LEGAL - PowerPoint PPT Presentation

About This Presentation
Title:

LEGAL

Description:

Title: LEGAL & ETHICAL ISSUES FOR COUNSELING CENTER TRAINING PROGRAMS Author: dummy3 Last modified by: dummy3 Created Date: 10/31/2005 9:07:45 PM – PowerPoint PPT presentation

Number of Views:170
Avg rating:3.0/5.0
Slides: 34
Provided by: dum76
Learn more at: https://www.occdhe.org
Category:

less

Transcript and Presenter's Notes

Title: LEGAL


1
LEGAL ETHICAL ISSUES FOR COUNSELING CENTER
TRAINING PROGRAMS
  • Gloria C. Saito, Ph.D.
  • University of California,
  • Berkeley

2
Introduction and Overview
  • Counseling Center settings agency issues to
    consider in training unlicensed professionals
  • Legal and ethical issues for supervisors
  • Guidelines for ethical decision-making
  • Case vignettes

3
Definitions Law and Ethics
  • Ethical standards are conceptually broad in
    nature, few in number and open to interpretation
    by the practitioner. . . . They are . . . A call
    to ethical excellence. Ethical standards are a
    statement from a particular profession to the
    general public regarding what they stand for.
  • (Bernard and Goodyear, 1998)

4
Definitions Law and Ethics
  • The law . . . is specific in nature and is
    introduced when a particular act has been
    perceived to have endangered or harmed those whom
    the profession serves. . . . The law is not
    concerned with the highest standards of
    professional practice when judging someone, but
    only in minimally acceptable behavior.
  • (Bernard and Goodyear, 1998)

5
Agency Issues for Counseling Center Training
Programs
  • Selection Issues
  • APPIC Match Policies (www.appic.org)
  • CAPIC Guidelines (www.capic.net)
  • University personnel and human resources policies
  • Local, state and federal regulations
  • Americans with Disabilities Act (ADA) regulations

6
Agency Issues, contd
  • Parameters for Employment and Informed Consent
  • Conditions of employment
  • Requirements for criminal background checks
  • Stipends, number of hours per week, evaluation
    process

7
Agency Issues, contd
  • Truth in Advertising about the program and
    training offered.
  • Is the program designed to provide appropriate
    training experiences and to meet requirements for
    academic programs, licensure and/or
    certification?
  • Is the description of the program in publicized
    materials current and accurate, providing
    information on the training goals and objectives,
    requirements, stipends, benefits, etc.?

8
Agency Issues, contd
  • Expectation of trainees clear statement about
    what is expected of trainees
  • Competency issues agency has the duty to assign
    only those clients whom the trainee is competent
    to treat
  • Confidentiality and limits to confidentiality
  • Written policies and procedures to guide the
    agency, supervisors and trainees in the
    management of clients who are dangerous or at
    risk.
  • Due process and grievance procedures
  • Contextual issues budget and staffing,
    licensing laws and regulations, agency pressures
    and the service delivery vs. training balance

9
Supervision Issues
  • Supervision defined
  • An interpersonal process that typically involves
    a more experienced clinician (master) with
    oversight and evaluative responsibility for a
    less experienced clinician (apprentice) who
    shares educational and therapeutic goals. The
    educational goal primarily concerns the growth
    and development of professional competence by the
    trainee. . . Therapeutically, supervisor and
    supervisee collaborate to ensure the welfare of
    the client. (Holloway, 1992)

10
Supervision Issues
  • Supervision defined (again)
  • An intervention that is provided by a senior
    member of a profession to a junior member of that
    same profession. This relationship is
    evaluative, extends over time and has the
    simultaneous function/purposes of enhancing the
    function of the junior member, monitoring the
    quality of professional services offered to
    clients and serving as a gatekeeper for those who
    are to enter the profession.
  • (Bernard and Goodyear, 1998)

11
Legal and Ethical Issues for Supervisors
  • Getting started nuts and bolts (Board of
    Psychology requirements)
  • Supervisory Agreement form
  • Supervision Disclosure form
  • Weekly log of activities
  • Verification of Experience form

12
Legal and Ethical Issues for Supervisors
  • Qualifications of supervisors
  • demonstrated professional training and competence
    in areas in which supervision is being provided
    (supervisor must be competent to see a client to
    whom trainee is assigned.)
  • formal training in supervision (Board of
    Psychology regulations)
  • meet continuing education requirements and have a
    current license

13
Legal and Ethical Issues for Supervisors, contd
  • Duties and responsibilities of supervisors
  • Heavy obligation to protect the welfare of the
    consumer/client
  • Have sufficient knowledge of each client to
    monitor the work of the trainee, i.e., client
    care
  • Oversight of therapeutic behavior of a less
    experienced, unlicensed professional whose skills
    may not be well-known or well-developed
  • Review and countersign client records

14
Legal and Ethical Issues for Supervisors, contd
  • Duties and responsibilities of supervisors,
    contd
  • Availability in case of emergencies (be available
    100 of the time either on site or by other
    means)
  • Keep records of supervision
  • Obligation to further the professional
    development of the trainee by focus on skill
    development as well as professional identity
    issues
  • Provide ongoing and timely feedback as well as
    formal evaluations based on actual performance
    and established program requirements
  • Avoid abuses of power in supervision that may
    potentially result in exploitation or harm

15
Legal and Ethical Issues for Supervisors, contd
  • Duties and responsibilities of supervisors,
    contd
  • Challenge supervisee about issues that may
    interfere with quality care while setting
    appropriate boundaries and limits (supervision is
    not therapy)
  • Special responsibility to structure and maintain
    a supervisory relationship that demonstrates
    ethically appropriate behavior and minimizes the
    potential negative quality of transference
    issues. (Upchurch, 1985)

16
Legal and Ethical Issues for Supervisors, contd
  • Informed consent for supervision
  • Do trainees have a choice of supervisor, and what
    are the choices? Are trainees aware of how
    supervisory assignments are made?
  • Need for clear specification of duties,
    supervision philosophy/approach, goals,
    requirements, expectations, evaluation procedures

17
Legal and Ethical Issues for Supervisors, contd
  • Informed consent of clients
  • Clients must be informed about the trainees
    status and about the supervisors oversight of
    the treatment
  • Supervisors must be available to clients if
    necessary
  • Supervisors must insure that trainees have
    informed their clients about the parameters of
    counseling
  • Clients must give consent for procedures
    necessary or required for supervision, e.g.,
    audio or videotaping

18
Legal and Ethical Issues for Supervisors, contd
  • Confidentiality
  • Whats confidential in supervision?
  • The trainees rights to privacy
  • What about group supervision, supervisors
    meetings, training committee meetings?
  • Do not require supervisee to disclose personal
    information about sexual history, history of
    abuse/neglect, psychotherapy, relationships with
    family, peers, etc., unless this is specified
    clearly in program admissions and training
    materials

19
Legal and Ethical Issues for Supervisors, contd
  • Multiple Relationships
  • Supervisor is guided by the principle of DO NO
    HARM
  • Supervisor is in the position of power and
    trainees have limited power in the relationship
  • Sexual Relationships between supervisor and
    supervisee prohibited
  • Sexual attraction is inevitable and important to
    discuss
  • Supervisors responsibility to teach trainees how
    to handle sexual attraction issues

20
Legal and Ethical Issues for Supervisors, contd
  • Multiple Relationships, contd
  • Supervisors should not provide psychotherapy
    services to supervisees and should avoid
    conflicts of interest which may impair their
    judgment
  • Supervisors avoid dual relationships where there
    is the potential for abuse of power and/or
    exploitation
  • Supervisors avoid actions that may impair their
    judgment and ability to objectively supervise and
    evaluate the trainee (e.g., supervising a friend
    or relative)

21
Legal and Ethical Issues for Supervisors, contd
  • Multiple Relationships, contd
  • Supervisors maintain appropriate boundaries (what
    about professional lunches, office parties,
    workshops, conferences?)
  • Differentiate between multiple relationships that
    abuse power, exploit or harm the supervisee and
    those that occur in the positive context of a
    developing professional relationship
  • Supervision and therapy and the distinction
    between them how to explore personal issues
    related to client care without crossing privacy
    boundaries
  • Conflicting roles inherent in the supervisor
    role mentor, supporter, evaluator, colleague,
    reference

22
Legal and Ethical Issues for Supervisors, contd
  • Due Process Issues
  • Policies and procedures are provided to the
    supervisee by the training program and the
    supervisor in writing at the beginning of the
    traineeship. These include
  • Trainee rights and responsibilities
  • Expectations, roles, rules, requirements
  • Procedures and process for feedback and
    evaluation
  • Formal guidelines for what happens when a trainee
    is impaired, including definitions of impairment
    and processes for notice, warning and appeal,
    remediation, time frame for notice and appeal
  • Primary goal is to avoid arbitrary or capricious
    actions on the part of the training program and
    the supervisor

23
Legal and Ethical Issues for Supervisors, contd
  • Liability Issues
  • Malpractice defined
  • harm to another individual due to negligence
    consisting of the breach of a professional duty
    or standard of care. (Disney Stephens, 1994)
  • The Good News
  • Why It Pays to Pay Attention
  • Supervisor is held responsible for supervisees
    actions and quality of client care

24
Legal and Ethical Issues for Supervisors, contd
  • Liability Issues
  • Direct Liability
  • Negligent supervision supervisors inattention
    or negligence caused the clients damages
  • Supervisor or training program assigned tasks
    which the trainee was not adequately trained or
    prepared to carry out, and the client was harmed

25
Legal and Ethical Issues for Supervisors, contd
  • Liability Issues, contd
  • Vicarious Liability supervisors can be sued and
    held liable even if they did nothing wrong under
    the concept of respondeat superior (let the
    master respond)
  • Final responsibility for client welfare rests
    with the supervisor, not the trainee

26
Legal and Ethical Issues for Supervisors, contd
  • Liability Issues Vicarious Liability, contd
  • Criteria
  • Trainee voluntarily agrees to work under the
    direction and control of the supervisor
  • Trainee acts within the scope of tasks permitted
    by the supervisor
  • Supervisor has the power to control and direct
    the supervisees work
  • The act that injured the client is within the
    supervisees scope of employment
  • Client has the burden to prove that an actual
    injury occurred

27
Legal and Ethical Issues for Supervisors, contd
  • Areas of Vulnerability for Supervisors
  • (from Campbell, 2000)
  • Client is not informed of supervisees trainee
    status and the limits of confidentiality
  • Supervisor has incomplete information about the
    client due to multiple factors (workload issues,
    incomplete/inadequate communication, trainee
    withholds information)
  • Trainee does not follow supervisors
    recommendations, but does not disclose this

28
To Summarize Dilemmas for Supervisors
  • Issues of Hierarchy and Power
  • Conflicting Roles and Multiple Hats
  • Negotiating Boundaries
  • Confidentiality

29
Guidelines for Ethical Decision-Making
  • Provide current and accurate information about
    your program
  • Set standards for training and performance in
    writing and communicate and discuss these with
    your trainees
  • Provide a timely and specific process for
    providing feedback and evaluation
  • Develop good record-keeping practices, both for
    client work and for supervision
  • Apply standards early and consistently
  • Base decisions on facts, not opinion or bias, and
    document behaviors
  • Document, document, document, but beware of email
    communication
  • Seek consultation

30
Guidelines for Ethical Decision-Making, contd
  • Bernard and Goodyear (1998) suggest the following
    cognitive map for resolving ethical dilemmas
  • 1. Identify the problem or dilemma
  • 2. Identify the potential issues involved
  • 3. Review relevant ethical guidelines
  • 4. Obtain consultation
  • 5. Consider possible and probably courses of
    action
  • 6. Enumerate the consequences of various
    decisions
  • 7. Decide what appears to be the best course of
    action

31
Case Vignettes
  • Vignette 1
  • The client is a 19 year-old Caucasian
    undergraduate woman with a severe eating disorder
    (anorexia). The supervisee is a 28 year old
    Caucasian woman on her predoctoral internship.
    The intern has had some experience in treating
    eating disorders and would like to specialize in
    this area. She has done an assessment of the
    students concerns and in addition to counseling
    at the University Counseling Center, has referred
    the student for medical care and follow-up.
    During supervision, the intern has down-played
    the severity of the eating disorder, and has
    assured the supervisor that the student has
    followed through with medical care.
  • While the intern is on vacation, the student
    comes into the CC in crisis. It is apparent that
    she has not in fact followed through with medical
    care. Moreover, the supervisor reviews the
    record and, in her assessment, the student is
    more severely impaired than the intern had
    indicated. The supervisor decides to involve the
    students parents, and in so doing, breaks
    confidentiality.
  • What are the legal and ethical issues involved in
    this case?

32
Case Vignettes
  • Vignette 2
  • The student is a 22 year old African American
    male graduate student in Physics who comes into
    the Counseling Center for an emergency drop-in
    appointment. The supervisee is a 30 year old
    Asian American male postdoctoral fellow. In
    doing the assessment, it is clear to the postdoc
    fellow that the student is experiencing manic and
    psychotic symptoms and is potentially suicidal.
    The postdoc seeks consultation from senior staff
    members, who strongly advise him to pursue
    hospitalization for the student. The postdoc
    feels great empathy for the student who is
    adamant that he does not want to be in the
    hospital. As a result, the postdoc is reluctant
    to hospitalize the student, but finally does so
    after many hours and numerous consultations with
    staff. Senior staff are concerned that the
    postdoc has let his countertransference reactions
    guide his behavior, thereby prolonging the
    process of getting the student to the hospital.
    They try to give the postdoc feedback about this,
    but the postdoc feels invalidated and wronged and
    cannot take in the feedback.
  • What are the ethical and liability issues in this
    case?

33
References
  • Bernard, J.M. Goodyear R.K. (1998).
    Fundamentals of clinical supervision.  Needham
    Heights, MA  Allyn Bacon. Campbell,J.M.
    (2000).  Becoming an effective supervisor. Ann
    Arbor, MI  Sheridan Books.Frankel, A.S.
    (2000).  Laws ethics  beyond the basics. 
    Huntinton Beach, CA  Psycho-Legal Associates,
    Inc.Harrar, W., VandeCreek, L. Knapp, S. 
    (1990). Ethical and legal aspects of clinical
    supervision.  Professional Psychology  Research
    and Practice.  21, 37-41.Nagy, T.F. (2005). 
    Ethics in plain english.  Washington D.C. 
    American Psychological Association.Roberts,
    G.T., Murrell, P.H., Thomas, R.E. Claxton, C.S.
    (1982).  Ethical concerns for counseling
    educators.  Counselor Education  and Supervision,
    22, 8-14.
  • State of California, Department of Consumer
    Affairs, Board of Psychology.  (2005).  Laws and
    regulations relating to the practice of
    psychology.  Sacramento, CA  Department of
    Consumer Affairs.Upchurch, D.W., (1985) 
    Ethical standards and the supervisiory process. 
    Counselor Education  and Supervision, 25, 90-98.
  • Wise, P.S., Lowery, S. Silverglade, L.
    (1989)  Personal Counseling for Counselors in
    Training - Guidelines for Supervisors.  Counselor
    Education and Supervision, 28- 326-336.
Write a Comment
User Comments (0)
About PowerShow.com