Review of Arizona Board of Behavioral Health Actions: June 2024 (Ethics)
Lack of Documentation: The therapist failed to document critical conversations and actions, such as the Department of Child Safety (DCS) request for a letter and the court testimony provided. Accurate and thorough documentation is essential in maintaining professional integrity and providing clear records for all interactions and decisions made. Therapists should document all conversations, requests, and actions to avoid misunderstandings and ensure accountability.
Boundaries of Competence: The counselor extended beyond their professional competence by offering personal opinions on matters such as the client’s anxiety and the complainant’s adherence to visitation rules without direct observation. Therapists must operate within the scope of their professional competence. Offering opinions or recommendations without sufficient evidence or direct observation can lead to ethical and professional violations.
Inadequate Training: The counselor admitted to receiving minimal training on how to handle subpoenas and court testimony, leading to inappropriate recommendations during legal proceedings. Ongoing training and education are crucial, especially regarding legal procedures and responsibilities. Therapists should seek additional training or consultation on handling subpoenas, court testimonies, and other legal matters to ensure they are well-prepared and knowledgeable. Typically, contacting your malpractice insurance for support in these situations is helpful.
Delayed Updates: There were delays in obtaining signed informed consent from the client's legal guardian and in documenting the treatment plan's review date, the latter of which consistently shows up in the board actions. Additionally, we should update consents annually or at the start of a new episode of care.
Inappropriate Access to Records: The therapist accessed the clinical records of the client's son without authorization, which is considered outside the scope of her job duties and violates privacy policies. The therapists used their position at the agency to gain access to these records.
Sharing Confidential Information: The counselor informed the client about information from their son's clinical records, breaching confidentiality. A.R.S. § 32-3251(16)(t) prohibits disclosing professional confidences or privileged communications except as required by law or permitted by a legally valid written release. Therapists must respect client privacy and confidentiality, only disclosing information when law requires or with client consent (ACA, Section B.1.c).
Impact on Client Care: The therapist's actions resulted in her termination, abruptly leaving the client without a therapist. Abrupt termination of therapy due to professional misconduct can harm clients. The ACA Code of Ethics requires counselors to consider client welfare when terminating services and to provide appropriate referrals to ensure continuity of care (ACA, Section A.11.c). While client abandonment was unintentional, it is a significant consequence of their misconduct.
Dual Relationships: The therapist married her former client. The client reached out to her a few weeks after the termination of therapy, leading to a romantic relationship. She has to surrender her license.
Unauthorized Practice: The therapist continued to provide psychotherapy services after her license expired on December 31, 2023, and did not renew it until three months later, which violated A.R.S. § 32-3286. Practicing without a valid license is illegal and can lead to severe disciplinary actions. The therapist believed she could continue practicing during the 90-day late renewal period due to misinterpretation of the Board's statutes, rules, and policies. Under R4-6-801 (E), a licensee whose license expires may have their license reinstated by complying with renewal requirements and paying a late renewal penalty ($100) within 90 days of the license expiration date. A license reinstated under this subsection is effective with no lapse in licensure. I can understand why she would be confused, as this appears to suggest a 90-day grace period to renew your license. However, the board clarified this in a Facebook post in 2023, stating, “The 90 days after expiration is a reinstatement period, and you may not practice with your license during this time.”