The Advocate Magazine Spring 2021 | Page 24

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Ethics Question :
I have a client who is being seen in couples counseling . His unwillingness to make a serious attempt to cooperate with counseling has been an obstacle to the process of therapy . His flirtatious remarks to me make me very uncomfortable . I feel that I should refer this couple to another therapist , but I do not want to be seen as abandoning these clients . Can I terminate my services and refer the couple out ?

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ANSWER : Trust your judgment and refer the client couple to another CMHC . By doing this , you are not abandoning the couple , you are complying with Code section I . A . 3 . a , which provides that “ CMHCs make every effort to avoid dual / multiple relationships with clients .” Flirtatious clients can create any number of problems , even when the counselor is not crossing boundaries . By terminating treatment and referring the couple to another counselor , no abandonment occurs .
Ethics Question :
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Ethics FAQ

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The AMHCA Ethics Committee has compiled the most frequently asked ethics questions it receives into a resource for counselors . Submit your own FAQ for consideration — no membership required !
AMHCA members : Use the online form to submit an ethical concern for the Ethics Committee .
To download the Code of Ethics , free , or to submit an ethics question , an FAQ question , or an ethical concern , go to :
www . amhca . org / publications / ethics
Note that AMHCA members should refer to their state licensing board for specific solutions or direction . Since this platform is intended for ethical decision-making assistance , it is not legal advice . For legal advice , please consult with an attorney in your state .
Read more Ethics FAQ questions at : www . amhca . org / publications / ethics / ethicsfaq

? cultural , religious , and economic backgrounds .” Then , of course , you must respect the client and be mindful that you are not imposing your attitudes , beliefs , or values on them .

Ethics Question :
In disclosing my fee to clients , am I required to inform them concerning my sliding scale or withhold that information until a client asks for it ?
ANSWER : Informed consent is intended to be a transparent process in which information about treatment is disclosed to clients . Accordingly , CMHCs should disclose billing practices including a sliding scale fee in compliance with I . B . 2 . a of the Code , which requires disclosure of information to clients including “ counselor credentials , issues of confidentiality , the use of tests and inventories , diagnosis , reports billing , and the therapeutic process .” Similarly , CMHC need to comply with section I . E . 2 , which provides that CMHCs “ clearly explain to clients , early in the counseling relationship , all financial arrangements related to counseling .”
When is telehealth not appropriate for a client ?
ANSWER : When a potential client is in crisis , the person is not appropriate for telehealth . If the crisis is imminent , such that the individual is imminently suicidal , dangerous to self , or dangerous to others , then the person needs to be referred immediately to a hospital for crisis evaluation and treatment . CMHCs are not required to provide services via TSCC or may decide not to offer services based on appropriateness ( B . 6 . c ).
Ethics Question :
I am a devoutly religious person , and I do not believe in divorce . When working with couples who have marital problems , I make every effort to preserve the marriage , and counsel my clients not to seek a divorce because of the guilt and emotional problems that this will cause the couple and their children . Is this permissible ?
ANSWER : CMHCs cannot impose their values on others . The Code , section I . A . 4 . d , cautions CMHCs to be “ aware of their own values , attitudes , beliefs , and behaviors , as well as how these apply in a society with clients from diverse ethnic , social ,
Ethics Question :
I am providing services online through e-mail with clients . Is this practice ethical ? Are there any special disclosures that I need to give these clients ?
ANSWER : Yes , at a minimum , two disclosures are needed regarding the security of email communication . First , in compliance with Code principle I . B . 6 . h ., “ unless email and text messages are encrypted or otherwise secured or confidential , the client should be informed of the risks and discouraged from using as a means to disclose personal information .” Section I . A . 2 . n states ; “ CMHCs take necessary precautions to ensure client confidentiality of information transmitted electronically through the use of a computer , e-mail , fax , telephone , voicemail , answering machines ,” or other media such as video conferencing platforms . The second disclosure that should be made pursuant to I . B . 6 . concerns “ the benefits and risks of entering into distance counseling ” including “ e-mail contact with a client .” The risk that a breach of confidentiality may occur if unencrypted e-mail is used is well known to most e-mail users , but should still be discussed in making this disclosure .
24 The Advocate Magazine Spring 2021 American Mental Health Counselors Association ( AMHCA ) www . amhca . org