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Ethics

  • December 09, 2018 9:00 AM | Emily Fell (Administrator)

    Frances Schopick, JD, MSW 

    The questions I hear most often about Disclosure and Informed Consent are:  1) Why do we have to bother with a long Informed Consent? and 2) Can’t I at least cut it down to one page?

    This is a really important topic, so I want to be clear: A well-written Informed Consent that is properly administered is very likely to be the single most important risk management tool that you have at your disposal. And here’s why:

    First of all, let’s answer the underlying question: “What is Informed Consent?”

    Informed Consent is a contract between you and your client--the State refers to it as Disclosure; Codes of Ethics (COE) use the term Informed Consent (IC). Strictly speaking, “disclosure” refers to your act of disclosing to the client the basics of your practice, and “IC” is the permission the client gives to you to treat. For the purposes of this article, I shall use the term Disclosure. Whichever term you use, the document should provide the basic information a client needs to understand your scope of practice and how you work. With that information, clients can independently decide, free of coercion, undue influence, or duress, whether they want to work with you. In so doing, you minimize and manage your own risk. IC is not just a signature. Proper administration of IC is an ongoing process that can--and in my experience should--be re-visited throughout the course of treatment in a transparent, conversational format that normalizes discussion of sensitive issues.

    The document has three main functions: clinical, legal, and ethical. Clinically, disclosure initiates the therapeutic alliance as you demonstrate to the client(s) that you want him/her/them to have what needs to be known in order to make an informed decision about initiating therapy: You must clearly explain your scope of practice, both what you do and don’t do; you explain that therapy is a process that requires the active participation of both the therapist and the client; you discuss clients’ rights along with boundaries, confidentiality and its limits; you invite the client to ask questions and to articulate expectations so that you can address them with respect, authenticity, and clarity. This should be an opportunity that gives both you and your client the chance to explore expectations and ambivalence in a transparent way. If a client has unreasonable expectations, or reasonable expectations that you cannot fulfill (for example, experience that may be out of your scope or expertise), you can address the discrepancy. If the client is not receptive to reassessment, you can determine if the clinical “fit” is workable or not. In doing all these things, you model both client and self-care.

    The document also has a legal function. Washington State statutes and administrative codes require some form of disclosure and that disclosure must be written in language that is easy to understand. I would add that the language may also be personable, conversational, and professional. Basic information must be included: For example, you must include your name, your agency/business name, business address, contact information, WA State license number, methods or treatment modality and therapeutic orientation, your relevant education and training, course of treatment when known, and billing information. Importantly, the law states that you have to inform clients that they have the right to refuse treatment, as well as the right and responsibility to choose the provider and treatment modality that best suits their needs.* You must inform the client that you keep a record and they have the right to access it (with some limits), the extent and limits of confidentiality, including mandatory reporting of abuse,** consultation or supervisory agreements, the fact that they can complain about you to the DOH and how to complain to the DOH, final acknowledgment, signed and dated by both you and your client(s). Remember, you WANT your clients to understand the terms of your practice. This is protective for them and for you.

    *A short comment about the language of “right” and “responsibility” to choose a treatment provider and modality that best suits the client’s needs: This language is actually used in the statute (responsibility) and WAC (right). I often encourage social workers to include this language because it helps to reinforce that the client has both the right and responsibility to be active, and should not just transfer all responsibility to you. You don’t want them to later claim you caused undue anxiety, acted without permission or, worse, against their will. You’d be surprised how easily the seed of misunderstanding can grow or be mischaracterized in later telling: A therapist’s casual touch to express condolence, a client’s request for a hug, a child’s spontaneous gesture. If a client should later assert that your approach to therapy had been unacceptable, you want to be able to respectfully remind the client(s) that he/she/they understood and agreed when you administered Disclosure regarding the right and responsibility to choose the treatment provider and modality that best suited need and that you had explicitly asked him/her/them to say if you did not meet those needs so as to correct your approach.

    ** It may be good practice to inform clients immediately that law requires mandatory reporting of child abuse (48 hrs), in case a client reveals past or present abuse before review of the IC.

    The ethical function of the IC is signaled through the COE. An ethical practice reflects the mission of the profession and adheres to professional guidelines. The COE may be used as a measure of your adherence to standards of care. Social Work is a systems approach to social justice, clients’ rights, and self-determination. Some social workers think the COE supersedes confidentiality law, but the NASW COE states clearly that the counselor should generally observe confidentiality “to the extent permitted by law.”

    In addition to the items that are required by law, you may choose to include other items that are personal to you and your practice. For example, you may want to provide your stance on dual roles, custody recommendations, legal involvement, rates of pay if court ordered, rules of collateral visits, policies regarding electronic communication, secrets, and touch. If you work with couples, children, or  families, you may want to include how you address issues particular to those contexts.

    I hope you’re getting the idea that the DISCLOSURE IS YOUR FRIEND. I realize a lot of people see Disclosure as an annoying burden and pain. I, however, see it as an opportunity. I don’t mean this in some romantic, hypothetical sense--I’m absolutely serious. It’s a precious and practical opportunity for you to state in writing what you’re obliged to do, willing to do or not willing to do, as well as to convey what you expect of your client. All these things can be written into the document. How often can you do that in life? When was the last time you told a friend, date, spouse, colleague, or other adult exactly where the line is and will always be in your relationship? We rarely set forth our terms in writing, and we break our own unwritten rules in relationships all too often. But here, where you are engaging in a therapeutic relationship with another person you’ve only just met, dynamics and expectations can get extremely complicated. This is like participating in a mystery novel, but you can’t flip to another page to learn about what the character is really after or how the story ends. Being a therapist takes skill and care; to do it best, you must be safe. You know how they tell you on a plane to put the air mask on yourself before helping others? The Disclosure is the air mask that keeps you breathing freely as you usher your clients to improved health.

    I invite you to view Disclosure as an opportunity to limit legal risk while you help your clients define and meet their therapeutic goals.

    copyright©2018 francesschopick

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    Disclaimer: This article is not intended as legal or clinical advice, consultation, or supervision. Every situation is fact-specific, and must be considered individually. If you have any questions, please feel free to contact me at fschopick@comcast.net or 425-891-3411. I give free consultations, and am happy to respond to your concerns.

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    Frances Schopick, JD, MSW is an attorney with a strong background in Social Work and psychiatric research. She represents counselors who have DOH complaints against them. She also provides consultation for risk management, setting up disclosure forms for your practice, and witness prep for subpoenas and testimony in court.

  • December 09, 2018 8:43 AM | Emily Fell (Administrator)

    Tiffany Chhuom, LSWAIC, CDPT, MPH, MSW

    Thanks for joining us for part two of this four-part series on technology and ethics. In this article, we’re going to take a look at the use of email. Let’s face it, it’s difficult to run a private practice, work for an agency, or even do community outreach without an email account. It’s a part of our lives and it is quickly becoming essential for healthcare practice. In my previous article from September 2018, I described the term “Business Associate Agreement”, better known as a “BAA.” Whether working in an agency or in your own private practice, every vendor you use for any electronic communication must include a BAA. Why? A BAA is required by federal law and protects the privacy of your clients’ information. How so? Well, let’s take a step back.

    An email provider, like AOL or Gmail, is a vendor. In addition to providing us with email services, they collect information from us to use for designing future products, marketing strategies, and can sell information to third parties for a lot of money. You may be asking, can they actually do this? Yes, because we sign a contract with them giving permission to do so when we become their customer and technically, “our data” includes all the data in our email messages, saved email addresses, names of contacts, etc. (therefore, email providers actually own our clients’ data too, for example if we email with clients to schedule appointments). In order to stop email providers from doing this, we have to get a signed BAA contract. Once they do so, they are not allowed to mine, or use, the data in our email account for their own purposes or to sell to third parties.


    I frequently attend workshops and other events with colleagues and when the topic of email comes up, many social workers will say to me “Oh, but that’s ok because I don’t use email with clients.” While that may be the case, it’s important to think through different risk scenarios first, to see if you’re using email in a way that really does necessitate a BAA; even when we set boundaries around email, we cannot always control when a client emails us and what information may be contained in the email. Here are three scenarios to consider:

    • Do people email you via your Psychology Today profile or from your website, wanting to schedule an appointment?

    • Do you email other providers about referrals, records requests, etc.?

    • Do you allow clients to email you if they need to change an appointment time or for billing purposes?

    If you answered “yes” to any of these questions, then you need to make sure your email provider has provided you with a BAA and other federal standards.  Unfortunately, many email providers do not offer a BAA--probably because doing so means they have to take on more liability and spend more money to ensure they are complying with the terms of the BAA contract. Here are two that do:

    • GSuite

    • Hushmail

    GSuite is the business option for a Google account which includes a Gmail account, Google Drive for cloud storage, Google Calendar, and other Google Apps. One Google App that is not covered under the BAA is Google chats, a.k.a. “Hangouts”. For this reason, you’ll want to make sure you only use the Google Apps that are covered, like Gmail, Google Drive and Google Calendar. If you choose to sign up for a GSuite account, make sure you then ask for a BAA. At the bottom of this article you’ll see helpful links for their BAA and information about GSuite. GSuite is available on any device, including iPhones and Android phones. I recommend giving Google a call to discuss questions and to ask about additional security features they can provide for free to keep your phone secure should you access your GSuite and Gmail account on your phone. When I called, they added a feature where they can wipe my phone if I call them to report it has been stolen or is missing--this service is only offered if you have a GSuite account.

    Hushmail is a company based out of Canada. Along with providing email services to the general public, they also provide healthcare providers with services to encrypt their emails and forms. While it does not offer all the features that GSuite does, it adheres to the same requirements for privacy, like encryption, outlined in the U.S. federal regulations and guidelines which include HIPAA and the Privacy Rule. Hushmail is currently available on computers and on iPhones, but not on Android phones.

    Regardless of which email provider you choose, you’ll want to be mindful of who you are sending emails to as well as ensuring that the storage of your email messages, drafts, etc. meets compliance requirements. However, your responsibility doesn’t end there: We are further required to ensure that the transmission of our email to the recipient is compliant with security standards and  we need to make a good faith effort to ensure that the recipient of the email is using a secure and compliant account. This can be hard, if not impossible to do, should you choose to use email with clients for scheduling, or other reasons. Ideally, we can avoid any compliance issues by using a secure patient portal to send electronic messages to clients,  instead of email--the client has the right to opt out of this option and use unsecured email instead--or you can adopt a no-email policy that is clearly stated in your consent and other forms.

    This may seem like a lot of work, but it is easily manageable. As we mentioned in the previous article on phones and PHI, members of NASW can contact the legal team for a copy of a template technology disclaimer and a technology use policy to have  clients sign. These two measures will document that clients are agreeing to opt out of using a patient portal, and instead agree to assume any risk they incur by using unsecured email or messaging(keep in mind, if you email PHI to another healthcare provider, both parties are required to have a BAA and encrypted emails for healthcare communication).When reviewing email vendors for your professional use, here are some key questions to ask:

    1. Do you provide a free Business Associate Agreement that you and I both sign and date? Will a copy be provided to me?

    2. Will I be the only person with access to my data? Does this include deleting the data?

    3. If I put your app on my phone, will your app share data with other apps on my phone?

    4. If your app does share data with other apps on my phone, is there firewall protection? How strong is the encryption?

    5. If my email messages are stored on my phone, how do you ensure that this data will be safe and accessible to only me in the event my phone is lost, damaged or stolen?

    6. To pay for email services that are HIPAA compliant, do I have the option to pay monthly versus annually? Is the cost reduced choosing one over the other?  Are there promotional codes or a referral reward program I can take advantage of to lower the cost?

    7. Is there a contract of service I sign with your company? If so, what penalties will I pay if I leave early?

     

    This may seem like a lot of questions but it is important to make the most informed choice possible about compliant email use and your practice. I would love to hear from members about other options they’re using for their email needs.

    Stay tuned for future articles about compliance, ethics and different forms of technology, like social media and video counseling! I use different forms of technology, including email, blogging, and texting in my own practice and have found them both useful and safe, but it took me some time to do the research. If you don’t have time to look into these things on your own, feel free to contact me for additional help and keep an eye out for my future training events. I’ve also added some links below for your reference. Roger that! Over and out….

    Hushmail

    https://www.hushmail.com/

    GSuite

    https://gsuite.google.com/

    G Suite HIPAA Business Associate Amendment

    https://gsuite.google.com/terms/2015/1/hipaa_baa.html

    G Suite and Cloud Identity: HIPAA Implementation Guide

    https://static.googleusercontent.com/media/gsuite.google.com/en//intl/en/terms/2015/1/hipaa_implementation_guide.pdf

     NASW, ASWB, CSWE, & CSWA Standards for Technology:

    https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf

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    Disclaimer: This article is not intended as legal or clinical advice, consultation, or supervision. Every situation is fact-specific, and must be considered individually. The references included in this article are up to date as of publication date. If you have any questions, please feel free to contact me at info@lucyintheskytherapy.com

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    Tiffany Chhuom, LSWAIC, CDPT, MPH, MSW is a member of the WSSCSW’s  Ethics Committee and owner of Lucy in the Sky Therapy. Her practice serves adults online and in the Yelm/Rainier area. She provides therapy while also working with clinics and healthcare systems to understand technology and compliance for clinical use. She continues to strengthen her training in trauma, addiction, disability, and adult giftedness.



     



  • September 23, 2018 2:39 PM | Emily Fell (Administrator)

    Do you use a phone to schedule or screen clients? Do they leave voicemails or send you text messages? If you said “yes” to either of these questions, then you need to make sure you’re using a phone service that is HIPAA compliant. How do you do so? You’ll need to sign a contract with the phone service provider called a “Business Associate Agreement”, better known as a “BAA.” This contract tells the phone service provider that they cannot use any data from your call logs, voicemail recordings or text messages for any reason. Why would service providers  want to? Because phone companies often use this data to better understand how their customers use their services and sometimes they also sell this data to third parties for marketing purposes. I know that’s scary, but don’t worry. There are several providers that will sign BAA’s with clinicians, the most common being AT&T, Verizon, and Spruce.

    Which one should you go with? The goal of this article is to help you learn HOW, not what, to choose when finding a phone and voicemail provider for your practice. Each provider’s price, options and quality of service will change over time, so the selection process is key.

    For example, I’ve heard wonderful stories about the ease of going with AT&T and recounts of nightmares. I’ve heard Verizon is very affordable and it’s astronomically expensive. I personally use Spruce and really like it, but it’s not perfect and some colleagues think the cost is far too high for their budget.

    When choosing the right provider for you, make sure you know if the provider is a traditional phone provider, like Verizon or AT&T, OR if it’s a “VOIP”, which stands for “Voice Over Internet Protocol”. With VOIP the phone services, the voicemail recordings, and the text messages between you and clients are stored online and not on phones, or computers. This helps to lower the risk of a data breach should a phone be lost or stolen. Communicating with clients through text in an unsecure environment (e.g. your personal cell phone), actually means you’re violating several laws, codes of ethics and regulations; if you don’t have to log in to get into a separate texting application, it’s also an indicator that you’re not as protected--and neither are your clients--in your communication. While you should evaluate any VOIP provider before choosing it, most provide a free smartphone app for you and your clients to use. Each time you need to make a call, send a text or check a voicemail, you just log in--the app stores your client’s information so you can safely access it on your phone. VOIP text messaging also provides the ability to attach web links, documents, and scheduling requests easily, which is a bonus for many clinicians (stay tuned for a follow up article I’m writing about texting and compliance).

    Some clients may not want to download another app and they can choose to respond to your messages through regular means. If clients prefer to go that route, just have them agree to this in a disclaimer form, signed by new clients and updated annually. Members of NASW can contact the legal team for a copy of a template technology disclaimer if you’d like an example.  VOIP plans do not require any additional minutes, just data from their phone plan, unless they are connected to WiFi. I cannot speak for others when it comes to VOIP apps, but my own clients have found the Spruce app easy to use even when they were fairly new to smartphone technology.

    Regardless if you go with a VOIP provider or a traditional phone provider, here are some key questions to ask:

    1. Do you provide a free Business Associate Agreement that you and I both sign and date? Will a copy be provided to me?

    2. Will I be the only person with access to my data? Does this include deleting the data?

    3. If I put your app on my phone, will your app share data with other apps on my phone?

    4. Are voicemail messages, call logs, and text messages stored online? If so, is there firewall protection? How strong is the encryption?

    5. If my call log, voicemail messages or texts with clients are stored on my phone, how do you ensure that this data will be safe and accessible to only me in the event my phone is lost, damaged or stolen?

    6. How much does this cost monthly versus annually? Are there promotional codes or a referral reward program I could take advantage of to lower the cost?

    7. Is there a contract of service I sign with your company? If so, what penalties will I pay if I leave early?

    8. (If asking about VOIP) How large should my data plan be with my phone service provider if I will be using this service approximately ______ minutes a week/month?

    9. (If asking about VOIP) Can I be reimbursed if too many of my clients cannot use your technology because it isn’t compatible with their device (e.g. Apple’s IPad, Android tablets, Google Pixel phones)?

    This may seem like a lot of questions but it is important to make the most informed choice possible about compliant phone use and your practice. I would love to hear from members about other options they’re using for their phone and voicemail needs. In a digital era, this is a difficult time for us all but I truly believe we’re in it together. Stay tuned for future articles about compliance, ethics and different forms of technology, like email, blogging and texting! I use different forms of technology, including email, blogging, and texting in my own practice and have found them both useful and safe, but it took me some time to do the research. If you don’t have time to look into these things on your own, feel free to contact me for additional help and keep an eye out for my future training events. I’ve also added some links below for your future reference. Roger that! Over and out….

     Spruce on Phone Lines and Faxes and HIPAA:

    https://blog.sprucehealth.com/phone-lines-faxes-hipaa-oh-my/

     NASW, ASWB, CSWE, & CSWA Standards for Technology:

    https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf

     DOH HIPAA Security Series:

    https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf?language=es


    Tiffany Chhuom, LSWAIC, CDPT, MPH, MSW is a member of the WSSCSW’s  Ethics Committee and owner of Lucy in the Sky Therapy. Her practice serves adults online and in the Yelm/Rainier area. She provides therapy while also working with clinics and healthcare systems to understand technology and compliance for clinical use. She continues to strengthen her training in trauma, addiction, disability, and adult giftedness.






  • September 23, 2018 2:15 PM | Emily Fell (Administrator)

    Are you a licensed social worker who is practicing without the kind of insurance policy that will cover the defense of your license?

    Social workers usually know they need to purchase liability insurance to protect against a lawsuit—that’s the insurance that you purchase for $1M/$3M or $2M/$4M—but there’s another type of insurance you also need to have. Equally important is the insurance to defend you from a “complaint” filed with the Department of Health (DOH) against your license. In fact, of the two types of actions, a “lawsuit” or a “complaint,” you are far more likely to encounter the DOH complaint—and yet that is the type of coverage many licensed social workers not only lack but don’t even realize they need.

    Insurance companies offer two types of policies: insurance for “lawsuit liability” and insurance for a DOH “complaint” or “license defense.” The first type is for coverage against a lawsuit, when a person sues you through the judicial court system. Again, that’s the $1M/$3M or $2M/$4M insurance and is imperative to carry.

    The second type of policy is for coverage of “license defense.” This insurance protects you if you have a DOH complaint against your license, which is not covered by the liability insurance for a lawsuit. License defense insurance may also cover expenses for subpoenas, which is a third important type of coverage to have that is usually included as a subset of the license defense coverage. For license defense (and subpoena) coverage, you usually have to buy a separate and additional rider on the lawsuit policy. Some companies do include a minimal amount with the liability coverage, but with the rider you may be able to purchase up to $150K for a relatively low price (some are about $75 annually). Read the fine print carefully: Some companies include subpoenas under this coverage, others don’t. Some companies allow you to choose your own attorney, others don’t.

    It’s important to think carefully about which company you choose for your insurance. The wrong choice could end up costing you tens of thousands of dollars in the end, or more!

    Here’s what you need to know: Not just “anybody” can file a lawsuit successfully. I won’t list all the details here, but for a person to be able to successfully sue you, they have to meet certain criteria: they have to show that you had a direct legal responsibility to them, that you breached it, and that you caused harm and damages. While a lawsuit is possible, the requirements make them infrequent.

    You are more likely to encounter a DOH complaint than a lawsuit because the DOH complaint is, simply put, easier to file. Whereas filing a lawsuit requires criteria explained above, the DOH complaint doesn’t. In fact, anyone can file a DOH complaint against a licensed social worker. A DOH complainant doesn’t have to have been your client, doesn’t have to have had any direct relationship to you, and doesn’t have to have been harmed by you. In fact, the complainant doesn’t even have to know you. There is no time limit, so the claim can be made years after a supposed event occurred. The complainant only has to suggest – not prove - to the DOH that you’ve done something that, if it were true, might pose a risk of harm to the public. Since the DOH mission is to protect the public, it will likely investigate. Even if the investigation is ultimately dismissed, you are required by law to respond to the complaint, and doing so can be time consuming, preoccupying, and highly distressing.

    The second reason a DOH complaint is more likely to occur than a lawsuit is that, even if the complainant wants to file a lawsuit, a good way to lay a foundation for the lawsuit is to first file a complaint. If the DOH decides the complaint is “founded,” that decision will lay the groundwork for the future lawsuit. When the DOH investigates, the cost of the investigation is paid by the State, so the complainant gets a lot of free work done by the DOH. Thus, even if a person were to sue, he or she would start by filing a DOH complaint against your license.

    Where do you fall in the spectrum of potential risk for a complaint? There are some social workers who are higher risk than others for a complaint: Social workers are at greater risk when they work with 1) children involved in custody cases, 2) children with disabilities, and 3) high conflict clients, couples, and families. Unfortunately, even excellent providers may have multiple complaints in a single year. The complicated dynamics involving custody cases, mandatory calls to Child Protective Services (CPS), and testing for school Individualized Education Plans (IEPs) may result in DOH involvement even when cases are ultimately dismissed. Without adequate coverage, providers may have to pay thousands in attorney’s fees; with the right coverage in sufficient amounts, providers’ costs may be zero when attorney’s fees are paid directly by the insurance companies.

    It is also important to consider whether you can choose your own attorney or if the insurance company wants you to use an attorney on their panel. Many social workers like to use an attorney they have already worked with or one that a colleague personally recommends when faced with this situation. Since the option to choose an attorney is offered at some insurance companies but not all, social workers need to also reflect on this need when selecting a policy. After all, it is his or her own license that is at stake.

    What can you do to protect yourself? Call your insurance company. Ask these questions regarding license defense, subpoena coverage, and choice of attorney:

    1) Do I have coverage for “license defense”? How much?

    2) Do I have coverage for a subpoena? How much?

    3) Can I choose my own attorney for a license defense?

    If you don’t have coverage or don’t have the full amount available, I suggest purchasing the highest amount possible, or at least the highest amount you can afford. If the cost is about as much as you might have to pay (or less) for an extra pair of shoes, I suggest purchasing the insurance rather than the extra pair of shoes. The amount is important--if the subpoena coverage is under $5,000–and I know of one company that only offers $400, which is certainly not enough—it may likely be inadequate if you are ever served a subpoena. Ideally, you will never have a complaint against you, and this will be the best $75 you spend just to be safe. It’s worth the peace of mind to know your license is adequately covered, you can afford to deal with a subpoena, and you can choose the attorney you want to help you through a DOH complaint, should one ever arise.

    Ultimately, I urge you to make sure your insurance covers you for license defense, subpoenas, and choosing your attorney for license defense. If you determine that you don’t have sufficient coverage, purchase it right away. If your current carrier does not offer what you need, consider switching to another carrier now or at the first opportunity. If you just renewed a policy that is insufficient, you may be able switch to another, cancel the first once the new policy is approved, and receive a pro-rated reimbursement. Even if you are an Associate level licensee working under a supervisor, or a licensee working at an agency, you are well-advised to have your own policy, should you and your agency or supervisor’s interests not be the same.

    Going through a DOH complaint is never pleasant, even under the best of circumstances where it is dismissed. It can be upsetting, embarrassing, and humiliating. Whether you work independently, under a supervisor, or at an agency, take advantage of your current complaint-free status to purchase the coverage that can save you future expense—you may be only one high-conflict client away from a complaint.

    If you have any questions, please feel free to contact me at fschopick@comcast.net or 425-891-3411. I give free consultations, and am happy to respond to your concerns.

    Frances Schopick, JD, MSW is an attorney with a strong background in Social Work and psychiatric research. She represents counselors who have DOH complaints against them. She also provides consultation for risk management, setting up disclosure forms for your practice, and witness prep for subpoenas and testimony in court.



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