Meguro Counseling Center
Code of Ethics
The following items comprise a non-exhaustive list of ethics that the therapists agree to follow in their therapy practice at the Meguro Counseling Center (MCC). This written set of ethics provides the clients seen at the MCC with a secure framework in which to receive counseling and psychotherapy, and gives the therapists at the MCC a set of guideposts intended to ensure the basis of a high-standard of care.
- 1. The well-being of the client as an individual, and all the clients at the MCC as a collective group, is the fundamental mission of the MCC, and all interactions with clients will be based on this premise. Information placed on the home pages will be provided only for the purpose of informing and educating the reader about counseling and mental illness, and to describe how the MCC will strive to help persons who have various mental health issues. The MCC will not discriminate in its efforts to provide empathic and thorough care for clients on the basis of ethnicity, country of origin, religion, age, gender, sexual orientation, gender identity, socioeconomic status, or other personal or demographic factor.
- 2. The MCC will have a set of policies in place to ensure the well-being of both the individual and collective group of clients, and the MCC in caring for these clients. All policies regarding scope of service, the making and breaking of appointments, fees, billing, confidentiality, etc. shall be open and presented to all clients via the sum of the media of home page, the first e-mail contact, and an Informed Consent that is acknowledged by clients via a web form upon making an appointment. Please see the policies as noted on the Counseling Practice Information page.
- 3. All therapists' qualifications and credentials regarding their counseling practices will be open and available for clients at all times as presented on the home page. Please see this page on Therapist Profiles.
- 4. Depending on the situation at hand, the protection of the well-being of the client may best be met by an action of the MCC that the client may not wish themselves. It may be necessary to have a face-to-face meeting to discuss the issues in context instead of e-mail or phone discussion, the MCC may need to insist that a family member is involved, etc.
- 5. Even if a client will react in disagreement or unpleasant surprise in being told they likely have a condition such as depression, manic-depression, alcohol use, etc., it is the MCC policy that it is unethical to not provide open information about a suspected condition to a client except in the rare case that the therapist feels this might lead to deterioration or bad reaction on the part of the client, and this needs to be determined on a case-by-case basis by the therapist. In addition, it would not be ethical for the MCC to provide a therapy approach requested by the client if the MCC does not deem that approach is in the best interest of the client.
- 6. The MCC can only function as a community counseling service. The MCC is not an out-patient psychiatric or medical clinic, nor an in-patient medical or psychiatric facility. All clients should have a prescription and ongoing medical supervision for any pharmaceutical treatment, and the MCC highly recommends medical supervision also for herbal/natural extracts or Chinese herbal medicines, etc. Please see this page on Psychiatric Medication Referral.
- 7. The MCC is ethically bound to help any client in ongoing therapy as an interface with their medical care, however, the MCC can not bear the responsibility for the end result received from a facility that provides medical care, nor guarantee the ability of a specific client to be admitted to a hospital even if that client or their family wishes for admission.
- 8. While the MCC can provide information on various therapeutic approaches, the MCC will never provide negative feedback or comments to clients about other outside therapists, counseling centers, or physicians, etc., unless there is public knowledge of criminal behavior on the part of this physician or therapist that would impact the well-being of the client. The MCC can not have first-hand knowledge of how another therapist actually functions with their clients, and the position of the MCC is that any and all clients are free to meet and have therapy with any therapist at any time. In the case that the client provides the MCC with information on an approach they are receiving or have been proposed to receive, however, the MCC would be ethically bound to comment on a specific intervention, or non-intervention, that the MCC would deem as not serving the client's interest. The final decision on what therapist or therapy they will receive is the client's.
- 9. The MCC will not promote itself and/or solicit donations or collect funds by sponsoring or attending social or recreational events because these events themselves do not speak for the value of the service provided to the attendees, can cause the donating entity to expect favors from the MCC that could promote conflict of interest, and are tangential from the main mission of the MCC which is to provide unbiased and professional mental health care. In this light, the MCC does not accept monetary notes or gifts of any significant value from clients or other persons or organizations in order to avoid conflicts of interest or favor-engendering relationships.
- 10. It is not ethical for the MCC to insist or order any life-choice on a client, i.e., marriage, divorce, job-related decision, etc. The MCC may ethically provide advice on how to think about these issues and choices, however, the final decision on these personal matters needs to reside with the client.
- 11. It is not ethical for the MCC to become involved with aspects of a client's personal life in legal proceedings. It is not possible for the MCC to have first-hand knowledge of the activities of clients or their significant others outside of the session hours, and there is the potential for letters or testimony to inadvertently harm the position of the client and/or their significant others. Clinical summaries that note that the client had attended counseling sessions for specific issues, and the recommendations the therapist made in regards to these issues, may be provided to clients at their request. It is not ethical, however, to provide descriptive clinical information related to persons other than the requestor in cases where multiple persons have attended sessions (i.e., a clinical summary requested by Mr. A may state that he attended the sessions with his wife for counseling, however, clinical details related to the wife would not be provided by letter to Mr. A).
- 12. The relationship between client and therapist is for counseling only. Because the therapists at the MCC are not licensed physicians in Japan, this relationship can not be deemed to be a physician-patient relationship. In addition, in order to protect the interests of the client, it is unethical for the therapist-client relationship to become an intimate personal relationship.
- 13. Clients shall never be over-billed, scheduled for sessions without the clients intended wish to have a session, charged more than the fee-structure agreed upon with clients before a session, or kept in ongoing therapy only for the purposes of receiving fees from the client. In cases where medications are prescribed for psychiatric problems, the policy at the MCC is to recommend that clients confer with their physician on the use of low-cost generic medications whenever possible.
- 14. Appointments for therapy sessions are a contract for a professional consultation service. They are only scheduled upon request by the client, and only after all cancellation and billing policies have been noted openly and agreed upon by the client. Because of this, it is the MCC policy that after multiple confidential requests for unpaid fees, that it is ethical to contact a client's family, significant other, the client and/or family or significant other's place of work, and ask these persons to follow-up with the client on the status of the unpaid fees. While a specific therapist's name or the name of the MCC may be noted in these requests, the clinical details of the person's therapy are maintained confidential. It is also the ethical right of the MCC to request unpaid fees thru the legal system in Japan when appropriate (ethics reference).
- 15. In the case of a missed session and non-contact from a client, as it is not uncommon for psychotherapy clients to be in great despair and to consider harming themselves, it is ethical for the MCC to exhaust all means to try to contact a client to confirm their situation and safety.
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The Meguro Counseling Center consists of Western-trained therapists able to provide face-to-face mental-health care for the international community in Tokyo. With extensive experience in Japan, these therapists have a deep understanding of the stresses of living in Japan.