Participants’ outline
TLPCA Conference 2015
Conversations in Ethics: The 2014 ACA Code
I.
Preliminaries & introductions – Dr. Casey
A. We’ve all been to ethics trainings that were tedious or boring. It doesn’t have
to be that way. We want this experience to be enjoyable and even fun.
B. Turn cell phones off or change to silent mode
C. Introduction of presenters: Terry A. Casey, Ph.D., Licensed Psychologist &
Jake Morris, Ph.D., LPC/MHSP
D. Evaluation forms -- completion of evaluation forms is required for CEUs.
E. Schedule for the program -- Case vignettes are the heart of the program.
F. Goal – our intent is not to supply you (workshop participants) with perfect
answers or to tell you exactly what you should do in a particular problematic
scenario but rather to help build the knowledge, skills and practice necessary
to successfully navigate challenging ethical situations.
G. Disclaimer: The presenters are not attorneys and nothing we present today is
intended to be legal advice. Legal matters are highly individualized and
laws/regulations vary greatly from state to state. We recommend that you
consult a qualified attorney before making significant decisions with potential
legal ramifications.
H. Learning Objectives
Participants will:
1. Learn about the changes in the 2014 ACA Code of Ethics.
2. Develop practical skills for successfully navigating complex or
problematic professional situations that pertain to the ACA code
of ethics.
3. Learn how to apply the key evaluative perspectives necessary to
evaluate ethical dilemmas.
4. Build confidence in one’s ability to properly handle difficult or
perplexing ethical scenarios.
II.
Activity -- Dr. Morris
III.
Perspectives for evaluating problematic situations :
a. Ethical (if there ethical issues are present, see ethical principles below)
b. Legal
c. Clinical / therapeutic
d. Board of Examiners (licensing board)
e. Client’s wishes/desires
f. Counselor’s well-being
IV.
Fundamental principles of ethical behavior (from the introductory portion of
the ACA COE).
a. autonomy
b. non-maleficence
c. beneficence
d. justice
e. fidelity
f. veracity
V.
Whole room discussion to illustrate III & IV above
Vignette #1 – Dr. Casey
Social media & supervision
Mitchell’s Facebook dilemma
Mitchell (25 years old) currently possesses a temporary license as an LPC/MHSP in
Tennessee and is estimating that he will receive his full license within the next three
months. His supervisor for the past six months has been Judy Wilson, Psy.D., a
licensed psychologist with Health Service Provider designation. Rachel (18 years
old and a former client of Mitchell’s from the previous year) contacted Mitchell
through FaceBook (FB) a month ago requesting that he become her FB “friend.”
Mitchell accepted the friend request and since then has occasionally communicated
with Rachel through FB. Dr. Wilson, also a FB friend of Mitchell, noticed through a
FB connection that Mitchell had become a FB friend of Rachel’s. Dr. Wilson strongly
recommends that Mitchell discontinue his FB friendship with Rachel. Mitchell
consults with Sara, a colleague and friend (the traditional kind), who tells him that
Dr. Wilson has no right to tell him with whom he can be friends.
1. Which perspectives are most important? Ethical, legal, B.O.E., etc.
2. If there are ethical issues then what fundamental principles (e.g., veracity,
non-maleficence, justice, etc.) are relevant?
3. What portions of the ACA COE are applicable?
4. What would you do if you were Mitchell?
VI. Breakout groups
Vignette #2 – intra-group discussions
Minors and social media
Ashley’s Tweets
Daniella is a 26 year old counselor who recently received her license as an
LPC/MHSP in TN. She currently works at group private practice where she sees
primarily children and adolescents. Ashley, 15, has been her client for four weeks
and is being treated for anxiety and depression. When Ashley began seeing Daniella
professionally, they were already casual friends and followed each other on Twitter.
This was due to the fact that Daniella was Ashley’s camp counselor two years ago.
After their second counseling session Daniella began receiving an increased amount
of contact from Ashley via FB and Twitter, some of which was related to recent
counseling sessions and seems to reflect increased feelings of frustration with her
life and signs of hopelessness. For the past several nights, Daniella has been
worried about Ashley and has been checking Facebook and Twitter for anything that
might be related to her.
1. Which perspectives are most important in this situation? Clinical, ethical,
legal, other?
2. If there are ethical issues present then what fundamental ethical principles
(e.g., veracity, non-maleficence, justice, etc.) are relevant?
3. What portions of the ACA COE are applicable?
4. What should Daniella do? What should she have done differently?
Notes:
----------------------------------------------------Break -- 15 min.
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VII.
Breakout group discussions
Groups present their vignettes, discuss their findings & discuss with
everyone.
Round 1-
two vignettes w/multiple groups doing each
Vignette #3 - multiple groups (Terry)
Competence/values/referrals
Kelly & Madison
Kelly is a 28 year-old LPC/MHSP in Tennessee. She has a private practice that
specializes in serving females, most of whom are struggling with mood and anxiety
problems. She has been working with a 24 year-old client, Madison, for three months.
Madison’s presenting problem was panic attacks and Kelly subsequently diagnosed her
as having Panic Disorder. Madison has been making steady progress and is now
experiencing fewer and less severe anxiety symptoms. During the last week’s session
Madison mentioned that when she was in college she attended a local church and became
very involved in the singles’ group there until her anxiety interfered. At that point she
abruptly stopped attending the church without telling anyone there what was happening.
She also announced that since she is now having fewer problems with panic attacks she
plans to return to the church, possibly go on some mission trips and perhaps rekindle a
previous romantic relationship with a man named Matt. In this week’s session Madison
states that she would like shift the bulk of their session time to helping her reintegrate
into the church and the potential relationship with Matt. Kelly has long described herself
as an atheist (including on her FaceBook page) and she is now somewhat uncomfortable
working with Madison so she decides it would be best to refer Madison to another
counselor.
1. Which perspectives are most important in this situation? Clinical, ethical,
legal, other?
2. If there are ethical issues present then what fundamental ethical principles
(e.g., veracity, non-maleficence, justice, etc.) are relevant?
3. What portions of the ACA COE are applicable?
4. What should Kelly do? What if anything should she have done differently?
NOTE: Change other variables [e.g., gender of client or counselor, age, etc.] to see
how this affects the situation and workshop participants’ views.
NOTES:
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Vignette #4 -- multiple groups (Jake)
End of life issues / distance counseling
Mike the client
Mike is a 58 year old male diagnosed with pancreatic cancer. Mike began coming to you
(an LPC/MHSP) post-diagnosis in order to sort through a number of issues. Over the
course of time you have grown very fond of Mike and look forward to his visits. In spite
of Mike’s unfortunate situation, he appears free of depression or anxiety.
To improve Mike's chances of recovery, he has moved to Dallas to be closer to T Boone
Pickens Cancer Center where he will have access to an experimental treatment for his
cancer. You have continued to work with Mike via
Skype.
One day during therapy, Mike reveals that he is increasingly tired of the pain and
suffering and is considering ending his life. As his therapist, what are your ethical
obligations toward Mike.
1.)
What are the major ethical, legal, and professional issues you should be aware of
as Mike’s therapist.
NOTES:
Round 2
Vignette #5 - multiple groups (Terry)
Stephen’s new practice
Stephen is a newly licensed LPC/MHSP in Tennessee. For several years he has been
planning to have his own practice and this has finally become a reality. Two months ago
he located office space in a suite of offices owned by Janice, an LMFT who has been in
this location for several years. Janice has a thriving practice and many people contact her
wanting evening hours. Unfortunately, she seldom has an opening. Stephen, on the other
hand, plans to build his practice by accommodating clients who want evening
appointments which also works out well for him and his wife regarding childcare for their
daughter. His very first client was a referral from Janice. Stephen was very appreciative
and sends her a thank-you note along with a Starbucks gift card. Over the next few
weeks this is replicated several times and Stephen makes it known to two LPC/MHSPs &
a psychologist who also have offices in the same suite that he will be happy to do the
same for them. As a result, within two months Stephen’s schedule is full four nights a
week and he is thrilled. While at Starbucks one morning (buying gift cards) Stephen sees
a former classmate, Jessica, and tells her how his practice has really taken off. Strangely,
her reaction seems less than enthusiastic. Afterward, Stephen thinks that it was unlike
Jessica to be jealous of his success.
1. Which perspectives are most important in this situation? Clinical, ethical,
legal, other?
2. If there are ethical issues present then what fundamental ethical principles
(e.g., veracity, non-maleficence, justice, etc.) are relevant?
3. What portions of the ACA COE are applicable?
4. What should Kelly do? What if anything should she have done differently?
NOTES:
Vignette #6 - multiple groups (Jake)
School counseling & LPCs/confidentiality/who & when is a client
Callie and the principal
Callie is working toward licensure as an LPC. She has worked for many years as an
elementary school counselor, although she is now completing the requirements for state
licensure as a Licensed Professional Counselor (LPC).
Recently, the relatively new principal of the school where she works asked her to present
him with a weekly list of every student who is referred for counseling, every student who
contacts her office, and what issues they are working on.
She comes to you, her supervisor, seeking guidance regarding her ethical responsibility
concerning confidentiality. This is particularly true in this case, where the principal has
been known for sharing information told to him in confidence by others. Callie tells you
that the principal's secretary is also privy to information which is designated only for the
principal to see, and that Callie has witnessed her sharing confidential information about
students with various instructors; hence, she is concerned the same may happen with this
"list."
Callie doesn't want to appear insubordinate, but she has some real concerns. Callie seeks
guidance on how to proceed in order to avoid jeopardizing her professional ethical
standards and, potentially, her job, as she is a single parent supporting her elderly parents
and one child.
1.) As Callie’s supervisor, what would you do?
2.) What are the potential ethical, legal, and other issues?
Notes:
VIII. Q&A
END