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Understanding Informed Consent in Outpatient Mental Health. Presented by: Robert W. Marrs, MS, LMFT AAMFT Approved Supervisor. On Behalf of Wisconsin Association for Marriage and Family Therapy. Wisconsin Law – DHS 94.
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Robert W. Marrs, MS, LMFT
AAMFT Approved Supervisor
On Behalf of Wisconsin Association for Marriage and Family Therapy
DHS 94.02(22), Wisconsin Administrative Code - "Informed consent" or "consent" means written consent voluntarily signed by a patient who is competent and who understands the terms of the consent, or by the patient's legal guardian or the parent of a minor, as permitted under s.51.61(6) and (8), Stats., without any form of coercion, or temporary oral consent obtained by telephone in accordance with DHS 94.03 (2m).
DHS 94.03, Wisconsin Administrative Code - "INFORMED CONSENT. (1) Any informed consent document required under this chapter shall declare that the patient or the person acting on the patient’s behalf has been provided with specific, complete and accurate information and time to study the information or to seek additional information concerning the proposed treatment or services made necessary by and directly related to the person’s mental illness, developmental disability, alcoholism or drug dependency, including:
(a) The benefits of the proposed treatment and services,
(b) The way the treatment is to be administered and the services are to be provided,
(d) Alternative treatment modes and services,
(e) The probable consequences of not receiving the proposed treatment and services,
(f) The time period for which the informed consent is effective, which shall be no longer than 15 months from the time the consent is given, and
(g) The right to withdraw informed consent at any time, in writing.
(2) An informed consent document is not valid unless the subject patient who signed it is competent, that is, substantially able to understand all significant information which has been explained in easily understandable language, or the consent form has been signed by the legal guardian of an incompetent patient or the parent of a minor, except that the patient’s informed consent is always required for the patient’s participation in experimental research, subjection to drastic treatment procedures or receipt of electroconvulsive therapy.
(2m) In emergency situations or where time and distance requirements preclude obtaining written consent before beginning treatment and a determination is made that harm will come to the patient if treatment is not initiated before written consent is obtained, informed consent for treatment may be temporarily obtained by telephone from the parent of a minor patient or the guardian of a patient. Oral consent shall be documented in the patient’s record, along with details of the information verbally explained to the parent or guardian about the proposed treatment. Verbal consent shall be valid for a period of 10 days, during which time informed consent shall be obtained in writing.
(3) The patient, or the person acting on the patient’s behalf, shall be given a copy of the completed informed consent form, upon request.
(4) When informed consent is refused or withdrawn, no retaliation may be threatened or carried out.“
*Also refer to DHS 35.18 & 35.24 regarding Outpatient Mental Health Clinics
AAMFT Ethical Code 1.2 Marriage and family therapists obtain appropriate informed consent to therapy or related procedures as early as feasible in the therapeutic relationship, and use language that is reasonably understandable to clients. The content of informed consent may vary depending upon the client and treatment plan; however, informed consent generally necessitates that the client: (a) has the capacity to consent; (b) has been adequately informed of significant information concerning treatment processes and procedures; (c) has been adequately informed of potential risks and benefits of treatments for which generally recognized standards do not yet exist; (d) has freely and without undue influence expressed consent; and (e) has provided consent that is appropriately documented. When persons, due to age or mental status, are legally incapable of giving informed consent, marriage and family therapists obtain informed permission from a legally authorized person, if such substitute consent is legally permissible.
4. The mental health consumer must be:
5. Informed consent must be signed by all consumers participating in the treatment process
6. Informed consent includes an explanation of the consumer’s rights (DHS 51.61):
7. Consumer’s have the right to file a formal grievance (DHS 94.28 & 94.29):
8. Consumer’s must be informed of any potential risks or negative outcomes associated with psychotherapy
9. Consumer’s must be informed of any potential benefits associated with psychotherapy (E.g.)
10. Consumer’s must be informed of any potential side effects of NOT receiving psychotherapy (E.g.)
11. Consumer’s must be informed about your qualifications to provide psychotherapy:
12. Consumer’s must be informed about your therapeutic approach:
13. Have a discussion about expectations and preferences (both the client’s and the therapist’s)
14. Explain any limitations in your approach or services
15. Consumer’s need to be informed about any and all financial costs and responsibilities associated with receiving mental health services:
16. Consumer’s need to be informed and educated about confidentiality as it relates to protected health information.
17. Consumer’s need to be informed and educated about confidentiality as it relates to protected health information.
18. Give consumer’s options should they ever feel a lack of progress in psychotherapy:
The purpose of informed consent is to honor the patient’s legal right to be informed about all aspects of his/her mental health treatment so that he/she can:
Providing individual therapy when couple or family therapy is indicated has the potential of destabilizing the patient’s relationships because individual therapy can oftentimes promote individuation and differentiation. It’s important to help patients consider the potential consequences of not providing couple and family therapy.
With changes in both federal and state law, please be sure to verify that your informed consent form is both HIPAA and Wisconsin compliant before implementation in your practice.
*Note: Ss 51.61 states that a client must be “fully informed of his or her treatment and care, and to participate in the planning of his or her care.” Any restriction of a client’s treatment record may NOT interfere with this right.