Jeffrey E. Barnett’s research while affiliated with Loyola University Maryland and other places

The integration of various technologies into clinical services and the provision of tele-mental health can help practices run more smoothly and efficiently, increase access to needed treatment for individuals in remote areas, and expand the reach of the professional services psychotherapists offer. While this brings many potential benefits to practitioners and clients alike, the practice of tele-mental health also brings a number of ethical, legal, and clinical challenges. These are addressed and highlighted through representative case examples. Ethics issues discussed include determining the appropriateness of tele-mental health services for clients, informed consent, confidentiality, clinical and technological competence, and emergency procedures and safeguards. Legal issues addressed include interjurisdictional practice and the role of laws in the jurisdictions where the practitioner and client each are located. Relevant ethics standards and professional practice guidelines are reviewed, and specific recommendations for the ethical, legal, and clinically effective practice of tele-mental health are provided.

The use of various technologies in the practice of psychology has increased greatly in recent years in concert with increases in the use of these technologies in the lives of most individuals. E-mail, text messaging, chat rooms, and the Internet have greatly changed how many individuals communicate and maintain relationships. The psychotherapy relationship is no exception. The scope and practice of telepsychology, the use of the Internet and other technologies in the provision of psychological services, is reviewed along with relevant research that supports their use in the treatment of a wide range of conditions and disorders. Clinical, ethical, and legal issues and challenges are addressed and recommendations for the effective and appropriate use of these technologies in psychological practice are provided.

The second edition of this highly practical and easily understood handbook provides counselors and students with the means to quickly apply the 2014 ACA Code of Ethics to practice and to professional roles and activities. It contains on-point recommendations for each standard of the Code, a decision-making model, and a listing of ethics resources. Part I presents each section of the Code, along with a brief commentary that emphasizes its most essential elements, common ethical dilemmas and problems relevant to that section, and specific strategies for risk prevention and positive practice. Part II contains ethical guidance sections focused on areas that counselors often encounter in their work, including culture and diversity, confidentiality and exceptions to confidentiality, counseling suicidal clients, multiple relation-ships in counseling, competence, supervision, managed care, termination and abandonment, and how to respond to an ethics complaint or malpractice suit. New to this edition is a section titled "Integrating Technology into Counseling Practice." Requests for digital versions from the ACA can be found on wiley.com. To request print copies, please visit the ACA website. © 2015 by the American Counseling Association. All rights reserved.

Counselors facilitate client growth and development in ways that foster the interest and welfare of clients and promote formation of healthy relationships. Trust is the cornerstone of the counseling relationship, and counselors have the responsibility to respect and safeguard the client's right to privacy and confidentiality. This chapter contains several subsections which deal with various aspects of counseling relationship. These include: informed consent in the counseling relationship; request for release from clients served by others; avoiding harming clients and imposing values; prohibited noncounseling roles and relationships; managing and maintaining boundaries and professional relationships; roles and relationships at individual, group, institutional, and societal levels; and abandonment and client neglect. The essential elements of each aspect, the common dilemmas and conflicts faced by the counselors and the positive practices that need to be followed, are provided.

The counseling relationship may end for a variety of reasons. These may include client-motivated reasons and counselor-motivated reasons. Client-motivated reasons for ending the counseling relationship are: client's goals are achieved; insurance benefits are exhausted; financial limitations; moving from the area; transferring to a new counselor; and dropping out of counseling. Counselor-motivated reasons for ending the counseling relationship include the following: counselor competence issues; lack of client progress; boundary issues and multiple relationships; and conflicts or threats. The way a counseling relationships ends has a significant impact on the success of a counselor. Every counselor is ethically obligated to anticipate, plan for, and openly discuss relationship endings with clients. Thoughtful planning related to termination protects clients' best interests in the same way that ignoring termination exposes clients to harm stemming from abrupt endings and feelings of abandonment. The chapter also presents some recommendations for terminating the counseling relationship.

In every counseling relationship, counselors help clients to achieve their goals while minimizing the risk of exploitation or harm. Maintaining appropriate boundaries and exercising caution when entering more than one relationship with a client are ways that counselors can help to prevent harm. Boundary violations (e.g., having sexual manner or romantic relationships, extending session time limits without a clear clinical rationale, disclosing personal information, accepting bartering services, and soliciting client testimonials) are often motivated by the counselor's needs and not by the client's best interests. However, it is important to note that rigid adherence to boundaries (e.g., never touching a client under any circumstances, refusing every small gift, refusing to extend a session for any reason) may be just as harmful to a client and the counseling relationship as a boundary violation.

Confidentiality is essential for a successful counseling relationship. Clients share their most personal thoughts in an atmosphere of trust in the hope of receiving much-needed assistance. There are many threats to confidentiality. Counselors must use forethought and vigilance to minimize risks to confidentiality. To reduce the probability of inadvertent disclosures of confidential information, this chapter offers several recommendations. The recommendations are to: provide clear informed consent; inform couples, families, and groups about the unique risks to confidentiality generated by these counseling contexts; pay special attention to office design; clarify office practices and procedures; take responsibility for staff training; be cautious when responding to requests for information; monitor record storage and disposal; inform clients about consultation and supervision; and be thoughtful about using technology.

Managed care refers to a range of insurance entities that provide oversight of the utilization of health insurance to pay for needed health care. Although managed care may help reduce some health care costs (costs to the insurance company), it also can bring with it a number of challenges and dilemmas that counselors must be prepared to confront and address to ensure their ethical practice. Issues to be addressed here include informed consent, confidentiality and its limits, competence, contracts, utilization review, and termination and abandonment. Attention to each of these issues should assist counselors to provide care to their clients in a managed care environment in compliance with the ACA Code of Ethics and in keeping with their clients' best interests.

Professional counselors behave in an ethical and legal manner. They are aware that client welfare and trust in the profession depend on a high level of professional conduct. This chapter contains several subsections which deal with various aspects of ethics. These are: legal standards; suspected violations; unwarranted complaints; and cooperation with ethics committees. The essential elements of each aspect, the common dilemmas and conflicts faced by the counselors, and the positive practices that need to be followed, and those that have to be prevented, are provided. When counselors are faced with an ethical dilemma, they use and document, as appropriate, an ethical decision-making model that may include, but is not limited to, consultation; consideration of relevant ethical standards, principles, and laws; generation of potential courses of action; deliberation of risks and benefits; and selection of an objective decision based on the circumstances and welfare of all involved.