Ricardo: The School and Licensed Counselor

Ricardo is a credentialed school counselor in his state and a licensed counselor. Currently, he works and lives in a large city. Monday through Friday 7:30AM- 3:30PM, during the months of August to June, Ricardo works as school counselor at a Middle School serving students in grades six through eight. On Thursday evenings from 5-9:30PM, Ricardo offers individual sessions at an office downtown. Ricardo specializes in working with adolescents and their families. Ricardo provides services here for clients who have a limited ability to pay for ongoing counseling. Many of the insurance companies used by these clients will not reimburse for family therapy, so Ricardo provides an individual diagnosis for one of the family members, such as "Generalized Anxiety Disorder" or "Adjustment Disorder with Depression," so the insurance companies will cover the sessions and the clients will only have to come up with the co-payment. Otherwise, they would not be able to receive any counseling at all. For clients without insurance, Ricardo lowers his fee substantially so they can afford their counseling sessions, and often lets clients go without payment because he knows that they really need the help. To help build his caseload, Ricardo refers students he works with at his school to see him off-campus when they need additional services that he cannot provide during the school day.

Ricardo has also sought additional clients from his friend who is also a licensed counselor; Ricardo pays her $50.00 for each client that she refers to him. Ricardo charges an hourly rate of $135 to these clients, knowing that the clients can easily afford this fee. Also, he administers a battery of tests as a standard intake process for all these clients, knowing that the clients` insurance companies reimburse at a high rate for these assessments.

Ricardo says that the money he makes from his friend`s referred clients supports his ability to see less fortunate clients.

Question:

Discuss your reaction to Ricardo`s approach to counseling and the decisions he has made to provide services to lower-income adolescents and families. Are his actions legal and/or ethical?