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59 Cards in this Set

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what does it mean for the Ethics Committee to act "sua sponte"?
on its own, without a complaint - done <1yr after discovery of felony conviction, malpractice, expulsion/suspension from state assoc. for unethical conduct, or de-licensure by state board.
In adjudicating ethics complaints, what options does committee have?
1. dismiss charges
2. sanctions less than formal charges, a)reprimand -no harm to others, or b)censure - harm but not substantial. Sanctions lead to issuing directives (5).
3. formal charges - recommendation to drop from membership. substantial harm.
4. stipulated resignation - offer chance to resign from membership
Which aspects of ethics code are aspirational, not enforceable?
1. Preamble
2. General Principles
Main point of Beneficence and Nonmaleficence principle.
-do no harm
-avoid misuse of influence
-awareness of own physical/mental health
Main point of Fidelity and Responsibility principle.
-relationships of trust
-aware prof/scien respon. to society/communities
-uphold prof standards of conduct
Main point of Integrity principle.
-accuracy, honesty, truthfulness
Main point of Justice principle.
-entitlement of all persons access/benefits of psyc services
-aware of biases, boundaries of competence and limitations of expertise so not condone unjust practices
Main point of Respect for People's Rights and Dignity principle.
-respect dignity & worth of all people, rights, confidentiality, autonomy
-aware of & respect cultural, ind, role differences
What is the primary purpose of the Ethics Code Principles & Standards?
protect welfare of clients and px (even though there are standards to protect non-clients, profession, society)
When does psychologist's personal misconduct constitue an ethical violation?
1. engaging in act w/serious consequences (rape, murder etc.)
2. conduct becomes highly publicized, esp. if professional identity is highlighted
exceptions to informal resolution of ethical violations
-attempts unsuccessful
-violations cause substantial harm or would not be resolved by way of discussion
-must not violte client confidentiality
requirements to switch fields w/i psychology or use new tx method?
switch fields: re-training, doctoral program
new tx: supervision except under emergency situations then treat so services not denied
In what situations can psychologists can refuse tx they are competent in?
1. not discriminating
2. give approp. referral
3. not emergency sit.
personal problems, what do and when?
suspect: consultation
know: refer px or temp suspension of tx
client-therapist differences, what do and when?
consultation approp. unless differences so great will prevent adequate tx, then refer (i.e. biases)
use of interpreters in tx, considerations
-ethical if steps are taken to avoid multiple relationship between interpreter and client (no std. addresses confidentiality but good to discuss importance of)
third party requests for services, considerations
1. clarify nature of rel with all parties
2. outline limits of confidentiality and obtain consent
3. take reasonable steps to minimize harmful effects of practices of third party
informed consent for those legally incapable of giving it
1. provide explanation
2. seek assent (not necc obtain)
3. document written or oral assesnt/consent
3. consider their wishes and interests
4. obtain substitute consent if permitted/required by law
court ordered consent?
inform individual nature of services and limits of confidentiality before proceeding
all px info is protected as confidential except when?
1. patient has waived right
2. identifying info disguised
3. breach req or permitted by law
What should supervisor be told if they referred px to EAP?
1. appt. attendence
2. necessity of tx
3. if px accepted/rejected tx
4. exceptions to confidentity spelled out in polity stmt
what should you do if doing a court-appointed eval and client refuses permission/disclosure accord. to limits of confidentiality?
psychologist should not proceed and inform court she cannot fulfill evaluation mandate
Important considerations for HIPAA
-only applies to covered entities: those who transmit health info electronically (internet)
-stds address use of protected health info (PHI), does not include therapy notes kept separate
privilege vs. confidentiality
privilege is legal right not have info disclosed in legal proceeding, confidentiality is ethical obligation
court-appointed psychotherapist, who has privilege?
-NO privilege
-px cannot refuse to have info released in court, but px can refuse evaluation when informed of limitations of confidentiality
How should you handle a subpoena situation w/privilege?
1. legally valid?
2. if valid, discuss w/client
3. give info if client consents, if not negotiate w/requestor
4. if pursued by requestor, seek guidance from court or have attorney file motion to protect
5. if court finds privilege doesn't apply, must comply w/court unless px appeals
According to APA, disclosure permitted for HIV/AIDS positive px when?
1. identifiable 3rd party
2. 3rd party unaware of their risk
3. client refused or not reliable to inform 3rd party
testimonials and in-person solicitation, when ok/not ok?
1. not ok to solicit from cx, px or ind vulnerable to influence - past or current.
2. unsolicited ok, not vulnerable non-px ok
3. invited or direct mail solicitation ok, or unsolicited to third-parties ok
Psychologists may only barter when..
1. not clinically contraindicated
2. arrangement is not exploitative - equitable exchange
When ok/not ok to withhold records?
if needed for px emergency tx, not ok to withhold because of no payment. If not emergency than withholding is not prohibited
standards regarding disposal of records
1. no ethical standard per se beyond "legal obligations and client welfare"
2. legal obligations vary by state but IRS requires business/financial records kept 7 years (no indication of client tx records)
informed consent not required for research in which situations?
1. no distress/harm
2. permitted by law/regs
a. normal educational practices
b. anonymous, naturalistic, archival responses
c. study job factors no risk to employability and confidentiality protected
3.
deception in research permissible when?
1. value outweighs cost of deception
2. no other way to accomplish research goal
3. timely debriefing
when should particiants never be deceived?
"about research reasonable expected to cause physical pain or severe emotional distress" i.e. Miligram's experiment in 1960s
exceptions to informed consent for assessments
1. mandated by law or govt regs
2. is implied as part of routine activity (ie. job)
3. purpose is to evaluate decisional capacity
T/F: insanity is a legal as well as psychological term
False. Insanity is only a legal term referring to a defendant's ability to distinguish right from wrong at time crime was committed. Is NOT a psychological term.
difference between fact and expert witness
Fact witness testifys only with regard to facts relevant to case, expert can testify about facts as well as offer an opinion or conclusion
discuss difference between legal vs. ethical rules about stmts made by client during court-ordered evaluation
no statement is privileged (by legal stds) but ethical guidelines prohibit use of info obtained that does not become a matter of public record
informed consent in condition of probation vs. court-ordered evals or tx
MUST be obtained in condition of probation cases, not necc in court-ordered cases. Limits of confidentiality must be explained
if court ordered to do eval, part of eval becomes public record, you write a book including info not mentioned in court and no consent was given by client...is this ethical? legal?
UNETHICAL, but LEGAL. No privilege in court-ordered evals
sexual intimacy with former clients, when okay and under what circumstances?
at least two years since termination and only under unusual circumstances.
Psychologists who get involved w/clients following 2-years bear the burden of demonstrating what?
1. no exploitation in light of: time passed, nature/intensity of tx, circumstances of termination, px history, px current mental status, likelihood of adverse impact, stmts suggesting/inviting post term contact during tx
waht is vicarious liability or respondeat superior?
situation in which a person is responsible for the acts/omissions of another under the person's control (ie. supervisor)
characteristics of psychologists who become involved sexually with clients
1. male
2. 40-50 y.o.
3. unstable marriage
4. professionally "burned out"
5. depression, sleep probs, &/or substance abuse
6. older than clients by about 10 yrs.
What is most frequent cause of complaints filed with APA ethics committee?
sexual misconduct, 33% of complaints filed, also most frequent and costly of malpractice claims
purpose of General Guidelines for Providers of Psychological Services
1. means of self-regulation to protect public interest
2. quality assurance and performance
purpose of the Specialty Guidelines for the Delivery of Services
1. educate public and profession as to policies relation to 4 applied fields
2. facilitate development of profession
3. 4 areas: clinical, counseling, school, I/O
4. only slightly more specific than general guidelines (applied to 4 areas)
purpose of Standards for Educational and Psychological Testing
1. criteria for eval whether tests are properly used
2. primary (all), secondary (desirable) and conditional (depends of 1' or 2')
purpose of Guidelines for Providers of Psyc Services to Ethnlic, Linguistic & Culturally Diverse Pops
1. aspirational in nature
2. provide suggestions to psychologists working with ethnic, linguistic, and culturally diverse pops
primary goal of state licensure/certification laws?
protect public welfare
goal of EPPP licensing exam?
measure of knowledge relevant to practice and professional ethics
primary validity of EPPP
content validity, ex. item review
Selling questions on licensing exam, ethical? legal?
both illegal and unethical
In the event of malpractice or liability issues, what is the best defense?
maintenance of adequate records
Name the three legal elements must be present before malpractice suit can succeed:
1. professional rel w/client
2. negligence
3. harm occurred as result of #2
Common causes of malpractice claims in order of occurence.
1. sexual and dual relationships
2. competence
3. confidentiality
4. financial arrangemetns
steps you should take when HMO refuses to authorize additional services
1. address possiblity at outset & options
2. appeal decision - std of care
3. make plans to address, ex. reduced cost, frequency, or referral to community-based clinic
Name 4 types of Managed Care Organizations:
1. HMO-closed group systems
2. PPO-open networks, cost contained, external reviews
3. IPA-practitioners contract w/HMOs
4. EAP-workplace rel, not ongoing review like PPOs
Managed Care utilization review vs. quality assurance
utilization review is concerned w/cost containment while quality assurance is concerned with delivery of health care resources through prof stds.