By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
If a therapist does not belong to a professional group do they have to follow an ethics code?
There are a lot of rules about the relationships between a client and the treating professional. There are things that the professional can do, can’t do, has to do and is required to not do. Sometimes these rules get confusing for the professional as well as the client.
Recently a situation came up in which a professional was not a member of any professional organization, so the client left that visit with the impression that this professional did not need to follow any ethics code. This report of a problem left me thinking we need to talk about some of these codes of ethics and why a professional would need to follow them and what happens if they do not belong to any organization.
Turns out there may well be a time when a mental health professional needs to follow the standards of a code of ethics even if they chose to not belong to the professional organization. More on that later in this post.
To be a mental health professional you need a license in the jurisdiction in which you intend to practice your trade. Joining a professional organization does not allow you to practice this profession. So while all professionals are encouraged to join a professional group some choose not to be members.
Here in the United States of America, the various states license the various mental health professions. Not all states license the same professions. There can be states that allow a particular profession to practice even if they do not issue a license to that profession. For example “Life Coaches” are not licensed anywhere I know. They can do all sorts of coaching on how to have a better life. What a Life coach should not do is treat a person for a mental illness if the state in which they are practicing requires that license.
This situation of when and how to follow a code of ethics is made more complicated by the multiplicity of professions and professional licenses. There are Licensed Social Workers (LCSW’s and ASW’s), Licensed Professional Clinical Counselors (LPCC’s and PCCI’s), Licensed Marriage and Family Therapists (LMFT, MFT, and MFT interns.)
Here in California, we make it even more complicated with 9 or so different registries for Registered or Certified Substance Abuse or Drug and Alcohol Counselors, each of which presumably has their own code of ethics. Here is the code of ethics for CAADE, the program in which I teach is CAADE accredited.
Recently all these registries came together to create a Uniform Code of Conduct” for California’s substance abuse counselors.
The code of ethics varies depending on your profession and the particular organization you belong to. So someone could belong to several organizations (I do), one organization or no organizations.
What if there are contradictions between the various codes of ethics? What if the professional decides to not join any group to avoid having to worry about ethical behavior? We have come up with some principles to handle those situations.
California was the last state to grant licenses to Professional Clinical Counselors. Most Licensed Professional Clinical Counselors (LPCC’s) belong to CALPCC. The exact name of the counseling professional and the specifics of what they do can vary from state to state. Many California Counselors may also be members of the American Counseling Association (ACA.) In this case, the problem was easily solved. CALPCC adopted the ACA code of ethics.
California was the first state to licensed Marriage and Family Therapists (originally called Marriage, Family, and Child Counselors.) There are more MFT’s in California that the rest of the country combined. (LMFT, MFT, MFCC are all the same thing.)
The California Association for MFT’s (CAMFT), which has members from a bunch of other states and even some other countries, is larger, so I am told, than the American Association of Marriage and Family Therapists (AAMFT.) Both of these groups have their own codes of ethics.
The Social Workers, mostly belong to the National Association of Social Workers (NASW), which has its own code of ethics.
So now we can look at problems with which code to follow if you are members of more than one group, and what happens if the counselor tries to duck ethical behavior by not being a member of any association.
Let’s use an easy to understand example for this.
Can a counselor date and have sex with a client? If so how long do they have to wait to do the dating-sex thing?
For starters no behavioral health profession I know of thinks it is ok to have sex with a current client. That is taking advantage of a weak person and frankly sounds predatory.
The rule for substance abuse counselors is that they must wait 3 years after the client stops attending their PROGRAM (not just after no longer being their client) before they can date that former client.
Now, this substance abuse counselor decides to go on and become a professional counselor, and while in school they join a professional counseling association. The norm in these groups is that you have to wait 5 years before dating a former client.
Now say this same person decides to become a Licensed Social Worker. The rule for the NASW is the professional may NEVER get sexually involved with a former client.
So which waiting period does this person need to observe 3 years, 5 years, or never?
The rule is that you observe whichever code of ethics has a HIGHER ethical requirement. So, in this case, the answer to how long to wait would be forever.
Can this person get out of this bind by not being a member of the Social Workers Association?
Most licensing laws require the professional to follow the customary ethics of the profession whether the professional is a member of that group or not. See if most other professionals think it is unethical then that behavior is probably illegal also.
Even if that behavior, dating or some other “dual relationship” is not outright illegal, should the professional get into that sexual relationship and then break up with that former client, they might get sued and in that case, code of ethics or not, the former client will probably win.
So the bottom line is that professionals should always adhere to the highest possible standard of ethical behavior whether they are members of a group or not.
Just not belong to a professional group does not allow you to do things the rest of the profession thinks are unethical.
Hope that helped explain this ethical issues problem. If you are not sure, you may need to contact the appropriate professional association and remember the client should be contacting an attorney or making a complaint to the appropriate licensing board if they think the professional harmed them.
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David, I would be interested to talk to you, I am doing some research on legal/ethical responsibilities and trying to find some info to compare/contrast with the UK, where I am based. We are not licensed here, what does a licence mean, and how do you get one?
Great question. I will email you. This sounds like something other people might want to know so watch for a full post on this within the next week.
Reblogged this on Trauma and Dissociation and commented:
The last thing someone that has been abused as a child needs is someone that is abusing them in the name of therapy. This is an important post.
I was seeing a LCSW for codependency group therapy. On August 1st 2012 – this therapist (who had also been counseling my husband, separately) suddenly verbally attacked me saying — what a terrible person I was, that I’m a terrible wife to my husband & he deserved better. The therapist then stormed out of the room – came back to hurl more insults @ me – then abruptly ended group. The therapist would not allow me or anyone else to address what he said or done by holding his hand up and repeating – NO!
Therapist had chosen to do this in front of 2 other group members.
I was crushed, humiliated and my trust was broken. I cried daily for months.
I’m certain not very therapist wants to work with every client that comes to them for help. Not everyone is a good fit. But,iIf this therapist didn’t wish to continue working with me, the least I would have expected from him is to ask to speak to me privately to discontinue therapy.
Does this seem as out of line to you as it does to me?
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“To be a mental health professional you need a license in the jurisdiction in which you intend to practice your trade.”
I went to one that did not have his license in the state he was practicing, so he just called it life coaching. Is that ethical? He said he looked into it and he simply does not step into any boundaries that would put him at risk, but I could not see any different between what he called life coaching and therapy.
I am confused
If you go because you have a mental or emotional problem. I would call that counseling or therapy and I think they need a license. If you just want to be more successful at dating or developing your career then a coach may be ok. Kind of like the difference between a physical therapist and a personal trainer. I think a whole lot of people are trying to get around the licensing laws by calling themselves coaches. The only time they get in trouble is when the client complains to the board that licensees therapists in their state or complains to another consumer protection agency. They usually do not listen if one professional reports another.
I went for dissociative identity disorder.
I would never complain, but I wanted to know the truth. I spent 2 years with this life coach and it was the worst roller coaster I ever went on. Now I am with a real therapist and healing. Thank you for your reply Dr. Miller.