The Ethical and Professional Practice of Counseling and Psychotherapy Book

Preface

I. ETHICAL, PROFESSIONAL, AND CONTEXTUAL CONSIDERATIONS.

1. The Ethical and Professional Practice of Counseling and Psychotherapy.

MAKING COUNSELING PRACTICE DECISIONS IN THE PAST

MAKING COUNSELING PRACTICE DECISIONS TODAY

Professional Domain Considerations

Ethical Domain Consideration

THE KEY ROLE OF ETHICAL CONSIDERATIONS IN MAKING COUNSELING

PRACTICE DECISIONS

PREMISES AND PERSPECTIVES ON ETHICAL AND PROFESSIONAL PRACTICE

Basic Premises

Three Perspectives on Ethical and Professional Practice

BASIC TERMINOLOGY

General Ethics

Applied Ethics

Ethical Dilemma

Personal Ethics

THE DOMAINS AND DIMENSIONS OF ETHICAL THINKING AND DECISION MAKING

Professional Domain

Ethical Domain

Contextual Domain

A STRATEGY FOR DECISION MAKING IN COUNSELING AND PSYCHOTHERAPY PRACTICE

2. Personal and Developmental Ethics.

THE PROFESSIONAL DEVELOPMENT OF COUNSELORS AND THERAPISTS

Levels of Counselor and Therapist Development

Levels of Ethical Development

ETHICAL VALUES IN COUNSELING AND PSYCHOTHERAPY

Ethical Principles

Ethical Values

Ethical Values and Practices of Master Therapists

ETHICAL THEORIES IN COUNSELING AND PSYCHOTHERAPY

Six Ethical Theories

Implications for Counseling and Psychotherapy Practice

ETHICAL CODES AND PRACTICE BEHAVIOR

FOSTERING ETHICAL DEVELOPMENT IN COUNSELING AND PSYCHOTHERAPY

Ethical Autobiography

Ethical Decision-Making Style

Ethical Acculturation

3. Multicultural, Relational, and Spiritual Issues in Ethics.

THE RELATIONAL DIMENSION

The Relational Dimension in Counseling

The Relational Dimension in

Supervision

The Relational Dimension in Ethical Decisions

THE MULTICULTURAL DIMENSION

Cultural Sensitivity and Competency

Core Cultural Competencies

The Primacy of Cultural Awareness

Cultural Considerations and Ethical Decisions

THE RELIGIOUS AND SPIRITUAL DIMENSION

Spirituality

Professional and Personal Stance Regarding Spirituality and Religion

Levels of Professional Incorporation of the Spiritual Dimension in Counseling Practice

Spiritual Assessment

Spiritual and Religious

Competencies for Counselors

4. Organizational Ethics.

ORGANIZATIONAL SYSTEMS AND DYNAMICS

Structural Subsystem

Cultural Subsystem

Administrative Subsystem

Staff Subsystem

Strategy Subsystem

Environmental Subsystem

DIFFERENTIATING PERSONAL, PROFESSIONAL, AND ORGANIZATIONAL ETHICS

THE CENTRALITY OF ORGANIZATIONAL ETHICS FOR ORGANIZATIONAL SUCCESS

The Central Role of Organizational Culture and Leadership

Three Differing Perspectives

SYSTEMIC FACTORS IMPACTING ORGANIZATIONAL ETHICS

Conflict between Personal Ethics and Organizational Policy

Impact of Organizational

Dynamics on Ethical Dilemmas

ORGANIZATIONAL ETHICS AND PROFESSIONAL ETHICS

Confidentiality

Informed Consent

COUNSELING PRACTICE AND ORGANIZATIONAL ETHICS

Financial Consideration

Efficiency and Expediency

Personal—Organizational Ethical Conflicts

ASSESSING AND EVALUATING ORGANIZATIONAL ETHICS IN A COUNSELING SETTING

Ethics Audits

Organizational Ethics Inventory

Ethics Compliance Audit

COMMUNITY VALUES

Impact of Community Values

Recognizing Community Values

5. Ethical and Professional Decision Making in Counseling and Psychotherapy.

DECISION MAKING IN COUNSELING AND PSYCHOTHERAPY

Professional Considerations

Contextual Considerations

Ethical

Considerations

APPROACHES TO ETHICAL DECISION MAKING

THE PROFESSIONAL AND ETHICAL PRACTICE DECISIONAL STRATEGY

The Eight Steps of the Decisional Strategy

CASE ILLUSTRATION OF THE ETHICAL AND PROFESSIONAL PRACTICE DECISIONAL STRATEGY

PROFESSIONAL DIMENSION

CONTEXTUAL DIMENSION

ETHICAL DIMENSION

APPLYING THE ETHICAL AND PROFESSIONAL PRACTICE DECISION STRATEGY

II. ETHICAL STANDARDS OF PROFESSIONAL PRACTICE.

6. Confidentiality.

THE CONTEXTUAL DOMAIN AND CONFIDENTIALITY

THE ETHICAL BASIS OF THE CONCEPT OF CONFIDENTIALITY

Beneficence and Confidentiality

Nonmalificence and Confidentiality

Care and Confidentiality

Respect for Privacy and Confidentiality

EMERGING BRAIN SCIENCE AND CONFIDENTIALITY

Attachment and Confidentiality

LEGAL ASPECTS OF CONFIDENTIALITY

Privileged Communication

The Health Insurance Portability and Accountability Act (HIPPA) of 1996

Personal-Developmental and Organizational Ethics in a Regulatory Context

EXCEPTIONS TO CONFIDENTIALITY

Abuse and Confidentiality

Suicide and Confidentiality

Threats to Others and Confidentiality

RIGHTS OF CHILDREN AND CONFIDENTIALITY

7. Informed Consent.

THE CONTEXTUAL DOMAIN AND INFORMED CONSENT

THE LEGAL AND ETHICAL BASIS OF THE NEED FOR CONSENT FOR TREATMENT

KEY ELEMENTS OF AN INFORMED CONSENT DOCUMENT

SYSTEMIC AND MULTICULTURAL CONSIDERATIONS IN INFORMED CONSENT PROCEDURES

INFORMED CONSENT AND MINORS

Assent to Treatment

Exceptions to the General Requirement of Parental Consent

INVOLUNTARY COMMITMENT AND INFORMED CONSENT

ON-LINE COUNSELING AND INFORMED CONSENT

8. Conflict of Interest, Boundaries, and the Use of Power.

THE CONTEXTUAL DOMAIN AND CONFLICT OF INTEREST, BOUNDARIES, AND THE USE OF POWER

Personal-Developmental

Relational-Multicultural

Organizational

Ethics—Community Values

POWER IN COUNSELING AND PSYCHOTHERAPEUTIC RELATIONSHIPS

Abuse of Power as a Process and Not an Event

DUAL AND MUTUAL RELATIONSHIPS

BOUNDARY VIOLATIONS

Process versus Event

Therapist Self-Care: A Way of Avoiding Boundary Violations

Sexual and Nonsexual Boundary Violations

BOUNDARY CROSSINGS

A TEMPLATE FOR EVALUATING THE ETHICS OF NONSEXUAL DUAL RELATIONSHIPS

9. Competency and Professional Responsibility.

COUNSELING AS A PROFESSION

Defining Profession and Professional

The Counseling Profession

COMPETENCE AND WORK ORIENTATION

Three Work Orientations

The Relationship between Work Orientation and Competence

ETHICAL AND LEGAL ASPECTS OF COMPETENCE

Ethical Aspects

Legal Aspects

PROFESSIONAL COMPETENCE

Continuum of Competence

Scope of Practice

ACHIEVING AND MAINTAINING COMPETENCE

Attaining Competence

Maintaining Competence

INCOMPETENCE

Impairment versus Incompetence

Three Types of Incompetence

DISTRESS, BURNOUT, AND IMPAIRMENT

Strategies for Preventing Burnout and Impairment

NEGLIGENCE AND MALPRACTICE

Negligence

Malpractice

VIEWING COMPETENCE FROM THE THREE PERSPECTIVES

Perspective I

Perspective II

Perspective III

MASTER THERAPISTS AND COMPETENCE

COMPETENCE AND THE DEVELOPMENTAL, RELATIONAL AND ORGANIZATIONAL DIMENSIONS

III. ETHICAL AND PROFESSIONAL PRACTICE IN SPECIALTY AREAS.

10. School Counseling.

ROUTINE PRACTICE FOR SCHOOL COUNSELING

CONTEXTUAL ISSUES IN SCHOOL COUNSELING

Personal-Developmental

Relational-Multicultural

Organizational Ethics—Community Values

CORE ETHICAL ISSUES FOR SCHOOL COUNSELORS

Confidentiality

Informed Consent

Conflicts of Interest and Boundaries

Competence

LEGAL ISSUES AFFECTING THE PRACTICE OF SCHOOL COUNSELING

Legal Rights of Parents and Confidentiality

Mandatory Abuse Reporting

Threat of Harm to Self or Others

Case Law Related to the Practice of School Counseling

Student Records

Students with Special Needs

Ethics and Sexual Behavior

Spirituality and School Counseling

CASE ILLUSTRATION OF ETHICAL-PROFESSIONAL DECISION MAKING IN SCHOOL COUNSELING

11. Mental Health Counseling.

ROUTINE PRACTICE OF MENTAL HEALTH COUNSELING

CONTEXTUAL ISSUES IN MENTAL HEALTH COUNSELING

Personal-Developmental

Relational-Multicultural

Organizational Ethics—Community Values

CORE ETHICAL ISSUES AND CODES OF ETHICS FOR MENTAL HEALTH COUNSELORS

Confidentiality

Informed Consent

Conflicts of Interest Competency

REPORTS OF THE ACA ETHICS COMMITTEES

LEGAL ISSUES AND CASE LAW AFFECTING MENTAL HEALTH COUNSELORS

Duty to Warn/Duty to Protect

Immunity from Suit for Breaking Confidentiality

Client—Counselor Privileged Communication/Confidentiality

SPECIAL TOPICS IN MENTAL HEALTH COUNSELING

Managed Care

Substance Abuse/Drug Addiction

Group Counseling

Spirituality and Mental Health Counseling

CASE ILLUSTRATION OF ETHICAL-PROFESSIONAL DECISION MAKING IN MENTAL HEALTH COUNSELING

12. Couples and Family Counseling and Therapy.

ROUTINE PRACTICE OF COUPLES AND FAMILY THERAPY

HIPAA Considerations

CONTEXTUAL ISSUES IN COUPLES AND FAMILY THERAPY

Personal-Developmental

Relational-Multicultural

Organizational Ethics—Community Values

CORE ETHICAL ISSUES AND CODES OF ETHICS FOR COUPLES AND FAMILY THERAPISTS

Confidentiality

Informed Consent

Conflicts of Interest

Competency

PREVALENCE OF ETHICAL BREACHES 323

LEGAL ISSUES AND CASE LAW AFFECTING COUPLES AND FAMILY THERAPISTS

Child Abuse

Immunity for Reporting

Threats to Others

Communication Regarding a Third Party

Threats to Self

SPECIAL ISSUES IN COUPLES AND FAMILY THERAPY

Training, Licensure and Certifications

CASE ILLUSTRATION OF ETHICAL-PROFESSIONAL DECISION MAKING IN COUPLES AND FAMILY COUNSELING

13. Rehabilitation Counseling and Career Counseling.

INTRODUCTION TO CAREER AND REHABILITATION COUNSELING

Career Counseling

Rehabilitation Counseling

ROUTINE PRACTICE OF CAREER COUNSELING

ROUTINE PRACTICE OF REHABILITATION COUNSELING

CONTEXTUAL ISSUES IN CAREER COUNSELING

Personal-Developmental

Relational-Multicultural

Organizational Ethics—Community Values

CONTEXTUAL ISSUES IN REHABILITATION COUNSELING

Personal-Developmental

Relational-Multicultural

Organizational

Ethics—Community Values

CORE ETHICAL ISSUES IN CAREER COUNSELING

Competency

Informed Consent

Confidentiality

CAREER-SPECIFIC ETHICAL ISSUES

Independent Practice

Boundary Issues and the Use of Power

Spiritual Issues

LEGAL ISSUES IN CAREER COUNSELING

CONCLUDING NOTE: PERSPECTIVE III AND RELATIONAL ISSUES

CORE ETHICAL ISSUES IN REHABILITATION COUNSELING

Competency

Confidentiality Informed Consent

Conflicts of Interest

SPECIFIC ETHICAL ISSUES IN REHABILITATION COUNSELING

Supervision

The Use of Power: Giving It to Clients

Spirituality

LEGAL ISSUES IN REHABILITATION COUNSELING

Privileged Communication

Mandatory Reporting

The Americans with Disabilities Act (ADA) and the Rehabilitation Act

CONCLUDING NOTE: PERSPECTIVE III

CASE ILLUSTRATION OF ETHICAL-PROFESSIONAL DECISION MAKING IN REHABILITATION COUNSELING

14. Ethical and Legal Issues in Supervision.

THE ROUTINE PRACTICE OF SUPERVISION

The Supervisory Agreement

The Development Issues Contract

Written Documentation of Supervision

THE CONTEXTUAL DOMAIN OF SUPERVISION

Personal-Developmental

Relational-Multicultural

Organizational Ethics—Community Values

CORE ETHICAL ISSUES IN SUPERVISION

Confidentiality

Informed Consent

Conflicts of Interest and Boundaries

Competency

SPECIAL CONSIDERATIONS IN SUPERVISION

Fair Evaluation and Due Process in Supervision

Multicultural Issues in Supervision

Religious and Spiritual Issues in Supervision

Clinical Supervision, Case Consultation, and Peer Consultation

LEGAL ISSUES AND CASE LAW AFFECTING SUPERVISION

Direct Liability and Vicarious Liability

Proper Monitoring of Supervisees: Some Practical Considerations

Key Legal Cases Involving Supervision

CASE ILLUSTRATION OF ETHICAL-PROFESSIONAL DECISION MAKING IN SUPERVISION

IV. ETHICS AND EFFECTIVE COUNSELING AND PSYCHOTHERAPY

15. Striving for Personal and Professional Excellence: Ethics as a Way of Life.

A WEEK IN THE LIFE OF BILL JAMES

Monday

Tuesday

Wednesday

Thursday

Friday

Commentary

A WEEK IN THE LIFE OF GERI JACKSON

Monday

Tuesday

Wednesday

Thursday

Friday

Commentary

CONCLUDING NOTE

REFERENCES

Appendix A: Ethical Theories

ETHICAL THEORY

TYPES OF ETHICAL THEORIES

Consequentialist Ethics

Rights Ethics

Duty Ethics

Virtue

Ethics

Care Ethics

Narrative Ethics

CASE ILLUSTRATION: THE ETHICAL THEORIES IN COUNSELING PRACTICE

Appendix B: Dictionary of Key Ethical and Legal Terms.

Index.