Ethics Flashcards
Purpose of Licensure at State Level
- Requirements for licensure are a means to ensure a minimum levels of competence for practicing psychologists.
Ethics Overview & Changes Since 1992
- Gender identity and culture have been added to the list of diversity factors.2. Psychologists may sometimes provide services for which they are not fully competent in emergency situations and when treatment would otherwise not be available.3. Multiple relationships are not inherently unethical.4. Psychologists are no longer told they should ordinarily refrain from bartering.5. Raw test data can now be released to anyone the client often authorizes.6. Termination is explicitly permitted when clients present a risk of harm to the therapist or when managed care contracts require termination.
Ethics (Introduction)
- Five General Principles and 10 Ethical Standards.2. General principles are aspirational.3. Ethical standards are enforceable.4. Ethics Code applies only to the professional and scientific activities of psychologist, and not to their private conduct.5. Ignorance or misunderstanding of an ethical standard is not considered to be an adequate defense.6. Psychologist who violate the ethics code may be sanctioned and: a. APA Membership maybe terminated. b. APA May also notify other bodies, such as state licensing boards, of the sanctions. c. Sanctions may occur if the member is convicted of a felony, expelled, or suspended from a state association, or has his/her license revoked.7. Ethics code is not intended to be a basis for civil liability.8. Civil liability is the issue and in malpractice and includes the following four D’s: a. Dereliction of Duty Directly causing Damages.
Ethics Code: Reasonable (Definition)
- Defined: “The prevailing professional judgment of psychologists engaged in similar activities in similar circumstances, given the knowledge the psychologist should have had at the time.”
Ethical Decision-Making
- When making decisions regarding ethics, psychologists are supposed to consider the Ethics Code, applicable laws, psychology board regulations, the guidelines of other scientific and professional organizations, and “the dictates of their own conscience.”
Higher Ethical Standard
- When the Ethics Code sets a higher standard of conduct than the law, psychologists are bound to uphold “the higher ethical standard.”2. When there is a conflict between ethics and law, psychologists must “make known their commitment to the ethics code and take steps to resolve the conflict in a responsible manner.”3. If the conflict is unresolvable, psychologists are permitted to comply with the law, assuming the basic principles of human rights are not violated.
Malpractice (Definition)
4 D’s: Dereliction of Duty Directly causing Damages.
Preamble
- Goals of the Ethics Code are: a. “the welfare and protection of the individuals and groups with whom psychologists work” and b. “the education of members, students, and the public regarding ethical standards of the discipline.”2. Psychologists work toward increasing scientific and professional knowledge of behavior and people’s understanding of themselves.3. The goal of psychologists is to improve the condition of individuals, organizations, and society.4. Psychologists respect and protect civil and human rights and the principles of freedom of inquiry and expression.5. Psychologist engage in a variety of roles such as researcher, educator, diagnostician, therapist, supervisor, consultant, administrator, social interventionist, an expert witness.6. Psychologists make a personal commitment to act ethically and encourage the ethical behavior ethical behavior of others.7. They consult with others regarding ethical problems.
Five General Principles
Principle A: Beneficience and NonmaleficencePrinciple B: Fidelity and ResponsibilityPrinciple C: IntegrityPrinciple D: JusticePrinciple E: Respect for Peoples Rights and Dignity
Principle A: Beneficence and Nonmaleficence
ASPIRATIONAL1. Psychologists aim “to benefit those with whom they work and take care to do no harm.”2. They safeguard the welfare and rights of the people they interact with professionally as well as the welfare of animals used in research.3. They attempt to resolve conflicts among the professional obligations and responsible manner that minimizes harm.4. They are aware of how their own physical and mental health may affect the capacity to help others.
Principal B: Fidelity and Responsibility
ASPIRATIONAL1. “Psychologists establish relationships of trust with those with whom they work.”2. Psychologists should be aware of the responsibilities to these people and uphold professional standards.3. Psychologists are encouraged to clarify the roles, manage conflicts of interest that may cause harm, and consult and collaborate with other professionals.4. Psychologists should be concerned with the ethical compliance of others.5. Psychologists are encouraged to contribute some of the professional services for little or no compensation.
Principle C: Integrity
ASPIRATIONAL1. Psychologists should promote “accuracy, honesty, and truthfulness”.2. They should avoid all fraudulent activities.3. Commitments and promises should be made carefully and then upheld.4. Although ethically permissible in certain situations, deception should only be used with great care.
Principle D: Justice
ASPIRATIONAL1. Recognizes that all persons should benefit from the contributions of psychology and should be treated with equal quality in all psychological activities.2. Enjoins Psychologists to ensure that their own biases and limitations of competence do not result in unjust practices.
Principle E: Respect for Peoples Rights and Dignity
ASPIRATIONAL1. Includes respect for the rights of privacy, confidentiality, and self-determination.2. Psychologists should recognize and respect differences among persons based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status.3. Psychologist should consider the aforementioned factors when providing psychological services.4. Psychologists should try to eliminate the effect of biases based on these factors, both in their work and in the work of others.
- Resolving Ethical Issues
1.01 through 1.08
1.01 Misuse of Psychologists’ Work
- Psychologists should take steps to correct the misuse or misrepresentation of their work.
1.02 Conflict Between Ethics and Law
- When conflicts arise between ethics and law, regulations, or other governing legal authority, psychologists should “make known their commitment to the ethics code and take steps to resolve the conflict.”2. If the conflict cannot be resolved, psychologists may comply with the law.
1.03 Conflicts Between Ethics and Organizational Demands
- When conflicts occur between the ethics code and the demands of an organization, psychologists should “make known their commitment to the ethics code” and “to the extent feasible, resolve the conflict in a way that permits adherence to the ethics code.”
1.04 Informal Resolution of Ethical Violations
- If psychologists know of an ethical violation by another psychologist, they should speak directly to the colleague, assuming an “informal resolution” seems appropriate and confidentiality will not be violated.
1.05 Reporting Ethical Violations
- If the attempt at an informal resolution is unsuccessful, or if the violation is inappropriate for an informal resolution (substantial harm has/may occurred), psychologists should take further action, such as referral to ethics committees or licensing boards.2. Such action should not be taken if confidentiality rights will be violated, or if the psychologists were retained to review the work of another psychologist whose conduct was in question.3. Client confidentiality must be protected above ALL.4. If the client provided the information, it may be helpful to provide the client with the necessary information and let the client decide whether to make a report.
1.06 Cooperating with Ethics Committees
- Failure to cooperate with ethics investigation, whether by APA or a State psychological Association, constitutes an ethical violation in and of itself.
1.07 Improper Complaints
- Psychologists should not file, or encourage the filing of, ethical complaints that deliberately disregard the facts of a situation.
1.08 Unfair Discrimination Against Complainants and Respondents
- Psychologists should not discriminate against a person because he or she has been the subject of an ethics complaint.2. Psychologists are permitted to take action based on the outcome of such proceedings.
- Competence
2.01 through 2.06
2.01 Boundaries of Competence
- Psychologists should practice within the boundaries of their competence.2. When an understanding of the effect of certain factors (age, gender, etc.) is necessary for appropriate services or research, psychologists must make sure that they either have or obtain appropriate training, supervision, or consultation (or make an appropriate referral).3. “Psychologists with closely related prior training or experience may provide such services in order to ensure the services are not denied and they make a reasonable effort to obtain the competence required by using relevant research, training, consultation, or study.”4. When they desire to practice in new areas, psychologists should also seek appropriate training, supervision, or consultation. a. Consultation b. Supervision c. Training d. Referring out
2.01 a Consultation
- Appropriate when psychologists are somewhat familiar with treating a particular disorder, but are not an expert in that area.2. Also appropriate when psychologists have concerns about whether they can remain objective in treating a client.
2.01 b. Supervision
- Might be required when psychologists are applying a newly learned technique (hypnosis or biofeedback).2. Also may be appropriate when they are beginning to work with a specialized population (e.g., hearing-impaired).3. Appropriate when psychologists are not yet ready to practice independently in the area or with the new population.
2.01 c. Training
- Vital when psychologists are unfamiliar with a certain area of knowledge.2. Typically followed by supervised experience prior to practicing independently.
2.01 d. Referring Out
- Appropriate in the following situations: a. The therapist’s personal believes and issues interfere with therapy. b. The client feels uncomfortable with the therapist. c. The therapist lacks competence in treating the presenting problem.
2.02 Providing Services in Emergencies
- In clinical emergencies, psychologists may provide services for which they are not fully competent in order to ensure that individuals receive necessary treatment.2. They should terminate the services as soon as the emergency has passed or more appropriate services have been secured.
2.03 Maintaining Competence
- Psychologists should make an ongoing effort to maintain competence.
2.04 Bases for Scientific and Professional Judgments
- Psychologists should always base their work on the scientific and professional knowledge that has been established in the field of psychology.
2.05 Delegation of Work to Others
- Psychologists should ensure that those to whom they delegate work perform only those duties for which they have adequate competence.2. These delegated individuals also should have no harmful multiple relationships with the person being served.3. Psychologists should ensure that the services are performed competently.
2.06 Personal Problems and Conflicts
- Psychologists should not Initiate any activity when they know or should know that their personal problems will impair their competence.2. Psychologists are required to address their problems appropriately and to seek consultation about whether to limit, suspend, or terminate practice.
- Human Relations
3.01 through 3.12
3.01 Unfair Discrimination
- Psychologists should not engage in discrimination based on age, gender, etc., or any other basis prohibited by law.
3.02 Sexual Harassment
- Sexual-harassment is specifically prohibited, and it is defined as sexual behavior that meets one of the following two criteria: a. Behavior that is “unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this”. b. Behavior that is so severe that any reasonable person would recognize it as abusive.
3.03 Other Harassment
- Psychologists are also prohibited from engaging in any other harassment based on age, gender, etc.
3.04 Avoiding Harm
- In general, psychologists are enjoined to avoid harming clients and others whenever possible, and to minimize harm when it is unavoidable.
3.05 Multiple Relationships
- Multiple relationship occurs when a psychologist is in a professional role with the person and: a. At the same time in another role. b. At the same time in a relationship with the person closely associated with or related to the person. c. Promises to enter into another relationship in the future with either of the above types of people.2. Should not enter into a multiple relationship if it might impair the psychologist’s objectivity, competence, effectiveness, harm or exploit the other party.3. Should attempt to resolve it with due regard for the best interest of the affected person should a harmful relationship occur.4. When Psychologists are required to serve in more than one role (judicial or administrative proceeding), should clarify roles and limits of confidentiality, update as often as changes occur.5. If due to unforeseen factors, a harmful multiple relationship does occur, the psychologist should “attempt to resolve it with due regard for the best interest of the affected person and maximal compliance with the Ethics Code.”
Child Custody Evaluations in Divorce Proceedings (1994)
- A psychologist should avoid conducting a custody evaluation in a case in which the psychologist has served as therapist to the child or immediate family.2. Therapy with the child or family after the evaluation is completed, should be undertaken with caution.3. This does not preclude the psychologist from testifying as a fact witness concerning the child’s treatment, but when this is the case the psychologist should generally declined the role of an expert witness who is giving a professional opinion regarding custody and visitation.
Parole Evaluations
- Most correctional psychologist are in the position of being both a therapist and evaluator for parole and release.2. Ethical guidelines for correctional psychologist encourage sensitivity to the ethical pitfalls inherent in this dual relationship but it is definitely a permitted relationship.
3.06 Conflict of Interest
- Psychologists should not enter into a professional relationship with someone with whom they already have other relationships or involvement if the result would be that the psychologists objectivity, confidence, or effectiveness would be impaired or that the other party would suffer harm or exploitation.
3.07 Third Party Requests for Services
- When psychologists provide services at the request any third party (insurance company), psychologists should clarify at the outset of treatment: a. their role, b. who the client is, c. the probable use of services, and d. any limits to confidentiality.2. When employees are referred by employers to an EAP program, the employer has the right to know whether or not the employee attended sessions, however, the employer does not have the right to know confidential information about session content.
3.08 Exploitative Relationships
- Psychologists should not exploit people over whom they are in a position of power, such as clients, students, supervisees, research participants, and employees.
3.09 Cooperation with Other Professionals
- Psychologists should cooperative with other professionals, as appropriate, in order to serve the best interests of their clients.
3.10 Informed Consent
- When psychologists engage in research, assessment, therapy, counseling, or consultation (in person or electronic), they must secure informed consent from the individuals with whom they work.2. The language used must be reasonably understandable to the clients.3. An exception to this requirement occurs when the law or governmental regulations mandate conducting these activities without consent.4. When clients are legally incapable of giving consent, psychologists must obtain permission from a legally authorized person (Guardian).5. Psychologists must also provide clients with an explanation, seek their assent, and consider their wishes and best interests.6. Psychologists should also protect the rights and welfare of these persons even when consent from legally authorized person is not mandated or not permitted by law.7. When persons are court-ordered or mandated to obtain psychological services, psychologists should inform them of the nature of the services to be provided, the fact that the services have been mandated, and any limits to confidentiality.8. Psychologists should appropriately document that informed consent or assent has been secured, whether it was secured in a written or oral format.9. The Ethics Code does not require a written consent form, only that informed consent be documented (in a progress note recording that information was given and understood
3.11 Psychological Services Delivered to or Through Organizations
- With psychologists work in or for organizations, they should thoroughly inform clients and those affected by the services about the following issues: a. The nature of the psychological services, b. The intended recipients, c. which persons are clients, d. the relationship between a psychologist and each person and between the psychologist and the organization, e. the probable uses of the services and information, f. who will have access to the information, and g. any limits of confidentiality.2. Psychologists should provide feedback after evaluation and treatment.3. If feedback is precluded for legal or organizational reasons, psychologists should inform the person of the fact ahead of time.
3.12 Interruption of Psychological Services
- Psychologists must make plans for continuation of care in the event of the relocation, illness, death, or in the event of the clients relocation or financial limitations.2. These plans are often termed “a professional will”.
- Privacy and Confidentiality
4.01 through 4.07
4.01 Maintaining Confidentiality
- The Ethics code emphasizes that psychologists have a primary obligation to protect the confidential information they obtain. ~ Psychologists site confidentiality of the ethical issue the most frequently address in their practice.
4.02 Discussing the Limits of Confidentiality
- Psychologists must discuss the limits of confidentiality with any persons or organizations with whom they work.2. They must also discussed the possible uses of any information that is obtained (part of a court assessment).3. Confidentiality is generally discussed at the outset of treatment, and whenever there are relevant changes in circumstances.4. If electronic transmission is used (email), psychologists must inform clients of the possible risks to privacy and any additional limits to confidentiality.
4.03 Recording
- Permission for taping or videotaping must be secured from clients.
4.04 Minimizing Intrusions on Privacy
- Psychologists should discuss confidential information obtained from client only for scientific or professional purposes.2. The discussion should only include the confidential information that is necessary when preparing oral or written reports.
4.05 Disclosures
- Confidential information may be disclosed of the client gives consent.2. It may be discussed without client consent when the disclosure is either mandated by law (Tarasoff) or when the disclosure is permitted by law (to protect client).3. Although psychologists may disclose confidential information without client consent in order to obtain payment for services (billing), they should only disclose the smallest amount of information that is necessary.
4.06 Consultations
- Psychologists should not reveal detailed information that could lead to identification of a client unless they have obtained prior consent or the disclosure cannot be avoided.2. Psychologists should only share information that is absolutely necessary purpose of consultation.
4.07 Use of Confidential Information for Didactic or Other Purposes
- When psychologists lecture or write, they must not include confidential information unless the person has consented in writing where there is legal authorization to do so.2. Otherwise, confidential information should be disguised.3. Issues of confidentiality are involved in: 4.07 a. Subpoenas 4.07 b. Court Orders 4.07 c. Court-Appointed Evaluations 4.07 d. Court-Ordered Therapy
4.07 a. Subpoenas
- Typically issued by attorneys.2. Maybe a subpoena alone (requiring therapist to appear for questioning) or subpoena duces tecum (requiring the therapist to appear with the client records).3. Subpoenas cannot be ignored!4. When a subpoena is received a therapist should: a. Contact the client, b. Inform the client of the subpoena, and c. Seek the client’s permission to release information.5. If the client grants permission, psychologist may release the records.6. If the client does not grant permission, psychologist may first contact the attorney who issues the subpoena, requesting the subpoena be quashed. Otherwise, the psychologist must appear at the designated location and bring any requested records.7. Psychologist should then assert patient-therapist privilege, and neither testify or turn over the records.
4.07 b. Court Orders
- A court order is signed by a judge and carries the weight of law.2. A psychologist may always request of the judge that the court order be modified, but otherwise, the psychologist must comply with any court order or be held in contempt of the court.3. A court-ordered mandates that the psychologist appear and demonstrate why the records or a portion of the records should not be released, or may mandate a psychologist appear with the records for an in camera review.4. Psychologist should always maintain frequent communication with the client and clients attorney.
4.07 c. Court-Appointed Evaluations
- If evaluation is a court-appointed evaluation, there is no confidentiality and client has waived right to privilege.2. No signed release of information is needed.3. Psychologists must explain the nature of evaluation and the limits of confidentiality to the defendant prior to beginning the evaluation.4. Court-appointed evaluation is considered an exception to privilege; thus while in most circumstances the client holds privilege, in a court-appointed evaluation privilege does not exist.
4.07 d. Court-Ordered Therapy
- Privilege is held by client.2. The court has ordered a defendant to seek therapy as a condition of his or her sentence.3. The psychologist who agrees to treat this client must make sure to clarify the nature of the treatment that has been ordered by the court as well as the information the court needs.4. The psychologist must then discuss this information with the client to obtain informed consent.5. Psychologists must generally obtain a signed release of information from the client in order to communicate with the court.
- Advertising and Public Statements
5.01 through 5.06
5.01 Avoidance of False or Deceptive Statements
- Public statements are any written or oral statements in any form other than an entirely private conversation.2. Psychologists should never make intentionally deceptive statements regarding a. training and experience, b. their academic degrees, credentials, affiliations, c. their services, d. the scientific and clinical basis for their services, e. their fees, or f. other public publications and research findings.3. When psychologists are presenting their credentials that are relevant to their health service, they should only present those degrees that are the basis for their psychology licensure or that they received from a regionally accredited institution.
5.02 Statements by Others
- Psychologists retain responsibility for public statements even when they hire someone else to promote their practice.2. Psychologists must try to prevent others (employers) from making any deceptive statements and correct them when possible.3. It is prohibited to compensate a media employee for publicity or reporting.4. When paid ads are used, they must be identified as such.
5.03 Descriptions of Workshops and Non-Degree Granting Educational Programs
- Psychologists must exercise whatever control they have to make sure that published material (brochures) about non-degree-granting programs (workshops) contain accurate information regarding: a. the intended audience, b. the objectives, c. the presenters, and d. the fees.
5.04 Media Presentations
- When psychologists provide public advice, their statements must be based on: a. appropriate psychological literature and practice, b. must be consistent with the ethics code, and c. must make clear that there is no therapeutic relationship established. 2. Media psychologists should make it clear that they are not providing treatment, but are only offering advice or feedback.
5.05 Testimonials
- Code allows for solicitation and in use of testimonials under certain narrowly circumscribed situations: a. May never be solicited from current clients. b. May never be solicited from any person who is vulnerable to undo influence.
5.06 In-Person Solicitation
- Solicitation of business is also prohibited when people are vulnerable to undue influence.2. The Ethics Code specifies that this prohibition does not apply to disaster or community outreach services.
- Record Keeping and Fees
6.01 through 6.07
6.01 Documentation of Professional and Scientific Work and Maintenance Records
- Psychologists should create and maintain records of their professional work with the following goals in mind: a. To facilitate future provision of services; b. To allow for replication of research results; c. To meet institutional requirements; d. To ensure accuracy and billing; e. To comply with the law.
6.02 Maintenance, Dissemination, and Disposal of Confidential Records of Professional and Scientific work
- To the extent they have control, psychologist create, maintain, and destroy records in a manner that protects confidentiality.2. When client information is entered into databases, appropriate measures should be taken to protect confidentiality including coding of personal identifiers.3. Psychologists should make advance plans to protect the confidentiality of records in case of their death or incapacity.
6.03 Withholding Records for Nonpayment
- Psychologists may not withhold records that are necessary for emergency treatment because the client owes them money.2. According to HIPAA, a psychologist may not withhold records for nonpayment under any circumstances.3. This is an example of where the ethics code and federal law conflict.4. As a result, psychologists should not withhold records for non-payment in any situation emergency or otherwise.