ethics - trudy gilbert

Ethics

Presented by:

Trudy Gilbert-Eliot, M.S., LMFT, LADC

Overview

State Law State Regulations AAMFT Ethics Code *Understanding Ethics Ethical Decision-making

Understanding Ethics

Handout

Law and Ethics

Nevada Revised Statutes (NRS) 641A Nevada Administrative Code (NAC) 641A American Association of Marriage and Family

Therapists (AAMFT) Code of Ethics Case Law

Definition

“Marriage and family therapist” means a person who describes himself or herself or his or her services to the public by any title or description which incorporates the term “marriage and family therapist” or “marriage and family counselor”

“Practice of marriage and family therapy” means the diagnosis and treatment of mental and emotional disorders, whether cognitive, affective or behavioral, within the context of interpersonal relationships…. services to a person, couple, family or family group or other group of persons.

Limitations: diagnosis/treatment of a psychotic disorder, and assessments of intelligence, personality, aptitude, interests or addictions.


A therapist with experience working with adolescents received a call from a family wanting him to work with their seven-year-old son. What should he tell the family?

Grounds for Denial, Suspension, or Revocation Conviction of felony Habitual drunkenness or addiction Impersonation Using fraud or deception in obtaining license or

taking/passing exam Rendering or offering to render services outside of

area of training, experience, or competence Committing unethical practices Unprofessional conduct as determined by the Board Operation of a medical facility when the license is

suspended or revoked Failure to pay child support

Discipline

Probation Suspending license for not more than a year Revoking license Public reprimand Limiting practice Fine not more than $5000.00 Complete another examination

Requirements

Age 21 or more Good moral character Citizen of US or entitled to work in US Education approved by Board Two years postgraduate experience in MFT 3000 hours supervised experience of which

1500 is direct contact with clients Undergraduate degree from accredited

institution approved by Board


A therapist had just gone through treatment for cancer and was returning to work after a sabbatical. She believed she was fully recovered from the chemotherapy, including symptoms of extreme fatigue and mental deficits, but isn’t quite sure. What would you tell your colleague if she came to you for feedback?

Professional Responsibility

Advertising Impairment Relationship Exploitation Boundaries Giving/receiving fees Consultation Disparaging colleagues Scope of practice


A client tells you that they were in therapy four years ago and had a sexual relationship with the therapist. What do you do?

Understanding Ethics, Redux

You share an office with three colleagues and frequently notice the comings and goings of their clients, as they do yours. One day you are at Starbucks to meet a friend for coffee and you notice one of your colleagues with a current client. He leans over and kisses her. What do you do?

Professional Responsibility, Cont.

Reporting Practice base Current knowledge Record keeping Records to the court Supervision/supervisee Board notification


A therapist had been working with XYZ insurance company and frequently experienced problems with them giving accurate benefits/coverage information. A new client attends their first appointment and the therapist found that they had XYZ insurance as their primary carrier. What should the therapist do?

Responsibility to Clients/Others

Professionalism and Competence Safeguard the interests of incompetent client Deal with legal representatives of clients Non-discrimination Cannot misrepresent efficacy/results of

services Apprise of rights, risks, financial obligations Consultation Termination


A therapist in private practice noticed that one of his neighbors had begun to date one of his clients. What should he do?

Responsibility to Clients/Others, Cont.

Withdrawing services Termination/Interruption of services Influence Personal/sexual relationships Dual relationships


You have an intern and regularly observe or watch video-tapes of sessions. In a recent review you watch a video of your intern performing a type of therapy that is not listed on their training outline and is not one that you have any experience with. What do you do?

Unprofessional Conduct

Intern: Performs services outside the scope of internship plan

Performing therapy with a lapsed license Failing to cooperate with an investigation Gross negligence Malpractice

Code of Ethics

AAMFT Code of Ethics utilized “as a standard for professional conduct in the State of Nevada”


A client attends his first session clearly under the influence of alcohol. Normally the therapist goes through the consents in the first session. What should this clinician do?

AAMFT Code of Ethics: Responsibility to Clients Non-Discrimination Informed Consent Multiple Relationships Sexual Intimacy with Current Clients and

Others Reports of Unethical Conduct No Furthering of Own Interests Client Autonomy in Decision-Making


You have a client you have been seeing for some time who is moving to a rural area of Nevada. They want to keep ‘seeing’ you as a therapist and suggests you set up a way to have sessions via Skype. What are your obligations?

AAMFT Code of Ethics: Responsibility to Clients, Cont. Relationship Beneficial to Client Referrals Non-Abandonment Written Consent to Record Relationships with Third Parties Electronic Therapy


During a break in a court-ordered evaluation for a client’s inclusion in a domestic battery group, the therapist hears the man brag to others he knows in the waiting room about the crime and that he is selling drugs. Can the therapist include this in the report to the court?


A therapist gives a speech to a group of colleagues and includes a case example with occupation, family constellation, city of residence, while other patient demographics were disguised. The therapist shares a dream the client had and someone in the audience was able to identify the patient because they had described this dream to them, as well. What should this therapist have done instead?

AAMFT Code of Ethics: Confidentiality Disclosing Limits of Confidentiality Written Authorization to Release Client

Information Confidentiality in Non-Clinical Activities Protection of Records Preparation for Practice Changes Confidentiality in Consultations Protection of Electronic Information


A therapist came home early one day to find her husband in bed with her best friend. A large portion of her practice was conducting couples therapy. She comes to you as a colleague devastated and wants to know what she should do about her work. What would you tell her?

AAMFT Code of Ethics: Professional Competence and Integrity Maintenance of Competency Knowledge of Regulatory Standards Seek Assistance Conflict of Interest Veracity of Scholarship Maintenance of Records Development of new Skills


An adolescent client had been in therapy and was preparing for termination after a very successful therapy experience. During the second to last session she brings you a hand-made necklace. Since therapists are discouraged from receiving gifts, what do you say? What if she was from a wealthy family and the necklace was clearly very expensive?

AAMFT Code of Ethics: Professional Competence and Integrity, Cont.

Harassment Exploitation Gifts Scope of Competence Accurate Presentation of Findings Public Statements Separation of Custody Evaluation form

Therapy Professional Misconduct


A therapist/supervisor was having a casual conversation with a colleague who revealed one of her supervisees had made several very harsh, racial comments at a recent professional lunch. In supervision there had never been any indication that the supervisee held racially-biased opinions. When reporting to the Board at the 6-month review, do you report this information? What would you do?

AAMFT Code of Ethics: Responsibility to Students and Supervisees

Exploitation Therapy with Students or Supervisees Sexual Intimacy with Students or Supervisees Oversight of Supervisee Competence Oversight of Supervisee Professionalism Existing Relationship with Students or

Supervisees Confidentiality with Supervisees

AAMFT Code of Ethics: Responsibility to Research Participants Protection of Research Participants Informed Consent Right to Decline or Withdraw Participation Confidentiality of Research Data


You work for ABC agency. A couple comes in for couples counseling to deal with the conflicts that have come up in their relationship due to their daughter who is bipolar. The couple does not have couples therapy coverage with their insurance. The clinic director says to bill it as individual therapy for the child. What do you do?

AAMFT Code of Ethics: Responsibility to the Profession Conflicts Between Code and Organizational

Policies Publication Authorship Authorship of Student Work Plagiarism Accuracy in Publication and Advertising Pro Bono Advocacy Public Participation


A therapist worked a part-time job in a rural community conducting school-based counseling for children acting out at school. The community suffered some economic consequences that precluded them from financially paying the therapist so they offered him room, board, office space and travel reimbursement. Should the therapist agree?

AAMFT Code of Ethics: Financial Arrangements Financial Integrity Disclosure of Financial Policies Notice of Payment Recovery Procedures Truthful Representation of Services Bartering Withholding Records for Non-Payment


When reviewing a publishing Website that was advertising her very first book, a therapist realized that they claimed that she was a professor of psychology at a university that she had taught at several years before as an adjunct professor. What should she do?

AAMFT Code of Ethics: Advertising

Accurate Professional Representation Promotional Materials Professional Affiliations Professional Identification Educational Credentials Correction of Misinformation Employee or Supervisee Qualifications Specialization


A therapist is has some questions about the treatment of a very contentious couple who are threatening divorce every session. She is concerned about her objectivity and interventions since the way they fight reminds her of her first marriage when she was 20. She took some notes to herself and wonders if she should seek consultation with a colleague. What are her obligations in regards to record keeping?

Other Ethical Issues

Domestic Violence—Child Abuse Emotional Abuse of Children Financial Abuse of Elders Guilty and No Contest pleas HIPAA Immunity from Liability Joint Legal Custody Record Keeping


A 16-year-old mother who is receiving State Medicaid makes an appointment to see you for help adjusting to parenting and dealing with friends who have rejected her because she kept her baby. She continues to live with her parents who are very religious and do not believe in therapy. Who signs the consent forms?

Other Ethical Issues, Cont.

Leaving an Agency Treating minors without Parental Consent Online therapy Privilege Billing Practices: Self and Interns Service of a Subpoena Termination Renewing license and Malpractice


A client leaves a series of voicemails that articulate a desire to hurt the therapist and the front office personnel. What are the therapists confidentiality obligations? What should she do? Can she terminate the therapeutic relationship?

Other Ethical Issues, Cont.

Hypnosis and Crime Victims CEU’s Violence against Therapist and Confidentiality Suicide and Confidentiality Experimental Therapies Referrals Abuse in other States


A judge ordered a convicted sex-offender to receive weekly therapy. What obligations does the therapist have to the court? What obligations does the therapist have to the client?

Ethical Decision Making (Fisher, 2003) Step 1: Professional commitment Step 2: Be familiar with the ethics code Step 3: Gather facts Step 4: Understand stakeholders’

perspectives Step 5: Apply 1-4 to generate ethical

alternatives Step 6: Select and implement and ethical

course of action.

Contact Information

Trudy Gilbert-Eliot, M.S., LMFT, LADC Nevada Marriage and Family Therapist

#0828 Nevada Licensed Alcohol and Drug

Counselor #0127L 458 Court Street Reno, NV 89501 775-772-9017 [email protected]

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