Legal Issues of Counselling

“Vanessa listens to me with total concentration and analyzes all the information I give her to give me very practical and realistic support and suggestions. She has greatly improved my life with her experience and knowledge in a very short time. She has been very helpful in managing my disability issues, family issues, relationships and careers. She`s covered everything, so I feel less worried and I`m confident I have a plan to keep all these things under control. I don`t feel alone. 1. Confidentiality: Anyone with a mental illness has appropriate confidentiality regarding their intellectual fitness, remedies, fitness care, and any fitness specialist who mediates care. Confidentiality of advice is morally and legally justifiable, as it serves to shift the consumer`s time and allows for excellent care. This is an extreme ethical responsibility and a pro-action action that is right in itself. When it comes to ethics and regulation in the board, however, the issue of confidentiality is regularly pitted against the requirement to issue warnings. One of the most difficult questions asked by expert advisors is how they should disclose personal statistics when they believe statistics are crucial to saving you the dangers of misuse or harm to different people. The regulation may require them to disclose private statistics under penalty of criminal penalties.

Therefore, weighing the pros and cons, documenting everything that happened in therapy, or documenting nothing, is often a big dilemma. From a medico-legal perspective, not documenting something can put therapists at increased risk. However, documenting everything can cause a lot of harm to the client if these documents are disclosed or evaluated by someone. From an ethical point of view too, it is unacceptable not to document anything. Therefore, the scope of documentation may vary from session to session and is strongly influenced by the type and intensity of psychotherapy. In addition, documentation should be based on the likelihood that files will be assessed by others. Therefore, clinicians should use their clinical judgment to maintain concise and factual documentation of psychotherapy while respecting the patient`s privacy. However, documentation should include significant events in the treatment environment or in the patient`s life, clinical observations of the patient`s mental and physical condition, the psychiatrist`s efforts to obtain relevant information from other sources, the results of the examination, including psychological test results, information provided to the client regarding medications, suicidal thoughts with intent to act, child maltreatment, threats of harm to others, consultations with other clinicians, if applicable, and basic information necessary to maintain continuity of care in all cases.

Documentation of information relating to intimate personal relationships, fantasies and dreams, as well as sensitive information about other people in the patient`s life, should be based on clinical judgment. However, documentation of assumptions or speculations should be avoided [Table 11]. [26,32,33,34] The therapist may keep a personal note, which may be kept separate from medical records, which may include details about the client`s intimate problems, problems related to other people in the patient`s life, the therapist`s own observations, assumptions, etc. These can serve as guidelines for future psychotherapeutic work. However, an important aspect is that there should be no information that can reveal the identity of customers to others. In addition, the client`s consent must be obtained if the therapist wishes to use these records for teaching purposes without identifying the client. In addition, banknotes should be destroyed as soon as they have served the purpose for which they were stored. It is also important to note that the content of these notes may not be helpful to the therapist in the event of a lawsuit. [32] As for the therapist, “he or she should terminate psychotherapy when it is clear that the client no longer needs psychotherapy, is unlikely to receive it, or will suffer more harm than the benefit of continuing psychotherapy.” Such a decision can be made by continually reviewing the progress of psychotherapy from time to time and the goals (initial or adjusted from time to time in therapy) of psychotherapy at the beginning. If the review of the evidence indicates that the client`s mental state is gradually deteriorating, it is advisable to consider discontinuation of psychotherapy. However, in such situations, when the therapist is in a dilemma, proper monitoring or referral to another therapist can be very beneficial for the therapist to confirm/disagree with their decision. Another important problem that can lead to the therapist stopping psychotherapy is the continuous uncontrollable countertransference and pressure on the self while the therapy continues.

Psychotherapy may also be discontinued if the client sues the therapist (by initiating legal proceedings). In addition, other reasons why the therapist interrupts therapy may be moving from the therapist`s workplace, the therapist`s illness, or leaving the therapist`s workplace. However, it is important to note that some of these situations may be expected before starting psychotherapy, such as: the end of the term/the date of training and the date of retirement. Accordingly, it is advisable to include it in the therapeutic contract. Similarly, the name of a colleague as an alternative therapist may be included in the therapeutic contract in unforeseen cases. [25] In addition, there are situations where confidentiality issues are not specifically defined for psychotherapy by law enforcement, general laws regarding confidentiality are applied in medical practice. Important situations where there are grey areas include confidentiality issues in the case of minors, where the parents have a conflictual relationship or are in the process of divorcing; Confidentiality in the event of the client`s death and confidentiality issues in the case of marital or family therapy. The therapist must anticipate these situations and discuss these issues while seeking informed consent and including it in the therapeutic contract. In case of lack of clarity, however, it is always advisable that the therapist and the client seek the advice of colleagues and lawyers before concluding the contract. “It`s ethically important to prioritize our work, which is voluntary,” says Duggan, a Certified Professional Counsellor and Certified Clinical Counsellor. “Ultimately, professional consultants who run a healthcare business should also act as ethical business people.

Always consider ethical, legal, and compliance considerations before reducing fees, co-payments, or sub-bills. “Ethical issues in counseling are usually the responsibility of the therapist. This means that it is the therapist`s responsibility to avoid unethical interactions with clients. This article will take a closer look at what the ethical responsibilities of the therapist entail and examine some common ethical issues that psychiatrists face. It may be noted that according to the guidelines of the Medical Council of India[35], treatment records must be kept for at least 3 years. Any request for medical records from a client, their authorized representative or judicial authorities must be duly confirmed and a copy of the records must be provided within 72 hours.