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National Psychology Exam > Ethics/Legal > Flashcards

Ethics/Legal Flashcards

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1
Q

What is the Psychology Board of Australia for?

A
  • Registers psychologists
  • Develops standards, codes, and guidelines
  • Handles notifications, complaints, investigations and disciplinary hearings
  • Assesses overseas trained practitioners for practice in Australia
  • Approves accreditation standards and courses of study
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2
Q

What is the Health Practitioner Regulation National Law?

A
  • It creates a national registration and accreditation scheme for registered health practitioners.
  • It restricts the use of the words psychology and psychologist.
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3
Q

What are the 8 Board registration standards?

A
  1. Continuing professional development
  2. Criminal history
  3. English language skills
  4. Professional indemnity insurance arrangements
  5. Recency of practice
  6. General
  7. Provisional
  8. Area of practice endorsement
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4
Q

What does the continuing professional development registration standard entail?

A
  • Psychologists have a responsibility to ensure that their knowledge and skills are maintained, improved and extended throughout their careers.
  • A learning plan based on skills and knowledge self-assessment identifyiing areas for development needs to be conducted.
  • Learning objectives are set and psychologist mum complete 30 hours of continuing professional development (CPD) activities per year (2.5h per month of general registration).
  • 1/3 of these hours must be peer consultation.
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5
Q

What are the recording requirements for CPD?

A

An up-to-date CPD portfolio must include:

  • Learning plan
  • CPD log
  • Written reflections
  • Associated receipts

And must be kept for 5 years in case of auditing.

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6
Q

What does the criminal history standard entail?

A

The Board considers 10 factors to determine whether a health practitioner’s criminal history is relevant to their practice of their profession:

  1. Nature and gravity of the offence/alleged offence
  2. The period of time since committed/allegedly committed the offence
  3. Whether a finding of guilt or a conviction was recorded for the offence or charge is still pending (Relevane in order = convictions, findings of guilt, pending charges, non-conviction charges)
  4. The sentence imposed for the offence
  5. The ages of the health practitioner and of any victim at the time of the offence
  6. Whether or not the conduct/offence has since been decriminalised
  7. The health practitioner’s behaviour since committing the offence
  8. The likelihood of future threat to a patient or health practitioner
  9. Any information given by the health practitioner
  10. Any other matter that the Board considers relevant
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7
Q

What does the English language skills standard entail?

A

Internationally qualified applicants, and those who did not complete secondary education in English must demonstrate that they have proficiency in the English language for registration.

English language competency is demonstrated by:

  • English being your primary language and studies were completed in English
  • At least 2 years of your secondary education was taught and assessed in solely English, including the relevant qualification for registration
  • You have completed 6 years’ continuous education taught and assessed solely in English
  • You achieve the minimum required scores on an English language test
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8
Q

What exemptions exist for the English language skills standard?

A

When you apply for limited registration:

  • to perform a demonstration in clinical techniques
  • to undertake research that involves limited or no patient contact
  • to undertake a period of postgraduate study or supervised training while working in an appropriately suppored environment where safety will not be compromised
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9
Q

What does the professional indemnity insurance standard entail?

A

While practising as a psychologist in Australia you must be covered by your own or third-party PII arrrangements that meet this registration standard:

  • For all aspects of your practice
  • In all locations where you practise
  • Whether you are working in the private, non-government and/or public sector
  • Whether you are full time, part time, self-employed, employed, or unpaid/volunteer

PII cover must include

  • Adequate civil liability cover
  • Appropriate retroactive cover for otherwise uncovered matters frm prior practise
  • Automatic reinstatement to ensure the amount of cover will not be exhausted by a single claim
  • Run-off cover to protect against claims that arise out of/consequences of activities carried out when the person was conducting that practice

You must have documentation proving your cover for at least 5 years.

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10
Q

What does the general registration standard entail?

A

Sets out the qualifications that lead to General Registration:

  • An accredited Master’s degree
  • A 5-year accredited sequence of study with a Board approved year of internship
  • A 4-year accredited sequence of study with a Board approved 2-year internship
  • An overseas qualification that the Board deems substantially equivalent
  • Requirement to pass the NPE and demonstrate competency in the 8 domains outlined by the Board and all other competencies in the internship guidelines
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11
Q

What does the recency of practic standard entail?

A

In order for a psychologist to renew their registration, they must demonstrate evidence of recent practice as a registered psychologist:

  • Completed a minimum of 250 hours of practice as a registered or provisional psychologist within the previous five years
  • Successfully completed a Board-approved program, study or internship within the past five years

Note: practic is defined broadly and can include working in management, education, research and clinical care as a psychologist.

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12
Q

What does the area of practice endorsements standard entail?

A

Those general registration psychologists who practic in certain areas may be elligible for endorsement in various approved areas. Endorsement areas are:

  1. Clinical
  2. Counselling
  3. Forensic
  4. Clinical neuropsychology
  5. Organisational
  6. Sport and exercise
  7. Educational and developmental
  8. Health
  9. Community

Requirements for endorsement:

  • A postgraduate qualification in that area of practice
  • Completed a Board-approved registrar program including 3,000 hours of supervised practice
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13
Q

What are guidelines does the Board provide?

A
  • Informing a National Board about where you practise
  • Transitional programs for overseas qualified applicants
  • Mandatory notifications about registered health practitioners
  • Advertising a regulated health service
  • Supervisors and supervisor training providers
  • Continuing professional development
  • Practice endorsements
  • 4+2 internship program
  • 5+1 internship program
  • National Psychology Exam
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14
Q

What are the guidelines for mandatory notifications about registered health practitioners?

A

Must report practitioners who:

  • Are practising with an impairment and place the public at substantial risk of harm
  • Are practising while intoxicated by alcohol or drugs and place the public at substantial risk of harm
  • Are significantly departing from professional standards and place the public at substantial risk of harm
  • Have engaged in, are engaging in, or might engage in sexual misconduct connected to their practice
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15
Q

What are the adveritising requirements of the National Law?

A
  1. A person must not advertise a regulated health service or business in a way that is false, misleading, or disceptive (e.g. not supported by science/evidence, underplays risks associated, makes claims about providing a superior regulated health service). A person must not claim holding a type of registration or endorsement, being qualified in something, be a specialist in something, a qualification, a position title, a protected title, use of “doctor” as unprotected, if in fact they do not.
  2. A person must not advertise a regulated health service in a way that offers a gift, discount or other inducement to attract a person to use the service or business, unless that advertisement also states the terms and conditions of the offer e.g. “free sessions” that require Medicare are not actually free
  3. A person must not advertised a regulated health service in a way that uses testimonials or purported testimonials about the service or business. There is risk of harm by use of testimonials where it creates unreasonable expectation of beneficial treatment, encourages unnecessary use of the service, or is false/misleading/disceptive.
  4. A person must not advertise a regulated health service in a way that creates an unreasonable expectation of beneficial treatment e.g. of recovery time, overstating potential benefits, minimising risks.
  5. A person must not advertise a regulated health service in a way that directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services e.g. creating a sense of urgency linked to health suffering if they do not access support, encouraging attendance without clinical indication to do so, using incentives/bonuses/prizes to encourage use of service regardless of clinical need or therapeutic benefit
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16
Q

What are the three main principles in the Code of Ethics?

A
  1. Respect for the rights and dignity of people = right to autonomy and justice
  2. Propriety = beneficence, non-maleficence, comptence, and responsibility to clients, the profession and greater society
  3. Integrity = good character, trust in psychological practice, impact of professional conduct on the overall profession
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17
Q

How are justice and respect reflected in the code of ethics?

A
  • Culturally appropriate and individualised servics are required for professional practice of psychology.
  • Unfair discrimination is to be avoided and psychologists are obliged to assist clients to address the same.
  • Same-sex or non-heterosexual orientation are not to be considered evidence of mental disorders, and psychologists recognised that this population has often experiencing discrimination. Psychologists must be aware of their own attitudes and knowledge and should avoid stereotypes.
  • The needs of clients presenting from various age ranges, women and girls, as well as sex/gender-diverse clients are attended to with sensitivity. E.g. ensuring privacy when working with elderly in residential/community settings.
  • All clients are to be treated respectfully, even in criminal settings, through respectful language and behaviour.
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18
Q

How is informed consent reflected in the Code of Ethics?

A

Psychologists help clients make informed decisions regarding psychological services by providing information in plain language regarding:

  • The nature of the services
  • Right to withdraw from services
  • Foreseeable risks
  • The nature of information collection and storage
  • Confidentiality and its limits (as well as responsibilities to the service payer)
  • For hypnosis: information must be provided regarding the impact hypnosis disclosures can have on litigation i.e. not being accepted as evidence.
  • Likely costs and who is responsible for payment
  • Psychologists responsibilities to third parties e.g. the court, Medicare, forensics
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19
Q

How is privacy reflected in the Code of Ethics?

A
  • Psychologists collect information that is relevant to service provision
  • Psychologists avoid undue privacy invasion
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20
Q

How is confidentiality reflected in the Code of Ethics?

A
  • Information gained while providing psychologicall services is safeguarded so it remains confidential
  • Disclosure of information occurs only when legally required to, when consent has been obtained, or to safeguard an identifiable person from a specified risk of harm
  • Clients are informed of confidentiality limits at the start of the professional relationship and as needed thereafter
  • Clients are informed that communications with psychologists are not privileged = can be compelled for information use in a court of law
  • Mandatory reporting means psychologists are legally required to report suspected abuse or neglect
  • Client disclosing criminal activity doesn’t necessarily mean it has to be reported
  • When working with young people, psychologists determine the capacity of the client to provide informed consent including the nature of the service, benefits and risks, consequences of receiving/not receiving the service, ability to make an informed choice, and understanding the limits to confidentiality
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21
Q

How is the release and collection of client information reflected in the Code of Ethics?

A
  • Psychologists do not refuse reasonable requests from clients to access their information
  • When collecting information from parties associated with clients, psychologists gain consent from the client
  • Psychologists identify the purpose, source, nature of information and method of information collection
  • Clients are made aware that they can withdraw their consent for contact and information gathering from associated parties
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22
Q

How is competence reflected in the Code of Ethics?

A
  • Psychologists undertake CPD to ensure they maintain their competence
  • Psychologists are aware of and use current nomenclature and research-based theortetical understandings
  • Psychologists are competent in current technologies and ar aware of the professional and ethical issues that may arise from using the internet/telecommunication
  • Psychologists care for their own physical and mental health and are not impaired by their emotional, mental or physical state
  • Supervision and consultation are acquired as needed
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23
Q

How is record keeping reflected in the Code of Ethics?

A
  • Adequate records are kept for psychological work
  • Records are kept for a minimum of 7 years (after the age of 18)
  • Records are kept confidential and include notes, messages, email, diary entries, appointment arrangements, test results and reports
  • Clients are aware of their rights to access records and the safeguards that are in place to prevent amending of such records retrospectively
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24
Q

How is professional responsibility reflected in the code of ethics?

A
  • Psychological servics are provided in a responsible manner with care and skill, preventing harm, which are necessary to the client and while maintaining boundaries and with the informed consent of the client involed
  • There are APS guidlines for: sexual relationships, professional boundaries, multiple relationships, physical contact with clients
25
Q

How are third parties, multiple clients and task delegation reflected in the Code of ethics?

A
  • Limits to confidentiality and the nature of the professional relationships with each involved person are made clear; each person accepts the limitations outlined when multiple clients/third parties are involved; coercion to accept said limitations must not occur as much as is possible
  • If tasks are delegated to a third party e.g. assistant or interpreter, psychologists act to see that the Code is adhered to and their duties are overseen to ensure competent service
  • Psychologists manage dual relationships (common in rural settings) = is the dual relationship necessary, exploitative, benefits anyone, is likely to damage the client, or disrupt the therapeutic relationship
26
Q

How is collaboration with others/professional consideration considered in the Code of Ethics?

A

-Psychologists maintain confidentiality when cooperating with other professionals for client benefit, offer second opinions to clients, and accept clients of other professionals only after considering the implications of the action considered, client welfare and impact on all involved.

27
Q

How is ending or suspending services reflected in the Code of Ethics?

A
  • Psychologists make arrangements for the care of clients when they are absent
  • When a client is not benefiting from service, they end the service with said client
  • Psychologists arrange continuity of service when they can no longer consult
  • Psychologists provide referrals for alternative service provision where appropriate
28
Q

How are psychological assessments and research reflected in the Code of Ethics?

A
  • Psychologists are clear in describing the purposes for assessment measures used with clients, use valid procedures, are accurate in reporting results, and do not misuse or disclose contents inappropriately
  • Psychologists comply with national and local guidelines relating to human and animal research
  • Data are accurately repored in research and can be made available for reanalysis
29
Q

How are reputable behaviour and communication considered in the Code of Ethics?

A
  • Psychologists avoid conduct that reflects badly on their ability to practice, or on the profession
  • Psychologists communicate honestly and correct misrepresentations about them and avoid advertising that is misleading or false
  • Psychologists do not hold out their services as superior over other psychologists
30
Q

How are conflict of interest and non-exploitation reflected in the Code of Ethics?

A
  • Psychologists avoid multiple relationships that may impair competence or harm others
  • Psychologists do not exploit others with whom they have or had a professional relationship, including clients, employees, colleagues, or assistants
  • Sexual relationships with former clients are not to occur for a period of 2 years from termination of psychological service
  • One does not see as a client as person with whom they have had sexual activity
31
Q

How are authorship and finances reflected in the Code of Ethics?

A
  • Psychologists are proactive and honest in assigning of authorship of scholarship, discussing authorship early in the work, having authorship accurately reflect the work performed
  • Psychologists are honest in their financial dealings and discuss up frnt frinancial arrangements and do not receive rumuneration or give same for client referrals
  • Psychologists clearly inform their clients, in advance, regarding the expected frequency and duration of therapeutic contract and associated feeds
  • Should client circumstances change, psychologists act responsibly in reviewing contractual client arrangements, with clients, including fees
  • Clients are to be informed of administrative related fees including but not limited to, session cancellation fees and travel fees
  • Psychologists avoid bartering or carefully consider any potential problems from bartering
  • Psychologists do not exploit students or volunteers by requiring them to enagge in work that is of no benefit to them
32
Q

How are ethical concerns reflected in the Code of Ethics?

A
  • Psychologists address ethical concerns as they become aware of and impacted by them
  • Psychologists cooperate with ethics investigations
  • Psychologists concerned about a psychologist’s behaviour contact the Board or APS or both - generally misconduct complaints involve incompetency, poor business practices, boundary violations, poor character, registration difficulties, impairment and inappropriate use of specialist titles
  • When confronted by an ethical dilemma, psychologists consult with senior colleagues, indemnity insurers, professional bodies and engage in thoughtful/ethical decision-making and document all of it
33
Q

What is the Ethical Decision Making Model from Kampf, McSherry, Ogloff and Rothschild?

A

Defining the Problem

  1. Identify the individuals and groups potentially affected by the decision
  2. Identify the problem, including the relevant ethical and legal issues and clinical practices
  3. Consider the significance of the context and the settings
  4. Identify and use relvant legal, ethical and professional resources

Considering Options
5. Develop and consider alternative solutions to the problem (analyse risks and benefits of each, and consider how your personal beliefs, values and baises may affect your decision-making)

Monitoring Actions

  1. Choose and implement the most appropriate course of action
  2. Monitor and assess the outcome chosen

Resolving the problem

8a. If the problem is resolved consider the need for an ethical action plan/practice modification
8b. If the problem is not resolve, repeat steps 5-7

34
Q

How should psychologists engage in professional self-management?

A
  • Self-reflect and self-assess how they are coping and how they have been impacted by events/work
  • Identifying the signs and symptoms of burnout e.g. feelings of anger/resentment, thoughts of failure, behaviours like isolation and withdrawal and clock watching
  • 5 common scenarios that lead to fear and indecision in practitioners: clients in danger of harm/in great pain, difficult or recalcitrant clients, practitioner being in danger fm the client, clients questioning pracitioner competence, and having to make difficult ethical decisions
  • Attending to needs of health: nutrition, sleep, realistic engagement with work activities
  • Continuous assessment of own thoughts, feelings and behaviours
35
Q

What are the uses of supervision and peer consultation?

A
  • Supervision = unequal relationship in terms of expertise/experience with a more senior person providing professional guidance
  • Peer consultation = non-hierarchical relationship, and involves peers assessing and sharing information, opinions, support and monitor/evaluating professional activities
  • Purpose of these is to support or maintain, improve and broaden knowledge, expertise and competence and to develop professional functioning-related personal characteristics
36
Q

What are the “checking” components of a decision assistance model?

A
  1. Are the psychologist’s individual characteristics or perception of the client’s characteristics interfering with the objective evaluation of the situation?
  2. Is there a legal obligation for the psychologists to act in a particular manner?
  3. Is there clear and non-conflicting advice in the Code of Ethics or Ethical Guidlines?
  4. Are there workplace issues or physical limitations that make following the ethical guidelines difficult?
37
Q

What are the components of the “action” phase in the decision assistance model?

A
  1. Consult with experts, peers and the literature
  2. Consider potential paths of action (guiding hypotheses)
  3. Consider past decisions
  4. Evaluate and act
  5. Review the decision after the outcome
38
Q

When may confidentiality of clients be breached?

A
  • Client requests psychologist to do so
  • There is a valid legal obligation to do so
  • If there is an immediate and specified risk of harm to an identifiable persons that can only be averted by disclosing information
  • When consulting colleagues/during supervision if identity is concealed or consent is obtained
  • If there is a mandatory reporting requirement or mandatory notification requirement
39
Q

What are examples of multiple relationships?

A

Multiple relationships occur when a psychologist rendering the service to a client also is or has been:

  • in a non-professional relationship with the same client
  • in a different professional relationship with the same client
  • in a non-professional relationship with an associated party
  • a recipient of a service provided by the same client
40
Q

When is it appropriate to provide a psychological service to family or friends?

A

Only in the absence of other feasible options and when harm is imminent if action is not taken.

41
Q

What is a broad definition of informed consent?

A

When the client knows the psychologist’s qualifications, what is being provided, that confidentiality will be maintained (and breach potentials), what the psychological service will cost and how it will end.

42
Q

How do you distinguish a boundary crossing versus violation?

A
  • Boundary crossing = a departure from commonly accepted practices which could potentially benefit clients.
  • Boundary violation = violation of professional boundaries is a severe breach that damages the client-psychologist therapeutic relationship and inevitably results in harm to clients and is therefore unacceptable and unethical.
43
Q

What questions shoulld you consider to determine if a boundary violation may be in danger of occurring?

A
  • Am I operating within my limits of competence?
  • Am I avoiding any topics?
  • Am I showing any uncharacteristic behaviours?
  • Do I have discomfort with boundaries?
  • Am I self-disclosing more than usual?
  • Am I taking into account any current personal difficulties?
  • Is there the possibility of a conflict of interest developing?
44
Q

Who is the client when working with young people?

A
  • 0-8 years = the legal guardian of the child is the client for the psychological services, so all rights and responsibilities associated with being the client lie with the parent. Psychologists should still attempt to gain consent from the child.
  • 8-14 years = the parent is still considered the client, however there should be a negotiation to develop an agreement regarding confidentiality and consent in the relationship between the child and psychologist
  • 14+ years = mature minors (possibly) who can make informed decisions about giving consent to psychological treatment/assessment.
45
Q

What should be considered when assessing the ability/maturity of a young person to make informed decisions?

A

Can they understand:

  • the nature of the proposed psychological service
  • the benefits and risks of the proposed psychological service
  • the consequences of receiving or not receiving the proposed psychological service
  • the limits to confidentilaity

And do they have the capacity to make an informed choice?

46
Q

Who is the client for mature minors?

A

If a young person is considered to be a mature minor, then they are the client, and all rights and responsibilities will rest with them, not the parents. However if they are not considered mature minors, then the legal guardian is technically the client.

47
Q

Who is entitled to information in separated parents?

A

If there are no specific court orders in place regarding health/medical decision-making, then the parent who requests psychological services is typically considered to have the legal authority to do so. Further, if this parent requests no disclosure to the other parent, the psychologist is obliged not to disclose this information.

48
Q

What are examples of when adults may be considered to be INconsenting?

A 
Inconsenting adults who although they can legally make decisions, but there are concerns from the psychologist about their ability to do so. For example, those with brief or lifelong impairements due to an acquired brain injury, a personality disorder, age-related cognitive decline. 
Legal guardians (appointed by courts or tribunals) may be invovled and therefore responsible for consent. If a guardian has not been appointed but client does not have the ability to make an informed decision about treatment, then might be worth the time in appointing an appropriate legal authority (friend, family member etc).
49
Q

When might deliberate self-injurious behaviour be acceptable?

A
  • When there is no suicidal ideation
  • When there is no risk of serious physical harm in the short term
  • When there will be ongoing monitoring (possibly more frequent appointments) and improvement in the psychological symptoms and subsequenct self-injurious behaviour

E.g. someone who is cutting when too anxious to cope, but is not attempting to end their life, is not cutting deeply, and is treating the wounds with antiseptic. The cutting is a coping mechanism and to take it away or breach confidentiality may prevent returning to service/accessing help.

50
Q

When should psychologists breach confidentiality due to risk to others?

A
  • Only if there is a serious risk of harm and there is an identifiable third party
  • After consultation with experienced colleagues and/or legal experts if possible
  • After exploring alternate options e.g. client hospitalisation
  • Legally there is no obligation in Australia to disclose confidential information to protect third parties, but in the Code it stipulates that psychologists may do so
51
Q

What are the Focussed Psychological Strategies covered by Medicare for general psychologists?

A
  1. Psychoeducation
  2. Motivational Interviewing
  3. Cognitive Behaviour Therapy including: behaviour modification, exposure techniques, activity scheduling, cognitive analysis/challenging/restructuring, self-instructional training, attention regulation, relaxation strategies (guided imagery, deep muscle/isomateric relaxation, contrlled breathing), skills training, problem-solving skills training (anger, stress, communication, social skills, parent management)
  4. Interpersonal therapy

Note: for this list, there is no schema therapy, ACT, hypnotherapy, EMDR, DBT, Mindfulness-Based CBT, psychoanalytic therapy, solution-focussed therapy

52
Q

What should be included in a client file?

A
  • Client details
  • GP referral and MHTP
  • A genogram
  • A pro-forma clinical assessment e.g. presenting problem,. formulation of the situation and pertinent history
  • A confidentiality agreement and consent form
  • Psychometrics used
  • Evidence of a treatment plan and interventions used (focussed psychologicla strategies)
  • Contemporaneous notes that record treatment
53
Q

What should initial appointment notes include?

A
  • Presenting complaint, diagnosis, or basis for request for services
  • History of presenting complaint including response to previous interventions and any relevant history e.g. developmental, health, forensic
  • Results of formal psychometric assessment when undertaken
  • Case formulation and/or diagnosis suppored by evidence
  • Plan for future sessions
54
Q

What should a session note include?

A
  • Date of service and duration of session
  • Type of service provided e.g. consultation,assessment, treatment, training
  • Formal or informal assessment of client status, including risk to self or others when relevant
  • Response to the intervention to date
  • Detail of the intervention provided at this contact
  • Plan for future services
55
Q

What should be kept in mind when writing client file notes?

A
  • Clients and courts may access and read these notes, therefore they should be written appropriately for all eyes/readers
  • Client report/statement versus opinion should be differentiated
  • If it is not written down, it did not happen
  • You cannot add to notes after the fact
  • The main purpose for notes is to allow another psychologist to read the records and continue to provide service (continuity of care during the current episode)
56
Q

How are you defined as mentally ill under the Mental Health Act (NSW)?

A

You have a condition that seriously impairs, either temporarily or permanently, your mental function and you are at risk of harming yourself or other people.

A condition that seriously impairs is shown by having:

  • Delulsions
  • Hallucinations
  • Serious disorder of thought form
  • Severe disturbance of mood
  • Sustained or repeated irrational behaviour indicating any of the above are present
57
Q

Steps for involuntary treatment under the Mental Health Act 2007 (NSW)?

A
  1. Examination by an “authorised medical officer” to determine if they deem you mentally ill or disordered (is not, you are allowed to leave).
  2. Second assessment (psychiatrist), and if this authorised medical officer finds you are mentally ill or disordered as well, then this is enough to force you to stay in hospital until the next mental health inquiry held by a single-member Mental health Review Tribunal. If the 2nd doctor does not find you mentally ill or disordered, you will be kept in hospital to be assessed by a third doctor.
58
Q

What are the MBS reporting requirements?

A
  1. A report is made to the referring practitioner at completion of the initial course of treatment (up to maximum of 6 sessions)
  2. A report is made to the referring practitioner at the completion of any subsequent treatment that forms the end of an episode of treatment provided to the client.
  3. Ensure the report includes information on: assessments carried out, treatment provided, and recommendations on the future management of the client’s disorder.

National Psychology Exam (12 decks)

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