Assessment

(a) Psychologists base the opinions contained in their recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings. (See also Standard 2.04, Bases for Scientific and Professional Judgments.) (b) Except as noted in 9.01c, psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support...

Assessment And Evaluation

The supervisor must assess continually both the clinical services provided to the client and the supervisee's professional development. This significant responsibility can make many of us supervisors uncomfortable. Being evaluated may make supervisees uncomfortable. In graduate training programs, internships, arrangements in which supervised hours are accumulated as a prerequisite to licensure, and many institutional settings, the supervisor must report to third parties an assessment of the...

Clear Tasks Roles And Responsibilities

Because supervision involves at least three people client, supervisee, and supervisor relationships and agendas can easily become confused. The supervisor has an ethical responsibility to clarify the tasks, roles, and responsibilities. He or she, for example, must ensure that the supervisee is neither encouraged nor allowed to become the supervisor's therapy patient. Some forms of supervision may share common aspects with some forms of therapy. Sometimes supervisees, in the course of...

Conclusion

Exceptional caution is appropriate in attempts to generalize, compare, or interpret this chapter's actuarial data from ethics committees, licensing boards, and malpractice courts. Various types of actual violations, as the research indicates, may only rarely lead to a formal complaint with a criminal court, civil court, licensing board, or ethics committee. Certain types of violation may be difficult to prove. Formal complaints may be informally resolved and not appear in archival data. And, as...

Consider how if at all your personal feelings biases or selfinterest might affect your ethical judgment and reasoning

Does the situation make you angry, sad, or afraid Do you find yourself eager to please someone (or an organization) Do you desperately want to avoid conflict Do you find yourself concerned that doing what you believe is most ethical will get you into trouble, will make someone mad at you, will be second-guessed by colleagues who disagree with you, or would be hard to square with the law or the ethics code Will doing what seems ethically right to you cost you time, money, referrals, prestige, a...

Coordinated Planning

Coordinated planning can make for a much more useful professional will and make it easier for the executor to carry it out. You can meet with your primary designee and both backups to outline what you want done, what needs to be done, and what information the designee will need. One person may think of something that the others have overlooked, and what may seem to the therapist writing the will to go without saying (You all know that bookshelf where I keep my appointment book, don't you ) may...

Ethical Standards

In adhering to the Principle of Respect for the Dignity of Persons, psychologists would General respect I.1 Demonstrate appropriate respect for the knowledge, insight, experience, and areas of expertise of others. Not engage publicly (e.g., in public statements, presentations, research reports, or with clients) in degrading comments about others, including demeaning jokes based on such characteristics as culture, nationality, ethnicity, colour, race, religion, sex, gender, or sexual...

Ethics and Critical Thinking

Ho claims to have perfect ethical judgment and ho claims to have perfect ethical judgment and reasoning Most of us admit the obvious we all have weaknesses that we can strengthen. One good place to start is how we think about ethics. The more we notice how we think about ethics, the more we can think critically about our own ethical judgment, reasoning, language, and justifications. When we learn to recognize major patterns and pitfalls in these areas, we can improve our approaches and avoid...

Ethics And Denial

If the stress overwhelms us, all of us are vulnerable to denial and other ways of dismissing, distorting, or discounting ethical questions. We all have our favored ways of making uncomfortable ethical challenges disappear, perhaps by transforming them almost magically into something else, perhaps by attacking the client or colleague who raises the ethical question, perhaps by viewing ourselves as helpless, as compelled by necessity to act in a way that we suspect may be unethical. Take a few...

Professional Commitment to Patient Needs Must Remain the Prime Concern

Patient-focused care has the potential to be threatened by economic pressures to abbreviate the utilization and scope of professional services. While mindful of economy and efficiency in health care services, an ethically based patient-practitioner relationship should admit to unreasonable diminution of the professional's commitment to the patient's need and care consistent with accepted standards of clinical care. It is the position of the National Academies of Practice that it is unethical to...

Confidentiality

The confidentiality of patient data in clinical encounters is a primary concern. Although utilization review and quality assurance are customary and appropriate functions in every health care environment, these activities should not breach the confidentiality of patient data. Safeguards must be adopted when persons engaged in utilization and quality assurance reviews have access to patient files. It is the position of the National Academies of Practice that utilization studies and quality...

Referral Sources

We tend to be very grateful to colleagues, friends, and anyone else who refer patients to us. But should we tell the referral source whether a specific individual has scheduled an appointment with us, whether the individual kept the initial appointment, or what might have been discussed or decided if the client has not authorized the disclosure Unfortunately, therapists may unintentionally violate confidentiality by sending referral sources a thank-you note mentioning a specific client and...

Seek Guidance from the Court

If, despite such discussions, the requesting party insists that confidential information or test data be produced, the safest course for the psychologist may be to seek a ruling from the court on whether disclosure is required. The simplest way of proceeding, and perhaps the least costly, may be for the psychologist (or his or her attorney) to write a letter to the court, with a copy to the attorneys for both parties, stating that the psychologist wishes to comply with the law but that he or...

Steps in Ethical Decision Making

His chapter provides some steps helpful in thinking through how to respond to an ethical dilemma, taking action, and assuming personal responsibility for our response. These steps may help us to identify important aspects of a situation, consider positive and negative consequences of the ways in which we might respond, and discover better approaches. The Canadian Psychological Association (CPA) emphasized the value and importance of such steps by including seven in its original ethics code...

The Fatal Disease

When George, a nineteen-year-old college student, began psychotherapy with Dr. Hightower, he told the doctor that he was suffering from a fatal disease. Two months into therapy George felt that he trusted his therapist enough to tell her that the disease was AIDS. During the next eighteen months, much of the therapy focused on George's losing battle with his illness and his preparations to die. After two stays in the hospital for pneumonia, George informed Dr. Hightower that he knew he would...

Trust

States and provinces grant therapists professional status in acknowledgment of the fiduciary relationship between therapist and client. Societies expect therapists to be trustworthy and not to exploit the trust that people invest in them and their enterprise. The social order depends on individual therapists to fulfill the trust for the benefit of individual clients as well as for the social order. (Many ethical dilemmas result from the clash between the benefit of the client and the benefit of...

Values Statement

In the course of their work as scientists, practitioners, or scientist-practitioners, psychologists come into contact with many different individuals and groups, including research participants clients seeking help with individual, family, organizational, industrial, or community issues students trainees supervisees employees business partners business competitors colleagues employers third party payers and, the general public. In these contacts, psychologists accept as fundamental the...

What Makes This Area So Hard For Us

Why is this area so difficult for virtually all of us as individuals and as a profession Here are five potential causes that may be at work. First, major boundary dilemmas often catch us off-guard and unprepared. They can sweep us into unfamiliar, unexpected territory where we must make a quick decision of great importance, perhaps influencing the therapy in a decisive way. In Chapter Seventeen on responding to suicidal risk, we provide an example of how a sudden decision about a boundary...

Therapy

(a) When obtaining informed consent to therapy as required in Standard 3.10, Informed Consent, psychologists inform clients patients as early as is feasible in the therapeutic relationship about the nature and anticipated course of therapy, fees, involvement of third parties, and limits of confidentiality and provide sufficient opportunity for the client patient to ask questions and receive answers. (See also Standards 4.02, Discussing the Limits of Confidentiality, and 6.04, Fees and Financial...

An Inherent Power Differential

The power differential is inherent in psychotherapy. Although certain approaches to therapy have emphasized egalitarian ideals in which therapist and client are equal, such goals are viewed only within a narrowly limited context of the relationship. In truly equal relationships, in which there is no appreciable power differential, there is no designation of one member as therapist in relation to the other member, there is no fee charged by one member to the other for the relationship, there is...

Ethics And Personal Responsibility

What we do can make a difference in whether a client loses hope and commits suicide or chooses to live, whether a battered spouse finds shelter or returns to someone who may kill, and whether an anorexic teenager gets help or starves to death. Even new therapists know that such dramatic examples tell only part of the story. So many people come to us facing what seem to be minor, hard-to-define problems, yet the hard, risky, unpredictable twists and turns of their therapy can lead to more...

Licensing Boards

Each of the fifty United States and each of the nine Canadian jurisdictions has its own requirements and standards for practicing as (or, in some states and jurisdictions to identify oneself as) a psychotherapist or counselor. Some, but not all, administrative standards embody ethical principles. (For example, some may set forth the relatively mundane obligation to pay an annual licensing fee.) Formal licensing actions are how therapists and counselors are held accountable to these standards of...

Scenarios For Discussion

After receiving your doctorate in psychology, you decide you want to live in an area of the country you have never visited before. After a long search, you secure a job at the only clinic in a small town. You'll be able to secure the year's worth of postdoc supervised hours required for licensing. You pack up and move and find you love the new town and your job at the clinic. Ten months into the year, your supervisor says, I have some bad news. The clinic has decided to get rid of us...

Awareness Of Financial Factors Leading To Misusing Diagnosis

Third-party reimbursement has become so prevalent that most therapists have become acutely aware of which diagnostic categories are covered and which are not. Insurance companies, HMOs, and a wide variety of managed care organizations may authorize services for only a very restricted range of diagnoses. For example, the personality or character disorders are rarely covered. Unfortunately, the temptation to substitute a fraudulent but covered diagnosis for an honest but unreimbursable one can...

Responding to Ethics Licensing or Malpractice Complaints

E might as well discuss it now, before going on to other topics. It happens. A client, former client, or someone else files a formal complaint against you. This can happen regardless of whether you have done anything wrong. In some cases, someone may file a complaint against you because you refused to do something wrong. We recommend considering this possibility and how to respond to it early, as part of thinking through an approach to ethics and therapy, which is why we do not tack this...

Managed Care Organizations

One of the most easily overlooked aspects of confidentiality is how confidential information can circulate within health maintenance organizations and other managed care facilities. Many patients feel betrayed when records of their psychotherapy sessions become part of their general medical or health record in an HMO and may in turn find their way into the hands of third parties. One women was shocked to find her treatment mentioned on the employee relations bulletin board where she worked....

Emotional Competence For Therapy Knowing Oneself

Emotional competence for therapy, as described by Pope and Brown (1996), reflects therapists' acknowledgment and respect for themselves as unique, fallible human beings. It involves self-knowledge, self-acceptance, and self-monitoring. Therapists must know their own emotional strengths and weaknesses, their needs and resources, the abilities and limits for doing clinical work. Psychotherapy often provides the occasion for strong emotional reactions for both therapist and client. To the degree...

Your Mental Health Rights Right to Know

Individuals have the right to be provided information from the purchasing entity such as the employer or union or public purchaser and the insurance third party payer describing the nature and extent of their mental health and American Psychological Association. 1997 . Mental Health Patient's Bill of Rights. Retrieved from http www.apa.org topics rights , September 26,2006. Also available Bill of Rights, brochures, posters through 800 374-2721. Copyright 2007 American Psychological Association....

Use Denied Motivation as Misdirection

Instead of honestly stating the motivation, the speaker seeks self-exoneration by talking about what the motivation was not. Denying an irrelevant charge that no one has made can be an effective rhetorical tactic. The denials are often true. For example, the person who repeatedly embezzles pension funds, uses substandard materials to build high rises, speeds while drunk, and stresses that he or she never meant to hurt anyone was probably not acting with the intention of making other people...

Appendix C Disclosure Issues Diagram

Code Ethics For Internet Authors

The following steps may be taken, as appropriate Disclosure Issues Diagram The following steps may be taken, as appropriate American Psychological Association Statement on Services by Telephone, Teleconferencing, and Internet AUTHORS' NOTE According to Steve Behnke, The Ethics Committee voted that statements issued under a version of the ethics code are valid only as long as that version is in effect. So with the adoption of the 2002 version, the APA Statement on Services by Telephone,...

Ethics Committees Codes And Complaints

Professional associations of therapists and counselors are voluntary organizations membership is not a state or federal requirement for the practice of the profession. One can, for example, be licensed by the state and practice as a psychologist without being a member of the American Psychological Association APA or any other association. An association, through its ethics committee, holds its members accountable to the ethical principles it sets forth in the code it has developed. To...