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Ethics and Malpractice
This article discusses the 7 essential basics of ethics in psychology.
Research shows that many organizations overlook needs and opportunities to strengthen ethics. Barriers can make it hard to see the need for stronger ethics and even harder to take effective action. These barriers include the organization's misleading use of language, misuse of an ethics code, culture of silence, strategies of justification, institutional betrayal, and ethical fallacies. Ethics placebos tend to take the place of steps to see, solve, and prevent problems. This article reviews relevant research and specific steps that create change.
The growing array of record-keeping laws, ethical standards, and professional guidelines has created controversy and confusion. Clinicians struggle with what to leave in, what to leave out, how to handle records securely, when to respond to requests for records versus when to refuse, and so on. This article focuses on 5 challenging areas: confidentiality; informed consent; the state, the law, and legal requirements; third-parties; and the implications of research findings for record keeping. It discusses published claims, critiques, proposals for change, and research reports, particularly those of Bemister and Dobson (2011, 2012); Castonguay (2013);Christie, Bemister, and Dobson (2014); Furlong (2013); and Mills (2012). It emphasizes the potential problems with any "1 size fits all" approach and the difficulties in creating sensible regulations that do justice to the diversity of values, contexts, cultures, and theoretical orientations.
This article provides some steps helpful in thinking through how to respond to an ethical dilemma, taking action, and assuming personal responsibility for our response. These steps may help us to identify important aspects of a situation, consider positive and negative consequences of the ways in which we might respond, and discover better approaches.
This brief article discusses 21 common fallacies and rationalizations we tend to use to justify unethical behavior and quiet a noisy conscience.
Developing & Practicing Ethics [The Portable Mentor: Expert Guide to a Successful Career in Psychology]
This chapter discusses important steps in developing and practicing professional ethics, as well as the ways in which we rationalize unethical behavior. It includes national actuarial data on ethical problems encountered by psychologists, the 9 most frequent causes of licensing board disciplinary actions involving psychologists over a 14 year period, and the 16 most frequent causes of malpractice suits against psychologists over a 15 year period.
A selection of sample forms for obtaining and documenting informed consent in psychotherapy & counseling; excerpts addressing informed consent from a large array of ethics codes and practice guidelines adopted by professional organizations; and excerpts from books, articles, and chapters discussing informed consent.
Ethics of Practice: The Beliefs and Behaviors of Psychologists as Therapists [American Psychologist]
This national survey of the degree to which clinical and counseling psychologists engage in each of 83 behaviors and the degree to which they considered each behavior to be ethical included such items as: treating homosexuality per se as pathological; accepting a client's decision to commit suicide; discussing clients (without names) with friends; engaging in sexual fantasies about a client; going into business with a client; breaking confidentiality if a client is suicidal; charging a client no fee; making a custody evaluation without seeing both parents; hugging a client; signing for hours a supervisee has not earned; filing an ethics complaint against a colleague; performing forensic work for a contingency fee; altering a diagnosis to meet insurance criteria; breaking confidentiality to report child abuse; inviting clients to a party or social event; accepting goods as payment; seeing a minor client without parental consent; telling a client "I'm sexually attracted to you"; terminating therapy if a client cannot pay; asking favors from clients; using a law suit to collect fees; lending money to a client; becoming sexually involved with a former client; and engaging in sex with clinical supervisees
Ethics of Teaching: Beliefs and Behaviors of Psychologists as Educators [American Psychologist]
This national survey of the degree to which psychology professors engage in each of 63 behaviors and the degree to which they considered each of these to be ethical included behaviors in such categories as course content, evaluation of students, educational environment, disrespectful behavior, research and publication issues, financial and material transactions, social relationships with students, and sexual relationships with students and other faculty.
Ethical Dilemmas Encountered by Members of the American Psychological Association [American Psychologist]
This survey of the general APA membership, based on the unique critical incident study that lead to APA's original code of ethics, examined 705 incidents (falling into 23 categories) that APA members described as ethically challenging or troubling.
Ethical and Malpractice Issues in Hospital Practice [American Psychologist]
This review of ethical and malpractice issues arising in hospital practice includes: (a) preparation and authorization to carry out clinical responsibilities, (b) personnel procedures, (c) financial and political forces influencing hospital policies, (d) billing procedures, (e) clinical procedures for responding to patients' needs, (f) confidentiality, (g) discrimination, (h) internship and training issues, (i) sexual abuse of patients, and (j) staff conflicts influencing patient care.
When Laws and Values Conflict: A Dilemma for Psychologists [American Psychologist]
This national study asked psychologists whether they believed "that formal legal and ethical standards should ever be violated on the basis of patient welfare or other deeper values" and "In the most serious, significant, or agonizing instance, if any, what law or formal ethical principle have you broken intentionally in light of a client's welfare or other deeper value?"
Disability, Accessibility, & Ethics in Psychology: 3 Barriers [Ethics & Behavior]
This article discusses the physical barriers, internet barriers, and cognitive & affective barriers in psychology training and practice that block accessibility for people with disabilities.
Identifying and Implementing Ethical Standards for Primary Prevention [Journal of Prevention & Intervention in the Community]
This article examines the prerequisites (e.g., group identity, recognition of need, and active participation) and necessary steps for establishing formal ethical accountability in the area of primary prevention, with emphasis on 5 ancient principles (avoiding harm, competence, avoiding exploitation, respect, and confidentiality) as well as two more historically recent principles (informed consent; social equity and justice).
This article presents 20 of the most common fallacies and rationalizations we tend to use to justify unethical behavior and quiet a noisy conscience.
When The Therapist Doesn't Know What To Do: Some Steps That May Help [American Psychological Association]
Based on the views (a) that there are no clear, one-size-fits-all answers to therapeutic dilemmas, complexities, and challenge; (b) that various theoretical orientations provide different, sometimes opposing ways of approaching question, and (c) that each therapist, each client, and each situation is unique, whatever qualities they may share with other therapists, clients, and situations, these 10 steps may be helpful when therapists reach an impasse or just aren't sure what to do.
Malpractice & Licensing Pitfalls for Therapists: A Defense Attorney's List [Innovations in Clinical Practice] A question asked of attorneys who defend psychotherapists in civil suits and before licensing boards is what are the most common areas where therapists leave themselves vulnerable to attack. In this article, a defense attorney identifies some of the more common pitfalls that psychotherapists may encounter in hope that they can be avoided in the future.
HIPAA & Forensic Practice [American Psychology Law Society News] Does the Health Insurance Portability and Accountability Act (HIPAA) apply to forensic practice? In particular, do forensic practitioners incur the obligations of "covered entities," as defined in the Privacy Rules (§160.103), a subset of HIPAA? Do our files and the information we compile constitute Protected Health Information (PHI)? If so, what steps must we take to be compliant? Do HIPAA obligations attach to some areas of forensic practice, but not others? Even if forensic practice does not fall under HIPAA regulation, must we still attend to some issues raised by HIPAA?
AIDS and HIV Infection Update: New Research, Ethical Responsibilities, Evolving Legal Frameworks, and Published Resources [Innovations in Clinical Practice]
This chapter discusses research, ethical responsibilities, and legal considerations for practitioners; denial, delay, and distortion; test reliability, risk factors, and risk groups; general principles of counseling those people who have AIDs or who are or might be HIV-positive; suicide, the dilemma of the right to die, and foregoing life-sustaining interventions; neuropsychological aspects of AIDS and HIV infections; is there a legal duty to protect or warn third parties; and education and prevention.
The Ethics of Research Involving Memories of Trauma [General Hospital Psychiatry]
This invited editorial emphasizes the importance of ethical considerations in research on traumatic memories.
This brief article notes threats to the privacy of records on computers and the steps that therapists and counselors can take to make their computerized records secure.
This article by Kenneth Drude, Ph.D. & Michael Lichstein, Ph.D. examines email guidelines in such areas as policies & procedures, turn-around time for responding, message content, when not to use email, emergencies or crises, confidentiality & privacy, security, informed consent, fees, documentation & record-keeping, licensing jurisdiction, and competency.
Sample Agreement Between Expert Witness & Attorney by Kenneth S. Pope, Ph.D., ABPP, James N. Butcher, Ph.D., & Joyce Seelen, J.D.
Ethics in Psychotherapy and Counseling: A Practical
Guide, (Fifth Edition, 2016),
by Kenneth S. Pope, Ph.D., ABPP & Melba J. T. Vasquez, Ph.D., ABPP
Publisher: John Wiley & Sons.
"[The 5th edition] is a must read book for both beginning and seasoned clinicians . I learned a lot reading this book. Kudos to Pope and Vasquez."
--Donald Meichenbaum, Ph.D. Distinguished Professor Emeritus, University of Waterloo; Research Director of the Melissa Institute for Violence Prevention
Pope and Vasquez continue to be the "conscience of psychology." This 5th edition gives us guidance at a time when American psychology must find its moral compass."
--Bonnie R. Strickland, Ph.D., ABPP; Former President, American Psychological Association
"Once again, with this 5th Edition, Drs. Pope and Vasquez provide us with indubitable evidence that what is already the best book on ethics can be made even better."
--Martin Drapeau, Ph.D.; Editor in Chief, Canadian Psychology/Psychologie canadienne
"A stunningly good book.... If there is only one book you buy on ethics, this is the one."
—David H. Barlow Ph.D, ABPP; Professor of Psychology and Psychiatry, Boston University
[The 5th edition] is a compassionate, must-have book…. emphasizes the importance of integrating of realistic self-knowledge with moral courage and sound ethical reasoning, - makes a significant contribution to our understanding of how to be ethical.
--Carole Sinclair, PhD, Chair, Committee on Ethics, Canadian Psychological Association
"Continues to be the gold standard.... A must read in every counseling/therapy training program. It is that good and valuable."
--Derald Wing Sue, Ph.D. Professor of Psychology Teachers College, Columbia University
"Two of psychology's national treasures, Drs. Ken Pope and Melba Vasquez, walk the walk of psychotherapy ethics. Simply the best book in its genre."
—John Norcross, PhD, ABPP, Professor of Psychology & Distinguished University Fellow, University of Scranton
"The 5th edition… continues to offer the most fully realized blending of scholarship and street smarts available.
—Eric Y. Drogin, J.D., Ph.D., ABPP (Forensic), Harvard Medical School; Former Chair, American Psychological Association Committee on Professional Practice & Standards
What Therapists Don't Talk About and Why: Taboos That Hurt Us and Our Clients by Kenneth S. Pope, Ph.D., ABPP, Janet L. Sonne, Ph.D., and Beverly Greene, PhD., ABPP Publisher: American Psychological Association
"This book is a must read for any psychotherapist. It explores the real world and often secret problems encountered in clinical practice in a creative, personal and very useful fashion. In this world of increasing professional accountability and liability, clinicians can be assured that their practices will be much better off for having implemented the common sense suggestions made by the authors."
Jeffrey N. Younggren, Ph.D., ABPP
Risk Management Consultant
American Psychological Association Insurance Trust
How To Survive and Thrive as a Therapist: Information, Ideas, & Resources for Psychologists by Kenneth S. Pope, Ph.D., ABPP & Melba J. T. Vasquez, Ph.D., ABPP
Publisher: American Psychological Association
"This comprehensive practical guidebook is a must for
all new and seasoned clinicians. From attorneys to ethics, from
billing to possible errors in logic--it is all here. A remarkable
compendium. Kudos to Pope and Vasquez!"
Donald Meichenbaum, PhD, University of Waterloo, Ontario, Canada
Law and Mental Health Professionals: California by Brandt Caudill & Kenneth S. Pope, Publisher: American Psychological Association
This book reviews legislation, case law, and regulations relevant to mental health practice in California.
The Ethics of Counseling: A National Survey of Certified Counselors [Journal of Counseling & Development]
This national survey of counselors certified by the National Board for Certified Counselors asked participants to report their beliefs about whether each of 88 behaviors was ethical and the degree to which they were confident of their judgment about the behavior.
A Community Psychology of Ethics [American Journal of Community Psychology]
The topics in this discussion of ethical responsibilities in community psychology include: (1) difficulties in adapting ethical codes to the values, concerns, and language of community psychology; (2) the elusive nature of community psychology; (3) unforeseen effects of interventions; (4) the necessity of assuming responsibility for the consequences of interventions; (5) the clarification of assumptions and values underlying any formal code of ethics; and (6) the creative nature of ethical decision making.
Fee assessment and outpatient psychotherapy [Journal of Consulting & Clinical Psychology]
This multivariate study of 3 predictor variables (fee, diagnosis, and socioeconomic status) found only diagnosis to be significantly related to the outcome, number of appointments, and attendance of individual outpatient psychotherapy