Exam prep

What are codes of ethics for? (3 objectives — Herlihy & Corey, 2015)

(1) Educate professionals;

(2) provide a mechanism for professional accountability;

(3) serve as catalysts for improving practice.

What character / nature do codes of ethics have?

They are NOT 'cookbooks' for responsible behavior (Welfel, 2010) — no recipes for ethical decision-making. They give clear guidance for only a few problems and tend to be reactive, not proactive.

The Four Component Model (Rest, 1982) — name the 4 components

1) Ethical sensitivity – interpreting the situation & recognizing an ethical issue.

2) Ethical reasoning – formulating the morally ideal course of action.

3) Ethical motivation – deciding what one actually intends to do.

4) Ethical implementation – executing/implementing the intended action.

Common themes across codes of ethics (Koocher & Keith-Spiegel, 2008)

Promoting the welfare of consumers;

practicing within scope of competence; doing no harm;

protecting confidentiality & privacy;

acting ethically & responsibly;

avoiding exploitation; '

upholding the integrity of the profession through aspirational practice.

9 Core Ethical Principles — Principle 1: Do No Harm

'Help, or at least do no harm' (Hippocrates). Example violation: harming a client through negligent or damaging treatment.

9 Core Ethical Principles — Principle 2: Respecting Autonomy

Promote the individual's independence / self-sufficiency. Example violation: fostering client dependence on the therapist.

9 Core Ethical Principles — Principle 3: Benefiting Others

The psychologist's primary role is to benefit others (raises the question 'who is the client?'). Example violation: serving your own interests over the client's.

9 Core Ethical Principles — Principle 4: Being Just

The 'Golden Rule' / Ethic of Reciprocity — do unto others. Example violation: treating clients unfairly or inequitably.

9 Core Ethical Principles — Principle 5: Being Truthful

Trusted professionals earn their reputation through others' trust. Example violation: deceiving or misleading a client.

9 Core Ethical Principles — Principle 6: Accord Dignity

Every client is treated with dignity & respect; many clients cannot represent themselves, so help them acquire skills to voice/signal their needs. Example violation: demeaning or disrespecting a client.

9 Core Ethical Principles — Principle 7: Treating Others with Caring & Compassion

Respect autonomy, work to benefit clients, and devise programs that accord dignity. Example violation: cold, indifferent treatment.

9 Core Ethical Principles — Principle 8: Pursuit of Excellence

Be aware of the latest research and use the most up-to-date methods. Example violation: using outdated or discredited techniques.

9 Core Ethical Principles — Principle 9: Accepting Responsibility

Diagnosis of the highest standard; proposed treatment is proper & justified; take responsibility if treatments fail — accept blame and make corrections.

Example violation: blaming the client when treatment fails.

Who proposed the 9 core ethical principles for psychologists?

Koocher & Keith-Spiegel (1998).

Limitations & problems with codes of ethics

Some issues can't be solved by codes alone;

some codes lack clarity/precision;

learning codes does not equal ethical practice;

conflicts exist within and among codes;

codes may clash with institutional policies or law;

must be adapted to culture; not all members agree;

multiple memberships create non-uniform codes;

codes are reactive not proactive;

personal values may conflict with a standard.

Risk management approach to ethics (risks of violating the CoE)

Prescribes ways to AVOID ethical problems: scrupulously uphold relevant laws, policies, professional standards and ethics codes, and take as many steps as possible to avoid ever being placed in a precarious ethical or legal circumstance.

Why do people FAIL to implement ethical action? (barriers)

1) Fear – of retaliation, of not being believed.

2) Difficulty/Fatigue – uncovering misconduct is draining & time-consuming.

3) Perverse reward systems – target/incentive cultures push people away from ethical action.

The 3 broad categories of most common ethical violations

1) Competence issues – lacking knowledge/understanding/commitment, inadequate skills, emotional instability.

2) Lack of / lapses in self-awareness – rationalizing decisions, acting on self-serving biases.

3) Insensitivity – indifference/disrespect, unreliability, lack of empathy, insufficient attention.

The two types of competencies a good psychologist needs

INTELLECTUAL competence AND EMOTIONAL competence.

Definition of 'competencies' (Rodriguez et al., 2002)

A measurable pattern of knowledge, skills, abilities, behaviors and other characteristics that an individual needs to perform work roles or occupational functions successfully.

von Treuer & Reynolds (2017), 'A Competency Model of Psychology Practice.' Core competencies (IAAP & IUPsyS, 2016):

knowledge/skills (KN, SK); professional behavior (PE-practices ethically, AP-acts professionally, ER-relates appropriately, WD-diversity/cultural competence, EP-evidence-based, SR-reflects on work);

professional activities (SG-sets goals, PA-assessments, PI-interventions, CO-communicates).

The impaired practitioner

When personal problems begin to interfere with professional activities, mental health professionals become a serious danger to clients and sometimes to themselves.

Definition of burnout

A kind of emotional exhaustion resulting from excessive demands on energy, strength, and personal resources in the work setting.

Maslach's 3 components of burnout

1) Overwhelming exhaustion; 2) cynicism & detachment; 3) a sense of ineffectiveness & lack of accomplishment (Maslach Burnout Inventory).

Factors that can predispose a person to burnout

Personal: losses through death/divorce, chronic helplessness, permeable emotional boundaries, substance abuse, 'savior complex'. Work: role ambiguity, conflict/tension, gap between ideal and real job, unrealistic expectations, lack of social support, perfectionism with external locus of control.

Definition of values

Concepts that reflect what is intrinsically worthwhile or worthy of esteem; they reflect the holder's worldview/culture and arise from experiences & interactions. Values are more than preferences — they involve beliefs with evaluative, emotional & existential aspects and guide human choice and action.

Difference between VALUES, ETHICS and MORALS

VALUES = things held to be worthwhile (e.g., love, family relations). ETHICS = standards that guide how to act in a specific circumstance (e.g., 'married people do not cheat'). MORALS = principles that guide behavior at the highest level (e.g., fidelity as a moral prerogative).

Values conversion (Kelly & Strupp, 1992)

When, over the course of treatment, clients adopt personal values similar to those of their psychotherapist — even when the therapist is NOT intentionally trying to alter the client's values.

Value imposition

When psychologists directly attempt to influence a client to adopt their values, attitudes, beliefs, and behaviors. (Contrast with ethical bracketing = managing your personal values so they do not unduly influence the counseling process.)

Discriminatory referral

An inappropriate referral of a client due to differing religious beliefs, sexual orientation, or cultural background. Referrals are appropriate ONLY for specific skill-based competency deficits — never as an excuse for discrimination against a whole class of people.

Tarvydas Integrative Decision-Making Model — the 4 STAGES

Stage I: Interpreting the situation through awareness & fact finding. Stage II: Formulating an ethical decision. Stage III: Selecting an action by weighing competing nonmoral values, personal blind spots, or prejudices. Stage IV: Planning & executing the selected course of action.

Tarvydas Model — the 4 THEMES / ATTITUDES

1) Maintain an attitude of reflection. 2) Address the balance between issues and parties to the dilemma. 3) Pay close attention to the context(s) of the situation. 4) Use a process of collaboration with all rightful parties.

Cottone's (2001) social constructivism model — highlighted terms

Social constructivism: 'facts' are not objective but evolve through interpersonal interaction & agreement. Decision-making is an interpersonal, interactive process involving NEGOTIATING (if necessary), CONSENSUALIZING, and ARBITRATING (if necessary). Goal = establish consensus among involved parties.

Grace et al. (2020) — factors that influence ethical decision-making

TWO types. (1) Factors relating to the DECISION-MAKER: professional perception of clients' best interests, principles of autonomy & beneficence, personal ethics, professional's gender, level of experience, work setting. (2) Factors relating to the DILEMMA ITSELF: dilemma context, gift value, cultural factors, situational pressure.

Informed consent — WHAT is it?

The client having the information necessary to decide about participation in all psychological services; a voluntary agreement to participate in research, diagnosis, intervention, or treatment. Participants must be aware of the nature of the procedure, possible benefits, available alternatives, and potential risks.

Informed consent — WHEN? (it is ongoing)

An ongoing process that begins at the first visit and is routinely revisited/updated, especially when competency can fluctuate. Includes verbal discussion + answering questions, documented with a signed written form filed in the record. Avoidance during testing/treatment is treated as withdrawal of consent.

Informed consent — what does it typically include?

Introduction; procedure; risks & benefits; fees & payment policies; confidentiality and its limits; contact/communication; general boundaries; client/participant rights; access to records; record retention.

Privacy vs Confidentiality — the difference

PRIVACY = the individual's RIGHT to keep oneself & personal information free from unauthorized disclosure (including the fact one sought services and what was communicated); a constitutional right in many countries. CONFIDENTIALITY = the professional's ethical DUTY to protect the client's identity, identifying characteristics & private communications. Confidentiality is rooted in the client's right to privacy.

Limits of confidentiality — legally mandated exceptions

Court orders disclosure; client files a complaint against the counselor; client claims psychological damage in a lawsuit; mandated reporting of abuse or harm; client poses a danger to themselves or others.

Privileged communication

A LEGAL concept that bars disclosure of confidential information in a legal proceeding. Where covered by statute, clinicians may not disclose; psychologists can refuse to answer questions or produce records in court. The privilege BELONGS TO THE CLIENT (for the client's protection). It lasts forever, even after the relationship ends; exception: danger to self or others.

Duty to warn — the Tarasoff case

The California Supreme Court ruled that failure to warn an intended victim is professionally irresponsible: the therapist has a 'duty to exercise reasonable care to protect the foreseeable victim.' Key line: 'The protective privilege ends where the public peril begins.' Confidentiality can be compromised to protect others.

Duty to warn — professional obligations (Bednar et al., 1991)

Dual responsibility: protect others from dangerous clients AND protect clients from themselves. Counselors must (1) identify clients likely to physically harm third parties, (2) protect those third parties, (3) treat dangerous clients. In cases of imminent danger, breaching confidentiality is not just acceptable but required.

Suicidal clients — what to do (duty to protect)

Inform clients of your ethical & legal obligation to break confidentiality when you suspect suicidal behavior. Reduce malpractice risk by: a reasonable assessment & intervention process, seeking professional consultation, making clinical referrals when appropriate, and thorough, current documentation.

Assessing suicidal behavior — key risk indicators

Take direct verbal warnings seriously (best single predictor); previous attempts & lethality; depression; hopelessness/helplessness; loss/separation stressors; severe anxiety/panic; recent serious health diagnosis; a definite, detailed plan; alcohol/drug abuse; giving away possessions/finalizing affairs; prior psychiatric treatment; lack of a support system.

Debriefing (research) — what & when

As soon as the research is over: give a full explanation of what the participant was involved in; correct misconceptions; avoid evaluative statements; consider effects on self-esteem; provide follow-up contact details; alert and refer participants if problems are revealed. After debriefing, participants may withdraw consent retrospectively and demand destruction of their data/recordings.

Oral consent (research) — what & when

Acceptable from participants who are illiterate and cannot read/sign consent forms. Requires: information given in an understandable form, AND a literate witness to sign on the participant's behalf after oral consent is given. The oral consent may also be audio-recorded and the recording witnessed as further confirmation.

Use of deception (research) — when is it allowed?

Generally deception should NOT be used. It is NOT acceptable if physical pain or emotional distress is expected. Special circumstance: if the research has 'scientific, educational, or applied value' (APA) and no effective alternative is possible, deception MAY be considered. (Forms: lying by omission vs. lying by commission.)

Levels of deception (extent)

1) Consent to a condition without knowing which one (e.g., drug vs placebo). 2) Consent but misled about the study's purpose (e.g., Milgram). 3) Consent but full details only given afterwards (e.g., vaguely 'memory'). 4) Studied without prior knowledge or consent (e.g., bystander behaviour).