Avoiding Common Ethical Violations | Counseling Ethics

Hey there everybody, and welcome to this video on avoiding common ethical violations. I'm your host, Dr. Donnelly Snipes. In this video, we're going to explore ethical guidelines with respect to multiculturalism, confidentiality, informed consent, documentation and discharge, and abandonment. So let's start out by talking about 10 of the most common ethical violations in counseling. The first one is either not getting an informed consent signed or not having all the components required for an informed consent. There's actually 15 or more, depending on the type of counseling that you're doing. Not respecting multicultural issues is another common ethical violation that is using assessment instruments that are not normed on your population or using counseling techniques and approaches that are not appropriate for your particular population. Confidentiality violations, that's pretty self explanatory and that can include HIPAA high tech as well as confidentiality violations in group. Competence is another common violation where people are acting outside of the scope of their competence, whether they are making dietary recommendations or they're using a technique for which they don't have sufficient training. Now, there are a lot of techniques out there that you can get trained on that you can gather CEUs and say that you're trained on, but are you really fully competent in that technique? EMDR is a perfect example. Technically, people don't have to be certified in EMDR to use that technique. However, it is a best practice. It is a professional expectation that someone who is using emdr, for example, has actually gone through the training and the internships and practice and is competent with that skill before they start using it with clients, couples and groups. Confidentiality is another area that's common for ethical violations. Where a clinician might be seeing a couple in session and then seeing each individual in individual counseling and then divulge something they learned in individual in couples counseling. So it's really important. And the same thing with group. You can be seeing somebody individually and also seeing them in group. And if you bring information that you learn in an individual session and divulge it in the group session, that is a violation of confidentiality. So it's really important to be very upfront about the bounds of confidentiality. It's also really important if you are seeing people in multiple different formats, if you will, that you are very cognizant of what is said and what is brought into either the couples or the group session. Counseling minors is another area where there are often a lot of violations because minors technically cannot consent for treatment in most cases in most states. And there are exceptions to the rule that we're not going to go into in this particular video. But it's important to recognize that legal guardians of minors do have the right to certain information. And identifying that boundary between what the legal guardian needs to know and protecting the minor's right to privacy can get a little bit dicey. Dual relationships are also another big area where there are frequently ethical violations. And dual relationships include everything from, you know, dating clients, which is completely foreboding, to things like accepting gifts or bartering with clients. When the American Counseling association ethical guidelines were was updated, I believe in 2014, it started taking a softer line toward bartering, recognizing that in some cultures it can be appropriate, but it's really important to have very clear informed consent, very clear contracts regarding the bartering arrangement. Suicidal clients is another area of common ethical violations. Because when we involuntarily commit someone, it does take away their right to choose. It violates their ethical right to autonomy. However, we've got to balance that with letting them have autonomy in a situation in which they are an imminent threat to themselves or others. It's really important if you are going to violate somebody's autonomy, if you're going to violate an ethical guideline that you consult, that you document, that you are very clear about your decisions. Likewise, you know, if you don't involuntarily commit someone and then they do harm themselves or others, then you could also be liable. So it's important to look at both sides and you've got to make a choice between two really strong decisions. Counselor training and supervision, surprisingly, is another area where there are common ethical violations. And this can be, and most often it happens in the form of, shall I say, shoddy supervision where supervisors are signing off on hours that don't actually happen or are not providing quality ethical supervision of each client. They're maybe bringing in a supervisee and talking about one client and then the other 10 clients the supervisee is seeing, they don't even talk about. The problem with this is that when a person is being seen by an intern, by a non licensed professional, then the supervising licensed professional is responsible for ensuring quality care. So if you're not talking about those other 10 clients, then you are not ensuring their quality care. And there can be a lot of problems. There's also problems ethical violations that involve the type of supervision. Sometimes people get too much group and not enough individual supervision. Some states limit how much supervision can be done virtually versus how much supervision has to be done actually in the same room with the supervisee some states require. And ethically it really is important in My opinion, when you're working with supervisees that you actually do direct supervision. You're either watching through a window or you are reviewing a videotape or worst case scenario, an audio tape, but you're actually seeing that clinician in practice in order to be able to assess verbals nonverbals ability to appropriately apply techniques at the right time. Unfortunately, that rarely happens in my experience. In talking to other supervisors, there's often resistance on the part of the supervisees, and therefore the supervisors often do not push that envelope, if you will. And then ultimately the people being served suffer because the clinician in training is not getting adequate supervision. Let's just call it what it is. And then finally, law violations. And some of these may come up because people think ethically they shouldn't do something, but the law says to do something. For example, reporting or not reporting a person who has HIV or AIDS who is engaging in unprotected sex with a significant other, with an identified other person. Some states allow that breach of confidentiality would allow the clinician to tell that identified significant other. Other states do not allow that. And it's important to know what your laws are in your state regarding treatment of minors, regarding breaking confidentiality about communicable diseases. It is important that you are aware of all of the laws. I recently taught an ethics class at a university, and it was befuddling to me, I guess, at the resistance that a lot of counselors in training had to learning the actual laws and going in and looking at all of the laws. Every state that I've been licensed in, and I've been licensed in Virginia, Tennessee and Florida, and I'm still licensed in both Tennessee and Florida. There are multiple laws. It's not just one law. There are multiple laws that apply to the practice of mental health counseling or social work. And it is so important that you're aware of all of those laws because they shape. They define the minimum standards for treatment, for documentation, for training, and for. For certain actions that you must do, including mandatory reporting and how you respond in. In regards to treating various other issues that come up. So do be aware if you are not familiar with the laws that govern your profession in your state or in the states in which you are licensed. Ask your board. Go find, go to your board's page, because generally they have a list of the relevant statutes and rules. Statutes and rules are ultimately the laws that govern our profession. You're responsible for knowing both. You can't just say, oh, well, you know, it wasn't called a law so why did I know? Not why did I need to know it? You are responsible for knowing all of the statutes and all of the rules. Same thing is true about continuing education. In most states, there is a rule that has been passed by the board that dictates what you need in terms of continuing education. For example, how many hours of ethics. And if those hours have to be live and face to face, or they can be on demand. They also dictate how many of the hours of continuing education can be done virtually. That is asynchronous training versus live interactive. And it also often dictates who is approved to provide continuing education. Does it have to be a provider that is approved by NBCC or nasw, or can it be a provider that's approved by that state? State? Or can it be a provider that's approved by any state board of counseling or social work? So it's important to know where you need to go in order to get approved counselor education or continuing education for your licensure, because you are required to have a certain number of hours for every license renewal. Some states, and actually, I know I'm off on a CEU tangent right now, but some states actually dictate how many hours you have to have every single year of your renewal period. So if you renew every three years, they may say you have to have a minimum of 10 hours every single year. So it's important to know what your state says. So let's talk about what our ethical guidelines tell us to do. And this part's going to be a little dry, but it's important. Ethical guidelines tell us that we need to act in the best interest of our clients at all times. We need to act in good faith and in the absence of malice. We're not doing it for personal gain. We're not doing it for malicious reasons. And we are acting in the best interest. So beneficence. We need to inform people of possible limitations of the counseling relationship prior to the beginning of that relationship. And too often, way too often, like probably 85% of the charts that I've looked at from different organizations or different people do not have an adequate informed consent. According to the ACA Ethical Guidelines subsection A2, there are a minimum of 15 things that need to be in every informed consent document. Now, you may be scratching your head going, Wow, 15 things. What can that be? I encourage you, if you don't know, to go look at the American Counseling association ethical guidelines subsection A2 to find those things out. Why am I not telling you What? Well, part of that is because I want you to know how to look up the ACA guidelines and ideally, download them and save them on your computer, and then be comfortable going in there and reading them. They're not in legalese, they're not hard to understand, and it's really important that you review them periodically. Ethical guidelines tell us that we need to increase our awareness of our personal values and attitudes and beliefs and refer when personal characteristics hinder effectiveness. Now, that can be an ethical issue right there. If you are seeing a client for eight months and have a good relationship established with them, have great rapport, are making progress, and then all of a sudden they drop a bomb that comes from out of nowhere, it's important to recognize the benefits of continuing to see that client, even if you have to seek supervision. So maybe you've been seeing them for 10 months, and then all of a sudden they open up to you that they are gay, lesbian, or transgender, and they want to become more open about that. But you haven't received any training on it. Well, your personal characteristics, your training in and of itself may say, hey, I don't know how to treat that. I don't know the best practices for that. Your initial reaction may be to refer to somebody else. However, it's really important to recognize what does that say to the client. And if all of a sudden they tell you something that makes them feel vulnerable and you push them away, you know that can be very damaging to a client. So it's important to recognize. Another instance that may come up is if you are working with a client again for a period of time, you've established a rapport, you're working together, and they admit to you that 15 years ago they abused their child. You have a history of being an abused child, so that brings up all kinds of feelings for you that you have difficulty navigating in this relationship with this client. Now, it's important to consult with your supervisor and other colleagues as needed, maybe even your own therapist, if you're seeing one, about whether you can effectively work with this client, or your feelings about people who abuse children are going to get in the way and make you ineffective at working with that person. So, again, you need to weigh the balance between continuing to see somebody who you. In this particular case, you have strong feelings about something that they did and whether you're going to be able to be effective versus the damage it causes when they reveal this to you. And all of a sudden you start pushing them away and becoming very rejecting of them, which is probably why they didn't tell you in the first place, because they were afraid of rejection, they were afraid of the response. So that helps you understand why it's important to be aware of your personal values, things that might hinder your ability to be effective as a therapist. Now, if these things happen during the initial meeting, if somebody comes in for an assessment and they put this stuff out during the assessment, you have an officially developed rapport with the LGBTQ client. You may be able to discuss with them. I am not well versed in the coming out process, and I'm not sure that I would be as effective as somebody else in helping you through this. But put it in the client's ballpark, so to speak, in the client's court, to say, I would rather work with you while you get supervision on it versus be referred to somebody else, or okay, I hear what you're saying. I would rather be referred to somebody else. We need to be aware and open with those things. Actively attempt to understand the diverse cultural backgrounds of the people with whom we work, including our own cultural, ethnic, racial identity and its impact on our values and beliefs about the counseling process. We're human. We have perceptions, we have beliefs, we have values. And they don't always align with those of the people that we serve. That's just the way life is. It's important to practice principles of multicultural counseling and recognize and respect the beliefs and values of, of the people we serve. But we definitely need to regularly check in with ourselves to make sure that we are doing that and we're not trying to push our own agenda, so to speak. And that is referenced in part in ACA Ethical Guidelines subsection B1. Multiculturalism is actually referenced multiple places throughout the document. We need to function within the boundaries of our personal competence and be aware of personal skill levels and limitations. ACA codes C2 and E2 are most germane here, but again, there's, you know, kind of comes up a lot throughout the entire ethical code. It's important to recognize what are you competent at if you are well versed. And okay, I'll give you the example. When I was in a young therapist, I was licensed to practice independently. I was working at a community mental health agency. And up until then I had seen adults. That's all I had ever worked with. I had never received training on play therapy or sand tray therapy or working with children in therapy at all for that matter. And all of a sudden my job description got switched and I was now supervising the school based counseling. Oh my gosh. You know, Because I recognized from that moment, legally, could I see children? Yes. There's nothing in the law that says that as an independent practitioner I need any particular special certification to see children, although I think there really should be, because they're not just little adults. But that's a whole different issue. However, ethically, I knew good and well I was not competent to provide treatment to children who were in elementary or even middle school, because developmentally they are not. You don't use the same techniques in the same way with, with children as you do with adults. So I was aware of the boundaries of my personal competence and my personal skill level and limitation. And I had to bring that up with my supervisor very quickly because I was transferred there. And I had to make it very clear that it was important, it was an ethical imperative that I was able to receive supervision and additional continuing education in that area in order for me to be able to maintain that position. As clinicians, we need to be able to fully explain why we do what we do. If we ask somebody to keep a symptom log, we need to be able to explain to them why. Why am I asking you to do this? It's not just busy work. Why am I asking you to do this? If we're asking them to abstain from drinking alcohol, we need to explain to them why that's important. If we're asked anything we ask them to do, we need to be able to connect it directly to one of their treatment goals. In what way will doing this help you move toward your ultimate treatment goals? Ethically, we're supposed to encourage family involvement where possible when working with minors, especially in sensitive areas. Minors typically are living with their family. Therefore, family involvement is often helpful in garnering support for that minor or helping that minor work through issues. This is not always the case and sometimes minors don't want their family involved. So it has to be a very well thought out process in order to respect the minor's autonomy and non malfeasance, do no harm to the minor. We do need, and I already said this, but I'm going to say it again, we need to read and adhere to the ethical standards of our profession. I dare say most clinicians haven't reread their ethical code from beginning to end, probably since they took their licensure exam. And there are a lot of things in the ethical codes that are common sense, but it is important to regularly reread them. They get updated and know what the changes have been in your profession, in the ethics of your profession. I think the ACA code of ethics right now is like 14 pages or something. It's not this huge document that takes hours and hours to read, but it is good to read the whole thing, not just go in and say, well, what does the ACA say about etherapy? You know, well, what does the ACA say about anything that I'm doing right now? And double check ourselves to make sure that we're still, we haven't started to, you know, slowly drift away from that center. Guideline of ethics ethical guidelines will tell you to regularly consult with other professionals not only to get feedback about what's going on, but also to get a different perspective. If, for example, if you're looking at involuntary commitment, what would they do? And that helps you make sure that you're acting in the way that another reasonable professional would. We also need to consult with other professionals when they have skills and specialties outside of our own. I regularly work with therapists who are certified in emdr. I am not certified in emdr, but I work with a lot of people that have trauma. Therefore I am regularly making referrals to those other professionals. I'm regularly consulting with them and saying, do you think EMDR might be helpful in this situation? Same thing with dietitians and physicians where we regularly consult. And I fully believe that a multidisciplinary team is essential in helping the person recover. But we need to join appropriate professional associations, read association publications, and participate in professional development opportunities. I was just talking to a student the other day who still had not become aware of the Counseling Compact. And if you haven't become aware of the Counseling Compact, it is a fabulous new movement in the counseling profession that is soon to become, is soon to allow us to more easily be able to get licensed in states when we move from one state to another. So you can look it up online. It's just the Counseling Compact. But if you're not a member of a professional association and you don't follow what's going on in your, in your field, then you probably didn't know about that. It's important to stay up to date with laws and current court rulings, particularly those pertaining to counseling with minors, handling suicidal or homicidal clients, hiv, it may become an issue at some point that we also need to become more aware of legal rulings pertaining to reporting we might need to do for red flag laws. I'm just going to leave it at that for now. But it is important to know what direction your state is going to and you need to have a knowledgeable attorney that you can consult with when necessary. Obviously, an attorney is not going to be able to tell you a right or a wrong with ethics, because oftentimes there is not a clear right or wrong with ethics. It is a best decision. However, an attorney will be able to advise you on your your legal requirements. The American Psychological Association's Tips to Avoid Ethical Pitfalls Understand what constitutes a multiple relationship. If you're in a dual or multiple relationship, what does that mean? And the ACA guidelines are pretty broad as to what constitutes multiple relationship. It's not just between you and the and the particular client. It can be between you and, for example, the client's immediate family. So when you're in a relationship that might be considered a multiple relationship whose needs are being served and is the client being exploited? Not every multiple relationship can be avoided, especially in smaller towns. So it's important to definitely regularly assess whose needs are being served and whether the client's being exploited. Protect confidentiality at the beginning of treatment and occasionally throughout treatment, if necessary, discuss the limits of confidentiality. You are required to break confidentiality under these circumstances. Ensure the safe storage of records and in this day of electronic medical records, it's actually more difficult in some ways than it used to be when it was the old paper pencil records. When you safely store your records, they need to be stored on a hard drive that's full drive encrypted. The computer that you use to write them on needs to be full drive encrypted if you print anything. Most printers have a hard drive and you need to make sure that that hard drive is wiped or full drive encrypted in order to protect records at the source. But it's also important in terms of confidentiality as well as continuity of care to make sure that you have a copy of those records that are saved somewhere off site or in a safe place. So fire, flood, hurricane, or just a hard drive going bad doesn't cause you to lose all of that data. So the the storage of those records needs to be somewhere else. The cloud is generally not a good option because that is not a safe storage place. Somewhere where you can back your information up onto a hard drive and have it be air gapped most of the time. So you unhook it from the Internet except for when you are backing it up. That's the ideal situation. Know your federal and state laws about what needs to be disclosed and obey mandatory reporting laws. Most states have mandatory reporting laws not only for child abuse, but for the abuse of elders or I don't remember what the term is, but adults who are not able to legally care for themselves obtain informed consent at the start of treatment. This includes, but is not limited to. Remember there's 15 plus things that need to go into an informed consent. The type of treatment to be provided, the benefits and risks to that type of treatment. So if you provide EMDR or DBT or whatever it is you use, this is what you have to offer. What are the benefits and risks? What are the alternatives, and what are the benefits and risks of those alternatives for this particular person? What is the cost and expense, expected duration of treatment? I have only ever seen it one other time on an informed consent where an expected duration of treatment is provided. And that is really important. So people know, am I going to be seeing this clinician for 10 weeks or is this like a five year endeavor? Just because there's an expected duration of treatment doesn't mean you can't update it at a certain point. But it is important for people to be aware of, you know, what you're hoping is going to be the expected course. And you need to make sure that everybody is very familiar about the limits, that of confidentiality in individual as well as in group. And on this note, I will identify that there are special additions to informed consent and confidentiality documents if you're providing etherapy. So just be aware of that. Identify your client and the role. Understand who you were hired to help and what's expected of you if you are. I remember my first job out of college. I was hired to work in probation and parole. And all of the people that I was seeing were people who were on felony probation or parole. Technically they were my clients, but the person who was paying the bill, the person who owned the contract, was the state of Florida. So what's expected of me? Who's my client? When you're in those situations, you need to be very clear about what you have to divulge. For example, with these particular people, I was able to say, okay, you know, you're getting ready to enter into a 10 week course of group treatment that is required by your probation. You don't have to take it. If you don't choose to enroll in this 10 week course of treatment, then these are the potential consequences. And generally it was laid out in their probation documents, but it was important that I allow them the option of opting out. Likewise, it was important to tell them, since you are participating in this program that is sponsored by Probation and Parole, your probation officer is regularly going to get updates on your progress. On the results of your drug screens and on your attendance. That is all part of informed consent, especially when working with involuntary clients. It's important to document properly in agency work. A lot of times there are formats and checks and balances that make sure that minimum documentation gets done. It's not always great, but minimum is done. In private practice, it can be very easy to get sloppy or lazy in our documentation, and that is an ethical violation. If for some reason, heaven forbid, you were to become incapacitated and someone else had to take over, but you hadn't done a chart note in the last six weeks on any of your clients, then whoever stepped in wouldn't have any idea where to begin, wouldn't have any idea of the treatment plan or, well, maybe it. Maybe the treatment plans in the file, but wouldn't have any idea of where these people were, which would waste a lot of time because the client would often have to start, you know, from jump all over again because you hadn't kept adequate notes. Likewise, if you're billing, there's the old saying, if it's not documented, it didn't happen. And if you get sued, if it's not documented, you can't protect yourself. And in today's world of online documentation and electronic medical records, every note you do, every form you fill out online, even if it's on your personal computer, has information about when it was created. Therefore, you can't go back eight months and write notes up until today and have it, you know, be legit. I mean, it wouldn't be legit anyway, but you can't make it look like you actually wrote that note eight months ago. Again, practice only where you have expertise. Some specifics that we need to include in documenting therapeutic interactions according to the guidelines and ethical experts include identifying information and the first contact. When did the therapeutic relationship begin? A relevant history, risk factors, medical status, and attempts to get prior treatment records. That's another thing that I often don't see in documentation when I do audits is therapists even attempting to reach out to prior therapists or the current medical provider. For example, the dates of service and the fees, diagnostic impressions, any assessments that you did, treatment plans, any consultation that you did, summary and supporting data and progress notes. It's important in the documentation to include not only the treatments chosen, but the treatments considered and rejected. So again, we'll take trauma. If you're treating somebody with trauma, you can use Trauma Focused Cognitive Behavioral Therapy. You could potentially use emdr. You could potentially use Humanistic. There are a lot of different approaches to treating trauma. And it's important to identify what was selected and why and also why the other, the person rejected the other things doesn't mean they can't change their mind. Maybe three months from now they decide, hey, I think I'd like to try that. Okay. And you can make a note in the documentation at that point. We need to include the informed consent documentation. And if you're audiotaping or videotaping, even for your own personal knowledge, so for your own personal supervision, you need to have a consent form from the person being taped so they know and it's documented that they agree that they are giving consent to be, to be recorded. We need to have a release of information and documentation of any releases that we made. So if you get a release of information for somebody's physician or for their probation officer or whomever, that's wonderful. And you're required to keep a running list of any releases that you made. So if you actually sent something to their doctor or their po, there needs to be a notation in the file, what you sent to whom it was sent and when it was sent. You need to include in the documentation relevant to telephone calls and out of office contacts. So if the client calls your answering service at 2 in the morning on Friday and your answering service patches them through and talk to them for a minute and agree to see them first thing the next morning, that's wonderful. But that contact needs to be included in the notes. There needs to be documentation of follow up efforts when clients just drop out. If somebody drops out, we don't know, were they unsatisfied with services? Did they reach maximal levels of benefit and so they were ready to go. Did something else come up? Did something happen to them? We don't know. And ethically it's our responsibility to follow up with them. Agencies I've worked with before have had a policy and it's one I've adopted for my private practice. When somebody drops out, they don't show up for an appointment, they don't call and try to reschedule. Then I call them and I, and if possible, if I'm allowed to, I leave a message. And that is, we need to know if we're allowed to leave a message. If I call and leave a message and they don't return my call, I'll call a second time and leave another message. And if they still don't return my call, I will send a letter indicating that they are about to be their charts about to be closed and providing at least three referrals but also letting them know that if they don't want their chart closed that they need to contact me back within a week. After all that's said and done, if they haven't contacted me back, I close their chart and send them one more letter. And this is a snail mail letter that says I sent you this letter on XYZ date letting you know your chart was about to be closed. If you didn't reach out to me by this date, still haven't heard from you, so your chart has been closed. To reiterate, these are three referrals that you might consider reaching out to if you still need help or you can recontact our office. It's important to do that for a variety of reasons, not the least of which is liability. If your client is still open on your caseload, then technically you've still got some responsibility for what's going on with them. So it's always helpful to follow up and close out. It also keeps your caseload nice and clean so you know how many people potentially might need to see you in any given week. And finally you need to have details necessary so another provider could take over in your absence. Maybe you go on maternity leave for three months or again, heaven forbid you get into a car accident and you're in traction for three months. The people that you're seeing likely are not able to just twiddle their thumbs for three months until you're ready to come back. They're probably still needing and wanting to make progress on their stuff. So what is the who's going to take over for you? And they have to have enough information that they they can actually pick up where you left off and continue to move forward. Know the difference between abandonment and termination. Treatment can be discontinued when people are not benefiting from treatment anymore. And this is an ethical imperative. You are actually kind of doing harm by continuing to take their money. If they're not benefiting from treatment, you also may be creating a dependency. If they've reached maximal levels of benefit and you're still continuing to see them, what message is that sending? We can discontinue treatment when the client might be harmed by treatment. We can discontinue treatment when the person no longer needs therapy or if they threaten you. Pre termination counseling involves the client in the process. Most insurance companies and hopefully most clinicians believe the in the statement, discharge planning begins at admission. Every time you see somebody in your office, that's wonderful, but there is no guarantee that they're going to come back. Hopefully they will but if they don't, you need to know in your heart of hearts that you provided the best quality of care and that they have resources that they can draw on should they not come back. Abandonment is when the person drops out of treatment and the therapist doesn't follow up. And then the and or the therapist discharges a person without appropriate referrals. You can't just kick somebody out or discharge them because they dropped out or they threatened you, or they're not benefiting from treatment, or they're, you know, and then not provide them referrals. It's important to make sure that they still have a lifeline somewhere. Stick to the evidence. When giving an expert opinion, conducting assessment or documenting, it's important that you can identify what you know and what you do not know. And my supervisees, when they do treatment planning, when they do notes, when they do assessment and the comprehensive summary. I want to see the phrase as evidenced by throughout that document, the person is presenting with major depressive disorder, as evidenced by difficulty sleeping, as evidenced by taking two hours to get to sleep, only being able to sleep for two or three hours, and then waking up and unable to get back to sleep. Okay, that's very clear. So I know reading that I know exactly what's going on with that person that helps them meet that particular criteria. Ethics involves constant awareness of your own motivations and attention to the client's best interest. Effective documentation can eliminate many sources of confusion at the beginning and and can support a clinician in legal situations. Annually, read any changes to your state statutes, the rules, or the statutes to ensure that you're not violating any legal and ethical dictates. And when in doubt, consult other professionals, ethics committees and or your attorney.