Monday, June 18, 2012
Hilton Garden Inn, Innsbrook – Richmond VA
1:00 – 4:00

   I. Establishing Clear Policies

A. Administrative, Scheduling, & Financial Policies

B. Clinical Policies (e.g., Session Frequency, Time, & Timing)

C. Boundaries

Within the Session (Physical Boundaries; Therapist Self-Disclosure, etc.)

Outside the Session (In Person or Electronically)

D. Confidentiality & Disclosure

E. Informed Consent

  II. Living Up to Our Informed Consent Promises

 III. Avoiding the Predictable Pitfalls 

A. Resisting Temptations to Breach Confidentiality Unethically

Voluntary Disclosures

“Involuntary” Disclosures

B. Avoiding the Creation of “Avoidable” Conflicts of Interest

C. Resisting Pulls Toward Problematic Dual Relationships

D. Remaining Alert to Avoid Real or Perceived Boundary Violations

 IV. Monitoring Our Current State

A. Personal Stressors Leading to Therapist Over-Disclosure

B. Unmet Need for Support

C. Inadequate Self-Care Leading to Tired/Sleepy/Burned-Out

D. Unmet Need for Therapy 

V. Acknowledging Our Clinical Limitations

 VI. Acknowledging Our Personal Vulnerabilities

  VII.  Understanding the Consequences for Patients

Friday, June 22, 2012
Fairview Park Marriott, Falls Church,  VA
9:00 - noon

I. Ethical & Professional Guidelines

II. Types of Self-Disclosure

A. Volunteering Certain Information to All Patients
B. Volunteering Certain Information Only to Selected Patients
C. Responding to Patients’ Direct Questions
D. Using Self-References for Clinical Reasons
E. Using Self-References for Personal Reasons

III. Pitfalls Related to Self-Disclosure

A. Ethical Pitfalls
B. Clinical Pitfalls
C. Personal Pitfalls

IV. Obtaining Consultation for Making Planned Self-Disclosure Decisions

A. Sharing Information Related to Planned Voluntary Absences
B. Sharing Information Related to Pregnancy/Surgery/Illness
C. Sharing Information About a Planned Wedding/Divorce
D. Sharing Information About Future Professional Plans
E. Sharing Information If Therapist Moves or Closes a Practice
F. Other

V. Separating Your “Breakable Rules” From the “Unbreakable Rules”

A. Naming Your “Unbreakable” Self-Disclosure Rules
B. Acknowledging the Self-Disclosure Rules You Consider “Breakable”

EDUCATIONAL GOALS
(a)  Describe your profession’s ethical standards and guidelines about self-disclosure
(b)  List some ethical, clinical, and personal pitfalls related to self-disclosure
(c)  Name your own “breakable rules” and “unbreakable rules” about self-disclosure

Saturday, June 16, 2012
Holiday Inn – Bypass Road, Williamsburg,  VA
9:00 – noon

   I. Ethical & Professional Guidelines

  II. Types of Self-Disclosure

A. Volunteering Certain Information to All Patients
B. Volunteering Certain Information Only to Selected Patients
C. Responding to Patients’ Direct Questions
D. Using Self-References for Clinical Reasons
E. Using Self-References for Personal Reasons

 III. Pitfalls Related to Self-Disclosure

A. Ethical Pitfalls
B. Clinical Pitfalls
C. Personal Pitfalls

 IV. Obtaining Consultation for Making Planned Self-Disclosure Decisions

A. Sharing Information Related to Planned Voluntary Absences
B. Sharing Information Related to Pregnancy/Surgery/Illness
C. Sharing Information About a Planned Wedding/Divorce
D. Sharing Information About Future Professional Plans
E. Sharing Information If Therapist Moves or Closes a Practice
F. Other

 V. Separating Your “Breakable Rules” From the “Unbreakable Rules”

A. Naming Your “Unbreakable” Self-Disclosure Rules
B. Acknowledging the Self-Disclosure Rules You Consider “Breakable”

EDUCATIONAL GOALS
(a)  Describe your profession’s ethical standards and guidelines about self-disclosure
(b)  List some ethical, clinical, and personal pitfalls related to self-disclosure
(c)  Name your own “breakable rules” and “unbreakable rules” about self-disclosure

Monday, June 4, 2012
DoubleTree Hotel, Charlottesville VA
9:00 – noon

   I. Establishing Clear Policies

A. Administrative, Scheduling, & Financial Policies

B. Clinical Policies (e.g., Session Frequency, Time, & Timing)

C. Boundaries

Within the Session (Physical Boundaries; Therapist Self-Disclosure, etc.)

Outside the Session (In Person or Electronically)

D. Confidentiality & Disclosure

E. Informed Consent;

  II. Living Up to Our Informed Consent Promises

 III. Avoiding the Predictable Pitfalls 

A. Resisting Temptations to Breach Confidentiality Unethically

Voluntary Disclosures

“Involuntary” Disclosures

B. Avoiding the Creation of “Avoidable” Conflicts of Interest

C. Resisting Pulls Toward Problematic Dual Relationships

D. Remaining Alert to Avoid Real or Perceived Boundary Violations

 IV. Monitoring Our Current State

A. Personal Stressors Leading to Therapist Over-Disclosure

B. Unmet Need for Support

C. Inadequate Self-Care Leading to Tired/Sleepy/Burned-Out

D. Unmet Need for Therapy 

V. Acknowledging Our Clinical Limitations

 VI. Acknowledging Our Personal Vulnerabilities

  VII.  Understanding the Consequences for Patients

Monday, June 18, 2012
Hilton Garden Inn, Innsbrook – Richmond VA
9:00 – noon

INTRODUCTION 
“Balancing” Therapist Duties and Patient Responsibilities

 I.  Beginning the Therapy Relationship

A. Therapist’s Duty To Discuss at Intake (Informed Consent Interview)

Confidentiality and its limits

Reimbursement

Duration of therapy

Explaining Potential reasons for termination

B. Others’ responsibilities (agency involvement, family collaterals, etc.)

C. Patient’s Responsibilities

Consent to accept therapist’s policies as described

Participate in goal-setting 

 II. Continuing the Therapy Relationship

A. Therapist’s Duties

Being available in emergencies or alternate plan

Providing services appropriate to problem

As appropriate, re-opening issues discussed in informed consent interview

B. Patient’s Responsibilities

Abide by initial agreements re policies, payment, behavior

Attend scheduled therapy sessions

Participate in therapy process

 III. Ending the Therapy Relationship

A. Therapist’s Duties

Discuss termination throughout treatment, as appropriate

Plan sessions for processing termination issues before ending

End relationship

B. Patients’ Responsibilities

 IV. Special Considerations

A. Third Party Referral Considerations

B. Third Party Reimbursement Considerations

C. Patients’ Threats Toward Therapist

D. Patient-Initiated Premature Termination

E. Therapist-Initiated Termination vs. Abandonment 

EDUCATIONAL GOALS:
1. Compare and contrast therapists’ duties with patients’ responsibilities
2. Name some of the issues which might arise that require weighing of various ethical principles
3. Use case vignettes to practice ways of dealing with such issues 

We waste a lot of energy and create a lot of unnecessary anxiety when we adopt a solely risk-management position, because it leads us to focus on possible risks to ourselves.  Instead, we must give priority to an ethics-based mindset which leads us to focus on avoiding the risks to patients — which is the best risk-management strategy, anyway!  So how can we hone our own ethical compass?

Friday, June 22, 2012
Fairview Park Marriott - Falls Church, VA
1:00 – 4:00

OUTLINE

  I. Clarifying Your Profession’s “Ethical Floor”

II. Determining Your Own “Ethical Ceiling”

A. Considering Available Professional Recommendations
B. Weighing & Choosing Personal Options Beyond Those Recommendations

III. Constructing Clear Policies That Fit Your Own Practice

A. Policies in Private Practice
B. Policies in Group Practices
C. Policies in Agencies & Organizations

IV. Recognizing & Avoiding “Law-Based” Mindsets

A. Learning Relevant Laws
B. Learning to Place Laws Into Ethical Context

 V. Recognizing & Avoiding “Risk-Management” Mindsets

A. Focusing on Preventing Risks to Patients Instead of Risks to Self
B.  Dealing With Anxiety About Complaints or Malpractice Suits

VI. Developing Strategies for Maintaining the Ethical Focus

A. Regularly Reviewing/Assessing/Revising/Updating Your Policies & Practices
B. Consulting and Collaborating With Others Who Share Your “Ethical Ceiling”

EDUCATIONAL GOALS:
(a)  Describe ways in which you can create an “ethical compass” by defining your “ethical ceiling”
(b)  List some risk-management mindsets that create anxiety and detract from an ethical focus(c)  Name types of support that could be helpful in avoiding anxiety-based behavior

We waste a lot of energy and create a lot of unnecessary anxiety when we adopt a solely risk-management position, because it leads us to focus on possible risks to ourselves.  Instead, we must give priority to an ethics-based mindset which leads us to focus on avoiding the risks to patients — which is the best risk-management strategy, anyway!  So how can we hone our own ethical compass?

Saturday, June 16, 2012
Holiday Inn – Bypass Road – Williamsburg VA
1:00 – 4:00

OUTLINE

  I. Clarifying Your Profession’s “Ethical Floor”

II. Determining Your Own “Ethical Ceiling”

A. Considering Available Professional Recommendations
B. Weighing & Choosing Personal Options Beyond Those Recommendations

III. Constructing Clear Policies That Fit Your Own Practice

A. Policies in Private Practice
B. Policies in Group Practices
C. Policies in Agencies & Organizations

IV. Recognizing & Avoiding “Law-Based” Mindsets

A. Learning Relevant Laws
B. Learning to Place Laws Into Ethical Context

 V. Recognizing & Avoiding “Risk-Management” Mindsets

A. Focusing on Preventing Risks to Patients Instead of Risks to Self
B.  Dealing With Anxiety About Complaints or Malpractice Suits

VI. Developing Strategies for Maintaining the Ethical Focus

A. Regularly Reviewing/Assessing/Revising/Updating Your Policies & Practices
B. Consulting and Collaborating With Others Who Share Your “Ethical Ceiling”

EDUCATIONAL GOALS:
(a)  Describe ways in which you can create an “ethical compass” by defining your “ethical ceiling”
(b)  List some risk-management mindsets that create anxiety and detract from an ethical focus(c)  Name types of support that could be helpful in avoiding anxiety-based behavior

Friday, June 8, 2012
Hilton Garden Inn, Fairfax VA
9:00 – noon

I. Potential Pitfalls & Ethical Dilemmas With Various Patients

Depressed

Anxious/Fearful

Angry/Rageful

Clinging/Dependent

Demanding/Entitled

Detached

Ambivalent

“Characterologically Difficult”

Other  ………………

Other  ………………

 II. Avoiding the “Avoidable” Ethical Dilemmas

Conscientiously Following Ethical Standards

Maintaining Clear Boundaries

Respecting Informed Consent Rights

Obtaining Consultation

Respecting Autonomy (Empowered Collaboration)

Attending to Documentation

Using “Redundant Protections” When Appropriate                                           

III. Anticipating & Preparing for the “Unavoidable” Ethical Dilemmas

 IV. Recognizing One’s Own Vulnerabilities With Certain Patients

Screening and Choosing Patients

Noticing Danger Signals

Recognizing Personal “Red Flags”

EDUCATIONAL GOALS:
(a)  Name the types of patients which raise ethical dilemmas in your own practice.
(b)  Describe some of the “avoidable” ethical dilemmas you failed to avoid.
(c)  List ways you can anticipate and plan for the “unavoidable” ethical dilemmas

Friday, June 8, 2012
Hilton Garden Inn - Fairfax VA
1:00 – 4:00

What Do You Wish You Had Known About …….

The ethics of how to begin a therapy relationship

The ethics of how to end a therapy relationship

What to to tell minors about confidentiality

What to tell couples about confidentiality 

How to run a business

What to do first if you receive a subpoena

Whether to keep “psychotherapy notes” or not

What are the legal options if a patient threatens to harm someone else

Whether there are legal obligations if a patient threatens suicide

How to turn down a gift without hurting the patient’s feelings

……………………

…………………….

Educational Goals:

1. List some examples of clinical circumstances in which you were not well prepared.

2. Describe the potential impact on patients or risks to you in those situations.

3. State what you now know that would lead you to handle the situation differently 

(Who Said Ethics Was Boring?)

The first half of this workshop is an overview of
some simple, basic topics in professional ethics and Va. law.
The second half of the workshop will be conducted a bit like a “Jeopardy” game.
Using the categories below, we will test our understanding of
what we have learned about the ethical/legal ABCs.
An unusual variation on the boring “post-test”!!

Monday, June 4, 2012
DoubleTree Hotel – Charlottesville VA

  Categories: “Ethical & Legal ABCs”