Monthly Archives: March 2006

Supporting, remembering those who counsel

Richard Yep March 27, 2006

Richard Yep

This special issue of Counseling Today is the result of numerous hours spent by our writers and editors researching, interviewing and writing about counseling around the world. While no one publication could hope to cover even a small portion of such a diverse and broad topic area, it is our hope that you will find the articles both interesting and thought-provoking.

Given that the American Counseling Association will be partnering with the Canadian Counselling Association for our first “jointly sponsored” convention in just a few months, this special issue of Counseling Today seems especially timely.

Counseling certainly encompasses a “world community,” and for this reason helping professionals must have the ability to access tools and resources that will allow them to do the best they can for their clients and students. At ACA, we recognize that our role is to support those of you doing such important work with millions of children, adolescents, adults and families each and every day. Our job is to listen to what you need.

I am pleased that last month we launched the latest generation of the ACA website at www.counseling.org. The new site features a cleaner design that includes easier navigation. This effort was the culmination of many months of research and feedback from our members and staff. I thank all who were part of making this important communication vehicle a reality.

In a previous column, I commented on the Counselors Care Fund, a project of the ACA Foundation. The fund was designed to help our members who were impacted by the ravages of the hurricanes in the Gulf Coast region last fall. When it comes to helping others, counselors are the best. With the outpouring of donations to the Counselors Care Fund, I’ve witnessed that same level of caring for your colleagues who suffered through such devastating events.

At the end of December, the Counselors Care Fund had received donations of more than $15,000. As you may remember, the ACA Foundation matches each dollar, resulting in a fund of more than $30,000. The heart-wrenching stories of our members and branches affected by the hurricanes reinforces to me that the ACA Foundation trustees made the right decision in organizing this important effort. Your donations are being put to good use, and I appreciate your compassion.

This column not only acknowledges those of you currently doing such good work, but also recognizes those who made their mark and are no longer with us. At the end of 2005, we lost two people who made significant contributions to the counseling profession, each in their own unique and talented way.

Roger Herring was a fine author and compassionate educator and was well known for his positions on issues relative to multicultural issues in counseling. When he passed away, he had already authored and edited numerous articles and texts that are continually cited and referenced by others. Perhaps more importantly, Roger’s passing resulted in many people sharing (via listservs and in print) the impact that he had on their lives.

We also marked the passing of Nancy Pinson-Millburn. She was well regarded in the career development field and on international issues, and was a strong believer in public advocacy on behalf of those less fortunate. Nancy also worked here at ACA headquarters and was my boss in the late 1990s. I came to know her as a superior scholar, excellent communicator and compassionate listener. During her memorial service at the University of Maryland, many people spoke of her spirit, her humor and how she positively impacted their lives. I remember her as someone who could easily move within the worlds of academia and advocacy and still be able to connect with leadership, staff and members.

Two of the counseling profession’s bright lights have gone out, but what they brought to the table, and their dedication to convey the importance and relevance of counseling in a global community, will continue to live on (see related articles on p. 56 and p. 57, respectively).

As we begin a new calendar year, I want to wish all of you a pleasant, healthy and peaceful 2006. Your work is so incredibly important, and I hope you will continue in your endeavors to help, serve and advocate for your clients and students. I also want you to know that ACA will continue to do what we can to support you in your good work.

As always, I hope you will communicate any comments, questions or suggestions that you have. Please contact me via e-mail at ryep@counseling.org or by phone at 800.347.6647 ext. 231.

Thanks and be well.

Allowing dual relationships

By David Kaplan

Editor’s note: American Counseling Association members received the 2005 ACA Code of Ethics bundled with the December 2005 issue of Counseling Today. Completed over a three-year period, this revision of the ethical code is the first in a decade and includes major updates in areas such as confidentiality, dual relationships, the use of technology in counseling, selecting interventions, record keeping, end-of-life issues and cultural sensitivity.

All ACA members are required to abide by the ACA Code of Ethics, and 21 state licensing boards use it as the basis for adjudicating complaints of ethical violations. As a service to members, Counseling Today is publishing a monthly column focusing on new or updated aspects of the ACA Code of Ethics (the ethics code is also available online at www.counseling.org/ethics). ACA Chief Professional Officer David Kaplan conducted the following interview with Rocco Cottone and Michael Kocet, two members of the ACA Ethical Code Revision Task Force.

 

David Kaplan: Two months ago we discussed a major change in the recent revision of the ACA Code of Ethics — changing the criterion for breaking confidentiality from “clear and imminent danger” to “serious and foreseeable harm.” This month we will be talking about another critical change in a core area of counseling ethics: allowing a dual relationship when it is beneficial to the client, supervisee, student or research participant (Editor’s note: See Standards A.5.d, F.3.e, F.10.f and G.3.d). It is interesting to note that the new 2005 Code of Ethics does not even mention the term “dual relationship.”

Rocco Cottone: The dual relationship term is really nondescript and does not give good guidance to the profession or to clients who have an ethical concern or complaint.

Michael Kocet: And over time our professional culture had developed the notion that you had to back away from any circumstance that might present a dual relationship, even if there was a potential for benefit to the client.

RC: When you sit down and analyze the concept of dual relationships, you will find that it relates to three different types of relationships: sexual/romantic relationships, nonprofessional relationships and professional role change. The first category, sexual and romantic relationships with current clients, is banned by the code of ethics because we have evidence of the damage that results. The second type of relationship, nonprofessional relationships, encompasses those activities where you might have contact or active involvement with a client outside of the counseling context. The third type of relationship that the old dual relationship term encompassed is a professional role change. An example is when you shift from individual counseling to couples counseling. Moving from one type of counseling to another with one client can be really confusing and ethically compromising.

So, in the end, moving away from the concept of dual relationships was really about the analysis of what the dual relationship term meant and the confusion it caused because of multiple meanings. The new ethics code addresses all three types of roles and relationships with clients.

DK: So instead of banning dual relationships across the board, the recent revision of the ethical code now allows professional counselors to interact with clients outside of a counseling session under certain conditions.

RC: Counselors may now interact with a client in a nonprofessional activity as long as the interaction is potentially beneficial and is not of a romantic or sexual nature. Even if it is a potentially beneficial relationship, counselors must use caution, forethought and proceed with client consent whenever feasible.

MK: Focusing on assessing beneficial versus harmful interactions allows the counselor to really partner with the client to determine whether a potential relationship will help or hurt.

DK: Can you give some examples of potentially beneficial interactions that may now be allowed?

MK: One example is a wedding. Let’s say a long-term client announces that he or she is getting married. The counselor is then asked to the wedding because the client feels that the counseling was instrumental in working through issues that blocked the client from considering new relationships. From the client’s perspective, the counselor’s attendance at the wedding would be very meaningful.

A second example involves a counselor who lives in an extremely rural area, needs to get her car fixed and has a client who is the only mechanic in town. A discussion with the client may lead to the clear conclusion that it is appropriate for the client to service the counselor’s car.

RC: Other examples include attending a graduation ceremony to honor a client’s academic accomplishment or attending a funeral to show respect to a client. It could be as simple as buying cookies from a Girl Scout or as complex as being actively involved in a shared community (e.g., a political party or a disability community) where you are working hand-in-hand with clients, students, supervisees or research participants. Counselors should not feel guilty for engaging in more than one role as long as it is potentially beneficial to the client.

DK: How does bartering fit into this new concept? What if a client would like to do yard work, carpentry, home repair, etc., in return for your services?

RC: Well, the standard we are talking about ( A.5.d, “Potentially Beneficial Interactions”) doesn’t in any way supersede the longstanding standard on bartering (A.10.d).

DK: One of the impressive things about Standard  A.5.d, “Potentially Beneficial Interactions,” is that it gives a very nice road map for how to ensure that the focus is on the client’s best interest when the issue of an interaction outside of counseling, supervision, teaching or research arises.

MK: Right. The counselor needs to have a thorough discussion with the client, supervisee, student or research participant about both the potential benefits and the potential harm that could occur. It is then critical that the counselor document this discussion in case records along with the rationale for engaging in the interaction.

DK: As we have pointed out in previous columns, a major theme through the new ACA Code of Ethics is consult, consult, consult! Is the issue of a potentially beneficial interaction with a client, student, supervisee or research participant an area that comes under this theme?

MK: Absolutely. If the counselor has any reservations, it is very useful to consult with a supervisor or colleague, search the literature, etc. There are many ways to consult.

DK: Dr. Cottone, you were the member of the Ethical Code Revision Task Force who spearheaded the change from banning dual relationships to evaluating beneficial versus harmful interactions. Why was this important to you?

RC: From a personal perspective, I have a son who has muscular dystrophy. I am very active in the community here in St. Louis, and at the same time I have a practice that focuses on counseling individuals affected by muscular dystrophy. So the people I counsel are the people in the same community where I am an active volunteer. I sit side by side my clients at the MDA telethons trying to raise money to save people’s lives. I go to parties with my son where my clients are present and we socialize. I began to realize there was nothing wrong with that. In fact, if I hadn’t been involved in that kind of activity, my clients would have looked at me as if I really was not sincerely interested in helping people with their condition.

I want to thank my colleagues on the task force because they were very receptive to the idea of evaluating beneficial versus harmful interactions rather than an across the board ban on dual relationships. The ideas I brought to the ethics task force were significantly different than those in the prior code, so I applaud my colleagues for letting me express my view and improving on some of the ideas I had.

DK: Thanks for giving a very human touch to the new ethical code.

 

****

Next month: New ethical code statements about end-of-life issues.

Letters to the editor: ct@counseling.org

It’s all about connecting

Richard Yep

Richard Yep

In this issue of Counseling Today, you’ll read about the many offerings and opportunities that await those attending our first international convention co-sponsored by the Canadian Counselling Association. For those of you who have somehow managed to avoid seeing a multitude of marketing and informational pieces during the past several months, the event begins on March 30 and continues through April 3 in Montréal.

As you read through this issue I hope that you’re saying to yourself, “I have to remember to get to that session” or “I need to visit the American Counseling Association bookshop and the 100 other booths in the expo” rather than “Oh, I sure wish I was going to the convention this year.” But if not, I have good news — you still have time to register for what will surely be one of the most important counseling events of the year.

This year’s convention will again provide opportunities to attend more than 500 educational offerings, including the “Counseling 20/20” town hall, which will bring together many experts to examine the future of counseling. There is also an even greater focus this year on what is being offered for counseling graduate students and emerging professionals. An enhanced Career Center, the ever-popular ACA Cyber Café and some terrific keynotes will also be featured.

I also want you to think about the fact that events representative of all 19 ACA divisions, as well as our four regions, and more than 20 committees and task forces will occur during our time together in Montréal.

Take a moment to consider where else you can go to find all the great offerings of the ACA divisions in one place. The answer, of course, is nowhere else but the convention. Look at the Education Sessions, a good many of which were selected by experts from our ACA divisions. And when you need a release from learning, you’ll find that our divisions offer many social and networking opportunities such as brunches, lunches and receptions. There is also the chance to meet with their leadership in the ACA expo!

ACA’s divisions originally helped to form our association. Those four groups, along with a number of others that have followed during the past 50 years, are key to the cutting-edge practice, research and scholarly work that is so important in moving the counseling profession forward. I appreciate the dedication and commitment of our division leaders, and I hope that all of you will take the time to learn more about what these special groups offer. What better way than to see them in action at the ACA Convention!

In the event you cannot make it to Montréal, I hope you will check out the ACA website at www.counseling.org during the first week of April, as we will make both keynote speeches from the convention available for your viewing pleasure. Tipper Gore and Stephen Lewis have both made an impact on the lives of countless people around the world. Gore’s advocacy of mental health services and Lewis’ efforts at addressing HIV/AIDS services in Africa are what make them exceptional human beings. So please “tune in” to the ACA website when we rebroadcast their remarks.

I also want to update you on ACA’s other new efforts in the digital world. We now have an online ethics course, “Building a Foundation for Ethical Practice.” (For more information, go to www.counseling.org/resources, click on “Professional Development” and then read the section on “Continuing Online Education.”). This course is part of our effort to provide you with the best information on ethical practice in counseling.

Last month we also began sending ACAeNews to our members for whom we have e-mail addresses so they can keep up on the latest trends, information and opportunities. If you didn’t get a copy in your e-mail inbox and would like to receive a free subscription (ACAeNews is published every two weeks), let me know by sending me your e-mail address. If you have colleagues (regardless of whether they are ACA members) who might be interested, have them contact me as well, and we’ll provide them with a trial subscription.

After 18 years with ACA, I can say that I am sensing a renewed energy in our association. The leadership of ACA, the commitment of our divisions and the hard work of our committees and task forces have combined to make this “new era” one in which ACA is thriving once again. I would be remiss if I did not specifically recognize our president, Patricia Arredondo, and also acknowledge the role of the ACA staff, who have been part of bringing us to this momentous point in our development. I am proud to work side by side with such dedicated professionals. I hope you also appreciate their efforts.

I trust you know how important it is for us to hear from you. As always, I hope you will contact me with any comments, questions or suggestions that you might have. Contact me via e-mail at ryep@counseling.org or by phone at 800.347.6647 ext. 231.

Thanks and be well.

Words of advice for establishing a Web presence

Robert J. Walsh and Norman C. Dasenbrook

Words of advice for establishing a Web presence

Q: I am an ACA member and obtained my New York mental health counselor license in October 2005. I am seeking some resource information for creating my own website, as I plan to have a private practice. Therefore, can you suggest some web design services?

A: First, let us congratulate you and New York on licensure and your decision to go into private practice. Websites are almost standard for anyone going into business for themselves, and private practice is no different. Just like business cards, letterhead and brochures, websites are a marketing tool and an information source that adds value to your practice.

In our workshops, we have always discussed websites as a value added service. Recently, a workshop participant reminded us that generations X and Y “Google” everything, which reinforced the marketing piece. This generational reminder was enlightening. So now, we strongly encourage all private practitioners to have a Web presence. The good news is that this technology is easily obtained and very affordable.

In terms of websites, you have a lot of options. One very inexpensive route is to go through your Internet provider (Optonline, Verizon, etc.) or large companies such AOL, Yahoo, 1and1.com or Godaddy.com. Most offer a do-it-yourself option for putting up a website.

If you only need a one-page website, then consider using an online referral service such as Psychology Today

(Psychologytoday.com) or Provisions Consulting through the American Mental Health Counselors Association (AMHCA.org). You simply upload your practice information to a template and off you go. For a nominal monthly fee, they will host your one-page site and include it in their “Find a Therapist” consumer referral. However, potential clients surfing the web will not be able to find your one-page site on Google or Yahoo.

Another avenue is to hire a private design and hosting firm. These professionals will help you create a customized website from scratch. The biggest advantage of hiring a professional is that they do all the work for you so you can focus your efforts on what you do best — treating clients. Moreover, tech support usually doesn’t cost extra, and you have access to a live person.

Our research found that you can get a customized 10-page website, from start to finish, from a professional firm for less than $600. The total fee should include domain registration and hosting for the first year, design, e-mail accounts and search engine submission. After the first year, there is an annual hosting fee of $125-$150. The best way to find these professionals is to ask for a referral from a colleague who already has a website that you like.

While we can’t endorse any one provider, we have used two different website firms. Our e-commerce site, Counseling-PrivatePractice.com, was done by Digitaleagles.com. With an e-commerce website (which has the ability to accept credit card payment online) there is an additional cost of $25 per month for hosting. We sell our book, The Complete Guide to Private Practice, through this site. My private practice website, DasenbrookandJohnson.com, was done by TherapyMatch.

com. Joshua Rosenthal is the president of Therapy Match Inc. and is also a clinician. Both firms were easy to work with and extremely helpful. Check them out.

In addition, check out Private Practice Pointers on ACA’s website in June for a more detailed bulletin on websites for counselors. And remember, websites are like most other things: You get what you pay for.

Q: Could you write something about the new CPT® (current procedural terminology) testing codes that specify (the services of) a psychologist? Is it accurate that professional counselors would come under that code even though it only says “psychologist”?

A: The American Psychological Association has published the following bulletin:

 “As of Jan. 1, 2006, the CPT® codes for psychological and neuropsychological testing have been revised. New code numbers have replaced the old CPT code numbers 96100, 96117 and 96115 for psychological testing, neuropsychological testing and the neurobehavioral status exam. The code for psychological testing, interpretation and reporting, formerly known as 96100, is now:

  • 96101, for psychological testing, interpretation and reporting per hour by a psychologist.

All of the other new testing code numbers are published in CPT 2006©, which is available from the American Medical Association at http://www.ama-assn.org/ama/pub/category/3113.html and (800) 621-8335.”

My initial read of the change is that it covers anyone licensed to do testing. This varies from state to state. CPT codes are for insurance reimbursement, and counselors are reimbursable for testing in many states. After calling provider relations for Magellan/Aetna, I was given information that these codes are for master’s level providers as well as Ph.D.s. We will continue to stay on top of this issue.

Q: I would appreciate your advice concerning the client confidentiality section of the “Informed Consent” form in your book. Do “supervisor/supervisee” relationship and also “court order” need to be specifically addressed and spelled out, or are these exceptions to client confidentiality covered respectively under “consultants” and “state and federal law” exceptions?

A: If your informed consent and HIPAA disclosure form lists consultants and stipulates that you follow state and federal law, you should be OK. Keep in mind that we are not attorneys. However, by including the above you are making an effort to comply with the sprit of the law, which is what HIPAA rules require.

Q: You have a section highlighting how to buy or sell a private practice but not steps to close your practice. Do you have that information?

A: We have a bulletin on buying and selling a private practice on ACA’s website, but ACA Professional Projects Coordinator Martha McIntosh was gracious enough to supply specific steps for closing a practice:

  • Designate a date you would like to close your practice.
  • Notify your state licensure board of your reason(s) and circumstances for closing your practice in case there are state-mandated steps for closing a practice.
  • Inquire about how long to keep your records. Seven years is the recommended time frame by the ACA Insurance Trust. Make sure your records are shredded, not simply thrown out.
  • Notify your insurance companies that you are closing your practice.
  • Notify present and past clients in writing of your closing. Do not take on additional clients in the meantime, thus ensuring that you will not have any more clients to treat at the desired date you wish to close.
  • Clinical issues with your clients may determine the time frame for closing your practice. In other words, putting proper closure on relationships, holding transitional sessions and providing referrals may determine the length of time you need to close your practice.
  • Inform clients how they can access their records in the future.
  • Buy tail insurance if you are ending liability insurance in case of a lawsuit after your practice is closed.
  • Offer clients who need continued treatment two or three good sources to contact. Also provide release forms that will enable records to be forwarded if the client wishes.

Robert J. Walsh and Norman C. Dasenbrook are the co-authors of The Complete Guide to Private Practice for Mental Health Professionals (www.counseling-privatepractice.com). ACA members can e-mail their questions to walshgasp@aol.com.

Resume or vita? What’s the difference?

Amy Reece Connelly

Q: What’s the difference between a resume and a vita? And how do I know which one I should use?

A: Let’s start with simple definitions. Webster’s Dictionary defines a resume as a “condensed statement, or summary.” In this case, it serves as a summary of your experience. A vita, short for curriculum vitae, is Latin for “the course of one’s life.”

The two terms are often used interchangeably, with resume the more frequently used in the general population. Vita or “C.V.” (for curriculum vitae) is more often used in academic and research environments. Both types of documents relate the same kinds of information, including academic background, work history, significant accomplishments, etc. However, the presentation and the amount of information can vary substantially.

In general, a resume is a one- to two-page document (sometimes a little longer) that concisely describes the background of an individual. Because of the widespread use and availability of computers, the resume has evolved during the last 20 years to become a document targeted for a specific purpose. With relatively few keystrokes and a good printer, a resume can be transformed to appropriately address the advertised needs of a potential employer — assuming, of course, you have the desired background.

A resume is intended to be brief. A chief executive officer with decades of experience in business may have a multipage resume, but a one-page executive summary that highlights the person’s most pertinent accomplishments is likely to accompany the document.

A vita, on the other hand, is supposed to lengthen over time. The vita includes the same general categories of information as are found in most resumes, but in addition it also features listings (often lengthy) of the individual’s publications and presentations. (This is, after all, a document targeted for academe, where “Publish or Perish” is the mantra for long-term survival.) As a result, vitae tend to be substantially longer than resumes.

In a vita, the “academic background” or “education” section is almost always presented first (a nod to its academic comfort zone), whereas “related professional experience” usually leads off a well-written resume.

If you are applying for a position in an agency or a counseling center, you’ll more than likely send a resume. On the other hand, the application process for research and faculty positions will usually require a curriculum vitae.

Career Center practical tip of the month: If you have to use an industrial-strength stapler for your resume, you should edit it down or write a one-page executive summary.

Common categories used in both resumes and vitae:

  • Education or academic background
  • Licensure/certification/endorsements
  • Professional experience
  • Clinical experience
  • Related experience
  • Internships/practica
  • Community involvement
  • Professional memberships
  • Awards/recognition/honors
  • PublicationsPresentations
  • Categories used more frequently in vitae
  • Books and book chapters
  • Refereed publications
  • Works in progress/manuscripts in progress
  • Presentations
  • Conference and workshop presentations
  • Institutional service/committees
  • Grants received
  • Supervision experience
  • Research or research in progress