Ethics & Professional Issues Flashcards

1
Q

Ethical Violations by Colleagues

A

1st before any action consider client confidentiality:
(1.04) Handel ethical violations informally by discussing them with the offender when “an informal resolution seems appropriate.”
(1.05) Not appropriate for informal resolution, make a forma report to appropriate authorities when the problem involves “substantial harm”
“substantial harm” Sexual misconduct
Insurance Fraud
Plagiarism

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2
Q

Client Welfare

A

“Take reasonable steps” to avoid and minimize harm.

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3
Q

Pro Bono Services

A

Professional services provided without charge.

Recommended by General Principles but not required

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4
Q

Compliant & Respondent

A

Prohibits psychologist from discriminating toward people who are a compliant or respondent to a pending charge of ethical misconduct solely on the basis of being the subject of an ethics complaint.
- It would be unethical to deny a person a promotion because they are the compliant/respondent in am unresolved complaint.

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5
Q

Informed Consent for Therapy

A

When obtain informed consent to therapy inform client’s “as early as is feasible” about:
Nature and anticipated course of treatment, Fees/Financial arrangements,
Limits of Confidentiality,
Involvement of 3rd Parties,
Opportunity for client to ask questions, When a trainee/intern inform client you are being supervised and give “supervisors name.” (10.01)

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6
Q

Client’s Receiving Services from Another Professional

A

When a client is receiving similar services from another professional, “proceed with caution,” and sensitivity to therapeutic issues.
Primary concern is the client’s welfare. (10.04)

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7
Q

Sexual Intimacies with Clients & Former Clients

A

Prohibits Psychologists from:
Sexual relationships with current clients (10.05)
Becoming sexually involved with people they know to be “close relatives,” guardians, or significant others of current clients. (10.06)
Providing therapy to people with whom they have had a sexual relationship “in the past.” This exclusion is absolute; no time limits or exceptions. (10.07) Having sexual relationships with former clients for at least “two years” after the cessation of therapy and then only in the “most unusual of circumstances.”(10.08)

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8
Q

Interruption & Termination of Therapy

A

Requires Psychologists to “terminate therapy when it is clear the client does not need services,
is not benefiting from it or
is being harmed by continued services” and to avoid abandonment of the client by providing them with “pre-termination counseling” and/or appropriate referrals. (10.09 & 10.10)
Exception: Pre-term counseling/referrals not necessary if terminating because the client or a person the client has a relationship with poses a threat to the Psychologist. (10.10 - b)

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9
Q

Test Data

A

“Raw & scaled scores”, the examinee’s responses to test questions, and the Psychologist’s notes/recordings concerning the examinee’s responses and behaviors during testings.
“Pursuant to a clients release, only provide test data to the person identified in the release.”(9.04)

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10
Q

Test Materials

A

Requires Psychologist to “make reasonable efforts” to protect the integrity & security of test materials (manuals, instruments, protocols, and test questions or stimuli)(9.11)

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11
Q

Test Scoring & Interpretation Services

A

Requires Psychologists to select test scoring and interpretation services on the basis of their “validity and other appropriate considerations” and are responsible for applying and interpreting the information in an appropriate manner.(9.09)

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12
Q

Obsolete Tests

A

Psychologists make sure that any recommendations or decisions they make are not based on the results of outdated or obsolete tests. (9.08)

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13
Q

Use (Misuse) of Psychological Tests

A

To avoid misusing tests and other assessment techniques, ensure that they are administered, scored, and interpreted by “qualified people” and that recommendations and conclusions are not based on the results of “obsolete tests.”

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14
Q

Deception in Research

A

Deception in research is acceptable as long as it is justified by:

  • The potential value of the study
  • Alternative procedures are unavailable
  • Participants are not deceived about conditions that may be “reasonably expected to cause physical pain or severe emotional distress”
  • Participants will be debriefed at the end of the study but no later than the conclusion of data collection. (8.07)
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15
Q

Informed Consent for Research

A

Research participants must be informed about the:

  1. Purpose, expected duration, and procedures of the research
  2. The right to decline and to withdraw from the study once it begun
  3. Foreseeable consequences of declining or withdrawing
  4. Any reasonably foreseeable factors that might affect their willingness to participate(risks, discomfort or adverse effects)
  5. Any prospective research benefits
  6. Limits of confidentiality
  7. Incentives for participation
  8. Whom to contact for questions about research and participants rights. (8.02)
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16
Q

Animals in Research

A

The use of animals in research states to “acquire, care for, use and dispose of animals according to federal, state, and local laws and regulations.”
Procedures that produce pain, stress, or privation are acceptable only when justified by:
Potential findings of the study and when alternative procedures are unavailable
If an animals life must be terminated, it must be done as “rapidly and painlessly” as possible. (8.09)

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17
Q

Publication Credit

A

Requires credit to be based on each person’s “contribution” rather than status.
Student to be listed as the “principal author” on multiple-authored articles based substantially on the students dissertation except “under exceptional circumstances.”(8.12)

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18
Q

Education & Supervision

A

Requires Psychologists to “act competently and responsibly”, and to take “reasonable steps” to ensure they do not misrepresent themselves or their work when teaching, supervising or designing education or training programs.
Course syllabi should be accurate, yet modifying course requirements is allowed when necessary or desirable.
Prohibited from requiring students to disclose personal information, yet may be acceptable when the requirement is clearly stated in program material or information is needed to evaluate or obtain assistance for a student or supervisee whose personal problems may be interfering with their education/training or “pose a threat” to others. (7.01 - 7.06)

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19
Q

Sexual Relations with Students & Supervisees

A

Prohibits Psychologists from engaging in sexual relationships with students and supervisees over whom they have or are likely to have “evaluative authority.”

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20
Q

Client Access to Records

A

Determined by law.
The Psychologist is the owner of the physical record, while the client has the right to inspect the contents of the record.
Psychologist = Owner of record
Client = Right to inspect contents

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21
Q

Record Keeping Guidelines

A

APA specifies that records of psychological services must include a minimum:
Identifying Information
Dates of Service
Types of Service
Fees
Assessment reports & intervention plans
Release of Information

Retain a client’s record for 7 years after termination of services for adults or 3 years after a minor reaches the age of majority.

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22
Q

Collection Agencies

A

Requires Psychologists to discuss fees and other financial matters with client’s “as early as feasible.”
Acceptable for Psychologists to use a collection agency to obtain outstanding fees, but first need to notify the client of the intent and give them the opportunity to pay fees.

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23
Q

Barter

A

Psychologists may barter only if:

  1. it is not clinically “contraindicated,” and
  2. The arrangement is not “exploitative.”
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24
Q

Referral Fees

A

Are not prohibited but must be based on the “actual costs of the services provided” and not the referral itself.

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25
Q

Sliding Fee Scale

A

Not addressed by the Ethics Code but are generally considered acceptable as long as they are “fair” and serves the “best interest of the client.”

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26
Q

FERPA

A

Family Education Rights and Privacy Act - 1974 (aka Buckley Amendment)
Applies to records maintained by educational institutions receiving federal funds.
Prohibits schools from disclosing personally identifying information from student records without the consent of the parents of students or students 18 and older.
Grants parents/students rights to inspect the educational records.

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27
Q

HIPAA’s Privacy Rule

A

Distinguishes between protected health information (PHI) and psychotherapy notes and allows clients to inspect and obtain a copy of PHI contained in a designated record set.

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28
Q

Client Testimonials

A

Prohibits Psychologists from “soliciting testimonials” from current clients or others who are “vulnerable to undue influence.” (5.05)

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29
Q

In-Person Solicitation

A

Prohibits Psychologists from engaging in “uninvited in-person solicitation” of business from people who are “vulnerable to undue influence.”(5.06)
2 Exceptions:
1. May invite current client’s family members to participate in therapy to benefit the client or
2. Offer “disaster or community outreach services”

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30
Q

Avoidance of False or Deceptive Statements

A

Requires Psychologists to claim as credentials for their health services only academic degrees that are from regionally accredited educational institution or were the basis for their psychological license. (5.01)

31
Q

Statements by Others

A

Prohibits Psychologists from compensating employees of the press, television, etc. in return for “publicity.” (5.02)

32
Q

Media Presentations

A

Requires Psychologists providing professional advice to the public via the internet, radio, television, or other media to ensure that they do not imply that a “professional relationship” has been established. (5.04)

33
Q

Confidentiality

A

This is an Ethical principle.
The obligation of Psychologists to protect client’s from unauthorized disclosure of information revealed in the context of a professional relationship.

34
Q

Privilege

A

This is a legal concept.

Protects a client’s confidentiality in the context of a legal proceeding.

35
Q

Holder of Privilege

A

The client (or the client’s legal guardian) is usually the holder of privilege, but a psychologist may claim the privilege on behalf of the client if asked to disclose confidential information in a legal proceeding.

36
Q

Limits of Confidentiality

A

Requires Psychologists to discuss the limits of confidentiality with clients, unless not feasible, at the “outset of the relationship and thereafter as new circumstances warrant.”(4.02)

37
Q

Consultation

A

When consulting with colleagues about a client, psychologists discuss only information that is relevant to the purpose of the consultation and must obtain “prior consent” from the client before doing so unless the client’s identity can be disguised. (4.06)

38
Q

Tarasoff Decision

A

Original Tarasoff decision established a “duty to warn”an intended victim of a therapy client.
In a rehearing (1976) of the case it was changed to a “duty to protect” when there is a “clear and imminent danger to an identifiable victim” by warning them, notifying the police or taking other steps.

39
Q

Child Abuse Reporting

A

Require psychologist to make a report to an appropriate authority whenever they know or suspect that child abuse has occurred. Confidentiality may be broken when it is “mandated” or permitted by law.

40
Q

Sexual Harassment

A

Behaviors that are sexual in nature (sexual solicitation, physical advances or verbal/nonverbal) and are “unwelcome, offensive, or create a hostile work or educational environment” or would be recognized by a “reasonable person” as being abusive.

41
Q

Quid pro Quo

A

(“this for that”)
Refers to an explicit or implicit requirement to trade sexual favors for a (promotion, raise, etc.) tangible job benefit. Term used to decide whether a behavior constitutes sexual harassment.

42
Q

Hostile Environment

A

Involves sexually offensive behavior that makes it difficult for an employee to perform their job (sexual gestures, jokes, remarks, and pictures).Term used to decide whether a behavior constitutes sexual harassment.

43
Q

Multiple Relationships

A

Prohibits Psychologists from entering into multiple relationships with a person when that relationship could be reasonably expected to impair their “objectivity or competence or risk exploitation or harm” to that person.

44
Q

Multiple Relationships in a Forensics Settings

A

When a Psychologist accepts multiple roles in a forensic setting, they must “clarify role expectations” and issues related to confidentiality.

45
Q

3 Factors in Multiple Relationships

A

Proposes that Psychologists consider 3 factors when assessing the acceptability of a multiple relationship:
1. Power differential - More influence has over client, less ethical.
2. Duration of the relationship - The longer either relationship, less acceptable.
3. Clarity of termination - Chance that either relationship will continue, less acceptable.
(Gottlieb, 1993)

46
Q

Informed Consent

A

Legally 3 conditions must be met for it to be informed consent:
1. Capacity - Can the person make rational decisions
2. Comprehension - Is the person given adequate information “using language that is reasonably understandable to that person” to make an informed decision.
3. Voluntariness - Has the person given consent freely without coercion.
Consent must be “documented.”

47
Q

Informed Assent

A

When the person is a minor or other person not legally capable of giving consent, provide the individual with:

  1. An appropriate explanation
  2. Seek the individuals “assent”
  3. Obtain permission from a legally authorized person.
48
Q

Competence

A

When Psychologist expand their services they must do so in a way that “minimizes potential harm” to the client.

  • In emerging areas where standards of training do not exist, take “reasonable steps to protect the welfare of the client.” (2.01)
  • Permits Psychologists to provide emergency services when they do not have adequate training as long as alternatives are unavailable and they discontinue services once the “emergency has ended or appropriate services become available.” (2.02)
49
Q

Delegation of Work to Others

A

Requires Psychologists to take “reasonable steps” to avoid delegating work when doing so will create a “multiple relationship” with those being served that is likely to limit their “objectivity or lead to exploitation.” (2.05)
Ex: It would be inappropriate to ask a client’s daughter to be an interpreter for her mother the client.

50
Q

Vicarious Liability

A

(Respondent Superior)
Under certain circumstances, supervisors and employers may be legally responsible for the actions of their supervisees and employees.

51
Q

Personal Problems

A

Requires Psychologists to:

  1. avoid starting work-related activity when there is a significant likelihood that a personal problem will interfere with their ability to perform their work “competently” and
  2. to take “appropriate measures” (professional consultation/assistance) when they become aware that a personal problem is affecting their work. (2.06)
52
Q

Cooperating with Ethics Committees

A

Failing to cooperate with the APA’s investigation of an ethical complaint constitutes an “ethical violation.”(1.06)

53
Q

Most Frequently Occurring Ethical Issue

A

Pope & Vetter (1992) did a survey of APA members and found that “confidentiality” was identified by respondents as the most frequently occurring “ethically troubling issue.”

54
Q

Use of Confidential Information for Didactic & Other Purposes

A

Psychologists do not reveal personally identifiable client information in their writings, lectures, etc. unless they take “reasonable steps to disguise the persons identity” or have obtained “written consent” from the client to do so. (4.07)

55
Q

Withholding Records for Non-Payment

A

Prohibits Psychologists from withholding a client’s record because of non-payment of fees when those records are needed for the clients emergency treatment.

56
Q

Sharing Research Data with Colleages

A

Requires Psychologists to share their research data with colleges for the purpose independent interpretation, verification, or re-analysis once the research results have been published. (8.14)

57
Q

Informed Consent for Assessment

A

Requires Psychologists to provide the client with an explanation of the nature and purpose of the assessment, fees, any limits of confidentiality and any involvement of third parties.
It is not always necessary to obtain an informed consent when the testing is part of a routine educational, institutional, or organizational activity or is mandated by law.(9.03)

58
Q

Specialty Guidelines for Forensic Psychologists

A

The goal is to provide aspirational model of desirable professional practices in an activity intended to provide professional psychology expertise to the judicial system. It does not define min. qualifications in terms of education and training but focuses on professional practices issues in the context of forensic work.
Areas addressed:
- “confidentiality of case materials” - states that psychologists attempt to protect a person’s privacy by disguising personally identifying information, using only information that is in the public domain, or obtaining the consent of the person or other relevant parties or organizations.

  • seek to minimize any detrimental effects of multiple relationships by avoiding involvement in them whenever feasible,
  • requires psychologists who are requested or ordered to provide concurrent or sequential forensic therapeutic services to disclose any potential risks and make reasonable efforts to refer the request to another qualified provider. (4.02.01)
  • requires psychologists to avoid providing professional services on the basis of conditional fees. (5.02)
  • requires forensic psychologists to obtain informed consent from an examinee unless the examination is court-ordered. (6.03.01)
  • If an examinee is ordered by the court to participate, the forensic practitioner can conduct the examination over the objection and without consent of the examinee. If the examinee declines to proceed after being notified of the nature an purpose of the forensic examination, the forensic practitioner may consider a variety of options including:
    Postponing the examination
    Advising the examinee to contact their attorney
    Notifying the retaining party about the examinee’s unwillingness to proceed. (APA, 6.03.02)
59
Q

General Guidelines for Providers of Psychological Services

A

Adopted as a means of “self-regulation in the public interest” for the purpose of improving “the quality, effectiveness, and accessibility of psychological services.” Describes the minimum qualifications required to provide psychological services such as “professional psychologists” have a doctoral degree in psychology from an organized, sequential program in a regionally accredited university or professional school. When psychologists want to change their area of specialty, they must meet the education and training requirements for a doctoral degree in that specialty.
Terms:

“psychological service unit” - can take one of several forms ~ e.g., one or more psychologists providing professional services in a multidisciplinary setting or one or more psychologists in a private practice.

“Users” include direct recipients of psychological services as well as public and private institutions, facilities, or organizations that receive those services. Finally, the General Guidelines state that the advancement of human welfare is “the primary principle guiding the professional activities of all members of the psychological service unit.”

Are aspirational and delineate basic guiding principles for all providers of psychological services except for those engaged in teaching psychology, conducting research, or writing and editing scientific manuscripts.

The goal is to “improve the quality, effectiveness and accessibility of Psychological services.”

60
Q

Guidelines for Providers of Psychological Services to Ethic, Linguistic, & Culturally Diverse Populations

A

Aspirational principles and guidelines for Psychologists working with members of ethnic, linguistic, and culturally diverse populations. It emphasizes the importance of competence and presents recommendations for incorporating cultural issues and knowledge into practice.
Requires:
- psychologists who do not have adequate knowledge or training to work with a cultural or ethnic group to seek consultation or make appropriate referrals,

  • encourages psychologists to strive to eliminate their own biases and prejudices.
  • urges psychologists to help clients determine whether their problems stem from racism or bias to ensure that clients do not “inappropriately personalize problems.”
  • encourages psychologists to consider including in an intervention religious/spiritual leaders/practitioners relevant to a client’s cultural background.
  • requires psychologists to make an appropriate referral when they cannot interact with a client in the client’s preferred language or, if that is not feasible, to obtain the services of a translator but, when doing, to refrain from using a translator who has a dual role with the client.
  • Sue and Sue (2003) caution against adopting a color-blind perspective since doing so denies the existence of important individual and group differences. The impact of a client’s culture and ethnicity is addressed in several paragraphs.
61
Q

Guidelines for Child Custody Evaluations in Divorce Proceedings

A

Goal is to “promote proficiency in the conduct of child custody evaluations, and it provides aspirational guidelines that are intended to “facilitate the continued systematic development of the profession and help facilitate a high level of practice by psychologists.”
The “child’s interests and well-being are paramount” in custody evaluations and that psychologists “generally avoid conducting a child custody evaluation in a case in which the psychologist served in a therapeutic role for the child or their immediate family.”

62
Q

Guidelines for Child Custody Evaluations in Family Law Proceedings

A

The Guidelines for Custody Evaluations states that determining the child’s psychological best interests is the primary purpose of a child custody evaluation and that the child’s welfare is paramount.
The focus of the evaluation should be on parenting attributes, the child’s psychological needs, and the fit between them.
Requires psychologists to avoid engaging in multiple relationships when doing so can be expected to result in reduced impartiality, competence, or effectiveness or expose individuals to harm or exploitation.
Psychologists attempt to obtain informed consent using language that is reasonably understandable to the examinee.
Encourages psychologists to employ multiple methods of data collection, to avoid being influenced by personal biases and unsupported beliefs, and to document the limitations of their data

63
Q

EPPP

A

The Examination for Professional Practice in Psychology (EPPP) is a requirement in the US and Canada and is designed to assist the boards in evaluating the qualifications of applicants for licensure by assessing the knowledge that has been identified as foundation to the competent practice of psychology. The psychology licensing boards protect the public by determining the standards for admission into the profession and monitoring the performance of licensed psychologists. IT is prepared by the Association of State and Provincial Psychology Boards (ASPPB).

64
Q

Insanity

A

Insanity is a legal concept that serves as the basis for a criminal defense in many jurisdictions.
States that a person is not guilty by reason of insanity (not responsible for alleged act) if, because of a mental disease or defect, “that person lacks substantial capacity to appreciate the wrongfulness of the act or behave according to the requirements of the law” (Gutheil, 1995, p. 2764)

65
Q

Competence to Stand Trial

A

competence to stand trial refers to a defendant’s ability to consult with his/her lawyer with a “reasonable degree of rational understanding.”
Laws related to competence to stand trial vary, but were derived from the standard set forth in Dusky vs. United States (1960), which defines a defendant as incompetent if, as the result of mental defect or illness, the defendant lacks “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding, and a rational as well as a factual understanding of the proceedings against him” (p. 171).
When evaluating a defendant’s competence to stand trial, the focus is on the defendant’s psycholegal abilities and impairments, including his/her capacity to comprehend the charges or allegations, disclose pertinent facts and events to counsel, and testify.
Like insanity, competence is a legal matter, and there is an on ongoing controversy about whether an evaluator should offer an opinion on the defendant’s competence in addition to reporting the results of the evaluation.

66
Q

Fact vs. Expert Witness

A

A “fact witness” testifies to what he/she has seen, heard, or observed regarding an event or occurrence and is usually not allowed to offer an opinion, while an “expert witness” is qualified by the court based on his/her expertise to offer opinions and respond to hypothetical situations.

A fact witness may provide information about a client in a legal proceeding only with the consent of the client or a court order.

67
Q

Malpractice

A

For a person to bring a claim of malpractice, four conditions must be met:

  1. The psychologist must have had a professional relationship with the person that established a duty of care.
  2. There must be a demonstrable standard of care that the psychologist has breached
  3. The person suffered harm or injury.
  4. The psychologist‘s breach of duty was the primary cause of the person’s harm or injury.
68
Q

Responding to a Subpoena

A
  1. The first step when responding to a subpoena is to determine if it is a legally valid demand.
  2. If so, a formal response is required and the psychologist should contact the client to discuss the implications of providing the requested information and 3. obtain the client’s consent and there are no reason for withholding information the psychologist should provided the requested information.

If the client does not consent and the requesting party continues to demand that the information be provided,

  1. The psychologist can have his/her attorney file a motion to quash the subpoena or a motion for a protective order.

When a request for confidential client information arises for the first time in court or at a deposition, the psychologist may assert the psychotherapist—patient privilege.

69
Q

Sexual Misconduct by Psychotherapist

A

Studies on sexual misconduct by psychotherapists have found that male therapists engage in sexual relationships with clients more often than female therapists do, that the clients they become involved with are most often female, and that these male therapists are typically older than the female clients. The research has also found that therapists reporting sexual boundary violations were also more likely to report being involved in non-sexual boundary crossings.

70
Q

Cost Analysis

A

Cost analysis is conducted to determine the optimal allocation of financial resources. Methods of cost analysis include:

  • Cost-benefit analysis (CBA) involves comparing the costs and benefits of an intervention in monetary terms. This method may be used to evaluate a single intervention or compare two or more interventions. A difficulty with CBA is that it may be difficult to assign a monetary value to an intervention’s outcomes.
  • Cost-effectiveness analysis (CEA) is useful when the interventions to be compared have similar goals but it is not possible to assign a monetary value to their outcomes, which are expressed in measurable terms such as number of clients who drop out prematurely or scores on a measure of symptom severity.
  • Cost-utility analysis (CUA) involves comparing alternative interventions by comparing their costs with the value of their outcomes in terms of quality-adjusted life-years (QALY’s).
  • Cost-feasibility analysis (CFA) is used to evaluate the feasibility of one or more interventions on the basis of the monetary and other resources they would require. The purpose of CFA is to determine if an intervention is worth considering. Unlike the above methods of cost analysis, CFA does not take into account the outcomes of an intervention.
  • Cost-minimization analysis (CMA) is used to determine the least costly option that produces equivalent outcomes. CMA could be used to determine if paraprofessionals can provide mental health services that are not only comparable to those provided by professionals but also at a lower cost.
  • Cost-offset analysis is also known as medical cost offset when it is used to determine the reduction in medical costs obtained by providing a mental health or other non-medical intervention. It involves comparing the costs incurred when implementing the intervention with the medical costs saved as a result of implementation. Note that, in general, the research confirms that providing psychotherapy or other psychological intervention results in substantial medical cost offset (e.g., Chiles et al., 1999).
71
Q

Avoiding Bias in Language

A

The Publication Manual of the APA provides recommendations for avoiding bias in language. For example, it recommends that references to racial and ethnic groups be as specific as possible, that the generic use of the masculine pronoun be avoided by using the plural form of the noun and pronoun or by omitting the pronoun when confusion is unlikely; and that people be put first when describing people with a physical or mental disability.
Ex: Putting “people first” - “Client with a disability” vs. “Disabled client”

Specific when referring to race & avoid using white as a comparison group

Using emotionally neutral terms - “People with a disease” vs. “people afflicted by a disease”

72
Q

Guardianship

A

Refers to a “legal right given to a person to be responsible for the necessities (food, health care, etc…) of another person legally deemed incapable of providing these necessities themselves.” (APA, 1998, P. 7)

73
Q

Guardian Ad Litem

A

“An adult appointed by the court to represent & make decisions for someone (Such as a minor) legally incapable of doing so on his/her own in a civil legal proceeding.” (APA, 1998, p.7)