(Downloadable template is for sample purposes only and is not distributed here for use).
As mental health professionals in Texas, obtaining informed consent from clients isn't just a legal requirement—it's a fundamental ethical obligation that protects both clients and counselors while fostering transparency and trust in the therapeutic relationship.
The Texas State Board of Examiners of Professional Counselors mandates that Licensed Professional Counselors (LPCs) obtain written informed consent from clients before initiating counseling services. This requirement is outlined in Texas Administrative Code, Title 22, Part 30, Chapter 681, which governs professional counseling practices in the state:
681.35. Informed Consent.
(a) Regardless of setting, a licensee must provide counseling only in the context of a professional relationship. Prior to providing services, a licensee must obtain from an individual a signed informed consent, signed written receipt of information, or in the case of involuntary treatment a copy of the appropriate court order, including the following:
(1) fees and arrangements for payment;
(2) counseling purposes, goals, and techniques;
(3) any restrictions placed on the license by the Council;
(4) the limits on confidentiality;
(5) any intent of the licensee to use another individual to provide counseling treatment intervention to the client;
(6) supervision of the licensee by another licensed health care professional including the name, address, contact information and qualifications of the supervisor;
(7) the name, address and telephone number of the Council for the purpose of reporting violations of the Act or this chapter; and
(8) the established plan for the custody and control of the client's mental health records in the event of the licensee's death or incapacity, or the termination of the licensee's counseling practice.
(b) A licensee must inform the client in writing of any changes to the items in subsection (a) of this section, prior to initiating the change.
(c) Prior to the commencement of counseling services to a minor client who is named in a custody agreement or court order, a licensee must obtain and review a current copy of the custody agreement or court order, as well as any applicable part of the divorce decree. A licensee must maintain these documents in the client's record and abide by the documents at all times. When federal or state statutes provide an exemption to secure consent of a parent or guardian prior to providing services to a minor, a licensee must follow the protocol set forth in such federal or state statutes.
(d) A licensee acting within the scope of employment with an agency or institution is not required to obtain a signed informed consent, but must document, in writing, that the licensee informed the client of the information required by subsection (a) of this section and that the client consented.
Essential Components of Informed Consent
A comprehensive informed consent document in Texas must include:
1. Counselor Qualifications
Professional credentials and licenses
Educational background
Areas of specialization
Therapeutic approach and methods
2. Client Rights and Responsibilities
Right to confidentiality and its limits
Right to terminate therapy
Right to access records
Responsibility for attending scheduled sessions
Payment obligations and cancellation policies
3. Confidentiality Parameters
Explanation of privileged communication
Mandatory reporting requirements
Situations requiring breach of confidentiality:
- Imminent harm to self or others
- Abuse of children, elderly, or disabled persons
- Court orders or subpoenas
- Insurance requirements
4. Practice Policies
Fee structure and payment expectations
Insurance and billing procedures
Emergency contact protocols
Communication methods and response times
Social media policies
Benefits of Proper Informed Consent
For Clients
1. Empowerment: Clients gain a clear understanding of their rights and the therapeutic process
2. Transparency: Establishes clear expectations about the counseling relationship
3. Trust Building: Creates a foundation of open communication
4. Protection: Ensures clients understand their rights and the limits of confidentiality
For Counselors
1. Legal Protection: Documents client agreement to services and understanding of policies
2. Professional Boundaries: Clearly establishes the therapeutic framework
3. Risk Management: Reduces liability and potential misunderstandings
4. Ethical Practice: Demonstrates commitment to professional standards
Best Practices for Implementation
1. Review in Person
Walk through the document with clients
Encourage questions and clarification
Ensure comprehension before signing
2. Regular Updates
Review and update consent forms annually
Obtain new consent when significant changes occur
Document all updates and reviews
3. Accessibility
Use clear, understandable language
Provide translations when necessary
Offer large print or alternative formats as needed
4. Documentation
Maintain signed copies in client records
Document verbal discussions about consent
Keep records of any amendments or updates
Consequences of Non-Compliance
Failing to obtain proper informed consent can result in:
Disciplinary action from the Texas State Board
Legal liability
Ethical violations
Damaged therapeutic relationships
Potential malpractice claims
Conclusion
Informed consent is more than a regulatory requirement—it's a cornerstone of ethical counseling practice that protects all parties involved. By implementing thorough informed consent procedures, counselors in Texas demonstrate their commitment to professional excellence while creating a foundation for successful therapeutic relationships.
Getting informed consent right from the start sets the stage for a transparent, ethical, and effective counseling relationship. It's an investment in professional practice that pays dividends in client trust, legal protection, and therapeutic success.
Remember: Always consult with legal professionals or professional organizations for the most current requirements and recommendations regarding informed consent in Texas.
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