Two central aspects of informed consent
Disclosure -ensure the client (service user) has the information they need to decide whether or not to initiate service
Free consent- Decision to engage in activity is made without coercion or undue pressure
Content of informed consent (5)
- Completed at the initial counselling session by having a client sign some forms
- Restricted to the limits of confidentiality
- Distraction from the real business of counselling
- Risk management to protect the practitioner
- Quickly understood and retained by the service user
Ethical principle
Autonomy and self-determination – service users may decide whether or not they wish to begin or continue service
Informed consent (4)
- Involves the right of clients to be informed about their counselling and to make autonomous decisions pertaining to it
- 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
Content of informed consent (12)
-Description of service process (including assessment)
-Background of service provide
-Costs (if any) to be paid by client
-The length of service provision and termination
-Consultation with colleagues
-Interruptions in service provision due to service providers, illness, vacation
-Clients’ right of access to their files
Rights pertaining to diagnostic labeling
-The nature and purpose of confidentiality
-Benefits and risks of service
-Alternatives to traditional therapy
-Tape-recording or videotaping sessions
content for inclusion in records (5)
- Current risk factors pertaining to danger to self or others
- Plans for future interventions
- Assessment or summary information
- Consultations with or referrals to other professionals
- Relevant cultural and sociopolitical factors
Record keeping from a clinical perspective
Record keeping provides a history that a social worker can use in reviewing the course of service.
Record keeping from an ethical perspective
Records can assist practitioners in providing quality care to their clients.
Record keeping from a legal perspective (2)
- Professional Standards of Practice requires professionals keep clear and accurate records.
- Many practitioners believe that accurate and detailed clinical records can provide an excellent defense against malpractice claims.
Record keeping from a risk management perspective
Keeping adequate records is the standard of care.
Content for inclusion in records (7)
- Identifying data
- Fees and billing information
- Documentation of informed consent
- Documentation of waivers of confidentiality
- Presenting complaint and diagnosis
- Plan for services
- Client reactions to professional interventions
Ethical issues in online counselling (2)
- It is the counselor’s responsibility to examine the ethical, legal, and clinical issues related to online counselling.
- Basic issues such as self-disclosure, confidentiality, boundaries, and dual relationships can take on unexpected shapes in online counseling.
Potential legal/professional issues in online counselling (3)
- 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
Advantages of Online Counseling (4)
- Reaching clients who are reluctant to participate in face-to-face therapy
- Reaching clients who have certain disabilities or chronic illnesses which limit mobility
- Improving client access in rural areas
- The potential for greater numbers of people to receive services
Disadvantages of Online Counseling (7)
- Danger of an inaccurate assessment
- Compromising confidentiality and privacy
- Difficulty in being able to protect clients in crisis situations
- Absence of traditional client-therapist relationship and challenges of working through transference and countertransference
- Lack of competence in providing online services and danger of the misrepresentation of professional qualifications
- Danger of clients misrepresenting themselves or minors pretending to be adults seeking treatment
- Danger of individuals other than the client logging on as if they were the client
Unethical behaviour of colleagues (3)
- Ignoring evidence of peer misconduct is an ethical violation in itself.
- Informal peer monitoring provides an opportunity for corrective interventions to ethically questionable acts.
- If informal measures are not enough, reporting a colleague to a professional board is one of several options open to you
