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Informed Consent: A Case Study

Further, it is crucial to provide the client with information pertaining to their individual rights. Particularly, concerning their right to be treated with dignity and respect, as well as confidentiality. Additionally, a counselor should discuss the limits to confidentiality, (duty to warn/protect) and the sorts of behaviors that motivate a counselor to express their concern to the suitable agency or law enforcement. The purpose of informed consent is to provide consistent attention to the client’s treatment, by systematically recording and renewing the treatment plan.

Essentially, both the counselor and client are held to specific obligations, in order to preserve the psychotherapeutic relationship, and omit any confusion. Informed Consent Further the ACA Code of Ethics discussed the matter of billing, saying, “counselors inform clients about fees and billing arrangements, including procedures for nonpayment of fees” (2014). The topic of payment is one that each counselor is allowed flexibility, permitting an unforeseen change in financial circumstance, the counselor is able to negotiate payment.

By accepting payments, through bartering, or pro Bono work. Moreover, a client has the right to privacy, confidentiality is critical to the rapport between client and counselor. The American Counseling Association describes privacy as, “Counselors respect the privacy of prospective and current clients. Counselors request private information from clients only when it is beneficial to the counseling process” (ACA, 2014, B. 1. b).

Facilitating the client’s needs is another responsibility that a counselor supports, all information is safeguarded by the counselor, and others who may come in contact with the records, (employees, supervisors, etc) all of whom are instructed to maintain the client’s privacy (ACA, 2014). Revisions to the 2014 ACA Code of Ethics, include guidelines from the Health Insurance Portability and Accountability Act of 1996 (HIPPA). The ACA Code of Ethics approved an addendum to include a new segment in the Code of Ethics to include section H, Distance Counseling Technology and Social Media.

Which identifies the importance of counselor competency regarding laws, technological advances, statutes, and digital media. Consequently, counselors are to observe the laws and statutes, (H. 1. b) and, acknowledge the “limits of confidentiality of electronic records and communications (H. 2. b). As well as, understanding the appropriate use of digital media and electronic reports in therapy (H. 2. d) (ACA, 2014). Because laws vary from state to state, and typically mandate the types of behavior that society deems unacceptable, it is important to recognize the importance of the Code of Ethics.

Adhering to the principles outlined within the ethical codes, by following the ethical principles, statutes and laws, one has a reliable means to link professional ethics, and personal values. The Credentialing Board, sees to it that each mental health professional, has met the requirements necessary for employment. Thus, Section C. 4. b. of the ACA states, “Counselors claim only licenses or certifications that are current and in good standing” (ACA, 2014).

Essentially, it is critical that the counselor inform the client of their credentials prior to treatment, in addition to having the client sign the appropriate documents for both the organization, and the credentialing board. Duty to Warn and Duty to Protect Confidentiality is central to the therapist-client relationship, it is generally understood that a counselor values the client’s anonymity and does not share information discussed in counseling. However, certain factors necessitate a counselor’s duty to warn/protect, such as, a client’s disclosing their intent to self-harm, or cause injury to others.

The ACA Code of Ethics Section B. 2. a. states, “…Confidential[ity] does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception” (ACA, 2014). Additionally, most states have adopted a duty to warn/protect, following the Tarasoff v. Regents of the University of California judgment in 1976 (Corey, Corey, Corey, and Callanan, 2014, p. 223).

New Mexico has passed its own statues with regard to a counselor’s duty to responsibility to warn, and protect. Accordingly, if the counselor is concerned for the client’s welfare or that of a third-party, written consent from the client is not required. As observed within the New Mexico statues, a client’s confidentiality is to be safeguarded, unless “… disclosure is necessary to protect against a substantial and imminent risk of serious harm being inflicted by the patient on the patient or another person” (Regulation and Licensing Department, New Mexico State Board of Psychologist Examiners, 1978).

Other factors that may influence confidentiality include, treating minor clients, provided that the parents ask to be conversant of the child’s sessions. A counselor should discuss the importance of confidentiality and how it is central to the relationship, and must be secured. Client Record Keeping Professional counselors take precautions to protect records and personal information. Additionally, professional counselors take heed to protect patient records, less they fall into the wrong hands. Accordingly, the American Counseling Association’s Code of Ethics, Section B. 6 explains Records and Documentation.

Ethical codes address the importance of proper record keeping, maintaining client privacy, and providing appropriate access to one’s personal file. Thus, counselors promote trust with client’s and earn respect through, “… [obtaining] permission from client’s before allowing any person to observe counseling sessions, review session transcripts, or view recordings of sessions with supervisors, faculty, peers, or others within the training environment” (ACA, Code of Ethics, B. 6. d). Further showing reverence for the client, by promoting concern for their anonymity and personal information.

Having executed the appropriate ethical mode of record keeping, one should also consider the ACA’s model which says that counselors do what is necessary to reveal information only with written consent from the client. Otherwise, if written authorization is not granted, or in the event of a court order, or summons a counselor will only reveal a minimal amount of information (ACA, 2014). Accordingly, a therapist must also maintain reasonable accessibility to client records, which may be beneficial to the counselor and the client in the years following.

In essence, a competent professional counselor treats the client’s records with dignity and handles all transcriptions, notes, and other data with respect. Self-Care According to the ACA Code of Ethics, “counselors participate in self-care activities to maintain and promote their own emotional, physical, mental, and spiritual well-being to best meet their professional responsibilities” (ACA, Code of Ethics, 2014, p. 8). Transparent, instructions for counselors to enrich their lives through various means, to better serve with grace. b) A proposed resolution to attain a balance between work and home requires creating a schedule that affords the time to rest.

Of course, one often focuses on the work and the passion associated with helping others. While I have great reverence in serving others, there is precious little one can give, if one does not first nurture their spirit. That is, spirituality, my relationship with Spirit fulfills me, and sustains me. To merge my two passions, I must take care to nurture my life through being in nature, taking walks under bright blue desert skies, or in fragrant clover fields, or freshly fallen snow.

Through storytelling, and playing board games at the kitchen table on Friday nights. By participating in my children’s lives, and being home to kiss them goodnight. By liking my job, and loving my life, and finding the joy that comes with a life fulfilled. (c) Regarding healthy self-care practices, I do my best to set aside time each day, for yoga, ideally, I would spend about forty-five minutes for yoga each day, but I have found that even thirty-minutes of stretching improves my mood, and decreases stress.

Mindfulness practices, such as meditation, (guided or otherwise) help to alleviate anxiety and add balance to my life. to prepare meals, because anemia and vitamin deficiencies are best avoided, and difficult treat. I have discovered that working around horses helps keep me grounded, and nourishes my soul, I donate time at a local horse rescue center one day a week. Some days I will brush their coat and clean their hooves, help treat injured horses, or help clean the stables. Being in nature, grounds me and awakens me to the part of my spirit that recalls her purpose and unites me with the divine.

Horses are my therapy. Spirituality is central to my life, within the context of my career as a counselor, my personal beliefs strengthen and sustain my personal values (d) On the topic of self-care, there are many ventures I should like to try. Such as tai chi, which is beneficial in relieving discomfort from fibromyalgia. Additionally, I find solace in painting, and gardening, it relaxes me. Laughter, and positive exchange with loving friends, and family. Reading books regarding spirituality, psychology, counseling and self-help, are beneficial. Who knows, perhaps I may be so bold as to try acupuncture therapy.

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