Assignment:
Peer review
300 words
APA style
David Kacsur
When a managed care clinician denies authorization for additional sessions, counselors still have an ethical responsibility to advocate for their client while still remaining honest and compliant with our professional standards. Several actions would be considered both professionally appropriate and ethical. First, the counselor can submit additional clinical documentation explaining why the client would benefit from continued treatment and also how the request meets medical necessity criteria. The counselor could also request a peer-to-peer consultation or appeal the decision through the managed care review process. Consulting with a supervisor or clinical director is also another appropriate step, especially when determining the best way to advocate for the client within agency policies. The counselor might also help the client explore other resources such as sliding-scale services, community programs, or possibly group counseling if additional individual sessions cannot be approved. These approaches reflect the counselor's innate duty to promote the client's well-being. The American Counseling Association Code of Ethics states, "The primary responsibility of counselors is to respect the dignity and promote the welfare of clients" (American Counseling Association, 2014, Standard A.1.a). At the same time, the counselor must ensure that all documentation and billing remain accurate. The ACA Code also states, "Counselors accurately represent their credentials and services when seeking payment from clients or third-party payers" (American Counseling Association, 2014, Standard C.3.a). Some responses to the situation, however, would violate ethical standards. For example, exaggerating a client's symptoms to meet medical necessity criteria, altering documentation to justify additional sessions, or encouraging the client to report symptoms they are not experiencing would all be unethical. These actions would misrepresent clinical information and undermine professional integrity. Although counselors may feel pressure when insurance companies limit treatment, ethical practice requires honesty and transparency in all documentation and communication. Advocacy should involve working within the system through proper appeals, consultation, and resource referrals rather than just attempting to "manipulate" the process. Need Assignment Help?
References:
American Counseling Association. (2014). ACA code of ethics. Author.
Corey, G., Corey, M. S., & Callanan, P. (2019). Issues and ethics in the helping professions (10th ed.). Cengage Learning.