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Flashcards in Ethics 5 Deck (43):
1

To what areas of psychology do the General Guidelines for Providers of Psychological Services apply?

Apply to:
- clinical
- counseling
- I/O
- school

Don't apply to:
- teaching
- scientific research or writing

2

What does General Guideline 1: Providers say about responsibility for planning, directing, and reviewing the provision of psychological services?

1.3 says professional psychologists are responsible for this in psychological service units.
1.4 says professional psychologists bring their expertise to bear in planning and development of overall services within organizational settings.

3

What do the General Guidelines say about personnel required to provide a service?

General Guideline 1: Providers, in 1.1 says as many professional psychologists as are necessary to assure quality of service are required.
General Guideline 2: Programs reiterates this in 2.1.2 Composition and organization of a psychological service unit, saying sufficient numbers of personnel should be included to achieve given goals.

4

What does General Guideline 2: Programs say about organizations' roles, objectives, and scope of services?

2.2.1 Policies: They should be developed in writing, reviewed annually, and made available to all staff, users, and sanctioners.

5

What does General Guideline 2: Programs say about use of privileged information?

2.3.8 Procedures says we don't use privileged information we get in the course of our work (for professional advantage or personal gain).

6

What does General Guideline 3: Accountability say about the field's self-review?

3.2 we act as members of an independent and autonomous profession and 3.3 we make periodic evaluations of our services.

7

For what purpose were the Specialty Guidelines for the Delivery of Services developed?

To educate the public, profession, and interested third parties (e.g., insurance companies) about the APA's polices in the referenced areas.

8

What are the 3 classifications of testing standards in the Standards for Educational and Psychological Testing?

- primary (standards that are necessary)
- secondary (those that are desirable but likely to be beyond reasonable expectations)
- conditional (those that are situationally either primary or secondary)

9

What are the 4 parts into which the Standards for Educational and Psychological Testing are divided?

Part I: Technical Standards for Test Construction and Evaluation
Part II: Professional Standards for Test Use
Part III: Standards for Particular Applications
Part IV: Standards for Administrative Procedures

10

What is the general gist of the Validity section of Standards for Educational and Psychological Testing Specialty Guidelines?

- Evidence should be given for the validity of all tests, constructs, criteria, etc.
- Departures from standard interpretations of data (e.g., using multiple items) should be supported by evidence.
- Arguments not supported by evidence should be noted as such and limitations to interpretations should be described.

11

What is the general gist of the Reliability and Errors of Measurement section of Standards for Educational and Psychological Testing Specialty Guidelines?

- Reliability and standard errors should be thoroughly described and quantified for scoring, test construction procedures (e.g., sampling), etc.
- Where reliability is limited, biased, or unknown, it should be clearly noted and limitations to interpretation described.

12

What are the 4 subfields of psychology for which the Specialty Guidelines for the Delivery of Services were developed?

- clinical
- counseling
- school
- I/O

13

What does standard 6.12 in General Principles of Test Use Specialty Guidelines say about screening tests?

That they should only be used to identify those who warrant further evaluation and not for any other purpose (e.g., diagnosis).

14

What is the general gist of the Employment Testing section of Standards for Educational and Psychological Testing Specialty Guidelines?

Tests used to evaluate personnel for suitability for employment or promotion should be valid for the job in question, both in content and construct.

15

What does the Protecting the Rights of Test Takers section of the Standards for Educational and Psychological Testing Specialty Guidelines say about assigning individuals to categories (in score reporting)?

This should be done based on carefully selected criteria and the least stigmatizing labels should always be assigned.

16

According to the Reliability and Errors of Measurement in the Standards for Educational and Psychological Testing Specialty Guidelines, are internal reliability analyses reasonable substitutes for alternate-forms or retest reliability?

Standard 2.6 says no, not unless other evidence supports that interpretation for this particular case.

17

According to the Introduction to the Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations, what are some important multicultural assessment and intervention skills?

- recognition of cultural diversity
- understanding the role of culture and ethnicity in the development of diverse populations
- understanding of the socioeconomic and political factors impacting diverse populations
- helping clients to understand their own sociocultural identification and the interaction of that with behavior and needs

18

According to the Introduction to the Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations, what have been some of the relevant research foci in this area?

- impact of racial similarity/differences in psychotherapy
- minority utilization of MHS
- relative effectiveness of therapy styles (directive vs non-)
- role of cultural values in treatment
- cultural competency

19

What are 4 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists bear in mind research and practice relevant to target populations?

a) We acknowledge and account for the impact of ethnicity and culture on behavior
b) We seek to increase our understanding and awareness of the needs of target populations
c) We recognize the limits of our competence
d) We consider and account for the validity of interventions and assessments as applied to target populations

20

What are 5 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists recognize ethnicity and culture as significant parameters in understanding psychological processes?

a) We are aware of our own background experiences and make efforts to correct any resulting biases
b) Our practices incorporate understanding of clients/patients' background, both in terms of challenges and strengths
c) We facilitate clients/patients' understanding of their own cultural values and norms and ways to apply this to enhance their quality of life
d) We seek to determine if issues arise from racism or bias, so as to help a client/patient to avoid inappropriate personalization of impersonal issues.
e) We consider cultural beliefs and values along with differential diagnoses.

21

What are 2 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists respect the roles of family and community structures and beliefs?

a) We identify family and community resources.
b) We make sure we are clear about our role and the client/patient's expectations.

22

What are 2 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists show respect for clients/patients' spiritual beliefs and values?

a) We become familiar with indigenous beliefs and observe and respect them.
b) When appropriate, we consult with and/or include community spiritual practitioners in interventions.

23

What are 3 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists address language issues?

Whenever possible, we interact with clients/patients in the language they prefer.
a) If we cannot do this, we refer to a mental health professional who can. If this is not possible, we offer a translator. If none are available, a trained paraprofessional from the client/patient's culture may translate.
b) We do not put translators/paraprofessionals into dual roles.
c) We communicate assessment data in terms clear and relevant to the needs of those assessed.

24

What are 2 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists consider the impact of adverse factors in assessment and intervention?

a) Our interventions match the client/patient's needs (e.g., Maslow's hierarchy).
b) Where there is a conflict between cultural values and human rights, we work to improve the welfare of all persons concerned.

25

What are 2 ways the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists work to eliminate biases, prejudices, and discriminatory practices?

a) We acknowledge them.
b) We develop sensitivity to oppression, sexism, elitism, and racism and bear them in mind when conducting evaluations and interventions.

26

What are 9 things the APA Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommend psychologists document when working with diverse populations?

1. # generations in country
2. # years in country
3. English fluency
4. extent of family support (or lack)
5. community resources
6. level of education
7. change in social status (as a result of immigration)
8. intimacy with diverse others
9. level of acculturation stress

27

What is the goal of licensure in professional psychology and how effective is it in meeting that goal?

State licensure is designed to protect the public welfare. Research indicates that it is not particularly effective in that regard and could even have adverse effects.

28

What are the options if you have a grievance related to your EPPP exam?

Complaints must be filed through the state board who will interact with the ASPPB. The ASPPB may, for a fee, hand-score your exam and provide you with feedback on your performance.

29

What is the best defense in the event of litigation?

Having complete and accurate records.

30

What are the 6 types of malpractice suits?

1. breach of contract
2. assault
3. abandonment
4. suicide (filed by survivors)
5. unauthorized disclosure of privileged information
6. negligence

31

What are the 3 elements that constitute malpractice?

1. The psychologist must have a professional relationship with, and therefore a duty to, the client.
2. The psychologist must have failed in that duty.
3. Some harm must have come to the client as a result of the psychologist's failure.

32

What is typically the hurdle to proving malpractice?

Criterion 2, the psychologist's negligence. Patient must prove the psychologist did not live up to the legally expected or usual and customary level of care for that geographic area. Expert testimony in this regard is often conflictual.

33

What are the most common malpractice claims?

- sexual misconduct and other dual relationships
- lack of competence
- confidentiality breaches
- improper financial arrangements

34

For providers, what are some of the ethical implications of managed health care?

- double agency, falling prey to managed care organizations' cost-cutting incentives at the expense of quality of care or service limitation
- confidentiality, as some contracts might grant an employer (as the subscribing party) rights to clients/patients' treatment information (where this is the case, it must be included in the Informed Consent)
- refusal of the MCO to pay for treatment you believe necessary
* prepare for this at outset of treatment (IC)
* appeal adverse decisions when they occur (this is standard of care)
* options: treatment at reduced cost, reduced frequency of sessions, referral to community clinic
* in emergencies, Pt must be seen until stable

35

What are the 5 trends responsible for increased healthcare costs as of 1993?

1. unnecessary, inappropriate service use
2. unlimited access to expensive equipment & procedures
3. fee-for-service disincentives for cost control
4. overemphasis on treatment rather than prevention
5. inordinate focus on insight & awareness rather than symptom reduction (primarily mental health?)

36

What are the 4 types of managed care organizations?

- Health Maintenance Organization
- Preferred Provider Organization
- Independent Practitioner Association
- Employee Assistance Program

37

What is an HMO?

A Health Maintenance Organization:
- is a closed group; services reimbursable only from HMO providers
- has providers paid per capita
- has tightly controlled cost containment and service quality

38

What is a PPO?

A Preferred Provider Organization:
- contains costs by gatekeeping and external review
- providers become "preferred providers" and operate relatively autonomously, but still reduce fees & limit service
- providers may be subject to review
- case managers are usually skilled clinicians
- patients use non-PPO providers at significantly higher cost

39

What is an IPA?

An Independent Practitioner Association:
- is an independent group contracting with an HMO for specific services
- providers are paid a previously agreed to rate or a discounted fee-for-service

40

What is an EAP?

An Employee Assistance Program:
- is designed to treat drug and alcohol abuse
- allows employees to get treatment voluntarily or at the direction of a supervisor
- EAP manager does minimal treatment but refers employee to brief, symptom-focused treatment
- review and/or restriction of practitioners is not generally required

41

What are some common criteria for receiving mental health referrals from a Managed Care Organization?

- being degreed & licensed
- having adequate malpractice insurance
- practice located in professional building rather than in-home

42

What are some examples of mental health benefits through Managed Care Organizations?

- 20 individual psychotherapy sessions per member per year (minimum Federally mandated prior to mental health parity laws)
- outpatient services
- some inpatient benefits

43

Compare utilization review and quality assurance.

- UR: assessment of patient use of services to reduce cost; requires provider to justify treatment formally and regularly
- QA: assessment of quality and adequacy of services to patient compared to standards of care; may reduce, but may also increase, cost