Immigrant & Refugee, Cultural Diversity & Ethical Boundaries: Freedom from Stereotypes
6 CEUs Cultural Diversity & Ethical Boundaries: Freedom from Stereotypes

Section 15
Excerpts from ACA, APA, NASW, AAMFT & NBCC Codes of Ethics
History and Evolution of Values and Ethics in Social Work
3 Key Legal Requirements and Considerations

Ethics CEU Question 15 | Ethics CEU Answer Booklet | Table of Contents
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

National Association of Social Workers
Code of Ethics

(excerpt summary)
1.07 Privacy and Confidentiality
(a) Social workers should respect clients’ right to privacy. Social workers should not solicit private information from clients unless it is essential to providing services or conducting social work evaluation or research. Once private information is shared, standards of confidentiality apply.
(c) Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed.
(e) Social workers should discuss with clients and other interested parties the nature of confidentiality and limitations of clients’ right to confidentiality. Social workers should review with clients circumstances where confidential information may be requested and where disclosure of confidential information may be legally required. This discussion should occur as soon as possible in the social worker-client relationship and as needed throughout the course of the relationship.
(k) Social workers should protect the confidentiality of clients when responding to requests from members of the media.
- Code of Ethics of the National Association of Social Workers http://www.naswdc.org/pubs/code/code.asp

American Association of Marriage and Family Therapists
Code of Ethics

2. Confidentiality
2.1 Marriage and family therapists disclose to clients and other interested parties at the outset of services the nature of confidentiality and possible limitations of the clients’ right to confidentiality. Therapists review with clients the circumstances where confidential information may be requested and where disclosure of confidential information may be legally required. Circumstances may necessitate repeated disclosures.

2.2 Marriage and family therapists do not disclose client confidences except by written authorization or waiver, or where mandated or permitted by law. Verbal authorization will not be sufficient except in emergency situations, unless prohibited by law. When providing couple, family or group treatment, the therapist does not disclose information outside the treatment context without a written authorization from each individual competent to execute a waiver. In the context of couple, family or group treatment, the therapist may not reveal any individual’s confidences to others in the client unit without the prior written permission of that individual.

2.3 Marriage and family therapists provide clients with reasonable access to records concerning the clients. When providing couple, family, or group treatment, the therapist does not provide access to records without a written authorization from each individual competent to execute a waiver. Marriage and family therapists limit client’s access to their records only in exceptional circumstances when they are concerned, based on compelling evidence, that such access could cause serious harm to the client. The client’s request and the rationale for withholding some or all of the record should be documented in the client’s file. Marriage and family therapists take steps to protect the confidentiality of other individuals identified in client records.
- Code of Ethics of the American Association for Marriage and Family Therapy http://www.aamft.org/iMIS15/AAMFT/Content/Legal_Ethics/Code_of_Ethics.aspx

American Psychological Association
Ethical Principles of Psychologists and Code of Conduct

4. Privacy and Confidentiality
4.01 Maintaining Confidentiality
Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship. (See also Standard 2.05, Delegation of Work to Others.)

4.02 Discussing the Limits of Confidentiality
(a) Psychologists discuss with persons (including, to the extent feasible, persons who are legally incapable of giving informed consent and their legal representatives) and organizations with whom they establish a scientific or professional relationship (1) the relevant limits of confidentiality and (2) the foreseeable uses of the information generated through their psychological activities. (See also Standard 3.10, Informed Consent.)

(b) Unless it is not feasible or is contraindicated, the discussion of confidentiality occurs at the outset of the relationship and thereafter as new circumstances may warrant.

(c) Psychologists who offer services, products, or information via electronic transmission inform clients/patients of the risks to privacy and limits of confidentiality.

4.03 Recording
Before recording the voices or images of individuals to whom they provide services, psychologists obtain permission from all such persons or their legal representatives. (See also Standards 8.03, Informed Consent for Recording Voices and Images in Research; 8.05, Dispensing with Informed Consent for Research; and 8.07, Deception in Research.)

4.04 Minimizing Intrusions on Privacy
(a) Psychologists include in written and oral reports and consultations, only information germane to the purpose for which the communication is made.

(b) Psychologists discuss confidential information obtained in their work only for appropriate scientific or professional purposes and only with persons clearly concerned with such matters.

4.05 Disclosures
(a) Psychologists may disclose confidential information with the appropriate consent of the organizational client, the individual client/patient or another legally authorized person on behalf of the client/patient unless prohibited by law.

(b) Psychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to (1) provide needed professional services; (2) obtain appropriate professional consultations; (3) protect the client/patient, psychologist, or others from harm; or (4) obtain payment for services from a client/patient, in which instance disclosure is limited to the minimum that is necessary to achieve the purpose. (See also Standard 6.04e, Fees and Financial Arrangements.)

4.06 Consultations
When consulting with colleagues, (1) psychologists do not disclose confidential information that reasonably could lead to the identification of a client/patient, research participant or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided, and (2) they disclose information only to the extent necessary to achieve the purposes of the consultation. (See also Standard 4.01, Maintaining Confidentiality.)

4.07 Use of Confidential Information for Didactic or Other Purposes
Psychologists do not disclose in their writings, lectures or other public media, confidential, personally identifiable information concerning their clients/patients, students, research participants, organizational clients or other recipients of their services that they obtained during the course of their work, unless (1) they take reasonable steps to disguise the person or organization, (2) the person or organization has consented in writing, or (3) there is legal authorization for doing so.
- The American Psychological Association's (APA) Ethical Principles of Psychologists and Code of Conduct (hereinafter referred to as the Ethics Code) http://www.apa.org/ethics/code/

American Counseling Association Code of Ethics Excerpt - Section B: Confidentiality and Privacy

B.4. Groups and Families
B.4.a. Group Work In group work, counselors clearly explain the importance and parameters of confidentiality for the specific group.
B.4.b. Couples and Family Counseling. In couples and family counseling, counselors clearly define who is considered “the client” and discuss expectations and limitations of confidentiality. Counselors seek agreement and document in writing such agreement among all involved parties regarding the confidentiality of information. In the absence of an agreement to the contrary, the couple or family is considered to be the client.
B.6. Records and Documentation
B.6.b. Confidentiality of Records and Documentation. Counselors ensure that records and documentation kept in any medium are secure and that only authorized persons have access to them.
B.6.c. Permission to Record. Counselors obtain permission from clients prior to recording sessions through electronic or other means.
B.6.g. Disclosure or Transfer. Unless exceptions to confidentiality exist, counselors obtain written permission from clients to disclose or transfer records to legitimate third parties. Steps are taken to ensure that receivers of counseling records are sensitive to their confidential nature.
B.7.a. Respect for Privacy. Information shared in a consulting relationship is discussed for professional purposes only. Written and oral reports present only data germane to the purposes of the consultation, and every effort is made to protect client identity and to avoid undue invasion of privacy.
- 2014 American Counseling Association’s Code of Ethics http://www.counseling.org/docs/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=4

National Board for Certified Counselors Code of Ethics

NBCC Code of Ethics - Excerpt
NCCs are accountable in their actions and adhere to recognized professional standards and practices.

85. NCCs shall comply with all NBCC policies, procedures and agreements, including all disclosure requirements.

86. NCCs shall adhere to legal standards and state board regulations.

87. NCCs shall not engage in unlawful discrimination.

88. NCCs who make statements in a public manner shall state that their opinions represent their personal views and not another organization unless officially authorized to do otherwise.

89. NCCs providing public presentations by any means, shall ensure that statements are consistent with this Code of Ethics.

90. NCCs who act as university, field placement or clinical supervisors shall require that supervisees provide the supervising NCC’s name, credentials and contact information to the supervisee’s clients.

91. NCCs shall follow administration and interpretation protocols for tests and assessments, including the use of appropriate software if using electronic measures.

92. NCCs shall comply with identified security protocols when using published tests and assessments.

93. NCCs shall comply with intellectual property laws and other accepted publication guidelines.

94. NCCs shall comply with applicable guidelines when designing, conducting or reporting research, including those of an institutional review board.

95. NCCs shall credit the work of others who have contributed to research or publication either through joint authorship, acknowledgment or other appropriate means.

Approved by the NBCC Board of Directors: June 8, 2012
2012 National Board for Certified Counselors, Inc. and Affiliates (NBCC)
- National Board for Certified Counselors (NBCC) Code of Ethics http://www.nbcc.org/assets/ethics/nbcc-codeofethics.pdf

Evolution of Social Work Ethics by Mary Rankin, J.D.

The change in a social worker’s approach to ethical concerns is one of the most significant advances in our profession.  Early in the 20th century, a social worker’s concern for ethics centered on the morality of the client, not the ethics of the profession or its practitioners.  Over the next couple of decades, the emphasis on the client’s ethics began to weaken as social workers began developing new perspectives and methods that eventually would be fundamental to the profession, all in an effort to distinguish social work’s approach from other allied health professions. 

The first attempt at creating a code of ethics was made in 1919, and by the 1940s and 1950s, social workers began to focus on the morality, values, and ethics of the profession, rather than the ethics and morality of the patient.  As a result of the turbulent social times of the 1960s and 1970s, social workers began directing significant efforts towards the issues of social justice, social reform, and civil rights.

In the 1980s and 1990s, the focus shifted from abstract debates about ethical terms and conceptually complex moral arguments to more practical and immediate ethical problems.   For example, a significant portion of the literature from the time period focuses on decision-making strategies for complex or difficult ethical dilemmas.   More recently, the profession has worked to develop a new and comprehensive Code of Ethics to outline the profession’s core values, provide guidance on dealing with ethical issues and dilemmas, and also to describe and define ethical misconduct.  Today, ethics in social work is focused primarily on helping social workers identify and analyze ethical dilemmas, apply appropriate decision-making strategies, manage ethics related risks, and confront ethical misconduct within the profession.

http://digitalcommons.ric.edu/cgi/viewcontent.cgi?article=1169&context=facultypublications

The following contains thee key Legal issues for mental health professionals: Tarasoff - Duty to Warn, Duty to Protect; and Mandatory Reporting of Child Abuse

Tarasoff - Duty to Warn, Duty to Protect
Most states have laws that either require or permit mental health professionals to disclose information about patients who may become violent often referred to as the duty to warn and/or duty to protect. These laws stem from two decisions in Tarasoff v. The Regents of the University of California. Together, the Tarasoff decisions impose liability on all mental health professionals to protect victims from violent acts. Specifically, the first Tarasoff case imposed a duty to verbally warn an intended victim victim of foreseeable danger, and the second Tarasoff case implies a duty to protect the intended victim against possible danger (e.g., alert police, warn the victim, etc.).

Domestic Violence – Confidentiality and the Duty to Warn
Stemming from the decisions in Tarasoff v. The Regents of the University of California, many states have imposed liability on mental health professionals to protect victims from violent acts, often referred to as the duty to warn and duty to protect. This liability extends to potential victims of domestic violence. When working with a client who has a history of domestic violence, a social worker should conduct a risk assessment to determine if whether there is a potential for harm, and take all necessary steps to diffuse a potentially violent situation.

Mandatory Reporting of Child Abuse
All states have laws that identify individuals who are obligated to report suspected child abuse, including social workers these individuals are often referred to as “mandatory reporters.” The requirements vary from state to state, but typically, a report must be made when the reporter (in his or her official capacity) suspects or has reason to believe that a child has been abused or neglected. Most states operate a toll-free hotline to receive reports of abuse and typically the reporter may choose to remain anonymous (there are limitations and exceptions that vary by state so please review your state’s laws).
- Rankin, Mary, JD employed by Healthcare Training Institute to research and write the article Evolution of Social Work Ethics

Personal Reflection Exercise #8
The preceding section contained information about the ACA, APA, NASW, AAMFT and NBCC Code of Ethics.  Write three case study examples regarding how you might use the content of this section in your practice.

Ethics CEU QUESTION 15
What stems from the decisions in Tarasoff v. The Regents of the University of California? Record the letter of the correct answer the Ethics CEU Answer Booklet.

 

Ethics CEU Answer Booklet for this course
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