EPPP (AATBS, 2013) - Ethics

Question 1

Animals in Research

Answer 1

Standard 8.09 requires psychologists to

• “acquire, care for, use, and dispose of animals in compliance with current federal, state, and local laws and regulations, and with professional standards” and
• to “make reasonable efforts to minimize the discomfort, infection, illness, and pain of animal subjects.”

Question 2

Competence

Answer 2

Standard 2.01 requires psychologists to

“provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.”

Question 3

Ethical Violations by Colleagues

Answer 3

Standard 1.04 encourages psychologists to handle ethical violations informally by discussing the matter with the offender when an “informal resolution appears appropriate”;

Standard 1.05 states that psychologists make a formal report to the Ethics Committee, state licensing board, or other appropriate authority when the problem involves “substantial harm” and is not appropriate for an informal resolution or has not been resolved satisfactorily by an attempt at an informal resolution.

Note that these Standards also require that, before psychologists take any action, they must consider the issue of client confidentiality, which always takes precedence over the need to educate or punish an offending psychologist.

Question 4

Informed Consent for Research

Answer 4

Standard 8.02 states

“(a) When obtaining informed consent as required in Standard 3.10, Informed Consent, psychologists inform participants about

• the purpose of the research, expected duration, and procedures;
• their right to decline to participate and to withdraw from the research once participation has begun;
• the foreseeable consequences of declining or withdrawing;
• reasonably foreseeable factors that may be expected to influence their willingness to participate such as potential risks, discomfort, or adverse effects;
• any prospective research benefits; limits of confidentiality;
• incentives for participation;
• and whom to contact for questions about the research and research participants’ rights.”

Question 5

Privilege and Holder of the Privilege

Answer 5

Privilege is a legal concept that protects a client’s confidentiality in the context of legal proceedings. Most jurisdictions now have laws that establish privilege for communications between licensed mental health practitioners and their clients.

The client is ordinarily the “holder of the privilege,” but a psychologist can assert the privilege on behalf of a client, and there are exceptions to privilege that are legally defined.

Question 6

Sexual Misconduct (By Therapists)

Answer 6

The data on sexual misconduct has consistently shown that male therapists engage in sexual and other dual relationships with clients much more often than female therapists. The data also show that male therapists who engage in sexual misconduct are usually older than the female clients they become involved with, with the average therapist being between 42 and 44 and the client being between 30 and 33.

No consistent relationship has been found between risk for sexual misconduct and theoretical orientation, professional experience, or education (Pope et al., 1993).

Question 7

Barter

Answer 7

Standard 6.05 states that “Psychologists may barter only if it is not clinically contraindicated, and the resulting arrangement is not exploitative.”

Question 8

Competence to Stand Trial

Answer 8

Laws related to competence to stand trial also vary, but all were derived from the standard set forth in Dusky v. United States (1960), which defines a defendant as incompetent if, as the result of mental defect or illness, the defendant lacks “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding, and … a rational as well as a factual understanding of the proceedings against him” (p. 171).

Question 9

Fact and Expert Witness

Answer 9

A fact witness is a person “who testifies as to what he/she has seen, heard, or otherwise observed regarding a circumstance, event of occurrence as it actually took place… Fact witnesses are generally not allowed to offer opinion, address issues that they do not have personal knowledge of or respond to hypothetical situations” (APA, 1998, p. 7).

An expert witness is a person “who by reason of education or specialized experience possesses superior knowledge respecting a subject about which persons having no particular training are incapable of forming an accurate opinion or deducing correct conclusions” (Nolan and Nolan-Haley, 1990, p. 578). A person who has been qualified as an expert witness by the court will be allowed to offer opinions and provide testimony based on hypothetical scenarios.

Question 10

Informed Consent for Therapy

Answer 10

Standard 10.01 states “(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.”

Question 11

Pro Bono Services

Answer 11

Although the term pro bono is not used in the Ethics Code, General Principle B (Fidelity and Responsibility) states that “psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.”

Because pro bono services are addressed in the Ethics Code’s aspirational General Principles rather than in its mandatory Ethical Standards, this means that pro bono services are recommended by the Code but are not required.

Question 12

Sexual Relations with Students and Supervisees

Answer 12

Standard 7.07 states “Psychologists do not engage in sexual relationships with students or supervises who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority.”

Question 13

Client Testimonials

Answer 13

Standard 5.05 states that “Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.”

Question 14

Consultation

Answer 14

Standard 4.06 states that “When consulting with colleagues, psychologists do not disclose confidential information that reasonably could lead to the identification of a client/patient, research participant, or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided, and they disclose information only to the extent necessary to achieve the purposes of the consultation.”

Question 15

Guidelines for Child Custody Evaluations in Divorce Proceedings

Answer 15

The Guidelines states that the “child’s interests and well-being are paramount” in custody evaluations and that psychologists “generally avoid conducting a child custody evaluation in a case in which the psychologist served in a therapeutic role for the child or his or her immediate family.”

Question 16

Malpractice

Answer 16

For a client or other person to bring a claim of malpractice against a psychologist, four conditions must be met:

1. The psychologist must have had a professional relationship with the person, which established a legal duty of care.
2. There must be a demonstrable standard of care that the psychologist has breached.
3. The person suffered harm or injury.
4. The psychologist’s breach of duty within the context of the standard of care was the proximate cause of there person’s harm or injury.

Question 17

Referral Fees

Answer 17

Standard 6.07 states “When psychologists pay, receive payment from, or divide fees with another professional, other than in an employer-employee relationship, the payment to each is based on the services provided (clinical, consultative, administrative, or other) and is not based on the referral itself.”

Question 18

Tarasoff Decision

Answer 18

The original Tarasoff decision established a “duty to warn” an intended victim of a therapy client; however, in a rehearing of the case, this was changed to a “duty to protect” the intended victim by warning him/her, notifying the police, or taking other steps.

Question 19

Client Welfare

Answer 19

Standard 3.04 addresses client welfare in a general way and states that psychologists “take reasonable steps” to avoid and minimize harm to clients, students, research participants and others with whom they work.

Question 20

Deception in Research

Answer 20

Standard 8.07 states that deception is acceptable only when the following conditions are met:

(a) The use of deception is justified by the “study’s significant prospective scientific, educational, or applied value and… effective non-deceptive alternative procedures are not feasible”;
(b) prospective participants are not deceived about conditions that can be “reasonably expected to cause physical pain or severe emotional distress”; and
(c) participants will be debriefed “preferably at the conclusion of their participation, but no later than at the conclusion of the data collection.”

Question 21

Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Answer 21

The Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations presents aspirational principles and guidelines for psychologists working with members of ethnic, linguistic, and culturally diverse populations.

Like many other APA documents, the Guidelines emphasizes the importance of competence (e.g., recognizing the limits of one’s competence, being familiar with relevant research). It also presents suggestions for incorporating cultural issues and knowledge into practice.

Question 22

Multiple Relationships

Answer 22

Standard 3.05 states that “a psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”

Question 23

Responding to a Subpoena

Answer 23

The first step is to determine if the subpoena is a legally valid demand.

• If the subpoena is valid, a formal response will be required, but the psychologist should first contact the client to discuss the implications of providing the requested information.
• If the client consents to disclosure and there are no reasons for withholding the information (e.g., client welfare, test security), the psychologist should provide the requested information.
• If the client does not consent, the psychologist or his/her attorney can attempt to negotiate with the party who issued the subpoena.
• If the requesting party continues to demand that the information be provided, the psychologist can seek guidance from the court informally through a letter or have his/her attorney file a motion to quash the subpoena or a motion for a protective order (APA, 1996).

Question 24

Test Data

Answer 24

Standard 9.04 defines test data as “raw and scaled scores, client/patient responses to test questions or stimuli, and psychologists’ notes and recordings concerning client/patient statements and behavior during an examination.”

It also states “Pursuant to a client/patient release, psychologists provide test data to the client/patient or other persons identified in the release.”

Question 25

Child Abuse Reporting

Answer 25

Although the specific laws very from jurisdiction to jurisdiction, all jurisdictions require psychologists to report known or suspected cases of child abuse to the appropriate authorities.

Question 26

Complainants and Respondents

Answer 26

Standard 1.08 states that “Psychologists do not deny persons employment, advancement, admissions to academic or other programs, tenure, or promotion, based solely upon their having made or their being the subject of an ethics complaint.

This does not preclude taking action based upon the outcome of such proceedings or considering other appropriate information.”

Question 27

FERPA

Answer 27

Another relevant law is the Family Education Rights and Privacy Act of 1974 (also known as FERPA and the Buckley Amendment), which applies to records maintained by educational institutions receiving federal funds.

FERPA prohibits schools from disclosing personally identifying information from student records without the consent of the parents of students or students aged 18 and older. It also grants parents and students the right to inspect the student’s educational records.

Question 28

Insanity

Answer 28

Insanity is a legal concept. Most definitions reflect the rule set forth by the American Law Institute, which states that

a person is not guilty by reason of insanity (i.e., is not responsible for the alleged act) if, because of a mental disease or defect, “that person lacks substantial capacity to appreciate the wrongfulness of the act or lacks substantial capacity to behave according to the requirements of the law” (Gutheil, 1995, p. 2764).

Question 29

Publication Credit

Answer 29

Standard 8.12 states:

“(a) Psychologists take responsibility and credit, including authorship credit, only for work they have actually performed or to which they have substantially contributed … [and]

(b) Principal authorship and other publication credits accurately reflect the relative scientific or professional contributions of the individuals involved, regardless of their relative status.”

Question 30

Sliding Fee Scales

Answer 30

Sliding fee scales are not explicitly addressed by the Ethics Code but are generally considered acceptable as long as use of a sliding fee scale is fair and serves the best interests of the client.

Question 31

Client Access to Records

Answer 31

Client access to records is determined by law but, in general, the psychologist is the owner of the physical record, while the client has the right to inspect the contents of the record.

Question 32

Confidentiality

Answer 32

Confidentiality refers to the obligation of psychologists to protect clients from unauthorized disclosure of information revealed in the context of the professional relationship. Confidentiality is both an ethical principle and, for some situations, a legal requirement.

Question 33

General Guidelines for Providers of Psychological Services

Answer 33

The General Guidelines were adopted “as a means of self-regulation in the public interest,” and its provisions are general and aspirational.

The Guidelines delineates basic guiding principles for all providers of psychological services (although teaching psychology, conducting research, and writing and editing scientific manuscripts are not considered “within the purview” of the Guidelines), and its goal is to “improve the quality, effectiveness, and accessibility of psychological services.”

Question 34

Interruption and Termination of Therapy

Answer 34

Standard 10.10 requires psychologists to “terminate therapy when it becomes reasonably clear that the client/patient no longer needs the service, is not likely to benefit, or is being harmed by continued service” and, when doing so, to “provide pre-termination counseling and suggest alternative service providers as appropriate.”

Question 35

Record Keeping Guidelines

Answer 35

Paragraph 1(a) of APA’s Record Keeping Guidelines specifies that records of psychological services must include, at a minimum, identifying data, dates of services, types of services, fees, assessment reports and intervention plans, and releases of information.

Question 36

Specialty Guidelines for Forensic Psychologists

Answer 36

The goal of the Specialty Guidelines for Forensic Psychologists is to

“provide an aspirational model of desirable professional practice by psychologist … in an activity primarily intended to provide professional psychological expertise to the judicial system.”

In contrast to the other specialty guidelines it does not define minimum qualifications in terms of education and training but, instead, focuses on professional practice issues in the context of forensic work.

Question 37

Clients Receiving Services from Other Professionals

Answer 37

Standard 10.04 states that “In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare. Psychologists discuss these issues with the client/patient … and proceed with caution.”

Question 38

Education and Supervision

Answer 38

Standards 7.01 through 7.06 address education and supervision and require psychologists to act competently and responsibly when teaching, supervising, and designing education and training programs and to avoid misrepresenting themselves or their work when performing these functions.

Question 39

In-Person Solicitation

Answer 39

Standard 5.06 states that “Psychologists do not engage, directly or through agents, in uninvited in-person solicitation of business from actual or potential therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.”

Question 40

Obsolete Tests

Answer 40

Standard 9.08 states that

“(a) Psychologists do not base their assessment of intervention decisions or recommendations on data or test results that are outdated for the current purpose … [and]

(b) Psychologists do not base such decisions or recommendations on tests and measures that are obsolete and not useful for the current purpose.”

Question 41

Sexual Harassment

Answer 41

Standard 3.02 prohibits psychologists from engaging in sexual harassment, which it defines as “sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with the psychologist’s activities or roles as a psychologist, and that either is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or is sufficiently severe or intense to be abusive to a reasonable person in the context.”

Question 42

Test Scoring and Interpretation Services

Answer 42

Standard 9.09 states

“(a) Psychologists who offer assessment or scoring services to other professionals accurately describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use … [and]

(c) Psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.”

Question 43

Collection Agencies

Answer 43

Standard 6.04 states that “If the recipient of services does not pay for services as agreed, and if psychologists intend to use collection agencies or legal measures to collect the fees, psychologists first inform the person that such measures will be taken and provide that person an opportunity to make prompt payment.”

Question 44

EPPP

Answer 44

The EPPP (Examination for Professional Practice in Psychology) is a requirement for licensure in the United States and Canada.

It is prepared by the Association of State and Provincial Psychology Boards (ASPPB) and is designed “to evaluate the knowledge that should have been acquired by any candidate who is seeking licensure to practice psychology.”

Question 45

Informed Consent and Assent

Answer 45

Standard 3.10 states that

“When psychologists conduct research or provide assessment, therapy, counseling, or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or persons.”

It also states that “for persons who are legally incapable of giving informed consent, psychologists nevertheless provide an appropriate explanation, seek the individual’s assent, consider such persons’ preferences and best interests, and obtain appropriate permission from a legally authorized person.”

Question 46

Personal Problems

Answer 46

Standard 2.06 states that

“(a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner … [and]

(b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties.”

Question 47

Sexual Intimacies with Clients and Former Clients

Answer 47

Standard 10.05 explicitly prohibits psychologists from having sexual relationships with current clients, while

Standard 10.08 forbids a psychologist from having a sexual relationship with a former client for at least two years after cessation of therapy.

The latter Standard also states that, even after the two-year limit has passed, a relationship may be acceptable only in the “most unusual circumstances.

“Standard 10.07 prohibits psychologists from providing therapy to people with whom they have had sexual relationships in the past. This exclusion is absolute; there are no time limits or other exceptions.

Question 48

Vicarious Liability

Answer 48

Under certain circumstances, supervisors and employers may be legally responsible for the actions of their supervisees and employees. This is referred to as vicarious liability (respondeat superior).