Marisa's Missed Ethical ?'s Flashcards
Question ID #128: A psychologist is undertaking a research project in a high security prison on the effects of certain food additives on behavior. The prison population is surveyed, informed of the purposes of the study, and volunteers are sought. The volunteer participants are again explained the purpose of the study and are asked to give their written consent to be participants. Because of the nature of the study, its importance to the food industry and the governmental regulatory agency, and the need to keep as much control of the participants’ food intake as is feasible, the participants are informed that, once they begin the study, they are expected to remain in it at least until the first evaluation period, six weeks from the beginning of the research program. They are told that they shouldn’t agree to participate unless they are reasonably sure they can complete at least this initial phase. Those participants who then agree and give written consent are included in the study. According to APA’s Ethical Principles, such a study
Select one:
A. should not be undertaken as the participants are not allowed to freely withdraw.
B. would be allowed only if the participants gave specific acknowledgment of their agreement to abide by the withdrawal arrangements.
C. is probably unethical because the prison research review committee did not also agree to the participation arrangements.
D. meets all research guidelines and can be undertaken.
Correct Answer is: A
The ethical standards require that research participants be allowed to withdraw from a study at any time. Hence the answer must be: “should not be undertaken as the participants are not allowed to freely withdraw”.
Additional Information: Informed Consent for Research
Question ID #189: You are the only provider in a rural community and your spouse’s coworker asks if he could schedule an appointment with you. Which of the following is the best course of action?
Select one:
A. You must refer him.
B. You must schedule an appointment with him.
C. You should refer him if you believe that treating him would impair your objectivity.
D. You should discuss this with your spouse and this coworker to determine if this constitutes a dual relationship.
Correct Answer is: C
According to APA’s Ethics Code regarding multiple relationships (3.05[a]), “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”
You must refer him.
This choice is too prohibitive. Although it may be necessary to refer this person, if it appears unlikely that entering into a professional relationship would impair your objectivity or would otherwise be harmful to the person, you could treat him.
You must schedule an appointment with him.
This choice can be eliminated because psychologists and other health professionals have no legal or ethical obligation to enter into a professional relationship.
You should discuss this with your spouse and this coworker to determine if this constitutes a dual relationship.
This choice can be eliminated because discussing the matter with your spouse would be a breach of confidentiality.
Question ID #303: You see a client for eight sessions for short-term therapy for depression following an accident at work that left him unable to work. A year later, the client’s attorney contacts you and asks you to testify on the client’s behalf in his lawsuit against the employer. In this case, you should
Select one:
A. refer the attorney and his client to a psychologist who specializes in forensic evaluations.
B. agree to testify since the attorney will likely compel your testimony via a subpoena.
C. clarify that it will be necessary to conduct a new evaluation in order to serve as an expert witness.
D. explain that you will be only able to testify as and clarify the role of a fact witness.
Correct Answer is: D
According to the APA’s Ethical Standards, when asked to provide service at the request of a third party “psychologists attempt to clarify at the outset of the service the nature of the relationship with all individuals or organizations involved.” In this question, you need to understand the role of psychologists in forensic settings to know how to explain the nature of your service to this client. In these settings, a psychologist can serve as either an expert or a fact witness. An expert witness is someone who has superior knowledge about a particular psychological issue in a legal case based on her training or experience, and offers that opinion if permitted or asked to do so by the court. A fact witness, on the other hand, is one who testifies about facts relevant to the case; when a psychologist testifies as a fact witness, it would be because he has treated a client and the events or disclosures that occurred in the treatment are relevant to the case. The roles of expert witness and fact witness are contradictory in numerous ways; for instance, an expert witness’s client is an attorney, whereas a treating psychologist’s client is the patient. Therefore, psychologists should not serve as both fact and expert witnesses in the same case. Additionally, the attorney’s request to testify “on behalf of the client” requires clarification; this could be interpreted to mean that your primary role would be to advocate for the client as opposed to testifying truthfully. For these reasons, of the choices listed, the best answer is to explain that you only can testify as a fact witness and to clarify you
Question ID #250: The director at the training agency, where you are a supervisor, has promised two new interns that they will have plenty of testing experience as part of their training. In order to meet quota, you are under a great deal of pressure to bill many hours. One intern has a great deal of previous testing experience and the other intern has very little. The majority of the testing cases are given to the more experienced intern, and as a result this intern is given the majority of your time and attention. This situation is:
Select one:
A. ethical
B. unethical
C. unethical because you are exploiting the more experienced intern
D. unethical because the less experienced intern is not getting the training as it was described to him by the director of the clinic
Correct Answer is: A
There is no indication that the more experienced intern is being exploited (“unethical because you are exploiting the more experienced intern” ) and while the interns are not receiving an equal number of testing opportunities, the situation is not unethical solely because the less experienced intern is getting fewer testing cases and/or attention. The director stated the interns would have “plenty of testing experience,” not necessarily an equal amount of testing cases, time, or attention. Additionally, the definition of plenty is relative to the individual intern, their previous education, training, and experience. Another relative term in the question to consider is “majority.” It would be unethical to have the intern with very little testing experience perform more than his/her current level of competency (Standard 2.05(2): Delegation of Work to Others). Note: this intern is receiving test cases, time, and attention - just not the “majority” of cases and attention.
Question ID #225: When conducting a custody evaluation, a psychologist should:
Select one:
A. advocate for the party that retained him
B. advocate for the party that retained him, unless retained by the court, in which case, he should remain impartial
C. remain impartial regardless of whether he is retained by the court or either party in the proceedings
D. acknowledge the fallacy of impartiality in an adversarial legal system
Correct Answer is: C
According to Guidelines for Child Custody Evaluations in Divorce Proceedings, “The psychologist should be impartial regardless of whether he or she is retained by the court or by a party to the proceedings. If either the psychologist or the client cannot accept this neutral role, the psychologist should consider withdrawing from the case. If not permitted to withdraw, in such circumstances, the psychologist acknowledges past roles and other factors that could affect impartiality” (American Psychologist, 49(7), 1994, 677-680).
Additional Information: Therapy Involving Couples or Families
Question ID #246: A father brings his 10-year-old son to a psychologist for therapy due to symptoms of depression. The father states that the boy’s symptoms began shortly after the parents separated several months ago. The boy is currently living with his father. The father further states that he only wants help for his son and does not want any report or testimony from the psychologist for the divorce proceedings. The psychologist should:
Select one:
A. have both parents sign an agreement that neither will require the psychologist to provide a report or testimony about the child’s therapy
B. contact the parents’ attorneys to clarify the psychologist’s role
C. refuse to treat the child unless you can evaluate both parents
D. provide therapy for the child but do not maintain any records that could be subpoenaed
Correct Answer is: B
Ethical Standard 10.02(b) states, “If it becomes apparent that psychologists may be called on to perform potentially conflicting roles (such as family therapist and then witness for one party in divorce proceedings), psychologists take reasonable steps to clarify and modify, or withdraw from, roles appropriately.” Although the patient’s father has indicated that he does not want a report or testimony from the psychologist, it would be more prudent to clarify the psychologist’s role with the attorneys of each of the parents.
have both parents sign an agreement that neither will require the psychologist to provide a report or testimony about the child’s therapy
Having the parents sign an agreement as suggested in this option does imply a clarification of the psychologist’s role, but it may not be legally binding or in the child’s best interests and is not as good a choice as the correct option.
refuse to treat the child unless you can evaluate both parents
This is incorrect because although it is necessary to evaluate all members of a family before making recommendations regarding child custody, in this case, it is therapy that is requested, not a custody evaluation.
provide therapy for the child but do not maintain any records that could be subpoenaed
This is incorrect because psychologists must maintain adequate records.
Question ID #297: A colleague of yours confides to you at a party after having a few drinks that he is involved in a sexual relationship with a current client. In this situation, your best course of action would be to
Select one:
A. meet with the colleague the next day to inform him you are going to report the violation to the state licensing board.
B. meet with the colleague the next day and help him to find options for resolving the problem.
C. take no action because of the patient confidentiality issues involved.
D. take no action because you did not learn of the issue in a professional setting.
Correct Answer is: A
Standards 1.04 and 1.05 of APA’s Ethical Standards and Code of Conduct deal with the issue of reporting violations by other psychologists. The first states in part that when psychologists learn of an ethical violation by another psychologist “they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate.” According to Standard 1.05 “if an apparent ethical violation has substantially harmed or is likely to substantially harm a person…and is not appropriate for informal resolution or is not resolved properly in that fashion”, psychologists must take “further action”, such as reporting the violation to an ethics committee or state licensing board. In other words, you attempt an informal resolution, such as the one described in this option (“meet with the colleague the next day and help him to find options for resolving the problem”) when such a resolution appears appropriate.
Sexual misconduct, however, is an example of an ethics violation that is very likely to cause substantial harm and attempting an informal resolution would not go far enough in meeting your obligation under the Ethics Code. Thus, a better course of action would be to report the violation.
Question ID #178: A therapist routinely waives co-payments for all low income clients. This is
Select one:
A. unethical, unless the client is on welfare.
B. ethical, if the psychologist is doing this in order to create a sliding scale.
C. unethical.
D. ethical.
Correct Answer is: C
This is unethical (and illegal) because it constitutes insurance fraud – the insurance company thinks it’s paying for a portion of the client’s treatment when it is really paying for the whole thing. Of course, it would not be unethical if you told the insurance company what you were doing. However, most if not all insurance companies would not accept such an arrangement; instead, the company would lower its own contribution to the fee.
Additional Information: Third Party Payors
Question ID #107: Although you have extensive experience in administering the WAIS-R, you have not yet administered the WAIS-III. If you would like to administer the WAIS-III you should:
Select one:
A. obtain additional training
B. obtain supervision by a psychologist experienced in the use of the WAIS-III
C. seek consultation to determine the most appropriate action to take
D. be able to administer the WAIS-III since it is very similar to the WAIS-R
Correct Answer is: A
Standard 2.01(c) (Boundaries of competence), requires psychologists who provide services involving populations, areas, techniques, or technologies that are new to them undertake relevant education, training, supervised experience, consultation, or study. When administering a test, or a new version of a test which you are not familiar with, the best course of action would be to obtain the necessary training.
Question ID #110: The police inform you that they have a warrant out on one of your clients who is suspected of several felony charges of grand theft auto. They want you to provide them with the client’s address and phone number. You should:
Select one:
A. cooperate with the police
B. require them to get a warrant before you release any information
C. refuse to provide them with the information and notify your client
D. inform them when your next scheduled appointment is with your client
Correct Answer is: C
Since there is no indication that your client is in imminent danger to self or others, you would be obligated to protect the confidentiality rights of your client. However, you should notify your client of this information that you received, and discuss the option of turning himself in to the police.
Additional Information: Mandated and Permitted Disclosures of Confidential Information
Question ID #251: To ensure that providers meet and maintain health plan participation requirements, managed care organizations (MCOs) use \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ as a review process. Select one: A. clinical audit B. concurrent review C. credentialing D. quality management
Correct Answer is: C
The formal process for determining if a provider meets and maintains the standards of qualification, as well as providing some legal protection for the managed care organization, is referred to as credentialing.
Clinical audit* is a quality assurance method. Concurrent review* describes the utilization review conducted during the course of treatment. Quality management* is another name for quality assurance (* incorrect options).
Question ID #177: A woman who has been abused by her husband comes to therapy. What would a family systems therapist do first in this case?
Select one:
A. invite the husband into therapy
B. teach her how to manage her husband’s anger
C. find out if the woman is currently safe from abuse and, if necessary, rehearse an escape plan with her
D. explore patterns of abuse in her family of origin
Correct Answer is: C
The key word in this question is “first.” The first concern in this case – for a systems therapist as well as any other therapist – is to ensure the client’s safety, and only the correct answer addresses this issue.
invite the husband into therapy
If the client’s safety were not an issue, this would probably be the best answer, since systems therapists would focus on the whole system rather than its constituent parts. In other words, they would want to work with the couple rather than just one of the spouses.
explore patterns of abuse in her family of origin
This choice sounds like something an extended family systems (Bowenian) therapist would do. Although Bowen’s work is based on systems theory, so are many other schools of family therapy.
Question ID #227: A psychologist working in the prison system is asked to evaluate a prisoner and make a recommendation about his eligibility for parole. The psychologist should
Select one:
A. refuse to do so since this is outside the scope of a psychologist’s work.
B. do the evaluation and report its results but refuse to make a specific recommendation.
C. make a recommendation as long as it is based on the results of valid standardized tests.
D. make a recommendation but point out any possible limitations of the data on which it is based.
Correct Answer is: D
This answer is most consistent with the requirements of the Ethics Code and the Specialty Guidelines for Forensic Psychologists. For example, Standard 9.06 of the Code requires that psychologists “indicate any significant limitations of their interpretations.”
make a recommendation as long as it is based on the results of valid standardized tests.
Although recommendations should be based on valid assessment techniques, those techniques do not have to be standardized tests.
Question ID #190: Which of the following terms refers to the right to refuse to have information released in a legal proceeding? Select one: A. privileged communication B. confidentiality C. privacy D. juris secretas
Correct Answer is: A
Privileged communication is the legal term which refers to a patient’s right to refuse to have information, disclosed in psychotherapy, released in a legal proceeding.
Question ID #261: Which of the following best describes the ethical requirements of a licensed clinical psychologist who tests positive for HIV?
Select one:
A. inform clients of his/her medical condition “as early as is feasible”
B. obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties
C. refrain from initiating any professional activities that might be adversely affected by the medical condition
D. there is no obligation to take precautions or special actions in this situation
Correct Answer is: C
Being diagnosed with HIV, when considering the ethical obligations of a psychologist, would be considered a health-related personal issue. Personal problems, including emotional, social, health-related and other personal issues, are addressed in Standard 2.06: Psychologists “refrain from initiating an activity when they know or should know there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.” If a psychologist thinks the condition may impair his/her ability to provide effective services or perform work-related duties then the psychologist would “take appropriate measures.”
However, there is no evidence that this is the case, so “obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties” is not the best answer. Informing clients of the condition is not necessary and may not be in the best interests of some of the clients to do so.
