Flashcards in Ethics Deck (98)
The primary value underlying the existence of ethical principles is:
A. Confidentiality of therapist-client communication.
B. the continued prosperity of the field of psychology.
C. The advancement of the welfare of society as a whole.
D. The advancement and protection of the welfare of the patients and clients of psychologists.
D. The preamble of APAs Ethical Principles states that the code "has as its goals the welfare and protection of the individuals and groups with whom psychologists work."
Pro bono work is:
A. Required by ethical principles.
B. encouraged by the ethical principles.
C. Discouraged by the ethical principles.
D. Prohibited by the ethical principles.
B. general principle B (fidelity and responsibility) states that psychologists "strive to contribute a portion of their professional time for little or no compensation or personal advantage."
If an ethical principle is not addressed in the ethics standards, it indicates that any related conduct:
A. Is ethical
B. is unethical
C. Is ethical, if not prohibited by any law or regulation.
D. May be ethical or unethical.
D. The Introduction and Applicability states that, "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."
You are contacted by the APA Ethics Committee in regard to a complaint filed against you by your client. The committee asks for your records related to the clients therapy with you. You should:
A. Cooperate fully with the committees request.
B. contact the client and obtain a release of information before cooperating.
C. Contact the client and attempt to settle the matter informally.
D. Call your travel agent and find out the next flight to Tahiti is.
A. When you are contacted by an ethics committee in response to a complaint from a client, you must cooperate fully. Confidentiality is not an issue since the committee must obtain a signed waiver of confidentiality from the complainant before it takes any action.
You share an office with one other psychologist. One morning, you arrive early to find your partner having sex with a current patient of his. You should:
A. Discuss the matter with him later.
B. report him to the ethics committee.
C. Discuss the matter with the patient, and explain to her that she has the option to take action against your partner.
D. Discuss the matter with the patient and attempt to get her to sign a release of information so you can pursue a complaint.
B. Usually, when you know or suspect that a colleague has committed an ethical violation, you attempt to resolve the matter informally by bringing it to his attention. However, if the violation is not amenable to informal resolution, as in this case, you must take further action, such as filing a report to an ethics committee. Of course, you should protect the confidentiality rights of the patient, thus in your complaint, you would not provide identifying information about the patient.
If a client tells you that he had sex with a previous therapist, you should:
A. Have the client sign a release of information and report the psychologist to the appropriate ethics committee.
B. with the clients permission, contact the psychologist yourself.
C. Report the psychologist to an ethics committee with or without the patients permission.
D. Outline the clients rights and options regarding legal action and ethics complaints.
D. Reporting the patients psychologist without the patients permission would constitute an unauthorized breach of confidence. If you had a waiver of confidentiality you could make the report yourself, but you can't "have the client sign a waiver" - this implies that you may be placing undue pressure on the client to do something he does not want or is not ready to do. In this situation, your best option would be to outline the patients rights and options and let him decide whether to take legal action or file a complaint with an ethics committee.
You want to work with clients from an ethnic group you have not worked with before. Your best option would be to:
A. Refer such clients to another therapist.
B. read books about the target group while working with the patients.
C. Seek supervision and/or consultation before taking on such clients and while you are working with them.
D. See the clients, since we are all human beings and why can't we all just get along?
C. Standard 2.01(b) requires psychologists to seek necessary training, experience, consultation, or supervision, or make appropriate referrals, when an understanding of client-therapist ethnic differences "is essential for effective implementation of their services." No specific guidelines exist regarding which option (I.e., training consultation, or referral) to choose in given situations. However, consultation is usually an appropriate option in the circumstance described by the question, since a client-therapist ethnic difference usually does not preclude an effective therapeutic relationship and since merely reading books is insufficient.
A psychologist who has been having marital problems begins to notice that during marital therapy with his clients he be is tending to agree more with the husbands perspective. He should:
A. Explain to his clients the reasons for his counter transference.
B. seek consultation.
C. Refer his marital therapy clients.
D. Suspend doing marital therapy until his marital problems are resolved.
B. Standard 2.06(b) requires psychologists who become aware of personal problems that may interfere with adequate performance in their work, take appropriate measures. In this case, the most appropriate measure would be to seek consultation. Through consultation the psychologist may be able to resolve his counter transference issue or would be better able to decide what further action to take, for example, suspending working with certain clients, listing his work load, referral of clients, or termination of work related duties.
The use of interpreters in psychotherapy:
A. Is always unethical due to the inherent lack of confidentiality.
B. Is always unethical because psychologists must refer clients if they cannot communicate directly in the same language.
C. Is ethical if the interpreter has signed an agreement to maintain clients confidentiality.
D. May be ethical if steps have been taken to avoid multiple relationship between the interpreter and the client.
D. Although the use of an interpreter in psychotherapy raises several clinical and ethical concerns,
A psychologist who obtained a Ph.D. in experimental psychology wants to change her specialty to clinical psychology. To meet the requirements set forth by the General Guidelines for Providers, the psychologist must
A. complete an internship in clinical psychology under the supervision of a professional clinical psychologist.
B. complete appropriate doctoral-level classes and supervised post-doctoral training.
C. obtain a Ph.D. in clinical psychology from an accredited college or university.
D. meet her state's requirements for licensure in clinical psychology.
B. The licensing exam often contains questions such as these, and in approaching them, you should remember these buzzwords: training AND experience. Specifically, the Specialty Guidelines state that "professional psychologists who wish to qualify as clinical psychologists meet the same requirements with respect to subject matter and professional skills that apply to doctoral and postdoctoral education and training in clinical psychology." Choice "B" is the only one that includes an element of both training and experience, and is therefore the best answer. Moreover, unlike as stated by choice "C", a second Ph.D. would not be necessary -- doctoral level coursework in clinical psychology would be sufficient to meet the academic training aspect of this requirement
Continuing Education Credits (CE Credits) earned through an APA approved sponsor means that the program is:
A. sanctioned by APA.
B. endorsed by APA.
C. approved by APA.
D. the responsibility of the sponsor.
D. An organization is approved by the APA to sponsor continuing education programs. The sponsor then becomes responsible for each program. The APA periodically asks for reports from the sponsor, but the specific program is not endorsed, sanctioned, or approved by the APA. Only the overall sponsorship is approved by the APA.
While attending a staff meeting at a mental health facility where you work, you learn that one of your colleagues, a psychologist, is behaving in an unethical manner toward one of her patients. Despite being advised to do so by several members of the staff, she states that she will not change her behavior. What should you do in this situation?
A. Approach the colleague individually and urge her to change her behavior; if she refuses, report her to the appropriate ethics committee.
B. Approach the colleague individually and urge her to change her behavior; if she refuses, recommend to the director of the facility that she be fired.
C. Report the colleague to the appropriate ethics committee immediately, since she has already stated that she will not change her behavior.
D. Announce in the staff meeting that you want to "go on the record" as noting that the psychologist is behaving unethically.
A. The Ethics Code states that you should deal with ethical violations by another psychologist in an informal manner, by bringing it to the attention of the psychologist. A report to an ethics committee should be made when the attempt at informal resolution has failed or if the violation is not amenable to informal resolution. Thus, you should speak to the psychologist privately and report her to an ethics committee if she still refuses to change her behavior. You may have thought that, since the psychologist has already stated her refusal to behave ethically, you should go ahead and report her, without bothering to talk to her. This actually makes sense, but the Ethics Code requires that you attempt an informal attempt at resolution first. A staff meeting is a formal setting, and does not personally give you the opportunity to attempt an informal resolution.
You have been working with a couple in marital therapy for four months, with slow but notable progress. After a session one day, the wife pulls you aside and asks to make some individual appointments with you. You should
A. refer her to another therapist.
B. wait until the completion of marital therapy and then see her individually.
C. terminate with the couple and see the woman individually.
D. encourage her to discuss any relevant issues within the context of marital therapy.
A. There is a potential for role conflict when a client in conjoint therapy asks you to see him or her individually. It's possible that there may be a conflict between your considerations as a couple's therapist and as an individual therapist. Thus, although your actions would vary depending on the parameters of the individual case, the best answer in light of the information we have is to refer the woman to another therapist for individual therapy.
Fee arrangements should be made with clients
A. at the beginning of treatment.
B. at the end of the first session.
C. on the phone before the first session.
D. as soon as possible.
D. This is an example of a question with more than one good answer. Choices “A”, “B”, and “C” may all be acceptable, depending on the circumstances. But because there are a number of acceptable answers to this question, you'd hope to find one general answer, such as “D”, that covers most or all of the specific possible options. More importantly, of the choices listed, “D” is most consistent with the language of APA's Ethical Standard 6.04(a), which states: “As early as is feasible in a professional or scientific relationship, psychologists and recipients of psychological services reach an agreement specifying compensation and billing arrangements.
A client suspects that she may have been sexually abused as a child, although she has no conscious recollection of the abuse. She asks her psychologist to use hypnosis to help her retrieve any repressed memories she may have of any abuse. The psychologist should:
A. agree to use hypnosis only if he or she has obtained adequate training and experience in it's use.
B. agree to use hypnosis but take detailed notes in the event of future legal action and avoid asking the client any leading questions.
C. advise against the use hypnosis, but recommend the use of guided imagery, which may be more admissible in court.
D. advise the patient that hypnosis may produce false recollections of abuse and is therefore inappropriate.
D. In a report titled "Final Conclusions of the American Psychological Association Working Group on Investigation of Memories of Childhood Abuse" [Psychology, Public Policy, and Law, 2000, 4 (4), 933-940] the authors acknowledge that "it is possible for memories of abuse that have been forgotten for a long time to be remembered." However, they recommend that "clients who seek hypnosis as a means of retrieving or confirming their recollections should be advised that it is not an appropriate procedure for this goal because of the serious risk that pseudomemories may be created in trance states and of the related risk due to increased confidence in those memories. Clients should also be informed that the use of hypnosis could jeopardize any future legal actions they might want to take."
An attorney contacts a psychologist requesting that his client be given a psychological evaluation prior to appearing in court. Following the evaluation the client asks that his records not be released to the court, although his attorney believes that releasing the records would be in his client's best interest. The psychologist should:
A. release the records since there is no privilege regarding forensic evaluations
B. release the records since the attorney requested the evaluation
C. not release the records
D. seek consultation
C. Since this does not appear to be a court-ordered evaluation, the examinee remains the holder of the privilege; thus, his records should not be released to the court without his consent.
The purpose of State Licensing Boards is primarily to
A. educate the public.
B. educate the profession.
C. protect the public.
D. set minimum standards of practice.
C. The State Boards derive their authority from the principle of protecting the public. That's the justification for giving exams, setting requirements for licensure, writing and enforcing regulations, and so on.
You are working with a couple in marital therapy and are conducting the initial interview. You realize that although the husband doesn't remember you, the two of you once dated. You should
A. speak to the husband alone, explain the situation and ask him if he feels comfortable with proceeding.
B. see the wife in individual therapy only.
C. refer the couple to another therapist.
D. let the couple know the situation and then proceed with therapy.
C. This question is fairly easy to answer once you remember you are not obliged to provide services for all your referrals. This is an initial interview and you have a situation that involves a multiple relationship. You need to refer this couple to one of your competent colleagues.
A manufacturing company hires a psychologist to screen job applicants using standardized cognitive ability tests. The company then asks the psychologist to train their human resources staff to administer and score the tests. The psychologist should:
A. agree to do so if the psychologist is able to provide adequate training to the staff
B. agree to do so if the psychologist is able to supervise the human resources staff
C. refuse to do so because cognitive ability tests are not valid predictors of job performance
D. refuse to do so because the human resources staff lacks the appropriate qualifications
D. Ethical Standard 9.07 states, "Psychologists do not promote the use of psychological assessment techniques by unqualified persons." A human resources staff would be unqualified to use these tests and should not be trained in their use. Contrary to C, cognitive ability tests are considered to be a relatively good predictor of job performance.
Utilization review, an important component of managed health care, refers to the idea that it is useful to
A. review benefits to eliminate or reduce unnecessary health care resources.
B. determine the adequacy of health care standards by comparing them to predetermined standards.
C. make decisions on patient care by a team of medical experts rather than an individual physician.
D. allow a patient to choose from several insurance plans.
A. Utilization review is concerned with conserving health care monies. It does this through having a utilization review committee assess the use of benefits and reduce or eliminate inappropriate or unnecessary use of health care resources. Answer B is a description of the concept of quality assurance and answer C is describing a medical team management approach to individual health care.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 applies to:
A. all health care providers
B. only health care providers who transmit patient information by fax and the internet
C. only health care providers who employ someone, such as billing services, with access to patient information
D. only health care providers who transmit patient information electronically
D. HIPAA does not apply to all health care providers. It only applies to “covered entities” — health plans, health care clearinghouses and healthcare providers — who transmit health information electronically. A provider who only communicates information by mail, phone, or fax is not a covered entity. Transmitting information electronically refers to use of the internet and includes receiving health information as well as transmitting information. For example, a provider is a covered entity even if she/he never transmits information but receives information, such as a description of benefits e-mail, via the internet. Additionally, a provider employing someone who sends or receives patient information on the provider’s behalf via the internet is also a covered entity.
A college psychology instructor gives a battery of psychological tests to some of his students who volunteered to be participants. Based on these tests, he finds that one of the participants is at risk for emotional disturbance. He talks to this student and suggests counseling. At the same time, he informs the director of the college counseling office who is a friend of his. According to APA ethical principles, the professor acted
A. unethically, because he revealed this information to a third party.
B. ethically, because he acted in accord with the student's welfare.
C. ethically, because he had responsibilities to the college as well as to the student.
D. unethically, because he isn't a clinician.
A. Suggesting counseling to the student is ethical and appropriate. However, barring an emergency situation characterized by imminent danger, informing a third party is unethical.
A psychologist is undertaking a research program in an elementary school on the effect of a new counseling program on enhancing children's self-esteem. The psychologist has received permission from the school's principal, the teachers, and from the parents of each student. However, when she explained the program to the children, some of them objected to being part of the study. The psychologist should
A. not use these children in her study.
B. call the parents of these children and ask them to try to convince the children to participate.
C. use the children in her study because she has all necessary legal consents.
D. re-design the study to eliminate the objection the children have to participating.
A. The best idea is to just leave out these children. Participants have the right to decline to participate in research, even if they are children. It wouldn't be practical or prudent to ask her to re-design the whole experiment because a handful of children object to being participants. Thus, the best answer is to just do the study without using the children who object to participating.
You have a client who does not want their records released under any circumstances. The attorney has subpoened you. Your best course of action is to:
A. Respond in-person, but don't take the records
B. Take the records, but don't turn them over
C. Ignore the entire matter
D. Destroy the records
B. You should respond to the subpoena by asserting the psychotherapist-client privilege on the client's behalf. If you cannot be released from the subpoena, you should appear at the legal proceeding with the documents requested, however, you should not actually release any information in the records, unless the judge orders you to do so. Keep in mind that a subpoena duces tecum requires a person to appear at a designated time and place with a copy of the records. It does not necessarily require the person to release those records.
A 16-year-old girl tells her therapist that she wants to kill herself and that she's been thinking of using her mother's prescription pain pills to overdose. The therapist then tells her that he will have to tell her parents about her suicide risk. The girl becomes enraged and says that she would not have disclosed the information if she knew that the therapist would tell her parents. The therapist should:
A. agree not to tell the parents if the girl agrees to a no-harm contract
B. agree not to tell the parents, but tell them without the girl's knowledge
C. tell the parents and refer the girl to another therapist because she will probably not be able to trust the therapist again
D. tell the parents and apologize to the girl for having to do so
D. According to both ethics and law, a psychologist may disclose confidential information without the client's consent to protect the client from harm. This applies to minors and adults alike. In this case, it would most likely be appropriate to inform the girl's parents about her suicide risk. The reasons for this should be explained to the girl and the therapist should apologize for the breach of confidentiality. Given the apparent level of risk involved, it would probably not be sufficient to rely on a no-harm contract (A). It would certainly be inappropriate and countertherapeutic to lie to the client (B). And it may not be necessary to refer the client (C). If handled empathically, it is likely that the girl will come to understand the therapist's reasons for disclosing to the parents and may come to appreciate that her safety was his overriding concern.
Which of the following best describes the ethical requirements of a licensed clinical psychologist who tests positive for HIV?
A. inform clients of his/her medical condition “as early as is feasible”
B. obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties
C. refrain from initiating any professional activities that might be adversely affected by the medical condition
D. there is no obligation to take precautions or special actions in this situation
C. Being diagnosed with HIV, when considering the ethical obligations of a psychologist, would be considered a health-related personal issue. Personal problems, including emotional, social, health-related and other personal issues, are addressed in Standard 2.06: Psychologists “refrain from initiating an activity when they know or should know there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.” If a psychologist thinks the condition may impair his/her ability to provide effective services or perform work-related duties then the psychologist would “take appropriate measures.” However, there is no evidence that this is the case, so (b.) is not the best answer. Informing clients of the condition (a.) is not necessary and may not be in the best interests of some of the clients to do so.
Therapists who become sexually involved with their clients
A. usually do so because they believe they are in love with the client as a result of the client's unique and desirable characteristics.
B. usually do so as a result of a lack of experience and poor judgment.
C. usually do so to fulfill personal needs resulting from events in their own life.
D. do not show any characteristics that distinguish them from therapists who do not become sexually involved with their clients.
C. The experts generally agree that therapists who have sexual relationships with their clients are not only exhibiting poor judgment but are also usually suffering from some type of impairment, often related to boundary issues or unfulfilled needs. See J. D. Guy, The Personal Life of the Psychotherapist, New York, John Wiley & Sons, 1987.
During the course of a research experiment, subjects witness someone who is apparently hurt, needing immediate help, and are unable to help or know if the person is assisted. The subjects become immediately distressed. In this situation:
A. debriefing occurs at the conclusion of participation
B. group debriefing occurs at the conclusion of collection of data
C. debriefing occurs when subjects become distressed
D. debriefing occurs at the conclusion of research
A. This question involves deception in research, distress and debriefing. Due to the use of deception and the resultant participant distress, debriefing immediately following participation is the best option as described by Standard 8.07(c) Deception in Research: “Psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection.” The Ethics Code on Debriefing, Standard 8.08(a), notes, “Psychologists provide a prompt opportunity for participants to obtain appropriate information about the nature, results, and conclusions of the research, and they take reasonable steps to correct any misconceptions that participants may have of which the psychologists are aware,” and in Standard 8.08(c) “When psychologists become aware that research procedures have harmed a participant, they take reasonable steps to minimize the harm.”
You have been court-ordered to evaluate a prisoner who is being tried for murder. You explain the purpose of the evaluation and complete it. As you are packing up your testing materials, the prisoner smirks, and says, "I agreed to this but I didn't sign anything. You are out of luck, doctor."
A. You should go ahead and complete the report, but leave out the prisoner's comments.
B. The prisoner is correct -- you should refer for a new assessment.
C. You should add this verbal comment to the report, noting the prisoner's passive-aggressive tendencies.
D. You should have read the case file because you would have learned that the accused is also an attorney; this would affect how you would treat this prisoner.
A. Because this evaluation was court-ordered you were not actually required to obtain informed consent. However Standard IV.E.1 of the Speciality Guidelines for Forensic Psychologists states that "if the client appears unwilling to proceed after receiving a thorough notification of the purposes, methods, and intended uses of the forensic evaluation, the psychologist should take steps to place the client in contact with his or her attorney for the purpose of legal advice on the issue of participation." Remember, you always want to take the most careful and conservative approach if possible. While you may be tempted to choose answer C and add the client's comments to your report, this would contradict Standard V.C. of the Forensic Guidelines which states that, "In situations where the right of the client to confidentiality is limited, the forensic psychologist makes every effort to maintain confidentiality with regard to any information that does not bear directly upon the legal purpose of the evaluation."
Finally, as a thorough evaluator you should have read the case file closely; however, you would not proceed with an evaluation differently just because your client is an attorney.