Week 2: Ethics and Conceptualisation Flashcards
Whats the go with ethics in psych in aus?
APS (Aust Psychological Society), endorsed by AHPRA For registered & provisionally registered psychologists Compiled 1949 (APA) Regular updates, revisions & additions
Whats the go with ethics in counselling in aus?
PACFA (Psychotherapy & Counselling Federation of Aust)
For PACFA psychotherapists or counsellors
Based on APA (2002), BACP Codes (2010)
Psychology: General Ethical Principles
What are they?
A. Respect for the rights & dignity of people & places
B. Propriety
Beneficence: promoting good, removing harm
Non-maleficence: Do not harm
Responsibility to clients, profession & society
C. Integrity
Reflects need for good character
Acknowledges high level of trust intrinsic in professional r’ships
Acknowledges impact of conduct on the reputation of the profession
PACFA: Ethical Standards for Clinical Practice
What are they?
Put clients first Work to high professional standards Build a relationship of trust Respect diversity Respect confidentiality . Respect professional boundaries 7. Work ethically with colleagues … 14. Take responsibility for self-care
From Principles to Practice Standards: both professions
Informed Consent
Informed consent
Explain nature & purpose of procedures
Clarify reasonably foreseeable risks
Explain how info is collected & recorded
Clarify frequency, expected duration, financial details of services
Making clear the circumstances under which services may be terminated
Obtain consent prior to using interventions (ongoing)
If capacity is impaired, consent obtained from people with legal authority to act on client’s behalf
Whats the go with confidentiality?
Standards: Confidentiality
Can disclose confidential info with consent of client
(e.g. to another professional involved in treatment)
Can disclose details in supervision or professional training, providing identifying info is concealed
Limits to confidentiality:
Legal obligation (subpoena, knowledge of criminal activity)
Imminent risk of harm to self
Risk of harm to others: must warn intended victim, where possible (Psych)
Must explain limits at the outset of the professional r’ship
“eg (Collection – soundproof room? Talking to client on phone in earshot of others
)
Record-keeping
Make & keep adequate records
Store securely for a minimum of 7 years
Client under 18 yrs: store until client reaches 25 years
Safeguarding of client info in the event of psychologist’s death: professional will
Professional Conduct
Must ensure competence to deliver services
Practice within the limits of expertise
Undertake continued professional development & maintain competence to practice (Psych: this is mandated)
Seek professional supervision as required (Psych: this is mandated)
Ensure emotional, mental & physical state does not impair competent practice
Must continually monitor problems that may impair competence & take steps to address problem
Conflicts of Interest & Professional Boundaries
Refrain from multiple (dual) relationships that impair confidence, effectiveness, objectivity or ability to provide a service
Are harmful/exploitative of clients
If a multiple relationship is unavoidable (eg rural setting), adhere to principles of informed consent
Cannot be friends, obtain professional services or favours from a client
Conflicts of Interest & Professional Boundaries
Do not exploit people with whom they have a professional r’ship, including research assistants, employees, colleagues, supervisees, students
Do not engage in a sexual r’ship with a client, or anyone closely related to a client
No sexual r’ships within 2 years of terminating the professional r’ship (psych)
PACFA: 5 yrs
Do not accept anyone as a client if there has been previous sexual r’ship
Do ethical breaches happen often?
Notifications to Psych Board 2013-2014 (n = 31,717 registered psychs):
1.4% voluntary notifications. Of these:
70% no further action taken; 15% withdrawn
Approx 15% limitations/cautions/restrictions on practice
0.2% fined; 1.2% suspended registration
Mandatory notifications
0.14% of psychs: 0.8% standards of practice; 0.05% impairment; 0.006% sexual misconduct (2)
Voluntary notifcations – from clients/families of clients. 6/14 highest. Medical 4.9%, dentists 4%, chiropractors 2%. Board does not report reasons
To manage ethical issues requires:
Willingness to discuss with colleagues/supervisor
Acknowledge & take responsibility for mistakes
Familiarity with ethical codes, capacity to interpret & analyse codes (ignorance is not a defence)
Be able to communicate ethical guidelines clearly with clients
Awareness of own competencies, limitations
Putting clients welfare & needs before own
Conceptualisation(also called ‘formulation’)
A psychological explanation of the client’s problems, that is used to guide treatment
What caused the problem, and what maintains the problem? (i.e why don’t they just get better on their own?)
A core psychotherapy skill
Dynamic: always a working hypothesis, may change with new info
Use the 4 ‘P’s model…Predisposing, Precipitating, Perpetuating & Protective factors
Predisposing Factors
Based on past events or underlying vulnerabilities…where the seeds were sown
Childhood trauma
Modelling or learning
Biological, temperamental & genetic influences
Sociocultural influences
Maladaptive schemas or beliefs (e.g. low self-worth)
Personality traits, etc
“I’ve always been a worrier. My Mum was too”
Precipitating Factors
What has triggered the problem? Why has the problem developed/worsened now? Why has the client has sought counselling now?
Loss (job, relationship)
Crisis or emergency
Stressors
Transition
Symptoms increase to intolerable level
Any event/circumstance that has triggered/interacted with a predisposing factor
