INFORMED CONSENT

 Informed consent involves the right of clients to be

informed about their therapy and to make
autonomous decisions pertaining to it.

 Professionals have responsibility to their clients to

make reasonable disclosure of all significant facts, the
nature of the procedure, and some of the more
probably consequences and difficulties.

 It increases the chances that the clients will become

involved , educated and willing participants in their
therapy.
INFORMED CONSENT

 All clients have the right to have treatment explain to

them.
Legal Aspect of Inform Consent
 3 elements are basic to the legal aspects of informed
consent:
 Capacity
 Comprehension of information
 Voluntariness
Legal Aspect of Inform Consent
 Capacity – means that the client has the ability to
make rational decisions.
 Comprehension of information - means that
therapists must give clients information in a clear way
and check to see that they understand it.
 Voluntariness – means that the person giving
consent is acting freely in the decision-making process
and is legally and psychologically able (competent) to
give consent.
The Content of Informed Consent
 The therapeutic process
 Background of the therapist
 Cost involved in therapy
 The Length of Therapy and Termination
 Consultation with colleagues
 Interruption in therapy
 Benefits and Risks of Treatment
The Content of Informed Consent
 Tape-Recording or Videotaping Sessions
 Clients’ right of access to their files
 The nature and purpose of confidentiality
1. The therapeutic process
 Give clients a detailed description of what occurs in
therapy.
 Clients should understand the procedures and goals of
therapy and know that they have the right to refuse to
participate in certain therapeutic techniques.

2. Background of the therapist

• Therapist can provide clients with a description of
their training and education, credentials, licenses any
specialized skills, theoritical orientation, the types of
clients and types of problems in which they have
competence and the types of problems that they
cannot work with effectively.
3. Cost involved in therapy
• Provide information about all costs involved in
psychological services at the beginning of these
services, including methods of payment.

4. The Length of Therapy and Termination

 Clients should know that they can choose to terminate
therapy at any time, yet it is important for the client to
discuss the matter of termination with the therapist.
 Client have a right to expect that their therapy will end
when they have realized the maximum benefits from it
or have obtained what they were seeking when they
entered it.
5. Consultation with colleagues
▪ Experienced clinicians often schedule consultation
meetings with their peers to focus on how they are
serving clients.
▪ Even though is ethical for clinicians to discuss their cases
with the professionals, it wise to routinely let clients
know about this.

6. Interruption in therapy
▪ It is good to practice to explain early in the course of
treatment with clients the possibilities for both expected
and unexpected interruption in therapy and how they
might best be handled. Example: When practitioners
plan vacations, ethical practice entails providing clients
with another therapist in case of need.
7. Benefit for risk of treatment
▪ Clients should have some information about both the
benefits and the risks associated with a treatment
program.
▪ Clients need to know that no promises can be made
about specific outcomes, which means that ethical
practitioners avoid promising a cure.
8. Tape-Recording or Videotaping Sessions
• Clients need to be informed about this procedure at
the initial session and it is important that they
understand why the recordings are made, how they
will be used, who will have access to them, and how
they will be stored.

9. Clients’ right of access to their files

• Clinical records are kept for the benefit of clients.
• Clients have a legal right to inspect and obtain copies
or records kept on their behalf by professionals.
 Clients have an ultimate responsibility for decisions
about their own health care, and in most
circumstances also have the right of access to complete
information with respect to their conditions and the
care provided.
10.The nature and purpose of confidentiality
▪ Clients should be educated regarding matters
pertaining to confidentiality. Clients have a right to
know about any limitation of confidentiality form the
outset.
 Informed consent should included both written and
verbal components. (ACA Code of Ethics, Section A.2)

 Any counselors who do not supplement discussion

with written consent forms or psychologists who fail to
document consent are in violation of current ethical
standards.

 Informed consent is not completed when the initial

discussion is over and the forms signed; all
professionals need to have an ongoing discussion with
clients about informed consent as necessitated by the
services provided and to document in the client record
each such discussion.
The Professional’s Responsibilities in Record Keeping
 The standard of care for all mental health
professionals requires keeping current records for all
professional contacts.

 Record keeping serves multiple purposes.

Record Keeping from a Clinical Perspective

 Maintaining clinical notes has dual purpose:

A. To provide the best service possible for
clients
B. To provide evidence of a level of care
commensurate with the standards of the
profession
.
Securing Records Now and in the Future

 Clients’ records must be handled

confidentially.
 ACA’s (2005) Code of Ethics provides
guidelines for storing, transferring, sharing,
and disposing of clinical records (see section
B.6.)
 Counselor have the responsibility for storing client
records in a secure place and exercising care when
sending records to others by mail or through
electronic means.
 Mental health practitioner bear the ultimate
responsibility for records and when and how they
destroy them. Clinicians are ethically and legally
required to keep records in a secure manner and to
protect client confidentiality.
 Practitioner need to be consider relevant state and
federal laws and the policies of their work working
setting in determining how long to retain client’s
records.
Malpractice Liability in the Helping Professions
 Malpractice means “bad practice”.
What is malpractice?
 …..the failure to render professional services or to
exercise the degree of skill that is ordinarily expected
of other professionals in a similar situation.
 Malpractice is a legal concept involving negligence
that results in injury or loss to the client.
Reason for Malpractice Suite
 Failure to obtain or Document informed Consent
 Client Abandonment and premature termination
 Therapist failed to warn others about and protect them
form a violent client.
 Marked Departures from Established Therapeutic
Practices.
 Practicing techniques beyond the scope of
Competency
 Misdiagnosis
Reason for Malpractice Suite
 Repressed or False memory
 Unhealthy transference relationship
 Sexual misconduct with a client
 Failure to Control a Dangerous Clients
 Reason for Malpractice Suite
1.Failure to obtain or Document informed Consent
Without a written document it may be very difficult to
ascertain whether counselors communicated clearly and
effectively to clients about the therapeutic process and
whether clients understood the information.

2. Client Abandonment and premature termination

 The failure of the psychologist to take the clinically
indicated and ethically appropriate steps to terminate
a professional relationship.
 Client need to be informed about termination and as
much as possible should be involved in making
decisions about when to end their treatment.
 When both client and therapist agree that the goals of
therapy have been achieved and that therapy is no
longer required there is a very low risk that the client
will file a malpractice compliant.
 Premature termination carries clear risks of a lawsuit
when made in the following situation:
1. The therapist recognized he or she is not the best
position to treat the client.
2. Client did not making progress toward therapy goal
3. Client lack motivation or commitment to work
toward agree-upon treatment goal.
3. Sexual misconduct with a client
 It is never appropriate for therapist to engage in sexual
contact with clients.

4. Marked Departures from Established

Therapeutic Practices.
 If counselors employ unusual therapy procedures ,
they put themselves at risk.
5. Practicing techniques beyond the scope of
Competency
 Therapist have been held liable for damages for providing
treatment below a standard of care. If the client follows the
treatment suggested by a professional and suffers damages
as a result the client can initiate a civil action

6. Misdiagnosis
• Lacking the ability to demonstrate diagnostic competence
can result in making a misdiagnosis or no diagnosis. ,
which could leave the therapist vulnerable to an allegation
of malpractice. Aproripratte assessment and diagnosis??
7. Repressed or false memory
 A memory is considered false if it is arrived at through
an untested intervention by therapist rather than
being the client’s actual memory.
 The style in which the therapist questions a client can
influence memories, particularly for young children.
 Repeated questioning can led to a person to believe in
a memory of an event that did not occur.
 If therapist are not specifically trained in child abuse
assessment and treatment, consult with a supervisor or
a professional with expertise in this area or refer client
for a clinical assessment.
8. Unhealthy transference relationship
 If a therapist’s personal reactions to clients cannot be
managed effectively, an abuse of power is likely and
this can have both ethical and legal consequences.

 When client cannot be served in a professional

manner due to a therapist personal feeling about him
/her, it is the therapist’s responsibility to seek
consultation , to undergo personal therapy and if
necessary to refer the client to another counselor.
9. Failure to control a dangerous
 Therapist may have a duty to intervene cases where
clients pose a grave danger to themselves or to others.
Activity
 In a small groups, create an informed consent
document.
 What does your group think clients must be told either
before therapy begins or during the first few session?
Conclusion
 Clients’ right can best be protected if therapists
develop procedures that aid their clients in making
informed choices.
Conclusion
 Therapist have responsibilities to their:
 A. clients
 B. agency
 C. profession
 D. community
 E. the members of their clients’ family
 F. themselves