Ethics Flashcards

1
Q

A practitioner billed her client’s insurance company for a completed appointment. The provider did not report that the client cancelled her session with less than 24 hours until the appointment start time. This practice is:

A

illegal and unethical.; Standard 6.06 of the APA’s Ethics Code demonstrates the correct course of action. It states, “In their reports to payors . . . psychologists take reasonable steps to ensure the accurate reporting of . . . fees, charges, or payments.” The practice described in this question is indicative of insurance fraud. Insurance fraud is both illegal and unethical. Always choose the answer that is most consistent with legal and ethical mandates when considering questions pertaining to insurance. Billing an insurance company for missed appointments would be acceptable only if the company agreed to this practice.

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2
Q

legality around collection agencies

A

Standard 6.04 of the APA’s Ethics Code explains the correct course of action, stating, “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.”

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3
Q

Which of the following best describes APA ethical guidelines regarding sexual intimacy with former therapy clients?

A

Psychologists are prohibited from having sexual intimacies with former therapy clients for two years, and after that time, sexual intimacies would only occur in the most unusual of circumstances.

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4
Q

purpose of psychology licensing board

A

protecting the public welfare.

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5
Q

According to ethical guidelines, deception can be used in research when

A

According to ethical guidelines, deception can be used in research when it is justified by the study’s potential value, when it has been determined that alternative procedures are not available, and when participants are not deceived about aspects of a study that would otherwise influence their willingness to participate

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6
Q

a researcher’s obligations regarding the use of animals in psychological research?

A

Standard 8.09(e) of the Ethics Code dictates that “psychologists use a procedure subjecting animals to pain, stress, or privation only when an alternative procedure is unavailable and the goal is justified by its prospective scientific, educational, or applied value.” Principle II.46 of the Canadian Code of Ethics provides a nearly identical guideline.

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7
Q

multiple relationship

A

Multiple relationships are addressed in Standard 3 of the APA’s Ethics Code and in the Ethics Manual. Keep in mind for the licensing exam that the prohibition against multiple relationships is not absolute; begin therapy with her and discuss the potential for conflicts during the initial session and, if necessary, in subsequent sessions.

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8
Q

Publication credit

A

dissertations usually have first author, the rest of the order goes in order of the people who contributed the most

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9
Q

Ethics of consultation

A

It is unnecessary to advise the client of the consultation as long as the client’s identity is not revealed.

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10
Q

Ethics of pro bono work

A

General Principle A of the Ethics Code, which states that psychologists “strive to contribute a portion of their professional time for little or no compensation or personal advantage.”

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11
Q

In person solicitation ethics

A

Standard 5.06 of the APA’s Ethics Code and Principle III.31 of the Canadian Code of Ethics limit the types of in-person solicitation that are acceptable. Standard 5.06 states that “psychologists do not engage . . . in uninvited in-person solicitation of business [from persons who] . . . are vulnerable to undue influence.” Principle III.31 states that psychologists do not exploit others by, for example, “taking advantage of trust or dependency to frighten clients into receiving services,” which might occur when in-person solicitations are uninvited.

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12
Q

Ethics of termination

A

“psychologists 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 Standard 10.10(c) states that, prior to termination, psychologists should “suggest alternative service providers as appropriate.”

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13
Q

The Buckley Amendment

A

the right of parents or legal guardians of a child to inspect the child’s school records; The Buckley Amendment, also known as the Family Education Rights and Privacy Act (FERPA), is described in the Ethics Manual. The Buckley Amendment states that any school district may be denied federal funds if parents or other legal guardians of students, or students who have reached the age of maturity, are not given access to the students’ school records.

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14
Q

Dating graduate students

A

Dating students is ordinarily prohibited or discouraged, because doing so represents a multiple relationship. If Marla is a graduate student in another department, a relationship with her would not represent a multiple relationship, because Dr. Carlson is not likely to be her instructor or advisor.

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15
Q

What to do when colleague has ethical violation?

A

Ethical guidelines require psychologists to take action when they learn that a colleague has committed an ethical violation. This may involve addressing the issue informally when it seems appropriate to do so or reporting the violation to the Ethics Committee or licensing board when it does not seem appropriate for, or has not been resolved adequately through, informal resolution.

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16
Q

How to ethically handle providing services for entity or third party

A

“when psychologists agree to provide services to a person or entity at the request of a third party, psychologists attempt to clarify at the outset of the service the nature of the relationship with all individuals or organizations involved. This clarification includes the role of the psychologist (e.g., therapist, consultant, diagnostician, or expert witness), an identification of who is the client, the probable uses of the services provided or the information obtained, and the fact that there may be limits to confidentiality.”

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17
Q

ANIMALS IN RESEARCH

A

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.” It also states that, “when it is appropriate that an animal’s life be terminated, psychologists proceed rapidly, with an effort to minimize pain and in accordance with accepted procedures.”

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18
Q

BARTER

A

Standard 6.05 states that “psychologists may engage in barter for their services only when (1) it is not clinically contraindicated, and (2) the resulting arrangement is not exploitative.

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19
Q

Bias free language

A

The Publication Manual of the American Psychological Association provides guidelines for using bias-free language related to race/ethnicity, gender, age, and sexual orientation. For example, it recommends putting “people first” (e.g., “clients with a disability” rather than “disabled clients”); being specific when referring to race and avoiding using Whites as a comparison group; and using emotionally neutral terms (e.g., “people with a disease” rather than “people afflicted by a disease”).

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20
Q

Child Abuse reporting

A

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

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21
Q

client access to records

A

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.

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22
Q

client testimonials

A

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.”

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23
Q

client welfare

A

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.

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24
Q

CLIENTS RECEIVING SERVICES FROM ANOTHER PROFESSIONAL

A

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.”

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25
collection agencies
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.”
26
competence
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.”
27
competence to stand trial
Laws related to competence to stand trial 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.”
28
Complaints and respondents
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 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.”
29
confidentiality
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 an ethical principle and, in some situations, a legal requirement.
30
consultations
Standard 4.06 states that “when consulting with colleagues, (1) 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 (2) they disclose information only to the extent necessary to achieve the purposes of the consultation.”
31
cost analysis
Cost analysis refers to techniques that are used to assess the costs of an intervention in order to facilitate decision-making about the intervention. Methods of cost analysis include cost-benefit, cost-effectiveness, cost-utility, cost-feasibility, cost-minimization analysis, and cost-offset analysis.
32
cost-benefit analysis
Cost-benefit analysis (CBA) involves comparing the costs and benefits of an intervention in monetary terms. This method may be used to evaluate a single intervention or compare two or more interventions. A difficulty with CBA is that it may be difficult to assign a monetary value to an intervention’s outcomes.
33
cost-effectiveness analysis
Cost-effectiveness analysis (CEA) is useful when the interventions to be compared have similar goals, but it is not possible to assign a monetary value to their outcomes. When using CEA, costs are expressed in monetary terms but outcomes are expressed in measurable (but nonmonetary) terms such as the number of clients who drop out of therapy prematurely or scores on a measure of symptom severity. The data are then used to calculate cost-effectiveness ratios that can be compared to determine which intervention has the greatest effect per dollar spent.
34
cost-utility analysis
Cost-utility analysis (CUA) involves evaluating alternative interventions by comparing their costs with the value of their outcomes in terms of healthy years of life – e.g., in terms of “quality-adjusted life-years” (QALYs), which combines measures of gain in the quantity (duration) and quality of life.
35
cost-feasibility analysis
Cost-feasibility analysis (CFA) is used to evaluate the feasibility of one or more interventions on the basis of the monetary and other resources they would require. The purpose of CFA is to determine if an intervention is worth considering. Unlike the above methods of cost analysis, CFA does not take into account the outcomes of an intervention.
36
cost-minimization analysis
Cost-minimization analysis (CMA) is used to determine the least costly option that produces equivalent outcomes. CMA could be used to determine if paraprofessionals can provide mental health services that are not only comparable to those provided by professionals but also at a lower cost.
37
cost-offset analysis
Cost-offset analysis is also known as medical cost offset when it is used to determine the reduction in medical costs obtained by providing a mental health or other non-medical intervention. It involves comparing the costs incurred when implementing the intervention with the medical costs saved as a result of implementation. Note that, in general, the research confirms that providing psychotherapy or other psychological intervention results in substantial medical cost offset (e.g., Chiles et al., 1999
38
deception in research
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 nondeceptive 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.”
39
education and supervision
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.
40
EPPP
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 assist the boards “in their evaluation of the qualifications of applicants for licensure and certification” by assessing “the knowledge that the most recent practice analysis has determined as foundational to the competent practice of psychology” (ASPPB, 2010).
41
ethical violations by colleagues
Standard 1.04 encourages psychologists to handle ethical violations informally by discussing the matter with the offender when an “informal resolution appears appropriate”; while 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. These Standards also require that, before psychologists take any action, they must consider the issue of client confidentiality.
42
fact versus expert witness
A fact witness is a person “who testifies as to what he/she has seen, heard, or otherwise observed regarding a circumstance, event or occurrence as it actually took place. Fact witnesses are generally not allowed to offer an 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 & Nolan-Haley, 1990, p. 578). A person who has been qualified as an expert witness by the court is allowed to offer opinions and provide testimony based on hypothetical scenarios.
43
Psychotherapy notes
Psychotherapy notes are notes recorded in any medium by a mental health professional that document or analyze the contents of conversations during therapy. Psychotherapy notes are used only by the psychologist who wrote them and are kept separate from the documentation required to provide a patient with health care treatment, obtain payment for health care services, or conduct health care operations. Note that the Privacy Rule allows psychologists to decide whether or not to release their psychotherapy notes to patients unless patients have access to them under state law
44
GENERAL GUIDELINES FOR PROVIDERS OF PSYCHOLOGICAL SERVICES:
The General Guidelines were adopted “as a means of self-regulation in the public interest,” and its provisions are general and aspirational. It delineates basic guiding principles for all providers of psychological services (except for those who teach psychology, conduct research, or write and edit scientific manuscripts), and its goal is to “improve the quality, effectiveness, and accessibility of psychological services.”
45
GUIDELINES FOR CHILD CUSTODY EVALUATIONS IN FAMILY LAW PROCEEDINGS:
The goal of the Guidelines for Child Custody Evaluations is “to promote proficiency” in the conduct of child custody evaluations, and it provides aspirational guidelines that are intended to “facilitate the continued systematic development of the profession and help facilitate a high level of practice by psychologists.” It states that determining the “psychological best interests” of the child is the primary purpose of a child custody evaluation and that the child’s welfare is always of paramount importance.
46
GUIDELINES FOR PROVIDERS OF PSYCHOLOGICAL SERVICES TO ETHNIC, LINGUISTIC, AND CULTURALLY DIVERSE POPULATIONS:
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. It emphasizes the importance of competence and presents recommendations for incorporating cultural issues and knowledge into practice.
47
In-person solicitation
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.” It also identifies two exceptions to this prohibition – i.e., making “collateral contacts for the purpose of benefiting an already engaged therapy client/patient ... [and] providing disaster or community outreach services.”
48
informed consent and assent
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 (1) provide an appropriate explanation, (2) seek the individual’s assent, (3) consider such persons’ preferences and best interests, and (4) obtain appropriate permission from a legally authorized person.”
49
informed consent for research
Standard 8.02 states: “(a) When obtaining informed consent ..., psychologists inform participants about (1) the purpose of the research, expected duration, and procedures; (2) their right to decline to participate and to withdraw from the research once participation has begun; (3) the foreseeable consequences of declining or withdrawing; (4) reasonably foreseeable factors that may be expected to influence their willingness to participate such as potential risks, discomfort, or adverse effects; (5) any prospective research benefits; (6) limits of confidentiality; (7) incentives for participation; and (8) whom to contact for questions about the research and research participants’ rights.”
50
informed consent for therapy
Standard 10.01 states: “(a) When obtaining informed consent to therapy ..., 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.”
51
insanity
Insanity is a legal concept and most definitions reflect the rule set forth by the American Law Institute, which states that a person is not guilty by reason of insanity when, 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).
52
INTERRUPTION AND TERMINATION OF THERAPY:
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 pretermination counseling and suggest alternative service providers as appropriate.” An exception to this general rule is provided in Standard 10.10(b), which states that pretermination counseling or referral is not necessary when a psychologist is terminating therapy with a client because the client or a person the client has a relationship with poses a threat to the psychologist.
53
Malpractice
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 that 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 the person’s harm or injury
54
Multiple relationships
Standard 3.05 states that “a psychologist refrains from entering into a multiple relationship if it 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."
55
Obsolete tests
Standard 9.08 states that psychologists “do not base their assessment or intervention decisions or recommendations on data or test results that are outdated for the current purpose ... [and] do not base such decisions or recommendations on tests and measures that are obsolete and not useful for the current purpose.”
56
Personal Problems
Standard 2.06 states: “(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.”
57
Privilege and holder of the privilege
Privilege is a legal concept that protects a client’s confidentiality in the context of legal proceedings. Most jurisdictions 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 claim the privilege on behalf of a client, and there are legally defined exceptions to privilege.
58
Pro Bono Services
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.
59
Publication Credit
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.”
60
Referral Fees
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.”
61
RESPONDING TO A SUBPOENA:
(1) The first step is to determine if the subpoena is a legally valid demand. (2) If the subpoena is valid, a formal response is required, but the psychologist should first contact the client to discuss the implications of providing the requested information. (3) If the client consents to disclosure and there is no valid reason for withholding the information, the psychologist should provide the requested information. If the client does not consent, the psychologist or their attorney can attempt to negotiate with the party who issued the subpoena. (4) If the client does not consent and 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 their attorney file a motion to quash the subpoena or a motion for a protective order.
62
Sexual Harassment
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 (1) is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or (2) is sufficiently severe or intense to be abusive to a reasonable person in the context."
63
SEXUAL INTIMACIES WITH CLIENTS AND FORMER CLIENTS:
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.
64
SEXUAL MISCONDUCT BY PSYCHOTHERAPISTS:
Research on sexual misconduct has found 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).
65
SEXUAL RELATIONS WITH STUDENTS AND SUPERVISEES:
Standard 7.07 states that “psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority.”
66
Sliding Fee Scale
A sliding fee scale is not explicitly addressed by the Ethics Code but is generally considered acceptable as long as the scale is fair and serves the best interests of the client.
67
SPECIALTY GUIDELINES FOR FORENSIC PSYCHOLOGY:
The goals of the Specialty Guidelines for Forensic Psychology “are to improve the quality of forensic psychological services; enhance the practice and facilitate the systematic development of forensic psychology; encourage a high level of quality in professional practice; and encourage forensic practitioners to acknowledge and respect the rights of those they serve.” It provides guidelines on several issues encountered by practitioners of “forensic psychology” (e.g., multiple relationships, fees, informed consent, and confidentiality), which it defines as “professional practice by any psychologist working within any sub-discipline of psychology (e.g., clinical, developmental, social, cognitive) when applying the scientific, technical, or specialized knowledge of psychology to the law to assist in addressing legal, contractual, and administrative matters.”
68
Tarasoff Decision
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” an intended victim by warning him/her, notifying the police, or taking other steps. In most jurisdictions, the duty to warn/protect applies only when a client poses a clear and imminent danger to an identifiable victim or victims (although, in some jurisdictions, the duty has been expanded to include an identifiable “class of victims”).
69
Telepsychology
The provision of psychological services using telecommunication technologies, which may occur in real time (synchronous) or at separate times (asynchronous). Telepsychology includes the utilization of a variety of technology platforms, including interactions via telephone, text message, email, chat, videoconferencing, and virtual reality applications.
70
Test Data and Test Materials
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 that “pursuant to a client/patient release, psychologists provide test data to the client/patient or other persons identified in the release.” Standard 9.11 requires psychologists to “make reasonable efforts” to protect the integrity and security of test materials, which include “manuals, instruments, protocols, and test questions or stimuli.”
71
Test Scoring and Interpretation Services
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.”
72
Vicarious Liability
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).