Ethical and Legal Aspects of Counseling

Introduction

This study guide summarizes the foundational concepts, principles, and professional standards related to ethics and law in clinical mental health counseling. Understanding these topics is essential for responsible and effective practice in community and agency settings.

Learning Objectives

• Define ethics, morality, and law

• Describe ethics in counseling

• Discuss the law and counseling

• Understand common legal and ethical concerns for clinical mental health counselors

• Describe using technology-assisted counseling responsibly

Ethics, Morality, & Law

Definitions and Distinctions

• Ethics: The philosophical discipline concerned with human conduct and moral decision making. Ethics guides professional behavior and decision-making in counseling.

• Morality: Involves judgment or evaluation of actions, often associated with terms such as good, bad, right, wrong, ought, and should. Morality is more personal and cultural than professional ethics.

• Law: A set of rules that governs particular activities in society. Laws are established by governmental bodies and are enforceable by the courts.

Ethical Principles

Core Principles Guiding Counseling Practice

Ethical principles form the foundation for ethical guidelines and decision-making in counseling:

• Autonomy: Freedom of choice and action for clients.

• Nonmaleficence: The obligation to not harm others.

• Beneficence: The duty to contribute to the welfare of clients.

• Justice: Treating all people fairly and equitably.

• Fidelity: Loyalty and faithfulness to clients and the profession.

• Veracity: Truthfulness and integrity in professional interactions.

Mandatory versus Aspirational Ethics

Types of Ethical Standards

• Mandatory Ethics: Compliance with the minimal standards required by the profession. These are enforceable rules that counselors must follow.

• Aspirational Ethics: Decisions based on internalized principles and ideals of the profession, going beyond minimal standards to strive for the highest ethical practice.

Model of Professional Practice

Balancing Internal and External Influences

The model of professional practice illustrates the balance between counselors' internal beliefs and values and the external forces that guide and support counseling practice.

• Internal Beliefs and Values:

  • Courage of convictions

  • Decision-making skills and models

  • Moral principles of helping professions

  • Intentionality

• External Forces:

  • Consultation, supervision, continuing professional development

  • Laws, codes of ethics, system policies

Ethics and Counseling

Professional Codes and Resources

• ACA (2014) Code of Ethics: The seventh version of the counseling profession's ethical code, revised periodically since its adoption in 1961.

• Ethics Desk Reference for Counselors: Provides practical guidance for ethical dilemmas.

• Ethical Standards Casebook: Offers case studies and applications of ethical standards.

• Separate codes of ethics exist within ACA divisions for specialized practice areas.

ACA Code of Ethics

Core Professional Values

• Enhancing human development throughout the lifespan

• Honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts

• Promoting social justice

• Safeguarding the integrity of the counselor-client relationship

• Practicing in a competent and ethical manner

Sections of the ACA Code of Ethics

• Section A: The Counseling Relationship

• Section B: Confidentiality and Privacy

• Section C: Professional Responsibility

• Section D: Relationships with Other Professionals

• Section E: Evaluation, Assessment, and Interpretation

• Section F: Supervision, Training, and Teaching

• Section G: Research and Publication

• Section H: Distance Counseling, Technology, and Social Media

• Section I: Resolving Ethical Issues

Recent Changes to the ACA Code of Ethics (2014)

• Clarification and emphasis of professional values

• Expanded guidelines for technology-assisted counseling and social media

• Prohibition of personal virtual relationships with clients

• Elimination of the end-of-life exception to the referral rule

• Clarification of counselors' duty to inform and responsibilities with mandated clients

• Expanded concept of pro bono services

• Updated requirements for counselor educators and researchers

Limitations of Ethical Codes

Challenges and Considerations

• Some issues cannot be resolved by a code of ethics

• Codes may be ambiguous and open to interpretation

• Enforcement of ethical codes can be difficult

• Conflicts may exist within or among different organizations' codes

• Legal and ethical issues may not always be covered

• Codes may not address every possible situation

• Knowledge of codes does not guarantee ethical practice

Making Ethical Decisions

Process of Separating Personal and Professional Values

1. Marginalization: Lack of awareness of personal and professional values

2. Separation: Well-developed moral values but lack of awareness of professional ethics

3. Assimilation: Adoption of new professional ethics and abandonment of former cultural values

4. Integration: Adoption of new profession's values while retaining important aspects of one's own personal values

Ethical Decision-Making Model

1. Define the problem, dilemma, and sub-issues

2. Identify relevant variables

3. Review/consult the law, ethics codes, and institutional policy

4. Be alert to personal influences

5. Obtain outside perspective

6. Enumerate options and consequences

7. Decide and take action

8. Document decision making and follow-up actions

Guidelines for Acting Ethically

• Personal and professional honesty

• Acting in the best interest of clients

• Acting without malice or personal gain

• Justifying actions

Law and Counseling

Legal Foundations and Case Examples

• Law: Based on court decisions interpreting statutes in specific cases.

• Duty to Warn: Legal obligation of health providers to not act negligently (e.g., Ramona case, Jaffee v. Redmond).

• Privilege: Communications between licensed psychotherapists and their patients are privileged and protected from disclosure in federal court.

Types of Law

• Criminal Law: Applies to acts considered crimes against society, prosecuted by the government.

• Civil Law: Applies to acts affecting the civil rights of individuals or organizations.

• Tort: A wrong that legal action is designed to set right.

• Negligence: Failure to carry out responsibilities according to professional standards of care.

• Malpractice: Most common cause of legal liability; occurs when counselors are negligent in their professional duties.

Administrative Law

• Created by government agencies to define laws passed by legislative bodies.

• HIPAA (Health Insurance Portability and Accountability Act, 1996): Addresses client privacy and security.

• HIPAA Privacy Rule and Security Rule set standards for protecting health information.

• HITECH Act: Addresses technology and electronic health records.

Common Ethical and Legal Concerns

Key Issues in Counseling Practice

• Privacy, confidentiality, and privileged communication

• Informed consent

• Professional boundaries and roles with clients

• Professional competence

Privacy

• Client's legal right to determine what information about themselves is shared with others.

• Factors jeopardizing privacy: waiting areas, billing practices, record disposal, session recording, business activities.

• Counselors must take steps to protect client dignity and privacy.

Confidentiality

• Promise not to disclose information revealed in counseling, except under specific conditions.

• Tarasoff v. Board of Regents: Established the duty to warn potential victims of dangerous clients.

• State laws vary; counselors should consult legal and professional resources.

Privileged Communication

• Legal protection of confidentiality between counselor and client.

• Privilege belongs to the client, not the counselor.

• Communication must be made in confidence with intent to keep information confidential.

• State law determines whether privilege exists in counselor-client relationships.

Informed Consent

• Clients' right to know what they are entering into when engaging in counseling.

• Allows clients to make informed decisions and be active partners in the counseling process.

• Usually provided both verbally and in writing.

• Key elements: disclosure, free consent, capacity to make rational decisions.

Professional Boundaries and Roles

• Defining, maintaining, and respecting boundaries is essential for ethical and legal practice.

• Boundaries protect the welfare and vulnerability of clients.

• Prohibited interactions include sexual/romantic relationships with clients, socializing, and business relationships.

Professional Competence

• Counselors must practice within their boundaries of competence.

• Competence is developed through education, training, and supervised practice.

• Ability to work with diverse populations is essential.

• Referral is necessary when client needs exceed counselor's competence.

End-of-Life Decisions

• ACA Code of Ethics provides guidance on confidentiality in end-of-life decisions.

• Counselors should consult and seek supervision when working with clients making end-of-life decisions.

Use of Technology in Counseling

Technology-Assisted Counseling

• Includes online counseling, internet therapy, cybercounseling, and distance counseling.

• Synchronous counseling: Occurs in real-time.

• Asynchronous counseling: Involves a time lapse between communications.

Responsible Use of Technology-Assisted Counseling

• Establish methods to verify client identity.

• Transfer client information electronically only to authorized recipients with secure systems.

• Obtain informed consent before engaging in technology-assisted counseling.

• Ensure adequate security and provide services only within areas of expertise.

• Do not provide services where it would violate local licensure laws.

• Have a plan for emergency situations.

• Consult with experienced professionals and refer to written resources.

• Participate in training programs for distance counseling credentials.

Counseling and Social Media

• Interacting with clients through social media without informed consent can cause harm.

• Main concerns: breach of confidentiality, invasion of privacy, and boundary violations.

Example Table: Comparison of Ethical Principles

Additional info: This guide expands on brief points from the original notes to provide full academic context and examples for each concept. It is suitable for exam preparation and self-study in college-level psychology and counseling courses.