 Welcome everybody to your course on legal and ethical guidelines for coaches. During this presentation, we're going to identify the legal and ethical guidelines for coaches, review common ethical principles that are, when I say common, common to health professionals, counselors, and coaches. We'll review ethical decision making and explore some common ethical issues such as social and sexual relationships with clients, payment, fee structure, and bartering, adherence to the scope of practice, HIPAA and confidentiality, documentation, and business management. Currently, coaches are not licensed in most states. That doesn't mean they won't become licensed. What that means is it's important that you stay on top of your regulatory agencies and regularly check with your state board of health to ensure that you're not required to be licensed to practice coaching in your state. Ethically, coaches should adhere to the recovery and resilience ethical guidelines, which are in your class. Some common ethical principles that are really important to be aware of and uphold are fidelity, which means being faithful to your client. If you tell them you're going to do something, do it. If you make a promise, keep it. Do things that are in their best interest, which takes us to beneficence. We're always trying to help our client and do things that are beneficial for them. Non-malfecence means we make sure that whatever we do doesn't hurt our client. And sometimes we have to do things that we don't necessarily want to do, like terminate our client. We want to make sure we do that in a way that doesn't cause harm. We want to make sure that whatever we do is in the best interest of our client. And we're going to talk throughout the different courses about how to avoid creating dependencies with our clients. Because if they become dependent on us, even if we think we're doing the best thing for them, ultimately they're not going to be able to basically do these same skills without us, which is creating a problem, creating a dependency, which is harmful to the client. So we want to make sure that we do no harm. Autonomy means we respect our client's choices. They are going to discharge when they want to discharge. But they are also going to follow a recovery and relapse prevention plan that they create. And we're going to empower them to identify what they need and what they want. And we're going to try to help them meet their goals. This is not about us. This is about the client. And finally, justice. Fair is fair. We want to make sure that we treat all of our clients the same. If you have a sliding fee scale, make sure it's documented, what qualifies for a sliding fee scale, what kind of proof people have to have, and that you adhere to it. Make sure that you're not taking on certain clients and giving special favors to certain types of clients as opposed to others. So what do we do as far as identifying an ethical issue? Well, first, we need to know that there's an ethical issue. And generally, I tell my trainees as well as my clients, there's an ethical issue if your spidey senses go off. If your head says it's wrong, well, there's an ethical issue there. If your heart says it doesn't feel right, there's probably an ethical issue. If your gut or your spidey senses are going off, then there's most definitely probably an ethical issue. Your head, heart and gut have to say, this is the right thing to do, or there's an ethical issue. So if any part of you feels that something you're doing might not be in your client's best interest or might bring them harm, then you need to figure out what to do about it. The first step is to get the facts. What are the relevant facts of the case? And do I know enough to make a decision? Do I know enough about what's going on with my client? Maybe you find out that your client is becoming progressively depressed and suicidal. Those are pretty relevant facts. You have to make sure those are accurate. And then you've got to figure out what to do. One of the hardest things as clinicians we have to do sometimes is have people committed involuntarily. Now, as a coach, the role is a little bit different, but it's still incumbent upon you to make sure that they don't harm themselves. So you're going to have to call law enforcement or call someone that's on their emergency contact to make sure that they are in a safe place. We want to identify stakeholders. What individuals and groups have an important stake in the outcome? If I make this decision or to do something or to not do something, who is it going to affect? It's going to affect me. It's going to affect my client. But who else? Is it going to affect my client's family? How might it affect the community? How might it affect the profession of coaching? Those are all things that we need to consider. Are some concerns more important? Is it more important to consider whether it's going to harm you or your client as opposed to the community? And that's not something that we can say yes or no. It's something you have to decide for each situation. Then brainstorm the options. What are your options here as far as how can you deal with it? I talked about a client who's becoming progressively depressed. What are the options that you have as a coach for acting? Refer them to their mental health professional. Hopefully you have a release of information if they're already seeing a clinician and you can call the mental health professional and go, uh, Jim Bob is not doing so good. Figure out what other options there are. Can you call 911? Do you need to call 911? Can you call their emergency contact? Is there someone that you can trust to come take care of them? Generally, if you're concerned for their safety, it's going to be more than just calling their emergency contact. Now, again, looking at the ethics of everything, do you transport them in your own car? That opens you up to a whole host of liability. So generally, it's recommended that you don't transport them in your own car, which is why 911 is a viable option. So you evaluate options by asking the following questions. Which option will produce the most good and do the least harm? Which option best respects the rights of all who have a stake? Which option treats people equally or proportionately? Which option best serves the community as a whole and not just some members? And obviously some of these questions are going to be more applicable to certain situations than others. After you figure out what your options are, then you make a decision. Eventually, you've got to make that decision. And then you test it before you act on it. You say, how would I feel if someone I respected knew my decision? Going back to that head, heart, and gut honesty. You also might ask yourself if the roles were reversed, how would I feel in the short term, and how would I feel in the long term? And do you want to ask yourself, does this decision conform with current laws? Because we've got to obey the law. Does it conform with current laws while doing the most good? Then you act. Once you've decided that, yes, this is the best decision, you've got to do something. So you act. Once that happens to reflect on the outcome, did it turn out the way you expected? If so, are there things that you can improve? Are there things you need to do differently next time? Did it turn out differently than you expected? If so, why? And what do you need to potentially do differently the next time? We need to adhere to the scope of practices coaches. Coaches only perform activities for which they have special training and are legally allowed to perform. This is one of my big hangups. I see a lot of coaches performing nutrition counseling. In most states, in order to provide nutrition counseling, you have to be a registered dietitian or a medical doctor. You can provide education, you can say, here's a book to read, but you can't prescribe for people what they need to be eating or what they should be doing. It's very important to understand the difference between educating and prescribing and very important to understand what you're legally allowed to do, because you can get a whole host of hot water criminally for practicing without a license. HIPAA and confidentiality. You know, always go with the strongest standards. And in this case, it would be the HIPAA standards that doctors and counselors have to follow. Coaches should protect all client information to these HIPAA standards requiring signed written releases, court orders, and documentation for any kind of release of information. Maintain all files behind at least two layers of security. So if it is sitting on the desk in your office, just open, which I hope it's not, but if it is, you should have the door to your office locked and you should also have another door between the door to your office and anybody else. So your exterior door and your office door. It is recommended that you always keep client charts stored in a secure location. Maintain all files for seven years after termination. That's a long time, especially if you're seeing a lot of clients, which is why digital files are good, but you need to make sure you have backups and can access those files. And you have to maintain an accounting of all disclosures made. So if your client, Sally Sue, wants you to call her therapist and give her an update on what's going on, you need to note in Sally Sue's chart that you called her therapist on X and so day and what you discussed. Documentation. It's really important that we maintain good documentation to protect ourselves legally and in the best interest of the client. You can't just walk into somebody's house and go, okay, yeah, your, your client Jane, I think I remember what's going on with you. That's not legal. Well, maybe legal, but it's not ethical by any standards, not professional. So you need to maintain demographic and emergency contact information. What's their name? How old are they? What's their telephone number? Who's their emergency contact? And ideally, do they have insurance? Now insurance doesn't cover coaching, but if for some reason your client should fall out on you and you need to call 911, it's good to have all this information. Have an informed consent documentation about your fees, payment methods and collections, what you're going to do if they start to rack up a bill. One of the most common ethical complaints or prompts for an ethical complaint against a clinician is when the unpaid bills start ramping up. If it gets to be overwhelming, sometimes the client may see that as an opportunity to say, well, the counselor wasn't providing the ethical service. So I shouldn't have to pay for services. Make sure you document. Ideally, make sure you get payment at the time services are due and never get more than two payments behind. Have releases of information. If you're going to be talking to anybody about anything, even though you're not required to as a coach required by law, ethically, let's go ahead and do it. That way we're not talking to people that our clients don't want us talking to. Now it gets a little stickier if you get asked by law enforcement or someone else about what's going on with the client because we don't have privilege as coaches. It's important to understand what your limits of confidentiality are, but ultimately keep it as confidential as possible. You need to have your intake interview or your assessment paperwork that shows that you got to know the client and you developed a service plan. The service plan needs to be in there. Let's prove that we worked with the client and developed a service plan. These are all things that you're probably billing your client for, so you need to have the documentation that it was done. If it's not in the chart, it didn't happen. Progress notes need to be in the chart. This protects you, but it also helps the client learn how to evaluate their own behaviors and their own progress. A quarterly reassessment at least. Sometimes I'll do reassessments every 30 days. That's up to you, but it really helps the client see what they're doing, what's working well, how far they've come, and make any adjustments necessary before it gets too far out of hand. A termination plan. It sounds kind of odd, but this should be in the chart from the beginning. If a client starts seeing you and sees you for five sessions and decides, you know this isn't working, you still have something to give them that has referral information on it, so they aren't just left kind of flapping out there in the wind no better off than they were when they started seeing you. Hopefully they are. But it's important, and if you're a clinician, you're required to do this by most insurance companies. Begin termination planning or discharge planning at intake. Make sure you have that termination plan or that game plan for what someone's going to do when they leave your care, whether it's tomorrow or two years from now. Documentation needs to be completed within 24 hours of service. It needs to be computer generated or written in ink, and if it's computer generated, you can save it as a Word document, but it's better legally if you save it as a PDF, because it's harder to modify PDFs and you can prove that it was a document that you created on X and so date and it hasn't been modified. Never erase once a document has been saved and signed. If you have to make changes, always strike through, initial, and annotate. If you can't do that for some reason, then create an addendum to add to it and just title it like addendum to progress note for August 3rd, 2015, and put what you need to put in there. If a situation required consultation with another professional, that needs to be in the notes. That will protect you as well as informing the client about what happened. Liability arises if the coach can't prove that he or she used the care and judgment of a reasonable professional, regardless of whether injury occurred. So the court is going to say, would another reasonable person have done this or failed to do this? It doesn't matter if the client was injured or not. If they say you were negligent, they can sue you. Business management. This is a big snafu for a lot of people. Really important to understand in your state and in your locale what it takes to open a business. You can't just start running a business. There are paperwork. There are hoops. First, you have to get a business license. All businesses are required to get a local business license through their clerk of the court. Go to your website, go to your computer, Google whatever your county name is plus clerk of the court or business license or your county name and starting a new business in. It will tell you all the steps you need to do. It's not hard. It's just time consuming. It's important to have a contract for services. That way you're laying out everything that you will do and you can be held responsible for. And then what your client is responsible for like payment of fees of X dollars per session. And if there are any additional fees for bounce checks for failure to show up for services, anything like that it needs to be included in your contract. Liability insurance is important even if you're a coach, not a clinician. It's important if you are a personal trainer. It's important if you're a nurse. It's important if you are a professional working with people. Have liability insurance. When it comes to collecting money, make sure you give receipts to your clients and keep a copy of the receipt. If they're in arrears, don't let them get more than two payments in arrears before you start a corrective action of some sort. And that can be writing up a new contract. There are a whole bunch of different things you can do but it's important to address it before it gets out of control. And finally bartering. Generally bartering is discouraged. Really, really discouraged because again, it opens you up for liability and ethical charges and all kinds of stuff. If they think that whatever service they're providing to you is worth more than the service that you're providing to them, it can get sticky. It is really better if you're going to do something like that, which again, I advise against that you exchange money. If you are providing coaching services and exchange for four dozen eggs, I'm just guessing here, if each dozen is worth $5, so your coaching services are $20. The person pays you $20 and you give them $20 for the eggs and everybody's happy. Yes, it's smoke and mirrors, but at least it's more legitimate at that point in time. And people aren't felt like they don't feel like they're obligated to continue with that arrangement if it's not working. Dual relationships, sexual or non-professional relationships with current clients should be avoided at all times while the professional relationship exists. It's just a whole host of problems if you start getting into a sexual relationship with a client for whom you are a sponsor, a coach, or a clinician. Avoid it because when you're in one of those roles, you're in a power position and the client could easily be hurt. Remember, non-malthecence, the client could easily be hurt and could potentially sue you for negligence. It's strongly recommended to avoid dual relationships in clients with clients in perpetuity. That means once you've had somebody as a client, you are not going to be BFFs. You are not going to be business partners. You are not going to be romantic partners. It's really better that way. For coaches, it's not a legal issue at this point. It is important to consider for your own ethics and your own integrity what you feel. Health professionals licensed by the state must adhere to the code of ethics of their licensed profession. So if you happen to be a nurse and a coach or a counselor and a coach, you are obviously held to the higher standard, the more stringent laws, the more stringent ethics. Other things that you need to consider are burnout, illness, and addiction. If you start getting burned out and all of us do at a certain point in time, we can get exhausted. And I don't think I've ever met a clinician who hasn't reached a point where they're just like, oh, wow, I need a vacation. Take a vacation. Take some time off. Make sure you have a backup plan for when you are on vacation for who your clients are supposed to call. But if you keep going past that point of exhaustion, you're not going to be able to provide them the type of services that they deserve and they need. You're not going to be able to be beneficent. If you are sick, it's important not to practice. If you are under the influence of medications, if you can't think clearly, if you are not going to be on your game, so to speak, ethically, you need to consider whether you should cancel your clients for that day or even for that week. If you are starting to experience problems with addiction, this is a big one. If you are starting to experience problems with addiction, you cannot see clients. You are not in the place at that point in time where you're able to deal with life on life's terms. So you need to back up and get help before you can start working with clients who are suffering from similar issues. This is not mutual support. When you are a coach, you are actually the professional that has a little bit more power. Even though we try to keep it as a egalitarian relationship, there's a power dynamic. Recovery coaching is a profession in which the coach holds a certain amount of influence over or with another person. Coaches are required to be aware of their personal and professional limitations in providing services and must adhere to all laws in their jurisdiction. Now, I say in your jurisdiction, because you may not be in the United States of America. So whatever your jurisdiction is, you need to conform to those laws. Coaches must strive to make the most ethical decisions when faced with ethical conflicts. And it's the coach's responsibility to be aware of all relevant laws and regulations in his or her jurisdiction, including but not limited to the practice of coaching, business regulation, confidentiality, and mandatory reporting of abuse issues. Saying, well, I didn't know isn't going to get you out of trouble. So ignorance is not bliss in this case. It is definitely your responsibility to be aware of the minimum standards to which you can be held accountable. Once you're finished watching this video, please go through. There's another video to watch and read the ethical guidelines that you are going to be held accountable to. And you're going to have to sign before getting your certification. It's important to remember that adequate timely documentation is an excellent step toward providing the best services to clients and protecting yourself from legal action. Recovery and resilience ethics board is always available to answer your questions regarding ethics. You are, however, advised to consult an attorney regarding laws in your area or any legal matters about which you may have concerns.