Question

• What does being a legal and ethical mental health professional mean to you?
• What are some firsthand legal and ethical challenges you encountered in your clinical practice? How did you handle the situation?
• From your perspective (whether or not you work with insurance companies), what are the advantages of insurance panels, what are the struggles? Any legal and ethical implications arise as a result of working with insurance companies?
• What does a good case note look like, what should be included or excluded? What advice can you give about effective record keeping in general? Is there information that you may reconsider recording due to legal and ethical reasons?
• What factors contribute to your decision of terminating the provision of therapy? How do you approach this process? What ethical aspects must be considered when introducing the idea of therapy termination to a client?

Write a paper that summarizes the results and responses of the interview. Conclude your paper with a discussion of the information that you found helpful.

Length: 3-5 pages, not including title and reference pages

References: Include a minimum of 5 scholarly resources

Answer 1

A legal and ethical mental health professional to me means that they are competent to work and treat an individual suffering from clinical issues. As psychologists and other such professionals, often work with those who are vulnerable due to factors like their age, intellectual disability, etc they must always strive to protect the welfare of their clients. In my personal opinion, a legal and ethical mental health professional is aware and follows the guidelines of the ethical codes. The main ones are namely:

• Confidentiality and disclosure- Therapy requires providing a safe place for clients to discuss highly personal issues without fear of having this information shared with others or made public. However, sometimes a psychologist might need to share some details such as when consulting with other professionals or when they are publishing research.
• Informed consent- Psychologists must ensure that there is consent from the patient at the beginning of the process. As consumers of psychological services, the patients have a right to know what to expect, and getting consent also involves letting them know about any possible risks that might occur.
• Competence- Psychologists must possess the skill and knowledge to properly provide the services that clients need. If a psychologist administers a test that they don't know well then the interpretation will have many errors causing a bad understanding of a patient's state in the diagnosing stage.

Some firsthand legal and ethical challenges you encountered in my clinical practice were keeping a stable and calm demeanor when dealing with problematic patients who may be struggling to keep their cool while maybe getting into aggressive moods. Some children with disorders of impulsivity(ADHD) may be tiring and hard to deal with as well so it would be beneficial to have and foster the needed skills to deal with them. Being able to handle such moods and problems of the clinical patient can be quite challenging for mental health professionals. To actively use theories of psychotherapy and other such behavioral sciences are important as they will help in the development of a patient's psyche to a more stable place. There will be struggles and there will be relapses and being a psychologist will require patience, perseverance, empathy, and rigorous recording(record keeping) of the improvements as well as the drawbacks to create a plan that works for that particular individual.

The advantages of insurance panels and some struggles:

Every therapist must weigh the benefits and drawbacks of accepting insurance, then decide which insurance panels and what approach to insurance payments will offer the greatest benefits with the least amount of hassle

BASICS OF ACCEPTING INSURANCE

• Join a provider panel
• Be an out-of-network provider

The advantages:

• Improving access to mental health care. Clients with limited financial means need mental health care, too. Indeed, sometimes the clients with the most intensive needs are also those who cannot afford to pay for therapy. By accepting insurance, including Medicaid, you increase their access to care.

• Diversifying your client base. If you accept insurance, you will have access to a larger and more diverse group of potential clients.

• A chance to earn more money. Insurance reimbursement may increase your profits by offering greater access to more clients and ensuring that clients can continue with therapy for as long as necessary.

• Marketing opportunities. Many insurance panels help market their preferred providers by listing them in a directory. An insurer is a steady source of referrals.

• Increased credibility. Clients may trust you more if you accept insurance.

• Improved client loyalty. Clients may be more likely to stay in therapy if they know your services are covered. Clients who do not have the financial means to continue therapy, by contrast, may unexpectedly drop out.

Insurance is not a viable strategy for every therapist. Some of the drawbacks include:

• A time-consuming process. If you opt to become a preferred provider, you will need to apply to each individual provider panel. This may require researching the best panels to join and completing mountains of paperwork.
• Reimbursement rates. Reimbursement rates are not always consistent with a therapist’s standard rate. Sometimes they are as low as $60 to $80 per hour.
• No balance billing. If you are a preferred provider on an insurance panel, you cannot engage in balance billing. This is the practice of billing a client for the difference between the reimbursement rate and your usual rate. If you are an out-of-network provider whose clients seek reimbursement, however, you can bill your clients the full amount.
• Complex billing. If you choose to accept insurance, you will need to follow the insurance provider’s requirements for billing. Out-of-network providers must create superbills that contain proper billing codes.
• Service coverage. Not all therapy services will be covered. The federal Mental Health Parity and Addiction Equity Act requires insurers to cover mental health services at similar rates and under similar criteria to physical health issues. Practically speaking, however, many disparities exist. You may have to fight for coverage of certain services or diagnose a client with specific conditions in order to provide approved types of care.
• Payment delays. In general, insurers must pay a claim within 30 days. If the claim is denied, however, you could wait longer pending an appeal. You might not even get paid at all.

A good case note consists of important bits of information that were discussed during a therapeutic session. A therapist may involve the client to participate in thinking and acknowledging what was the most important things they talked about during the session. This may be helpful later on as keeping records is always useful to see real progress in practical ways for the client. It is important to keep a record as a psychologist. Data must be accurately recorded. The question -What are the mental health needs of the client on how to best meet these needs? must be kept in mind.

It must include systems like SOAP( Subjective.Objective.Assessment.Plan) is an acronym that is useful for taking good case notes and observations.SOAP notes are part of the problem-oriented medical records(POMR) approach most commonly used by physicians and other mental health professionals. It improves the quality and continuity of client services by enhancing communication among health professionals. This model enables us to identify, prioritize, and track clients' problems so that it is systematically attended to. The subjective component consists of the client's perception of the problem. The Objective consists of factual and quantifiable terms like that which can be heard, smelled, counted, and measured. Word with negative connotations must be avoided as well as labels. Assessment is a summarization of the counselor's clinical thinking regarding the client's problems. Plans could be described as the parameters of counseling interventions used. It consists of an action plan and prognosis. The action plan consists of the date of the next meeting, interventions used, treatments researched, and used as well. Prognosis is a forecast of probable gains to be made by the client given the diagnosis, the client's personal resources, and motivation to change. What should be excluded are the negative words and ideas that may push the clients to progress back. The notes made by professionals may sometimes be frustrating as one may not be sure of what is actually important to be noted.

Factors that contribute to the decision of terminating the provision of therapy:

A psychologist must make sure that the client knows when the therapy should be ended. This must and will usually be discussed in the first meeting with the client so that the goals are crystal clear and can be followed accordingly in a systematic way. Each client or family is to be briefed at the onset of therapy regarding the treatment. There are circumstances in which sessions can be extended if needed. On the other hand, if a client is unwilling to do the assigned homework given to them, if they're unresponsive to the therapy method or if the therapist believes that the methods being used are counter productive then termination is done. Termination helps solidify counseling gains. It can empower clients to involve their experiences and resiliently face their life. Termination can also help model healthy boundaries and a natural and appropriate end to a relationship. Some clients may find that they are dissatisfied with their therapist as they may not like the methods used and may find that there is no real change in their mental health. Such clients may choose to drop out early due to poor treatment outcomes, over-utilizing mental health services and they may even demoralize clinicians.