Section 5 Flashcards
What are the CAP Regulations on entering sexual relationships with clients?
(S5: C)
- Prohibited from entering sexual relationships with existing clients
- Prohibited for after 24 months after services
- Prohibition extends to as long as the psychologist has “power over” the persom
True or False: Complaints related to CAP’s Standards of Practice that address “sufficient professional knowledge” have increased in recent years.
(S5: E)
True
Partially because psychology have become more complex and intertwined with the legal process
Goals of CAP - 2
S5: F
- To protect the public
- Enhance the practice of psychology in a remedial manner, wherever possible
They do this by ensuring that complaints are handled according to the principles of justice, transparency, objectivity, independence and fairness
Which act requires CAP to act to protect the public?
S5: F
HPA - Health Professions Act
True of False: The college resolves the vast majority of formal complaints without proceeding to a formal
hearing
(S5: F)
True
What are consent agreements?
S5: F
A remedial measure to a complaint that involves ethics/practice reviews, apologies, reimbursement of fees, etc)
This option may offer advantages to both parties in terms of timelines and outcomes
True or False: A formal hearing will take place if the complainant and the psychologists cannot agree to a negotiation resolution
(S5: F)
True - both complainant and psychologist MUST agree to a negotiated resolution, otherwise it will proceed to formal hearing
THIS IS UNCOMMON
The CAP Council will appoint regulated members to serve on which two panels in order for a hearing to take place?
(S5: F)
- The Hearing Tribunal - conducts hearings regarding alleged unprofessional conduct made against psychologist
- Complaint Review Committee - reviews the Complaint’s Directors dismissal of complaint
Both consist of two CAP members, and one AHS appointed member of the public
Psychologists who work with in which kinds of areas are most at risk of having a complaint filed against them?
Which kinds of clients are most likely to file complaints?
(S5: G)
High-risk areas:
- custody evaluation
- contested divorce
- supervision
- third-party evaluations
High-risk clients:
- suicidal
- violent
- involved in unrelated lawsuits
- history of abuse (specifically recovered memory of abuse)
Psychologists who do _____evaluations are most likely to experience complaint, even though only _ % are formally found at fault
(S5: G)
custody evaluations, 1%
What are some of the impacts a complaint can have on a psychologist’s practice?
(S5: G)
- loss of insurance
- loss of hospital privileges
- increased premiums
- loss of membership in professional associations
- decreased referrals
- financial loss
What are two reasons that clients are becoming conscious around filing board complaints?
(S5: G)
- Clients are more well-informed about their rights and the responsibility of psychologists
- Increased access to consumer information
- - can help clients to be more sophisticated clients OR may increase risk of misunderstanding terminology, etc
Which types of clients are most vulnerable to misunderstanding psychologists interventions, as well as the intent/applications of ethical codes?
WHY?
(S5: G)
Clients with history of:
- abuse
- deprivation
- neglect
BECAUSE: these clients may be more at risk of experiencing these feelings within the context of transference, regardless of how ethical clients can be
What are two ways that a complaint might impact a psychologists ability to do her job as a therapist?
(S5: G)
- May compromise objectivity
- May compromise effectiveness in clinical work
(professional impairment)
True or False: Due to the stress of a complaint, a psychologist may undermine their defense by prematurely agreeing to a resolution or admitting to violations they did not commit
(S5: G)
True
What are some of the sources of stress a psychologist may endure during a complaint process?
(S5: G)
- Length of time between notification and resolution
- length of time may depend on factors that do not concern the individual e.g. staff resources
- Time and money required to deal with complaint
- board meetings, providing records, lawyer fees, lost income - Finding appropriate personal and professional support
- not allowed to discuss case with anyone (can be very straining) - Rumors –> increasing self-consciousness
- especially problematic for psychologists in small communities - Steps of disciplinary action can cause stress
- meetings with board members, increase possibility of public attention, grief over anticipated loss of status
What are some of the emotional, psychological and behavioral responses psychologists may have to board complaints?
(S5: G)
- Denial/overconfidence
- May minimize seriousness of situation, may lead to impulsive responding, procrastination, and avoidance - Anxiety
- May be more likely to panic and attempt an informal solution with client (SABOTAGES case!) - Depression
- very common, 45% of psychologists facing complaint
- may be overly confessional, exaggerated sense of guilt
- may also compromise ability to deal with complaint demands e.g. returning phone calls, missing deadlines, etc
True or False: Complaints filed by clients with serious mental health illnesses are likely to be dismissed.
(S5: G)
True, BUT dismissal is not automatic because these clients are at least as vulnerable to mistreatment as other clients
What type of impacts might a complaint have on a psychologists clinical judgement?
(S5: G)
- increased number of mistakes
- increased anxiety with similar clients to the complainant
- general mistrust of clients
- decreased self confidence and sense of vulnerability
- kind clients may become subjects of countertransference
In what complaint situations are psychologists at greatest risk for clinical impairment
(S5: G)
When they continue to work with clients who case is the subject of an ethical complaint –> ethical landmine
What are some coping strategies to dealing with a complaint?
S5: G
- Select a qualified lawyer ( familiar with psychology regulations)
- Notify malpractice insurance
- Notifiy health insurance providers
- Seek personal support
- Use professional resources e.g. consultations, supervision, ethics consultations
- View complaint as opportunity for self reflection and improvement
What is the objective of the gatekeeping role that clinical training faculty take on ?
(S5: I)
To protect consumers by identifying and intervening with graduate students who exhibit problematic behaviour
What are the ethical obligations of clinical faculty?
S5: I
a) consider possibility that student’s personal issues may lead to harm of others
b) make sure students aren’t harming others under their watch
c) consider possibility that students may misuse their influence
d) evaluate student’s performance for competence and ethical practice
e) Articulate clear ethical standards
f) Evaluate students on clear, relevant requirements
Most common reasons for dismissal from academics:
Most common psychological reasons for dismissal
(S5: I)
- poor academic performance
- poor clinical performance
- poor interpersonal skills
- unethical behavior
Psych:
- emotional instability
- personality disorders
- psychopathology
- unprofessional demeanor
True or False: Administrations are usually supportive of faculty decisions to dismiss students for nonacademic reasons
(S5: I)
False; gatekeeping functions continue to present many challenges to faculty in counselling programs
What are the three main characteristic of the Canadian Legal System?
S5: A
p 235-236
Truscott & Crook
- Adversarial (pits one party against another;one wins one looses; only reaches this stages if case goes to trial because lawyers were not able to help resolve dispute via agreements)
- Visible (courtrooms are open to public except in certain circumstances e.g. childhood sexual abuse)
- Remedial (Tries to maintain social order by providing a remedy to correct a wrong or to settle a conflict; often through a sentence
What is the difference between criminal and civil law
S5: A
p 236-237
Truscott & Crook
- Criminal Law
- deals with offenses listed in the Criminal Code of Canada
- guilty verdict will lead to: monetary fine or loss of liberty
- criminal acts = offense against society SO prosecution is conducted by Crown
- Crown’s role to prove guilt beyond reasonable doubt (innocent until proven guilty) - Civil Law
- involves regulating relationships and helping to resolve disputes between parties
- based on common law (law made by court decisions)
- complaining party: PLAINTIFF
- responding party: DEFENDANT
- plaintiffs burden to demonstrate valid basis for complaint (otherwise court will not hear case) - Civil Law
What legal document protects Canadian rights?
S5: A
p 236
Truscott & Crook
The Charter of Rights and Freedoms - includes
- right to life, liberty and security
- right to not be unreasonable search and seizure
- right to not be detained or arbitrarily imprisonsed
- right to be informed for reason of arrest
- right to have legal counsel
Describe the Youth Criminal Justice Act
S5:A
p 237
Truscott & Crook
- Applies to people aged 11 - 18
- purpose: to treat you and adults differently: to provide more alternative measures of justice than just custody
- has extra provisions that deal with confidentiaity
Most laws that affect the practice of psychologists are criminal or civil laws??
S5:A
p 237
Truscott & Crook
Civil Laws
True or False: In civil cases, most plaintiffs are successful in demonstrating a valid basis for their complaint against a psychologist
S5:A
p 237
Truscott & Crook
False: most plaintiffs fail to demonstrate a valid basis for their complaint against a psychologist; as such most complaints are settled without going to court
What is the most common harm that psychologists are likely to be accused of in a court of law?
S5:A
p 238
Truscott & Crook
Negligence
Define: Negligence
S5:A
p 238
Truscott & Crook
When a professional FAILS TO MEET STANDARDS OF CARE and INJURY OCCURED. Valid negligence claims has five components:
DFCDP
Dead Fish Can’t Drink Pee
Duty Failure Causation Damage Plaintiff
- Duty of Care owed to plaintiff
- Failure to provide Reasonable Care
- Degree of Causation between defendants conduct and injury
- Damage to plaintiff
- Plaintiff’s Conduct cannot have been such that it would preclude recovery
Define: Duty of Care
(part of negligence charge)
S5:A
p 238
Truscott & Crook
psychologists have a duty to care for clients due to their professional relationship with client
Define: Reasonable Care
(part of negligence charge)
S5:A
p 238
Truscott & Crook
decided by Crits v Sylvester
- practitioners are required to exercise degree of care and skills which could reasonably be expected of a normal, prudent practitioner of same level
Define: Causation (2 types)
(part of negligence charge)
S5:A
p 239
Truscott & Crook
- most difficult issues to resolve in malpractice cases
Factual causation: without the psychologist’s negligence, the plaintiff would be uninjured
Proximate causation: (general expectations that psychologist should not be responsible for damage that has nothing to do with out conduct); client must establish PROXIMITY between cause (psychologist’s actions) and damage (whatever their problem is)
Define Plaintiff’s conduct
(part of negligence charge)
S5:A
p 240
Truscott & Crook
What role did the client have in the psychologist’s negligent action??
e.g. harm may have occurred because the client lied about important information
True or False: the relative inexperience of a psychologists is not a defense against negligence, specifically the ability to provide reasonable care
S5:A
p 239
Truscott & Crook
True - psychologist must meet the same standard of reasonable of care with 2 months or 2 decades experience
Summarize Stewart v. Noone
S5
Truscott & Crook
Mr Stewart was hospitalized for a suicide attempt. The next day, he said he was OK and the psychiatrists risk assessment was in agreement. He was released. Later that day, he jumped off a parking garage and then sued the hospital for premature release. The court agreed that the doctors did all they could. This demonstrates the legal standard of reasonable care over perfection.
From a legal standpoint, explain why it is a duty of psychologists to provide accurate assessment of their clients condition
Truscott & Crook
S5
Undiagnosed/misdiagnosed conditions can lead to long term harm which the psychologist may be held liable for
Describe “sufficient professional knowledge”
S5
p.251
Cap Documents
Giving your professional psychological opinion, which may impact other people, without having enough information to have a well formed opinion.
E.g. Psychologists who is treating mother and child is asked for opinion on father who they have never seen before
E.g. Colleague A tells another colleague B that a client is suicidal; colleague B reports suicidal behavior without ever seeing client
What principles are used when considering complaints at CAP?
S5
p.253
Cap Documents
- natural justice
- transparency
- objectivity
- independence
- fairness
What is CAP’s mandate?
S5
p.253
Cap Documents
Protecting the public interest and enhancing the practice of psychology in a remedial manner whenever possible
CAP Complaint Process
S5
p.253-254
Cap Documents
Most complaints are resolved without going to a hearing
-But the psychologist and complainant must agree on a resolution, which is difficult
Risk assessment: 3 questions to consider
S5
p.273
Handout
- Is there a clear risk to an identifiable person or group of persons?
- Is there a risk of serious bodily harm or death?
- Is the danger imminent? (could mean within months)
During risk assessments: Questions to ask
p.273
S5
Handout
- History of violence
- client’s relationship to threatened person
- Clients opportunity to act on the threat (do they have weapons? do they see the victim often?)
- Factors that provoked the threat and whether the triggers are going to continue (e.g. drugs, relationship abuse)
- Client’s response to treatment (current & historical)
Risk management: Record keeping
p.273
S5
Handout
Document the time and date of:
- All efforts/successes to get consent to receive and release information about client
- What information about the client was released and to whom
- Where you obtained information on the client
- Summaries of consultations with others regarding risk and recommendations
- Summaries of supervisions related to case
- Decision making process to reduce risk/solve ethical dilemma
- All actions taken to ensure safety
- Follow up actions
Wigmore Criteria
p.292
Used to determine if confidentially obtained information should be disclosed during a legal proceeding
- Did the communication originate within a confidential relationship?
- Is the element of confidence essential to the full and satisfactory maintenance of the relationship?
- Is the relationship one that the community believes should be actively, carefully and constantly protected and maintained?
- Will the injury done to the relationship by disclosure be of greater consequence than the benefit gained to the legal proceedings by disclosure?
Define battery vs Negligence
(Section 5, Malpractice ppnt. 271)
Battery: Client fails to give consent, but the activity was still done to the client
Negligence: Client gave consent but was not given proper disclosure about nature of activity (e.g risks)
What are some of the common negligence conditions that give a client grounds to sue a client?
What is one way you can avoid this?
- Failure to receive enough info to make an informed decision
- received the wrong diagnosis
- Therapists was not competent to deliver service
*Pair empirically supported techniques with supported techniques
Therapist may have to pay client’s for damages such as:
medical costs loss of wages loss of future wages damages for pain and suffering legal fees
