Teaching: An Unauthorized Guide to Surviving the Profession

Tips for Surviving in a Time of Immigration Uncertainty
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If you have a Direct Loan loans available to the borrower directly from the Ford Federal Loan , and you have fulfilled certain conditions, you may be eligible to apply for a loan forgiveness under the PSLF scheme. Teacher Loan Forgiveness details. Income Driven Repayment Plans details. Federal Perkins Loan Cancellation details. Total and Permanent Disability Discharge details. Death Discharge details. Bankruptcy Discharge details. Candidates who have surrendered their bankruptcy status can get their federal student loans discharged upon proper adversarial court proceedings in the presence of creditors.

Closed School Discharge details. In the unforeseen circumstance of finding your school shut down, while you are enrolled, you can avail a full discharge of your Direct, FEEL or Perkins loans. It can mean criminal prosecutions for unlawfully copying or removing government records. There have even been cases where federal employees have been threatened with prosecution for sharing non-classified information.

Depending on the potential legal liabilities involved, whistleblowers should store their copies of evidence in a secure, independent location away from their homes, preferably through an attorney where confidentiality is generally protected by attorney-client privilege. Copies of electronic records can be stored under misleading folder names or in locations that are unlikely to be discovered see Chapters 2 and 3 for more discussion of the risks of moving agency records. That way the whistleblower can be a navigator for law enforcement authorities, instructing them on what records to seek, and then where to find them if an employer denies their existence.

Time is also an institutional resource. Depending on the circumstances, you could end up enabling your organization to make the argument that you committed time fraud, misappropriated agency time or resources, or simply are a poor performer. Even off the clock, you also should make it clear that you do not speak for the agency—especially if you are communicating concerns to the press. Solidarity is important for your ability to make a difference and survive professionally.

Do not wait to be cut off by your agency. Without exposing yourself as a threat to the organization, gauge the level of support among your co-workers for the concerns you might raise. See if others share your concerns. This is important for quality control, not just for your sense of solidarity. They may have knowledge to which you were not privy, and that could change your mind or modify or expand your concerns. Get a sense of whether key people will back up your account. Try to stay on good terms with administrative staff who may be in a position to know of impending agency actions.

Seek out potential allies before your situation heats up, and work through intermediaries when possible. Enlist the assistance of sympathetic interest groups, elected officials, or journalists. The strength of your support coalition is often key to making the legal rights you have on paper work for you in reality. As with preventative medicine, getting a little legal advice up front can protect against the need for extensive intervention later. Be careful to find an attorney who respects your goals as a whistleblower, and who is willing to safeguard your evidence.

Many attorneys see their duty as preventing you from incurring the liability you are willing to risk but that you should be prepared for. This will be an intimate professional partnership, so make sure you trust and are compatible with your lawyer. One reason some whistleblowers hire attorneys is because they can make disclosures on behalf of an anonymous client, legally shielded by attorney-client privilege. If possible, pick a time and set of circumstances where you will have the most impact with your disclosure.

The timing of your disclosure, particularly to the press, is a serious strategic decision that can affect the chances your disclosure will receive attention. Timing can also affect whether you face retaliation. Press coverage can cut both ways: it could shield you from immediate retaliation while you remain in the media spotlight, but it could also anger your management more than if your disclosures were more discreet.

If you do decide to disclose your evidence to the press, it may be wise to release your evidence incrementally rather than all at once. This can spark repeated stories that sustain the spotlight, and provide a chance to call the bluffs of overly broad institutional denials. See Chapter 5 for an extended discussion of working with the press. Those who are abusing their power must be reacting to you, not vice versa.

Be clear-headed about precisely what you expect to accomplish and how. Do not premise your actions on the vague notion that the truth will prevail. As part of your advance work, get information into the hands of key potential organizational and political allies, and earn their commitment to reinforce your disclosure.

The tenor of this first exchange may determine if the immediate battle with your organization will be quick or drawn-out. Map out where your actions will leave you a year from now, two years from now, five years, and further on. Plan out the route you want to take and how you reasonably expect your professional path to proceed. There is little doubt that you are about to embark upon a journey that will have a significant impact on your professional and personal life, and you should be prepared with a realistic roadmap of how you might get where you want to go in your career. However, you should also have contingency plans since once you make a disclosure, particularly if it becomes public, your career and life may change in unexpected ways.

Throwing away your entire career, particularly if there are other ways to air the problem, can be imprudent and counterproductive. The longer you can keep the spotlight on the issue and not on you, the greater the chance the problem will be addressed, the longer you will maintain access to evidence necessary to prove your concerns, and the greater the chance you can keep your job and avoid retaliation. The best way to do this is by providing powerful evidence to those who can expose the wrongdoing and take action without leaving an obvious trail for managers to trace back to you.

One way you can spur change at your agency is by releasing information about wrongdoing while staying under the radar. In order to be anonymous, you must shield all of the identifying information that can be traced back to you, not just your name, from public disclosure and from your management. Your desire to remain anonymous may force you to make some high-stakes choices on what information to disclose. In some instances, the evidence that reveals agency misconduct also inherently reveals the whistleblower source, such as a sensitive memo with an extremely limited circulation or an email sent to only a few recipients.

In other words, when few people know the truth, the facts can be the equivalent of your signature. In these cases, you could suffer career damage if your agency learns that you were the employee who released the information. The key then is to stay undercover and work on your own time with others, such as an advocacy group or journalist, to share the critical information in a way that leaves no fingerprints or as few as reasonably possible. Strict confidentiality procedures coupled with ready legal assistance can help maximize your protection.

In short, anonymity prevents retaliation. Anonymity does not necessarily mean that reporters, advocacy partners, or Congressional staffers you choose to work with will not know your identity. Being anonymous also allows you to keep your job and to access a sustained flow of information from your agency. If you are able to maintain your anonymity, you may get advance access to any organizational strategy to deny or cover up your anonymous disclosures.

This can keep authorities or the public a step ahead of government attempts to perpetrate a cover-up. Techniques that have been effective at shielding identities and getting the truth out for past whistleblowers include working with advocacy partners, using the Freedom of Information Act to get documents released, and working through collective action to shield individual whistleblowers. Some groups less sensitive to the plight of whistleblowers may choose to risk exposing your identity for what they believe is the greater good. Congressional staff may not realize they are exposing you when they demand answers from agencies by asking questions that sound like the points you are known to have made internally.

Because of the great risks that come with whistleblowing, it is important to make a plan with a trustworthy advocacy group or publishing partner to prevent your exposure. Sometimes developing and implementing such a plan takes weeks, months, or even years. Considering the alternatives, however, the wait and effort in planning are well worth it. Having external allies and public opinion on your side can help you safely and effectively bring the truth to light. Advocacy partners can be a networking lifeline to neutralize workplace isolation, whether you are a secret source for disclosures and thus cannot talk to anyone at work about what you are doing, or you become ostracized because management identified you as the source.

An outside group can help provide you with resources, connections, and assistance in developing a constituency for the truth about abuses of power your agency is hiding. This outside affiliation can be key to effectively utilizing your limited time outside of work. An advocacy partner may be a union, nonprofit organization, or professional society. An advocacy partner can work with you, your attorney, reporters, or any other players relevant to getting the truth out, such as Congressional committees.

The advocacy partner can act as both a shield to protect your identity and a conduit for your information to get to the outside world so that your concerns become known and hopefully acted-upon. This partner may also be able to identify allies within your organization. Take the classic example of a leaked document.

A document detailing disconcerting information the public should know about has been broadly circulated within an organization. In other words, it helps to have friends. But remember, each advocacy organization has its own agenda. Even if your interests appear to be aligned, the organization has no formal obligation to be loyal to you. Thus, you may want to establish a formal attorney-client relationship with an attorney at an advocacy organization.

The relationship is covered by the attorney-client privilege, 70 which generally requires the attorney not to disclose certain information you share with them. The privilege generally shields information from being released, but can be challenged in court if there is some factual basis showing that an attorney gave advice related to committing a future crime.

You should be careful not to disclose any restricted information to the attorney until the attorney advises you regarding liability; as noted below, there are many scenarios in which a disclosure is protected only if it is made to certain recipients, which often does not include private attorneys. Not all advocacy organizations will legally represent whistleblowers, though. When that happens, one party or the other must waive its rights, and the advocacy organization may not want to hamper its options. So, another course is to seek out your own attorney who can act as an intermediary between you and an advocacy organization.

The attorney can shield your identity, serve as a go-between for communications, and make sure your interests are not sacrificed. If you share information with an advocacy group or others anonymously and without legal representation, those communications are inherently less controlled. Unless you obtain an advance agreement on conditions for the material you provide, the organization has a blank check to use the information however it wants, without regard to or even knowledge of the consequences for you the whistleblower. So make sure you are comfortable with your partners and how little control you may have once you hand over information.

They may point out considerations you have not thought of. There are some additional cautionary notes to consider before you hand over documents to an advocacy group. See Chapter 3 for details on how to minimize your digital fingerprints when moving evidence from your agency to an advocacy partner or anyone else. Before doing so, check to make sure there are not restrictions on emailing or otherwise moving the government documents you need. You need to be especially careful with how you handle classified information see the section below on the risks of classified information or information that the law specifically prohibits public release of, 85 such as material covered by the Privacy Act or medical-patient privacy protections.

If you are not careful, your agency could target you for improperly taking possession of restricted information. Even this is not foolproof. Your agency may have rules on how government information must be secured even if the information does not leave the workplace, so you should consider that as well.

If you decide that removing evidence is necessary, you may want to consider hiring your own lawyer and asking them if they can maintain the files, and if attorney-client privilege would shield the files. Smoking guns and proof of cover-ups make a difference. By working with an advocacy partner, you can inform the public of the existence of incriminating documents or other evidence of malfeasance. Public awareness is often the key to holding government entities accountable for malfeasance. Handing over evidence is only one of the ways you can work with advocacy partners.

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Another is educating them on the complicated bureaucratic issues, abuses of power, or violations of law that you have witnessed. While these problems can seem arcane to the general public, they often have profound impacts on public policy, and an advocacy group may be able to translate your specialized knowledge in a way that the public can easily understand.

Another option for educating the public is to submit a public comment in a federal rule-making process, as long as you do so outside of work time and using non-governmental equipment. But some offices are so politicized that many employees dare not participate in that process. The result is a media- and public-friendly report that could only have come from an insider. These employee-written white papers have formed the basis of litigation, been the subject of legislative hearings, and helped shift the tide of policy.

Similarly, you can anonymously draft public comments, administrative appeals, document requests, or letters for signature by the advocacy group. You remain anonymous, of course. But the advocacy partner works with you to ensure that the facts are well documented. This includes citing publicly available materials and referring to—or even appending—reproduced copies of internal memos not easily available to the public see Chapter 3 on how to minimize risks when using electronic communications and digital devices.

Virtually all states also have some form of public records law. For employees inside an agency, FOIA can be a tremendous tool for putting the agency on the record.

Learning Objectives

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The whistleblower can tutor advocacy partners about which records to seek, or even ghostwrite FOIA requests. If you write documents as part of your job at an agency, you should try to minimize the chance these records can be withheld from public view under FOIA exemptions. For example, you could write a memo that includes a timeline of relevant facts in one section and legal analysis in another section. If you are receiving key records, you may consider circulating them as widely as possible without drawing unwanted attention to your action.

Email is another asset in the war to make government business public. Many managers write candid thoughts in emails that they would never put into formal correspondence, yet an email is just as much a public record as an old-fashioned memo is. Anonymous whistleblowers can act as watchdogs for FOIA cover-ups. For example, during investigations of unsafe nuclear facilities, the Government Accountability Project worked with public employees to draft precisely targeted FOIA requests. These employees made copies of the records, and provided notice when documents were moved off-site, concealed, or destroyed.

This appears to have happened with then-FBI agent Terry Albury, who pleaded guilty to providing classified information to The Intercept. Union organizers know that collective action provides both power and anonymity for members of groups. While bad managers can punish individual employees for simply bringing up problems, both retaliation and smears become more difficult to carry out when a group of employees speaks with one voice. The larger the group, the more the power imbalance is neutralized.

For example, the Government Accountability Project recruited the president of the Food Inspectors Union to publicly speak in congressional testimony for a number of whistleblowers, providing cover for those concerned about harassment—a way to launder the truth on the record. A way to put this principle into action is to use employee surveys to document or dramatize problems within organizations without putting individual employees in the spotlight.

With the help of an advocacy partner, surveys can be worded with employee input to expose the most important problems facing the organization. Once the survey is finalized, an advocacy partner works with employees to distribute the questions, encourage participation, and compile the results. There are other benefits to conducting employee surveys. Aside from diagnosing problems within organizations and holding leaders accountable, surveys can show individual employees that they are not alone in their concerns, reducing the sense of isolation. Best of all, if the survey is credibly designed to protect the identity of its participants, this can be accomplished without threatening the job security of any employees who participate.

Technology can be a valuable tool for blowing the whistle, but it can also make it easier to identify those who expose wrongdoing. While you may be able to share information with the click of a button, chances are that click will be tracked. Luckily, there are tools that can help you remain anonymous when reaching out to advocacy groups, journalists, or other potential allies online.

Digital security best practices are constantly evolving, as are detection technologies and techniques, so there are some general principles that are important to keep in mind while you decide whom and what to trust. State and private actors have the ability to infiltrate many digital devices. The good news is that if you do your homework and are careful, some tools can help maintain the security of your conversations even if all your communications have been intercepted.

Basic lessons to keep in mind are summarized below, with references for more advanced homework.

Teachers Create what they Experience - Katie Martin - TEDxElCajonSalon

Taking precautions such as using multi-factor authentication to lock down online accounts and using strong unique passwords or better yet, a password manager can help reduce your exposure to online threats, such as criminal hackers, or government investigations seeking the source of leaked information. Even the best encryption will not help if you already have exposed yourself as a threat.

Monitoring software is widely reported to be used by employers, both in and outside the government. Be careful about what information you access at work. Many organizations consider high-tech leakers to be like hackers, and use highly advanced specialists to uncover both. Employers usually maintain logs, keep careful track of who has access to information, and monitor for unusual patterns of access.

For example, you could come under suspicion if logs show you were one of only a few people to print or email a document that later leaks. In some cases it may be advisable to avoid removing data from networks directly. Some organizations automatically identify which machine accessed a file, and removing information through a flash drive, for instance, may look suspicious or even immediately trigger alarms. Another approach is to transcribe the information word for word on paper. You may want to leave a physical copy of the information hidden somewhere secure inside the organization.

If possible without revealing your identity, save an electronic copy of the file to a location where it is unlikely to be found, to safeguard against later erasure of the original. Many different entities, such as social networks, email providers, and the companies that actually provide internet access, also collect massive amounts of information about users in order to carry out their work and to fuel the online advertising market. While the government may not have immediate access to your online activities, online-service providers may be legally compelled to turn over records in certain circumstances, such as during the course of a criminal investigation.

Consider only doing research about your next steps while using some of the tools described later in this section, such as the Tor Browser or Tails. Carefully consider if documents can identify you as the source before you share them. How many people within the agency have access to them?

Is there identifying information built into the text such as timestamps, or tweaks to language or formatting unique to a certain version? If you plan to share digital files, you should strip that information when possible. Tips on how to strip the info from file types such as Word documents, PDFs, and images are readily available online. Research on ways to cover your digital footprints is best done via Tails or Tor, tools that will be discussed later in this chapter, because searching for this type of information could throw suspicion on you if uncovered later during a leak investigation.

Scans of physical copies of documents may also include identifying information. For example, most printers leave tracking information in the form of dots not obvious to the human eye. These should be scrubbed before the document is shared, if at all possible, through methods such as converting the document to black and white and making repeated printed copies that can distort the trackers. Also avoid cloud storage services like iCloud or Google Drive that can be linked to you.

Instead, keep them isolated and encrypted on new, securely stored flash drives that have never been used on a computer that can be traced to you. The best defense against digital snooping at this time is using technologies that incorporate strong encryption, both for communications and stored data. For communications, end-to-end encryption—encryption that applies throughout the process to help ensure that only the sender and receiver can read the contents—is currently the best tool to use. That means that even if communications are secured with the strongest options currently available, future advances in computing may make something that would take years or decades to crack now easier to crack in the future.

Encryption can protect the content of different types of communications, including instant messages, email, and voice calls. Generally, metadata, such as when and who you contact, may still be observable because this information is necessary to deliver messages. Some encrypted-communication products mitigate that risk by retaining minimal records or logs of such data.

Check the tools section of this chapter for more information. Be sure to verify the identity of contacts before sharing sensitive information. Private information sent via unsecured sites may also be vulnerable to snooping by other people connected to your same network. The Electronic Frontier Foundation offers a web browser extension to assist in preventing this problem. Reality Winner was exposed when The Intercept shared her documents with a government agency to verify their authenticity.

Before sharing records with a journalist or organization, make sure the recipient will be satisfied to authenticate the record by using other information or by proof such as supporting witnesses, not by running the document past its originating agency. Your communications may also be exposed if their or your devices are compromised, either through malicious hacking or a legal method, such as being forced to comply with a court order. If you have safely accessed information, one option is to transmit that information through a tech-savvy lawyer who uses encryption best practices.

In addition to the technological safeguards, you may be shielded by the attorney-client privilege if you pursue this route. However, that protection may not hold up in all situations, such as when facing Congressional inquiry. Research the security track records of individuals and organizations before you reach out to them. Do they use recommended encrypted communication services?

Will they commit to stripping any identifying information from documents, and explain to you their process for doing so? What is their policy on responding to government demands for information, and how have they responded to past demands? Have they been the victims of hacks before? If so, what was the fallout? Have sources been compromised due to their digital security failures?

These questions and more will play into how much information you feel comfortable sharing with those you contact. If not, do you want them to know who you are? In some cases, in-person meetings may be less risky. When setting up a physical meeting, look for places without cameras and where neither you nor the person you are meeting have to sign in or are likely to be recognized.

Examples include public parks, community centers, and trails. And remember: most people now carry an incredibly sophisticated digital snooping device around with them—their smartphone. If compromised, your phone could even be turned into a video- or audio-recording bug. Cars can also be easily scanned and tracked through methods such as automated license plate readers; if you are using a vehicle associated with you to travel to a meeting, assume it can be tracked.

Similarly, public transit that you pay for with a reloadable card, and apps like Uber and Lyft, collect information about your travels that could potentially be turned over to law enforcement during the course of an investigation. In some cases, going old-school and using foot- or pedal-power to get to a meeting may be the best option.

The tools and best practices laid out in this guide are recommendations based on what is known at the time of publication. But the rapid pace of innovation in information security and the increasing sophistication of digital attacks mean things may be different by the time you are reading this. What is digitally secure now may not stay that way forever. For example, encryption depends on the complexity of keys, but future developments in computing may make what are now considered secure keys easy to guess.

Other surveillance technologies in development or on the rise may later uncover actions taken now. Just imagine future investigators using facial recognition technology against security-camera archives to look for who may have met with a particular whistleblower advocacy group or journalist.

You should research recent security news about a tool before deciding to use it for sensitive communications. Note that in almost all cases, using a digital method will create some sort of data trail. However, the tools below can help minimize and hide that trail better than using ordinary communication methods. The most commonly recommended way of encrypting email is called PGP and relies on public key encryption.

This can be done using a laptop or desktop computer and involves installing special software to set up encryption keys for your email account and then connecting with another person who has gone through the same process. The Electronic Frontier Foundation has a good step-by-step guide for the process.

Note that, as with other tools discussed in this section, PGP has encountered security problems in the past. This method is effective at securing the content of email messages, but still leaves metadata, including subject lines, the sender, the recipient, and the date of a message, exposed. Consult current online resources like the Freedom of the Press Foundation or the Electronic Frontier Foundation for best practices to minimize your digital trail.

Signal is an app that provides end-to-end encrypted messaging and voice calls. Signal can also be used to share digital documents. Signal is available for Android and Apple smartphones, as well as for desktop computers. Signal is open source and has undergone independent security audits. The smartphone apps have a longer security record and have had fewer reported security issues to date.

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One pitfall of using Signal is that the app, even when using the desktop variant, is inherently tied to a phone number. Be sure to erase your call history, which Signal otherwise will maintain locally on your device. It also allows you to access special websites that end in. At the time of publication, the most accessible way to use this network is by downloading an internet browser called the Tor Browser, a version of Firefox with various security functions built into it. Although Tor is a vital tool for those seeking anonymity online, it has suffered security failures in the past, and some experts believe traffic over the network may receive extra scrutiny from law enforcement or intelligence agencies.

For example, Tails automatically routes online activities performed while the operating system is in use through the Tor network and comes preloaded with the Tor Browser to secure your browsing from prying eyes.

SPLC guide to surviving underground

It is important to note that these added protections generally cause Tails to run slower than other modern operating systems. Tails is an open source project that is continually being improved upon, so it is important to ensure you are running the most recent version. SecureDrop is a system designed to facilitate anonymous communication between sources and non-governmental organizations or journalists and is generally considered the most secure digital method to contact a reporter or advocacy group.

SecureDrop also does not record many forms of potentially identifying information about submitters, such as the IP address or the type of operating system being used. SecureDrop requires users to install and send information through the Tor Browser. One of the most treacherous situations for a public servant is navigating the bureaucracy of filing whistleblower disclosures. This chapter is focused on the official channels through which you can report wrongdoing. Note that filing a whistleblower disclosure is not the same thing as filing a complaint of whistleblower retaliation.

The channels through which you can file a retaliation allegation are addressed in Chapter 6. Many employees first disclose concerns to their supervisors. Conversely, failing to report a problem can also lead to difficulties, particularly if the problem becomes embarrassing and the agency starts looking for a scapegoat. If reporting the problem to a supervisor resolves the matter, great. If it does not, and you need to go to oversight bodies outside the chain of command, the water becomes murkier.

When you go outside of your immediate organization, especially when your concerns become public, it heightens the chance that your management will become angry with you. Because there is the potential for retaliation when you blow the whistle, especially if you decide to file a formal disclosure outside of the chain of command, you should seek legal advice from trustworthy counsel before taking any action although there may not be time for this, especially if you are reporting an imminent health, safety, or security matter.

Legal counsel will explain what protections are available to you and how to best take advantage of them, and can also help you work with offices that may investigate your disclosure. If you want to swim in these official channels, the following should be taken as cautionary advice. Every major federal agency has an inspector general IG. See Chapter 6 to learn more about their role in investigating whistleblower retaliation claims. One of the main roles of an inspector general is to investigate whistleblower disclosures of internal fraud, waste, abuse, and other types of misconduct.

An IG office generally conducts investigations and audits. Investigations that find violations of criminal laws can result in referrals for prosecutions, but whether to prosecute is a decision made by a Justice Department attorney. Under the Inspector General Act of , IGs are supposed to be independent of the agencies they oversee. Some agency, commission, board, and legislative-branch IGs are appointed by the head of the organization they monitor, creating a structural conflict of interest. Agency employees may view the IG as a kind of knight in shining armor—an outside, objective force charging up the hill to make all right in the agency world.

That said, there are dedicated IG staffers who fairly and aggressively work with whistleblowers. The therapist became angry. The therapeutic alliance collapsed. The client posted on Yelp that the therapist was a cheater with anger issues. The newly licensed therapist's own cultural ignorance and fear-based judgments led to a misguided decision. Without informing the client, he called the husband to try to get more information about why she was so miserable. The husband seemed irritated and hung up. The client never returned, and the therapist read in the local newspaper shortly thereafter that she had been badly beaten by her husband and may not survive.

This therapist eventually lost his license. The therapist, who had sandbagged his feeling toward the client he so disliked exploded into a rage when the client pushed his buttons one too many times. The therapist then insisted he leave the office and told him to never return. It was getting dark out and he and was running late for a birthday dinner with his wife and children.

It seems fitting to quickly review underlying values and virtues that should guide ethical decision-making. These same elements are expressed in the ethics codes of all major mental health professions. Although we may all strive to behave correctly and do good, a gap often exists between the ideal outcome and what can realistically be accomplished. We acknowledge upfront that ethical perfection lies beyond reach for virtually all of us humans, even if we could completely agree on the ethically correct response in every situation.

And, unfortunately, good intentions may prove insufficient to ensure that wrongs will not occur. An effective response requires developed skills, planned resources, the right information, a keen ethical foundation, and self-awareness. Below are the core principles we believe should serve as an overall guide to the behavior of mental health professionals:. At times, some therapists willfully, even maliciously, decide to engage in acts they know to be in violation of ethical and legal standards.

A clinical social worker abruptly terminated treatment with a client who was still struggling with depression and alcohol dependence. The following day, he called his just-terminated client and invited her to his apartment to watch a movie. The social worker served popcorn and wine and, during the movie, sexually assaulted her.

The client told her minister about the incident, who contacted the social worker for an explanation. The social worker offered the minister a new computer if he could convince the client to refrain from calling the authorities. A certified counselor plotted against a former client who had accused him of over-billing and was threatening to take the counselor to small claims court.

A psychologist used the services of a sex worker, but had insufficient cash to pay her fee. He left his laptop computer containing over unencrypted client files from his employing agency as collateral while he went to find an ATM. When he returned 15 minutes later, the prostitute and laptop were gone. The psychologist reported the theft without mention of the associated sexual activity, but eventually replaced his initial false account with an accurate one. The laptop was recovered from a pawn shop.

Nevertheless, the psychologist lost his job and his license to practice. Thankfully, such extreme cases are exceedingly rare and suggest at the very least an inadequate moral foundation. In our experience, the more prevailing portrait of therapists who cross over the line is muted and complex and often includes people of decency, intelligence, and emotional fitness who somehow became caught up in circumstances that they did not evaluate or respond to appropriately.

Most mental health professionals who engage in questionable, unethical, or unprofessional behavior could be described as having one or more of the following underlying characteristics, which are rarely mutually exclusive. The Unaware or Misinformed. A substantial number of violators appear to be either naive or uneducated about the standards of their profession and how they are expected to behave. Sometimes the violation is minor and due to inexperience, but even seasoned therapists can lose touch with the professional standards governing their practice.

It is of critical importance to keep up with the ever-changing landscape of professional practice. Ethics committees, licensing boards, and the courts do not consider ignorance to be an adequate defense. When questioned by an ethics committee about a sexual affair with a client he had terminated only three months earlier, the therapist wrongly asserted that the ethics code of the American Psychological Association specifically allows sex with former clients upon termination of professional services.

The Incompetent or Undertrained. The misconduct of mental health professionals can sometimes arise from an incapacity to perform the services being rendered, as a result of inadequate training, lack of skill, or both. Emotional disturbances or substance abuse may blunt the ability to perform satisfactory work even if the therapist has been properly trained. More often, however, inadequate training and experience are the cause.

Many therapists who come to the attention of ethics committees, licensing boards, or the courts have vastly miscalculated the level of their overall skills or their ability to apply sophisticated techniques or specialized services such as a neuropsychological assessment or expert forensic testimony. A clinic supervisor recognized that many clients seemed to acquire misdiagnoses or inappropriate treatment plans.

The Insensitive. Although insensitivity is an elusive category, mental health professionals often exceed the bounds of ethical propriety because of insufficient regard for the needs and feelings — and sometimes the rights and welfare — of the individuals with whom they work. Reasons vary and include lack of empathy, a need to exercise control, overzealousness regarding a specific approach, self-absorption, and prejudicial attitudes toward certain individuals or groups.

Often, such insensitivity precludes recognizing that an ethical issue even exists. A therapist was usually late for therapy sessions. The Exploitive. When mental health professionals take premeditated advantage of clients by abusing their positions of trust, expertise, or authority, a particularly nefarious ethical infraction is committed. Therapists who allow their own needs or temptations to take precedence over those of the clients they serve, or who put the lure of financial gain above client welfare, best fit the common stereotype of the unethical professional.

Therapists who themselves have character disorders seem most likely to fall into this category, although other risky therapists include those who are professionally isolated, those who disclose too much of themselves i. Engaging in sexual activity with current clients constitutes the most commonly discussed form of exploitation.

The young client was attractive and appreciative. The therapist was going through a difficult divorce. They started by having lunch after every appointment, then dinners, and finally retreats to a local motel. The sexual activity was not as exciting as the client had expected. She felt disillusioned and guilty about having sex with a still-married man, quit therapy, and contacted a licensing board.

The Irresponsible. Irresponsibility can result from laziness, stress, lack of awareness, or other reasons that divert attention from professional responsibilities. He informed the client that he could no longer counsel her, and she would need to find another therapist. The Vengeful. Cases of mental health professionals who have sought revenge on a colleague, a client, or others who they perceive as having done them wrong are not common and seldom make their way to ethics committees, licensing boards, or to the courts.

However, some outraged mental health professionals have allowed their emotions to supersede professional judgment, and charges of defamation have been upheld. Usually the infraction involves an impulsive act — as opposed to a premeditated plot — to retaliate against an antagonist. The behavior often has a childish quality, such as sending angry emails. Impulsively vengeful therapists often feel remorseful and foolish later and frequently apologize for their loss of control.

Unfortunately, damage may have already occurred because the impact of such outbursts cannot always be fully rectified. A mental health professional working in a research university gathered strong circumstantial evidence that his colleague and professional rival stole research notes from her lab. The Self-Serving Rationalizers. Rationalization often operates under subtle and seemingly harmless circumstances, sometimes in order to justify inaction or convenience.

She also visited her elderly mother in a nursing home 50 miles away every Saturday. When apprehended several weeks later, the client claimed that he had a partner and, as proof, reported that stolen items were in her office. Therapists without Boundaries. Role-blending accounts for a large proportion of the most inappropriate or mindless decisions that therapists make. Boundaries become especially thin in the presence of self-serving circumstances and, if not perceived and reversed in time, cross a line.

While recognizing that it is impossible to avoid all boundary crossings and that not all are unethical or harmful and some may even be helpful , therapists who are unaware, rationalizing, or malintentioned can inflict considerable harm to those with whom they work. Whether this is the result of ignorance, self-absorption, avarice, neediness, or a mental condition is not always clear.

A therapist considered his clients to be his friends and often took them to dinner, gave them gifts, and enjoyed telling them his personal life stories. The client quit therapy and contacted a licensing board claiming that his therapist tried to bully him into doing his bidding. The Burned-out, Vulnerable, or Otherwise Impaired. Such problems often lead to poor professional judgment and incompetent performance. Although some who fall into this category may be sympathetic characters, they can also cause considerable harm to vulnerable clients.

A therapist became frustrated with the lack of progress in many of his clients. He quit taking any notes, resulting in his inability to keep track of what transpired during previous sessions. At home, he was caring for his ailing mother while also trying to keep two rebellious teenagers from getting into trouble. One client quit and complained to an ethics committee that the therapist did not seem to know anything about her issues, and sometimes even called her by the wrong name, despite having been her client for nine sessions.

Therapists Who Momentarily Slip. A fairly substantial percentage of ethics violators appear to be mental health professionals who usually conduct themselves in a principled and competent manner and who, under normal circumstances, show sufficient sensitivity to ethical dilemmas. However, circumstances can converge to displace one's usual awareness with temporary blindness, sometimes due to an inconvenient situation or distraction.

For example, sensitive confidential information may slip out. Sometimes, as the result of immediate situational demands, therapists commit acts with unintended consequences, such as revealing too much about their own personal life, and it ends up backfiring. A client in acute distress called his therapist to ask for an appointment as soon as possible. The therapist scheduled the client for 6 p. The regularly scheduled client left at and the now-hungry therapist engaged in her usual routine and went right home, forgetting about the emergency appointment.

The ideal way to avoid a difficult decision is to minimize the chances of having to make one in the first place. A risk management approach to ethics provides a practical way to avoid ethical dilemmas, although it has some ethical and personal liabilities of its own, as we will present. The key to effective risk management is to scrupulously uphold the tenets of relevant laws, policies, professional standards, and ethics codes, while taking as many steps as possible to avoid ever being placed in precarious ethical or legal circumstances.

Taube, et al. Strategies to manage risks include the basic elements of good practice, such as refraining from having sexual contacts or other intense multiple role relationships with clients, keeping careful treatment notes, reviewing client files often, recording reasons for termination, and consulting with colleagues or appropriate others about very difficult clients while protecting their identities and carefully documenting such meetings Kennedy, Taube, et al.

A potential negative aspect to an overly strict adherence to a risk management perspective is that clients who urgently need help can be shut out. Hazard-averse therapists might choose to avoid any high-risk clients, even when they are trained to competently treat them. Individuals with borderline personalities especially if accompanied by substance abuse, impulsive acting-out, or paranoid thinking , or who have a history of dangerous behavior or suicide attempts, would have a difficult time finding appropriate help should all therapists ascribe to a rigid risk-management style. Clients who develop rapid and intense transferences may frighten some therapists, causing them to refer the client elsewhere or terminate treatment, a decision not based on sound clinical judgment but on the fear of ethical or legal entanglements.

Therapists who approach their work from a very strong risk-management perspective might also choose to avoid high-risk practice areas such as child custody or other forensic work, and in practice venues where scrutiny will be intense. However, many people desperately need these services. Who will provide them if too many mental health professionals hide out in a safe zone? Nevertheless, therapists can become overly obsessed with avoiding risk, such as by viewing articulate clients with suspicion because if things go badly they could make a cogent complaint, or avoiding clients with anger issues, or putting up extra walls whenever clients disclose a complaint about previous therapists.

Although the scrupulous practice of risk management is understandable in a litigious society, a mindset that views every client as a potential land mine may also become insidiously instilled. Harboring constant apprehension and distrust toward those we were trained to help constitutes an unhealthy foundation for an authentic therapeutic alliance and a satisfying career.

We take the position that the primary rationale for being an ethically aware and sensitive therapist is not self-protection. There is a far more positive reason. Reaching for the highest standards emboldens us in the face of ethical uncertainty. We respect ourselves and what we do if we feel confident that we are practicing appropriately and within the boundaries of our training and competence. This, in turn, enhances the quality of our services. Maintaining high standards allows us to act with benevolence and courage rather than donning protective armor.

Aristotle speaks of the ethical life as a happy life. This makes sense in our context. Maintaining high ethical standards may well be the prerequisite to a personally gratifying career. Part of vigilance is attending to red flags. Not every item in Table 1 adapted from Keith-Spiegel, is necessarily unethical or would lead to an unethical outcome. For example, it is possible for bartering to work out in a way that satisfies the client and avoids the potential risks of exploitation or contraindication.

Therapists are human and may find themselves sexually attracted to clients. The ethical issue will be how those feelings are dealt with. However, whenever one of these flags waves, one should pause to carefully evaluate the next step. Table 1 - Red Flags: Proceed with Caution. Alert, well-meaning, sensitive, mature, and adequately trained therapists functioning within their bounds of competence will encounter ethical dilemmas that can result in vulnerability to charges of misconduct. Unforeseen Dilemmas. Sometimes an ethical issue is simply not predictable. For example, suppose that a conflict of interest does not become known until some time has passed after taking on a client.

Crisis situations may present ethical challenges, and these, too, are usually unforeseen. Further discussion on this point follows in a later section. Inadequate Anticipation. A therapist may understand a potential ethical problem, but not expect it to arise. Or, a therapist might underestimate the magnitude of the problem or decide that taking safeguards would prove unnecessary or too costly.

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For example, a therapist treating a couple may not attend sufficiently to the possible confidentiality dilemmas that could develop if a divorce occurs and one parent later attempts to subpoena the treatment records for use in a custody dispute. Potential ethical problems may never materialize, but, if they do, the therapist may be held responsible for not taking reasonable precautions. Unavoidable Dilemmas.

Even when a potential ethical problem can be foreseen, there may be no apparent way to avoid it. In some circumstances, at least one party will become upset or feel betrayed, but no feasible options exist to prevent the distress. For example, to protect the welfare of a client or of a person the client plans to harm, a therapist may recognize no other course of action except to disclose information obtained in confidence.

In another situation, a therapist may intervene on behalf of a client who claims to have experienced abuse, and other family members may become distraught and feel wronged. Unclear Dilemmas. In a variation of the inadequately anticipated dilemma, a problem could be seen as possibly arising, but ambiguous features cloud the choice of what action to take. We cannot always predict the consequences of available alternatives as we attempt to make a decision about how best to confront an ethical problem. The use of an innovative or controversial therapeutic technique, for example, becomes problematic because the risks, if any, are simply unknown.

Inadequate Sources of Guidance. An ethical problem may arise whenever relevant guidelines or laws prove inadequate, nonexistent, ambiguous, or contradictory. The general or nonspecific nature of codes of ethics and other regulations can create considerable confusion. The revision of ethical codes is a long and arduous process. In the meantime, new issues arise, such as social media and other technological advances and their potential for ethical pitfalls. Loyalty Conflicts.

An ethical problem may present itself whenever discrepancies exist among the demands of laws, government policies, employers, and ethical principles that simultaneously jeopardize the welfare of client. In individual situations, therapists may feel torn among those who pay for their services or to whom they owe a favor, taxpayers or other third-party payers, colleagues, employers, or employees. These thorny dilemmas cause considerable distress, because a single choice must often be made from among several legitimate loyalties. Someone, or some entity, may not feel well served as a result.

It often becomes difficult — if not impossible — to protect the rights and fulfill the legitimate needs of every involved constituent simultaneously. Conflicting Ethical Principles. When making ethical decisions, a thorny dilemma arises when one moral principle conflicts with another. Which one takes precedence? The values listed at the beginning of this course are not prioritized. Clashes between ethical principles occur more regularly than you might think.

For example, you might consider holding back a truthful response because the client would likely be upset or harmed by it. When an ethical conflict arises, the best possible outcome becomes far more likely if certain conditions pertain. These include: having sufficient time for the systematic collection of all the pertinent information necessary to plan the appropriate strategies, consultation, intervention, and follow-up; properly identifying the persons or entities to whom one owes primary allegiance; taking the opportunity to involve all relevant parties; operating under low stress and with a mindset that maximizes objectivity and self-awareness; and being able to maintain an ongoing evaluation that allows for midcourse corrections or other changes to satisfactorily resolve the dilemma [adapted from Babad and Salomon ].

Fortunately, most of the time, one does not need to rush into a decision before meeting the conditions listed above. Either nothing will happen until these conditions can be satisfied, or the problematic act has already occurred, but any ensuing damage will not materialize right away.

Because professional codes of ethics are general proscriptive guidelines that cannot inform us of how to deal with specific ethical dilemmas and their associated variables, we suggest that all mental health professionals internalize a decision-making strategy to assist in coping with ethical matters as they arise. We expect that such a process will maximize the chances of an ethically sound result, although we also readily acknowledge that this does not always happen.

Sometimes outcomes will remain unsettled no matter how hard one tries to resolve them. However, therapists who can document a sustained effort to deal with the dilemma, including well-reasoned accounts of their decision-making rationale, will have a distinct advantage should their actions ever be questioned or challenged. We must stress that the application of ethical decision-making strategies does not actually make a decision. However, a systematic examination of the situation will likely have a powerful influence on your final determination. People differ in their abilities to perceive that something they might do — or are already doing — could directly or indirectly affect the welfare of others.

As we have already noted, violators of ethics codes can judge a situation inaccurately, for reasons such as bias, ignorance, or denial, and thus fail to undertake any decision-making process at all before acting. When an incident is perceived to have ethical ramifications, a knee-jerk reaction is not likely to lead to the best response. Whereas one should undertake decision-making deliberately, the actual process can range from a few minutes to days or weeks. We discuss a necessity to make rapid decisions under emergency or other urgent conditions in the next section.

It has been updated here as new perspectives and data became available. Other models may supplement ours when issues become complex and involve disparate stakeholders Laletas, Determine whether the matter truly involves ethics. First, the situation must involve an ethical issue germane to your profession and its professional image.

The distinction between the merely unorthodox or poor professional etiquette and unethical behavior may be clouded, particularly if one feels emotionally involved or under attack. A helpful starting point requires identifying the general moral or ethical principle applicable to the situation at hand. As we have already noted, overarching ethical principles such as respect for autonomy, non-maleficence doing no harm , justice, according dignity, and caring toward others rank among those often cited as crucial for the evaluation of ethical concerns.

Readers will find elements of these principles reflected in most ethics codes. The overarching ethical issue in question can often be linked to a specific element of a relevant code of ethics, policy, or law, which makes this phase easier to complete. Strive to discover all the available facts before proceeding.

As Rogerson, et al. The authors point out that, for example, the fundamental attribution error attributing the behavior of others to their stable personality characteristic rather than to any situational variables while judging ourselves based on a given situation may lead to misinterpretations. Or, we may make pre-judgments and fail to consider disconfirming data that might have provided a more accurate assessment. For example, a cynical individual with a weak ability to empathize may, without awareness, commit an ethical infraction.

One psychologist, for example, was furious with the committee for its objection to his practice of insisting that his clients pay for 15 sessions in advance. These are crazy times. Even after collecting data, the best ethical solution still may not become clear, and uncovered contradictions can sometimes cause more confusion than before the decision-making process started. Nevertheless, collecting relevant information constitutes a critical step that must be taken conscientiously. A disregard for extant policy or relevant ethical obligations may result in unwanted consequences for you or for a colleague.

Early in the process, consider collecting information from other involved parties as appropriate. Sometimes this step reveals a simple misunderstanding that led to an improper interpretation. Or, the new data may reveal the matter to be graver than first suspected. Confidentiality rights must be assessed and protected throughout the decision-making process. In some cases, confidentiality issues may preclude taking any further steps. Consult existing guidelines that might offer a possible mechanism for resolution. Prepare to do some homework by finding the resources that represent the moral responsibilities of mental health providers.

Codes of ethics and policy statements from relevant professional associations, federal law, or local and state laws including those regulating the profession , research evidence including case studies that may apply to the particular situation , and general ethics writings are among the materials that you might find helpful. All mental health professionals must stay well informed about the most relevant ethics codes and changing laws relevant to their respective professions. However, it is also wise to stay aware of the provisions of the codes promulgated by their sister professions because of the high probability of interacting with colleagues with different training backgrounds.

The ethics codes of the following organizations can be found online:. American Psychological Association apa. American Counseling Association counseling. National Association of Social Workers socialworkers. American Association of Marriage and Family Counseling aamft. American Psychiatric Association psychiatry. Pause to consider, as best as possible, all factors that might influence the decision you will make. We recommend pausing to gain an awareness of any inflexible mindsets that could affect your judgment. Except in those instances when the issues appear clear-cut, salient, and specifically defined by established guidelines, mental health professionals may well have differing opinions regarding the best decision.

Personality styles and primary guiding moral or religious principles can significantly influence the ethical decision-making process. Other personal characteristics influencing decisions include criteria used to assign innocence, blame, and responsibility; personal goals including level of emotional involvement ; a need to avoid censure; a need to control or for power; and the level of risk one is willing to undertake to get involved.

Divergent decisions could also be reflected in judgments about the reprehensibility of a particular act. For example, no bright line demarcates the appropriate level of personal involvement with clients. Indeed, we have personally observed marked discrepancies in opinions about the seriousness of an alleged violation during actual ethics committee deliberations. Consideration of any culturally relevant variables becomes important, as do any values held by your clients that differ substantially from your own Taube, et al. If such factors as the degree of expected confidentiality, gift-giving traditions, bartering practices, geographic locale, placement of professional boundaries, gender, age, ethnicity, or culturally based expressive behaviors exhibited during therapy sessions play a part in an ethical matter, an inappropriate decision might result if culturally-based variables are not considered in the mix.

Many proscribed acts e. Unwarranted and possibly poor decisions could follow from believing everyone from a certain culture or group is pretty much alike.

Consult with a trusted colleague. Because ethical decision-making involves a complicated process influenced by our own perceptions and values, we can usually benefit by seeking input from others. We suggest choosing consultants known in advance to have a strong commitment to the profession and a keen sensitivity to ethical matters. Choose a confidant with a forthright manner, and not an individual over whom you have advantaged status; otherwise, you may hear only what that person thinks you want to hear.

If you doubt a confidant's advice, seek a second opinion. Evaluate the rights, responsibilities, and vulnerability of all affected parties. These evaluations should include, if relevant, any involved institution and perhaps even the general public. Generate alternative decisions. This process should take place without focusing on the feasibility of each option, and may even include alternatives otherwise considered too risky, too expensive, or even inappropriate.

The possibility of not making a decision at this time and the choice to do nothing should be considered also. Establishing an array of options allows the occasional finding that an alternative initially considered less attractive may be the best and most feasible choice after all. Enumerate the consequences of making each decision. Whenever relevant, attempt to identify the potential consequences of a decision. These include psychological and social costs; short-term, ongoing, and long-term effects; the time and effort necessary to implement the decision; any resource limitations; other risks, including the violation of individual rights; and any benefits.

Consider any evidence that the various consequences or benefits resulting from each decision will actually materialize. The ability to document this phase may also prove useful should others later question the rationale for your final decision and resulting action. Make the decision. If the above phases have been completed conscientiously — perhaps with the ongoing support of a consultant — a full informational display should now be available. Happily, a decision that also feels like the right thing to do may well become obvious at this point. Even so, many moral and just decisions do not always protect every involved person from some form of injury.

Therefore, if anyone could suffer harm, pause to consider any actions that could minimize the damage. Sometimes, a more positive outcome can occur with parental engagement rather than alienation, as depicted in the next case. A therapist treated an alcoholic single mother of two for 18 months. The client had remained sober for more than a year and had made sincere efforts to attend effectively to her children, now ages 6 and 8. One day, she appeared for a therapy session intoxicated. She had just learned that she faced a layoff from her job at a local business that had filed for bankruptcy.

She felt embarrassed and depressed that she had broken her sobriety and mentioned that she had lost her temper and beaten the children with a belt before coming to the therapy session. In most states, the therapist would have an obligation to breach the client's confidentiality by filing a report of suspected child abuse with child protection authorities. Doing so would protect the children, conform to state law, and constitute ethically acceptable behavior. The therapist could, however, go a step further by attempting to engage the client in collaborating in filing the report, and by attempting to engage the authorities in assisting the family while the client strives to restore her sobriety and find alternative employment.

The first course of action addresses ethical necessity. The second alternative involves considerably more effort and advocacy, but also could yield a better outcome all around. Ideally, information about the decision should be shared with all affected parties, or at least with some subset of representatives if a larger population is involved. Sometimes these people cannot be contacted, are unable to participate, or cannot give consent due to age or physical, mental, or other limitations. In such cases, additional responsibilities to protect their welfare apply. Special advocates or other safeguards may become necessary in complex situations.

Sometimes, several decisions appear equally feasible or correct. Alternatively, the best decision may not be feasible due to other factors, such as resource limitations, and require adopting a less preferable option. However, in our experience the right decision usually clearly presents itself, and it is time to proceed to the next, and perhaps most difficult step. Sometimes when this happens, therapists experience a personal dilemma. Whereas we are morally obligated to make decisions in the best interests of those with whom we work, clients may choose to make decisions we would not have made on their behalf.

Implement the decision. The mental health professions will remain strong and respected only to the extent that their members willingly take appropriate actions in response to ethical dilemmas. This often demands moral backbone and courage. It is at this point that the decision-making process comes to fruition, and the decision-maker must DO something. How the decision is implemented is also important Knapp, et al. A poorly executed transaction, especially if one or more of the parties is angry, can cause additional harm.

Acting on a decision becomes the most difficult step, even if the decision and course of action seem perfectly clear.

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The ideal resolution occurs when a decision can be made prior to the commission of an ethical infraction that would otherwise have untoward consequences. Often enough, however, the decision occurs in response to an already ongoing, problematic situation. Sometimes, the appropriate action involves simply ceasing and desisting from a practice that, after careful analysis, seems ethically risky even if no harm has yet occurred.

Sometimes the best course of action is the recognition that one lacks some specific competencies and should now undertake continuing education or seek supervision. Often the implementation will involve the need to do something differently going forward, while attempting to ameliorate any damage now.

Remediation attempts can range from making an apology to conducting an additional intervention to providing services or resources to those who were wronged. On occasion, the implementation will involve contacting an ethics committee or a licensing board to determine the appropriate resolution. Callahan notes that behavioral emergencies and crises are often described as interchangeable, yet distinguishing the two has relevance for how decisions are made.

A behavioral emergency requires an immediate response and intervention to avoid possible harm to the client or someone else. Behavioral emergencies include suicidal or violent behavior or interpersonal victimization. Interventions can range from the simple, such as nonjudgmental listening, to ordering inpatient hospitalization. These may range from more commonplace events causing anxiety or stress to trauma resulting from a life or death situation. In these types of crises, the individual may reach out for, or at least welcome, assistance. Behavioral emergencies often involve little time to reflect before acting.

As a result, ethical dilemmas demanding an immediate response can and do arise. With no time to prepare a carefully reasoned decision using a process, such as the ones we have presented, therapists may feel understandably anxious and be prone to react in a less-than-satisfactory manner.

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Both coping and decision-making skills must be brought to bear Sweeny, A mother brought her year-old daughter to therapy because the child was becoming unusually reserved and withdrawn. When the mother left the room, the child revealed that for the past three months her stepfather had entered her room after everyone else was asleep. He touched her body and requested that she fondle his genitals. The stepfather had warned the girl not to tell her mother or brothers because, if she did, the police would break up the family and it would be her fault.

Halfway through a therapy session, an angry husband pulled a gun from his jacket and shot at his wife, who promptly pulled a gun from her purse and shot back. Involving the appropriate authorities would be acceptable in both of the above cases, even though reporting might violate a confidence. In the second case — and we swear this incident actually occurred — the warring spouses recovered from their wounds and the police credited the therapist's crisis intervention skills that resulted in both clients placing their guns into the therapist's custody.

Sometimes behavioral emergencies do not involve immediate danger but do necessitate immediate action. A marriage and family counselor took a call from the year-old daughter of a couple he was seeing.