Ethics questions -difficult ones Flashcards
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 early as is feasible” after participation in a research study.
B. Participants should ordinarily be debriefed as soon as possible but, in some cases, debriefing may not be necessary.
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.
Correct answer
B. Participants should ordinarily be debriefed as soon as possible but, in some cases, debriefing may not be necessary.
Explanation
Debriefing is addressed in Standard 8.08 of the APA Ethics Code and Standards II.47 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.”
With regard to ethical requirements, which of the following is true about withholding a therapy client’s record for nonpayment of fees?
A. Withholding a client’s record for nonpayment of fees is always unethical when it’s needed for the client’s treatment.
B. Withholding a client’s record for nonpayment of fees is always unethical when it’s needed for the client’s emergency treatment.
C. Withholding a client’s record for nonpayment of fees is ethical only when the client has not responded to multiple requests for payment.
D. Withholding a client’s record for nonpayment of fees is ethical only when the client had been informed of this practice during the informed consent process.
Answer B is correct. This answer is most consistent with Standard 6.03 of the APA’s Ethics Code. It states that “psychologists may not withhold records under their control that are requested and needed for a client’s/patient’s emergency treatment solely because payment has not been received.” This answer is also consistent with the Preamble and Standards II.1 and II.2 of the Canadian Code of Ethics. (Note that withholding client records for nonpayment of fees in any situation may be illegal or inconsistent with laws or institutional regulations, but this question is asking specifically about ethical requirements.)
A recently divorced psychologist joins an online dating service that matches him to a former therapy client. When deciding what to do in this situation, the psychologist should remember that ethical guidelines:
A. prohibit psychologists from becoming sexually involved with former clients under any circumstances.
B. prohibit psychologists from becoming sexually involved with former clients only when therapy was terminated less than 12 months ago.
C. prohibit psychologists from becoming sexually involved with former clients unless certain conditions are met.
D. do not explicitly prohibit psychologists from becoming involved with former therapy clients.
Answer C is correct.
This answer is most consistent with Standard 10.08 of the Ethics Code. Standard 10.08(a) states that “psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.” And Standard 10.08(b) states that, even when two years have passed, psychologists do not engage in sexual intimacies with former clients “except in the most unusual circumstances,” which includes ensuring that the relationship is not exploitative. This answer is also consistent with Standard II.28 of the Canadian Code of Ethics.
As described in the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA), a therapist can deny clients access to their protected health information when they believe that access 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 another person.
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 client has the right to have the denial reviewed by another designated licensed health care professional.
When conducting group therapy, you should:
A. remind group members that they’re legally required to maintain the confidentiality of other group members.
B. remind group members that, because they’re in therapy, they’re ethically obligated to maintain the confidentiality of other group members.
C. discuss the importance of maintaining confidentiality with group members in the initial and subsequent sessions.
D. discuss the limits of confidentiality with potential members during the screening interview and have them sign a waiver of confidentiality.
Answer C is correct. Confidentiality in group therapy is addressed in Standard 10.03 of the APA Ethics Code and Standard I.44 of the Canadian Code of Ethics. Standard 10.03 states that psychologists should inform group members about “the roles and responsibilities of all parties and the limits of confidentiality.” Although psychologists cannot ensure the confidentiality of information revealed in group therapy, they can reduce the likelihood that confidential information will be disclosed by educating group members about the importance of maintaining confidentiality and the possible negative consequences of not doing so in the initial session and then reminding them of the need to maintain confidentiality in subsequent sessions.
To serve as an expert witness in a court case, a psychologist must be:
A. determined to be qualified to do so by the attorney requesting his/her services.
B. determined to be qualified to do so by the judge.
C. certified as an expert witness by a professional forensic organization.
D. certified as an expert witness by the Association of State and Provincial Psychology Boards.
Answer B is correct. When an attorney representing the plaintiff or defendant in a court case wants a psychologist to provide expert testimony, the judge decides whether or not to allow that testimony. The judge’s decision is based on consideration of the relevance of the psychologist’s knowledge, skills, experience, training, and education.
Which of the following provides global scores that correspond to two theoretical models – the Cattell-Horn-Carroll model of cognitive abilities and the Luria neuropsychological processing model?
A. Kaufman Assessment Battery for Children, Second Edition
B. Slosson Intelligence Test, Revised Third Edition
C. Cognitive Assessment System, Second Edition
D. Peabody Picture Vocabulary Test, Fourth Edition
Answer A is correct. The Kaufman Assessment Battery for Children, Second Edition (KABC-II) provides five scale scores (Simultaneous, Sequential, Planning, Learning, and Knowledge) and two global scores. The global score based on the Cattell-Horn-Carroll model of cognitive abilities includes performance on measures of acquired (crystallized) knowledge, while the global score based on the Luria neuropsychological processing model does not include performance on measures of acquired knowledge.
Toward the end of his second date with Susie S., Dr. Browne realizes that Susie is the sister of one of his clients. Dr. Brown is very attracted to Susie, would like to continue dating her, and thinks she could be “the one.” However, as an ethical psychologist, Dr. Browne:
A. will continue dating Susie only if she’s the sister of a former (not current) client of his.
B. will continue dating Susie if she’s the sister of a current client only if he discusses the potential for problems with the client and with Susie.
C. will continue dating Susie if she’s the sister of a current client only if he terminates therapy with the client.
D. will not continue dating Susie whether she’s the sister of a current or a former client.
Answer A is correct.
This situation is addressed in Standard 10.06 of the APA’s Ethics Code. It 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.” This answer is also consistent with the requirements of Standard III.28 of the Canadian Code of Ethics.
Dr. Merritt overhears Alice, one of the interns she’s supervising, making disparaging remarks about people with addictions to a group of friends on two separate occasions. However, Dr. Merritt has never observed Alice acting in an inappropriate way with clients who have any type of addiction and she hasn’t discussed what she overheard with Alice. When Alice receives her performance evaluation, Dr. Merritt has noted that one of the low ratings she assigned was due to her concern that Alice is likely to have trouble working with clients who have an addiction. With regard to ethical guidelines:
A. Dr. Merritt’s evaluation is acceptable because of the unacceptability of the disparaging remarks Alice made.
B. Dr. Merritt’s evaluation is acceptable as long as it includes an explanation for her concerns about Alice’s ability to work with clients who have an addiction.
C. Dr. Merritt’s evaluation is acceptable as long as it was provided to Alice in a timely manner and she’s willing to discuss her concerns with Alice.
D. Dr. Merritt’s evaluation is not acceptable because it was not based entirely on Alice’s actual performance as an intern.
Answer D is correct.
This answer is most consistent with Standard 7.06(b) of the APA Ethics Code and Standard II.26 of the Canadian Code of Ethics. Standard 7.06(b) states that “psychologists evaluate students and supervisees on the basis of their actual performance on relevant and established program requirements.”
Research on the Fagan Test of Intelligence has confirmed that ____________ in infancy is a good predictor of IQ in childhood, adolescence, and young adulthood.
A. socio-emotional behavior
B. language production and comprehension
C. sensorimotor development
D. selective attention to novel stimuli
Answer D is correct. The Fagan Test of Intelligence is a measure of selective attention to novel stimuli, and research has found that performance on the Fagan Test is a good predictor of IQ scores in childhood, adolescence, and early adulthood. See, e.g., J. F. Fagan, C. R. Holland, and K. Wheeler, The prediction, from infancy, of adult IQ and achievement, Intelligence, 35(3), 225-231, 2007.
Which of the following best describes ethical requirements regarding in-person solicitation of business?
A. Psychologists must never engage in in-person solicitation of business.
B. Psychologists must never engage in uninvited in-person solicitation of business.
C. Psychologists must not engage in in-person solicitation of business from current therapy clients who are vulnerable to undue influence.
D. Psychologists must not engage in uninvited in-person solicitation of business from current or potential therapy clients or others who are vulnerable to undue influence.
Answer D is correct. This answer is most consistent with the requirements of Standard 5.06 of the APA’s Ethics Code. It prohibits psychologists from engaging “in uninvited in-person solicitation of business from actual or potential therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.” This answer is also consistent with Standard III.28 of the Canadian Code of Ethics, which prohibits psychologists from exploiting “any relationship established as a psychologist to further personal, political, or business interests at the expense of the dignity or well-being of their primary clients, contract examinees, research participants, students, trainees, employers, or others.”
Sally S., age 14, began therapy at the request of her parents who were concerned about her increasing moodiness and oppositional behaviors. During her fifth therapy session, Sally tells you she’s been thinking about killing herself. When you express your concern, she says she’s “just kidding” and asks you not to say anything to her parents. Your best course of action would be to:
A. maintain Sally’s confidentiality but monitor her suicidal ideation in future therapy sessions.
B. continue to discuss Sally’s feelings about killing herself to determine if she is actually at risk for attempting suicide.
C. contact her parents immediately to inform them of her suicidal ideation and discuss their options in this situation.
D. tell Sally you won’t contact her parents as long as she signs a no-suicide contract.
Answer B is correct. Suicide threats should always be taken seriously and, in this situation, you’d want to determine if Sally is actually at risk for attempting suicide before contacting her parents or taking any other action. Note that there’s evidence that no-suicide contracts (answer D) do not guarantee a person’s safety and should be used only as one element of a comprehensive intervention.
Which of the following best describes ethical requirements regarding the use of automated and other professional test scoring and interpretation services?
A. Psychologists should ordinarily avoid using these services.
B. Psychologists should use only services that have been approved by the APA or other professional organization.
C. Psychologists may use these services only for tests that are objectively scored.
D. Psychologists may use these services but the psychologists are responsible for the appropriate application, interpretation, and use of tests.
Answer D is correct. This answer is most consistent with the requirements of Standard 9.09(c) of the APA’s Ethics Code. It states that “psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.” It is also consistent with the requirements of Standards II.3 and II.18 of the Canadian Code of Ethics.
Emiko E. was a client of Dr. Beck for seven months. She ended therapy with Dr. Beck four months ago but calls to request an appointment because she’s feeling very anxious and depressed and has started thinking about killing herself. For the past three months, Dr. Beck has been reducing his practice by referring current clients to other therapists and not accepting new clients because he and his wife are planning to move to another state to be closer to their adult son and his family. The best course of action for Dr. Beck is to:
A. explain to Emiko that he’s no longer accepting clients and provide her with a referral to a colleague.
B. explain to Emiko that he’s no longer accepting clients and provide her with a referral to a colleague and tell her he’s willing to consult with the new therapist.
C. agree to see Emiko in therapy until her crisis has passed and then provide her with a referral to a colleague if she needs additional therapy sessions.
D. tell Emiko to have a friend or family member take her to the hospital if she starts feeling that she can’t control the impulse to kill herself.
Answer C is correct. This situation is not directly addressed in ethical guidelines. However, this answer is most consistent with the “spirit” of the guidelines because it’s the response that best addresses Emiko’s welfare (see, e.g., Standard 10.09 of the APA’s Ethics Code and Principle II.35 of the Canadian Code of Ethics). Answers A and B are not the best answers because Emiko seems to need immediate assistance due to her suicidal ideation, and starting therapy with a new therapist (who may not be able to see her right away) would not be adequate.
And answer D is not the best answer because Emiko may or may not be capable of or motivated to follow through on the suggestion to have someone take her to the hospital if she starts feeling like she can’t control the impulse to attempt suicide.
During your second session with Anita A., she says she wants to tell you something she hasn’t told anyone else. After a few moments of silence, she reveals that she’s been seeing another therapist for three months but started seeing you because she’s concerned about his behavior. She tells you that, in her last few sessions with that therapist, he touched her inappropriately and said he was doing so to help her deal with her fear of physical and sexual intimacy. As an ethical psychologist, you should:
A. convince Anita to terminate therapy with the other therapist immediately and then help her work through her feelings about what has happened.
B. encourage Anita to terminate therapy with the other therapist immediately and file a complaint against him with the ethics committee.
C. explain to Anita the seriousness of her allegation and discuss the options she has in this situation.
D. tell Anita you’re ethically required to file a complaint against the other therapist because of the seriousness of her allegation.
Answer C is the correct. Of the answers given, this is the best one because it respects Anita’s autonomy (i.e., it doesn’t involve convincing or encouraging her to do something) and it does not violate the ethical requirement to address ethical violations by colleagues but to do so in a way that does not violate the client’s confidentiality.
To be consistent with ethical guidelines when conducting research, psychologists:
A. must always debrief research participants immediately after their participation.
B. must debrief research participants after their participation only when they may have been physically or psychologically harmed by their participation in the study.
C. should ordinarily debrief research participants immediately after their participation but, when that isn’t possible, should take steps to reduce the risk for harm.
D. should debrief research participants immediately after their participation if they’ve been deceived about some aspects of the study.
Answer C is correct. This answer is most consistent with Standard 8.08 of the APA’s Ethics Code and Principles II.47 and III.25 of the Canadian Code of Ethics. Standard 8.08(a) states that “psychologists provide a prompt opportunity for participants to obtain appropriate information about the nature, results, and conclusions of the research, and they take reasonable steps to correct any misconceptions that participants may have of which the psychologists are aware. Standard 8.08(b) states “if scientific or humane values justify delaying or withholding this information, psychologists take reasonable measures to reduce the risk of harm.”
Dr. Stein is a family therapist who believes therapy is most effective when all members of the immediate family attend all therapy sessions. During his second session with the Miller family, Mr. Miller is absent and Mrs. Miller says that, while her husband came to the first therapy session, he is unwilling to attend any additional sessions. The best course of action in this situation is for Dr. Stein to:
A. continue seeing Mrs. Miller and the children but encourage Mrs. Miller to convince Mr. Miller to attend at least some of the therapy sessions.
B. continue seeing Mrs. Miller and the children only if Mr. Miller agrees to see Dr. Stein in individual therapy.
C. continue seeing Mrs. Miller and the children only if his initial impression is that the family’s presenting problem is due primarily to Mrs. Miller’s relationships with her children.
D. refer Mrs. Miller to another family therapist who is willing to see only some members of the family.
Answer D is correct. To identify the correct answer to this question, you have to notice that the question states that Dr. Stein “believes therapy is most effective when all members of the immediate family attend all therapy sessions.” Some family therapists are amenable to seeing only some family members. However, Dr. Stein is not one of these therapists, so a referral to another therapist is the best course of action.
Your current client, Maggie M., invites you to a party she’s having to celebrate the completion of her dissertation. As an ethical psychologist, you:
A. refuse the invitation and explain to Maggie why it would be unethical for you to attend her party.
B. accept the invitation but make sure Maggie understands that you normally don’t attend social events with clients but will attend this party because it’s a special occasion.
C. discuss the potential conflicts that could arise with Maggie and ways to avoid them before accepting her invitation.
D. consider the nature of your therapeutic relationship with Maggie and the potential effect on her of your acceptance or refusal of her invitation before deciding whether or not to accept the invitation.
Answer D is correct. Standard 3.05 of the APA’s Ethics Code prohibits multiple relationships that “could be reasonably expected to impair the psychologist’s objectivity, competence, or effectiveness … or otherwise risks exploitation or harm to the person.” And Standard III.30 of the Canadian Code of Ethics requires psychologists to “avoid dual relationships … that are not justified by the nature of the activity, by cultural or geographic factors, or where there is a lack of reasonably accessible alternatives.” Neither document prohibits all types of multiple relationships; and, in the situation described in this question, your first action would be to consider the nature of your therapeutic relationship with Maggie and the possible effects on that relationship of accepting or refusing her invitation. Discussing potential conflicts with Maggie (answer C) isn’t a better answer because it implies that you would accept her invitation regardless of the outcome of that discussion.
Dr. Maddox has been in private practice for nearly 25 years, and her specialty has been treating depression in adolescents and young adults. Now that she’s turned 50, she has more interest in working with older adults. To be consistent with ethical requirements, Dr. Maddox should:
A. see older adults in therapy only if alternative mental health services for members of this population are unavailable in her community.
B. take a relevant APA-approved continuing education course before accepting older adults as clients.
C. see older adults in therapy if she’s able to obtain consultation while doing so with a colleague who has experience working with members of this population.
D. see older adults in therapy but closely monitor her effectiveness and obtain consultation or additional education if she encounters any problems.
Answer C is correct. This answer is most consistent with the requirements of Standard 2.01 of the APA’s Ethics Code and Standard II.6 of the Canadian Code of Ethics. Standard 2.01 requires psychologists to obtain appropriate education, training, and consultation when they want to provide professional services to members of new populations or use new therapeutic techniques. While obtaining additional education would be useful, taking a single continuing education course (answer B) or obtaining additional education when a problem arises (answer D) would not be adequate.
A psychology intern working at a mental health clinic tells her supervisor that, during the first session with a new client, he revealed that he’s gay. The intern says she does not want to work with this client or any other gay or lesbian clients because homosexuality violates her religious beliefs. The supervisor should:
A. tell the intern that she should just treat the client like any other client and volunteer to provide her with additional supervision as needed to help her do so.
B. tell the intern that she has to work with diverse clients (including homosexual clients) to complete her internship and volunteer to provide her with additional supervision to help her resolve the conflict between her religious beliefs and the requirements of her internship.
C. determine if it’s necessary to reassign the intern’s current client to another therapist and reassure the intern that she has the right to refuse to work with gay and lesbian clients.
D. determine if it’s necessary to reassign the intern’s current client to another therapist and discuss with the intern ways that might help her reconcile the conflict between her religious beliefs and the requirement that psychologists work effectively with diverse (including homosexual) clients.
Answer D is correct. Conflicts between religious values and professional competence when working with diverse clients have been addressed by a number of experts. For example, the APA’s Virtual Working Group on Restrictions Affecting Diversity Training in Graduate Education developed a Sample Program Policy Statement that articulates the policy for APA-accredited programs when trainees experience conflicts when working with diverse clients. Among other things, its states that the program is committed to helping trainees develop the knowledge and skills they need to work with diverse clients and to providing trainees with additional time and faculty support to help them integrate their personal values with the professional competence they need to work with all clients. Answer D is the best answer because it not only reflects this position but also takes into account the welfare of the intern’s current client. See, e.g., E. H. Wise, K. J. Bieschke, L. Forrest, J. Cohen-Filpic, W. L. Hathaway, and L. A. Douce, Psychology’s proactive approach to conscience clause court cases and legislation, Training and Education in Professional Psychology, 9, 259-268, 2015.
A psychologist routinely administers a measure of clinical symptomology to most of his clients, who are young and middle-aged adults. Several older adults have been recently referred to him, but the measure he routinely uses has little or no information about its validity for members of this population. With regard to ethical requirements:
A. it would be acceptable for the psychologist to administer this measure to older clients as long as alternative measures are unavailable.
B. it would be acceptable for the psychologist to administer this measure to older clients if alternative measures are unavailable and he explains the possible limitations of its results to the clients.
C. it would be acceptable for the psychologist to administer this measure to older clients as long as he obtains informed consents from the clients before doing so.
D. it would be unacceptable for the psychologist to administer this measure to older clients under any circumstances.
Answer B is correct. This answer is most consistent with the requirements of Standard 9.02(b) of the APA Ethics Code and Standard III.8 of the Canadian Code of Ethics. Standard 9.02(b) states that, when the reliability and validity of the tests they use haven’t been established for members of the population being tested, psychologists “describe the strengths and limitations of test results and interpretations.” And Standard III.8 requires psychologists to acknowledge the limitations of their findings.
By the end of the first session with a client, you realize that his symptoms meet the diagnostic criteria for antisocial personality disorder. You’ve learned from past experience that clients with this diagnosis often fail to pay their bills and, for this reason, decide not to continue seeing him in therapy. With regard to ethical requirements, this is:
A. unacceptable because it violates the prohibition against discrimination.
B. unacceptable if you have adequate training and experience to treat this client.
C. acceptable as long as you provide the client with referrals to other mental health professionals.
D. acceptable as long as you explain to the client why you cannot continue seeing him in therapy.
Answer C is correct. Standard 3.01 of the APA Ethics Code prohibits psychologists from unfairly discriminating on the basis of age, gender, ethnicity, sexual orientation, or other basis proscribed by law. And Standard I.9 of the Canadian Code of Ethics states that psychologists do “not practice, condone, facilitate, or collaborate with any form of unjust discrimination,” which is defined in the Preamble as “activities that are prejudicial to or promote prejudice against persons or peoples because of their
culture, nationality, ethnicity,
colour, race,
religion,
sex, gender, marital status, sexual orientation,
physical or mental abilities,
age,
socio-economic status, or any other preference or personal characteristic, condition, or status.”
Neither Code requires psychologists to accept all individuals seeking their services, and not seeing clients who may be unwilling or unable to pay their fees would not constitute unfair or unjust discrimination as defined in these standards.
When a parent, insurance company, or other third party is no longer willing to pay a client’s fee for therapy and the client is unable to pay the full fee him/herself, a psychologist should do which of the following to be consistent with ethical requirements?
A. provide services at a reduced fee until the client is able to pay the full fee
B. help the client find another source of financial assistance
C. provide pretermination counseling and referrals to alternative services
D. make sure the client understands why the psychologist is no longer able to provide services
Answer C is correct. Standard 10.10(c) of the APA Ethics Code and Standard II.34 of the Canadian Code of Ethics apply to this situation. Standard 10.10(c) states, “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.” And Standard II.34 states that psychologists should provide clients “with reasonable assistance to find a way to receive needed services in the event that third party payments are exhausted and the primary client cannot afford the fees involved.”
Dr. O’Leary, a neuropsychologist, administers a number of tests to new patients with traumatic brain injury to assist with differential diagnosis and treatment planning. She decides to also use her patients’ test data in a research study she will be conducting on the effects of traumatic brain injury on memory. In terms of ethical requirements, this is:
A. acceptable.
B. acceptable as long as she takes steps to protect the confidentiality of the data that will be used in her research study.
C. unacceptable unless she gets the patients’ consent to use their test information in the research study.
D. unacceptable under any circumstances.
Answer C is correct. This answer is most consistent with the requirements of Standard 9.03(a) of the APA Ethics Code and Standard I.23 of the Canadian Code of Ethics, which require informed consents for assessment to include a description of the purpose of the assessment. Dr. O’Leary originally administered the tests for the purpose of diagnosis and treatment planning (and presumably obtained consent from her patients for that purpose) and she must also obtain consent to include their test data in her research study.
Dr. Crosby, a licensed psychologist, wants to take two weeks off next month from her full-time private practice to spend time with her father who lives alone and will be having hip replacement surgery. With regard to her current therapy clients, Dr. Crosby’s best course of action is to:
A. let her clients know about her plans and arrange to conduct their sessions on the phone or Internet during her absence.
B. give her clients the phone number of a colleague who is willing to accept their calls and see them in case of an emergency.
C. let her clients know about her plans as soon as she finalizes them so they have time to process her absence before she leaves.
D. explain to her clients that she is leaving because of a family emergency and reassure them that they’ll be okay without her for two weeks.
Answer B is correct. Standard 3.12 of the APA Ethics Code and Standard II.33 of the Canadian Code of Ethics address the interruption of services in a general way, and it’s up to psychologists to determine the best course of action. Since Dr. Crosby’s absence is going to be relatively brief, the best action of those described in the answers would be to discuss it with clients immediately and provide them with the phone number of a colleague whom they can contact in case of an emergency. Note that answer A is not the best answer because psychologists may, of course, take time off from work and it’s not likely that Dr. Crosby would be able to keep all of her appointments while caring for her father.
The parents of 10-year-old Corey bring him to therapy at the recommendation of his school counselor who is concerned about his increasing oppositional behavior and failing grades. You decide that you will initially see Corey in individual therapy. To be consistent with ethical requirements you will do which of the following?
A. obtain written consent from Corey’s parents and verbal assent from Corey as soon as possible
B. obtain written consent from Corey’s parents as soon as possible and verbal assent from Corey after establishing a therapeutic relationship with him
C. obtain written consent from Corey after establishing a therapeutic relationship with him
D. obtain written or verbal consent from Corey’s parents as soon as possible
Answer A is correct. Obtaining informed consent from Corey’s parents and assent from Corey is consistent with the requirements of Standard 3.10 of the APA Ethics Code and Standard I.34 of the Canadian Code of Ethics, and obtaining consent and assent as soon as possible is consistent with the requirements of Standard 10.01 of the APA Ethics Code and Standard I.19 of the Canadian Code of Ethics. For example, Standard 3.10 requires that, for people who aren’t legally capable of giving consent, psychologists seek their assent and permission from a legally authorized person, while Standard 10.01(a) requires psychologists to obtain informed consents “as early as is feasible.”
In his dissertation proposal, a graduate student uses the organization and headings used by the author of a published journal article and uses arguments and data presented by that author and the author of another published article on the same topic to justify his study’s hypotheses. He cites both authors once in the introductory paragraph to his proposal. In terms of ethical requirements, this is:
A. acceptable since the graduate students cited the authors in the opening paragraph of his proposal.
B. acceptable even if the graduate student doesn’t cite the authors since this is just a dissertation proposal.
C. acceptable as long as the headings and arguments are not verbatim replications of the other authors’ work.
D. unacceptable since the graduate student has not given adequate credit to the other authors.
Answer D is correct. This answer is most consistent with the requirements of Standard 8.11 of the APA Ethics Code and Standard I.7 of the Canadian Code of Ethics. Standard 8.11 prohibits psychologists from presenting “portions of another’s work or data as their own, even if the other work or data source is cited occasionally,” and Standard III.7 requires psychologists to “take credit only for the work and ideas that they have actually done or generated, and give credit for work done or ideas contributed by others.” Simply citing the authors once in an introductory paragraph is inadequate given the extent to which the student has included their work in his proposal.
Which of the following statements best describes the requirements of the ethics codes published by the American and Canadian Psychological Associations for bartering?
A. Bartering is always unacceptable.
B. Bartering is acceptable only in the “most unusual circumstances.”
C. Bartering may be acceptable when it’s not clinically contraindicated.
D. Bartering may be acceptable when potential conflicts are discussed with the client.
Answer C is correct. Bartering is addressed in Standard 6.05 of the APA Ethics Code and Standard III.28 of the Canadian Code of Ethics, which both prohibit bartering when it is “clinically contraindicated.”
Which of the following best describes a psychologist’s ethical obligations with regard to the use of automated test scoring and interpretation services?
A. Psychologists who use these services are responsible for the validity of the conclusions they derive from them.
B. The providers of these services are responsible for ensuring that users are able to derive accurate conclusions from the information they provide.
C. The use of automated test scoring and interpretation services is discouraged by ethical guidelines.
D. The use of automated test scoring and interpretation is explicitly prohibited by ethical guidelines.
Answer A is correct. The use of automated scoring and interpretation services is not discouraged or prohibited by ethical guidelines, and their validity is directly addressed in Standard 9.09(c) of the APA Ethics Code and indirectly addressed in Standard II.3 of the Canadian Code of Ethics. Standard 9.09(c) states that “psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.” And Standard II.3 states that psychologists “accept responsibility for the consequences of their actions.”
Dr. King teaches classes on neuropsychology and conducts research on neurological correlates of aging at a large university. In her introductory neuropsychology class, she covers only research on aging that’s produced results that are similar to her own studies. In terms of the requirements of the ethics codes of the American and Canadian Psychological Associations, this is:
A. acceptable.
B. acceptable as long as Dr. King is willing to answer students’ questions about contradictory research.
C. acceptable because it’s up to Dr. King to decide what information to present in her classes.
D. unacceptable.
Answer D is correct. This issue is addressed in Standard 7.03 of the APA Ethics Code and Standard III.11 of the Canadian Code of Ethics, which both require psychologists to present instructional information in an accurate and unbiased manner.
You’ve just moved to a new town and want to “drum up” business for your private practice. As an ethical psychologist, you will keep in mind that in-person solicitation of business:
A. is always unacceptable.
B. is always unacceptable when it’s uninvited.
C. may be acceptable if it’s uninvited as long as it does not target people who are vulnerable to undue influence.
D. may be acceptable if it’s uninvited as long as it’s done in an appropriate manner.
Answer C is correct. This issue is explicitly addressed in Standard 5.06 of the APA Ethics Code, which prohibits psychologists from engaging “in uninvited in-person solicitation of business from actual or potential therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.” This answer is also consistent with Standard I.27 of the Canadian Code of Ethics which requires that consent for professional services not be obtained “under any conditions of coercion, undue pressure, or undue reward.” Note that answer D is not the best answer because it’s too vague.
Dr. Miller has been hired by the court to conduct a court-ordered evaluation of Edward E., a defendant in a criminal case. During his first meeting with Ed, Dr. Miller informs him of the purpose of the evaluation and that it’s court-ordered. Which of the following accurately describes Dr. Miller’s ethical obligations with regard to informed consent in this situation?
A. He does not have to obtain informed consent from Ed before proceeding with the evaluation but should inform him of the limits on confidentiality.
B. He must obtain informed consent from Ed before proceeding with the evaluation unless Ed is incapable of giving consent.
C. He must obtain informed consent from Ed or Ed’s attorney before proceeding with the evaluation.
D. He must obtain assent from Ed and informed consent from Ed’s attorney before proceeding with the evaluation.
Answer A is correct. Court-ordered evaluations are an exception to the ethical requirement to obtain an informed consent. For example, Paragraph 6.03.02 of the APA’s Specialty Guidelines for Forensic Psychology states that, when an evaluation is court-ordered, forensic psychologists must describe the nature and purpose of the examination but can conduct it without obtaining the examinee’s informed consent. However, in this situation, the examinee should be informed about the purpose of the evaluation, that it’s court-ordered, and about limits of confidentiality. In addition, in a discussion of psychologists’ responsibilities regarding moral rights, the Values Statement for Principle I of the Canadian Code of Ethics notes the following: “There might be circumstances in which the possibility of serious detrimental consequences to themselves or others, a diminished capacity to be autonomous, or a court order, would disallow aspects of some rights (e.g., privacy and confidentiality, self-determination, liberty).”
You had seen Lloyd in therapy for four months when he suddenly announced he had to quit therapy because he was moving to another city to be near his parents. When Lloyd quit therapy, he owed you for his last three sessions. You have sent Lloyd two letters requesting that he pay his outstanding fees but he hasn’t responded, and you are thinking about hiring a collection agency to collect the fees. With regard to ethical requirements, using a collection agency is:
A. unacceptable under any circumstances.
B. acceptable only if there’s no other way to collect the fees.
C. acceptable only if you notify Lloyd of your intent and give him an opportunity to pay the outstanding fees before doing so.
D. acceptable only if you discussed this option with Lloyd during the informed consent process.
Answer C is correct. This situation is covered in Standard 6.04(e) of the APA Ethics Code. It states that psychologists may use collection agencies and other legal measures to collect unpaid fees but “must first inform the person that such measures will be taken and provide that person an opportunity to make prompt payment.” The use of a collection agency is not explicitly addressed in the Canadian Code of Ethics, but this answer is most consistent with Standard I.12, which requires psychologists to “work and act in a spirit of fair treatment to others.”
When providing psychotherapy to employees through their company’s employee assistance program (EAP), psychologists should let the employees know that:
A. they will not release any confidential information to the employees’ supervisors without the employees’ authorization to do so.
B. they can provide the employees’ supervisors with confidential information only if the supervisors referred them to the EAP.
C. the only information they can release to the employees’ supervisors without the employees’ authorization is that they’re receiving therapy through the EAP.
D. the only information they can release to the employees’ supervisors is information directly related to their work-related activities.
Answer A is correct. Clients of EAPs have the same right to confidentiality as other therapy clients do, and they should be reassured that confidential information will not be shared with their supervisors or employers without their authorization.
A psychology professor at a large university has just developed a new screening test for depression and wants to compare scores on her test to scores on the Beck Depression Inventory and two other measures of depressive symptoms. She will do so by having a sample of adults who have and have not received a diagnosis of major depressive disorder complete the four measures. If the professor hires psychology graduate students to administer the measures to participants, this will be:
A. unacceptable since graduate students are unqualified to do so.
B. acceptable as long as the students will administer (but not score or interpret) them.
C. acceptable as long as the students have completed at least one course in psychological assessment.
D. acceptable as long as the students are provided with training in administering the measures and relevant ethical guidelines.
Answer D is correct. This answer is most consistent with Standard 2.05 of the APA Ethics Code and Standard II.7 of the Canadian Code of Ethics, which require psychologists to delegate to others only work they’re competent to perform. In the situation described in this question, this would include ensuring that the students administering the tests have adequate training in test administration and relevant ethical requirements.
A psychologist provides therapy using interactive videoconferencing for some of her clients. One of the psychologist’s videoconferencing clients is temporarily moving to another city to care for his sick mother and wants to continue therapy with her after he moves. With regard to ethical guidelines, complying with the client’s request:
A. is acceptable.
B. is acceptable if she provides the client with emergency contacts in the city where he will be temporarily residing.
C. is acceptable whether the client will be temporarily residing in the same jurisdiction as the psychologist or in a different jurisdiction.
D. is acceptable if the client will be temporarily residing in the same jurisdiction and may be acceptable if he will be residing in a different jurisdiction.
Answer D is correct. When you’re licensed in a jurisdiction (state or province), providing professional services to a client who is outside that jurisdiction is essentially practicing without a license. (The location of the client, not the psychologist, determines where professional services are being provided.) However, some jurisdictions allow psychologists to provide services outside the jurisdiction(s) where they’re licensed; however, for most jurisdictions, this is only for a brief period of time. See, e.g., J. E. Barnett and K. Kolmes, Avoiding a disconnect from telemental health, Monitor on psychology, 47(5), 48-55, 2016, retrieved from http://www.apa.org/monitor/2016/05/ce-corner.aspx
A research psychologist decides that it’s not possible to conduct a research study without deceiving participants about the true purpose of the study. Being familiar with ethical requirements, the psychologist knows that:
A. she doesn’t have to tell participants about the true nature of the study following their participation if she allows them to withdraw from the study at any time and the study doesn’t involve physical or emotional pain.
B. she doesn’t have to tell participants about the true purpose of the study following their participation if she’s determined that deception is justified by the prospective value of its results.
C. she must tell participants about the true purpose of the study immediately after their participation and allow them to withdraw their data.
D. she must tell participants about the true purpose of the study as early as feasible and allow them to withdraw their data.
Answer D is correct. The use of deception in research is covered in Standard 8.07 of the APA Ethics Code and Standard III.25 of the Canadian Code of Ethics. Standard 8.07(c) states that “psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection, and permit participants to withdraw their data.”
During the first session with Gerard G., age 32, Dr. Hassan learns that Gerard spent time in jail for sexual assault when he was in his mid-20s and that his current symptoms of depression seem to be unrelated to the assault or incarceration. Dr. Hassan is a cognitive behavioral therapist who has extensive experience treating depression in adults. However, her younger sister was sexually assaulted several years ago and, because of her feelings about that incident, she decides she doesn’t want to work with this client. With regard to ethical requirements, Dr. Hassan’s decision to not provide therapy to this client is:
A. unacceptable because it violates the prohibition against discrimination.
B. unacceptable since she has adequate experience to treat the client.
C. acceptable if she provides the client with referrals to other mental health professionals.
D. acceptable if she explains to the client why she cannot see him in therapy.
Answer C is correct. Standard 3.01 of the APA Ethics Code prohibits psychologists from unfairly discriminating on the basis of age, gender, ethnicity, sexual orientation, or other basis proscribed by law. And Standard I.9 of the Canadian Code of Ethics states that psychologists do “not practice, condone, facilitate, or collaborate with any form of unjust discrimination.” Neither Code requires psychologists to accept all individuals seeking their services, however, and seeing a client they know they prefer not to work with for personal reasons would not be in a client’s best interests. The best course of action would be to provide the client with referrals, but it’s not necessary to tell him why she’s doing so.
Dr. Willard encountered a former intern whom she had not seen for at least two years at a party. After talking to the intern for most of the evening, Dr. Willard realized that she was very attracted to the intern and that the feeling was mutual. Dr. Willard and her former intern began dating and eventually became sexually involved. With regard to ethical guidelines, Dr. Willard’s relationship with the former intern is:
A. clearly unacceptable.
B. acceptable since more than two years have passed since Dr. Willard was the intern’s supervisor.
C. acceptable if it’s not likely that Dr. Willard will have evaluative authority over the former intern in the future.
D. acceptable if they discussed the potential conflicts before becoming sexually involved.
Answer C is correct. This answer is most consistent with Standard 7.07 of the APA Ethics Code and Standard II.29 of the Canadian Code of Ethics. Standard 7.07 states that “psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority,” and Standard II.29 provides a similar prohibition. Note that answer D is not the best answer because, while discussing potential conflicts may be desirable, it’s not required by ethical guidelines.
Dr. Unger, a cognitive behavioral psychologist, has just moved to a rural community and is interested in providing therapy to clients via telephone or interactive videoconferencing so that he can provide services to individuals who have trouble getting to his office because of transportation problems or physical disabilities. One of his new clients has expressed interest in receiving therapy via telephone. Although there’s evidence that cognitive behavioral therapy is useful for treating the client’s disorder when it’s conducted face-to-face, there’s no empirical information on its effectiveness when conducted via telephone. In this situation, Dr. Unger:
A. should not conduct therapy via telephone since there’s no empirical evidence that this format is effective for the client’s disorder.
B. should agree to conducting therapy via telephone for this client only in emergency situations.
C. may conduct therapy via telephone for this client if he’s received adequate training in telepsychology.
D. may conduct therapy via telephone for this client since there’s empirical evidence that face-to-face cognitive behavioral therapy is effective for treating the client’s disorder.
Answer C is correct. This situation is directly addressed in Standard 2.01(e) of the APA Ethics Code and APA’s Guidelines for the Practice of Telepsychology and indirectly addressed in Standard II.18 of the Canadian Code of Ethics. Guideline 1 of the Guidelines for the Practice of Telepsychology states that “psychologists who provide telepsychology services strive to take reasonable steps to ensure their competence with both the technologies used and the potential impact of the technologies on clients/patients.” In addition, the discussion of the application of Guideline 1 states the lack of empirical evidence for providing therapy via telephone or other telecommunication format “in and of itself, may not be grounds to deny providing the service to a client/patient” (2013, pp. 793-794).
In response to the Heinz dilemma, Morgan says that Heinz shouldn’t steal the drug that his wife needs because people will think he’s a thief if he does so. Morgan’s response suggests that he’s in Kohlberg’s __________ level of moral development.
A. preconventional
B. conventional
C. transconventional
D. postconventional
Answer B is correct. The two stages of Kohlberg’s conventional level are (a) the “good boy/good girl” stage, during which the acceptability of a behavior depends on whether or not it’s socially approved of or liked by others, and (b) the law and order orientation stage, during which the acceptability of a behavior depends on whether or not it violates laws and rules that have been established by legitimate authorities. Morgan’s response indicates that he’s in the first stage of the conventional level.
You receive a written request from a former client to send a copy of her file to another psychologist. The client stopped coming to therapy six weeks ago and has not paid for her last two sessions even though you’ve sent her a letter requesting that she do so. Being familiar with ethical guidelines for this situation, you know that withholding a client’s record for nonpayment of fees is:
A. always unethical when the record is needed for the client’s treatment.
B. always unethical when the record is needed for the client’s emergency treatment.
C. ethical only when the client has not responded to multiple requests for payment.
D. ethical if the client was informed of this practice during the informed consent process.
Answer B is correct. This answer is most consistent with Standard 6.03 of the APA Ethics Code and Standards II.1 and II.2 of the Canadian Code of Ethics. Standard 6.03 states that “psychologists may not withhold records under their control that are requested and needed for a client’s/patient’s emergency treatment solely because payment has not been received.” (Note that withholding client records for nonpayment of fees in any situation may be illegal or inconsistent with institutional regulations, but this question is asking specifically about ethical guidelines.)
Dr. Wendy Wundt is supervising an intern, Lloyd L., who has recently not shown up for two of his therapy appointments with clients. In addition, one of the intern’s clients has complained to Dr. Wundt that the intern sometimes seems like he’s not listening to her and has made several sexually suggestive comments during sessions. If Dr. Wundt terminates Lloyd’s internship because of these behaviors:
A. she will have acted ethically because of the serious nature of Lloyd’s unacceptable behaviors.
B. she will have acted ethically if she informs Lloyd of the reasons for the termination.
C. she will have acted ethically only if she has directly observed Lloyd engage in unacceptable behaviors with clients.
D. she will have acted ethically only if she first provides Lloyd with a plan to remediate his unacceptable behaviors and Lloyd continues to engage in those behaviors.
Answer D is correct. This answer is most consistent with the provisions of Standard 7.06 of the APA’s Ethics Code and Standard II.26 of the Canadian Code of Ethics, which require psychologists to provide supervisees with timely feedback. Although neither Code directly addresses the termination of internships, doing so without having provided an intern with feedback and opportunities to correct undesirable behaviors would violate these standards and the “spirit” of the Codes. Note that answer C is not the best answer because, while supervisors should base their evaluations of interns on actual behaviors rather than hearsay (e.g., on behaviors they have actually observed), observation of the behaviors would not be sufficient justification for terminating an internship without providing the intern with feedback and a remediation plan.
Which of the following is not one of the required conditions for a claim of malpractice?
A. professional relationship
B. direct or proximate causation
C. negligence
D. dereliction or breach of duty
Answer C 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. Negligence (answer C) is a possible cause of a breach of duty (answer D) but it’s not required for a claim of malpractice because a breach of duty can be due other factors.
A client who you stopped seeing in therapy two months ago calls you to request that you send her a summary of her assessment results by email. You should:
A. refuse to send the information by email and discuss other options with her.
B. send the client the requested information by email only after ensuring it will go the client’s personal email account.
C. send the client the requested information by email if she has been informed of the potential limits on confidentiality when information is transmitted by email.
D. send the client the requested information by email if she has been informed of the potential limits on confidentiality and the information in the email is encrypted.
Answer D is correct. This answer is most consistent with Standards 4.01 and 4.02 of the APA Ethics Code and Standards I.41 and I.23 of the Canadian Code of Ethics, which require psychologists to maintain the confidentiality of client information and to discuss the limits of confidentiality with clients during the informed consent process. It’s also consistent with guidelines for the use of technology: For example, Guideline 4 of the APA’s Guidelines for the Practice of Telepsychology states that “psychologists who provide telepsychology services make reasonable efforts to protect and maintain the confidentiality of the data and information relating to their clients/patients and inform them of the potentially increased risks of loss of confidentiality inherent in the use of the telecommunication technologies, if any” (2013, p. 4). Encryption is a recommended method for protecting the confidentiality of emails.
Dr. Hannigan has just started seeing a husband and wife in therapy. The husband’s insurance covers individual therapy but not couple or family therapy, and the couple cannot afford to pay for therapy themselves. If Dr. Hannigan bills the insurance company for individual therapy for the husband, he has acted:
A. ethically since he is, in fact, providing therapy to the husband.
B. ethically since the couple wouldn’t be able to pay for therapy themselves.
C. ethically since this is common practice.
D. unethically.
Answer D is correct.
Billing an insurance company for a reimbursable form of therapy instead of the non-reimbursable form that’s actually being provided is insurance fraud and is both illegal and unethical.
A therapy client whom you have been seeing for seven weeks is suddenly laid-off from his job and can no longer afford to pay your fee. The client asks if he can barter yard work and minor home repairs for therapy until he’s able to find another job. In terms of ethical guidelines, agreeing to this arrangement would be:
A. unethical.
B. ethical if a fair market value can be established for the client’s work.
C. ethical since it’s a temporary arrangement.
D. ethical if you discuss the possible conflicts with the client before accepting the arrangement.
Answer A is correct. Bartering is addressed in Standard 6.05 of the APA Ethics Code and Standard III.28 of the Canadian Code of Ethics, which both prohibit bartering when it’s “clinically contraindicated.” In the bartering arrangement described in this question, you would be acting as both therapist and employer, and it would be clinically contraindicated since doing so could affect your objectivity and the therapeutic relationship if you’re dissatisfied with the client’s work.
Dr. Wallace’s new clients are a married couple and their three children, ages 9, 13, and 17. The family moved to the United States from Croatia four years ago. The children are fluent in both Croatian and English, but the parents have limited English skills and prefer to speak Croatian. Dr. Wallace does not speak Croatian, but the oldest daughter says she often acts as interpreter for her parents and is willing to do that in therapy. To be consistent with ethical requirements, Dr. Wallace should:
A. allow the daughter to act as interpreter if she’s sufficiently fluent in English and Dr. Wallace believes that family therapy is an appropriate form of therapy.
B. allow the daughter to act as interpreter if she’s sufficiently fluent in English and the parents and other children agree to this arrangement.
C. explain to the family why the daughter cannot act as interpreter and obtain the services of a professional interpreter.
D. refer the family to a therapist who speaks Croatian but, if that’s not possible, obtain the assistance of a professional interpreter.
Answer D is correct. This answer is most consistent with the provisions of Standard 2.05 of the APA’s Ethics Code and Standard II.7 of the Canadian Code of Ethics. Standard 2.05 states that psychologists “who use the services of others, such as interpreters, take reasonable steps to … avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity.” In other words, it would not be appropriate to have the daughter act as a translator. In addition, Guideline 6 of the APA’s Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations states that, when a psychologist’s language does not match the language of a client, the psychologist refers “the client to a mental health professional who is competent to interact in the language of the client” or, if that’s not possible, the psychologist offers “the client a translator with cultural knowledge and an appropriate professional background” (2013, p. 796).
With regard to ethical guidelines, using monetary or other inducements to encourage people to volunteer for a research study is:
A. unacceptable under any circumstances.
B. unacceptable if they’re likely to coerce participation.
C. acceptable only when alternative methods for obtaining participants are unavailable.
D. acceptable only when participants are not deceived about any aspect of the research.
Answer B is correct. Offering inducements to potential research participants is addressed in Standard 8.06 of the APA Ethics Code and Standards I.27 and III.29 of the Canadian Code of Ethics. Standard 8.06 states that “psychologists make reasonable efforts to avoid offering excessive or inappropriate financial or other inducements for research participation when such inducements are likely to coerce participation.” Note that answer D is not the best answer because deceiving potential participants about the study might be coercive in some circumstances, but there are other reasons why coercion may occur.
Dr. Ballard, a licensed psychologist, has just started working at a community health center in a small town and is asked to provide therapy to an adult client from an ethnic background that he’s relatively unfamiliar with. However, there are no mental health professionals working at the center or in the community who have more experience than he has, and the client’s presenting problem is one that he’s experienced treating. Dr. Ballard’s best course of action would be to:
A. agree to see the client but seek supervision or consultation by telephone, videoconference, or other means with someone who has experience working with members of this population.
B. agree to see the client only if he’s able to complete an online continuing education course on providing therapy to members of this population.
C. tell the client about his lack of experience and let the client decide if she wants to continue therapy with him.
D. decline the request to see the client since he doesn’t have experience working with members of this population.
Answer A is correct. This answer is most consistent with Standard 2.01 of the APA Ethics Code and Standard II.8 of the Canadian Code of Ethics, which require psychologists to obtain consultation, make a referral, or take other appropriate action when they do not have the necessary competence to provide professional services to a client. From the information given in this question, a referral doesn’t seem feasible since there are no mental health professionals in the community who have more experience than Dr. Ballard does (and it’s not given as an alternative answer). In addition, taking a single online continuing education course (answer B) is not likely to be adequate.
Which of the following best describes the provisions of the ethics codes of the American and Canadian Psychological Associations regarding unresolvable conflicts between a psychologist’s ethical responsibilities and legal requirements?
A. Psychologists must always prioritize ethical responsibilities over legal requirements.
B. Psychologists should ordinarily prioritize legal requirements over ethical responsibilities.
C. Psychologists should prioritize legal requirements if doing so doesn’t involve violating basic human rights.
D. Psychologists may prioritize ethical responsibilities or legal requirements, depending on the nature of the situation.
Answer D is correct. Unresolvable conflicts between ethical responsibilities and legal requirements are addressed in Standard 1.02 of the APA Ethics Code and Standard IV.17 of the Canadian Code of Ethics. Both require psychologists to make a reasonable effort to resolve a conflict in a way that’s consistent with ethical responsibilities but do not require psychologists to abide by ethical responsibilities in all situations. As noted by C. B. Fisher, “when reasonable actions taken by psychologists do not resolve the conflict, they are permitted to make a conscientious decision to comply with the legal or regulatory authority under circumstances in which their actions cannot be used to justify or defend violating human rights” (Decoding the Ethics Code: A practical guide for psychologists, Thousand Oaks, CA, SAGE Publications, Inc., 2017, p. 59). Note that answer C is not the best answer because of its inclusion of the word “should.”
You work at a community health center that employs three licensed psychologists, several physicians, and a marriage and family therapist. You overhear two members of the clerical staff complaining about the behavior of one of the licensed psychologists, and it sounds like her behavior violates ethical guidelines. Assuming that client confidentiality is not an issue and that you are not legally required to report the psychologist’s behavior to appropriate authorities, your best course of action is to:
A. discuss the possible ethical violation with the psychologist.
B. advise the staff members of their options.
C. do nothing unless you have reason to believe the psychologist will repeat the behavior in the future.
D. do nothing unless you have reason to believe the psychologist’s behavior has caused substantial harm.
Answer A is correct. This answer is most consistent with Standards 1.04 and 1.05 of the APA Ethics Code and Standards II.43 and II.44 of the Canadian Code of Ethics, which require psychologists to take action when they believe another psychologist has acted unethically as long as doing so does not violate client confidentiality. Consequently, of the answers given, this is the best one.
A psychologist who is starting her own private practice is thinking about offering the first therapy session for free to new clients. She believes that doing so will allow clients a chance to determine if she’s someone whom they want to see in therapy. With regard to ethical requirements, this:
A. is clearly unacceptable.
B. is acceptable because it’s a form of pro bono services.
C. may be acceptable if the psychologist clearly specifies her usual hourly fee and the purpose of the first session.
D. may be acceptable if doing so is common practice in the area where the therapist is providing professional services.
Answer C is correct. There’s no clear consensus among the experts regarding the acceptability of offering a first therapy session for free to new clients. However, there is some agreement that it’s acceptable when special precautions are taken, including making sure the person understands the limited purpose of the session (to help the person decide if he/she wants to work with the therapist) and is made aware of the subsequent fee before the first session. See, e.g., R. Miranda Jr. and B. P. Marx, Fees and financial arrangements, in W. O’Donohue and K. Ferguson (Eds.), Handbook of professional ethics for psychologists: Issues, questions, and controversies (pp.135-146), Thousand Oaks, CA, SAGE Publications, Inc, 2003.
During her second session with Dr. Tolvardson, Marie tells him that she’s also seeing another psychologist but has started therapy with Dr. Tolvardson because “things aren’t going well” with the other therapist. To be consistent with ethical guidelines, Dr. Tolvardson should:
A. discuss the situation further with Marie to determine the best course of action.
B. recommend that Marie discuss her dissatisfaction with the other therapist but continue seeing her in therapy.
C. tell Marie that he’ll have to call the other therapist to determine what arrangements would be in Marie’s best interests.
D. explain to Marie why he can’t continue seeing her in therapy while she’s seeing another therapist and terminate therapy immediately.
Answer A is correct. This answer is most consistent with the requirements of Standard 10.04 of the APA’s Ethics Code and Standard II.1, II.18, and III.32 of the Canadian Code of Ethics. Standard 10.04 requires psychologists to “carefully consider the treatment issues and the potential client’s/patient’s welfare” when deciding whether to provide services to individuals who are receiving mental health services from another professional. Dr. Tolvardson would want to obtain more information from Marie (e.g., what she means by “things aren’t going well”) before choosing a course of action.
Answer B is correct. The results of Project MATCH indicated that the three treatments produced similar reductions in drinking with only a small (nonsignificant) advantage for twelve-step facilitation. The results also provided some support for the hypothesis that matching type of treatment to certain patient characteristics improves treatment outcomes. For example, at the three-year follow-up, patients who had higher levels of anger had better outcomes with motivational enhancement therapy, while those low in psychiatric severity and those with a pre-treatment social network that supported drinking had better outcomes with twelve-step facilitation (Project MATCH Research Group, 1997, 1998).
Answer D is correct. This answer is most consistent with Standard 5.01(b) of the APA Ethics Code and Principles III.1 and III.2 of the Canadian Code of Ethics, which prohibit psychologists from making false or misleading statements about their credentials, institutional or associational affiliations, etc. Listing the University of Illinois on her business card violates this ethical responsibility because it might be interpreted as indicating that her clinical practice is sponsored or endorsed by the University of Illinois (see, e.g., G. G. Ford, Mental health reasoning for mental health professionals, Thousand Oaks, CA, Sage Publications, Inc., 2006).
Which of the following best describes ethical requirements regarding a psychologist’s use of animals as subjects in a research study?
A. Psychologists are prohibited from using animal subjects in research when the procedures of the research are likely to cause the animals pain or stress.
B. Psychologists should not use animal subjects in research that may cause the animals pain or stress unless their use is justified by the potential value of the research.
C. Psychologists may use animal subjects in research that may cause the animals pain or stress when alternative nonpainful and nonstressful procedures are unavailable and use of animals is justified by the potential value of the research.
D. Psychologists may use animal subjects in research that may cause the animals pain or stress when the pain or stress is minimized and ended as soon as feasible.
Answer C is correct. This answer is most consistent with the provisions of Standard 8.09(e) of the APA’s Ethics Code and Principles II.49 and II.51 of the Canadian Code of Ethics. Standard 8.09(e) states that “psychologists use a procedure subjecting animals to pain, stress, or privation only when an alternative procedure is unavailable and the goal is justified by its prospective scientific, educational, or applied value.”
At the request of the editor of a professional journal, a psychologist is reviewing a research paper that has been submitted to the journal for publication. The psychologist is impressed with the research and wants to apply some of the unique ideas and procedures presented in the paper to the research he is currently conducting. In this situation, the psychologist (reviewer):
A. can use the unique ideas and procedures in his own research since the article has not been published.
B. can use the unique ideas and procedures in his own research only if he gives credit to the paper’s authors when his own research is published.
C. cannot use the unique ideas and procedures in his own research unless he obtains permission from the paper’s authors to do so.
Answer C is correct. Standard 8.15 of the APA Ethics Code and Standard I.13 of the Canadian Code of Ethics apply to this situation. Standard 8.15 requires reviewers to respect the proprietary rights of the authors of the documents they review. This means that reviewers must not make personal or professional use of proprietary and unique ideas, procedures, and information presented in the documents without permission from the authors. Note that reviewers are often not given the names of authors and, therefore, cannot contact them directly. In this situation, reviewers should ask the journal editor to contact the authors about their willingness to interact with them.
Which of the following best describes ethical guidelines for soliciting client testimonials to be used by psychologists in advertisements for their professional services?
A. Psychologists are prohibited from soliciting testimonials from current clients but not former clients.
B. Psychologists are prohibited from soliciting testimonials from current clients and, in some circumstances, former clients.
C. Psychologists are prohibited from soliciting client testimonials from current and former clients in any circumstances.
D. Psychologists are allowed to solicit testimonials from current and former clients if the information in the testimonials is not false or misleading.
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Answer B is correct. This issue is directly addressed by Standard 5.05 of the APA Ethics Code and indirectly by Principle III.31 of the Canadian Code of Ethics. Standard 5.05 prohibits psychologists from soliciting testimonials from current therapy clients and from others “who because of their particular circumstances are vulnerable to undue influence.” In other words, soliciting testimonials from current clients always violates ethical responsibilities, while soliciting testimonials from former clients violates ethical responsibilities when those clients are vulnerable to undue influence.
A psychologist who is providing individual therapy to inmates of an adult correctional facility is told by one of the inmates during a therapy session that he is very angry at another inmate and intends to physically harm him. The psychologist knows that the inmate (his client) has a history of violent behavior. The psychologist should:
A. maintain the inmate’s confidentiality.
B. warn the intended victim of the inmate’s intent.
C. inform the appropriate prison official of the inmate’s intent.
D. warn the intended victim and inform the appropriate prison official of the inmate’s intent.
Answer C is correct. This situation is addressed by Pinta (2010), who states that, in correctional facilities, protecting the safety of staff and inmates takes precedence over concerns about client confidentiality. Consequently, when inmates tell their therapists they are planning to harm staff members or other inmates and therapists believe the threat is serious, therapists should meet the duty to protect by breaching confidentiality and informing the warden or other appropriate prison official of the threat. Pinta also notes that warning the inmate who is the intended victim (answers B and D) is not the best course of action because doing so could lead to retaliation.
When a psychologist is providing therapy to an employee through an employee assistance program (EAP), the psychologist:
A. must not provide information to the employee’s supervisor without authorization from the employee whether the employee’s participation is the result of a self-referral or referral from the supervisor.
B. must not provide information to the employee’s supervisor without authorization from the employee only when the employee’s participation is the result of a self-referral.
C. may provide information about the employee’s attendance to the employee’s supervisor without authorization from the employee only if the employee’s participation is the result of a referral from the supervisor.
D. may provide information about the employee’s attendance to the employee’s supervisor without authorization from the employee when the employee’s participation is the result of a self-referral or referral from the supervisor.
Answer A is correct. Employees participating in EAPs have the same right to confidentiality as other therapy clients do. Consequently, information about their participation is provided to their supervisors only when the employees have signed an authorization to release information. This is true whether participation is the result of a self-referral or a referral from the supervisor. (Note that, ordinarily, the authorization will be to release information only pertaining to the employee’s attendance and adherence to EAP recommendations.)
A therapist accepted a small gift from a 65-year-old Chinese therapy client because he was concerned that rejecting the gift might have caused the client to “lose face.” The therapist’s acceptance of the gift is most consistent with which of the General Principles contained in the APA’s Ethics Code?
A. Beneficence/Nonmaleficence and Respect
B. Beneficence/Nonmaleficence and Fidelity/Responsibility
C. Respect and Integrity
D. Fidelity/Responsibility and Integrity
Answer A is correct. Neil A. Massoth notes that, of the five General Principles, Beneficence and Nonmaleficence and Respect for People’s Rights and Dignity are most relevant to this situation. Beneficence and Nonmaleficence is Principle A. It states that “psychologists strive to benefit those with whom they work and take care to do no harm.” As noted in the question, rejecting the gift might have harmed the Chinese client by causing the client to lose face. Respect for People’s Rights and Dignity is Principle E. It states that “psychologists are aware of and respect cultural, individual, and role differences.” In Chinese and many other Asian cultures, gift-giving is a common ritual in interpersonal relationships. [Massoth is cited in D. S. Bailey, Approaching ethical dilemmas, Monitor on Psychology, 35(9), 62, 2004, https://www.apa.org/monitor/oct04/dilemmas.]
A psychologist is conducting a research study that will involve interviewing and administering several tests to psychiatric inpatients who have legal guardians. To be consistent with ethical guidelines, the psychologist should obtain:
A. assent from each patient and informed consent from each patient’s legal guardian.
B. informed consent from each patient and assent from each patient’s legal guardian.
C. informed consent from each patient’s legal guardian.
D. informed consent from each patient.
Answer A is correct. This answer is most consistent with the provisions of Standard 3.10(b) of the APA’s Ethics Code and Standard I.35 of the Canadian Code of Ethics. Standard 3.10(b) states that, for minors and others not capable of giving informed consent, psychologists obtain their assent and “appropriate permission from a legally authorized person.”
Dr. Lansky returned to school when she was 48 years old to obtain a Psy.D. in clinical psychology. She already had a Ph.D. in business administration and, now that she’s a licensed psychologist, decides to list both doctoral degrees in her business card and advertisements for her clinical practice. This is:
A. acceptable.
B. acceptable only if she indicates that her Ph.D. is in business administration.
C. unacceptable only if one or both degrees are not from an accredited educational institution.
D. unacceptable.
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Answer D is correct. This answer is most consistent with Standard 5.01(c) of the APA’s Ethics Code and Standards III.1 and III.2 of the Canadian Code of Ethics. Standard 5.01(c) states that psychologists can claim as credentials for their health services only degrees that “were earned from a regionally accredited educational institution or … were the basis for psychology licensure.” In other words, the psychologist should not include her Ph.D. in business administration in her business card or advertisements since that degree was not used as a credential for her health services.
Dr. Hedges has been seeing Betty in therapy for three months to help her deal with the sudden death of her mother. She’s made progress toward achieving her therapy goals, and they’ve started talking about terminating therapy. During her current session, Betty tells Dr. Hedges that her best friend is going through a divorce and she’d like to refer her to Dr. Hedges for therapy. Dr. Hedges should:
A. tell Betty he cannot see her friend in therapy until Betty’s therapy has ended.
B. tell Betty he cannot see her friend in therapy and offer to give her friend referrals to other mental health professionals.
C. agree to see Betty’s friend in therapy only if he has experience working with clients who are going through a divorce.
D. agree to see Betty’s friend in therapy only if he discusses the potential problems with Betty and her friend that could arise because he’s seeing them both in therapy.
Answer B is correct. Seeing the best friend of a client in therapy would constitute an unacceptable multiple relationship as defined in Standard 3.05 of the APA’s Ethics Code and Standard III.30 of the Canadian Code of Ethics because of the potential adverse effects of doing so. For example, Betty might disclose information about her friend to Dr. Hedges that her friend doesn’t want Dr. Hedges to know.
Dr. Higashi believes she can obtain more useful data if she deceives research participants about certain aspects of her study. As an ethical psychologist, Dr. Higashi should keep in mind that use of deception in research:
A. is acceptable only in the “most unusual circumstances.”
B. may be acceptable when alternative procedures are not available and subjects are informed about the deception “as early as is feasible.”
C. may be acceptable as long as its use is justified by the potential value of the results of the study and subjects are not given any inducement for their participation.
D. may be acceptable as long as its use is justified by the potential value of the results of the study and subjects sign a conditional informed consent.
Answer B is correct. This answer is the best one because, even though it doesn’t list all requirements for using deception, it’s most consistent with the provisions of Standard 8.07 of the APA Ethics Code and Standards III.23 and III.25 of the Canadian Code of Ethics. Standard 8.07 allows the use of deception
1. when it’s justified by the prospective value of the study,
2. non-deceptive alternatives are not feasible,
3. subjects aren’t deceived about aspects of the study that are likely to cause pain, and
4. subjects are informed about the deception as early as is feasible.
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.
Answer D is correct. Privilege is a legal concept that protects a client’s confidential information from being disclosed in legal proceedings.
Halfway through his participation in a research study, a subject becomes unhappy with the study and tells the researcher, a licensed psychologist, that he wants to quit. The subject is a student in an introductory psychology class and is receiving class credit for participating in the study. The researcher should:
A. remind the student that, by signing an informed consent, he agreed to participate in the entire study.
B. discuss the situation with the student’s instructor and allow the instructor to decide how to handle the situation.
C. offer the student payment or other incentive to continue in the study.
D. allow the student to withdraw from the study.
Answer D is correct. This answer is consistent with the provisions of Standard 8.02(a) of the APA Ethics Code and Standard I.23 of the Canadian Code of Ethics, which require psychologists to allow research participants to withdraw from a study at any time during the study.
You have just received a subpoena requesting that you appear in court to provide information about the diagnosis and treatment of a former client of yours who is suing her current therapist for malpractice. You are unable to contact the client or confirm that she has signed an authorization to release information. In this situation, you should:
A. notify the party who issued the subpoena that you cannot appear in court without a signed authorization from the client.
B. appear in court as requested but provide only information you believe is relevant to the case.
C. appear in court as requested but claim the privilege on behalf of the client.
D. appear in court and provide the requested information since privilege is waived in this situation.
Answer C is correct. When you receive a subpoena to appear in court and provide confidential information about a client and do not have authorization from the client to disclose the information, you should appear in court and claim the privilege on behalf of the client. You would then provide the information only if authorized to do so by the client or the client’s legal representative or ordered to do so by the court. Note that answer D is not correct because it is the court that decides if privilege is waived.
You have been seeing Evan in therapy for four months to treat his social anxiety. Although Evan seemed to make progress in the first few weeks, his symptoms have not changed since then and you do not think he’s benefitting from treatment. When you bring up the possibility of ending therapy and referring him to another therapist, Evan says he feels therapy is very helpful and wants to continue. In terms of ethical requirements, your best course of action would be to:
A. continue seeing Evan in therapy since he believes he’s benefitting from it.
B. continue seeing Evan in therapy if you can agree on specific treatment goals but, if not, set a termination date.
C. continue seeing Evan in therapy for several more sessions but, if nothing changes, bring up the possibility of ending therapy again.
D. explain to Evan why you believe he’s not benefitting from therapy and refer him to another therapist.
nswer B is correct. This answer is most consistent with the requirements of Standard 10.10(a) of the APA Ethics Code and Standard II.40 of the Canadian Code of Ethics. Standard 10.10(a) states that “psychologists terminate therapy when it becomes reasonably clear that the client/patient no longer needs the service, is not likely to benefit, or is being harmed by continued service.” Unless a reason for continuing therapy (e.g., new therapy goals) can be identified, you would not want to continue seeing a client when you believe the client is no longer benefitting from therapy.
Your neighbor tells you that one of her co-workers, a licensed psychologist, sometimes makes sexually suggestive comments that make her very uncomfortable and self-conscious. She says she asked him to stop making the comments last week because she finds them offensive, and he said his intention was to be funny but that he’d stop if that’s what she wants. In terms of ethical requirements, it appears that the co-worker’s comments:
A. represent sexual harassment because they’re sexual in nature and occurred on more than one occasion.
B. represent sexual harassment only if they would be identified as unacceptable by a “reasonable person.”
C. represent sexual harassment if the co-worker does not stop making sexually suggestive comments after being told they’re offensive.
D. do not represent sexual harassment because the co-worker was unaware that they were offensive while he was making them.
Answer C is correct. As defined in Standard 3.02 of the APA Ethics Code, comments of a sexual nature constitute sexual harassment if (a) they are unwelcome, offensive, or create a hostile workplace and the person knows or is told this or (b) they’re “sufficiently severe or intense to be abusive to a reasonable person.” The co-worker’s comments would meet the first criterion if he continues making them after being told they’re unwelcome and offensive. This answer is also consistent with Standard I.4 of the Canadian Code of Ethics which prohibits sexual harassment and with the definition of sexual harassment provided in the Code’s Preamble.
Dr. Shadid, a licensed psychologist, has a private clinical practice and teaches and conducts research at a large university. Dr. Shadid routinely administers cognitive ability and personality tests to many of his clients as part of his initial assessment and plans to also use the results of tests administered to therapy clients in his research study. In terms of ethical requirements, use of the test results in the research study is:
A. acceptable as long as he obtains informed consent from the clients for use of the assessment results for both therapy and research.
B. acceptable as long as the identity of each client is removed from the data he uses in his research study.
C. acceptable as long as the test results are genuinely needed for the purposes of diagnosis and treatment of his therapy clients.
D. unacceptable under any circumstances.
Answer A is correct. Standard 9.03 of the APA Ethics Code applies to this situation. It requires psychologists to obtain informed consent for assessment and to include, as part of the informed consent, “an explanation of the nature and purpose of the assessment.” This answer is also consistent with the requirements of Standards I.26 and I.36 of the Canadian Code of Ethics.
You receive a letter from a colleague requesting that you send her a copy of the record of Donald D., a former client of yours. The request is accompanied by an authorization to release information signed by Donald. Donald abruptly ended his sessions with you three months ago, at which time he owed you for his past four therapy sessions. You’ve sent two letters to Donald about his unpaid bill, but he has not responded. To be consistent with ethical requirements, you:
A. must forward the record to the colleague since Donald has signed an authorization allowing you to do so.
B. may refuse to forward the record to the colleague until you and Donald reach an agreement about how he will pay his outstanding fees.
C. may refuse to forward the record to the colleague for nonpayment of fees only if they are not needed for Donald’s emergency treatment.
D. may refuse to forward the record to the colleague for nonpayment of fees only if you explained this policy to Donald as part of the informed consent process when he began therapy.
Answer C is correct. Ethical requirements for this situation are provided in Standard 6.03 of the APA Ethics Code. It states that “psychologists may not withhold records under their control that are requested and needed for a client’s/patient’s emergency treatment solely because payment has not been received.” This answer is also consistent with the Preamble and Standards II.1 and II.2 of the Canadian Code of Ethics.
Note, however, that withholding client records for nonpayment of fees in any situation may be illegal or inconsistent with institutional regulations.
Dr. Robinson, a licensed psychologist who specializes in treating eating disorders, decides to offer a 90-minute presentation for parents on detecting and treating eating disorders in children and adolescents. In the advertisement for the presentation, Dr. Robinson describes it as a “lecture on the early identification of eating disorders in children and adolescents and treatment options.” There’s a good turnout for the lecture but, at the end of the first 45 minutes, only two parents have asked questions and Dr. Robinson notes that many attendees seem bored. She decides to “liven up” her presentation by having attendees describe their personal experiences with eating disorders. With regard to the requirements of the APA Ethics Code and the Canadian Code of Ethics, this change in format is:
A. ethical as long as she explains why she’s changing the format of the presentation.
B. ethical as long as she makes it clear that attendees should share information only if they feel comfortable doing so.
C. ethical as long as she explains the importance of maintaining confidentiality to the attendees.
D. unethical because she advertised her presentation as a “lecture.”
Answer D is correct. Dr. Robinson advertised her program as a lecture, and suddenly changing the format during the lecture would violate the requirements of Standard 7.02 of the APA Ethics Code and Standard III.5 of the Canadian Code of Ethics, which require psychologists to provide accurate descriptions of the content of the programs they provide.
Which of the following best describes ethical requirements regarding sexual relationships with students?
A. Psychologists are prohibited from becoming sexually involved with current and former students in their department.
B. Psychologists are prohibited from becoming sexually involved with students who are “vulnerable to undue influence.”
C. Psychologists are prohibited from becoming sexually involved with students when doing so creates an unacceptable multiple relationship.
D. Psychologists are prohibited from becoming sexually involved with students over whom they have or are likely to have evaluative authority.
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Answer D is correct. This is the best answer because it’s closest to the language of Standard 7.07 of the APA Ethics Code and Standard II.29 of the Canadian Code of Ethics, which prohibit psychologists from becoming sexually involved with students who are in their departments or over whom they have evaluative authority.
Dr. Axelrod’s new client is Michael Moreland, a 35-year-old African American man. Mr. Moreland has worked steadily as a dishwasher since he was 17, but he was laid off six months ago and has been unable to find a job. His presenting symptoms suggest he’s dealing with depression. Dr. Axelrod, a White middle-class cognitive behavioral therapist, specializes in treating depression but hasn’t worked with African American or low-income clients. However, he wants to expand his scope of practice to include members of populations he has not yet worked with. To be consistent with ethical requirements, Dr. Axelrod should:
A. agree to see Mr. Moreland in therapy as long as he consults while doing so with a colleague who has experience working with African American and low-income clients.
B. agree to see Mr. Moreland in therapy but monitor his effectiveness and obtain relevant education if needed.
C. refer Mr. Moreland to another therapist who has experience working with low-income and African American clients.
D. explain his lack of experience to Mr. Moreland and let him decide whether or not to continue therapy.
Answer A is correct. This answer is most consistent with Standard 2.01 of the APA Ethics Code and Standard II.6 of the Canadian Code of Ethics. Standard 2.01 requires psychologists to obtain appropriate education, training, and consultation when they want to provide professional services to members of new populations or use new therapeutic techniques. An alternative would be to make a referral (answer C), but that’s not required in this situation since Dr. Axelrod specializes in treating depression and wants to expand his scope of practice.
A psychologist would most likely violate ethical requirements for maintaining test security when he or she:
A. provides clients with the raw or scaled scores they obtained on a test.
B. discusses clients’ responses to test items to help them understand their test results.
C. provides a client’s attorney with a copy of test items and the client’s answers to the items in response to a subpoena and with the client’s permission.
D. allows clients to complete self-administered tests online at home when doing so is approved by the test publisher.
Answer C is correct. Standard 9.11 of the APA Ethics Code and Standard IV.11 of the Canadian Code of Ethics apply to this situation. Standard 9.11 requires psychologists to “maintain the integrity and security of test materials,” which it defines as “manuals, protocols, and tests questions or stimuli.” Answers C and D both address test security. Answer C is the best answer because providing test items to an attorney is questionable since an attorney is unlikely to be trained in psychological testing and to be legally or ethically required to maintain test security. As noted by the APA Committee on Psychological Tests and Assessments (https://www.apa.org/science/programs/testing/test-security-faq), the best course of action in this situation is to request that test materials be released to a qualified psychologist or obtain a protective order from the court that requires all parties to maintain test security. Answer D describes an acceptable course of action. Note, however, that precautions should be taken to maintain test security. For example, clients should be advised that third-party observation and recording of the test in any form are not allowed. Answers A and B can be eliminated because they address the use of test data (which is not covered by this Standard) and describe acceptable actions.
Dr. Wilson is hired by the court to evaluate the mental competence of a man who has been charged as an accomplice in a bank robbery that ended in the death of a bank employee. During a break, the man brags to Dr. Wilson about his role in the bank robbery. To be consistent with ethical requirements, Dr. Wilson should:
A. not provide the court with any information she obtains without a signed authorization from the man.
B. provide the court only with information she obtains that is relevant to the man’s mental competence.
C. provide the court with information about the man’s confession along with the results of the evaluation as long as she informed the man about the limits of confidentiality prior to beginning the evaluation.
D. provide the court with information about the man’s confession along with the results of the evaluation whether or not she informed the man about the limits of confidentiality prior to beginning the evaluation.
Answer B is correct. This answer is most consistent with Standard 4.04 of the APA Ethics Code and Paragraph 10.01 of the Specialty Guidelines for Forensic Psychology, which require psychologists to disclose only client information that’s relevant to the purpose of a report or other communication. This answer is also consistent with the requirements of Standards I.37 and I.45 of the Canadian Code of Ethics.
Vicarious liability refers to which of the following?
A. an employer’s legal responsibility for the acts of his/her employees
B. a chief investigator’s responsibility for the welfare of his/her research subjects
C. an employer’s “psychological contract” with his/her employees
D. a therapist’s obligation to maintain client confidentiality
Answer A is correct. When delegating work to an employee or supervisee, psychologists must be aware that, in certain circumstances, they might have vicarious liability – i.e., they might be legally responsible for the actions of the employee or supervisee.
As a favor to another psychology professor, Dr. Oliver requires students in his Psychology 101 class to participate in the professor’s research project. In terms of the requirements of the APA Ethics Code and the Canadian Code of Ethics, Dr. Oliver’s requirement is:
A. acceptable as long as Dr. Oliver believes that participation in the study will benefit his students.
B. acceptable as long as students are told about this requirement during the first class meeting.
C. acceptable only if students are given the choice of participating in the study or completing an alternative assignment.
D. acceptable only if Dr. Oliver is not involved in the research project.
Answer C is correct. This situation is addressed in Standard 8.04(b) of the APA Ethics Code and Standard I.36 of the Canadian Code of Ethics. Standard 8.04(b) states that “when research participation is a course requirement or an opportunity for extra credit, the prospective participant is given the choice of equitable alternative activities.”
Dr. Edison is a behavior therapist who specializes in treating cigarette smoking, nail biting, and other undesirable habits. While at a charity fundraiser, he meets the editor of a local newspaper and they agree that Dr. Edison will help the editor stop smoking in exchange for an article about his services in the newspaper. In terms of ethical requirements, this arrangement is:
A. acceptable as long as it does not interfere with Dr. Edison’s ability to provide treatment to the editor in an objective, competent manner.
B. acceptable as long as Dr. Edison and the editor agree that it’s an equitable exchange.
C. unacceptable because psychologists are prohibited from compensating employees of newspapers in exchange for a newspaper article about their services.
D. unacceptable because psychologists are required to avoid conflicts of interest.
Answer C is correct. This is the best answer because it accurately describes the requirements of Standard 5.02(b) of the APA Ethics Code. It states that psychologists “do not compensate employees of press, radio, television, or other communication media in return for publicity in a news item.” This answer is also consistent with Standard III.28 of the Canadian Code of Ethics, which prohibits psychologists from exploiting “any relationship established as a psychologist to further personal, political, or business interests at the expense of the dignity or well-being of their primary clients, contract examinees, research participants, students, trainees, employers, or others.”
A newly licensed psychologist finds that some of her clients are dealing with a high level of stress, and she encourages them to get a therapeutic massage between therapy sessions to alleviate physical tension. If they ask her for a referral, she gives them the business card of her husband, who’s a licensed massage therapist. This is:
A. acceptable since the psychologist gives her husband’s business card only to clients who ask for a referral.
B. acceptable only if the psychologist and her husband do not talk about referred clients without their authorization to do so.
C. unacceptable because doing so violates ethical prohibitions against engaging in multiple relationships.
D. unacceptable because doing so violates ethical prohibitions against engaging in situations that create a conflict of interest.
Answer D is correct. Standard 3.06 of the APA Code of Ethics requires psychologists to avoid conflicts of interest that might impair their objectivity, competence, or effectiveness. The psychologist is violating this prohibition because the financial benefits of having her husband provide services to her clients may bias her judgment about a client’s need for those services. This situation does not constitute a multiple relationship (answer C), which occurs when a psychologist has two professional relationships with the same person or with the person and someone closely associated with that person. This answer is also consistent with the requirements of Standard III.28 of the Canadian Code of Ethics.
Which of the following is most consistent with ethical guidelines for contingent fees?
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 as long as it is not prohibited by law.
Answer B is correct. The APA Ethics Code does not refer to contingent fees, but they are addressed in Paragraph 5.02 of the 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., Standard III.28).
Dr. Sipowicz has been seeing Annie for six weeks to treat her social phobia and decides it would benefit Annie if her husband attends several of her sessions. When Dr. Sipowicz discusses this with Annie, she agrees and says she’ll bring him to her next session. Annie’s husband is seeing another therapist to deal with his gambling problem. Inviting Annie’s husband to participate in Annie’s therapy sessions is:
A. unacceptable since he’s already receiving therapy from another therapist.
B. unacceptable unless you’ve determined that he’s not vulnerable to undue influence.
C. acceptable since you believe his participation in therapy will benefit Annie.
D. acceptable as long as he will only participate in a few sessions with Annie
Answer C is correct.
Standard 5.06 prohibits psychologists from engaging in uninvited in-person solicitation of business, but it also states that this prohibition does not include “attempting to implement appropriate collateral contacts for the purpose of benefiting an already engaged therapy client/patient.” This answer is also consistent with Standard III.28 of the Canadian Code of Ethics, which prohibits psychologists from exploiting “any relationship established as a psychologist to further personal, political, or business interests at the expense of the dignity or well-being of their primary clients, contract examinees, research participants, students, trainees, employers, or others.”
When a supervisor has legal responsibility for the actions of a psychology intern, the intern:
A. must inform clients that he/she is being supervised.
B. must inform clients that he/she is being supervised and give them the supervisor’s name.
C. must inform clients about his/her experience and licensure status.
D. may or may not inform clients that he/she is being supervised, depending on the situation.
Answer B is correct. This situation is addressed in Standard 10.01(c) of the APA Ethics Code, which states that “when the therapist is a trainee and the legal responsibility for the treatment provided resides with the supervisor,” the client must be informed that the therapist is a trainee who is being supervised and be given the supervisor’s name. This answer is also consistent with the requirements of Standards III.13 and III.22 of the Canadian Code of Ethics.
You saw Mr. Miller in therapy for four months when he suddenly terminated therapy with no warning or explanation. In addition, he has not paid for his last five sessions and has not responded to the two letters you’ve sent him asking him to contact you to discuss his unpaid bill. You want to use a collection agency to collect the money he owes you. To be consistent with ethical requirements, you will:
A. notify Mr. Miller that you will contact a collection agency if you don’t hear from him by the end of the month.
B. notify Mr. Miller of your intent to use a collection agency and explain why you’ve chosen to do so.
C. use a collection agency without notifying Mr. Miller as long as you informed him of this practice during the initial informed consent process.
D. contact a collection agency but provide it only with Mr. Miller’s name, address, phone number, and the amount owed.
Answer A is correct. Standard 6.04(e) of the APA Ethics Code applies to this situation. It states: “If the recipient of services does not pay for services as agreed, and if psychologists intend to use collection agencies or legal measures to collect the fees, psychologists first inform the person that such measures will be taken and provide that person an opportunity to make prompt payment.” Note that you would also want to provide the collection agency with limited information (answer D). However, before doing so, you’d want to notify the client of your intent to use a collection agency if arrangements have not been made to pay the outstanding fee by a specific date. The Canadian Code of Ethics does not directly address the use of collection agencies, but this answer is consistent with the “spirit” of the Code (see, e.g., Standard I.12).
Many of Dr. Israel’s therapy clients are employed in low-paying jobs, and she routinely waives their insurance co-payments. With regard to ethical requirements, this practice is:
A. unacceptable only if insurance companies are billed at a higher fee to cover the loss of the co-payments.
B. unacceptable only if the insurance companies explicitly prohibit this practice.
C. acceptable only if it’s justified by a client’s financial situation.
D. acceptable only if the insurance companies have agreed to this arrangement.
Answer D is correct. Routinely waiving insurance co-payments means the insurance company is paying 100% of the therapist’s fee, but most insurance companies agree to pay only part (e.g., 50%) of the fee. Therefore, regularly waiving co-payments without the insurance company’s agreement constitutes insurance fraud and is unethical and illegal.
Dr. Merritt overhears Alice, one of the interns she’s supervising, making disparaging remarks about people with addictions to a group of friends on two separate occasions. However, Dr. Merritt has never observed Alice acting in an inappropriate way with clients who have any type of addiction and she hasn’t discussed what she overheard with Alice. When Alice receives her performance evaluation, Dr. Merritt has noted that one of the low ratings she assigned was due to her concern that Alice is likely to have trouble working with clients who have an addiction. With regard to ethical guidelines:
A. Dr. Merritt’s evaluation is acceptable because of the unacceptability of the disparaging remarks Alice made.
B. Dr. Merritt’s evaluation is acceptable as long as it includes an explanation for her concerns about Alice’s ability to work with clients who have an addiction.
C. Dr. Merritt’s evaluation is acceptable as long as it was provided to Alice in a timely manner and she’s willing to discuss her concerns with Alice.
D. Dr. Merritt’s evaluation is not acceptable because it was not based entirely on Alice’s actual performance as an intern.
Answer D is correct. This answer is most consistent with Standard 7.06(b) of the APA Ethics Code and Standard II.26 of the Canadian Code of Ethics. Standard 7.06(b) states that “psychologists evaluate students and supervisees on the basis of their actual performance on relevant and established program requirements.”
Dr. Soltis is having difficulty determining the appropriate diagnosis and treatment for a 72-year-old client who has symptoms consistent with several disorders. He decides to consult with a colleague who works primarily with older adults. When doing so, Dr. Soltis should keep in mind that:
A. he needs to get authorization from the client to discuss confidential information with the colleague before doing so.
B. he does not need to get authorization from the client as long the colleague is a licensed mental health professional.
C. he does not need to get authorization from the client as long as he’s able to avoid disclosing the client’s identity to the consultant.
D. he does not need to get authorization from the client as long as he discussed exceptions to confidentiality with the client during the initial informed consent process.
Answer C is correct. Consultation with colleagues is addressed in Standard 4.06 of the Ethics Code. It states that, when consulting with a colleague, psychologists should not disclose confidential client information unless they have obtained the client’s authorization to do so or they do not disclose information “that reasonably could lead to the identification” of the client. This answer is also consistent with the requirements of Standards I.38 and I.45 of the Canadian Code of Ethics.
Dr. Andersen is having trouble with her abrasive father-in-law, a 58-year-old alcoholic, who moved in with Dr. Andersen and her husband two months ago. She realizes that she hates going home after work and that she’s started feeling negatively toward therapy clients who resemble her father-in-law. To be consistent with ethical guidelines, Dr. Andersen should:
A. temporarily suspend her practice and seek family therapy with her husband and father-in-law.
B. refer all clients who resemble her father-in-law to other mental health professionals.
C. realize this is a normal countertransference reaction and closely monitor her behavior with clients who resemble her father-in-law.
D. consult with a colleague to help her monitor her effectiveness with clients and determine the best course of action.
Answer D is correct. This answer is most consistent with Standard 2.06(b) of the APA Ethics Code and Standard II.11 of the Canadian Code of Ethics. Standard 2.06(b) states that, “when psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties.”
You’re conducting a research study that will involve interviewing and observing 50 sixth grade students. To fulfill ethical requirements, you should obtain:
A. an informed consent from each student.
B. assent from each student and permission from the school principal.
C. assent from each student and permission from the parent(s) of each student.
D. informed consent from the parent(s) of each student.
Answer C is correct. This answer is consistent with Standard 3.10(b) of the APA Ethics Code. It states that, for minors and others not capable of giving informed consent, “psychologists should provide them with an appropriate explanation, consider their best interests, seek their assent, and obtain permission from a legally authorized person when doing so is permitted or required by law.”
You have been hired by a company to assist with its hiring process by administering, scoring, and interpreting a battery of tests to applicants for sales jobs. The director of human resources has asked you to include a personality test that you know has not been validated as a predictor of job performance for salespeople. As an ethical psychologist, you will tell the director that:
A. you cannot comply with this request.
B. you’ll administer the test but will not base your evaluation of applicants on its results.
C. you’ll have to get consent from applicants before administering the test to them.
D. the test has not been validated as a predictor of job performance but you’ll let her make the final decision about whether or not to include it in the evaluation process.
Answer A is correct. Standard 9.02(a) of the Ethics Code requires psychologists to “administer, adapt, score, interpret, or use assessment techniques, interviews, tests, or instruments in a manner and for the purposes that are appropriate in light of the research on or evidence of the usefulness and proper application of the techniques.” Since you know the personality test has not been validated as a predictor of job performance for salespeople, you would not want to use it to evaluate job applicants. This answer is also consistent with the requirements of Standards II.13, II.14, and II.18 of the Canadian Code of Ethics.
The Introduction and Applicability section of the APA Ethics Code states that APA may take action against a member not only when a complaint has been filed against him or her but also when a member:
A. has been expelled or suspended from an affiliated state psychological association.
B. has been expelled or suspended from an affiliated state psychological association or convicted of a felony.
C. has been expelled or suspended from an affiliated state psychological association or convicted of a felony or misdemeanor.
D. has been expelled or suspended from an affiliated state psychological association or convicted of a felony or misdemeanor that’s related to the practice or profession of psychology.
Answer B is correct. The Introduction and Applicability section of the APA 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).
APA’s Record Keeping Guidelines recommend that, in the absence of legal and institutional requirements, psychologists retain the full client record until _____ years after the last date of service delivery for adults or _____ years after a minor reaches the age of majority, whichever occurs later.
A. 5; 2
B. 7; 3
C. 9; 5
D. 11; 7
Answer B is correct. APA’s (2007) Record Keeping Guidelines states that, “in the absence of a superseding requirement, psychologists may consider retaining full records until 7 years after the last date of service delivery for adults or until 3 years after a minor reaches the age of majority, whichever is later.”
A graduate program in clinical psychology requires first-year students to participate in individual therapy. With regard to the requirements of the APA Ethics Code and the Canadian Code of Ethics, this is:
A. acceptable as long as special steps are taken to protect students’ confidentiality.
B. acceptable as long as there are no multiple relationships between the students and the therapists.
C. acceptable only if students are given the choice of participating in an alternative activity.
D. unacceptable under any circumstances.
Answer B is correct. This answer is most consistent with Standard 7.05 of the APA Ethics Code and Standard III.30 of the Canadian Code of Ethics. Standard 7.05(a) states that “when individual or group therapy is a program or course requirement, psychologists responsible for that program allow students in undergraduate and graduate programs the option of selecting such therapy from practitioners unaffiliated with the program.” And Standard 7.05(b) states that “faculty who are or are likely to be responsible for evaluating students’ academic performance do not themselves provide that therapy.” In other words, when therapy is a program or course requirement, a student’s therapist should not have another relationship with the student.
When conducting group therapy, you should:
A. remind group members that they’re legally required to maintain the confidentiality of other group members.
B. remind group members that, because they’re in therapy, they’re ethically obligated to maintain the confidentiality of other group members.
C. discuss the importance of maintaining confidentiality with group members in the initial and subsequent sessions.
D. discuss the limits of confidentiality with potential members during the screening interview and have them sign a waiver of confidentiality.
Answer C is correct. Confidentiality in group therapy is addressed in Standard 10.03 of the APA Ethics Code and Standard I.44 of the Canadian Code of Ethics. Standard 10.03 states that psychologists should inform group members about “the roles and responsibilities of all parties and the limits of confidentiality.” Although psychologists cannot ensure the confidentiality of information revealed in group therapy, they can reduce the likelihood that confidential information will be disclosed by educating group members about the importance of maintaining confidentiality and the possible negative consequences of not doing so in the initial session and then reminding them of the need to maintain confidentiality in subsequent sessions.
Dr. Liu, a licensed psychologist, is asked to provide emergency mental health services to members of a nearby rural community that has just been devastated by a flood. Dr. Liu has never worked with victims of natural disasters, but she completed a course in crisis intervention in graduate school and there’s no one else in or near the community who has relevant experience. To be consistent with ethical requirements, Dr. Liu should:
A. decline to provide the requested services because of her lack of experience.
B. provide the requested services because no one else is available to do so.
C. provide the services only if she is able to obtain appropriate consultation while doing so.
D. provide the services only until they’re no longer needed or alternative services become available.
Answer D is correct. This answer is most consistent with Standard 2.02 of the APA Ethics Code, which states that psychologists may provide services in emergency situations when they do not have the necessary training if alternative services are unavailable and they discontinue providing the services as soon as the emergency ends or appropriate services become available. This answer is also consistent with the “spirit” of the Canadian Code of Ethics (see, e.g., Standard II.8).
At the end of her third therapy session, Mrs. Walters tells her therapist, Dr. Kramer, that her husband is very angry with Dr. Kramer because he seems to be telling her things in therapy that are destroying their marriage. When Dr. Kramer asks Mrs. Walters about her husband’s anger, she says he’s been threatening to beat Dr. Kramer “to a pulp.” From what Mrs. Walters has already told Dr. Kramer about her husband, he knows that Mr. Walters has a history of violent behavior and spent time in jail for severely beating and nearly killing a neighbor several years ago. To be consistent with ethical guidelines, Dr. Kramer:
A. should continue seeing Mrs. Walters in therapy but contact the police about Mr. Kramer’s threat.
B. should suggest that Mrs. Walters bring her husband to the next therapy session.
C. may terminate therapy with Mrs. Walters but must provide her with pretermination counseling before doing so.
D. may terminate therapy with Mrs. Walters with or without providing her with pretermination counseling.
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 a client [Decoding the ethics code (4th ed.), Los Angeles, SAGE, 2017].
Which of the following is not a condition 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.
Answer D is correct. Four conditions must be met for a claim of malpractice:
(1) The psychologist must have a legal duty to provide professional services to the client.
(2) The psychologist must have breached that duty as the result of negligence or by providing services that did not meet the professional standard of care.
(3) The client was psychologically or physically harmed or injured.
(4) The psychologist’s breach of duty was the cause of the client’s harm or injury.
Emiko E. was a client of Dr. Beck for seven months. She ended therapy with Dr. Beck four months ago but calls to request an appointment because she’s feeling very anxious and depressed and has started thinking about killing herself. For the past three months, Dr. Beck has been reducing his practice by referring current clients to other therapists and not accepting new clients because he and his wife are planning to move to another state to be closer to their adult son and his family. The best course of action for Dr. Beck is to:
A. explain to Emiko that he’s no longer accepting clients and provide her with a referral to a colleague.
B. explain to Emiko that he’s no longer accepting clients and provide her with a referral to a colleague and tell her he’s willing to consult with the new therapist.
C. agree to see Emiko in therapy until her crisis has passed and then provide her with a referral to a colleague if she needs additional therapy sessions.
D. tell Emiko to have a friend or family member take her to the hospital if she starts feeling that she can’t control the impulse to kill herself.
Answer C is correct. This situation is not directly addressed in ethical guidelines. However, this answer is most consistent with the “spirit” of the guidelines because it’s the response that best addresses Emiko’s welfare (see, e.g., Standard 10.09 of the APA’s Ethics Code and Principle II.35 of the Canadian Code of Ethics).
Answers A and B are not the best answers because Emiko seems to need immediate assistance due to her suicidal ideation, and starting therapy with a new therapist (who may not be able to see her right away) would not be adequate.
And answer D is not the best answer because Emiko may or may not be capable of or motivated to follow through on the suggestion to have someone take her to the hospital if she starts feeling like she can’t control the impulse to attempt suicide.
Dr. Bernstein, a school psychologist, has just been hired by a school district in a Southwestern town. Part of his job will be to administer tests to students to help determine if they qualify for special education. Spanish is likely to be the first language of some of the students he will evaluate, and many of these students will have limited English skills. To be consistent with ethical requirements when evaluating these students, Dr. Bernstein:
A. must use only tests that have a Spanish-language version.
B. must use only tests that have a Spanish-language version or are culture-fair tests that do not require verbal instructions or responses.
C. may use an interpreter who is fluent in both Spanish and English and has appropriate training.
D. may use an interpreter who is fluent in both Spanish and English and has appropriate training and must indicate the possible limitations of the test results in his report.
Answer D is correct. This answer is most consistent with Standard 9.03(c) of the APA’s Ethics Code and Principles I.24, I.27, and III.8 of the Canadian Code of Ethics.
Standard 9.03(c) states that “psychologists using the services of an interpreter obtain informed consent from the client/patient to use that interpreter, ensure that confidentiality of test results and test security are maintained, and include in their recommendations, reports, and diagnostic or evaluative statements … discussion of any limitations on the data obtained.”
Answers A and B are not the best answers because available Spanish-language versions of tests and culture-fair tests may not be adequate for the purposes of Dr. Bernstein’s evaluations and because ethical guidelines do not state that psychologists MUST use these tests when evaluating children with limited English skills.
Answer C is not the best answer because it does not include the requirement to discuss the possible limitations of the test data in recommendations.
To be consistent with ethical guidelines when conducting research, psychologists:
A. must always debrief research participants immediately after their participation.
B. must debrief research participants after their participation only when they may have been physically or psychologically harmed by their participation in the study.
C. should ordinarily debrief research participants immediately after their participation but, when that isn’t possible, should take steps to reduce the risk for harm.
D. should debrief research participants immediately after their participation if they’ve been deceived about some aspects of the study.
Answer C is correct. This answer is most consistent with Standard 8.08 of the APA’s Ethics Code and Principles II.47 and III.25 of the Canadian Code of Ethics. Standard 8.08(a) states that “psychologists provide a prompt opportunity for participants to obtain appropriate information about the nature, results, and conclusions of the research, and they take reasonable steps to correct any misconceptions that participants may have of which the psychologists are aware. Standard 8.08(b) states “if scientific or humane values justify delaying or withholding this information, psychologists take reasonable measures to reduce the risk of harm.”
Your current client, Maggie M., invites you to a party she’s having to celebrate the completion of her dissertation. As an ethical psychologist, you:
A. refuse the invitation and explain to Maggie why it would be unethical for you to attend her party.
B. accept the invitation but make sure Maggie understands that you normally don’t attend social events with clients but will attend this party because it’s a special occasion.
C. discuss the potential conflicts that could arise with Maggie and ways to avoid them before accepting her invitation.
D. consider the nature of your therapeutic relationship with Maggie and the potential effect on her of your acceptance or refusal of her invitation before deciding whether or not to accept the invitation.
Answer D is correct.
Standard 3.05 of the APA’s Ethics Code prohibits multiple relationships that “could be reasonably expected to impair the psychologist’s objectivity, competence, or effectiveness … or otherwise risks exploitation or harm to the person.” And Standard III.30 of the Canadian Code of Ethics requires psychologists to “avoid dual relationships … that are not justified by the nature of the activity, by cultural or geographic factors, or where there is a lack of reasonably accessible alternatives.” **Neither document prohibits all types of multiple relationships; **and, in the situation described in this question, your first action would be to consider the nature of your therapeutic relationship with Maggie and the possible effects on that relationship of accepting or refusing her invitation. Discussing potential conflicts with Maggie (answer C) isn’t a better answer because it implies that you would accept her invitation regardless of the outcome of that discussion.
Toward the end of his second date with Susie S., Dr. Browne realizes that Susie is the sister of one of his clients. Dr. Brown is very attracted to Susie, would like to continue dating her, and thinks she could be “the one.” However, as an ethical psychologist, Dr. Browne:
A. will continue dating Susie only if she’s the sister of a former (not current) client of his.
B. will continue dating Susie if she’s the sister of a current client only if he discusses the potential for problems with the client and with Susie.
C. will continue dating Susie if she’s the sister of a current client only if he terminates therapy with the client.
D. will not continue dating Susie whether she’s the sister of a current or a former client.
Answer A is correct. This situation is addressed in Standard 10.06 of the APA’s Ethics Code. It 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.” This answer is also consistent with the requirements of Standard III.28 of the Canadian Code of Ethics.
As described in the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA), a therapist can deny clients access to their protected health information when they believe that access 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 another person.
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 client has the right to have the denial reviewed by another designated licensed health care professional.
Which of the following best describes ethical requirements regarding the use of deception in research studies that may subject participants to pain?
A. Deception is never acceptable when a study’s procedures may cause participants physical pain.
B. Deception is never acceptable when a study’s procedures may cause participants physical pain or severe emotional distress.
C. Deception may be acceptable when a study’s procedures may cause participants pain when the deception is justified by the study’s prospective value.
D. Deception may be acceptable when a study’s procedures may cause participants pain when the deception is justified by the study’s prospective value and alternative procedures are unavailable.
Answer B is correct. This situation is covered in Standard 8.07(b) of the APA’s Ethics Code and Standards I.20 and III.23 of the Canadian Code of Ethics. Standard 8.07(b) states that “psychologists do not deceive prospective participants about research that is reasonably expected to cause physical pain or severe emotional distress.”
Marsha comes to her first therapy session 10 minutes late. She’s disheveled, seems very nervous, and says she doesn’t “really want to be here” but her roommate insisted it was a good idea. When you begin taking notes, Marsha says she doesn’t want you to keep a record of her sessions. As an ethical psychologist, you should:
A. find out the reason for her request and, if it seems valid, agree not to keep a record of her sessions.
B. tell her that you’ll comply with her request for now but will probably want to discuss it again in a subsequent session.
C. discuss her concerns and tell her that you need to keep a record of her sessions and explain your reasons for doing so.
D. tell her that you need to keep a record of her sessions and reassure her that anything you include in her record will be confidential.
Answer C is correct. Standard 6.01 of the APA Ethics Code, APA’s Record Keeping Guidelines, and Standard II.21 of the Canadian Code of Ethics require psychologists to create and maintain adequate records. Of the answers given, this is the best one because it includes discussing the client’s concerns and informing her of the reasons why record keeping is necessary.
You have been hired by a company to help determine whether current employees should be considered for promotion to managerial-level jobs. The human resources director says, to cut down on costs, he wants you to base your decisions primarily on the results of tests that were administered to the employees when they applied for their original jobs with the company. When you look at the employees’ files, you realize that most of the test results are outdated. As an ethical psychologist, you will:
A. comply with the director’s request but describe the possible limitations of your conclusions in your evaluation reports.
B. tell the director you cannot base your recommendations solely on the outdated test results.
C. ignore the outdated test results and base your conclusions only on results you believe are still valid.
D. explain to the director why you cannot comply with this request and recommend an alternative procedure for evaluating the employees.
Answer D is correct. This is the best answer of those given because using outdated test results would not be in the best interests of the employees and would violate ethical guidelines regarding test use. For example, Standard 9.08 of the Ethics Code prohibits psychologists from basing their assessment decisions on outdated test data, and Standards II.13 of the Canadian Code of Ethics requires psychologists to use appropriate assessment methods.
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 early as is feasible” after participation in a research study.
B. Participants should ordinarily be debriefed as soon as possible but, in some cases, debriefing may not be necessary.
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.
Answer B is correct. Debriefing is addressed in Standard 8.08 of the APA Ethics Code and Standards II.47 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.”
To ensure she obtains a sufficient number of volunteers for her research, Dr. Turay offers volunteers a gift card to the local restaurant of their choice. With regard to ethical guidelines, this is:
A. unacceptable under any circumstances.
B. acceptable since the inducement is a gift card rather than cash.
C. acceptable only if volunteers can choose either cash or a gift card.
D. acceptable as long as a gift card is not likely to coerce participation.
Answer D is correct. Offering inducements to research participants is addressed in Standard 8.06 of the APA Ethics Code and Standard III.29 of the Canadian Code of Ethics. Standard 8.06 states that “psychologists make reasonable efforts to avoid offering excessive or inappropriate financial or other inducements for research participation when such inducements are likely to coerce participation.”
“Quid pro quo” sexual harassment:
A. continues after the perpetrator of the harassment has been asked to stop.
B. involves a demand for sexual favors in exchange for job benefits.
C. creates a hostile work environment because it’s persistent.
D. occurs only once but is severe.
Answer B is correct.
Quid pro quo sexual harassment occurs when an employer demands sexual favors from an employee in exchange for a promotion, salary increase, or other job benefit.
A graduate student has just been hired as a research assistant for a psychology professor’s research study. The student quickly realizes that the psychologist is requiring undergraduate students in his Psychology 101 class to act as subjects in the study as a course requirement and is not offering them the choice of an alternative assignment. To fulfill ethical requirements, the graduate student should:
A. do nothing since this is an acceptable practice.
B. discuss the ethical violation with the psychologist.
C. advise the students of their right to refuse to participate in the study.
D. quit his job as research assistant.
Answer B is correct. Standards 1.04 and 1.05 of the APA Ethics Code and Standards II.43 and II.44 of the Canadian Code of Ethics require psychologists to take action when they believe a colleague is acting unethically by attempting to resolve the situation informally or reporting the colleague to an ethics committee or licensing board. The psychology professor’s requirement that his students participate in his research without providing an alternative assignment violates Standard 8.04(b) of the APA Ethics Code and Standard I.36 of the Canadian Code of Ethics, so this is the best answer. While the situation described in this question involves a graduate student and a professor, the requirement is the same.
Which of the following best describes the provisions of the ethics codes of the American and Canadian Psychological Associations regarding unresolvable conflicts between a psychologist’s ethical responsibilities and legal requirements?
A. Psychologists must always prioritize ethical responsibilities over legal requirements.
B. Psychologists should ordinarily prioritize legal requirements over ethical responsibilities.
C. Psychologists should prioritize legal requirements if doing so doesn’t involve violating basic human rights.
D. Psychologists may prioritize ethical responsibilities or legal requirements, depending on the nature of the situation
Answer D is correct. Unresolvable conflicts between ethical responsibilities and legal requirements are addressed in Standard 1.02 of the APA Ethics Code and Standard IV.17 of the Canadian Code of Ethics. Both require psychologists to make a reasonable effort to resolve a conflict in a way that’s consistent with ethical responsibilities but do not require psychologists to abide by ethical responsibilities in all situations. As noted by C. B. Fisher, “when reasonable actions taken by psychologists do not resolve the conflict, they are permitted to make a conscientious decision to comply with the legal or regulatory authority under circumstances in which their actions cannot be used to justify or defend violating human rights” (Decoding the Ethics Code: A practical guide for psychologists, Thousand Oaks, CA, SAGE Publications, Inc., 2017, p. 59). Note that answer C is not the best answer because of its inclusion of the word “should.”
A therapy client whom you have been seeing for seven weeks is suddenly laid-off from his job and can no longer afford to pay your fee. The client asks if he can barter yard work and minor home repairs for therapy until he’s able to find another job. In terms of ethical guidelines, agreeing to this arrangement would be:
A. unethical.
B. ethical if a fair market value can be established for the client’s work.
C. ethical since it’s a temporary arrangement.
D. ethical if you discuss the possible conflicts with the client before accepting the arrangement.
Answer A is correct. Bartering is addressed in Standard 6.05 of the APA Ethics Code and Standard III.28 of the Canadian Code of Ethics, which both prohibit bartering when it’s “clinically contraindicated.” In the bartering arrangement described in this question, you would be acting as both therapist and employer, and it would be clinically contraindicated since doing so could affect your objectivity and the therapeutic relationship if you’re dissatisfied with the client’s work.
Dr. Wallace’s new clients are a married couple and their three children, ages 9, 13, and 17. The family moved to the United States from Croatia four years ago. The children are fluent in both Croatian and English, but the parents have limited English skills and prefer to speak Croatian. Dr. Wallace does not speak Croatian, but the oldest daughter says she often acts as interpreter for her parents and is willing to do that in therapy. To be consistent with ethical requirements, Dr. Wallace should:
A. allow the daughter to act as interpreter if she’s sufficiently fluent in English and Dr. Wallace believes that family therapy is an appropriate form of therapy.
B. allow the daughter to act as interpreter if she’s sufficiently fluent in English and the parents and other children agree to this arrangement.
C. explain to the family why the daughter cannot act as interpreter and obtain the services of a professional interpreter.
D. refer the family to a therapist who speaks Croatian but, if that’s not possible, obtain the assistance of a professional interpreter.
Answer D is correct. This answer is most consistent with the provisions of Standard 2.05 of the APA’s Ethics Code and Standard II.7 of the Canadian Code of Ethics. Standard 2.05 states that psychologists “who use the services of others, such as interpreters, take reasonable steps to … avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity.” In other words, it would not be appropriate to have the daughter act as a translator. In addition, Guideline 6 of the APA’s Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations states that, when a psychologist’s language does not match the language of a client, the psychologist refers “the client to a mental health professional who is competent to interact in the language of the client” or, if that’s not possible, the psychologist offers “the client a translator with cultural knowledge and an appropriate professional background” (2013, p. 796).
Your client, who has received a diagnosis of binge-eating disorder, is not responding to treatment as well as you expected, and you decide to consult with a colleague who has experience treating clients with eating disorders. Which of the following best describes the provisions of the ethics codes of the American and Canadian Psychological Associations regarding consultation?
A. Psychologists must always obtain a client’s authorization before discussing the client’s case with a consultant.
B. Psychologists do not have to obtain a client’s authorization before discussing the client’s case with a consultant if the consultant is a licensed mental health professional.
C. Psychologists do not have to obtain a client’s authorization before discussing the client’s case with a consultant if they can disguise the client’s identity while doing so.
D. Psychologists do not have to obtain a client’s authorization before discussing the client’s case with a consultant if they share only the minimum amount of information necessary to achieve the purpose of the consultation.
Answer C is correct. This answer is most consistent with ethical guidelines. Standard 4.06 of the APA Ethics Code states that, when consulting with a colleague about a client, psychologists do not disclose confidential information “that reasonably could lead to the identification of a client/patient … unless they have obtained the prior consent of the person.” And Standard I.45 of the Canadian Code of Ethics states that psychologists “share confidential information with others only to the extent reasonably needed for the purpose of sharing, and only with the informed consent of those involved, or in a manner that the individuals and groups … involved cannot be identified.”
A psychologist realizes he has unknowingly become involved in a potentially harmful multiple relationship that involves a current therapy client and a relative of the client. To be consistent with ethical requirements, the psychologist should:
A. terminate the therapeutic relationship with the client and provide the client with referrals.
B. ask the client to bring her relative to the next therapy session to discuss the matter and determine the best course of action.
C. terminate the relationship with the relative as soon as possible.
D. seek consultation to help determine the best course of action.
Answer D is correct. This situation is addressed in Standard 3.05(b) of the APA Ethics Code and Standards III.31 and III.32 of the Canadian Code of Ethics. Standard 3.05(b) states that, “if a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.” The question does not describe the nature of the multiple relationship and it may or may not be necessary for the psychologist to terminate the relationship with the client or the relative. Consequently, of the answers given, seeking consultation best meets the requirement to take “reasonable steps.”
A client who you stopped seeing in therapy two months ago calls you to request that you send her a summary of her assessment results by email. You should:
A. refuse to send the information by email and discuss other options with her.
B. send the client the requested information by email only after ensuring it will go the client’s personal email account.
C. send the client the requested information by email if she has been informed of the potential limits on confidentiality when information is transmitted by email.
D. send the client the requested information by email if she has been informed of the potential limits on confidentiality and the information in the email is encrypted.
Answer D is correct. This answer is most consistent with Standards 4.01 and 4.02 of the APA Ethics Code and Standards I.41 and I.23 of the Canadian Code of Ethics, which require psychologists to maintain the confidentiality of client information and to discuss the limits of confidentiality with clients during the informed consent process. It’s also consistent with guidelines for the use of technology: For example, Guideline 4 of the APA’s Guidelines for the Practice of Telepsychology states that “psychologists who provide telepsychology services make reasonable efforts to protect and maintain the confidentiality of the data and information relating to their clients/patients and inform them of the potentially increased risks of loss of confidentiality inherent in the use of the telecommunication technologies, if any” (2013, p. 4). Encryption is a recommended method for protecting the confidentiality of emails.
Dr. Wendy Wundt is supervising an intern, Lloyd L., who has recently not shown up for two of his therapy appointments with clients. In addition, one of the intern’s clients has complained to Dr. Wundt that the intern sometimes seems like he’s not listening to her and has made several sexually suggestive comments during sessions. If Dr. Wundt terminates Lloyd’s internship because of these behaviors:
A. she will have acted ethically because of the serious nature of Lloyd’s unacceptable behaviors.
B. she will have acted ethically if she informs Lloyd of the reasons for the termination.
C. she will have acted ethically only if she has directly observed Lloyd engage in unacceptable behaviors with clients.
D. she will have acted ethically only if she first provides Lloyd with a plan to remediate his unacceptable behaviors and Lloyd continues to engage in those behaviors.
nswer D is correct. This answer is most consistent with the provisions of Standard 7.06 of the APA’s Ethics Code and Standard II.26 of the Canadian Code of Ethics, which require psychologists to provide supervisees with timely feedback. Although neither Code directly addresses the termination of internships, doing so without having provided an intern with feedback and opportunities to correct undesirable behaviors would violate these standards and the “spirit” of the Codes. Note that answer C is not the best answer because, while supervisors should base their evaluations of interns on actual behaviors rather than hearsay (e.g., on behaviors they have actually observed), observation of the behaviors would not be sufficient justification for terminating an internship without providing the intern with feedback and a remediation plan.
During the first session with Gerard G., age 32, Dr. Hassan learns that Gerard spent time in jail for sexual assault when he was in his mid-20s and that his current symptoms of depression seem to be unrelated to the assault or incarceration. Dr. Hassan is a cognitive behavioral therapist who has extensive experience treating depression in adults. However, her younger sister was sexually assaulted several years ago and, because of her feelings about that incident, she decides she doesn’t want to work with this client. With regard to ethical requirements, Dr. Hassan’s decision to not provide therapy to this client is:
A. unacceptable because it violates the prohibition against discrimination.
B. unacceptable since she has adequate experience to treat the client.
C. acceptable if she provides the client with referrals to other mental health professionals.
D. acceptable if she explains to the client why she cannot see him in therapy.
Answer C is correct. Standard 3.01 of the APA Ethics Code prohibits psychologists from unfairly discriminating on the basis of age, gender, ethnicity, sexual orientation, or other basis proscribed by law. And Standard I.9 of the Canadian Code of Ethics states that psychologists do “not practice, condone, facilitate, or collaborate with any form of unjust discrimination.” Neither Code requires psychologists to accept all individuals seeking their services, however, and seeing a client they know they prefer not to work with for personal reasons would not be in a client’s best interests. The best course of action would be to provide the client with referrals, but it’s not necessary to tell him why she’s doing so.
A psychologist has been asked to serve as a fact witness in court by the attorney of a former client. The psychologist assessed the client several months ago, but the client dropped out of therapy before completion of treatment due to financial problems. During her testimony about the results of the assessment, the psychologist is asked by the client’s attorney for her opinion about the impact of the client’s disorder on his future functioning. In this situation, the psychologist should:
A. provide an opinion if she also indicates its possible limitations.
B. provide an opinion since the request was made by the client’s attorney.
C. not provide an opinion unless she has adequate expertise to do so.
D. not provide an opinion unless ordered to do so by the judge.
Answer D is correct. Knowing that fact witnesses testify only about facts (what they have observed) while expert witnesses offer opinions would have helped you identify the correct answer to this question. If asked to provide an opinion when testifying as a fact witness, the best course of action for a psychologist is to state that he/she is not qualified to offer an opinion and then provide an opinion only if ordered to do so by the judge. See, e.g., T. P. Remley, Preparing for court appearances, ACA legal series (vol. 1), Alexandria, VA, American Counseling Association, 1991.
A psychologist who is starting her own private practice is thinking about offering the first therapy session for free to new clients. She believes that doing so will allow clients a chance to determine if she’s someone whom they want to see in therapy. With regard to ethical requirements, this:
A. is clearly unacceptable.
B. is acceptable because it’s a form of pro bono services.
C. may be acceptable if the psychologist clearly specifies her usual hourly fee and the purpose of the first session.
D. may be acceptable if doing so is common practice in the area where the therapist is providing professional services.
Answer C is correct. There’s no clear consensus among the experts regarding the acceptability of offering a first therapy session for free to new clients. However, there is some agreement that it’s acceptable when special precautions are taken, including making sure the person understands the limited purpose of the session (to help the person decide if he/she wants to work with the therapist) and is made aware of the subsequent fee before the first session. See, e.g., R. Miranda Jr. and B. P. Marx, Fees and financial arrangements, in W. O’Donohue and K. Ferguson (Eds.), Handbook of professional ethics for psychologists: Issues, questions, and controversies (pp.135-146), Thousand Oaks, CA, SAGE Publications, Inc, 2003.
Dr. Lisa Linden’s new client is Raymond R., who says he gets a lot of complaints about his temper. He tells Dr. Linden that he’s “always had a short fuse” and that the only way he deals with his anger is to leave the situation. Further questioning suggests that Raymond gets angry fairly easily but that his anger has never led to physical aggression and doesn’t seem to be related to depression or other disorder. Raymond says he’s heard that meditation is useful for reducing anger and would like to try that first. Dr. Linden, a practitioner of cognitive therapy, has never used meditation in her practice, but she attended a two-hour workshop on mindfulness meditation several months ago. To be consistent with ethical requirements, Dr. Linden should:
A. inform Raymond of her limited experience with meditation and let Raymond decide if he wants to continue seeing her in therapy.
B. inform Raymond of her lack of experience with meditation, discuss Raymond’s options with him, and give him a referral if he continues to want training in meditation.
C. advise Raymond that it’s more important at this point for him to understand how the way he thinks about things affect his anger and suggest he start cognitive therapy with her.
D. accept Raymond as a client and include mindfulness meditation in the client’s treatment plan.
Answer B is correct. This answer is most consistent with the requirements of Standard 2.01(c) of the APA Ethics Code and Standards II.6 and II.8 of the Canadian Code of Ethics, which require psychologists to provide professional services that are within their boundaries of competence. Psychologists often want to expand their professional services by using new therapeutic techniques, but a two-hour workshop on mindfulness meditation is not sufficient to qualify a psychologist to provide this intervention to clients.
A psychologist is asked by a local radio station to host a one-hour call-in show on Saturday nights. Being familiar with ethical guidelines, she:
A. declines the offer because providing professional advice over the radio, TV, or Internet is prohibited.
B. declines the offer unless she has control over which callers she talks to.
C. accepts the offer but makes sure that callers understand that, by taking their calls, she has not established a professional relationship with them.
D. accepts the offer but provides callers with factual information only and avoids providing advice or offering an opinion.
Answer C is correct. This situation is directly addressed in Standard 5.04 of the APA Ethics Code and indirectly addressed in Standard III.5 of the Canadian Code of Ethics. In this situation, the psychologist would want to make sure that callers understand that a professional therapeutic relationship is not established when she responds to their questions and that the advice or opinions she provides do not constitute therapy.
During her second session with Dr. Tolvardson, Marie tells him that she’s also seeing another psychologist but has started therapy with Dr. Tolvardson because “things aren’t going well” with the other therapist. To be consistent with ethical guidelines, Dr. Tolvardson should:
A. discuss the situation further with Marie to determine the best course of action.
B. recommend that Marie discuss her dissatisfaction with the other therapist but continue seeing her in therapy.
C. tell Marie that he’ll have to call the other therapist to determine what arrangements would be in Marie’s best interests.
D. explain to Marie why he can’t continue seeing her in therapy while she’s seeing another therapist and terminate therapy immediately.
Answer A is correct. This answer is most consistent with the requirements of Standard 10.04 of the APA’s Ethics Code and Standard II.1, II.18, and III.32 of the Canadian Code of Ethics. Standard 10.04 requires psychologists to “carefully consider the treatment issues and the potential client’s/patient’s welfare” when deciding whether to provide services to individuals who are receiving mental health services from another professional. Dr. Tolvardson would want to obtain more information from Marie (e.g., what she means by “things aren’t going well”) before choosing a course of action.
Which of the following is not one of the required conditions for a claim of malpractice?
A. professional relationship
B. direct or proximate causation
C. negligence
D. dereliction or breach of duty
Answer C 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. Negligence (answer C) is a possible cause of a breach of duty (answer D) but it’s not required for a claim of malpractice because a breach of duty can be due other factors.
You work at a community health center that employs three licensed psychologists, several physicians, and a marriage and family therapist. You overhear two members of the clerical staff complaining about the behavior of one of the licensed psychologists, and it sounds like her behavior violates ethical guidelines. Assuming that client confidentiality is not an issue and that you are not legally required to report the psychologist’s behavior to appropriate authorities, your best course of action is to:
A. discuss the possible ethical violation with the psychologist.
B. advise the staff members of their options.
C. do nothing unless you have reason to believe the psychologist will repeat the behavior in the future.
D. do nothing unless you have reason to believe the psychologist’s behavior has caused substantial harm.
Answer A is correct. This answer is most consistent with Standards 1.04 and 1.05 of the APA Ethics Code and Standards II.43 and II.44 of the Canadian Code of Ethics, which require psychologists to take action when they believe another psychologist has acted unethically as long as doing so does not violate client confidentiality. Consequently, of the answers given, this is the best one.
A psychologist provides therapy using interactive videoconferencing for some of her clients. One of the psychologist’s videoconferencing clients is temporarily moving to another city to care for his sick mother and wants to continue therapy with her after he moves. With regard to ethical guidelines, complying with the client’s request:
A. is acceptable.
B. is acceptable if she provides the client with emergency contacts in the city where he will be temporarily residing.
C. is acceptable whether the client will be temporarily residing in the same jurisdiction as the psychologist or in a different jurisdiction.
D. is acceptable if the client will be temporarily residing in the same jurisdiction and may be acceptable if he will be residing in a different jurisdiction.
Answer D is correct. When you’re licensed in a jurisdiction (state or province), providing professional services to a client who is outside that jurisdiction is essentially practicing without a license. (The location of the client, not the psychologist, determines where professional services are being provided.) However, some jurisdictions allow psychologists to provide services outside the jurisdiction(s) where they’re licensed; however, for most jurisdictions, this is only for a brief period of time. See, e.g., J. E. Barnett and K. Kolmes, Avoiding a disconnect from telemental health, Monitor on psychology, 47(5), 48-55, 2016, retrieved from http://www.apa.org/monitor/2016/05/ce-corner.aspx
With regard to ethical guidelines, using monetary or other inducements to encourage people to volunteer for a research study is:
A. unacceptable under any circumstances.
B. unacceptable if they’re likely to coerce participation.
C. acceptable only when alternative methods for obtaining participants are unavailable.
D. acceptable only when participants are not deceived about any aspect of the research.
Answer B is correct. Offering inducements to potential research participants is addressed in Standard 8.06 of the APA Ethics Code and Standards I.27 and III.29 of the Canadian Code of Ethics. Standard 8.06 states that “psychologists make reasonable efforts to avoid offering excessive or inappropriate financial or other inducements for research participation when such inducements are likely to coerce participation.” Note that answer D is not the best answer because deceiving potential participants about the study might be coercive in some circumstances, but there are other reasons why coercion may occur.
Dr. Ballard, a licensed psychologist, has just started working at a community health center in a small town and is asked to provide therapy to an adult client from an ethnic background that he’s relatively unfamiliar with. However, there are no mental health professionals working at the center or in the community who have more experience than he has, and the client’s presenting problem is one that he’s experienced treating. Dr. Ballard’s best course of action would be to:
A. agree to see the client but seek supervision or consultation by telephone, videoconference, or other means with someone who has experience working with members of this population.
B. agree to see the client only if he’s able to complete an online continuing education course on providing therapy to members of this population.
C. tell the client about his lack of experience and let the client decide if she wants to continue therapy with him.
D. decline the request to see the client since he doesn’t have experience working with members of this population.
Answer A is correct. This answer is most consistent with Standard 2.01 of the APA Ethics Code and Standard II.8 of the Canadian Code of Ethics, which require psychologists to obtain consultation, make a referral, or take other appropriate action when they do not have the necessary competence to provide professional services to a client. From the information given in this question, a referral doesn’t seem feasible since there are no mental health professionals in the community who have more experience than Dr. Ballard does (and it’s not given as an alternative answer). In addition, taking a single online continuing education course (answer B) is not likely to be adequate.
Dr. Morten is conducting research on attachment with rhesus monkeys at the university where he’s employed. It’s not his first study involving animal subjects and he has had training in the care of laboratory animals. His study has been approved by the school’s Institutional Animal Care and Use Committee. Dr. Morten’s team includes Dr. Chang, a postdoctoral fellow, two graduate students, and an undergraduate student. Dr. Chang has also had training in the care of laboratory animals and experience working with them, and Dr. Morten has given Dr. Chang the responsibility of supervising the graduate and undergraduate students. In this situation:
A. Dr. Morten is solely responsible for the appropriate treatment of animal subjects.
B. Dr. Chang is solely responsible for the appropriate treatment of animal subjects.
C. Dr. Morten and Dr. Chang are both responsible for the appropriate treatment of animal subjects.
D. The Institutional Animal Care and Use Committee is responsible for the appropriate treatment of animal subjects.
Answer C is correct. This answer is most consistent with the provisions of Standards 2.05 and 8.09 of the APA Ethics Code and Standards II.56 and III.37 of the Canadian Code of Ethics. Standard 8.09(b) states that “psychologists trained in research methods and experienced in the care of laboratory animals supervise all procedures involving animals and are responsible for ensuring appropriate consideration of their comfort, health, and humane treatment.” And Standard 2.05 of the APA Ethics Code and Standards II.56 and III.37 of the Canadian Code of Ethics similarly state that psychologists are responsible for the professional activities that they designate to others.
our new clients are married partners who have been arguing more often since their youngest child left home two months ago to attend college. They say that all three of their children are no longer living at home and they don’t seem to have much in common any more. As the partners describe their daily lives, you learn they just joined the same church that you belong to. As an ethical psychologist, you should:
A. continue seeing them in therapy but take special precautions to protect their confidentiality.
B. tell them you belong to the same church they belong to and that you’ll have to refer them to another therapist.
C. tell them you belong to the same church they belong to and ask them what they would like to do.
D. consider if their church membership is likely to impact your effectiveness as a therapist before deciding what to do.
Answer D is correct. Standard 3.05 of the APA Ethics Code prohibits multiple relationships that “could be reasonably expected to impair the psychologist’s objectivity, competence, or effectiveness … or otherwise risks exploitation or harm to the person.” And Standard III.30 of the Canadian Code of Ethics requires psychologists to “avoid dual relationships … that are not justified by the nature of the activity, by cultural or geographic factors, or where there is a lack of reasonably accessible alternatives.” Neither Code prohibits all types of multiple relationships; and, in the situation described in this question, your first action would be to determine if belonging to the same church as your clients constitutes a multiple relationship that’s likely to have an adverse impact on therapy.
Dr. O’Leary, a neuropsychologist, administers a number of tests to new patients with traumatic brain injury to assist with differential diagnosis and treatment planning. She decides to also use her patients’ test data in a research study she will be conducting on the effects of traumatic brain injury on memory. In terms of ethical requirements, this is:
A. acceptable.
B. acceptable as long as she takes steps to protect the confidentiality of the data that will be used in her research study.
C. unacceptable unless she gets the patients’ consent to use their test information in the research study.
D. unacceptable under any circumstances.
Answer C is correct. This answer is most consistent with the requirements of Standard 9.03(a) of the APA Ethics Code and Standard I.23 of the Canadian Code of Ethics, which require informed consents for assessment to include a description of the purpose of the assessment. Dr. O’Leary originally administered the tests for the purpose of diagnosis and treatment planning (and presumably obtained consent from her patients for that purpose) and she must also obtain consent to include their test data in her research study.
By the end of the first session with a client, you realize that his symptoms meet the diagnostic criteria for antisocial personality disorder. You’ve learned from past experience that clients with this diagnosis often fail to pay their bills and, for this reason, decide not to continue seeing him in therapy. With regard to ethical requirements, this is:
A. unacceptable because it violates the prohibition against discrimination.
B. unacceptable if you have adequate training and experience to treat this client.
C. acceptable as long as you provide the client with referrals to other mental health professionals.
D. acceptable as long as you explain to the client why you cannot continue seeing him in therapy.
Answer C is correct. Standard 3.01 of the APA Ethics Code prohibits psychologists from unfairly discriminating on the basis of age, gender, ethnicity, sexual orientation, or other basis proscribed by law. And Standard I.9 of the Canadian Code of Ethics states that psychologists do “not practice, condone, facilitate, or collaborate with any form of unjust discrimination,” which is defined in the Preamble as “activities that are prejudicial to or promote prejudice against persons or peoples because of their culture, nationality, ethnicity, colour, race, religion, sex, gender, marital status, sexual orientation, physical or mental abilities, age, socio-economic status, or any other preference or personal characteristic, condition, or status.” Neither Code requires psychologists to accept all individuals seeking their services, and not seeing clients who may be unwilling or unable to pay their fees would not constitute unfair or unjust discrimination as defined in these standards.
You’ve just moved to a new town and want to “drum up” business for your private practice. As an ethical psychologist, you will keep in mind that in-person solicitation of business:
A. is always unacceptable.
B. is always unacceptable when it’s uninvited.
C. may be acceptable if it’s uninvited as long as it does not target people who are vulnerable to undue influence.
D. may be acceptable if it’s uninvited as long as it’s done in an appropriate manner.
Answer C is correct. This issue is explicitly addressed in Standard 5.06 of the APA Ethics Code, which prohibits psychologists from engaging “in uninvited in-person solicitation of business from actual or potential therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.” This answer is also consistent with Standard I.27 of the Canadian Code of Ethics which requires that consent for professional services not be obtained “under any conditions of coercion, undue pressure, or undue reward.” Note that answer D is not the best answer because it’s too vague.
Mark Martinez is a graduate student in clinical psychology and is on-staff at a behavioral health clinic. He notices that the clinic’s most recent newspaper ad lists staff members and their credentials and identifies him as “Ph.D. (Cand.).” This designation of Mark’s credentials is:
A. acceptable as long as it accurately identifies his status.
B. acceptable as long as it accurately identifies his status and he’s earning his doctoral degree from an accredited educational institution.
C. acceptable as long as it accurately identifies his status and “Ph.D. (Cand.)” is changed to “Ph.D. Candidate” in future ads.
D. unacceptable even if it accurately identifies his status.
Answer D is correct. The use of “Ph.D. (Cand.)” or similar designation violates Standard 5.01 of the APA Ethics Code and Standard III.2 of the Canadian Code of Ethics, which require psychologists to avoid false, deceptive, or fraudulent public statements. As noted by Koocher and Keith-Spiegel (2008), “Ph.D. (Cand.)” and “Ph.D. Candidate” are misleading because they imply that the person has some type of earned credential.
A psychologist’s manuscript describing his dissertation research was accepted for publication by a journal. When the article is published, the psychologist discovers an error in the description of the results of his statistical analysis of the data. According to the ethics codes published by the American and Canadian Psychological Associations, the psychologist is:
A. required to inform the journal editor or publisher about the error.
B. required to take action to correct the error.
C. not required to take action if the error was made by the journal.
D. not required to take action if the error doesn’t affect the conclusions that can be drawn from the results of the study.
Answer B is correct. This issue is addressed in Standard 8.10(b) of the APA Ethics Code, which requires psychologists to take action to correct errors in their published data. It’s also addressed in Standard III.6 of the Canadian Code of Ethics, which requires psychologists to take action to correct misrepresentations of their work. Note that answer A is not the best answer because it doesn’t include requesting that the journal editor or publisher correct the error.
When a parent, insurance company, or other third party is no longer willing to pay a client’s fee for therapy and the client is unable to pay the full fee him/herself, a psychologist should do which of the following to be consistent with ethical requirements?
A. provide services at a reduced fee until the client is able to pay the full fee
B. help the client find another source of financial assistance
C. provide pretermination counseling and referrals to alternative services
D. make sure the client understands why the psychologist is no longer able to provide services
Answer C is correct. Standard 10.10(c) of the APA Ethics Code and Standard II.34 of the Canadian Code of Ethics apply to this situation. Standard 10.10(c) states, “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.” And Standard II.34 states that psychologists should provide clients “with reasonable assistance to find a way to receive needed services in the event that third party payments are exhausted and the primary client cannot afford the fees involved.”
Which of the following best describes a psychologist’s ethical obligations with regard to the use of automated test scoring and interpretation services?
A. Psychologists who use these services are responsible for the validity of the conclusions they derive from them.
B. The providers of these services are responsible for ensuring that users are able to derive accurate conclusions from the information they provide.
C. The use of automated test scoring and interpretation services is discouraged by ethical guidelines.
D. The use of automated test scoring and interpretation is explicitly prohibited by ethical guidelines.
Answer A is correct. The use of automated scoring and interpretation services is not discouraged or prohibited by ethical guidelines, and their validity is directly addressed in Standard 9.09(c) of the APA Ethics Code and indirectly addressed in Standard II.3 of the Canadian Code of Ethics. Standard 9.09(c) states that “psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.” And Standard II.3 states that psychologists “accept responsibility for the consequences of their actions.”
Dr. Friedman’s new client, Elsa E., says she feels anxious “a lot of the time” and wants to be trained in mindfulness meditation to reduce her anxiety. Dr. Friedman is a psychodynamic psychotherapist, but she knows there’s evidence that mindfulness interventions have been found to be effective for treating anxiety and she attended a one-hour introductory workshop on mindfulness-based stress reduction several weeks ago. To be consistent with ethical requirements, Dr. Friedman should:
A. inform Elsa of her limited experience with mindfulness meditation and let Elsa decide if she wants to continue seeing Dr. Friedman.
B. inform Elsa of her limited experience with mindfulness meditation, discuss Elsa’s options with her, and refer her to a qualified therapist if she continues to want training in mindfulness meditation.
C. advise Elsa that it’s more important at this point for her to understand the cause of her anxiety and recommend that she begin individual psychodynamic psychotherapy.
D. accept Elsa as a client and incorporate mindfulness meditation into her treatment plan.
Answer B is correct. Of the answers given, this one is most consistent with the requirements of Standard 2.01(c) of the APA Ethics Code and Standards II.6 and II.8 of the Canadian Code of Ethics, which require psychologists to provide professional services that are within their boundaries of competence.
Psychologists often want to expand their professional services by using new therapeutic techniques, but a one-hour introductory workshop on mindfulness-based stress reduction is not sufficient to qualify a psychologist to provide this intervention to clients.
Dr. Miller has been hired by the court to conduct a court-ordered evaluation of Edward E., a defendant in a criminal case. During his first meeting with Ed, Dr. Miller informs him of the purpose of the evaluation and that it’s court-ordered. Which of the following accurately describes Dr. Miller’s ethical obligations with regard to informed consent in this situation?
A. He does not have to obtain informed consent from Ed before proceeding with the evaluation but should inform him of the limits on confidentiality.
B. He must obtain informed consent from Ed before proceeding with the evaluation unless Ed is incapable of giving consent.
C. He must obtain informed consent from Ed or Ed’s attorney before proceeding with the evaluation.
D. He must obtain assent from Ed and informed consent from Ed’s attorney before proceeding with the evaluation.
Answer A is correct. Court-ordered evaluations are an exception to the ethical requirement to obtain an informed consent. For example, Paragraph 6.03.02 of the APA’s Specialty Guidelines for Forensic Psychology states that, when an evaluation is court-ordered, forensic psychologists must describe the nature and purpose of the examination but can conduct it without obtaining the examinee’s informed consent. However, in this situation, the examinee should be informed about the purpose of the evaluation, that it’s court-ordered, and about limits of confidentiality. In addition, in a discussion of psychologists’ responsibilities regarding moral rights, the Values Statement for Principle I of the Canadian Code of Ethics notes the following: “There might be circumstances in which the possibility of serious detrimental consequences to themselves or others, a diminished capacity to be autonomous, or a court order, would disallow aspects of some rights (e.g., privacy and confidentiality, self-determination, liberty).”
A psychology professor at a large university has just developed a new screening test for depression and wants to compare scores on her test to scores on the Beck Depression Inventory and two other measures of depressive symptoms. She will do so by having a sample of adults who have and have not received a diagnosis of major depressive disorder complete the four measures. If the professor hires psychology graduate students to administer the measures to participants, this will be:
A. unacceptable since graduate students are unqualified to do so.
B. acceptable as long as the students will administer (but not score or interpret) them.
C. acceptable as long as the students have completed at least one course in psychological assessment.
D. acceptable as long as the students are provided with training in administering the measures and relevant ethical guidelines.
Answer D is correct. This answer is most consistent with Standard 2.05 of the APA Ethics Code and Standard II.7 of the Canadian Code of Ethics, which require psychologists to delegate to others only work they’re competent to perform. In the situation described in this question, this would include ensuring that the students administering the tests have adequate training in test administration and relevant ethical requirements.
The personnel committee at a school of professional psychology has decided to deny Dr. Valdez a promotion because one of his clinic clients recently filed an ethics complaint against him. The client’s complaint claims that Dr. Valdez breached the client’s confidentiality by revealing information she told him in individual therapy during a group therapy session without her permission to do so. With regard to ethical requirements, the committee’s decision is:
A. acceptable since Dr. Valdez’s breach of confidentiality clearly violates ethical requirements.
B. acceptable only if the committee reconsiders Dr. Valdez’s promotion if he’s acquitted of the ethics charge.
C. unacceptable if the decision to deny Dr. Valdez’s promotion was based solely on the pending ethics complaint.
D. unacceptable if Dr. Valdez had not been given an opportunity to defend himself to the personnel committee before the decision was made.
Answer C is correct. This answer is consistent with Standard 1.08 of the APA Ethics Code and Standard I.13 of the Canadian Code of Ethics. Standard 1.08 directly addresses this situation and states that psychologists must not “deny persons employment, advancement, admissions to academic or other programs, tenure, or promotion, based solely upon their having made or their being the subject of an ethics complaint.” And Standard I.13 indirectly addresses this situation and requires psychologists to “abide by due process and other natural justice procedures for employment, evaluation, adjudication, editorial, and peer review activities.”
In his dissertation proposal, a graduate student uses the organization and headings used by the author of a published journal article and uses arguments and data presented by that author and the author of another published article on the same topic to justify his study’s hypotheses. He cites both authors once in the introductory paragraph to his proposal. In terms of ethical requirements, this is:
A. acceptable since the graduate students cited the authors in the opening paragraph of his proposal.
B. acceptable even if the graduate student doesn’t cite the authors since this is just a dissertation proposal.
C. acceptable as long as the headings and arguments are not verbatim replications of the other authors’ work.
D. unacceptable since the graduate student has not given adequate credit to the other authors.
Answer D is correct. This answer is most consistent with the requirements of Standard 8.11 of the APA Ethics Code and Standard I.7 of the Canadian Code of Ethics. Standard 8.11 prohibits psychologists from presenting “portions of another’s work or data as their own, even if the other work or data source is cited occasionally,” and Standard III.7 requires psychologists to “take credit only for the work and ideas that they have actually done or generated, and give credit for work done or ideas contributed by others.” Simply citing the authors once in an introductory paragraph is inadequate given the extent to which the student has included their work in his proposal.
Dr. Crosby, a licensed psychologist, wants to take two weeks off next month from her full-time private practice to spend time with her father who lives alone and will be having hip replacement surgery. With regard to her current therapy clients, Dr. Crosby’s best course of action is to:
A. let her clients know about her plans and arrange to conduct their sessions on the phone or Internet during her absence.
B. give her clients the phone number of a colleague who is willing to accept their calls and see them in case of an emergency.
C. let her clients know about her plans as soon as she finalizes them so they have time to process her absence before she leaves.
D. explain to her clients that she is leaving because of a family emergency and reassure them that they’ll be okay without her for two weeks.
Answer B is correct. Standard 3.12 of the APA Ethics Code and Standard II.33 of the Canadian Code of Ethics address the interruption of services in a general way, and it’s up to psychologists to determine the best course of action. Since Dr. Crosby’s absence is going to be relatively brief, the best action of those described in the answers would be to discuss it with clients immediately and provide them with the phone number of a colleague whom they can contact in case of an emergency. Note that answer A is not the best answer because psychologists may, of course, take time off from work and it’s not likely that Dr. Crosby would be able to keep all of her appointments while caring for her father.
Which of the following best describes the requirements of the ethics codes of the American and Canadian Psychological Associations regarding the release of test data and other client information to adult clients?
A. Psychologists must always release a client’s test results to the client when asked to do so.
B. Psychologists must always release a client’s test results to the client unless not doing so was discussed during the informed consent process.
C. Psychologists may refuse to release a client’s test results to the client when they believe that doing so may cause imminent serious physical harm to the client.
D. Psychologists may refuse to release a client’s test results to the client when they believe the client is not capable of understanding them.
Answer C is correct. This answer is most consistent with the requirements of Standard 9.04 of the APA Ethics Code and Standard I.45 of the Canadian Code of Ethics. Standard 9.04(a) states that “psychologists may refrain from releasing test data to protect a client/patient or others from substantial harm or misuse or misrepresentation of the data or the test, recognizing that in many instances release of confidential information under these circumstances is regulated by law.” And Standard I.45 states that psychologists may refrain from sharing confidential information “in circumstances of possible imminent serious bodily harm.” Note that answer D is not the best answer because a client’s lack of understanding of test results does not necessarily mean that releasing the results to the client will result in serious harm.
Dr. Bonnie Bright specializes in treating substance abuse and has provided individual and family therapy to many of the well-known citizens of the small town where she lives. During a workshop for licensed clinical psychologists who reside in the town and nearby rural communities, Dr. Bright describes the series of events that led one prominent family in the town to begin therapy with her. Although Dr. Bright changes the last name and first names of the family members, one of the participants in the workshop recognizes who she’s talking about and reveals their identity to other participants. Which of the following best describes this situation?
A. Dr. Bright fulfilled ethical requirements by not revealing the last name and first names of the family she treated.
B. Dr. Bright did not violate ethical requirements because participants in her workshop were all licensed psychologists.
C. Dr. Bright did not violate ethical requirements as long as she did not confirm the family’s identity after it was revealed by one of the workshop participants.
D. Dr. Bright violated ethical requirements because changing the names of the family members was not adequate given that they are prominent citizens residing in a small town.
Answer D is correct. Standard 4.07 of the APA Ethics Code and Standard I.45 of the Canadian Code of Ethics prohibit psychologists from disclosing confidential information about clients to others without client consent or without adequately disguising their identity unless there’s legal authorization to do so. Given the fact that the workshop took place in a small town and the family described by Dr. Bright is a prominent family in that town, changing only the names of the family members was not adequate.
A psychologist routinely administers a measure of clinical symptomology to most of his clients, who are young and middle-aged adults. Several older adults have been recently referred to him, but the measure he routinely uses has little or no information about its validity for members of this population. With regard to ethical requirements:
A. it would be acceptable for the psychologist to administer this measure to older clients as long as alternative measures are unavailable.
B. it would be acceptable for the psychologist to administer this measure to older clients if alternative measures are unavailable and he explains the possible limitations of its results to the clients.
C. it would be acceptable for the psychologist to administer this measure to older clients as long as he obtains informed consents from the clients before doing so.
D. it would be unacceptable for the psychologist to administer this measure to older clients under any circumstances.
Answer B is correct. This answer is most consistent with the requirements of Standard 9.02(b) of the APA Ethics Code and Standard III.8 of the Canadian Code of Ethics. Standard 9.02(b) states that, when the reliability and validity of the tests they use haven’t been established for members of the population being tested, psychologists “describe the strengths and limitations of test results and interpretations.” And Standard III.8 requires psychologists to acknowledge the limitations of their findings.
When providing psychotherapy to employees through their company’s employee assistance program (EAP), psychologists should let the employees know that:
A. they will not release any confidential information to the employees’ supervisors without the employees’ authorization to do so.
B. they can provide the employees’ supervisors with confidential information only if the supervisors referred them to the EAP.
C. the only information they can release to the employees’ supervisors without the employees’ authorization is that they’re receiving therapy through the EAP.
D. the only information they can release to the employees’ supervisors is information directly related to their work-related activities.
Answer A is correct. Clients of EAPs have the same right to confidentiality as other therapy clients do, and they should be reassured that confidential information will not be shared with their supervisors or employers without their authorization.
