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Professional Orientation, Licensing, And Credentialing

1. Describe the ethical issues encountered by counselors who work in private or public mental health organizations or school settings.
2. Determine professional organizations, preparation standards, and credentials relevant to the practice of clinical mental health counseling or school counseling. [CACREP 5.F.2.n, 5.C.2.k]
3. Determine the requirements for credentialing, licensure, certification, accreditation practices, and standards, including tiered levels, in the state in which the counselor in training plans to practice clinical mental health counseling or school counseling and how public policy affects the requirements. [CACREP 2.F.1.g]
4. Describe the key roles and functions of clinical mental health counseling or school counseling licensure/certification and credentialing boards and how such boards attempt to protect the public from substandard counseling practices. [CACREP 2.F.1.i, 5.G.2.l]
5. Describe steps that counselors can take to minimize their professional liability and the likelihood that complaints will be filed against them for failing to maintain a professional standard of care.

Janet has been seen by you for treatment of depression. During her intake assessment, she disclosed that she was in AA and had been sober for six months. Janet seems to be happy with her progress, but after a few sessions, she seems to be noncommunicative and upset. After six sessions, she discontinues therapy with you. You learn that she has engaged another counselor who treats alcohol use and co-occurring disorders. This morning you received notice from your licensing board that Janet filed a complaint against you alleging that you attempted to treat Janet’s addiction to alcohol and that you did not have the expertise necessary to do so. You are a licensed professional counselor, but you have not obtained training in addictions. Based on this information, answer the following questions:
• Does Janet have a valid complaint? Why or why not?
• How would you respond to the licensing board complaint?
• How would you avoid this type of complaint in the future?
• How might this impact the school counselor’s role if this were a student in the school setting?

Sample Answer

Ethical Issues in Mental Health and School Settings

Counselors in diverse settings encounter complex ethical dilemmas that require a balance of legal mandates and moral obligations.

Confidentiality vs. Duty to Warn: In both settings, counselors struggle with when to break confidentiality. In schools, this is complicated by the rights of parents versus the privacy of the minor.

Dual Relationships: In rural or tight-knit school communities, a counselor may encounter clients at social events or local businesses, risking a "dual relationship" that can blur professional boundaries.

Informed Consent with Minors: School counselors must navigate the ethical challenge of providing services to students who may not be legally able to provide consent, often requiring parental involvement while maintaining the student’s trust.

Competence: Counselors face ethical violations if they practice outside their scope of expertise (e.g., treating a complex eating disorder without specialized training).