Chapter Five

1. Chapter Five Ethical, Legal, and Professional Issues in School Counseling

2. Professional Associations and Credentialing Organizations 1. American Counseling Association (ACA) ACA’s mission is to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity. ACA contains 19 divisions. It influences all aspects of professional counseling through programs, committees, and functions (i.e., credentialing of counselors, accreditation of counselor education programs, ethical standards, professional development, professional resources and services, and public policy and legislation). ACA has 15 committees, including an Ethics Committee which is responsible for updating ethical standards and investigating ethical complaints. ACA covers current research, professional practices, and other pertinent information regarding counseling. ACA produces a monthly newsletter called CounselingToday. ACA’s Webpage is http://www.counseling.org .

3. Professional Associations and Credentialing Organizations 2. American School Counselors Association (ASCA) ASCA is a semiautonomous division of ACA and addresses school counseling issues. ASCA targets its efforts toward professional development, publications and other resources, research, and advocacy specifically for school counselors.

4. Professional Associations and Credentialing Organizations 3. National Board for Certified Counselors (NBCC) NBCC is the only national credentialing organization for professional counselors. The National Counselor Exam (NCE) must be passed as part of the process for becoming nationally certified. The NCE is frequently used by states for professional counselor licensure or certification.

5. Professional Associations and Credentialing Organizations 4.The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) CACREP is a corporate partner of ACA. CACREP is responsible for establishing state-of-the-art standards for counselor education programs. CACREP standards address program objectives and curricula, faculty and staff requirements, program evaluation, and other requirements for accreditation. Students who graduate from CACREP programs are usually in an advantageous position to be hired because their programs include 48 graduate credit hours and 700 hours of field placement.

6. Ethical Standards and Laws Standards Developed by professional associations to guide the behavior of a specific group of professionals. Ethical standards serve the purpose of educating members about ethical conduct, provide a mechanism for accountability, and serve as a means for improving professional practice. Updated periodically to ensure relevance. Based on generally accepted norms, beliefs, customs, and values. Laws Laws are more prescriptive. They have been incorporated into code, and carry greater penalties for failure to comply. Differences Between Standards and Laws

7. Ethical Standards and Laws Both exist to encourage appropriate behavior to provide for the best interests of the client. Both concern behaving in an appropriate professional manner, practicing within the scope of one’s education, training and experience. Because there are penalties associated with laws, the counselor will generally follow the legal guidelines if there is no harm to the client. Similarities Between Standards and Laws

8. ACA Code of Ethics Revised August, 2005. Aspirational ethics (i.e., standards of practice) have been incorporated into the body of the Code of Ethics and are no longer a separate section. Each section now has an introduction. Several new issues and a glossary have been added.

9. ACA Code of Ethics 5 Main Purposes: 1. Enables ACA to clarify to current and future members, and those served by members, the nature of the ethical responsibilities held in common by its members. 2. Helps support the mission of ACA. 3. Establishes principles that define ethical behavior and best practices of association members. 4. Ethical guide to assist members in constructing a professional course of action that best serves those using counseling services and best promotes the values of the counseling profession. 5. Serves as the basis of processing ethical complaints and inquiries initiated against members of the association.

10. ACA Code of Ethics The ACA’s Code of Ethics is based on Kitchener’s five more principles: Autonomy refers to the concept of independence and the ability to make one’s own decisions. Justice means treating each person fairly, but it does not mean treating each person in the same way. Beneficence refers to doing what is in the best interests of the client. Nonmaleficence means doing no harm to others. Fidelity involves the concepts of loyalty, faithfulness, and honoring commitments.

11. ACA Code of Ethics The Code of Ethics is divided into eight areas: The Counseling Relationship Confidentiality, Privileged Communication and Privacy Professional Responsibility Relationships with Other Professionals Evaluation, Assessment and Interpretation Supervision, Training and Teaching Research and Publication Resolving Ethical Issues

12. ASCA Ethical Standards for School Counselors ASCA developed a set of ethical standards designed specifically for school counseling. These standards contain eight sections, which include responsibilities to students, parents, colleagues and professional associates, as well as responsibilities to the community, self, and profession. A final section addresses maintenance of standards and resources. ASCA’s standards discuss putting the student’s best interests first, treating each student as an individual and with respect, involving parents as appropriate, maintaining one’s expertise through ongoing professional development and learning, and behaving professionally and ethically. Both ACA and ASCA have developed guides to ethical decision making should an ethical dilemma arise.

13. Ethical Decision Making The ACA has a model to guide ethical decision making that consists of seven steps: Identify the problem. Apply the ACA Code of Ethics. Determine the nature and dimensions of the dilemma. Generate potential courses of action. Consider the potential consequences of all options. Choose a course of action. Evaluate the selected course of action.

14. Ethical Decision Making Remley and Herlihy (2001) suggested four self-tests to consider once a decision has been made to determine whether the decision was ethically sound: Would you treat others this same way if they were in a similar situation? Would you suggest to other counselors this same course of action? Would you be willing to have others know how you acted? Do you have any lingering feelings of doubt or uncertainty about what you did?

15. Sources of Information and Guidance Ethical standards have an important function in guiding the behavior of counselors; however, other sources are valuable in maintaining the highest standards of ethical and legal behavior. These other sources include the court system, statutory law, and state and local agencies.

16. The Court System Counselors are affected by three main types of laws: 1. Statutory law - created by legislatures. 2. Constitutional law - results from court decisions concerning constitutional issues. 3. Common law - results from other court decisions.

17. Statutory Law Body of mandates created through legislation passed by U.S. Congress and state legislatures. The structure of education and health systems, as well as many of the policies that govern implementation are found within these mandates.

18. Statutory Law • The majority of legislation influencing schools and counselors is passed by state legislatures and concerns two types of legislation: 1. Creating state legislation to implement federal legislation 2. Enacting new state-specific legislation. • State laws may be more restrictive than federal legislation, but never less restrictive.

19. State and Local Agencies State departments of education have the ability to enact regulations that are binding on the school districts within the state. State agencies develop policies on how to implement a specific law. State agencies may also issue guidelines, which are suggestions about how to address a specific issue. For example, the state attorney general may issue an “advice of counsel” in response to a new court case or law. Local school systems and agencies may develop their own policies, procedures, and guidelines. For example, school systems often take state regulations and rewrite them to reflect their specific situation.

20. Making Decisions Failure to understand the law is not an acceptable legal defense. The professional school counselor needs to be familiar with sources of ethical information in order to perform job responsibilities. Counselors ordinarily have a supervisor who can help them become familiar with the regulations. When mandates appear to be in conflict, follow the logical course of action and document your actions and why you chose that course of action.

21. Making Decisions Two issues that are sometimes confusing to counselors are: The differing ways counselors in different settings operate. For example, mental health counselors from outside agencies need to have informed consent for students to participate in various programs. However, schools may not require informed consent. Counselors with multiple credentials. Employees must follow the mandates that apply to their work setting.

22. Additional Legal Considerations Counselors have different levels of experience, education, training, values, morals, and spiritual influences. As a result, professional school counselors must be aware of how their beliefs impact the client. The bottom line – ALWAYS TRY TO DO WHAT IS IN THE BEST INTEREST OF THE CLIENT!

23. Professional Competence 1. Maintain professional growth through continuing education. * Stay current with theories, trends, and information. 2. Maintain accurate knowledge and expertise in areas of responsibility. * Information changes rapidly, so it is paramount to maintain accurate, up-to-date knowledge. 3. Accurately represent credentials. * Counselors who hold doctorates in non-mental health fields should not use the title “doctor” in their work as a counselor. 4. Provide only those services for which you are qualified and trained. * Counselors should have training in a particular technique before using it. In addition, counselors should only work with clients whose problems are within their area of treatment expertise.

24. Can I Be Sued? YES! Anyone can be sued for anything at any time. If professional school counselors fail to exercise “due care” in fulfilling their professional responsibilities, they can be found guilty (civil liability). When counselors fail to exercise “due care,” they can be found guilty of negligence. An example of negligence would be a counselor who failed to report an abuse case. The counselor had a duty to the client and failed to fulfill that duty. The “standard of practice” will be used in any liability proceeding to determine the counselor’s performance. The standard of practice question is, “…did the counselor provide the level of care and treatment that is consistent with the degree of learning, skill and ethics expected by reputable counselors practicing under similar circumstances?” The standard of practice is established through the testimony of peers and based on education and experience.

25. What is Malpractice? Malpractice is professional misconduct or any unreasonable lack of skill in the performance of professional duties. For a counselor to be held liable for malpractice, four conditions must be met. 1. A duty was owed to the plaintiff (client) by the defendant (counselor). 2. The duty was breached. 3. There was a causal link between the breach and the plaintiff’s injury. 4. The client suffered some damage. As an example: If a counselor treating a client with an eating disorder used hypnosis, but was not trained to use hypnosis, malpractice could be claimed.

26. What is Malpractice? A counselor will usually be found guilty of malpractice if one or more of the following situations occurs: * The practice was not within the realm of acceptable professional practice. * The counselor was not trained in the technique used. * The counselor failed to follow a procedure that would have been more helpful. * The counselor failed to warn and/or protect others from a violent crime. * The counselor failed to obtain informed consent. * The counselor failed to explain the possible consequences of treatment.

27. Subpoenas The most common reason counselors receive subpoenas are because of cases involving custody disputes, child abuse/neglect allegations, and special education disputes. Under no circumstances should the counselor automatically comply with the subpoena without discussing it first with the client, client’s attorney, and/or employing agency/school system attorney. If both a subpoena and a court order are received, the counselor must release information with or without the client’s consent.

28. Subpoenas According to ACA (1997), counselors should take the following steps when receiving a subpoena: Contact the client or the client’s attorney and ask for guidance. If you work for a school system, contact the school system’s attorney. If the above parties advise you to comply with the subpoena, discuss the implications of releasing the requested information. Obtain a signed informed consent form to release the records. The form should specify all conditions of release. If the decision is made to not release the records, the attorney should file a motion to “quash.” This allows the counselor to not comply with the subpoena. Maintain a record of everything the counselor and attorneys did, keep notes regarding all conversations and copies of any documents pertaining to the subpoena. **DO NOT PANIC, BUT DO CONSULT AN ATTORNEY**

29. Confidentiality Confidentiality is essential for counseling to be successful. Confidentiality belongs to the client, not to the counselor. The client always has the right to waive confidentiality. Minors have an ethical right to confidentiality, but the legal rights belong to their parents or guardian. At the beginning of the first session of each new counseling relationship, the professional school counselor should discuss confidentiality. For example, discuss what it means and point out the limits.

30. Limits to Confidentiality There are several instances in which counselors must break confidentiality. The most important is the “duty to warn.” When the client is in danger of being harmed or is likely to harm someone else, the counselor may break confidentiality and tell the appropriate persons. Exercising a duty to warn was made famous by the 1974 Tarasoff case in California in which a graduate student told his psychologist about his intent to kill a girl who had rejected his advances. The psychologist told the campus police and supervisor, but failed to warn the intended victim or her family.

31. Limits to Confidentiality Several other situations constrain the limits of confidentiality: Subordinates - They should have limited access to information. Treatment teams - The client should be informed of the team and the information being shared. Consultation - The professional school counselor has a right to consult with a colleague or supervisor. Group/family counseling - Because there is more than one client in the room, it is impossible to guarantee confidentiality.

32. Limits to Confidentiality Third-party payers - The counselor should disclose information to third-party payers only with the client’s permission. Minors - Numerous minor consent laws apply and vary across states. Contagious, life-threatening diseases - The counselor is justified in breaking confidentiality if a third party’s relationship with the client involves the possibility of contracting the disease and the client does not plan on telling the third party. Court-ordered disclosure - Even if ordered to reveal confidential information by a judge, counselors should limit what they reveal to only what is absolutely necessary.

33. Confidentiality and Privileged Communication Privileged communication is the legal term to describe the privacy of the counselor-client communication. It applies only to testifying in a court of law. The privilege belongs to the client, who always has the right to waive the privilege and allow the counselor to testify. It is essential that counselors become familiar with their local mandates and policies for determining the extent to which privileged communication applies to their situation.

34. Minor Consent Laws Minor consent laws allow certain minors to seek treatment for certain conditions, usually involving substance abuse, mental health, and some reproductive health areas. These laws are based on the federal regulation 42 CFR Part 2. The law prohibits the release of these records to anyone without the client’s informed consent and includes clients under the age of 18 years, even if they are in school and living with a parent/guardian.

35. Minor Consent Laws Students suspected of having a substance abuse problem can be referred to school-based student assistance programs (SAPs). If the team believes the student has a substance abuse problem, they can have the student assessed and referred for appropriate assistance. However, there is some controversy surrounding the role of parents in this process. Under federal law, the student can be referred and complete treatment without the parent’s/guardian’s knowledge. As a result, states have taken different approaches in deciding to whom this law applies. In general, the patient must be old enough to understand the problem, the treatment options, and the consequences

36. Minor Consent Laws According to the Guttmacher Institute: 25 states and DC allow all minors to consent to contraceptive services. 21 states allow minors to consent to contraceptive services in one or more circumstances. 4 states have no minor consent law for contraceptive services. 30 states allow minors to consent to prenatal treatment when pregnant, while 20 have no law. All 50 states allow minors to consent to treatment for STDs and HIV/AIDS. 44 states allow minor consent for drug abuse treatment.

37. Minor Consent Laws 20 states allow minor consent outpatient mental health services, 29 do not. 22 states allow minor consent for general medical care, and 29 do not. 3 states allow minor consent for abortion services, 30 require parental consent or notification and 18 states have no law. THERE IS TREMENDOUS VARIATION BETWEEN THE 50 STATES IN WHAT IS PERMISSABLE UNDER LAW. Laws clearly cover medical personnel, therefore a school nurse is covered but a school counselor or school psychologist may not be covered.

38. Minor Consent Laws It is critical that professional school counselors and other student services personnel become familiar with the minor consent laws in the state in which they work to ensure compliance. Counselors should not wait until they are faced with a situation to figure out where they stand on an issue. For example, parents may be angry when they discover they were not informed of their children’s substance abuse treatment or that their child has a sexually transmitted disease and the counselor knew and did not notify them of the situation.

39. Educational Records and FERPA Educational records are all the records of a student’s achievement, attendance, behavior, testing, school activities, and other information the school collects. The inspection, dissemination, and access to student educational records must be in accordance with the Family Educational Rights and Privacy Act (FERPA) of 1974, also known as the Buckley Amendment. The first provision requires schools/systems annually to send a notice to parents/guardians regarding their right to review their children’s records and to file a complaint if they disagree with anything in the record.

40. Educational Records and FERPA Second, the law limits who may access records and specifies what information can be disclosed without informed consent.

41. Educational Records and the Hatch Amendment The Hatch Amendment of 1978: Requires informed parent consent before the student undergoes any psychological, psychiatric, or medical examination, testing or treatment, or any school program designed to affect the personal values or behavior of the student. Gives parents the right to review instructional materials in experimental programs. Requires informed consent for all studies that are funded with federal money.

42. Revealing Educational Records to Various Individuals Parents - Unless there is a court order in the child’s file that limits or terminates the rights of one or both parents, both parents have the same access to the child’s records. Stepparents and other family members - Have no legal right to the student’s records without court appointed authority. Outside Agencies - May not access records of any student without the signed consent of the parent. School Team Meetings - Local policies dictate whether signed informed consent is needed to share information at school team meetings.

43. Personal Notes Personal notes are notes written by professional school counselors to serve as an extension of their memories. They are an impression of the client or session. Notes must remain “in the sole possession of the maker” and cannot be shared with anyone except “a substitute maker”. These notes must remain separate from the educational records and kept in a secure place. It is preferable to keep the notes separate and not tell anyone they exist, even if the information is of no particular interest.

44. Health Insurance Portability and Accountability Act (HIPAA) of 1996 Required the U.S. Department of Health and Human Services to adopt national standards for the privacy of individually identifiable health information, outlined patients’ rights, and established criteria for access to health records. Required the adoption standards for electronic health care transactions. School systems need to address any potential conflicts between FERPA and HIPAA.

45. Child Abuse The 1974 Child Abuse Prevention and Treatment Act has been revised and renamed Keeping Children and Families Safe Act of 2003. Every health practitioner, educator, human services worker, and law enforcement officer must report suspected abuse or neglect, generally within 24-72 hours of first “having reason to suspect.” It is pertinent that the first person who suspects the abuse or neglect call Child Protective Services. The oral report must be followed by a written report. There is no liability for reporting, unless done with malicious intent.

46. Child Abuse Parents/guardians have no right to information during this process. The school making the report should not inform the parents that a report has been made. Social services and law enforcement are responsible for contacting the parent and conducting the investigation.

47. Suicide The Eisel case in Maryland changed the standard for reporting suicide threats. This case involved two middle school students who became involved in Satanism and were obsessed with death. Friends of one of the girls, Nicole Eisel, went to their professional school counselor and informed her that Eisel was going to commit suicide. Their counselor consulted with Nicole’s counselor. Both professional school counselors spoke with Eisel who denied thinking about killing herself. Shortly thereafter, Nicole’s friend shot and killed Nicole Eisel, then herself.

48. Suicide Court Conclusion: Professional school counselors have a duty to use reasonable means to prevent a suicide. As a result of this case, professional school counselors (in MD) must always tell the parent whenever there is any indication from a child or someone else that the child is thinking about suicide, regardless of the seriousness of the threat. They must also inform the principal.

49. Summary/Conclusion Due to the constantly changing issues encountered by professional school counselors, here are a few guidelines to follow when dealing with ethical issues. 1. Always document in writing what you did and why you did it. 2. If you did not follow a policy, document why you did not. 3. Know federal, state, and local laws, regulations, policies, and guidelines. 4. Consult with a colleague or supervisor when you have questions or doubts. 5. Read and use resources. 6. Consult with a lawyer when appropriate.