Ethics in Counseling – Flashcards
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What are the 5 principles of ethical practice?
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autonomy, beneficence, nonmaleficence, fidelity, and justice
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What is autonomy?
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to have will or freedom to make independent choices
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What is nonmaleficence?
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to do no harm and duty to avoid ineffective treatments
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What is beneficence?
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benefiting our clients
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What is justice?
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fairness, being impartial with our clients
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What is fidelity?
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maintain the trust and confidence of our clients
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What is mandatory ethics?
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letter-of-the-law level, complying with basic ethical codes; self-focused; more interested in covering all of one's bases than on the client
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What is aspirational ethics?
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spirit-of-the-law; focus is on client welfare
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What is an ethical autobiography?
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a way to understand our personal and professional ethics; helps new counselors to explore any preexisting beliefs or values; method of self-reflection
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What is a counseling ethics audit?
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a self-exploration tool intended for practicing counselors
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When are counselors expected to engaged in an EDM?
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when they are faced with ethical issues
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What are the general steps to the EDM process?
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1. identify if an ethical issue exists 2. review the ethical code, rules, and laws 3. consult 4. make a decision and implement it
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Is lack of knowledge or misunderstanding of an ethical responsibility a defense against a charge of ethical misconduct?
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NO
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Parents have the right to consent to or refuse treatment unless...."
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they have lost parental rights
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What are four ethical traps?
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commonsense objectivity, values, circumstantiality, who will benefit
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Which ethical trap is the belief that if the solution makes sense, then it is right?
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commonsense objectivity trap
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Which ethical trap has to do with distinct differences between our personal and professional values?
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the values trap
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Which ethical trap is the idea that there can never be a right or wrong response to an ethical dilemma because of the circumstances under which the behavior occurred?
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the circumstantiality trap
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Which ethical trap describes the implicit/explicit fact that there is a winner and loser in most ethical decisions?
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the who will benefit trap
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What are some ways we can avoid ethical traps?
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by avoiding rationalizations that skew our thinking
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What do we do when we suspect another counselor of unethical behavior?
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determine if an ethical issue exists at all, try to informally resolve the issue
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Why is continuing education necessary?
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helps counselors to stay informed and keep up-to-date
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What do you do if informal resolution with a colleague is unsuccessful?
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report the ethical violation to the state board, credentialing body, or committee
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When should ethical violations be reported?
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when there is a potential for substantial harm to come to a client and if the matter was not able to be resolved informally
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What do counselors do when there is a conflict between ethics and the law?
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make known their commitment to the ACA Code of Ethics - if no resolution can be made, the counselor adheres to the law or other regulations
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What do ethical autobiographies help you to do?
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takes you beyond memorizing the code and places your understanding of morals and values within the code
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When does ethical decision-making occur?
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when counselors are faced with a dilemma and must develop a solution
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What types of ethical decision-making models are there?
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theory-based, practice-based, cultural-based, and speciality-based
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What are examples of theory-based EDMs?
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Kitchener's ethical justification model, Betan's hermeneutic model, and Jordan and Meara's virtue ethics
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What does Kitchener's Ethical Justification Model say?
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it addresses autonomy, nonmaleficence, beneficence, and justice in ethical decision-making
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What does Betan's Hermeneutic Model say?
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highlights the differences that counselors bring in the process of making decisions; counselors interpret things differently; counselors are a PART of the ethical decision; need to acknowledge the gray areas; counselors are required to engage in ongoing self-exploration
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What does Jordan and Meara's Virtue Ethics Model say?
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should not focus on what the counselor should do; should focus on whom the counselor should BE
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What are the practice-based models?
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Sileo & Kopala's ABCDE Worksheet; Corey, Corey, Corey, & Callahan; Forester-Miller and Davis; Tarvydas Integrative Decision-Making Model of Ethical Behavior; and, Kocet, McCauley, and Thompson Decision Making for Student Affairs
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What are the steps in the Sileo & Kopala Model?
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A - assessment B - benefit C - consequences and consultation D - duty E - education
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What are the steps in the Corey, Corey, Corey, & Callahan Model?
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1. identify the problem 2. identify the potential issues involved 3. review the relevant ethical codes 4. know the applicable laws and regulations 5. obtain consultation 6. consider possible and probable courses of action 7. enumerate the consequences of various decisions 8. decide on what appears to be the best course of action
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What are the steps in the Forester-Miller and Davis Model?
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1. identify the problem 2. apply the ACA Code of Ethics 3. determine the nature and dimensions of the dilemma 4. generate possible courses of action 5. consider the potential consequences of all options and determine a course of action 6. evaluate the selected course of action 7. implement the course of action
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Which EDM is recommended by the ACA?
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Forester-Miller and Davis Model
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What are the steps in the Tarvydas Integrative Decision-Making Model of Ethical Behavior?
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1. interpreting the situation through awareness and fact-finding 2. formulating an ethical decision 3. selecting an action by weighing competing nonmoral values, personal blind sports, or prejudices 4. planning and executing the selected course of action
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What are the steps in the Kocet, McCauley, and Thompson Ethical Decision Making for Student Affairs?
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1. develop an ethical worldview 2. identify the ethical dilemma or problem 3. weigh competing ethical principles 4. select relevant ethical guidelines 5. examine potential cultural and contextual issues impacting the ethical dilemma 6. investigate applicable laws, regulations, policies. 7. search for ethical, legal, and professional precedence 8. engage in collaborative consultation 9. evaluate possible consequences of actions 10. choose a course of action 11. implement the selected course of action 12. reflect on the experience as it relates to ethics
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What are the cultural-based models?
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Cottone's Social Constructivism Model; and, Garcia, Cartwright, Winston, & Borzuchowska's Transcultural Integrative Model
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What are the steps in Cottone's Model?
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makes relationships important 1. obtain info from all involved 2. assess the nature of the relationships involved 3. consult colleagues, experts, ethical codes, and laws 4. negotiate among the first 3 concepts to arrive at a consensual decision 5. engage in interactive reflection throughout the process
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What are the steps in the Garcia, Cartwright, Winston, and Borzuchowska Model?
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1. interpret the situation through awareness and fact-finding 2. formulate an ethical decision 3. weigh competing, nonmoral values, and affirm the course of action 4. plan and execute the selected course of action
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What are examples of speciality EDMs?
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Crisis Counseling and Addictions Counseling
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What are the steps in the Crisis Counseling EDM?
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1. identify the ethical concern within the context of the disaster 2. consider personal self, beliefs, values, skills, and knowledge 3. identify the code of ethics involved 4. determine possible ethical traps 5. frame a preliminary response 6. consider the consequences 7. prepare an ethical resolution 8. get feedback and consultation 9. take action 10. review the outcome
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What are the steps in Addictions Counseling EDM?
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1. increase ethical sensitivity 2. identify and prioritize guiding principles 3. develop an ethical plan of action 4. implement ethical action 5. evaluate the outcome
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What should counselors do before deciding on an EDM?
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read through many and decide which is best for your practice
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What is involved in an EDM?
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identifying key ethical issues, reviewing relevant standards from ethical codes, determining potential legal issues, consultation, reviewing literature, and weighing core ethical principles
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How frequently are ethical codes revised?
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every 7-10 years
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What is a head and heart process?
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a cognitive and emotional response in counselors due to ethical issues
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What is included in the EDM process?
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consultation, reviewing ethical standards and laws, generating possible courses of action and reviewing the consequences of the actions; implementing an action
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What are the steps in the Seven-Steps Ethical Assessment Screen?
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1. identify the relevant professional values and ethics, your personal values, and societal values 2. determine what you can do to minimize conflicts between personal, professional, and social values 3. identify alternative ethical options 4. determine which option will minimize the conflicts the most 5. decide on an action that will do the least amount of harm 6. consider and weigh long/short-term consequences 7. is the planned action impartial, generalizable, and justifiable?
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When do we need to assess our client's cultural needs?
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Always
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In what areas can counselors show cultural sensitivity?
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1. support network 2. informed consent 3. differing ways to view confidentiality and privacy 4. not discriminating against clients 5. diagnosis and assessment 6. inclusiveness in training, teaching and supervision 7. disability issues and with technology
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What does the counseling relationship include?
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assessment, theories, techniques, communication, trust
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What must we be comfortable with?
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asking clients questions to learn more about their cultural values, traditions, and beliefs; also, engaging in personal research
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Every interaction is a ______________________ interaction.
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multicultural
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What does the Counselor Value-Based Conflicts Model (CVCM) do?
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designed to help counselors when faced with a conflict regarding a clash in personal/professional values between themselves and a client
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What are the 5 steps in the CVCM?
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1. determine the source/nature of the value conflict within the counseling relationship 2. challenges the counselor to explore the central issue (i.e. his/her personal morals, beliefs, or values) 3. seek guidance and consultation 4. determine the course of action and evaluate its appropriateness - need to evaluate if the issue is in values or competency 5. ensure the formal action promotes the dignity and welfare of the client
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What are the different types of consultation?
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relational and scholarship/research
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What is relational consultation?
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reaching out to a colleague, supervisor, professor, or expert to discuss the issue
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What are the advantages of relational consultation?
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gives you different perspectives, helps to organize your thoughts, formal mechanism to document your EDM
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When counselors consult, what do they share?
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basic and pertinent info about the case - not intimate details about the client's life
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What is research/scholarship consultation?
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looking at counseling literature, reviewing journals
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What are the advantages of research/scholarship consultation?
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helps us to identify practices based on empirical data, demonstrates we are using an EDM, may provide us with a deeper and richer understanding of the client's culture
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What is relational ethics also known as?
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collaborative ethics
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What values are included in "building and maintaining interpersonal attachments?"
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relational connection, autonomy, beneficence, and nonmaleficence
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What values are included in "building and maintaining expertise?"
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competence, humility, professional growth, openness to complexity/ambiguity, and self-awareness
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What are the steps in the relational ethical decision-making model?
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1. examine role of ethics in counseling relationship 2. identify the issue 3. discuss with the client your ethical obligations 4. examine core ethical principles that are most prominent with the client 5. consider things from both the counselor's and client's POV 6. Examine boundaries in the relationship and how they are affected by the ethical issue 7. look into laws and policies 8. consult professional literature and colleagues 9. collaborate with the client possible consequences of actions 10. choose a course of action 11. implement it 12. evaluate how the decision will affect the relationship in the future
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What is the Brief Ethical Decision-Making Model?
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ETHICS E - examine ethical principles T - trust H - have a conversation with the client about your ethical responsibilities I - investigate a safety plan C - Code of Ethics - review it - can it be reviewed right now with the client? S - self-reflect
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What do counselors need to focus on in relational EDMs?
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the involement of the client
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What is scientific basis for treatment?
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using techniques/modalities that are grounded in theory or have an empirical foundation
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What are empirically sound interventions?
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ones that have been tested or proven in an experimental fashion
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Where do counselors learn about reviewing counseling research?
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counselor education programs, workshops, membership in professional organizations
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What are scientific bases for treatment, empirically based interventions, and evidence-based practices?
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treatments that have been shown through clinical research to produce positive outcomes; shown in 2+ studies by different researchers
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Empirically based interventions should show __________ in symptoms.
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improvement
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Why do some counselors not use empirically-based interventions?
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lack of creativity in manuals, empirical interventions may not fit our client's needs, some interventions may be too complex
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What is competence?
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an attribute held by the counselor, and is the extent to which a therapist has the knowledge and skill required to deliver a treatment
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What is competence based on?
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education, experience, and certification
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Which ACA Division is focused on multicultural counseling competence?
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AMCD
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What is one of the biggest challenges to counselor competence?
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impairment
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What are types of impairment?
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compassion fatigue, vicarious trauma, or secondary traumatic stress
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What steps should be taken when intervening with an impaired colleague?
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evaluate the info, determine who the colleague should talk to, prepare for the meeting, balance empathy & compassion with clarity and facts, be prepared for the discussion, and follow up
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What is informed consent?
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the client's right to be provided with enough information to make decisions about treatment
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What does informed consent allow the client to develop?
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autonomy
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What is the purpose of informed consent?
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to give the clients enough information to decide about counseling; to help build trust with the client
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Informed consent is a one-time process.
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False
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How is informed consent done?
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implementing best practices: being clear in language and paying attention to culture...should be an ongoing process, and include state/ethical codes
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What is health literacy?
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ensuring your client understands his/her rights in relation to counseling
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How do we make sure that the client understands the informed consent?
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ask them if they understand, invite the client to ask questions, ask them how they prefer to be told info (verbal, reading, on a screen), continuously check in and document the process, know your state statutes and ethical codes
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Informed consent is a voluntary process.
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True
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What are some important parts of consent documents?
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permission to seek info from other treatment professionals, consent for treatment, HIPAA compliance form, support systems and contact info, client contact info and history, intake exam, and approval to tape
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Informed consent needs to be done with:
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assessment, research, supervision of a CIT, with minors or incapacitated adults, involuntary/mandatory clients
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In assessment, what needs to be addressed in informed consent?
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the administration, delivery, and feedback
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In informed consent with research, what does debriefing involve?
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working with the participants to process their experience in the study, discussing future steps to research, and keeping communication open and clear
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What is assent?
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When clients (minors or incapacitated adults) cannot legally give consent, they can give assent, which is an agreement to treatment
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What other components does electronic informed consent need?
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ensure confidentiality of all communications, include others who may have access to the info, how counseling will resume if connection is lost during a session, laws of states involved, a backup emergency contact for the client, list of appropriate referrals, defining emergency, obtain written consent for minors or incapacitated individuals
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Who does informed consent belong to?
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the client
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What is privilege?
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a legal concept that refers to state law granting a right to a counselor to maintain confidentiality
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What is privileged communication?
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communications that are permitted to remain confidential based on who the law grants the privilege to
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What is privacy?
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a legal term and refers to the client's right to nondisclosure of content that is discussed in session
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What are the primary purposes of confidentiality?
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provide privacy for the client and to place control over information shared in their hands
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What should counselors do before breaching confidentiality?
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consult with a colleague, implement an EDM, document all steps and the rationale behind each step
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What must counselors do when they decide to breach confidentiality?
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include the client, discuss the outcomes of the breach
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What is duty to warn?
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came from the Tarasoff case; warning the potential target
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What is duty to protect?
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warning the intended target AND calling the police to warn them of the disclosure
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Why should counselors not discuss private counseling matters with family or friends?
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they may influence our thoughts on the case, they are not qualified, this is inappropriate behavior
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What is minimal disclosure?
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counselors take precautions to provide only the info that is necessary to any inquiring authority or individual
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Who are approved recipients to minimal disclosure?
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judges, law officials, or specific allied health professionals
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What should counselors do before releasing confidential information?
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attempt to retain a written release of info from the client prior to releasing, consult with an attorney
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CITs need to make it known to clients that they are under supervision.
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True
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When a client/counselor dies, the counselor is still responsible for confidentiality.
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True
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What type of counseling setting is confidentiality not guaranteed?
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group counseling or FMT
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What are 3 potential negative side effects of using client stories in research?
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not disguising the info well enough, effects on the counseling relationship, and the public's perception of confidentiality
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How many methods of lock and key should counselors use to safeguard records?
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two
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What are 5 types of boundaries?
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emotional, psychological, social, financial, and physical
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What is a dual/multiple relationship?
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occurs when a counselor engages in a professional-counseling relationship with someone while also engaging in a nonprofessional relationship with that same person; holding 2+ roles with the same person at the same time
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What is a slippery slope?
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once a counselor starts to blur boundaries, there is a greater chance of ethical misconduct
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What are some steps in deciding whether to engage in a boundary extension or not?
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consultation, review code of ethics, review literature, reflect on motivation, examine risks/benefits of the extension
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What are the EDM steps in relation to boundaries?
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1. think about your response; think about the implications on the relationship 2. review the available info 3. identify possible options 4. consult the ethics codes 5. assess the foundational ethical issues 6. identify legal issues and agency policy 7. reassess options and identify a plan 8. implement the plan and document it 9. reflect on the outcome
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What is ethical identity or ethical idealogy?
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examine our motivation to act ethically
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What should counselors take into account in regards to gifts?
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the therapeutic relationship, monetary value of the gift, client's motivation for giving the gift, and the counselor's motivation for wanting to accept/decline the gift
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What are some terms used to describe counselors taking on roles outside of the counseling relationship?
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boundary crossings, boundary extensions, dual relationships, multiple relationships
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What should always be at the forefront of whether or not to engage in a boundary extension?
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therapeutic goals and welfare of the client
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What is required of counselors working with minors?
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knowledge of ethical codes, state laws, school regulations, health care, interpersonal skills, multicultural competence
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When counseling minors, who is ethically and legally the client?
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Ethically - the child Legally - the parent
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What is mandated reporting?
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those individuals & circumstances that require a breach of the minor's confidentiality regardless of whether the client or parents want the info released
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What EDM is useful when working with minors?
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Relational Ethical Decision-Making Model
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Must informed consent be documented in all 50 states?
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Yes
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What are some occassions where minors are able to consent to treatment?
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over age 16 who live independently, and manage their own finances
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What federal code protects minor's confidentiality?
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Title 42 of the Code of Federal Regulations Public Health
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What settings are minors' confidentiality and consent rights different?
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drug/alcohol facility
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In school settings, the counselor has to make sure the ______________________.
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focus remains on the student and their best interests
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What should be practiced when determining a treatment group?
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minimization
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Counselors should teach students how to?
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self-advocate
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What are the cultural needs of minors?
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to assimilate into the culture of their peers while also pleasing their parents and their cultural values
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Counselors should not ____ their values on their clients.
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impose
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Minors have no right to ____.
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privileged communication
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Why is confidentiality not guaranteed in group settings?
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because group members or family members may inappropriately disclose what is mentioned in counseling
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What must you first decide when working in group settings?
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who the client is
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In group counseling, who is the client?
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each individual is a client
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In family counseling, who is the client?
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the family
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In couples counseling, who is the client?
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the couple
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What must the counselor do when role changes occur in group counseling?
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explain any related consequences of the role change to the client, do a new informed consent
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What must counselors protect clients from in group settings?
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physical, emotional, or psychological trauma
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Counselors cannot ______ clients into participating in group exercises.
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force
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What does screening allow a counselor to do?
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see which clients may be inappropriate for the group, assess client fit, see who may be a problem in the group
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What sort of client diagnosis should not be invited into a general group setting?
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those with personality disorders
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What leads to best client improvement in group settings?
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group cohesion
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What is a good group size?
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8-12 members
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When is termination appropriate in group counseling?
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when the client is no longer benefiting from counseling, the client is being harmed from counseling, those who have not paid fees, or if they exhibit threatening behavior
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Why do we have to refer clients to other counselors after termination?
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to avoid client abandonment or neglect charges
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Group facilitation is a ______.
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speciality field
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What is the most frequent unethical practice in group counseling?
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untrained leaders leading groups
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What should counselors do when dual relationships exist?
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document boundary extensions
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What is included in inadequate family training?
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gender bias or paradoxical directives
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How can counselors remind group clients of confidentiality?
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by regularly discussing it, having group rules, having it mentioned on the sign-in sheet, or using a confidentiality contract
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What kind of notes should counselors keep in FMT?
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minimal, effective notes; maintain separate notes for each family member
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Advocacy should always include....?
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client education and participation
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What are the responsibilities of counselor educators?
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create, implement, and supervise educational programs
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What must be integrated within the counseling curriculum?
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ethics and multiculturalism
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What is appropriate supervision from counselor educators during field experience?
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at least 50 minutes to an hour per week
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How should relationships between students and faculty be kept?
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on a professional level
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How frequently should CITs hear about information related to the program?
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multiple times
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What do CITs have to learn about?
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field experience, interpersonal skills work, management of crises, diagnoses and pathology, theory and application, note-taking, self-care, treatment planning, ethical codes, and state law
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When should orientations be held?
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before entering the program, prior to field placement, and about postgraduation
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Besides teaching students, what else can orientations do?
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help determine student fit with the program and the profession
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What are the responsibilities of clinical supervisors?
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reviewing CITs case notes, videos, or actual counseling; reminding the CIT to convey their student/supervisory status to clients, having emergency contact info
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Why are counseling supervisors discouraged from supervising friends, romantic partners, or relatives?
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due to the power differential and associated displacement of judgment that may occur
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What kind of environment should counseling supervisors create?
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a supportive one
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What is a key aspect of the relationship between a supervisor and supervisee or counselor educator and student?
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relationships
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How can counselors engage in self-care?
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exercise, yoga, relaxation, meditation; maintaining a reasonable client load, participating in supervision, having a supportive work environment; spirituality and family connections
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What is moral turptitude?
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a legal concept that refers to conduct that violates or is contrary to generally acceptable standards of morality or justice
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Who is allowed to give prescriptions?
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psychiatrists
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Where are psychologists allowed to give prescriptions?
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New Mexico and Louisiana
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What is dependent prescribing privileges?
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when a counselor, when under the oversight of a physician, is able to prescribe meds to a client
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What are the levels of assessment?
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A, B, and C
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Which two levels of assessment can a counselor do?
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A and B
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What is a restricted test law?
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allows a state psychology board the right to establish a restricted test list, which prohibits qualified counselors from using tests that the publishers deem them able to do
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What client populations are good for distance counseling?
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those living in rural areas, those without transportation, those traveling abroad, those unable to speak
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What is the difference between ethics and the law?
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ethics - values and morals adopted by a code law - standards that a society accepts; has clear punishments
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What are the 3 components of licensure for professional counselors?
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education, competency exam, and supervised clinical experience
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How many jurisdictions, out of 52, have adopted the ACA Code of Ethics as their ethical standard?
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19
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What are examples of professional membership organizations?
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ACA, ASCA, and AMHCA
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How many divisions does the ACA have?
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20
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What are a few credentialing bodies?
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NBCC, APT, and NAFC
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What are 4 sanctions the ACA is able to do with an accused counselor?
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remediation, probation, suspension, and expulsion
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How can counselors practice risk management?
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purchasing liability insurance, practicing aspirational and relational ethics, using EDMs, and staying up-to-date
