1 / 46

Ethics: Issues in the Mental Health Profession

Ethics: Issues in the Mental Health Profession. Michael W. Nettles, D.Min ., M.Ed., LPC, LCPC, CCDP, MAC. DC Mental Health Counselors Association (DCMHCA) 2014 Spring Conference University of District of Columbia. Course Description.

clyde
Download Presentation

Ethics: Issues in the Mental Health Profession

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Ethics: Issues in the Mental Health Profession Michael W. Nettles, D.Min., M.Ed., LPC, LCPC, CCDP, MAC DC Mental Health Counselors Association (DCMHCA) 2014 Spring Conference University of District of Columbia

  2. Course Description • This training is designed to allow participants to become familiar with issues and ethics in the helping professions. • Participants will be provided with a framework and a direction for working through ethical dilemmas • Participantswill become familiar with ethics for helping professionals according to the AMHCA Code of Ethics

  3. Ethical Codes • Ethical codes are not intended to be blueprints for resolving every ethical dilemma; nor do they remove all need for judgment and ethical reasoning. • Formal ethical principles can never be substituted for an active, deliberative, and creative approach to meeting ethical responsibilities (Pope & Vasquez, 2007)

  4. Common Themes of Codes of Ethics (Koocher & Keith-Spiegel, 2008) • Promoting the welfare of consumers • Practicing within the scope of one’s Competence • Doing no harm • Protecting client’s confidentiality

  5. Common Themes of Codes of Ethics • Acting ethically and responsibly • Avoiding exploitation • Upholding the integrity of the profession by striving for aspirational practice

  6. Limitations of Codes of Ethics(Herlihy & Corey, 2006a; Pope & Vasquez, 2007; Herlihy & Remley, 1995) • Simply learning the ethics codes and practice guidelines will not necessarily make for ethical Practice • Practitioners who belong to multiple professional associations, licensed by their state and hold national certifications, may be responsible to practice within the framework of numerous codes of ethics, yet these codes may not be uniform

  7. Limitations of Codes of Ethics • A practitioner’s personal values may conflict with a specific standard within an ethics code • Codes may conflict with institutional policies and practices • Codes may not align with state laws or regulations regarding reporting requirements

  8. The AMHCA Code of Ethics AMHCA’s Code of Ethics is intended to be a guide to do the following: • Assist members to make sound ethical decisions • To define ethical behaviors and best practices for association members • To support the mission of the association • To educate members, students and the public at large regarding the ethical standards of mental health counselors

  9. The AMCHA Code of Ethics Seven Main Sections • Commitments to Clients • Commitments to Other Professionals • Commitments to Students, Supervisees and Employees • Relationships • Commitments to Profession • Commitments to Public • Resolution of Problems

  10. Ethics Codes and the Law • All of the codes of ethics state that practitioners are obligated to act in accordance with relevant federal and state statutes and government regulations

  11. Ethics and Law I. A. 2. c. Confidentiality • The release of information without consent of the client may only take place under the most extreme circumstances: • the protection of life (suicidality or homicidality) • child abuse, and/ or abuse of incompetent persons • elder abuse. • Above all, mental health counselors are required to comply with state and federal statutes concerning mandated reporting.

  12. Ethics and Law I. A. 2. d. Confidentiality • Mental health counselors make every attempt to release only information necessary to comply with the request or valid court order. • Mental health counselors are advised to seek legal advice upon receiving a subpoena in order to respond appropriately.

  13. Unethical • When the word unethical is used, people think of extreme violations of established codes. In reality, most violations of ethics happen quite inadvertently in clinical practice. • The best method of practice is to ask yourself, • “Is what I am doing in the best interest of my client?” • “Would my professional organization agree?”

  14. Transference • The process whereby clients project onto their therapists past feelings or attitudes they had toward significant people in their lives. • If therapist are unaware of their own dynamics, they may miss important therapeutic issues when they should be helping their clients to understand and resolve the feelings they are bringing into the present from their past.

  15. Counter-Transference

  16. Counter-Transference • Counter-transference is a situation in which a therapist, during the course of therapy, develops positive or negative feelingstoward the patient. • These feelings may be the therapist's unconscious feelings that are stirred up during therapy and directed toward the patient..

  17. Counter-Transference Issues • Being overprotective with a client • Treating clients in kind ways that goes beyond the norm • Rejecting a client • Seeing yourself in your clients • Developing sexual or romantic feelings • Developing a social relationship with clients

  18. Exploitive Relationships • A. 4. a., b. • Romantic or sexual relationships with clients are strictly prohibited. Mental health counselors do not counsel persons with whom they have had a previous sexual relationship. • Mental health counselors are strongly discouraged from engaging in romantic or sexual relationships with former clients. Counselors may not enter into an intimate relationship until five years post termination or longeras specified by state regulations. Documentation of supervision or consultation for exploring the risk of exploitation is strongly encouraged.

  19. Exploitive Relationships (cont’d) 1A. 4.d. Personal Values • Mental health counselors are aware of their own values, attitudes, beliefs and behaviors, as well as how these apply in a society with clients from diverse ethnic, social, cultural, religious, and economic backgrounds. • Value imposition refers to counselors directly attempting to influence a client to adopt their counselor’s values, attitudes, and beliefs, and behaviors. • It is possible for mental health practitioners to do this either actively or passively.

  20. Value Sharing? • “Is it possible for you to disagree with a client's values and still accept him or her as a person?” • “Is the purpose of counseling to teach values to clients or to teach clients how to discover their own values?” • “What is the difference between exposing or imposing your values on clients?” • “Is it ever justifiable for you to impose your values on clients? What about those situations in which you are convince that the client's values will result in self-destructive behavior?”

  21. Role of Spiritual and Religious Values • Acounselors role is not to prescribe a particular pathway to clients in fulfilling their spiritual needs, but to help clients clarify their own pathway.

  22. Addressing Sexual Orientation • 1973 the American Psychiatric Association stopped labeling homosexuality, a sexual orientation in which people seek emotional and sexual relationships with same-gendered individuals, as a form of mental illness • 1975, the American Psychological Association endorsed this move by recommending that psychologists actively work to remove the stigma that had been attached to homosexuality

  23. Addressing Sexual Orientation • Counselors understand that attempting to change the sexual orientation or gender identity of LBGT clients may be detrimental, and further, such a practice is not supported by research and therefore should not be undertaken

  24. Confidentiality Confidentiality I. A. 2. a. • Confidentiality is the heartbeat of relationship building and client confidence in the counseling process

  25. Confidentiality • Confidentiality, which is rooted in a client’s right to privacy, is at the core of effective therapy. • “Itis the counselor’s ethical duty to protect private client communication” (Wheeler & Bertram, 2008, p.65) • Obtain and document your client’s consent before disclosing. • Respond ethically to legal requests for disclosure

  26. Duty to Warn and to Protect Mental health professionals driven by the courts, have come to realize that they have a dual professional responsibility: • Identify those clients who are likely to do physical harm to third parties • Protect third parties from those clients judged potentially dangerous.

  27. Duty to Warn • Duty to warn applies to those circumstances where case law or statute requires the mental health professional to make a reasonable effort to contact the identified victim of a client’s serious threats of harm, or to notify law enforcement of the threat. • Tarasoff

  28. Duty to Protect • Duty to protect applies to situations where the mental health professional has a legal obligation to protect an identified third party who is being threatened.

  29. HIV/AIDS Related Issues • The HIV+ duty to protect decision is one of the more controversial and emotion-laden issues practitioners might encounter. • For practitioners who work with persons who are HIV+, the choice is often between protecting the client-therapist relationship and breaching confidentiality to protect persons at risk of infection. • This situation can put practitioners in a moral, ethical, legal, and professional bind. • State laws differ regarding HIV and the limits of confidentiality and the law is often different for medical professionals than for licensed psychotherapists.

  30. HIV/AIDS Related Issues • Some states forbid any disclosure of HIV status to third parties. • Some states allow some disclosure to at-risk third parties by physicians and psychiatrists, but not by other mental health professionals. • Some states prohibit psychotherapists from warning identifiable victims of persons who are HIV-positive. • Other states have yet to address this issue by statute

  31. HIV/AIDS Related Issues • Therapists need to keep current with regard to relevant medical information related to the transmission of HIV, know which sexual practices are safer and which are not, and encourage their clients to practice safer sex

  32. Confidentiality and HIV/AIDS Related Issues I.A.2.n. Contagious, Life-Threatening Diseases • Mental health counselors may justify disclosing information to identifiable third parties if clients disclose that they have a communicable or life threatening illness. • However, prior to disclosing such information, mental health counselors must confirm the diagnosis with a medical provider. • The intent of clients to inform a third party about their illness, and to engage in possible behaviors that could be harmful to an identifiable third party, must be assessed as part of the process of determining whether a disclosure should be made to identifiable third parties.

  33. Tarasoff Decision California Supreme Court “1976” • A failure to warn an intended victim was professionally irresponsible • When a therapists determines“that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger”

  34. Bartering Bartering - Exchanging goods or services in lieu of a fee

  35. Bartering I.E. 2.b. Bartering • Accepting goods or services for professional services can open the door to misunderstandings, perceived or actual exploitation, boundary violations, and reduced effectiveness as a clinician. • Although bartering is not prohibited by ethics or law, most legal experts frown on the practice. • Mental health counselors usually refrain from accepting goods or services from clients in return for counseling services because such arrangements may create the potential for conflicts, exploitation and distortion of the professional relationship. • However, bartering may occur if the client requestsit, there is noexploitation, and the cultural implications and other concerns of such practice are discussed with the client and agreed upon in writing.

  36. Gift Giving When determining whether or not to accept a gift from clients, counselors take into account the following: • The therapeutic relationship • The monetary value of a gift • The client’s motivation for the gift • The counselor’s motivation for wanting or declining the gift

  37. Steps In Making Ethical Decision Making • Identify the problem or dilemma • Identify the potential issues involved • Review the relevant ethics codes • Know the applicable laws and regulations • Obtain consultation • Considerpossible and probable courses of action • Itemizethe consequences of various decisions • Choosewhat appears to be the best course of action (Barnett & Johnson, 2010)

  38. Vignettes

  39. Counselor Responsibility and Integrity1.C.1. a-n • Competence is both an ethical and a legal concept. • From an ethical perspective, competence is required of practitioners if they are to protect and serve their clients. • From a legal standpoint, incompetent practitioners are vulnerable to malpractice suits and can be held legally responsible in a court of law

  40. Competence - 1.C.1.a-n • Even though mental health professionals may not intend to harm client, lack of competence often is a major contributing factor in causing harm. • Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. • Provide only those services and use only techniques for which they are qualified by education, training, or expertise.

  41. Summary • Professionals are required to engage in ongoing study, education, training, and consultation in their areas of practice. • A practitioner’s level of competence can diminish over time, which is a rationale for continuing education. • Failure to maintain one’s competence is considered “practitioner decay”

  42. References • American Mental Health Counselors Association, 2010 • American Counselors Association, 2014 • NAADAC Code of Ethics, 2011

  43. AMCHA American Mental Health Counselors Association 801 N. Fairfax Street, Ste. 304 Alexandria, VA 22314 V: 800-326-2642 F: 703-548-4775 www.amhca.org Note: AMHCA revises its Code of Ethics every few years, but it does not follow a predetermined schedule. The current 2010 version will be revised within the next several years.

  44. ACA American Counseling Association 5999 Stevenson Avenue Alexandria, VA 22304 counseling.org • 800-422-2648 x222 Note: The 2014 ACA Code of Ethics was approved by the Governing Council at its meeting at the ACA conference held in Honolulu, Hawaii.

  45. NAADAC The Association for Addiction Professionals 1001 N. Fairfax Street, Suite 201 Alexandria, Virginia 22314 800.548.0497 • 703.741.7686 Fax 800.377.1136 • 703.741.7698 naadac.org. Note: Revised March 28, 2011

  46. Thank you.. Michael W. Nettles D.Min., M.Ed., LPC, LCPC, CCDP, MAC Community Outreach Services, Inc. 6215 Greenbelt Road, Suite 206 College Park, MD 20740 mwnettles@yahoo.com

More Related