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46 Cards in this Set
- Front
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What does HIPPA do with respect to minors |
Designates parents as personal reps of minor child, does not require therapist to share info, but does not provide protection to adolescent |
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Who should be consulted during ethical conflicts |
Barnett et al., 2007 1. Colleague well versed in ethics/ professional issues 2. Lawyer for legal issues 3. Insurance carrier for risk management |
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In the case or an anorexic client in danger of starving, duty to protect apply? |
APA, 2002 Allow to break confidentiality to protect but do not mandate it |
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Are you liable for failure to report child abuse? |
Small et al., 2002 Yes, civil and criminal immunity if you follow child abuse statute |
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What are 3 requirements prior to warning |
Chenneville, 2000 1. Special relationship (therapist-client) 2. Forseeability of harm 3. Identifiable victim (has been challenged so counselor should know state laws) |
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Does duty to report always trump duty to maintain confidentiality |
APA, 1995 Yes |
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5 general principles of APA ethics |
APA, 2010 Beauchamp & Childress, 2011 1. Beneficence & Nonmalficence 2. Fidelity and responsibility 3. Integrity 4. Justice 5. Respect for people's rights and dignity |
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What is Gottlieb's ethical decision making model |
Gottlieb, 1993 Model examines 3 dimensions - power, duration of relationship, clarity of termination Recognizes that high power, long duration, and unclear terminations are especially dangerous |
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What is Kitchener, 1984 model for ethical decision making |
Rules (codes), ethical principles, and ethical theory guide decision making |
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Should multiple relationships be entered to meet a psychologists own needs? |
No Barnett et al., 2007 |
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What are questions you can ask before entering into a multiple relationship |
Younggren & Gottlieb, 2004 1. Is entering into a relationship in addition to the professional one necessary or should I avoid it? 2. Can the duel relationship harm the client? 3. If harm seems unlikely or avoidable would the additional relationship prove beneficial 4. Is there a risk that the duel relationship could disrupt the therapeutic relationship? 5. Can I evaluate the matter objectively? |
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Accepting the principles prima facie does not relieve psychologists from the burden of decision making in ethical dilemmas (citations) |
Kitchener, 1984 |
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What is the difference between privacy, confidentiality, and privilege |
Privacy: right to decide how much is disclosed and how much personal data is shared with others Confidentiality: general standard that obliges professionals not to discuss info about clients Privilege: legal term describing certain specific types of relationships that enjoy protection in legal proceedings, granted by law and belongs to the client in the relationship |
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What are the 10 ethical standards - APA, 2010 |
1. Resolving ethical issues 2. Competence 3. Human relations 4. Privacy and confidentiality 5. Advertising and other public statements 6. Record keeping and fees 7. Education and training 8. Research and publication 9. Assessment 10. Therapy
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What is the most widely cited ethical decision making model and what does it entail |
Koocher & Keith-Spiegel, 1998 1. Determine whether the situation is an ethical one 2. Consult APA ethical guidelines 3. Consult knowledgeable peers and ethics hotline 4. Explore own possible motivations 5. Evaluate the rights and vulnerabilities of all involved parties 6. Come up with alternatives 7. Consider the outcomes of the alternatives 8. Make a decision 9. Implement the decision 10. Document everything |
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If law and ethics are you in a fight who wins |
Koocher & Keith-Spiegel, 1998 Law |
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Tarasoff vs Board of Regents of the university of California, 1976 led to |
Duty to warn and protect |
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Do therapists need to warn people of someone with HIV is having unprotected sex |
Difficult ethical dilemma (Lamb et al., 1989) A function of assessment of fangerousness and whether there is an identifiable victim. Society is too broad of a victim. As of 1990 no courts applied Tarasoff to HIV (Knapp & VandeCreek, 1990) |
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Child abuse refers to what 5 areas |
APA 1995 Physical abuse Emotional abuse Sexual abuse Physical neglect Emotional neglect |
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Do states grant immunity if you report child abuse |
Small et al., 2002 Yes but only if you follow the state's procedures |
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Are there any arguments for having multiple relationships |
Lazarus, 1994 Argues that overly rigid boundaries fail to really help some clients a d it is possible to help or exploit regardless of boundary issues |
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Internet treatment pros |
Naglieri et al., 2004 Quick, easy, cheap, serves rural areas, convenience |
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6 myths about internet research |
1. Internet samples are not sufficiently diverse 2. Internet samples are unusually maladjusted 3. Internet findings do not generalize across presentation formats 4. Internet participants are not sufficiently motivated 5. The anonymity provided by web questionnaires compromises the integrity of the data 6. Internet findings are not consistent with the findings from traditional methods |
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Internet treatment cons |
Don't know if client or someone else is taking the test Can't judge clients mental state when giving feedback High stakes situations are problematic Testing is possible but not assessment |
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General argue t's in favor of allowing psychologists to prescribe medication |
Bush, 2001 Koocher & Keith-Spiegel, 1998 Psychotropic medications are a helpful intervention for clients Logical extension of practice to address biological factors Fills the gap between psychiatrists and psychologists May be a matter of economic survival in managed care context Majority of psychiatric drug prescribing originates with primary care providers Psychologists practice in areas without psychiatrists Psychologists already have much of knowledge and skills to assess behavioral and cognitive Some other non physician providers already have prescribing privileges Psychologists typically have better training in human psychopathology and therapy at initial licensing than do most psychiatry residents |
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Arguments against prescription privileges |
Lichtenberg et al., 2008 Bush, 2001 Heiby, 2002 Safe and effective use of medication requires expensive training of brain and body Adding rx will dilute the existing scope of psychological practice where psychologists make unique combinations Adding coursework may erode focus on basic psychological science, research methods |
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Are there any empirically supported online treatments |
Yes Ritterband et al., 2003 |
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What are best practices for handling social networking online |
Clinton et al., 2010 Develop tech competence McMinn et al., 2011 Know what personal info of yours is online, set privacy controls, consult with colleaguesWheeler, 2011Avoid dangerous speech colleagues Wheeler, 2011 Avoid dangerous speech |
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What are solutions to the prescribing privileges debate? |
Buelow & Chafetz, 1996 More elaborate ethical practice guidelines: 1. Specially trained psychipharmacologists 2. Assessment as precursor to prescription 3. Drug intervention alone is insufficient for most patients 4. Benefit to risk ratio 5. Avoid polypharmacy 6. Special attention to unique needs of medically ill 7. Avoid medical model where every physician prescribes drugs Heiby et al., 2004 Pause push on legislation to investigate possible impact of laws and training, come to some consensus |
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What are two sides of the multiple role debate |
Borys, 1994 Clear consistent boundaries provide safety and structure, it is curative factor itself Lazarus, 1994 Rigid boundaries will make it difficult for us to help anyone |
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How do clients view therapists who choose not to attend an art showing of a client |
Diyankova, 2008 Individuals who have engaged in therapy previously viewed therapists who did not go ad more cold, less empathic, less caring |
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What 2 duel roles should always be avoided |
Koocher & Keith-Spiegel, 1998 Sexual and business They involve loss of objectivity, potential for exploitation, potential feelings of rejection by client |
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3 ethical challenges for psychology |
Koocher, 2007 Telepsych - contracting, competence, confidentiality, regulation The invisible psychologist - consulting or working outside of the view of those directly affected by work The demise of psychiatry |
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APA, 2002 code of ethics define 3.04 |
Avoiding harm Reasonable steps to avoid harming clients, students, supervisees, research participants, organizational clients, others, to minimize harm where it is foreseeable and unavoidable
Psychologists do not participate in, facilitate, assist, or otherwise engage in torture (severe pain or suffering whether physical or mental is inflicted on any person) |
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APA, 2002 code of ethics define 4.01 |
Maintaining confidentiality Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained though or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship |
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APA, 2002 code of ethics define 4.02 |
Discuss the relevant omits of confidentiality, the foreseeable used if the information gathered though their psychological activities Discussing limits of confidentiality Unless it is not feasible or is contraindicated the discussion of confidentiality occurs at the outset of the relationship and thereafter as new circumstances warrent Inform clients of risks to privacy, limits to confidentiality via electronic transmission |
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APA, 2002 code of ethics define 4.04 |
Minimising intrusions on privacy Psychologists include in written and oral reports and consultations only information germane to the purpose of the communication Psychologists discuss confidential information obtained in their work only for appropriate scientific if professional purposes and only with persons clearly concerned with such matters |
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APA, 2002 code of ethics define 4.05 |
Disclosures May disclose confidential information with appropriate consent of client unless otherwise prohibited by law Disclose information with consent of client only for: provide needed professional services, obtain appropriate professional consultation, protect client, psychologist, or others from harm, obtain payment for services from client |
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APA, 2002 code of ethics define 2.03 |
Maintaining competence Psychologists undertake ongoing efforts to develop and maintain competence |
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APA, 2002 code of ethics define 3.06 |
Conflict of interest Refrain from taking on a professional rile when personal, scientific, professional, legal, financial, or other interests or relationships could be reasonably expected to: Impair objectivity, competence, effectiveness Expose person or organization with whom professional relationship exists to harm or exploitation |
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APA, 2002 code of ethics define 3.05 |
Multiple relationships Multiple relationship = psychologist is in a professional role and in another role with same person, or in a relationship with person closely associated, or promises to enter into a relationship in the future Refrain if it could reasonably be expected to impair objectivity, competence, or effectiveness, or risks harm to other person (other multiple relationships are not unethical) If you find out about a potentially harmful multiple relationship you have to take reasonable steps to resolve it If you are required to be in a multiple relationship clarify role expectations and confidentiality from the start |
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APA, 2002 code of ethics 10.05 |
Sexual intimacies with current therapy client Don't |
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APA, 2002 code of ethics define 10.06 |
Sexual intimacies with relatives or sig. Others of current clients Don't. Don't terminate to avoid this. |
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APA, 2002 code of ethics define 10.07 |
Therapy with former sexual partners Don't. |
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APA, 2002 code of ethics define 10.08 |
Sexual intimacies with former therapy clients Wait 2 years, and even then only in unusual circumstances Have to prove: Amount of time that has passed, nature, duration, intensity of therapy, circumstances of termination, clients personal history, clients current mental status, likelihood of negative impact on client, any statements made during therapy about the possibility of a sexual relationship |
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APA, 2002 code of ethics define 10.10 |
Terminating therapy Terminate when it becomes reasonably clear that client no longer needs service, is not likely to benefit, is being harmed by continuing Psychologists may terminate when threatened or otherwise endangered by client or person client has a relationship with Unless you can't, provide determination counseling and suggest alternative seevice providers as appropriate |
