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EPPP: Ethics
Ethics code applies... - to psychologists' activities as part of their role and also to conviction of felony (can be unrelated to psychologist role), expulsion/suspension from a psychological association, or suspension/loss of licensure Five general ethical principles - -Beneficence and Nonmaleficence (strive to do good and do no harm) -Fidelity and Responsibility (establish relationships of trust and be aware of professional/scientific responsibilities to society/community) -Integrity (promote accuracy, honesty, and truthfulness) -Justice (recognize that fairness and justice entitle all people to access and benefit from contributions of psychology) -Respect for People's Rights and Dignity (respect dignity and worth of all people and rights of individuals to privacy, confidentiality, and self-determination) Conflicts between ethics code and legal/organizational demands - -psychologists clarify the nature of the conflict, make known their commitment to the ethics code, and take reasonable steps to resolve the conflict -under no circumstances may this standard be used to justify violating human rights -"when reasonable actions taken by psychologists do not resolve the conflict, they are permitted to make a conscientious decision to comply with the legal or regulatory authority under circumstances in which their actions cannot be used to justify or defend violating human rights" Responding to ethical violations by colleagues - -bring it to the psychologist's attention when this seems appropriate -must report ethical violation to an ethics committee, licensing board, or other appropriate authority when the ethical violation has caused or is likely to cause substantial harm, is not appropriate for internal resolution, or was not adequately resolved informally -NOTE: this only applies when intervening does not violate confidentiality rights (patient tells you that her last therapist sexually harassed her but doesn't want you to tell anyone; you would maintain confidentiality) Situations where informal resolution is not likely to be helpful -
-psychologist's violation involves addiction to alcohol/drugs or is related to a serious mental illness/emotional disturbance -violation is due to psychologist's general incompetence -pre-existing bad feelings between psychologists would make an informal approach too confrontational What to do if an ethics committee asks you for information about a current client who has filed a complaint against her previous therapist - -need to make sure the client has signed an ROI before providing information -when issues of confidentiality are not involved, must comply with investigations/proceedings of APA and affiliated organizations Determining whether you are competent enough to see a client - -when there's a substantial difference between client's needs and psychologist's competence and an alternative provider is available, referral is typically the best choice -in other circumstances, it may be acceptable to see the client while obtaining consultation and/or training/education -when alternative services are not available, psychologists can provide services in emergency situations even if they do not have adequate training, but they should stop when the emergency ends or appropriate services become available Practicing when there has not yet been adequate research on something (like delivering therapy via phone) - -can still do it but inform client about lack of empirical evidence and treatment options Considerations for use of an interpreter - -family member should not be asked to be the interpreter -when possible, psychologists should use professional interpreters who are certified by a national organization, although not all jurisdictions require this -obtain client's consent -discuss the need to maintain client confidentiality with the interpreter -helpful to have a written contract for interpreters that addresses confidentiality issues Vicarious liability -
-similarly, avoid providing concurrent or sequential forensic and therapeutic services (when not possible, attempt to minimize negative effects) Gottlieb's decision making model on multiple relationships: 3 things to consider - -power differential between psychologist and client -expected duration of each relationship -clarity of termination of each relationship When a potentially harmful multiple relationship has occurred... - take reasonable steps to resolve it, including discussing the situation with the involved individuals and consulting a colleague to determine best course of action Conflict of interest example - recommending that current clients buy a product or participate in another service when the psychologist has a financial interest in that product/service Who is the "client" in evaluations that are court-ordered or requested by an attorney/agency? - The individual/entity requesting the evaluation What to do when individuals are legally incapable of giving consent - -provide them with an appropriate explanation, consider their best interests, seek their assent, and obtain permission from a legally authorized person when doing so is permitted/required by law -this applies to adults who have been found legally incompetent and most youth under 18 (however, some states allow younger adolescents to consent to treatment) "Doctrine of implied consent" - -consent is presumed when a parent of legal guardian is not available to provide consent and the circumstances are life-threatening for the minor (e.g., high risk of suicide) -legal in all states to provide emergency treatment to minors in an ED without parental consent -consent should be obtained for any resulting ongoing treatment Court-ordered evals and consent -
-Psychologist must describe nature and purpose of examination but can conduct it without examinee's consent -if examinee refuses to participate, can postpone it, advice examinee to contact their attorney, and notify the retaining party about the examinee's unwillingness to proceed Planning for interruption of services due to provider death - -Should designate someone to be the executor in the case of your own death - will contact clients and ensure security of client records -Ideally a member of the profession or another regulated health profession; should not be a member of psychologist's own family due to conflict of interest Confidentiality considerations for couples/families - -inform them of who the client is -inform them how info shared privately by one individual with therapist will be handled / who it will be shared with Confidentiality in group therapy - -Group therapy members are not legally/ethically bound to maintain confidentiality, but providers can educate group members about importance of maintaining confidentiality Confidentiality and minors` - -Confidential if minor is old enough to consent to own treatment -Otherwise parent/guardian has the right to info disclosed by the minor-- best to establish confidentiality agreement with all parties at start of relationship -Make sure everyone is aware of mandated reporting situations as well Confidentiality and deceased clients - -ethics code doesn't specifically address, but most laws have states that allow disclosure of confidential info about deceased client only with authorization from executor/estate administrator or other legal representative Confidentiality within the military - -Confidentiality is not guaranteed -Provide detailed and exhaustive informed consent around this
-"changing the season or year of an event or modifying details of family composition and other social networks that are not essential to the didactic goal" (p. 199). The Health Insurance Portability and Accountability Act (HIPAA) allows covered entities to disclose a patient's personal health information (PHI): A. only with an authorization signed by the patient or the patient's legal representative. B. without an authorization signed by the patient when it's going to be used for the purpose of treatment, payment, or health care operations. C. without an authorization signed by the patient only when it's needed for the patient's emergency treatment. D. without an authorization signed by the patient when it meets the "minimum necessary" standard.
- B. without an authorization signed by the patient when it's going to be used for the purpose of treatment, payment, or health care operations. Dr. Horowitz learns that a current therapy client has started dating one of Dr. Horowitz's close friends. To be consistent with ethical guidelines, Dr. Horowitz should: A. reduce her interactions with her best friend. B. discuss the situation with her client to help determine the best course of action. C. do nothing unless she notices that the situation is affecting her effectiveness as a therapist. D. say nothing to the client or friend but take special precautions to protect the client's confidentiality. - B. discuss the situation with her client to help determine the best course of action. ____________ are the standards used in the APA's Ethics Code to define sexual harassment. A. Quid pro quo and reasonable woman B. Hostile environment and reasonable person C. Quid pro quo and hostile environment D. Tangible detriment and reasonable person - B. Hostile environment and reasonable person When consulting with a colleague about a client who's not responding to treatment, you: A. must get authorization from the client before doing so.
B. must get authorization from the client before doing so if you cannot disguise her identity while discussing the situation with the colleague. C. do not need to get authorization from the client as long as you disclose only confidential information that's pertinent to the purpose of the consultation. D. do not need to get authorization from the client as long as the colleague is a licensed mental health professional. - B. must get authorization from the client before doing so if you cannot disguise her identity while discussing the situation with the colleague. Which of the following is NOT a HIPAA-compliant videoconferencing platform? A. Zoom for Healthcare B. Consumer Skype C. thera-LINK D. Doxy.me - B. Consumer Skype Which of the following is true about privilege? A. It can be claimed and waived only by the client. B. It can be claimed by the client and the client's legal representative but waived only by the court. C. It can be claimed and waived by the client, the client's legal representative, and the therapist. D. It can be claimed and waived by the client and the client's legal representative and claimed by the therapist on behalf of the client. - D. It can be claimed and waived by the client and the client's legal representative and claimed by the therapist on behalf of the client. The client or the client's legal representative is the holder of the privilege, which means that the client or his/her representative decides when to claim or waive the privilege. However, psychologists may claim the privilege on behalf of a client when asked to disclose confidential client information in a legal proceeding. Public statements - -obviously do not make false statements -can only claim degrees that were earned from a regionally accredited educational institution or were approved to qualify for licensure
-diagnosis -types of services provided -fees charged Referral fees - -can't pay people for referring to you, but can pay them for services provided (e.g., based on the time they spent copying/forwarding info to you) The use of a sliding scale when setting fees for therapy clients: A. may be acceptable but is not explicitly mentioned in the ethics codes published by the American and Canadian Psychological Associations. B. is unacceptable but is not explicitly mentioned in the ethics codes published by the American and Canadian Psychological Associations. C. is explicitly recommended in the ethics codes published by the American and Canadian Psychological Associations. D. is explicitly prohibited in the ethics codes published by the American and Canadian Psychological Associations. - A. may be acceptable but is not explicitly mentioned in the ethics codes published by the American and Canadian Psychological Associations. You receive a written request from a colleague asking you to forward a copy of the file of a former client of yours who is now seeing him in therapy. To expedite receiving the file, the colleague asks you to send it to him as an attachment to an email. The colleague's request is accompanied by an authorization to release information signed by the client. You should send the colleague the file as an attachment to an email: A. since the client has signed an authorization. B. after confirming that you have the correct email address for the colleague. C. only if you are able to remove all information that identifies the client from the electronic copy of the file. D. only if you're able to clearly label each page of the record "confidential." - C. only if you are able to remove all information that identifies the client from the electronic copy of the file. Sending info electronically- must consider that other unauthorized individuals could access this- best bet is to deidentify it
To be consistent with ethical requirements, you should discuss fees and other financial matters with therapy clients: A. before the first therapy session. B. during the first therapy session. C. as part of the informed consent process. D. as early as feasible. - D. as early as feasible. Which of the following best describes ethical requirements regarding psychologists' use of client testimonials in brochures and other statements describing their professional services? A. They may use only unsolicited testimonials from former and current therapy clients. B. They may use solicited or unsolicited testimonials from former and current therapy clients as long as the clients are not compensated for them. C. They may use solicited testimonials from former therapy clients who are not vulnerable to undue influence. D. They may use solicited testimonials from former therapy clients as long as they do not include misleading information. - C. They may use solicited testimonials from former therapy clients who are not vulnerable to undue influence. Routinely waiving the insurance co-payments of therapy clients is acceptable: A. only when the insurance company has approved of this arrangement. B. as long as it's justified by the clients' inability to pay the co-payment. C. only if the insurance company is not charged an increased fee to make up for the co-payment. D. because it's a "standard practice." - A. only when the insurance company has approved of this arrangement. Requiring students to disclose info in classes - -may not require personal disclosure unless (1) the program or training facility has clearly identified this requirement in its admissions and program materials or (2) the information is necessary to evaluate or obtain assistance for students whose personal problems could reasonably be judged to be preventing them from performing their training- or professionally related activities in a competent manner or posing a threat to the students or others."
-research offers benefits to the health of the child that cannot be obtained outside of the study -in these cases, consent of guardians overrides assent of child (ordinarily, the child's dissent would override the consent of the guardians when the research does not offer direct health benefits to the child) Situations where researchers can dispense with informed consent - -when doing so is permitted by law or institutional regulations -when research is not likely to cause distress/harm and involves: (a) studying routine educational practices in educational settings; (b) studying factors related to job or organizational effectiveness in organizational settings when participants' confidentiality will be maintained and there's no risk to their employment; or (c) using anonymous questionnaires, naturalistic observations, or archival research when participants' confidentiality will be maintained and there's no risk for legal liability or other harm. -may not be needed to get informed consent to record people's voices/images in public places where there's no expectation of privacy and where observations are not likely to cause personal identification/harm OR where deception is involved and consent to use recording will be obtained during debriefing Deception in research - -must be justified by significant prospective value of research -participants must not be deceived about procedures likely to cause physical pain or severe emotional distress -must be allowed to withdraw from the study at any time -must be informed about the deception as early as possible, but no later than at the conclusion of the data collection Use of animals in research - Standard 8.09 requires psychologists to use procedures that cause animals to experience "pain, stress, or privation only when an alternative procedure is unavailable ... [and doing so is justified by the study's] prospective scientific, educational, or applied value." When an animal's life must be terminated, psychologists must do so rapidly and in a way that minimizes pain and is consistent with accepted procedures. :( :( :( Can you submit an article to multiple journals for publication simultaneously? - -no- submit to one and wait for rejection before submitting to another
-also cannot publish same info in multiple places unless it is clearly cited as coming from the first source How long to retain raw data after publication of an article - -at least five years -if it involves identifiable health info, at least 6 years after participant has signed an authorization -may also vary with institutional/funder requirements, etc. Standards for reviewers of journal articles - -treat the article as confidential and get permission from journal editor before letting someone else review it -avoid reviewing articles when there's a conflict of interest (e.g., research that contradicts or supports their own research) At the request of the editor of a professional journal, a psychologist is reviewing a research paper that has been submitted to the journal for publication. The psychologist is impressed with the research and wants to apply some of the unique ideas presented in the paper to the research he is currently conducting. In this situation, the psychologist (reviewer): A. can use the ideas in his own research since the article has not been published. B. can use the ideas in his own research only if he gives credit to the paper's authors when his own research is published. C. cannot use the ideas in his own research unless he obtains permission from the paper's authors to do so. D. cannot use the ideas in his own research unless he obtains permission from the journal's editor to do so. - C. cannot use the ideas in his own research unless he obtains permission from the paper's authors to do so. Dr. Barry Bull advertised his two-hour workshop for licensed psychologists as a "hands-on experience administering and scoring neuropsychological tests." However, during the workshop, he only shows videos that demonstrate how to administer and score the Wisconsin Card Sorting Test and three other frequently used neuropsychological tests. In terms of ethical requirements, Dr. Bull has acted: A. unethically because he violated test security. B. unethically because his advertisement did not accurately describe his workshop. C. ethically as long as he had determined the videos were the most effective way to train participants in the use of the tests.
D. provide the psychologist with the data as long as the confidentiality of research participants is protected. This answer is most consistent with Standard 8.14 of the APA Ethics Code, which requires psychologists to share research data with other professionals for the purpose of verifying the claims they made on the basis of that data as long as the confidentiality of participants can be protected. While Standard 8.14 requires psychologists to provide data only to "competent professionals," it does not state that the professionals must be licensed psychologists. Accommodations vs modifications - -accommodations maintain original construct and result in scores comparable to those on originally test (using a large print or Braille version) -modifications are changes to test content and/or testing conditions that alter the construct to some extent and result in scores that don't have the same meaning as scores on the original test (should be documented and treated as a newly developed assessment that needs to be evaluated for reliability/validity/etc) Recommendations for telehealth assessment - -use wider confidence intervals because margin of error is increased when assessment procedures are nonstandard -note in reports and feedback how assessment procedures were altered and how this might affect test scores What to tell examinees at start of malingering battery - Fisher (2017) notes that describing the purpose of a test of malingering to an examinee might compromise the test's validity but that deceiving the examinee about the purpose might violate the examinee's autonomy rights. She states that, as a resolution of this dilemma, "current standards of practice support communicating to ... [examinees] that measures will be used to assess the examinee's honesty and efforts to do well, without describing the particularities of the tests that will be used to measure exaggeration or other elements of malingering" Can you discuss individual test items with a client in order to help them understand their test results? - yes, this is fine. generally just make reasonable efforts to protect integrity/security of test materials Obtain informed consent when for therapy? -
-As early as feasible -Should also be viewed as a continuous process whenever changes are made to existing agreement Considerations for sexual relationships with former clients - -must be 2 years after termination of therapy and then "only in the most unusual circumstances" -consider these factors: (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a post-termination sexual or romantic relationship with the client/patient. Rule for sexual intimacy with known relatives/significant others of current therapy clients - don't do it! As described in the Standards for Educational and Psychological Testing (2014): A. test accommodations and modifications should be documented in test reports. B. test accommodations (but not modifications) should be documented in test reports. C. test modifications (but not accommodations) should be documented in test reports. D. neither test accommodations nor modifications need to be documented in test reports. - A. test accommodations and modifications should be documented in test reports. During her second therapy session with Dr. Simone, a cognitive-behavioral therapist, Millie tells him that she has been seeing another psychologist for therapy for nearly three months. As an ethical psychologist, Dr. Simone will: A. explain to Millie that it would be inappropriate to see her in therapy while she's seeing another therapist. B. discuss with Millie the potential problems of seeing two therapists at the same time and let her decide what she wants to do. C. contact the other therapist after obtaining Millie's consent to do so to help determine the best course of action. D. determine why Millie is seeing another therapist to help determine the best course of action. - D. determine why Millie is seeing another therapist to help determine the best course of action.
-if this is unsuccessful, seek guidance from the court informally by letter or formally with a motion to quash the subpoena or a protective order -if requested to provide info about client in court and you don't have the authorization to do so, assert psychotherapist-patient privilege and don't reveal info (unless there is a court order) Fact vs. expert witness - -fact witness- testifies to what they have seen/heard/observed (may only provide confidential info with client authorization or court order) -expert witness- has education of specialized experience and is able to offer opinions and testimony about hypothetical situations Psychological autopsy - -Equivocal death psychological autopsy- used for ambiguous death to determine whether it was a suicide, accident, homicide, natural cause, or undetermined -Suicide psychological autopsy- used to determine psychological factors that contributed to a person's suicide (may be for forensic- insurance/contested wills/malpractice/worker's comp, research (identify suicide risk factors and prevention steps), or clinical purposes- help family understand the death) CRITICISMS: lack of standardized procedures, limited empirical evidence for reliability/validity, and potential for incomplete/biased info Capitalization and hyphenation for racial groups - -Capitalize Black, White, etc. -don't hyphenate Asian American, etc. Telehealth in other jurisdictions - -Laws vary across jurisdictions- check requirements in jurisdiction where therapist resides and jurisdiction where client will be -some states require in-state licensure for providing telepsychology to clients permanently or temporarily located in those states, while other states allow psychologists licensed in a different state to provide telepsychology services to clients located in those states for a limited number of days Supervision records - -Maintain records on dates of supervision and an accurate summary of supervision and supervisee's competence
-Keep these records for at least 7 years after the termination or until supervisee obtains a license, whichever is later Telepsychology supervision at the practicum, doctoral, and post-doctoral levels shall not account for more than ____ of a supervisee's supervision - 50% Psychotherapy-based supervision models - -theoretical orientation informs the observation/selection of clinical data for discussion in supervision -Examples: person-centered supervision, CBT supervision (supervision process mirrors therapy process) Developmental supervision models - -Based on assumption that supervisees progress through stages and require different supervisory responses as they move through these stages Integrated Developmental Model (IDM) - 3 stages: -Level 1- focused on self but engage in limited self-evaluation, high in motivation and anxious about evaluation, very dependent on supervisor -Level 2- better able to focus on clients and exhibit empathy, have fluctuating levels of confidence, and vacillate between autonomy and dependence -Level 3- able to stay focused on a client while attending to their own reactions to client, have consistent motivation, and are confident about own skills/judgment Process-based supervision models - -developed to provide descriptions of component roles, tasks, and processes within the supervision as a means to uniformly classify events occurring in supervision -includes Bernard's discrimination model Bernard's discrimination model (of supervision) - -process-based supervision model that identifies three focus areas for supervision (intervention skills, conceptualization skills, and personalization skills) and three supervisor roles (educator, counselor, consultant)
