Ethics: The Basics of Protecting Yourself
January 21, 2015
If you want to protect yourself from potential ethical violations there are a number of things you can do. Consider these factors:
First: Everyone should have malpractice insurance; everyone must get informed consent from their client(s); everyone should follow the rules regarding diagnosing, treatment plans, objectives, and case notes; everyone should have either supervision, case consultation, or peer review no matter how long you've been in the field; everyone should only practice within their scope of practice - that is, in areas of practice where you can demonstrate licensure, certification, education, or experience; and everyone should familiarize themselves with legal and ethical procedures in the areas of practice where they work.
Second: Remember that the likelihood of your being reported on and disciplined is very, very small on a yearly basis. In Ohio and Kentucky, the states where I work and the states I'm most familiar with, the number of disciplinary actions, as a percentage of licensees, is 1/4 to 1/3 of 1 percent per year. To make this real consider these numbers: the Ohio Counselor, Social Worker, MFT Board has approximately 32,000 licensees. The number of complaints per year is around 300. Of these 300 cases two thirds do not result in any disciplinary action. So about 100 licensees per year are disciplined. That represents about 1/3 of 1 percent. The raw numbers for the Ohio Chemical Dependency Professionals Board and the Ohio Psychology Board are very different - 9000 and 3500 licensees. But the percentage of licensees disciplined are remarkably similar. If you go to the website of the Ohio Counselor, Social Worker, MFT Board and look up the number of licensees disciplined it looks like a huge number. That is because there is no statue of limitations. Once you're disciplined and you name goes up on the board website it remains there forever. In Kentucky the raw numbers are smaller still, but the percentages remain similar.
Third: If you want a shorthand for making ethical decisions, consider this: No matter what your area of expertise is, you are governed by the medical model. The medical model is a way of providing services which completely permeates physical, mental health, and substance abuse services. The medical model, simply put, follows this process: (1) we gather data we call symptoms, (2) on the basis of these symptoms we make diagnoses regarding clients, (3) we create treatment plans which are designed to treat the diagnosis, (4) we identify an overall goal and specific objectives which are ways of measuring progress in treating the diagnosis, and (5) we write case notes which describe progress, or lack of progress, in meeting the goal and objectives. The medical model begins with an assumption that the client is sick and the provider is well. Because of this the relationship between us is considered inherently unequal. Because the relationship between us is considered inherently unequal we are not supposed to do anything which carries the risk or potential for exploitation. If you bother to read the Code of Ethics from your national association, or the Code of Ethics written into your state licensing board laws and regulations, you will see the phrase "the risk or potential for exploitation" repeated again and again. If you want a shorthand for decision making in every situation ask yourself if your behavior carries a risk or potential for exploitation.