Current through Register Vol. 41, No. 3, September 23, 2024
A. The
protection of the public health, safety, and welfare and the best interest of
the public shall be the primary guide in determining the appropriate
professional conduct of all certified practitioners who provide services to sex
offenders. Sex offender treatment providers respect the rights, dignity, and
worth of all people, regardless of the nature of one's crimes or offenses, and
are mindful of individual differences. Regardless of the delivery method,
whether in-person or by use of technology, these standards shall apply to the
practice of sex offender treatment.
B. Persons certified by the board and
applicants under supervision shall:
1.
Practice in a manner that ensures community protection and safety;
2. Provide or supervise only services and use
only techniques for which they are qualified by education, training, and
experience;
3. Accurately represent
their areas of competence, education, training, experience, professional
affiliations, credentials, and published findings to ensure that such
statements are neither fraudulent nor misleading;
4. Accurately inform sex offender clients of
(i) the purposes of an interview, testing, or evaluation session; (ii) the ways
in which information obtained in such sessions will be used before asking the
sex offender client to reveal personal information or allowing such information
to be divulged; (iii) the methods of interventions, including any experimental
methods of treatment; and (iv) the risks and benefits of any
treatment;
5. Clearly document at
the outset of service delivery what party the sex offender treatment provider
considers to be the client and what, if any, responsibilities the provider has
to all related parties. Explain to juvenile sex offender clients the rights of
their parents, legal guardians, or both to obtain information relating to the
sex offender client;
6. Maintain
current competency in the areas of practice through continuing education,
consultation, or other procedures consistent with current standards of
scientific and professional knowledge;
7. Be able to justify all services rendered
to clients as necessary for diagnostic or therapeutic purposes;
8. Avoid harming, exploiting, misusing
influence, or misleading patients or clients, research participants, students,
and others for whom they provide professional services and minimize harm when
it is foreseeable and unavoidable;
9. Maintain cooperative and collaborative
relationships with corrections, probation, or parole officers or any
responsible agency for purposes of the effective supervision and monitoring of
a sex offender client's behavior in order to assure public safety;
10. Construct, maintain, administer,
interpret, and report testing and diagnostic services in a manner and for
purposes that are current and appropriate. Sex offender treatment providers
shall consider the validity, reliability, appropriateness, and limitations of
assessments and data selected for use with sex offender clients, including to
the plethysmograph and polygraph. Where questions exist about the
appropriateness of utilizing a particular assessment with a sex offender
client, expert guidance from a knowledgeable, certified sex offender treatment
provider shall be sought;
11.
Safeguard the use of sexual arousal assessment testing and treatment materials,
due to the sensitivity of such materials in compliance with §
18.2-374.1:1
of the Code of Virginia and use them only for the purpose for which they are
intended in a controlled penile plethysmographic laboratory
assessment;
12. Not engage in
conversion therapy with any person younger than 18 years of age;
13. Withdraw from, avoid, adjust, or clarify
conflicting roles with due regard for the best interest of the affected party
and maximal compliance with these standards;
14. Neither accept nor give commissions,
rebates, or other forms of remuneration for referral of clients for
professional services. Make appropriate consultations and referrals consistent
with the law based on the interest of the patients or clients;
15. Make arrangements for another
professional to deal with emergency needs of clients during periods of
foreseeable absences from professional availability and provide for continuity
of care when services must be terminated;
16. Conduct financial responsibilities to
clients in an ethical and honest manner by:
a. Informing clients of fees for professional
services and billing arrangements as soon as is feasible;
b. Informing clients prior to the use of
collection agencies or legal measures to collect fees and provide opportunity
for prompt payment;
c. Obtaining
written consent for fees that deviate from the practitioner's usual and
customary fees for services; and
d.
Not obtaining, attempting to obtain, or cooperating with others in obtaining
payment for services by misrepresenting services provided, dates of services,
or status of treatment;
17. Design, conduct, and report research in
accordance with recognized standards of scientific competence and research
ethics. Practitioners shall adhere to requirements of §
32.1-162.18 of
the Code of Virginia for obtaining informed consent from patients prior to
involving them as participants in human research, with the exception of
retrospective chart reviews;
18.
Report to the board known or suspected violations of the laws and regulations
governing the practice of sex offender treatment providers, as well as any
information that a sex offender treatment provider is unable to practice with
reasonable skill and safety because of physical or mental impairment or
substance misuse or otherwise poses a danger to the provider, the public, or
clients;
19. Document the reasons
for and steps taken if it becomes necessary to terminate a therapeutic
relationship (e.g., when it becomes clear that the client is not benefiting
from the relationship or when the sex offender treatment provider feels
endangered). Document assistance provided in making arrangements for the
continuation of treatment for clients, if necessary, following termination of a
therapeutic relationship; and
20.
Comply with laws of the Code of Virginia and regulations of the board
applicable to the practice of sex offender treatment
providers.
C. In regard
to confidentiality, persons regulated by the board shall:
1. Inform sex offender clients of the limits
of confidentiality and any circumstances which may allow an exception to the
agreed upon confidentiality, including (i) as obligated under dual-client
situations, especially in criminal justice or related settings; (ii) when the
client is a danger to self or others; (iii) when under court order to disclose
information; (iv) in cases of suspected child or elder abuse; and (v) as
otherwise required by law or regulation;
2. Not require or seek waivers of privacy or
confidentiality beyond the requirements of treatment, training, or community
safety;
3. Keep confidential their
professional relationships with patients or clients and disclose client
information to others only with written consent except as required or permitted
by law;
4. Protect the
confidentiality in the usage of client information and clinical materials by
obtaining informed consent from the client or the client's legally authorized
representative before (i) videotaping, (ii) audio recording, (iii) permitting
third party observation, or (iv) using identifiable client information in
teaching, writing, or public presentations; and
5. Not willfully or negligently breach the
confidentiality between a practitioner and a client. A disclosure that is
required or permitted by applicable law or beyond the control of the
practitioner shall not be considered negligent or willful.
D. In regard to client records, persons
regulated by the board shall:
1. Maintain
timely, accurate, legible, and complete written or electronic records for each
client. For a sex offender treatment provider practicing in an institutional
setting, the recordkeeping shall follow the policies of the institution or
public facility. For a sex offender treatment provider practicing in a
noninstitutional setting, the record shall include:
a. The name of the client and other
identifying information;
b. The
presenting problem, purpose, or diagnosis;
c. Documentation of the fee
arrangement;
d. The date and
clinical summary of each service provided;
e. Any test results, including raw data, or
other evaluative results obtained;
f. Notation and results of formal consults
with other providers; and
g. Any
releases by the client;
2. Maintain client records securely, inform
all employees of the requirements of confidentiality, and dispose of written,
electronic, and other records in such a manner as to ensure their
confidentiality; and
3. Maintain
client records for a minimum of five years or as otherwise required by law from
the last date of service, with the following exceptions:
a. At minimum, records of a minor child shall
be maintained for five years after attaining 18 years of age;
b. Records that are required by contractual
obligation or federal law to be maintained for a longer period of time;
or
c. Records that have been
transferred pursuant to §
54.1-2405
of the Code of Virginia pertaining to closure, sale, or change of location of
one's practice.
E. In regard to dual relationships, persons
regulated by the board shall:
1. Not engage
in a dual relationship with a person under supervision that could impair
professional judgment or increase the risk of exploitation or harm. Sex
offender treatment providers shall take appropriate professional precautions
when a dual relationship cannot be avoided, such as informed consent,
consultation, supervision, and documentation to ensure that judgment is not
impaired and no exploitation occurs;
2. Not engage in sexual intimacies or a
romantic relationship with a student, supervisee, resident, intern, therapy
patient, client, or those included in collateral therapeutic services, such as
a parent, spouse, or significant other of the client, while providing
professional services. For at least five years after cessation or termination
of professional services, not engage in sexual intimacies or a romantic
relationship with a therapy patient, client, or those included in collateral
therapeutic services. Consent to, initiation of, or participation in sexual
behavior or romantic involvement with a sex offender treatment provider does
not change the exploitative nature of the conduct nor lift the prohibition.
Because sexual or romantic relationships are potentially exploitative, sex
offender treatment providers shall bear the burden of demonstrating that there
has been no exploitation, based on factors such as duration of therapy, amount
of time since therapy, termination circumstances, client's personal history and
mental status, and adverse impact on the client;
3. Not engage in a personal relationship with
a former client in which there is a risk of exploitation or potential harm or
if the former client continues to relate to the sex offender treatment provider
in the provider's professional capacity; and
4. Recognize conflicts of interest and inform
all parties of the nature and directions of loyalties and responsibilities
involved.
F. Upon
learning of evidence that indicates a reasonable probability that another
mental health provider is or may be guilty of a violation of standards of
conduct as defined in statute or regulation, persons licensed by the board
shall advise their clients of their right to report such misconduct to the
Department of Health Professions in accordance with §
54.1-2400.4
of the Code of Virginia.
Statutory Authority: §§
54.1-2400 and 54.1-3605
of the Code of Virginia.