Law & Ethics

Front 1

What is the most important law in the state and federal government?

Back 1

Constitution

Front 2

What are Case Laws?

Back 2

- court decisions from appeals courts
- ex. common law, Tarasoff v UC Regents
-called a case law b/c it is derived from a case and upholded by the court

Front 3

What are "codes of ethics?"

Back 3

Not law
-written by private assoc
-can be amended w/o consent or approval of an elected rep, judge, or govt employee
-est. acceptable standards of conduct
-can be adopted by state licensing boards

Front 4

Necessity of License

Back 4

In CA, one needs a license in order to provide psychotherapy/counseling services for money

Front 5

B&P Code 2903 - Psychologist Scope of Practice

Back 5

any psychological service to individuals, gps, orgs, or the public, including but not restricted to: diagnosis, prevention, treatment, & amelioration of psychological problems & emotional & mental disorders of individuals and groups

Front 6

What does IRAC stand for?

Back 6

Issue
Rule & exception
Application
Conclusion

Front 7

3 parts of Competence

Back 7

Technical knowledge
Social Skills
Emotional Well being

Front 8

Why must psychologists ensure that they are practicing legally & ethically?

Back 8

to protect the welfare of the client

Front 9

Statutes

Back 9

- written by legislatures (fed & state laws) these reflect the minimum standards that society will tolerate
-sometimes termed "citations" in CA
-ex: Welfare & Institutions Code, Business & Professions Code

Front 10

Regulations

Back 10

- written by agencies under the authority of a legislature
- ex: CA Code of Regulations

Front 11

Ethical Standards

Back 11

-reflect the IDEAL standards set forth by a profession
ex: APA standards

Front 12

Major CA codes affecting Psychologists

Back 12

- considered binding to APA members & disciplinary actions can come from violations
-Business & Professions Code
-Civil Code (marriage; minors)
-Evidence Code (Psy-Patient privilege)
-Welfare & Institutions Code (5150; elder abuse)
-Penal Code (child abuse recording)
-Family Code (parental custody)

Front 13

What is the difference between STANDARDS & GUIDELINES?

Back 13

Standards - mandatory & enforced (APA Ethical Code)

Guidelines - newer; aspirational & edu about specific professional bx or conduct

Front 14

How is the APA Ethical Principles of Psychologists & Code of Conduct organized?

Back 14

1. Intro & Applicability (what's enforceable)
2. Preamble (relevance)
3. General Principles (aspirational; not enforceable)
4. Ethical Standards (mandatory)

Front 15

Principle A: Beneficence & Nonmaleficence

Back 15

Psychs seek to safeguard the welfare & rights of clients, etc
-alert to personal factors that may pose challenges to client's treatment

Front 16

Principle B: Fidelity & Responsibility

Back 16

-Psychs est trust
-are aware of responsibilities
-uphold pro standards of conduct
-clarify their role & refer out/consult

Front 17

Principle C: Integrity

Back 17

In APA Principles of Psychs & Codes of Conduct
-promote accuracy, honesty, truthfulness; don't cheat, steal, defraud, or misrepresent

Front 18

Principle D: Justice

Back 18

-entitle all ppl access to/benefit from quality serves of psychs
-take precautions to avoid biases/crossing boundaries

Front 19

Principle E: Respect for Ppl's Rights & Dignity

Back 19

-respect rights of indis to privacy, confidentiality, & self determination
-respect cultural, indiv, & role differences

Front 20

What do the ethical standards in Ethical Principles of Psychs & Code of Conduct address?

Back 20

1. Resolving ethical issues
2. Competence
3. Human Relations (avoid harm, informed consent, multiple relationships)
4. Privacy & Confidentiality
5. Ads & other Public Statements
6. Record Keeping & Fees
7. Edu & Training
8. Research & Pub
9. Assessment
10. Therapy

Front 21

What are the ethical codes regarding COMPETENCE?

Back 21

2.01 Boundaries of Competence
2.02 Providing services in Emergencies
2.03 Maintaining Competence
2.04 Bases for Scientific & Prof Judgments
2.05 Delegation of work to others
2.06 Personal Problems & Conflicts

Front 22

What are the ethical codes regarding HUMAN RELATIONS?

Back 22

3.01 Unfair Discrimination
3.02 & 3.03 Sexual; Other Harassment
3.04 Avoiding Harm
3.05 Multiple Relationships (avoid, resolve, clarify confidentiality)
3.06 Conflict of Interest
3.07 3rd Party Requests for Services
3.08 Exploitative Relationships
3.09 Cooperation w/other Pros
3.10 Informed Consent
3.11 Psych Services Delivered to/thru Orgs
3.12 Interruption of Psych Services

Front 23

APA Ethics Committee -

Complaint Process

Back 23

Submitted by members & non members, evaluation to determine if it warrants investigation

Front 24

Possible Recommendations/Outcomes of the complaint process done by APA Ethics Committee

Back 24

-Dismissal, censure/reprimand of psych
- Expulsion from APA
- Offer opp to resign w/stipulations
-If expelled, CA & BoP can take away your license

Front 25

CA Board of Psychology (BoP)

Back 25

-is in charge of licensing & regulation of psychologists
-can investigate anonymous ethical complaints & impose sanctions

Front 26

Virtue Ethics

Back 26

-rely on character traits of the provider
-involve ideals to which the profession aspires
-involve the right mixture of motives, knowledge, & character

Front 27

Principle Based Ethics

Back 27

Set of principle-based obligations that hold unless over-ridden by a superior obligation
-supererogatory obligations

Front 28

Kitchener Model of an approach to ethical decision making

Back 28

There are levels of ethical decision-making
1. Intuitive Level (ex. child abuse)
2. Critical Evaluative Level
--ethical rules (APA Ethics Code, standards)
--ethical principles
-----Autonomy, non-malificence, beneficence, fidelity, justice, veracity
--ethical theory
-----Univeralizability (look at lgr impact), Balancing Principle (least amount of harm)

Front 29

Keith- Spiegel & Koocher approach to ethical decision making

Back 29

ID the Problem --> See Ethics Code
Consider sources of what you could do
Find colleague --> See JD to consult
Eval rights/respons of all affected parties
generate alt decisions --> look at consequences of each
make decision --> implement

Front 30

Problem Solving approaches to Ethical Decision Making

Back 30

-consistent, methodical
- consider rights, responsibilities, vulnerabilities
-consider alternative decisions

Ex. Keith-Spiegel & Koocher, Canadian PA

Front 31

Which PRINCIPLES and STANDARDS in the APA Ethics Code address MULTICULTURAL CONCERNS?

Back 31

Principles -
D: Justice
E: Respect for Rights & Dignity
Standards- Competence, Human Relations, Therapy

Front 32

Business & Practice Code 2903 [Psychologist Scope of Practice]

Back 32

-any psychological service offered to individuals, gps, orgs, or public, including diagnosis, prevention, treatment, & amelioration of psych and emotional problems and mental disorders to gps and individuals

Front 33

3 parts to COMPETENCE

Back 33

1. Technical knowledge
2. Social Skills
3. Emotional well-being (emotional competence, prudence)

Front 34

What does IRAC stand for? What is it?

Back 34

-a template used in clinical situations
ISSUE- ex. confidentiality,
RULE & exception - every issue has a rule
APPLICATION - what does this look like?
CONCLUSION - resulting decision

Front 35

Boundaries

Back 35

- rules of the prof relationship btwn a psych-client
-set limits, provide structure, prevent harm to client
-support idea that primary purpose of therapy is to promote the welfare of the client

Front 36

Boundary Crossing

Back 36

-when a prof deviates from a strictly prof role (ex. helpful therapist self-disclosure)
-may or may not also be a boundary violation (ex. having sex w/a patient)

Front 37

Boundary Violation

Back 37

-a boundary crossing that creates a reasonable risk of harming/exploiting a patient
-represent 1/2 of the disciplinary actions of APA Ethics Committee

Front 38

Standard 3.05 Multiple Relationships

Back 38

when a psych is in a prof role w/a person and
1. simultaneously is in another relationship w/the person
2. is simultaneously in a relationship w/a closely assoc/related person
3. promises to enter into another relationship in future w/the person or close relation/relative

Front 39

How does the APA define a concurrent multiple relationship?

Back 39

-when psychs have social/business relationships w/patients at the same time as they have prof relationships

Front 40

How does the APA define a Consecutive Multiple Relationship?

Back 40

-as when psychs have a social/business relationship w/patient either before/after professional relationship

Front 41

Positive Limit Setting

Back 41

responding to a client's request that pushes boundaries, while simultaneously reframing the response in a way that meets a legitimate underlying need (ex. reject a social invitation but recognize client's need to dvlp other social relationships)

Front 42

Standard 10.08a &b Sexual Intimacies w/Former Therapy Clients/Patients

Back 42

a. Psychs can't engage in sexual intimacies w/former clients/patients for at least 2 yrs after end of therapy; after 2 yrs only in highly unusual circumstances

b.if psychs do have sexual relations w/ former patients they must not involve exploitation, and have to show
1. the amount of time since therapy ended
2. nature, duration, & intensity of therapy
3. circumstances of termination
4. client's/patient's personal history/ (5) current mental status
6. likelihood of adverse impact on client/patient
7. any statements/actions by therapist during therapy suggesting/inviting chance of posttermination sex/romantic relationship

Front 43

What was the legal case that established informed consent?

Back 43

Medical : Canterbury v Spence
Psychology - Osheroff v. Chestnut Lodge

Front 44

Tarasoff, Civil Code 43.92, and Ethics Code 4.05 all cover what?

Back 44

duty to protect and disclosure of info in specific cases

Front 45

What are the components of informed consent?

Back 45

Competency of the client
Disclosure of material information
Comprehension of Info
Voluntary consent

Front 46

When is informed consent not necessary?

Back 46

-situations that are life-threatening to the client
-when client is deemed incompetent to consent to treatment
- the client's prerogative
-therapeutic privilege

Front 47

What if an individual is legally incapable of giving informed consent?

Back 47

-provide an appropriate explanation
-seek individual's assent
- consider individual's prefs/ best interests
- obtain approp permission from legally authorized person, if req by law

Front 48

What does informed consent look like in therapy without established techniques & procedures?

Back 48

-an explanation of the dvlping nature of the treatment
-potential risks
-alternative treatments
- voluntary nature of participation

Front 49

What are the 4 reporting options for therapist sexual misconduct?

Back 49

-Administrative action (filing w/ licensing board)
-Criminal Action (filing w/local law enforcement)
-Civil Action (lawsuit to seek compensation)
- Professional Association action (filing w/ prof assoc's ethics committee; doesn't keep therapist from practicing)

Front 50

What are the exceptions to confidentiality that must be included prior to getting a client's informed consent?

Back 50

1. danger to self
2. danger to others
3. child abuse
4. elder abuse
5. dependent adult abuse

Front 51

When can a clinician withhold information from a client regarding their diagnosis?

Back 51

When the potential impact is very severe (ex. you can w/hold diagnosis from someone with paranoid schizophrenia if you know it would be detrimental)

Front 52

Which APA Ethics Code Standards have to do with informed consent?

Back 52

Standard 3.1 - age appropriate language

Standard 10.01b - therapy w/o est'd techniques & procedures

Telemedicine B&P - redo informed consent specifically in regard to each electronic transaction

Front 53

According to Civil Code 43.93, what must you tell any client who reports having been sexually exploited by another therapist?

Back 53

- information regarding document titled "professional therapy never includes sex"

Front 54

What steps do most individuals take when filing a complaint against a therapist who sexually exploited them during therapy?

Back 54

1. Professional (to est. it as unethical)
2. Administrative (to have license revoked)
3. Criminal or civil

Front 55

What is an Ethical Dilemma

Back 55

Kitchener; situations in which there is no "right" decision, only a decision that is thoughtfully made & perhaps "more right" than the alternatives

Front 56

Who proposed the ethical decision making model?

Back 56

Kitchener

Front 57

What did Tarasoff establish?

Back 57

"duty to warn"; informed consent

Front 58

What is the CPA's Problem Solving approach to ethical decision making?

Back 58

1.Who might be impacted by possible solutions?
2. For each effected part, list reason for consideration, why, & the rights & responsibilities involved
3. Which action would you choose & why?
4. What alternatives are there? Why not pick them?
5. If something changed that might influ your decision, what would the change need to be? Why?
6. Any further thoughts/comments?
7. Assume responsibility for consec of action taken

Front 59

What are Kitchener's 5 moral principals that are basis for ethical guidelines

Back 59

1. Autonomy
2. Beneficience
3. Justice
4. Nonmaleficence
5. Fidelity

Front 60

Feminist ethical decision making model

Back 60

1. Recognize problem
2. Define problem
3. Develop solutions
4. Choose a solution
5. Review the process
6. Implement & evaluate decision
7. Continue reflection

Front 61

Kitchener's Model of ethical decision making - what are the steps?

Back 61

1. Intuitive - look at facts & use ordinary moral sense (prereflective)
(critical evaluative level)
2. Look at ethical rules/ codes
3. ID ethical principle it impacts
4. Ethical theory - which consequence is the most in balance?

Front 62

What are the 4 prerequisites for establishing malpractice claims?

Back 62

1. Duty (of care)
2. Deviation (breach of that duty)
3. Damages
4. Direct causation (deviation caused damages)