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COUNSELORS:
SELECTED ETHICAL STANDARDS*
RELATED TO INFORMED CONSENT
Section
A: The Counseling Relationship
. . .
A.2. Informed Consent in the
Counseling Relationship
A.2.a. Informed Consent: Clients have the
freedom to choose whether to enter into or remain in a counseling relationship
and need adequate information about the counseling process and the counselor.
Counselors have an obligation to review in writing and verbally with clients the
rights and responsibilities of both the counselor and the client. Informed consent
is an ongoing part of the counseling process, and counselors appropriately document
discussions of informed consent throughout the counseling relationship.
A.2.b.
Types of Information Needed: Counselors explicitly explain to clients the
nature of all services provided. They inform clients about issues such as, but
not limited to, the following: the purposes, goals, techniques, procedures, limitations,
potential risks, and benefits of services; the counselor's qualifications, credentials,
and relevant experience; continuation of services upon the incapacitation or death
of a counselor; and other pertinent information. Counselors take steps to ensure
that clients understand the implications of diagnosis, the intended use of tests
and reports, fees, and billing arrangements. Clients have the right to confidentiality
and to be provided with an explanation of its limitations (including how supervisors
and/or treatment team professionals are involved); to obtain clear information
about their records; to participate in the ongoing counseling plans; and to refuse
any services or modality change and to be advised of the consequences of such
refusal.
A.2.c. Developmental and Cultural Sensitivity: Counselors
communicate information in ways that are both developmentally and culturally appropriate.
Counselors use clear and understandable language when discussing issues related
to informed consent. When clients have difficulty understanding the language used
by counselors, they provide necessary services (e.g., arranging for a qualified
interpreter or translator) to ensure comprehension by clients. In collaboration
with clients, counselors consider cultural implications of informed consent procedures
and, where possible, counselors adjust their practices accordingly.
A.2.d.
Inability to Give Consent: When counseling minors or persons unable to give
voluntary consent, counselors seek the assent of clients to services, and include
them in decision making as appropriate. Counselors recognize the need to balance
the ethical rights of clients to make choices, their capacity to give consent
or assent to receive services, and parental or familial legal rights and responsibilities
to protect these clients and make decisions on their behalf. . . . A.3.
Clients Served by Others When counselors learn that their clients are in a
professional relationship with another mental health professional, they request
release from clients to inform the other professionals and strive to establish
positive and collaborative professional relationships. . . .er; mutual membership
in a professional association, organization, or community. . . . A.7.
Multiple Clients When a counselor agrees to provide counseling services to
two or more persons who have a relationship, the counselor clarifies at the outset
which person or persons are clients and the nature of the relationships the counselor
will have with each involved person. If it becomes apparent that the counselor
may be called upon to perform potentially conflicting roles, the counselor will
clarify, adjust, or withdraw from roles appropriately. A.8.
Group Work
A.8.a. Screening: Counselors screen prospective group
counseling/therapy participants. To the extent possible, counselors select members
whose needs and goals are compatible with goals of the group, who will not impede
the group process, and whose well-being will not be jeopardized by the group experience.
A.8.b. Protecting Clients: In a group setting, counselors take reasonable
precautions to protect clients from physical, emotional, or psychological trauma.
A.10.
Fees & Bartering
A.10.b. Establishing Fees: In establishing fees
for professional counseling services, counselors consider the financial status
of clients and locality. In the event that the established fee structure is inappropriate
for a client, counselors assist clients in attempting to find comparable services
of acceptable cost.
A.10.c. Nonpayment of Fees: If counselors intend
to use collection agencies or take legal measures to collect fees from clients
who do not pay for services as agreed upon, they first inform clients of intended
actions and offer clients the opportunity to make payment.
A.10.d. Bartering:
Counselors may barter only if the relationship is not exploitive or harmful
and does not place the counselor in an unfair advantage, if the client reques5ts
it, and if such arrangements are an accepted practice among professionals in the
community. Counselors consider the cultural implications of bartering and discuss
relevant concerns with clients and document such agreements in a clear written
contract. . . . A.12.
Technology and Informed Consent
A.12.g. Technology and Informed Consent
As part of the process of establishing informed consent, counselors do the following:
1. Address issues related to the difficulty of maintaining the confidentiality
of electronically transmitted communications. 2. Inform clients of all
colleagues, supervisors, and employees, such as Informational Technology (IT)
administrators, who might have authorized or unauthorized access to electronic
transmissions. 3. Urge clients to be aware of all authorized or unauthorized
users including family members and fellow employees who have access to any technology
clients may use in the counseling process. 4. Inform clients of pertinent
legal rights and limitations governing the practice of a profession over state
lines or international boundaries. 5. Use encrypted Web sites and e-mail
communications to help ensure confidentiality when possible. 6. When the
use of encryption is not possible, counselors notify clients of this fact and
limit electronic transmissions to general communications that are not client specific.
7. Inform clients if and for how long archival storage of transaction records
are maintained. 8. Discuss the possibility of technology failure and alternate
methods of service delivery. 9. Inform clients of emergency procedures,
such as calling 911 or a local crisis hotline, when the counselor is not available.
10. Discuss time zone differences, local customs, and cultural or language
differences that might impact service delivery. 11. Inform clients when
technology-assisted distance counseling services are not covered by insurance.
Section
B: Confidentiality, Privileged Communication & Privacy
B.1.
Respecting Client Rights . . .
B.1.d. Explanation of Limitations:
At initiation and throughout the counseling process, counselors inform clients
of the limitations of confidentiality and seek to identify foreseeable situations
in which confidentiality must be breached. . . .
B.4.b. Couples and Family Counseling: In couples and family counseling,
counselors clearly define who is considered "the client" and discuss expectations
and limitations of confidentiality. Counselors seek agreement and document in
writing such agreement among all involved parties having capacity to give consent
concerning each individual's right to confidentiality and any obligation to preserve
the confidentiality of information known.
B.5. Clients Lacking Capacity
to Give Informed Consent
B.5.a. Responsibility to Clients: When
counseling minor clients or adult clients who lack the capacity to give voluntary,
informed consent, counselors protect the confidentiality of information received
in the counseling relationship as specified by federal and state laws, written
policies, and applicable ethical standards.
B.5.b. Responsibility to Parents
and Legal Guardians: Counselors inform parents and legal guardians about the
role of counselors and the confidential nature of the counseling relationship.
Counselors are sensitive to the cultural diversity of families and respect the
inherent rights and responsibilities of parents/guardians over the welfare of
their children/charges according to law. Counselors work to establish, as appropriate,
collaborative relationships with parents/guardians to best serve clients.
B.5.c.
Release of Confidential Information: When counseling minor clients or adult
clients who lack the capacity to give voluntary consent to release confidential
information, counselors seek permission from an appropriate third party to disclose
information. In such instances, counselors inform clients consistent with their
level of understanding and take culturally appropriate measures to safeguard client
confidentiality. B.6.
Records . . .
B.6.b. Permission to Record: Counselors obtain permission
from clients prior to recording sessions through electronic or other means.
B.6.c.
Permission to Observe: Counselors obtain permission from clients prior to
observing counseling sessions, reviewing session transcripts, or viewing recordings
of sessions with supervisors, faculty, peers, or others within the training environment.
. . . Section
D: Relationships With Other Professionals
D.1. Relationships With Colleagues,
Employers, & Employees
D.1.d.
Confidentiality: When
counselors are required by law, institutional policy, or extraordinary circumstances
to serve in more than one role in judicial or administrative proceedings, they
clarify role expectations and the parameters of confidentiality with their colleagues.
. . .
Section E: Evaluation, Assessment, and Interpretation
E.13.b. Consent for Evaluation: Individuals being evaluated are informed
in writing that the relationship is for the purposes of an evaluation and is not
counseling in nature, and entities or individuals who will receive the evaluation
report are identified. Written consent to be evaluated is obtained from those
being evaluated unless a court orders evaluations to be conducted without the
written consent of individuals being evaluated. When children or vulnerable adults
are being evaluated, informed written consent is obtained from a parent or guardian. Section
F Supervision, Training, and Teaching
F.6. Responsibilities of Counselor
Educators . . .
F.6.h. Professional Disclosure Before initiating counseling
services, counselors-in-training disclose their status as students and explain
how this status affects the limits of confidentiality. Counselor educators ensure
that the clients at field placements are aware of the services rendered and the
qualifications of the students and supervisees rendering those services. Students
and supervisees obtain client permission before they use any information concerning
the counseling relationship in the training process.
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*These
are only selected Ethical Standards from
American
Counseling Association (2005) Code of Ethics and Standards of Practice.
Familiarity
with these standards is not a substitute for knowing all of the sections of your
Ethics Code. Return
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