Ethics

Question 1

Court-Ordered Evaluations/ Assessments

Answer 1

coercive (court-ordered) assessments involve special considerations: the informed consent process is quite different than for psychotherapy.

psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions. When, despite reasonable efforts, such an examination is not practical, psychologists document the efforts they made and the result of those efforts, clarify the probable impact of their limited information on the reliability and validity of their opinions, and appropriately limit the nature and extent of their conclusions or recommendations.

Question 2

Informed Consent in Assessments for court-ordered evaluations

Answer 2

Psychologists inform persons with questionable capacity to consent or for whom testing is mandated by law or governmental regulations about the nature and purpose of the proposed assessment services, using language that is reasonably understandable to the person being assessed.

Question 3

What is HIPPA?

Answer 3

is the federal Health Insurance Portability and Accountability Act of 1996

Question 4

What are goals of HIPPA?

Answer 4

increase efficiency (standardized format for electronic data). Improved privacy. Better security.

Question 5

To whom does HIPPA apply?

Answer 5

The HIPPA provisions apply to anyone who provides health care and does electronic transmission of health care info.

Question 6

What are the key areas of compliance and dates of implementation regarding HIPPA?

Answer 6

1. Transactions (billing operations like faxing)
2. Privacy (individually identifiable health care info like date of birth)
3. Security (the security rule is intended to provide for the security of confidential electronic patient info)
4. National provider identification
5. “Red flag” rule (helps prevent identity theft).

Question 7

All transaction/electronic billing must follow what federal guidelines?

Answer 7

HIPPA compliant software, and have a business associates agreement

Question 8

what are key elements to keep your records private as a clinician?

Answer 8

1. privacy notice forms
2. Patient authorization forms
3. Policy and procedure guidelines (aka disclosure statement)
4. Business associate agreements
5. Privacy officer
6. Privacy compliance plan
7. Grievance process
8. Employee training
9. Posted privacy notification.

Question 9

HIPAA compliance privacy of records applies to….

Answer 9

All personal health information

Question 10

HIPAA compliance security applies to….

Answer 10

electronically stored transmitted information

Question 11

HIPAA compliance security steps include…

Answer 11

1. security officer
2. security plan
3. security of documentation

Question 12

what is “risk analysis” in regards to HIPAA security compliance?

Answer 12

identifies potential security threats and vulnerabilities such as floods, computer viruses, breaks ins, thefts, etc. The risk analysis should be documented. Safe guards implemented and documented, and policy and procedures amended to reflect these changes.

Question 13

when are “business associate contracts” required?

Answer 13

They are required to ensure that business partners comply with security rules. Conversely, if you have no employees, it is not necessary to train staff in security requirements.

Question 14

what is “scalability”

Answer 14

a provision that as a size and complexity of the organization increases the standard has wider implications

Question 15

what are “administrative standards?” for HIPPA

Answer 15

they involve policies and procedures, staff training, and other strategies to carry out security policies.

Question 16

what are “physical standards?” for HIPPA

Answer 16

they involve such steps as limiting access to areas where electronic health info is stored.

Question 17

Court-ordered Evaluations and Assessments: Client

Answer 17

If hired by court or legal counsel the court or legal counsel is the client not the person being evaluated.

Question 18

California Tarasoff Statute

Answer 18

• Duty to report harm to self, others, abuse, animals
• California has adopted this, but Oregon has not fully
• Start of: more important to warn than to keep confidentiality.
• 1976 court ruling off of a murder in 1968.

Question 19

Tarasoff

Answer 19

Duty to warn: therapist can break confidentiality to warn someone if their is believed to be an imminent risk a patient will harm them.

Question 20

Record Keeping

Answer 20

• Recordkeeping - 7 years
• Minor - 7 years after an adult
• Security - two locks

Behind double lock
Keep for 7 years and destroy
Psychotherapy notes kept separate from medical record.

Question 21

Multiple Relationships

Answer 21

A multiple relationship is one in which a therapist is in both a therapist role and a non-therapist role simultaneously with a client or someone closely associated with or related to the client. Not necessarily illegal. Stick to do no harm and confidentiality and you’re golden.

Question 22

Legal Ethics

Answer 22

• Laws and statutes, not guidelines. Guidelines are not legal, they are aspirations.
• Subpoena

Question 23

Subpoena

Answer 23

• a court order requiring appearance and/or testimony
• Clinical notes need a second subpoena
• Always check the validity of the subpoena

Question 24

Informed Consent

Answer 24

Covers supervision, confidentiality, nature and course of treatment, payment and duty to report/warn.
-in general its good for up to 6 years unless revoked in writing. records must be kept for 6 years. in OR they must be kept for 7.

Permission granted in the knowledge of the possible consequences, typically that which is given by a patient, to a doctor for treatment with full knowledge of the possible risks and benefits.

Question 25

Ethics with diverse clients

Answer 25

Be mindful of diversity. Practice cultural humility, become informed about culture, APA’s “cultural competence”

Question 26

APA code of conduct (10)

Answer 26

Enforceable standards

1. Resolving ethical issues
2. Competence
3. Human relations
4. Privacy and confidentially
5. Advertising and other public statements (false identification of
6. Record keeping and fees
7. Education and training
8. Research and publications
9. Assessment
10. Therapy

Question 27

APA General Principles (5)

Answer 27

Strive to achieve these-guidelines

1. Beneficence and non-maleficence (do no harm)
2. Fidelity and responsibility (establish relationships of trust)
3. Integrity (promote accuracy, honesty, and truthfulness in the science, teaching, and practice of psychology)
4. Justice (fairness and justice to all persons, equal opportunity and treatment options)
5. Respect for people’s rights and dignity (respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination)

Question 28

Risk Assessment

Answer 28

Assessment of risk including but not limited to:

Danger to self- suicidal ideation, self-injurious behaviors, inability to care for self

Danger to others- homicidal ideation, inability to care for those under care

Elder Abuse
Child Abuse

Question 29

Termination

Answer 29

1. Termination summary of treatment/report
2. Inform services have completed
3. Termination when it is clear and time
4. Terminate when feeling threatened
5. Terminate when insurance or funding is not available, therapist provides pre-termination counseling and alternative services/referral

Question 30

APA Code of Conduct

Answer 30

The American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct (for short, the Ethics Code, as referred to by the APA) includes an introduction, preamble, a list of five aspirational principles and a list of ten enforceable standards that psychologists use to guide ethical decisions in practice, research, and education. The principles and standards are written, revised, and enforced by the APA. The code of conduct is applicable to psychologists in a variety of areas across a variety of contexts. In the event of a violation of the code of conduct, the APA may take action ranging from termination of the APA membership to the loss of licensure, depending on the violation. Other professional organizations and licensing boards may adopt and enforce the code.

Question 31

HIPAA

Answer 31

Law for electronic exchange, privacy, and security of health information.
The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.