Chapter 3: Ethical Issues in Counseling Practice – Flashcards

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mandatory ethics
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the view of ethical practice that deals with the minimum level of professional practice
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aspirational ethics
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a higher level of ethical practice that addresses doing what is in the best interests of clients
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positive ethics
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an approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble
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ethics codes
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- fundamental component of effective counseling - guidelines that outline professional standards behavior and practice - APA ethics code
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Ethical decision making model
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1. IDENTIFY the problem or dilemma 2. look at the relevant ETHICS CODES for general guidance 3. seek CONSULTATION from more than one source to obtain various perspectives on the problem 4. BRAINSTORM various possible courses of action 5. EVALUATE the consequences of various decisions, and reflect on the implications of each course of action for your client 6. DECIDE on what appears to be the best possible course of action
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informed consent
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involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it - inform patients about everything, from type of treatment to pay
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confidentiality
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the legal duty of therapists not to disclose information about a client
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privileged communication
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the legal concept that generally bars the disclosure of confidential communications in a legal proceeding - does not apply in group counseling, family therapy, or child and adolescent therapy
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when to break confidentiality:
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- child abuse -abuse of elderly - abuse of dependent adults - self danger / needs hospitalization - under 16 year old is victim of incest, rape, abuse - needed in court
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assessment
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evaluating the relevant factors in a client's life to identify themes for further exploration in the counseling process
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diagnosis
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sometimes part of the assessment process - consists of identifying a specific mental disorder based on a pattern of symptoms
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APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
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guides practitioners in making diagnostic assessments - it represents an initial step in comprehensive evaluation
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evidence based practice (EBP)
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- the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences - treatments have been validated by empirical research - replication/ reliable , valid - calls for accountability to provide effective treatments - prevents getting sued for malpractice - preferred by APA ethics code and psych places - Dr. Frisch says these are good in psychology, medicine or organizational psychology
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Evidence based treatment (EBT)
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- most powerful research method - RCCT tells us if treatments are effective -RCCTs use a type of experiment - 2 or more RCCT's at different labs with same result= reliable and valid (replication is required) - EBT are preferred in clinical psychology programs and psychiatry
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practice-based evidence
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using data generated during treatment to inform the process and outcome of treatment
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criticisms of EBT
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focuses on only one of these techniques in change 1. treatment technique********* (this one) 2. therapist characteristics 3. client characteristics 4. therapist client relationship - no creativity - impersonal, mechanical, insensitive to patient differences
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4 factors in change
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1. treatment technique 2. therapist characteristics 3. client characteristics 4. therapist client relationship
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T in EBT can stand for three things:
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1. evidence based THEORY 2. evidence based PSYCHOLOGICAL TEST (or assessment) 3. evidence based TREATMENT or intervention
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dual or multiple relationships
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occurs when counselors assume two or more roles simultaneously or sequentially with a client - either sexual or nonsexual
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boundary crossing
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a departure from a commonly accepted practice that could potentially benefit a claim eg= attending the wedding of a client
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boundary violation
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serious breach that harms the client and unethical eg=sexual relationship with client
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Case study: Cinderella
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- patient tells her therapist she loves him and wants an affair - what should therapist do? - say thanks but no - therapist cares about what is best for patient and this ruins that and is harmful to her -he says that its common
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Case Study: Henry Richter
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- multiple or dual relationships - therapist has affair with patient (melissa) - both are married - richter's wife is mentally ill - richter says that melissa has a damaged superego (conscience) -blaming melissa - melissa thought therapist could be both lover and therapist, richter agreed - they had sex during appointment hours, he raped her, only saw each other a few times a month
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ethics codes related to Richter
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- fidelity and responsibility - respect for people's rights and dignity - sexual harassment - conflict of interest - exploitative relationships - interruption of psych services - sexual intimacies with former therapy clients (wait 2 years) - interruption of therapy - terminating therapy
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Principle A: beneficence and nonmaleficence
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Richter violated this -do not harm patients - do what is best for patient - avoid any harm - also a standard
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Principle B: Fidelity and responsibility
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Richter violated this - keep promises and commitments without deceit or exploitation
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Standard 2.06: Personal Problems and Conflicts *
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Richter violated this - psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work- related activities in a competent manner - when psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as seeking help, decide if they should continue working
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Standard 10.05: Sexual intimacies with current therapy clients/ patients Standard 10.08 Sexual intimacies with former therapy clients/ patients
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Richter violated this - psychologists do not engage in sexual intimacies with current therapy clients/patients even after a two year interval except in the most unusual circumstances - psychologists who engage in such activity after the two years after therapy bear the burden of demonstrating that has been no exploitation
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5 general principles of the APA ethics code
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A. beneficence and nonmaleficence B. fidelity and responsibility C. integrity D. justice E. respect for people's rights and dignity
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dancing naked rule
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if patient takes off their clothes and starts dancing and wants sex, it is NEVER okay for therapist to say yes
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Steps in dealing with sexual or emotional abuse
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1. criminal (against the law) 2. civil (sue the person) 3. complain to license board (person could lose license) 4. professional association (person could be kicked out)
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Richter info
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- could have a disorder (no empathy, no emotion) - depressed - isolated - wife is in mental hospital - works a lot
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"The Giving Tree"
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- tree: therapist - person: client - giving tree syndrome (burnout) - always take care of yourself to help others
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inner abundance
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refers to life in its abounding fullness of joy and strength for mind, body, and soul.
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