Managed Care: Ethical Considerations for Counselors

Key factors and trends in health care will have an impact on the ethical practice of counselors. Ethical challenges to clinical practice presented by trends in managed care are discussed in relation to the American Counseling Association (1995) Code of Ethics and Standards of Practice. Recommendations for practice are also included.     

Ethical Considerations for Assessing Parent Mental Health during Child Assessment Services

Parents play an integral role in the mental health service provision of children and adolescents, and they can have significant effects on the outcomes of youth. A growing body of research has linked parents’ own mental health status to numerous outcomes for their children, and recent guidelines have emerged recommending the assessment of parent psychopathology when treating child patients. However, these recommendations present a range of ethical considerations. Mental health professionals must determine if the assessment of a parent is empirically supported and that an assessment procedure appropriate for parents can be feasibly implemented. They must also respect the autonomy and confidentiality of parents while ensuring that assessment findings can be translated to meaningful benefits for child patients. This article details and discusses each of these concerns within the context of the relevant principles and standards of the 2016 American Psychological Association’s Code of Ethics. Further, it provides guidelines, relevant clinical examples, and an applied model for mental health professionals to consider the ethical implications of assessing parent mental health when serving child patients.     

Criticisms of the Ethical Principles for Psychologists and Code of Conduct

ABSTRACT

Beginning in 1953 the American Psychological Association (APA) has advanced twelve iterations of a professional ethical code. In recent years the adequacy of the Ethics Code as well as APA’s ethics enforcement has come under increased scrutiny. In 2015 the APA empaneled an Ethics Commission which made a series of recommendations; however, the Commission itself as well as its recommendations are also controversial. This paper presents criticisms of the Ethics Code that have generally not been discussed in the previous literature.     

Ethical Analysis and Recommended Action in Response to the Dangers Associated With Youth Consumerism

Research shows that a culture of consumerism and materialism has a dramatic and negative impact on children's physical and psychological health. Psychologists have a duty to act to reverse this trend. Information on why and how to act is the key. This article explores the use of psychology to improve the effectiveness of advertising to youth and details the harm suffered by children as a result of some of this advertising. A discussion of ethical considerations related to specific guiding principles and ethical standards of the 2002 American Psychological Association (APA) Ethics Code frames why action is imperative. Actions for psychologists to take in applying the 2002 APA Ethics Code are suggested herein.     

How Psychotherapists Address Hypothetical Multiple Relationships Dilemmas with Asian American Clients: A National Survey

This study examined how psychotherapists address hypothetical nonsexual multiple relationships dilemmas with Asian American clients and identified predictors of conservative decisions and the use of culture-based rationales. This survey of 787 Asian American and non-Asian American psychotherapists revealed that clinicians rely on mostly their personal policies and seldom focus on the clients' cultural backgrounds. Psychotherapists who consider their clients' Asian culture have more cultural knowledge and awareness, have been mental health providers longer, and are Asian American and female. Clinicians who avoid multiple relationships tend to cite formal policies as justification and are less likely to consider clients' cultural worldviews, the therapeutic relationship, or their own values. The results are discussed in terms of specific revisions needed in the American Psychological Association Ethics Code, the benefits of more frequent consultation with colleagues and supervisors about ethical dilemmas, and recommendations for psychotherapists.     

When Psychotherapy Is Not Working: Ethical Considerations

Evidence-based practice (EBP) models have been developed, in part, to enhance the likelihood that the outcome of health care treatment, including psychotherapy, leads to positive improvement. However, two additional outcomes can occur: no change and poor outcome (e.g., harm, worsening of symptoms). What does the clinician do when psychotherapy is not working? When faced with various treatment decisions, such as this, the EBP model posits that therapists should apply their clinical expertise in considering the “best available research” within the context of various patient characteristics. In part because of various limitations of this approach, I suggest that another important set of principles are important to consider in tandem when faced with this clinical dilemma—that is, ethical concerns. Borrowing from the American Psychological Association’s (2017a) Ethics Code, I discuss how the following issues exist when clinicians wrestle with this question: avoidance of harm, competence, conflicts of interest, and informed consent. I conclude this paper with a list of suggestions that can potentially foster the application of ethical principles when making treatment decisions.     

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues (e.g., Americans with Disabilities Act) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population.     

Reference Ethics: Theological Librarianship in Conversation with ALA Reference Ethics Guidelines

This particular article will look at one ethical concern that is likely to be very familiar to most theological reference librarians. This question is what the theological reference librarian's ethical responsibilities are when the American Library Association's Code of Ethics seems to conflict with an institution's expectations for an employee of that institution. In order to adequately solve this question, the article will first summarize the basic elements of the American Library Association's Code of Ethics that relate to the reference interview. Next, the special nature of theological reference librarianship will be discussed. Third, the Association of Theological Schools accreditation guidelines will be examined to determine the relationships that theological librarians have to their religious institutions. Fourth, in light of the theological librarian reference ethics that emerge from the proposed investigation, possible ethical solutions will be suggested. The article will conclude that the article's research question is actually a false question, not because theological librarians have not raised it or because it is not worth considering, but because the American Library Association's Code of Ethics and the Association of Theological Schools accreditation standards expect the same thing from their librarians.     

The ethics of interrogation and the American Psychological Association: A critique of policy and process

The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights.     

Establishing an ethical climate in support of research integrity: Efforts and activities of the American Sociological Association

The article provides an overview of the recent efforts and activities of the American Sociological Association (ASA) to keep its Code of Ethics visible and relevant to its membership. The development process and challenges associated with the most recent revision of the ASA's code are reviewed, the current education and support activities are described, and other strategies for taking a proactive and leadership role in establishing an ethical climate are proposed. In conclusion, while the ASA has made significant progress in this area, it recognizes that a lot of work remains.     

Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals With Serious Mental Illness

Mental health professionals frequently work with family caregivers in the provision of psychotherapy services to individuals with serious mental illness. To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. When working with family caregivers, practitioners utilize the American Psychological Association’s Ethics Code (2010), legal codes, and a complex decision-making plan; identify and communicate ethical obligations to family caregivers; consider the unmet needs of this population; avoid harm resulting from multiple relationships; and balance ethical duties of beneficence and respect for autonomy.     

Ethical Issues and Potential Solutions Surrounding the Use of Spoken Language Interpreters in Psychology

The need for psychological services to limited English proficient clients is increasing. Psychologists who provide clinical services to limited English proficient clients are frequently required to use the services of spoken language interpreters. Research has shown that the quality and consistency of interpretation services are often in question. Interpreters are generally not required to hold any certifications or to meet training requirements prior to providing interpretation services. This lack of oversight leaves the psychologist responsible for the quality of the interpretation when adhering to the American Psychological Association’s (APA) 2010 Ethical Principles of Psychologists and Code of Conduct. This article includes a discussion of the ethical and clinical issues inherent in providing psychological services through an interpreter, how those issues affect a psychologist’s adherence to the APA Ethics Code, and recommendations for meeting the ethical standards while providing sound clinical services through the use of spoken language interpreters.     

Report of the ACA Ethics Committee: 1995–1996

This report contains data about ethical complaints and inquiries processed by the American Counseling Association (ACA) Ethics Committee from 1995 to 1996. This report also includes a discussion of the findings of the committee, information about the approval of the new ACA Code of Ethics and Standards of Practice, and educational efforts undertaken by the committee.     

With crisis comes opportunity: Building ethical competencies in light of COVID-19

ABSTRACT

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has wide-ranging implications for the field of professional psychology. As clinical practice has rapidly adapted to ensure continuity of care, doctoral students have encountered unique opportunities for ethics-related competency development across practicum training settings. This article discusses the relevant American Psychological Association (APA) Ethics Code standards and additional ethical considerations facing trainees as they navigate their foundational clinical experiences and develop as professional psychologists in light of a pandemic.     

The Ethics Code Does Not Equal Ethics: A Response to O’Donohue

ABSTRACT

O’Donohue has identified 37 criticisms of the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (Ethics Code), although many of his criticisms go far beyond what is found written in the APA Ethics Code, to include the process of adjudicating ethics complaints by the American Psychological Association Ethics Committee, and the process by which the Ethics Code was developed. The authors claim that a major shortcoming of O’Donohue’s article is that he adopted an unrealistically expansive role for the Ethics Code that was not clearly linked to furthering the goals of the ethics code revision.     

Healthcare at Your Fingertips: The Professional Ethics of Smartphone Health-Monitoring Applications

Health professionals are inundated by the surfeit of health apps while lacking guidance to help them critically evaluate whether a particular health-monitoring app is safe, likely to lead to clinical benefit, and not introduce additional liability. Our objective is not to argue for or against the use of mobile health-monitoring apps but to illuminate the associated ethical issues and provide recommendations to guide the ethical decision-making process for clinicians who are considering the use of a mobile health-monitoring app. To this end, the Canadian Code of Ethics for Psychologists is used as a framework to situate recommendations.     

Influence of Culture on Ethical Decision Making in Psychology

This study focused on the influence of American and Chinese cultures on consequentialism orientation in decision-making within the broader context of psychologists’ academic roles and responsibilities. In addition, this study hypothesized that educational level would affect culturally influenced ethical decision making in both cultures. Based on the American Psychological Association Ethics Code, 20 ethical scenarios in 5 domains in psychology were created and used to examine the influence of culturally ethical beliefs on psychologists’ decision making among 181 participants. The results indicated that significant cultural differences in consequentialism orientation differentiated Chinese and American participants and influenced their resolution of ethical issues.     

Ethical Considerations for Psychologists Screening Applicants for the Priesthood in the Catholic Church: Implications of the Vatican Instruction on Homosexuality

The release of the Vatican instruction on homosexuality in the priesthood and Catholic seminaries poses several challenging ethical issues for the psychologists who conduct psychological screening evaluations for those men interested in religious life as Catholic priests. This brief article reviews some of the key ethical issues associated with these evaluations in light of the new Vatican instruction on homosexuality. The RRICC model based on the American Psychological Association's Code of Ethics (i.e., responsibility, respect, integrity, competence, and concern) is used to highlight some of the ethical challenges for psychologist evaluators.     

Promoting a Contextual Perspective in the Application of the ACA Code of Ethics: The Ethics into Action Map

Because community counselors work within an increasingly broad array of practice settings, it is imperative for them to understand how to apply the ACA Code of Ethics (American Counseling Association, 2005) to specific practice settings. The author examines ethics applied to unique practice settings and proposes the Ethics into Action Map as a method to promote an increased understanding of the application of ethical standards to specific contexts. Case examples are provided to illustrate the use of the Ethics into Action Map.     

Ethics in Publication

This article describes ethical dilemmas in publication and provides recommendations for guidelines involving publication ethics. Counselors may be confronted with a variety of ethical dilemmas such as authorship issues, student-professor research, plagiarism, and other publication problems. The American Counseling Association's Code of Ethics and Standards of Practice (ACA, 1995) provides only general information regarding publication ethics for counselors and researchers.