Aspirational Ethical Clinical Mental Health Counselor’s Self-Assessment
Working within my Current Professional Competencies as a CMHC
_____Yes _____No (1) I have a clear understanding of my competencies and recognize the knowledge, skills and abilities which are needed to help each of the people whom I have accepted as my clinical clients.
_____Yes _____ No (2) I understand and can describe the full range of risks involved in working with clients for whom I am fully competent to treat for their mental health needs
_____Yes _____No (3) I recognize the risk of working with a client whose needs exceed my current level of clinical competence.
_____Yes _____No (4) I will not even contact a referral, who is assigned to me, until I have a better understanding of what this person’s needs are so that I can determine if I am fully competent to provide appropriate services to this client, given that once I contact this referred person from that point on the person is considered a “client” of mine even if I end up not working with this person. I prefer to assess my limitations in working with such a person prior to my contacting the person.
_____Yes _____No (5) I only provide services which are consistent with my State License, level of education, and specialized training and/or certifications.
_____Yes _____No (6) I make it a point to obtain continuing education and training to update and upgrade my current competencies as a CMHC and to increase my competencies to work with populations for whom I have not had prior training.
_____Yes _____No (7) I make it a point to seek out a complete orientation and copy of the policies and procedures manuals of any agency or organization in which I am involved with to provide clinical services.
Maintaining my Professional Competencies
_____Yes _____No (1) I am faithful in obtaining the Continuing Education Credits required by the State Licensing Board for my Professional Licensure Renewal by attending continuing education and/training sessions..
_____Yes _____No (2) I make it a point to stay current in the latest research into Evidenced Based Treatment Practices for treating clients in my clinical specialty.
_____Yes _____No (3) I consistently seek out consultation and/or collaboration with fellow CMHC’s, my supervisors, or other Mental Health Professionals so that I can insure that I offer my clients as optimal mental health therapeutic care as possible.
_____Yes _____No (4) I voluntarily participate in at least a monthly support session with fellow mental health professionals ,either in my agency or in the private practice community, in which we review cases with one another so as to insure we are maintaining our clinical and ethical competence.
Working within the Scope of Practice for CMHC’s
_____Yes _____No (1) I review on an annual basis the state’s understanding of the scope of practice of CMHC’s in my state so that I both understand and comply with the legal scope of practice of my profession in my state.
_____Yes _____No (2) I decline to work with clients if the services they need are outside of my legal scope of practice.
_____Yes _____No (3) I am licensed and/or certified in each state in which I provide cyber /distance counseling, and I am fully knowledgeable about each state’s scope of practice regulations when providing this service.
_____Yes _____No (4) Prior to working with a client, go over in person with the client a thorough “Informed Consent” form which we openly discuss and clarify before we both sign and date it and put in the client’s clinical file.
_____Yes _____No (5) If the client is uninsured or unable to afford necessary counseling services, I refer the client to get financial assistance or if this is not possible then I provide the services pro bono.
Assessment
For every client I work with, I complete and document in the client’s file, a thorough Clinical Assessment which involves:
_____Yes _____No (1) Establish the Why Now: which fully clarifies the client’s rationale for seeking out mental health services so as to best address the symptoms and issues involved in the “why now” issues.
_____Yes _____No (2) Review of Client’s Mental Health History: which identifies previous treatment for mental health problems, if had prior psychiatric hospitalizations, was involved in family therapy as a child or received previous treatments for substance abuse issues
_____Yes _____No (3) Determine if Client is on any psychotropic medications: which helps identify which medications are currently being prescribed, by whom, at what level of prescription and for what issues the medications are prescribed.
_____Yes _____No (4) Review Client’s relevant medical history: which reveals current overall physical health of the client, when the client last had a physical and if there is any comorbidity of physical health problems and the current mental health issues.
_____Yes _____No (5) Review of Client’s family history: to determine what are the psychosocial stressors within the family which could account for the current mental health distress and what is the history in the family of previous mental health and/or substance abuse treatment.
_____Yes _____No (6) Review of Client’s social history: including school history as to academic success and/or failure and highest academic level achieved, as well as community history in terms of level of social networks, peer group activities and other measures of social functioning
_____Yes _____No (7) Review of Client’s vocational history: including current level of employment, prior employment history and level of satisfaction with current employment
_____Yes _____No (8) Review of Client’s strengths brought into therapy
_____Yes _____No (9) Review of Client’s liabilities brought into therapy
_____Yes _____No (10) Rating of the Client on the Adverse Childhood Experience Scale
Diagnosis and Treatment Planning
After completing a thorough Initial Clinical Assessment I then am ready to delineate the diagnosis which is most appropriate for each client I assess. This includes:
_____Yes _____No (1) Using evidence-based objective clinical standards of care to determine diagnosis which address the client’s current expressed concerns
_____Yes _____No (2) Utilizing all existing past records in the Client’s file including previous clinical assessments, psychosocial histories, psychological testing and records from previous psychotherapeutic interventions
_____Yes _____No (3) Utilize and document current assessment measures which quantify the client’s emotional state and concerns
_____Yes _____No (4) Utilize consultation with previous or current medical and/or psychiatric providers to help clarify and identify relevant diagnostic factors to better serve the client
_____Yes _____No (5) Documenting the client’s diagnosis within the Initial Clinical Assessment Document
Tentative Diagnosis
After completing the Tentative Diagnosis of the client, I then develop a tentative treatment plan based on established evidenced based treatments specific to the client’s diagnosed needs which includes:
_____Yes _____No (6) A minimum of three long term goals to help the client achieve reduction of the “why now” symptoms which were the reasons for the request for mental health services
_____Yes _____No (7) For each long term goal, I identify three short term objectives which are measurable and verifiable
_____Yes _____No (8) For each of the short term objectives, I identify an intervention to be used with the client to reach each of the short term objectives so that the long terms goals are achieved through our mutual clinical interaction
Review with Client
Once the Clinical Assessment, Tentative Diagnosis and Treatment Plan is completed I then:
_____Yes _____No (9) Review the findings, assessment results, and proposed treatment plan which includes reasonable expectations for a desired outcome with the client and secure the client’s understanding of this care plan and how we each have responsible roles to plan to effect a successful treatment outcome. This dialogue is then documented and kept in the client’s clinical file.
_____Yes _____No (10) In the dialogue concerning the treatment plan, I counsel the client about the risks of not complying with the treatment plan. I point out if noncompliance with the treatment plan is potentially affecting the client’s safety and the current counseling has been ineffective, then it would be incumbent on me to consider discharging the client from my clinical practice.
Insuring Quality Client Treatment and Care
_____Yes _____No (1) I conscientiously follow the course of treatment outlined for the clients and get their ongoing feedback as to their assessment if the treatment goals, objectives and interventions are working well or not for them and document this ongoing client observation as we proceed through our treatment regimen
_____Yes _____No (2) I facilitate emergency medical and or mental health treatment in the event of an emergency or crisis
_____Yes _____No (3) I remind clients of regular appointments and document these reminders
_____Yes _____No (4) I contact clients after missed appointments for rescheduling and document these contacts
_____Yes _____No (5) I explain to clients that if they are noncompliant to the point of self-endangerment or creating a liability risk, I may be forced to withdraw my care. I document this interaction.
_____Yes _____No (6) I counsel noncompliant clients about the risks and possible consequences of such behaviors
_____Yes _____No (7) I terminate from treatment persistently noncompliant clients, and I assist in transitioning them to another healthcare provider, and document actions taken and support provided
_____Yes _____No (8) All my formal clinical records and notes are electronically recorded, duplicated and saved in at least two safe repositories.
Maintaining an Ethical Relationship and Healthy Boundaries with Clients
_____Yes _____No (1) From the first moment I speak with a prospective client either in person or by phone, that person is a “client” to me from that point on.
_____Yes _____No (2) From the moment a person becomes a “client” with me I consider that person as a “client” for life, even if that person has been referred out to another professional or has successfully completed the therapy for the original issues for which our counseling relationship was initiated. I am committed to the belief of “Once a Client always a Client.”
_____Yes _____No (3) I hold to the belief of “Never Hug a Client” and I also practice “Tissue Therapy” with boxes of tissues available to allow clients to feel free to expose their emotions in my office as a “safe setting” with no fear of being put in a compromising position with me when they are feeling extremely vulnerable..
_____Yes _____No (4) I make it a point to never allow myself to give any conscious thought to being attracted to a client and make every effort to never act upon such attitudes or feelings.
_____Yes _____No (5) I would never allow myself to engage in a sexual relationship with a client (or a client’s family member) while in active counseling or after our counseling process has been terminated-in others words: I will never have any sexual or romantic relationship with anyone who has entered my professional life that was considered a “client” of mine.
_____Yes _____No (6) If clients find that they cannot afford to pay me for their clinical services, even after I have made adjustments for these fees, then I am committed to serve such clients “pro bono” with no expectation of being compensated in the future for the actual fees that would have been incurred.
_____Yes _____No (7) If clients find that they cannot afford to pay me for their clinical services, even after I have made adjustments for these fees, I would never barter for my services and rather provide the services “pro bono.”
_____Yes _____No (8) I never solicit gifts from clients but if a client gives me a gift unsolicited, I only accept the gift, which must not be worth more than $25, so as to be culturally sensitive to my clients’ offering such gifts because it is a culturally expected and accepted practice for these clients.
Remedial Actions I must take:
Given my responses on the above questions, for all of the “no” answers I gave I will commit to doing the following remedial actions so that within one year I will be able to answer all the above questions with a “yes” since I desire to follow a consistent Aspirational Ethical style of clinical practice in my professional life.
