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Center for Ethical Practice, Inc.
Index of Forms & Resources

On This Site:

1. INFORMED CONSENT:
ETHICAL STANDARDS + FORMS + CHECKLISTS

 

 

A. Ethical Obligations About Informed Consent:

  CHART: Counselors, Psychologists, Social Workers (referencing Ethics Codes)
Selected Ethical Standards: Counselors (from ACA Code of Ethics)
Selected Ethical Standards: Psychologists (from APA Code of Ethics)
Selected Ethical Standards: Social Workers from NASW Code of Ethics)
 B. Summaries:
 Informed Consent Discussions in Couple & Family & Child Therapy
Informed Consent Discussions in Group Therapy
  C. Checklists:
  

Checklist - Informed Consent for Couple, Family or Child+Parent
Checklist - Informed Consent for M.H. Services in School Setting (Student; Parent)

     
  D. SAMPLE INFORMED CONSENT FORMS & CONTRACTS
   

Informed Consent for Psychotherapy - Adolescent (Sherry Kraft, Ph.D.)
Informed Consent for Psychotherapy - Couple (John T. Schroll, Ph.D.)
Informed Consent for Child Therapy - Separated/Divorced Parents (Bernadette Landolf, Ph.D.)
Informed Consent for Therapy Services - Adult
Informed Consent For Clinical Consultation (Consultant-Consultee Contract)

     
  E. INFORMED CONSENT RIGHTS OF VIRGINIA MINORS & PARENTS
   

Rights of Virginia Minors Under HIPAA - (Legal Opinion re: Consent and Disclosure)
Rights of Separated/Divorced Parents to Consent to Tx for Minor Child (legal opinion)

     

F. INFORMED CONSENT ABOUT CONFIDENTIALITY AND ITS LIMITS IN VIRGINIA:

   

1a. Client Handout: Confidentiality and its Limits in My Practice

      NOTE: Clinicians must "personalize" this to reflect policies in their own settings
    1b. Clinician Resource: Virginia Statutes Protecting or Limiting Patient Confidentiality
      (with links to Code of Virginia for complete text of each statute or court case)
   


2a. Client Handout: Sample "Notice of Privacy Practices"

2b. Clinician Resource: [Sample "Notice of Privacy Practices"]

   
(w links to text of each statute or court case that protects or limits confidentiality)
       
       
2. CONFIDENTIALITY:
ETHICAL STANDARDS AND CONTRACTS

A. Ethical Distinctions Between "Absolute Confidentiality" and "Conditional Confidentiality"

    Confidentiality Ethics - Yesterday and Today
     
  B. Ethical Obligations About Confidentiality & Disclosure
    Selected Ethical Standards: Counselors (from ACA Code of Ethics)
Selected Ethical Standards: Psychologists (from APA Code of Ethics)
Selected Ethical Standards:: Social Workers (from NASW Code of Ethics)
     
  C. CONFIDENTIALITY - USING AN ETHICAL PRACTICE MODEL - (also see article)
   

Ethical Practice Model (html)
Ethical Practice Model (pdf)
Ethical Practice Model + Law +HIPAA (pdf)

     
  D. Confidentiality in Virginia Legal Protections and Legal Limits
    Virginia Statutes Protecting or Limiting Patient Confidentiality
(with links to Code of Virginia for text of each statute or court case)
     

E. CONFIDENTIALITY: "NON-SUBPOENA CONTRACTS" WITH CLIENTS

   

Clients in Multi-Client Therapy - "Non-Subpoena Promise" ( Fisher )
Couple or Marital Therapy - "Non-Subpoena Promise" ( Hembree )
Client in Individual Therapy (+ Non-Participating Spouse) - "Non-Subpoena Promise" ( DeMaio )

     
  F. CONFIDENTIALITY CONTRACTS WITH STAFF, EMPLOYEES, STUDENTS, INTERNS
   

Confidentiality & Non-Disclosure Contract - Non-Clinical Staff, Stundents/Interns, Volunteers
Confidentiality & Non-Disclosure Contract - On-Site Agents - No Approved Access to Patient Info.
(e.g., janitor, "plant lady," computer technician, etc.)

     
  G. COURT-RELATED FORMS & CHARTS
   

A. Filing A Motion to Quash a Subpoena
B. Chart: Court-Related Roles "Which Hat are you Wearing?"

     
  
On Other Sites:


A. Informed Consent Forms: Ken Pope Website
http://kspope.com/

  Index of Forms: http://kspope.com/consent/index.php
 B. Informed Consent Contracts: APA Insurance Trust: http://www.apait.org
 Forms below (in WORD or PDF) at http://www.apait.org/apait/download.aspx
  Sample Informed Consent (Psychotherapy) Contract
Sample Forensic Psychotherapist-Patient Contract
Sample Child Therapy Contracts
Sample Coaching Contract
  Sample Outpatient Services Agreement for Collaterals:
  

http://www.apait.org/apait/resources/riskmanagement/cinf.aspx

 C. Contract: Fee Agreement For Working with Attorney(s) on Forensic Case
  http://www.drlaurabrown.com/doc/FeeAgreementForAttorneys.pdf
 

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