Standards of Conduct Applicable to Licensed Mental Health Counselors and Licensed Supervised

Mental Health Counselors (1) Licensed Mental Health Counselor and Licensed Supervised Mental Health Counselor treatment records shall include, but not be limited to, at a minimum: (a) a signed informed consent document; (b) an intake summary; (c) an assessment or diagnosis; (d) a treatment plan; (e) dates and progress notes for each treatment session; (f) communications with collateral entities; (g) communications with clients relating to treatment, including electronic communications; and (h) a termination summary. (2) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors must inform clients, in writing, of policies regarding confidentiality of information and the legal limits and exceptions to confidentiality. Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall not communicate either verbally or in writing with others about a client without the client's express written consent, including any legal proceedings, except when the limits of confidentially may legally be invoked, such as, but not limited to, cases of potential harm to the client or significant or deadly harm to others by the client, and legal proceedings under M.G.L. c. 112, § 172(a). Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall ensure the accuracy of client information shared with other parties, including any third party payers. (3) Informed Consent and Performance of Services without Consent. (a) A Licensed Mental Health Counselor and Licensed Supervised Mental Health Counselor shall not perform nor attempt to perform any mental health services or function without the written and signed informed consent of the client or prospective client who is to receive that service or function. (b) Where the client or prospective client who is to receive the mental health counseling service is not mentally competent to give legally valid consent for the performance or provision of that service or function, the Licensed Mental Health Counselor and Licensed Supervised Mental Health Counselor shall not perform nor attempt to perform that service or function without the prior written consent of an individual who is legally authorized to give consent on behalf of that client or prospective client, or of a guardian appointed by a court of competent jurisdiction to act on behalf of that client or prospective client. (c) Where the client or prospective client who is to receive the mental health service or function is a minor, the Licensed Mental Health Counselor or Licensed Supervised Mental Health Counselor shall make and document reasonable attempts to obtain informed consent from both parents when custody is held jointly, or from the minor's legal guardian(s) unless the minor: 1. is emancipated by court petition and decree; 2. is married, widowed or divorced; 3. is a parent of a child himself or herself; 4. is a member of any of the armed forces of the United States of America; is living separate and apart from his or her parent(s) or legal guardian and is managing his or her own financial affairs; 6. reasonably believes that he or she is suffering from, or has come in contact with, a disease defined as dangerous to the public health pursuant to M.G.L. c. 111, § 6, and the service(s) or function(s) to be performed pertain to the diagnosis or treatment of that disease; will be served by not notifying his or her parent(s) or legal guardian of the performance of the proposed service(s) or function(s), and the Licensed Mental Health Counselor or Licensed Supervised Mental Health Counselor reasonably believes and documents in the treatment record that the minor fully understands the nature of the proposed service(s) or function(s) and the risks and benefits of those service(s) or function(s); or 8. would suffer a detrimental effect as a result of contact with one or more of the custodial parents. Such clinical opinion shall be documented in the treatment record. (d) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall not knowingly withhold any information that would inhibit a client or prospective client from making an informed choice when selecting a provider of mental health services. (e) Written and signed Informed consent shall include but is not limited to: the Licensed Mental Health Counselor's or Licensed Supervised Mental Health Counselor’s credentials; 2. a statement regarding Confidentiality and its limits; 3. information regarding the use of tests and inventories; 4. information regarding accurate and appropriate billing procedures; an explanation of services provided and of the risks and benefits of counseling services, including an explanation of the risks and benefits of engaging in the use of distance counseling, technology, and/or social media within the counseling process; and 6. a client bill of rights which includes but is not limited to information concerning informed consent, the licensee's grievance process, client respect, and the client's right to terminate treatment; (4) Supervision. (a) In providing supervision services to graduate students, post-graduate individuals seeking licensure, including Licensed Supervised Mental Health Counselors, and other clinicians, Licensed Mental Health Counselors shall: 1. have an informed consent agreement with the supervisee, including an agreement for supervision that includes rights and responsibilities of both supervisor and supervisee; 2. have a process for resolving differences; 3. keep accurate and appropriate records of the supervision sessions; have a responsibility to know the current 262 CMR governing licensure as a Licensed Mental Health Counselor and Licensed Supervised Mental Health Counselor; 5. regularly attend continuing education and participate in activities regarding topics and skills for both counseling and supervision; 6. maintain appropriate boundaries with supervisees; make supervisees aware of professional and ethical standards and legal responsibilities of licensure; and 8. address the role of multiculturalism and diversity in the supervisory relationship. (b) In addition, Licensed Mental Health Counselors providing supervision as an Approved Supervisor to graduate students or post-graduate individuals seeking licensure, including Licensed Supervised Mental Health Counselors, shall: 1. understand and accept their responsibilities to monitor the welfare of clients treated by their supervisees; 2. provide supervisees with ongoing performance appraisal and evaluation feedback, as well as formal evaluations; and refrain from endorsing supervisees who fail to meet professional standards of practice. (5) Termination, Absences and Referral. (a) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall not abandon or neglect their clients in counseling. (b) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall make appropriate arrangements for any necessary treatment of their client if the Licensed Mental Health Counselor or Licensed Supervised Mental Health Counselor is on vacation or is ill for an extended period of time. (c) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall make arrangements for emergency backup to cover expected and unexpected absences; (d) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall make reasonable efforts to assess treatment goals and outcomes with the client and terminate a relationship when it is reasonably clear that the treatment no longer serves the needs of the client; (e) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors may terminate counseling when: 1. he or she reasonably believes to be in jeopardy of harm by the client or by another person with whom the client has a relationship; 2. the client does not pay the fees charged; or insurance denies such treatment and the Licensed Mental Health Counselor or Licensed Supervised Mental Health Counselor recommends other service providers. (f) When transferring or referring clients to other practitioners, Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall ensure and document that appropriate clinical and administrative processes are completed for an appropriate transition. (6) Professional Responsibilities and Conduct. (a) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall provide services within the scope of practice for the profession and within the bounds of their particular competencies and the limitations of their expertise. When practicing new specialty areas, Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall obtain proper education, training, or supervision. (b) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall obtain consultation and supervision when needed as clinically indicated, including but not limited to when practicing outside of an area of expertise or when treating at-risk clients. (c) Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall not practice if they are impaired and unable to practice competently. Licensed Mental Health Counselors and Licensed Supervised Mental Health Counselors shall seek professional assistance to determine whether to limit, suspend or terminate their professional responsibilities until such time as it is determined that they may safely resume their work.