Chapter 4757-5 | Code of Ethics

Rule 4757-5-01 | Standards of ethical practice and professional conduct.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) The code of ethical practice and professional conduct constitutes the standards by which the professional conduct of licensees and registrants shall be measured. Each subject area is in a separate rule within Chapter 4757-5 of the Administrative Code.

(B) The rules of standards of ethical practice and conduct shall, unless otherwise indicated, apply to the conduct of all licensees and registrants.

(C) A violation of these rules of standards of ethical practice and professional conduct constitutes unprofessional conduct and is sufficient reason for a reprimand, suspension, revocation, other disciplinary action, or for restrictions placed upon a license or for the denial of the initial license or renewal, or reinstatement of a license.

(D) The board subscribes to codes of ethics and practice standards for counselors, social workers, and marriage and family therapists promulgated by the "American Counseling Association," "National Association of Social Workers," "American Association for Marriage and Family Therapy," "American Music Therapy Association," "Ceritification Board for Music Therapists," "American Art Therapy Association," and "Art Therapy Credentials Board." These association standards shall be used as aids in resolving ambiguities which may arise in the interpretation of the rules of professional ethics and conduct, except that the board's rules of standards of ethical practice and professional conduct shall prevail whenever any conflict exists between these rules and the professional association standards.

Last updated July 2, 2024 at 10:24 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 7/1/2029
Prior Effective Dates: 1/1/2006, 10/18/2009

Rule 4757-5-02 | Standards of ethical practice and professional conduct: clients/consumers of services.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Responsibility to clients/consumers of services as to competency:

(1) Licensees and registrants shall be able to present reliable and substantial evidence of competency in the areas in which they practice. Licensees and registrants shall not misrepresent directly, indirectly or by implication their professional qualifications such as education, specialized training, experience, or area(s) of competence. Licensees or registrants shall not use a doctorate designation in their professional capacity unless it is related to the field of mental health and is from a recognized accredited educational institution.

(2) Licensees and registrants shall practice only within the competency areas for which they are qualified by education and training. Licensees and registrants shall maintain appropriate standards of care based on their individual professional license. Standards of care shall be defined as what an ordinary, reasonable professional with similar training would have done in a similar circumstance.

(3) While developing new skills in specialty areas, a licensee or registrant of the board shall take steps to ensure the competence of their work and to protect the clients from possible harm. A licensee or registrant shall claim skills in specialty areas only after appropriate education, training, and while receiving appropriate peer consultation.

(4) Licensees and registrants do not diagnose, treat, or advise on problems outside the recognized boundaries of their competencies and scope of practice. Licensees and registrants shall make appropriate referrals when the client's needs exceed the licensee's or registrant's competence level or scope of practice. The referrals shall be made in a timely manner.

(5) All licensees or registrants of the board, in accordance with their scope of practice and competence level, shall use techniques/ procedures/ modalities in diagnosing and treating mental and emotional disorders that are grounded in theory and/or have an empirical or scientific foundation, otherwise, they shall define the techniques/ procedures as "unproven" or "developing" and explain to their clients the potential risks and ethical considerations of using such techniques/ procedures and take steps to protect clients from possible harm. Individuals licensed at the level of professional counselor, social worker and marriage and family therapist shall diagnose and treat mental and emotional disorders only under proper supervision.

(B) Responsibility to clients/consumers of services as to informed consent:

(1) Licensees or registrants of the board shall inform clients/consumers of services the extent and nature of services available to them, as well as the limits, rights, opportunities and obligations associated with the services to be provided which might effect the clients/consumers of services decisions to enter into or continue the relationship.

(2) Licensees and registrants shall provide services to clients only in the context of a professional relationship based on valid informed consent. Licensees and registrants shall use clear and understandable language to inform clients of the purposes of services, limit to the services due to legal requirements, relevant costs, reasonable alternatives, the clients' rights to refuse or withdraw consent, and the timeframe covered by the consent.

(3) In instances when clients are unable to read or understand the consent document or have trouble understanding the primary language contained in the informed consent document, licensees shall take steps to ensure the client's comprehension including providing a detailed verbal explanation or arranging for a qualified interpreter or translator as needed. If a client because of age or mental condition is not competent to provide informed consent, the licensee shall obtain consent from the parent, guardian, or court appointed representative.

(4) When licensees and registrants provide services in public settings, such as, but not limited to hospital rooms, residential or institutional settings, or similar locations where confidentiality cannot be maintained, the licensee or registrant shall obtain written consent from the client or guardian, or verbal consent if written consent is not possible, prior to providing services. Verbal consent must be documented by the licensee or registrant.

(5) Best professional practice dictates that a licensee or registrant of the board shall adhere to the court documents provided such documents do not conflict with Chapter 4757. of the Revised Code or agency 4757 of the Administrative Code. If a counselor, social worker, or marriage and family therapist does not understand the court document, they shall attempt to gain clarification before proceeding with treatment.

(6) Licensees and registrants, as part of the on-going informed consent process, shall obtain any relevant court documents pertaining to custody, visitation, shared parenting, guardianship, or other matters, before proceeding with treatment.

(7) In situations when clients are receiving services involuntarily, licensees and registrants shall provide information about the nature and extent of the services and about the client's right to refuse services and the consequences of that refusal.

(8) Licensees or registrants of the board who provide services via electronic means shall inform the clients and recipients of the limitations and risks associated with such services.

(9) Licensees and registrants should not duplicate professional services to a current or prospective client who is receiving treatment from another licensee or registrant of the board, or professional licensed by another board with a similar scope of practice. When a client discloses that they are receiving treatment from another licensed professional for the same or similar presenting issues, to minimize potential confusion in treatment and avoid duplicate billing, licensees and registrants should consider the client's needs and the nature of the presenting treatment issues prior to providing services or treatment. The licensee or registrant must discuss these issues with the prospective client. The licensee or registrant should consult with the other professional providing services to ensure coordination of care. Determining the appropriateness of potential duplication of services is required regardless of the funding source for client treatment.

(10) When a licensee or registrant provides services to two or more clients who have a relationship with each other and who are aware of each other's participation in treatment (for example couples, family members), a licensee or registrant shall clarify with all parties the nature of the licensee's professional obligations to the various clients receiving services, including limits of confidentiality. A counselor, social worker, or marriage and family therapist who anticipates a conflict of interest among the clients receiving services or anticipates having to perform in potentially conflicting roles (for example a licensee who is asked or ordered to testify in a child custody dispute or divorce proceeding involving clients) shall clarify their role with the parties involved and take appropriate action to minimize any conflict of interest.

(11) When a licensee or registrant sees clients for individual or group treatment, there may be reason for a third party to join the session for a limited purpose. The licensee shall ask the client or legal guardian to provide written authorization that describes the purpose and need for the third party to join the session and describes the circumstances and extent to which confidential information may be disclosed to the third party. The licensee or registrant shall make it clear that the third party is not a client and there is no confidentiality between the licensee and the third party. The licensee or registrant shall make it clear to the third party that the third party shall not have rights to access any part of the client's file including any session in which they participated unless the client signs a release. A licensee or registrant shall not make recommendations to courts, attorneys or other professional concerning non-clients.

(12) When a court or other judicial body orders an evaluation, assessment or other official report, the licensee shall inform the client of the parameters of the court order. The counselor, social worker, or marriage and family therapist shall not go beyond the parameters of the court order without obtaining written permission from the court or other judicial body.

(13) Licensees and registrants shall only make recommendations concerning a client to a court, attorney or other professional. Licensees and registrants shall not diagnose or make a recommendation regarding any person who is not a client.

(14) Licensees and registrants shall communicate information in ways that are both developmentally and culturally appropriate. Licensees and registrants shall use clear and understandable language when discussing issues related to informed consent. When clients have difficulty understanding the language used by the licensee or registrant, they shall provide necessary services (e.g., arranging for a qualified interpreter or translator) to ensure comprehension by clients. In collaboration with clients, licensees and registrants shall consider cultural implications of informed consent procedures and, where possible, licensees and registrants shall adjust their practices accordingly.

(C) Responsibility to clients/consumers of services as to delegation: Licensees and registrants shall delegate professional responsibilities to another person only when the licensee delegating the responsibilities knows that the task is within the person's scope of practice and the person qualifies by training, experience and/or licensure to perform them.

(D) Responsibility to clients/consumers of services as to confidentiality:

(1) Licensees and registrants shall have a primary obligation to protect the client's right to confidentiality as established by law and the professional standards of practice. Confidential information shall only be revealed to others when the clients or other persons legally authorized to give consent on behalf of the clients, have given their informed consent, except in those circumstances in which failure to do so would violate other laws or result in clear and present danger to the client or others. Unless specifically contraindicated by such situations, clients shall be informed and written consent shall be obtained before the confidential information is revealed.

(2) Licensees and registrants shall discuss with clients and the clients' legally authorized representatives, the nature of confidentiality and the limitation of clients' right to confidentiality. Licensees and registrants shall review with clients circumstances where confidential information may be requested and where disclosure of confidential information is legally required. This discussion shall occur as soon as possible in the professional relationship and as needed throughout the course of the relationship.

(3) When licensees and registrants, within their scope of practice, provide counseling services to families, couples, or groups, licensees and registrants shall seek agreement among the parties involved concerning each individual's right to confidentiality and obligations to preserve the confidentiality of information shared by others. Licensees and registrants shall inform participants in family, group, or couples counseling that the licensee cannot guarantee that all participants shall honor such agreements.

(4) Licensees and registrants shall take reasonable and appropriate steps to protect the confidentiality of information transmitted to other parties when using computers, electronic mail, facsimile machines, telephones and telephone answering machines, and other electronic or computer technology.

(5) Licensees and registrants shall explain the required limitations of confidentiality imposed by a mandating authority when working with clients who have been mandated for counseling services. Licensees shall also explain what type of information and with whom that information is shared prior to the beginning of counseling. The mandated client has the right to refuse services and the licensee shall, to the best of their ability, explain the consequences possibly imposed by the mandating authority of refusing the counseling services.

(6) Licensees and registrants should not use identifiable information, any videos or pictures of clients, or pictures, videos, or other representations of work product created during treatment in advertisements, social media, or other promotional materials without the written consent of the client or guardian. The consent should outline the terms of use, including but not limited to the media for distribution and time period of potential use, as well as the process for terminating consent. In obtaining consent, licensees and registrants must clearly communicate that consent is voluntary.

(E) Responsibility to clients/consumers of services as to termination:

(1) Licensees and registrants shall terminate services only after giving careful consideration to factors affecting the relationship and making effort to minimize possible adverse effects. If an interruption or termination of services is anticipated, reasonable notification and appropriate referral for continued services shall be provided to the client/consumer of services.

(2) Licensees and registrants employed by or contracted with an agency or practice, when leaving the agency or practice, shall offer referrals to the client. The referral shall include multiple options for the client to choose from, and the agency where the client is currently being seen shall be included as an option, the licensee's new practice location or agency may be one of the multiple options. A licensee or registrant shall not offer their new practice or agency location as the sole referral for services upon termination. Licensees and registrants are prohibited from soliciting former clients of the agency or practice.

(3) In the event that a licensee or registrant is terminated for cause from a position as a volunteer or paid licensee, it is not the responsibility of the licensee or registrant to provide continuation of services or appropriate referrals. Licensees and registrants who are terminated for cause shall not contact their ex-clients.

(F) Responsibility to clients/consumers of services as to sexual harassment: Licensees and registrants shall not sexually harass clients/consumers of services family members of clients, ex-clients or other persons encountered in professional settings. Licensees shall not sexually harass supervisees, students, or colleagues. Sexual harassment includes sexual advances, sexual solicitation, requests for sexual favors, and other verbal, non-verbal or physical conduct of a sexual nature. A client of the agency is considered a client of each licensee and registrant employed or contracted by the agency for purposes of ethics under the sexual harassment section of this chapter. The duty of the licensee or registrant is based on that particular clinician's knowledge of a client's identity prior to starting a relationship.

(G) Responsibility to clients/consumers of services as to discrimination:

(1) Licensees and registrants shall not practice, condone, facilitate or collaborate with any form of discrimination on the basis of age, sex, gender identity and expression, sexual orientation, race, ethnicity, national origin, immigration status, disability, religion, language, culture, veteran status, marital status, political belief, housing status, and socioeconomic status.

(2) Licensees and registrants should obtain education about and seek to understand the nature of diversity with respect to age, sex, gender identity and expression, sexual orientation, race, ethnicity, national origin, immigration status, disability, religion, language, culture, veteran status, marital status, political belief, housing status, and socioeconomic status.

(H) Responsibility to clients/consumers of services as to conduct with clients and other individuals:

(1) Licensees and registrants shall not physically or verbally abuse or threaten clients, family members of clients, ex-clients or other persons encountered in professional settings. Licensees and registrants shall be aware that any physical touching between the professional and the client is subject to review for appropriate professional boundaries. Any physical touching must occur with the consent of the client and be within practice standards at the time services are rendered. The licensee shall have the burden of proof to explain why physical touching was professionally necessary.

(2) Licensees and registrants shall not use derogatory language in their written or verbal communications to or about clients, ex-clients or family members of clients or ex-clients. Licensees and registrants shall use accurate and respectful language in all communications to and about clients and other persons in professional settings.

(I) Licensed independent social workers, professional clinical counselors, and independent marriage and family therapists shall provide appropriate supervision to dependent licensees, registrants, or certificate holders whom they are assigned to supervise. This shall include ensuring all supervision documentation is provided to the appropriate board in a timely fashion and meeting with the supervisee on a regular basis to discuss the specific issues in the dependent supervisee's practice. Supervisors shall be accurate and timely with all supervision reporting. Supervisors shall not sign as the training supervisor, if they did not provide direct supervision. Licensed independent social workers, professional clinical counselors, and independent marriage and family therapists who enter into an agreement to provide clinical or training supervision to a licensee, registrant, or certificate holder may be subject to discipline if the licensee fails to fulfill the terms of the agreement.

(J) Licensees may not accept art materials from clients. Any materials used during sessions that are provided by the client must be returned to the client at the conclusion of treatment. Materials abandoned by the client may be retained and used if the licensee has documented multiple attempts to return the materials.

(K) Art or music produced by a client shall be the property of the client or clients in the case of group therapy, regardless of the contribution to or role of the licensee or registrant in the production of the art or music product.

(L) Art therapists must provide a safe and functional environment in which to offer art therapy services. This includes, but is not limited to proper ventilation, adequate lighting, and access to water supply for hand washing and material clean up.

(M) Art therapists must be aware of the hazards or toxicity of art materials and use only those materials or techniques that can be used safely in the environment in which services are being provided, and to whom the services are provided.

Last updated July 2, 2024 at 10:24 AM

Supplemental Information

Authorized By: 4757.10
Amplifies: 4757.11
Five Year Review Date: 12/26/2028
Prior Effective Dates: 9/19/1985 (Emer.), 8/2/2001, 9/20/2002, 4/10/2004, 11/8/2007

Rule 4757-5-03 | Standards of ethical practice and professional conduct: multiple relationships.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Counselors, social workers, or marriage and family therapists shall avoid multiple relationships and conflicts of interest with any client/consumer-of-services, ex-clients, family members of clients or ex-clients, or other persons encountered in professional or non-professional setting, which are not in the best interest of the client and might impair professional judgment or which increases the risk of client/consumer-of-services exploitation.

(1) When a multiple relationship is first recognized or cannot be avoided, licensees and registrants shall take the following appropriate professional precautions:

(a) All potential multiple relationship and/or conflicts of interest shall be discussed with the client as soon as possible after being first recognized and shall continue only with both parties agreement;

(b) All multiple relationships and/or conflicts of interest shall be noted in the client record with reasoning as to why it is in the best interest of the client and/or not harmful;

(c) Such notation shall be continually reassessed and justified in the record;

(d) Issues such as informed consent, consultation, and supervision shall be considered to ensure that judgment is not impaired and that no exploitation occurs.

(2) A client of the agency is considered a client of each licensee or registrant employed or contracted by the agency for purposes of ethics under the multiple relationships rule of this chapter.

(3) The licensed professional shall not undertake or continue a professional relationship with a client/consumer-of-services when the objectivity or competency of the licensee or registrant is, or could reasonably be expected to be, impaired or where the relationship with the client/consumer-of-services is exploitative.

(4) Examples of multiple relationships that shall be avoided include but are not limited to those listed in this paragraph.

(a) Familial relationships;

(b) Social relationships;

(c) Emotional relationships;

(d) Business and financial relationships;

(e) Supervisory relationships;

(f) Political relationships;

(g) Administrative relationships; and/or

(h) Legal relationships;

(i) Social media/personal virtual relationships, including online communities.

(5) The list of relationships in paragraph (A)(4) of this rule as well as others require careful consideration to ensure that impaired judgment or exploitation is not involved and that the best interest of the client is served at all times.

(6) Licensees and registrants should decline gifts. Gifts from a client may be considered as establishing a multiple relationship. Examples of gifts may include but are not limited to food, material goods, gift certificate/gift card, artwork or products resulting from treatment. A licensee may accept a gift of nominal value if the licensee determines that for treatment reasons not accepting the gift will result in diminishing the licensee's ability to provide appropriate client care. In accepting a gift of nominal value, the license must discuss with the client the ethical limitations of accepting gifts. The licensee shall have the burden of proof to explain why a gifted was accepted.

(B) Licensees and registrants shall avoid potentially harmful effects of non-client contacts on their practice that would reasonably impair the professional's objectivity or otherwise interfere with the professional's effectiveness as a licensee or registrant or would reasonably harm or exploit the other party. The standard to be used shall be what an ordinary, reasonable professional with similar education and training would have considered in similar circumstances.

(C) Licensees and registrants should adhere to paragraph (B)(6) of rule 4757-5-13 of the Administrative Code regarding internet searches for information about current or prospective clients.

(D) When licensees and registrants provide services to two or more people who have a relationship with each other (for example couples, family members), licensees and registrants shall clarify with all parties which individuals shall be considered clients and the nature of the licensee's professional obligations to the various individuals who are receiving services. Licensees and registrants, who anticipate a conflict of interest among the individuals receiving services or who anticipate having to perform in potentially conflicting roles (for example, a licensee who is asked or ordered to testify in a child custody dispute or divorce proceeding involving clients), shall clarify their role with the parties involved and take appropriate action to minimize any conflict of interest. If a licensee is asked to testify in a child custody case, they should review rule 4757-6-01 of the Administrative Code prior to any court appearance for guidance as to their role in these circumstances.

Last updated July 2, 2024 at 10:26 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 7/1/2029
Prior Effective Dates: 7/3/1997, 10/18/2009, 1/1/2013

Rule 4757-5-04 | Standards of ethical practice and professional conduct: sexual relationships.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Licensees and registrants of the counselor, social worker, and marriage and family therapist board shall not engage in sexual relations with current clients, whether such contact is consensual or forced. A client of the agency is considered a client of each licensee or registrant employed or contracted at the agency for purposes of ethics under the sexual relationships section of this chapter. The duty of the licensee is based on that particular licensee's knowledge of a client's identity prior to starting a relationship.

(B) Licensees and registrants shall not have sexual relations with clients and shall not counsel persons with whom they have had a sexual relationship.

(C) Licensees and registrants shall not engage in sexual relations with former clients within a minimum of five years after terminating the therapeutic relationship. Licensees and registrants who choose to engage in such a relationship after a minimum of five years following termination have the responsibility to thoroughly examine and document in the clients record that such a relationship does not have an exploitative nature, based upon factors such as duration of therapy, amount of time since therapy, termination circumstances, client's personal history and mental status, adverse impact on the client, power differentials, and actions by the professional suggesting a plan with the client after termination.

(D) A client of the agency is considered a client of each licensees or registrants employed or contracted by the agency for purposes of ethics under the sexual harassment, multiple relationships and sexual relationships sections of this rule. Licensees and registrants shall not engage in sexual activities or sexual contact with clients' relatives or other individuals with whom clients maintain a close personal relationship when there is a risk of exploitation or potential harm to the client. Sexual activity or sexual contact with clients' relatives or other individuals with whom the client maintains a personal relationship has the potential to be harmful to the client and may make it difficult for the licensee or registrant to maintain appropriate professional boundaries. Licensees and registrants, not their clients, their clients' relatives, or other individuals with whom the client maintains a personal relationship assume the full burden for setting clear, appropriate, and culturally sensitive boundaries. The duty of the licensee is based on that particular licensee's knowledge of a client's identity prior to starting a relationship.

Last updated July 2, 2024 at 10:27 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 12/26/2028
Prior Effective Dates: 9/19/1985 (Emer.), 12/19/1985, 9/3/2018, 12/26/2023

Rule 4757-5-05 | Standards of ethical practice and professional conduct: impaired practice.

• Effective: July 1, 2024
• Promulgated Under: 119.03

In impaired practice situations: licensees and registrants shall not undertake or continue professional relationships with a client, supervisee, or student when the objectivity or competency of the licensee or registrant is or could reasonably be expected to be, impaired due to mental, emotional, physiological, pharmacological, or substance abuse conditions. If such a condition develops after a professional relationship has been initiated, the licensee or registrant shall terminate the professional relationship in an appropriate manner, shall notify the client of termination in writing, and shall assist the client in obtaining services from another professional.

Last updated July 2, 2024 at 10:29 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 7/1/2029
Prior Effective Dates: 6/11/1985 (Emer.), 7/3/1997, 1/1/2006

Rule 4757-5-06 | Standards of ethical practice and professional conduct: assessment and testing instruments.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) General use of assessment and testing instruments:

(1) Appraisal techniques: The primary purpose of educational and psychological assessment is to provide measures that are objective and interpretable in either comparative or absolute terms. licensees and registrants shall interpret the statements in this rule as applying to the whole range of appraisal techniques, including test and non-test data.

(2) Client welfare: Licensees and registrants shall promote the welfare and best interests of the client in the development, publication, and utilization of educational and psychological assessment results and interpretations and take reasonable steps to prevent others from misusing the information these techniques provide. They shall respect the client's rights to know the results, of the interpretations made, and the bases for their conclusions and recommendations.

(B) Competence to use and interpret assessment and testing instruments:

(1) Limits of competence: Licensees and registrants shall recognize the limits of their competence and perform only those testing and assessment services for which they have training. They shall be familiar with reliability, validity, related standardization, error of measurement, and proper application of any technique utilized. licensees and registrants using computer-based test interpretations shall be trained in the construct being measured and the specific instrument being used prior to using this type of computer application. licensees and registrants shall take reasonable measures to ensure the proper use of psychological assessment techniques by persons under their supervision.

(2) Appropriate use: Licensees and registrants are responsible for the appropriate selection, application, scoring, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use computerized or other services.

(3) Decisions based on results: Licensees and registrants responsible for decisions involving individuals or policies that are based on assessment results shall have a thorough understanding of educational and psychological measurement, including validation criteria, test research, and guidelines for test development and use.

(4) Accurate information: Licensees and registrants shall provide accurate information and shall not make false claims when making statements about assessment instruments or techniques. licensees and registrants shall seek to identify and correct client misconceptions about assessment instruments or techniques and about the meaning of scores, charts, or graphs given to them as assessment product. Special efforts shall be made to avoid unwarranted connotations of such terms as "IQ" and grade equivalent scores.

(C) Informed consent in the use of assessment and testing instruments:

(1) Explanation to clients: Prior to assessment, licensees and registrants shall explain the nature and purposes of assessment and the specific use of results in language the client (or other legally authorized person on behalf of the client) can understand, unless an explicit exception to this right has been agreed upon in advance. Regardless of whether scoring and interpretation are completed by counselors, social workers, marriage and family therapists, by assistants, or by computer or other outside services, licensees and registrants shall take reasonable steps to ensure that appropriate explanations are given to the client.

(2) Recipients of results: The examinee's welfare, explicit understanding, and prior agreement shall determine the recipients of test results. Licensees and registrants shall include accurate and appropriate interpretations with any release of individual or group test results.

(D) Release of information to competent professionals of assessment and testing instrument results:

(1) Misuse of results: Licensees and registrants shall not misuse assessment results, including test results, and interpretations, and take reasonable steps to prevent the misuse of such by others.

(2) Release of raw data: Licensees and registrants shall ordinarily release data (e.g. protocols, counseling or interview notes, or questionnaires) in which the client is identified only with the consent of the client or the client's legal representative. Such data shall usually be released only to persons recognized by licensees and registrants as competent to interpret the data.

(E) Proper diagnosis of mental disorders with the use of assessment and testing instruments:

(1) Proper diagnosis: Licensees and registrants, shall take special care to provide accurate diagnosis of mental disorders. Assessment techniques (including personal interview) used to determine client care (e.g., locus of treatment, type of treatment or recommended follow-up) shall be carefully selected and appropriately used.

(2) Cultural sensitivity: Licensees and registrants, shall recognize that culture affects the manner in which client's problems are defined. Clients' socioeconomic and cultural experience shall be considered when diagnosing mental disorders.

(F) Test selection in the use and interpretation of assessment and testing instruments:

(1) Appropriateness of instruments: Licensees and registrants shall carefully consider the validity, reliability, psychometric limitations and appropriateness of instruments when selecting tests for use in a given situation or with a particular client.

(2) Culturally diverse populations: Licensees and registrants recognize that the psychometric characteristics of a test (e.g., reliability, validity) are a function of the cultural composition of the population in which they were evaluated, validated, or normed. Licensees shall exercise due diligence in selecting tests to be used within a culturally diverse population in order to minimize the risk of inappropriate interpretation of test scores.

(G) Conditions of test administration when using assessment and testing instruments:

(1) Administration conditions: Licensees and registrants shall administer tests under the same conditions that were established in their standardization. When tests are not administered under standard conditions or when unusual behavior or irregularities occur during the testing session, those conditions shall be noted in interpretation, and the results may be designated as invalid or of questionable validity.

(2) Computer administration: Licensees and registrants shall be responsible for ensuring that assessment administration programs function properly to provide clients with accurate results when a computer or other electronic methods are used for test administration.

(3) Unsupervised test-taking: Licensees and registrants shall not permit unsupervised or inadequately supervised use of tests or assessments unless the tests or assessments are designed, intended, and validated for self administration and/or scoring.

(4) Disclosure of favorable conditions: Prior to test administration, conditions that produce most favorable test results shall be made known to the examinee.

(H) Diversity when using assessment and testing instruments: Licensees and registrants shall be cautious in using assessment techniques, making evaluations, and interpreting the performance of populations not represented in the norm group on which an instrument was standardized. They shall recognize the effects of age, culture, disability, ethnic group, gender, race, religion, sexual orientation and socioeconomic status on test administration and interpretation and place test results in proper perspective with these and other relevant factors.

(I) Test scoring and interpretation when using assessment and testing instruments:

(1) Reporting reservations: In reporting assessment results, Licensees and registrants, shall indicate any reservations that exist regarding validity or reliability because of the circumstances of the assessment or the inappropriateness of the norms for the person tested.

(2) Research instruments: Licensees and registrants shall exercise caution when interpreting the results of research instruments possessing insufficient technical data to support respondent results. The specific purposes for the use of such instruments shall be stated explicitly to the examinee.

(3) Testing services: Licensees and registrants who provide test scoring and test interpretation services to support the assessment process shall confirm the validity of such interpretations. They shall accurately describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use. The public offering of an automated test interpretations service is considered a professional-to-professional consultation. The formal responsibility of the consultant is to the consultee, but the ultimate and overriding responsibility of the counselor, marriage and family therapist, or social worker is to the client.

(J) Test security when using assessment and testing instruments: Licensees and registrants shall maintain the integrity and security of tests and other assessment techniques consistent with legal and contractual obligations. licensees and registrants shall not appropriate, reproduce, or modify published tests or parts thereof without acknowledgment and permission from the publisher.

(K) Obsolete tests and outdated test results when using assessment and testing instruments: Licensees and registrants shall not use data or test results that are obsolete or outdated for the current purpose. licensees and registrants shall make every effort to prevent the misuse of obsolete measures and test data by others.

(L) Test construction for assessment and testing instruments: Licensees and registrants shall use established scientific procedures, relevant standards, and current professional knowledge for test design in the development, publication, and utilization of educational and psychological assessment techniques.

Last updated July 2, 2024 at 10:30 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 7/1/2029
Prior Effective Dates: 9/19/1985 (Emer.), 5/22/1986, 9/20/2002, 1/1/2006, 9/3/2018

Rule 4757-5-07 | Standards of ethical practice and professional conduct: research and publication.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Responsibilities in conducting research:

(1) Use of human subjects: Licensees and registrants shall plan, design, conduct, and report research in a manner consistent with pertinent ethical principles, federal and state laws, host institutional regulations, and scientific standards governing research with human subjects. Licensees and registrants shall design and conduct research that reflects cultural sensitivity appropriateness.

(2) Deviation from standard practices: Licensees and registrants shall seek consultation and observe stringent safeguards to protect the rights of research participants when a research problem suggests a deviation from standard acceptable practices.

(3) Precautions to avoid injury: Licensees and registrants who conduct research with human subjects are responsible for the subjects' welfare throughout the experiment and shall take reasonable precautions to avoid causing injurious psychological, physical, or social effects to their subjects. Licensees and registrants shall warn clients of any possible harm that might come from being involved in a research project.

(4) Principal researcher responsibility: The ultimate responsibility for ethical research practice lies with the principal researcher. All others involved in the research activities share ethical obligations and full responsibility for their own actions.

(5) Minimal interference: Licensees and registrants shall take reasonable precautions to avoid causing disruptions in subjects' lives due to participation in research.

(6) Diversity: Licensees and registrants shall be sensitive to diversity and research issues.

(B) Informed consent in conducting research and publishing:

(1) Topics disclosed: In obtaining informed consent for research, licensees and registrants shall use language that is understandable to research participants and that:

(a) Accurately explain the purpose and procedures to be followed;

(b) Identify any procedures that are experimental or relatively untried;

(c) Describe the attendant discomforts and risks;

(d) Describe the benefits or changes in individuals or organizations that might be reasonably expected;

(e) Disclose appropriate alternative procedures that would be advantageous for subject:

(f) Offer to answer any inquiries concerning the procedures;

(g) Ascribe any limitations on confidentiality, and;

(h) Instruct that subjects are free to withdraw their consent and discontinue participation in the project at any time.

(2) Deception: Licensees and registrants shall not conduct research involving deception unless alternative procedures are not feasible and the prospective value of the research justifies the deception. When the methodological requirements of a study necessitate concealment or deception, the investigator shall explain clearly the reasons for this action as soon as possible.

(3) Voluntary participation: Licensees and registrants shall ensure that participation in research is voluntary and without any penalty for refusal to participate. Involuntary participation shall be appropriate only when investigators can demonstrate that participation shall have no harmful effects on subjects and is essential to the investigation.

(4) Confidentiality of information: Licensees and registrants shall be responsible for ensuring information obtained about research participants during the course of an investigation is confidential. When the possibility exists that others may obtain access to such information, ethical research practice requires that the possibility, together with the plans for protecting confidentiality, shall be explained to participants as a part of the procedure for obtaining informed consent.

(5) Persons incapable of giving informed consent: When a person is not capable of giving informed consent, counselors, social workers and marriage and family therapists shall provide an appropriate explanation, obtain agreement for participation and obtain appropriate consent from a legally authorized person.

(6) Commitments to participants: Licensees and registrants shall take reasonable measures to honor all commitments to research participants.

(7) Explanations after data collections: After data is collected, licensees and registrants shall provide participants with full clarifications of the nature of the study to remove any misconceptions. Where scientific or human values justify delaying or withholding information, counselors, social workers and marriage and family therapists shall take reasonable measures to avoid causing harm.

(8) Agreements to cooperate: Licensees and registrants who agree to cooperate with another individual in research or publication incur an obligation to cooperate as promised in terms of punctuality of performance and with regard to the completeness and accuracy of the information required.

(9) Informed consent for sponsors: In the pursuit of research, licensees and registrants shall give sponsors, institutions, and publication channels the same respect and opportunity for giving informed consent that they accord to individual research participants. Licensees and registrants shall be aware of their obligation to future research workers and ensure that host institutions are given feedback information and proper acknowledgment.

(C) Reporting results of research and publishing:

(1) Information affecting outcome: When reporting research results, licensees and registrants shall explicitly mention all variables and conditions known to the investigator that may have affected the outcome of a study or the interpretation of this data.

(2) Accurate results: Licensees and registrants shall plan, conduct and report research accurately and in a manner that minimizes the possibility that results will be misleading. They shall provide thorough discussions of the limitations of their data and alternative hypotheses. Licensees and registrants shall not engage in fraudulent research, distort data, misrepresent data, or deliberately bias their results.

(3) Obligation to report unfavorable results: Licensees and registrants shall communicate to other licensees and registrants the results of any research judged to be of professional value. Results that reflect unfavorably on institutions, programs, services, prevailing opinions, or vested interests shall not be withheld.

(4) Identity of subjects: Licensees and registrants who supply data, aid in the research of another person, report research results, or make original data available shall take due care to disguise the identity of respective subjects in the absence of specific authorization from the subjects to do otherwise.

(5) Replication studies: Licensees and registrants shall make available sufficient original research data to qualified professionals who may wish to replicate the study.

(D) Publication of research results:

(1) Recognition of others: When conducting and reporting research, licensees and registrants shall be familiar with, and give recognition to, previous work on the topic, observe copyright laws, and give full credit to those to whom credit is due.

(2) Contributors: Licensees and registrants shall give credit through joint authorship, acknowledgment, footnote statements, or other appropriate means to those who have contributed significantly to research or concept development in accordance with such contributions. The principal contributor shall be listed first and minor technical or professional contributions shall be acknowledged in notes or introductory statements.

(3) Student research: For an article that is substantially based on a student's dissertation or thesis, the student shall be listed as the principal author.

(4) Duplicate submission: Licensees and registrants shall submit manuscripts for consideration to only one journal at a time. Manuscripts that are published in whole or in substantial part in another journal or published work shall not be submitted for publication without acknowledgment and permission from the previous publication.

(5) Professional review: Licensees and registrants who review material submitted for publication, research, or other scholarly purposes shall respect the confidentiality and proprietary rights of those who submitted it.

Last updated July 2, 2024 at 10:30 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 7/1/2029
Prior Effective Dates: 4/10/2004, 1/1/2006

Rule 4757-5-08 | Standards of ethical practice and professional conduct: payment for services.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Payment for services: When setting fees, licensees and registrants shall ensure that the fees are fair, reasonable, and commensurate with the services performed.

(B) Licensees and registrants shall not accept goods or services as payment for professional services. Bartering is prohibited.

(C) Licensees and registrants shall not solicit a private fee or other remuneration for providing services to clients who are entitled to such available services through the license's or registrant's employer or agency.

Last updated July 2, 2024 at 10:31 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 7/1/2029
Prior Effective Dates: 9/19/1985 (Emer.), 7/3/1997, 9/20/2002

Rule 4757-5-09 | Standards of ethical practice and professional conduct: record keeping.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Record keeping requirements: For each client/consumer of services, a licensee or registrant shall keep records and case notes of the dates of counseling, social work, marriage and family therapy, art therapy, and music therapy services; types of counseling, social work, marriage and family therapy, art therapy, or music therapy services; and billing information. Records held by the licensee shall be kept for seven years. Records held or owned by government agencies or educational institutions are not subject to this requirement. Licensees shall keep all records in a secure location and shall allow only authorized persons access to records.

(B) Licensees and registrants shall take reasonable steps to ensure that documentation in records is accurate and reflects the services provided. Dates reflected in case notes shall be accurate with respect to dates of service and dates the case notes were recorded. Clinical records shall include but not be limited to appropriate diagnosis, if any; treatment plan, revisions to the treatment plan, correspondence, individual service plans, in-take assessments, informed consent documents, and releases of information documents. All notes regarding a client(s) must be developed and approved by the licensee or registrant and shall not be the sole work product of any other person or software/information technology system.

(C) Licensees and registrants shall include sufficient and timely documentation in records to facilitate the delivery of services and to ensure continuity of services provided to clients in the future.

(D) Licensee or registrant documentation shall protect clients' privacy to the extent that it is possible and appropriate and shall include only information that is directly relevant to the delivery of services.

(E) Licensees and registrants shall store records following termination of services to ensure reasonable future access. Records should be maintained as required by this rule unless a longer retention period is required by statute or relevant contracts.

(F) If storing clinically relevant original artwork is not possible owing to storage space limitations or the type of art work, a photographic representation should be maintained.

(G) Upon termination of services, art produced by a client that is not retained by the client may be disposed of by the licensee if the licensee documents reasonable attempts to contact the client regarding taking possession of the art work and if the licensee has retained a record of any clinically relevant art work as described in paragraph (F) of this rule.

(H) Art therapists and music therapists shall take into consideration the benefits and potential negative impact of photographing, videotaping, using other means to duplicate, and/or display or broadcast client artwork with the client's best interest in mind. Art therapists and music therapists shall provide to the client and/or parent or legal guardian clear warnings about the therapist's inability to protect against the use, misuse, and republication of the art or music product and/or session by others once it is displayed or posted.

(I) Licensees and registrants shall obtain written informed consent from a client, or when applicable, a parent or legal guardian, before photographing the client's art expressions, making video or audio recordings, otherwise duplicating, or permitting third-party observation of art or music therapy sessions.

(J) Art therapists shall not make or permit any public use or reproduction of a client's art therapy sessions, including verbalization and art expression, without express written consent of the client or the client's parent or legal guardian.

(K) Requirements regarding client access to records are established in section 3701.74 of the Revised Code. Licensees and registrants shall provide clients with reasonable access to records concerning the client. Licensees and registrants who are concerned that a client's access to their records could cause serious misunderstanding or harm to the client shall provide assistance in interpreting the records and consultation with the client regarding the records. If a licensee or registrant who has treated the client determines for clearly stated treatment reasons that disclosure of the requested record is likely to have an adverse effect on the client, the licensee shall provide the record to a physician, psychologist, licensed professional clinical counselor, licensed professional counselor, independent social worker, social worker, independent marriage and family therapist, marriage and family therapist, or chiropractor designated by the client. The licensee shall take reasonable steps to establish the identity of the person making the request to examine or obtain a copy of the client's record.

(L) A licensee or registrant shall not condone, partake, or assist in billing irregularities with respect to insurance companies or direct billing.

(M) Licensees and registrants shall be aware of and adhere to divisions (H)(1) and (H)(2) of section 3109.051 of the Revised Code. That section in part states: "a parent of a child who is not the residential parent of the child is entitled to access, under the same terms and conditions under which access is provided to the residential parent, to any record that is related to the child and to which the residential parent of the child legally is provided access...unless the court determines that it would not be in the best interest of the child for the parent who is not the residential parent to have access to the records under those same terms and conditions...any keeper of a record who knowingly fails to comply with the order or division (H) of this section is in contempt of court." A complete reading and understanding of this section is mandatory for any counselor, social worker or marriage and family therapist providing services for children.

(N) When licensees and registrants leave a practice, they shall follow a prepared plan for transfer of clients and files. Licensees and registrants, with the exception of registered social work assistants and registered trainees, shall prepare and disseminate to an identified colleague or "records custodian" a plan for the transfer of clients and files in the case of their incapacitation, death, or termination of practice. Licensees at agencies that close can reference division (A)(14) of section 5122.31 of the Revised Code for proper transfer of records.

Last updated July 2, 2024 at 10:31 AM

Supplemental Information

Authorized By: 4757.11
Amplifies: 4757.11
Five Year Review Date: 12/26/2028
Prior Effective Dates: 7/3/1997, 8/2/2001, 11/2/2008, 12/26/2023

Rule 4757-5-10 | Standards of ethical practice and professional conduct: reporting unethical actions.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Mandatory reporting: All licensees, registrants, supervisors and trainees have a responsibility to report any alleged violations of this act or rules adopted under it to the counselor, social worker, and marriage and family therapist board. Also, if a licensee or registrant has knowledge or reason to suspect that a licensed colleague or registrant, or other licensee or registrant, who is not a client, is acting in an unethical way or is incompetent or impaired they shall report that practitioner to the board. All mandatory reporting shall be in writing and bear the name and license number or registration of the reporter. When client confidentiality limits the licensee's ability to provide details the licensee is still mandated to report the allegations against another licensee without breaching client confidentiality.

(B) Licensees and registrants are required to comply with all mandatory reporting requirements set forth in the Revised Code to include, but not limited to:

(1) Section 2305.51 of the Revised Code - immunity of mental health professional for reporting violent behavior by a client or patient;

(2) Section 2151.421 of the Revised Code - duty to report child abuse or neglect;

(3) Section 5101.61 of the Revised Code - duty to report abuse, neglect or exploitation of an adult;

(4) Section 2317.02 of the Revised Code - privileged communications; and

(5) Section 5123.61 of the Revised Code - mandatory duty to report any abuse, neglect, other major unusual incident (MUI) for a child or adult with an intellectual disability or other developmental disability.

(6) Section 959.07 of the Revised Code - animal abuse reporting requirements.

Last updated July 2, 2024 at 10:32 AM

Supplemental Information

Authorized By: 4757.10
Amplifies: 4757.10
Five Year Review Date: 7/1/2029
Prior Effective Dates: 9/19/1985 (Emer.), 1/1/2006, 4/19/2021, 12/26/2023

Rule 4757-5-11 | Standards of ethical practice and professional conduct: change of name and/or address.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) All licensees or registrants are required within forty-five days to notify the board of any changes of name or mailing address. Failure to do so may result in disciplinary action by the board.

(B) All applicants, licensees, or registrants must provide to the board, and maintain, an electronic mail (e-mail) address for the purposes of licensure system access.

Last updated July 2, 2024 at 10:32 AM

Supplemental Information

Authorized By: 4757.10
Amplifies: 4757.11
Five Year Review Date: 9/25/2028
Prior Effective Dates: 12/19/1985, 7/3/1997, 11/8/2007, 3/5/2018

Rule 4757-5-13 | Standards of practice and professional conduct: teletherapy.

• Effective: July 1, 2024
• Promulgated Under: 119.03

(A) Teletherapy means the use of real-time audio or audiovisual communications that permit accurate and meaningful interaction between at least two persons, one of whom is a licensee or registrant ("licensee") as defined in Chapter 4757. of the Revised Code. For the purposes of this rule, modalities, including but not limited to phone, video, text, email, instant messaging/chat, are considered teletherapy.

(1) All licensees and registrants providing services via teletherapy to persons physically present in Ohio shall be licensed in Ohio.

(2) All licensees and registrants of this board providing services to client(s)s outside the state of Ohio shall comply with the laws and rules of the jurisdiction where the client is located at the time services are rendered.

(B) Licensees and registrants shall consider their education, training, and experience before providing teletherapy services and provide only services for which they are competent. Licensees shall assume responsibility to continually assess both their professional and technical competence when providing teletherapy.

(C) No initial in person or face to face audiovisual visit is necessary to initiate services using teletherapy modalities.

(D) Licensees and registrants shall screen client(s) for appropriateness to receive services via teletherapy throughout the course of treatment, which includes considering their current mental and emotional status, conducive treatment modalities, and ongoing effectiveness of the service. The licensee shall screen the client(s)'s technological capabilities as part of the intake process and document any assistance provided to facilitate access. Licensee shall regularly review whether use of teletherapy is meeting the clinical needs of the client(s).

(E) A licensee or registrant is under no obligation to provide services via teletherapy if their clinical judgement indicates teletherapy is not an appropriate modality for delivering services to the client(s).

(F) No licensee or registrant shall engage in teletherapy while operating a motor vehicle or similar equipment, nor shall any licensee engage in activities during teletherapy that do not allow the licensee to focus on the client(s) or prepare to document session. The licensee should terminate a session if it is determined while in a session the client is engaged in activities that could endanger themselves or others.

(G) A licensee or registrant shall not provide teletherapy when either the client or licensee is in a setting where the confidentiality of the session could reasonably be expected to be compromised.

(H) Licensees and registrants shall be aware of cultural and developmental differences and how they can affect non-verbal cues. Licensees shall also be aware of audio, visual, and cognitive impairment and the impact of these on the use of teletherapy services. Teletherapy methods should be appropriate to the client and their environment.

(I) Licensees and registrants must maintain records in accordance with rule 4757-5-09 of the Administrative Code. Such records must clearly indicate when services are provided through teletherapy.

(J) Licensees and registrants shall document all therapeutically relevant communication with client(s)s, to include emails, texts, instant messages, and chat history.

(K) The licensee or registrant should ensure that practice or agency staff who are assisting a client(s) with teletherapy services or providing teletherapy services are adequately trained in the usage of relevant software or equipment.

(L) Licensees are not responsible for client(s) misuse of teletherapy devices during the provision of services.

(M) During the initial session, licensees and registrants must establish informed consent in accordance with paragraph (B) of rule 4757-5-02 of the Administrative Code. Informed consent shall include information defining teletherapy delivery as practiced by the licensee, as well as potential risks, security issues, and confidentiality issue when receiving teletherapy. In the case of a minor client, the licensee must address any potential issues specifically associated with treating minors.

(1) Client(s) shall be given sufficient opportunity to ask questions and receive answers about teletherapy. These discussions should be documented in the client(s) record.

(2) Informed consent should include a discussion of how teletherapy may affect billing and access to insurance benefits.

(3) Licensees and registrants shall document permission prior to recording any part of the teletherapy session. If licensees are storing audiovisual records from sessions, these cannot be released to client(s) unless authorization from the client(s) is obtained specifically stating the records are to be released.

(4) Licensees and registrants shall not provide services without client(s) informed consent which can be documented through verbal acknowledgement, online signature, or by signing a hard copy form. Licensees must make available to the client a copy of the consent documents regardless of the form of consent by the client.

(5) Licensees and registrants shall make available to clients links to websites for all certification bodies and licensure boards to facilitate consumer protection. Licensees shall provide a link to the board online license verification site on their web page.

(6) Licensees and registrants shall obtain client(s) consent when conducting web searches to gather information about the client(s), except when searches are of public criminal records/public safety databases prior to an initial session with a client or when such searches may provide information to help protect the licensee, client(s) or other parties who may be at risk.

(7) The licensee or registrants shall provide the client(s) information on how to access assistance in a crisis and outside of established business hours.

(N) Licensees and registrants shall have a contingency plan for providing services to client(s) when technical problems occur during a teletherapy session, or when technical problems prevent a session from occurring. This plan may include information on other qualified therapists who can provide services if needed.

(O) Licensees and registrants shall confirm the client(s) location at the time services are rendered.

(P) Licensees and registrants shall comply with all requirements under state and federal law regarding the protection of client confidentiality while providing services. Each provider shall ensure that any username or password information and any electronic communications between the provider, client, or third parties are securely transmitted and stored.

Last updated July 2, 2024 at 10:32 AM

Supplemental Information

Authorized By: 4757.10, 4757.11, 4757.50, 4743.09
Amplifies: 4757.11, 4757.50, 4743.09
Five Year Review Date: 7/1/2029
Prior Effective Dates: 10/18/2009