1.3 Legal & Ethical Guidelines for Mental Health Counseling

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Legal & Ethical Guidelines for Mental Health Counseling

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• 4 Minutes

Legal & Ethical Guidelines for Mental Health Counseling

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• 5 Minutes

At the beginning of therapy, therapists provide clients with verbal and written information, much of which is legally required. Some information is not legally required but affords some legal protection to the therapist. Other information is helpful in setting client expectations in order to improve client understanding and adherence to terms and conditions of the services provided. This informed consent refers to a patient having adequate information, including understanding the risks and rewards of services, in order to make a decision regarding their care.

Confidentiality is generally considered to be a cornerstone of the doctor-client relationship. Professionals assume that mental health treatment is most likely to be successful when the client has a trusting relationship with the therapist. People tend to reveal much of their private selves in the course of receiving mental health services. Trust that client privacy will be preserved is necessary to maintain the value of these services. Laws that protect confidentiality attempt to preserve this trust, so participants will be more likely to benefit from treatment. With trust in confidentiality, people are more likely pursue services and are more likely to divulge information that is needed to ensure effective treatment. In addition to the needs of individuals, confidentiality laws serve the interests of family members, employers and society in general, by helping to reduce the impact of mental and emotional disorders and personal problems.

The confidentiality of clients includes the question of whether they are participating in mental health services. Providers must refrain from confirming or denying that any individual is or has been a client, so long as there is no legal exception to confidentiality. All details of verbal and written communications are also protected.

Confidentiality has its limits, and California law spells out several exceptions to client confidentiality. They are threat of harm to self or others, certain lawsuits, a court order, detention of a mentally disordered person for evaluation, and reasonable suspicion of abuse of a minor or dependent adult.

In general telehealth practices are subject to the same regulations, code of ethics, and professional guidelines that define the relationship in in-person office-based services (as they fall within the same standard of care), however state and international psychological associations have developed or are beginning to develop guidelines specific to the provision of distance mental health counseling. In California, state licensure is required to provide distance mental health (telehealth) services to California residents, this includes consent and documentation of consent in records. Consent must include potential risks and limitations of receiving services via telehealth.

A California therapist may provide telehealth services to clients located in another state/jurisdiction only if the therapist meets the requirements to lawfully provide services in that jurisdiction and delivery of services through telehealth is allowed by that jurisdiction. If a client is a California resident and temporarily travels to another state, the therapist must check with the other state’s licensing board to to see if telepsychology is permitted in that state before providing services.