psychology practicum final
To whom does the statute for reporting child abuse or neglect apply?
"an individual" ANYONE
According to Wise, Hersh, and Gibson, the authors of the assigned article on self-care, there are key foundational principles that help psychologists support effective well-being and self-care . Name and explain 2 of these 4 foundational principles. Self-care should ...
1. SURVIVING VS FLOURISIHING- Surviving is making ends meet, doing the minimum to stay afloat with everything. Flourishing is finding a balance of everything in your life so you are not overworked and your relationships, professional or otherwise can be healthy to maintain and grow. 2. INTENTIONALITY- the act of choosing our self-care plan and being willing to change our attitudes and practices if (or as) they become unworkable. Being mindful of the persoanl practices we put in place and how they help us.
8 parts of informed consent
1. The nature of treatment/program 2. anticipated course of treatment 3. Fees and financial arrangements 4. Involvement of third parties 5. Limits of confidentiality 6. implications of HIPAA 7. Consent for new and untested treatments (optional) 8. Trainee status (when applicable)
In class, we have spoken repeatedly about the 8-elements of Informed Consent. By now, you should know them by heart. Fortunately, I am only going to ask you to list and briefly explain four of them.
1. The nature of treatment/program: inform the client what therapy is and how it works. 2. Anticipated course of treatment: how long it may take and what you plan on doing/exposing the client to 3. Fees and financial arrangements: how much sessions cost, when payment is expected, what types of payments are accepted 4. Involvement of third parties: how much others may be informed such as insurance for payment needs or parents if the client is a minor.
How is vulnerable adult defined?
18+ years old, mental/physical impairment which affects a person's daily living
How many choruses does a country, pop, or rock song typically have?
3
How many choruses does a typical rock, pop, or country song have? Why does this matter?
3! Just because you're exposed to something doesn't mean you truly know and understand it
In Mahoney's survey of psychotherapists, what percentage of respondents reported feeling "emotional exhaustion" within the past year?
40%
Divide 30 by half and add 10. What is the answer?
70
Is a free introduction session a violation of the ethics code? What specific provisions must be addressed if such a practice occurs?
A free introduction session is not a violation of the ethics code. But you still need to provide the documents necessary that the client agrees to the session and that you are not charging them, and you should still cover informed consent.
cognitive skills
A leader's ability to understand the internal and external environments, make decisions with sound reasoning, and communicate effectively
To whom does the statute for duty to warn apply?
A licensed: psychiatrist, psychologist, etc.
What is the statute for duty to warn?
A therapist has no duty to warn or take precautions to provide protection from any violent behavior of his client or patient, except when that client or patient communicated to the therapist an actual threat of physical violence against a clearly identified or reasonably identifiable victim.
When is a report for duty to warn to be made?
ASAP
How is abuse, neglect, and exploitation defined?
Abuse-knowingly or intentionally: attempting to cause harm, causing harm, or placing another in fear of harm Neglect-failure of a caretaker to provide necessary care Exploitation-(1) creates, transmits, or displays a photographic or electronic image or recording (2) causes adult to participate in an act that is highly offensive or demeaning
To whom is the report of abuse, neglect, or exploitation of a vulnerable adult made?
Adult Protective Services
If it becomes clear, the complaint from above is valid, according to the readings, what should the next course of action be?
After consulting with an attorney, make a sincere apology to the client, and try to make things right
Explain at least 4 things covered in a Professional Will.
Appointment book and patient contact information. Patients should be informed of their therapist's death, so they don't unknowingly show up for an appointment that will never occur. E-mail and voice mail access codes, and keys to the psychologist's office, file cabinets and storage facility. Executors have to have access to all of these things to make sure affairs are in order. Patient notification. The therapists knows their clients best and how to notify them, or that preference may be personal to the therapist. Either way, the patients deserve to know. Liability insurance. Malpractice investigators should be notified in case of any on going or future allegations.
When should psychologists present each client with the information necessary for informed consent?
As early as feasible in the therapeutic relationship
Expressive skills
Aspects that contribute to performance artistry and that engage the audience, such as focus and musicality
When should discussion about termination begin? I know the right answer is "it depends" but which of the following is the best rule-of-thumb?
At the beginning of the relationship
What is the difference between ethics, morals, laws, and social controls?
Basic morality condemns murder, adultery, lying and stealing. Ethics explores the idea of morality and its place in society and addresses questions about morality. The law is based on principles and regulations established in a community by some authority and applicable to its people.
When the ethic's code addresses standards related to termination, ______ is pertinent in that psychotherapists should, "actively work to benefit their psychotherapy patients through the termination process and specifically to take steps to minimize the risk of harming them."
Beneficence and Nonmaleficence
Suppose your agency's policies put you in a position where you are at conflict with your professional ethics code. According to the APA, what is the first step?
Clarify the nature of the conflict to yourself and your agency
According to the article, what is confidentiality vs. privilege?
Confidentiality is a therapists duty Privilege is the the client's right
What is a professional will. List at least two situations when a professional will might be a good idea.
Death or incapacitate
Review the APA Ethics Code. Explain how effective termination is an ethical issue. Cite specific language from the code.
Effective termination is an ethical issue by the fact that most termination reasons aren't legally required. They are for the respect of your client and the expirational relationship you have made with them. At the very least, it is directly addressed in the ethics code. You will ethically terminate if the relationship "no longer serves," if you feel "threatened," or if you have complied with ethics and have provided "pretermination counseling" for the client.
What is emotional competence? Why is this an ethical issue?
Emotional competence is your ability to intimately get to know and relate to your client. It's an ethical issue because it could lead to boundary crossings.
Why is informed consent important?
Ensure Ethical Standards For Research. Ensure That The Participant Is Aware Of The Associated Risks.
Which of the following is of the recommendations made in the article, or spoke about in class, regarding the clinically appropriate and effective termination of a client? Mark all that apply.
Ensure that the psychotherapist and client collaboratively agree on the goals for psychotherapy and the ending of psychotherapy. Make sure you understand termination, abandonment, and their potential effects on patients. Provide periodic progress updates that include discussions of termination and ,toward the end of psychotherapy, provide pre-termination counseling.
Psychotherapists should view consent capacity as an all-or-none ability
False
True or False: When a client unilaterally drops out of treatment, the therapist's obligations are, therefore, done as well. Explain.
False. It is the therapist's responsibility to make a reasonable effort to reach out to the client and offer resources they may be missing.
True or False, Self-Care is directly addressed in the APA ethics code. Explain
False. The ethics code mentions it, but it is not directly addressed in the way other things such as termination are.
Remind me what you did for your self-care exercise from a few weeks ago. What have you done differently since our Self-Care exercise to continue addressing this principle? What challenges, if any, have you encountered in maintaining the practice?
For my self car exercise, I spent time away from school, work and chores, to spend an hour playing card games with my roommates. To continue addressing this principle, I have been more mindful to take breaks between each substantial task I accomplish so I don't feel so burnt out. The challenges I have faced are mostly due to COVID-19. I didn't anticipate staying home in Vegas, so all of my books and coloring books are still in cedar city, and my family doesn't play games very often.
Dr. Roberts has been asked to take on a client who has PTSD. He has never treated a patient with PTSD before and is unsure about his capability to do so. He has read some articles and research on the subject, as well as attending a conference on PTSD five years ago. Should Dr. Roberts agree to take on the client? Why or why not?
IT DEPENDS
Can youth under 18 give legal informed consent?
IT DEPENDS on state, emancipation, situation
How might Ethical Code be a higher standard than the law? In such situation to which standard are psychologists held?
If the Ethics Code establishes a higher standard of conduct than is required by law, psychologists must meet the higher ethical standard. If the Ethics Code standard appears to conflict with the requirements of law, then psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict in a responsible manner. If neither law nor the Ethics Code resolves an issue, psychologists should consider other professional materials and the dictates of their own conscience, as well as seek consultation with others within the field when this is practical.
What is the statute for reporting abuse, neglect, or exploitation of a vulnerable adult?
If you have reason to believe that the protected person has been abused, neglected or exploited you must immediately notify the nearest peace officer, law enforcement agency, or Adult Protective Services.
According to the book, if a former client files an Ethics Complaint against you, what is the first thing you should do?
In a brutally honest way, ask yourself if you did what the person has accused you of doing
Who are the health care providers (mental health professionals)?
Includes any person, partnership, association, corporation, or other facility or institution who causes to be rendered or who renders health care or professional services as a hospital health care facility, physician, physician assistant, registered nurse, licensed practical nurse, nurse-midwife, licensed direct-entry midwife , dentist, dental hygienist, optometrist, etc.
7 baseline skills that students should have prior to their practicum training experience
Interpersonal skills Cognitive skills Affective skills Personality/ Attitude skills Expressive skills Reflective skills Personal skills
According to the article, what happens to a patient's privilege if that patient dies?
It depends because laws differ from state to state
Under which condition(s) does a psychologist terminate with a client? Select all that apply.
It is reasonably clear the client no longer needs the service It is reasonably clear the client is not likely to benefit from ongoing services It is reasonably clear the client is being harmed by continued services When the client begins stalking or otherwise threatening the psychologist and her family
From the question above, why does this matter, and why do we still talk about it in class?
Just because you're exposed to something doesn't mean you truly know and understand it. We still talk about it in class because it's important to be mindful of what we are competent in and what we need more work and information on.
Why does Dr. Barney keep talking about Utah State law about confidentiality, and having you recall specific details from the code?
Knowing the details of the law are important for you to be ethical practitioners within your profession.
What if the Ethics code contradicts law?
Laws>Ethics>Morals
True or False A person can be licensed to work with children, families, adolescents, emerging adults, adults, or older adults. The licensure ensures competence in working with those specific populations.
Licensure does not specify a population with whom you can work, it merely grants a legal scope of practice.
What does MPPP stand for?
Mindfulness-based Positive Principles and Practices
What should a psychotherapist do if sexual attraction to a client arises?
Phone a friend (do not tell client, but talk to colleague or therapist)Refer client to someone else
What are the Preamble and General Principles not?
Preamble and General Principles are not themselves enforceable rules
What might pre-termination counseling preceding the end of a therapeutic relationship include? (Select all that apply)
Providing clients with advance notice or negotiating together the end date of services Reviewing gains made in treatment Considering potential relapse risks and how to handle them Addressing future challenges to be dealt with either outside of psychotherapy or when the patient returns to psychotherapy Offering referrals for alternative practitioners when the patient has ongoing treatment needs
What is the statute for reporting a communicable disease?
Report to the department or the local health department regarding any individual suffering from or suspected of having a disease that is communicable as required by department rule
According to Utah law, what are examples of a legally appropriate exception to the confidentiality statute for a therapist?
Reporting suspected child abuse Reporting abuse, neglect, or exploitation of a vulnerable adult Reporting actual threat of physical violence against the patient themselves or against others Reporting a client with a communicable disease to the Heath Department Giving a treatment summary to parents of your 15 yr old client in Utah, even when the client says she does not want parents involved Refusing to provide parents access to their child's records, if they have reasonable belief the child is or has been subject to abuse, or if doing so would endanger the child
Under what circumstances may a psychologist ethically terminate with a client without notice. Give the specific section of the APA Ethics Code that deals with this situation.
Termination may occur when it becomes ethically relevant that the client is no longer benefiting from therapy. "10.10 Terminating Therapy (a) Psychologists terminate therapy when it becomes reasonably clear that the client/patient no longer needs the service, is not likely to benefit, or is being harmed by continued service. (b) Psychologists may terminate therapy when threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship. (c) Except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists provide pretermination counseling and suggest alternative service providers as appropriate."
A colleague is doing something that seems to violate the Ethics Code, and, in your opinion, her behavior is likely to adversely impact a. client's emotional state or damage the reputation an organization An informal resolution has not worked or is not appropriate to the situation. To whom should you report the behavior? Select all that apply.
The APA Ethics Board The State Licensing Board
What sanctions may the APA apply in cases of ethical violations?
The APA allows two types of formal sanctions against institutions: censure and letter of concern. Recommendations for censure or letters of concern must be brought to the board by the committee on the defense of professional rights, or by the ombudsperson for nondiscrimination, after formal complaint review.
Are the Ethics Standards exhaustive? What implications does this have on professional behavior?
The Ethical Standards set forth enforceable rules for conduct as psychologists. The Ethical Standards are not exhaustive. The fact that a given conduct is not specifically addressed by an Ethical Standard does not mean that it is necessarily either ethical or unethical.Psychologists avoid improper and potentially harmful dual relationships. Psychologists uphold professional standards of conduct, clarify their professional roles and obligations, accept appropriate responsibility for their behavior, and adapt their methods to the needs of different populations.
What are the Preamble and General Principles?
The Preamble and General Principles are aspirational goals to guide psychologists toward the highest ideals of psychology. Although the Preamble and General Principles are not themselves enforceable rules, they should be considered by psychologists in arriving at an ethical course of action.
A client loses her job and is unable to pay for therapy. The person's therapist says, "don't worry, we will work it out" and the therapy continues. What is the ethical problem with this scenario? How should the conversation have gone? Be specific.
The ethical problem with the scenario is that the response was not specific. The client can interpret that in a number of ways. The conversation should have touched on when payment would be expected or if any sessions are pro bono or how long sessions can continue without payment. They could set up a payment plan or the therapist could have offered resources to help.
According to our readings. What happens to a client's legal privilege with a therapist if that client dies?
The state of the privilege varies from state to state because of variations in the law
You meet with a woman who is Navajo by heritage. After helping her work through some anxiety issues, you jointly terminate the relationship, and she is very appreciative. A week or so later, a package comes to your office. Inside, is a beautiful hand-made Native American blanket. Your agency has no specific policy about accepting gifts from current or former clients. What course of action should you take? Think about the APA Code of Ethics, and discussions we had in class. Give a well-thought out responses.
There is no specific ethic standard that addresses gifts from clients. The psychologist must weigh the options on what it may mean to accept the gift. If accepting the gift could cause any harm to the client or relationship, the psychologist should not accept. APA suggests considering the factors of "whether it's personal in nature, a one-time occurrence or a pattern, for a special occasion or no apparent reason, and expensive or reasonable in cost." In this specific situation if my agency has no policy and I don't have a no gift policy of my own and if my client had not previously mentioned giving me something, I would probably accept it so long as I knew that she wouldn't be giving me another gift.
Why, according to the article, while sexual relationships with clients/students expressly forbidden, these types of interactions are the most common form of ethics complaint against psychologists. Why do psychologists commit these types of boundary violations? Explain two possible reasons.
These are the most common form of ethics complaint because it is the most common form of boundary crossing. Psychologists do this because they are not meeting their own therapeutic needs and seek acceptance from their clients. 1. They excuse what they're doing because they're lonely/in a bad relationship. 2. They could be preying on a vulnerable target to fulfill some sick need.
Psychologists try to provide a full and complete informed consent even though the information provided might scare the patient. Why is it important?
They may not fully understand
To what part of a psychologist's life do the ethical standards apply?
This Ethics Code applies only to psychologists' work-related activities, that is, activities that are part of the psychologists' scientific and professional functions or that are psychological in nature.
The first General Principle of the APA Code of Ethics is Beneficence and Nonmaleficence. To what does this principle refer? Why is it the first General Principle?
This principle refers to benefiting the client and making sure you are not inducing any harm. This is the first general principle because it is the cornerstone of psychology. Helping people is supposed to be the core of our work, and we can't do that without actively benefiting the client and eliminating any harm we may cause them.
The Superior Court of New Jersey opined that the confidential communications between a licensed psychologist and clients have the same status as those communications that occur between an attorney and a client.
True
One of the Four C's in working with children is "Consent". We talked about this as an essential element in ethics back in week #1. Why are we still talking about it? Give a well-developed rationale, outline at least four important points.
We are still talking about this because it is important! 1. Consent is an ongoing process, making sure both parent and child are routinely informed and agree to treatment. This is important not only for the business relationship, but for the child to observe and recognize a healthy relationship and how consent is always a part of that. 2. The child most likely does not want to be in therapy, it is usually decided by parents or school authority figures, so finding ways to make the child feel comfortable to consent to therapy will vastly improve what they get out of your sessions. 3. Consent is also for the parents, so they know that the goal setting in therapy may have some effort on their part and a willingness to be open minded about why their child may be acting out and what they need. 4. Conflicting interests may arise among child, parent, and therapist. It is the consent to talk about the touchy subjects and the willingness to work on them that will make therapy a worthwhile experience for everyone.
What is the statute for reporting child abuse or neglect?
When an individual has reason to believe that a child has been subjected to abuse or neglect, individual must immediately report
From Positive Psychology give two ideas about the kinds of things you can do for your own self-care.
When intentionally induced, positivity can broaden attention, cognition, and creativity; enhance feelings of closeness with and trust in others. Being intentional with yourself and others has many positive impacts. Gratitude practice has also received increasing attention as a method of cultivating greater well-being. There is lots of research on the positive effects of gratitude journals and meditation and motivating mantras. If you surround yourself with positive energy, chances are, you will be a more positive person within and to be around.
How do psychologists go about resolving ethical violations they see in colleagues or other psychologists?
When psychologists believe that there may have been an ethical violation by another psychologist, they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate and the intervention does not violate any confidentiality rights that may be involved.
What can the APA do if they find you in serious violation of a standard in the Ethics Code? Select all that apply.
Write a letter of censure, advising you to come back into compliance Notify state licensing agencies of the violation Expel you from the organization
Define slippery slope
a fallacy which assumes that taking a first step will lead to subsequent steps that cannot be prevented
To whom does the statute for reporting child abuse or neglect NOT apply?
a member of the clergy, with regard to any confession made to member
To whom does the statute for reporting abuse, neglect, or exploitation of a vulnerable adult apply?
a person who has a reason to believe that a vulnerable adult has been subject of abuse, neglect, or exploitation
Under what situations does the law of duty to warn apply?
a) client communicates to therapist an actual threat of physical violence against a clearly identified or reasonably identifiable victim b) therapist communicates information to a third party in an effort to discharge his duty c) duty to report child abuse or neglect
how is child neglect defined?
action or inaction causing: (i) abandonment of a child(ii) lack of proper parental care of a child by reason of the fault or habits of the parent, guardian, or custodian; (iii) failure or refusal of a parent, guardian, or custodian to provide proper or necessary subsistence, education, or medical care, or any other care necessary for the child's health, safety, morals, or well-being (iv) a child to be at risk of being neglected or abused because another child in the same home is neglected or abused
How is child abuse defined?
an action that causes harm (or threatens to cause harm) to the welfare or health to a child.
Professional boundaries assist psychologists in the OVERALL requirement of
avoiding harm to all those they work with including clients, research participants, etc.
interpersonal skills
concerning or involving relationships between people
Affective skills
emotional feeling
competence
having enough skills to do something
To whom does the statute for reporting a communicable disease apply?
health care providers facilities licensed under Title 26 health care facilities operated by the federal government mental health facilities care facilities licensed by DHS nursing homes,dispensaries, clinics, or labs that deal w/ disease ind. who knows of sick person ind. in charge of schools having some responsibility child care programs
When is a report of child abuse or neglect to be made?
immediately
Which could be main underlying cause for boundary violations according to the article
naivety manipulation of boundaries problems with professional competence coercion character issues family issues
To whom is the report of child abuse or neglect made?
nearest peace officer, law enforcement agency, or office of the division
Which of the following are current beliefs about the slippery slope
not every boundary crossing will lead to violating others the slippery slope may exist, but in many situations and with many psychotherapists, it does not
What happens if the statute for reporting abuse, neglect, or exploitation of a vulnerable adult is not followed?
person is guilty of class B misdemeanor
What type of individual is described in the General Principles?
psychologists toward the very highest ethical ideals of the profession
Why does this question keep coming up in our discussions?
read carefully
What is scope of practice?
refers to education and clinical experience
Pick ONE of the exemptions from above, and give exact wording from Utah State Law regarding when the exemption is supposed to take place, and to whom information is supposed to be given.
reporting vulnerable adult abuse, neglect, or exploitation "A person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation shall immediately notify Adult Protective Services intake or the nearest law enforcement agency." Question 3
Outline the four exceptions to professional confidentiality we reviewed in class.
reporting vulnerable adult abuse, neglect, or exploitation child abuse or neglect reporting limitation of a therapist's duty to warn reporting of a communicable disease
personal skills
the ability to manage aspects of your life outside of work
What happens if the statute of child abuse or neglect is not followed?
the individual is guilty of a class B misdemeanor. Action for failure to report must be commenced within 4 years from date of knowledge
Why is reporting vulnerable adult abuse, neglect, or exploitation an exception to confidentiality?
there is potential harm to an individual
Why is child abuse or neglect an exception to confidentiality?
to protect the child
How can we best develop competence in a specific area?
training + education + supervised practice
What is a communicable disease?
when an infected host can transmit the infectious agent to another host and establish infection in that host
personality/attitude skills
you should be welcoming
Reflective Skills
•Stepping back •Debriefing •Self reflecting/ owning responsibility •Perspective-taking/ switching •Contextualizing
