Ethics and the forensic expert: a case study of child custody involving allegations of child sexual abuse

Psychologists who participate as forensic evaluators in custody and visitation cases involving allegations of child sexual abuse must possess advanced assessment skills and a thorough knowledge of child development, child sexual abuse, and child interviewing techniques. This case study illustrates the types of problems that are inevitable when psychologists violate the boundaries of their role as an independent evaluator and fail to uphold their ethical obligation to be knowledgeable and competent in the area in which they profess expertise.     

Balancing Confidentiality and Collaboration Within Multidisciplinary Health Care Teams

As multidisciplinary perspectives are increasingly integrated into the treatment of health problems, opportunities for clinical psychologists in medical settings are expanding. Although cross-discipline collaboration is at the core of multidisciplinary treatment models, psychologists must be particularly cautious about information sharing due to their profession??s ethical standards regarding patient confidentiality. Psychologists?? ethical obligations require them to achieve a delicate balance between contributing to the treatment team and protecting patient confidentiality. In the current review, relevant ethical standards and federal guidelines are applied to everyday practices of clinical psychologists in medical settings. Additionally, recommendations for individual psychologists, health care organizations, and graduate training programs are presented.     

Clinical Geropsychology: Implications for Practice in Medical Settings

Older adults are a rapidly growing segment of the population, who have high rates of chronic illness and who utilize health care resources heavily. Psychologists must become better prepared to work with older patients in geriatric settings, including geriatric assessment units, memory disorders clinics, and nursing homes. In addition, all psychologists will increasingly encounter older patients in environments such as primary care clinics, rehabilitation settings, and disease management programs focusing on problems that are prevalent in older patients (e.g., cancer, diabetes). Suggestions are offered for adaptation of usual clinical practice to address the special needs of older patients and their families, and recommendations made for advancing and expanding the practice of clinical geropsychology.     

Ethical Concerns of Nonclinical Forensic Witnesses and Consultants

Current research suggests that nonclinical forensic psychologists[sup1] are appearing increasingly more often in the legal arena. We argue that many of the ethical dilemmas that face these psychologists differ from those encountered by clinical forensic psychologists. To test the accuracy of this assertion, 37 nonclinical forensic psychologists were surveyed to identify some of the ethical issues and dilemmas they have encountered while engaging in expert testimony or pretrial consulting. Respondents were asked also about how they have resolved these ethical issues and whether they were aware of the "Specialty Guidelines for Forensic Psychologists" (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Results of the survey are discussed in terms of the need for additional regulatory guidelines or professional standards that speak directly to the ethical issues confronting nonclinical, forensic expert witnesses and consultants.     

Pediatrician/Psychologist Collaboration: Opportunities for Clinical Child Psychologists

In the United States, pediatricians prescribe the majority of medications used to treat children with psychological disorders, such as ADHD. However, because pediatricians have limited background in psychology or psychiatry, opportunities exist for properly trained clinical child psychologists to assist pediatricians in assessing and treating youngsters with psychological disorders. Psychologists with additional training in psychopharmacology can make even greater contributions by helping pediatricians select and monitor appropriate medications. This paper reviews models of consultation that are especially relevant to psychologists who seek to expand their practice by consulting with pediatricians. Consultant-centered models seem most appropriate in private practice settings, but institutionally employed psychologists have opportunities to also utilize some system-centered approaches. Examples of methods in which pediatric clinical psychologists and child psychologists with psychopharmacology training can assist pediatricians in treating a child with ADHD are discussed.     

Child Protection and Psychology Education in Australian Universities

Child maltreatment is a significant problem in Australia. Psychologists in a wide range of occupations play an important role in the identification and prevention of child abuse and neglect, the provision of interventions to children and families, and the development and conduct of research in related areas. Psychology graduates must be adequately prepared to work in this field; however, little is known about the extent to which child abuse and neglect related contents are taught in current university curricula. A purpose‐developed curriculum‐mapping survey was used to examine Australian undergraduate, fourth year, and postgraduate Australian Psychology Accreditation Council‐accredited programmes available in 2008. Results showed that students in the majority of programmes were exposed to child protection‐related content; however, the extent of exposure was limited. Three postgraduate units specifically addressed the prevention, identification, and response to child abuse and neglect. Course coordinators reported that child maltreatment content was mostly integrated into general units throughout the programme, typically within developmental psychology units in the undergraduate curriculum and in ethics, research, or professional issues units in the fourth year and postgraduate programmes. Results suggest the need for child protection content to be included in minimum national standards and accreditation guidelines for universities.     

Cultural competency and humanistic psychology

Abstract

Developing cultural competence is increasingly important for humanistic psychologists in our ethnoculturally diverse society. In the past, training in ethnocultural issues involved learning about the cultural values and characteristics of a small number of cultural groups. Today, cultural competence requires that the psychologist become aware of their own ethnocultural values and their own ethnocentrism. This process of self‐examination can be emotionally challenging. This paper addresses some of the problems encountered on the path to increasing cultural sensitivity and the effect of unexamined cultural values upon the therapeutic interaction. Psychologists are encouraged to become aware of the privilege associated with European American culture, with the cultural values embedded within psychological theory in general, and with cultural values of humanistic psychology.     

Assessment of ADHD: differences across psychology specialty areas

Child psychologists are frequently involved in the assessment of ADHD symptoms among school-aged youth. There is limited information regarding the extent to which psychologists adhere to recommended assessment practices and whether differences exist in assessment strategies among psychologists from different specialty areas (clinical, counseling, and school) and/or who practice in different settings (university, school, or outpatient clinic). A 3 (specialty area) x 3 (employment setting) between-groups design is used wherein 230 child psychologists completed surveys regarding diagnostic practice. Psychologists differ in adherence with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) diagnostic criteria, use of clinical interviews, and type of behavior observation. Only 15% of psychologists report using multiple methods consistent with recommended standards of best practice. Differences between groups of psychologists indicate that the diagnosis of ADHD in children is influenced by the type of psychologist conducting the evaluation and the setting in which the evaluation is conducted.     

FACTS, FANTASIES AND THE FUTURE OF CHILD CARE IN THE UNITED STATES

Psychologists in both family practice and developmental research may be puzzled about the scientific status of research on child care as it affects children, parents, and caregivers. What conclusions can be reached about mothers in the labor force, about the advisability of various child care arrangements, about their short and long-term consequences, and what advice do we as psychologists have to offer in the public interest to parents of infants and young children? In this article, we review research on child care, and discuss its implications for the nation and for psychology as a research enterprise and a helping profession.     

Psychologists’ Leadership Roles and Leadership Training Needs in Academic Health Centers

Journal of Clinical Psychology in Medical Settings - Psychologists are increasingly called upon to become more involved in academic health centers (AHCs) as leaders across a range of leadership...     

Preface

Abstract

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Psychologists' role in family-centered approach to practice, training, and research with young children

Family-centered, community-based, coordinated care for children with special needs is presented as the best practice model for providing services to children and families. Psychologists must learn to play an active role in this frame-work that both integrates psychology with other health and education disciplines and uses the broad spectrum of psychological knowledge about families, development, community organization, and intervention strategies. Key principles of family-centered child psychology affect practice research and training. The psychologist becomes part of a team created to support families as the primary care-givers of their children. Training programs must reorganize the types of experiences both in the classroom and the field to train new psychologists within this model. As mandates for family-centered care affect policies at the state and federal levels, research will remain a critical factor in understanding the effects of these policy shifts on child and family functioning and the delivery of services.     

Preface

Summary

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Implementing the Scientist–Practitioner Model in the Hospital Setting

Psychologists who work in hospital settings confront assorted challenges in implementing the scientist–practitioner model. Clinical psychologists must deal with the tension between an evidence-based model and the realities of clinical practice. Psychologists can gain a better understanding of what it means to function as a scientist–practitioner by understanding current debates in both psychology and medicine on the relationship between research and practice. Psychologists are not unique in the slow pace of implementing research into practice. Psychologists in hospitals can make a contribution to the treatment of medical patients by emphasizing the role of the treatment relationship in health-care outcomes. Medicine’s use of practice-based research networks provides a valuable structure for psychologists to emulate in order to function as active participants in the collection of practice-based evidence rather than passively accommodating to the evidence-based clinical practice guidelines.     

Inclusion of Disabled Children and School Reform

Summary

Over the past three decades, special and general education have undergone dramatic philosophical and structural changes. The mission of special and general education and the roles and responsibilities of school personnel have become increasingly blurred. The inclusion movement has captivated the interest of scholars, educators, politicians and the public alike. This paper reviews the major historical and current socio-political, legal, and professional forces that have led to the inclusion movement and national educational reform initiatives (e.g., Goals 2000, IASA, IDEA) in America. Psychologists assume significant leadership roles in the refinement and implementation of inclusion models and national reform initiatives. The expertise and contributions of psychologists to this movement are outlined. Critical issues and unanswered questions are presented to stimulate future research and debate.     

The triumph of the segregationists? A historiographical inquiry into psychology and the Brown litigation

Psychologists testified at the trials of Brown v. Board of Education and helped write briefs that were submitted to the Supreme Court on appeal. Psychologists were once proud of what they did in Brown but are now seen as liberal reformers who masked their political wishes in the guise of social science. The argument that psychologists involved with Brown were social reformers rather than objective scientists dates to the segregationist critique of Brown. The author traces the history of the critique of the Brown psychologists from its segregationist origins to its acceptance by mainstream social scientific and historical scholars. The author concludes that the critique is based on a misreading of what the Brown psychologists did during the litigation.     

Expectations and preferences regarding confidentiality in the psychologist-client relationship

Two hundred and fifty-six members of the Australian public were surveyed regarding situations in which a psychologist might breach confidentiality and third parties to whom information might be disclosed. There was strong agreement between respondents' expectations about the way in which psychologists would act, and their preferences regarding how psychologists should act. While respondents supported confidentiality within the psychotherapeutic relationship, they clearly distinguished situations in which, and third parties to whom, disclosure could appropriately occur. Disclosure was expected and preferred when a client revealed a murder (planned or confessed), suicide plans, child abuse, or treason, and where the recipients of the information were colleagues of the psychologist or parents of a client younger than 13 years. Compared to nonparents, parents more strongly supported disclosure regarding illegal drug use and child abuse, and believed that parents should have access to a child's records. In general, respondents' view of the way in which psychologists should treat confidentiality issues were consistent with the guidelines prescribed by the Australian Psychological Society in the Code of Professional Conduct (1986).