Georgia LPC Legal and Ethical Issues in Clinical Supervision

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Ethical and Legal Issues in
Clinical Supervision
Glenn Duncan LPC, LCADC, CCS,
ACS

Why have legal and ethical standards?
One of the main purposes of the courts
is to determine innocence or guilt.
One of the main purposes of Federal
and State laws and statutes, licensure
regulations, professional standards,
and sound personal judgment is
to keep you out of court.

Are YOU Qualified!?
People seeking - Licensed Professional Counselor (LPC)
 HISTORY: Code 1981, § 43-7A-10, enacted by Ga. L. 1984, p. 1406, § 1; Ga. L.
1990, p. 1484, § 2. 43-10A-11. Requirements for licensure in professional counseling
(2) For licensure as a professional counselor:
 (A) A doctoral degree from a recognized educational institution in a program that is
primarily counseling in content and requires at least one year of supervised internship
in a work setting acceptable to the board; or
 (B) A specialist degree from a recognized educational institution in a program that is
primarily counseling in content with supervised internship or practicum and two years
of post-master's directed experience under supervision in a setting acceptable to the
board; or
 (D) A master's degree from a recognized educational institution in a program that is
primarily counseling in content with supervised internship or practicum and four years
of post-master's directed experience under supervision in a setting acceptable to the
board. Up to one year of such experience may have been in an approved practicum
placement as part of the degree program (after 09/30/18 – 600 hours);

Are YOU Qualified!?
People seeking - Licensed Professional Counselor (LPC)
 Rule 135-5-.01 Associate Professional Counselors
 "Directed Experience" means time spent under direction engaging in the practice of
Professional Counseling as defined in 135-5-.01 (a)(1). (i)
 All work sites must include a formal structure related to the practice of professional
counseling as defined in Rule 135-5-.01(a) (1). Valid work sites should have measurable
detailed documentation for every candidate, to include a signed contractual agreement
that outlines the job description, office hours, performance review procedures and
dismissal policies.


Q&A with LPCAGA & GA Licensing Board
1. Is there a requirement for a clinical supervisor to provide both individual and
group sessions to supervisees?
A. No, it is not a requirement.
2. Must supervisees have means of obtaining 1000 hours of directed experience
in order to qualify to begin supervision?
A. Supervisees need to be working under direction in order to begin counting
hours of supervision.
C. Is the 35 hours of supervision counted by calendar year (Jan - Dec), Oct
through Sept, or any 12 month period?
A. Hours under direction/supervision may be after the individual’s degree is
conferred; each “year” is a minimum of 12 months and up to 20 months.

4. What happens if supervisees have some previous years that they received
some hours but not 30? Can those hours be counted?
A. A minimum of 30 hours must have been obtained within a minimum of 12
months and no more than 20 months to be counted.
5. Does there need to be a contract between the clinical supervisor and
supervisee?
A. YES!!!

6. Are hours of supervision counted if the supervisee is not APC?
A. Yes; the APC is not a requirement.

7. What if I don’t like the actions of a supervisee … do I have to sign off
on supervision hours?
A. Supervisors are required to sign off on the supervision, if they do not
think a person should be licensed check the NO box. Telling a
supervisee, they are not going to signoff, is unacceptable.
8. Who must I notify if I decide to termination a working relationship with
a supervisee?
A. Supervisor must notify the licensing board when they terminate clinical
supervision.

Contract with APC/Unlicensed Clinician
You need 2 things:
1.A written contract (a sample provided on your USB)
2.Filled out by both supervisor & supervisee GA Contract Affidavit (USB):
“this contractual agreement whether written or implied. This includes, but
is not limited to, the payment of local, state and federal taxes, minimum
wage guidelines, assessment and collection of fees, insurance
reimbursement claims, etc.
Independent private practice or practice under O.C.G.A. § 43-10A-7,
sections (9), (10), (13), (14), (15), (16), or (17) is not acceptable as a work
setting to the Board for the purposes of obtaining directed experience
under supervision.
NOTE: You must complete a SEPARATE CONTRACT AFFIDAVIT for
EACH directed experience site and supervisor.”

Major Legal Issues For Clinical
Supervisors
Malpractice
 Harm to another individual due to negligence consisting of the
breach of a professional duty or standard of care.
 When you take the role of supervisor, you are expected to know
and follow the law, as well as the profession’s ethical standards.

Increase in Lawsuits?
 A general decline in the respect afforded helping professionals by
clients and society at large.
 Increased awareness of consumer rights in general.
 Highly publicized malpractice suits where settlements were
enormous, leading to the conclusion that a lawsuit may be a means
to obtain easy money.

What is needed to prove Malpractice?
 A professional relationship with the therapist (or supervisor) must
have been established.
 The therapist’s (or supervisor’s) conduct must have been improper
or negligent and have fallen below the acceptable standard of care.
 The client (or supervisee) must have suffered harm or injury, which
must be demonstrated.
 A causal relationship must be established between the injury and
the negligence or improper conduct.

How to Reduce Legal Liability
 One of the most important things a supervisor can do to reduce the
risk of a charge of negligence is to screen prospective employees
carefully.
 In addition to information on academic credentials and work
experience, it is important to know if their present skill level is
consistent with the expectations of the supervisor.
 Supervisors scrupulously should follow the regulations of their
respective accrediting board (e.g., Psychologists, Social Workers,
CADCs) regarding supervision.
 They should check with their malpractice carrier to be certain that
their supervisory functions are covered. It also may be prudent to
require the supervisee to carry his or her own professional liability
insurance.

How to Reduce Legal Liability
 Supervisors should take whatever actions are necessary to ensure the
quality of services delivered to the patient.
 The extent of the monitoring will depend on several factors, including the
skill level of the supervisee, the type of services being performed, and the
direct knowledge of the supervisor of the skill of the supervisee.
 As noted above, the minimal supervisory requirements for clinicians-in-
training are more specific than those for other unlicensed employees.
 Supervisors would be liable if they assigned a patient to a supervisee
who did not have the skill level to provide adequate services.
 Finally, supervisors must document all supervisory sessions in a manner
consistent with established record-keeping rules and requirements.

The Duty to Warn and Protect
 Case Name: Vitaly TARASOFF v. REGENTS OF UNIV OF CA.,
et. al. Date, Location, Cite: 1976 CA. 131 Cal Rptr 14, 551 p2d
334.
 CA Supreme Court: Prosenjit Poddar told student health he
wanted to kill Tatiana Tarasoff. Psychologist told supervising
psychiatrist, who told campus police, who checked & let Poddar
go.
 Poddar killed Tatiana. Parents sued for "failure to warn"- Trial
Court said no duty existed, but CA Supreme Court cited
Simenson v Swensen, ordered trial; heard twice, settled out:
 “Tarasoff #1” -"Privilege ends where public peril begins."
“Tarasoff #2” - Therapist has an obligation to use reasonable
care to protect potential victim.
 SUPER LAND MARK - created whole new cause for action, but
based on Simenson v Swensen because settled out of court.

The Duty to Warn and Protect
 1975 “Tarasoff #1” -"Privilege ends where public peril begins."
1976 “Tarasoff #2” - "When a therapist determines, or pursuant
to the standards of his profession should determine, that his [client]
presents a serious danger of violence to another, he incurs an
obligation to use reasonable care to protect the intended victim
against such danger. The discharge of this duty may require the
therapist to take one or more various steps, depending upon the
nature of the case. Thus it may call for him to warn the intended
victim or others likely to apprise the victim of the danger, to notify
the police, or to take whatever other steps are reasonably
necessary under the circumstances."
 SUPER LAND MARK - created whole new cause for action, but
based on Simenson v Swensen because settled out of court.

Georgia Duty to Warn & Protect Law
 Uhmmm ….

So About that GA Duty to Warn & Protect Law

LPCAGA Duty to Warn & Protect Code
 2. Supervisee Confidentiality Disclosure to Clients: Ensure that supervisees
inform clients of clients’ rights to confidentiality and privileged communication
when applicable, as well as the limits of confidentiality and privileged
communication.
 The general limits of confidentiality are when harm to self or others is
threatened, when the abuse (or imminent harm) of children, adolescent, elders
or persons with disabilities is suspected, and in cases when the court compels
the mental health professional to testify and break confidentiality. These are the
current generally accepted limitations to confidentiality and privileged
communication, but they may be modified by state law or federal statute.

GA Duty to Warn & Protect Law
 Georgia Rules of the State Board of Examiners of Psychologists have a
provision allowing for discretionary disclosure of confidential information to
protect the client, the psychologist or others from harm. This does not have
the force of statutory law.
 Interpretation of Law: "Where the course of treatment of a mental patient
involves an exercise of “control” over him by a physician who knows or
should know that the patient is likely to cause bodily harm to others, an
independent duty arises from that relationship and falls upon the physician
to exercise that control with such reasonable care as to prevent harm to
others at the hands of the patient." - Bradley Center v. Wessner (161 Ga.
App. 576). The case involved a hospitalized patient who had made threats
and was released. The provider and facility failed to continue exercising
control over the patient. Subsequent case law has enforced
confidentiality laws in actions against providers for providing
warnings.

 Bradley Center v. Wessner (1982)
 Although Georgia statutory law does not address the so-called duty to warn, Georgia
does have a legal precedent as defined by case law that establishes a duty to protect
identifiable third parties (Bradley Center v. Wessner, 1982a, 1982b). In Bradley v.
Wessner, the Georgia Supreme Court upheld an appellate decision that determined a
failure to exercise control over a potentially violent inpatient who made a clear threat
toward a readily identifiable intended victim. In affirming the appellate decision below,
the Georgia Supreme Court held that the Court of Appeals properly identified the
legal duty in this case:
 Where the course of treatment of a mental patient involves an exercise of "control"
over him by a physician who knows or should know that the patient is likely to cause
bodily harm to others, an independent duty arises from that relationship and falls
upon the physician to exercise that control with such reasonable care as to prevent
harm to others at the hands of the patient. (Bradley Center v. Wessner, 161 Ga. App.
576, supra, at 581, 1982a)


 Garner v. Stone (1999)
 Although Georgia case law has established a legal precedent for a duty to protect,
there is no statutory duty to warn, nor is there any statutory immunity for a
psychologist making such a warning to a third party. In other words, although there is
a legally established duty to protect a readily identifiable intended victim from
imminent and foreseeable danger, there is no statutory duty to warn the victim nor is
there any statutory protection from legal liability for mental health professionals who
make such warnings. The absence of statutory immunity means that there is no
immunity from professional liability for a psychotherapist making an unauthorized
disclosure of confidential information.
 Although the case was never appealed and therefore never established as legal
precedent, in Garner v. Stone (1999) a six person jury in a DeKalb County, Georgia,
state court found in favor of a former police officer with Gwinnett County, Georgia,
who sued a psychologist for violating the physician-patient privilege after the
psychologist made a warning call to an identifiable third party.

 Garner v. Stone (1999)
 Interestingly, the trial judge’s charge to the jury included discussion of the
discretionary allowance under the Georgia Code of Conduct, which permits
psychologist disclosure to prevent harm to the patient or others, as well as
discussion of the California Tarasoff ruling, which is legally binding only in
the state of California. Again, it is important to remember that the
discretionary allowance of disclosures permitted under the Georgia licensing
board administrative rules is superceded by statutory laws, such as the
psychotherapist-patient privilege.
https://www.facebook.com/DutyToWarnGeorgia/
Doverspike, W. F. (2007). The So-called Duty to Warn: Protecting the public versus protecting the patient. Georgia Psychological Association
[online]. Accessed 10/15/17.

 Rule 135-7-.03 Confidentiality
 (1) The licensee holds in confidence all information obtained at any time during
the course of a professional relationship, beginning with the first professional
contact. The licensee safeguards clients' confidences as permitted by law.
 (2) Unprofessional conduct includes but is not limited to the following: (a)
revealing a confidence of a client, whether living or deceased, to anyone except:
 4. where there is clear and imminent danger to the client or others, in which case
the licensee shall take whatever reasonable steps are necessary to protect those
at risk including, but not limited to, warning any identified victims and informing
the responsible authorities;

42-CFR-Part 2 – Exceptions to
Confidentiality
 § 2.22 Notice to patients of Federal confidentiality requirements.
 The confidentiality of alcohol and drug abuse patient records maintained by this program is
protected by Federal law and regulations. Generally, the program may not say to a person
outside the program that a patient attends the program, or disclose any information
identifying a patient as an alcohol or drug abuser Unless:
 (1) The patient consents in writing:
(2) The disclosure is allowed by a court order; or
(3) The disclosure is made to medical personnel in a medical emergency or to qualified
personnel for research, audit, or program evaluation.
 Violation of the Federal law and regulations by a program is a crime. Suspected violations
may be reported to appropriate authorities in accordance with Federal regulations.
 Violation of the Federal law and regulations by a program is a crime. Suspected violations
may be reported to appropriate authorities in accordance with Federal regulations. Federal
law and regulations do not protect any information about a crime committed by a patient
either at the program or against any person who works for the program or about any threat
to commit such a crime. Federal laws and regulations do not protect any information about
suspected child abuse or neglect from being reported under State law to appropriate State
or local authorities.

Confidentiality
 § 2.22 Notice to patients of Federal confidentiality
requirements.
 Federal law and regulations do not protect any information about a crime
committed by a patient either at the program or against any person who
works for the program or about any threat to commit such a crime. Federal
laws and regulations do not protect any information about suspected child
abuse or neglect from being reported under State law to appropriate State
or local authorities.
 § 2.14 Minor patients (d)(2) The applicant's situation poses a
substantial threat to the life or physical well being of the applicant or any
other individual which may be reduced by communicating relevant facts to
the minor's parent, guardian, or other person authorized under State law to
act in the minor's behalf.

Confidentiality
 § 2.63 Confidential communications.
 (a) A court order under these regulations may authorize disclosure of
confidential communications made by a patient to a program in the course
of diagnosis, treatment, or referral for treatment only if:
 (1) The disclosure is necessary to protect against an existing threat to life or
of serious bodily injury, including circumstances which constitute suspected
child abuse and neglect and verbal threats against third parties;
 (2) The disclosure is necessary in connection with investigation or
prosecution of an extremely serious crime, such as one which directly
threatens loss of life or serious bodily injury, including homicide, rape,
kidnapping, armed robbery, assault with a deadly weapon, or child abuse
and neglect; or
 (3) The disclosure is in connection with litigation or an administrative
proceeding in which the patient offers testimony or other evidence
pertaining to the content of the confidential communications.

Imminent Danger Defined
Imminent danger is a concept used to describe problems that can
lead to dire consequences for the client (and others). Imminent
danger is defined as the following 3 components:
1. A strong probability that certain behaviors (such as continued
alcohol or drug use or continued self harm) will occur.
2. The potential for such behaviors to present a significant risk of
serious adverse consequences to the individual and/or others.
3. The likelihood that such harmful events will occur in the near future.

NBCC Code of Ethics: Duty to Warn
 When a client’s condition indicates that there is a clear and
imminent danger to the client or others, the certified counselor must
take reasonable action to inform potential victims and/or inform
responsible authorities.
 Consultation with other professionals must be used when possible.
 The assumption of responsibility for the client’s behavior must be
taken only after careful deliberation, and the client must be involved
in the resumption of responsibility as quickly as possible.

The Duty to Warn
 Was their supervisor issues in this case?
 What relevance did supervision have on the case?
 It is imperative for supervisors to inform supervisees of conditions under
which it would be appropriate to implement the duty to inform an intended
victim.
 The clinical supervisor was implicated in the finding of a negligent failure to
warn the prospective victim. If the supervisor had examined Poddar and
found him to not be dangerous, the grounds for liability based on
foreseeability would have been less clear.
 The expectation is that sound clinical judgment and reasonable or due care
are taken regarding the determination of dangerousness.

Duty to Warn Vignette
Paul is referred to your organization for domestic violence. The domestic violence was
towards a girlfriend who was attempting to break up with him. Paul and the girlfriend
have since broken up, and she has a restraining order against him (which he states he
abides by). Both clinicians with experience with this type of client are full and cannot
accept any addtional clients. As the clinical director you decide to give this case to an
intern, who is supervised by one of your master’s level clinicians. The intern is assigned
the case and not much happens for a few months that you are aware of. One week in
supervision, your clinician comes to you to inform you that a situation has happened with
this client.
You come to find out that Paul has been increasingly making threatening statements
towards other drivers on the road when he travels to work. He describes how he gets
“infuriated” by other drivers who cut him off, or don’t move out of the fast lane when he is
behind them. At first “altercations” were just gestures back and forth between he and the
other driver at the time. However, in the past week he followed another driver all the way
to that person’s job, and proceeded to fight him in the parking lot.

Duty to Warn Vignette
When asked if anybody was hurt, Paul replied that the other person was “a bit
bloody” when Paul left him on the parking lot grounds. Paul confided to the intern that
he has now started carrying a gun in the car. He at first played with the intern by
stating the gun was there for his “protection”, but later hinted that it might “come in
handy” on his way to work. When pressed, Paul stated that he would only wave the
gun at a potential “highway offender” to scare him/her. He also stated he is licensed
to carry the gun, and the gun is loaded. The final piece of information that the
clinician tells you is the nature of the domestic violence towards the ex-girlfriend was
Paul hitting this woman on the face with the barrel of a gun.
Paul has been diagnosed with Intermittent Explosive Disorder (DSM-5 F63.81). Paul
is employed full-time at Home Depot and works as the customer service manager for
returns. Basically his job consists of being the returns and complaints manager at
the Home Depot.

Duty to Warn Vignette Questions
 What are your obligations, if any? If you find you have obligations,
who are you obliged to warn? (There are 3 different
groups/individuals you need to discuss). Do you have imminent
danger with Paul in regards to any of these groups/individuals?
1. Currently the only form of feedback on this case comes from self-
report of the intern to the clinician supervising the intern. Is this
sufficient?
2. Were there any problems in the supervisory process that was
described in this example?

Duty to Warn Vignette 2 – “Man found
guilty of serial HIV assaults”
From CNN.com, 11/09/2004
OLYMPIA, Washington (AP) -- A
man was convicted by a judge
Monday on charges he deliberately
exposed 17 women to HIV by having
unprotected sex with them. Five of
the women have tested positive for
the virus, which causes AIDS.
Anthony E. Whitfield, 32, faces a
minimum sentence of 137 years in
prison on the 17 counts of first-degree
assault with sexual motivation and
other charges.
Health officials said as many as 170
people may have been exposed to the
virus because of Whitfield's actions,
counting subsequent partners of
women he slept with. No additional
people have tested positive for HIV,
but 45 refused to be tested or couldn't
be found.
During the trial in Thurston County
court, an Oklahoma prison official
testified that Whitfield was diagnosed
with HIV while incarcerated in 1992.
Two women testified that Whitfield
once said, seemingly in jest, that if he
had HIV, he would give it to as many
people as he could.
Defense lawyer Charles Lane said
Whitfield was addicted to
methamphetamine and used women
for shelter, money and sex but never
meant to inflict "great bodily harm" as
required for him to be convicted of
first-degree assault.
February 22nd
, 2010 – R.D.W. of
Alexandria, NJ charged with
knowingly spreading HIV. This is a
3rd
degree diseased-person charge
(reserved for HIV or AIDS), 4th
degree is for gonorrhea/syphilis.
Anthony E. Whitfield, right,
is handcuffed by a Thurston
County corrections officer
Monday.
http://www.cnn.com/2004/LAW/11/09/hiv.assault.ap/index.html
http://www.lehighvalleylive.com/hunterdon-county/express-

GA HIV Statute
HIV status must be disclosed to sexual partners to avoid criminal penalties.
Georgia’s HIV exposure statute targets people living with HIV (PLHIV) who do not
disclose their HIV status prior to engaging in anal, oral, and/or penile-vaginal sex with
another person. A violation of this statute results in felony penalties of up to ten years’
imprisonment. Neither the intent to transmit HIV nor the actual transmission of HIV is
required for prosecution.
In a January 2009 case, a 38-year-old man living with HIV was sentenced to two years’
imprisonment and eight years’ probation after pleading guilty to reckless conduct by an
HIV-infected person for having sex with a woman without disclosing his status. The first
day they met and had sex, the man and his partner—who later tested negative for HIV—
went to the defendant’s home at a housing center for PLHIV. Nonetheless, the fact that
the defendant was staying at a home solely for PLHIV was not enough to constitute
disclosure for the purpose of the reckless conduct statute.

GA HIV Statute
PLHIV have also been prosecuted under aggravated assault charges.
In Scroggins v. State, the defendant, while struggling with a police officer, sucked extra
saliva into his mouth and then bit the officer. When the defendant was treated at the
hospital he “told a nurse he was HIV positive” and laughed when the officer who was bit
asked the defendant about his HIV status. He was convicted of aggravated assault with
intent to murder.
A Georgia Appellate Court upheld this ruling stating that this was sufficient evidence to
establish a wanton and reckless disregard for whether HIV was transmitted.
A person commits aggravated assault when there is intent to murder, rape, or rob
someone using a deadly weapon that does or is likely to result in serious bodily injury.
Georgia’s application of its aggravated assault statute continues to prosecute PLHIV for
acts that, at best, have only a remote possibility of transmitting HIV.

Direct and Vicarious Liability
Simmons vs. United States (1986)
o A client was encouraged by a therapist to have sexual relations with
him as a means of acting on her transference feelings and
ultimately attempted suicide. The court found both the therapist and
his supervisor negligent. The supervisor should have known about
the “negligent acts of a subordinate” as there was reason to suspect
something inappropriate was taking place.

Direct and Vicarious Liability
 Direct Liability: When the actions of the supervisor were
themselves the cause of harm.
If the supervisor did not perform supervision adequate for a
clinician.
If the supervisor suggested (and documented) an
intervention that was determined to be the cause of harm.
 Vicarious Liability: Being held liable for the actions of the supervisee
when these [actions] were not suggested or even known by the
supervisor.
“The supervisor is generally only held liable for the negligent acts of
supervisees if these acts are performed in the course and scope of
the supervisory relationship” (Disney & Stephens, 1994).

Vicarious Liability (Continued)
“The psychotherapy supervisor assumes, in general, clinical
responsibility much as if the patient were under his or her own care”
(Slovenko, 1980).
 Failure to properly oversee the functioning of the clinician is one of
the highest liability issues. How does one best demonstrate
supervisory involvement and prevent malpractice suits:
1. Documentation: supervisor should maintain personal
records of dates and times when supervision was provided.
(Client Name? Clinical Area Covered? Supervisee Issues Only?
Writings should be brief in nature.)
2. Consultation: Regularly scheduled supervision, offering careful
assessment, oversight of clinicians, and regular evaluation.
3. It is advisable for the supervisor to make an independent
assessment of severely disturbed or dangerous clients.

Vicarious Liability (Continued)
Vicarious Liability was part of the legal argument in the Tarasoff vs.
Regents of California case.
 In that case, the lawyer for the plaintiff argued that if the supervisor
independently assessed the client (Prosenjit Poddar) and
determined that the client was not dangerous, the plaintiff might not
have had a case to sue.

Supervisor Role and Responsibilities
Inherent and integral to the role of supervisor are responsibilities for:
1. Monitoring client welfare.
2. Encouraging compliance with relevant legal, ethical, and
professional standards for clinical practice.
3. Monitoring clinical performance and professional development
of supervisees.
4. Evaluating and certifying current performance and potential of
supervisees for academic, screening, selection, placement,
employment, and credentialing purposes.

Priority Sequence in Resolving Conflicts
1. Relevant legal and ethical standards (e.g., duty to warn, state
child abuse laws, etc.)
2. Client welfare
3. Supervisee welfare
4. Supervisor welfare
5. Program and/or agency service and administrative needs.

Scope of the Supervisory Relationship
1. The supervisor is the person responsible for the evaluation of the
supervisee, and is able to control supervisee clinical actions.
2. It is the supervisee’s duty to perform the act in question (i.e., doing
therapy with assigned clients).
3. Was the act done within the proper time, place and purpose of the
act (e.g., was the act done in the counseling session or away from
the counseling facility).
4. Whether the supervisor could have reasonably expected the
supervisee to commit the act.

Confidentiality
Jaffee vs. Redmond (1996)
o The family of a deceased individual who was killed by a police
officer attempted in a civil lawsuit to obtain information from the
police officer’s therapist who was a licensed social worker, but not a
licensed psychologist or psychiatrist. This case went all the way to
the Supreme Court who sided with the social worker stating that
legislation (that exists in all 50 states) that creates privilege for
licensed psychotherapists extends to licensed psychotherapists
other than psychologists and psychiatrists.

Confidentiality
 Confidentiality represents the essence of therapy (a safe place
where secrets and hidden fears can be exposed), and because
much of our professional status comes from being the bearer of
such secrets.
 Videotapes and audiotapes are secured and confidential
documents, and all supervisees must understand this.
 Supervisee’s right to privacy and it is the supervisor’s responsibility
to keep information confidential. It is also the supervisor’s
responsibility to ensure the clinician is keeping client information
confidential.

Confidentiality Components
 Confidentiality is defined as: “an explicit promise or contract to reveal
nothing about an individual except under conditions agreed to by the source
or subject” (Siegel, 1979).
 Privacy is defined as: “the client’s right not to have private information
divulged without informed consent, including the information gained in
therapy” (Siegel, 1979).
 Privileged Communication is defined as: “the right of clients not to have
their confidential communications used in open court without their consent”
(Siegel, 1979).

Exceptions to Confidentiality
1. Suicidal/Homicidal Risk
2. Medical Emergency
3. Court Order
4. Child/Elder Abuse
5. Internal Communication (e.g., billing issues, cancelled
appointments).
6. When clients express the intent to commit a crime or when they
commit a crime on the premises (What about admission of a
crime?).
7. When the client initiates a malpractice suit against the therapist or
supervisor.

Exceptions to Confidentiality (continued)
8. No identifying information.
9. Research/Audit and Evaluation.
10. Qualified Service Agreement (3rd Party Payer)

Legal Standards of Confidentiality
1. The licensee holds in confidence all information obtained at any time during the
course of a professional relationship, beginning with the first professional contact.
The licensee safeguards clients' confidences as permitted by law.
2. Unprofessional conduct includes but is not limited to the following:
a. revealing a confidence of a client, whether living or deceased, to anyone except:
 1. as required by law;
 2. after obtaining the consent of the client, when the client is a legally competent
adult, or the legal custodian, when the client is a minor or a mentally
incapacitated adult. The licensee shall provide a description of the information to
be revealed and the persons to whom the information will be revealed prior to
obtaining such consent. When more than one client has participated in the
therapy, the licensee may reveal information regarding only those clients who
have consented to the disclosure;

1. The licensee holds in confidence all information obtained at any time during the
course of a professional relationship, beginning with the first professional contact.
The licensee safeguards clients' confidences as permitted by law.
2. Unprofessional conduct includes but is not limited to the following:
a. revealing a confidence of a client, whether living or deceased, to anyone except:
 3. where the licensee is a defendant in a civil, criminal, or disciplinary action
arising from the therapy, in which case client confidences may be disclosed in
the course of that action;
 4. where there is clear and imminent danger to the client or others, in which
case the licensee shall take whatever reasonable steps are necessary to
protect those at risk including, but not limited to, warning any identified
victims and informing the responsible authorities; and
 5. when discussing case material with a professional colleague for the purpose
of consultation or supervision;

b. failing to obtain written, informed consent from each client before electronically
recording sessions with that client or before permitting third party observation of their
sessions;
c. failing to store or dispose of client records in a way that maintains confidentiality, and
when providing any client with access to that client's records, failing to protect the
confidences of other persons contained in that record;
d. failing to protect the confidences of the client from disclosure by employees,
associates, and others whose services are utilized by the licensee; and
e. failing to disguise adequately the identity of a client when using material derived from
a counseling relationship for purposes of training or research.

Case Records & Confidentiality
Suslovich vs. New York State Education Department (1991)
o This was an appeal by a psychologist whose license was
suspended by the state licensing board for a lack of record keeping
regarding a case brought to the board by an insurance company for
fraudulent billing practices. The appeal upheld the ruling on the
grounds that simple record keeping, such as relying on one’s
memory, was not sufficient to provide an adequate record.

Some recommended guidelines:
1. Record no more than is essential to the functions of the agency.
Identify observed facts and distinguish them from opinions.
2. Omit details of clients’ intimate lives from case records; describe
intimate problems in general terms.
3. Do not include process recordings or other clinical supervision
notes in case files.
4. Keep case records in locked files and issue keys only to those who
require frequent access to the files.

5. Do not remove case files from the agency or private practice except
under extraordinary circumstances with special authorization (if in
private practice get permission from … yourself, but only in an
extraordinary circumstance).
6. Do not leave case files on desks where janitorial personnel or
others might have access to them.
7. Use in-service training sessions to stress confidentiality and to
monitor observance of agency policies and practices instituted to
safeguard confidentiality.

 Federal Privacy Act of 1974 was enacted to safeguard people
against “harmful disclosures of information whether through
inaccurate information being used in irrelevant circumstances, or
through inaccurate information being used in important decisions
affecting individuals.”
 Even though this is a federal law, many states have enacted
corresponding statutes to protect people’s rights to privacy.
 The Federal Privacy Act specifies duties for agencies/professionals
that maintain record-keeping systems, including the following:

Agency Record Keeping Duties
1. Maintaining only information relevant and necessary to the
agency’s purposes.
2. Collecting as much information as possible from the client directly.
3. Informing clients of the agency’s authority to gather information,
whether disclosure is mandatory or voluntary, the principal purpose
of the use of the information, the routine uses and effects, if any, of
not providing part or all of the information.
4. Maintaining and updating records to assure accuracy, relevancy,
timeliness and completeness.

Agency Record Keeping Duties
5. Notifying clients of the release of records owing to compulsory legal
actions.
6. Establishing procedures to inform clients of the existence of their
records, including special measures if necessary for disclosure of
medical and psychological records and a review of requests to
amend or correct the records.

Clients Access to their Own Records
 Both the Freedom of Information Act (1966) and the Privacy Act
(1974) establish the right of the client to have access of their own
records.
 Research by Freed (1978) found that agencies that tried sharing
case records with clients have found that the practice contributes
favorably to enhancing client’s trust and the openness of the
therapeutic relationship.
 When should records be withheld?
1. Only in very limited circumstances when there is compelling
evidence that such access would cause serious harm to the client.

Clinical Supervision Recordkeeping
Clinical Supervision Notes:
Clinical supervision notes serve a number of functions, including:
 Gathering evidence for your personal log of reflective practice.
 Helping you to keep a track of your trainee’s professional development
and competence during the course of his/her placement.
 Provides you with evidence to help form a judgment of competence
throughout the continuum, not just at evaluation points.
 Can provide a focus for future supervision issues, such as reflecting on
development later on in the placement.
 Provides a record of decisions, judgments and perspectives taken during
a supervision session.
 Helps a supervisor to keep track of clinical work undertaken by the
trainee.
 Can provide detailed feedback to your trainee.

Notes should be kept in such a way that the reasoning behind opinions and
decisions can be understood.
 Alternative courses of action that have been considered should be noted.
 Alternative points of view, including disagreements between trainee and
supervisor should be noted.
 The way in which disagreements or interpersonal difficulties are resolved
can be noted and are good topic area for future supervision discussions.

Supervision notes are the official record of your supervision practice, over the
course of a supervisee’s placement.
 For the purposes of personal development and reflection, the supervisor
may wish to record personal information, such as countertransference
material (awareness of thoughts about being a supervisor or about the
trainee, strong feelings, activation of schemas) and behavior during a
supervision session. This information will be useful when seeking your
own supervision.
 Be aware however that all records kept in the course of your work can
potentially become a matter of public record should there be a future
court case or licensing board inquiry.

NBCC Code of Ethics: Recordkeeping
 Certified counselors must ensure that data maintained in electronic storage
are secure. By using the best computer security methods available, the data
must be limited to information that is appropriate and necessary for the
services being provided and accessible only to appropriate staff members
involved in the provision of services. Certified counselors must also ensure
that the electronically stored data are destroyed when the information is no
longer of value in providing services or required as part of clients’ records.
 Any data derived from a client relationship and used in training or research
shall be so disguised that the informed client’s identity is fully protected. Any
data which cannot be so disguised may be used only as expressly
authorized by the client’s informed and un-coerced consent.

LPCA & GA Code of Ethics: Recordkeeping
 LPCA
4. Confidentiality of Supervision Records: Keep and secure supervision
records and consider all information gained in supervision as confidential.
 GA
 Rule 135-7-.03 Confidentiality (c)
 failing to store or dispose of client records in a way that maintains
confidentiality, and when providing any client with access to that client's
records, failing to protect the confidences of other persons contained in that
record;

Informed Consent
 "Informed consent" is a process of sharing information with clients
that is essential to their ability to make rational choices among
multiple options in their perceived best interest.
 Informed consent was founded as a legal standard of care on the
principle of individuals' rights over their own bodies and was well
established by the turn of this century.
 Informed consent had been enforced progressively: first for surgical
procedures, then medical (non-surgical) ones, and finally for
medication itself.
 Until recently mental health and addictions counseling had largely
avoided this standard.

Informed Consent
 According to Beahrs & Gutheil (2001) several factors traditionally
shielded psychotherapy from standard of informed consent:
1. “First and foremost was that therapeutic communications were
considered sacrosanct and rarely made available to others in
uncensored form.”
2. “An additional distinction was the fact that psychotherapy is
physically noninvasive, with patients being conscious and able
to monitor the process themselves.”
3. “Finally, the multiple uncertainties and complexities that can
influence the outcome of treatment for a mental disorder make
it very difficult to demonstrate convincingly any specific harm
allegedly caused by the psychotherapeutic process itself.”

Informed Consent
 The supervisor must determine that clients have been informed by
the supervisee regarding the parameters of therapy.
 The supervisor must also be sure that clients are aware of the
parameters of supervision that will affect them.
 Supervisor must provide the supervisee with the opportunity for
informed consent (i.e., the conditions and parameters that dictate
their existence in their workplace).
 A clinician shall not withhold information that the client needs or
reasonably could use to make informed treatment decisions,
including options for treatment not provided by the clinician.

Informed Consent with Clients
 What are the reasonable risks of therapy?
 What are the reasonable benefits of therapy?
 What are the logistics of treatment (cost, length of sessions, number
of sessions)?
 What are the financial incentives or penalties which limit the
provision of appropriate treatment (especially when dealing with
third party providers, and the limitations imposed by those payers)?
 What type of therapy will be offered (what is your theoretical
orientation … cognitive behavioral, marital, gestalt)?

GA LPC Informed Consent
Rule 135-7-.01 Responsibility to Clients
(1) A licensee's primary professional responsibility is to the client. The
licensee shall make every reasonable effort to promote the welfare,
autonomy and best interests of families and individuals, including
respecting the rights of those persons seeking assistance, obtaining
informed consent, and making reasonable efforts to ensure that the
licensee's services are used appropriately.
(2e) knowingly withholding information about accepted and prevailing
treatment alternatives that differ from those provided by the licensee;
(2f) failing to inform the client of any contractual obligations, limitations,
or requirements resulting from an agreement between the licensee
and a third party payer which could influence the course of the client's
treatment;


GA LPC Informed Consent
Rule 135-7-.01 Responsibility to Clients
(2g) when there are clear and established risks to the client, failing to
provide the client with a description of any foreseeable negative
consequences of the proposed treatment;
(2i) taking any action for nonpayment of fees without first advising the
client of the intended action and providing the client with an
opportunity to settle the debt;
(2j) when termination or interruption of service to the client is anticipated,
failing to notify the client promptly and failing to assist the client in
seeking alternative services consistent with the client's needs and
preferences;
(2k) failing to terminate a client relationship when it is reasonably clear
that the treatment no longer serves the client's needs or interest;

CPCS Informed Consent
1. Supervisee Status Disclosure to Clients: Ensure that supervisees inform
clients of their professional status (e.g., intern) and of all conditions of
supervision. A CPCS shall ensure that supervisees inform their clients of
any status other than being fully licensed or qualified for independent
practice. For example, a CPCS shall ensure that supervisees inform clients
if they are students, interns, trainees or, if licensed with restrictions, the
nature of those restrictions (e.g., associate or license-eligible). Additionally,
a CPCS shall ensure that supervisees inform clients of the pertinent
requirements of supervision (e.g., the audio recording of all counseling
sessions for purposes of supervision).
3. Supervisee Informed Consent to Supervision: Inform supervisees about the
process of supervision, including supervision goals, case management
procedures, evaluation processes, and the CPCS’s preferred supervision
model(s). A CPCS shall also inform supervisees of the CPCS’s credentials,
areas of expertise, and training in supervision.

Informed Consent Vignette
You are supervising an MA intern in a behavioral healthcare outpatient
facility. This trainee sees a client for the first time and begins doing the
intake information. You view the tape of the client and trainee, and let him
know that he forgot to inform the client about the procedure of therapy, cost,
and the risk/benefit of entering into therapy. You model how this should be
done (as this is the intern’s first client), and assign this as the first task to
happen during the next session. You also tell the intern that the tasks at
hand (for the next couple of sessions) are completing the intake
(assessment phase) forms, assessing client
needs/wants/problems/strengths, and formulating agreed upon treatment
goals. The intern states he understands.
Next session, the intern follows your instructions and provides the informed
consent you requested. He then continues with ASI and other standardized
assessment forms with the client. During the session the client begins to
talk about some of his problems, and your intern seizes the moment to do
some guided imagery with him regarding the problem he was talking about
(feeling abandoned by his father). After the exercise, the intern continues to
fill out assessment forms.

After viewing the tape, you caution the intern not to get ahead of himself
and start doing therapy (guided imagery exercise). You also informed the
intern that he did not explain this technique to the client, nor did he ask the
client’s permission to utilize this technique. You clearly outline to the intern
what should happen in the next session (restating what was said previously
regarding assessment stage tasks).
The next session, the intern again continues to complete assessment
forms, when the client discloses that he feels inept as a father. A light
flashes in your interns mind, and he discloses to the client that privately he
does work with a men’s movement organization. This organization helps
men “gain integrity with themselves, with their family of origin, and with their
current family’s structure.” He informs the client of a powerful technique he
knows which involves blindfolding the client and leading the client around
the room while the therapist asks him questions about his manhood and
fatherhood. The client agrees to have this procedure done.

Excited at the prospect of doing his “life’s work” with the client, the intern
scrambles to make a makeshift blindfold. He then stands the client up,
holds the client’s hand, leads the client walking around the room asking the
client a series of questions (e.g., “In what way are you less than a whole
man” and “In what way are you strong”).
Excited about the exercise he just did, and before his next scheduled
supervision session with you, the intern describes to the staff (in peer
supervision meeting) the details of the aforementioned exercise and his
rationale for doing the exercise. In the questioning of this intern, you sense
some concern from some other clinicians (e.g., one clinician asked if the
client consented to this procedure and the intern stated he fully explained
the procedure to the client before proceeding). At one point the meeting
gets quiet and people look to you to see if you have any feedback to give
your intern.

Informed Consent Vignette Questions
1. Has the MA intern properly done informed consent in this case
example?
2. What feedback should you give the intern in peer supervision
meeting?
3. Once you get this intern alone, what next?

Americans with Disabilities Act
 The ADA Amendments Act of 2008 (ADAAA) was enacted on
September 25, 2008, and became effective on January 1, 2009.
 This law made a number of significant changes to the definition of
“disability.”
 It also directed the U.S. Equal Employment Opportunity
Commission (EEOC) to amend its ADA regulations to reflect the
changes made by the ADAAA.
 The final regulations were published in the Federal Register on
March 25, 2011.

 Who is not affected by the ADA?
 Corporations fully owned by the U.S. Government (though the U.S.
government is are covered by similar regulations promulgated by
other disability and discrimination laws.
 Indian Tribes.
 Bona fide private clubs that are exempt from taxation under the
Internal Revenue Code.
 Private clubs and religious organizations are exempt from Title III
(public accomodation) provisions.

 The ADAAA and the final regulations define a disability using a
three-pronged approach:
1. a physical or mental impairment that substantially limits one or more
major life activities (sometimes referred to in the regulations as an
“actual disability”), or
2. a record of a physical or mental impairment that substantially limited
a major life activity (“record of”), or
3. when a covered entity takes an action prohibited by the ADA
because of an actual or perceived impairment that is not both
transitory and minor (“regarded as”).

 Definition of a person with a disability (continued)
 As defined by the ADA, a disability is a physical or mental
impairment that substantially limits a major life activity, such as
caring for oneself, performing manual tasks, seeing, hearing, eating,
sleeping, walking, standing, sitting, reaching, lifting, bending,
speaking, breathing, learning, reading, concentrating, thinking,
communicating, interacting with others, and working.
 The final regulations also state that major life activities include the
operation of major bodily functions.
 The final regulations state that major bodily functions include the
operation of an individual organ within a body system ( e.g., the
operation of the kidney, liver, or pancreas).

 What is “substantially limit” a major life activity mean?
 The individual must be substantially limited in performing a major life activity
as compared to most people in the general population.
 The determination of whether an impairment substantially limits a major life
activity requires an individualized assessment.
 An impairment need not prevent or severely or significantly limit a major life
activity to be considered “substantially limiting.” Nonetheless, not every
impairment will constitute a disability.
 An individual need only be substantially limited, or have a record of a
substantial limitation, in one major life activity to be covered under the first
or second prong of the definition of “disability.”

 Do the final regulations require that an impairment last a particular length of
time to be considered substantially limiting?
 In prong 3 (“regarded as” prong) ADAAA excludes from “regarded as”
coverage an actual or perceived impairment that is both transitory ( i.e., will
last fewer than six months) and minor.
 An impairment that is episodic or in remission meets the definition of
disability if it would substantially limit a major life activity when active.
 Employment discrimination can also include discriminating based on a
qualified individual’s relationship or association with another individual (such
as a spouse or child) with a known disability.

 Reasonable Accommodation:
 Making reasonable accommodation for the disability of a qualified applicant
or employee is key to the successful employment of people with disabling
conditions.
 The ADA defines reasonable accommodation as efforts that may include
the following adjustments (these are major examples, but not a
comprehensive list):
1. Making the workplace structurally accessible to people with
disabilities.
2. Restructuring jobs to make best use of an individual’s skills.

 Reasonable Accommodation (continued):
3. Modifying work hours.
4. Reassigning an employee with a disability to an equivalent
position as soon as one becomes available.
5. Acquiring or modifying equipment or devices.
6. Appropriately adjusting or modifying examinations, training
materials, or policies.
7. Providing qualified readers for the blind or interpreters for the deaf.

 ADA and Drug Use:
 The definition of an individual with a disability does not include anyone who
is currently engaged in the illegal use of drugs.
 However, a person who has successfully completed a supervised drug
rehabilitation program or has otherwise been rehabilitated successfully, or
is participating in a supervised rehabilitation program is covered. ADA gives
additional authority to employers:
1. Employers may utilize drug testing to ensure that individuals who
have completed or are enrolled in rehabilitation programs remain
drug free.
2. Employers may prohibit the use of drugs and alcohol at the
workplace.
3. Hold all employees, regardless of disability, who abuse drugs or
alcohol to the same job performance criteria as other employees.
4. An employer will have to prove Financial or Resource Hardship in
order not to provide reasonable accommodations.

Dual Relationships
o When a supervisor extends the boundary beyond the workplace,
and specifically the supervisory relationship, the supervisory creates
the potential for complications.
o Dual relationships occur when a person assumes two or more roles
simultaneously or sequentially with a person seeking help (client) or
with a person being supervised.
What makes a dual relationship unethical?
1. The likelihood that it will impair the supervisor’s judgment.
2. The risk to the supervisee of exploitation.

Sexual Involvement, Sexual Harassment,
Harassment
 Sexual Attraction
 Sexual Harassment – Harassment in the workplace needs to be a pattern of behavior
or a single egregious incident. There has been case precedent (3) for the latter in
NJ.
 ‘ “Harassment” means deliberate comments, contacts, or gestures which intimidate or
offend an individual on the basis of that person’s race, religion, color, national origin,
marital status, sexual orientation, physical or mental disability, or any other
preference or personal characteristic, condition or status.’
 It recently got easier for accusers to show they have suffered as a result of
harassment.
 The New Jersey Supreme Court ruled in 2004 that victims of workplace sexual
harassment can sue employers for emotional stress without having to demonstrate
through experts they suffered severe psychological harm.

Sexual Involvement, Sexual Harassment,
Harassment
 ‘ “Sexual Harassment” means solicitation of any sexual act, physical advances, or verbal
or nonverbal conduct that is sexual in nature, and which occurs in connection with a
licensee’s activities or role as a provider of professional counseling services and that is
either unwelcome, offensive to a reasonable person, or creates a hostile work place
environment, and the licensee knows, should know, or is told this, or is sufficiently severe
or intense to be abusive to a reasonable person in that context. “Sexual Harassment” may
consist of a single, extreme or severe act, or of multiple acts, and may include, but is not
limited to the conduct of a licensee with a client, co-worker, employee, student, supervisee
or research subject, whether or not such individual is in a subordinate position to the
licensee.’
 Some definitions of sexual harassment also include the following line: ‘ “Sexual
Harassment” may include content of a nonsexual nature if it is based upon the sex of an
individual.’
 Consensual (but Hidden) Sexual Relationships. “Sexual involvement may further a human
relationship, but it does so at the expense of the professional relationship” (Rubin, 1990).
 (FOR SUPERVISORS) Intimate Romantic Relationships. The American Psychiatric
Association, while discouraging all sexual involvement between clinicians and trainees,
“realized that romantic relationships often develop in professional settings and that it in no
way intended to stifle them.”

Nonsexual Dual Relationships
 Supervisor/Therapist (the supervisor will be challenged
at times to determine where supervision ends and
therapy begins).
 Supervisor/Recovery (how does recovery issues, AA
attendance, sponsoring).
 Professional/Personal (just how personal is too
personal)?

Dual Relationships/Conflicts of Interest
 LPC/APC should not engage in sexual activities or sexual advances with any
client, trainee, or student;
 participating in dual relationships with clients that create a conflict of interest
which could impair the licensee's professional judgment, harm the client, or
compromise the therapy;
CPCS Dual Relationship Regulation
5. Supervisor/Supervisee Dual Relationships: Avoid all dual relationships with
supervisees that may interfere with the CPCS’s professional judgment or
exploit the supervisee to include social media and other areas not previously
addressed. Sexual, romantic, or intimate relationships between a CPCS and
supervisees shall not occur. CPCS shall not engage in sexual harassment or
sexual bias towards supervisees. Certified Professional Counselor Supervisors
shall not supervise relatives.

Dual Relationships 135-5-.01 & -.02
 Rule 135-5-.01 and 135-5-.02 “with particular attention being paid to
prohibited dual relationships.” This means the supervisor is not
also the Director.

NBCC Code of Ethics on Harassment
11. 11. Certified counselors do not condone or engage in sexual harassment,
which is defined as unwelcome comments, gestures, or physical contact of a
sexual nature.
12. 12. Through an awareness of the impact of stereotyping and unwarranted
discrimination (e.g., biases based on age, disability, ethnicity, gender, race,
religion, or sexual orientation), certified counselors guard the individual rights
and personal dignity of the client in the counseling relationship.

Sexual Relationships with Clients
 National Board for Certified Counselors – Sexual, physical, or romantic intimacy can be engaged
within a minimum of 2 years after terminating the counseling relationship.
http://www.nbcc.org/Assets/Ethics/nbcc-codeofethics.pdf (Section A10).
 American Counseling Association – 5 years (clients only). Must demonstrate forethought and
document no potential harm or exploitation will occur.
http://www.counseling.org/Files/FD.ashx?guid=ab7c1272-71c4-46cf-848c-f98489937dda (Clients:
Section A5. Colleagues/Students: Section F.3.b. no sex with only current supervisees)
 American Psychological Association – 2 years … for those “most unusual circumstances”.
http://www.apa.org/ethics/code/index.aspx (Clients: regulation 10.08, Colleagues/Students:
regulation 7.07).
 National Association of Social Workers – No sex, no time, no how … unless the social worker can
prove an exception to this prohibition is “warranted because of extraordinary circumstances” and the
social worker must prove it (NASW). 2 years (LCSW).
http://www.socialworkers.org/pubs/code/code.asp (Clients: regulation 1.09, Colleagues/Students:
regulation 2.07).
LSW/LCSW Code of Ethics - http://www.njconsumeraffairs.gov/laws/socialregs.pdf (13:44G-10.7[c]
and [c1]).

Sexual Relationships with Clients
 American Association for Marriage and Family Therapists – 2 years.
http://www.aamft.org/imis15/content/legal_ethics/code_of_ethics.aspx (Section 1.5).
http://www.njconsumeraffairs.gov/laws/mftregs.pdf (Section 13:34-6.4 [d and d(1)]).
 Licensed Professional Counselor (LPC) – 2 years. Being in love and consensual relationships are not
defenses.
 http://www.nj.gov/oag/ca/laws/pcregs.pdf (Section 13:34-19:3[b, c, h, and i]).
NJ LCSW, LPC and LMFT all read the same exclusion: “In the circumstances where the client is, or should
be recognized by the licensee as, clearly vulnerable by reason of emotional or cognitive disorder to the
exploitive influence by the licensee, the prohibition on sexual contact shall extend indefinitely.”
 CADC/LCADC – Again, 2 years.
http://www.njconsumeraffairs.gov/laws/adcregs.pdf (13:34C-3.3[c and c(1)d]).
CADC/LCADC exclusion: “The 24 month rule shall not apply and the prohibition shall extend indefinitely in
the circumstances where the former client is or should be recognized by the licensee or certificate holder as
clearly vulnerable by reason of emotional or cognitive disorder to the exploitive influence by the licensee or
the certificate holder.”
All links were checked on 02/17/12

Dual Relationship Vignette
Ann is your intake coordinator at the residential facility you head (as Clinical
Director). One of the responsibilities you have given Ann is the scheduling
of overnight staff. She does not have any type of supervisory capacity other
than scheduling the overnight workers. It has come to your attention,
through one of the clients, that Ann has begun a romantic relationship with
one of the overnight workers. At this point you don’t do anything regarding
this information.
3 weeks later, one of the other overnight workers approaches you with a
complaint directed towards Ann. He states that she is playing favorites with
Rodney (the alleged boyfriend). He shows you the overnight schedule and
shows how Rodney has almost every weekend off, while the other 2
overnight workers fill in the majority of weekend shifts. He asks for your
help to correct this situation and does not want his name put out to Ann. He
states the reason for this favoritism by Ann towards Rodney is due to their
romantic involvement with each other, and the fact that Ann has weekends
off.

Dual Relationship Vignette Questions
1. Is there a dual relationship issue in this example, if so
what is it?
2. Since Ann has not publicly stated she and Rodney are
romantically involved, how do you go about dealing with
this situation?
3. If in your conversations with Ann, she does admit to this
relationship, what call do you make regarding their
relationship in regards to professional functioning?

APC Clinical Supervision Standards
Rule 135-5-.01 Associate Professional Counselors
Definitions (A-7) "Directed Experience Under Supervision Contract" is
a document, obtained from the Board, that defines the working relationship for the
purposes of obtaining the required post-masters directed experience under
supervision. Directed experience sites in the contract must meet the requirements of
rule 135-5-.01(a) (6) above, the definition of "Directed Experience".
Requirements for Licensure (B-2) “Registration of a contract for
obtaining postmaster's directed experience under supervision.” The
applicant shall register with the Board an acceptable contract, the Directed
Experience Under Supervision Contract, for obtaining the post-master's experience
required for licensure as a Professional Counselor. The applicant is responsible for
notifying the Board of any changes in the contract, by submitting a new contract
within fourteen (14) days of the change. Directed experience sites in the contract
must meet the requirements of rule 135-5-.01(a) (6) above, the definition of "Directed
Experience".

Rule 135-5-.01 Associate Professional Counselors
C.Restrictions on Practice.
1. A person who holds a license as an Associate Professional Counselor may
only use the title "Associate Professional Counselor."
2. A person who holds a license as an Associate Professional Counselor may
engage in the practice of Professional Counseling, but only under direction
and supervision, and only for a period not to exceed five years while
obtaining the post-master's experience and supervision required for licensure
as a Professional Counselor. Directed experience sites in the contract must
meet the requirements of rule 135-5-.01(a) (6) above, the definition of
"Directed Experience".

Rule 135-5-.02 Professional Counselors
A.Definitions – Years of Directed Practice
(v) 600 hours currently. After September 30, 2018 "One year of
Directed Experience" means a minimum of 1000 hours of directed
experience acquired in not less than a twelve (12) month period. The
number of required years of Directed Experience is based on the applicant's
educational credentials as defined in Rule 135-5-.02 (b, c, d, e and f).
(vi) After September 30, 2018, all Directed Experience must be
obtained within the sixty (60) months prior to the date of application.
Endorsement applications will be considered on a case by case basis at the
discretion of the Board.


A.Definitions – Years of Supervision
Currently it is 30 hours. After September 30, 2018, "One year of
Supervision" means a minimum of thirty five (35) hours of supervision
obtained during one twelve (12) month period of Directed Experience as
defined in Rule 135-5-.02(7).
After September 30, 2018, all Supervision must be obtained within the
sixty (60) months prior to the date of application. Endorsement applications
will be considered on a case by case basis at the discretion of the Board.

LPC Clinical Supervision Standards
B.An applicant who holds a master's degree from a program primarily
counseling in content must meet the following requirements for
licensure as a Professional Counselor.
3.Directed Experience under Supervision. The applicant must present evidence of four
(4) years of post-master's directed experience under supervision [see definitions in Rule 135-
5-.02(a) ] in the practice of Professional Counseling in a work setting acceptable to the Board
OR three (3) years of post-master's directed experience under supervision in the practice of
Professional Counseling in a work setting acceptable to the Board and a supervised counseling
practicum or internship of at least 300 hours which was part of the graduate degree program.
After September 30, 2018, 600 practicum or internship hours will be required. A
minimum of two (2) years of the supervision must be provided by a supervisor who is a licensed
Professional Counselor and meets the requirements in Rule 135-5-.02(a) 5, except that if the
supervision was acquired prior to September 23, 1993, such supervision may have been
provided by any qualified supervisor. Directed experience sites in the contract must meet the
requirements of rule 135-5-.02(a) (6) above, the definition of "Directed Experience".

Contract Affidavit – Clinical Supervisor
Responsibilities
1. Ensure compliance with current Georgia Composite Board of Professional
Counselors, Social Workers, and Marriage & Family Therapist Rules.
2. Provide ongoing, clinical supervision in a professional setting.
3. Ensure that supervision of the supervisee is compliant with Board rules 135-5-.01
(Requirements for Licensure) and 135-11-.01 (Tele-mental Health)
4. Discuss and review case notes, charts, records, and available audio or video for
clients with the applicant.
5. Review and closely supervise the applicant and all problem cases, providing
special attention to assessments, treatment planning, ongoing case management,
emergency intervention, record keeping, and termination.
6. Focus on the appropriateness of the treatment plans and monitor the
appropriateness of clients served based on the applicant’s therapeutic skill. Direct
the applicant to refer clients who fall beyond their level of competence.
7. Maintain confidentiality of all client and supervisory materials.

Contract Affidavit – Clinical Supervisor
Responsibilities
8. Review the Georgia licensing laws (OCGA 43-10A), Board rules (135-
5), and Code of Ethics (135-7) with applicant.
9. Seek timely clarification/consultation from the Board if there are any
problems or conflicts between commitments to agency, administrative
supervisor, and client or other conflicts relating to the authority, or
shared responsibility for fulfilling the responsibilities under this Plan.
10. Establish and maintain a record-keeping system to track the direct client
contact and supervision hours.
11. Supervisor will be prepared to provide supporting documentation
verifying the accuracy of information reported, if requested by Board.
12. Notify the Board of any changes to supervisor’s business address and
phone number or change in credential status.
13. Notify the Board of any interruption or proposed termination of the plan.

Contract Affidavit – APC/Unlicensed
Supervisee Requirements
1. Abide by the Code of Ethics for Counselors and Therapists as specified
in Board rule: Code of Ethics 135-7.
2. Establish and maintain a record keeping system to track the direct client
contact and supervision hours.
3. Applicant will be prepared to provide supporting documentation verifying
the accuracy of information reported, if requested by Board.
4. Submit requests to change or modify the “Work Plan” to Board prior to
implementing changes.
5. Ensure supervisor has authority to review records, determine
appropriateness of records, direct referrals of inappropriate clients,
determine caseload, and report to Board.

Contract Affidavit – Administrative Supervision
- Director Responsibilities
 Providing direction and oversight for this applicant;
 Ensuring the applicant is provided opportunities for progression of
professional counseling skills and techniques;
 Assuring the quality of the services rendered by this applicant;
 Ensuring qualified supervision or intervention occurs in situations
requiring expertise beyond that of the applicant; and,
 Ensuring work site(s) include a formal structure related to the practice of
professional counseling as defined in Rule 135-5-.01(a) (1). Work site(s)
must have measurable, detailed documentation for this applicant, as well
as a signed contractual agreement that outlines job description, office
hours, performance review procedures, and dismissal policies.

Bibliography
42-CFR-Part 2: Title 42--Public Health CHAPTER I--PUBLIC HEALTH SERVICE,
DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 2--CONFIDENTIALITY OF
ALCOHOL AND DRUG ABUSE PATIENT RECORDS
http://www.access.gpo.gov/nara/cfr/waisidx_02/42cfr2_02.html
Association for Counselor Education and Supervision (ACES). (2001). Ethical Guidelines for
Counseling Supervisors. http://www.siu.edu/~epse1/aces/documents/ethicsnoframe.htm [online,
link no longer active]
Bradley Center, Inc. v. Wessner, et al., 161 Ga. App. 576 (287 SE 2d 716) (1982a).
Bradley Center, Inc v. Wessner, et al., 250 Ga. 199, 296 SE 2d 693 (1982b).
Beahrs, J. O. & Gutheil, T. G. (2001). Informed consent in psychotherapy. The American Journal
of Psychiatry, 158(1), 4-10.
Bond, T. (2015). Standards and Ethics for Counselling in Action, 4th
Ed. Sage, Los Angeles.
Bernard, J. M. & Goodyear, R. K. (2013). Fundamentals of Clinical Supervision, 5th
Ed. Pearson,
Boston, MA.
Disney, M. J. & Stephens, A. M. (1994). Legal Issues in Clinical Supervision. ACA Press,
Alexandria, VA.

Bibliography
Doverspike, W. F. (2007). The so-called duty to warn: Protecting the public versus protecting the
patient. Georgia Psychologist, 61(3), 20.
Durham, T. G. (1996). The Supervisor’s Role in Ethical Decision-Making. The Counselor.
May/June, p. 7.
Flinders, C. A. & Shafranske, E. P. (2004). Clinical Supervision: A Competency-Based
Approach. American Psychological Association, Washington, DC.
Falvey, J. E. (2002). Managing clinical supervision: Ethical practice and legal risk management.
Pacific Groove: Wadsworth
Garner v. Stone, No. 97A-320250-1 (Ga., DeKalb County Super. Ct. Dec. 16, 1999).
Godlaski, T. M. & Leukefeld, C. G. (1996). Ethics of Supervision. The Counselor. May/June, pp.
17 – 20.
Jaffee v. Redmond, WL 315 841 (US 1996).
Keith-Spiegel, P. & Koocher, G. P. (1985). Ethics in Psychology: Professional Standards and
Cases. McGraw-Hill, New York, NY.

Bibliography
Knapp, S. & Tepper, A. M. (1996). Legal and Ethical Issues in Supervision. http://www.papsy.org/
Taken from The Pennsylvania Psychologist Quarterly. [online]
Knapp, S. & Vandecreek, L. (1997). Ethical and Legal Aspects of Clinical Supervision. In Watkins,
C. E. Jr., Handbook of Psychotherapy Supervision. New York, John Wiley & Sons, Inc.
Lamb, D., Presser, N., Pfost, K., Baum, M., Jackson, R., & Jarvis, P. (1987). Confronting
Professional Impairment During the Internship: Identification, Due Process, and Remediation.
Professional Psychology: Research and Practice, 18, pp. 597-603.
Mead, D. E. (1990). Effective supervision: A task-oriented model for the mental health
professionals. Brunner/Mazel, Inc., New York, NY.
Pope, K. & Vasquez, M. J. T. (2016). Ethics in Psychotherapy and Counseling: A Practical Guide,
5th
Ed. John Wiley & Sons, Hoboken, NJ.
Powell, D. J. & Brodsky, A. (2004). Clinical Supervision in Alcohol and Drug Abuse Counseling.
Jossey-Bass Publishers, San Francisco, CA.

Bibliography
Seigel, M. (1979). Privacy, Ethics and Confidentiality. Professional Psychology, 10, pp. 249-258.
Slovenko, R. (1980). Legal Issues in Psychotherapy Supervision. In A. K. Hess, Ed., Psychotherapy
Supervision: Theory, Research and Practice. New York, NY. Wiley.
Stoltenberg, C. D., McNeil, B., & Delworth, U. (1998). IDM Supervision: An Integrated Developmental
Model for Supervising Counselors and Therapists. Jossey-Bass Publishers, San Francisco, CA.
Tarasoff v. Board of Regents of the University of California, 13 Cal.3d 177, 529 P.2d 533 (1974),
vacated, 17 Cal.3r 425, 551 P.2d 334 (1976).
Welfel, E. R. (2015). Ethics in Counseling and Psychotherapy: Standards, Research, and Emerging
Issues, 6th
Ed. Cengage Learning, Boston, MA.

Woody, R. H. (2013). Legal Self-Defense for Mental Health Practitioners, Springer Publishing
Company. New York, NY.
Woody, R. H. (2013). Legal Self-Defense for Mental Health Practitioners, Springer Publishing
Company, Boston, New York, NY.

Bibliography
Portions of the duty to warn material has been reproduced here with permission from
http://mentalhelp.net/, Copyright 2000 Mental Health Net. All rights reserved. [online]
Understanding the ADA. (2000). Eastern Paralyzed Veterans Association. 75-20 Astoria Boulevard,
Jackson Heights, NY 11370-1177. 718-803-EVPA.

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