Ethics & Professional Issues Flashcards
You have been seeing 9-year-old Jackson in therapy at the recommendation of the school counselor who’s concerned about his recent change in behavior. Jackson had been a good student and cooperative in class until he returned from winter break when he started being disruptive, argumentative, and short-tempered. After Jackson’s third therapy session, you receive a letter from the school counselor asking about Jackson’s progress in therapy. An authorization to release information signed by Jackson’s parents is attached to the letter. To be consistent with ethical requirements, you should:
A. send the requested information to the counselor.
B. send the requested information to the counselor only if she’s a licensed mental health professional.
C. send the counselor only information you believe is relevant to Jackson’s problems at school.
D. discuss the request with Jackson and his parents before you send any information to the counselor.
C. send the counselor only information you believe is relevant to Jackson’s problems at school.
This answer is most consistent with Standard 4.04(a) of the APA’s Ethics Code and Principles I.37 and I.45 of the Canadian Code of Ethics. Standard 4.04(a) requires psychologists to “include in written and oral reports and consultations only information germane to the purpose for which the communication is made.” Because Jackson’s parents have signed an authorization, it would be acceptable to provide the counselor with information relevant to his problems at school.
Pretest
Toward the end of her third date with Cedric, Dr. Sheldon realizes that Cedric is the brother of one of her therapy clients. Dr. Sheldon is very attracted to Cedric, wants to continue dating him, and thinks they might have a future together. To be consistent with ethical requirements, Dr. Sheldon:
A. will continue dating Cedric only if he’s the brother of a former (not current) client of hers.
B. will continue dating Cedric if he’s the brother of a current client only if she discusses the potential for problems with the client and with Cedric.
C. will continue dating Cedric if he’s the brother of a current client only if she terminates therapy with the client.
D. will not continue dating Cedric whether he’s the brother of a current or former client under any circumstances.
A. will continue dating Cedric only if he’s the brother of a former (not current) client of hers.
This situation is addressed in Standard 10.06 of the APA’s Ethics Code and Principle III.28 of the Canadian Code of Ethics. Standard 10.06 states that “psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients … [and they] do not terminate therapy to circumvent this standard.” The Codes do not prohibit becoming sexually involved with relatives of former clients, although a psychologist would want to consider the potential impact of doing so. However, because none of the answers address this responsibility, answer A is the best answer of those given.
The Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) states that health care professionals can deny patients access to protected health information when they believe that doing so is:
A. reasonably likely to cause psychological or emotional harm to the client or other person.
B. reasonably likely to endanger the life or physical safety of the client or other person.
C. reasonably likely to endanger the psychological or physical health of the client or other person.
D. not in the best interests of the client or other person.
B. reasonably likely to endanger the life or physical safety of the client or other person.
EXPLANATION
EPPP-D1-ETH-APA Ethics Code Standards 3 & 4-04 Answer B is correct. Denial of access to protected health information is addressed in 45 CFR 164.524(a)(2)-(4), and the language of this answer is most similar to Section (a)(3)(i). It states that a licensed health care professional can deny an individual access to his/her protected health information, when the “professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger the life or physical safety of the individual or another person.” Note that, in this situation, the patient has the right to have the denial reviewed by another designated licensed health care professional.
Pretest
Which of the following best describes ethical requirements regarding debriefing research participants about the nature and results of a research study?
A. Participants must always be debriefed as soon as possible after their participation in a research study.
B. Participants should ordinarily be debriefed as soon as possible but, in some cases, debriefing may be delayed or withheld.
C. Participants must be debriefed only when there’s a chance they were psychologically or physically harmed by the research.
D. Participants must be debriefed as soon as possible only when they were deceived about important aspects of the study.
B. Participants should ordinarily be debriefed as soon as possible but, in some cases, debriefing may be delayed or withheld.
EXPLANATION
EPPP-D1-ETH-APA Ethics Code Standards 7 & 8-06 Answer B is correct. Debriefing is addressed in Standard 8.08 of the APA’s Ethics Code and in Principles III.16 and III.25 of the Canadian Code of Ethics. Standard 8.08(a) requires psychologists to promptly debrief research participants “about the nature, results, and conclusions of the research.” However, Standard 8.08(b) states that “if scientific or humane values justify delaying or withholding this information, psychologists take reasonable measures to reduce the risk of harm.” Answer D is not the best answer because it’s not true that participants must be debriefed as soon as possible only when the study involved deception.
The Introduction and Applicability section of APA’s Ethics Code states that the APA may take action against a member when:
A. a complaint has been filed against the member with the ethics committee.
B. a complaint has been filed against the member with the ethics committee or the member has been expelled from an affiliated state psychological association or convicted of a felony.
C. a complaint has been filed against the member with the ethics committee or the member has been expelled from an affiliated state psychological association or convicted of a felony or misdemeanor.
D. a complaint has been filed against the member with the ethics committee or the member has been expelled from an affiliated state psychological association or convicted of a felony or misdemeanor that’s related to his/her role as a psychologist.
B. a complaint has been filed against the member with the ethics committee or the member has been expelled from an affiliated state psychological association or convicted of a felony.
EXPLANATION
EPPP-D1-ETH-APA Ethics Code Overview and Standards 1 & 2-08 Answer B is correct. The Introduction and Applicability section of APA’s Ethics Code states that “APA may take action against a member after his or her conviction of a felony, expulsion or suspension from an affiliated state psychological association, or suspension or loss of licensure.” As noted by C. B. Fisher, the felony conviction does not have to be related to activities the member performed in his or her role as a psychologist (Decoding the Ethics Code, Thousand Oaks, CA, SAGE Publications, 2017).
Which of the following is not one of the required conditions for a claim of malpractice against a psychologist?
A. The psychologist had a legal duty to provide professional services to the client.
B. The client was psychologically or physically harmed or injured.
C. The psychologist breached his/her legal duty by providing services that did not meet the professional standard of care.
D. The psychologist knew or should have known the professional services he/she provided would cause harm to the client.
D. The psychologist knew or should have known the professional services he/she provided would cause harm to the client.
EXPLANATION
EPPP-D1-ETH-Professional Issues-09 Answer D is correct. Four conditions are required for a claim of malpractice: (a) The psychologist must have had a professional relationship with the client that established the psychologist’s duty to conform to a professional standard of care. (b) There was a dereliction or breach of the duty on the part of the psychologist. (c) The client suffered injury or harm as a result of this dereliction or breach. (d) The psychologist’s dereliction or breach of duty was the direct or proximate cause of the person’s harm or injury.
Which of the following is most consistent with ethical guidelines for accepting contingent fees when providing professional services in a legal proceeding?
A. Accepting contingent fees is prohibited under any circumstances.
B. Accepting contingent fees should usually be avoided.
C. Accepting contingent fees is acceptable when all parties voluntarily agree to this arrangement.
D. Accepting contingent fees is acceptable only when a psychologist has determined that doing so is in the best interests of all parties.
B. Accepting contingent fees should usually be avoided.
EXPLANATION
EPPP-D1-ETH-APA Ethics Code Standards 5 & 6-10 Answer B is correct. The APA Ethics Code does not refer to contingent fees, but they are addressed in Paragraph 5.02 of the APA’s Specialty Guidelines for Forensic Psychology. It states that, “because of the threat to impartiality presented by the acceptance of contingent fees and associated legal prohibitions, forensic practitioners strive to avoid providing professional services on the basis of contingent fees.” This answer is also consistent with the requirements of the Canadian Code of Ethics regarding fees for professional services and conflicts of interest (e.g., Principle III.28).
You have been seeing Ramona in therapy for four weeks and, at the beginning of her current session, she tells you her ex-boyfriend is threatening to physically harm you because he blames you for her unwillingness to get back together with him. You know from what Ramona has told you about her ex-boyfriend that he has a history of violent behavior and that you should take his threat seriously. To be consistent with ethical requirements, you:
A. should continue seeing Ramona in therapy but contact the police about her ex-boyfriend’s threat.
B. should continue seeing Ramona in therapy and suggest that she bring her ex-boyfriend with her to the next therapy session.
C. may terminate therapy with Ramona but only after providing her with pretermination counseling and a referral to another therapist.
D. may terminate therapy with Ramona with or without providing her with pretermination counseling and a referral.
D. may terminate therapy with Ramona with or without providing her with pretermination counseling and a referral.
EXPLANATION
EPPP-D1-ETH-APA Ethics Code Standards 9 & 10-05 Answer D is correct. This situation is addressed in Standard 10.10 of the Ethics Code and the Values Statement for Principle II of the Canadian Code of Ethics. Standard 10.10(b) states that psychologists may terminate therapy with clients when they’re “threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship.” And Standard 10.10(c) states that, “except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists provide pretermination counseling and suggest alternative service providers as appropriate.” As noted by C. B. Fisher, Standard 10.10(c) applies when a psychologist terminates therapy with a client because he/she is endangered by the client or someone involved in a relationship with the client [Decoding the ethics code (4th ed.), Los Angeles, SAGE, 2017].
You’ve just been asked to provide mental health services to residents of a small town who have been traumatized by a shooting at the elementary school. To be consistent with ethical requirements, you should provide the requested services:
A. only if you have relevant training and experience.
B. even if you don’t have relevant training and experience as long as you’re able to obtain appropriate consultation while providing the services.
C. even if you don’t have relevant training and experience as long as alternative services are unavailable and you inform clients of their options during the informed consent process.
D. even if you don’t have relevant training and experience as long as alternative services are unavailable and you discontinue providing services when the emergency ends or appropriate services become available.
D. even if you don’t have relevant training and experience as long as alternative services are unavailable and you discontinue providing services when the emergency ends or appropriate services become available.
EXPLANATION
Answer D is correct. This answer is most consistent with the requirements of Standard 2.02 of APA’s Ethics Code. It states that psychologists may provide services in emergency situations when they do not have the necessary training if alternative mental health services are unavailable and “the services are discontinued as soon as the emergency has ended or appropriate services are available.”
____________ are the standards used in the APA’s Ethics Code to define sexual harassment.
A. Quid pro quo and reasonable woman
B. Hostile environment and reasonable person
C. Quid pro quo and hostile environment
D. Tangible detriment and reasonable person
B. Hostile environment and reasonable person
EXPLANATION
Answer B is correct. Standard 3.02 of APA’s Ethics Code distinguishes between two types of behavior that constitute sexual harassment: behaviors that create a hostile work environment and behaviors that are sufficiently severe or intense “to be abusive to a reasonable person.”
Psychologists delivering mental health services in military settings should keep in mind that members of the military:
A. have the same confidentiality rights as other therapy clients.
B. have the same confidentiality rights as other therapy clients only when they were self-referred for therapy.
C. should be informed at the beginning of therapy about the military’s disclosure policies that affect confidentiality.
D. do not have any of the ethical or legal protections regarding confidentiality that other therapy clients have.
C. should be informed at the beginning of therapy about the military’s disclosure policies that affect confidentiality.
EXPLANATION
Answer C is correct. Client confidentiality is not handled in exactly the same way in the military as it is elsewhere because psychologists providing therapy to members of the military must adhere to Department of Defense rules that limit the confidentiality of mental health information. Informing members of the military about these limitations is consistent with the requirements of Standard 4.02 of APA’s Ethics Code. Note that answer D is incorrect because members of the military have some confidentiality rights – e.g., they have the right to be told about the limits of confidentiality.
During her second therapy session with Dr. Simone, a cognitive-behavioral therapist, Millie tells him that she has been seeing another psychologist for therapy for nearly three months. As an ethical psychologist, Dr. Simone will:
A. explain to Millie that it would be inappropriate to see her in therapy while she’s seeing another therapist.
B. discuss with Millie the potential problems of seeing two therapists at the same time and let her decide what she wants to do.
C. contact the other therapist after obtaining Millie’s consent to do so to help determine the best course of action.
D. determine why Millie is seeing another therapist to help determine the best course of action.
D. determine why Millie is seeing another therapist to help determine the best course of action.
EXPLANATION
Answer D is correct. Standard 10.04 applies to the situation described in this question. It states that psychologists must “proceed with caution and sensitivity to the therapeutic issues” when asked to provide services to a person who is receiving services from another mental health professional. Whether or not it would be appropriate for Dr. Simone to continue seeing Millie depends on the reason why she has started therapy with him while seeing another therapist. Therefore, this is the best answer of those given.
You receive a letter from a former client’s attorney requesting that you provide her with information from the client’s file, including the actual items from two projective tests, the client’s responses to those items, and the client’s test scores. The letter is accompanied by an authorization to release information signed by the client who is being represented by the attorney in a criminal case. As an ethical psychologist, you will send the attorney:
A. all of the requested test information.
B. the client’s responses to the test items and test scores only.
C. the client’s test scores only.
D. only a summary of the client’s performance on each test.
B. the client’s responses to the test items and test scores only.
EXPLANATION
Answer B is correct. This answer is most consistent with Standards 9.04 and 9.11, which distinguish between test data and test material. Standard 9.11 requires psychologists to “make reasonable efforts” to protect the integrity and security of test materials. As defined in this standard, test material includes test items, which means that providing items to the attorney would breach test security. In contrast, Standard 9.04 describes test data as including an examinee’s responses to test items and his/her test scores, which can be released with appropriate authorization.
You receive a letter from a former client’s current therapist asking you to fax confidential information about the client’s treatment. The request is accompanied by a signed authorization for release of information from the client. You should:
A. ask the therapist to confirm that he received the documents after you send them.
B. mark each page “confidential” before faxing the requested information to the therapist.
C. fax the requested information to the therapist after ensuring that all information that identifies the client has been removed.
D. refuse to fax the information and send a copy of the file by courier instead.
C. fax the requested information to the therapist after ensuring that all information that identifies the client has been removed.
EXPLANATION
EPPP-P1-ETH-APA Ethics Code Standards 5 & 6-124 Answer C is correct. This answer is most consistent with the requirements of Standard 6.02(b) of the APA Ethics Code and Standard I.42 of the Canadian Code of Ethics. Standard 6.02(b) states that, “if confidential information concerning recipients of psychological services is entered into databases or systems of records available to persons whose access has not been consented to by the recipient, psychologists use coding or other techniques to avoid the inclusion of personal identifiers.” When information is faxed or otherwise transferred electronically, it is not possible to guarantee it will not be accessed by unauthorized individuals. Therefore, removing identifying information is the best course of action.
Privilege refers to:
A. the ethical requirement to protect a client’s confidentiality.
B. the legal requirement to protect a client’s right to privacy.
C. the legal and ethical requirement to disclose confidential client information only with appropriate authorization to do so.
D. the legal requirement to protect client confidentiality in court testimony, depositions, and other legal proceedings.
D. the legal requirement to protect client confidentiality in court testimony, depositions, and other legal proceedings.
EXPLANATION
EPPP-P1-ETH-APA Ethics Code Standards 3 & 4-091 Answer D is correct. Privilege is a legal concept that protects a client’s confidential information from being disclosed in legal proceedings.
