|(a) A licensee must not make any false, misleading,
deceptive, fraudulent or exaggerated claim or statement about the
licensee's services, including, but not limited to:
(1) the effectiveness of services;
(2) the licensee's qualifications, capabilities, background,
training, experience, education, professional affiliations, fees,
products, or publications; or
(3) the practice or field of counseling.
(b) A licensee must not make any false, misleading,
deceptive, fraudulent or exaggerated claim or statement about the
services of a mental health organization or agency, including, but
not limited to, the effectiveness of services, qualifications, or
(c) A licensee must discourage a client from holding
exaggerated or false ideas about the licensee's professional services,
including, but not limited to, the effectiveness of the services,
practice, qualifications, associations, or activities. If a licensee
learns of exaggerated or false ideas held by a client or other person,
the licensee must take immediate and reasonable action to correct
the ideas held.
(d) A licensee must make reasonable efforts to discourage
others whom the licensee does not control from making misrepresentations;
exaggerated or false claims; or false, deceptive, or fraudulent statements
about the licensee's practice, services, qualifications, associations,
or activities. If a licensee learns of a misrepresentation; exaggerated
or false claim; or false, deceptive, or fraudulent statement made
by another, the licensee must take immediate and reasonable action
to correct the statement.
(e) Regardless of setting, a licensee must provide
counseling only in the context of a professional relationship. Prior
to providing services, a licensee must obtain from an individual a
signed informed consent, signed written receipt of information, or
in the case of involuntary treatment a copy of the appropriate court
order, including the following:
(1) fees and arrangements for payment;
(2) counseling purposes, goals, and techniques;
(3) any restrictions placed on the license by the board;
(4) the limits on confidentiality;
(5) any intent of the licensee to use another individual
to provide counseling treatment intervention to the client; and
(6) supervision of the licensee by another licensed
health care professional including the name, address, contact information
and qualifications of the supervisor;
(7) the name, address and telephone number of the board
for the purpose of reporting violations of the Act or this chapter;
(8) the established plan for the custody and control
of the client's mental health records in the event of the licensee's
death or incapacity, or the termination of the licensee's counseling
(f) A licensee must inform the client in writing of
any changes to the items in subsection (e) of this section prior to
initiating the change.
(g) Technological means of communication may be used
to facilitate the therapeutic counseling process.
(h) In accordance with §503.401(a)(4) of the Act,
a licensee must not intentionally or knowingly offer to pay or agree
to accept any remuneration directly or indirectly, overtly or covertly,
in cash or in kind, to or from any person, firm, association of persons,
partnership, corporation, or entity for securing or soliciting clients
(i) A licensee employed or under contract with a chemical
dependency facility or a mental health facility must comply with the
requirements in the Texas Health and Safety Code, §164.006, relating
to soliciting and contracting with certain referral sources. Compliance
with the Treatment Facilities Marketing Practices Act, Texas Health
and Safety Code Chapter 164, will not be considered as a violation
of state law relating to illegal remuneration.
(j) A licensee must not engage in activities for the
licensee's personal gain at the expense of a client.
(k) A licensee may promote the licensee's personal
or business activities to a client if such activities, services or
products are to facilitate the counseling process or help achieve
the client's counseling goals. Prior to engaging in any such activities,
services or product sales with the client, the licensee must first
inform the client of the licensee's personal and/or business interest
therein. A licensee must not exert undue influence in promoting such
activities, services or products.
(l) A licensee must set and maintain professional boundaries.
(m) Except as provided by this subchapter, non-therapeutic
relationships with clients are prohibited.
(1) A non-therapeutic relationship is any non-counseling
activity initiated by either the licensee or client that results in
a relationship unrelated to therapy.
(2) A licensee may not engage in a non-therapeutic
relationship with a client if the relationship begins less than two
(2) years after the end of the counseling relationship; the non-therapeutic
relationship must be consensual, not the result of exploitation by
the licensee, and is not detrimental to the client.
(3) A licensee may not engage in sexual contact with
a client if the contact begins less than five (5) years after the
end of the counseling relationship; the non-therapeutic relationship
must be consensual, not the result of exploitation by the licensee,
and is not detrimental to the client.
(4) For purposes of paragraphs (2) and (3) of this
subsection, the licensee must be able to demonstrate there has been
no exploitation and the non-therapeutic relationship is not detrimental
to the client in light of all relevant factors, including, but not
limited to, the factors set forth in §681.42(b)(4)(A) - (G) of
this title (relating to Sexual Misconduct).
(5) The licensee must not provide counseling services
to previous or current:
(A) family members;
(B) personal friends;
(C) educational associates; or
(D) business associates.
(6) The licensee must not give or accept a gift from
a client or a relative of a client valued at more than $50, borrow
or lend money or items of value to clients or relatives of clients,
or accept payment in the form of goods or services rendered by a client
or relative of a client.
(7) The licensee must not enter into a non-professional
relationship with a client's family member or any person having a
personal or professional relationship with a client if the licensee
knows or reasonably should have known such a relationship could be
detrimental to the client.
(n) The licensee must not knowingly offer or provide
counseling to an individual concurrently receiving counseling treatment
intervention from another mental health services provider except with
that provider's knowledge. If a licensee learns of such concurrent
therapy, the licensee must request release from the client to inform
the other professional and strive to establish positive and collaborative
(o) A licensee may take reasonable action to inform
medical or law enforcement personnel if the licensee determines there
is a probability of imminent physical injury by the client to the
client or others, or there is a probability of immediate mental or
emotional injury to the client.
(p) The licensee must take reasonable precautions to
protect clients from physical or emotional harm resulting from interaction:
(1) within a group; or
(2) individual counseling.
(q) For each client, a licensee must keep accurate
(1) signed informed consent, signed written receipt
of information, or, in the case of involuntary treatment, a copy of
the appropriate court order
(2) intake assessment;
(3) dates of counseling treatment intervention;
(4) principal treatment methods;
(5) progress notes;
(6) treatment plan; and
(7) billing information.
(r) Records held by a licensee must be kept for a minimum
of six (6) years from the date of the last contact with the client.
(s) Records created by licensees during the scope of
their employment by agencies or institutions that maintain client
records are not required to comply with (q) and (r) of this section.
(t) Billing Requirements.
(1) A licensee must bill clients or third parties for
only those services actually rendered or as agreed to by mutual understanding
at the beginning of services or as later modified by mutual written
(2) Relationships between a licensee and any other
person used by the licensee to provide services to a client must be
so reflected on billing documents.
(3) Pursuant to Texas Health and Safety Code Chapter
611, on the written request of a client, a client's guardian, or a
client's parent (sole managing, joint managing or possessory conservator)
if the client is a minor, a licensee must provide, in plain language,
a written explanation of the types of treatment and charges for counseling
treatment intervention previously made on a bill or statement for
the client. This requirement applies even if the charges are to be
paid by a third party.
(4) A licensee may not knowingly overcharge a client.
(5) With the exception of an unkept appointment, a
licensee may not submit to a client or a third party payor a bill
for counseling treatment intervention the licensee knows or should
know is improper, unreasonable, or unnecessary.
(u) A licensee must comply with all requirements of
Texas Health and Safety Code Chapters 611 and 181 concerning the release
of mental health records and confidential information.
(v) Prior to the commencement of counseling services
to a minor client who is named in a custody agreement or court order,
a licensee must obtain and review a current copy of the custody agreement
or court order as well as any applicable part of the divorce decree.
A licensee must maintain these documents in the client's record and
abide by the documents at all times. When federal or state statutes
provide an exemption to secure consent of a parent or guardian prior
to providing services to a minor, a licensee must follow the protocol
set forth in such federal or state statutes.
(w) A licensee must terminate a professional counseling
relationship when it is reasonably clear the client is not benefiting
from the relationship.
(x) Upon termination of a relationship, if professional
counseling is still necessary, the licensee must take reasonable steps
to facilitate the transfer to appropriate care.
(y) A licensee must not evaluate any individual's mental,
emotional, or behavioral condition unless the licensee has personally
interviewed the individual or the licensee discloses in the evaluation
the licensee has not personally interviewed the individual.
(z) A licensee must not knowingly overtreat a client.
(aa) A licensee must not aid or abet the unlicensed
practice of professional counseling by a person required to be licensed
under the Act.
(bb) A licensee must report to the board knowledge
of any unlicensed practice of counseling.
(cc) A licensee or an applicant must not participate
in the falsification of any materials submitted to the board.
(dd) A licensee must not provide services while impaired.
|Source Note: The provisions of this §681.41 adopted to be effective September 1, 2003, 28 TexReg 4134; amended to be effective November 21, 2004, 29 TexReg 10512; amended to be effective September 1, 2005, 30 TexReg 4978; amended to be effective April 27, 2008, 33 TexReg 3268; amended to be effective September 1, 2010, 35 TexReg 7801; amended to be effective May 20, 2012, 37 TexReg 3591; amended to be effective December 12, 2013, 38 TexReg 8889; amended to be effective January 12, 2015, 40 TexReg 233; amended to be effective July 14, 2016, 41 TexReg 5057; amended to be effective July 16, 2017, 42 TexReg 3487; amended to be effective February28, 2019, 44 TexReg 844