1
Q
principles vs. standards
A
principles are ASPIRATIONAL,
standards are ENFORCABLE/MANDATORY
2
Q
consultation
A
- commonly sought out on a one-time or occasional basis
- appropriate when psychologist is somewhat familiar with treating a particular disorder but are not an expert in the area
- appropriate when a psychologist has concerns about whether they can remain objective in treatment
3
Q
supervision
A
- ongoing process with careful scrutiny of a case
- required when learning a new technique, new to working with a specific population, or treating a disorder you have no experience in
4
Q
training
A
- required when psychologist is unfamiliar with a certain area of knowledge
5
Q
referring out
A
appropriate when…
- personal beliefs / issues interfere with therapy
- client feels uncomfortable with the therapist
- therapist lacks competence in treating the presenting problem
6
Q
subpoenas
A
requires a therapist to appear for questioning
7
Q
subpoena duces tecum
A
- requires a therapist to appear with the client records
- if the client gives permission to release information → release the information
- if client does not give permission → contact whoever issued the subpoena, request that it be quashed
- if it is not quashed, go to court and assert patient-therapist privilege and neither testify nor release information (unless ordered to do so by the court)
8
Q
court order
A
- signed by a judge, must comply
9
Q
court-appointed evaluation
A
- the court is the client, client has no confidentiality rights
- If client is not cooperating in a court eval, eval should be postponed and advise defendant to contact attorney
- no need for informed consent from client but they should be told confidentiality limits
*in questions where they just say they’re conducting a psychological evaluation of a defendant and it’s not clear who asked for it. Go with the answer that says “the client” is whatever person/entity retained the psychologist. In court appointment= court. But it can be a law firm, lawyer, entity, party or other person who has retained and has a contractural relationship with the forensic psychologist.
10
Q
court-ordered therapy
A
- the client is the client, client has confidentiality rights
11
Q
child custody evaluation
A
- when the courts intervene in a divorce and order a child custody evaluation to determine the restructuring of rights and responsibilities
- focuses on parenting attributes, the needs of the child, and the resulting fit
- therapists should not be involved in child custody evaluations of former or current clients
- both parents and child are examined
12
Q
bartering
A
permissible as long as it is not clinically contraindicated and not exploitative
13
Q
Case of family that doesn’t speak English what to do?
A
Can’t get kids to be translators
Discuss (if possible - bc don’t speak language)
Refer
If not possible, get professional translated
14
Q
Ask for training practitioner doesn’t have
A
Inform of lack of training
Provide options
If they still want that training - Refer
* can’t operate outside of competence
If referral is not possible - must make reasonable efforts to get training, knowledge and consultation (so long as they have closely related training/experience)
15
Q
Deceiving participants in research (when is it OK vs NOT ok?)
A
Psychologists are NOT to deceive if there is reasonable/expected cause for physical pain/severe emotional distress.
Psychologists OK to deceive: when there is no risk for pain/distress, no alternative methods available, prospective value is increased if deceived.
16
Q
Withholding fees for nonpayment
A
Withholding fees is always unethical**
17
Q
Debriefing participants
A
Psychs are to debrief immediately after their participation but when it isn’t possible, take steps to reduce risk for harm.
18
Q
ASPPB guidelines for qualifications of supervisors (primary vs delegated)
A
Primary: must be licensed psych and is responsible for most of interns supervision
Delegated: may be licensed psych or other mental health practitioner
19
Q
Insanity defence
A
Rare in felony cases (raised in less than 1%) & usually unsuccessful (~25% of the time)
20
Q
Tarasoff decision and duty to warn changes
A
Nowadays, many agree that tarasoff isn’t relevant in situations because:
1) it doesn’t apply to past behaviours
2) applies ONLY when potential victims are identifiable
3) risk for harm doesn’t rise to the level of foreseeable harm (dangerousness) I.e. unsafe sex with HIV involves risk but no certainty that HIV will be transmitted
- always consider provincial laws that address actions pertaining to HIV
21
Q
Minor client says they want to take their own life but then say.. jk.. I lied.. how do you proceed according to ethical standards?
A
Continue to discuss with client feelings about killing self to determine if they’re actually at risk. If risk» report.
22
Q
Minor client says they want to take their own life but then say.. jk.. how do you proceed according to ethical standards?
A
Continue to discuss with client feelings about killing self to determine if they’re actually at risk. If risk» report.
23
Q
Client invite you to a party how do you proceed?
A
Going to party is allowed but before going you:
consider nature of relationships and potential effect on her of your acceptance/refusal of invitation. BEFORE deciding whether or not to accept the invitation.
24
Q
In person solicitation of business
A
Must not engage in uninvited in person solicitation from current /potential clients who are vulnerable to undue influence
25
Test administration for non English speakers
Ethical guidelines don’t state that psychologists must use tests in another language when evaluating children with limited English skills. Because maybe they have a specific test they must use.
So… psychologist can hire an interpreter who has appropriate training and must indicate limitations of test results in report
26
3 developmental levels of IDM model of supervision
Self-other awareness, motivation and autonomy
27
Personal problems
1) refrain from accepting cases where it’s likely a personal problem will impede your effectiveness
2) take appropriate measures if personal problem pops up during: seek consultation to determine whether to limit, suspend or terminate.
28
Multiple relationships
NOT unethical but should be avoided*. OK as long as they don’t cause: harm, exploitation, impairment.
- Small town/someone you know asks for support: consider the potential risks and make decisions accordingly.
- enter into a non professional relationship with client (barter/providing services for you): not OK if you’re their boss
- client starts dating friend: take reasonable steps to resolve with due regard for client best interests and maximal compliance to ethics code
- this is also why you can’t date relatives or friends or clients.
29
Request to amend client records
Can reject request if it means PHI would be less accurate. Even if this happens, we still must document a request was made.
If we do amend, then we must record it as an amendment to the record
30
Assessments
Job asks you to admin an assessment but you don’t have experience and they refuse to pay. You must pay and get consultation/training.
If you don’t have experience assessing a certain thing, you must refer out.
If you use an interpret: get them to sign an informed consent too, discuss with client and include in report the limitations of using an interpreter
MAY BE OK to use obsolete tests and test results in certain circumstances. (When it’s appropriate for the purposes of the current evaluation ie. has norms for a clients racial group but new version doesn’t)
31
Research in schools/with kids
Get informed consent from school admin/teachers + consent from parents + assent from child
With kids: get consent from parents + assent from child. Exception: regulations allow for waiver of child assent when the kid doesn’t have: 1) capacity to consent 2) when research offers benefits to the health of the child that can’t be obtained outside of research study
32
Consent for child
Pick answer with legal guardian vs both parents.
33
Professional psychologist
Preferred title over PhD candidate
34
Court cases: Brown vs board of Ed, Larry vs riles, & Griggs vs duke
Brown: no more segregation in schools
Larry: schools can’t use IQ tests to put AA into special Ed classes
Griggs: no more disparate impact (can’t use intelligence tests as a means of determining promotions)
35
APA taking action against member for law breaking
Misdemeanours don’t count (Misdemeanors are minor offenses or crimes typically punishable by fines, probation, community service, or a short jail term. Examples include petty theft, disorderly conduct, or simple assault.)
Only felonies count*= murder, kidnapping, arson, robbery, and certain types of fraud or white-collar crimes.
36
Fee-splitting
OK but it has to be based on services provided. Can’t take $ for sending clients your way
37
Client admits to crime while under competency assessment
Only write matters in report relating to competency
38
Research contributions
Co-authorship: requires substantial contributions (complete entire literature review etc).
Simply editing or suggesting a different method of analysis is not enough. Thanking in footnote is more appropriate.
Students who complete dissertation are always first author. This doesn’t count for masters. Listing of author should always reflect actual contributions to student research.
CANNOT republish the exact same in another publication, must make changes, give different spin, use different analysis
39
Record keeping
Keep for 7 yrs after last session. Minors: 7 years or 3 years past 18.
Parents have a right to kid school records. And to challenge an ammendemdnt (Ferpa)
If client asks you not to keep a record - 1) explain you are required to do so 2) have to do it for future sessions 3) required by law
40
HIPPA disclosure
Without client authorization for payments, treatment or health care operations. Only progress notes are released with authorization.
HIPPA always trumps state law, unless state law is more strict.
HIPPA also allows for NON disclosure of test materials if it’s likely to endanger/cause harm
41
Legal conflicts
Go with whichever is more strict.
Psychologists should make known their commitment to code and take steps to resolve conflict
Can’t use this as excuse to violate human rights.
42
Deception in research
It should be avoided
Ok if: justified by prospective value, alternative methods aren’t available, participants can withdraw anytime. **Debriefing MUST occur: end of participation or by the end of data collection.
Not ok: participants will be in pain/emotional distress
43
Bad Online reviews
1) can’t respond
2) create a positive online presence, post good reviews from former clients or supervisors/colleagues
3) can’t solicit those who are vulnerable to influence or current clients. OK to solicit from former clients (so long as they’re not vulnerable to due influence)
4) if several negative reviews, consultation is needed
44
Animals in research
OK to cause pain, if alternative methods unavailable and results could be valuable. but should minimize it. Researchers don’t need special training.
45
Informed consent
Can be written/verbal. Must be documented and must use understandable language.
- to give consent person must be able to make rational decisions and give it freely (capacity)
- not required if doing routine education or organizational activity when it is implied
- if not able to give, then assent & consent from guardian must be obtained.
- don’t need informed consent in court ordered evaluations but DO need to discuss limits of confidentiality. Don’t have to give feedback to defendant on results.
46
Contingency fees
ALWAYS UNETHICAL!!!!
* Contingency fees in law mean the attorney gets paid a percentage of the client's winnings, only if the case is successful. No win, no fee.
47
Delegating work to others
Consider vicarious responsability for coworkers
48
Malpractice conditions
1) must have legal duty to provide services to client (had a professional relationship with client)
2) must have breached by being negligent / not meeting standards of care
3) client was harmed (psych/physically) in breach
4) psychologists breach was direct cause* of harm
49
Expert witness vs fact witness
Expert: must be determined qualified by judge/court. (Based on knowledge skills, experience, training— don’t need certifications). They can HYPOTHESIZE and offer opinions.
Fact: CANNOT give opinions, only facts, testify about what happened. Can only provide confidential information if there is a signed authorization or court order
* one person can be both in a trial IF roles are clarified. (Even if they have prior relationships, although it is often discouraged as this would be a multiple relationship)
50
Who holds privilege?
**The client** (right to keep confidential communications from being disclosed in legal proceedings).
**The client’s legal representative (if client not of sound mind)**
And the psychologist can claim it on behalf of the client.
51
2 behaviours that constitute sexual harassment & when does it clearly occur?
Hostile work environment & Behaviours that are severe/intense to be abusive to a reasonable person
It clearly occurs where there is: quid pro quo situation where employer demands sexual favours from employee in exchange for promotion/job benefit.
When behaviour is ambiguous: behaviour continues even after being told it’s unwelcome/offensive
52
Military
Don’t have same confidentiality rights BUT should be informed of these limitations
53
Do psychologists have to accept all clients from all backgrounds?
Not if the psychologist believes it would negatively affect their ability to provide competent services.
Also ok to refuse service if they are unwilling/unable to pay
54
Advertisements (licensing, and public ads)
Only include credentials (two max) that were earned from a regionally accredited institution OR were basis of psychology licensure.
Ads: responsible for public statements, must include that online interactions don’t establish a professional relationship. CANNOT compensate people in media in return for publicity.
55
APA guidelines for retaining data after publication
5 years after publishing
If mistake found - psychologist’s responsibility to contact for corrections.
56
Sharing research data
Required to share if to verify claims. SO LONG AS confidentiality of participants is maintained. Data must also be shared only to competent professionals (this doesn’t include psychologists).
57
Reviewing article and want to publish another one to extend on findings
Cannot use these ideas in own research as reviewer.
Has to obtain permission from paper’s author’s to do so.
58
Test security
Reasonable steps should be made to protect integrity or security of test materials.
Ok to chat with client about a test item so they can better understand their results
Ok to release answers to questions and test scores.
59
Sex with clients/those close to clients
Clients: prohibits sex with current clients under ANY circumstances. Former client OK for at least **2 years** post termination and only in most unusual circumstances.
To demonstrate it’s not exploitative, the following factors are considered:
1) amount of time that has passed since termination
2) nature, duration and intensity of therapy
3) circumstances of termination
4) client’s personal history
5) client’s mental status
6) likelihood of adverse impact on client
7) any statements/actions made during therapy that could have been suggestive/inviting of a post termination sexual or romantic relationship
Prohibited from engaging in sexual intimacy with individuals u know to be related/close to current therapy clients.
Also prohibited from providing therapy to those they’ve been sexually involved with in the past
60
Assessment techniques not valid by research
Ideally should only use things that are supported by research and validated/found reliable for the population being tested
If not, such limitations should be included in the report.
61
Automated scoring & interpretation services
Must choose on basis of validity and other factors. Psychologists are responsible for appropriate application, interpretation and use of instruments.
62
Describing the purpose of a malingering test is bad why
Because it compromises its validity but not telling them anything might violate rights. So they are to be told that you will assess their honesty and efforts to do well, without describing specifics of test
63
Assessment reports
Modifications and accommodations should be recorded in reports
64
Equivocal death psychological autopsy (EDPA) vs Suicide Psychological Autopsy (SPA) = both are psychological autopsy types
EDPA= classifies manner of death
SPA= identifies psychosocial factors in suicide
Done by: psychologists, psychiatrists and trained professionals
Data sources: crime scenes, records and interviews
Criticisms: lack of empirical evidence, lack of standard procedures, bias, limited acceptance in criminal cases
BUT can be used as basis for expert testimony
65
Avoiding bias in language (gender, sexual orientation, age, disability, race/ethnicity)
** prefer “person with” phrasing or person first/identity first language
gender: use self ID’d pronouns, if unknown “they” “their” “them”
sexual orientation: use “**sexual and gender minorities”**, accept LGBTQ with definitions. Be specific not “homosexual” but “**lesbian woman” or “bisexual people**”
age: avoid using “males/females” but be specific and include ages. Kids (**child, boy, girl**). Teens (**young person, adolescent**). Adults (**adult, woman, man**). OAs (**older adult, persons 65 years of age and older**.. avoid elderly, aged, senior citizens)
disability: avoid derogatory language. Use “**person in wheelchair**” not “person confined to wheelchair”, “**person with AIDS**” vs “AIDS victim”. Or: “**adolescent with austism spectrum disorder**” (person first language), “**autistic adolescent**” (identity first language)
race/ethnicity: capitalize races. Use minorities as a modifier (instead of “minority students” use “**ethnic minorities” or “racial ethnic minority students**”. Make parallel comparisons among groups (instead of “African Americans and whites” use “**African Americans and European Americans**”/“Black & Whites”. Be specific by indicating region of origin. “latinx” “Asian canadian”, “indigenous peoples”. Use preferred terms if none, then keep broad “middle eastern”
66
Psychotherapy-Based Models (Person centered & Cognitive behavioural)
Focus: Theoretical orientation guides data selection.
Examples: Person-centered and cognitive-behavioral.
Person-Centered: Emphasis on relationship and empathy.
Cognitive-Behavioral: Mirrors CBT structure and techniques.
67
Developmental Supervision Models (IDM)
Assumption: Supervisees progress through stages.
Levels: self other awareness, motivation and autonomy
Level 1: Focus on self, high motivation, dependent on supervisor. Supervisor: focused on developing a relationship, providing lots of structure and help them acquire skills
Level 2: Client-focused, fluctuating autonomy and motivation. Supervisor: less structure and provides support.
Level 3: client-focused, attend to own reactions, consistent in motivation and have autonomy/confidence on own skills. Collegial Role of supervisor.
68
Process based model (social role models; Bernard discrimination model)
Focus areas: intervention, conceptualization and personalization
Supervisor roles: educator, counselor, consultant
Ie. educator role to teach on exposure intervention, when supervised is unaware that client is attracted to them, supervisor would adopt a counsellor role to help them see cues
69
Paramount goals of supervision
Only ONE is paramount: Protect the public
Other goals include:
Protect supervised
Act as a gatekeeper by assessing readiness for autonomous practice
Facilitate professional development
Remediate areas supervisee is not meeting for competence
Prepare for independent practice
70
APA Commission of Acreditation acredits
Graduate programs, doctoral internships and post doctoral residencies
71
Evaluation of defendants competency to stand trial (focus of evaluation is what?)
Ensure they understand the charges against them and ability to cooperate with their attorneys
72
E Passport (PSYPACT)
requirement to provide telepsychology services for 30 days across jurisdictional lines
73
5 main principles (beneficience/nonmalficience, fidelity/responsability, integrity, Justice & respect for people’s rights/dignity)
Beneficience: strive to benefit and do no harm
Fidelity/resp: establish trust (accepting gifts for asian clients), be aware of responsability to society, contribute professional time for little to no compensation (probono services)
Integrity: promote accuracy, honesty and truthfulness
Justice: fairness/justices, ensure equal access to psychology contributions (articles, free webinars etc also can include pro bono services)
Respect: respect dignity and worth of all, recognize and respect cultural differences
74
Test modifications and test accommodations
Both must be recorded in report if they occur.
Only test modifications (not accommodations) alter the construct measured by the original test
75
Client discloses being raped as a child
- Psychologist can continue working with client without reporting
- in most jurisdictions psych’s are not required to report when an adult reveals they were abused as children UNLESS there is reason to believe the perp. Is still victimizing a minor
- but even in that case, unless the client indicates the abuser is still abusing children/youth psych should NOT conduct an investigation to determine this
- client wants to report to police, psych can support but psych can’t go to police to report without clients consent
76
New client tells you she stopped seeing old therapist (you don’t know them) due to untoward/unethical behaviour
Talk to client about options
Don’t report or talk to previous psychologist unless you have clients permission
77
Reporting colleague
Try to resolve informally UNLESS violation has substantially harmed/will harm or it’s not appropriate for informal resolution (drugs, psychosis)
If not possible report to board so long as you don’t violate confidentiality rights
Psych Prep Key Terms
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