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25 Cards in this Set
- Front
- Back
- 3rd side (hint)
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When conducting a custody evaluation, a psychologist should:
advocate for the party that retained him advocate for the party that retained him, unless retained by the court, in which case, he should remain impartial remain impartial regardless of whether he is retained by the court or either party in the proceedings acknowledge the fallacy of impartiality in an adversarial legal system |
remain impartial regardless of whether he is retained by the court or either party in the proceedings
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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).
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A psychologist receives a request for information about treatment for a patient from the patient's insurance carrier. The request for a treatment report includes the appropriate signed authorization from the patient. The psychologist should:
not provide the information because this is still an unsettled issue. provide only the dates of service and the diagnosis. refuse the request unless the patient himself or herself asks that it be sent. provide the information requested. |
provide the information requested.
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This ethics question will have some of you stumped unless you deal with these types of clinical situations regularly. In practice, clinicians often get requests for information, especially with insurance companies using managed-care organizations to approve visits. Similar authorizations are necessary when information is released from a hospital, from a clinic, and so forth. The confidentiality of information belongs to the patient. It is up to him or her to waive that confidentiality, as we assume he or she has done by signing the release. In addition, such authorizations should specify the type and extent of information that the patient authorizes to be released, for what purposes, and to whom.
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You have been court-ordered to evaluate a prisoner who is being tried for murder. You explain the purpose of the evaluation and complete it. As you are packing up your testing materials, the prisoner smirks, and says, "I agreed to this but I didn't sign anything. You are out of luck, doctor."
You should go ahead and complete the report, but leave out the prisoner's comments. The prisoner is correct -- you should refer for a new assessment. You should add this verbal comment to the report, noting the prisoner's passive-aggressive tendencies. You should have read the case file because you would have learned that the accused is also an attorney; this would affect how you would treat this prisoner. |
You should go ahead and complete the report, but leave out the prisoner's comments.
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Because this evaluation was court-ordered you were not actually required to obtain informed consent. However Standard IV.E.1 of the Speciality Guidelines for Forensic Psychologists states that "if the client appears unwilling to proceed after receiving a thorough notification of the purposes, methods, and intended uses of the forensic evaluation, the psychologist should take steps to place the client in contact with his or her attorney for the purpose of legal advice on the issue of participation." Remember, you always want to take the most careful and conservative approach if possible. While you may be tempted to choose answer C and add the client's comments to your report, this would contradict Standard V.C. of the Forensic Guidelines which states that, "In situations where the right of the client to confidentiality is limited, the forensic psychologist makes every effort to maintain confidentiality with regard to any information that does not bear directly upon the legal purpose of the evaluation."
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Which of the following client's rights are protected in a court of law?
A second opinion Tarasoff Right of confidentiality Right to receive medication. |
Right of confidentiality
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A client's right to confidentiality is protected by a court of law. The client's right to keep his/her matters confidential is referred to as privilege. The court also determines exceptions to privilege, such as the Tarasoff Statute.
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The friend of a psychologist is the owner of a small publishing firm. The friend offers the psychologist substantial compensation if she would lend her name to endorsements for his publications, and at times advise and consult on book acquisitions and marketing plans. The psychologist:
could accept this as long as APA affiliation is not mentioned in the endorsements. could accept this only if the publications she would be dealing with are in her area of competency. could accept this only if the publications she would be dealing with are in her area of competency, and the endorsements will be based on the psychologist's honest opinion of the publications. should consult the local ethics committee before making her decision. |
could accept this only if the publications she would be dealing with are in her area of competency, and the endorsements will be based on the psychologist's honest opinion of the publications.
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The ethical standards say that psychologists cannot make false, deceptive, fraudulent, or misleading statements. Unless the psychologist's endorsements were based on sound expertise and her honest opinion of the publications in question, these standards would be violated.
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The APA’s position on notification of partners of clients/patients with HIV/AIDS is consistent with its emphasis on:
duty to protect confidentiality informed consent protection from civil or criminal liability |
confidentiality
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B. The American Psychological Association’s position on partner notification is consistent with the emphasis on maintaining client confidentiality. Specifically, it recommends “a legal duty to protect third parties from HIV infection should not be imposed.” In its statement, Legal Liability Related to confidentiality and the Prevention of HIV Transmission, the APA (1991) also addresses the possibility of such legislation passing and recommends disclosure should be permitted only when (1) there is a known identifiable third party at significant risk for infection; (2) the third party is unaware of the risk; (3) the client has been urged to tell the partner and has refused to do so; and (4) the psychologist is protected legally from civil or criminal liability for disclosing.
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To testify as an "expert witness" in a court case, you must
obtain certification as a forensic psychologist. obtain certification in the specific area you are testifying about. be recognized by both sides' attorneys as an expert. have specialized knowledge in the area about which you are testifying. |
have specialized knowledge in the area about which you are testifying.
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There are no special certifications that psychologists must obtain in order to testify as expert witness. Nor do they need to be recognized by both parties in the legal proceeding as an expert -- in fact, in a substantial proportion of cases, the psychologist's expertise is likely to be challenged by one of the parties. From an ethical standpoint, the relevant requirement is that psychologists testifying as experts (like all other psychologists) should not practice outside the scope of their competence. In other words, psychologists representing themselves as experts in a particular area should have specialized knowledge in that area.
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You've completed a psychological assessment on a child whose parents are divorced. They have joint custody. The child's mother doesn't want the father's girlfriend present for the debriefing session although the father does want her there. What do you do? (The mother paid for the testing).
Have only the custodial parents present Have only the mother present Have two sessions, one with the mother, one with the father and his girlfriend Send everyone a copy of the report and only meet if one of the parents needs |
Have only the custodial parents present
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Having just the custodial parents present is probably your best course of action. You don't have the right to breach the child's confidentiality to the girlfriend–that is the father's call. Both parents do have a right to the results unless you can think of a reason that such access would be harmful to the child. Avoiding the situation by just sending a copy of the report isn't in line with the Standard 15.10 of Test Administration, Scoring and Reporting that indicates that those responsible for testing programs should provide appropriate interpretations when test score information is released. Finally, who paid for the testing is not pertinent to who has access to the results.
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Baumrind in 1964 indicated that whose study was unethical?
Bandura's Zimbardo's Milgram's Harlow's |
Milgram's
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Baumrind wrote the article, "Some thoughts on the ethics of research: After reading Milgram's behavioral study of obedience." American Psychologist 19 421-423. Milgram's study would be considered unethical today as would Zimbardo's. It is also doubtful that parents would be keen on having their children watch and imitate aggressive models, and the animal rights people would object to Harry Harlow's techniques.
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Your new patient is a 20-year-old gang member who informs you that he has killed a couple of people in the past and that he will probably kill others in the future. He states that he has no intentions of leaving the gang but wants help dealing with his cocaine addiction. You should:
notify the police of the patient's previous murders notify the police of the patient's danger to others provide the patient with substance abuse treatment refuse to provide treatment for this patient unless he agrees to leave the gang |
provide the patient with substance abuse treatment
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Many states have laws based on Tarasoff that require psychologists to warn or protect a potential victim from serious harm when there is an imminent threat to an identifiable victim. However, this question does not indicate an imminent threat nor an identifiable victim; therefore, confidentiality should be maintained. The Ethics Code similarly permits a breach of confidentiality without client consent in order to protect others from harm, but without an identifiable victim such a breach would not serve to protect others and would be inappropriate. The best option would be to provide the treatment requested (C). Refusing to provide treatment for this patient unless he leaves the gang (D) would be a clinical option, but would probably be ineffective at this stage because he has stated that he has no intentions of leaving the gang. Besides, engaging the patient in treatment for his substance abuse might later lead him to want to leave the gang.
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A psychologist is consulted by the parents of a child who was referred by a pediatrician for evaluation. During the interview with the parents, they report the girl suffered a severe head injury which they haven't told the pediatrician about. Assuming appropriate consents have been obtained, the psychologist:
should have the parents report this to the pediatrician. should report this to the pediatrician. should not report this until the parents tell the pediatrician first. should keep this information to herself. |
should report this to the pediatrician.
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This question looks like one on confidentiality, and, indeed, there are some aspects of confidentiality embedded here. But, more than that, it's about professional relationships. You're told in the item stem that all consents have been obtained, so the confidentiality issue was already addressed. The question then is, "What should the psychologist do?" Since we're all here to help the patient, the most appropriate thing to do is to let the pediatrician know about your findings. You would call (probably call rather than write since calling is quicker) the pediatrician and report your findings. It was the pediatrician who made the referral in the first place, and you have the parents' consent.
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A psychology program requires its students to attend group therapy. This is permissible if:
the therapy is only provided by the program's faculty the students are given the option of obtaining individual therapy in lieu of group therapy the program does not require approval of the therapist's credentials the students are given the option of receiving therapy from therapists not affiliated with the program |
the students are given the option of receiving therapy from therapists not affiliated with the program
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APA's 2002 Ethics Standard 7.05 permits undergraduate and graduate programs to have individual or group therapy as a program or course requirement. However, the students must be allowed "the option of selecting such therapy from practitioners unaffiliated with the program." Contrary to C, programs are not prohibited from approving credentials of the outside therapist.
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A 14-year old is brought to your office. He does not want to be there. His mother notes that they are referred by the school. The only presenting complaint is that his grades are much poorer than last year. Your evaluation indicates no significant other problematic areas in his life. Your best course of action is to:
schedule ongoing treatment with yourself. continue your assessment to ascertain the presence of hidden pathology. explore the possibility of an educational intervention. not do anything. |
explore the possibility of an educational intervention
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This is a practical, and often realistic, problem. You have a 14-year-old who doesn't want to come to you. You have a referral from the school that his grades are going down. You made an assessment that there doesn't appear, now anyway, to be any psychiatric disorder. So, what would you do? There's no need to suggest treatment since he doesn't want to come see you. And, besides, you haven't found any problems. You wouldn't continue an assessment since, from the information given, you already concluded there isn't much psychological conflict present. You could do nothing, telling him to come back to you if things get worse. That's one possibility. Another possibility presented as a choice is to explore some educational intervention, such as talking to his teachers to investigate how his school environment might be optimized. So you could certainly propose intervening with the school. And between suggesting this, and doing nothing, we'd go with exploring a school-based intervention.
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A woman comes to you who has been put on morphine due to her pain. She is an ex-alcoholic in recovery and does not want to become addicted to the morphine. She asks your assistance in lowering the dosage. You should:
Work with her physician to lower the dose–but explain that synthetic morphine isn't addicting Tell her she needs to speak directly to her physician Suggest she give you the extra morphine and you will dispose of it properly Support her choice to not get addicted and work with her physician |
Support her choice to not get addicted and work with her physician
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It is really alright to support your client's idea even if it isn't yours. You would want to get a signed release to speak to the prescribing physician and work with him or her to support your client's choice.
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Dr. Emm believes that one of his patients would benefit from in-patient treatment. The patient's HMO (health maintenance organization) is most likely to approve this type of treatment if:
Dr. Emm will be providing services at the in-patient facility. Dr. Emm is a licensed psychologist. the patient's presenting problem has become chronic. the patient has recently shown a decline in functioning. |
the patient has recently shown a decline in functioning.
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Policies regarding in-patient treatment vary from HMO to HMO. However, most emphasize the patient's level of functioning and consider approval of in-patient treatment when there has been a recent decline in functioning.
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A psychologist tests a child from a home in which the parents were divorced at the request of the noncustodial parent. The custodial parent complains that the psychologist acted without her permission. According to accepted professional standards of practice, the psychologist acted
unethically because she failed to obtain proper consent. ethically but with poor judgment. ethically because the noncustodial parent still retains this right. unethically because she first should have consulted a lawyer. |
unethically because she failed to obtain proper consent.
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In many states, it is illegal to provide assessment or treatment to a child in this situation. Even in states where the non-custodial parent has the right to consent to his or her minor child's psychological treatment, it is not considered ethical to begin treatment (except of course in emergency situations) without the custodial parent's consent. This is because the child's best interests are threatened by such an arrangement.
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When a psychologist believes that her patient's records will be used in a legal proceeding, she should:
rewrite them to meet the higher standards of a forensic setting avoid the use of any psychological terminology in favor of legal terminology maintain them in the same kind and quality as all of her patients' records maintain them in the kind and quality consistent with reasonable scrutiny in an adjudicative forum |
maintain them in the kind and quality consistent with reasonable scrutiny in an adjudicative forum
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According to the Specialty Guidelines for Forensic Psychologists (1991), “When forensic psychologists conduct an evaluation or engage in the treatment of a party to a legal proceeding, with foreknowledge that their professional services will be used in an adjudicative forum, they incur a special responsibility to provide the best documentation possible under the circumstances."
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You have been treating a client for six months, and the original problem the client sought treatment for is in remission. The client tells you that he wants to terminate. You, however, are reluctant to terminate because you believe that the client can benefit from further psychotherapy. In this situation, you should:
terminate in line with the client's wishes, since the client's presenting problem is solved. seek consultation. discuss the client's reasons for wanting to terminate. discuss the reasons why you feel he shouldn't terminate, and, if he still wants to terminate, allow him to do so. |
discuss the reasons why you feel he shouldn't terminate, and, if he still wants to terminate, allow him to do so.
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Even though you might not have too much difficulty handling this situation in real life, this question might have been difficult because none of the choices is clearly "wrong." The best answer is choice D -- it's in the client's best interests that you explain why you feel he should not terminate, but, if he chooses to do so, you must respect his right to self-determination. Choice A does not include your explaining your concerns to the client, so it is not as good. You might have been seduced by choice B, because seeking consultation is never a bad thing to do, but it is not necessary in this common and relatively straightforward situation. Similarly, when clients want to terminate, it's always important to discuss their reasons, as stated by choice C. In this case, however, the client's reasons are pretty clear -- the problem for which he sought therapy is solved.
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In a court-ordered evaluation the evaluator:
must obtain informed consent from the evaluatee must obtain informed consent from the evaluatee's attorney does not need to obtain informed consent but must inform the evaluatee of the intended use of the evaluation does not need to obtain informed consent nor inform the evaluatee of the purpose of the evaluation |
does not need to obtain informed consent but must inform the evaluatee of the intended use of the evaluation
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According to APA's Specialty Guidelines for Forensic Psychologists, "psychologists obtain informed consent unless the service is court ordered." Thus, in a court-ordered evaluation, it is not necessary to obtain informed consent. However, the subject of an evaluation should always be informed of the purpose, methods, and intended use of the evaluation.
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You are having lunch with a colleague, Dr. O. Timer, who has been a clinical psychologist for over 25 years. You and Dr. Timer start talking about the aspects of your work that are most distressful. Like many psychologists, Dr. Timer mentions that, most often, the ethical dilemmas he encounters in his practice are related to:
deciding when it is acceptable to breach client confidentiality. dealing with the sexual advances of his female clients. providing accurate information to insurance companies. knowing when to continue versus terminate therapy with a client who doesn't seem to be improving. |
deciding when it is acceptable to breach client confidentiality.
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Surveys have been conducted to determine what issues psychotherapists have the most difficulty with at work. When asked what ethical/legal issue they encounter most frequently, confidentiality is cited most often.
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A psychologist who is very fearful of getting sued decides for this reason that he will not treat any patients with a diagnosis of Borderline Personality Disorder. The psychologist's actions are:
unethical, assuming that the psychologist is competent to treat such patients. ethical as long as appropriate referrals are provided. ethical regardless of whether appropriate referrals are made. unethical, because it is inappropriate to consider the possibility of getting sued in making any clinical or treatment decision. |
ethical as long as appropriate referrals are provided.
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Psychologists and other health professionals have no legal or ethical obligation to enter into a professional relationship. Though they cannot discriminate on the basis of race, gender, sexual orientation, or any basis proscribed by law, they can refuse to enter into a relationship based on a client's diagnosis -- even if they are competent to treat individuals with that diagnosis and even if their reasons for doing so are not valid. However, if they do refuse to take a case, psychologists are required to make appropriate referrals.
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A graduate assistant is working on a research study originally initiated by the psychologist. However, the graduate assistant has contributed throughout the duration of the study on defining the research hypothesis, data analysis and developing conclusions based on the results. With respect to authorship, the graduate assistant would be:
listed as co-author. listed as first author. credited in a footnote. given no formal credit. |
listed as co-author.
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A. Given the graduate assistant has made a significant contribution to the research study some credit for authorship is due and the graduate assistant would be listed as a co-author. Since the study was the psychologist’s original project, it would be appropriate for the psychologist to be listed as the first author (b.). The graduate assistant’s work extends beyond “Minor or routine professional contributions or extensive nonprofessional assistance (e.g., typing a complicated manuscript, coding data, or helpful ideas offered by a colleague) may be acknowledged in a footnote or in an introductory statement” [See: Keith-Spiegel, P. and Koocher, G. P. (1998). Ethics in psychology: Professional Standards and Cases. New York: Random House] (c.) and deserves some authorship credit (d.).
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A psychologist sends the MMPI to a client through the mail. The client will complete the test at home and return it to the psychologist by mail. This is:
acceptable as long as the client has signed a statement saying she will not breach test security. acceptable as long as the psychologist provides adequate instructions over the phone. acceptable as long as the test is sent by certified mail. unacceptable. |
unacceptable.
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This is pretty clear: As a psychologist, you're responsible for maintaining test security. In addition, you'd want to administer the MMPI under controlled conditions to obtain valid results. If you sent the test to the client, you'd have no control over testing conditions.
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A managed care company asks a psychologist to conduct a study on the relative effectiveness of a 10-week therapy program for depression vs. a 20-week therapy program. The company plans to publish the results of the research if no significant difference is found but will not publish the results if the longer therapy program is more effective. The psychologist should:
agree to conduct the study because it is within the company's rights to publish or not publish their research findings agree to conduct the study if the psychologist is able to approve any article submitted for publication agree to conduct the study only if all research participants are appropriately debriefed at the conclusion of the study refuse to conduct the study |
refuse to conduct the study
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Ethical Standard 5.01 states, "Psychologists do not knowingly make public statements that are false, deceptive, or fraudulent, concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated." Although in this case the psychologist is asked not to publish data, this would still be deceptive. It also is inconsistent with General Principle A of the Ethics Code which states that, "psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons.... Because psychologists' scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence."
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A psychologist is planning to retire in the next few months and has been decreasing her caseload. One of the psychologist's former clients, who had terminated a few months earlier, phones the psychologist and reports having suicidal thoughts. The psychologist should:
inform the client that she is retiring and that she cannot accept any clients refer the client to a colleague immediately meet with the client until the client no longer needs treatment meet with the client until the situation is stabilized and then refer |
meet with the client until the situation is stabilized and then refer
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Although this question is referring to a former client, due to the potential danger for a suicidal client, the most appropriate action would be to meet with the client until the situation is stabilized and then refer
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