Ethical Issues of Guardianship Evaluations
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the evaluation in order to get their opinion on whether the person is incapacitated .
• Only after a summation and analysis of the information I ’ ve gathered do I determine my opinion . Then I write a report based on my findings . Remember that “ CMHCs do not provide written conclusions or forensic testimony regarding any individual without assessment of that individual adequate to support statements and conclusions offered in the forensic setting .” ( Code of Ethics , Part I , D . 4 . e )
ALTERNATIVES TO GUARDIANSHIP
According to a proposed change to the American Mental Health Counseling Association ’ s Code of Ethics , “ Before offering any professional opinions or recommendations , such as those related to guardianships , disability , or vocational abilities , the
Four Tools and Measures That Evaluators Can Use to Determine a Client ’ s Ability to Function
• “ Evaluation for Guardianship ”: a book by Eric Y . Drogin and Curtis L . Barrett , is part of the “ Best Practices for Forensic Mental Health ” series from the Oxford University Press . Pages 91 – 98 list and describe several such measures , amzn . to / 3NLI9ZG
• Mini-Mental Health Status Exam ( sometimes called the Mini-Mental Health State Exam ): bit . ly / 3yNG9fg
The MMHSE can assess mental abilities in six areas : ◊ Orientation to time and place — knowing the date and where you are ◊ Attention / concentration ◊ Short-term memory ( recall ) ◊ Language skills ◊ Visuospatial abilities — visual and spatial relationships between objects ◊ Ability to understand and follow instructions
• Personality Assessment Inventory : The PAI assesses psychopathological syndromes and provides information relevant for clinical diagnosis , treatment planning , and screening for psychopathology . www . parinc . com / Products / Pkey / 287 and bit . ly / 3uqGpOI
• Montreal Cognitive Assessment : The MoCA is a cognitive screening test designed to assist health professionals in the detection of mild cognitive impairment and Alzheimer ’ s disease . www . mocatest . org
CMHC engages in a sufficient , comprehensive , and appropriate evaluation . When recommending any loss of an individual ’ s autonomy , the CMHC has ruled out less-restrictive alternatives .”
In my experience conducting guardianship evaluations , it is easy to place someone under a guardianship ; however , because a guardianship is restrictive , before we make that decision , we need to be sure that a guardianship is truly the best opinion for the person . Doing that requires that we look at alternatives to guardianship before making that recommendation . Some common alternatives to guardianship include powers of attorneys , healthcare proxies , the use of a joint checking account , and supported decision-making .
Supported decision-making , which has received growing attention in recent years , is an alternative to guardianship that places an individual in control of his or her life by allowing them to make decisions with the support of others . ( See the National Resource Center for Supported Decision-Making at www . supporteddecisionmaking . org and the Center for Public Representation at supporteddecisions . org / about-supported-decision-making .) Therefore , supported decision-making is a person-centered process that enables individuals to take control of their own choices and increases their ability to live self-determined lives . Supported decision-making increases self-determination for individuals with disabilities and is recognized as a best practice by :
• The American Bar Association , bit . ly / 3nJJaXw
• The United Nations , bit . ly / 3AzK40i
• The American Psychological Association , bit . ly / 3P3gzIe
As Clinical Mental Health Counselors , we have all had to become comfortable with being responsible for helping others with their emotional well-being and knowing that the work we do together can change their lives . The decisions we make related to guardianship and guardianship evaluations similarly affect many lives .
Naturally it ’ s crucial that we conduct our clinical and forensic work ethically , for the sake of our clients , and for our own peace of mind .
If you have questions about guardianship evaluations , or if you would like additional information , I hope you will also feel free to reach out to me at RichardChapman829 @ gmail . com , or 813 – 666 – 4981 .
12 The Advocate Magazine 2022 , Issue # 2 American Mental Health Counselors Association ( AMHCA ) www . amhca . org