Professional Issues - Research Paper Example

Court Ordered Professional Issues in Clinical Mental Health Counseling Court Ordered Professional Issues in Clinical Mental Counseling 1.0 Introduction A court ordered therapist has been defined by the Association of family and conciliation courts as any mental health professional who provides psychotherapeutic treatment of a parent, child, couple or family undertaken because it was ordered by a judge. Courts may order mental health counseling for therapeutic services for clients involved in child custody and juvenile dependency court processes (AFCC, 2010). They also render the court ordered therapeutic services to those who require rehabilitative services. In carrying out this duties, they are bound by ethical, professional and legal obligations regarding how, where and when to release their client records, test data and any other relevant information (APA Committee on Legal Issues, 2006). This academic paper will offer a literature review discussion on the current professional issues affecting practitioners of mental health counseling with reference to court ordered clients. The paper is arranged as follows, the first part focuses on trends pertaining to best practices, and the next part will assess the efficacies of treatment and interventions. The third part will look at measures necessary to improve or enhance service delivery. 2.0 Best Practices in Mental Health Counseling The American Mental Health Counselors Association (AMHCA) code of ethics affects the clinical practice of mental health practitioners. This code of ethics provide guidelines that enable them to make sound ethical decisions, behavioral standards and best practices when handling their clients including the ones referred to them court (AMHCA, 2010). According to AMHCA, a mental health counselor is required to uphold high professional standards by respecting the dignity and promoting the welfare of their clients. Fundamentally, they are required to treat the information that they have obtained in the course of their practice with utmost confidence unless permitted by the client (AMCHA, 2010). It is important to take note of the fact that the legal requirements of the court order may conflict with the responsibility to keep client information confidential (APA, Committee on Legal Issues, 2006). This is because disclosure of client information in the event of such an order requires that the outcomes of the treatment to be made available to the court (AMCHA, 2010). The courts and the legal system therefore have an overriding authority to overrule the established code of practice for mental health professionals through legal and judicial exceptions (APA, Committee on Legal Issues, 2006). Courts may sometimes order mental health counselors to render services to minors or clients who lack the capacity to consent. Regardless of their legal position of incompetence, their parents or legal guardians may be privy to their information and even include them in the process of counseling as circumstances permit (AMHCA, 2010). For the counselor to disclose that information to any third party, they must seek permission of the guardians or parents. Collaborations between parents and legal guardians should be used to serve the client’s best interests (CRCC, 2010). The mental health counselors as a general matter of practice are required to foster an environment where their clients make informed choices. In this regard, they must respect their client’s entitlement to know and understand what is expected of them, how the information disclosed will be utilized and the liberty to choose whom and whether to enter into a counseling relationship (AMCHA, 2010). The Association of Family and Conciliation Court stresses on the need to establish and maintain appropriate role boundaries. In its guidelines for Court involved therapy, therapists are urged to resist any compulsion from anyone to provide exceeding their recognized ethical standards (AFCC, 2010). However, in the endeavor to respect the requirements of the legal system by the mental health counselors, clients have a very limited informed choice range as to the choice of therapists. They also have a restricted choice as to whether to choose or reject a form of treatment, which disregards their autonomy (AFCC, 2010). Generally, in terms of practice, mental health counselors are required to act in the best interest of the client. They must only render services that they are competent enough to render with due regard to their training, supervised experience and professional expertise (AMHCA, 2010). It is imperative that mental health professionals avoid potentially harmful relationships with their clients, their romantic partners, and closest friends. This enables them to carry out their evaluations in a professional and objective manner (CRSS, 2009). Mental health counselors should also respect the right and dignity of their clients through appropriate assessment, interpretation, and diagnosis of mental disorders. They are called upon to rely on multiple sources of information when diagnosing mental health conditions and provide evidence for their conclusions (AMHCA, 2010). When dealing with court-referred clients mental health practitioners should avoid carrying out roles that create conflict of interest. There must be clarity in the role being played without playing simultaneously conflicting roles (AFCC, 2010). This helps to avoid impaired objectivity, competence and effectiveness of the counseling services (AFCC, 2010). Professional standards of practice demand that a mental health counselor avoid actions that promote their selfish needs at the client’s expense. An example of such relationships includes existing and present romantic relationships (AMHCA, 2010). 3.0 Efficacy of Treatment and Interventions Mental health counseling orders have a therapeutic value because it is aimed at addressing the psychosocial needs of the individual mentally ill offender. This has helped to reduce recidivism which is attributed to poor treatment compliance by offenders by early identification and treatment rather than jail terms (Cosden et al, 2005). The cultural competency aspect in the effective application of mental health counseling techniques has also been fronted. It presupposes the adoption of interventions that maximizes on the optimal development of clients and their systems (Whaley & Davis, 2007). In other words Whaley and Davis advocate for culture specific interventions rather than a uniform approach to mental health counseling. This is because different races and classes have diverse and unique issues that lead to mental illness or drug abuse and therefore response to their psychosocial needs should target their socio-economic settings. There are competing ethical interests between Empirically Supported Therapies (EST) and Potentially Harmful Treatments (PHT). EST treatments respect the first-do-no-harm principle (primum noncore) while the latter takes is largely experimental provided the patient consents (Lilienfeld, 2011). Research has established that EST’s are effective for certain mental conditions like depression and panic disorders but it has been criticized for being a product of inadequate research. EST on the other hand is a last resort option with a risk potential but its counter-effects are managed as they arise provided the patient is attended to (Lilienfeld, 2011). 4.0 Improvement of Service Delivery The Federal Drug Court Guidelines advocate for tried and tested interventions in mental health counseling. The agency has developed a system which values collaboration, communication, early identification and assessment, sufficient funding as well as constant evaluation of shared outcomes (FDG, 2013). This should be adopted across the board when dealing with court ordered patients as circumstances shall permit. Courts must adopt medication monitoring and drug testing coupled with screening and assessment approaches that examine the level of mental health deterioration and substance abuse content. They should apply graduated sanctions to accommodate the needs of participants and educate themselves on substance abuse and related disorders (Peters and Osher, 2004). Collaboration between court systems and health systems is important and so is the identification of mental health needs among the youths and all other demographic groups in need of rehabilitation. Diversion to treatment has also been advocated rather than incarceration and provision of access to treatment services for people in need (Skowyra & Coccoza, 2013). Cultural and gender sensitive approaches should also be applied by making interventions that appreciate the unique circumstances and therefore needs (Whaley & Davis, 2007). 5.0 Conclusion In conclusion, mental health counselors are called upon to balance the professional, ethical legal considerations to be taken into account whenever their services are needed by the courts. This involves a ensuring a delicate balance between the professional standards of practice, the statutory regime and the court orders. Professional considerations should serve as the yardstick for the measurement of how relevant and appropriate a court order or a subpoena is. Professional ethics cannot be overlooked therefore by the court or any written law but should be co-opted at all times in all court ordered mental health counseling. References AFCC. (2010). Association of Family and Conciliation Courts: Guidelines for Court-Involved Therapy. Retrieved from http://www.afccnet.org/Portals/0/PublicDocuments/ CEFCP/Guidelines%20for%20Court%20Involved%20Therapy%20AFCC.pdf AMHCA. (2010). Principles for AMHCA Code of Ethics. Retrieved from https://www.amhca.org/assets/news/AMHCA_Code_of_Ethics_2010_w_pagination_cxd_51110.pdf Committee on Legal Issues, APA. (2006). Strategies for Private Practitioners Coping with Subpoenas or Compelled Testimony for Client Records or Test Data. Professional Psychology; Research and Practice, 37(2), 215–222. Cosden, M., Ellens, J., & Yamini-Diouf, Y. (2005). Efficacy of a Mental Health Treatment Court with Assertive Community Treatment. Behavioral Sciences and the Law, 23, 199-214. CRCC. (2010). Code of Professional Ethics for Rehabilitation Counselors. Chicago IL: Commission on Rehabilitation Counselor Certification. Lilienfield, S.O. (2011). Psychological Treatments That Cause Harm. Perspectives on Psychological Science, 2 (1), 53-70. Retrieved December 5, 2014 from pps.sagepub.com OJJDP. (2014). Guidance to States; Recommendations For Developing Family Drug Court Guidelines. Retrieved December 5, 2014, from http://www.cffutures.org/files/publications/FDC-Guidelines.pdf Peters, R.H., & Osher, F.C. (2004). Co-occurring Disorders and Specialty Courts. Delmar, NY: The National Gains Center. Whaley, A.L., & Davis, K.E. (2007). Cultural Competence and Evidence-Based Practice in Mental Health Services; A Complementary Perspective. American Psychologist, 62 (6), 563-574. Skworya, K.R, & Coccoza, J.J. (2007). A Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth With Mental Health Needs in Contact with the Juvenile System. Delmar, NY: National Center for Mental Health and Juvenile Justice. Read More