4.0 INFORMED CONSENT

Question 1

4.1 No services without informed consent

Answer 1

A registrant must obtain adequate informed consent prior to providing psychological services unless otherwise provided by law, including this Code. In such specified circumstances in which it is not possible to obtain adequate informed consent, a registrant must attempt to obtain informed assent prior to providing the psychological services, unless otherwise provided by law, including this Code. Registrants must document the informed consent and/or assent, or the steps taken to obtain either consent or assent and the basis for proceeding without either, in the record.

Question 2

4.2 Elements of informed consent

Answer 2

Although the required elements for informed consent may vary depending upon the particular circumstances, and additional elements may be necessary in certain circumstances, a registrant must ensure that the following general elements are satisfied when seeking informed consent:

a) the client has the capacity to consent;
b) the client has been informed of all appropriate significant information concerning the psychological service(s);
c) the client has freely and without undue influence expressed consent;
d) the client has been informed of the fees for the intended service(s);
e) the client has been informed of the limits of confidentiality, including but not limited to those aspects of confidentiality limits expressed in Standard 6.7;
f) the consent has been obtained in writing where possible; and
g) the consent of the client, or of other appropriate persons where the client is not legally capable of giving informed consent, has been appropriately documented in the registrant’s practice record.

Question 3

4.3 Lack of capacity to give informed consent

Answer 3

If an individual is not legally capable of giving an informed consent to a
registrant, the registrant must:

a) obtain any necessary documentation to determine the identity of all parties with legal entitlement to provide or withhold consent for
services;

b) obtain informed written consent from all of the parties specified in part (a), above;

c) provide an appropriate and understandable explanation of the
services to the individual;

d) where possible obtain the individual’s assent to the procedure or intervention; and
e) document the explanation and any consents and assents in the registrant’s practice record.

Question 4

4.3 Lack of capacity to give informed consent

Answer 4

If an individual is not legally capable of giving an informed consent to a
registrant, the registrant must:

a) obtain any necessary documentation to determine the identity of all parties with legal entitlement to provide or withhold consent for
services;

b) obtain informed written consent from all of the parties specified in
part (a), above;

c) provide an appropriate and understandable explanation of the
services to the individual;

d) where possible obtain the individual’s assent to the procedure or intervention; and
e) document the explanation and any consents and assents in the registrant’s practice record.

Question 5

4.4 Informed consent and family law proceedings

Answer 5

Subject to any court order or court direction, a registrant providing psychological services to parents or to children for the purposes of a family law proceeding, including such services as custody and access assessments, must, prior to providing the services:

a) determine any issues of custody and parental rights or status prior to or as part of obtaining informed consent from all appropriate persons; and
b) obtain and document all necessary consents prior to proceeding with the services.

Question 6

4.5 Informed consent continuing throughout psychological services

Answer 6

A registrant must obtain informed consent from the recipient of their services before altering the treatment plan or changing any psychological services that they have agreed to provide to them.

Question 7

4.6 Structuring the relationship

Answer 7

A registrant must discuss with their clients as early as practicable in the professional relationship such issues as the nature and anticipated course of the intervention or assessment, the obligation of confidentiality attached to the provision of such services, the potential risks of the intervention or assessment, and alternative treatments that may be available.

Question 8

4.7 Supervised services

Answer 8

If a student, intern, testing assistant, test scorer, or any other type of supervisee will be providing any psychological services under the supervision of a registrant, the registrant must ensure that the client (and the payer, if different from the service recipient) is informed of the supervisee’s status and the name of the supervisor. The registrant must also ensure the client (and the payer, if different from the service recipient) has provided informed consent for the supervised services prior to the initiation of those services. Any and all such informed consents must be documented in the registrant’s practice record.

Question 9

4.8 Innovative services and applications

Answer 9

A registrant must inform clients of the innovative nature of any proposed
psychological service or technique or any non-standardized application of a standardized service or technique, and of the known risks associated with the service or technique, and/or its nonstandard application, including any known or anticipated risks associated with the method of service delivery (for example, possible increased risk of a confidentiality breach, access limitations imposed by the contemplated technology, etc., associated with telepsychology services).

Question 10

4.9 Avoiding misunderstandings

Answer 10

A registrant must make reasonable efforts to answer clients’ questions and to avoid any apparent misunderstandings about the psychological services to be performed.

Question 11

4.10 Using understandable language

Answer 11

Whenever possible when providing information orally or in writing, a registrant must use language that is reasonably understandable to the client.

Question 12

4.11 Informing about assessment procedures

Answer 12

A registrant must ensure that each participant in an assessment process is informed at the outset of the purpose, procedures, and methods involved in the evaluation process, any involvement of third parties, the limits to confidentiality, and feedback and interpretation of test results that may be expected at the conclusion of the assessment process.

Question 13

4.12 Observing and recording

Answer 13

When diagnostic interviews or therapeutic sessions with a client are to be observed by a third party or recorded in any mechanical or electronic manner for audio or visual purposes, a registrant must obtain informed consent from the client or the client’s legal guardian in advance.

Question 14

4.13 Informed consent for research

Answer 14

Before conducting research, except research involving only anonymous
surveys, naturalistic observations, or similar research, a registrant must enter into an agreement with research participants that clarifies the nature of the research and the responsibilities of each party, and that includes the following elements:

a) the purpose of the research, expected duration, and procedures;
b) participants’ right to decline to participate or to withdraw from the research once participation has begun;
c) the foreseeable consequences of declining or withdrawing;

d) reasonably foreseeable factors that may be expected to influence the person’s willingness to participate, such as potential risks, discomfort,
or adverse effects;

e) any prospective benefits of the research and/or of involvement as a participant;
f) the limits of confidentiality;
g) any incentives for participation;
h) who to contact for questions about the research and research participants’ rights; and
i) an explanation of any other aspects about which the prospective participants inquire.

Question 15

4.14 Informed consent for intervention research

Answer 15

A registrant conducting intervention research involving the use of experimental treatments must inform participants at the outset of the research about:

a) the experimental nature of the treatment;
b) any known risks associated with the treatment;
c) the services that will or will not be available to the control group(s), if appropriate;
d) the means by which assignment to treatment and control groups will be determined;
e) available treatment alternatives if an individual does not wish to participate in the research or wishes to withdraw after the study has begun; and
f) any compensation for, or monetary costs of, participating, including whether reimbursement from the participant or a third-party payer will be sought.

Question 16

4.15 Research with subordinates

Answer 16

When a registrant conducts research with individuals such as students, employees, or subordinates, they must take special care to protect the prospective participants from any adverse consequences of declining or withdrawing from the research.

Question 17

4.16 Required research participation

Answer 17

When research participation is a course requirement or an opportunity for extra credit, a registrant must give prospective participants the choice of equitable alternative activities.

Question 18

4.17 Respect for research participants

Answer 18

A registrant must treat all research participants with respect, including by avoiding any behaviour that is demeaning, harassing, humiliating, abusive, exploitive, or gratuitously harmful in any other way.

Question 19

4.18 No sex with research participants

Answer 19

A registrant must not have any form of intimate or sexual relationship with their current research participants, or any former research participants, where a therapeutic relationship was created.

Question 20

4.19 Research filming/recording

Answer 20

A registrant must obtain informed consent from research participants before filming or recording them in any form, unless:

a) the research involves simply naturalistic observations made in public places; and
b) it is not anticipated that the recording will be used in a manner that could result in personal identification of participants or cause harm to participants

Question 21

4.20 Deception in research

Answer 21

A registrant must not conduct a study involving deception unless:

a) they have determined that the use of these techniques is justified by the study’s significant prospective scientific, educational, or applied
value; and

b) effective non-deceptive alternative procedures are not feasible.

Question 22

4.21 No deception about risks

Answer 22

A registrant must never deceive prospective participants about research that would likely cause physical pain, emotional distress, or any other type of threat to their well-being.

Question 23

4.22 Dispensing with informed consent

Answer 23

A registrant is not required to obtain the informed consent of an individual who may be affected by or involved in research involving only anonymous questionnaires, naturalistic observations, or certain kinds of archival research, but before determining that such consents are not required the registrant must consider applicable regulations and institutional review board requirements, and consult with professional colleagues as appropriate.

Question 24

4.23 Debriefing

Answer 24

A registrant must:

a) provide a prompt opportunity for participants to be debriefed, if necessary, and to obtain appropriate information about the nature, results, and conclusions of the research. If scientific or human values justify delaying or withholding this information, registrants must take reasonable measures to reduce the risk of harm;
b) explain to participants any deception that was an integral feature of the design and implementation of an experiment as early as is feasible, preferably at the end of their participation, but no later than at the end of data collection, and permit participants the opportunity to withdraw their data; and
c) take reasonable steps to rectify the situation when they become aware that research procedures have harmed a participant (e.g., by offering to help obtain psychological services if needed).

Question 25

4.24 Court ordered assessments or treatment

Answer 25

If a treatment, assessment, or other form of psychological service has been ordered by a court, the registrant must first endeavour to obtain the client’s informed consent to proceed. If the circumstance represents one in which the
subject individual is compelled to comply, the registrant must endeavour to obtain the individual’s informed assent to proceed. In the event the client cannot or will not consent or assent to the service, the registrant must inform the individual to the fullest extent possible of information about the service before proceeding. The registrant must:

a) document why the requirements of Standard 4.1 cannot be met;

b) either inform the client of significant information concerning the
psychological service to be provided (including at a minimum the purpose and relevant expectations of the service, limitations to confidentiality, to whom and for what purpose the registrant may provide reports, the client’s rights in the context, and possible consequences to the client of refusing to participate), or clearly
document the reason for not providing the information if retainer-terms, a court order, a court-supervised process, or legislation to the
contrary prevents informing the client; and

c) in all cases document the client’s informed consent or assent, or lack thereof, and state clearly in the record and in any report the ways in which the client’s consent or assent, or lack thereof, may impact on the treatment, assessment, or other psychological service.

Question 26

4.25 Informed consent and file reviews

Answer 26

When conducting a file review, regardless of whether the purpose is to offer an opinion regarding file evidence pertaining to the client (such as when one is
asked to provide input to a case manager regarding a client who is not receiving direct services from the registrant) or to provide an opinion regarding the sufficiency of a report itself, registrants must:

a) either fully inform the individual who is the subject of the file being reviewed about the process, including that the registrant will be writing a review report, or document why it is not appropriate or possible to fully inform the individual in the circumstance;
b) either obtain the informed consent or assent of the individual who is the subject of the file being reviewed, or if consent or assent need not be obtained, inform the individual of the court order or other basis on which a file review will be conducted absent informed consent or assent, or document why it is not appropriate or possible to obtain the informed consent or assent of the individual in the circumstance; and
c) in the case of repeated or ongoing file reviews involving the same subject, either ensure the subject is informed at the outset that this is the case and provides consent for repeated or ongoing reviews, or document why it is not appropriate or possible to fully inform the individual and obtain informed consent or assent in the circumstance.