Chapter 5 Ethical Issues in Clinical Psychology
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Chapter 5 Ethical Issues in Clinical Psychology

Ethical . Issues in Clinical Psychology. APA Code of Ethics guides the behavior of clinical psychologists. Relevant issues include. Confidentiality. Informed consent. Multiple relationships. Competence.

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Chapter 5 Ethical Issues in Clinical Psychology




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Presentation on theme: "Chapter 5 Ethical Issues in Clinical Psychology"— Presentation transcript:

Slide1

Chapter 5

Ethical Issues in Clinical Psychology

Slide2

Ethical Issues in Clinical Psychology

APA Code of Ethics guides the behavior of clinical psychologists

Relevant issues include

Confidentiality

Informed consent

Multiple relationships

Competence

Others

Slide3

APA Code of Ethics

First published in 1953

Revised 9 times

Most recent edition was published in

2002

Two amendments in 2012

Slide4

APA Code of Ethics:

Aspirational

and Enforceable

Aspirational

General Principles

section describes an ideal level of ethical functioning, or what to strive for

Enforceable

Ethical Standards

section includes rules of conduct that can mandate minimal levels of behavior and can be specifically violated

Slide5

APA Ethical Principles

Beneficence and

Nonmaleficence

Fidelity and Responsibility

Integrity

Justice

Respect for People’s Rights and Dignity

Slide6

Categories of Ethical Standards

Resolving Ethical Issues

Competence

Human Relations

Privacy and Confidentiality

Advertising and Other Public Statements

Record Keeping and Fees

Education and Training

Research and Publication

Assessment

Therapy

Slide7

Ethical Decision Making

8-step model

Prior to any ethical dilemma arising, make a commitment to doing what is ethically appropriate.

Become familiar with the APA ethical code.

Consult any law or professional guidelines relevant to the situation at hand.

Try to understand the perspectives of various parties affected by the actions you may take. Consult with colleagues (always protecting confidentiality) for additional input and discussion.

Slide8

Ethical Decision Making (cont.)

8 step model (cont.)

Generate and evaluate your alternatives.

Select and implement the course of action that seems most ethically appropriate.

Monitor and evaluate the effectiveness of your course of action.

Modify and continue to evaluate the ethical plan as necessary.

Slide9

Psychologists’ Ethical Beliefs

Some behaviors are viewed as absolutely unethical (e.g., sex with clients)

Some behaviors are views as absolutely ethical (e.g., addressing clients by first name)

Many behaviors fall in “gray area” in between

Lots of difficult judgment calls

Slide10

Confidentiality

In general, psychologists are ethically obligated to maintain confidentiality

Some situations can arise in which breaking confidentiality is appropriate

Slide11

Confidentiality:

Tarasoff

and the Duty to Warn

Tarasoff

is a court case regarding a

college student

client who told his therapist he was going to kill his girlfriend (Tatiana

Tarasoff

)

Therapist contacted campus police who detained him, but after he was released, he killed her

Slide12

Confidentiality:

Tarasoff

and the Duty to Warn (cont.)

Her family sued and

won

Tarasoff

v. The Regents of the University of California

The

finding was that the therapist had the “duty to warn” the potential victim

This finding now sets a precedent for all therapists for breaking confidentiality

Slide13

Confidentiality:

Tarasoff

and the Duty to Warn (cont.)

How credible are clients’ threats?

What kinds of threats merit warnings?

How should the unsafe behavior of clients with HIV/AIDS be understood in terms of threat?

Slide14

Confidentiality:

When the

Client

is a Child

Often, children will confide more if they can be assured that psychologists will not repeat everything

to their

parents

Parents, of course, have a right to be informed

Psychologists often make arrangements by discussing this with families up front

Some issues, such as child abuse, require breaking of confidentiality to protect the child

Slide15

Informed Consent

Required for research, assessment, therapy, and other professional activities

For therapy, informed consent is an ongoing process rather than a one-time event

As psychologist learns more about client, more information can be shared

Slide16

Informed Consent (cont.)

Informed consent for therapy must allow client the opportunity to ask questions and receive answers

Informed consent process can be an early part of a strong therapeutic relationship

Slide17

Boundaries and Multiple Relationships

Knowing someone professionally and in some other way

Romantic/sexual, friendship, business, etc.

Unethical when:

Psychologist’s

objectivity, competence, or judgment can be impaired

Exploitation or harm could result

Boundary crossings (minor, often harmless) can lead to boundary violations (major, often harmful)

Slide18

Competence

Sufficiently capable, skilled, experienced, and expert to complete the professional tasks they undertake

Boundaries of competence

Psychologists should know their limits and seek additional training or supervision when necessary

Slide19

Competence (cont.)

Continuing education can maintain

competence

Importance of cultural competence

Burnout can impair competence

Burnout can be minimized by efforts by the psychologist to keep job varied, keep life balanced, keep expectations reasonable, and keep self healthy

Slide20

Ethics in Clinical Assessment

Test selection

Consider competence, culture, test’s reliability and validity

Test security

Don’t allow test materials to enter public domain

Test data

Raw data collected during assessment

Should generally be shared at client’s request

Slide21

Ethics in Clinical Research

Psychotherapy efficacy research

What should control group receive?

No treatment (“Wait-list” control)

Placebo treatment

Alternate treatment

What ethical issues arise when any of these three options are used?

Slide22

Contemporary Ethical Issues: Managed Care

Managed care companies’ emphasis on financial bottom line can cause ethical conflicts

Perhaps include info about managed care in the informed consent process

Diagnostic decisions can be influenced by managed care companies’ requirements

Slide23

Contemporary Ethical Issues: Technology

“Psychological tests” on Internet

Many have questionable reliability and validity

Other issues include

Identity of client

Testing conditions

Inability to observe behavior during testing

Similar concerns about online therapy

Slide24

Contemporary Ethical Issues:

Small

Communities

Small communities can be rural areas or defined by ethnicity, religion, or other variables

Multiple relationships can be unavoidable

Discuss up front with clients

Clarify boundaries

Avoid impaired judgment and exploitation