Category Archives: counseling and the law

New Pennsylvania Mandated Reporting Bills Signed Into Law


My local newspaper informs me that Governor Corbett signed into law HB 431 436 and SB 21 and 33 into law today. The paper reports what this means:

“Senate Bill 21 ensures that virtually anyone who works with children in a professional or volunteer capacity, including school personnel, personnel at colleges and universities, youth sports coaches, child care providers, religious leaders, physicians and other health care workers, social services workers, law enforcement officers, librarians, emergency medical service providers and employees and independent contractors for each of those entities are required to report suspected child abuse.

“House Bill 436,” Stephens continued, “adds attorneys for organizations caring for children to this list of reporters, while preserving the attorney client privilege, bringing Pennsylvania in line with a majority of states across the U.S.”

So, anyone who works with or volunteers with children is now considered a mandatory reporter. Attorneys who work for those organizations who serve children cannot keep quiet when child abuse is reported to them. Mental health and other health professionals continue to be mandated reporters when potentially abused children present to them or their colleagues.

Besides expanding who is mandated to report suspected child abuse, HB431 also now requires evidence of 3 hours of training on child abuse recognition and reporting for all seeking PA licenses AND evidence of 2 hours of continuing education on the same subject for all who seek to renew their PA licenses. 30 CE hours are still the minimum required per licensing period, but now 2 of those 30 must be about child abuse recognition and reporting. Not sure if that means the existing mandate to take at least 3 hours in ethics will be on top of the 2 for child abuse reporting or if the 2 for child abuse reporting will count towards the 3 in ethics.

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Comparing ACA and AACC ethics codes: Addressing counselor values impact


Over the next few post I plan to review similarities and differences between the ACA and AACC codes (see this post for the first in this mini-series). Today I want to look at how the two codes talk about counselors as they manage their own value systems with their clientele.

The ACA code raises the issue of values like this:

  • Section A Introduction

Counselors actively attempt to understand the diverse cultural backgrounds of the clients they serve. Counselors also explore their own cultural identities and how these affect their values and beliefs about the counseling process.

  • A.4.b. Personal Values

Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.

In addition, the ACA clearly states that when there are significant values differences, a counselor is NOT to make referral on the basis of values differences alone. Values clashes cannot be treated as lack of competency in a particular area of counseling.

  • A.11.b. Values Within Termination and Referral

Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.

The AACC code addresses the value systems of the counselor in these sections

  • ES1-010 Affirming Human Worth and Dignity

…Christian counselors express appropriate care towards any client, service-inquiring person, or anyone encountered in the course of practice or ministry, without regard to race, ethnicity, gender, sexual behavior or orientation, socioeconomic status, age, disability, marital status, education, occupation, denomination, belief system, values, or political affiliation. God’s love is unconditional and, at this level of concern, so must that be of the Christian counselor.

  • ES1-120 Refusal to Participate in Harmful Actions of Clients

Within this section are paragraphs discussing the application and limits of the “do no harm” virtue to certain client behaviors deemed not to fit within the biblical framework articulated at the beginning of the ethics code. The AACC code expressed an ethic to avoid supporting or condoning (while respecting and continuing to help) in the following areas: abortion-seeking, substance abuse, violence towards others, pre or extramarital sex, homosexual/bisexual or transgender behavior, and euthanasia. On this last issue, the ACA notes that the duty to breach confidentiality may be optional (thus indicating a values insertion since in all other cases we have a duty to breach confidentiality so as to warn others or protect the life of our client).

  • 1-530: Working with Persons of Different Faiths, Religions, and Values

Counselors work to understand the client’s belief system, always maintain respect for the client and strive to understand when faith and values issues are important to the client and foster values-informed client decision-making in counseling. Counselors share their own faith orientation only as a function of legitimate self-disclosure and when appropriate to client need, always maintaining a posture of humility. Christian counselors do not withhold services to anyone of a different race, ethnic group, faith, religion, denomination, or value system.

  • 1-530-a: Not Imposing Values

While Christian counselors may expose clients and/or the community at large to their faith orientation, they do not impose their religious beliefs or practices on clients.

  • 1-550: Action if Value Differences Interfere with Counseling

Christian counselors work to resolve problems—always in the client’s best interest—when differences between counselor and client values become too great and adversely affect the counseling process. This may include: (1) discussion of the issue as a therapeutic matter; (2) renegotiation of the counseling agreement; (3) consultation with a supervisor or trusted colleague or; as a last resort (4) referral to another counselor if the differences cannot be reduced or bridged (and then only in compliance with applicable state and federal law and/or regulatory requirements).

Differences between codes?

There are many but let me identify two. Notice that the most significant difference between the two is on the basis of the AACC code biblical/christian ethic regarding what is good and what is harmful behaviors. Both codes express the need to respect persons without regard to their beliefs, values, identities, and actions. The AACC code differentiates between imposing of values and exposing of values. What is the difference between exposing and imposing? I suspect it will be in the eye of the beholder. However, I suspect that one of the results of the ACA code is that faith and spiritual values will be less likely to be brought up by counselors since “not imposing” is more emphasized than “exploring.” There is much literature out there suggesting that the failure to explore and utilize spiritual resources actually harms clients in that it slows recovery.

Both codes address the issue of values differences between client and counselor. Both point to a path (though different) about what to do when this happens. The ACA code places pressure on the counselor to work it out while the AACC code suggests a path to resolution either with re-negotiation or referral. Which one sounds better to you?

When the difference is with a colleague? 

Both ACA and AACC codes addresses differences with colleagues. In section D (Relationships with other professionals), the ACA code states,

D.1.a. Different Approaches. Counselors are respectful of approaches that are grounded in theory and/or have an empirical or scientific foundation but may differ from their own. Counselors acknowledge the expertise of other professional groups and are respectful of their practices.

The AACC codes says something similar,

1-710-a: Honorable Relations between Professional and Ministerial Colleagues. Christian counselors respect professional and ministerial colleagues, both within and outside the church. Counselors strive to understand and, wherever able, respect differing approaches to counseling, and maintain collaborative and constructive relations with other professionals serving their clients—in the client’s best interest.

Fun facts

The ACA code never uses the word “faith”, does suggest counselors need to address self-care (includes spirituality), and does suggest counselors seek to utilize client’s spiritual resources…”when appropriate.”

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New Ethics Codes for Counselors


Both the American Counseling Association (ACA) and the American Association of Christian Counselors (AACC) have published 2014 editions of their codes of ethics (links above to pdf of codes). Given these new documents, I highly encourage all Christian counselors (both professional and pastoral/lay) to review these two codes. Even if you do not belong to either the ACA or the AACC, you should spend some time with these documents. Here’s why:

  • The codes represent the current thinking of the ACA and the AACC about best practices for counselors. Even if you disagree, you need to know where you diverge (both for integrity sake with clients and for protection from unnecessary risk)
  • It is easy to become sloppy about ethical matters. We tend to believe what we do is good. Reviewing our practice habits against a standard can reveal slippage
  • It can be helpful to clients to know what code of ethics you subscribe to. Reading codes can help you determine which code you subscribe to and your reasons for doing so

Comparing Values and Principles

The following chart shows similarities and differences regarding the bases for ethics codes. It is worth reviewing these to see how they compare and contrast. In the next post, I will compare a few specific standards.

Content AACC ACA
Mission 1. help advance the central mission of the AACC—to bring honor to Jesus Christ and promote excellence and unity in Christian counseling;

2. promote the welfare and protect the dignity and fundamental rights of all individuals, families, groups, churches, schools, agencies, ministries, and other organizations with whom Christian counselors work;

3. provide standards of ethical conduct in Christian counseling that are to be advocated and applied by the AACC and the IBCC, and are respected by other professionals and institutions; and

4. provide an ethical framework from which to work in order to assure the dignity and care of every individual who seeks and receives services.

1. enhancing human development throughout the life span;

2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts;

3. promoting social justice;

4. safeguarding the integrity of the counselor–client relationship; and

5. practicing in a competent and ethical manner.

Principles Compassion in Christian Counseling – A Call to Servanthood Competence in Christian Counseling – A Call to ExcellenceConsent in Christian Counseling – A Call to Integrity

Confidentiality in Christian Counseling – A Call to Trustworthiness

Cultural Regard in Christian Counseling – A Call to Dignity

Case Management in Christian Counseling – A Call to Soundness

Collegiality in Christian Counseling – A Call to Relationship

Community Presence in Christian Counseling – A Call to Humility

autonomy, or fostering the right to control the direction of one’s life;nonmaleficence, or avoiding actions that cause harm;beneficence, or working for the good of the individual and society by promoting mental health and well-being;justice, or treating individuals equitably and fostering fairness and equality;

fidelity, or honoring commitments and keeping promises, including fulfilling one’s responsibilities of trust in professional relationships; and

veracity, or dealing truthfully with individuals with whom counselors come into professional contact.

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Abuse in the Church Course/Conference Begins Tonight!


At 6 pm, our class/conference kicks off at BranchCreek church (Harleysville, PA) and runs through tomorrow afternoon. Boz Tchividjian of GRACE and myself will be providing plenary and breakouts on a variety of topics designed to help church leaders and counselors prevent and respond well to abuse within the church family. We are expecting a good crowd of pastors, church leaders, mental health workers, and of course, grad students!

Still want to come?

It is not too late. Information here. Bring payment (CC or cash/check) to the door. We’ll fit you in!

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Supervisors: FREE Ethics CE at Biblical, 11/5/11


If you supervise counselors, would be willing to consider supervising a Biblical Seminary MA Counseling student for a practicum or internship, then we have an offer for you. On Saturday, November 5th, 2011, we will be holding our annual fieldwork expo. It is a time when supervisors come and meet first and second year MA students over lunch. Students get to find out about potential sites and supervisors get a quick feel for the students and may even be able to identify ones that would make good interns.

During the 3 hours, we offer a one hour CE (NBCC approved) for all supervisors, an ethics update. The CE and certificate are free of charge! Check out Expo Flyer for all the details.

Coming does not mean you have to take a student as an intern (though you should be open to it) nor that you will automatically receive an intern. But, by coming you do get a CE for your efforts and students get a chance to see those doing the work they one day hope to do.

If you are coming be sure to follow the directions on the flyer and register. Last minute walk-ins may not get to eat!

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Abuse and Trafficking Conference: Day 2b


I attended Pearl Kim’s presentation in the afternoon. Pearl is the assistant DA in Delaware county. She works on SVU cases. I did not take notes during this presentation due to her excellent PPT and visuals (video clips, case materials). Sadly, she did not want her talk recorded so I cannot forward anything to readers. But, here are some important takeaways:

1. Abusers almost always “find Jesus” while awaiting sentencing. Pearl believes one of her many cases was in fact true. How does she know? This person asked her to give him the maximum sentence so he could get help and so he would not be able to abuse others. She commented on another convicted offender (rapist, attempted murder) who claimed to have found Jesus and even acknowledged that if it hadn’t been for Pearl’s work, he might not have stopped his behavior. However, this offender continued to violate an order of protection by mailing letters to the victim from jail. His refusal to obey a protection order suggests he is less than repentant.

2. Churches are too gullible. Repentance is not in a few words and tears (also mentioned by Diane). Recognize that the average! number of abuse victims for an offender before first arrest is about 50 with about 150 before incarceration.

3. Allow the legal system to do its job. While not perfect, the legal system is designed to work with victims and offenders. When churches try to determine truth (rather than reporting the possible abuse), they may make it impossible for an offender to be convicted. It is easy to contaminate a case, especially when child victims are involved.

4. Churches can do some good things: background checks for all childcare workers, policies for ministry leaders and their time with vulnerable parishioners, making the church a safe place.

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Psychological mystery recommendation: White Lies


Just finished Anna Salter’s novel, White Lies. The book was published 10 years ago, so you may have already come across this great read. If not, Dr. Salter is a forensic psychologist with expertise in the area of sex offending. I highly recommend the book if you want to see how a psychologist goes about gathering data on a perpetrator so as to recommend treatment or predict future re-offending.

What I found most interesting was her use of sentence analysis (written and spoken) to highlight how we tend to deceive self and others. Lying comes in what we say and don’t say. At one point, the offender (a doctor) states that he started his residency at such-and-such a place but never mentions where he finishes it. She evaluates the sentence and tells the reader that the offender has told more of the truth than he planned. No one would say they started it somewhere unless they didn’t finish it there. Instead, you would say, “I did my residence at…”

Her work reminds me of some training I got from Eric Ostrov as an intern at a juvenile jail facility. Dr. Ostrov told us that people generally want to confess their sins–or at least a more acceptable version of them. They make themselves passive in an event, they confess a sin they wished they committed (e.g., crossing sexual lines with a client who seduced them) rather than the sin they did commit (inviting and manipulating a client into a sexual situation).

Long ago I had aspirations of becoming a forensic psychologist. In fact, I did some training and practice in my pre and post doc and had a job offer lined up. I ended up choosing to come to Biblical Seminary. While I don’t regret that choice, the work of exploring self and other deception still interests me.

Anybody out there read her other two novels: Fault Lines or Shiny Water?

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Should you Google your clients?


Dr. Zur has a new blog post on this topic that raises question (no answers at this point). Should you Google your clients? Dr. Zur wants to consider the ethics of this. There are two ways to try to explore this topic from an ethical point of view.

  1. What do the ethics codes say? Codes say nothing directly about this. Indirectly, we are to work to protect their dignity and human freedom. We are to act beneficently. We are to seek consent before we provide treatment or access private and protected information. We are not to give out their information without consent. Questions to ask: oes googling a client risk revealing their identity to others? It might if you use a shared computer. Would Googling access private and protected information? It shouldn’t. However, many people blog and post private information that might shock them if others in their various circles found out. Many do not consider this when posting comments or personal information.
  2. Beyond the codes, is it good practice to search for information about your clients? Or put another way, how might searching for information about your clients cause harm? Might it change the relationship? Change your opinion of them? Make you less interested in helping them? What if the information you find isn’t accurate? Might it cause you to use that information in a coercive manner? Might it be used to practice a form of voyeurism (which is a form of using clients for our own pleasure)? These kinds of questions raise moral and theoretical issues as much as ethical ones.

Dr. Zur lists a number of vignettes that might well cause you to answer yes to our initial question. Googling might reveal safety issues, legal issues, even life issues that would be helpful to know. So, our answer will never be that it is unethical.

I would leave you with this question. How will you feel if your clients know you have googled them? Will you be embarrassed? If so, you ought not to do it. Similarly, if a client comes in knowing lots of things about you that they gleaned from the Internet (work history, family, etc.), do you feel stalked? Maybe we should consider the “Do unto others…” command here.

One last pragmatic point. It is sometimes possible today to find out who is Googling you. Keep that in mind as you think about this issue.

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Seeing clients outside the office


Much of what we do in counseling or therapy is enculturated. Confidentiality, the 50 minute session, avoiding dual relationships…these things developed out of the culture of psychoanalysis. Now, that is not a criticism. I personally agree that good therapy requires privacy and the assurance of confidentiality. Who would talk about the deepest matters of the heart if they thought it would be broadcast to the world? And it isn’t as if this is a modern invention. Pastors have been practicing this since the early church.

One of those culture founded practices is seeing patients only in the office setting. Supposedly, this would maintain the “frame” of the counseling hour so as to avoid unnecessary outward intrusions. Further, it maintains one picture of the therapist. Having coffee with your therapist at the local diner would completely change that frame–and reduce confidentiality when your neighbor comes up and says, “Oh, I saw you go into the diner with Dr. Monroe. How do you know him?”

But there are some reasons why a counselor might intentionally see a client outside the office. Here are some reasons I have:

  1. Observation of a child in a school or home setting as part of an assessment
  2. Visiting a client in the hospital (either as a courtesy call or as part of a treatment continuity plan)
  3. Joint meeting with other providers (therapists, pastors, care team) at another location
  4. Part of a treatment plan (e.g., to practice walking over a bridge, get on an elevator, etc.

I have been asked to have coffee by current clients. I have been invited to house-warming parties. I have been asked to attend other celebrations. I’m more inclined to attend celebrations for kids or if the relationship is quite limited (wedding of a pre-marital client seen for 6 sessions only). I have taken clients outside my office for one reason or another (a brief walk, thrown a ball with a kid, etc.).

Whatever you choose to do. Be sure to evaluate the effect it will have on your relationship with the client. What potential pit-falls exist? Talk to them about it. Afterwards, continue to see if such actions introduce any relationship confusion. Be wary of informality. You don’t have to be stiff but informality breeds complacency and soon you are doing things you never dreamed of doing. Also be especially wary if the client has any history of abuse or boundary violations. Take care to protect those boundaries for their sake.

While psychological ethics are built on “Do no harm,” we know that the bible also supports this. Watch out for your weaker brother or sister!

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Blogging this month for the Society of Christian Psychology


This month (really, the 4 Mondays of February), I’ll be the guest blogger at the Society for Christian Psychology’s site. You can find it at www.christianpsych.org or from my links on this page. Here’s a tease from my first post:

Should Christian Psychology become a Profession?

Right now, in the Commonwealth of Pennsylvania, lawmakers are considering a bill that would place more restrictions on who can provide counsel. Currently, the state has a number of mental health credentials. Among those is the Licensed Professional Counselor credential for those with a requisite master’s degree and post graduate supervised practice. If passed, the new bill will not only protect the title of “Professional Counselor” but also the practice of professional counseling. Per the law, one may not “style” themselves as a counselor unless they are licensed as such.

Who does this effect? This will especially impact the many Christian counselors who are not licensed but practice a form of counseling (aka biblical counseling, Christian counseling, etc.). While these counselors do not provide diagnoses or bill insurances they do collect fees, keep progress notes, maintain confidentiality, and provide counsel for those struggling with issues such as anxiety, anger, depression, marital conflict and the like. So, the 64 million dollar question: Do these unlicensed Christian counselors “style” themselves as professional counselors? And who decides the line between the two? As an aside, the bill does contain an exemption for pastoral counselors. Pennsylvania does not yet define that title but in other locales that title is reserved for those ordained, trained in a pastoral counseling graduate program, and doing work in church-related institutions.

Here’s where the bill gets interesting. It describes what typifies a profession that might overlap with counseling but have a separate (and thus exempted) identity and practice. Here are some of the criteria they might use to discern a separate profession (note my bolded text to emphasize interesting details):

[For the rest of this post, click here.

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