Standard of Care

Standard of care, a term used in medical and mental health treatment, refers to the usual and customary practices within the field. The standard of care is designed to protect consumers of health services by setting a minimum standard for what is considered acceptable behavior by treatment providers.

Understanding the Standard of Care

Seeking therapy can be beneficial for a number of reasons, but the process of doing so can also be intimidating. When going to therapy, or seeking any other kind of health treatment, an individual may be stepping into unknown territory while also being required to place their trust in a complete stranger. In order to ensure therapists are using safe and effective techniques and not engaging in harmful or dangerous practices, a standard of care was developed. This standard of care outlines a reasonable set of behaviors and practices that are expected to be followed by all helping professionals, no matter their chosen field.

Why Is the Standard of Care Important?

With particular regard to therapy, the standard of care offers protection to both therapists and the people they treat. This set of conditions essentially provides a norm for what is acceptable behavior in therapy, providing consumers with some knowledge of what to expect and therapists with an understanding of what their duties entail. By following the standard of care, therapists adhere to principles that reduce the likelihood consumers will be subject to inappropriate or unethical practices and are held accountable for their work with people seeking treatment. Further, the standard of care can help create a sense of trust between the person seeking help and the person providing help, as consumers may feel more assured that treatment providers will follow certain ideals and will be held accountable should they fail to do so.

Therapists are also protected by a standard of care, since establishing guidelines for what practices are acceptable can help reduce confusion around legal and ethical issues. By practicing within the standard of care, a therapist protects themselves from potential litigation. The standard of care does not require therapists to be “perfect” or refrain from ever making a mistake, but it does provide guidelines for good decision-making and using one’s judgment effectively, thus helping therapists gain a clearer idea of what is expected of them.

How Was the Standard of Care Developed?

No single governing body sets the standard of care within a given field. Rather, it is determined by what prudent professionals with similar qualifications would do in similar situations or circumstances. In some instances, the standard of care is very clear. For example, therapists should never engage in sexual relationships with the people in their care, and they should never forge documentation. In other situations, however, there may be considerable disagreement among qualified therapists about the treatment approaches and practices that are considered to be most effective.

Therapists are typically held to clinical, legal, and ethical guidelines. Each state has specific laws about how long records must be maintained, for example, and practicing professionals are also held to an ethics code that is specific to their training and credentials. The standard of care, which takes all of these factors into account, is determined by statutes, licensing board regulations, case law, ethics codes, consensus among professionals, and consensus among members of the community.

The standard of care is neutral and does not consider any one type of therapy to be better or more effective than another, nor is it based on any one theoretical orientation or therapeutic approach. Regardless of the approach they have chosen to take toward treatment, therapists are expected to adhere to the standard of care within their profession.

The standard of care may be subject to change as new research emerges and advances in technology help mental health treatment grow and adapt to best suit the needs of those seeking help. New statutes and case law may also play a part in helping shape the standard of care.

Legally Complying with the Standard of Care

Therapists typically rely on clinical documentation to show they are practicing within the standard of care. Clinical records, which are kept for each individual receiving treatment, include information about diagnosis and assessment, the presenting issue, treatment goals, interventions used by the therapist, and the person’s progress in treatment. In emergency situations or situations which involve complex ethical or legal considerations, therapists may complete extra documentation to show they are practicing within the standard of care. Such documentation may include actions they took, the reasoning behind their actions, and any consultation they sought from other professionals.

What Lies Outside the Standard of Care?

Practices that lie outside the standard of care’s guidelines are generally considered to be negligent or otherwise substandard, and these generally include practices that are illegal and/or unethical.

It is important to note, though, that not every negative outcome falls outside the standard of care. Therapists make mistakes, and a positive outcome is never guaranteed in therapy. In this way, the standard of care is not necessarily determined by the outcome of the therapist’s actions, but rather by their decision-making process. If a therapist does what any other therapist would have done in similar circumstances, then they are practicing within the standard of care, regardless of the outcome.

References:

1. Reamer, F. G. (2014). The concept of standard of care. Social Work Today. Retrieved from http://www.socialworktoday.com/news/eoe_051314.shtml
2. Zur, O. (2015). The standard of care in psychotherapy and counseling: Bringing clarity to an illusive standard. Retrieved from http://www.zurinstitute.com/standardofcaretherapy.html

Last Updated: 01-17-2017