIES WHEN MAKING REFERRALS CACREP ACCREDITATION, ETHICS, AND THE AFFIRMATION OF BOTH RELIGIOUS AND SEXUAL IDENTITIES: A RESPONSE TO SMITH AND OKECH Introduction to Values and Ethics 1. ACA has put in code of ethics that we as professional counselors must know and understand our own personal values a. We cannot impose our own personal values on those we are treating 2. Ethical bracketing a. Where you have a value that clashes with the client you put that value to the side in order to effectively work with the client b. Not saying you shouldn’t have values, its saying you should put your client and their treatment above these values 3. Populations a. What if you are dealing with a population you don’t feel comfortable working with? i. The ACA says we are not to refer people out based on values, referrals are based on whether or not we have the competence to work with the population(s)

Ethical Considerations: Working with Diverse Populations 1. Working with diverse populations a. Age b. Gender c. Ethnicity 2. Potential client who was a. Foreign born b. Military c. Disability d. Home with a single parent e. Computer? Internet? 3. All clients bring diversity 4. Important to consider ways to grow and be comfortable with diversity 5. Ethical items when working with diversity a. Examine and work on your own assumptions and stereotypes when working with diverse populations or different groups i. We all have our own biases b. Grow in culture sensitivity i. All theories and theoretical framework models are not one size fits all or universal. Its important that we adapt and modify these models or theories in order to really fit our clients and their contexts c. Be intentional in seeking ways to grow our own awareness when it comes to working with diverse populations

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Attitudes and Beliefs Reflection Paper Quiz: Multiculturalism, Values, Social Justice, and Advocacy 1. Because race, ethnicity, gender, and social class are salient cultural variables for all people, a. Individuals simultaneously experience both privilege and oppression 2. According to McIntosh, examples of White privilege may include all of the following EXCEPT: a. Growing up in a White middle or upper-class family environment 3. The term “culturally encapsulated counselor” refers to a counselor who: a. Defines reality according to one set of cultural assumptions and fails to evaluate other viewpoints, which renders the counselor insensitive to cultural variations 4. To be effective when counseling clients with physical disabilities, counselors should: a. Focus on the clients’ abilities rather than limitations 5. When counseling a client from a racial, ethnic, or cultural group different from the counselor’s, it is important for the counselor to remember that: a. Although certain groups share similar traits or beliefs, each individual is unique and may not be like most others from his or her group 6. The most important resource for counselors to use in learning about different racial, ethnic, or cultural groups is: a. Their clients 7. Counselors who work with female clients should have an understanding of the high- prevalence problems and issues experienced by women, including each of the following EXCEPT:

a. Tendency to be passive aggressive 8. When a counselor determines that a gay or lesbian client may have been illegally discriminated against, the counselor should: a. Help the client determine whether or not to seek legal advice 9. As advocates, counselors are aware that: a. Clients’ mental health is affected by their experiences of marginalization and oppression 10. If a Southeast Asian client refuses to seek police assistance when he or she has been the victim of a crime, the counselor should: a. Understand that the client may have negative feelings toward police because of police oppression in his or her native country Quiz: Professional Writing, Conducting Research, and Publishing 1. The requirement that universities establish committees to review research proposals to ensure that human participants are protected is: a. A federal law that carries with it the penalty of loss of federal funds if violated 2. Plagiarism: a. Is claiming the words and ideas of someone else as one’s own 3. Research participants: a. Must sign a document in front of a notary if they agree to waive their privacy 4. Students can ensure that they do not commit plagiarism by: a. Using a website such as Turnitin.com to check their work before submitting it to the professor 5. In regard to giving credit to contributors to research projects in published reports,

a. Appropriate credit must be given, but there are no firm rules 6. University committees that review research proposals to ensure that human participants are protected are called: a. Institutional review boards 7. Before students agree to serve as research assistants, counselor educators should discuss and provide: a. All of the above i. Assurance that those who decline to participate will not be penalized ii. An agreement regarding the type of acknowledgement students will receive when the research is published iii. A time-line to complete the various tasks iv. A clarification of expectations regarding who will do which parts of the work 8. Students do NOT have to cite a particular source of information, when the information: a. Is considered common knowledge 9. It is ethically questionable for a university professor to: a. Require a student to participate in a research project 10. When children are participants in a research study: a. Even though parental consent is legally sufficient, the assent of the children should be obtained as well Module 3: Client Rights, Counselor Responsibilities, Supervision, and Consultation

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Overview This module will provide you with an introduction to clients’ rights and counselors’ responsibilities and to the ethics related to supervision and consultation in counseling. You will become familiar with the ethical codes that governs supervision and consultation. Learning Outcomes Upon successful completion fo this module, you will be able to: - Identify the counselor’s responsibility to the client. - Identify the rights for the client in counseling. - Apply the state and ACA Codes of Ethics to an informed consent document. - Identify ACA ethics codes that apply to supervision and consultation. REMLEY & HERLIHY: CHAPTER 4 REMLEY & HERLIHY: CHAPTER 15 DANIEL: CHAPTERS 3 – 4 Watch: Informed Consent & The Counselor 1. ACA Code, Section A..2.a a. Clients have the freedom to choose whether to enter into or remain in a counseling relationship and need adequate information about the counseling process and the counselor. Counselors have an obligation to review in writing and verbally with clients the rights and responsibilities of both the counselor and the client 2. Purpose fo the Informed Consent a. Define the boundaries and clarify the nature of the counseling relationship between the counselor and the client

3. ACA Recommendations a. Purposes & goals b. Techniques & procedures c. Limitations, potential risks, and benefits of services d. Counselor’s qualifications, credentials and relevant experience continuation of services upon the incapacitation or death of a counselor e. The implications of diagnosis f. The intended use of tests and reports g. Fees and billing arrangements h. Confidentiality & limitations i. Information on records j. Rights to participate in the ongoing counseling plans & to refuse and to be advised of the consequences of such refusal 4. Informed Consent & State Regulations a. Consult your state rules and regulations 5. Informed Consent & Industry Standards a. The purpose and goals of counseling b. Only promise what you know you can deliver i. About the counseling process not the outcome of the counsleing process c. If treatment is voluntary or involuntary i. Voluntary 1. Explain that the client can terminate therapy at anytime ii. Involuntary

1. Court mandated client 2. Provide information of written documents that will need to go to specific people such as probation officers, judges etc. d. Potential risks and benefits i. All counseling comes with a risk ii. Change can bring about different feelings iii. Clients can make changes in their lives that will make changes in their relationships with others that others might not like e. Counselor’s theoretical orientation or philosophy i. Techniques 1. Mindfulness based stress reduction training 2. Hypnosis 3. Etc f. Counselor qualifications i. Student or new graduate being supervised must provide writing and verbal understanding that you are unders supervision along with supervisors information g. Confidentiality and its’ limitaitons i. Suspected child or elderly abuse or neglect ii. Suicide iii. Homicide iv. These will legally break confidentiality amongst other things v. Must explain this to the client

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h. Handling of records, access to files i. Secured and for how long they will be kept and how they will eventually be destroyed ii. HIPPA dictates the handling and storage of client information 1. Responsible to learn this and abide by this i. Fee and charges i. How delinquent accounts will be handled ii. Insurance and how those fees will be handled with insurance iii. Copayments and how those will be handled iv. Information on appointment cancellation policy 1. How much notice is required 2. Fees for missed appointment or late cancellation j. Disputes and complaints i. Who can client go to? 1. Supervisor? ii. Provide client information of who they can go to iii. Provide name and phone number of state licensure board k. Emergency procedures i. How can you be reached in an emergency and if you can’t be reached who can the client call or where can they go in the case of an emergency l. Social media i. 2005 ACA does not address it ii. 2015 ACA (soon to come out) does address it as it is more popular now

iii. Inform clients of how you’ll interreact such as emails, texting, facebook etc Quiz: Client Rights and Counselor Responsibilities 1. When involuntary clients are required to sign documents waiving their privacy before beginning counseling sessions, a. Counselors should carefully explain to clients’ the limits of their privacy within the counseling relationship 2. It is vital for counselors to become aware of their own personal needs and values so that they: a. Can avoid getting their own personal needs met through their counseling relationships 3. All of the situations below may lead to client dependency EXCEPT: a. Managed care programs that limit the number of counseling sessions 4. The court cases in Bruff and Walden demonstrated that: a. Counselors may be terminated from their employment if they take rigid positions regarding referring out LGBTQIQ clients 5. Because counselors have a fiduciary relationship with their clients, counselors must: a. Protect the best interests of their clients and not benefit inappropriately from the counselor-client relationship 6. Research has shown that: a. At least 30% of clients in counseling drop out prematurely 7. It is ethically permissible for counselors to terminate a counseling relationship for all of the following reasons EXCEPT:

a. The client experiences a crisis 8. Regarding counselors’ personal values, counselors: a. Could disclose their values to a client, if it is possible to do so in a way that conveys to the client that the client’s values can be accepted or rejected without risking the relationship 9. When clients seek counseling related to issues such as abortion, assisted suicide, interracial marriage, premarital sex, or sexual identity, counselors: a. Must examine their own values regarding these issues to ensure they can provide counseling services without allowing their own beliefs to interfere 10. Because clients may have emergencies between counseling sessions, it is usually wise for counselors to: a. Instruct clients to call a 24-hour mental health hotline number or report to a hospital emergency room Quiz: Chapter Supervision and Consultation 1. A counselor who is under the clinical supervision of another counselor SHOULD: a. Inform clients that he or she is in supervision and disclose the name of the supervisor to them 2. With respect to cultural differences in supervision: a. It is the supervisor’s responsibility to initiate discussions of cultural differences with their supervisees 3. When administrative and clinical supervisors give corrective feedback to supervisees, that feedback:

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a. Should be ongoing, coupled with periodic evaluation and opportunities to correct deficiencies 4. An agreement for clinical supervision between a supervisor and supervisee when the supervisee has an administrative supervisor at a work site SHOULD: a. State that the clinical supervisor defers to the authority of the administrative supervisor 5. A supervisor is competent if he or she: a. Can supervise other counselors in a professional and appropriate manner 6. If a supervisee is having emotional problems that are interfering with his or her ability to function effectively as a counselor, the clinical supervisor SHOULD: a. Address the personal issues in relationship to their impact on the supervisee’s effectiveness as a counselor but avoid becoming the supervisee’s personal counselor 7. Clinical supervision is the process whereby the work of counselors is reviewed by other mental health professionals, usually with the goal of: a. Increasing the counselor’s effectiveness 8. Supervision agreements between a clinical supervisor and supervisee: a. Should be in writing so both parties understand the terms of the relationship clearly 9. When a counselor who is working under supervision shares confidential information about clients with her or his supervisor: a. This is acceptable behavior because the supervisor needs the information in order to supervise effectively

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10. Ethical standards for consultants in the mental health field are: a. Given minimal attention in codes of ethics Module 4: Confidentiality, Privileged Communication Issues in Counselor Education Overview This module will provide an introduction to the ethical and legal issues related to privileged communication. You will learn the role of confidentiality within the counseling relationship and the ethics of counselor education. Learning Outcomes Upon successful completion of this module, you will be able to: - Differentiate among confidentiality, privileged communication, and privacy - Identify the limits of confidentiality in the counseling relationship. - Apply the ethics code to common issues of confidentiality in counseling. - Identify the ethical and legal issues that pertain to counselor education and training. REMLEY & HERILIHY: CHAPTER 5 REMLEY & HERLIHY: CHAPTER 14 DANIEL: CHAPTERS 5-6 Quiz: Confidentiality and Privileged Communication 1. Privileged communication statutes: a. Protect clients from having confidential communications with their counselors disclosed in a court of law without their permission

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2. When a husband subpoenas a counselor to reveal information in a court hearing that was provided by the wife in joint couples counseling sessions, and the wife objects to the information being revealed, the counselor: a. Should consult with an attorney because laws and court cases vary as to whether the counselor will have to reveal the information over the wife’s objection 3. Disclosure of confidential information is acceptable under all of the following conditions EXCEPT: a. An attorney sends a counselor subpoena. 4. When uncertain about the privileged status of information requested for disclosure through a subpoena, a counselor should consult with: a. An attorney who represents the counselor or his or her employer 5. If a counselor is asked to disclose privileged information about a client who cannot be located, then the obligation to assert the privilege rests with: a. The counselor 6. When a client accuses a counselor of wrongdoing through a complaint with the counselor’s licensure board or through a malpractice law suit filed in court: a. The client automatically waives his or her privacy rights and the counselor can reveal private information related to providing counseling services to the client 7. During the time that a counseling student is counseling clients in a practicum or internship setting, the student counselor: a. Has the same ethical obligations to uphold confidentiality as does a licensed counselor 8. Breaches of client confidentiality by counselors:

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a. Occur rarely and, when they do occur, usually are inadvertent 9. All of the following statements are true EXCEPT: a. Confidentiality and privilege belong to the counselor, not the client 10. With respect to confidentiality and privileged communication: a. Confidentiality is primarily an ethical issue, and privileged communication is primarily a legal issue Quiz: Issues in Counselor Education 1. How do relationships in counselor education, supervision, and training differ from clinical relationships? a. They are tripartite 2. Which of the following is NOT information that must be provided to prospective students before they enter a program? a. Faculty advisor assignment 3. When making graduate program admissions decisions, counselor educators: a. May use their subjective judgement regarding a number of factors 4. While you are a counseling graduate student: a. You must follow the same code of ethics as practicing counselors 5. When counselor educators evaluate the performance of a student’s counseling skills, the counselor educators: a. May apply subjective standards as long as they do not abuse their discretion 6. One of the most ethically sensitive components of counselor training that has generated considerable debate is: a. Self-growth experiences

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7. The gatekeeping responsibilities of counselor educators may involve all the following EXCEPT: a. Documenting decisions to dismiss students. 8. In matters of student evaluations or dismissals from academic programs, courts: a. Defer to the judgement of professors, unless established procedures were violated or the evaluations were clearly unfair. 9. Sexual relationships between counselor educators and their students: a. Are expressly forbidden in the ACA Code of Ethics 10. Flexibility in relationship boundaries between counselor educators and students may be more acceptable than between counselors and clients, because in counselor educator/student relationships the student: a. Eventually becomes a colleague. Module 5: Records, Subpoenas, Professional Relationships and Healthcare Overview This module will introduce the ethics surrounding records, interdisciplinary cooperation (especially in crises), and legal issues surrounding court orders and subpoenas. You will gain an understanding of how HIPAA impacts counseling practice. Learning Outcomes Upon successful completion of this module, you will be able to: - Identify ethical standards related to record keeping. - Describe HIPAA and its relationship to counseling practice and ethics.

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- Differentiate between court orders and subpoenas as well as the counselor’s legal and ethical responsibilities to each. READ REMLEY & HERILY: CHAPTER 6 READ REMLEY & HERILY: CHAPTER 13 READ DANIEL: CHAPTERS 7 – 8 Quiz: Records and Subpoenas 1. When counselor trainees make audiotapes or videotapes of counseling sessions for supervision purposes: a. All the above i. Supervisors must handle the tapes appropriately during the time the tapes are in the supervisor’s possession. ii. Supervisors should return tapes to trainees after the tapes have been reviewed. iii. The tapes should be labeled simply, in a manner that does not bring attention to the fact that the tapes are confidential records. iv. Trainees must retrieve the tapes after the supervisors have reviewed them and then erase the tapes. 2. Which of the following statements is most appropriate regarding clinical case notes? a. Counselors should take the clinical notes they need in order to function effectively as professionals. 3. Generally, counselors create clinical case notes: a. For their own use, so that they may be effective counselors.

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4. The three major types of records that counselors keep are: a. Recordings, clinical case notes, and administrative 5. If a subpoena for the counseling records of a client is received, a counselor who works in a mental health agency should: a. Ask his or her supervisor to obtain a legal opinion as to whether the records should be copied for the attorney who has issued the subpoena. 6. Keeping good records can benefit both counselors and clients in the following ways EXCEPT: a. Proving that the counselor is not impaired or suffering from burnout. 7. When documenting for self-protection: a. As much detail as possible (e.g., dates, times of events, and exact words spoken) should be included. 8. Subpoenas are used: a. All the above i. To obtain copies of records. ii. To require witnesses to appear at a deposition, hearing, or trail and to bring their records with them. iii. To ask potential witnesses to respond in writing to written questions. iv. To cause potential witnesses to testify at a deposition, hearing, or trial. 9. The Health Insurance Portability and Accountability Act (HIPAA) requires that: a. All the above i. A written process exists for clients to request amendments to their records. ii. Clients have access to their records.

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iii. A written history of most disclosures of client information be available to clients. iv. Counselors give clients a clear written explanation of how they use, keep, and disclose their health care information. 10. Legal principles view the contents of a client’s counseling records as belonging to: a. The client Quiz: Professional Relationships, Private Practice, and Healthcare Plans 1. A sliding scale in counseling refers to: a. A fee structure based on the client’s family income and family size. 2. Which of the following behaviors WOULD constitute insubordination? a. Refusing to carry out a directive of your immediate supervisor when that directive does not violate any laws or company policy. 3. Freedom of choice legislation allows health care consumers to choose: a. The type of healthcare provider they prefer under state authorized health care plans. 4. When a counselor must render a DSM-5 diagnosis before a client may be reimbursed for mental health care services, the counselor: a. Must render the proper diagnosis, whether the client will be reimbursed. 5. According to Remley and Herlihy, In the event a counselor has a client with a large bill for services that is several months late, the counselor SHOULD: a. Forget the bill and take steps in the future to prevent these bills from developing. 6. If a counselor were to purposefully make false oral statements that damaged the reputation of another mental health professional, the counselor could be sued for:

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a. Slander 7. If you believe your supervisor at your work setting is forcing, you to act in what you consider to be an unethical manner you SHOULD: a. Try to work with your supervisor to resolve the problem. 8. All the following statements are true EXCEPT: a. When disputes arise between employer and employees, the law generally favors the employer. 9. When a counselor must render a DSM-5 diagnosis before a client may be reimbursed for mental health care services, the counselor: a. Must render the proper diagnosis, whether the client will be reimbursed. 10. A Preferred Provider Organization (PPO): a. Must accept all counselors who apply to be added to their list of providers of health care services. Module 6: Competence, Assessment, Diagnosis, and Technology in Counseling Overview This module will introduce the ethics that surround counselor competence, assessment, diagnosis, and new technologies. You will learn how to navigate counseling boards’ websites for counselor infractions and sanctions. Learning Outcomes Upon successful completion of this module, you will be able to: - Describe counselor competence and methods of developing and maintaining competence within the field.

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- Differentiate between licensure and certification. - Describe malpractice as it relates to the counseling field. - Identify common complaints brought against counselors. READ REMLEY & HERILY: CHAPTER 7 READ REMLEY & HERILY: CHAPTER 10 Quiz: Competence, Assessment, Diagnosis 1. With respect to what mental health professionals are qualified to diagnose using the DSM system: a. The DSM manual specifically includes counselors as users of the DSM system. 2. An argument AGAINST licensing specialties within the counseling profession (such as marriage and family counselors, rehabilitation counselors, career counselors, etc.) is: a. Other professions – such as medicine and law – license professionals to practice their profession generally, and those who are licensed decide which areas they are competent to practice in 3. Which of the following statements regarding counselor competence is FALSE? a. Licensure ensures that practitioners are competent to do what their licenses permit them to do. 4. The primary purpose of diagnosis is to: a. Facilitate effective treatment. 5. Key points with respect to diagnosis include all the following EXCEPT: a. Clients should not be told the diagnosis that has been assigned to them. 6. Distressed counselors or counselors suffering from burnout are terms used to refer to: a. Impaired counselors

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7. Graduate degree programs in counseling attempt to ensure their graduates are competent counselors by doing all the following EXCEPT: a. Eliminating from graduate programs any students who have their own emotional issues. 8. When a counselor determines that a client may be at risk for harming self or others, the counselor must ALWAYS: a. Take the steps necessary to prevent harm. 9. Studies regarding cultural bias in diagnosis have shown that: a. African American clients are more likely to be diagnoses with severe mental illnesses such as schizophrenia. 10. Counselor competency can be assured if: a. There is no way to ensure counselor competency. Quiz: Technology in Counseling 1. Counselors who use social media platforms for personal purposes should NOT: a. Friend their clients 2. Storing clients’ records electronically: a. Provides a higher level of security than paper records. 3. When a counselor uses a networked or shared computer for the storage of confidential client information, the counselor SHOULD: a. Store confidential records on a portable storage device, rather than on the computer’s hard drive. 4. All the following are challenges associated with distance counseling EXCEPT: a. Limited effectiveness of counseling services that are not delivered face-to-face.

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5. When a counselor communicates with a client using e-mail: a. The client should be advised that e-mail messages can always be retrieved and that e-mail systems are not as secure as other means of communication. 6. Counselors may view a client’s social media profile: a. When the client has given the counselor consent to view the information. 7. distance counseling, Informed Consent SHOULD include: a. Distance counseling credentials, cultural/language differences, time zone differences, emergency procedures to follow if the counselor is not available, anticipated response time, and possible denial of insurance. 8. Internet sites that contain career information that might be helpful to clients: a. Are not monitored for content or quality. 9. When communicating with clients over the phone, counselors SHOULD: a. Attempt to verify the client’s identity and demonstrate caution and professionalism when discussing confidential information. 10. The following are TRUE of distance counseling services EXCEPT: a. Is controversial because the ACA Code of Ethics does not address this practice. Module 7: Malpractice, Resolving Legal and Ethical Problems & Boundary Issues Overview This module will provide an introduction to both the ethics surrounding evaluation, testing, and diagnosis of the client. You will learn how to apply and identify best practice in private practice. Learning Outcomes

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Upon successful completion of this module, you will be able to: - Identify the ethical and legal issues surrounding testing, assessment, and diagnosis of clients. - Identify the best practice guidelines for private practice. - Apply an ethical decision-making model. READ REMLEY & HERILY: CHAPTER 8 READ REMLEY & HERILY: CHAPTER 9 Watch: Responding to Ethical Dilemmas and Issues: BACP Ethical Framework for the Counseling Professions 1. Ethical Dilemmas a. It is impossible to do this sort of work without encountering situations where its not always clear what the right thing is to do. i. Sometimes find yourself choosing between two similarly good actions and sometimes more challenging. ii. One is where there isn’t an obvious good action and you’re trying to identify which is the least worst way to respond. iii. Important thing to realize is that it’s ok not to know what to do for the best 1. Recognizing this is so much better than blundering on regardless, when we face these dilemmas. b. Ethics is a discipline that helps us to solve these issues c. Sometimes specialist advice from lawyers or from other specialists and the techniques that we’re trying to use or the approach that we’re using in our work is necessary.

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d. There are also some very useful tests we can use to test whether we think we’ve got the best possible solution to our ethical dilemma. Quiz: Malpractice and Resolving Legal and Ethical Challenges 1. If a formal ethics complaint is filed against you, you should NOT: a. contact the client who filed the complaint to see if you can work things out. 2. If you believe another counselor is behaving in an unethical manner, the first thing you should do is: a. discuss the matter with the counselor and attempt to get him or her to change the behavior. 3. It is impossible for counselors to understand all aspects of the law, but the best advice for counselors who face legal questions is to: a. listen to their lawyer and do what the lawyer says. 4. Malpractice is a type of civil lawsuit that can be filed against counseling professionals for practicing in a manner that leads to: a. injury to a recipient of their services. 5. Most legal issues faced by counselors involve: a. acting as a witness in litigation concerning other people. 6. Counselors engage in many activities that could result in ethical complaints against them; however, they are still obligated to report: a. cases of suspected child abuse. 7. The primary purpose of the ACA Code of Ethics is: a. to set standards for ethics committees to use when complaints are filed.

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8. To avoid accusations of unethical or illegal behavior, the authors suggested the following regarding counselor self-disclosure: a. Counselors may engage in self-disclosure as long as the disclosure benefits the client and not the counselor’s personal needs. 9. When you have an ethical question and you are having trouble making a decision, you should first: a. consult with colleagues. 10. If you determine that another counselor is engaging in an illegal activity, a. you must report the crime to the police. Quiz: Boundary Issues 1. It would be ethically permissible for you to consider entering into a bartering arrangement with a prospective client if: a. bartering is an acceptable practice among other professionals in your community. 2. A definition of a “boundary” that is offered in the text is: a. a limit that promotes nonmaleficence. 3. The primary difference between a boundary crossing and a boundary violation is: a. a violation involves a serious breach of the code of ethics that results in a client being harmed. 4. Friendships with former clients: a. are prohibited by the ACA Code of Ethics. 5. Regarding dual relationships between counselors and clients: a. counselors are in agreement that such relationships are always wrong.

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6. Alice is a Licensed Professional Counselor who has counseled Thomas for several months. An issue to which they have devoted considerable time is Thomas’ fear of failure, particularly in terms of his ability to succeed academically and complete his G.E.D. When Thomas learns that he has passed his G.E.D. exam, he asks Alice to attend the ceremony at which he will receive his G.E.D. diploma, and she accepts the invitation. This is an example of: a. a boundary crossing. 7. The typical counselor who enters into a sexual relationship with a client is: a. one who has had a number of ethical complaints filed against him or her in the past. 8. A counselor’s self-disclosure in a counseling session: a. may be acceptable if the counselor believes the disclosure will benefit the client. 9. Boundaries serve to protect the welfare of clients because: a. counselors are vulnerable in counseling relationships. 10. To be a culturally sensitive counselor, when a client from a different culture offers a counselor a gift, the counselor SHOULD: a. evaluate the meaning the client attaches to the offering of the gift. Module 7: Couple, Family, Minors & Group Counseling Issues Overview

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This module will provide an introduction to the ethics surrounding the practice of couples, family, minor, incapacitated adults, and group counseling. You will learn how to appropriately apply an ethical decision – making model. Learning Outcomes Upon successful completion of this module, you will be able to: - Identify the ethical and legal issues that pertain to couple and family counseling. - Identify the ethical and legal issues that pertain to group counseling. - Identify the ethical and legal issues that pertain to counseling a minor or incapacitated adult. - Apply the ACA ethical decision-making model to a case scenario. READ: REMLEY & HERILY: CHAPTER 11 READ: REMLEY & HERILY: CHAPTER 12 Quiz: Counseling Children and Vulnerable Adults 1. The 2014 ACA Code of Ethics: a. Contains few standards specifically related to counseling children. 2. School counselors have a legal obligation to do all of the following EXCEPT: a. Obtain written parental permission before counseling students in most circumstances. 3. As a professional counselor, you are required by law in all states to report:

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a. Suspected child abuse or neglect. 4. Each of the following groups might be considered to be vulnerable adults who are protected from abuse in some states by statute EXCEPT: a. Emotionally distressed adults 5. Minor clients have: a. An ethical right to privacy and confidentiality, but no legal rights in most states. 6. Dual relationships in school settings: a. Generally, should be avoided. 7. Many states have laws requiring reports of suspected abuse of all of the following EXCEPT: a. Abused spouses or domestic partners. 8. In determining whether a child is a danger to self or others, the counselor should do all of the following EXCEPT: a. Assure the client of complete confidentiality. 9. When reporting suspected child abuse in good faith, counselors should review their particular state statute to determine all of the following EXCEPT: a. Counselor liability for defamation of character. 10. Parents who object to their child’s participation in counseling: a. May have the right to demand that services be discontinued. Quiz: Counseling Families and Groups 1. Pre-screening group members: a. Is required by the ACA Code of Ethics

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2. In order for a counselor to be competent to engage in group work, the counselor: a. Must have had a minimum of group work preparation and supervised experience. 3. Counselors who intend to conduct family counseling as part of their professional practice SHOULD: a. Gain specific training in marriage and family counseling, including supervised experience. 4. A family counselor who uses paradoxical directives or interventions could get into trouble, because clients who follow their prescriptions for behavior may be: a. Harmed 5. In the process of explaining Informed Consent in family counseling, counselors SHOULD: a. Describe possible changes in family relationships that could occur as a result of family counseling. 6. A counselor who is beginning a group SHOULD: a. Explain that while the counselor will keep things confidential, there is no guarantee others in the group will do the same. 7. Family counselors often view the family system as their client and treat the family as one entity – as opposed to treating individual family members – and our laws: a. View family members as having separate and distinct rights and responsibilities that are individual in nature. 8. Because children cannot give their legal consent to participate in family counseling, a. They should be informed of the process of family counseling and their consent should be secured even though it is not legally required.

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9. If a counselor wants a person other than a biological parent or legal guardian (such as a step-parent or grandparent) to have confidential information regarding a minor client, a simple solution is to: a. Get a signed statement from one of the biological parents or legal guardians, allowing the counselor to disclose information to the step-parent or grandparent. 10. Regarding the law of privileged communication, in relation to family and group counseling, a. Generally, privilege is waived if there is a third-party present during cousneling. Quiz: Dispositions Reflections 1. Please rate yourself on your sense of social responsibility including your ability to demonstrate a sense a fairness, justice, and equity for all and to demonstrate sensitivity and empathy. a. Exceeds expectations – I believe I do this exceptionally well 2. Please rate yourself on your work ethic and your level of commitment including class attendance, self-discipline, and preparation. a. Clearly meets expectations – I believe I am able to do this in an appropriate way as expected for graduate students at my current position in the program. 3. Please rate yourself on your reflective practice including utilizing data to make informed decisions and making choices after pondering ideas and experiences. a. Clearly meets expectations – I believe I am able to do this in an appropriate way as expected for graduate students at my current position in the program

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4. Please rate yourself on your integrity including your honesty inside and outside of the class, trustworthiness, and your adherence to the professional code of ethics. a. Exceeds expectations – I believe I do this exceptionally well 5. Please rate yourself on your professionalism including your respect for authority and appropriate behavior (i.e. patience, self-control, and flexibility). a. Exceeds expectations – I believe I do this exceptionally well 6. Please rate yourself on your cooperativeness, ability to work well with others and resolve conflict. a. Adequately meets expectations – I believe I do this but could use improvement and growth in this dispositional area 7. Please rate yourself on your openness to feedback, advice, and mentoring without becoming defensive. a. Exceeds expectations – I believe I do this exceptionally well 8. Please rate yourself on your responsibility in meeting due date, punctuality, and conscientiousness. a. Exceeds expectations – I believe I do this exceptionally well 9. Please rate yourself on your emotion regulation including mature, appropriate, and effective expression of emotions and your ability to manage your anxiety. a. Does not meet expectations – I believe I do not do this well and could use improvement 10. Using at least three complete sentences, please identify the following: 1. One dispositional area in which you believe you need to improve 2. One step you will take to improve in the above-mentioned area. Be specific and include an action plan.

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The dispositional area that I need to improve on is emotional regulation – specifically when it comes to the ability to manage my anxiety. I am already taking steps to manage this by being on medication as well as meeting with a counselor. However, I could also talk to my supervisor about my anxiety’s to see if they had any advice or stories of their own that would make me feel a little bit better and less anxious about said situation. If the situation seems to be something that triggers my anxiety to the point I would not be able to efficiently help my client (right now I’m going through an issue with a mentally unstable brother where my anxiety has turned into paranoia worrying if he is going to kill my mom and sister who he lives with, so if I would have a case relating to this for example that would bring back a lot of PTSD flashbacks or anxieties) I would talk to my supervisor about referring them out so that they can get the adequate care that they need and deserve.

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CEFS501

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