Module 4 Flashcards
1
Q
What are the 3 basic guidelines for consent in the client/therapist relationship?
A
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Consent is Informed: Clients are educated about
- The nature and expected duration
- Fees and payment policies,
- Any potential involvement of third parties,
- Confidentiality and its limits.
- Consent is Voluntary: Psychologist takes steps to ensure the client’s initial and continuing participation does not involve direct or indirect coercion.
- Consent is Rational: Includes clients’ abilities to appreciate the relevance of the information presented to them and each client can make a sound judgement about participation on this basis
2
Q
What are the different components of the right of privacy?
A
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Between psychologist and client:
- The right to guard against unjust intrusion into one’s private life.
- The right to exercise control over one’s personal information
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Australian Privacy Principles Legislation: APPs are divided into 5 parts:
- Consideration of personal information
- Collection of personal information
- Dealing with personal information
- Integrity of personal information
- Access to, and correction of, personal information
3
Q
What are some context specific examples of times when confidentiality made be superseded?
A
- Where the provision of psychological services requires information to be shared among colleagues or family:
- eg gathering history for a neuropsychological competency assessment or giving feedback to next of kin.
- Client revelations of potentially serious harm to self or others, including harm or potential harm to minors.
- Where court orders are served on a psychologist to disclose confidential information to courts or legal bodies.
- When dealing with multiple clients (for example, couples or family therapy).
- Payment may necessitate sharing a client’s personal information with third parties
- e.g. Medicare, health insurers.
4
Q
What are the four different models of confidentiality?
A
- Absolute; Nothing at all is disclosed
- Limited; At discretion of psychologist, what information is disclosed is left murky
- Contractual; A set of rules is negotiated between the client and psychologist
- Discretionary; similar to limited (decided by physician)
5
Q
What elements of the contractual confidentiality are outlined by Dr White?
A
- Need to include the details, purpose, and rationale of the service
-
Examples of issues to discuss
- Purpose/rationale of service
- Duration of service and level of client involvement
- Cost
- Potential risks and benefits
- Whether a report will be written
- Your qualifications
- Limits of confidentiality
- Complaints procedure
6
Q
Under what conditions are psychologists permitted to disclose information?
A
-
Legally obliged if 1+ conditions met:
- With client (or legal guardian’s) consent
- Where there is a legal obligation to do so. eg subpoenas,
- If there is an immediate and specific risk of harm averted only by disclosure.
- Consulting colleagues in supervision where identities are concealed.
-
Factors to consider when permissable but not required
- Circumstances for disclosure
- Level of risk
- Who to inform? eg KIMS, CAT
- How much to disclose?
- Can you de-identify the info?
7
Q
What 5 factors did Teo et al (2012) identify as important in predicting violence?
A
- Five factors resulted in correct identification 70% of the time
- Active symptoms of serious mental illness (particularly command hallucinations)
- Impulsivity
- Lack of insight and/or disconnection from reality
- Lack of empathy or remorse
- Poor response to treatments such as anxiolytics.
- Paranoia was not found to predict violence
8
Q
What three different types of suicidal client are identified by Geldard and Geldard (2005)?
A
- Those who are chronically ill, in chronic pain, seriously disabled, or in extreme poverty; where the common factor is hopelessness
- Those who have suffered severe trauma and may be in a state of chronic depression
- Those who exhibit suicidality as a ‘last resort’ to express their pain.
9
Q
According to Dr White, what are the key components in a suicide risk assessment?
A
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Detection; Psychologists are in a good position to detect suicidality
- 40% deaths by suicide had contact with a psychologist
- Remember a client may not always tell you directly
- Engagement; Quality of therapeutic relationship is key indicator of success of intervention
-
Comprehensive Assessment; Identify level of risk required before any reporting
- Identify both risk and protective factors
- Management; Establish a realistic safety plan
- Re-Assessment of Risk
10
Q
What are some examples of suicide risk factors which need to be examined in an assessment?
A
-
Initial Assessment;
- How specific is the suicide plan?
- Do they have access to means/method?
- Beliefs/certainty regarding suicide
-
Personal Risk Factors;
- Mental Health status (eg hopelessness)
- Recent interpersonal crisis/ financial stress (eg breakup)
- Drug/alcohol use
- Level of social support network
-
Demographic Risk Factors;
- Males 25-44 or 70+
- Phsyically or socially isolated (Rural, minority group)
-
Other Risk Factors
- Family/friend history of suicide
- History of mental illness (or first presentation) or serious physical illness
- History of (sexual) abuse
- Prisoners
11
Q
What do O’Connor et al recommend as appropriate actions once suicide risk levels have been identified?
A
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High Risk OR Medium risk with low assessment confidence or high changeablity
- Face-to-face assessment within 24 hours
-
Medium Risk OR Low risk with current distress
- Face-to-face assessment within 1 week
-
Low Risk with no current problems
- Face-to-face assessment within 1 month, regular review
12
Q
What are common themes in psychologists responses to client suicide?
A
- Rossouw (2011) three themes:
- Shock at hearing news
- Experiencing suicide risk assesment as a burden
- Resultant professional personal crisis
- Ethical practices as a psychologist
- Competence; not all psych’s are capable of working with a suicidal risk client
- Giving out phone numbers; need to maintain work boundaries, ensure client knows to call emergency response units not you
- Formulate an action plan at first ideation and keep updating it
- Ongoing training and mindfullness of own mental health
13
Q
What are the legal requirements regarding confidentiality in Australia?
A
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Legal and ethical requirements
- In Aus, no legal requirement to disclose if client is dangerous (just permitted)
- 64% psych’s thought there was a legal duty
- Up to the Psych’s judgement
-
Alternatives to disclosure
- Intensify treatment or frequency of sessions
- Recommend inpatient facilities to the client (eg hospitalisation)
- Directly attempt to control situation (eg gain possession of the weapon)
14
Q
What is culture? What are the elements of cultural awareness outlined in Corey’s (2007) questionnaire?
A
15
Q
What parts of the code of ethics are important when working with culturally diverse clients?
A
-
Diversity and ethics; Respect Principle
- Justice standard; avoid, understand and assist clients in addressing discrimination
- Ethical guidelines for working with specific subgroups
-
Communication with diverse clients; Propriety Principle
- Use of interpreters; must consider impact of another person in the room - you are responsible
- Collaboration with others
