Ethical and Legal
Challenges in Mental Health
Theodore P. Remley, Jr., J.D., Ph.D.
University of Holy Cross
New Orleans, Louisiana
Ethical Dilemmas:
Right, Wrong or It Depends
University of South Alabama
Mobile, Alabama
March 11, 2016
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 1
DIFFERENCES BETWEEN ETHICAL AND LEGAL
STANDARDS OF CONDUCT FOR PROFESSIONALS
ETHICS
standards set by the profession
standards are idealistic and aspirational
standards are found in a published code of ethics
actions are judged by words in the code of ethics
Standard: "What should an ethical counselor have done in this particular situation?"
LAW
standards set by society
standards are the minimum society will tolerate from professionals
standards are found in federal and state constitutions,
statutes, regulations, and common law
actions are judged by law of torts
Standard: "What would a reasonable similarly educated professional practicing in this
community have done in this particular situation?"
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 2
BASIC PRINCIPLES
IN ADDRESSING
LEGAL ISSUES IN COUNSELING
1.
Keep current on legal and ethical issues in counseling by reading the professional
literature and attending workshops on the topic.
2.
When you have a question about a legal matter, request legal advice.
3.
When you are exercising your professional judgment in a difficult area, consult with
colleagues and experts before making a decision and taking action.
4.
Whenever possible, shift responsibility for legal decisions to your administrative
superiors by explaining the situation to them and asking them to make the decision.
5.
Be sure to maintain your own personal professional liability insurance policy at all times.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
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EMPLOYEE RESPONSIBILITIES AND LIABILITY
RESPONSIBILITIES
1.
2.
3.
4.
Conform to all institutional policies and procedures.
A.
Request and read all policy or procedure handbooks for the system in which you
work. Ask for official interpretations of ambiguous or vague information.
B.
If a policy or procedure is counterproductive to your goals for your counseling
program, try to work through established administrative channels within your
organization to get the policy or procedure changed.
Always follow the orders of your supervisors unless you are directed to do something
that is illegal, clearly unethical, or in violation of an institutional policy or procedure.
A.
Employees may be dismissed for insubordination (unwillingness to submit to
authority).
B.
You may protest an order, but you must follow the instructions of your
supervisors.
C.
You may appeal an order to you supervisor's supervisor if you feel the order is
unfair or inappropriate.
Maintain a current, up-to-date job description that has been signed and dated by your
supervisor.
A.
Revise your job description as often as necessary.
B.
Delete any activities that you do not perform.
C.
Add any activities that you do perform that are not listed.
Remember that while employees may win an occasional battle, employers usually win a
war.
A.
When dealing with those who have power over you, persuasion and negotiation
are much more effective than confrontation.
B.
Even if you prevail in a controversy with supervisors, they can make your
working environment so uncomfortable, you may be ineffective thereafter.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 4
C.
Be sure an issue is worth fighting over before you begin a battle and be prepared
to pay a price later no matter who prevails.
LIABILITY
1.
Professionals are legally responsible for any harm suffered by others as a result of their
negligence.
2.
Generally, employees are indemnified by their employers if they are working for the
benefit of their employer. In other words, employers will accept responsibility for the
acts of their employees. However, indemnification is not automatic or required by
statutory law in all situations.
3.
In many instances, courts will find as a matter of law that employers are responsible for
the acts of their employees.
4.
In civil lawsuits, plaintiffs may sue employees as individuals. Plaintiffs may also sue
employers in the same law suit, but it is not required.
5.
In states with sovereign immunity, a governmental agency cannot be held responsible
for harm caused by an employee. However, the individual employee can be held
individually responsible.
6.
Institutional liability insurance covers the institution, not the individual.
7.
If an institution is determined to be free of responsibility but an employee is held
responsible, institutional liability insurance will not pay the legal expenses or pay any
monetary judgment against the employee.
8.
If an institution can prove that an employee was not acting in the capacity of an
employee when the negligent act occurred that caused the harm, institutional liability
insurance will not pay the legal expenses or pay any monetary judgment against the
employee.
9.
All employees should purchase their own individual professional liability insurance.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 5
QUIZ
Legal and Ethical
Issues in School Counseling
1) The best way to characterize the difference between ethical standards and legal standards
is
a) Ethical standards are created by the profession and are more idealistic and aspirational
than legal standards.
b) Ethical standards are created by society and are less rigorous than legal standards.
c) Ethical standards and legal standards are very similar, except that ethical standards are
more important to professionals than legal standards.
d) Ethical standards are based on constitutions, statutes, case law, and government
regulations.
2) If you get a subpoena at your school, you know that you need legal advice. The best way to
obtain that legal advice is to
a) Hire the best lawyer in town to help you.
b) Call the school board attorney and ask for assistance.
c) Ask a colleague in another school to explain to you how he or she has handled similar
situations in the past.
d) Ask your principal to give you legal advice as to how to proceed.
3) If your principal asks you to do something that you consider unethical
a) You do not have to do it and you should inform him/her that you will not do it.
b) You should explain your position and then do as your principal says, unless you believe
what he/she has told you to do is illegal.
c) You should contact your principal’s supervisor, probably the school superintendent and
ask him/her to intervene.
d) You should set aside your beliefs and do as your principal has instructed without
questioning his/her request.
4) In states in which LPCs have privilege with their clients, but school counselors do not
a) School counselors who are also licensed as LPCs have privilege with their clients (or the
parents or guardians of their clients).
b) All certified school counselors have privilege with their clients (or the parents or
guardians of their clients).
c) No school counselors have privilege with their clients (or the parents or guardians of
their clients).
d) It would depend on the nature of confidential information as to whether school
counselors have privilege with their clients (or the parents or guardians of their clients).
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 6
5) Regarding counseling records, school counselors
a) Must always keep detailed notes of each counseling session they conduct.
b) Should not keep any records and then their records cannot be subpoenaed.
c) Should keep any records they need in order to be effective.
d) Must keep three different sets of records for each student which would include the
cumulative record, a summary of interactions with students, and documentation of
having had counseling sessions with students.
6) Destroying general case notes that do not include any documentation for self-protection
and that have been taken in conjunction with a student’s counseling sessions
a) Is dangerous because a counselor could be held in contempt of court for destroying
records.
b) Should only be done if a counselor believes that the records are going to be
subpoenaed.
c) Is a good idea and should be done systematically, probably when the student leaves the
school permanently.
d) Is a good idea and should be done at the end of each academic year, even if the student
is returning the next year.
7) Records that are kept in the sole possession of the maker
a) Are exempt under FERPA from subpoenas that are issued by a lawyer who is
representing someone in a law suit.
b) May never be shown to a secretary because if they are, they will lose their exemption
under FERPA.
c) May be summarized, rather than copied and turned over, if they are ever subpoenaed,
according to FERPA.
d) Are exempt from parent review under FERPA.
8) If you receive a subpoena to a deposition and are told by your principal, who has consulted
with the school board attorney, that the subpoena is valid and you must comply,
a) Request that you be allowed to send your notes rather than appearing in person.
b) Explain to your principal that there must be a mistake because school counselors should
not have to reveal confidential information they have gained in counseling relationships.
c) Request that your principal request that the school board attorney accompany you to
the deposition.
d) Refuse to answer any questions that you believe would violate your client’s rights to
privacy during the questioning.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 7
9) If you determine that a student in your school may be at risk for suicide, the best action to
take (after conferring with your principal) is
a) Call an ambulance immediately to transport the student to a hospital for an evaluation
to determine if he/she is actually at risk for suicide.
b) Have the student to sign a contract saying that he/she will not cause any harm to
himself/herself before your next appointment.
c) Ask your principal to make the final judgment as to whether the student is at risk.
d) Do your best to get the student’s parents to come to the school and take charge of the
student as soon as possible.
10) The statute in Louisiana that requires school counselors to report cases of suspected child
abuse requires that
a) Counselors not use their judgment, but simply report suspected abuse if a child says
he/she has been abused.
b) Counselors report suspected abuse if counselors believe abuse may have occurred,
given the evidence and circumstances of the situation.
c) Counselors report suspected abuse even if counselors do not believe abuse may have
occurred after reviewing the evidence and circumstances of the situation.
d) Counselors report abuse in all situations if someone else tells them that they believe a
child has been abused.
11) When school counselors counsel minors, school counselors must understand that
a) Even though the counselor has ethical obligations to the minor, the counselor’s legal
obligations are to the minor’s parents or guardians.
b) A counselor’s obligations to the minor are always more important than their obligations
to the minor’s parents or guardians.
c) A counselor’s ethical and legal obligations to the minor and to his/her parents or
guardians are the same.
d) Ethical and legal obligations often conflict, so counselors must adhere to ethical
requirements, even when legal standards might suggest a different response.
12) If a parent of a child a school counselor has been counseling asks the counselor to go to
court and explain to a judge that the parent is parenting in a positive manner, the school
counselor
a) Should refuse to go to court, even if a subpoena is issued by the parent’s attorney.
b) Should refuse to go because it is unethical to become involved in the personal matters
of clients.
c) Should explain to the parent why it would not be a good idea to provide such testimony,
and should refuse to go.
d) Should explain to the parent why it would not be a good idea to provide such testimony,
but should agree to go if the parent believes your testimony would be helpful.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 8
QUIZ KEY TO CORRECT ANSWERS
Legal and Ethical
Issues in School Counseling
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
a
d
b
a
c
c
d
c
d
b
a
c
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 9
CONFIDENTIALITY AND PRIVILEGED COMMUNICATION
CONFIDENTIALITY
Ethical Principle
A Right of the Client
Privacy Right
Encourages Disclosure
Necessary for Counseling Relationships
PRIVILEGED COMMUNICATION
Legal Principle
Statute Required
Initiated by Other Professions
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 10
EXCEPTIONS
TO
CONFIDENTIALITY
AND
PRIVILEGED COMMUNICATION
Barbara Herlihy, Ph.D.
University of New Orleans
Theodore P. Remley, Jr., J.D., Ph.D.
University of Holy Cross
New Orleans, Louisiana
Counselors may share information with other professionals when
(1) Clerical or other assistants handle confidential information.
(2) Consulting with colleagues or experts.
(3) Working under supervision.
(4) Other professionals are involved in coordinating client care.
Counselors may need to act to protect someone who is in danger when
(5) There is suspected abuse or neglect of a child or others who are presumed to have limited
ability to care for themselves.
(6) A client may be homicidal.
(7) A client may be suicidal.
(8) A client has a fatal, communicable disease and the client's behavior is putting others at risk.
Counselors cannot guarantee confidentiality when
(9) They are conducting group counseling.
(10) They are counseling families or couples.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 11
(11) Their clients are minor children.
Other exceptions to confidentiality and privileged communication occur when
(12) A court orders release of information.
(13) Clients raise the issue of their mental health in a law suit.
(14) They need to defend themselves against a complaint made to a licensing or
certification board or in a court of law.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 12
TYPES OF COUNSELING RECORDS

Charts (often used in hospitals or residential treatment centers)

Process Notes (often used for educational purposes)

Progress Notes (often used in connection with a treatment plan)

Documentation for Self-Protection (used to protect the counselor)

Case Notes (used by counselors in most settings)
My Recommendation
Three Kinds of Records for Each Client
1.
Business Records
2.
Treatment Plan and Progress Notes
3.
Case Notes
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 13
HIPAA Basics
(Health Insurance Portability and Accountability Act of 1996)
 HIPAA is a federal law that applies to organizations and individuals who transmit any
health care information in electronic form in connection with a health care transaction.
Since it would be very difficult to have a “paper only” mental health practice, it is
recommended that all mental health organizations and professionals in private practice
comply with the law’s requirements.
 the compliance date for the privacy standards is April 14, 2003 or, for small health plans,
April 14, 2004.
 All records and other individually identifiable health information held or disclosed by a
covered entity in any form, whether communicated electronically, on paper, or orally, is
covered.
 Providers must give consumers of health care services a clear written explanation of
how they can use, keep, and disclose their health care information.
 Consumers must have access to their records. They must be able to see and get copies
of their records. A process must be in place for consumers to request amendments to
their records. A history of most disclosures must be available to consumers.
 Consumer consent, that is not coerced, must be obtained to release information for
treatment, payment, and health care operations purposes, and for non-routine uses and
most non-health care purposes, such as releasing information to financial institutions
determining mortgages and other loans or selling mailing lists to interested parties such
as life insurers.
 Disclosures of medical information with specific consumer authorization are allowed
under certain circumstances including, but not limited to quality assurance oversight
activities, research, judicial and administrative hearings, limited law enforcement
activities, emergency circumstances, and facility patient directories.
 If consumers are given a right to orally object, providers may give health care
information to the public in the form of facility directories, to family members or others
assisting in the consumer’s care, and to disaster relief organizations.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 14
 When consumer permission to transfer information is given, only the minimum amount
of information may be transferred. This provision does not apply to the transfer of
health records for purposes of treatment, since providers need access to the full record
to provide the best quality care.
 Psychotherapy notes (used only by a psychotherapist) are held to a higher standard of
protection because they are not part of the medical record and were never intended to
be shared with anyone else. Disclosure of psychotherapy notes requires more than just
generalized consent; it requires patient authorization – or specific permission – to
release this sensitive information. Now health plans cannot refuse to provide
reimbursement if a consumer does not agree to release information covered under the
psychotherapy notes provision.
 Providers of mental health care services must adopt written privacy procedures that
include who has access to protected information, how it will be used with the entity,
and when the information would or would not be disclosed to others. They must also
take steps to ensure that their business associates protect the privacy of health
information.
 Providers must train employees regarding procedures and must designate a privacy
officer.
 Providers must establish a means for consumers to make inquiries or complaints
regarding the privacy of their records.
 Civil penalties for violations of this law are $100 per incident, up to $25,000 per person,
per year, per standard.
 Criminal penalties for providers who knowingly and improperly disclose information or
obtain information under false pretenses are up to $50,000 and one year in prison for
obtaining or disclosing protected health information; up to $100,000 and up to five
years in prison for obtaining protected health information under false pretenses; and up
to $250,000 and up to 10 years in prison for obtaining or disclosing protected health
information with the intent to sell, transfer, or use it for commercial advantage,
personal gain, or malicious harm.
 State laws that are stricter about protecting consumer privacy than this federal law
must be adhered to if they exist.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 15
HIPAA Consent Form
To comply with the HIPPA law, here are some areas you need to include on the form
your client’s sign saying they have been informed about your proposed treatment and agreeing
to the treatment and the arrangement with you:
 State that your client’s personal information may be used and disclosed to complete
their treatment. Also state that information may be provided to health care companies
related to payment for your services.
 Develop a complete written description of the procedures you will follow in your office
regarding keeping or disclosing personal information of clients.
 Tell your client that you have a more complete description of the way in which you will
keep or disclose their personal information, and that the complete description is
available for them to see. State that the client has a right to review the complete
description prior to signing this consent form. Explain that your practices may change in
the future and if they want to see any revisions, they must request to see them in
writing and that you will then make them available.
 Tell your client that he or she may request that you restrict how the client’s personal
information is used or disclosed. Explain that you will consider any such requests and
will notify the client whether you have agreed to them.
 Explain that the client has the right to revoke his or her consent in writing, except to the
extent actions have already been taken by you based on their prior consent.
 Get the client’s signature and have him or her indicate the date on the form.
 Keep the form for at least six years.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 16
GUIDELINES FOR
COUNSELING CASE NOTES
1.
Write any case notes that assist you in being a more effective counseling practitioner.
Do not hesitate to keep case notes if they help you be a better counselor.
2.
Although there is no general legal duty to keep case notes, because maintaining case
notes is a standard procedure in the counseling profession, it could be considered
unusual if a counselor did not have case notes for a particular case.
3.
Always assume any note you write will someday be read in open court with you and
your client present along with newspaper, radio, and television reporters.
4.
Separate your notes into at least two distinct sections: objective and subjective.
5.
In the objective section, record precisely what the client said, what you said, and what
you observed. Do not draw any conclusions or enter any speculations at this point. You
might entitle this section, "Observations."
6.
In the subjective section, record any thoughts that you will need for the future.
Impressions of the client, speculations about the reasons for the client's problems,
reminders to yourself of your present thoughts, or plans for the next session would all
be acceptable. You might entitle this section, "Impressions."
7.
Keep case notes in locked file drawers and ensure that only clerical assistants and you
have access to your notes. If notes are kept in a computer, ensure they are not
accessible to others.
8.
There is no general legal principle regarding the length of time you need to keep case
notes once they are recorded. However, there are federal statutes that cover certain
federally-funded projects, hospital and counseling center accreditation standards, and
particular agency procedures that require that case notes be kept for certain periods of
time. Of course, such statutes, standards, and procedures should be followed if they
exist.
9.
Regularly destroy your case notes. When you destroy them, be sure all identifying
information cannot be read. It is best to shred, burn, or in some other manner, totally
destroy the records.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 17
10.
In the absence of requirements in work settings regarding the length of time they
should be kept, keep case notes as long as you think you might need them. However,
you should destroy case notes on a systematic basis. For example, some counselors
destroy case notes of terminated clients six months after termination, one year after
termination, or three years after termination. It is a good idea to destroy notes only
one day each year, for example on every December 31st.
11.
When you destroy your case notes on a regular basis, do not include case notes in which
you have documented steps you have taken to protect yourself in the event you are
accused of wrongdoing. Keep these case notes for longer periods of time, perhaps
indefinitely.
12.
Never, under any circumstances, destroy case notes after you receive a subpoena or if
you think you might be receiving a subpoena in the future. Such acts could be
interpreted as obstruction of justice and you could be held in contempt of court.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 18
DOCUMENTATION THROUGH RECORDS
FOR SELF-PROTECTION
1.
It would be impossible to write a summary of every action taken by a counselor or make
an audiotape or videotape of every counseling session. Excessive documentation can
take away valuable time that might be spent providing counseling services to clients.
2.
On the other hand, there are circumstances in which counselors should document their
actions to create a record showing that they have done what they should have done.
3.
Documentation should be undertaken in circumstances in which a counselor's actions or
inaction may later be reviewed by an ethics panel, a licensure board, an administrator,
or within the context of a legal proceeding.
4.
The following is a list of some of the situations in which some level of documentation is
called for:
Someone accuses a counselor of unethical or illegal behavior.
A counselor reports a case of suspected child abuse.
A counselor determines that a client is a danger to self.
A counselor determines that a client is a danger to others.
A client is being counseled who is involved in a legal controversy that
could lead to the counselor being forced to testify in court. Such
controversies include counseling a child whose parents are arguing about
custody in a divorce case, counseling a husband or wife who is involved in
a contentious divorce case, counseling a couple who are contemplating a
divorce, or counseling a person who is involved in a personal injury law
suit.
5.
Documentation efforts should begin as soon as counselors determine they are in a
situation in which documentation is important.
6.
When documenting for self-protection, as much detail as possible should be included.
Dates, exact times events occurred, and exact words spoken should be included to the
degree details are remembered. Only factual information should be included.
Thoughts, diagnoses, and conclusions of counselors should be avoided when
documenting. If these kinds of things need to be written down, they should be included
in clinical case notes rather than records kept for documentation.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 19
7.
The best documentation is created very soon after a conversation or event has
occurred. Indicate the date and time anything is written. Never back date anything that
is written. In other words, do not infer or state that something was written on an earlier
date than it was actually written.
8.
In the event counselors realize that documentation should have been occurring sooner,
they should write a summary of what has happened up to that point in time. Include as
much detail as can be remembered. The date and time the summary was written
should be included on the summary.
9.
Maintain a documentation file that includes the originals of notes written to counselors,
copies of notes written by counselors to others, copies of relevant papers counselors
cannot keep for themselves, and other papers that might be relevant to the situation.
10.
Records kept for documentation should be kept secure in a locked file drawer or
cabinet. If counselors agree to provide copies of their files, they should never release
originals of their records, only copies.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 20
HIGHLIGHTS
from the
"BUCKLEY AMENDMENT"
or
FAMILY EDUCATIONAL AND PRIVACY RIGHTS ACT (FERPA)
The entire text of the Buckley Amendment can be found in the United States Code
(which is available in most school and public libraries) at 20 U.S.C. 1232(g).
1.
Federal funding will be denied to educational agencies or institutions that deny or
prevent parents of students the right to inspect and review the education records of
their children. Access to records must be granted within 45 days of a request. (a.1.A.)
2.
Educational agencies or institutions must grant a hearing to parents if they wish to
challenge the contents of their child's records if they feel the records contain
information that is "inaccurate, misleading, or otherwise in violation of the privacy or
other rights of students." (a.2.)
3.
The rules regarding inspection of educational records do not extend to records "which
are in the sole possession of the maker thereof and which are not accessible or revealed
to any other person except a substitute." (a.4.B.i.)
4.
The rules regarding inspection of educational records also do not extend to records of
students who are 18 or older or who are attending a postsecondary institution if the
records were "made or maintained by a physician, psychiatrist, psychologist, or other
recognized professional or paraprofessional acting in his professional or
paraprofessional capacity, or assisting in that capacity, and which are made, maintained,
or used only in connection with the provision of treatment to the student." These
records can be personally reviewed by a physician or other appropriate professional of
the student's choice. (a.4.B.iv.)
5.
Directory information may be published without specific consent, but parents must be
given the opportunity to object to such information being published after having been
informed of the type of information that is anticipated being published. Directory
information includes the following: "the student's name, address, telephone listing,
date and place of birth, major field of study, participation in officially recognized
activities and sports, weight and height of members of athletic teams, dates of
attendance, degrees and awards received, and the most recent previous educational
agency or institution attended by the student." (a.5.A. & a.5.B.)
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 21
6.
Federal funding will be denied to educational agencies or institutions that release the
education records of students without the written consent of their parents. Exceptions
to this rule include, among others, educators in the institution or agency who "have
legitimate educational interests;" officials of other schools in which the student seeks to
enroll; those processing financial aid applications; and those involved in an emergency
"if the knowledge of such information is necessary to protect the health or safety of the
student or other persons." (b.1.A-I.)
7.
Educational agencies or institutions must keep a record of individuals (except educators
within the institution or agency) who have requested or obtained access to a student's
education records. (b.4.A.)
8.
Personal information legitimately transferred to a third party from a student's record
must be transferred on the condition that the person receiving the records will not
permit any other party to have access to such information without the written consent
of the parents of the student. (b.4.B.)
9.
All of the rights of the parent to access and authority to transfer records transfer to the
student when he/she has attained the age of 18 or is attending a postsecondary
institution. (d.)
10.
Federal funding will be denied to educational agencies or institutions that do not inform
the parents (or students themselves when appropriate) of the rights accorded them by
this law. (e.)
11.
A noncustodial parent has the same rights under this law as the parent who has been
awarded custody, even if the custodial parent objects. Page v. Rotterdam-Mohonasen
Central School Dist., 1981, 441 N.Y.S.2d 323, 109 Misc.2d 1049.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 22
RESPONDING TO A SUBPOENA
Four types of subpoenas:
1.
2.
3.
4.
For you to answer written questions in writing.
For you to appear at a deposition, hearing, or trial.
For you to provide copies of your records.
For you to appear with copies of your records with you.
A subpoena is an invitation you cannot ignore. Although it appears to be clear as to
what it requires, there are a number of reasons why a subpoena should be challenged legally.
If you receive a subpoena with your name on it, you should
A.
Notify your immediate supervisor and request assistance in determining how to
respond. Generally, an attorney should be consulted. If you are in private practice,
contact your attorney.
B.
Respond as you are directed to by your supervisor or by the attorney provided by your
supervisor. If in private practice, do what your attorney advises you to do.
C.
If you must appear at a proceeding because of a subpoena, ask that you be prepared by
an attorney. As a part of your preparation, you should be told the kinds of questions
you should expect at the proceeding, should be coached in how you should properly
respond, and should be informed what to expect regarding the atmosphere, physical
arrangements, and length of the proceeding. An attorney should accompany you to
advise you in some situations. If the date or time specified for your appearance is
inconvenient for you, ask your attorney to request an alternate date or time.
D.
If you are directed to deliver records, make copies and deliver them. Do not relinquish
the originals of your records. Include only copies of records you or your agency has
generated; do not include records you have obtained from others.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 23
PROFILE OF ADOLESCENTS
AT HIGH RISK FOR SUICIDE
David Capuzzi
Walden University
Listed below are characteristics of adolescents who are at risk for suicide. No one
characteristic would identify a high risk adolescent. However, an adolescent who has a number
of these characteristics could be at a high risk for suicide.
Behaviors
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Lack of concern about personal welfare.
Changes in social patterns.
A decline in school achievement.
Concentration and clear thinking difficulties.
Altered patterns of eating and sleeping.
Attempts to put personal affairs in order or to make amends.
Use or abuse of alcohol or drugs.
Unusual interest in how others are feeling.
Preoccupation with death and violence themes.
Sudden improvement after a period of depression.
Sudden or increased promiscuity.
Verbal Cues
1.
2.
Direct statements such as, “I am going to commit suicide,” or “I am thinking of taking my
life.”
Indirect statements such as, “I’m going home,” “I wonder what death is like,” “I’m
tired,” She’ll be sorry for how she has treated me,” or “Some day I’ll show everyone just
how serious I am about some of the things I’ve said.” Clarification should be requested
when indirect statements are made.
Thinking Patterns
1.
2.
3.
4.
5.
Wanting to escape from a situation which seems (or is) intolerable (e.g., sexual abuse,
conflict with peers or teachers, pregnancy, etc.).
Wanting to join someone who has died.
Wanting to attract the attention of family or friends.
Wanting to manipulate someone else.
Wanting to avoid punishment.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 24
6.
7.
8.
Wanting to be punished.
Wanting to control when or how death will occur (an adolescent with a chronic or
terminal illness may be motivated in this way).
Wanting to end a conflict that seems unresolvable.
Personality Traits
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Low self-esteem.
Hopelessness/helplessness.
Isolation.
High stress.
Acting out.
Need to achieve.
Poor communication skills.
Other directedness.
Guilt.
Depression.
Poor problem-solving skills.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 25
Responding to School Bullying Incidents:
Guidelines for Action
Theodore P. Remley, Jr., J.D., Ph.D.
University of Holy Cross
Neal Gray, Ph.D.
Lenoir-Rhyne University
Mary Herman, J.D., Ph.D.
Virginia Commonwealth University
Advice for School Teachers, Administrators, and Staff











Set a good example by responding to conflict in an appropriate manner.
Stay alert to signs of bullying. Always address bullying incidents.
Monitor play periods and free time closely with adequate adult supervision.
Avoid blaming the victim. Tell victims they have a right to be treated with respect.
Encourage students to report bullying incidents and allow such reports to be made in a
confidential manner.
Do not tell a victim to fight back.
Avoid yelling at or ridiculing a bully.
Teach bullies to negotiate rather than coerce. Reward their negotiating behavior that is
demonstrated after it has been taught.
Give bullies an opportunity to receive adult approval and recognition in positive ways.
Assign to victims an out-going, self-confident classmate as a “buddy.”
Develop and implement a school-wide effective bullying prevention program.
Advice for Victims





Tell your parents, guardians, or teachers. Ask for protection if you are being physically
attacked.
Walk in groups. Don’t go alone.
Avoid the bully to the extent possible.
Ignore the bully to the extent possible.
Confront the bully if you are not being physically attacked.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 26
Advice for Parents or Guardians of Victims











Help your child become more self-confident. Advise your child to stand up straight and
look the bully child right in the eyes.
Take a child’s complaints about bullying seriously. Encourage the child to talk openly
without fear or shame.
Talk with your child about the school day and listen with respect. Respond with
patience, love, and support.
Do not tell your child to fight back.
Avoid over-reacting. Consider your options and then proceed in a manner that will help
your child most.
Teach your child to avoid students who typically pick on other students. Give your child
a chance to learn how to avoid bullying situations in the future before you intervene.
Discuss ways that you child could react to a particular situation, and let the child role
play or practice responses.
Investigate whether your child is being bullied if any of the following symptoms appear:
withdrawal, abrupt lack of interest in school, a drop in grades, asking for excessive
money or supplies, or signs of physical abuse.
If your child is being bullied at school, ask that school officials correct the problem.
Keep your own written records of the names, dates, times, and circumstances of
bullying incidents. Submit a copy of this report to the school principal.
Help your child learn the social skills needed to make friends.
Avoid confronting the bully personally or the bully’s parents or guardians. Such action
increases the perception that your child is weak.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 27
Advice for Parents or Guardians of Bullies

















Make it clear that bullying is not acceptable in your family or in society.
Avoid being defensive when being told of your child’s bullying behaviors. Ask for
specific information and listen carefully.
Take the problem seriously. Children who are bullies often grow up to be unsuccessful
adults.
Avoid addressing the issue of “why” your child has engaged in bullying behaviors.
Instead focus on discontinuing that kind of behavior.
Supervise your child’s play more closely than you have in the past.
Teach your child the skill of negotiating, rather than coercing. Reward negotiating
behavior that occurs later.
Consult with school teachers and counselors to develop ways to defuse your child’s
aggressive behavior.
Punish your child for bullying behavior, but do not use physical punishment.
Concretely specify the consequences if bullying behaviors occur again and then follow
through with punishments.
Reward your child for positive relationships with other children, particularly children
who might have been victims in the past.
Require your child to apologize to other children they have bullied.
Require your child to do volunteer work with younger or weaker children to help the
child develop sensitivity and empathy toward others.
Discuss each bullying episode with the child and suggest a more acceptable way of
dealing with peers.
Be affectionate in everyday interaction.
Role play positive behaviors with children they have bullied.
Provide healthy, non-violent entertainment. Avoid TV and movie violence, as well as
games and toys that promote aggression.
Be a positive role model by being a more compassionate, helpful, and understanding
parent. Avoid becoming aggressive yourself and never spank your child who has been
involved in bullying behaviors.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 28
A Proposed Bullying
Prevention Program
Theodore P. Remley, Jr., J.D., Ph.D.
University of Holy Cross
Neal Gray, Ph.D.
Lenoir-Rhyne University
Mary Herman, J.D., Ph.D.
Virginia Commonwealth University
This proposed program was adapted from the model introduced in the following article:
Ballard, M., Argus, T., & Remley, T. P., Jr. (1999). Bullying and school violence: A proposed
prevention program. National Association of Secondary School Principals Bulletin, xx,
38-47.
Program Goal: To provide a school atmosphere free of psychological and physical abuse
for all students.
Program Components: The prevention program must include a number of components
to be effective. Some components may already exist in a school, while others may have to be
instituted and developed. The components of this proposed bullying prevention program
include the following:
Playground Monitoring
1.
2.
3.
Adequate adult supervision exists when student are playing or having breaks or
free time.
To avoid older student bullying younger students, recess time or breaks are
scheduled to avoid wide ranges of age groups on the playground at the same
time.
A plan exists for immediate action when bullying episodes are noticed. Faculty
and staff are trained to implement the plan.
Classroom Response
1.
2.
3.
Posters or signs are posted in all classrooms stating that the school does not
tolerate bullying.
All student are given information about bullying through homeroom or classes
required of all students.
Students are encouraged to report bullying and should not consider reporting to
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 29
4.
5.
6.
be “tattling.” An anonymous means of reporting bullying is provided (such as a
locked “suggestion” box).
Faculty and staff are instructed to report all bullying incidents to the principal or
school disciplinarian.
Teachers are provided with suggestions of how to empower bullies and victims
in the classroom.
Instructional methods that utilize groups are encouraged. Group activities in
classroom improve social integration and encourage mixing among individuals
who might otherwise be isolated.
Parents
1.
2.
A program is presented for parents and guardians regarding the myths of
bullying and the importance of addressing the problem in a proactive manner.
Parents and guardians are informed when their children are identified as bullies
or victims. They are given specific strategies for addressing the problem at
home.
Counselors
1.
2.
3.
All victims are referred to the counselor. Victims are given specific coping
strategies.
Bullies, after being disciplined by the principal or school disciplinarian, are
referred to the counselor. The goal of counseling is to eliminate the bullying
behavior.
Teachers are provided with assistance in developing techniques that are unique
for specific bully-victim pairs.
Peer Mediation Program
1.
2.
A peer mediation program is implemented. Students are trained as mediators to
intervene in student disputes and may address bullying situations.
Faculty, staff, parents, and guardians are informed of the peer mediation
program and its goals and processes are explained.
Court Established
1.
2.
Students are trained to serve on bully courts.
Cases of bullying are brought before the court. After hearing the circumstances,
members of the court determine whether guilt exists and impose punishments
on those found guilty of bullying.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 30
Training
1.
2.
Separate training session on the bullying prevention program and held at the
inception of the program ( an annually) for
1.
Faculty and staff;
2.
Students; and
3.
Parents and guardians.
These programs are accomplished through in-service faculty training, student
assemblies, and parent programs.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 31
Managing a Minor Who
May Be At Risk for Suicide
If you determine that a minor for whom you are responsible has exhibited some
behaviors that are related to suicide, but currently does not appear to be at risk for committing
suicide...
1.
If you believe that a child may be thinking about suicide or if you have observed or have
information that a child has exhibited some minor behaviors that might be interpreted
as suicidal, but you do not consider the situation to be an emergency, summarize in
your case notes the child’s behavior that supports your concern. Do not write that you
believe the child may be at risk for suicide. Instead, write that although you do not
believe the child may be at risk for suicide, you believe his or her parents need to be
informed of the child’s behaviors that concern you.
2.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
3.
Tell the child your concerns and, if appropriate, obtain an agreement from the child to
inform his parent or guardian of your concerns. Tell the child to have his or her parent
or guardian contact you after talking being told.
4.
If the child is not capable of telling the parent or guardian himself or herself, or for some
other reason asking the child to inform his parent or guardian does not seem like an
appropriate course of action, explain to the child that you will be contacting his or her
parent or guardian to inform him or her of your concern. If you are not in independent
private practice, inform your supervisor of the actions you will be taking and follow any
directives that he or she gives you.
5.
Document in your case notes all conversations with the child, his or her guardian, and
your supervisors.
If you determine that a minor for whom you are responsible MAY BE seriously at risk for
committing suicide...
1.
You are dealing with a very serious matter that requires immediate and decisive action.
Make the determination that a minor may be at risk for committing suicide only if the
minor has made a suicide gesture or attempt, has told you or someone else in a
believable fashion that he or she plans to commit suicide, or has engaged in a pattern of
behavior that the professional literature suggests is the behavior of a suicidal minor.
Follow any agency or school policies that exist regarding managing suicidal children. If
you are not in an independent private practice, notify your supervisor of the situation
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 32
and follow any directives that he or she may give. If policies dictate or if your supervisor
directs you to proceed differently from the steps below, follow the policies or the orders
of your supervisor.
2.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
3.
Explain to the child that you will have to notify his or her parents or legal guardians so
that they can help.
4.
Assure the child that you will continue to help him or her and that you will disclose only
the minimum information necessary for him or her to get assistance. Try to calm the
child, but do not minimize the seriousness of the situation. Explain to the child what
may happen in the next few hours, next few days, and long term.
5.
Insure that the child is not left alone and does not have any opportunity to harm himself
or herself prior to turning the child over to his or her parent or guardian.
6.
Contact a parent or guardian and explain that you believe his or her child may be at risk
for suicide and give specific details that led to your concern. Insist that the parent or
guardian come to pick up the child immediately.
7.
If a parent or guardian cannot be found, make sure the child is under the supervision of
a responsible person until a parent or guardian is located.
8.
If you cannot contact a parent or guardian and if it is impossible to keep the child safe
for an extended period of time, call an ambulance and have the child transported to a
hospital that has psychiatric services. If you are not in an independent private practice,
be sure to inform your supervisor and obtain his or her permission and support for
taking this action. If your supervisor directs you take a different course of action, do so
and document in your case notes what you were told and did. Make arrangements for
someone (perhaps you) to ride in the ambulance with the child to the hospital. If you do
not accompany the child to the hospital in the ambulance, give the ambulance
attendant your contact information and offer to speak with the person at the hospital
who will be conducting the evaluation, if requested to do so. Continue to attempt to
contact the child’s parent or guardian.
9.
When you talk to the parent or guardian, ask him or her to take possession and
responsibility immediately for the child.
10.
When the parent or guardian arrives, explain to him or her that you believe that the
child may be at risk for suicide, give specific details that led to your concern, instruct the
parent or guardian of what he or she should do next, and ask that a document be signed
that acknowledges that the parent or guardian has been informed of your concerns, has
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 33
been given directions of steps to take next, and has agreed to take responsibility for his
or her child. Also, have the parent or guardian sign a form giving you permission to
disclose any information you have to mental health professionals who may evaluate or
treat their child in the future.
11.
Explain to the parent or guardian that he or she must insure that the child is not left
alone, does not have any opportunities to harm himself or herself, and is taken for an
evaluation as soon as possible to determine whether the child is at risk for suicide.
12.
If a parent or guardian refuses to sign the document or communicates to you in some
way that he or she will not take the situation seriously, notify your supervisor and make
a report of suspected child neglect.
13.
As events occur, document in your case notes in detail all of the events that transpired
in relation to this situation. Be sure to date each entry and indicate the time you wrote
it. Make several entries if necessary, and do not delay in writing details in your case
notes.
14.
When the child returns to you or your agency or school for services, obtain written
permission from a parent or guardian to contact the professional who determined that
the child was not at risk for suicide, or was no longer at risk for suicide.
15.
Contact you’re the child’s treating physician, psychologist, or mental health provider
and explain that his or her patient or client has returned to you or your agency or school
for services. Ask the treating provider to summarize his or her evaluation and treatment
of the child. Inquire as to whether the provider will continue to treat the child, and if so,
the details of the planned treatment. Also ask the treating provider the types of
counseling services he or she would like for you to provide to the child. Do not agree to
provide any counseling services that your position does not allow you provide
(especially in a school setting). Ask the provider to tell you the circumstances under
which you should return the child to him or her for further evaluation or treatment.
As soon as possible after you have talked to the provider, document in your case notes
details of your conversation. Be sure to date the entry and indicate the time you wrote
it.
16.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 34
Managing an Adult Client Who
May Be At Risk for Suicide
If you determine that an adult client has exhibited some behaviors that are related to
suicide, but currently does not appear to be at risk for committing suicide...
1.
If you believe that an adult client may be thinking about suicide or if you have observed
or have information that an adult client has exhibited some behaviors that might be
interpreted as suicidal, but you do not consider the situation to be an emergency,
summarize in your case notes the client’s behavior that supports your concern. Do
not write that you believe the client may be at risk for suicide. Instead, write that
although you do not believe the client may be at risk for suicide, you believe a
significant person in his or her life needs to be informed of the client’s behaviors
that concern you.
2.
A significant person might be your adult client’s spouse, parent, adult child, other
relative, domestic partner, dating partner, or close friend. Choose a person who
lives with the client or who is in frequent contact with the client.
3.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
4.
Tell your adult client your concerns and, if appropriate, obtain an agreement from the
client to inform a significant person in his or her life of your concerns. Tell the client
to have the person he or she informs to contact you after being told.
5.
If your adult client is not capable of telling the significant person himself or herself, or
for some other reason asking the client to inform his significant person does not
seem like an appropriate course of action, explain to the client that you will be
contacting a significant person to inform him or her of your concern. If you are not
in independent private practice, inform your supervisor of the actions you will be
taking and follow any directives that he or she gives you.
6.
Document in your case notes all conversations with your adult client, his or her
significant person, and your supervisors.
If you determine that an adult client MAY BE seriously at risk for committing suicide...
1.
You are dealing with a very serious matter that requires immediate and decisive action.
Make the determination that an adult client may be at risk for committing suicide
only if the client has made a suicide gesture or attempt, has told you or someone
else in a believable fashion that he or she plans to commit suicide, or has engaged
in a pattern of behavior that the professional literature suggests is the behavior of a
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 35
suicidal adult. Follow any agency policies that exist regarding managing suicidal
adults. If you are not in an independent private practice, notify your supervisor of
the situation and follow any directives that he or she may give. If policies dictate or
if your supervisor directs you to proceed differently from the steps below, follow
the policies or the orders of your supervisor.
2.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
3.
Explain to your adult client that you will have to notify a significant person in his or her
life so that the individual can help.
4.
Assure your adult client that you will continue to help him or her and that you will
disclose only the minimum information necessary for him or her to get assistance.
Try to calm the client, but do not minimize the seriousness of the situation. Explain
to the client what may happen in the next few hours, next few days, and long term.
5.
Insure that your adult client is not left alone and does not have any opportunity to harm
himself or herself prior to turning the client over to his or her significant person.
6.
Contact a significant person in your adult client’s life and explain that you believe his or
her relative, partner, or friend may be at risk for suicide and give specific details
that led to your concern. Insist that the significant person come to pick up the
client immediately.
7.
If a significant person cannot be found, make sure your adult client is under the
supervision of a responsible person until a significant person is located.
8.
If you cannot contact a significant person and if it is impossible to keep your adult client
safe for an extended period of time, call an ambulance and have the client
transported to a hospital that has psychiatric services. If you are not in an
independent private practice, be sure to inform your supervisor and obtain his or
her permission and support for taking this action. If your supervisor directs you
take a different course of action, do so and document in your case notes what you
were told and did. Give the ambulance attendant your contact information and
offer to speak with the person at the hospital who will be conducting the
evaluation, if requested to do so. Continue to attempt to contact the client’s
significant person.
9.
When you talk to the significant person, ask him or her to take possession and
responsibility immediately for your adult client.
10.
When the significant person arrives, explain to him or her that you believe that your
adult client may be at risk for suicide, give specific details that led to your concern,
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 36
instruct the significant person of what he or she should do next, and ask that a
document be signed that acknowledges that the significant person has been
informed of your concerns, has been given directions of steps to take next, and has
agreed to take responsibility for your client.
11.
Also, have the adult client sign a form giving you permission to disclose any information
you have to mental health professionals who may evaluate or treat him or her in
the future. If the client refuses or is not capable of signing the form, ask the family
member of significant person to sign on your client’s behalf.
12.
Explain to the significant person that he or she must insure that your adult client is not
left alone, does not have any opportunities to harm himself or herself, and is taken
for an evaluation as soon as possible to determine whether the client is at risk for
suicide.
13.
If a significant person refuses to sign the document or communicates to you in some
way that he or she will not take the situation seriously, call an ambulance and
follow the steps in item 8 above.
14.
As events occur, document in your case notes in detail all of the events that transpired
in relation to this situation. Be sure to date each entry and indicate the time you
wrote it. Make several entries if necessary, and do not delay in writing details in
your case notes.
15.
When your adult client returns to you or your agency for services, obtain written
permission from your client to contact the professional who determined that your
client was not at risk for suicide, or was no longer at risk for suicide.
16.
Contact your adult client’s treating physician, psychologist, or mental health provider
and explain that his or her patient or client has returned to you or your agency for
services. Ask the treating provider to summarize his or her evaluation and
treatment of the client. Inquire as to whether the provider will continue to treat
the client, and if so, the details of the planned treatment. Also ask the treating
provider the types of counseling services he or she would like for you to provide to
the client. Do not agree to provide any counseling services that your position does
not allow you provide. Ask the provider to tell you the circumstances under which
you should return the client to him or her for further evaluation or treatment.
17.
As soon as possible after you have talked to the provider, document in your case notes
details of your conversation. Be sure to date the entry and indicate the time you
wrote it.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 37
Managing a Minor Client Who
May Be At Risk for Violence
If you determine that a minor client has exhibited some behaviors that are related to
violence, but currently does not appear to be at risk for harming others...
1.
If you believe that a minor client may be thinking about harming others or if you have
observed or have information that a minor client has exhibited some behaviors that
might be interpreted as leading to harming others, but you do not consider the
situation to be an emergency, summarize in your case notes the client’s behavior
that supports your concern. Do not write that you believe the client may be at risk
for violence. Instead, write that although you do not believe the client may be at
risk for violence, you believe a parent or guardian needs to be informed of the
client’s behaviors that concern you.
2.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
3.
Tell your minor client your concerns and, if appropriate, obtain an agreement from the
client to inform a parent or guardian of your concerns. Tell the client to have the
parent or guardian he or she informs to contact you after being told.
4.
If your minor client is not capable of telling the parent or guardian himself or herself, or
for some other reason asking the client to inform his parent or guardian does not
seem like an appropriate course of action, explain to the client that you will be
contacting a parent or guardian to inform him or her of your concern. If you are not
in independent private practice, inform your supervisor of the actions you will be
taking and follow any directives that he or she gives you.
5.
Document in your case notes all conversations with your minor client, his or her parent
or guardian, and your supervisors.
If you determine that a minor client MAY BE seriously at risk for harming others...
1.
You are dealing with a very serious matter that requires immediate and decisive action.
Make the determination that a minor client may be at risk for harming others only if
the client has told you or someone else in a believable fashion that he or she plans
to harm others, or has engaged in a pattern of behavior that the professional
literature suggests is the behavior of a violent person. Follow any agency policies
that exist regarding managing violent adults. If you are not in an independent
private practice, notify your supervisor of the situation and follow any directives
that he or she may give. If policies dictate or if your supervisor directs you to
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 38
proceed differently from the steps below, follow the policies or the orders of your
supervisor.
2.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
3.
Explain to your minor client that you will have to notify a parent or guardian so that the
individual can help.
4.
Assure your minor client that you will continue to help him or her and that you will
disclose only the minimum information necessary for him or her to get assistance.
Try to calm the client, but do not minimize the seriousness of the situation. Explain
to the client what may happen in the next few hours, next few days, and long term.
5.
If you know the identity of an individual your minor client intends to harm, notify that
person of your concern. If you cannot locate the intended victim, notify the police
and ask them to locate and notify and protect the intended victim.
6.
Insure that your minor client is not left alone and does not have any opportunity to
harm another person prior to turning the client over to his or her parent or
guardian.
7.
Contact a parent or guardian and explain that you believe his or her child may be at risk
for suicide and give specific details that led to your concern. Insist that the parent
or guardian come to pick up the client immediately.
8.
If a parent or guardian cannot be found, make sure your minor client is under the
supervision of a responsible person until a parent or guardian is located.
9.
If you cannot contact a parent or guardian and if it is impossible to keep your minor
client safe for an extended period of time, call an ambulance and have the client
transported to a hospital that has psychiatric services. If you are not in an
independent private practice, be sure to inform your supervisor and obtain his or
her permission and support for taking this action. If your supervisor directs you
take a different course of action, do so and document in your case notes what you
were told and did. Give the ambulance attendant your contact information and
offer to speak with the person at the hospital who will be conducting the
evaluation, if requested to do so. Continue to attempt to contact the client’s parent
or guardian.
10.
When you talk to the parent or guardian, ask him or her to take possession and
responsibility immediately for your minor client.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 39
11.
When the parent or guardian arrives, explain to him or her that you believe that your
minor client may be at risk for violence, give specific details that led to your
concern, instruct the parent or guardian of what he or she should do next, and ask
that a document be signed that acknowledges that the parent or guardian has been
informed of your concerns, has been given directions of steps to take next, and has
agreed to take responsibility for your client. Also, have the parent or guardian sign
a form giving you permission to disclose any information you have to mental health
professionals who may evaluate or treat their child in the future.
12.
Explain to the parent or guardian that he or she must insure that your minor client is not
left alone, does not have any opportunities to harm himself or herself, and is taken
for an evaluation as soon as possible to determine whether the client is at risk for
violence.
13.
If a parent or guardian refuses to sign the document or communicates to you in some
way that he or she will not take the situation seriously, notify your supervisor and
make a report of suspected child neglect.
14.
As events occur, document in your case notes in detail all of the events that transpired
in relation to this situation. Be sure to date each entry and indicate the time you
wrote it. Make several entries if necessary, and do not delay in writing details in
your case notes.
15.
When your minor client returns to you or your agency for services, obtain written
permission from your client to contact the professional who determined that your
client was not at risk for suicide, or was no longer at risk for suicide.
16.
Contact your minor client’s treating physician, psychologist, or mental health provider
and explain that his or her patient or client has returned to you or your agency for
services. Ask the treating provider to summarize his or her evaluation and
treatment of the client. Inquire as to whether the provider will continue to treat
the client, and if so, the details of the planned treatment. Also ask the treating
provider the types of counseling services he or she would like for you to provide to
the client. Do not agree to provide any counseling services that your position does
not allow you provide. Ask the provider to tell you the circumstances under which
you should return the client to him or her for further evaluation or treatment.
17.
As soon as possible after you have talked to the provider, document in your case notes
details of your conversation. Be sure to date the entry and indicate the time you
wrote it.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
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Managing an Adult Client Who
May Be At Risk for Violence
If you determine that an adult client has exhibited some behaviors that are related to
violence, but currently does not appear to be at risk for harming others...
1.
If you believe that an adult client may be thinking about harming others or if you have
observed or have information that an adult client has exhibited some behaviors
that might be interpreted as leading to harming others, but you do not consider the
situation to be an emergency, summarize in your case notes the client’s behavior
that supports your concern. Do not write that you believe the client may be at risk
for violence. Instead, write that although you do not believe the client may be at
risk for violence, you believe a significant person in his or her life needs to be
informed of the client’s behaviors that concern you.
2.
A significant person might be the adult client’s spouse, parent, adult child, other
relative, domestic partner, dating partner, or close friend. Choose a person who
lives with the client or who is in frequent contact with the client.
3.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
4.
Tell your adult client your concerns and, if appropriate, obtain an agreement from the
client to inform a significant person in his or her life of your concerns. Tell the client
to have the person he or she informs to contact you after being told.
5.
If your adult client is not capable of telling the significant person himself or herself, or
for some other reason asking the client to inform his significant person does not
seem like an appropriate course of action, explain to the client that you will be
contacting a significant person to inform him or her of your concern. If you are not
in independent private practice, inform your supervisor of the actions you will be
taking and follow any directives that he or she gives you.
6.
Document in your case notes all conversations with your adult client, his or her
significant person, and your supervisors.
If you determine that an adult client MAY BE seriously at risk for harming others...
1.
You are dealing with a very serious matter that requires immediate and decisive action.
Make the determination that an adult client may be at risk for harming others only
if the client has told you or someone else in a believable fashion that he or she
plans to harm others, or has engaged in a pattern of behavior that the professional
literature suggests is the behavior of a violent person. Follow any agency policies
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 41
that exist regarding managing violent adults. If you are not in an independent
private practice, notify your supervisor of the situation and follow any directives
that he or she may give. If policies dictate or if your supervisor directs you to
proceed differently from the steps below, follow the policies or the orders of your
supervisor.
2.
If you have consulted with colleagues, experts, or supervisors in reaching your position,
document the consultations in your case notes.
3.
Explain to your adult client that you will have to notify a significant person in his or her
life so that the individual can help.
4.
Assure your adult client that you will continue to help him or her and that you will
disclose only the minimum information necessary for him or her to get assistance.
Try to calm the client, but do not minimize the seriousness of the situation. Explain
to the client what may happen in the next few hours, next few days, and long term.
5.
If you know the identity of an individual your adult client intends to harm, notify that
person of your concern. If you cannot locate the intended victim, notify the police
and ask them to locate and notify and protect the intended victim.
6.
Insure that your adult client is not left alone and does not have any opportunity to harm
another person prior to turning the client over to his or her significant person.
7.
Contact a significant person in your adult client’s life and explain that you believe his or
her relative, partner, or friend may be at risk for suicide and give specific details
that led to your concern. Insist that the significant person come to pick up the
client immediately.
8.
If a significant person cannot be found, make sure your adult client is under the
supervision of a responsible person until a significant person is located.
9.
If you cannot contact a significant person and if it is impossible to keep your adult client
safe for an extended period of time, call an ambulance and have the client
transported to a hospital that has psychiatric services. If you are not in an
independent private practice, be sure to inform your supervisor and obtain his or
her permission and support for taking this action. If your supervisor directs you
take a different course of action, do so and document in your case notes what you
were told and did. Give the ambulance attendant your contact information and
offer to speak with the person at the hospital who will be conducting the
evaluation, if requested to do so. Continue to attempt to contact the client’s
significant person.
10.
When you talk to the significant person, ask him or her to take possession and
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 42
responsibility immediately for your adult client.
11.
When the significant person arrives, explain to him or her that you believe that your
adult client may be at risk for suicide, give specific details that led to your concern,
instruct the significant person of what he or she should do next, and ask that a
document be signed that acknowledges that the significant person has been
informed of your concerns, has been given directions of steps to take next, and has
agreed to take responsibility for your client.
12.
Also, have the adult client sign a form giving you permission to disclose any information
you have to mental health professionals who may evaluate or treat him or her in
the future. If the client refuses or is not capable of signing the form, ask the family
member of significant person to sign on your client’s behalf.
13.
Explain to the significant person that he or she must insure that your adult client is not
left alone, does not have any opportunities to harm himself or herself, and is taken
for an evaluation as soon as possible to determine whether the client is at risk for
suicide.
14.
If a significant person refuses to sign the document or communicates to you in some
way that he or she will not take the situation seriously, call an ambulance and
follow the steps in item 9 above.
15.
As events occur, document in your case notes in detail all of the events that transpired
in relation to this situation. Be sure to date each entry and indicate the time you
wrote it. Make several entries if necessary, and do not delay in writing details in
your case notes.
16.
When your adult client returns to you or your agency for services, obtain written
permission from your client to contact the professional who determined that your
client was not at risk for suicide, or was no longer at risk for suicide.
17.
Contact your adult client’s treating physician, psychologist, or mental health provider
and explain that his or her patient or client has returned to you or your agency for
services. Ask the treating provider to summarize his or her evaluation and
treatment of the client. Inquire as to whether the provider will continue to treat
the client, and if so, the details of the planned treatment. Also ask the treating
provider the types of counseling services he or she would like for you to provide to
the client. Do not agree to provide any counseling services that your position does
not allow you provide. Ask the provider to tell you the circumstances under which
you should return the client to him or her for further evaluation or treatment.
18.
As soon as possible after you have talked to the provider, document in your case notes
details of your conversation. Be sure to date the entry and indicate the time.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 43
Notification and Agreement Form
to be Signed by Relative or Significant Person in the Life
of an Individual Who May be At Risk for Suicide
_____________________________________________
Name of Person who may be At Risk for Suicide
I acknowledge that the mental health professional who has signed this form has told me
that he or she believes that the individual listed above may be at risk for suicide. I understand
that this belief is based on specific information regarding this individual. I further understand
that this mental health professional is not in a position to make a determination as to whether
the individual listed above is at risk for suicide.
I agree to care for the individual listed above until he or she can be evaluated by a
qualified professional to determine whether the individual is at risk. I further agree to ensure
that the individual listed above is provided the mental health care he or she needs after the
evaluation is completed.
I understand that if an emergency arises, I should take the individual listed above to a
hospital for emergency mental health treatment.
____________________________________________________________
Signature of Family Member or Significant Person in the Individual’s Life
___________
Date
____________________________________________________________
Signature of Mental Health Professional
__________
Date
NOTES: (1) Parent or guardian should sign for minors; (2) For an individual who may be
at risk for violence, substitute the word “violence” for the word “suicide” above.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 44
Assisting Family Members
or Significant Persons in the Individual’s Life
Arrange for an Evaluation to Determine Whether
an Individual is a Danger to Self or Others
1.
These recommendations represent “best practice.” Although most mental health
professionals do not provide all of the information suggested in these guidelines, it
would be very helpful to clients and their loved ones if it were provided.
2.
A close family member or a significant person who is very close to the individual must be
enlisted to assist someone who may be at risk for suicide or for harming others. It
would be best if the relative or significant person lived with the individual. If the
individual lives alone or lives with people who cannot help, then choose a responsible
family member of significant person to help. Family members might include a spouse,
adult child, parent, sibling, or other close relative. Significant persons might include a
domestic partner, roommate who is close friends with the individual, or someone else
who is a very close friend.
3.
Explain that the individual must be cared for constantly before the evaluation takes
place. Explain that constant care includes monitoring the individual’s activities, ensuring
someone is with the individual at all times, and making sure the individual does not have
access to means of harming self or others.
4.
Explain that, if necessary, the person who may be at risk should be taken to the
emergency room of a hospital that offers psychiatric emergency services before an
appointment with a physician occurs. Explain that it would be necessary to seek an
emergency evaluation if the person who may be at risk becomes violent, refuses to
cooperate with his or her care giver, or engages in behavior that alarms the care giver in
any way. Give the relative of significant person the names, addresses, and telephone
numbers of local hospitals that offer psychiatric emergency services.
5.
If the individual who may be at risk is covered by health care insurance or is a
participant in some type of health care plan, follow the procedures for obtaining health
care services required by the insurance or health care plan. If the procedures are not
known, the family member or significant person should call the health care plan’s
information number and ask what procedures they should follow to have the
individual’s mental status evaluated to determine whether he or she is a danger to self
or others.
6.
If the process for scheduling an appointment takes too long, then the emergency
treatment option of the health care insurance or health care plan should be utilized.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 45
7.
The major types of health care plans include the following:
a. Health Maintenance Organization (HMO). If the individual is an HMO member,
then he or she should be scheduled to see his or her primary care physician. Use
the expedited appointment option for HMO services if it would take too long to
schedule an appointment with the individual’s primary care physician.
b. Preferred Provider Organization (PPO) or Exclusive Provider Organization (EPO).
If the individual is a PPO or an EPO member, then he or she should make an
appointment according to that organization’s procedures. The PPO or EPO may
require that the appointment be made with the individual’s primary care
physician. Use the expedited option for PPO or EPO services if it would take too
long to schedule an appointment with the individual’s primary care physician. If
seeing the primary care physician is not required, an appointment should be
made directly with a psychiatrist who is on the PPO or EPO list of providers.
c. Traditional health insurance. If the individual has traditional health insurance,
then he or she should make an appointment to see a psychiatrist.
8.
If the individual who may be at risk does not have any type of health insurance or is not
a member of any type of health care plan, then the public mental health system should
be utilized. Follow the steps below:
a. Provide the family member or significant person with the name, address, and
telephone number of the community mental health facility in the political
jurisdiction the person who may be at risk lives in that performs mental health
evaluations for indigent persons.
b. Explain how the mental health facility accepts referrals and its policies for
performing mental health evaluations for indigent persons.
9.
Give the family member or significant person your contact information and offer to
speak with the professional who performs the evaluation if they are interested in
speaking to you.
10.
Ask the family member or significant person to contact you after the evaluation has
taken place to summarize the results of the evaluation and to give you the name and
telephone number of the person who completed the evaluation.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 46
School Counseling Case Law: Suicide
Mary A. Hermann, J.D., Ph.D.
Virginia Commonwealth University
CASE 1
Nicole was a 13-year-old student allegedly involved in Satanism. Nicole’s friends told their
school counselor that Nicole had stated that she wanted to kill herself. Nicole's school counselor
confronted Nicole about her suicidal statements. Nicole denied ever making the statements. The
counselor did not contact Nicole's parents. Unfortunately, Nicole had made a suicide pact with
another student. A few days later, the other student shot Nicole and then shot herself. The
incident occurred off campus. Could the school counselor be found liable for Nicole’s suicide?
Eisel v. Board of Education, 597 A.2d 447 (Md. 1991)
CASE 2
Shawn, a 13-year-old student, attempted suicide at school during school hours before
killing himself at home. School officials failed to notify Shawn's mother. Shawn's mother knew
he had emotional and behavioral problems, but she did not know he was suicidal.
The first suicide attempt was in the locker room at school where Shawn tried to hang
himself. Jonathan, another student, found him. Jonathan told his mother about what happened.
Jonathan's mother did not call Shawn's mother. She did call the school and spoke with the Dean
of Students who said he would "take care of it." The Dean of Students took care of it by calling
Shawn into his office and reading him verses from the Bible. He took no other action. Testimony
indicated that the Dean of Students did nothing else because "there was just too much red tape."
The second incident occurred in the boys' restroom. Shawn told a custodian that he
would have killed himself if he had been in the restroom alone any longer. The custodian found
a hanger and cord hanging from the ceiling. The custodian told the vice-principal that a boy had
been talking about killing himself, but she did not identify the boy or tell the vice-principal about
the hanger and cord. The vice-principal responded by asking if the custodian could find
something better to do than gossip. Could school personnel be found liable for Shawn’s suicide?
Wyke v. Polk County School Board, 129 F.3d 560 (11th Cir. 1997)
CASE 3
Armijo, a special education student, made comments to a school aide such as "maybe I'd
be better off dead" and "I'm just going to shoot myself." Both the aide and the school counselor
knew that the student had access to firearms. The student was referred to a social worker to
help him cope with his difficulties in school and his low self-esteem. A few months later, the
student threatened to do physical harm to a teacher, the teacher's son, and the teacher's car. He
was immediately suspended. The school counselor was instructed by the principal to drive the
student home, though the parent/student handbook provides that when a student is placed on
an out-of-school suspension and the parents cannot be reached, the student is to remain at
school on an in-school suspension. In this case, the student's parents were not even notified of
the suspension.
The student expressed to the counselor that he did not understand why he was in trouble.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 47
He told the counselor that maybe he would be better off dead. During the drive home, the
counselor observed that the student was "very angry." Still, the counselor dropped the student
off and drove away. When the student's parents returned home later that day, they found their
son
dead from a self-inflicted gunshot wound. Could the school counselor be found liable for the
student’s suicide?
Armijo v. Wagon Mound Public Schools, 159 F.3d 1253 (10th Cir. 1998)
CASE 4
A high school student was asked to make journal entries for his English class. According
to the English teacher, the student asked her not to read the entries and the teacher assured him
that she would only check the length of the journals. After his suicide, the teacher read the
journals and gave them to the counselor who gave them to the parents of the boy.
The journal entries contained passages in which the student pronounced himself dead
and wrote poems to his friends telling them good-bye. Then he wrote that he had met some old
friends so he would be around for awhile. Could school officials be found liable for the student’s
suicide?
Brooks v. Logan, 903 P2d 73 (Idaho 1995), aff'd. Brooks v. Logan, 944 P.2d 709 (Idaho 1997)
CASE 5
Five months prior to her suicide, Jill, a ninth grade student, expressed her suicidal
thoughts to her guidance counselor. The counselor informed Jill's parents and recommended
counseling. The parents followed this advice and Jill was brought to a psychologist who
diagnosed her as suffering from clinical depression.
A few months later, Jill wrote an essay for her English class about a teenage girl who
committed suicide by shooting herself in the chest. The English teacher reported the incident to
the counselor. Neither the teacher nor the counselor informed Jill's parents about the essay.
A few weeks later, a student told another school counselor that she had received a letter
from Jill. According to the letter, Jill was going to get a gun from the basement of her house and
kill herself. The school counselor told Jill's school counselor about the letter the next day. The
counselor spoke with Jill and Jill said that she was angry when she wrote the letter and she was
not thinking about suicide any longer. Jill also told her counselor that she was still seeing a
psychologist. The counselor did not contact Jill's parents about the letter. A few days later, Jill
killed herself with a loaded gun kept in the basement of her home. Could the school counselor
be found liable for the student’s suicide?
Killen v. Independent School District No. 706, 547 N.W.2d 113 (Minn.App. 1996)
CASE 6
Jason, a senior in high school, told other students that he was going to kill himself. The
students told the counselor. The counselor met with Jason and questioned him. The counselor
called his mother but did not discuss Jason's suicide threats. Instead, she told his mother to take
Jason to the hospital for drug abuse treatment. On the way to the hospital, Jason jumped out of
the car and over a highway overpass. Could the school counselor be found liable for Jason’s
suicide?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 48
Grant v. Board of Trustees of Valley View School District No. 365-U, 676 N.E.2d 705 (Ill.App. 3 Dist.
1997)
CASE 7
A second grade class watched a film at school about an amputee who tried to hang
himself. The teacher showed the film because she believed that the film dealt with important
issues related to disabilities. Unfortunately, one of the students hung himself that night. Could
school personnel be found liable for the student’s suicide?
Nalepa v. Plymoth-Canton Community School District, 525 N.W.2d 897 (Mich.App. 1994)
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 49
School Counseling Case
Law: Danger to Others
Mary A. Hermann, J.D., Ph.D.
Virginia Commonwealth University
CASE 1
A 14-year-old student brought guns to school, showed them to other students, and wrote
homicidal and suicidal thoughts in school papers. Shortly thereafter, the student went on a
shooting rampage at school leaving three girls dead and five other students wounded. Could
school personnel be held liable in a lawsuit?
West Paducah, Kentucky case
CASE 2
Two students wrote about their anger, hatred, and intent to kill in their psychology and
creative writing classes. They also created a violent Web site (of which school officials had
knowledge). They even made a video for their video production class in which they enacted
shooting students. These students then shot and killed 12 students and 1 teacher before killing
themselves. Could school personnel be held liable in a lawsuit?
Columbine case
CASE 3
A 15-year-old threatened to shoot her school counselor because she was dissatisfied with
her schedule. The student did not act in a physically threatening manner toward the counselor,
and yet the counselor reported that she felt threatened because the counselor had witnessed
the student’s volatile nature and lack of impulse control on other occasions. The student
defended her action and claimed that she had merely used a figure of speech. Describe the
school counselor’s legal rights and legal and ethical responsibilities in this situation.
Lovell v. Poway Unified Sch. Dist., 90 F.3d 367 (9th Cir. 2001)
CASE 4
A student wrote a poem containing suicidal and homicidal imagery including a passage
depicting a school shooting, 28 people dying, the student feeling no remorse, and the student
shooting himself. The English teacher expressed her concern about the poem to the school
counselor. The shooting in Springfield, Oregon had just occurred. The student had previously
admitted to the school counselor that he had thoughts of committing suicide. The school
counselor also knew that the student was having serious problems at home and was allegedly
stalking the girl who had just broken up with him. The student had a discipline record that
included a fight and an incident of insubordination to a teacher. What are the school counselor’s
legal and ethical responsibilities in this case?
Lavine v. Blaine Sch. Dist., 257 F.3d 981 (9th Cir. 2001)
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 50
CASE 5
A 15-year-old wrote a note stating “There’s a bomb in this School bang bang!!” This
incident took place a few weeks after the Columbine school shooting. The student claimed the
note was just a joke. The student was on probation because he had blown up a shed on the
property of another school. The school administrators believe that the best course of action is
to expel the student. They consult the school counselor. Describe the school counselor’s ethical
and legal duties.
Brian A. v. Stroudsburg Area Sch. Dist., 141 F.Supp.2d 502 (MD.Pa. 2001)
CASE 6
An 11th grade student wrote a poem about killing a specific teacher. The student
explained that she was upset with the teacher at the time and wrote the poem to express her
frustration. The student stated that she did not intend for anyone to see the poem. Neither the
teacher nor the administration believed the threat was a serious threat because the student had
not been engaged in violent conduct at school before. However, because of the “zero tolerance”
policy, the school administrators plan to suspend the student. They consult the school counselor.
Describe the school counselor’s ethical and legal duties.
D.G. vs. Indep. Sch. Dist. No. 11 of Tulsa County Oklahoma, 2000 U.S. Dist. LEXIS 12197, (N.D.
Okla. 2000).
CASE 7
When Adam was 14 years old, he drew a picture of student pouring gasoline on East
Ascension High School. In the picture, the student was also holding a torch and missile, two other
students held guns, and another student was throwing a brick at the principal and telling the
principal to shut up (using profanity). The picture was drawn at home. Two years later, Adam’s
brother Andrew showed the sketch pad containing Adam’s picture to another student while they
were riding the school bus home from school. That student told the bus driver that Andrew and
his brother were going to blow up the high school. The bus driver confiscated the sketch pad and
took it to the principal of the middle school Andrew attended. Andrew was questioned by school
administrators. Considering that earlier that year Andrew had been suspended for verbally
threatening to kill several classmates, school administrators want to suspend Andrew for having
his brother’s violent drawing at school.
Adam, a student at East Ascension High School, was questioned by the high school
administrators. He admitted he drew the picture. The administrators searched his book bag and
found notebooks containing references to drugs, sex, and death as well as sketches of gang
signals. They also found a fake ID and a razor blade/box cutter. Adam said he needed the box
cutter for his after school job. Considering Adam’s past disciplinary record, school administrators
want to expel Adam and have him arrested for terrorizing and illegal possession of a weapon.
If administrators consult a school counselor in this case, describe the school counselor’s
ethical and legal duties.
Porter v. Ascension Parish Sch. Bd., 2004 U.S. Dist. LEXIS 1175, (M.D. La.)
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 51
CASE 8
Nine high school students created and distributed a pamphlet on school grounds. The
pamphlet contained a picture of the school principal with a dart in his head and an essay about
what would happen if the principal was shot. The students involved were called to the principal’s
office. They were arrested. At the correctional facility the students were booked and stripsearched. If the school counselor had found the pamphlet before any action was taken, what
would have been the school counselor’s ethical and legal duty?
Cuesta v. School Bd. Of Miami-Dade County, Fla., 285 F.3d 962 (11th Cir. 2002)
CASE 9
After breaking up with his girlfriend, J.M. (a seventh grader) wrote a letter describing how
he planned to rape, sodomize and murder her. J.M. explained that he was trying to write a rap
song like Eminem and Kid Rock, but had trouble finding a beat or rhythm for his song. His song
writing attempt turned into a letter. He wrote the letter at home. J.M.’s best friend found the
letter and read it with J.M.’s permission. J.M.’s best friend brought the letter to school (without
J.M.’s permission) and showed it to J.M.’s ex-girlfriend. The principal recommends that J.M. be
expelled. If the school counselor had found the letter, what would have been the school
counselor’s ethical and legal duty?
Doe v. Pulaski County Special Sch. Dist., 306 F.3d 616 (8th Cir. 2002)
CASE 10
Three male students are bullying a seventh grader named Shea.
Shea’s mother
complains to the principal but does not disclose the names of the bullies. She asks that her son
be allowed to see the social worker who provides counseling services to the students at the
school. The mother told the social worker that the principal wanted to know the names of the
bullies, but she did not want to provide them. The social worker told Shea’s mother that she
would not disclose the names of the bullies to the principal. The social worker also told Shea that
she would not tell anyone the names of the bullies. Yet, after talking to Shea, the social worker
believed that Shea was in immediate danger of serious harm so she told the principal the names
of the three bullies. What are the legal and ethical implications of the social worker’s action?
Albers v. Breen, 806 N.E.2d 667 (Ill. App. 2004).
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 52
Risk Management Suggestions
When Clients are Potentially Violent
1. Train staff in methods of identifying and managing clients who have been determined to be
potentially violent. Document this training is writing (memos, announcements, etc.).
Update training periodically (annually, semi-annually, etc.).
2. Develop written policies in your agency that give step by step instructions for handling
potentially violent clients. Such policies should not instruct professionals in how to identify
potentially violent clients, but instead should give instructions to professionals to be used
after the professional has made the professional judgment that a client may be potentially
violent. The nature of the agency will determine the best approach to managing potentially
dangerous clients.
3. State that the goals of the written policies are to protect all individuals from injury and to
maintain the privacy and dignity of the client to the extent possible.
4. Have the attorney for your agency review and approve the policies before they are
implemented or changed in any way after being implemented.
5. Distribute written policies to all new employees and distribute changes to the policies when
changes are made.
6. Take action against employees if policies are not followed.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 53
Suggestions for Client Management
And Your Personal Safety
When Clients are Potentially Violent
From pages 480-482 of
James, R. K., & Gulliland, B. E. (2001). Crisis intervention strategies (4th ed.). Belmont, CA:
Wadsworth/Thomson Learning.
Adequate training should endow the crisis worker with the ability to make certain
assumptions and take certain precautions when dealing with potentially violent clients
(Turnbull et al., 1990; Zold & Schilt, 1984, pp. 98-99):
1. Assume the need to set limits and provide clear instructions with options that define what
positive and negative consequences will occur
2. Assume the client feels a number of debilitating emotions such as fear, depression, anxiety,
helplessness, anger, rejection, and hopelessness and demonstrate concern by encouraging
verbal ventilation through how and when questions, and reinforcing appropriate behavior
and communication of feelings
3. Assume frustration of normal activity and boredom when the client is in residence, and
provide activities to keep the client fruitfully busy
4. Assume a threat to the client’s self-esteem, independence, and self-control and provide
choices and opportunities to help in carrying out medical and psychological activities
5. Assume tension and arousal and provide a calm and relaxing atmosphere, particularly in
high-tension periods, by manipulating environmental variables and using a cooperative
“we” approach
6. Assume confusion and provide a careful explanation of all procedures to be employed,
being particularly sure that all staff are operating from the same frame of reference
7. Assume responsibility and provide for one primary staff member to act as chief caretaker
and advocate of each client
8. Assume disconnectedness and rootlessness if the client is to be institutionalized for any
length of time and provide familiarity and psychologically calming anchors associated with
pleasant memories
While providing support through the preceding practive behaviors, the wise human services
worker should observe a number of precautionary measures (Blair, 1991; Forster, 1994;
Greenstone & Leviton, 1993; Moran, 1984, p. 244; Piercy, 1984, p. 143; Turnbull et al., 1990;
Wood & Khuri, 1984, p. 69):
1. Don’t deny the possibility of violence when early signs of agitation are first noticed in the
client.
2. Don’t dismiss warnings from records, family and peers, authorities, or fellow workers that
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 54
the client is violent.
3. Don’t become isolated with potentially violent clients unless you have made sure that
enough security precautions have been taken to prevent or limit a violent outburst.
4. Don’t engage in certain behaviors that may be interpreted as aggressive, such as moving too
close, staring directly into the client’s eyes for extended periods of time, point fingers, or
displaying facial expressions and body movements that would appear threatening.
5. Don’t allow a number of the institution’s workers to interact simultaneously with the client
in confusing multiple dialogues.
6. Don’t make promises that cannot be kept.
7. Don’t allow feelings of fear, anger, or hostility to interfere with self-control and professional
understanding of the client’s circumstances.
8. Don’t argue, give orders, or disagree when not absolutely necessary.
9. Don’t be placating by giving in and agreeing to all the real and imagined ills the client is
suffering at the hands of the institution.
10. Don’t become condescending by using childish responses that are cynical, satirical, or
otherwise designed to denigrate the client.
11. Don’t let self-talk about your own importance be acted out in an officious and “know-it-all”
manner.
12. Don’t raise your voice, put a sharp edge on responses, or use threats to gain compliance.
13. Conversely, don’t mumble speak hesitantly, or use a tone of voice so low that the client has
trouble understanding what you are saying.
14. Don’t argue over small points, given strong opposition from the client.
15. Don’t attempt to reason with any client who is under the influence of a mind-altering
substance.
16. Don’t attempt to gain compliance based on the assumption that the client is as reasonable
about things as you are.
17. Don’t keep the client waiting or leave a potentially violent client alone with freedom to
move about.
18. Don’t allow crowd to congregate as spectators to an altercation.
19. Don’t use why and what questions that put the client on the defensive.
20. Don’t allow the client to get between you and an exit.
21. Don’t dismiss increasingly vociferous client demands as merely attention-seeking, petulant,
or narcissistic behavior.
22. Don’t enter a room ahead of unknown clients. Stay behind and visually “frisk” them as you
go into the room.
23. Don’t remain after hours with a potentially violent client unless proper security is available.
24. Don’t fail to make contingency plans for violent incidents. Take your personal safety
seriously by playing “what if this happens” scenarios in your mind and with others.
25. Most important, don’t attempt to be a hero.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 55
REPORTING SUSPECTED
CHILD ABUSE
1.
Child abuse reporting statutes vary a great deal from state to state. The exact language
of your statute should be read and understood.
2.
Once you determine that a child may be being abused, a report must be made under
most statutes.
3.
If you are unsure whether the possibility exists that a child is being abused, consult with
your professional peers or experts.
4.
Follow the reporting procedures specified in your state statute. In addition, be sure to
follow any institutional or agency policies regarding the filing of such reports.
5.
When possible, inform the child before a report is made.
6.
Also, when possible, include the alleged perpetrator, family members, or guardians in
the reporting process.
7.
Monitor the child's needs after the report is made. Insure proper services are rendered
and serve as an advocate for the child.
8.
Make additional reports if the abuse appears to continue.
9.
Remember that our society believes that children should be reared by their natural
parents if at all possible. As a result, courts are very reluctant to remove children from
their homes.
10.
Invite social services workers to your agency or institution to explain their role and
function if you do not feel satisfied with their services.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 56
MINORS AS CLIENTS
1.
Children have a moral right to privacy. The law does not enforce this moral right. The
privacy rights of minors belong legally to their parents or guardians.
2.
Counselors have legal responsibilities to the parents or guardians of the children they
counsel.
3.
Under the "danger to self or others" exception to confidentiality, counselors often must
disclose to other adults information related to them by minors in counseling sessions.
Many children sometimes are not developmentally capable of making decisions that
affect their welfare.
4.
Parents or guardians probably have a legal right to know the content of counseling
sessions with minors.
5.
Generally, there is no legal requirement that consent to counsel minors has to be
obtained from parents or guardians. However, many agencies have policies that require
such consent.
6.
Parents or guardians may terminate a counselor's counseling relationship with their
children.
7.
Non-custodial divorced or separated parents have some of the same legal rights
regarding their children as custodial parents. In some states, statutes restrict the rights
of non-custodial parents to a substantial degree.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 57
8.
In some situations, counselors feel adults should not be given information related to
them by children. Possible responses to demands from parents, guardians, or other
adults for information regarding the content of counseling sessions with minors include
the following:
A.
Discuss the inquiry with the minor and see if he/she is willing to disclose the
content of the counseling session to the adult. Sometimes counselors are more
concerned than a child about his/her privacy. If that doesn't work...
B.
Try to persuade the adult that the child's best interests are not served by
revealing the information. Attempt to educate the inquiring adult about the
nature of the counseling relationship, and assure the adult that he/she will be
informed if the child is in danger. If that doesn't work...
C.
Schedule a joint session with the adult and the minor. Assume the role of a
mediator at this session. Hope that the adult will change his/her mind about
wanting the information or that the minor will be willing to disclose enough
information to satisfy the adult. If that doesn't work...
EITHER
D.
Inform the child ahead of time and then disclose the content of the session to
the inquiring adult. If the adult is not a parent or guardian, inform the parent or
guardian before disclosing the information.
OR
E.
Refuse to disclose the information to the inquiring adult. Secure approval from
your direct administrator before doing this.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 58
CONFIDENTIALITY IN SCHOOLS
THE LEGAL RIGHT TO PRIVACY
1.
All citizens have a legal right to privacy that is established by the United States
Constitution.
2.
The right to privacy is not absolute in that we live in a society in which many of our
actions naturally become known to others.
3.
Professionals who gain access to any private information about others have a duty to
keep such information secret. In the school setting, all professionals have a legal duty to
keep secret private information they learn about students and their families.
4.
There is a legal privilege, however, that allows school professionals to discuss private
information among themselves if there is a legitimate educational purpose for doing so.
5.
School professionals could be held responsible for libel or slander if they repeated false
information they knew or should have known was false. The legal privilege that allows
discussions for legitimate educational proposes does not allow discussions that include
damaging false information.
6.
Some school professionals have a higher duty of confidentiality to students and parents.
They may repeat information told to them only if a danger to self or others exists or if
they have permission from the student or family members to repeat the information.
Professionals with this higher duty of confidentiality include counselors, psychologists,
nurses, and social workers.
7.
Students or family members whose privacy rights are violated may sue professionals for
malpractice.
GUIDELINES FOR SCHOOL PERSONNEL
1.
Do not voluntarily discuss personal information about students except with other
professionals who need to know the information to help students.
2.
Do not repeat rumors or gossip that you hear regarding the personal lives of students,
their families, or faculty.
3.
Encourage anyone who requests personal information about students or their families
to pose the questions to the students themselves.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 59
4.
Rather than telling another professional in the school who might be able to help a
student about a student's problem, send the student to tell the professional or
accompany the student to the professional's room or office.
5.
If a student is having problems, let other school professionals know you are concerned
about a student and offer your assistance, but do not ask for specific information. The
professional will tell you what you need to know.
6.
Do not discuss personal situations regarding students in public areas. If someone else
brings up the topic, offer to discuss it in private later, if appropriate.
7.
Never give any type of information regarding students to nonschool parties. Refer those
requesting information to the administrative offices.
8.
Avoid personal involvements with students. Refer students who request help with
personal problems to others either within or outside the school whose jobs are to
provide assistance.
9.
Limit discussions of students and written statements about them to content you know
to be true or have reason to believe is true.
10.
Limit discussions of students and written statements about them to content you know
to be true or have reason to believe is true.
11.
Always consider that people outside the school may see what you have written or hear
what you have said about students.
12.
Whenever possible when you need to know information about a situation, make
attempts to talk directly to persons involved to determine the source of statements and
to verify the truth.
13.
Before making or writing any statements, ask if it holds another up to contempt, hatred,
or ridicule. If so, be especially sure of the truth of the statement and of the educational
purpose in repeating it.
14.
Always assume statements made in confidence or made in the teacher's lounge will be
repeated.
NOTE: Recommendations 9-14 are taken from
Strickland, R., Phillips, J. F., & Phillips, W. R. (1976). Avoiding teacher malpractice: A practical
legal handbook for the teaching professional. New York: Hawthorn Books.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 60
ADVERSARIAL SYSTEM
LEGAL SYSTEM
IS BASED ON
ADVERSARIAL METHOD
OF SEEKING TRUTH
LITIGANT'S ROLE:
PROSECUTOR/DEFENDANT
PLAINTIFF/RESPONDENT
LAWYER'S ROLE
JUDGE AND JURY'S ROLE
GENERAL WITNESS'S ROLE
EXPERT WITNESS'S ROLE
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 61
METHODS OF PROVIDING LEGAL ADVICE
In-House Counsel
Law Firm on Retainer
Independent Attorney on Retainer
Relationship with Law Firm or Independent Attorney
State Attorney General’s Office
Verbal Questions
Written Questions
Questions Sent Up to and Advice Passed Down from Attorney
Direct Contact with Attorney
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 62
CONSULTING WITH YOUR OWN ATTORNEY
OR THE ATTORNEY FROM YOUR AGENCY
1.
If you are discussing legal issues that are relevant to a particular client or patient, you
have a privileged relationship with these attorneys, so you may tell them anything
without concern about compromising your client’s or patient’s privacy.
2.
Be 100% truthful, even if you are concerned about some action you took or failed to
take or something you said or failed to say.
3.
Ask questions if you don’t understand.
4.
Education the attorneys regarding your professional responsibilities, statutes you know
about, or other matters, as appropriate.
5.
Object to advice if you feel it is inappropriate or ill-advised.
6.
Listen carefully to advice you are given and follow it even if you do not agree.
7.
If you are dealing with your agency’s attorney and you feel as if your best interests are
different from those of your agency, retain your own private attorney and follow his
or her advice.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 63
TALKING TO ATTORNEYS
WHO REPRESENT OTHERS
Some common situations in which mental health professionals talk with attorneys:
1.
A prosecutor or defense attorney calls about a suspected child abuse report you have
made.
2.
An attorney representing someone other than your client requests information related
to your client.
3.
You client requests that you talk to his or her attorney regarding a lawsuit in which he or
she is involved. The lawsuit might be related to any of the following issues:
A.
Your client might have been charged with committing a crime;
B.
Your client might be involved in a child custody hearing;
C.
Your client might be suing someone for an injury he or she sustained;
D.
Your client might be contesting a dismissal from a job; or
E.
Your client may have been arrested for driving while intoxicated.
Before you acknowledge that the individual is your client or give any information to an
attorney about your client, either obtain written permission from your client to disclose
information to the attorney or have a valid subpoena issued by the attorney.
When you are talking to attorneys, keep the following in mind:
1.
An attorney has legal and ethical obligations only to his or her client; not to you as a
witness.
2.
An attorney must vigorously represent his or her client's best interests, even if it means
compromising you in some way. An attorney's job is protect his or her client, even if it
means accusing you of some wrong doing or making you look bad in some way.
3.
Nothing you say is "off the record," even if the attorney says it is. You may have to
repeat, under oath, anything you say to an attorney.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 64
4.
Avoid making judgments or rendering diagnoses.
6.
If you are asked to explain judgments or diagnoses you have made in the past,
remember what you say to an attorney.
6.
Say as little as possible. Do not offer information. Answer questions directly, without
elaboration.
7.
Never exaggerate or express strong personal opinions.
8.
If you are unsure of something, or do not know an answer to a question, just say your
are unsure or do not know.
9.
Be courteous, but firm, if necessary.
10.
Attempt to protect your client's privacy by disclosing only limited information.
If you feel threatened or anxious during a conversation with an attorney, ask that
the remainder of the conversation be continued with your attorney present.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 65
REASONS COUNSELORS
MIGHT GO TO COURT
1. To respond as a defendant to allegations of wrong-doing as a counselor.
2. To serve as a fact witness after making a report of suspected abuse or neglect.
3. To serve as a fact witness in a child custody hearing.
4. To serve as a fact witness when a client has been accused of committing a crime or
when a client has been a victim of a crime.
5. To serve as a fact witness when a client is a part to a civil law suit (such as a personal
injury law suit, a real estate transaction, or an employment related law suit).
6. To serve as an expert witness in a criminal or civil law suit.
GENERAL ADVICE

If you’re not getting paid as an expert witness, tell clients you will not attend court on
their behalf.

If validly subpoenaed to a deposition, hearing, or trial, answer only factual questions.
Answer with very short responses. Offer no opinions.

If asked your opinion, state, “I do not have enough information to form a professional
judgment regarding that.”
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 66
ELEMENTS OF A MALPRACTICE LAW SUIT
DUTY
BREACH OF DUTY
HARM
PROXIMATE CAUSE OF HARM
DAMAGES
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 67
EXPERT WITNESS TESTIMONY
1.
Any citizen can be subpoenaed to court to provide factual information related to a legal
proceeding. Such witness may only relate what they saw, heard, or said. They are not
allowed to give their opinions.
2.
Expert witnesses are persons with specialized knowledge, experience, or expertise in a
particular area that is relevant to a court proceeding. Expert witnesses are allowed to
state their professional opinions.
3.
There are no specific qualifications required for a person to be designated an expert
witness. A judge, after hearing a person's credentials, decides whether an individual will
be "qualified" as an expert witness. Any mental health professional (i.e., LPC or licensed
social worker) or paraprofessional (recovering substance abuse counselor) could be
qualified as an expert witness in a mental health matter. However, a judge could refuse
to qualify any professional as an expert as well.
4.
Generally, expert witnesses are hired by parties to a lawsuit to provide their expert
opinion regarding a matter.
5.
Expert witnesses must be unbiased and objective. As a result, a mental health
professional who has provided counseling services to a client should not agree to
provide expert testimony because the mental health professional is biased in favor of
the client by the nature of the counseling relationship.
6.
Mental health professionals who are asked by their clients to provide expert testimony
in a legal proceeding should decline because their role is to provide counseling, not
evaluation. In addition, the mental health professional is biased toward the client and
usually does not have sufficient information to form an expert opinion regarding a
matter at issue in a court proceeding.
7.
Mental health professionals who are subpoenaed to court to testify should refuse to
give opinions, stating that they "do not have sufficient information to form a
professional opinion regarding the matter."
8.
Mental health professionals who choose to offer their services as expert witnesses
should prepare thoroughly for the role of expert witness, gather extensive
information before forming an opinion, and avoid taking cases in which their
opinions might be perceived as being biased.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 68
Some Expert Opinions Allowed by Courts
Is this defendant presently competent to stand trial?
Was this defendant sane at the time the crime was committed?
Is this person competent to manage his/her affairs?
Should this person be involuntarily committed because he/she is a danger to self or
others?
What is this convicted felon's potential for rehabilitation?
What assumptions would this consumer normally make about this product based on its
advertising, directions, or packaging?
What psychological injury did this person suffer as a result of being harmed?
Is this person able to perform certain required tasks of a job?
Of what value are psychological tests?
What impact does a trademark, a logo, or advertising have on the general public?>
Is this parent fit to raise this child?
What is the general practice of mental health professionals with similar training in this
community?
Which parent would be the better parent for this child?
Would a child be harmed if this parent were awarded visitation rights?
Did this parent abuse this child?
Does the potential exist for this parent to abuse this child in the future?
How credible is eyewitness testimony?
What effect do prison conditions have on this prisoner?
Did this person have an adequate understanding of this contract when he/she entered
into it?
Was this person killed in an accident or did he/she commit suicide?
Was this police officer justified in the amount of force he/she used in this circumstance?
Was this mental health professional responsible for this client's suicide because the
mental health professional was negligent in performing his/her responsibilities?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 69
Facts of Hypothetical Case
for an Expert Witness Counselor
John, a 13-year-old boy, was attending a suburban high school in the Midwest. John
was of average height, but was overweight and wore glasses.
John’s parents had divorced five years ago. After living with his mother for two years,
John moved in with his father and his father’s new wife three years ago.
About two years ago, John was hospitalized in a local psychiatric hospital because of
John’s depression. John indicated that he was upset over his parent’s divorce and did not like
his step-mother. John was in the hospital for a week. He saw a psychiatrist once a month for
about six months and was taking an anti-depressant. However, when he started feeling better,
John stopped taking the medication and stopped going to see the psychiatrist.
In May of 1998, a 16-year-old boy in a high school across town committed suicide by
shooting himself. In August of 1998, a 15-year-old girl in a neighboring school committed
suicide by taking an over-dose of her mother’s prescription sleeping pills. There have been
rumors in the community that many other children had attempted suicide in the past year.
In October of 1998, John’s father made an appointment with John’s middle school
principal and complained that several boys at John’s school were bullying John. John’s father
told the principal that he expected his son to be protected from such torment while he was at
school. The principal brought in the school counselor, Mr. Smith, and, during the meeting, the
school counselor agreed to talk to John to see if he could help with the situation.
Mr. Smith saw John weekly for three weeks. During his meetings with John, Mr. Smith
talked to John about strategies to use if was being teased or attacked by other boys. Mr.
Smith’s main advice was to avoid the other boys and to tell an adult if he was distressed by the
acts of other kids. After the three weeks had gone by, Mr. Smith asked John to drop in
periodically without an appointment to tell Mr. Smith how things were going with him. John
stopped by thereafter on two occasions, about a month apart.
On a Friday, in mid-February of 1999, John stopped by Mr. Smith’s office at the end of
the school day. John was crying and told Mr. Smith that he just didn’t know what to do. He
said that he was having trouble with his step-mother and was continuing to be teased by older
boys. Mr. Smith sensed that John was distressed and asked him directly if he was thinking
about killing himself. John answered, “No.” Mr. Smith then asked John if he had access to any
weapons in his home. John said that his father had rifles and shotguns in a cabinet, but that the
cabinet was locked. Mr. Smith asked John if he had ever tried to kill himself and John said that
he had not. After John stopped crying, he told Mr. Smith that he felt better and left Mr. Smith’s
office to go home.
Mr. Smith called John’s father’s office after John left. John’s father was in a meeting, so
Mr. Smith left a message for John’s father to call him back. John’s father never returned the
call. Mr. Smith left his office and went home at the regular time of 3:30 p.m. that day.
When John left Mr. Smith’s office, he went home, opened his father’s unlocked gun
case, took out a rifle, and shot himself in the head. He killed himself about 5:30 p.m. that same
day.
John’s father has sued Mr. Smith, the principal, the superintendent, and the school
district for negligence, claiming that Mr. Smith is responsible for his son’s death.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 70
Multiple Relationships
Issues and Related ACA Code of Ethics Sections
Issue
Must treat clients with respect.
No inappropriate sexual or romantic
relationships with clients.
No inappropriate non-sexual or nonromantic relationships with clients.
Avoiding problems when counseling
persons involved in a relationship.
Avoiding problems related to collecting
fees or accepting gifts from clients.
Must terminate and refer appropriately.
Must respect children or adults clients who
are vulnerable.
No inappropriate sexual or romantic
relationships with supervisees or students.
No inappropriate non-sexual or nonromantic relationships with supervisees or
students.
No inappropriate relationships with
research participants.
Dealing with suspected violations by other
counselors.
Related Code Sections
A.1.a., A.4.a.
A.5.a., A.5.b., A.5.c., C.6.a.
A.5.c., A.5.d., A.5.e., C.6.d.
A.7., B.4.b.
A.10.a., A.10.d., A.10.d., A.10.e.
A.11., A.11.a., A.11.b., A.11.c., A.11.d.
B.5.b.
F.3.b., F.3.c., F.10.a., F.10.b., F.10.c.
F.3.a., F.3.d., F.3.e., F.5.c., F.9.c., F.10.d.,
F.10.e., F.10.f., G.5.e., G.5.f.
G.3.b., G.3.c., G.3.d.
G.2.a., H.2.b., H.2.c, H.2.d., H.2.e., H.2.f.,
H.2.g.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 71
MULTIPLE RELATIONSHIPS
How should you respond to each of the situations below?
1.
The last session before Christmas, one of your counseling clients gives you a small box of
chocolates worth $3 as a present.
2.
The last session before Christmas, one of your counseling clients gives you a desk clock
worth $25 as a present.
3.
The last session before Christmas, one of your counseling clients gives you a gift
certificate to your favorite restaurant in the amount of $85 as a present.
4.
The last session before Christmas, one of your counseling clients gives you a watch
worth $200 as a present.
5.
A counseling client sends you an invitation to his/her formal wedding and dinner
reception.
6.
A former counseling client calls a month after termination and invites you to have lunch
with him/her at an expensive restaurant.
7.
During the second session, a counseling client asks you about your marital status,
whether you have ever been a counseling client yourself, where you live, and what
month and day you were born.
8.
When you enter a party at the home of one of your friends, the host introduces you to
one of your current counseling clients.
9.
An adult client of the opposite sex who seems to be sexually attracted to you asks for a
hug at an intensely emotional moment during a session.
10.
A client who is going through a divorce asks you if you would be willing to testify in court
that he/she is a responsible parent.
11.
A client tells you that he/she is sexually attracted to you and wants to terminate the
counseling relationship so that a personal friendship might be developed.
12.
A casual acquaintance who lives in your subdivision asks if you will see him/her for
counseling.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 72
13.
Your next door neighbor you have known for 10 years and whose children are close
friends of your children asks if you will see him/her for counseling.
14.
A close friend you have known for 10 years asks if you will see him/her for counseling.
15.
A former employee you supervised for six weeks at work three years ago asks if you will
see him/her for counseling.
16.
A former employee you supervised for six years at work up until six weeks ago asks if
you will see him/her for counseling.
17.
The son of your second cousin, who lives 500 miles away and whom you have met only
once, asks if you will see him for counseling.
18.
A first cousin you see frequently at family gatherings asks if you will counsel him/her
about a personal problem.
19.
During a counseling session, a client asks you to pray to God with him/her for guidance.
20.
You are seeing a nonpaying counseling client in the agency or school where you work.
He/she is having a very serious financial crisis and asks you for a short-term loan of $10.
21.
A counseling client asks you to call his/her boss and explain that work-related stress is
causing him/her severe emotional distress.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 73
CLIENT INFORMATION AND AGREEMENT
FOR COUNSELORS EMPLOYED IN A SCHOOL
Include a statement similar to the one below in a letter to parents at the beginning of
the year, orientation materials, etc. The statement could be easily modified to be addressed to
students themselves and included in a student handbook.
"I'm Your Child's School Counselor"
The counseling program at _______ ____ school is designed to assist your child make
the most of his or her educational experience. As your child's counselor, I am concerned about
his or her emotional well-being, academic progress, and personal and social development.
I have a master's degree in school counseling from the University of_____________. My
graduate program is accredited by the American Counseling Association's Council for the
Accreditation of Counseling and Related Educational Program (CACREP), the nationally
recognized accrediting agency for counseling graduate programs. I am a National Certified
Counselor (NCC), National Certified School Counselor (NCSC), and a Licensed Professional
Counselor (LPC) in __________. In addition, I am certified as a school counselor by the state of
_________. Before beginning my duties as a counselor at _____ ____ school, I held the
following positions: __________. I currently serve as President of the __________ School
Counselor Association.
1.
2.
3.
etc.
The following specific activities are offered by the counseling program:
Periodic classroom lessons related to positive personal growth and development.
Reasons that I might contact parents regarding their child include, but are not limited to,
the following:
1.
Assistance is needed from parents in specific areas to help their children achieve success
in school.
2.
etc.
Unfortunately, I am not able to provide the following services to your child or to
parents:
1.
Testifying in court in child-custody matters.
2.
Providing intensive long-term counseling services when they are needed by a child.
3.
etc.
Your child will be participating in the school counseling program on a regular basis. In
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 74
the event you have questions about the counseling program, please call me at _____. I
sincerely look forward to working with you in the coming year to help your child have a
successful experience in our school.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 75
CLIENT INFORMATION AND AGREEMENT
FOR COUNSELORS EMPLOYED IN AN AGENCY
___________________ Community Mental Health Center
address
city, state, zip
telephone number
___________________, M.Ed., NCC
Licensed Professional Counselor (LPC)
_____________ Community Mental Health Center will be providing counseling services
to you and I have been assigned as your counselor. This document is designed to inform you
about the services provided by this agency and my background.
______________ Community Mental Health Center offers a variety of services which
include the following: ___________________________. All residents of ________ County are
eligible for services.
I am licensed as a Professional Counselor by the _____________ Board of Examiners for
Licensed Professional Counselors. In addition, I am certified by the National Board of Certified
Counselors, a private certifying agency that recognizes counselors who have distinguished
themselves through meeting the board's standards for education, knowledge, and experience.
I hold a Master’s (M.Ed.) degree in counseling from the University of ____________.
The graduate program I completed is accredited by the Council on Accreditation of Counseling
and Related Educational Programs (CACREP).
I have been a counselor since _____. A counseling relationship between a Professional
Counselor and client is a professional relationship in which the Professional Counselor assists
the client in exploring and resolving difficult life issues. I believe that as people become more
accepting of themselves, they are more capable of finding happiness and contentment in their
lives. Self-awareness and self-acceptance are goals that sometimes take a long time to achieve.
While some clients may need only a few counseling sessions to feel complete, others may
require months or even years of counseling. Clients are in complete control and may end our
counseling relationship at any point and I will be supportive of that decision. If counseling is
successful, clients should feel that they are able to face life's challenges in the future without
my support or intervention.
My counseling services are limited to the scheduled sessions we have together. In the
event you feel your mental health requires emergency attention or if you have an emotional
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 76
crisis, you should report to the emergency room of a local hospital and request mental health
services.
Although our sessions will be very intimate, it is important for you to realize that we
have a professional, rather than a personal, relationship. Our contact will be limited to the paid
session you have with me. Please do not invite me to social gatherings, offer gifts, or ask me to
relate to you in any way outside our counseling sessions. You will be best served if our
relationship stays strictly professional and if our sessions concentrate exclusively on your
concerns. You will learn a great deal about me as we work together during your counseling
experience However, it is important for you to remember that you are experiencing me only in
my professional role.
My counseling practice is limited to adolescents and adults and includes career,
personal, couples, marriage, and group counseling. I also am available for divorce mediation.
I will keep confidential anything you say to me with the following general exceptions:
you direct me to tell someone else, I determine you are a danger to yourself or others, or I am
ordered by a court to disclose information.
In the event you are dissatisfied with my services for any reason, please let me know. If
I am not able to resolve your concerns, you may report your complaints to
____________________, my supervisor here at the _______________ Community Mental
Health Center.
The general fee for services at ________________ Community Mental Health Center is
$75 per session. However, if you apply for a reduction in fees for services based on your
family’s income, you may be eligible for a reduction in fees. If you are granted a reduction in
fees, United Way, a local charitable organization pays the portion of the fees that you cannot
afford. Based on your application for a reduction in fees for services, your fees have been
established at $_____ per session.
Sessions are 50 minutes in duration. It is impossible to guarantee any specific results
regarding your counseling goals. However, I assure you that my services will be rendered in a
professional manner consistent with accepted ethical standards.
The fee for each session will be due and must be paid at the conclusion of each session.
Cash or personal checks are acceptable forms for payment. I will provide you with a monthly
receipt for all fees paid.
In the event you will not be able to keep an appointment, you must notify me 24 hours
in advance. If I do not receive such advance notice, you will be responsible for paying for the
session you missed.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 77
If you are a member of a HMO, PPO, or some type of managed health care plan, I can
tell you if this agency is an authorized provider of services under that plan. If this agency is an
authorized provider, services will be provided to you under the terms of that plan’s contract.
Fees will be billed and collected according to the requirements of that plan. If this agency is not
an authorized provider, you may still receive services from me for a fee, but your plan will not
reimburse you for the cost of any of my services. Plans often will reimburse for only a limited
number of visits per year. If you exceed that limit, you may still receive services from me, but
your plan will not reimburse you for the cost of services that exceed their maximum number of
visits.
___________ Community Mental Health Agency does not participate in any type of
health insurance reimbursement. If you have a health insurance policy that allows reimburses
you for mental health services, it is suggested that you seek a provider who is qualified to
render those services to you. If you receive services from me at this agency, you will be
responsible for the fees for all services received.
If you have any questions, feel free to ask. Please sign and date both copies of this
form. You keep one and give the other copy to me.
________________________________
Your Signature
_____________________________
Your Client’s Signature
________
Date
_________
Date
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 78
CLIENT INFORMATION AND AGREEMENT
FOR COUNSELORS EMPLOYED IN AN AGENCY
WHO ARE COUNSELING INVOLUNTARY CLIENTS
___________________ Community Mental Health Center
address
city, state, zip
telephone number
___________________, M.Ed., NCC
Licensed Professional Counselor (LPC)
_____________ Community Mental Health Center will be providing counseling services
to you and I have been assigned as your counselor. This document is designed to inform you
about the services provided by this agency and my background.
______________ Community Mental Health Center offers a variety of services which
include the following: ___________________________. All residents of ________ County are
eligible for services.
You have been required to obtain counseling sessions from this agency by the judge
who is handling your criminal case. As your counselor, I will be required to report to your
probation officer whether you attended counseling sessions, whether you paid for services
received, and whether I believe that you are benefitting from our counseling sessions. As a
result, you must understand that anything you say to me in counseling may be transmitted to
your probation officer and that I may be required to testify regarding the contents of our
sessions at court proceedings regarding your case.
I am licensed as a Professional Counselor by the _____________ Board of Examiners for
Licensed Professional Counselors. In addition, I am certified by the National Board of Certified
Counselors, a private certifying agency that recognizes counselors who have distinguished
themselves through meeting the board's standards for education, knowledge, and experience.
I hold a Master’s (M.Ed.) degree in counseling from the University of ____________.
The graduate program I completed is accredited by the Council on Accreditation of Counseling
and Related Educational Programs (CACREP).
I have been a counselor since _____. A counseling relationship between a Professional
Counselor and client is a professional relationship in which the Professional Counselor assists
the client in exploring and resolving difficult life issues. I believe that as people become more
accepting of themselves, they are more capable of finding happiness and contentment in their
lives. Self-awareness and self-acceptance are goals that sometimes take a long time to achieve.
While some clients may need only a few counseling sessions to feel complete, others may
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 79
require months or even years of counseling. If counseling is successful, clients should feel that
they are able to face life's challenges in the future without my support or intervention.
My counseling services are limited to the scheduled sessions we have together. In the
event you feel your mental health requires emergency attention or if you have an emotional
crisis, you should report to the emergency room of a local hospital and request mental health
services.
Although our sessions will be very intimate, it is important for you to realize that we
have a professional, rather than a personal, relationship. Our contact will be limited to the paid
session you have with me. Please do not invite me to social gatherings, offer gifts, or ask me to
relate to you in any way outside our counseling sessions. You will be best served if our
relationship stays strictly professional and if our sessions concentrate exclusively on your
concerns. You will learn a great deal about me as we work together during your counseling
experience However, it is important for you to remember that you are experiencing me only in
my professional role.
My counseling practice is limited to adolescents and adults and includes career,
personal, couples, marriage, and group counseling. I also am available for divorce mediation.
In the event you are dissatisfied with my services for any reason, please let me know. If
I am not able to resolve your concerns, you may report your complaints to
____________________, my supervisor here at the _______________ Community Mental
Health Center.
The general fee for services at ________________ Community Mental Health Center is
$75 per session. However, if you apply for a reduction in fees for services based on your
family’s income, you may be eligible for a reduction in fees. If you are granted a reduction in
fees, United Way, a local charitable organization pays the portion of the fees that you cannot
afford. Based on your application for a reduction in fees for services, your fees have been
established at $_____ per session.
Sessions are 50 minutes in duration. It is impossible to guarantee any specific results
regarding your counseling goals. However, I assure you that my services will be rendered in a
professional manner consistent with accepted ethical standards.
The fee for each session will be due and must be paid at the conclusion of each session.
Cash or personal checks are acceptable forms for payment. I will provide you with a monthly
receipt for all fees paid.
In the event you will not be able to keep an appointment, you must notify me 24 hours
in advance. If I do not receive such advance notice, you will be responsible for paying for the
session you missed.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 80
If you are a member of a HMO, PPO, or some type of managed health care plan, I can
tell you if this agency is an authorized provider of services under that plan. If this agency is an
authorized provider, services will be provided to you under the terms of that plan’s contract.
Fees will be billed and collected according to the requirements of that plan. If this agency is not
an authorized provider, you may still receive services from me for a fee, but your plan will not
reimburse you for the cost of any of my services. Plans often will reimburse for only a limited
number of visits per year. If you exceed that limit, you may still receive services from me, but
your plan will not reimburse you for the cost of services that exceed their maximum number of
visits.
___________ Community Mental Health Agency does not participate in any type of
health insurance reimbursement. If you have a health insurance policy that allows reimburses
you for mental health services, it is suggested that you seek a provider who is qualified to
render those services to you. If you receive services from me at this agency, you will be
responsible for the fees for all services received.
If you have any questions, feel free to ask. Please sign and date both copies of this
form. You keep one and give the other copy to me.
________________________________
Your Signature
________
Date
_____________________________
Your Client’s Signature
_________
Date
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 81
CLIENT INFORMATION AND AGREEMENT
FOR COUNSELORS IN PRIVATE PRACTICE
___________________, M.Ed., NCC
Licensed Professional Counselor (LPC)
I am pleased you have chosen me as your counselor. This document is designed to
inform you about my background and to insure that you understand our professional
relationship.
I am licensed as a Professional Counselor by the _____________ Board of Examiners for
Licensed Professional Counselors. Only licensed mental health professionals may provide
counseling services in this state. In addition, I am certified by the National Board of Certified
Counselors, a private certifying agency that recognizes counselors who have distinguished
themselves through meeting the board's standards for education, knowledge, and experience.
I hold a Master’s (M.Ed.) degree in counseling from the University of ____________.
The graduate program I completed is accredited by the Council on Accreditation of Counseling
and Related Educational Programs (CACREP).
I have been a counselor since _____. I provide services for clients in my private practice
who I believe have the capacity to resolve their own problems with my assistance. A counseling
relationship between a Professional Counselor and client is a professional relationship in which
the Professional Counselor assists the client in exploring and resolving difficult life issues. I
believe that as people become more accepting of themselves, they are more capable of finding
happiness and contentment in their lives. Self-awareness and self-acceptance are goals that
sometimes take a long time to achieve. While some clients may need only a few counseling
sessions to feel complete, others may require months or even years of counseling. Clients are
in complete control and may end our counseling relationship at any point and I will be
supportive of that decision. If counseling is successful, clients should feel that they are able to
face life's challenges in the future without my support or intervention.
My counseling services are limited to the scheduled sessions we have together. In the
event you feel your mental health requires emergency attention or if you have an emotional
crisis, you should report to the emergency room of a local hospital and request mental health
services.
Although our sessions will be very intimate, it is important for you to realize that we
have a professional, rather than a personal, relationship. Our contact will be limited to the paid
session you have with me. Please do not invite me to social gatherings, offer gifts, or ask me to
relate to you in any way outside our counseling sessions. You will be best served if our
relationship stays strictly professional and if our sessions concentrate exclusively on your
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 82
concerns. You will learn a great deal about me as we work together during your counseling
experience However, it is important for you to remember that you are experiencing me only in
my professional role.
My counseling practice is limited to adolescents and adults and includes career,
personal, couples, marriage, and group counseling. I also am available for divorce mediation.
I will keep confidential anything you say to me with the following general exceptions:
you direct me to tell someone else, I determine you are a danger to yourself or others, or I am
ordered by a court to disclose information.
In the event you are dissatisfied with my services for any reason, please let me know. If
I am not able to resolve your concerns, you may report your complaints to the State of
_________ Licensed Professional Counselors Board of Examiners, (address, telephone number).
I hold license #_____.
In return for a fee of $____ per session, I agree to provide counseling services for you.
Sessions are 50 minutes in duration. It is impossible to guarantee any specific results regarding
your counseling goals. However, I assure you that my services will be rendered in a
professional manner consistent with accepted ethical standards.
The fee for each session will be due and must be paid at the conclusion of each session.
Cash or personal checks are acceptable forms for payment. I will provide you with a monthly
receipt for all fees paid.
In the event you will not be able to keep an appointment, you must notify me 24 hours
in advance. If I do not receive such advance notice, you will be responsible for paying for the
session you missed.
If you are a member of a HMO, PPO, or some type of managed health care plan, I can
tell you if I am an authorized provider of services under that plan. If I am an authorized
provider, services will be provided to you under the terms of that plan’s contract. Fees will be
billed and collected according to the requirements of that plan. If I am not an authorized
provider, you may still receive services from me for a fee, but your plan will not reimburse you
for the cost of any of my services. Plans often will reimburse for only a limited number of visits
per year. If you exceed that limit, you may still receive services from me, but your plan will not
reimburse you for the cost of services that exceed their maximum number of visits.
If you wish to seek reimbursement for my services from your health insurance company,
I will be happy to complete any necessary forms related to your reimbursement provided by
you or the insurance company. Since you will be paying each session for my services, any later
reimbursement from the insurance company should be sent directly to you. Please do not
assign any payments to me.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 83
Most health insurance companies will reimburse clients for my counseling services, but
some will not. Those that do reimburse usually require that a standard amount be paid by you
before reimbursement is allowed and usually only a percentage of my fee is reimbursable. You
should contact a company representative to determine whether your insurance company will
reimburse you and the schedule of reimbursement that is used.
Health insurance companies usually require that I diagnose your mental condition and
indicate that you have an illness before they will agree to reimburse you. In the event a
diagnosis is required, I will inform you of the diagnosis I plan to render before I submit it to the
health insurance company.
If you have any questions, feel free to ask. Please sign and date both copies of this
form. You keep one and give the other copy to me.
________________________________
Your Signature
_____________________________
Your Client’s Signature
________
Date
_________
Date
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 84
CLIENT INFORMATION AND AGREEMENT
FOR COUNSELORS EMPLOYED IN AN AGENCY
WHEN CLIENT IS A MINOR
___________________ Community Mental Health Center
address
city, state, zip
telephone number
___________________, M.Ed., NCC
Licensed Professional Counselor (LPC)
_____________ Community Mental Health Center will be providing counseling services
to your child and I have been assigned as your child’s counselor. This document is designed to
inform you about the services provided by this agency and my background.
______________ Community Mental Health Center offers a variety of services which
include the following: ___________________________. All residents of ________ County are
eligible for services.
I am licensed as a Professional Counselor by the _____________ Board of Examiners for
Licensed Professional Counselors. In addition, I am certified by the National Board of Certified
Counselors, a private certifying agency that recognizes counselors who have distinguished
themselves through meeting the board's standards for education, knowledge, and experience.
I hold a Master’s (M.Ed.) degree in counseling from the University of ____________.
The graduate program I completed is accredited by the Council on Accreditation of Counseling
and Related Educational Programs (CACREP).
I have been a counselor since _____. A counseling relationship between a Professional
Counselor and client is a professional relationship in which the Professional Counselor assists
the client in exploring and resolving difficult life issues. I believe that as people become more
accepting of themselves, they are more capable of finding happiness and contentment in their
lives. Self-awareness and self-acceptance are goals that sometimes take a long time to achieve.
While some clients may need only a few counseling sessions to feel complete, others may
require months or even years of counseling. The parents or guardians or minor clients are in
complete control and may end the counseling relationship at any point and I will be supportive
of that decision. If counseling is successful, minor clients and their parents and guardians
should feel that they are able to face life's challenges in the future without my support or
intervention.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 85
My counseling services are limited to the scheduled sessions your child and I have
together. In the event you feel your child’s mental health requires emergency attention or if
your child has an emotional crisis, you should report to the emergency room of a local hospital
and request mental health services for your child.
Although my sessions with your child will be very intimate, it is important for you to
realize that your child, you, and I have a professional, rather than a personal, relationship. Our
contact will be limited to the paid session your child has with me. Please do not invite me to
social gatherings, offer gifts, or ask me to relate to you in any way outside our counseling and
consultation sessions. You will be best served if our relationship stays strictly professional and
if our sessions concentrate exclusively on your child’s concerns. You will learn a great deal
about me as we work together during your counseling experience. However, it is important for
you to remember that you are experiencing me only in my professional role.
My counseling practice is limited to adolescents and adults and includes career,
personal, couples, marriage, and group counseling. I also am available for divorce mediation.
I will keep confidential anything you or your child says to me with the following general
exceptions: you direct me to tell someone else, I determine you or your child is a danger to self
or others, or I am ordered by a court to disclose information.
I ask you to trust me to determine whether you need to be informed of anything your
child has disclosed to me in counseling sessions. In the event I believe you need to know
information your child has told to me to protect your child’s health or welfare, I will inform your
child I am going to disclose that information to you and will tell you. It is important for your
child to feel comfortable disclosing personal information to me and I ask that you not ask the
contents of my counseling sessions with your child if I do not offer to disclose such information
to you. I assure you I will let you know any information that may put your child at risk for harm.
In the event you are dissatisfied with my services for any reason, please let me know. If
I am not able to resolve your concerns, you may report your complaints to
____________________, my supervisor here at the _______________ Community Mental
Health Center.
The general fee for services at ________________ Community Mental Health Center is
$75 per session. However, if you apply for a reduction in fees for services based on your
family’s income, you may be eligible for a reduction in fees. If you are granted a reduction in
fees, United Way, a local charitable organization pays the portion of the fees that you cannot
afford. Based on your application for a reduction in fees for services, your fees for counseling
for your child have been established at $_____ per session.
Sessions are 50 minutes in duration. It is impossible to guarantee any specific results
regarding your child’s counseling goals. However, I assure you that my services will be
rendered in a professional manner consistent with accepted ethical standards.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 86
The fee for each session will be due and must be paid at the conclusion of each session.
Cash or personal checks are acceptable forms for payment. I will provide you with a monthly
receipt for all fees paid.
In the event your child will not be able to keep an appointment, you must notify me 24
hours in advance. If I do not receive such advance notice, you will be responsible for paying for
the session your child missed.
If you are a member of a HMO, PPO, or some type of managed health care plan, I can
tell you if this agency is an authorized provider of services under that plan. If this agency is an
authorized provider, services will be provided to your child under the terms of that plan’s
contract. Fees will be billed and collected according to the requirements of that plan. If this
agency is not an authorized provider, your child may still receive services from me for a fee, but
your plan will not reimburse you for the cost of any of my services. Plans often will reimburse
for only a limited number of visits per year. If you exceed that limit, your child may still receive
services from me, but your plan will not reimburse you for the cost of services that exceed their
maximum number of visits.
(if your agency does not accept health insurance reimbursement) ___________ Community
Mental Health Agency does not participate in any type of health insurance reimbursement. If
you have a health insurance policy that allows reimburses you for mental health services, it is
suggested that you seek a provider who is qualified to render those services to you. If you
receive services from me at this agency, you will be responsible for the fees for all services
received.
If you have any questions, feel free to ask. Please sign and date both copies of this
form. You keep one and give the other copy to me.
________________________________
_____________________________
Your Signature
Your Client’s Parent’s or Guardian’s Signature
________
Date
_________
Date
You may also wish to have a similar agreement for your client to read and sign if he/she
has the capacity to understand such a form. In a form for minor clients to sign, you would make
it clear that you will notify the parent or guardian of information told to you in sessions if you
determine it is in the client’s best interest to do so. You would also make it clear the parent or
guardian is responsible for your fees for services.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 87
CLIENT INFORMATION AND AGREEMENT
FOR COUNSELORS WHO EVALUATE INDIVIDUALS
The purpose of our relationship is for me to gather information from you and to
evaluate you so that I will be able to render an opinion regarding the best custody situation for
your minor child. This process will work best if you are cooperative in providing me with the
information I need and if we maintain a professional relationship throughout the evaluation.
Nothing that we discuss will be confidential. I will be required to give a written opinion
to the judge who appointed me to your case. I may use any information in that report that you
give to me during the duration of our relationship. In addition, I may be required to testify
under oath at legal proceedings regarding interactions we have had and opinions I have
rendered.
I guarantee you that I will be fair and unbiased in rendering my opinions in this case.
The best interest of your child will guide my decisions.
In the event you feel I am acting in an unfair or biased manner, please have your
attorney notify the judge who is presiding in this case and request that the judge determine
whether my actions have been unprofessional.
Although I am a Licensed Professional Counselor in this state, I am not serving as your
counselor. In the event you feel a need for counseling, I will be happy to refer you to agencies
or individuals who might be able to assist you.
If you have any questions, feel free to ask. Please sign and date both copies of this
form. You keep one and give the other copy to me.
________________________________
Your Signature
________
Date
___________________________________
Signature of Individual Being Evaluated
_________
Date
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 88
LICENSING AND CERTIFICATION REQUIREMENTS
Who sets requirements?
state
accreditation agencies
agency policies
contracts for services
Who can do what?
scope of practice
Can unlicensed or uncertified persons be hired?
depends on state statutes
if yes, must be under supervision or work directly under licensed professional
What is required for the maintenance of a license or certificate?
periodic renewal fees
current contact information
continuing education
Do those who are licensed or certified have special duties?
check statute
What happens if a formal complaint is filed with a licensure or certification board?
process followed
proper response
legal advice suggested
emotional issues
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 89
PRIVATE PRACTICES
1.
A private practice is a business.
2.
Structure options for private practices.
a.
Sole proprietorship.
b.
Partnership.
c.
Corporation.
d.
Nonprofit corporation.
3.
Business license requirement.
4.
Fees.
a.
b.
c.
d.
Setting them.
Collecting them.
Avoid sliding scales.
Collect as services are rendered.
5.
Attorney and Accountant needed.
6.
Professional liability insurance.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 90
Legal and Ethical Issues
In Marriage and Family Counseling
1.
You have been counseling a couple for two months regarding problems they
have been having in their five-year marital relationship. They have no children. During
the counseling sessions, the wife has admitted she had an affair one year after getting
married. Last week, the husband filed for divorce based on infidelity and he has asked
you to testify at an upcoming hearing. You asked the wife about the situation and she
told you that if you testify, she will file a complaint against you with the licensure board
for violating her privacy. What do you do?
2.
You have been counseling a couple for two months regarding problems they
have been having in their five-year marital relationship. They have two children aged 3
and 1. During the counseling sessions, the wife has admitted she had an affair one year
after getting married. Last week, the husband filed for divorce based on infidelity and
he has asked you to testify at an upcoming child custody hearing. You asked the wife
about the situation and she told you that if you testify, she will file a complaint against
you with the licensure board for violating her privacy. What do you do?
3.
You have been counseling a 6th grader for about six months primarily regarding
issues related to her parents’ separation and upcoming divorce. During the six month
period, you have gotten to know the child’s mother quite well through frequent visits
and consultations. The father lives in another state. The mother has told you many
negative things about the father (excessive alcohol use, extra marital affairs, trouble
holding a job, and some minor domestic violence). The mother is on the telephone.
The says the father has unexpectedly sued for custody of their child and says that her
attorney asked her to ask you to come to court and tell the judge about your work with
her and her child so the judge will know that she should have custody. How do you
respond?
4.
The mother and father of a child you are counseling in your school have joint
custody of the child. You have met with the father a number of times and he has asked
you to counsel his child and you have been counseling the child weekly for the past
three weeks. The mother calls and tells you that you should not see her child again.
How do you respond?
5.
An attorney comes to you office and has a release signed by his client, the
mother of one of the children you counsel, saying that you may disclose any personal
information you have to the attorney. How do you respond?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 91
6.
You have been counseling a family for three sessions. The family includes a wife,
a husband, and the wife’s mother who lives with the couple. At the fourth session, the
father arrives alone and says he wants to talk to you about things he doesn’t want his
mother-in-law to hear. How do you respond?
7.
You are counseling a mother and her 14 year old daughter. The roles appear to
be reversed in the relationship in that the daughter is very responsible and the mother
is irresponsible. The mother does little housework, often misses work, and seldom
cooks meals. You are thinking about doing a paradoxical intervention in which you will
suggest to the daughter that perhaps she needs to be more responsible than she has
been in the past. That perhaps she should look for a part-time job, cook dinner more
often, do more of the housework, etc. What ethical issues might be raised in using such
an intervention?
8.
You are counseling a gay male couple and they are very upset that Virginia does
not allow or recognize gay marriages. The couple is thinking about suing the state on
the grounds that the Virginia constitution says that all citizens should be treated equally.
The couple wants to know if you know a lawyer they can talk to and wants your advice
about filing a law suit. How do you respond?
9.
You are counseling a 15 year old girl whose parents are paying for her counseling
sessions. The girl asks you in the first session if you plan to tell her parents everything
she tells you in the sessions. How do you respond?
10.
You are counseling a woman who was a former victim of domestic violence, but,
after living in a shelter for a month, she is now living alone and has ended her abusive
relationship with her former boyfriend. Your client tells you a horrible story about
witnessing a friend of hers being beaten, choked, and burned with a cigarette by her
former husband. The incident took place in your client’s home the night before. Your
client did not tell anyone other than you what she saw because she is afraid of her
friend’s ex-husband. What legal, ethical, or moral responsibilities do you have to your
client’s friend?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
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Secrets in Family Counseling:
Differences in Ethical Standards
American Association for Marriage and Family Therapy Code of Ethics
Effective July 1, 2001
Section 2.2
In the context of couple, family or group treatment, the therapist may not reveal any
individual’s confidences to others in the client unit without the prior written permission of that
individual.
American Counseling Association Code of Ethics
(2005)
B.4.b. Couples and Family
Counseling
In couples and family counseling, counselors clearly define who is considered “the client” and
discuss expectations and limitations of confidentiality. Counselors seek agreement and
document in writing such agreement among all involved parties having capacity to give consent
concerning each individual’s right to confidentiality and any obligation to preserve the
confidentiality of information known.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 93
CASE STUDIES
Counseling Parties Involved
in a Child Custody Dispute
One
You are a licensed mental health professional. You have been counseling Cathy, a young
woman who is 23 years old, who was mandated by a criminal court judge to receive counseling
for one year after she was arrested for stealing money from a retail store where she was
employed. You have counseled Cathy for 16 sessions over a four month period.
Cathy told you that she had never stolen anything in her life. However, she had begun
taking money from the store cash register, usually taking $20 to $30 at a time. She had stolen
about $200 when she was caught. She admitted she had taken the money and pled guilty to
the crime of stealing. She says she was very embarrassed about what happened and would
never, ever steal anything again. She had never been arrested before or gotten into any serious
trouble, so the judge told her he would expunge her criminal record if she would attend
counseling for a year and get a positive report from the counselor at the end of that period of
time.
Cathy has a four year old son, Carl. She was never married, but lived with Carl’s father,
Jim, for about six months prior to Carl being born. Just three weeks before Carl was born, Cathy
and Jim had an argument about their mutual finances and Jim moved out of a small apartment
they were sharing and Cathy moved back home with her parents.
Cathy’s parents have provided meals and housing for her son since he was born and do
most of the child care for her son. Both of her parents work, but they take her son to and from
day care and stay with him when Cathy is not at home.
Jim acknowledged being Carl’s father. Cathy’s parents paid for a lawyer to draw up child
support and custody papers, which Jim agreed to sign voluntarily. He provides $500 a month
for child support and has visitation rights with Carl from Friday night until Sunday night each
weekend. So far, Jim has paid child support regularly and spends most weekends with Carl.
Occasionally, Jim takes Carl during the week with Cathy’s agreement and sometimes Carl will
stay home with Cathy over a weekend, with Jim’s agreement. Jim and Cathy are generally civil
to each other, but occasionally argue about issues such as pick-up and drop-off times for Carl,
Carl’s clothing, and Carl’s behavior. Cathy has reported to you that Jim has a quick temper and
lashes out at her and Carl frequently. She has suspected that Jim is a harsh disciplinarian with
Carl, but has no evidence of that.
Although her parents disapprove, Cathy occasionally spanks Carl when he misbehaves.
In the past, she has used a belt to his him across his buttocks and legs when disciplining him.
On one occasion, about a year ago, a social worker visited Cathy at her home because the day
care center workers where Carl goes each day reported that he had belt marks on his legs.
Cathy admitted she had hit him with a belt and agreed not to do so again. Cathy enrolled in a
four week child management parenting class suggested by the social worker. She reported that
she learned more effective positive reward approaches to managing Carl’s behavior in that class
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 94
and has not spanked him since.
Cathy has held a series of full and part-time jobs, mostly in fast food chain restaurants
and retail stores, but has kept jobs for only short periods of time, usually three to six months.
She either quits because she doesn’t like the work or is fired because of too many absences or
unacceptable work performance. Cathy is very interested in her appearance and has recently
enrolled in a yearlong training program in cosmetology and will be a licensed hairdresser when
she completes the program in about 10 months. For the two months she has been in the
program, she has not missed a day of classes and has received praise and encouragement from
her teachers because of her superior performance and positive attitude.
Cathy has disclosed to you that she is concerned that she drinks too much, but she does
not feel she is addicted to alcohol. She drinks heavily on weekends when she goes out on dates
and occasionally drinks during the week when she goes to bars with friends. Cathy set goals for
herself to drink heavily less often on weekends and to not drink at all during the week. For the
past two months, she has met those goals.
Cathy told you that she has had sexual relationships with a number of her boyfriends
and the men she has dated since her live-in relationship with Jim ended. Some relationships
have lasted months at a time, but she has not considered moving in with or marrying any of her
boyfriends for the past three years. Cathy has told you that she believes she becomes sexually
intimate too quickly with men. She set a goal for herself to avoid having sex with men she
dates until after she gone out with a man for at least five times. Since setting that goal three
months ago, Cathy has done well and currently is having a sexual relationship with a man she
has dated seven or eight times.
You are pleased with Cathy’s progress in counseling. She has been consistent in
attending sessions and has missed only one due to her son’s illness. The goals she has set in
counseling have led to a number of positive changes in her life and she is making excellent
progress toward becoming more responsible as an adult. You have grown fond of Cathy and
have hope that she will develop into a good parent and an employed self-sufficient adult.
Cathy has an engaging personality, and, during the time you have been counseling her, has
become less self-absorbed and more self-aware.
Cathy told you that Jim got married a few months ago. In the past year, Jim has
completed a bachelor’s degree in engineering while working full-time in a construction
company. He has taken a new job as an engineer at a good salary. His wife has a two-year old
daughter from a previous marriage and they will be raising the child in their home. Jim’s wife is
a school teacher. Then have bought a home together in a suburban community.
In her last session, Cathy tells you that Jim has filed a petition to obtain full-time custody
of Carl, which would leave Cathy with week-end visitation rights. Cathy was hysterical about
the prospect of losing custody of Carl. Cathy told you she has hired an attorney to represent
her in this custody situation. She told her attorney she had been seeing you for counseling and
had been making good progress. Her attorney asked her to ask you if you would be willing to
come to court and give information to the judge about her counseling experiences and her
positive progress.
You want to help Cathy if you can. You weren’t sure whether you should agree to her
attorney’s request, so you called a professor you had in your graduate degree program. Your
professor told you he did not see any reason you shouldn’t agree to help your client out this
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 95
way. There is not confidentiality issue because your client is asking you to give private
information to a judge. You talked it over with a former clinical supervision you had while you
were working toward licensure and she told you she has testified in similar situations before
and thought you should agree to help Cathy out.
You tell Cathy that although it makes you a bit nervous to go to court and testify that
you are willing to do so in an effort to help her.
TWO
You have been providing marriage counseling services for the past month (four sessions)
to John and Julie, a couple who has been married for 12 years. They own their own home, a
vacation home, and have substantial savings. John is a banking executive and Julie is a
housewife.
During the counseling sessions, John disclosed to Julie, in your presence, that he had
had a sexual affair with a co-worker from his office five years ago that lasted for six months.
Also, during a counseling session, Julie told you that John had fondled her teenage
daughter from a previous marriage while the daughter was going to high school and living with
him. John admitted he had fondled the girl, but said that he had been drinking too much and
that the girl had initiated the contact and later admitted to her mother that she had “seduced”
John.
Julie called you last week and told you she has filed for divorce from John, so they will
not be returning for counseling. Julie said to you that her attorney intends to subpoena you
and your records regarding their counseling because her attorney wants the judge to know
about John’s affair and his inappropriate sexual activity with his step-daughter. The next day,
John calls and tells you that Julie has filed for divorce and he wants to make sure you will
maintain your promise you made to them when counseling began that you would keep
confidential what they told you in the marriage counseling sessions.
What do you do?
THREE
You have been a couples and marriage counselor for 10 years. Recently, one of your
former clients called. You had seen her and husband for marriage counseling for about three
sessions prior to the husband filing for divorce. The wife asks you if you will agree to be
appointed by a court to be a child custody evaluator related to their divorce. You have had
some training in child custody evaluation and have considered doing that in the future.
How do you respond?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 96
School Counselor
Counseling Children of Divorce
Scenarios
ONE
You have been counseling a 6th grader for about six months primarily regarding issues
related to her parents’ separation and upcoming divorce. During the six month period, you
have gotten to know the child’s mother quite well through frequent visits and consultations.
The father lives in another state. The mother has told you many negative things about the
father (excessive alcohol use, extra marital affairs, trouble holding a job, and some minor
domestic violence). The mother is on the telephone. The says the father has unexpectedly
sued for custody of their child and says that her attorney asked her to ask you to come to court
and tell the judge about your work with her and her child so the judge will know that she
should have custody. How do you respond?
TWO
You explained to the father of a child you have counseled over the past two years that
you are unwilling to become involved in child custody disputes and that you will not go to court
on his behalf. Today, you received a subpoena from the father’s attorney stating that you must
attend a deposition related to the child custody law suit. What do you do?
THREE
A father you have not met before shows up at the school in which you are the counselor
for his two children. The mother has given you a copy of the child custody decree which says
she has physical custody of the children and the father has visitation rights. The father
demands to see his child’s academic and counseling records and he says that his attorney told
him he has a right to those records even though his wife has physical custody of the children.
How do you respond?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 97
FOUR
The mother and father of a child you are counseling in your school have joint custody of
the child. You have met with the father a number of times and he has asked you to counsel his
child and you have been counseling the child weekly for the past three weeks. The mother calls
and tells you that you should not see her child again. How do you respond?
FIVE
The stepmother of a child you have counseled in the past comes to your office and asks
you to summarize the counseling sessions you have had with her stepson. How do you
respond?
SIX
The principal brings a child to your office. The principal explains that the child’s mother
is in the office waiting to pick the child up to take her home for the weekend because they
mother has weekend visitation rights. The child is saying that her father told her not to go with
the mother, but instead to wait at the school until he picks her up. What do you say to the
principal?
SEVEN
An attorney comes to you office and has a release signed by his client, the mother of
one of the children you counsel, saying that you may disclose any personal information you
have to the attorney. How do you respond?
EIGHT
After you have been sworn in at a deposition, and after an attorney has asked you a
number of factual questions, which you have answered, the attorney asks the following
question, “Given what you know about the children of this marriage, and given what you know
about the father and the mother, would you have any concerns about either of them being
given sole custody of these children?” How do you respond?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 98
NINE
A teacher brings a child to your office on Monday morning. You know the child from a
number of past counseling sessions. The teacher says that the child told her that his father hit
him in the face on Sunday and you can see two cuts in the child’s face that look recent. You
know the mother since she has consulted with you about her child on a number of occasions.
You know that the parents are involved in a contentious divorce and child custody law suit. You
know that the child sometimes spends weekends with his father, but in the past, has said his
father is very stern and unreasonable in his discipline of the child. How do you proceed?
TEN
A child custody evaluator, who is a Licensed Professional Counselor (LPC) you know,
shows up in your office. The LPC has an order signed by a judge saying that she is to complete a
child custody evaluation and signed releases from both the father and mother saying that
anyone may disclose any information they have to the evaluator. How do you react to the LPC
who says she needs to ask you for detailed information about your counseling of the children
and your interactions with the two parents?
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 99
School Counselor
Counseling Children of Divorce
Scenario Answers
ONE
You tell the mother that you understand how stressful this is for her. You explain that
you cannot agree to go to court to help her for a number of reasons including:
 Your job is to provide counseling services; not to serve as an advocate in legal
proceedings.
 You are biased in favor of your clients and therefore could not provide objective
testimony.
 The factual information you might provide to a judge or jury might not always be
in your client’s best interests.
 You cannot take time away from your job or practice to attend court
proceedings.
 You have limited information about your client’s situation. You know only what
others have told you. You have little, if any, firsthand knowledge of your client’s
situation.
TWO
You take the subpoena to your principal. You explain to the principal that you do not
believe it is appropriate for you to be involved in this child custody litigation. You ask the
principal to see if the school board attorney can assist you. Tell the principal that you would
like for the school board attorney to get the subpoena withdrawn, if possible, and if not, you
would like the attorney’s advice on how to deal with this situation.
THREE
You take the father to the principal’s office and ask the principal to respond to the
father’s request. In most states, the father will have a right to the child’s academic record, but
not to counseling records. The principal has 15 days under FERPA to produce the records if the
father does have a right to them.
FOUR
You tell the mother that you will notify the father that she has called and does not want
you to continue counseling the child and you will discontinue the counseling at this point.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 100
FIVE
You thank the stepmother for her concern and interest in her stepchild. You explain
that the father will have to sign documents releasing information to her before you would be
able to give her any information.
SIX
You explain to the principal that you will be happy to counsel the child regarding her
feelings at this moment, but that he will have to deal with the mother because she may or may
not have legal rights to pick up the child and the principal needs to get legal advice, if
necessary, to determine how to proceed with the mother.
SEVEN
After clearing the situation with your principal, you answer questions the attorney has,
being careful how you word your responses and showing no bias. You give no opinions, only
facts. If you feel threatened or uncomfortable, you tell the attorney that you will have to
schedule another time to talk with him/her when your principal or the school board attorney is
present.
EIGHT
Since you are a fact witness and an attorney asks you an opinion question, answer
simply, “I do not have enough information to form a professional opinion about that.” Stick to
that response. Refuse to give an opinion, unless a judge orders you to do otherwise.
NINE
You or the teacher (depending on state statutory language and your school’s
procedures) make an immediate report of suspected child abuse. You then notify the mother
of what happened, being as factual and unbiased as possible.
TEN
After clearing the situation with your principal, you answer questions the LPC has, being
careful how you word your responses and showing no bias. You give no opinions, only facts. If
you feel threatened or uncomfortable, you tell the LPC that you will have to schedule another
time to talk with him/her when your principal or the school board attorney is present.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 101
Suggested Practices
to Avoid Court Appearances
when Counseling Children or Families
of Divorce
These guidelines are relevant when counseling any individuals who are children or
who have custody of children, or might seek custody of children.
2. Avoid court and legal proceedings unless you have agreed to conduct a child custody
evaluation.
 Counselors and other mental health professionals are often abused when they
become involved in legal proceedings.
 As a witness who is biased in favor of your clients, you are not the kind of
objective witness courts are seeking to give them advice.
 Court proceedings can take you away from your job or your practice for
extended periods of time. You are legally entitled to little or no pay for testifying
in court as a fact witness.
 If you are counseling a child and become involved in a custody dispute, you often
will lose any relationship you might have had with one or both parents.
 Legal proceedings are complex and you can easily make mistakes or become
embarrassed if you do not know how to conduct yourself.
3. If you are asked by a client to come to court voluntarily related to their child custody
dispute, decline giving the following reasons:
 Your job is to provide counseling services; not to serve as an advocate in legal
proceedings.
 You are biased in favor of your clients and therefore could not provide objective
testimony.
 The factual information you might provide to a judge or jury might not always be
in your client’s best interests.
 You cannot take time away from your job or practice to attend court
proceedings.
 You have limited information about your client’s situation. You know only what
others have told you. You have little, if any, firsthand knowledge of your client’s
situation.
4. If you receive a subpoena to appear at a legal proceeding or to produce records, consult
with an attorney (see guidelines for responding to subpoenas and for consulting with
attorneys).
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 102
5. If you do end up in court as a fact witness, answer all factual questions with short
answers and do not offer information not specifically requested.
6. If you are a fact witness and an attorney asks you an opinion question, answer simply, “I
do not have enough information to form a professional opinion about that.” Stick to
that response. Refuse to give an opinion, unless a judge orders you to do otherwise.
7. Focus on your counseling relationships with your clients and avoid taking sides in legal
controversies.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 103
Ethical Standards and Guidelines
Related to Counseling Families of Divorce
and Conducting Child Custody Evaluations
Model Standards of Practice
for Child Custody Evaluation
Association of Family and Conciliation Courts
May, 2006
Located at
http://www.afccnet.org/pdfs/Model%20Stds%20Child%20Custody%20Eval%20Sept%202006.p
df
Retrieved September 30, 2006
These model standards of practice are not binding. They were developed with the goal
of getting states to adopt them and make them law.
§ P.1.b. states that evaluators shall take reasonable steps to secure court orders or
consent agreements appointing them to conduct a child custody evaluation. These orders or
agreements should clearly define the purposes and focus of the evaluation.
§ P.3.b. says that evaluators should decline appointment if they have ethical concerns.
If they decline an appointment, evaluators must give written notice to courts and attorneys
involved in the case.
§ 1.1. states that child custody evaluators must gain specialized knowledge and training
related to conducting child custody evaluations.
§ 1.2.a. says, “Child custody evaluators shall have a minimum of a master’s degree (or
its regionally-recognized equivalent) in a mental health field that includes formal education and
training in child development, child and adult psychopathology, interviewing techniques, and
family systems. In addition, by formal education or by supervised work experience, evaluators
shall possess advanced knowledge of the
complexities of the divorce or separation process, a working knowledge of the legal issues in
divorce or separation in their jurisdictions of practice, knowledge of the sources of evaluator
bias and methods for maintaining neutrality, and an understanding of the many issues—legal,
social, familial, and cultural—involved in custody and access.”
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 104
§ 1.2.b. states, “Areas of expected training for all child custody evaluators include:
(1) the psychological and developmental needs of children, especially as those needs
relate to decisions about child custody and access;
(2) family dynamics, including, but not limited to, parent-child relationships, blended
families, and extended family relationships;
(3) the effects of separation, divorce, domestic violence, substance abuse, child alienation, child
maltreatment including child sexual abuse, the effects of relocation, sexual orientation issues,
and inter-parental conflict on the psychological and developmental needs of children,
adolescents, and adults;
(4) the significance of culture and religion in the lives of parties;
(5) safety issues that may arise during the evaluation process and their potential effects on
all participants in the evaluation;
(6) when and how to interview or assess adults, infants, and children;
(7) how to gather information from collateral sources;
(8) how to collect and assess relevant data and recognize the limits of the reliability and
validity of different sources of data;
(9) how to address issues such as general mental health, medication use, and learning or
physical disabilities;
(10) how to apply comparable interview, assessment, and testing procedures that meet
generally accepted forensic standards to all parties;
(11) when to consult with or involve additional experts or other appropriate persons;
(12) how to inform litigants, children, other participants, and collateral sources, of the
purpose, nature, and method of the evaluation and the limits of confidentiality;
(13) how to assess parenting capacity and co-parenting capacity and to construct effective
parenting and co-parenting plans;
(14) the legal context within which child custody and access issues are decided and
additional legal and ethical standards to consider when serving as a child custody
evaluator;
(15) how to make the relevant distinctions among the roles of evaluator, mediator, therapist,
parenting coordinator, and co-parenting counselor;
(16) how to write reports for the courts to which they will be presented;
(17) how to prepare for and give testimony at deposition or at trial; and,
(18) how to maintain professional neutrality and objectivity when conducting child custody
evaluations.
§ 1.2.c. states, “Areas of additional specialized training include:
(1) the assessment of allegations of child sexual abuse issues;
(2) the assessment of children’s resistance to spending time with a parent or parent figure
and allegations of attempts to alienate children from a parent, parent figure, or
significant other;
(3) the assessment of children’s best interests in the context of relocation (move-away)
requests by one parent;
(4) the assessment of substance abuse; and,
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 105
(5) the assessment of child abuse and domestic violence and the assessment of safety
plans for both parents and children.”
§ 1.3. says that evaluators with less than two years of experience are encouraged to
practice under supervision of more experienced evaluators and to seek consultation.
§ 2.1.a. states that evaluators will be familiar with laws related to child custody in the
jurisdictions in which they practice.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
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Guidelines for Child Custody Evaluations
in Divorce Proceedings
American Psychological Association
February, 1994
Located at http://www.apa.org/practice/childcustody.html
Retrieved September 30, 2006
These guidelines were developed to assist psychologists who conduct child custody
evaluations. The guidelines are characterized as aspirational in intent. This disclaimer is
published with the guidelines, “As guidelines, they are not intended to be either mandatory or
exhaustive. The goal of the guidelines is to promote proficiency in using psychological expertise
in conducting child custody evaluations.”
The introduction to the guidelines points out that 90% of divorcing parents agree to
child custody arrangements. In cases where agreement cannot be reached, judges apply a
“best interest of the child” standard to determine the decision making authority and physical
contact each parent will have with a child. Child custody evaluators help judges assess the best
interests of children by providing objective information.
Listed below is a summary of selected sections from the guidelines:
§ I.3. states that the focus of an evaluation is “on the parenting capacity of the
prospective custodians in conjunction with the psychological and developmental needs of each
involved child.” This section also states that “an evaluation of the interaction between each
adult and child” is a part of an evaluation. This section says that “Psychopathology may be
relevant to such an assessment, in so far as it has impact on the child or the ability to parent,
but it is not the primary focus.”
§ II.4. suggests that child custody evaluators may be retained either by a court or by one
of the individuals seeking custody. If evaluators are retained by one of the individuals seeking
custody, those individuals must accept the neutral role of the evaluator. This section states, “If
either the psychologist or the client cannot accept this neutral role, the psychologist should
consider withdrawing from the case. If not permitted to withdraw, in such circumstances, the
psychologist acknowledges past roles and other factors which could affect impartiality.”
§ II.5.A. says that evaluators acknowledge that “special competencies and knowledge
are required.” This section suggests that evaluators should be competent to conduct
psychological assessments of children, adults, and families. In addition, evaluators should have
“Education, training, experience, and/or supervision in the areas of child and family
development, child and family psychopathology, and the impact of divorce on children…” This
section also says that evaluators should strive to become familiar with state laws and
procedures governing divorce and custody adjudications.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 107
§ II.5.C. says that if allegations of child abuse, neglect, family violence, or other related
issues come up and evaluators do not have expertise in those areas, evaluators should seek
consultation from those who do have such expertise.
§ II.6. states that an evaluators recognize and strives to overcome biases they have
regarding age, gender, race, ethnicity, national origin, religion, sexual orientation, disability,
language, culture, and socioeconomic status. If evaluators cannot overcome such biases, then
they are advised to withdraw from the evaluation.
§ II.7. addresses the need for evaluators to avoid multiple relationships. This section
says that psychologists “generally avoid” agreeing to serve evaluators in situations where they
have counseled children or family members or have had other involvement with the family that
could compromise their objectivity. This section says that evaluators, during the course of an
evaluation, do not accept any evaluation participants as counseling clients, and should only
accept participants as counseling clients after an evaluation has concluded “with caution.” This
section that if a judge requires a psychologist who is counseling a client to testify regarding that
client in a child custody case, the psychologist should testify only as a fact witness regarding
factual information he or she became aware of in a professional relationship with the client,”
and should “generally decline the role of an expert witness who gives a professional opinion
regarding custody and visitation issues,” unless the psychologist is ordered by a judge to give an
opinion. This section says that psychologists who are asked to testify in child custody matters
(presumably by counseling clients or their attorneys) are “aware of the limitations and possible
biases inherent in such a role, and possible impact on the ongoing therapeutic relationship.”
§ III.8. states that the scope of the evaluation is dependent upon the nature of the
question or issue raised by the referring person or the court. This section says that child
custody evaluations that are comprehensive “generally require an evaluation of all parents or
guardians and children, as well as observations of interactions between them.” However, this
section says that it is appropriate in some cases to evaluate the parenting capacity of one
parent without attempting to compare parents. In addition, evaluators might be asked to
evaluate a child, “critique the assumptions and methodology of the assessment of another
mental health professional,” or provide information on child development without relating the
information to the parties involved in a particular case.
§ III.9. says the informed consent of child custody evaluation participants must be
obtained. This section says each adult participant is told “1) the purpose, nature, and method
of the evaluation; 2) who has requested the psychologists’ services; and 3) who will be paying
the fees.” In adult participants is informed “about the nature of the assessment instruments
and techniques,” and “about the possible disposition of the data collected.” This section also
says, “The psychologist provides this information, as appropriate, to children, to the extent that
they are able to understand.”
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 108
§ III.10. says that evaluators inform child custody evaluation participants that “they are
consenting to the disclosure of the evaluation’s findings in the context of forthcoming litigation,
and any other proceedings deemed necessary by the courts.” This sections confidentiality
waivers are obtained from all adult participants or from the authorized legal representatives of
adult participants. This section says that children are told they are waiving their privacy as well,
to the extent feasible.
§ III.11. says that evaluators generally use multiple methods of data gathering,
“including, but not limited to, clinical interviews, observation and/or psychologist assessments.”
This section states, “Important facts and opinions are documented from at least two sources
whenever their reliability is questionable.” This section enumerates that evaluators may review
reports from schools, health care providers, child care providers, agencies, and institutions, and
may interview extended family, friends, and other individuals.
§ III.12. This section cautions evaluators to avoid inappropriate interpretations of data.
This section says, “The psychologist refrains from drawing conclusions not adequately
supported by the data. The psychologist interprets any data from interviews or tests, as well as
any questions of data reliability and validity, cautiously and conservatively, seeking convergent
validity. The psychologist strives to acknowledge to the court any limitations in methods or
data used.”
§ III.13. This section states that evaluators do not given opinions regarding the
psychological functioning of any individual who has not been personally evaluated. This
sections also says, “The guideline, however, does not preclude the psychologist from reporting
what an evaluated individual (such as the parent or child) has stated, or from addressing
theoretical issues or hypothetical questions, so long as the limited basis of the information is
noted.”
§ III.14. This section states, “the profession has not reached consensus about whether
psychologists ought to make recommendations about the final custody determination to the
courts…” This section also says, “If the psychologist does choose to make custody
recommendations, they should be derived from sound psychological data, and must be based
upon the best interests of the child, in the particular case. Recommendations are based on
articulated assumptions, data, interpretations, and inferences based upon established
professional and scientific standards. Psychologists guard against relying upon their own biases
or unsupported beliefs in rendering opinions in particular cases.”
§ III.15. says that evaluators do not misrepresent the nature of their services when
billing for child custody evaluations.
§ III.16. states that records “obtained in the process of conducting a child custody
evaluation are properly maintained and filed in accord with the APA Record Keeping Guidelines
(APA, 1993) and relevant statutory guidelines.” This section states that evaluators provide
reports to courts upon request.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 109
The Specialty Guidelines for Forensic Psychologists
Joint Statement of
American Psychology-Law Society
and Division 41 of the American Psychological Association
(not an official statement of the American Psychological Association)
Endorsed by
American Academy of Forensic Psychology
1991
Located at http://www.apls.org/links/currentforensicguidelines.pdf#search=%22Committee%20on%20Ethical%20Guideli
nes%20for%20Forensic%20Psychologists%22
Retrieved September 30, 2006
The introduction to the guidelines states that they are intended to be consistent with
the Ethical Principles of Psychologists published by the American Psychological Association.
These guidelines “represent an aspirational model of desirable professional practice by
psychologists . . . when they are engaged regularly as experts and represent themselves as
such, in an activity primarily intended to provide professional psychological expertise to the
judicial system.”
§ III.A. says that forensic psychologists “provide services only in areas of psychology in
which they have specialized knowledge, skill, experience, and education.”
§ III.E. states, “Forensic psychologists recognize that their own personal values, moral
beliefs, or personal and professional relationships with parties to a legal proceeding may
interfere with their ability to practice competently. Under such circumstances, forensic
psychologists are obligated to decline participation or to limit their assistance in a manner
consistent with professional obligations.”
§ IV.D.2. This section states, “When it is necessary to provide both evaluation and
treatment services to a party in a legal proceeding (as may be the case in small forensic hospital
settings or small communities), the forensic psychologist takes reasonable steps to minimize
the potential negative effects of these circumstances on the rights of the party, confidentiality,
and the process of treatment and evaluation.”
§ VI.F.1. This section says, “While many forms of data used by forensic psychologists are
hearsay, forensic psychologists attempt to corroborate critical data that form the basis for their
professional product. When using hearsay data that have not been corroborated, but are
nevertheless utilized, forensic psychologists have an affirmative responsibility to acknowledge
the uncorroborated status of those data and the reasons for relying upon such data.”
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 110
§ VI.H. This section states, “Forensic psychologists avoid giving written or oral evidence
about the psychological characteristics of particular individuals when they have not had an
opportunity to conduct an examination of the individual adequate to the scope of the
statements, opinions, or conclusions to be issued.”
§ VII.D. This section says, “When testifying, forensic psychologists have an obligation to
all parties to a legal proceeding to present their findings, conclusions, evidence, or other
professional products in a fair manner. This principle does not preclude forceful representation
of the data and reasoning upon which a conclusion or professional product is based. It does,
however, preclude an attempt, whether active or passive, to engage in partisan distortion or
misrepresentation. Forensic psychologists do not, by either commission or omission, participate
in a misrepresentation of their evidence, nor do they participate in partisan attempts to avoid,
deny, or subvert the presentation of evidence contrary to their own position.”
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 111
Books and Journal Articles
Related to Conducting Child Custody Evaluations
Ackerman, M. J. (1994). American Psychological Association Guidelines for Child Custody
Evaluations in Divorce Proceedings. American Journal of Family Law, 8, 129-134.
Ackerman, M. J. (2006). Clinician’s guide to child custody evaluations (3rd ed.). Hoboken, NJ:
John Wiley & Sons.
Ackerman, M. J., & Ackerman, M. C. (1997). Custody evaluation practices: A survey of
experienced professionals (revisited). Professional Psychology: Research and Practice,
28, 137-145.
Ackerman, M. J., & Ackerman, M. C. (1999). Custody evaluation practices: A survey of
experienced professionals (revisited): Notice of clarification to Ackerman and Ackerman
(1997) article. Professional Psychology: Research and Practice, 30, 599.
Ash, P., & Guyer, M. (1986). The functions of psychiatric evaluations in contested child custody
and visitation cases. Journal of American Academy of Child Psychiatry, 25, 554-561.
Association of Family and Conciliation Courts. (1994). Model standards of child custody
evaluations. Madison, WI: Author.
Azar, S. T., & Cote. L. R. (2002). Sociocultural issues in the evaluation of the needs of children
in custody decision making: What do our current frameworks for evaluating parenting
practices have to offer? International Journal of Law and Psychiatry, 25, 195-217.
Benjamin, G. A., & Gollan, J. K. (2003). Family evaluation in custody litigation: Reducing risks of
ethical infractions and malpractice. Washington, DC: American Psychological
Association.
Bow, J. H., & Quinnel, F. A. (2001). Psychologists’ current practices and procedures in child
custody evaluations: Five years after American Psychological Association Guidelines.
Professional Psychology: Research and Practice, 32, 261-268.
Deed, C. (1991). Court-ordered child custody evaluations: Helping or victimizing vulnerable
families? Psychotherapy, 28, 76-84.
Emery, R. E. (2001). Changing the rules for determining child custody in divorce cases. Clinical
Psychology: Science and Practice, 6, 323-327.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 112
Gindes, M. (1995). Competence and training in child custody evaluations. American Journal of
Family Therapy, 23, 273-280.
Glassman, J. B. (1998). Preventing and managing board complaints: The downside risk of
custody evaluation. Professional Psychology: Research and Practice, 29, 121-124.
Gould, J. W. (1998). Conducting scientifically crafted child custody evaluations. Thousand
Oaks, CA: Sage.
Halon, R. (2000). The comprehensive child custody evaluation, ten years later. University of
Arkansas Little Rock Review, 481, 491.
Hysjulien, C., Wood, B., & Benjamin, G. A. H. (1994). Child custody evaluations: A review of
methods used in litigation and alternative dispute resolution. Family and Conciliation
Courts Review, 32, 466-489.
Kirkland, K., & Kirkland, K. (2001). Frequency of child custody evaluation complaints and
related disciplinary action: A survey of the Association of State and Provincial
Psychology Boards. Professional Psychology: Research and Practice, 32, 171-174.
Schutz, B. M., Dixon, E. B., Lindenberger, J. C., & Ruther, N. J. (1989). Solomon’s sword: A
practical guide to conducting child custody evaluations. San Francisco: Jossey-Bass.
Stahl, P. M. (1994). Conducting child custody evaluations: A comprehensive guide. Thousand
Oaks, CA: Sage Publications.
Weissman. H. N. (1991). Child custody evaluations: Fair and unfair professional practices.
Behavioral Sciences and the Law, 9, 469-476.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 113
Relationships with Attorneys for the Parties
when You are Conducting
Child Custody Evaluations
Suggestions 5-9 below are taken from Conducting Child Custody Evaluations: A
Comprehensive Guide, by Philip Michael Stahl, published in 1994 by Sage Publications,
Thousand Oaks, California.
Suggestions 10 and 11 are taken from Family Evaluation in Custody Litigation: Reducing
Risks of Ethical Infractions and Malpractice, by G. Andrew H. Benjamin and Jackie K. Gollan,
published in 2003 by the American Psychological Association, Washington, D.C.
1. If you are retained by an attorney for one of the parties to conduct a child custody
evaluation, request that the attorney obtain an order from the court appointing you to
do the evaluation. This may not be possible in some jurisdictions, but you should
request a court appointment. A stipulated agreement signed by both attorneys for you
to conduct a child custody evaluation would be a good alternative if a court order is not
possible.
2. Avoid collecting excessive information from either attorney for the parties prior to
conducting your evaluation (to avoid becoming biased from information given to you by
attorneys).
3. Ensure that the attorney or judge who is contracting with you to perform a child custody
evaluation understands your fee schedule and expectations for payment. In the event a
party to the case is required to pay for the evaluation and fails to do so, inform the
judge of the nonpayment if you have been appointed by the court, or notify the
attorney for the party if you were not appointed by the court.
4. Be clear and firm with attorneys regarding your professional and ethical standards
regarding conducting child custody evaluations.
5. Try to develop a relationship with attorneys in which the attorneys and you are working
toward the same goal, which is the development of a greater understanding of the
family for the purpose of meeting children’s needs.
6. If an attorney wants to talk extensively during a child custody evaluation, either request
that the attorney put the information he or she is providing in writing and explain the
document will be provided to the other attorney, or request a three-way conversation
in which the other attorney is present.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 114
7. If anyone requests a referral to a counselor or mediator, provide your recommendations
in writing to the attorneys of both parties.
8. Join organizations that promote understanding between attorneys and mental health
professionals, such as the Association of Family and Conciliation Courts (AFCC).
9. Do your best to develop a clear understanding of the role lawyers in litigation, rules of
courts in which you practice, and statutes and case law that is relevant to your role as a
child custody evaluator.
10. If a party to a child custody dispute contacts you and requests that you perform a child
custody evaluation, you should either tell the person to discuss the matter with his or
her attorney, or you could contact his or her attorney yourself.
11. Ask attorneys in the case to outline the issues they want to have examined and
addressed in the evaluation. If there are unresolved allegations that have prevented
settlement, ask the attorneys to identify them for you.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 115
A FEW MENTAL HEALTH
PRIVATE PRACTICE BOOKS
Author
Title
Publisher
Year
Beigel, Joan
Kaye & Earle,
Ralph H.
Poynter,
William L.
Successful Private Practice in the 1990s: A
New Guide for the Mental Health
Professional
The Preferred Provider’s Handbook:
Building a Successful Private Therapy
Practice in the Managed Care Marketplace
Building and Managing Your Private
Practice
Brunner/Mazel,
Publishers, New York
1990
Brunner/Mazel,
Publishers, New York
1994
American Counseling
Association,
Alexandria, Virginia
Woody,
Business Success in Mental Health Practice Jossey-Bass
Robert Henley
Publishers, San
Francisco
Woody,
Fifty Ways to Avoid Malpractice
Professional
Robert Henley
Resource Exchange,
Inc., Sarasota, Florida
Woody,
Protecting Your Mental Health Practice:
Jossey-Bass
Robert Henley How to Minimize Legal and Financial Risk
Publishers, San
Francisco
1990
Richards,
Daniel L.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
1989
1988
1988
Page 116
HEALTH INSURANCE FRAUD
1.
Misrepresenting to the insurance company the individual who is providing the direct
health care service to the subscriber.
2.
Assigning a client a diagnosis solely to satisfy insurance company requirements when
the diagnosis cannot be justified according to present professional knowledge and
accepted practices concerning the diagnosis of mental illnesses.
3.
Billing couples, family, or group therapy as individual therapy so that client expenses will
be reimbursable by a health insurance company.
4.
Indicating on a bill that fees for services are a specified amount, but in reality charging
clients only the lesser amount reimbursed by the insurance company.
5.
Billing clients for hourly appointments that are missed by the clients without indicating
on the bill that appointments were missed.
6.
Misrepresenting professional credentials to an insurance company.
7.
Failing to report previous contact with a client who has recently applied for health
insurance reimbursement.
8.
Attempting to conceal from an insurance company the fact that clients are seeking
reimbursement from two or more health insurance companies for the same expenses.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 117
CRIMINAL ACTIVITIES OF CLIENTS
1.
Citizens do not have an obligation to report crimes they have observed or know about.
They cannot be held accountable for crimes they did not report.
2.
Generally, counselors have no obligation to report crimes reported to them by clients in
counseling sessions.
3.
Under the danger to self or others exception to confidentiality, counselors MAY have an
obligation to take some action related to crimes reported to them by clients in
counseling sessions.
4.
If a counselor is unsure whether to take some kind of action after learning of a crime
from a client, the counselor should consult with colleagues and experts before taking
action.
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 118
WEB COUNSELING ISSUES
Is it Ethical?

Can the basic principles associated with effective counseling be accomplished through
written communication (either instantaneous or sequential over time)?

Can a client who is at risk of harming self or others be adequately assessed and
managed when the client is not close by?
Is it Legal?

Which state laws govern a web counseling client/counselor relationship? The laws of
the state in which the client is located, or the laws of the state in which the counselor is
located, or both?

Is it legal to provide counseling services to a client in another state if the counselor is
not licensed in that state?
If you are going to provide counseling services over the web, be sure to read and follow
the following published guidelines:
www.nbcc.org/ethics/wcstandards.htm (NBCC published standards)
www.cousneling.org/gc/cybertx.htm (ACA published standards)
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 119
RESOURCES
LEGAL AND ETHICAL ISSUES IN COUNSELING
Ethical, Legal, and Professional Issues in Counseling, 5th Edition
2016
Pearson Higher Education
Upper Saddle River, New Jersey
By Theodore P. Remley, Jr. and Barbara Herlihy
Order at http://www.pearsonhighered.com
Ethical, Legal, and Professional Issues in the Practice of Marriage and Family Therapy, 5th
Edition
2014
Published by Pearson Higher Education
Upper Saddle River, New Jersey
By S. Allen Wilcoxon, Theodore P. Remley, Jr., & Samuel T. Gladding
Order at http://www.pearsonhighered.com
Ethical and Legal Issues in School Counseling, 3rd Edition
2010
Published by the American School Counselor Association
Alexandria, Virginia
Edited by Mary A. Hermann, Theodore P. Remley, Jr., and Wayne C. Huey
Order at http://www.schoolcounselor.org
Theodore P. Remley, Jr., JD, PhD, LPC, LMFT ∞ University of Holy Cross ∞ New Orleans, Louisiana ∞ tremley@olhcc.edu ∞
Page 120