Legal and Ethical Issues Final
sexual exploitation
"Sexual exploitation" refers to any of the following: (1) Conduct involving matter depicting a minor engaged in obscene acts in violation of Section 311.2 (preparing, selling, or distributing obscene matter) or subdivision (a) of Section 311.4 (employment of minor to perform obscene acts). (2) A person who knowingly promotes, aids, or assists, employs, uses, persuades, induces, or coerces a child, or a person responsible for a child's welfare, who knowingly permits or encourages a child to engage in, or assist others to engage in, prostitution or a live performance involving obscene sexual conduct, or to either pose or model alone or with others for purposes of preparing a film, photograph, negative, slide, drawing, painting, or other pictorial depiction, involving obscene sexual conduct. For the purpose of this section, "person responsible for a child's welfare" means a parent, guardian, foster parent, or a licensed administrator or employee of a public or private residential home, residential school, or other residential institution. (3) A person who depicts a child in, or who knowingly develops, duplicates, prints, downloads, streams, accesses through any electronic or digital media, or exchanges, a film, photograph, videotape, video recording, negative, or slide in which a child is engaged in an act of obscene sexual conduct, except for those activities by law enforcement and prosecution agencies and other persons described in subdivisions (c) and (e) of Section 311.3. [new sexting law amendment in bold]
W.I.C. 15610.23: dependent adult laws
(a) "Dependent adult" means any person between the ages of 18 and 64 years who resides in this state and who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, including, but not limited to, persons who have physical or developmental disabilities, or whose physical or mental abilities have diminished because of age. (b) "Dependent adult" includes any person between the ages of 18 and 64 years who is admitted as an inpatient to a 24- hour health facility...
Penal Code 11166: mandated reporting
...A mandated reporter shall make a report to an agency specified in Section 11165.9 whenever the mandated reporter, in his or her professional capacity or within the scope of his or her employment, has knowledge of or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect. The mandated reporter shall make a report to the agency immediately or as soon as is practicably possible by telephone, and the mandated reporter shall prepare and send a written report thereof within 36 hours of receiving the information concerning the incident....For the purposes of this article, "reasonable suspicion" means that it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect. For the purpose of this article, the pregnancy of a minor does not, in and of itself, constitute a basis for a reasonable suspicion of sexual abuse....[Failure] to report an incident of known or reasonably suspected child abuse or neglect...[is] a misdemeanor punishable by up to six months confinement in a county jail or by a fine of $1,000 or by both that fine and punishment
W.I.C. 15630: CENTRAL ELDER ABUSE REPORTING LAWS
...Any mandated reporter who, in his or her professional capacity, or within the scope of his or her employment, has observed or has knowledge of an incident that reasonably appears to be physical abuse, abandonment, abduction, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that he or she has experienced behavior, including an act or omission, constituting physical abuse, abandonment, abduction, isolation, financial abuse, or neglect, or reasonably suspects that abuse, shall report the known or suspected instance of abuse by telephone immediately or as soon as practicably possible, and by written report sent within two working days [to the adult protective services agency and the local law enforcement agency]. ... A mandated reporter who is a... psychotherapist...shall not be required to report an incident where all of the following conditions exist: (i) The mandated reporter has been told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse, abandonment, abduction, isolation, financial abuse, or neglect. (ii) The mandated reporter is not aware of any independent evidence that corroborates the statement that the abuse has occurred. (iii) The elder or dependent adult has been diagnosed with a mental illness or dementia, or is the subject of a court-ordered conservatorship because of a mental illness or dementia. (iv) In the exercise of clinical judgment, the... psychotherapist...reasonably believes that the abuse did not occur....(c) 1) Any mandated reporter who has knowledge, or reasonably suspects, that types of elder or dependent adult abuse for which reports are not mandated have been inflicted upon an elder or dependent adult, or that his or her emotional well-being is endangered in any other way, may report the known or suspected instance of abuse.
Penal Code 11165.6: child abuse or neglect
...As used in this article, the term "child abuse or neglect" includes physical injury inflicted by other than accidental means upon a child by another person, sexual abuse as defined in Section 11165.1, neglect as defined in Section 11165.2, willful cruelty or unjustifiable punishment as defined in Section 11165.3, and unlawful corporal punishment or injury as defined in Section 11165.4. "Child abuse or neglect" does not include a mutual affray between minors...[or]... an injury caused by reasonable and necessary force used by a peace officer acting within the course and scope of his or her employment as a peace officer.
four exceptions to the rule of parental consent
1. "mature minor": minors with sufficient maturity to understand the nature and consequences of treatment 2. "emancipated minor": minors who are legally entitled to the rights and duties of adulthood for reasons that vary from state to state (ex.- married minors) 3. "emergency treatment": it is assumed parental consent is implied because of the urgency of the situation 4. when treatment is court ordered for a minor - 15 and above is the age minors can provide consent on their own (not legally but developmentally) but some believe it could be 12 and above - kids 12 and above can come to therapy without parental consent as long as the therapist believes they are mature enough to consent and it would be harmful if they did not get therapy
Elder/Dependent Adult Abuse
1. 2% of those over 65, with mean age of 84., and more women 2. Developing countries don't have gerontology 3. USA by 2030 will be TOP heavy distribution! (Hazzard, 1995) DEFINITIONS: 1. An elder is anyone 65 or over. 2. A dependent adult is 18-64 unable to protect her/his rights or carry out normal daily activities.
WHAT ABOUT EMOTIONAL ABUSE? What do you do?
1. Abuse includes any "other treatment with resulting physical harm or pain or mental suffering" (see W.I.C. 15610.07) 2. For a time, reporting laws stopped not refer to "abuse", only to physical abuse, abandonment, abduction, isolation, financial abuse, or neglect. 3. Now, permission to report is reinstituted. (W.I.C. 15630 C.1
Confidentiality when treating families/couples
1. CONFIDENTIALITY: one extreme = no confidence for individuals; other extreme = treat each individual like an individual case and absolute confidence. 2. I suggest intermediate, and spelled out. 3. Consider written agreement that no family member will ask you to testify on her/his behalf. 4. If you DONT keep confidence, say this up front. 5. I SAY, If you feel that individuals in a couple NEED individual confidentiality, then REFER.
establishing trust
1. Establishing a trusting relationship may be more important than promises of confidentiality when one is dealing with minors (Koocher, 1976, 1983; Ross, 1966)....[V]erbal explanations of confidentiality, although necessary, may not be as important as real-life experiences with a therapist who maintains confidentiality" (Gustafson & McNamara, 1987). 2. TRUST begins with informed consent: Explain limits to kids in way they can understand. However, Don't let kids pull you into "secrets". Empower children clients to take the lead in reporting. - Children don't have the right of consent, but you should pursue ASSENT. 3. When assessing level for "confidentiality," assess age and IQ. Explain "limits" to parents and child (write up a form?). Assess whether discuss parental jealousy of therapist-child. MAINTAIN relationship with parents!
There are cases where you don't need consent to treat a minor (see FC 6924)
1. F.C. 6924. (b) A minor...12 years of age or older may consent to mental health treatment or counseling on an outpatient basis, or to residential shelter services, if both of the following requirements are satisfied: 2. The minor, in the opinion of the attending professional person, is mature enough to participate intelligently in the outpatient services or residential shelter services. 3. The minor (A) would present a danger of serious physical or mental harm to self or to others without the mental health treatment or counseling or residential shelter services, or (B) is the alleged victim of incest or child abuse. 4. A professional person offering residential shelter services...shall make his or her best efforts to notify the parent or guardian of the provision of services. 5. The mental health treatment or counseling of a minor authorized by this section shall include involvement of the minor's parent or guardian unless, in the opinion of the professional person who is treating or counseling the minor, the involvement would be inappropriate. The professional person who is treating or counseling the minor shall state in the client record whether and when the person attempted to contact the minor's parent or guardian, and whether the attempt to contact was successful or unsuccessful, or the reason why, in the professional person's opinion, it would be inappropriate to contact the minor's parent or guardian. 6. The minor's parents or guardian are not liable for payment for...services provided pursuant to this section unless the parent or guardian participates in the mental health treatment or counseling, and then only for services rendered with the participation of the parent or guardian.... 7. Minors 12 or over can also get pregnancy treatment/prevention (including abortion) without consent, and drug and/or alcohol treatment]
Importance of Ethics when Serving Students
1. It is more ethical to have students "work in your area" than to let them "do anything," but do provide latitude. 2. Remember multiple relationships vs. roles. Avoidance of dual relationships is important, yet challenging: "[S]ometimes, what with so many social and other types of activities available to both students and faculty on and off campus, boundary-blurring seems practically built into the academic system" (Tabachnick et al., 1991, p. 514). [cited in Goodyear et al., 1992, in Bersoff, 1995]. 3. Supervision of research, etc. must be competent, and not exploitative (i.e., just doing prof's work). 4. AUTHORSHIP: Give credit where (and only where) it is due. (frequently violated out of kindness.) 5. Keith-Spiegel et al. (1993) note that undergraduates viewed "teaching that one race is intellectually inferior" as unethical. - This might reflect student premise that human value should be equated with intelligence. - This might reflect student premise that intelligence tests should be sole decision rules. - PLEASE SEE: Helms, J. E. (1992). Why is there no study of cultural equivalence in standardized cognitive ability testing? American Psychologist, 47, 1083-1101.
sexual abuse of minors
1. Lewd Acts with those 14 or 15 by perpetrator at least 10 years older 2. Voluntary sexual intercourse with those under 16 when perpetrator is over 21 3. So, age 14 to 18, you decide what acts equal abuse. 4. NOTE: Abuse is NOT: a) pregnancy b) mutual affray between minors 5. NOTE: Emotional abuse that is "willful cruelty or unjustifiable punishment" must be reported, but any degree of mental suffering may be reported.
The Type of Test Impacts Ethics
1. Make sure the test is standardized for individuals vs. groups, with acceptable reliability/validity. 2. Assess the relevance of the test's purposes and the referral questions. 3. Remember that computer reports are never actually "raw data." YOU compile the test results.
treating families/couples
1. ONE person's best might be bad for another. ALL therapists must consider those who are not identified patient, but family therapists are more accountable, since others are present. 2. If one person is threatened in a family, you must become advocate (vs. "patient" is the family). 3. Privilege works the same as in groups. There is none, but get all to agree to confidentiality
The Importance of Ethics in Advertising and Public Statements
1. Psychology is now a business more than ever, even regulated by the FTC more actively. B. FTC overrules APA's restraint of commercial free speech. This raises some ethical issues. 2. Truthful mailers are OK, but "in-your-face" solicitation is still not ok. (How about glamour shots?) 3. Testimonials from patients not ok, but former patients ok. Problems? a. Who is a "former" patient? b. Are testimonials misleading because not everyone the same, or not misleading because consumers already know this? 4. Appeals to fear are now OK. Should they be? - Bjorck says no
Importance of Ethics in Research
1. To be ethical, research must be "safe," but also "useful" and "competent" (else a waste of time). - Careful when dropping outliers (report it and say why), or dropping participants. - Failing to do a study or publish it, when it is feasible and is good research, can be unethical. - Failing to run a study with "condition-ignorant" technicians, unless impossible, can be unethical. 2. Ethical research avoids "causism" at any stage (e.g., proposal, publication), and other overblown claims. 3 If research design calls for a control group, consider alternative treatment over no treatment.
WHEN IS REPORTING MANDATED (not doing so a misdemeanor)?
1. When you observe, have knowledge, or reasonably suspect an incident that you believe constitutes physical abuse, abandonment, abduction, isolation, financial abuse, or neglect. 2. When the elder/dependent adult tells you of her/his abuse. 4. Phone immediately or ASAP (Adult Protective Services agency and/or police) 5. File written report within two working days.
IF parents request records:
1. You don't have to let them see IF you think it would: "have a detrimental effect on the provider's professional relationship with the minor patient or the minor's physical safety or psychological well-being." 2. If you refuse, you need to follow the same guidelines used when refusing an adult client (i.e., in writing, documenting why, and permitting another professional to inspect) 3. But TRUST is more likely important
WHEN IS IT OK TO NOT REPORT? When all 4 of these criteria are met...
1. You have been told by an elder/dependent adult that he or she has experienced behavior constituting physical abuse, abandonment, abduction, isolation, financial abuse, or neglect. 2. You are not aware of any independent corroborating evidence. 3. The elder/dependent adult has a mental illness or dementia 4. In your clinical judgment, you reasonably believe that the abuse did not occur.
authorship
1. authorship should only be given where it is due (not our of kindness) 2. % of professional decision making (e.g. reseach design, writing discussion, collecting data, etc.) determines who is first, second, and third author 3. don't accept authorship as a compliment
Compentency to stand trial
1. concerns the defendant's present mental state; whether the defendant suffers from a mental condition that impairs his or her ability to defend himself or herself at the trial 2. This defendant has no choice about submitting to an evaluation of competency to stand trial
reporting past abuse
1. different states have different guidelines for reporting past abuse 2. if there are no guidelines, then the pros and cons of reporting should be considered, as well as potential risk of harm for the client
Consider your values and their impact when treating couples/families
1. e.g., preserve family?—never urge divorce/separate or stay together. But you CAN say you don't do divorce mediation (there are referrals), and only do marital THERAPY. 2. affairs?—suggest that you cannot help a couple if one is "split" (e.g., affair) 3. sex roles?—let family decide, even if reinforces stereotypes. (but note the dilemma) 4. BE AWARE OF COUNTERTRANSFERENCE re: imposition of hints of your VALUES.
psychological assessments should be used when we can answer these two questions:
1. is the test any good as a measure of the characteristics it is interpreted to assess? 2. should the test be used for the proposed purpose in the proposed way?
Assessment of ADHD
1. symptoms of ADHD can be present in many disorders, so you need to rule out other possible causes 2. symptoms of ADHD can develop as the result of different underlying mechanisms, so look out for those
what to do if you find out a colleague has been having a sexual relationship with a client?
1. the confidentiality of the client is key; if they do not consent to you reporting, you cannot report 2. if you cannot report, you need to try to resolve the issue with the psychologist in question
criminal responsibility
1. the defendant's mental state at the time of the alleged offense; whether the defendant suffered from a mental condition that would exculpate him or her from criminal charges 2. Here the defendant is the one who initiated a claim of insanity and they retain complete authority to refuse or cancel and evaluation 3. If they disagree with assessment results, they can request an independent evaluation by another professional
Resolving Ethical Issues
1.01 If you learn your work has been misused or misrepresented, reasonably try to correct/minimize this. 1.02 If your ethics conflict with legal constraints, make known your ethical commitment and try to resolve the conflict. If you cannot do so legally, then follow the law (but Dr. B says state your conflict again.) But no human rights violations since 2010 amendments. 1.03 Attempt to identify, clarify and resolve conflicts between APA Ethics and any organizational demands in a way that permits the fullest adherence to the Ethics Code, including NO acceptable circumstance for human rights violations.. 1.04 If you think another psychologist has violated Ethics, first go to that person and attempt to resolve UNLESS this is not appropriate or your informal contact violates confidentiality. 1.05 If you know a psychologist who has apparently violated ethics and it has (or is likely to) caused substantial harm AND informal resolution is inappropriate or doesn't work, take further action unless such action violates confidentiality rights. This could be report to Ethics Committee or Licensing Board, etc. This does not apply when you are already being retained to evaluate a psychologist whose ethics are in question. 1.06 FULLY cooperate in ethics investigations, proceedings, and resulting requirements of the APA or any affiliated state psychological association to which you belong. This includes addressing confidentiality issues. Failure to cooperate is an ethical violation, but you can ask to defer adjudication pending a parallel legal case outcome. 1.07 If you file a complaint with reckless disregard for or willful ignorance of facts that would disprove the complaint, you are committing an ethical violation (i.e., don't file frivolous complaints). 1.08 Don't deny someone employment, advancement, admissions, tenure, etc., based soley on a pending ethics complaint (innocent until proven guilty). You can do so based on a confirmed violation.
FORENSIC ACTIVITIES (Discussed elsewhere in Code. Here are the three specifically kept).
2.01 (f) If doing forensic work, ensure that you know that relevant judicial/administrative rules for your role. 3.05 (c) If required (law, policy, etc.) to be in dual relationship, continually clarify roles and limits of confidentiality. 9.01 (b) If you try but can't get sufficient information, document your attempts, clarify the limits of your opinion, and limit your conclusions appropriately.
Ethical Standards Ch. 5: Advertising and other public statements
5.01 (a) Public statements include but are not limited to paid or unpaid advertising, product endorsements, grants, brochures, printed matter, directory listings, personal resumes or curriculum vitae, interviews or comments for use in media, statements in legal proceedings, lectures and public oral presentations, and published materials. Don't knowingly make a....oh just DON"T LIE, OK? Simple enough? (b) Again, DON'T LIE! :o) (c) Only use degrees in your credentials that are accredited and relevant. 5.02 (a) You are responsible for paid promotional statements in your behalf (e.g., commercial). (b) Don't pay for news publicity! And (c) always identify a paid ad as such. 5.03 To the extent that you are in control, insure that advertisements of any workshop, etc. you do is accurately described (e.g., intended audience, presentation objectives, presenters, and fees). 5.04 Make sure your media presentations are ethical and backed up with appropriate literature and practice. Also make sure no one at such a presentation can infer a personal relationship has been formed. 5.05 Don't solicit testimonials from "current" contacts or those "vulnerable to undue influence." (Others?). 5.06 Don't solicit psychotherapy clientele (in person or by proxy) from among those who are vulnerable to undue influence. (So you CAN hand out business cards at a presentation. You could also suggest that significant others be invited to couples therapy, to help an individual already in treatment., and you could offer disaster or community ourtreach services.)
Ethical Standards Ch. 7: Education and Training
7.01 Design education/training programs competently, and meet the claimed goals (e.g., licensure) of program 7.02 Make sure you provide a current accurate description of your program (e.g., content, goals, and requirements for satisfactory completion). Note required therapy, groups, community service, etc. 7.03 (a) Make sure you provide a current accurate description of each course in the program. You can modify the syllabus if pedagogically beneficial, but you must notify students so they can readily adjust. (b) Only teach, train, supervise, etc. accurately! (Duh?). 7.04 No program can require personally sensitive information as part of program unless you state requirement in writing in catalog, etc. or if it is necessary to evaluate or help a student having problems (e.g. a psychological evaluation). 7.05 (a) If therapy is required, you must provide the option of students using outside therapist. (b) Regular academic faculty can't be the therapists. 7.06 (a) Assess student and/or supervisee performance based on actual performance on requirements, and use appropriate feedback mechanisms regularly. Process should be described at onset. (b) Evaluations can only be based on actual performance on relevant established program requirements. 7.07 Psychologists don't have sexual relationships with students/supervisees in their department, agency, training center, etc., OR over whom psychologists are likely to have authority.
Ethical Standards ch. 8: Research and Publication
8.01 Obtain institutional approval before conducting research, based on accurate proposals, and in accordance with approved research protocol. 8.02 (a) When obtaining/documenting informed consent, tell participants about 1) purpose, expected duration, and procedures of research; 2) their right to decline/withdraw; 3) the consequences of declining or withdrawing; 4) possible deterrents such as risk, discomfort, etc.; 5) potential benefits; 6) limits of confidentiality; 7) incentives for participating; 8) whom to contact with any questions. (b) When doing experimental intervention research, tell participants about 1) experimental nature of intervention; 2) what services control groups can expect to/not to receive; 3) how group assignment is made; 4) treatment alternatives for those who decline/withdraw; 5) compensation or costs re: participation, including whether reimbursement will be sought from a third party or the participant. 8.03 Get additional informed consent for filming or recording participants, unless 1) the research is naturalistic observation in a public place and the recordings cannot result in personal identification or harm, or 2) research involves deception and permission to use films/recordings is obtained in debriefing. 8.04 (a) When participants are subordinates (e.g., students, patients), carefully guard against adverse effects of declining/withdrawing. (b) When participation is a course requirement or extra credit, provide equitable alternatives. 8.05 Do not dispense with informed consent unless: 1) research is presumably harmless and involves a) study of normal educational practices, b) only anonymous questionnaires, naturalistic observations, or archival data where disclosure of responses does not place participants at any risk of violation of confidentiality, etc., or c) study of factors related to job/organization effectiveness and there is no risk of violating confidentiality or negative job repercussions) or 2) it is permitted by law or federal or institutional regulations. 8.06 (a)Inducements cannot be excessive, so as to coerce participation. (b) If professional services are offered as participation inducement, specify the services, as well as the risks, obligations, or limitations of participation. 8.07 (a) Only use deception when alternatives are infeasible and when deception is justified by the value of the study. (b) Deception can never obscure information that would affect willingness to participate (e.g., pain, stress), (c) Deception must be explained ASAP (preferably after participation, but no later than conclusion of study). AND participants must be told that they can choose to withdraw their data. 8.08 (a) Provide prompt opportunity for participants to get full summary of research, and work to eliminate any misunderstandings (b) If delaying debriefing is scientifically or humanely justified, work to reduce any risk of resulting harm. (c) When you discover that your research has harmed someone, work to minimize or resolve that harm. 8.09 (a) Treat animals according to legal and professional standards. (b) You are responsible to be trained and you must supervise all Insure animal care to insure optimal comfort, health, and humane treatment. (c) You ensure that those using animals under your supervision are trained and competent. (d) Minimize animal discomfort, infection, illness, and/or pain. (e) Only cause these factors when alternative procedures are unavailable and the goal is justified (scientifically, educationally, etc.). (f) Only do surgery with correct anesthesia, and minimize infection/pain during and after surgery. (g) When needing to kill animals, do so quickly to minimize pain, in accordance with accepted procedures. 8.10 (a) Do not make up data or falsify results, and (b) publicly correct published errors that you discover. 8.11 Do not plagiarize, which includes reproducing a large portion of another work with occasional references. 8.12 (a) Publication credit (e.g., authorship, acknowledgements) must accurately reflect work actually performed. (b) Author order reflects relative scientific or professional contribution, regardless of status. (c)Publications based on dissertations usually cite the student as first author. Faculty discuss publication credit issues ASAP and throughout process as appropriate. 8.13 Publications cannot be republished unless officially acknowledged as such. 8.14 (a) Be ready to share data from publications with competent professionals wanting only to verify claims, provided that confidentiality of participants is preserved and data is not owned by others. (b) If you request data from another researcher to verify claims, only use the data for that purpose, unless you get permission in writing in advance to do otherwise. 8.15 When reviewing submissions (for publications, grants, etc.), treat them as confidential and proprietary.
Ethical Standards Chapter 9: Assessment
9.01 (a) Make sure your assessment, recommendations, reports, and diagnostic/evaluative statements are based on sufficient information (including personal clinical interview, when appropriate) to substantiate your findings. (b) If you try but can't get sufficient information, document your attempts, clarify the limits of your opinion, and limit your conclusions appropriately. (c) If you believe an individual exam is not necessary for the type of opinion you are providing, explain this and cite the sources you do use to form your opinion. 9.02 (a) Only use measures appropriately, in light of research. (b) Only use tests that are valid/reliable for whom you test (e.g., religious group). If none are available, note pros and cons of using the best available test. (c) Only test in the person's preferred language and language level, unless "second-language" is relevant to your test (e.g., TOEFL). 9.03 (a) Get informed consent always, unless testing is legally required, consent is implied, or you are testing decisional capacity. Informed consent includes: explanation of nature/purpose of assessment, fees, 3rd party involvement, confidentiality limits, and questions/answers by/for client. (b) If testee has questionable capacity to consent or is legally required to comply, still explain the nature/purpose of assessment in understandable language (and attempt to get assent, says Dr. B). (c) If using an interpreter, get client's permission to do so, confidentiality is still YOUR responsibility (not the interpreter's) , and note in any results the limitations that may occur due to the needed interpretation. 9.04 (a) Test data = raw/scaled scores, client responses, and your notes. You need to release this information if appropriate release of info is obtained unless you think there is risk of harm, misuse, or misrepresentation unless you are ordered to do so by law. (b) Without client/patient release-of-info, never release test data unless legally required to do so. 9.05 Design, standardize, and validate tests and measures appropriately, e.g., reduce or eliminate bias. 9.06 Consider test (e.g., situation) or person (e.g., culture) factors that might affect your judgment or reduce interpretation accuracy, and include any reservations with test results. 9.07 Guard against unqualified use of assessment techniques (e.g., Wechsler Adult Intelligence Scale at a party!!) except for training with appropriate supervision (e.g., grad school!) or AQ test for Autism 9.08 (a) Don't use outdated tests as basis for a decision; (b) don't use obsolete or unuseful tests either. 9.10 (a) If you offer test scoring or interpretation services, describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use. (b) If you use such services, make sure they are valid and appropriate. (c) You are responsible whether you do testing yourself or have it done. 9.11 Test materials = manuals, instruments, protocols, and other non-test-data. Make reasonable efforts to maintain security of test materials, in accordance with law. (Data easier to release than materials, but note HIPAA). For example, don't FAX test anything (test data, materials, letters, etc.) .
Penal Code 11165.1: CENTRAL CHILD ABUSE LAWS
As used in this article, "sexual abuse" means sexual assault or sexual exploitation as defined by the following: (a) "Sexual assault" means conduct in violation of one or more of the following sections: - rape, statutory rape, rape in concert, incest, sodomy, lewd or lacivious acts upon a child, oral copulation, sexual penetration, child molestation (b) Conduct described as "sexual assault" includes, but is not limited to, all of the following: (1) Penetration, however slight, of the vagina or anal opening of one person by the penis of another person, whether or not there is the emission of semen. (2) Sexual contact between the genitals or anal opening of one person and the mouth or tongue of another person. (3) Intrusion by one person into the genitals or anal opening of another person, including the use of an object for this purpose, except that, it does not include acts performed for a valid medical purpose. (4) The intentional touching of the genitals or intimate parts, including the breasts, genital area, groin, inner thighs, and buttocks, or the clothing covering them, of a child, or of the perpetrator by a child, for purposes of sexual arousal or gratification, except that it does not include acts which may reasonably be construed to be normal caretaker responsibilities; interactions with, or demonstrations of affection for, the child; or acts performed for a valid medical purpose. (5) The intentional masturbation of the perpetrator's genitals in the presence of a child.
Importance of Ethics in Assessment
Assessment (especially testing) permeates peoples' lives (e.g., educational placing in special education, gifted, etc.). Validity concerns not only the psychometrics of the test, but also the VALUES involved with using it. You must guard against overselling OR underselling test results
LAW REGARDING ADULTS REQUESTING CHILDRENS' RECORDS
H.S.C. 123115. (a) The representative of a minor shall not be entitled to inspect or obtain copies of the minor's patient records [when]... the health care provider determines that access to the patient records requested by the representative would have a detrimental effect on the provider's professional relationship with the minor patient or the minor's physical safety or psychological well-being...(b) When a health care provider determines there is a substantial risk of significant adverse or detrimental consequences to a patient in seeing or receiving a copy of mental health records requested by the patient, the provider may decline to permit inspection or provide copies of the records to the patient, subject to the following...
informed consent with families/couples
INFORMED CONSENT and RIGHT TO REFUSE THERAPY: Get consent from all, so no one is "patient" 1. Note the "risks of treatment" e.g., more likely that one family member won't like treatment outcome. 2. Benefits might be greater! 3. Alternative treatment, e.g., individual, but for MARITAL concerns, marital is better.
What do you need to do if you reasonably suspect child abuse?
Phone the Child Protective Agency immediately or as soon as possible. 2. Prepare a written report to the Child Protective Agency within 36 hours
What is NOT Child Abuse?
Pregnancy, a mutual affray between minors, or reasonable force by a policeman
privilege when treating minors
Privilege: (Parents hold it normally), but there are two exceptions: 1. You think it would have a detrimental effect on your relationship with minor OR on their well- being. 2. IF you refuse, you must follow protocol as outlined in first half of course regarding records. YOU hold the privilege with a minor 12 seen without consent and over, unless emancipated. "emancipated minor" (married, enlisted, court ordered emancipation/must be 14)
Ethical Conflicts in Forensics
Psychology and Law have conflicting models. The former says one person objectively evaluates, and no conclusion is OK. The latter says two people enthusiastically argue it out, and conclusion REQUIRED. A. BEWARE! Lawyers prefer a good arguer over a good scientist, and pressure you this way! This is not unethical for the lawyer, but it can be for you. B. BEWARE! Lawyers may want to introduce hearsay evidence by having you include it in your report! 1. Nonmaleficence: DON'T include incriminating statements of criminal defendant in testimony unless you must. 2. You should not be an "expert witness" regarding a therapy client, but you can be a "fact witness." - You may wish to discuss pros and cons with such a client. 3. Custody battles most often include accusations from both sides of "experts" being "hired guns." - There are ASPIRATIONAL guidelines just for this area (custody evaluations). - There are ASPIRATIONAL guidelines for forensic work in general
Importance of Ethics in Academia
The academy is vulnerable to ethical violations just as much as is the therapy room! Here, ethics are for the welfare of STUDENTS, and others in positions of relatively less power (e.g., junior faculty)
Ethics and Managed Care Organizations (MCOS) or other Insurance Plans
This is a HARD topic! 1. MCOs look for short- vs. long-term savings. They also seek to have you show that your treatment is Medically/clinically necessary. 2. You are responsible to "appeal" rejections for authorization at least at some level (phone?). 3. You must inform patient if your treatment is likely to be cut short by MCO (e.g., long-term). 4. You must inform patient of your relationship to the MCO. MCOs affect confidentiality. 1. Tell the patient/client up front the limits of confidentiality. Insurance plans still have treatment plan reviewers, and you may need to discuss treatment with the Insurance company. 2. A good (not perfect!) standard to go by is to review with your patient the material you plan to submit. Focus on observable, measurable factors (e.g., a 20% drop in score on Beck Depression Inventory-II) versus more vague, holistic criteria (e.g., increase emotional competence). 3. If you give MCO what it needs, the MCO is less likely to ask for lots of information! (e.g., the problem, its severity, what is being done about it, and the progress that has been made.) 4. Only disclose what is essential to establish ongoing clinical necessity of treatment and to document the patient's progress. (i.e., preserve confidentiality as much as possible).
The Type of Referral Impacts Ethics of Assessment
Three types of referrals: 1. Describe current function: Consider how this description will affect the testee. 2. Rule out/identify a condition/diagnosis: Avoid temptations of choosing a less/more serious diagnosis. 3. Predict behavior: CAREFUL! There are MANY extraneous factors which influence behaviors. Who gets the information? How does this influence our assessment? 1. Write as though the PATIENT/CLIENT will read (review). 2. Don't include RAW scores in your reports. But DO turn over if a court order. 3. Don't "release" information about TESTS. (public domain threat, or at least invalidated for viewers). 4. Should jurors not see psychology RAW DATA if they CAN see such data from other professions?
Importance of Resolving Ethical Conflicts
Unresolved ethical conflicts are a violation in themselves, as they permit the potential harm of clients. A. Ask "Who are you helping?" when you feel hesitant to confront. B. Consultation regarding hypothetical scenarios (provided they protect confidentiality) can be a helpful first step (e.g., if unsure whether to start "informally one-on-one." C. Resolution has several channels, not just one. 1. CPA Ethics (they refer you to APA now). 2. APA Ethics committee 3. Board of Psychology (licensing board in your state). 4. Internal resolution in an institutional setting (but may be insufficient).
Consider spouse abuse effects on children:
Women more likely to be assaulted, battered, raped, or murdered by current or former male partner than all other assailants combined (1993, Jecker, cited in Ryan, 1995) 1. NOT required to report spousal abuse (some other professionals are). 2. Instead, attempt to empower the adult to report it. 3. BUT consider reporting it if you believe it represents EMOTIONAL ABUSE of child.
Importance of Ethics in Forensics
You will likely have some forensic involvement, even if you do not specialize as a forensic psychologist. Most common involvement would be as a "fact witness." Second would be as an "expert witness." Third would be as a "forensic assessor." A. Criminal forensic tasks include: competency, mental state at time of crime, & decisions re: sentence. B. Civil forensic tasks include: mental capacity, potential for harm, and treatment recommendations. C. Juvenile forensic tasks include: try as adult?
What is Child Abuse?
a non-accidental physical injury, sexual abuse, willful cruelty or unjustifiable punishment of a child (emotional abuse), or neglect of a child. Furthermore, sexual abuse is: 1. Sexual assault and sexual exploitation (pornography, prostitution): for all under 18. 2. Lewd acts: for all under 14 3. Lewd acts: for 14 or 15 children when perpetrator is 10 years or more older 4. Unlawful intercourse with child under 16 with a party over age of 21 5 You judge whether a minor 14 or over is being sexually abused, and then report.
causation
avoid assuming causation; to have causation, you just do an experiment
funding
don't avoid doing a study just because of who's funding the study (i.e. don't avoid doing a study because the results may not be favorable for the person funding the study)
waitlist participants
instead of leaving half of your participants on a wait list with no treatment, give them a different type of treatment and then compare the two treatments tested
reporting truth
it is our ethical duty to report the truthful findings of our data even if it's uncomfortable
Reporting Abuse and Neglect is the law:
misdemeanor not to report, also open for civil suit
diagnoses based on assessment
tests don't diagnose, they inform and you diagnose (do more than one test)
what qualifies one to be an expert witness?
you must have knowledge, skill, experience, training, or education in the field