5.3 Counselor Responsibilities

One of the fundamental responsibilities of a counselor is to abide by ethical codes. Adhering to ethical codes is essential to the counseling profession because it safeguards the integrity of the therapeutic process, protects client welfare, and upholds public trust in the profession. Ethical codes provide a clear framework for navigating complex situations, ensuring counselors act with accountability, competence, and respect for clients’ rights. By abiding by these standards, counselors demonstrate their commitment to fostering a safe and supportive environment where clients can explore sensitive issues without fear of exploitation or harm. Additionally, ethical adherence helps counselors mitigate potential risks, such as breaches of confidentiality or conflicts of interest, which can damage both the client-counselor relationship and the profession’s reputation. Ultimately, ethical codes are not just guidelines but a reflection of the values and responsibilities that define counseling as a profession dedicated to enhancing the well-being and dignity of all individuals.

The ACA (2014) addresses this in its ethical code:

NAACAC (2021) also covers this in its ethical code:

In this section, we outline the key responsibilities of counselors, providing comprehensive guidance on their professional obligations, drawing from the ACA Code of Ethics and the NAADAC Code of Ethics as foundational frameworks.

Informed Consent

Counselors have a legal and ethical responsibility to provide informed consent, the first task that precedes a therapeutic relationship. Informed consent means that when clients consent to treatment, they are given all the information required about the treatment, including risks and benefits, mandated reporting laws, and other essential elements of treatment before they decide to partake in treatment.  According to Cocanour (2017), the three fundamental criteria for informed consent include the client’s competency to consent, the client’s being adequately informed, and the client not being coerced. When talking about a client’s competency, the client must be intellectually and educationally competent enough to analyze the information provided, communicate their decision, and understand the consequences of their decision (Cocanour, 2017). It is the counselor’s responsibility to provide reasonable accommodations such as using simplified language with minimal to no technical terms, providing a translator for language accommodations such as a foreign language interpreter or a sign language interpreter, and reading out the informed consent in cases a client has a learning disability or language barrier.

The ACA (2014) discusses informed consent in its ethical code:

NAADAC (2021) also covers informed consent in its code:

Both ACA and NAADAC also provide guidelines into what is mandatory to include in an informed consent. We discuss informed consent in greater detail in Chapter 7.

Informed Consent with Minor Clients and Mandated Clients

Informed consent can vary significantly depending on the population being served. For instance, when working with minors, parents or caregivers are often involved in the consent process, while the minor’s assent may also be required. Similarly, when working with adults who have reduced capacity to consent, legal guardians or representatives may be assigned to make decisions on their behalf. These situations require counselors to navigate ethical complexities while ensuring the rights and well-being of all parties involved. In Chapter 10, we offer deeper insights into the unique considerations and strategies for working effectively with adolescents in these contexts.

The ACA (2014) mentions considerations for working with minor clients and others who are unable to give voluntary consent in its ethical code:

Another consideration would be court mandated clients who although have the right to deny treatment services, may have to be informed about possible repercussions, as discussed by the ACA (2014):

NAADAC (2021) also addresses working with mandated clients:

Record Keeping

Documentation is an important aspect of counseling services, allowing counselors to record essential details about sessions, including insights into the client’s presenting concerns, the interventions employed, and the client’s progress over time.

The ACA (2014) discusses the importance of documentation:

NAADAC (2021) also mentions the importance of documentation:

Counselors are responsible for maintaining records in compliance with applicable laws and regulations. In general, records must document and detail each significant contact with a client, including the services provided. For clients in substance use treatment, records should align with criteria outlined by the American Society of Addiction Medicine (ASAM), including initial treatment plans that address problems in each dimension, goals and objectives tailored to these dimensions, and documentation of client progress. Treatment planning should be a collaborative process with the client, and counselors should adhere to their treatment agency’s specific guidelines while incorporating required elements.

For mental health services, a diagnostic assessment should encompass all necessary biopsychosocial information, an appropriate summary, and a concluded diagnosis. Documentation of counseling sessions must include the diagnosis, client goals relevant to mental health needs, presenting concerns or behaviors during the session, counselor interventions, client responses to these interventions, observations, progress, and plans for future sessions. While treatment centers may use varied templates for record-keeping, all must include these essential components.

Counselors should consider maintaining documentation and records that include the following elements to reflect the services provided, client progress, treatment plans, and other necessary details demonstrating that care meets professional standards:

• Name of the individual providing service
• Name and credentials of individual who is professionally responsible for services provided such as a supervisor signing off on a student intern’s documentation.
• Date and time of service
• Documentation that informed consent was explained to the client and relevant signatures taken
• Copies of release of information
• Chronological documentation of all fees charged for each service provided.
• Any other documentation pertaining to the client

When documenting sessions with clients, particularly when noting progress and interventions, counselors must exercise caution in how they detail the client’s narration of events. Overly detailed accounts of a client’s personal story or sensitive disclosures may compromise confidentiality or lead to misinterpretation if accessed by third parties. Instead, counselors should focus on summarizing relevant information, framing the narration in a clinically appropriate manner, and emphasizing how it informs the client’s treatment goals and progress. This approach ensures that records remain professional, concise, and aligned with ethical and legal standards while respecting the client’s privacy.

Discussion of Case Example

The above case underscores the potential risks associated with the details a client reveals during therapy sessions, particularly when clinical notes are subpoenaed or accessed by others. While this concern frequently arises with incarcerated clients, it is equally relevant for other populations, such as the LGBTQ+ community or survivors of intimate partner violence. For instance, a minor client whose parents or caregivers have access to their records may be hesitant to disclose their Queer identity, fearing parental reactions that could lead to emotional or physical harm. Similarly, a victim of intimate partner violence might feel coerced into signing a release of information (ROI) under pressure from an abusive partner, granting access to their treatment records and jeopardizing their safety. These scenarios highlight the critical need for counselors to carefully consider documentation content, prioritize client safety, and remain vigilant about the ethical implications of record-keeping, mainly when working with vulnerable populations.

The ACA (2014) addresses this in its ethical code:

NAADAC (2021) discusses this as well:

As you can see, counselors must approach documentation with care and discretion when recording client interactions. Records should avoid overly detailed or unnecessary information that could pose risks if accessed by unintended parties. For instance, in the case study above, instead of specifying details about safe houses, the counselor might consider documenting the situation with general or vague terms. Doing this ensures the record is clinically relevant while safeguarding the client’s privacy. Counselors must maintain confidentiality to the fullest extent possible, documenting only what is necessary and ethically appropriate. We provide additional guidance on record-keeping, confidentiality, and privacy is provided in Chapter 7.

Competency Training and Continuing Education

Clients have the right to receive high-quality care grounded in evidence and delivered by competent, experienced providers. Counselors are ethically obligated to attain the competencies to practice effectively and provide evidence-based interventions. This includes completing required coursework, obtaining a degree, and gaining relevant supervised practical experience. When pursuing a new area of specialization, counselors must acquire additional education, supervised experience, and appropriate certifications before practicing independently. This ensures that clients receive competent care while protecting their safety and well-being. Therefore, counselors must remain mindful of practicing within their scope of practice, aligning their work with their qualifications and expertise.

The (ACA) covers this in its ethical code:

NAADAC (2021) also emphasizes the importance of this practice:

Counselors must also keep up to date with the latest evidence-based interventions by enrolling in continuing education, including participating in conferences, teaching relevant subjects, or engaging in relevant training workshops.

The ACA (2014) reminds counselors of this:

NAADAC (2021) highlights this as well:

We discuss licensure requirements and other relevant details are discussed in Chapter 8.

Peer Consultation

While years of experience provide counselors with valuable insights and enhance their clinical judgment, there are times when they may encounter unique cases that require a fresh perspective. This is particularly true in situations involving ethical dilemmas, risk assessments, or cases where mandated reporting is necessary. These scenarios often demand careful consideration, consultation with colleagues or supervisors, and adherence to ethical and legal standards to ensure the best outcome for the client. Even experienced counselors must remain open to seeking guidance and additional perspectives to navigate such complex cases effectively and responsibly.

Discussion of Case Example

Counselors are responsible for seeking appropriate consultation to ensure they make well-informed clinical decisions about a client’s case. For instance, as a newly licensed professional, Alex can review mandated reporting requirements and consult with a supervisor or colleagues who may offer more experience or a different perspective. Hill (2017) emphasized the value of deliberate practice, stating that “therapists spend considerable amounts of time in deliberate practice through such activities as peer and professional supervision, reflecting about clients between sessions, and planning specific interventions.” The article also highlighted that supervision contributes to positive client outcomes, reinforcing the importance of seeking supervision or consultation with peers to enhance decision-making and client care (Hill et al., 2017, p.37).

The ACA (2014) covers this in its ethical code:

Impairment

As we highlighted in Chapter 3, counselors must be self-aware of their capacity to continue counseling and other related activities. It is essential to account for any transference or countertransference experienced and how it may impact one’s ability to provide counseling services to clients.

The ACA (2014) Code of Ethics discusses this:

NAADAC (2021) also emphasizes the importance of self-monitoring:

There may be times when a counselor becomes incapacitated and unable to make sound clinical judgments or rational decisions, thereby impairing their ability to provide effective counseling services. In such instances, counselors are responsible for ensuring that alternative arrangements are made for their clients’ care. Best practices include having a contingency plan in place, which involves designating a trusted colleague or treatment center to oversee the transfer of clients. This plan should also account for situations such as long-term incapacitation or, in some cases, the counselor’s death. Proactively establishing these arrangements safeguards clients’ continuity of care and demonstrates the counselor’s commitment to ethical and professional responsibilities. The ACA (2014) offers this suggestion in its ethical code:

And NAADAC (2021) offers this consideration:

Public Responsibility

In addition to their responsibilities within the treatment center, counselors are expected to uphold professional etiquette in all settings, including outside counseling environments. The ACA (2014) Code of Ethics emphasizes a zero-tolerance policy for sexual harassment and exploitation, underscoring the importance of maintaining ethical conduct in all interactions. Specifically, it states that counselors must avoid any behavior that could exploit or harm others, whether clients, colleagues, or community members. This principle reflects the counselor’s obligation to act with integrity and respect, ensuring their actions consistently align with the profession’s values:

Counselors also have responsibilities when engaging in media presentations or public lectures about the counseling field. In these contexts, counselors must ensure that their statements are accurate, evidence-based, and grounded in reputable research. Whether speaking to the public, presenting at conferences, or participating in interviews, counselors must represent the profession with integrity and professionalism. This includes avoiding misinformation, acknowledging the limitations of their expertise, and ensuring that their messaging aligns with the profession’s ethical standards. Such mindfulness helps maintain public trust in counseling and upholds the field’s credibility. The ACA (2014) mentions this:

Additionally, the ACA (2014) outlines that counselors are expected to differentiate between personal and professional statements when making such statements in public:

Malpractice and Liability

Malpractice and liability are important issues in counseling, as they pertain to the ethical and legal responsibilities counselors have to their clients. Malpractice is defined as “professional conduct and skill that fall below the standard established for similar professionals in good standing under similar circumstances” (Swenson, 1993, p.150). Malpractice occurs when a counselor engages in professional misconduct or fails to provide the standard of care expected in the profession, resulting in harm to the client (Granello & Witmer, 1998). Liability refers to the legal accountability counselors may face when their actions—or inactions—cause harm. To establish a malpractice claim, four key elements must typically be proven: the counselor owed a duty of care to the client, the counselor breached this duty by failing to meet the standard of care, the breach directly caused harm, and the client suffered damages as a result. Understanding these elements is essential for counselors to protect both their clients and their professional practice.

Counselors may face malpractice claims for several reasons, such as failing to obtain informed consent, breaching confidentiality, engaging in inappropriate dual relationships, practicing negligently, or violating professional boundaries. For example, a breach of confidentiality, even if unintentional, can cause significant harm to a client and result in legal consequences. Similarly, failing to address high-risk situations, such as suicidal ideation or abuse, can lead to claims of negligence. Boundary violations, including inappropriate self-disclosure or social media interactions, may also harm clients and lead to professional liability.

Liability in counseling extends beyond direct actions. Counselors can be held directly liable for their own negligence, while supervisors may face either direct or vicarious liability if they fail to provide adequate oversight or address ethical concerns with their supervisees. Agencies or employers may also bear vicarious liability for the actions of their employees or contractors if those actions occurred within the scope of professional duties. These varying forms of liability highlight the importance of ethical and legal diligence in all aspects of counseling practice.

To minimize the risk of malpractice, counselors should adhere to ethical standards, provide services within their areas of competence, and maintain thorough documentation of client interactions. Obtaining informed consent, practicing sound risk management, and maintaining professional boundaries are also critical strategies. Engaging in continuing education ensures that counselors remain informed about changes in ethical standards, legal requirements, and best practices. Carrying professional liability insurance offers additional protection in the event of a claim. These steps help counselors manage risks and maintain the trust and safety essential to the counseling relationship.

A study conducted by Lindgren and Rozental (2021) in Sweden identified contributing factors to malpractice issues in counseling settings. Primary themes that led to accusations of malpractice included:

• Lack of continuity of care from the provider (canceling appointments, inconsistent treatment plans, difficulty contacting the provider)
• Slow administrative processes (delayed referrals, incorrect diagnosis)
• Lack of client involvement in treatment planning
• Inadequate assessment and diagnostic processes
• Lack of transparency regarding limitations of counselor competence and scope of practice
• Negative attitude and communication
• Lack of empathy
• Insincere or disrespectful recommendations and psychoeducation
• Lack of collaborative stance

Failing to uphold professional and ethical standards can have serious consequences, including lawsuits, loss of licensure, and damage to a counselor’s reputation. Beyond legal implications, malpractice claims can undermine public trust in the profession and compromise the safety and well-being of clients. By proactively managing risks and adhering to ethical guidelines, counselors can reduce the likelihood of malpractice claims and ensure that they provide high-quality, ethical care to their clients. Regular consultation, self-reflection, and a commitment to ongoing professional development are essential components of responsible counseling practice.