2015 ACA Annual Conference Learning Institute Train the Trainer: Delivering ACA-Approved Presentations on the 2014 ACA Code of Ethics 2015 ACA Annual Conference Learning Institute

David M. Kaplan, PhD, Chief Professional Officer Erin T. Shifflett, MLA, MEd. Director, Ethics and Professional Standards Michelle E. Wade. EdD, NCC, LCPC-S, ACS ACA Ethics Specialist

Why us?

One of us was the ACA President that appointed the 2005 Ethics Revision Task Force And the ACA staff liaison to the 2005 code revision Two of us were the ACA staff liaisons to the 2014 code revision One of us was a member of the ERTF

Members of the ACA Ethics Revision Task Force Jeannette Baca Janelle Disney Perry Francis (Chair) Gary Goodnough Mary Hermann Shannon Hodges Lynn Linde Linda Shaw Shawn Spurgeon Michelle Wade Richard Watts Erin Martz (staff liaison) David Kaplan (staff Liaison)

The 500 Pound Gorilla Effect Why do you need to know this stuff? The 500 Pound Gorilla Effect

55,000 professional counselors agree to abide by the ACA Code of Ethics

22 state licensing boards have adopted the ACA Code of Ethics Alaska Arizona Arkansas California District of Columbia Idaho Illinois Iowa Louisiana Massachusetts Mississippi New Jersey North Carolina North Dakota Ohio Pennsylvania South Carolina South Dakota Tennessee Utah West Virginia Wyoming

The judicial system uses the ACA code as the ethical standard for counselors Ward v. Wilbanks Keeton v. Anderson-Wiley

Dual Relationships Be gone! Beneficial vs Harmful Prohibited Relationships Role Changes

Managing and Maintaining Professional Boundaries Previous Relationships Extending Boundaries Clarification (A.6.b) Documenting (A.6.c) Nonprofessional Interactions (A.6.e.)

I have been counseling an adult woman with a presenting problem of difficulty in coping with the death of her mother. Her mother and grandmother (who is also deceased) suffered from progressive Alzheimer’s disease. My client revealed to me that she administered a lethal dose of sleeping pills to her grandmother during the final stages of the Alzheimer’s, and that she also caused the death of her mother by withholding cardiac medication. It was then revealed that it is likely she will have to take care of a third relative with Alzheimer’s disease, an elderly Aunt. It is important to understand that my client is not a bad person and did what she did while under tremendous stress and pressure and with feelings of compassion for the deteriorating condition of her mother and grandmother. My question is in two parts: First, what are my ethical obligations upon hearing the manner in which my client’s mother and grandmother died? Second, am I responsible to do anything about the upcoming situation with the Aunt?

Let‘s Get to All the New Things Two categories Old concepts strengthened Completely New Ideas

C.2.g.Impairment: What does it look like? “[…]physical, mental, or emotional problems[…]” What should counselors do? Monitor, seek assistance, assist colleagues…

End of Life Issues: Exception to the referral rule removed—why? Legal vs. ethical obligations

Give me a Break 15 Minute Break!!!

Gatekeeping is now explicitly stated “[Counselor educators] recommend dismissal from training programs…when students are unable to demonstrate they can provide competent professional services to a range of diverse clients.” (F.6.b) “Counselor Educators may require students to address any personal concerns that have the potential to affect professional competency” (F.8.d)

We added a whistleblower policy “Counselors do not harass a colleague or employee or dismiss an employee who has acted in a responsible and ethical manner to expose inappropriate employer policies or practices.” (D.1.i)

Technology Strengthened Benefits and Limitations Appropriateness of Services Laws and Statutes Technology and Informed consent: Security

Extension of Privacy and Confidentiality to Prospective Clients When is a client a client? Prospective clients have some rights Not the same as legal obligations

Relationships: What can counselors do…and with whom? Introducing the personal virtual relationship!

Yes, Ebola… B.2.c. Contagious, Life-Threatening Diseases: “[…]counselors may be justified in disclosing information to identifiable third parties, if the parties are known to be at serious and foreseeable risk of contracting the disease.”

A.10.d. Nonpayment of Fees Intend to use collection agencies Include in informed consent Inform clients in a timely fashion Intended actions Offer clients opportunity The loss of tone and body language can really impact how an email or text is read/received.

Give me a Break Lunch Time

Brand New Concepts

Raising the bar for professional values

The values of our profession are now explicitly stated Human development Multiculturalism and diversity Social Justice Safeguarding the counselor-client relationship Practicing in a competent & ethical manner

A Practitioner’s Guide to Ethical Decision Making by Forrester-Miller & Davis (1996) Identify the problem Apply the ACA Code of Ethics Determine the dimensions

Generate potential courses of action Consider the consequences of all options Select an evaluate an option Implement the course of action

Fee splitting is now prohibited Section A.10.b

Sliding Scale Fees? OK! C.6.e. Contributing to the Public Good (Pro Bono Publico) Counselors make a reasonable effort to provide services to the public for which there is little or no financial return (e.g., speaking to groups, sharing professional information, offering reduced fees).

Mandated Clients (A.2.e.) Required limitations to confidentiality What information and with whom is shared Client may choose to refuse services Discuss potential consequences

Who’s the Client Here? B.4.b. Couples and Family Counseling: “In couples and family counseling, counselors clearly define who is considered ‘the client’[…]” Additional Considerations: Divorce, Custodial Evaluations, Guardian ad Litem involvement

Raising the bar for counselor educators

ACA Professional Standards Committee survey Less than 50% of programs assured field placements. Over 50% of students did not receive assistance.

Counselor educators now have the ethical obligation to provide: Current information & knowledge (F.7.b) Instruction only within their areas of competency (F.7.b) Direct assistance with field placements (F.7.i) Career assistance to students (F.8.b)

Research Qualitative Research is just as valuable Case Examples Independent Researchers Confidentiality and Records Custodian Managing Boundaries

Social Media World Over 50% < 30 World Population #s: China India Facebook Tencent WhatsApp United States Google Plus Indonesia LinkedIn Twitter Over 50% < 30 53% of millennials – smell/technology mobile device > toothbrush #SocialNomics 2014 by Erik Qualman

Social Media World Relationships are becoming more digital LinkedIn = IVY LEAQUE enrollment DAILY Avg person has a :07 attention span #SocialNomics 2014 by Erik Qualman

Social media H.6.a. Virtual Professional Presence - separate professional and personal web pages H.6.b. Social Media as Part of Informed Consent

Client Virtual Presence H.6.c. Client Virtual Presence – Counselors respect clients’ privacy H.6.d. Use of Public Social Media - Avoid disclosing through public social media.

Relevant Definitions Distance Counseling – counseling other than face-to-face meetings Social Media – technology-based forms of communication Encryption –encoding information to limits access

Relevant Definitions Virtual Relationship – a non–face-to-face relationship Personal Virtual Relationship –blurs the professional boundary Professional Virtual Relationship – used in a professional manner and maintaining appropriate professional boundaries

Managing boundaries H.4.b. Professional Boundaries in Distance Counseling - Necessary Discuss and establish appropriate use and/or application of technology It is incredibly easy to have the professional boundaries become blurred when using these instant forms of communication. You have to be aware of unintended messages as well as expectations. This is a conversation that needs to be had in today’s society, even if you are not really engaging in these types of communications, be prepared for clients to push them. Some examples of what should be in a social media policy – not engaging in a personal virtual relationship, hours that you will be available via text, expected response time, etc.

Communication considerations H.4.f. Communication Differences in Electronic Media Nonverbal Vs Verbal cues Impact the counseling process Prevention and Addressing potential misunderstandings The loss of tone and body language can really impact how an email or text is read/received.

Ethical Considerations A.1.b. Records and Documentation A.5.c. Sexual and/or Romantic Relationships With Former Clients A.5.e. Personal Virtual Relationships B.3.e. Transmitting Confidential Information C.3.c. Statements by others A. – in any medium A.5.e. – can’t friend a client C.3.c. If your client rates you on ratemytherapist.com or Yelp, you cannot acknowledge the bad review because you would be breaking confidentiality F.2.c. Iowa and Oregon allow 75% of supervision to be conducted at a distance, LA, NC and Kansas allow secure, confidential, synchronous videoconferencing, and CO requires the first 2 hours to be done face to face

Ethical Considerations F.2.c. Online Supervision F.4.a. Informed Consent for Supervision F.7.a. Counselor Educators F.7.b. Counselor Educator Competence G.3.b. Relationships with Participants A. – in any medium A.5.e. – can’t friend a client C.3.c. If your client rates you on ratemytherapist.com or Yelp, you cannot acknowledge the bad review because you would be breaking confidentiality F.2.c. Iowa and Oregon allow 75% of supervision to be conducted at a distance, LA, NC and Kansas allow secure, confidential, synchronous videoconferencing, and CO requires the first 2 hours to be done face to face

Give me a Break 15 Minute Break!!!

Putting it into Practice Ethics Competition Scenarios

Putting it into Practice You are now the Trainer

Putting it into Practice Quiz Time

The ACA knowledge center www.counseling.org Where to go from here The ACA knowledge center www.counseling.org

ACA 2014 ethics code resources The code itself Podcast Webinar series Interview series Books * See handout

www.counseling.org/kaplan 1-800-347-6647 David M. Kaplan – dkaplan@counseling.org Erin T. Shifflett – eshifflett@counseling.org Michelle E. Wade – mwade@counseling.org 1-800-347-6647 www.counseling.org/kaplan