APA & The Hoffman Report

The Hoffman Report And the American Psychological Association:

Meeting the Challenge of Change

Kenneth S. Pope, Ph.D., ABPP

Revised September 15, 2015 - Published January 19, 2016

Excerpted from Ethics in Psychotherapy and Counseling: A Practical Guide, Fifth Edition by Kenneth S. Pope and Melba J.T. Vasquez, pp. 361-369, (paperback, Kindle, Nook, Apple iBook, Google Book). ISBN: 978-1-119-19544-3.  Copyright © 2016 by John Wiley & Sons, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

PLEASE NOTE: A more recent article addressing this topic is available on this site:
The Code Not Taken: The Path From Guild Ethics to Torture and Our Continuing Choices --
Canadian Psychological Association Member of the Year Award Address
by Ken Pope, in Canadian Psychology / Psychologie canadienne (2016).

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If I value transparency, it is a good idea for me to practice it, so in the interest of transparency and self-disclosure of my perspective (or potential bias), it is important that readers know upfront that I resigned from APA in 2008 over changes APA had been making in its approach to ethics. The Hoffman Report discusses these changes. I wrote that "I respectfully disagree with these changes; I am skeptical that they will work as intended; and I believe that they may lead to far-reaching unintended consequences." Both my letter of resignation online at http://kspope.com/apa/index.php and my articles and chapters (Pope, 2011a, 2011b, 2014, in press; Pope & Gutheil, 2009) present my beliefs along with the evidence and reasoning that in my opinion support them.

In 2014, the American Psychological Association (APA) made a monumental move toward more transparency. The organization took a courageous step unthinkable at any time in its 121-year history: Having denied for years reports of evidence that APA had covertly supported, enabled, and provided cover for torture during the war on terror--including the recent evidence revealed by Pulitzer Prize winning investigative reporter James Risen (2014) - the organization opened up to a former federal prosecutor, giving him access to all documents and personnel. They announced this striking step in a press release that began:

The American Psychological Association (APA) Board of Directors has reviewed the allegation in James Risen's book, Pay Any Price: Greed, Power and Endless War, that APA colluded with the Bush administration to support torture during the war on terror. Specifically, Risen alleges that APA supported the development and implementation of "enhanced" interrogation techniques that constituted torture, and was complicit with the CIA and U.S. military to this end. We believe that APA's October 16th statement refuting Risen's assertion was a fair and accurate response. However, the allegation made by Mr. Risen is highly charged and very serious. His book has created confusion for the public and APA members. This confusion, coupled with the seriousness of the allegation, requires a definitive, independent and objective review of the allegation and all relevant evidence. Toward that end, and to fulfill its values of transparency and integrity, the APA Board has authorized the engagement of David Hoffman of the law firm Sidley Austin to conduct an independent review of whether there is any factual support for the assertion that APA engaged in activity that would constitute collusion with the Bush administration to promote, support or facilitate the use of "enhanced" interrogation techniques by the United States in the war on terror. (APA, 2014c)

This Independent Review Report, commonly known as the Hoffman Report (Hoffman, Carter, Lopez, et al., 2015a & b) set off an ethical earthquake. It revealed evidence that validated Risen's disclosures. It also supported other books, articles in newspapers and professional journals, books, and reports from human rights and humanitarian organizations that had been published over the years exploring APA's role in the war on terror and the stark contrast between APA's ethics policies and public statements and its behavior (for a review, see Pope (2011a & b, in press).

The investigation uncovered e-mails and other documents containing linguistic tricks that mislead and manipulate, logical fallacies in ethical reasoning, biased ethical judgment, hypocrisy, and creative cheating that this book's five chapters (chapters 4-8) focusing on critical thinking in ethics prepare us to notice and avoid. These uncovered documents confront us with the challenge of change.
The challenge brings questions. What changes need to occur in ourselves as individuals, in APA as an organization, and in the larger professional community? What internal and external forces will block, weaken, delay, or divert needed change? How can we respond effectively to these forces? Can we avoid mistaking quick changes in policy and personnel for meaningful changes in the organization's ethical culture, character, and dynamics?

None of these questions comes with a simple answer that will please everyone. All come wrapped in complex puzzles of politics, practicality, and conflicting values. None of the questions allows us easy escape. How we answer them--or fail to answer them--will determine whether we bring about needed change. This appendix looks at the questions and challenges that the Hoffman Report has brought to our doorstep.

What Does the Hoffman Report Have to Do With Each of Us as an Individual APA Leader, Member, or Outsider?

What does the Report have to do with us? When scandal explodes, our shared human tendency is to blame bad apples: "It's their fault! Maybe we made some well-intentioned mistakes, which we regret, but if you're looking for the real cause of this mess, it's them, not us." Bad apples come in three varieties: personnel, policies, and procedures. We toss the bad apples, find shiny new replacements, and think we've fixed the problem. Countless organizations make personnel moves that affect only a handful of people who are seen as "bad apples," vote to replace "bad apple" policies, and create committees to cancel some "bad apple" procedures and issue new guidelines. They find out only long after that they've gained little beyond better public relations and the illusion of reform. Both the external forces and the organizational culture, character, and dynamics that gave rise to the problem remain unchanged.

Or we can head into discrediting mode as a tactic to avoid change: "We chose the person we thought best suited to give us the definitive account of what happened, but he failed us. He gave us a report that, whatever new facts it brought out, is full of flaws and wild conjecture. A psychologist would have understood our profession, our organization, our history, our culture, and the way we do things. But he's a prosecutor and he was out to prosecute us in public and make us look bad. He started with a biased view, did sloppy work, and got key things wrong. And after all, it's just one outsider's opinion."

Answering the question "What does this have to do with us?" requires us to move beyond our human habit to deny, discredit, or dismiss what we do not want to know or be known. We may find that harder than usual in this case. The Hoffman Report documents years of improper behavior. But it also documents that for years APA as an organization and some APA defenders denied, discredited, or dismissed revelations of this improper behavior as they appeared in newspapers, professional journals, books, reports from human rights organizations, and other media. Changing habitual behavior that has settled into a familiar routine is rarely easy for any of us. Changing habitual behavior that is part of organizational culture, character, and dynamics can be even harder.

Moving beyond our shared tendency to shield ourselves from unwanted information and personal responsibility allows each of us to learn what the report has to do with each of us as an individual: If we can summon the courage and resolve to look without squinting or flinching away, the Hoffman Report and particularly the emails and other documentary evidence that accompanied it can serve as an ethical mirror. The evidence collected during the investigation was organized into 6 pdf binders (available at http://www.apa.org/independent-review/index.aspx). I strongly recommend reading all 6 binders for two major reasons. First, reading the primary source data allows us to judge for ourselves the emails and other documentary evidence instead of simply viewing it through the perspective of someone else. Second, the full arrays of evidence fills in what the Hoffman Report only summarizes. What may seem unclear, unjustified, or incomplete when reading the report may come across in a different way in view of the full range of evidence in the binders.

Taking the time to read the report and the full range of evidence on which it is based can teach us something about ourselves and help us take a personal ethics inventory. Reading the entire report and all the evidence, we can begin to see the complex relationship between what we did or failed to do and the events that the report describes and documents. When we take time to read these documents, they point the way to effective change, in ourselves and in our profession. If we set them aside unread or settle for second-hand summaries, we turn the ethics mirror to the wall and imagine a more personally flattering picture.

What Could Each of Us Have Done Differently?

Reading the Hoffman Report and the binders of documents that accompany it prepares us to struggle with one of the hardest challenges: Answering the questions: As an APA leader, member, or outsider, what could I have done differently? How does my answer to that question help me decide what to do from this point forward? No matter what our position or circumstance, each of us can think of things we might have done, or done better. Only the delusional can gaze into the Report's mirror and see ethical perfection. Only those needing an ethics ophthalmologist will notice merely a handful of things they could and should have done or done differently over the days, weeks, months, and years covered in the Hoffman Report.

Struggling with this challenge is hard, often painful work. It takes time-- not a sprint and perhaps not so much a marathon as a continuing daily run. And aren't we all tempted to cheat, sleep in, or go easy on ourselves? We all know how to put denial, discrediting, and dismissing to work when searching for our own ethical disconnects, flaws, weaknesses, and violations. Politicians master this art of pseudo-self-examination.

We can use the Hoffman Report and its binders of evidence to hold ourselves personally accountable for all the things we might have done, or done differently. This puts us in a better position to join with others in our diverse communities from our small informal groups and networks to large national and international professional organizations to bring about needed, meaningful change in our profession in all its diversity.

What Do We Want Our Ethics and Our Ethics Enforcement to Be?

The Hoffman Report challenges us to decide what kind of ethics each of us believes in and whether we are willing to be held accountable. A fundamental question is: Do we choose professional ethics or guild ethics? Professional ethics protect the values that its members affirm as greater than self-interest and protect the public against misuse of professional power, expertise, and practice. Guild ethics place the interests of the guild and its members above the public interest, edge away from actual enforcement and accountability, and draw on skilled public relation to resemble professional ethics.

The Hoffman Report documents that for over 15 years APA had turned its ethics policies and enforcement procedures toward protecting its members from public accountability. In the words of the report, APA "prioritized the protection of psychologists--even those who might have engaged in unethical behavior-- above the protection of the public" (p. 63). The Association made this switch to "a highly permissive APA ethics policy based on strategy and PR, not ethics analysis" (p. 16) well before the detainee controversy, all the way back to the 1990s. The Report provides accounts of extraordinary interventions to undermine the process of adjudicating ethics complaints and protect high-profile or well- connected members dating back to the mid-1990s. Depriving people who file formal complaints of a fair hearing and a just resolution can serve guild interests but it can also encourage members and nonmembers alike to believe that voicing ethical questions or concerns that might reflect badly on individual members or damage the organization's interests "will at best come to nothing" (Pope, 2015b, p. 144).

APA had turned away from its responsibility to protect the public. The Hoffman Report quotes the APA's Ethics Director's statement that the role of APA Ethics "is not protection of the public and that protection of the public is a function for state licensing boards" (p. 475). APA embraced this model of ethics and modeled it for students, trainees, its members, state psychological associations, and the national and international community for 15 years.

APA's initial move away from protecting the public sparked great controversy with publication of the 1992 ethics code. As Carolyn Payton, who had served on both the APA Policy and Planning Board and the Public Policy Committee, wrote in 1994 in Professional Psychology: Research and Practice:

All previous codes seemed to have been formulated from a perspective of protecting consumers. The new code appears to be driven by a need to protect psychologists . . . . It reads as though the final draft was edited by lawyers in the employment of the APA. (p. 317)

She critiqued the "many instances of exceptions to the rule" that protect members against enforcement of the ethical standards:

The forcefulness of the proscriptions on harassment, e.g., is diminished in the Other Harassment standard, Standard 1.12, which brings up the qualifier "knowingly" (APA, 1992, p. 1601), as in psychologists do not knowingly engage in harassment. Try using the argument of ignorance with the Internal Revenue Service to explain your failure to withhold appropriate taxes for the housekeeper or baby-sitter. (p. 320)

She wrote that "removal of the many instances of exceptions to the rule would make the code more enforceable and more reflective of our discipline, which at one time was dedicated to the promotion of human welfare" (p. 320).

Don Bersoff used a colorful term to describe these exceptions and qualifiers that characterized the 1992 code: "weasel words." Bersoff, who had served as APA's general counsel and would later serve as its president, emphasized that "as almost all the reviewers pointed out, the code is full of such lawyer-driven 'weasel words' as reasonable and feasible." (1994, p. 383). He summed up a dominant theme emerging from the reviewers: "it is a document designed more to protect psychologists than to protect the public" (1994, p. 383).

APA's new ethics, based on "First, do no harm to psychologists," created a public relations problem. How could the Association explain to the public that protecting them from the harm that can result from unethical assessment, therapy, counseling, forensic practice, research, publication, teaching, and so on, was not its concern? Could it honestly announce that the function of APA ethics "is not protection of the public and that protection of the public is a function for state licensing boards"? The answer had the simplicity of Orwell's double-speak: War is peace, ignorance is strength, freedom is slavery--"To advance its PR strategy, APA issued numerous misleading statements that hid its true motives, in an attempt to explain and justify its ethics policy" (Hoffman et al., 2015, p. 15).

But what are our true motives--yours and mine? What do each of us see when we look in the mirror? What are our own personal ethics? To what extent are they public relations, more appearance than practice? How much time do we spend searching for ways to strengthen them and eliminate gaps, flaws, and contradictions? How rigorous are we in holding ourselves accountable to these ethics? What would we do if we knew we could get away with it and no one would find out?

When we struggle with these questions, we put ourselves in a better position to join with others to think through how to use the Hoffman Report to strengthen the ethical culture and practices of psychologists and our diverse groups, networks, and organizations.

What Do We Do to Discover or Screen Out What Happens?

Reading the Hoffman Report provides each of us with an opportunity to take a look at how we personally respond to critical information and criticism. The 6 binders of emails and other documents that accompany the Report show the fascinating but dismaying ways that "based on strategic goals, APA intentionally decided not to make inquires . . . thus effectively hiding its head in the sand" and "remained deliberately ignorant" (p. 11). This very human process of protecting ourselves from what we don't want to see or hear rings a familiar bell throughout history. When scandals or atrocities, especially those involving human rights, rattle a business, organization, or country, shocked looks of innocence spring to face after face, accompanied by the refrain: "I saw nothing! I knew nothing! We never suspected!"'

But what about both the documented information and criticism published year after year in newspapers, professional journals, books, human rights reports, and other sources? Critical information that ran contrary to APA's strategic goals met with vigorous denial, discounting, and discrediting. The Hoffman Report describes how those who defended the PENS ethics policy and APA's actions dismissed the criticism as "baseless" and the critics' statements "as false and defamatory." They made claims about the critics' "political and financial motivation" (p. 2).

The Hoffman Report invites each of us to consider our personal strategies to avoid finding out what we don't want to know. How do we screen out or distract ourselves from troubling information? How do we snuggle into the warm, protective blanket of denial? How do we discount, discredit, and dismiss the bearers of bad news? The hard work of looking deep into the mirror to answer these questions prepares us to communicate more clearly, openly, and honestly within our own groups, networks, and organizations, especially with those who express different views. It readies us to work with a wider array to create real and lasting change.

Where Do We Go From Here?

The Hoffman Report challenges us do some critical thinking about:

When complicity with torture, violations of human rights, misleading the public, and other vital matters are at stake, organizations must address not only personnel, policies, and procedures but also the powerful incentives from inside and outside the organization, sources of institutional resistance to change, conflicting ethical and political values within the organization, and issues of institutional character, culture, and dynamics that allowed the problems to metastasize for years, protected by APA's denials.

Organizations facing ethical scandals often publicly commit to admirable values such as accountability, transparency, openness to criticism, strict enforcement of ethical standards, and so on. These institutional commitments often meet the same fate as our own promises to stick with a program of personal change. We make a firm New Year's resolution to lead a healthier life. We pour time, energy, and sometimes money into making sure the change happens. We buy jogging shoes and a cookbook of healthy meals. We take out a gym membership. We discuss endlessly what approaches yield the best results. We commit to eating only healthy foods and to getting up 5 days a week at 5 a.m. for an hour of stretching, aerobics, and resistance exercises. But 1, 2, and 3 months later, the commitment to change that had taken such a fierce hold of us and promised such wanted, needed, and carefully planned improvement has somehow loosened or lost its grip.

Decades of research and case studies in organizational and individual psychology show that major change is hard to make and maintain over the long haul. Distractions grab attention and drain our will. Old habits return. Temptations hit at unguarded moments. Memories of the need for change fade. Imaginary change starts to look like the real thing. We find that the more things change, the more they remain the same.

How can we hope to tell if what we are creating meaningful change? Pseudo-change often appears only in public statements, pledges of improvement, personnel turnover, the formation of committees, new organizational charts, and discussions. Meaningful change is reflected in measurable progress. We can look to see if all our discussions, statements, and activities are creating meaningful, measurable progress.

The enforcement of the ethics code itself gives us a possible measure of meaningful change. The 6 binders of emails and other documents that accompanied the Hoffman Report show a wide range of improper behaviors involving conflicts of interest, improper handling of ethics complaints to protect psychologists, issuing misleading statements that hid true motives, to name but a few, as well as activities related to torture and violations of human rights. If none of these diverse improper behaviors violates any ethical standard in APA's Code that may tell us something about the code itself. If any of the diverse improper behaviors violates any standard in APA's code, and neither the APA Ethics Committee, nor any state psychological association or state psychology licensing board that has adopted APA's code as enforceable, takes action sua sponte (on its own initiative) or in response to a formal complaint, that may also tell us something.

Enforcement of APA's policies on interrogation and torture provide a second possible measure of meaningful change. For many years, APA has countered criticism by citing its various policies prohibiting torture and a 2008 policy governing interrogation of detainees. Critics, however, have discussed not only the seeming lack of enforcement in this area--see, for example, "U.S. Psychology Body Declines to Rebuke Member in Guantanamo Torture Case" in the Guardian (Ackerman, 2014) --but the question of whether these policies are enforceable per se (see Pope, 2011a & b, in press for a review). The most recent policy (23B), which the APA Council of Representatives passed after the Hoffman report was released and which bans psychologists' participation in detainee interrogations, raises similar complex questions of enforceability. For example! APA's Associate General Counsel wrote:

A policy passed by COR [Council of Representatives] does not become part of the Ethics Code no matter what the policy says. Only the Ethics Committee can make changes to the Ethics code under the Bylaws and Rules. So when CoR acts to pass a policy that says that psychologists cannot do X, there is no enforcement mechanism through the Ethics Committee and an enforcement mechanism cannot be built in to it unilaterally as this violates the bylaws. With regards to 23B (and therefore with the 2008 resolution) while this new Council resolution invokes Ethical Principle A to "take care to do no harm," it does not amend the Ethics Code and is not enforceable as a result. (J. Raben, personal communication, August 17, 2015; see also Grohol, 2015)

Evidence that these publicly promoted policies are not just enforceable but are enforced when APA members are involved would be a clear measure of meaningful change.

These and other observable signs of meaningful change (e.g., whether APA and its elected officers representing the membership publish formal corrections or retractions of factually incorrect statements appearing in journals or press releases that denied, discounted, or dismissed reports of improper behavior, just as researchers fulfill their ethical responsibility to correct the formal record) allow us to hold a mirror up to both own individual and our psychological community's ability and willingness to meet the challenge of change.

References

Ackerman, S. (2014, January 22). U.S. Psychology Body Declines to Rebuke Member in Guantánamo Torture Case. The Guardian. Retrieved from http://www.theguardian.com/world/2014/jan/22/guantanamo-torture-mohammed-al-qahtani-suspected-9-11-hijacker

Grohol, J. M. (2015, August 18). American Psychological Association's new torture policy is unenforceable. PsychCentral. Retrieved from http://bit.ly/1N7EUZl

Hoffman, D. H., Carter, D. J., Lopez, C. R.V., Benzmiller, H.L., Guo, A. X., Latifi, S. Y., & Craig, D. C. (2015a, July 2). Report to the Special Committee of the Board of Directors of the American Psychological Association: Independent review relating to APA Ethics Guidelines, national security interrogations, and torture. Chicago, IL: Sidley Austin LLP. Retrieved from http://www.apa.org/independent-review/APA-FINAL-Report-7.2.15.pdf

Hoffman, D. H., Carter, D. J., Lopez, C. R.V., Benzmiller, H.L., Guo, A. X., Latifi, S. Y., & Craig, D. C. (2015b, September 4). Report to the Special Committee of the Board of Directors of the American Psychological Association: Independent review relating to APA Ethics Guidelines, national security interrogations, and torture (revised). Chicago, IL: Sidley Austin LLP. Retrieved from http://www.apa.org/independent-review/revised-report.pdf

Pope, K. S. (2011a). Are the American Psychological Association's detainee interrogation policies ethical and effective? Key claims, documents, and results. Zeitschrift für Psychologie/Journal of Psychology, 219(3), 150-158. Retrieved July 26, 2015, from http://bit.ly/APADetaineeInterrogationPolicies

Pope, K. S. (2011b). Psychologists and detainee interrogations: Key decisions, opportunities lost, and lessons learned. Annual Review of Clinical Psychology, 7, 459-481. Retrieved July 26, 2015, from http://bit.ly/dXpclC

Pope, K. S. (2014). Ethics in clinical psychology. In D. H. Barlow (Ed.), Oxford Handbook of Clinical Psychology: Updated Edition (pp. 185-210). New York: Oxford University Press.

Pope, K. S. (2015). Steps to strengthen ethics in organizations: Research findings, ethics placebos, and what works. Journal of Trauma & Dissociation, 16(2), 139-152. Retrieved July 26, 2015, from http://bit.ly/KenPopeStrengtheningEthicsInOrganizations

Pope, K. S., & Gutheil, T. G. (2009). Contrasting ethical policies of physicians and psychologists concerning interrogation of detainees. British Medical Journal, 338. 1178-1186.

Risen, J. (2014). Pay Any Price: Greed, Power, and Endless War. New York: Houghton Mifflin Harcourt. (Kindle edition)

 

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