Ethics and Mental Health Law

Sex: menAge: 15-24, males 75+, females 45-54, 65+Depression: hopelessnessPrior History: attemptsEthanol Abuse: alcohol/drugsRational Thinking Loss: psychosisSupport System LossOrganized PlanNo Significant OtherSickness: terminal illness(?)assessment to determine risk of suicide in a client.
1 point each
Sex: gender; males more than females
Age: risk increases with age
Depression: clinical depression is inc risk
prior history of violence or attempts
ETOH use
rational thinking loss
support system loss
organized plan
no significant other
sickness of self or others
rating scale: 0-2 keep watch
3-4 send home; call often
5-6 consider hospitalization
7-10 hospitalize.

Assent: make sure the child understands therapy process at a developmentally appropriate level and have them assent, parents can not force them into therapy(need consent)

Offering therapeutic services in exchange for something other than the set fee. Generally, it is not good to barter bc it can affect the client/therapist relationship, cause misunderstandings and ill feelings.Boundary Crossing:A therapist provides serves in exchange for use of a vacation home in the tropics and the patient begins to feel they are only being helped because they are offering a vacation home; Client may be mistreated if therapist is not happy w/ home/deal.(?)involves an exchange of goods in place of monetary compensation for therapeutic services. bartering should only be done when the value is agreed upon before and when there is an obvious monetary value attached to the goods that are being bartered. best to avoid.
Ex: Dr. Brown agrees to have Tim exchange $100 worth of painting for a $100 session

To safeguard the welfare and safety of the clients.Mandated reporting is in practice in order to fulfill the basic purpose of ethical practice in reporting abuse, etc. in order to look out for the safety welfare of the client. to safeguard the welfare and safety of the clients.
Ex: clients well being should have a higher priority than the clinicians compensation, thus if the client is well enough for therapy to end then the clnicial should not continue just to maintain an income

Additional training in an area of a profession in order to broaden knowledge in the field"In order to administer ABA therapy, one must receive proper certification through attending classes, etc"the process in which a therapist receives approval and acknowledgement of skill in a profession. it indicates that the practitioner has met a set of minimum standards established by a certification agency. it gives the right to use a professional title, but does not ensure quality and/or governed practice.
Ex. David received his certification to be a LPC

General rule is that patient's information must be kept confidential/private except w/ a court oder, mandated reporting, parents of minors, etc.(?)the foundation of safe therapy. it is rooted in a client's right to privacy, a practitioner has a legal duty to not disclose info about the client, every effort should be made to maintain confidentiality. therapists are prohibited from disclosing confidential communications to a third party unless mandated or permitted by law.the duty imposed on professionals to keep info disclosed in professional relationship in confidence
exceptions:
1.) judge suponeos
2.) duty to warn/protect/report
Ex: MHP receives a fax from an attorney requesting client records, he faxes back that he can neither confirm nor deny that the person is a client, later he receives a subpoena. he advises the client regarding confidentiality and the request for information. he then leaves it up to the client as to whether he will consent to the release of his records, only specific information is given.

Confidentiality with group members is ethically different; what's discussed in group may be discussed by other members of the group. Marriages- the patient of record is the couple and both have access to the recordFamilies- (same as above)(?)the nature of group or marital counseling limits the privacy, there are no secrets. what is said in therapy is to be shared with all members of therapy. limited because privileged communication is void in the presence of a 3rd party. the therapist is the only one who is legally bound. to facilitate trustful, open session, the therapist can have patients sign confidentiality agreements, but remind them that they are under no legal obligation to remain silent.
Ex: if a wife discloses a desire to move away while in a private session, it must be disclosed to the husband

The ability to perform according to the standards of the profession. the three basic factors related to competence are knowledge base, technical skills, and emotional competence. Ex: sara has been overwhelmed lately by a heavy client load, problems with her teen son and her husband's infidelity. it is in her and her client's best interest that she take some time off adn work through her own issues because her emotional competence may be diminished.

Link between damage to patient and behavior of professional."If a patient says they will kill themselves and the therapist does not take them seriously and follow proper protocol, yet notes they were feeling suicidal and the patient kills themselves, direct liability can be drawn between the therapist being aware the patient was suicidal and not doing more to prevent the suicide."pertains to the responsibilites that supervisors have because of the actions of the supervisees. from both a legal and ethical standpoint, trainees are not expected to assume final responsibility for clients, rather, their supervisors are legally bound to carry the decision making responsibility and liability.
occurs when a supervisors actions are derelict in supervision of their trainees, if they give inappropriate advice or give tasks that exceed supervisee's competence
Ex: supervisor tells supervisee to take a patient outside of scope of knowledge

If you blend/confuse your professional relationship with any other relationship.Practitioner is in a professional role with a person as well as another role with the same person-providing therapy to friend/friend's relative-socializing with clients, etc.Exists along a continuum ranging from boundary crossings to sexual relationships.such relationships occur when a MHP has a professional role with a client and another role, a relationship with a person closely related to patient, or promises to engage in another relationship w the client or person closely related once therapy is complete
1.) rx w them outside of tx
2.) rx w friend/relative
3.) rx w them after therapy is completed
Ex: therapist enters into a business venture with client

Mental health professionals have a duty to warn or protect third parties who have been threatened with violence- factors to consider:1. verbal threat2. context in which threat was made3. intent of threat4. availability of opportunityPatient threatening the life of another person with clear plan and strong intent=duty to warn/protect individual therapist believes may be in danger.(need ex.)in the result of the Tarasoff case, when a threat of harm is made towards an identifiable 3rd person, the therapist has an obligation to use reasonable care to protect the intended victim against such danger. duty to warn potential victims.
Ex: MHP has duty to warn if client says, "I am going to kill my wife tonight by shooting her in the head with my shot gun when she comes home from work"

Have been researched under rigorous criteria, including having controls, reliability, validity etc. (need more)refers to treatments that have repeatedely produces statistically significant results. Must have the following criteria:
1.) must have at least 2 randomized clinical trials supporting well defined treatment protocol
2.) must be replicated by independent objective investigators
3.) must be able to be duplicated by others and yield similar results
Ex: using CBT to treat depression has been empirically validated

Refers o the standards that govern the conduct of professional members"As a function of ethics, mental health professionals must provide clients with informed consent, safeguarding the welfare of the patient & allowing them autonomy."the standards that govern the conduct of professional members within the community, represent aspirational goals and maximum ideals set by profession and enforced by associations and certification boards
on a continuum, mandatory ethics to aspirational ethics
Ex: therapist must consider bx when treating pts as it must be consistent with ethical codes

Focus is on the welfare of the patient, not the psychologist; neutral therapeutic position, avoiding potentially harmful multiple relationships, etc.Therapist must continually assess their motivations/actions to be sure they are only looking out for the welfare of the client.ethical boundaries that limit the nature of a clinician and client's interaction ensuring the protection of professional relationships and the patients well being, the clinician provides services in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study or professional experience. they may not treat friends, colleagues, the children of friends or colleagues, take gifts from patients, engage in outside social relationships with patients, barter, or have sex with patients.
imp: ensures protection of the professinal rx and the clients wellbeing
boundary crossing: blurring of boundaries, accepting small gift from client
boundary violation: sex with client
Ex: a therapist may maintain ethical boundaries when a pt asks person ?'s by redirecting and not answering

Therapists must have competence with diverse populations- patients can express distress and react in different ways. You should be aware of unique needs or perspectives of patients.All patients should be able to receive mental health services rom someone who understands.practioners must be educated and aware of cultural issues and their relevance to tx. they must also explore their own cultural identities and how they shape their values and beliefs about the counseling process. the counselor must also be aware of values, beliefs and biases of different ethnic groups, and how they can impact therapy and the therapeutic relationship
Ex: a therapist must be understanding of the importance of family when engaging in therapy w a Hispanic family that has been fighting over family involvement