ACA Code of Ethics: Quick and Dirty Reference Guide

2023-2024-aca-code-of-ethics-quick-guide

Do you ever feel that reading the ACA Code of Ethics is like interpreting ancient scrolls? We are all familiar with this feeling! That’s why we made this helpful pocket guide—a readily available resource to help you navigate the ethical landscape of counseling.

Think of it as your Cliff’s Notes for ethical practice! This guide is not intended to replace the official Code but to act as your practical resource. We will dissect and simplify the main principles into manageable portions so that you can confidently apply them in your daily work.

Is There a 2023 or 2024 ACA Code of Ethics

Don’t worry if you are wondering if there’s a recent ACA Code of Ethics version. As of May 13, 2024, we are still using the old 2014 version.

So, is this guide still relevant?

This companion guide, made in partnership with Eric Groh, LPC (a previous state licensing board complaints investigator with more than seven years of experience! ), is still helpful. It provides clear explanations and practical situations to understand and implement the ACA Code in your daily practice.

Eric has seen it all—dealing with over 200 consumer complaints against Georgia counselors, social workers, and marriage and family therapists. He has consulted many times for attorneys representing licensees about different legal issues. Now, Eric shares what he learned from all these years of experience, hoping it can assist therapists in becoming more confident in their work field.

Section A: The Counseling Relationship

A dependable connection between counselor and client is vital for good therapy results. A counselor who is not trustworthy might misuse the details shared by their clients, harming them. Messing up here can lead to severe consequences.

Clients who feel hurt or betrayed by their counselor may be more prone to make complaints and sometimes even lawsuits. Remember that the ethical rule is based on “do no harm,” so a broken therapeutic connection goes against this principle.

Intimate Relationships With Current or Previous Counseling Clients

One crucial element of the counseling relationship is setting clear boundaries. This involves not getting into intimate relationships with present or past clients. The ACA Code of Ethics is clear: counselors must avoid intimate relationships with clients for five years starting from the last date of contact.

Your state’s licensing board might have stricter regulations than the ACA Code of Ethics. Always research your state’s laws and rules regarding close relationships with clients. If unsure, it’s better to be cautious and get legal advice.

Records and Documentation

Another element of the counseling relationship is maintaining accurate and secure records. These records document your client’s progress over time and tell the story of their struggles and mental health journey, information which is essential for treatment planning and future reference. These records are especially crucial for:

  • Psychotherapeutic interventions: Any intervention you implement should be documented, especially if not doing so could be considered irresponsible.
  • Suicide risk: Thorough documentation of suicide risk assessments and interventions is vital.
  • Couples and minor clients: Therapists working with couples or minors should maintain exceptionally detailed records due to the complex dynamics involved.

Thorough documentation can also be your shield in case of legal issues. For example, imagine a lawsuit from a parent whose child tragically committed suicide. Detailed notes showing you documented suicide risk and coordinated care with the child’s psychiatrist can be your strongest defense.

Suicide Risk

Ethical dilemmas can be tricky, but when they involve the risk of suicide, the significance elevates. Failing to intervene responsibly in these situations can raise questions about your competence and ability to practice within your expertise.

The ACA Code of Ethics highlights putting client safety first through:

  • Comprehensive Assessment: Apply a risk scale to assess your client’s suicidal thoughts, considering if they have a plan or means, intention, and any protective aspects (such as worry about people they care for).
  • Appropriate Level of Care: Determine the level of care your client needs. If outpatient therapy is necessary, document that in your notes. In more severe cases, facilitate access to a higher level of care (e.g., hospitalization).

Family or Child Counseling

Family and child therapy presents unique ethical challenges due to legal issues with minors and complex boundary management. Some of the most frequent lawsuits against therapists involve poor boundary management between parents and children and a lack of understanding of custody and reporting requirements.

The therapy requires ongoing training to stay up-to-date on legal issues related to minors and family therapy. Document any family/child counseling training because the court or licensing board will continually evaluate your competence in treating the client. Additionally, avoid crossing boundaries, especially when working with families involved in custody disputes.

Informed Consent

Informed consent empowers clients to make informed decisions about their treatment. Here’s what the ACA Code of Ethics highlights regarding informed consent:

  • Written and ongoing: Insist on written informed consent from clients at the beginning of therapy. Additionally, verbally discuss consent throughout treatment.
  • Transparency is vital: Explain any interventions you plan to use, including therapy types (e.g., sex therapy, crisis intervention) and potential actions (e.g., involuntary hospitalization).
  • Beyond talk therapy: Get your client’s consent for therapies that are not typical, such as hypnosis and EMDR (Eye Movement Desensitization and Reprocessing).

To maintain the therapeutic relationship, “check in” with your client regularly. Ensure they understand the treatment plan and allow them to ask any questions regarding the treatment.

Developmental and Cultural Sensitivity

The ACA Code of Ethics emphasizes cultural competence as an essential aspect of ethical practice. This means demonstrating sensitivity to your client’s cultural background and ensuring clear communication throughout therapy. Explain informed consent and other key concepts in terms that are culturally appropriate and easy for your client to understand.

According to an Australia Psychological Society study, 35.5% of misconduct reports often stemmed from poor communication standards. Therapists with unconscious biases or a reluctance to learn about their clients’ cultures risk providing incompetent care. This can lead to licensing board complaints and potential liability issues.

Inability To Give Consent

The idea of informed consent is based on a client’s understanding and agreement with the treatment. But what if a person’s mental condition influences their capability to make decisions? When faced with such a scenario, you need to consider developing your skills in assessing a client’s capacity to understand the nature and implications of treatment. Finding the right balance is crucial. While protecting clients from harm is essential, you also want to respect their autonomy as much as possible.

Clients Served By Others

Often, clients also receive care from other mental health professionals. The ACA Code of Ethics highlights the need for coordinated care in these cases. If your client is seeing a psychiatrist, establish a communication channel with them (with your client’s consent).

This will help in having a shared understanding of treatment objectives and methods. Also, if the client takes medicine, keeping up with their progress and medication management appointments is essential.

You can do this by directly communicating with the psychiatrist or motivating your client to give you regular updates.

Bartering

The ACA Code of Ethics is cautious about bartering for therapy services. Even though it is technically permitted with written consent and is not exploitative, there are considerable ethical issues to consider.

  • Dual relationship concerns: When you barter, you become the client’s customer and their therapist. This creates a dual relationship that can compromise your objectivity and potentially harm the client.
  • Power imbalance: The therapeutic relationship inherently involves a power dynamic. Bartering introduces financial considerations that can further distort this balance and potentially exploit the client.
  • Boundary crossing: Bartering is a clear boundary violation. Your professional relationship with your client should be separate from any business transactions.

Imagine a client filing a complaint after a bartering arrangement goes sour. This can lead to a licensing board investigation and highlight the boundary crossing inherent in such a situation.

Receiving Gifts

The ACA Code of Ethics acknowledges that cultural norms and the value of a gift might influence its appropriateness. However, the most crucial factor lies within you, the counselor.

Carefully examine your motivations for accepting a gift from a client. Are you feeling obligated? Is it creating an unbalanced dynamic in the therapeutic relationship? When unsure, consult a trusted colleague or supervisor for their ethical perspective.

Termination and Abandonment

When the therapy relationship ends, it must be handled ethically. Sometimes, you may have to choose between shifting a client to a provider with more specialized knowledge or pursuing the treatment yourself. The best interest of the client should guide this decision. There are also other situations where the transfer is needed:

  • If your client needs more intensive treatment than you can offer (e.g., hospitalization), assist in arranging an orderly transfer to an appropriate provider.
  • If your client moves to another state, it might not be legal for you to provide services anymore. The client should be quickly and ethically transferred to a local therapist.

There might be situations where a rapid transfer is necessary, such as when you can no longer treat a client for legitimate reasons. Hold brief “summary sessions” in these cases to help clients acknowledge their progress and prepare for the transition.

Section B: Confidentiality and Privacy

Respecting Client Confidentiality

Section B of the ACA Code of Ethics delves into confidentiality and privacy, the core of establishing trust in therapeutic relationships. It assures clients that they can freely share their vulnerabilities with you, confident that their information will remain private.

Even if the client has signed a release of information form, it remains crucial to ensure that they understand why they share their details and what will be revealed. Take the time to explain the details in a way that’s easy to understand.

Clients Lacking Capacity To Provide Informed Consent

Confidentiality is especially difficult when working with minor clients who can’t yet give informed agreements. While parents or legal guardians participate in their child’s therapy, ensure they understand the limits. You might need to maintain confidentiality to guarantee the child’s safety.

Explain and write out the expected results for sharing details with parents/guardians and the minor client (to their capacity). After getting permission, stick to it. Don’t share more information than what was agreed upon, and always put the welfare of the minor client first.

Storage and Disposal of Records

Confidentiality extends beyond conversations with your clients. It also applies to how you store and dispose of their records. While no federal laws dictate how long you should keep therapy records, some states have specific regulations.

To ensure everything is per regulations, start by reviewing the laws in your state regarding record retention for psychotherapy records. If your state laws need clarification, consider seeking legal counsel for tailored guidance based on your state’s regulations.

Without specific psychotherapy record retention laws, the ACA Code suggests following the guidelines for general medical records in your state.

Section C: Professional Responsibility

Nondiscrimination

The ACA Code of Ethics position on discrimination is strict and broad. The Code strongly opposes discrimination based on various factors, including age, culture, race, religion/spirituality, gender, marital status, immigration status, or any basis proscribed by law.

Does this require us to treat every client regardless of the above factors?

  • Non-discrimination vs. selective practice: The Code doesn’t require you to treat every single client who comes to you. You can specialize in certain areas or limit your practice to specific populations.
  • Discrimination = incompetence: Licensing boards may consider discriminatory counseling to be a kind of incompetence or work in an area where one lacks enough knowledge.
  • Protecting clients from harm: Your ethical duty is to ensure that your clients are not harmed. This even refers to instances when your beliefs might interfere with a client’s welfare.

    There are instances when therapists do not want or simply cannot change their viewpoints on a demographic. An example is if a counselor holds strong religious beliefs that could hurt an individual seeking guidance.

Client Access To Records

Ever wonder what clients can (and can’t) see when they request their therapy records? The ACA Code of Ethics clarifies this for us. While clients have a right to most of their files, one key exception is psychotherapy notes.

Consider psychotherapy notes as your private roadmap for a client’s therapy journey. They might include your initial impressions, treatment hunches, and ongoing observations. HIPAA law recognizes these notes as uniquely sensitive, so clients don’t have direct access to them.

But that doesn’t mean clients are left in the dark! They can still get the information they need. You can send the psychotherapy notes directly to a trusted third party, like their lawyer or doctor, with the client’s consent.

Testimonials

While positive feedback is always lovely, it’s a big no-no to solicit them from current or past clients or even supervisees you’re working with. Why? Because of the power imbalance.

Think about it: you’re in a position of authority, and your clients or supervisees might feel pressured to say nice things, even if they’re not entirely comfortable. The ACA wants to ensure clients feel empowered and protected, so testimonials are off-limits during therapy or supervision.

But once supervision ends, the power dynamic shifts. You and your former supervisee become professional colleagues. At that point, if they offer a glowing testimonial, that’s perfectly acceptable!

Section D: Relationships With Other Professionals

The ACA Code of Ethics offers guidance for tricky situations that can arise when working with other mental health professionals. If you encounter unethical or harmful workplace policies, the ACA Code encourages you to voice your concerns to your employer and work towards positive change. If your employer insists on practices that could harm clients, the Code emphasizes taking “appropriate further action,” which might even include resigning.

Avoid filing ethics complaints out of spite or without a solid basis. Ground your complaints in fact and think about protecting your clients. It’s wrong to harass or punish someone who has ethically exposed a colleague’s wrongdoings. If you were fired for raising ethical concerns (not violating the Code yourself), the ACA Code encourages seeking legal support to defend yourself.

Section E: Evaluation, Assessment and Interpretation

Section E of the ACA Code of Ethics focuses on using psychological assessments responsibly and competently.

Psychological tests are great for diagnosing, defining someone’s personality type, and comprehending a client’s mental and emotional performance. But their use should be cautious and thoughtful. You must only administer tests you have been suitably trained to apply and understand.

If you’re looking to expand your practice into using psychological testing, thoroughly research the different types of assessments available, including:

  • Forensic evaluations
  • Competency assessments
  • Immigration assessments

Misusing assessments can have severe legal and ethical consequences. For instance, improper child custody or family violence evaluations can have a significant impact on people’s lives.

The Code also highlights the need for a designated mental health professional to assume responsibility for your client records in situations such as death, retirement, or termination of practice. Certain states have explicit laws about how long mental health records should be kept, but others depend on general medical record retention rules.

Section F: Supervision, Training and Teaching

Supervisors should be open and honest in giving helpful comments to their supervisees so they can improve professionally. The relationship should be built on mutual respect and trust.

Multicultural Issues/ Diversity in Supervision

The ACA Code of Ethics advises supervisors to consider cultural awareness while working with supervisees. Suppose the supervisee lacks the skill or knowledge to work well with a specific client group because of culture or other reasons. In that case, the supervisor must assist the supervisee in gaining those skills or direct the client toward another therapist who may be more suitable for their needs.

Sexual Relationships With Supervisees

The ACA Code of Ethics is crystal clear: sexual relationships with supervisees are strictly prohibited, both during and after supervision. This is because the power imbalance inherent in supervision creates an environment where consent might be compromised.

There are fundamental differences between the therapeutic relationship and the boundaries of an LPC supervisor/supervisee relationship:

Mentoring and Development

Supervision is a unique blend of professional guidance and personal growth. Unlike therapy, where clear boundaries are essential, some level of self-disclosure by the supervisor can be appropriate in supervision.

Supervisors act as mentors, and sharing their own experiences (including failures and successes) can help build trust and confidence. This vulnerability can be a powerful learning tool, fostering a supportive environment where supervisees feel comfortable asking questions and taking risks.

Once supervision concludes, it’s natural to feel a sense of camaraderie and perhaps even consider developing a friendship. However, the power dynamic still exists to some degree.

Legal Confidentiality and Supervision

Unlike therapy communications, which have strong legal protections, most states don’t offer the same blanket protection for everything discussed in supervision. However, information about specific clients usually remains confidential under ethical guidelines.

Multiple Relationships and Supervision

Supervision creates a unique situation—a dual relationship. The supervisee is both a student under your guidance and a future colleague. This is why multiple-client relationships (e.g., a therapist treating a friend or family member) are generally prohibited, but supervision is an essential exception.

Section G: Research and Publication

University policies and government laws heavily regulate research involving human subjects. The ACA Code of Ethics emphasizes adhering to these established frameworks and conducting research in a genuine academic setting with proper protection. If your study involves clients, you must follow the rules explained in the ACA ethical codes just like you do with other parts of the Code—emphasizing getting consent and safeguarding the client.

Section H: Distance Counseling, Technology and Social Media

Counselors don’t search for clients’ presence on social media unless given consent to view such information.

Counselors maintain separate professional pages for interacting with clients and the public at-large. Social media account settings should block counselor personal profiles from public viewing. There are over 100 documented risks of telemental health.

It has become common practice for websites and social media to track site visitors. This raises the problem of following the client in an inappropriate manner. 

Distance Counseling Relationship

The ACA Code of Ethics emphasizes the importance of informed consent when providing telehealth therapy. Your informed consent document clearly outlines online therapy’s benefits and limitations. This helps clients decide whether telehealth is the right fit for them.

Section I Resolving Ethical Issues

A common misconception is that the ACA Code of Ethics requires reporting every suspected ethical violation. The Code encourages counselors to develop a personal approach to handling ethical concerns about colleagues. This model should guide your decisions while considering all relevant factors

Unwarranted ACA Ethical Codes Complaints

Filing complaints based on retaliation, rumor, or without a solid basis goes against the Code’s principles. Reports should be grounded in facts and aimed at protecting clients. Investigating and collecting evidence of counselor misconduct falls under the jurisdiction of licensing boards. They have the resources and legal authority to handle such matters. Only the ACA or counselor licensing board determines whether there has been a violation.

Conclusion: Navigate Your Ethical Journey with Confidence

In this article, we have briefly covered a few main parts of the Code. But always remember – it’s only the start! The ACA Code of Ethics is a complex and detailed document that needs continuous exploration.

For therapists seeking guidance and support in upholding ethical practices, consider seeking supervision from a qualified professional. We provide supervision services that are expertly designed to match the requirements of mental health professionals like yourself. Our supervisors with experience can assist you in dealing with ethical problems, enhancing your clinical expertise, and ensuring that you offer top-quality care to your clients.

Talk to us today and get more details on how we can help you with supervision services.

You deserve a former licensing board president on your side.

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