Ethics Flashcards
(180 cards)
2
Q
Purpose of Licensure at State Level
A
- Requirements for licensure are a means to ensure a minimum levels of competence for practicing psychologists.
3
Q
Ethics Overview & Changes Since 1992
A
- Gender identity and culture have been added to the list of diversity factors.2. Psychologists may sometimes provide services for which they are not fully competent in emergency situations and when treatment would otherwise not be available.3. Multiple relationships are not inherently unethical.4. Psychologists are no longer told they should ordinarily refrain from bartering.5. Raw test data can now be released to anyone the client often authorizes.6. Termination is explicitly permitted when clients present a risk of harm to the therapist or when managed care contracts require termination.
4
Q
Ethics (Introduction)
A
- Five General Principles and 10 Ethical Standards.2. General principles are aspirational.3. Ethical standards are enforceable.4. Ethics Code applies only to the professional and scientific activities of psychologist, and not to their private conduct.5. Ignorance or misunderstanding of an ethical standard is not considered to be an adequate defense.6. Psychologist who violate the ethics code may be sanctioned and: a. APA Membership maybe terminated. b. APA May also notify other bodies, such as state licensing boards, of the sanctions. c. Sanctions may occur if the member is convicted of a felony, expelled, or suspended from a state association, or has his/her license revoked.7. Ethics code is not intended to be a basis for civil liability.8. Civil liability is the issue and in malpractice and includes the following four D’s: a. Dereliction of Duty Directly causing Damages.
5
Q
Ethics Code: Reasonable (Definition)
A
- Defined: “The prevailing professional judgment of psychologists engaged in similar activities in similar circumstances, given the knowledge the psychologist should have had at the time.”
6
Q
Ethical Decision-Making
A
- When making decisions regarding ethics, psychologists are supposed to consider the Ethics Code, applicable laws, psychology board regulations, the guidelines of other scientific and professional organizations, and “the dictates of their own conscience.”
7
Q
Higher Ethical Standard
A
- When the Ethics Code sets a higher standard of conduct than the law, psychologists are bound to uphold “the higher ethical standard.”2. When there is a conflict between ethics and law, psychologists must “make known their commitment to the ethics code and take steps to resolve the conflict in a responsible manner.”3. If the conflict is unresolvable, psychologists are permitted to comply with the law, assuming the basic principles of human rights are not violated.
8
Q
Malpractice (Definition)
A
4 D’s: Dereliction of Duty Directly causing Damages.
9
Q
Preamble
A
- Goals of the Ethics Code are: a. “the welfare and protection of the individuals and groups with whom psychologists work” and b. “the education of members, students, and the public regarding ethical standards of the discipline.”2. Psychologists work toward increasing scientific and professional knowledge of behavior and people’s understanding of themselves.3. The goal of psychologists is to improve the condition of individuals, organizations, and society.4. Psychologists respect and protect civil and human rights and the principles of freedom of inquiry and expression.5. Psychologist engage in a variety of roles such as researcher, educator, diagnostician, therapist, supervisor, consultant, administrator, social interventionist, an expert witness.6. Psychologists make a personal commitment to act ethically and encourage the ethical behavior ethical behavior of others.7. They consult with others regarding ethical problems.
10
Q
Five General Principles
A
Principle A: Beneficience and NonmaleficencePrinciple B: Fidelity and ResponsibilityPrinciple C: IntegrityPrinciple D: JusticePrinciple E: Respect for Peoples Rights and Dignity
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Q
Principle A: Beneficence and Nonmaleficence
A
ASPIRATIONAL1. Psychologists aim “to benefit those with whom they work and take care to do no harm.”2. They safeguard the welfare and rights of the people they interact with professionally as well as the welfare of animals used in research.3. They attempt to resolve conflicts among the professional obligations and responsible manner that minimizes harm.4. They are aware of how their own physical and mental health may affect the capacity to help others.
12
Q
Principal B: Fidelity and Responsibility
A
ASPIRATIONAL1. “Psychologists establish relationships of trust with those with whom they work.”2. Psychologists should be aware of the responsibilities to these people and uphold professional standards.3. Psychologists are encouraged to clarify the roles, manage conflicts of interest that may cause harm, and consult and collaborate with other professionals.4. Psychologists should be concerned with the ethical compliance of others.5. Psychologists are encouraged to contribute some of the professional services for little or no compensation.
13
Q
Principle C: Integrity
A
ASPIRATIONAL1. Psychologists should promote “accuracy, honesty, and truthfulness”.2. They should avoid all fraudulent activities.3. Commitments and promises should be made carefully and then upheld.4. Although ethically permissible in certain situations, deception should only be used with great care.
14
Q
Principle D: Justice
A
ASPIRATIONAL1. Recognizes that all persons should benefit from the contributions of psychology and should be treated with equal quality in all psychological activities.2. Enjoins Psychologists to ensure that their own biases and limitations of competence do not result in unjust practices.
15
Q
Principle E: Respect for Peoples Rights and Dignity
A
ASPIRATIONAL1. Includes respect for the rights of privacy, confidentiality, and self-determination.2. Psychologists should recognize and respect differences among persons based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status.3. Psychologist should consider the aforementioned factors when providing psychological services.4. Psychologists should try to eliminate the effect of biases based on these factors, both in their work and in the work of others.
16
Q
- Resolving Ethical Issues
A
1.01 through 1.08
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Q
1.01 Misuse of Psychologists’ Work
A
- Psychologists should take steps to correct the misuse or misrepresentation of their work.
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Q
1.02 Conflict Between Ethics and Law
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- When conflicts arise between ethics and law, regulations, or other governing legal authority, psychologists should “make known their commitment to the ethics code and take steps to resolve the conflict.”2. If the conflict cannot be resolved, psychologists may comply with the law.
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Q
1.03 Conflicts Between Ethics and Organizational Demands
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- When conflicts occur between the ethics code and the demands of an organization, psychologists should “make known their commitment to the ethics code” and “to the extent feasible, resolve the conflict in a way that permits adherence to the ethics code.”
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Q
1.04 Informal Resolution of Ethical Violations
A
- If psychologists know of an ethical violation by another psychologist, they should speak directly to the colleague, assuming an “informal resolution” seems appropriate and confidentiality will not be violated.
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Q
1.05 Reporting Ethical Violations
A
- If the attempt at an informal resolution is unsuccessful, or if the violation is inappropriate for an informal resolution (substantial harm has/may occurred), psychologists should take further action, such as referral to ethics committees or licensing boards.2. Such action should not be taken if confidentiality rights will be violated, or if the psychologists were retained to review the work of another psychologist whose conduct was in question.3. Client confidentiality must be protected above ALL.4. If the client provided the information, it may be helpful to provide the client with the necessary information and let the client decide whether to make a report.
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Q
1.06 Cooperating with Ethics Committees
A
- Failure to cooperate with ethics investigation, whether by APA or a State psychological Association, constitutes an ethical violation in and of itself.
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Q
1.07 Improper Complaints
A
- Psychologists should not file, or encourage the filing of, ethical complaints that deliberately disregard the facts of a situation.
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Q
1.08 Unfair Discrimination Against Complainants and Respondents
A
- Psychologists should not discriminate against a person because he or she has been the subject of an ethics complaint.2. Psychologists are permitted to take action based on the outcome of such proceedings.
25
Q
- Competence
A
2.01 through 2.06
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2.01 Boundaries of Competence
1. Psychologists should practice within the boundaries of their competence.2. When an understanding of the effect of certain factors (age, gender, etc.) is necessary for appropriate services or research, psychologists must make sure that they either have or obtain appropriate training, supervision, or consultation (or make an appropriate referral).3. "Psychologists with closely related prior training or experience may provide such services in order to ensure the services are not denied and they make a reasonable effort to obtain the competence required by using relevant research, training, consultation, or study."4. When they desire to practice in new areas, psychologists should also seek appropriate training, supervision, or consultation. a. Consultation b. Supervision c. Training d. Referring out
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2.01 a Consultation
1. Appropriate when psychologists are somewhat familiar with treating a particular disorder, but are not an expert in that area.2. Also appropriate when psychologists have concerns about whether they can remain objective in treating a client.
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2.01 b. Supervision
1. Might be required when psychologists are applying a newly learned technique (hypnosis or biofeedback).2. Also may be appropriate when they are beginning to work with a specialized population (e.g., hearing-impaired).3. Appropriate when psychologists are not yet ready to practice independently in the area or with the new population.
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2.01 c. Training
1. Vital when psychologists are unfamiliar with a certain area of knowledge.2. Typically followed by supervised experience prior to practicing independently.
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2.01 d. Referring Out
1. Appropriate in the following situations: a. The therapist's personal believes and issues interfere with therapy. b. The client feels uncomfortable with the therapist. c. The therapist lacks competence in treating the presenting problem.
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2.02 Providing Services in Emergencies
1. In clinical emergencies, psychologists may provide services for which they are not fully competent in order to ensure that individuals receive necessary treatment.2. They should terminate the services as soon as the emergency has passed or more appropriate services have been secured.
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2.03 Maintaining Competence
1. Psychologists should make an ongoing effort to maintain competence.
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2.04 Bases for Scientific and Professional Judgments
1. Psychologists should always base their work on the scientific and professional knowledge that has been established in the field of psychology.
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2.05 Delegation of Work to Others
1. Psychologists should ensure that those to whom they delegate work perform only those duties for which they have adequate competence.2. These delegated individuals also should have no harmful multiple relationships with the person being served.3. Psychologists should ensure that the services are performed competently.
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2.06 Personal Problems and Conflicts
1. Psychologists should not Initiate any activity when they know or should know that their personal problems will impair their competence.2. Psychologists are required to address their problems appropriately and to seek consultation about whether to limit, suspend, or terminate practice.
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3. Human Relations
3.01 through 3.12
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3.01 Unfair Discrimination
1. Psychologists should not engage in discrimination based on age, gender, etc., or any other basis prohibited by law.
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3.02 Sexual Harassment
1. Sexual-harassment is specifically prohibited, and it is defined as sexual behavior that meets one of the following two criteria: a. Behavior that is "unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this". b. Behavior that is so severe that any reasonable person would recognize it as abusive.
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3.03 Other Harassment
1. Psychologists are also prohibited from engaging in any other harassment based on age, gender, etc.
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3.04 Avoiding Harm
1. In general, psychologists are enjoined to avoid harming clients and others whenever possible, and to minimize harm when it is unavoidable.
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3.05 Multiple Relationships
1. Multiple relationship occurs when a psychologist is in a professional role with the person and: a. At the same time in another role. b. At the same time in a relationship with the person closely associated with or related to the person. c. Promises to enter into another relationship in the future with either of the above types of people.2. Should not enter into a multiple relationship if it might impair the psychologist's objectivity, competence, effectiveness, harm or exploit the other party.3. Should attempt to resolve it with due regard for the best interest of the affected person should a harmful relationship occur.4. When Psychologists are required to serve in more than one role (judicial or administrative proceeding), should clarify roles and limits of confidentiality, update as often as changes occur.5. If due to unforeseen factors, a harmful multiple relationship does occur, the psychologist should "attempt to resolve it with due regard for the best interest of the affected person and maximal compliance with the Ethics Code."
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Child Custody Evaluations in Divorce Proceedings (1994)
1. A psychologist should avoid conducting a custody evaluation in a case in which the psychologist has served as therapist to the child or immediate family.2. Therapy with the child or family after the evaluation is completed, should be undertaken with caution.3. This does not preclude the psychologist from testifying as a fact witness concerning the child's treatment, but when this is the case the psychologist should generally declined the role of an expert witness who is giving a professional opinion regarding custody and visitation.
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Parole Evaluations
1. Most correctional psychologist are in the position of being both a therapist and evaluator for parole and release.2. Ethical guidelines for correctional psychologist encourage sensitivity to the ethical pitfalls inherent in this dual relationship but it is definitely a permitted relationship.
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3.06 Conflict of Interest
1. Psychologists should not enter into a professional relationship with someone with whom they already have other relationships or involvement if the result would be that the psychologists objectivity, confidence, or effectiveness would be impaired or that the other party would suffer harm or exploitation.
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3.07 Third Party Requests for Services
1. When psychologists provide services at the request any third party (insurance company), psychologists should clarify at the outset of treatment: a. their role, b. who the client is, c. the probable use of services, and d. any limits to confidentiality.2. When employees are referred by employers to an EAP program, the employer has the right to know whether or not the employee attended sessions, however, the employer does not have the right to know confidential information about session content.
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3.08 Exploitative Relationships
1. Psychologists should not exploit people over whom they are in a position of power, such as clients, students, supervisees, research participants, and employees.
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3.09 Cooperation with Other Professionals
1. Psychologists should cooperative with other professionals, as appropriate, in order to serve the best interests of their clients.
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3.10 Informed Consent
1. When psychologists engage in research, assessment, therapy, counseling, or consultation (in person or electronic), they must secure informed consent from the individuals with whom they work.2. The language used must be reasonably understandable to the clients.3. An exception to this requirement occurs when the law or governmental regulations mandate conducting these activities without consent.4. When clients are legally incapable of giving consent, psychologists must obtain permission from a legally authorized person (Guardian).5. Psychologists must also provide clients with an explanation, seek their assent, and consider their wishes and best interests.6. Psychologists should also protect the rights and welfare of these persons even when consent from legally authorized person is not mandated or not permitted by law.7. When persons are court-ordered or mandated to obtain psychological services, psychologists should inform them of the nature of the services to be provided, the fact that the services have been mandated, and any limits to confidentiality.8. Psychologists should appropriately document that informed consent or assent has been secured, whether it was secured in a written or oral format.9. The Ethics Code does not require a written consent form, only that informed consent be documented (in a progress note recording that information was given and understood
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3.11 Psychological Services Delivered to or Through Organizations
1. With psychologists work in or for organizations, they should thoroughly inform clients and those affected by the services about the following issues: a. The nature of the psychological services, b. The intended recipients, c. which persons are clients, d. the relationship between a psychologist and each person and between the psychologist and the organization, e. the probable uses of the services and information, f. who will have access to the information, and g. any limits of confidentiality.2. Psychologists should provide feedback after evaluation and treatment.3. If feedback is precluded for legal or organizational reasons, psychologists should inform the person of the fact ahead of time.
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3.12 Interruption of Psychological Services
1. Psychologists must make plans for continuation of care in the event of the relocation, illness, death, or in the event of the clients relocation or financial limitations.2. These plans are often termed "a professional will".
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4. Privacy and Confidentiality
4.01 through 4.07
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4.01 Maintaining Confidentiality
1. The Ethics code emphasizes that psychologists have a primary obligation to protect the confidential information they obtain. ~ Psychologists site confidentiality of the ethical issue the most frequently address in their practice.
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4.02 Discussing the Limits of Confidentiality
1. Psychologists must discuss the limits of confidentiality with any persons or organizations with whom they work.2. They must also discussed the possible uses of any information that is obtained (part of a court assessment).3. Confidentiality is generally discussed at the outset of treatment, and whenever there are relevant changes in circumstances.4. If electronic transmission is used (email), psychologists must inform clients of the possible risks to privacy and any additional limits to confidentiality.
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4.03 Recording
1. Permission for taping or videotaping must be secured from clients.
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4.04 Minimizing Intrusions on Privacy
1. Psychologists should discuss confidential information obtained from client only for scientific or professional purposes.2. The discussion should only include the confidential information that is necessary when preparing oral or written reports.
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4.05 Disclosures
1. Confidential information may be disclosed of the client gives consent.2. It may be discussed without client consent when the disclosure is either mandated by law (Tarasoff) or when the disclosure is permitted by law (to protect client).3. Although psychologists may disclose confidential information without client consent in order to obtain payment for services (billing), they should only disclose the smallest amount of information that is necessary.
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4.06 Consultations
1. Psychologists should not reveal detailed information that could lead to identification of a client unless they have obtained prior consent or the disclosure cannot be avoided.2. Psychologists should only share information that is absolutely necessary purpose of consultation.
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4.07 Use of Confidential Information for Didactic or Other Purposes
1. When psychologists lecture or write, they must not include confidential information unless the person has consented in writing where there is legal authorization to do so.2. Otherwise, confidential information should be disguised.3. Issues of confidentiality are involved in: 4.07 a. Subpoenas 4.07 b. Court Orders 4.07 c. Court-Appointed Evaluations 4.07 d. Court-Ordered Therapy
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4.07 a. Subpoenas
1. Typically issued by attorneys.2. Maybe a subpoena alone (requiring therapist to appear for questioning) or subpoena duces tecum (requiring the therapist to appear with the client records).3. Subpoenas cannot be ignored!4. When a subpoena is received a therapist should: a. Contact the client, b. Inform the client of the subpoena, and c. Seek the client's permission to release information.5. If the client grants permission, psychologist may release the records.6. If the client does not grant permission, psychologist may first contact the attorney who issues the subpoena, requesting the subpoena be quashed. Otherwise, the psychologist must appear at the designated location and bring any requested records.7. Psychologist should then assert patient-therapist privilege, and neither testify or turn over the records.
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4.07 b. Court Orders
1. A court order is signed by a judge and carries the weight of law.2. A psychologist may always request of the judge that the court order be modified, but otherwise, the psychologist must comply with any court order or be held in contempt of the court.3. A court-ordered mandates that the psychologist appear and demonstrate why the records or a portion of the records should not be released, or may mandate a psychologist appear with the records for an in camera review.4. Psychologist should always maintain frequent communication with the client and clients attorney.
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4.07 c. Court-Appointed Evaluations
1. If evaluation is a court-appointed evaluation, there is no confidentiality and client has waived right to privilege.2. No signed release of information is needed.3. Psychologists must explain the nature of evaluation and the limits of confidentiality to the defendant prior to beginning the evaluation.4. Court-appointed evaluation is considered an exception to privilege; thus while in most circumstances the client holds privilege, in a court-appointed evaluation privilege does not exist.
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4.07 d. Court-Ordered Therapy
1. Privilege is held by client.2. The court has ordered a defendant to seek therapy as a condition of his or her sentence.3. The psychologist who agrees to treat this client must make sure to clarify the nature of the treatment that has been ordered by the court as well as the information the court needs.4. The psychologist must then discuss this information with the client to obtain informed consent.5. Psychologists must generally obtain a signed release of information from the client in order to communicate with the court.
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5. Advertising and Public Statements
5.01 through 5.06
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5.01 Avoidance of False or Deceptive Statements
1. Public statements are any written or oral statements in any form other than an entirely private conversation.2. Psychologists should never make intentionally deceptive statements regarding a. training and experience, b. their academic degrees, credentials, affiliations, c. their services, d. the scientific and clinical basis for their services, e. their fees, or f. other public publications and research findings.3. When psychologists are presenting their credentials that are relevant to their health service, they should only present those degrees that are the basis for their psychology licensure or that they received from a regionally accredited institution.
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5.02 Statements by Others
1. Psychologists retain responsibility for public statements even when they hire someone else to promote their practice.2. Psychologists must try to prevent others (employers) from making any deceptive statements and correct them when possible.3. It is prohibited to compensate a media employee for publicity or reporting.4. When paid ads are used, they must be identified as such.
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5.03 Descriptions of Workshops and Non-Degree Granting Educational Programs
1. Psychologists must exercise whatever control they have to make sure that published material (brochures) about non-degree-granting programs (workshops) contain accurate information regarding: a. the intended audience, b. the objectives, c. the presenters, and d. the fees.
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5.04 Media Presentations
1. When psychologists provide public advice, their statements must be based on: a. appropriate psychological literature and practice, b. must be consistent with the ethics code, and c. must make clear that there is no therapeutic relationship established. 2. Media psychologists should make it clear that they are not providing treatment, but are only offering advice or feedback.
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5.05 Testimonials
1. Code allows for solicitation and in use of testimonials under certain narrowly circumscribed situations: a. May never be solicited from current clients. b. May never be solicited from any person who is vulnerable to undo influence.
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5.06 In-Person Solicitation
1. Solicitation of business is also prohibited when people are vulnerable to undue influence.2. The Ethics Code specifies that this prohibition does not apply to disaster or community outreach services.
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6. Record Keeping and Fees
6.01 through 6.07
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6.01 Documentation of Professional and Scientific Work and Maintenance Records
1. Psychologists should create and maintain records of their professional work with the following goals in mind: a. To facilitate future provision of services; b. To allow for replication of research results; c. To meet institutional requirements; d. To ensure accuracy and billing; e. To comply with the law.
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6.02 Maintenance, Dissemination, and Disposal of Confidential Records of Professional and Scientific work
1. To the extent they have control, psychologist create, maintain, and destroy records in a manner that protects confidentiality.2. When client information is entered into databases, appropriate measures should be taken to protect confidentiality including coding of personal identifiers.3. Psychologists should make advance plans to protect the confidentiality of records in case of their death or incapacity.
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6.03 Withholding Records for Nonpayment
1. Psychologists may not withhold records that are necessary for emergency treatment because the client owes them money.2. According to HIPAA, a psychologist may not withhold records for nonpayment under any circumstances.3. This is an example of where the ethics code and federal law conflict.4. As a result, psychologists should not withhold records for non-payment in any situation emergency or otherwise.
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6.04 Fees and Financial Arrangements
1. Must be agreed upon as early as is feasible.2. Practices must be consistent with law.3. Psychologists may not misrepresent their fees.4. Psychologist must also inform client if using a collection agency. a. Do not have to inform client at the outset of treatment, however must give client sufficient warning before a collection agency is used.5. Must provide clients with opportunity to make prompt payment.6. Waiving a copayment is considered unethical and illegal. a. Exception is when insurance company pre-approves waiver and therapist not increasing rates to get insurance to cover more.
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6.05 Barter with Clients/Patients
1. Ethics Code defines bartering as "the acceptance of goods, services, or other nonmonetary remuneration from clients/patients in return for psychological services."2. Bartering is permissible as long as it is not clinically contraindicated and not exploitive.
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6.06 Accuracy in Reports to Payors and Funding Sources
1. Psychologists must provide accurate information to payors (insurance companies) and to sources of research funding.2. Diagnoses, fees, services provided, and similar information must all be accurately stated.3. Psychologists may not submit false diganoses or exaggerate their clients problems in order to ensure continuation coverage.4. Nor may they understate diagnoses in an effort to reduce stigma.
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6.07 Referrals and Fees
1. Any payments or fee-splitting between psychologist and other professionals must be based on services provided (clinical, consultative, administrative, or other).2. Psychologists may never pay another professional for a referral.
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7. Education and Training
7.01 through 7.07
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7.01 Design of Education and Training Programs
1. Psychologists who are responsible for educational and training programs must ensure that the programs are designed to provide appropriate education and experience to meet the requirements of licensure or other goals stated by the program.
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7.02 Descriptions of Education and Training Programs
1. Psychologists must ensure that descriptions of education and training programs are accurate in terms of their content, goals, stipends, as well as any requirements for counseling.
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7.03 Accuracy in Teaching
1. Course outlines and syllabi should be accurate and not misleading. 2. Instructors may nevertheless change or adapt course outlines when necessary as long as students are still given the opportunity to fulfill course requirements. 3. Psychologists should present information accurately.
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7.04 Student Disclosure of Personal Information
May be required under 3 conditions: 1. Instructors may require students to disclose personal information if the educational program has made this requirement clear in its admission and program materials. 2. May be permitted if a student's personal problems are posing a threat to the student or others. 3. May be permitted if an educational program needs the information to evaluate or help a student whose personal problems seem to be preventing him/her from performing competently.
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7.05 Mandatory Individual or Group Therapy
1. If an educational program requires participation in individual or group therapy, students must have the option of obtaining treatment from practitioners who are not associated with the program. 2. Similarly, instructors who will be evaluating the students work may not provide therapy to the student. 3. The program may require that it approves the credentials of outside therapists.
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7.06 Assessing Student and Supervisee Performance
1. Psychologists must provide feedback to students and supervisees, and inform them of the process for feedback at the outset of the relationship. 2. Evaluation should be made on "the basis of… actual performance on relevant and established program requirements."
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7.07 Sexual Relationships with Students and Supervisees
1. Psychologists should not engage in sexual relationships with current students or supervisees or those over whom they will have evaluative authority.2. Psychologists should also not date current or future students or supervisees. 3. The ethics code does not prohibit having a sexual relationship with former students or supervisees, as it does with clients.
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8. Research and Publication
8.01 through 8.15
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8.01 Institutional Approval
1. When it is required, psychologists should provide accurate information and appropriate approval from host institutions or organizations before conducting research.
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8.02 Informed Consent to Research
1. Informed consent in the research setting should include information about the following: a. the purpose of the research, it's duration and procedures; b. the subjects right to decline to; c. the foreseeable consequences of declining or withdrawing; d. the factors that might significantly affect the decision to participate (risks); e. prospective research benefits; f. limits of confidentiality; g. Incentives for participation; and h. a contact person for questions or concerns. 2. Questions from the prospective subjects should also be answered.3. "Psychologists must appropriately document written or oral consent, permission and assent." ~ Written consent is not required by the APA Ethics Code. ~ It is possible to find another way to ensure consent (e.g., oral consent).
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8.02 Informed Consent to Research (Experimental Treatments)
1. Research involving the use of experimental treatments, informed consent should also include information about the following: a. the experimental nature of the treatment; b. the availability or non-availability of treatment for the control c. how subjects are assigned to groups; d. available treatment alternatives if the subject declines or withdraws from the research; and e. compensation for cost of participating as well as whether third-party reimbursement will be sought.
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8.03 Informed Consent for Recording Voices and Images in Research
1. Informed consent is necessary for the use of filming and recording in research. 2. One exception to this requirement is the use of naturalistic observations in which personal identification and harm are avoided. 3. Another exception is the use of recording in a research design that involves deception. a. In such cases, consent for the recording must be obtained during de-briefing
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8.04 Client/Patient, Student, and Subordinate Research Participants
1. When research subjects are clients, students or other subordinates, psychologists must take care to protect them from any adverse consequences due to declining or withdrawing from research. 2. When participation in research is part of a course requirement or an option for extra credit, other alternatives must be made available for students to obtain credit.
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8.05 Dispensing with Informed Consent for Research
1. Psychologists may dispense with informed consent when permitted by law or institutional regulations. 2. In addition, they may dispense with informed consent if the research is unlikely to create distress or harm in one of the following situations: a. normal educational practices; b. anonymous questionnaires, naturalistic observations, or archival research; and c. the study of a job or organization's effectiveness.
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8.06 Offering Inducements for Research Participation
1. When professional services are offered to induce people to participate in a study, psychologists have to clarify the nature of the services offered, including possible risks and limitations. 2. Excessive financial or other inducements are prohibited as they may act as coercion.
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8.07 Deception in Research
1. Should be avoided unless: a. Justified by "significant prospective scientific, educational, or applied value". b. Alternate procedures without deception not available.2. Can never use procedures that will cause physical pain or emotional distress:3. Subjects debriefed as early as possible (usually at the end of participation, no later than end of data collection).4. If deception is involved, consent from subjects must be obtained before they participate in the research.
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8.08 Debriefing
1. Participants are entitled to a prompt opportunity to obtain information about the research, including its results and conclusions. 2. When participants have suffered harm, psychologists must take reasonable steps to reduce the harm.
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8.09 Humane Care and Use of Animals In Research
1. Psychologists must treatment animals humanely. 2. They must obey all laws and regulations with regard to acquiring, caring for, and disposing of animals. 3. They must supervise and accept responsibility for the handling of animals, and provide training to ensure the competence of those who handle the animals. 4. Psychologists must make efforts to minimize the discomfort and pain of animals. 5. Animals are only to be subject to pain or stress when an alternative procedure is unavailable and the study is justified in terms of it "prospective scientific, educational, or applied value."6. Appropriate anesthesia should be used when surgical procedures are performed.7. When an animal's life is to be terminated, it should be done rapidly and with an attempt to minimize pain.
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8.10 Reporting Research Results
1. When reporting results, psychologist should never fabricate data. 2. Psychologists must take reasonable steps to correct any errors that may occur in their published data.
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8.11 Plagiarism
1. Plagiarism is strictly prohibited.
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8.12 Publication Credit
1. Publication credit should accurately reflect contribution to the research. 2. A position like "department chair" does not qualify a person for publication credit unless the individual has made substantial contributions. 3. Minor contributions should be a denoted in footnote or an introductory statement. 4. The Ethics code specifies that students should usually receive first authorship when their dissertations are published as articles. 5. Issues of publication credit should be discussed with students as early as possible and throughout the publication process.
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8.13 Duplicate Publication of Data
1. Previously published data should not be published in a manner that implies they are original data.
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8.14 Sharing Research Data for Verification
1. Psychologists should make available data to others who wish to replicate their results.2. This standard assumes confidentiality and legal concerns are addressed prior to sharing data.3. Psychologists can require that the requesting party party pay for any costs incurred in the data sharing process.4. Psychologists who request data for purposes of verification may not use the data for any other purpose, unless they obtain explicit written permission for other uses.
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8.15 Reviewers
1. When reviewing articles for publication, or presentation, psychologists should respect confidentiality and proprietary rights.
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9. Assessment
9.01 through 9.11
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9.01 Bases for Assessments
1. Assessment, recommendations, and reports, including forensic testimony, should be based on techniques that are appropriate and sufficient. 2. Forensic evaluation should normally include an examination of the person involved. 3. If such an examination is not possible, psychologists must explicitly clarify what the effect will be on the validity of the reports, and limit their conclusions accordingly. 4. When psychologists are providing services that do not require a direct examination of the person (record review or consultation), psychologists should explain this fact as well as explaining the sources of information that they're using.
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9.02 Use of Assessments
1. Assessment tools are to be used appropriately in light of relevant research. 2. Assessment instruments should generally be based on populations for which they have demonstrated validity and reliability.3. The strengths and limitations of the results and interpretation should be described. 4. Typically, assessment methods should be appropriate to the person's language preference and competence unless the use of another language is relevant to the assessment's purpose.
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9.03 Informed Consent in Assessments
1. Psychologists must usually secure informed consent prior to completing an assessment. 2. There are three exceptions to this requirement: a. When testing is mandated by law or government regulations; b. When the assessment is part of a routine educational or organizational activity and informed consent is implied (job application); c. When the testing is designed to assess decisional capacity.3. Informed consent to assessment generally includes information about the nature and purpose of the assessments, fees, third-party involvement, limits of confidentiality, as well as including an opportunity to have any questions answered.4. When persons have a "questionable capacity to consent" or testing is mandated by law, psychologists use reasonably understandable language to explain the nature and purpose of the assessment.
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9.03 Informed Consent in Assessment (Interpreters)
1. When an interpreter is used, this information must be included as part of informed consent. 2. Psychologists must also ensure that confidentiality and test security are maintained. 3. In the results, psychologists must discuss potential limitations of the data due to the use of an interpreter.
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9.04 Release of Test Data
1. Test data is "raw and scaled scores, client/patient response to test questions or stimuli, and psychologist's notes and recordings concerning client/patient statements and behavior during an examination." 2. Psychologists should release test data to the client to or to whomever is designated on a client's release of information form.3. From an ethical perspective, psychologists may refuse to release the data if they believe doing so would cause "substantial harm, or the misuse or misinterpretation of test data."4. However, laws may nevertheless require data to be released. 5. If a client has not signed a release of information, psychologists may only release data as mandated by law or a court order.6. There is no requirement in the Ethics Code for the person to whom test data is released be competent to understand and interpret it.7. Nor is there a requirement to inform clients of the risks of releasing raw test data to individuals without the necessary competence.
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9.05 Test Construction
1. Psychologists who develop assessment instruments must ensure appropriate design, standardization, validation, and reduction of bias.
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9.06 Interpreting Assessment Results
1. Psychologists interpret assessment results in light of all relevant factors, including issues of culture and language. 2. They should also indicate any limitations of their interpretations.
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9.07 Assessment by Unqualified Persons
1. Psychologists should not promote the use of assessments by unqualified persons, unless it is in the context of an appropriate training program.
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9.08 Obsolete Test and Outdated Test Results
1. Psychologists should not base treatment or other decisions on obsolete test data or on obsolete measures.
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9.09 Test Scoring and Interpretation Services
1. Psychologists retain ultimate responsibility for the use and interpretation of assessment instruments, regardless of whether they score and interpret the tests themselves or whether they use interpretation services.
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9.10 Explaining Assessment Results
1. Psychologists should explain assessment results to clients. 2. When the nature of the assessment situation precludes the sharing of results (forensic examinations), the client should be informed in advance that they will not receive the results.
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9.11 Maintaining Test Security
1. Psychologists must make efforts to maintain test security.
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10. Therapy
10.01 through 10.10
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10.01 Informed Consent to Therapy
1. As part of the requirement of securing informed consent, psychologists should, "as early as is feasible in the therapeutic relationship," discuss with client the nature and anticipated course of treatment, fees, involvement of third parties, and limits of confidentiality. 2. They should also provide an opportunity for clients to have their questions answered. 3. When treatment involves intervention techniques that have not yet been generally recognized or established, psychologists should inform the client of this fact, and any potential risks and possible alternative treatments. 4. When trainees treat clients, the client should be informed that the therapist is in training, but the case is being supervised, and they should be given the name of the supervisor who is legal responsibility for the case.
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10.02 Therapy Involving Couples or Families
1. When psychologists provide services to more than one person at a time (family therapy), psychologists should clarify which of the individuals are clients and what relationship the psychologist will have each person. 2. If psychologists are asked to perform conflicting roles (therapist and witness for one party in a divorce), psychologists must "take reasonable steps to clarify, modify, or withdraw from, roles appropriately."
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10.03 Group Therapy
1. At the beginning of group therapy situations, psychologists should clarify the roles of the psychologist and the participants, as well as the limits of confidentiality.
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10.04 Providing Therapy to Those Served by Others
1. When clients are in treatment with other mental health professionals, psychologists should carefully consider the treatment issues and potential welfare of clients, discuss the issues with clients to minimize any confusion, consult with the other providers when appropriate, and proceed with caution and sensitivity.
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10.05 Sexual Intimacies with Current Therapy Clients/Patients
1. Psychologist may never engage in sex with current clients.
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10.06 Sexual Intimacies with Relatives or Significant Others of Current Therapy Clients/Patients
1. Psychologists may not have sexual relations with persons who are near to clients, including close relatives and significant others. 2. In addition, psychologists may not terminate therapy with the client in order to engage in such a relationship.
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10. 07 Therapy with Former Sexual Partners
1. May never treat previous sexual partners.
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10.08 Sexual Intimacies with Former Therapy Clients/Patients
1. Psychologists may never have sex with a former client unless at least two years have passed since treatment ended. 2. After this two-year interval, psychologists still should not enter into sexual relationships with former clients unless the "most unusual circumstances" exist. 3. The burden remains on the psychologist to prove that there has been no exploitation, especially in light of seven factors: a. Time passed since termination; b. The nature, intensity, and duration of treatment; c. Circumstances of termination; d. Personal history of the client; e. The client's current mental status; f. Likelihood of adverse impact; and g. Sexual statements made during treatment.
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10.09 Interruption of Therapy
1. When psychologists enter into employment or contractual arrangements (managed-care), they take reasonable steps to ensure the responsibility for clients' care will be resolved appropriately when the contract ends. 2. The welfare of the client should be the overriding consideration.
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10.10 Terminating Therapy
1. Psychologists should terminate therapy when it is reasonably clear that the client no longer needs, is not benefiting from, or is being harmed by treatment.2. It is ethically permissible to terminate therapy if the client, or someone in a relationship with the client, is threatening or endangering the psychologist. 3. Termination should usually be preceded by pre-termination counseling, which may include suggesting alternative treatment providers when appropriate. a. Exceptions include: ~ When actions of clients make it impossible (sudden refusal to attend therapy). ~ When it is prohibited by third-party payors (managed-care).
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Standards for Educational and Psychological Testing (1999)
1. Standard divided into three parts: a. Test construction, evaluation, and documentation, b. Fairness in testing (e.g. diverse linguistic backgrounds, etc.), and c. Testing application (e.g., educational testing, etc.).2. Address "professional and technical issues of test development and use in education, psychology, and employment".3. Test users should have a sound technical and professional basis for their actions (can be derived from research done by test developers).4. In selecting a test, a potential user should depend heavily upon the developer's documentation that is clearly related to the intended application.5. Ultimate responsibility for appropriate test use lies with user.
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Mental Measurement Yearbook (MMY)
1. Contains the most comprehensive and authoritative compilation of test reviews. 2. Test reviews generally include: a. a description of the test; b. information about the uses of the test; c. test construction, administration and scoring; d. types of scores; e. normative data; f. reliability and validity. 3. Reviews included evaluations and the meaning of the available research on each test.
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Tests in Print
1. A comprehensive bibliography of all-around commercially available test that are currently in print in the English language. 2. I ncludes cross-referencing with the MMY. 3. It lists information on each test such as: a. title; b. the population it was designed for; c. available sub-tests; d. updating; e. authors; and f. publisher.
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General Guidelines for Providers Psychological Services (GGPPS)
1. Areas discussed include: a. Professional Psychologists b. Retraining Psychologists c. Records
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Professional Psychologists (GGPPS)
1. Providers of psychological services include professional psychologists. 2. Professional psychologists have a doctoral degree in psychology from an organized, sequential program in a regionally accredited university or professional school. 3. Specific definitions of professional psychologists by each of the recognized specialties are provided in the specialty Guidelines for the Delivery of Services (now an obsolete publication).
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Retraining Psychologists (GGPPS)
1. Retraining psychologists to qualify for a change in specialty must be under the auspices of a program in a regionally accredited university or professional school that offers a doctoral degree in that specialty. 2. The education and training is individualized, with due credit given for relevant coursework requirements previously satisfied. 3. Merely taking an internship or acquiring experience in a practicum or employment setting is not adequate preparation to become a clinical, counseling, I/O or school psychologist.
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Records (GGPPS)
1. At a minimum, records of psychological services should include: a. diagnoses; b. initial findings; c. treatment plan; d. dates of service; e. progress in the treatment plan. 2. One generally follows state regulations with regard to the keeping of records. 3. In the absence of such regulations, APA's Record keeping Guidelines (2007) state that psychologists may retain a full set of records for adults for seven years after the last date of service delivery, and for minors psychologists may retain a full set of records for seven years or three years after the minor reaches the age of majority, whichever is later.4. In some cases, records should be maintained in perpetuity (e.g., for individuals with disabilities who need to comply with Social Security Administration to document childhood disability).
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Guidelines for Child Custody Evaluations in Divorce Proceedings (GCCEDP)
1. Divorce requires a restructuring of parental rights and responsibilities in relation to the children. 2. If the parents are unable to reach an agreement, the courts intervene, applying the principal of the "best interest of the child" in determining restructuring of rights and responsibilities.3. Guidelines for child custody evaluations include: a. Focus of evaluation is on parenting capacity, psychological and development needs of the child, and the resulting fit. b. Role of the psychologist is that of a professional expert who strives to maintain an impartial, objective stance. c. Psychologists avoid multiple relationships (avoid evaluations when previously the therapist) d. Therapy with the child or family after the evaluation is undertaken with caution. e. Psychologist can testify as a fact witness but should generally decline the role of an expert witness who is giving a professional opinion regarding custody and visitation.4. Psychologists conducting evaluations obtain informed consent from adults, assent from children, and inform participants that in consenting to an evaluation they are consenting to disclosure of the evaluations findings in the forthcoming litigation or proceedings (no confidentiality).5. Psychologist uses multiple methods of data gathering and neither over-interprets nor inappropriately interprets clinical or assessment data.6. Psychologists do not give any opinion regarding the psychological functioning of any individual who is not personally evaluated. This does not preclude the psychologist from reporting what an evaluated person (child) has stated.
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Guidelines for Parole Evaluations and Recommendations (GPER)
1. Most correctional psychologists are in the position of being both a therapist and the evaluator for parole and release. 2. Ethical guidelines encourage sensitivity to the ethical pitfalls inherent in this dual relationship, but it IS definitely a permitted relationship. 3. Concerns include: a. patient may not be completely honest as a therapy client if he or she knows that the therapist will be making parole recommendation; b. informed consent may not be given in a truly free manner & may be somewhat forced; c. patient may recognize therapist may not recommend parole if client does not cooperating treatment.
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Health Insurance Portability and Accountability Act (HIPAA; 1996)
1. Designed to protect Americans with medical conditions from losing health insurance when they change jobs or move. 2. Intent is to streamline healthcare system by requiring practitioners and institutions to follow consistent standards for transmitting uniform electronic health care claims. a. HIPAA's 3 Rules b. HIPAA Compliance c. HIPAA and State Law d. HIPAA and FERPA e. Penalties f. Basic Definitions g. Generalized Consent and Authorization h. Summary of Patients' Rights i. Duties of the Psychologist
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HIPAA's 3 Rules
1. Privacy Rule2. Transaction Rule3. Security Rule
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The Privacy Rule (Rule #1, HIPPA, 2003)
1. Provides regulations and safeguards regarding confidential patient information.
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The Transaction Rule (Rule # 2, HIPAA, 2003)
1. Requires that a nationally standardized format be used for all health-care transactions transmitted electronically (insurance claims). 2. The average practitioner who submits claims electronically must use appropriate software or contract with the health-care clearinghouse (transforms written data into electronic format). 3. It is predicted that insurance companies will eventually require electronic transmissions (APA), although written claims are currently allowed except Medicare (and they exempt solo practitioners and small groups).
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The Security Rule (Rule #3, HIPAA, 2005)
1. Addresses issues of physical security, such as locking filing cabinets and encrypting emails.
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HIPAA Compliance
1. Compliance only required when health information transmitted in electronic form. 2. Once any information is transmitted electronically, HIPAA's rules apply to the entire practice of a psychologist or institution.3. Except for rare private practice practitioners who do not except 3rd-party reimbursement or use electronic transmissions, HIPAA applies to all psychologists. 4. It is believed that HIPAA will eventually be considered "standard of practice" and will be applied to all psychotherapists.
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HIPAA and State Law
1. Issues about confidentiality and patient access to records are typically governed by state laws and regulations. 2. HIPAA is a federal law that can take precedence over state law. 3. When HIPAA is stricter, it supersedes state law. 4. A practitioner also follows HIPAA guidelines when it contradicts state law, making it impossible to comply with both.5. When state law is stricter, it supersedes HIPAA.
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HIPAA and FERPA
1. HIPAA Have no jurisdiction over educational records. 2. Privacy rights and educational records are governed by FERPA (1974), also known as the Buckley Amendment. a. It includes provisions granting the right of access to one's own records; b. Limits disclosure of the records, such that parents cannot access these records (including student health records) without consent of the student.
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Family Educational Rights and Privacy Act (FERPA, 1974)
1. Privacy rights and educational records are governed by FERPA (1974), also known as the Buckley Amendment. a. It includes provisions granting the right of access to one's own records; b. Limits disclosure of the records, such that parents cannot access these records (including student health records) without consent of the student.
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Penalties (HIPAA)
1. No grace period for failure to comply with HIPAA.2. Federal government has indicated that it is more interested in supporting and educating practitioners, than in punishing them.3. Failure to comply with HIPAA includes: a. Administrative sanction by the office for Civil Rights and Health and Human Services; b. Civil penalties penalties of $100 for each violation up to a total of $25,000 a year; c. Fines up to $250,000 or 10 years imprisonment (or both) for deliberate and knowing violations of patient's privacy rights.
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Protected Health Information (PHI)
1. Health information that identifies a patient, and that is transmitted or maintained in any form (e.g., on computer, handwritten notes). 2. PHI includes information about: a. the mental health condition of a patient (diagnosis, symptoms). b. the provision of services (medication, treatment), and c. payments.3. Chart notes kept on a psychotherapy patient are considered to be PHI.
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Psychotherapy Notes (HIPAA)
1. Refers to what has historically been termed "process notes". 2. Process notes document or analyze the content of counseling sessions (dreams). 3. In order for process notes to be considered "psychotherapy notes", and to be accorded special protection, requires that these notes be "separated from the rest of an individual's medical record".
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Generalized Consent (HIPAA)
1. Patients must be informed of a practitioner privacy policy, however, they do not have to get written consent to disclose PHI for the purposes of treatment, payment, or to carry out healthcare operations.2. Psychologists, medical doctors, and hospitals may disclose and is PHI without a patient's consent if they are doing so for treatment (consultation), payment (billing), or healthcare operations (utilization review). 3. Use and disclosure of PHI for other purposes still requires specific patient authorizations.
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Authorization (HIPAA)
1. Refers to obtaining patient permission to disclose information on a release of information form. 2. Practitioners do not need to obtain authorization (written release) for disclosures as long as the disclosures are for the purpose of treatment, payment, or healthcare operations (PHI).3. An authorization is needed for any other disclosure (psychotherapy notes).4. Psychotherapy notes are recognized as a special class of information for special protections. a. Managed-care organizations and other third-party reimbursement entities may not require the release of psychotherapy notes in order to provide reimbursement; b. If psychotherapy notes are to be disclosed, the patient must complete a specific and detailed authorization; c. exceptions include averting a serious threat to the health and safety of a person or when required by law.
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Summary of Patients' Rights (HIPAA)
1. HIPAA allows: a. patients greater access to their records and b. an increased understanding of how the records will be used.
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Right of Notice (HIPAA)
1. Patients have right to be informed about the psychologists privacy policy and the ways in which PHI maybe used or disclosed. 2. Patients also have the right to understand patients' rights to limit uses and disclosures. 3. Patients should be provided with a written copy of the psychologist's privacy policy.
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Right to Request Restrictions (HIPAA)
1. Psychologists are obligated to agree to "reasonable requesst" to restrict use and disclosure of PHI.2. Psychologists are not obligated to agree to any and all limits of disclosure and use as requested by patients.3. Psychologists may refuse to provide treatment if the patient does not consent to disclose (does not sign consent form).
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Right to Receive Confidential Communications by Alternative Means at Alternative Locations (HIPAA)
1. Patients may elect to have psychologists mail their bills to an address other than their home address or not to call them at their home phone, in order to protect patient's confidentiality.
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Access to Records and Psychotherapy Notes (HIPAA)
1. Patients have the right to inspect and receive a copy of PHI that is in the medical record. 2. Records may only be withheld when disclosure would jeopardize the life or physical safety of the patient or others.3. Patients do NOT have a right to inspect or obtain a copy of their psychotherapy notes.
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Right of Amendment (HIPAA)
1. Patients may request changes to their PHI to improve accuracy. 2. If a psychologist determines that such a change would make the PHI less accurate, the request may be denied. 3. In all events, the record may never be expunged (deleted and replaced).4. Changes to records should be noted as amendments. 5. All requests for amendment, as well as communications regarding granting or denying requests, must be documented in the patient's record.
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Right of Accounting (HIPAA)
1. Patients have the right to receive an accounting of all disclosures of their PHI for the past six years. 2. This accounting must include information about: a. the date of the disclosure, b. the parties and information disclosed, and c. a description of what was disclosed and for what purpose. 3. Written authorizations by the patient may be used in lieu of such an accounting procedure.
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Duties of the Psychologist (HIPAA)
1. HIPAA Compliance is "scalable", meaning more is expected of a hospital than of a practitioner with 15 patient hours.
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Written Privacy Policy (HIPAA)
1. Psychologists must have a written privacy policy, and this privacy policy must be given to all patients. 2. This policy must reflect compliance with HIPAA and state laws. 3. A compliance officer must be designated (most small practices would be the practitioner herself).
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Tracking Disclosures (HIPAA)
1. Psychologists must track disclosures of PHI.
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Compliance of Employees and Business Associates (HIPAA)
1. Psychologist must ensure that employees (e.g. secretaries, psych assistants) are trained in compliance with HIPAA requirements. 2. Psychologists must obtain contractual assurances that business associates (billing companies) comply with HIPAA.
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Protection for Psychotherapy Notes (HIPAA)
1. If psychologists want psychotherapy notes to receive more stringent protections, they must maintain these notes separately from the rest of the medical record.
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Safeguarding Access to PHI (HIPAA)
1. Access to PHI must be safeguarded.2. Practitioners must take appropriate and reasonable actions such as locking filing cabinets, ensuring that electronic records are protected with passwords and firewalls, and encouraging encryption of emails that contain PHI.
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Retention of Records (HIPAA)
1. Records must be obtained for 6 years from: a. The date of their original creation or b. The date when they were last in effect2. Whichever date is later is the one utilized.
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Expert Witness (Definition)
1. A person who is a specialist in the subject, often technical, who may present his or her expert opinion without having been a witness to any occurrence relating to the lawsuit or criminal case.2. Must be recognized by the court as an expert witness.3. Must be "reasonably familiar with the judicial or administrative rules governing their roles."
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Incompetence (to Stand Trial)
1. Also known as a Competency Evaluation.2. Dusky v. United States 1960.3. District Judge must: ~ Find that the defendant is oriented to time and place and have some recollection of events. ~ Must have sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding & have a rational and factual understanding of the proceedings against him.4. An assessment of the ability of a defendant to understand and rationally participate in a court process.5. A person must be capable of understanding the court proceedings, the crime, and the possible penalties and effects.6. A person deemed incompetent: ~ Must Must receive psychiatric treatment (inpatient or jail) and specifically at enabling the person to stand trial with this little delay as possible. ~ When the psychiatric staff believes the defendant has become competent, the court will hold a hearing. ~ If the defendant is found competent, the court will then order the defendants release if the defendant is an inpatient psychiatric treatment facility and safety for trial. ~ There is no timeframe required for number of days until next reevaluation. will be tried if he regains competence.
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Confidentiality and EAP
1. A supervisor who may have suggested an employee contact an EAP program is entitled to know what visits were made.2. The supervisor is not entitled to know the content of such visits.
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Larry P. v. Riles (1979)
1. Established the legal precedent that tests administered to minority children must have been validated for use with the population.2. Provides the legal precedent against cultural bias in testing.3. Challenged that the evaluation for eligibility using only IQ test results was biased.4. Larry P was a young African-American child who was diagnosed as having EMR and was receiving services in a self-contained classroom for children with EMR. The evaluation for eligibility used IQ test results as sole criterion for placing children in EMR classrooms.
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APA's Record keeping Guidelines - Guideline 7: Retention of Records (2007)
1. In the absence of a superseding requirement, psychologists may consider retaining full records until: a. For Adults: ~ 7 years after the last date of service delivery for adults. b. For minors: ~ Until 3 years after a minor reaches the age of majority (or 7 years), whichever is later.2. In some circumstances, the psychologist may wish to keep records for a longer period, weighing the risks associated with obsolete or outdated information, privacy laws, versus the potential benefits associated with preserving the records.
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M'Naghten Rule
1. It is a test applied to determine whether a person accused of a crime was sane at the time of its commission and, therefore, criminally responsible for wrongdoing.2. A test for criminal insanity.3. A criminal defendant is not guilty by reason of insanity if: a. At the time of the alleged criminal act, the defendant was so deranged that she did not know the nature or quality of her actions or b. If she knew the nature and quality of her actions, she was so deranged that she did not know that what she was doing was wrong.4. Based on the events in 1843 when Daniel M'Naghten tried to kill England's Prime Minister Sir Robert Peel due to a psychotic disorder that caused Daniel to believe the prime minister wanted to kill him.
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\*\*\*\*APA Guidelines for Test User Qualifications
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Privacy
1. Professionals and support staff should take reasonable steps based on appropriate standards of practice to ensure they do not reveal your identity, discuss information, or reveal the content of their communications with others.2. Privacy is not a statutory protection, but rather a professional relationship.3. Information is not confidential if you are not treatment relationship.
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Confidentiality
1. A legal protection and assurance of your right to privacy to the fullest extent allowable by state law.2. Psychotherapy, counseling, assessment and associated services that are related to diagnosis and treatment are confidential and protected in accordance with state law.3. Patient confidentiality applies only to those aspects related to a diagnostic and treatment relationship with the clinician.
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Clinical Privilege
1. Refers to the process through which individuals are credentialed within institutions to provide specific patient care services.
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Legal Privilege
1. Also called testimonial privilege.2. The patient's right to keep confidential communications from being disclosed in a legal proceeding.
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Buckley Amendment (FERPA, 1974)
1. Refers to the Family Educational Rights and Privacy Act of 1974 (FERPA).2. Protect the privacy of student records in higher education institutions.3. It includes provisions granting: a. The right of access to one's own records. b. Limiting the disclosure of records.
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The Elementary and Secondary Education Act (1965)
1. Federal legislation guaranteeing a high-quality education for all individuals.2. Also address the importance of a fair and equal opportunity to obtain an education.
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Court Orders (and Responding)
1. Receiving a court order means that you must submit your treatment records, even if the client refuses to sign a release of information.2. You can request the court order be modified, if you have reason to believe the disclosure of treatment information will not be helpful.3. If the request for modification is refused, you must release the records.4. Once a court order is received, asserting privilege is no longer an option.
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Pro Bono Services
Psychologists are encouraged to contribute a portion of their time for little or no financial advantage.
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\*\*\* Standards for Educational and Psychological Testing (APA)
1. It is unethical to administer tests without justification.
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Capp v. Rank (1990)
1. California Association of Psychology Providers v. Rank.2. Case taken to the Supreme Court that resulted in psychologists being permitted to have primary responsibility for patient care within and outside hospital settings.3. Psychologists do not require psychiatric supervision.
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Informed Consent (re: Assessments)
There are 3 exceptions to obtaining consent prior to conducting assessments: 1. When the assessment is mandated by law or governmental regulations. 2. When testing is part of routine educational or organizational activity. 3. When testing is being conducted to assess decisional capacity.
