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Chapter 5 Client Rights and Counselor Responsibilities Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Unit 4 Project Research the chances of being diagnosed with Alzheimer’s as an elderly adult. Explain the numerical data from at least three different studies that support your findings as outlined below. Find at least three studies that discuss Alzheimer's Disease and that include a table or graph of data that displays the percentages or numerical differences in being diagnosed with Alzheimer's in regards to variations of age, gender, and/or race. Explain the differences of the data from each of the three studies. You should compare the averages among different categories within each study being sure to cite each study using APA in-text citation and reference format. Unit 4 Project How would you explain this to Catherine and her family? Investigate the legal challenges of working with elder adult clients. Describe and discuss the reporting laws in your state. How might you expect to address such legal issues and requirements in your work with elder adult populations? How might you assess and evaluate Catherine's needs at this time? Incorporate any diagnostic guidelines from a professional organization that may help you to diagnosis Catherine and determine your legal obligations on her behalf. Unit 4 Project What are the ethical and legal implications of this case study? What are your concerns? As Catherine's counselor, how might you direct therapy from this point forward? What, if any, mandatory reporting challenges do you see? Please be sure to actively introduce Catherine's case study in your paper. You should include specifics of Catherine's case in illustrating your understanding and research of our topic. Unit 4 Project This project should be approximately 750– 1,200 words, double-spaced, and created in 12 point font. Include at least two references in support of your observations and conclusions using proper APA citation and reference formatting. Client’s Right to Informed Consent Informed consent – involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining to it – a shared decision-making process – a powerful clinical, legal, and ethical tool – requires that the client understands the information presented, gives consent voluntarily, and is competent to give consent to treatment – a process that continues for the duration of the professional relationship as issues and questions arise Issues and Ethics - Chapter 5 (1) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Content of Informed Consent When educating clients about informed consent, the following information should be provided in writing and discussed: The therapeutic process Background of therapist Costs involved in therapy The length of therapy and termination Consultation with colleagues Interruptions in therapy Issues and Ethics - Chapter 5 (2) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Content of Informed Consent Clients’ right of access to their files Rights pertaining to diagnostic labeling The nature and purpose of confidentiality Benefits and risks of treatment Alternatives to traditional therapy Tape-recording or videotaping sessions Issues and Ethics - Chapter 5 (3) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Questions Should clients have access to their clinical files? Is it primarily the therapist’s responsibility to determine the appropriate time for termination of therapy for most clients. Why or why not? Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Ethical Issues in Online Counseling It is the counselor’s responsibility to examine the ethical, legal, and clinical issues related to online counseling. Providing counseling services online is controversial. There are potential legal issues that must be addressed, a few of which include: – Competence of practitioner in providing online counseling – Informing client of limits and expectations of the relationship – Developing a plan for how emergencies can be addressed Issues and Ethics - Chapter 5 (7) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Question What are your thoughts about online counseling? Is it a good therapeutic tool? Why or why not? Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Some Advantages of Online Counseling Reaching clients who may not participate in face-to-face therapy Improving client access in rural areas Increasing flexibility in scheduling Facilitating assigning and completing of client homework Augmenting a problem-solving approach Improving an orientation to the counseling process Enhancing the provision of referral services Issues and Ethics - Chapter 5 (8) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Some Disadvantages of Online Counseling Danger of making an inaccurate diagnosis Compromising of confidentiality and privacy Problems involved in being able to protect suicidal clients Difficulties in attending to clients who are in crisis situations Absence of traditional client-therapist relationship Inability to address a range of more complex psychological problems Inability to deal with interpersonal concerns in the therapy process Issues and Ethics - Chapter 5 (9) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Working With Children and Adolescents Important issues to consider: – Minors’ rights regarding informed consent – Parental rights to information about a minor’s treatment – Minors’ assent versus consent – Involving parents in the counseling process with minors – Limits to confidentiality – Dealing with reluctance – Need for supervised clinical experience in play therapy, art and music therapy, and recreational therapy Issues and Ethics - Chapter 5 (12) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Reasons for Malpractice Suits Failure to obtain or document informed consent Client abandonment or premature termination Marked departures from established therapeutic practices Practicing beyond the scope of competency Misdiagnosis Crisis intervention Issues and Ethics - Chapter 5 (14) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Reasons for Malpractice Suits Repressed or false memory Unhealthy transference relationships Sexual misconduct with a client Failure to control a dangerous client Managed care and malpractice Issues and Ethics - Chapter 5 (15) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Limits of Confidentiality – When clerical assistants handle confidential information – When a counselor consults – When a counselor is being supervised – When a client has given consent – When a client poses danger to self or others – When a client discloses intention to commit a crime – When a counselor suspects abuse or neglect of a child or vulnerable adult – When a court orders counselor to make records available Issues and Ethics - Chapter 6 (3) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Implications of HIPAA for Mental Health Providers The Health Insurance Portability and Accountability Act of 1996 (HIPAA) – passed by Congress to promote standardization and efficiency in the health care industry and to give patients more rights and control over their health information. – The HIPAA Privacy Rule developed out of the concern that transmission of health care information through electronic means could lead to widespread gaps in the protection of client confidentiality. Issues and Ethics - Chapter 6 (7) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Duty to Protect Potential Victims Balancing client confidentiality and protecting the public is a major ethical challenge Counselors must exercise the skill and care of a reasonable professional to: 1. 2. 3. Identify clients who are likely to do physical harm to third parties Protect third parties from clients judged potentially to be dangerous Treat those clients who are dangerous Issues and Ethics - Chapter 6 (9) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Guidelines for Assessing Suicidal Behavior Take direct verbal warnings seriously. Pay attention to previous suicide attempts. Identify clients suffering from depression. Be alert for feelings of hopelessness and helplessness. Monitor severe anxiety and panic attacks. Ascertain whether there has been a recent diagnosis of a serious or terminal health condition. Issues and Ethics - Chapter 6 (16) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Guidelines for Assessing Suicidal Behavior Determine whether the individual has a plan. Identify clients who have a history of severe alcohol or drug abuse. Be alert to client behaviors (e.g. giving prized possessions away, finalizing business affairs, or revising wills). Determine the history of psychiatric treatment. Issues and Ethics - Chapter 6 (17) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Protecting Children, the Elderly, and Dependent Adults From Harm Mandatory reporting – designed to encourage reporting of any suspected cases of child, elder, or dependent adult abuse; thus, therapists are advised to err on the side of reporting in uncertain circumstances. – If children, the elderly, or other dependent adults disclose that they are being abused or neglected, the professional is required to report the situation under penalty of fines and imprisonment. – The professional has an obligation to protect those who cannot advocate for themselves. Issues and Ethics - Chapter 6 (18) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Types of Elder Abuse Physical abuse Sexual abuse Psychological or emotional abuse Neglect Abandonment Financial or material exploitation Issues and Ethics - Chapter 6 (19) Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning Quote The time is always right to do what is right. — Martin Luther King, Jr Corey, 8e, ©2011, Brooks/ Cole – Cengage Learning