Lecture 3- Working with Children and Families Flashcards
What are the four overarching ethical principles for psychologists?
- Respect for dignity of persons and peoples.
- Responsible caring.
- Integrity of relationships.
- Social justice.
What is the overarching ethical principle underlying all of the foundational four?
Do no harm: don’t escalate the distress of the individual. There is a fine balance between addressing trauma and bringing up pain pointlessly.
In relation to evidence based practice what do we have to keep in mind when we ‘do know harm’?
Even evidence based practice can do harm. It’s about catering to the individual and their needs. What works for most might not work for all. Constant reevaluation + checking is required.
What is transference? What might you need to be prepared to do?
- As a psychologist you need to constantly remain aware of your own bias and how that might influence your treatment of patients.
- Even if you don’t agree with an individuals actions you still have to respect their world view
- If you feel that you can’t for whatever reason remain professional/ non judgmental then you should refer the patient on.
What are some situations where you should refer patients on? What about the way psychological practices are set up allows this?
- Your own world views are biasing your treatment towards them
- If you think someone else could provide better care/ connect better with the patient
- Their issues rely outside your area of expertise/ scope or qualification(psychologists are registered in a certain area)
Often psychologists work as part of multi-disciplinary teams and so referring someone on is relatively easy
In terms of integrity of relationships what is the concern ethics wise?
- Need to make sure there are no conflicts of interests i.e. you can’t be friends or pursue relationships with current or previous clients
- This is particularly important because of the power imbalance.
- Limit contact with the patient outside of the workplace i.e. if you brought a car from a patient they might feel like they have to give you a better deal because of your status in their life
How is social justice an ethical concern and how does this relate to confidentality?
Psychologists have a duty to not just look out for the wellbeing of individuals but society as a whole. This relates to confidentiality in that while what is said in a session usually stays there if the person is talking about harming another then that’s something that needs to be reported.
When should you clarify the confidentiality rules with a patient?
- At the start of seeing them you need to set out who will have access to the information they tell you
- Generally you keep it to yourself as much as possible but if you are a student it may be that your supervisor will or if you are in a multidisciplinary team it may be easier to share information with colleges in order to provide the best care possible + refer them to someone more suited
When can you break confedienatly?
Only when individual is at risk of harming self (suicide, drink driving, elderly: dementia) or others
In regards to confidentiality what does the court have access to? What do you need to keep in mind?
If a patient appears before the court a search warrant may be issued in which case the police can come and take your files on the patient - but the information in it can not directly be used as evidence in the case.
The notes may however influence their opinion/ how they approach the case. Therefore there is a fine line between recording sessions in enough detail but not incriminating the client.
What is the purpose of the mental health act? How might you go about getting someone to conform to testing?
-Compulsory Assessment and Treatment.
-Can be used to ensure patients who are at imminent risk to themselves or others are assessed and treated.
-Always try and have patients volunteer for assessment and treatment - but if they are not able to and it is in their/others best interest they can be admitted under the Mental Health Act. However, family must be consulted and involved in the process whenever
possible.
Does someone who suspects child abuse have to report it? What about of maltreatment and neglect- are the rules so clear cut?
- Yes if child abuse is serious then yes. Maximum prison sentence could be 10 years if you did nothing.
- For maltreatment and neglect it is not as clear. There is no legislatively mandated reporting in NZ (sometimes employer will require it though), but better to err on side of reporting rather than not reporting.
- Usually there is someone you can go to for consultation of whether you need to report without actually reporting. That way if you get called up in a court of law you can say that you did seek advice.
What is the purpose of Oranga Tamariki and how does this relate to reporting/ breaking confidentiality?
- Many professionals are afraid of the consequences of reporting. Keep in mind that Oranga Tamariki operates on a principle of supporting the family to care for the child. They do not remove the child until it is absolutely necessary.
- Reporting can be done in a way that keeps the patient- therapist relationship intact if it is framed in a way to help the individual/ provide additional support.
What take precedence in the ethical code in terms of safety?
The safety of the child
What does the assessment of children usually involve?
- Interview child.
- Interview as many family members who are frequently and actively involved in the child’s life as possible (e.g., parents, siblings, grandparents etc..).
- Interview the teacher.
- Collect ratings.
- Administer neuropsychological tests (if appropriate to the referral question).