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Informed consent is not only a basic right of all clients, but it also helps to protect the client’s privacy and can be utilized to empower them to make their own educated decisions about aspects of their own therapy. Ideally, the goal of the practice of informed consent is to provide patients with the most relevant and accurate information regarding their own treatment, so that they can decide for themselves to become involved and willing participants in their own therapy sessions. One of the best methods for instituting informed consent practices is to establish a protocol for enabling clients to make their own educated decisions.
It is important to note that the practice of informed consent carries with it a number of legal implications as well, primarily due to the fact that its purpose is to protect the rights and privacy of the client. From a legal standpoint, there are three aspects of informed consent that are of primary concern: the client’s capacity for rational decision-making, the client’s comprehension or understanding of the information, and the client’s voluntariness, which ensures that decisions made by the client are of their own free will.
For the therapist, informed consent governs many aspects of administrative duties as well, such as confidentiality, record-keeping and maintenance, and the transfer and disclosure of client files. While these aspects are more clearly defined in terms of what therapists can and cannot do, therapists are also left with the additional task of ensuring that all clients are properly educated and informed about procedures and the legal implications and also that each individual client has the ability to comprehend such information and make decisions regarding their own treatment. It is this aspect of informed consent that often lacks such clearly defined rules and is often a matter of judgment on the part of the therapist.
Adequate informed consent is becoming increasingly important for today’s mental health professionals, as more and more people are seeking individual or marital counseling as a means of improving aspects of their own lives or relationships. In all aspects of healthcare, the appropriate procedures for obtaining adequate informed consent are still debatable. Because therapists have the unique opportunity to be able to work with clients in order to improve decision-making skills, this process is even more important. The goal is not to steer clients in any one direction or another, but rather provide each client with all of the information in a manner which they understand, be able to answer questions regarding the policies, and enable each client to make their own educated decision about what is best for them and their particular situation.
Informed consent for therapists is often more difficult when faced with clients who may be in danger, under psychological distress, or faced with a domestic violence situation. Often, these clients may lack the ability to make rational decisions or may be fearful of participating in their own therapy due to the risk of confidentiality breaches and concern for their own personal safety. In this instance, it is often the therapist’s responsibility to not only offer additional reassurance regarding confidentiality, but also accurately represent the legal implications of informed consent and if and when records may be disclosed, along with what kind of information can be shared and under what circumstances. In addition, when there is a great deal of psychological distress present, it may be necessary to reiterate policies at a time when clients are more stable, and also take greater measures to enable the clients to adequately make their own decisions.
In cases where a client lacks the capacity to make informed decisions on their own, due to age or disability, a parent or guardian may be necessary in order to provide adequate protection of the client’s rights and sign legal documents. In terms of comprehension of the information provided, therapists should frequently have question and answer sessions with the client regarding the goals of treatment, client participation, availability of other services, expectations, and any risks involved. Clear communication and guidelines are the best way to ensure that a client adequately understands not only the purpose of treatment but their roles and responsibilities as well.
Informed consent procedures for therapy can be seen as more than just legal practices. The continuously evolving methods of ensuring informed consent for clients also further enable and empower clients to educate themselves, take an active role in ensuring their own well-being, and learn to make more choices regarding their own personal care.
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