Fluent Essays

Locate and review an informed consent document used by a social work or human service agency in your area. It can be from your place of employment, your field placement site, an organization where you volunteer, or a similar organization. You do not need to name the organization in your assignment, but briefly describe the services it provides and any specific populations served (e.g., youth, immigrants, seniors, LGBTQ, etc.).  2. Write a single-page critique of the agency’s form using the standards for informed consent described by Corey, Corey, and Corey (2019), Chapter 5. Your mini-paper should follow APA formatting guidelines and include an evaluative assessment of the following elements: Expectations about the service relationship including assessment and client/practitioner roles Background of the practitioner(s) Potential risks and benefits to clients Confidentiality expectations and exceptions Duration of the service relationship Costs and/or payment expectations Opportunity for clients to ask questions  Create your own (i.e., original) version of the consent form resolving each of the concerns you identified in your one-page critique. in the helping professions,10e Issues &Ethics Gerald Corey California State University, Fullerton Diplomate in Counseling Psychology American Board of Professional Psychology Marianne Schneider Corey Consultant Cindy Corey Licensed Clinical Psychologist in private practice Multicultural Consultant Australia • Brazil • Mexico • Singapore • United Kingdom • United States © 2019, 2015 Cengage Learning ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced or distributed in any form or by any means, except as permitted by U.S. copyright law, without the prior written permission of the copyright owner. Library of Congress Control Number: 2017952223 Student Edition: ISBN: 978-1-337-40629-1 Loose-leaf Edition: ISBN: 978-1-337-56100-6 Cengage Learning 20 Channel Center Street Boston, MA 02210 USA Cengage Learning is a leading provider of customized learning solutions with employees residing in nearly 40 different countries and sales in more than 125 countries around the world. Find your local representative at www.cengage.com. Cengage Learning products are represented in Canada by Nelson Education, Ltd. To learn more about Cengage Learning Solutions, visit www.cengage.com. Purchase any of our products at your local college store or at our preferred online store www.cengagebrain.com. Issues and Ethics in the Helping Professions, 10th Edition Gerald Corey, Marianne Schneider Corey, Cindy Corey Product Director: Marta Lee-Perriard Product Manager: Julie Martinez Content Developer: Alexander Hancock Product Assistant: Ali Balchunas Marketing Manager: Zena Craft Content Project Manager: Rita Jaramillo Digital Content Specialist: Jennifer Chinn Art Director: Vernon Boes Manufacturing Planner: Karen Hunt Intellectual Property Analyst: Deanna Ettinger Intellectual Property Project Manager: Nick Barrows Production Service/Compositor/Project Manager: Cenveo® Publisher Services, Ben Kolstad Compositor: Cenveo® Publisher Services XML Tagging: MPS Text and Cover Designer: Jeanne Calabrese Cover Image Credit: saemilee/Getty Images For product information and technology assistance, contact us at Cengage Learning Customer & Sales Support, 1-800-354-9706. For permission to use material from this text or product, submit all requests online at www.cengage.com/permissions. Further permissions questions can be e-mailed to [email protected] Printed in the United States of America Print Number: 01 Print Year: 2017 in memory of our lifelong friend and colleague, patrick Callanan. patrick was a generous, honest, witty, and adventurous man who left his mark on the world through his roles as priest, father, uncle, teacher, counselor, author, mentor, and friend. We will always remember him, as he is impossible to forget! iv About the Authors Gerald Corey is Professor Emeritus of Human Services and Counseling at California State University at Fullerton. He re- ceived his doctorate in counseling from the University of South- ern California. He is a Diplomate in Counseling Psychology, American Board of Professional Psychology; a licensed psychol- ogist; and a National Certified Counselor. He is a Fellow of the American Psychological Association (Division 17, Counseling Psychology, and also Division 49, Group Psychotherapy); a Fel- low of the American Counseling Association; and a Fellow of the Association for Specialists in Group Work. He also holds mem- berships in the American Group Psychotherapy Association; the American Mental Health Counselors Association; the Association for Spiritual, Ethical, and Religious Values in Counseling; the Association for Counselor Education and Supervision; and the Western Association of Counselor Education and Supervision. Both Jerry and Mar- ianne Corey received the Lifetime Achievement Award from the American Mental Health Counselors Association in 2011, and both of them received the Eminent Career Award from ASGW in 2001. Jerry was given the Outstanding Professor of the Year Award from Cali- fornia State University at Fullerton in 1991. He regularly teaches both undergraduate and graduate courses in group counseling and ethics in counseling. He is the author or coauthor of 15 textbooks in counseling currently in print, along with more than 60 journal articles and book chapters. Several of his books have been translated into other languages. Theory and Practice of Counseling and Psychotherapy has been translated into Arabic, Indonesian, Portuguese, Turkish, Korean, and Chinese. Theory and Practice of Group Counseling has been translated into Korean, Chinese, Spanish, and Russian. During the past 40 years Jerry and Marianne Corey have conducted group counseling training workshops for mental health professionals at many universities in the United States as well as in Canada, Mexico, China, Hong Kong, Korea, Germany, Belgium, Scotland, England, and Ireland. In his leisure time, Jerry likes to travel, hike and bicycle in the mountains and the desert, and drive his grandchildren in his 1931 Model A Ford. Marianne and Jerry have been married since 1964. They have two adult daughters (Heidi and Cindy), two granddaughters (Kyla and Keegan), and one grandson (Corey). In addition to Issues and Ethics in the Helping Professions, Tenth Edition (2019, with Mari- anne Schneider Corey and Cindy Corey), which has been translated into Japanese, Chinese, and Korean, other recent publications by Gerald Corey, all with Cengage Learning, include: • Groups: Process and Practice, Tenth Edition (2018, with Marianne Schneider Corey and Cindy Corey) • I Never Knew I Had a Choice, Eleventh Edition (2018, with Marianne Schneider Corey and Michelle Muratori) • Theory and Practice of Counseling and Psychotherapy, Tenth Edition (and Student Manual) (2017) • Theory and Practice of Group Counseling, Ninth Edition (and Student Manual) (2016) • Becoming a Helper, Seventh Edition (2016, with Marianne Schneider Corey) • Group Techniques, Fourth Edition (2015, with Marianne Schneider Corey, Patrick Callanan, and J. Michael Russell) About the Authors / v • Case Approach to Counseling and Psychotherapy, Eighth Edition (2013) • The Art of Integrative Counseling, Third Edition (2013) Jerry Corey is coauthor (with Barbara Herlihy) of Boundary Issues in Counseling: Multi- ple Roles and Responsibilities, Third Edition (2015) and ACA Ethical Standards Casebook, Sev- enth Edition (2015); he is coauthor (with Michelle Muratori, Jude Austin, and Julius Austin) of Counselor Self-Care (2018); he is coauthor (with Robert Haynes, Patrice Moulton, and Michelle Muratori) of Clinical Supervision in the Helping Professions: A Practical Guide, Second Edition (2010); he is the author of Creating Your Professional Path: Lessons From My Journey (2010). All five of these books are published by the American Counseling Association. He has also made several educational DVD programs on various aspects of counseling practice: (1) Ethics in Action: DVD and Workbook (2015, with Marianne Schneider Corey and Robert Haynes); (2) Groups in Action: Evolution and Challenges DVD and Workbook (2014, with Marianne Schneider Corey and Robert Haynes); (3) DVD for Theory and Prac- tice of Counseling and Psychotherapy: The Case of Stan and Lecturettes (2013); (4) DVD for Integrative Counseling: The Case of Ruth and Lecturettes (2013, with Robert Haynes); and (5) DVD for Theory and Practice of Group Counseling (2012). All of these programs are avail- able through Cengage Learning. Marianne Schneider Corey is a licensed marriage and family therapist in California and is a National Certified Counselor. She received her master’s degree in marriage, family, and child coun- seling from Chapman College. She is a Fellow of the Associa- tion for Specialists in Group Work and was the recipient of this organization’s Eminent Career Award in 2001. She received the Lifetime Achievement Award from the American Mental Health Counselors Association in 2011 and is a member of the Ameri- can Mental Health Counselors Association. She also holds mem- berships in the American Counseling Association, the American Group Psychotherapy Association, the Association for Specialists in Group Work, the Association for Multicultural Counseling and Development, the Associ- ation for Counselor Education and Supervision, and the Western Association of Counselor Education and Supervision. Marianne has been involved in leading groups for different populations, providing training and supervision workshops in group process, facilitating self-exploration groups for graduate students in counseling, and cofacilitating training groups for group counselors and weeklong residential workshops in personal growth. Both Marianne and Jerry Corey have conducted training workshops, continuing education seminars, and personal-growth groups in the United States, Germany, Ireland, Belgium, Mexico, Hong Kong, China, and Korea. In addition to Issues and Ethics in the Helping Professions, Tenth Edition (2019, with Gerald Corey and Cindy Corey), which has been translated into Japanese, Chinese, and Korean, Mari- anne has coauthored the following books with Cengage Learning: • Groups: Process and Practice, Tenth Edition (2018, with Gerald Corey and Cindy Corey), which has been translated into Korean, Chinese, and Polish • I Never Knew I Had a Choice, Eleventh Edition (2018, with Gerald Corey and Michelle Muratori), which has been translated into Chinese • Becoming a Helper, Seventh Edition (2016, with Gerald Corey), which has been translated into Korean and Japanese • Group Techniques, Fourth Edition (2015, with Gerald Corey, Patrick Callanan, and Michael Russell), which has been translated into Portuguese, Korean, Japanese, and Czech vi / About the Authors Marianne has made educational video programs (with accompanying student workbooks) for Cengage Learning: Groups in Action: Evolution and Challenges DVD and Workbook (2014, with Gerald Corey and Robert Haynes); and Ethics in Action: DVD and Workbook (2015, with Gerald Corey and Robert Haynes). Marianne and Jerry have been married since 1964. They have two adult daughters, Heidi and Cindy, two granddaughters (Kyla and Keegan), and one grandson (Corey). Marianne grew up in Germany and has kept in close contact with her family and friends there. In her free time, she enjoys traveling, reading, visiting with friends, bike riding, and hiking. Cindy Corey is a licensed clinical psychologist in private prac- tice in San Diego, California. She worked for over a decade as a full-time visiting professor in the Department of Counseling and School Psychology at San Diego State University in both the Community-Based Block and Marriage and Family Therapy pro- grams. She received her master’s degree in Marriage and Family Therapy from the University of San Diego and her Doctorate (PsyD) in Multicultural Community Clinical Psychology at the California School of Professional Psychology in Alhambra, California. She is a member of the American Counseling Association, the Association for Specialists in Group Work, the American Psychological Asso- ciation, and the San Diego Psychological Association (SDPA). She served as the chair of the Lesbian, Gay, Bisexual, and Transgender Committee for the SDPA and has been a member of the Multicultural Committee and Women’s Committee. Cindy has focused much of her work in the area of counselor education, specializing in multicultural training, social justice, and community outreach. In addition to teaching at San Diego State University, she taught part time in the PsyD program at Alliant International Uni- versity in Alhambra. Cindy has also worked as a Contracted Clinician for Survivors of Torture International, focusing primarily on helping Sudanese refugee youth adjust to life in the United States, gain employment, and attend colleges and universities. Cindy works as a multicultural consultant and has created clinical intervention programs, training manuals, and diversity sensitive curriculum for a variety of schools, businesses, and organizations in the San Diego area. Her private practice focuses on working with women, couples, counselors, and graduate students in counseling programs. Cindy is coauthor, with Marianne Corey and Gerald Corey of Groups: Process and Practice, Tenth Edition (2018). vii Contents Preface xiii 1 Introduction to Professional Ethics 1 The Focus of This Book 2 Some Suggestions for Using This Book 3 Professional Codes of Ethics 4 Ethical Decision Making 11 Steps in Making Ethical Decisions 19 Self-Assessment: An Inventory of Your Attitudes and Beliefs About Ethical and Professional Issues 24 Chapter Summary 34 Suggested Activities 35 2 The Counselor as a Person and as a Professional 37 Self-Inventory 38 Introduction 39 Self-Awareness and the Influence of the Therapist’s Personality and Needs 39 Personal Therapy for Counselors 42 Transference and Countertransference 47 Client Dependence 54 Stress in the Counseling Profession 57 Counselor Burnout and Impairment 60 Maintaining Vitality Through Self-Care 63 Chapter Summary 64 Suggested Activities 65 3 Values and the Helping Relationship 67 Self-Inventory 68 Introduction 69 Controversies Regarding Integrating Personal Values With a Professional Identity 69 Clarifying Your Values and Their Role in Your Work 71 viii / Contents The Ethics of Imposing Your Values on Clients 73 The Legal Framework Regarding Values Discrimination 77 Values Conflicts Regarding Sexual Attitudes and Behavior 82 Value Conflicts Pertaining to Abortion 85 Case Study of Other Possible Value Conflicts 87 The Role of Spiritual and Religious Values in Counseling 88 Value Conflicts Regarding End-of-Life Decisions 94 Chapter Summary 101 Suggested Activities 101 4 Multicultural Perspectives and Diversity Issues 105 Self-Inventory 106 Introduction 107 The Problem of Cultural Tunnel Vision 110 The Challenges of Reaching Diverse Client Populations 112 Ethics Codes From a Diversity Perspective 113 Cultural Values and Assumptions in Therapy 114 Addressing Sexual Orientation 122 The Culture of Disability 129 Matching Client and Counselor 133 Multicultural Training for Mental Health Workers 137 Chapter Summary 144 Suggested Activities 145 5 Client Rights and Counselor Responsibilities 148 Self-Inventory 149 Introduction 150 The Client’s Right to Give Informed Consent 152 The Content of Informed Consent 157 The Professional’s Responsibilities in Record Keeping 166 Ethical Issues in Online Counseling 175 Working With Children and Adolescents 182 Contents / ix Dealing With Suspected Unethical Behavior of Colleagues 189 Malpractice Liability in the Helping Professions 191 Chapter Summary 202 Suggested Activities 202 6 Confidentiality: Ethical and Legal Issues 204 Self-Inventory 205 Introduction 206 Confidentiality, Privileged Communication, and Privacy 206 Privacy Issues With Telecommunication Devices 220 Implications of HIPAA for Mental Health Providers 222 The Duty to Warn and to Protect 224 Protecting Children, the Elderly, and Dependent Adults From Harm 244 Confidentiality and HIV/AIDS-Related Issues 248 Chapter Summary 252 Suggested Activities 253 7 Managing Boundaries and Multiple Relationships 254 Self-Inventory 255 Introduction 256 The Ethics of Multiple Relationships 257 Perspectives on Boundary Issues 266 Managing Multiple Relationships in a Small Community 268 Bartering for Professional Services 272 Giving or Receiving Gifts 278 Social Relationships With Clients 281 Sexual Attractions in the Client–Therapist Relationship 283 Sexual Relationships in Therapy: Ethical and Legal Issues 287 Sexual Relationships With Former Clients 292 A Special Case: Nonerotic Touching With Clients 294 Chapter Summary 297 Suggested Activities 298 x / Contents 8 Professional Competence and Training 301 Self-Inventory 302 Introduction 303 Therapist Competence: Ethical and Legal Aspects 303 Ethical Issues in Training Therapists 309 Evaluating Knowledge, Skills, and Personal Functioning 313 Gatekeeper Role of Faculty in Promoting Competence 320 Dismissing Students for Nonacademic Reasons 323 Professional Licensing and Certification 326 Continuing Professional Education and Demonstration of Competence 328 Review, Consultation, and Supervision by Peers 330 Chapter Summary 331 Suggested Activities 331 9 Ethical Issues in Supervision 334 Self-Inventory 335 Introduction 336 Ethical Issues in Clinical Supervision 337 The Supervisor’s Roles and Responsibilities 339 Ethical and Effective Practices of Clinical Supervisors 341 Competence of Supervisors 342 Legal Aspects of Supervision 344 Ethical Issues for Online Supervision 347 Special Issues in Supervision for School Counselors 348 Multicultural and Diversity Issues in Supervision 349 Multiple Roles and Relationships in the Supervisory Process 352 Chapter Summary 362 Suggested Activities 362 10 Issues in Theory and Practice 365 Self-Inventory 366 Introduction 367 Developing a Counseling Style 367 The Division of Responsibility in Therapy 369 Contents / xi Deciding on the Goals of Counseling 370 The Use of Techniques in Counseling 372 Assessment and Diagnosis as Professional Issues 373 Using Tests in Counseling 386 Evidence-Based Therapy Practice 388 Chapter Summary 393 Suggested Activities 394 11 Ethical Issues in Couples and Family Therapy 395 Self-Inventory 396 Introduction 397 The Systems Theory Perspective 397 Ethical Standards in Couples and Family Therapy 398 Special Ethical Considerations in Working With Couples and Families 401 Informed Consent in Couples and Family Therapy 402 Contemporary Professional Issues 403 Values in Couples and Family Therapy 406 Gender-Sensitive Couples and Family Therapy 410 Responsibilities of Couples and Family Therapists 414 Confidentiality in Couples and Family Therapy 416 Chapter Summary 420 Suggested Activities 420 12 Ethical Issues in Group Work 422 Self-Inventory 423 Introduction 424 Ethical Issues in Training and Supervision of Group Leaders 424 Ethical Issues in the Diversity Training of Group Workers 427 Ethical Considerations in Coleadership 432 Ethical Issues in Forming and Managing Groups 433 Confidentiality in Groups 440 Social Media in Group Work: Confidentiality and Privacy Considerations 443 Ethical Issues Concerning Termination 445 xii / Contents How to Determine What Works in a Group 447 Chapter Summary 449 Suggested Activities 450 13 Community and Social Justice Perspectives 451 Self-Inventory 452 Introduction 453 Why a Community Perspective Is a Concern for Counselors 455 Ethical Practice in Community Work 456 The Community Mental Health Orientation 458 Social Justice Perspective 460 Advocacy Competencies 464 Roles of Helpers Working in the Community 465 Promoting Change in the Community 468 Working Within a System 470 Chapter Summary 475 Suggested Activities 475 Authors’ Concluding Commentary 477 References and Suggested Readings 478 Name Index 507 Subject Index 515 xiii PrefacePreface Our friend and colleague, Patrick Callanan, died on March 17, 2017 (St. Patrick’s Day). He was a coauthor with us on the previous editions of Issues and Ethics in the Helping Professions. For many years we enjoyed working with Patrick on vari- ous projects, and we will miss his companionship and professional involvement with us. Patrick devoted much of his life to the counseling profession as a practi- tioner and made a significant difference in the lives of many clients, students, and professionals. Issues and Ethics in the Helping Professions is written for both graduate and undergraduate students in the helping professions. This book is suitable for courses in counseling, mental health counseling, human services, couples and family therapy, counseling and clinical psychology, school counseling, and social work. It can be used as a core textbook in courses such as practicum, fieldwork, internship, and ethical and professional issues or as a supplementary text in courses dealing with skills or theory. Because the issues we discuss are likely to be encountered throughout one’s professional career, we strive to use language and concepts that will be meaningful both to students doing their fieldwork and to professionals interested in keeping abreast of developments in ethical, profes- sional, and legal matters pertaining to therapeutic practice. In this book, we want to involve our readers in learning to deal with the eth- ical and professional issues that most affect the actual practice of counseling and related helping professions. We address such questions as: How aware are you of how your values and life experiences affect your professional work? What are the rights and responsibilities of both the client and the counselor? How can you determine your level of competence? How can you achieve and maintain your competence? How can you provide quality services for culturally diverse populations? In what ways could you involve yourself in social justice and advocacy work? How can you go outside of the office and make a difference in the community? What major ethical issues might you encounter in couples and family therapy? in group work? in com- munity agencies? in a school setting? in private practice? Our goal is both to pro- vide a body of information and to teach a process for thinking about and resolving the basic issues counselors will face throughout their career. For most of the issues we raise, we present various viewpoints to stimulate discussion and reflection. We also present our personal views and commentaries, when appropriate, and chal- lenge you to develop your own position. The ethics codes of various professional associations offer some guidance for practice. However, these guidelines leave many questions unanswered. We be- lieve that as a student or a professional you will ultimately struggle with the issues of responsible practice, deciding how accepted ethical principles apply in the spe- cific cases you encounter. Throughout this book, we aim to involve you in an active and meaning- ful way. We provide many opportunities for you to respond to our discussions. xiv / Preface Each chapter begins with Learning Objectives to guide your reading and a Self- Inventory designed to help you focus on the key topics to be discussed in the chap- ter. Within the chapters we frequently ask you to think about how the issues apply to you. Open-ended cases and situations are designed to stimulate thought and discussion, and we encourage you to apply the codes of ethics of the various men- tal health professions to the case illustrations. Reflecting on the questions follow- ing each case example will help you determine which of the therapist responses are ethically sound and which are not. We offer our commentaries after each case to guide you in the process of determining sound ethical decisions. We also cite related literature when exploring ethical, legal, professional, and clinical issues. Instructors will find an abundance of material and suggested activities, surely more than can be covered in a single course. An Instructor’s Resource Manual is available that contains chapter outlines, sug- gestions for teaching an ethics course, additional exercises and activities, a list of PowerPoint slides, and study guide questions. A Test Bank for each chapter and online quizzes are available to instructors. An electronic version of the Instructor’s Resource Manual is available for all platforms. Issues and Ethics in the Helping Professions comes with MindTap®. MindTap, a digital teaching and learning solution, helps students be more successful and confident in the course—and in their work with clients. MindTap guides stu- dents through the course by combining the complete textbook with interactive multimedia, activities, assessments, and learning tools. Readings and activities engage students in learning core concepts, practicing needed skills, reflecting on their attitudes and opinions, and applying what they learn. Videos of client sessions illustrate skills and concepts in action, and case studies ask students to make decisions and think critically about the types of situations they will encounter on the job. Helper Studio activities put students in the role of the helper, allowing them to build and practice skills in a nonthreatening environ- ment by responding via video to a virtual client. Instructors can rearrange and add content to personalize their MindTap course and easily track students’ progress with real-time analytics. MindTap integrates seamlessly with any learning management system. An integrated learning package titled Ethics in Action: DVD and Workbook (third edition, 2015) is available to enhance the 10th edition of Issues and Ethics in the Helping Professions. The Ethics in Action DVD is designed to bring to life the ethical issues and dilemmas counselors often encounter and to provide ample opportunity for discussion, self-exploration, and problem solving of these issues and dilemmas. The vignettes on the DVD are based on a weekend workshop cofa- cilitated by Marianne Schneider Corey and Gerald Corey for a group of counseling students, which included challenging questions and lively discussion, role plays to bring the issues to life, and comments from the students and the Coreys. Addi- tional material on the DVD program is designed to provide a self-study guide for students who are also reading this book. This educational program is divided into three segments: ethical decision making, values and the helping relationship, and boundary issues and multiple relationships in counseling. At the end of several chapters in this book are suggested activities and guidelines for integrating the Ethics in Action video program with this textbook. Preface / xv What’s new in the 10th edition of Issues and Ethics For the 10th edition, each chapter has been carefully reviewed and updated to present the current thinking, research, and trends in practice. The following chapter-by-chapter list of highlights outlines some sample material that has been added, updated, expanded, and revised for the 10th edition. Chapter 1 introduction to professional ethics • Citation of updated ethics codes whenever available • Inclusion of themes common to most codes of ethics • Increased emphasis on positive ethics rather than rule-based ethics Chapter 2 the Counselor as a person and as a professional • Updated literature on personal therapy for trainees and for practitioners • Updated material on sources of stress in the helping professions • Expanded discussion of self-compassion and self-care strategies for professionals • Updated discussions of burnout, practitioner impairment, and maintaining vitality Chapter 3 Values and the helping relationship • A new section on controversies regarding integrating personal values with a professional identity • Increased attention to the responsibility of counselor education programs in being clear with students about managing personal values • Increased attention to the necessity for graduate students in counseling to learn how to work within the framework of the client’s value system • More focus on avoiding value imposition by ethical bracketing • Implications of several court cases in dismissing students unwilling to keep their personal values separate from counseling clients with a different set of values • New section on state legislation to protect religious freedom • New literature on the ethics of values-based referrals and discriminatory referrals • New material on the role of spirituality and religion in counseling • New section on ethical and clinical issues with nonreligious clients • Description of an ethical decision-making model to determine whether religious or spiritual beliefs may be clinically salient Chapter 4 Multicultural perspectives and Diversity issues • Increased coverage of cultural pluralism and cultural competence • Updated section on ethical issues regarding sexual orientation • Increased and updated coverage of ethical issues and competencies required in counseling lesbian, gay, bisexual, and transgender clients xvi / Preface • Introduction to how a social justice orientation relates to a multicultural perspective • Updated discussion regarding acquiring and maintaining cultural competence • Presentation of authors’ views on multicultural training Chapter 5 Client rights and Counselor responsibilities • Updated and expanded section on content of informed consent process • Updating of all of the ethics codes on the topic of client rights and counselor responsibilities • More attention to cultural factors related to the informed consent process • Revised discussions of informed consent and confidentiality as it pertains to managed care • Added literature on addressing risks of diagnosis in the informed consent process • Expanded treatment of clinical record keeping • Revised guidelines for keeping …