While professionals agree that counseling services must be documented, there remains
disagreement about what the documentation should include. This presentation will review the
foundational ethical guidelines for documentation from the AACC and other mental health
ethics codes. Legal responsibilities of documentation reflected in HIPAA will also be reviewed.
The two presenters have a combined experience of more than 45 years in counseling, quality
assurance, and past service on a state licensing board. Bringing together the ethical and legal
standards, literature related to documentation, and this wealth of experience, the presenters
will share practical guidelines for clinicians on what should and should not be included in
mental health records.
Presented by: James Dalton, Ph.D. & Mike Cravens, Ed.D.
- Apply ethical and legal standards in their mental health documentation
- List types of information that should always be documented in a mental health record
- Describe the type of information that should not be documented in a mental health record