how to report that a patient is not benefiting from counseling

by Dr. Joshuah Volkman 6 min read

Assessing a Client's Potential for Harm in Counseling

25 hours ago The counselor decides to assess for potential for harm. Assessing potential for harm in counseling means that a therapist will evaluate the possibility that someone will … >> Go To The Portal


What happens if a client does not show up to therapy?

When a client repeatedly no-shows, a therapist loses time they could spend with other clients. A therapist may also need to terminate therapy with a client who makes unreasonable demands, whose insurance will not pay for therapy, or who otherwise presents practical or logistical concerns.

Are you legally obligated to report what your clients say during therapy?

However, there are some specific situations when mental health professionals are legally obligated to report something that a client does or says during a therapy session. “I like to tell my clients that therapy is kind of, ‘What happens in Vegas stays in Vegas.’

How can counselors avoid the mistake of poor client–counselor fit?

Along with providing clients with easy access to such information, a discussion regarding the counselor’s background and treatment approach should occur before initiating therapy. By taking these steps, the counselor is in a better position to avoid the mistake of poor client–counselor fit.

Why does the counselor recommend this therapy to the client?

As a result, the counselor recognizes that this client in particular would provide a particularly valuable case study for developing the therapy. The counselor recommends this therapy to the client.

What do you do when counseling doesn't help?

What To Do When Therapy Doesn't WorkTherapy Isn't The Same For Everyone. Perhaps you grew up in a household or culture where mental health and therapy were viewed as taboo topics of conversation or concern. ... Identify Why You Think Therapy Doesn't Work. ... Talk To Your Therapist and Set Goals. ... Find A New Therapist.

What are the most common ethical violations in counseling?

found that the most common ethical issues associated with complaints against counselors were dual relationships (24%), incompetence (17%) professional misrepresentation (8%), sexual relationships with clients (7%), breach of confidentiality (5%), inappropriate fee assessments (4%), failure to obtain informed consent (1 ...

How do you decline a therapy client?

How to turn down a client with graceReturn the message in the format it was received. ... Give the client an answer as soon as possible. ... Thank the client. ... Give a reason, but don't go into detail. ... Suggest an alternative. ... Keep your opinions to yourself. ... Reassess how you obtain new leads.More items...•

What happens if a counselor violates the code of ethics?

A breach of the code has certain consequences, while a violation of law has other consequences. If a professional counselor does something unethical, we might remove them from ACA membership, but if that counselor breaks a law, they can actually go to jail or pay a significant fine.

What are examples of ethics violations?

Ethics violations such as discrimination, safety violations, poor working conditions and releasing proprietary information are other examples. Situations such as bribery, forgery and theft, while certainly ethically improper, cross over into criminal activity and are often dealt with outside the company.

What is unethical in Counselling?

It is unethical for a client to see a counselor without a purpose (Kochhar, 1999). This implies that there should be a felt need or a purpose for seeing a counselor without it the counselor cannot be respected or promote client's welfare. Rapport.

What do you say to no show clients therapy?

How to Handle No Shows and CancellationsHave a Policy in Place. ... Hand Over an Appointment Card. ... See Clients Sooner. ... Educate Your Clients on the Importance of Therapy. ... Check Up on Your No Show Clients. ... Understand the Reason Behind the Cancellations. ... Take Notes. ... Implement a Fee.More items...•

How do you tell a customer you will no longer serve them?

Address the letter to the customer and write that as of today's date your company will no longer be able to serve him. Use simple, clear, firm language so that the customer understands that this decision is final and is not open for negotiation, argument or pleading.

How do you tell a customer you Cannot help them?

7 Tips on How to Say No to CustomersAsk for clarification.Explain what's going to happen next.Be honest.Reframe the “no” using positive language.Make the customer feel heard.Offer alternatives.Explain the reasoning behind the current design.

What is negligence in counselling?

Failing to enter into an appropriate counselling/therapy contract. Failing to explain at the outset the style of counselling or therapy. Changing days/times of sessions or cancelling sessions with insufficient notice. Acting in an aggressive, critical and abusive way. Inappropriately increasing the frequency of ...

What are the possible circumstances if the counselor failed to maintain confidentiality?

By breaching confidentiality with a client, you expose yourself to several different legal issues. The client may sue you for financial or emotional damage as a result of you exposing their information. You may also be at risk for losing your license to practice.

What are some legal and ethical issues in counseling?

Ethical Issues In Counseling With Children And AdultsMaintaining Boundaries.Professional Ability.Personal Problems.Maintaining Confidentiality.Respecting Client Differences.Getting the Authorities Involved.Maintain Their Role.Maintaining Therapy.More items...•

Why is occupational therapy inappropriate?

There are multiple medical and non-medical reasons why certain patients/clients should be considered inappropriate for occupational therapy services. This could include severe conditions, like in the case study, where therapy actually causes more harm than good. Other examples include that the patient continuously provided verbal refusal ...

What is the AOTA OT practice act?

The Code of Ethics may be “guidelines,” but such guidelines are carefully woven into the Practice Act for licensure which means you can still be subject to legal action for violating those ethical codes.

Why did Speech Therapy put the patient on a thickened liquid and puree diet?

Speech therapy placed the patient on a thickened liquids and puree diet just to be safe. Although the patient had a personal goal to eat better, he did not want to address anything else due to severe pain and fatigue. Four days of OT services for self-feeding went by and the patient’s condition was worsening.

Can your boss question your evaluation?

If your team leader is generally an understanding individual, then be ready to have a discussion. Yes, your boss will question your evaluation but consider it a good way to keep your skills in check. You’re a clinician, but you’re also human and sometimes OTs can miss things on evaluations. 3.

What happens if a client is unhappy with the therapist?

When a client is unhappy with the therapist’s services, objects to the therapist’s philosophy, or accuses the therapist of wrongdoing, the client may terminate the relationship. If the client does not, the therapist must assess whether the relationship can continue.

How to help a child who is no longer in therapy?

Plan a termination activity to memorialize therapy and the progress the child has made. Talk to the child about strategies for managing painful emotions when they are no longer in therapy. Help the child develop a list of supportive people, especially adults, whom they can contact when they need help.

What are the general guidelines for therapy termination?

Therapy Termination Activities: General Guidelines for Therapy Termination. Therapy termination can make both the therapist and client feel insecure. Therapists may wonder if they did enough to serve the client and may feel defensive if the client is unsatisfied. Clients may worry that termination is their fault or may fear leaving therapy means ...

Why is it important to know when to terminate therapy?

For therapists, knowing when to terminate therapy is an important skill that can protect both the client and the therapist. The following strategies can help you manage your therapy termination session no matter why therapy has ended.

Why is it important to discuss termination with a child?

It is important to discuss termination at the beginning of therapy and to prepare the child as far in advance as possible.

When a therapist and client agree that it's time to move on, both may have mixed feelings.?

When a therapist and client agree that it’s time to move on, both may have mixed feelings. The client has formed a trusting and close relationship with the therapist and may have even come to see the therapist as a friend. So it’s important to be warm and supportive, but also to set clear boundaries.

When is the end of therapy important?

When a therapist and client have a long and trusting relationship, the end of therapy is a major milestone. But when a therapist is not a good fit for a client or there is an issue in the relationship—such as repeated no-shows or dissatisfaction with therapy—handling termination is even more important. Clients can terminate therapy ...

What should a psychologist know about confidentiality?

Your psychologist should let you know the limits of confidentiality and explain how confidential records are stored.

Is it okay to have a sexual relationship after therapy ends?

One type of relationship that’s never acceptable is a sexual relationship with a current client. And even though sexual relationships that occur at least two years after therapy ends may be technically acceptable, they can still be harmful.

Do psychologists have to share information?

APA’s Ethics Code says that psychologists may only share the minimum information necessary.

Can a therapist bill you under a supervisor's name?

Keep in mind that bills may be under the supervisor’s name, not the trainee’s. You don’t want to report a billing problem when none exists!

Can a psychologist be your friend?

Your psychologist shouldn't also be your friend, client or sex partner. That’s because psychologists are supposed to avoid relationships that could impair their professional performance or harm their clients. Of course, it’s usually impossible for psychologists to avoid all contact with clients outside their offices.

Counseling & Psychotherapy Ethics Code Explained

Most of us live by a certain set of values that guide our behavior and mark the difference between right and wrong. These values almost certainly influence how you approach your work as a counselor.

7 Interesting Case Studies

In this section, we will describe a series of case studies, each featuring a different ethical challenge that focuses on one of the principles described above.

3 Common Ethical Issues & How to Resolve Them

Ethical issues do not occur randomly in a vacuum, but in particular situations where various factors make them more likely. As a result, although ethical issues can be challenging to navigate, they are not necessarily difficult to anticipate.

Ethical Considerations for Group Counseling

Group counseling can be an effective form of practice with several intuitive benefits.

A Take-Home Message

Take a structured approach to preparing for and dealing with ethical issues, whether this is referring to a framework published by a professional organization or simply navigating by a set of core values.

What are the best outcomes for a counselor?

Moreover, optimal outcomes are more attainable when counselors build trust with clients; are sensitive to the influence of boundaries; avoid making assumptions; practice self-compassion; and approach therapy with adequate knowledge, skills, confidence, and flexibility.

What are the mistakes counselors make when dealing with groups?

In summary, when dealing with groups, counselors should avoid making the following mistakes: Lacking a clear purpose. Failing to establish objectives, rules, and structure at the outset. Lacking in leadership skills or confidence. Failing to deal with challenging client personalities and behaviors.

How does quality counseling work?

Quality counseling means that the therapist does not make the mistake of jumping in too quickly, but instead, builds rapport early on, taking adequate time to establish trust.

Why is counseling important?

With its widespread use, it is imperative that counseling is performed based on research-supported methods that promote positive client adjustment. Researchers have identified some key behaviors ...

What is group therapy?

As with couples counseling, group therapy requires a seemingly unbiased therapist who allows equal attention and time for each member of the group. Because the counselor is dealing with multiple people, personalities, and issues at once, they need to be prepared for several problems that may arise.

What is an unprofessional therapist?

Unprofessional therapist behavior represents a grave mistake with the potential to undermine the goals of therapy. In many ways, professionalism in the therapeutic setting is much the same as that in other types of jobs. For example, counselors are expected to be on time, well groomed, and appropriately dressed.

How do therapists violate boundaries?

Therapists also violate boundaries by allowing sessions to go long and oversharing personal information. Failing to attend to nonverbal cues is another area related to boundaries, as clients have reported a therapist’s body language as important for early therapeutic alliance building (Bedi, 2006).

What happens if a therapist fails to take reasonable steps to protect the intended victim from harm?

“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.

Should clients withhold anything from their therapist?

“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.

Can a therapist report a patient's intent to harm someone else?

A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.

Do therapists have to disclose information in court?

For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court. The last thing a therapist wants to do is defy their patient’s trust.

Do you have to report child abuse to a therapist?

“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.

SUMMARY OF COUNSELING

Specialist Smith, At 0600, on 14 April 13, you failed to be at your appointed place of duty, our morning formation in front of Bldg 11. At 0900, you called me and stated that you overslept and would be in as soon as possible. You arrived at 1010.

PLAN OF ACTION

Due to your inability to be at the appointed place of duty at the appointed time, the following corrective action will be taken:

SESSION CLOSING

SPC Smith will report to every formation 15 minutes ahead of time. This is not to be considered to be 15 minutes early. It is SPC Smith's actual reporting time. I will be present at every formation and if you are not present at the required time, I will take immediate administrative action.

LEADER RESPONSIBILITIES

I will ensure that our leadership is aware of this counseling and will provide guidance and assistance if requested.

ASSESSMENT OF THE PLAN OF ACTION

SPC Smith was only 10 minutes early to formation on one occasion and did not have a valid excuse. I did submit additional counseling but our current leadership did not want to accept it. However it is on file and will be resubmitted in the event of any future failures.

Multiple Relationships

Confidentiality

  • Employers, spouses, school administrators, insurance companies and others often ask psychologists to provide information about their clients. APA’s Ethics Codesays that psychologists may only share the minimum information necessary. 1. Your psychologist should be clear about whether and why he or she is disclosing information. Sometimes, for instance, a l…
See more on apa.org

Informed Consent

  • Your psychologist should give you the information you need to give informed consent right from the start. Topics to discuss include: 1. Limits of confidentiality 2. Nature and extent of your psychologist’s record-keeping 3. Expertise, experience and training 4. What servicesyour psychologist can’t or won’t provide 5. Estimated lengthof therapy 6. Alternative approachesto tre…
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Trainees

  • Sometimes a therapist in training may provide your treatment. The therapist should let you know he or she is a trainee and give you the supervising psychologist's name. 1. Keep in mind that bills may be under the supervisor’s name, not the trainee’s. You don’t want to report a billing problem when none exists!
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Roles

  • When psychologists work with organizations or groups, there may be confusion about who the actual client is. 1. In court, for instance, it may not be clear whether a psychologist is serving as an expert witness or an advocate for one side. Confusion is also possible when psychologists provide services to one person at the request of another, such as parents requesting therapy for …
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Expertise

  • Psychologists should only practice in areas where they are competent. 1. If you’re in a custody battle, for instance, a psychologist who’s unfamiliar with working with courts could harm your case no matter how well-intentioned he or she is. 2. If you ask your psychologist to write a letter to the judge about your child’s relationship with you and your spouse, the psychologist could get in …
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Billing

  • Your psychologist has an ethical obligation to bill patients and insurers accurately. Your psychologist should explain financial policies at the beginning of treatment. 1. Sloppy bookkeeping lands some psychologists in hot water. Others get in trouble because they try to manipulate the systemto get clients more benefits than they’re entitled to. 2. Don’t ask your psyc…
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End of Therapy

  • You should know the difference between treatment termination and abandonment. 1. Psychologists can ethically discontinue treatmentwhen clients aren’t benefiting from therapy, may be harmed by treatment, no longer need therapy or threaten the therapist, themselves or others. 2. Your psychologist should explain why the current treatment is no longer appropriate, suggest alt…
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