Ethics Flashcards
1
Q
APA 2016 Ethics Code Standards 1&2
Who does it apply to
A
- activities that are professional, educational, or scientific roles as a psychologist
2
Q
1&2 Code
APA can take action against
A
- complaints from community and professionals
- also, a conviction of felony, suspension or revoke of licensure from state psych board
- felony does NOT need to be related to the role/duties as a psychologist
3
Q
1&2 Preamble
A
- welfare and protection of individuals and groups, other psychs, students and the Public regarding ethical standards
4
Q
1&2
5 General Principles
A
- aspirational “to inspire” NOT enforceable
- Beneficence & Nonmaleficence
- Responsibility & Fidelity
- Intergrity
- Justice
- Respect for Peoples Rights & Dignity
5
Q
1&2 Ethical Standards
A
- Enforceable/mandatory by both APA & State Boards
- 10 Categories
- Resolving Ethical Issues
- Competence
- Human Relations
- Privacy & Confidentiality
- Advertising & other public statements
- Record Keeping & fees
- Education & Training
- Research & Publication
- Assessment
- Therapy
6
Q
Standard I
Resolving Ethical Issues
with whom do these issues address
A
- resolving issues with
- ethical
- legal
- organizations
7
Q
Standard I
Conflict and How to address
A
- Conflict
- make position known
- take steps to resolve
- may not justify violating human rights
8
Q
Standard I
when to follow legal authority
A
- Resonable efforts then permitted to follow legal authority when actions do not justify or defend human rights
9
Q
Ethical Violation by a colleague
A
- bring violation to the attention of the psychologist
- if not resolved, report the violation to ethics committee or licencing board to take action if likeness of harm or unable to address informally
10
Q
Request from Ethics Committees
A
- cooperate with investigation with APA although you have to consider confidentiality
11
Q
Unfair Discrimination
A
- cannot discriminate based on eithics compliant although action can be taken after the preceedings/rulings are completed
12
Q
Competence Standard 2
Boundaries of Competence
scope
gender
refer out
A
- must work w/n one’s education, scope of practice
- in conjunction w/understanding gender, race, culture or/and other characteristics is also something to consider
- if you do not have training must refer out
13
Q
Services to new populations or techniques
A
- When Psychs are asked about things outside scope of practice or training
- must get new training and supervision
- if too great of a challenge must refer out
14
Q
Telepsychology
delivery
training
consultation
A
- must be competent in the area to deliver telepsychology
- obtain the training needed to deliver the telepsychology
- get a consultation with a psychologist that is familiar w/telepsych area if needed
15
Q
Evidence-Based Practice
A
- treatment is based on the lastest research combined with clinical expertise in context with patients characteristics, culture and preferences
16
Q
Emergency Services
A
- allows psychs to work with patients on an emergency services bases
17
Q
Delegating work to others
A
- no multiple relationships impede objectivity or effectiveness
- completely independent or while supervised
- psychologist ensures the person can provide the services completely
18
Q
Use of interpreter
A
- do not use family member-conflict of interest
- obtain consent BEFORE assessment or to assist with therapy and explain why it is necessary
- the psychologist must have a business contract with interperter that addresses confidentiality
19
Q
Vicarious Liability
A
- legally responsible
- has authority to control employee or supervise
- employee deviated from standard of care & caused recipient damage
- supervision must have been w/n scope of practice competence
20
Q
Personal Problems
A
- refrain from taking clients that may impede your effectiveness-if you have an issue personally to treat must refer out
- take appropriate measures-if personal problem only affect professionally (-) seek consultation to determine if therapy should be suspended, limited or terminated
21
Q
Discrimination
A
cannot discriminate
don’t have to accept& can refer out if believe it is
individual bias will impact diagnosis, values
or (-) affect competence
22
Q
Sexual Harassment
A
- sexual solicitation physical, verbal or nonverbal
- unwelcome work or education place & psych knows or has been told
- sever or intense can be single or multiple occasions
- quid pro quo -something for something
23
Q
Sexual Harassment
ambiguous situations
A
- no longer unclear when person is told not to do it anymore
- example off-color jokes are not okay once the person has been told that they have gone too far and continues to do it
24
Q
Harm
A
- reasonable steps to avoid harm, minimize foreseeable effects
25
Multiple Relationships
definition and an example
* current or former clients or closely related
* when asked to do forensic and therapeutic services must refer out
26
Multiple relationship
3 factors to consider treated patient
* power differential between therapist and client
* duration of each relationship
* clarity of termination of each relationship
* ↑differential ↑longer duration between two ↑ likelihood 1 or both may resume in future
*
27
Potential Harmful Multiple relationship
* if occured psychologist must take reasonable steps to resolve
* best interest of the affected person and max compliance w/ethics code
* speak w/colleague to determine the best course of action
* speak with individual
28
Conflict of Interest
* cannot accept if it will impair judgement, effectiveness, exposure, harm or exploitation
* violation can include if psych recommendation proceeds they gain benefit from it (psych recommends client purchase a product because they get a kick back from purchase)
29
Third Party
* Identify role (therapist, diagnostician, or expert witness) & also discuss limits in confidentiality
30
Supervision Guidelines for Education
Who is the client
* the client ordinarily refers to a direct recipient of psychological health care service
* adult
* adolescent
* child
* couple
* family group
* organization
* community
31
Guidelines for Forensic Psychology
Client
* CLIENT
* attorney
* law firm
* court
* agency
* entity
* party
* or other people who has retained
* contractual relationship
32
Informed Consent
definition
* must obtain unless mandated by courts or governmental agency
* exception court order evaluations & research with deception
33
Informed consent
Legally incapable of giving consent
* provide explanation, assent, permission from legal government by the state
* minors w/cog maturity
* minors w/medical condition
* alcohol, substance or STD
* presumed consent-life threatening for a minors
* should be obtained w/ ongoing treatment
* ↑risk for suicide
34
Doctrine of implied consent
assumes if minors parent were present they would consent
35
Informed Consent
Court Ordered Services
* psych must inform person nature of service and limitations of confidentiality
36
Informed consent
Forensic court-ordered services
* must explain nature of exam but can proceed w/o consent
* if subject refuses psych can postpone, contact attorney, or notifiy retaining party
37
Informed Consent Documentation
***must document***:
written
or oral permission
or assent
38
39
Informed Consent
Teletherapy
* strive to obtain and document informed consent that will adhere concerns of teletherapy
* this includes
* emergency plan
* procedures of contact between sessions
* process of documenting and storing information
* potential technical failure
* procedure for coordinating care with other professionals
* conditions under which teletherapy must terminate and a referral made for in-person treatment
*
40
Informed consent
Interruption of services
* when forseeable , predetermination counseling, discuss w/client and find provide counseling and referrals
* due to death or illness must plan a professional will where Executor will contact clients and ensure severity of clients records
41
Privacy and Confidentiality
Limits of Confidentiality
* limits of confidentiality and foreseeable uses of information generated through their psychological activities
* and onset of relationship occurs may need to discuss as needed or with new circumstances
42
Limits of confidentiality
Couples and families
* discuss how family information will be shared
* will all information disclosed by an individual separately be shared or kept closed from other family members and partners
43
Limits of Confidentiality
Group Members
* cannot gaurantee confidentiality in groups nor are group members ethically bond
* ↓likelihood of disclosure by explaining the importance of maintaining the confidentiality and possible negative consequences
* discuss at
* initial screenings
* group sessions
* subsequent and final sessions
44
Limits of Confidentiality
Minors
* confidentiality with minors best to discuss with all parties at the same time
* devise a confidentiality agreement with minor and parent to know what will and will not be discussed
* inform parents that law enforcement, medical personnel and others will be informed if sexual or physical abuse is suspected
* also make known that parent/gaurdian will be contacted if client is engaging in potentially harmful behavior that may impact his/her safety
45
Limits of Confidentiality
Deceased Clients
* disclose only with permission from executor, estate admin
46
Limits of Confidentiality
Members of the Military
* DoD limited confidentiality-confidentiality can never be guaranteed in the military
* may need to keep conservative documentation
47
Limits of Confidentiality
Correctional Facilities
treatment driven vs security-driven
* range from essential confidentiality to no confidentiality
* treatment driven-therapeutic benefit (acting best4client)
* security driven-confidentiality respect but safety of others is more important
*
48
Correctional Facility
Level of threat-duty to protect
inside vs outside of jail
* level of threat includes
* inside jail could cause harm (office, inmate)
* breach confidence to warn (wardon)
* outside jail
* less likely to pose a threat due to the inability to carry out
* continue therapy to reduce violence of threat and behavior
* may need to breach if inmate is due to release soon or person to harm may be a possible visitor
49
Limits of Confidentiality
Employee Assistance Programs
person seen information is not shared with employers without authorization
50
Limits of Confidentiality
telepsychology
* telepsychology increases risk for confidentiality in both delivery of services and recordkeeping
51
Limits of Confidentiality
Disclosing Confidential Information
* appropriate authorization
* mandated by law legally required to breach for child abuse
* legally permitted to contact a collection agency for a fee
52
Limits of Confidentiality
Danger to self
* must take into consideration safety of client
* ↑ risk of suicide must take actions to protect safety (hospitalization)
53
Client is a danger to others
Tarasoff
* dut to protect only when clear and imminent threat of physical harm to an identifiable victim
* warn victims, notify police, take reasonable steps to hospitalize client
54
Health Insurance Portability & Accountability Act (HIPPA) & Protective Health Information (PHI)
* health information can be disclosed without patients authorization for
* treatment
* payment
* or other health care operations
* however it cannot be disclosed if state law trumps HIPPA if they indicate do not disclose
*
55
How much do you disclose in HIPPA
health information
forensic information
* Health information should always be kept in a minimum disclosure necessary specifically for the purpose and requirement
* Forensic Psychology-should focus on relevant information to questions only regarding evaluation
56
HIPPA
Psych consult w/collegues
* can get a consultation from another psych but cannot provide/ask any identifying information without authorization
* names must be changed, birthdates, locations, and other private information in addition to changing the season or year of the event to modify details, including family size.
57
Confidentiality Vs Privilege
* ***confidentiality***-ethical, legal requirement
* ***privilege*** (privileged communication is a legal term for the right to have confidentiality in legal process
58
Holder of Privilege
* the client or the clients legal representative holds the privilege
* a psychologist may exert privilege on behalf of the client
59
Exceptions to privilege
* court decides if an exception applies
* For example court order examination to determine competency, person sue therapist for malpractice, person uses mental status as claim for defense
60
APA Code 5 and 6
Advertising and Public Statements
Public Statements
* do not make false statements & fraudulent which includes training, experience, service, fees, advertisements, listing, lectures
* responsible for statement made by others
* can only acknowledge degrees from an accredited agency or one that has received approval from qualified licensing agency
61
Public statements
Press
Public advice in print
* cannot compensate press for statements
* must be based on training, education or experience
* a psychologist cannot indicate that interaction during media establishes professional relationship
62
Client testimonials
* cannot use current therapy clients/patients because of possible vulnerable to undue influence
63
In-Person Solicitation of Business
* cannot encourage others to get therapy due to influence
* excludes encouraging family members to participate in current therapy or disaster relief
64
Record keeping and fees
Maintaining, Disseminating Disposing of Records
* maintain confidentiality of records
* when entering information be sure information & access is coded if needed
* leave a plan to transfer files & clients
* record if a patient withdraws from practice
65
66
Disposing of records
* Record adults 7 years
* Children 3 years after they turn of age whichever greater
* federal support 3 years after project completion
* Publication Manual raw data 5 years after publication
67
Fees
* as early as feasible
* must inform client first before sending them to collections
* if session is free must understand the limits of the session and what is expected for the future sessions
68
Financial Arrangements
withhold records
barter
* cannot withhold client records just because of unpaid fees if needed for emergency services
* it maybe illegal to withhold
* Barter is accepted when not clinically contradicted or exploitative although goods less risky than services
69
Forensic Psychology contingency fees
* due to impartiality presented forensic practitioners should avoid providing services on the basis of contingent fees
70
Payors (insurance company)
diagnosis
billing
group therapy vs individual billing
copay (waive)
* insurance company should receive actual diagnosis
* do not say you are billing for one thing and treat for another or say psych did service when really the assistant did
* it is illegal to bill for individual therapy if it was group therapy
* cannot waive copay
*
71
Referral fee
* only the cost of actual time with the client
* or copying and forwarding the clients file
* does not apply to dividing fees with another professional when both service client or paying a percentage of clients fee
72
APA Ethics 7 & 8
Education and Training programs
program accuracy
course syllabi
* reasonable steps programs accurate
* course syllabi should provide accurate information for grading and expectations
* changes must be made in a manner student can still complete degree
73
Education and Training Programs
Private information disclosure
admission material
threat/harm
1. must be a part of admissions materials
2. or information found may be harm/threat to others keep them from performing training or professional competent manner
74
Individual/group therapy requirement
individual/group therapy required cannot be current professor and must be allowed to seek outside of university if desired
75
Assessment of student and supervisee performance
* timely feedback for students and supervisor
* eval must be based on actual performance
*
76
dismissal of supervisees
supervision has due process rights
* must provide regular feedback (constructive)
* including remediation if necessary
* ↑supervision hours
* recommend personal therapy
* ↓workload
* complete additional course work
* recommending a leave of absence or second internship in another setting
77
Sexual relationships with students/supervisees
* prohibits sexual involvement with students/supervisee that is in their department, agency or training center or over them
* or if they have or likely to have evaluative authority
78
Informed Consent for research
1. purpose of research, duration & procedures
2. right to decline or withdraw at any time
3. foreseeable consequence to withdraw or decline
4. potential risks, discomforts & adverse effect
5. research benifits
6. limits of confidentiality
7. incentives
8. content information about who to contact regarding rights & questions
must also be given the right to ask and receive answers to questions about research
79
Informed consent
effects of experimental treatment, control group
* people must be given information regarding treatment, available alternative treatments & any other things not assigned to control group
80
Informed consent
NOT NEEDED
* look at others at schools
* looking at job behaviors & confidentially maintained
* anonymous questionnaires
* does not need to consent to record images or voices when the is
* in public places & not likely to cause personal identification
* or harm or cause deception AND consent will be obtained during debriefing
81
Inducement for Research
* course requirement of opportunity for extra credit provide alterations more reasonable efforts to avoid excessive financial inducements
* offer things in exchange for research
82
Deceptions in research
* certain conditions or applied value
* alternative non-deception option not available
83
Cannot be deceived about
* things that will cause physical pain or emotional distress
* can quit at anytime
* told as feasible possibly no later than conclusion of date of collection of data
84
Use of Animals in Research
* these with animals experience must supervise all procedures & are responsible for ensuring
* comfort
* health
* humane treatment
* can only experience pain, stress, privation (food and warmth lacking) only when NO other alternative is available
* when animal needs to die it must be quick & with little pain
85
Reporting & Publishing Research
* cannot lie about data & must correct errors
* when you know it is wrong, no plagiarizing
86
Principal Authorship
* principle author must reflect contribution not status
* if student did the work they should get 10 credit
* must be listed principal on doctoral dissortations
87
Duplicate Publication of Data
* can not publish old data as new data unless it is acknowledged
* can only submit one article at a time to be published
88
Assessment Techniques and Results
and interpretation
7 key components
1. conclusion are derived from sufficient information past or present. Be able to explain why you used previous testing
2. use updated test materials and standard procedures
3. do not allow others to use test w/o supervision
4. updated test result should be recognized and when retest due to new skills learned
5. you are responsible for test data & scoring templates
6. explain results unless for employment screening or courts
89
Informed consent for assessment
4 parts
* informed consent must include nature & purpose of assessment fee and limits of confidentiality
* it is not needed if
* mandated by law
* routine & educational
1. questionable capacity & must be in understandable language
2. an interpreter must hold confidentiality & discussion of limitation testing with interpreter
90
Test data and Test materials
* test data, notes, scores, materials can release to client unless the worry is it may cause harm if the law allows
91
Test scores and items discussion with client
* protect integrity of test materials, consult with law requirement and can discuss a test item to help person understand results
92
Informed consent for therapy
* as early as feasible in therapeutic relationship
* includes fees, third party & limits of confidentiality
93
Informed consent regarding trainee
* if trainee supervisor is responsible client must be informed of trainee status and given name of supervisor
94
Provide therapy to clients serviced by others
* caution if person is seeing someone for the same issue in group but wants individual it maybe okay
* if person is seeking treatment for the same issue its not
* Also get permission 2 speak w/therapist to coordinate treatment
95
Sexual Intimacies
bear the burden of demonstrating
* no to current
* former patient must wait 2 years **and** no exploitative
* time passed
* nature of therapy
* circumstances
* clients history
* mental status
* impact on client
* action from a therapist (no suggesting to end a therapeutic relationship in order to have sex or have a mutual relationship
* NO SEX with known relatives of current therapy clients
* cannot provide therapy to someone you have had sex relations with in the past
96
Termination of therapy
* clearly no longer needs it
* therapist and client can reevaluate progress
* terminate when feeling treaten by or engaged by client or relative
* when therapist feels threaten they specifically by client must provide preterm counseling and referrals for alternative service providers
97
Professional Issues
Malpractice Claims
* Four conditions
* professional relationship
* dereliction of breach of duty
* client suffered harm
* direct or approximate harm can be measured
98
Professional Issues
Responding to Subpoena
* subpena legal (served correctly)
* formally respond after contacting a client
* if client authorizes release information if not contact party to ask if they will withdraw
* attempt to negotiate to seek guidance informally from court or formally motion quash a subpoena
99
Forensic Psychology Legal Teams
Insanity
* legal term
* not guilty by insanity-mental issues or defeated
* fail to recognize actions were wrong or immoral
* aka guilty by insane, or guilty but mentally ill
* 1% of all cases successful 25% of the time
100
Competency to stand trial
* cooperate with an attorney & understand charges against them
* methods to evaluate, interviews, mental status psych test
* review of information
* psych tests as well as determine competency to insanity, stand trial, waive right to counsel
* & can person really make the decision he is making
101
Fact Witness
* testify on what he has seen or what has taken place
* not allowed to provide an opinion
* not allowed to respond to hypothetical situations
* can only give confidential information w/permission from client or court order
102
Expert Witness
* eduction or expertise
* person possesses superior knowledge
* respecting subject the are allowed to provide an opininon and answer hypothectical situations
103
Avoiding Bias in Language
Gender vs sex
* get rid of gender exclusivity
* gender refers to social identity
* sex-refers to sex assignment
* if gender or sex identity is unknown use *they, them and their*
104
Sexual Orientation
* avoid inaccurate terms
* identity-first terms to describe sexual orientation (lesbian woman, bisexual people)
* sexual and gender minorities use these terms
* LGBTQ (+) are acceptable
*
105
Age
* avoid using *males and females* with groups of a wide range of ages
* 12 years or less say child, boy, or girl
* 13-17 say young person or adolescent
* 18+ say adult, woman and man
* 65+ say *older adult* **NOT** elderly, senior citizen or the aged
106
Disability
Physical, psychological, socioemotional impairments
* avoid - and condescending language
* person in a wheelchair
* person with AIDS
* *person-first* language
* Adolescent w/ASD
* people w/visual impairments
* *identity first language*
* **autistic adolescent
* visually impaired person
107
Race/Ethnicity-General Guidelines
* Capitalize racial/ethnic groups
* Do not hyphenate names of racial groups
* avoid using term without a specifier
* use *ethnic* *minority students* not minorities
* use *racial-ethnic minority students*
* parallel comparisons
* *African Americans and European Americans*
* *or Blacks and Whites*
108
Race/Ethnicity
Racial and Ethnic groups
* African American, Black
* or more specific to region Nigerian or Haitian
* Asain, Asian American, Asian Canadian, Japanese, Japanese American
* Latinx, Salvadoran, Costa Rican
* European, European American, European Canadian in North America *White* is acceptable
* Native American, Hawaiian Native, Pacific Islander, Alaska Native
* alternatively, Indigenous People, or First Nations may be preferred
* Middle East or North African Origin or Arab American is fine
109
Responding to negative online reviews
* responding to negative reviews violates HIPPA privacy
* ↓ (-) views by establishing + online presence, patient satisfaction rating & + evals from colleagues
110
Telepsychology
* aka telehealth and teletherapy
* services by phone, email, chat, text, internet
111
Telepsychology
Interisdictional Practice
* patient is located in another state,, province or country than the therapist
* the therapist needs to be considered in the location of the patient (state) permanently or temporarily at the time of the services
112
Telepsychology
Interisdictional Practice
regarding PSYCPACT
* therapist needs to know child abuse reporting laws in another state
* duty to warn
* local resources available to the client
* should only advertise to people they can legally provide services consider in brochures and professional websites
113
PsychPact
* Psychology interjurisdictional compact (PsychPact)
* aggreement allows doctoral level psychs to provide services across compact states through telepsychology or temporary in-person basis without licensure in that state
114
PsychPact
Telepsychology
* psychs in a compact state must obtain *E.Passport* and Authority to Practice Interjurisdictional Telepsychology (APIT) from PSYPACT commission
* must initiate while client is in their home state
* psych must remain w/n scope of practice in clients home state
115
PsychPact
Temporary Services
* psychs provide temporary in-person services to clients in other compact states
* must obtain Interjurisdictional Practice Certificate (IPC) and Temporary Authorization to Practice (TAP) from PSYPact Commission
* after certificates may provide in any compact state up to 30 days per year
116
Journal Article reporting Standards
* APA created Journal Article Reporting Standards (JARS)
* Consolidated Standards of Reporting Trials (CONSORT)-medical experts guidelines for reporting randomized control trials.
* JAS also includes guidelines for research experimental and nonexperimental, meta analyses, replication studies and structural equation models
117
Clinical Supervision
Professional Guidelines
118
Clinical supervision
Professional/Ethical Guidelines
* assist in thoughtful relevant & consultant, supervision, competency &
* enhance accountability& protection to the public
* fixing areas where not meeting the criteria for competence
* prepare for independent practice
* act as a gatekeeper to make sure supervise is ready for independent practice
* facilitate professional development
* discrete competency that presents unique eitical issues
119
Clinical Supervision
competence
* ongoing monitoring & professional development to supervise
120
Clinical supervision
Confidentiality
* limits of confidentiality and be sure clients have been informed
* when they are a trainee clients should be informed
121
Clinical Supervision
Multiple relationships
* ***Power differiential***-closely monitor that they have objectivity and not explore the supervisor
1. 10 ***Primary supervisor*** doctoral level ultimate responsibility
2. ***Delegate supervisor*** license health practitioner with a supervisor
1. may delegate certain supervisor responsibilities
3. maintain dates of supervision, adequate notes and maintain until supervise gets licensed or 7 years which ever greater
122
Clinical Supervision
Telepsychology
* cannot be more than 50% of total supervision.
* Must be in the same state and must verify identity at beginning of contact.
123
Clinical Supervision
Health Service Provider
* developed to inform educate & training regarding implementation of competency asked coperations-
124
Clinical Supervision HSP
\*metatheatrical approach
* knowledge, skills, attitude and learning, evaluation procedures, criterion reverence standards and evidenced-based practice
* priority is given to protecting clients
125
Supervisors Roles
* supervisors are gatekeepers
* also look at supervisees abililty to sustain in this role independently
126
Ethical Guidelines of Supervision
4 principles
* respect dignity of people
* responsible caring
* integrity & relationship
* responsibility to society
127
Models of Supervision
Psychotherapy-based supervision model
* observation/selection data for discussion during supervision as well as meaning of data
128
Models of supervision
person-centered supervision
* relationship between supervisor & supervisee rather than supervision
* involves empathy, genuineness, unconditional regard
129
Models of supervision
cognitive behavioral supervision
* parrells cognitive therapy
* collaborative relationship behavioral rehearsal
* Socratic questioning & guided imagery
* consists of
* check-ins
* building a bridge
* getting work agents
* summary work
* assigning homework
* giving feedback
130
Development Model supervision
* Intergrated developmental model-3 levels
* self-awareness, motivation & autonomy
131
Developmental supervision model
Integrated development 3 stages
* Level 1
* supervisees are focus on self, limited self -eval, ↑ motivation, ↑anxiety depending on supervisor
* Level 2
* supervisees focus better on client, empathetic, ↑↓ motivation, & confidence, (-) autonomy & independence from supervisor
* Level 3
* Remain focus on client & attend & attend to actions
* consistent motivation, confident about skills and judgements (it is important to foster independence)
132
Models of supervision
Process-Based
* aka social role models
* describes competent roles, and task process w/in supervision to classify events, discrimination model
133
Models of Supervision
Process-based focus areas
* intervention (process) skills
* conceptualization skills
* personalization skills
* also, supervisors roles are
* educator
* counselor
* consultation
*
