Protecting confidentiality rights: the need for an ethical practice model

All psychologists must uphold the same ethical standards about confidentiality even though each state imposes different legal limits on their ability to protect clients' confidences. The resulting ethical-legal confusion is exacerbated by legally based confidentiality training that treats legal exceptions as if they were the rule and fosters the impression that attorneys are now the only real experts about this aspect of practice. This article provides an ethics-based confidentiality practice model that clarifies the ethical rule and puts its legal exceptions into ethical perspective. Like the Confidentiality section of the American Psychological Association's (2002) Ethical Principles of Psychologists and Code of Conduct, this outline would apply to all psychologists regardless of state laws, but the details of its implementation would vary according to role and setting. It can be used as a universal training outline, a consultation and supervision tool, a guide to professional practice, and a basis for clearer ongoing conversation about the ethics of "conditional confidentiality." Psychologists can use this practice model to regain their status as experts about the confidentiality ethics of their own profession.     

Psychologists' perceptions of legal and ethical requirements for breaching confidentiality

This paper outlines the legal and ethical duties of psychologists in relation to preserving as well as breaching confidentiality in therapeutic relationships. It analyses the results of a questionnaire examining psychologists’ perceptions of the legal and ethical constraints on confidentiality and their likelihood of breaching confidentiality in different situations. The vast majority of participants indicated that the law permits them to disclose confidential information and that there is an ethical duty to disclose information to a third party when the patient is perceived to be dangerous. The results suggest that there is some uncertainty as to when confidentiality should be breached in practice and it is argued that the law is overly complex in this area and that guidelines are needed to assist psychologists in their clinical practice.     

Issues in training clinical health psychologists

The author describes general issues in the training of clinical health psychologists and provides an overview of specific content needed in core health psychology and clinical health psychology assessment and intervention. Special attention is given to training in professional, personal, ethical and legal issues of practice.     

An Exploratory Study: Perceptions of Ethical Behaviors Among Psychologists Practicing in the Caribbean

A sample of 44 psychologists who practice in the Caribbean completed a web-based survey containing 73 behavioral items related to ethical issues in professional practice. The aim of this exploratory study was to learn about perceptions regarding ethical behaviors that create ethical dilemmas and the level of agreement to their responses and to identify how demographic variables influenced their perceptions of ethical behaviors. Findings suggest that there was approximately an equal level of agreement on behaviors such as being an advocate for your client and being sexually involved with a current client rated as ethical and unethical, respectively. Several demographic variables and ethical behaviors such as level of degree and confidentiality issues were statistically significant. Finally, psychologists prefer the presence of a professional psychological association with an ethics committee.     

Confidentiality in psychological practice

Confidentiality has long been a cornerstone of trust in the professional relationship between psychologists and their clients. Developments in computer technology, litigation, insurance reimbursement schemes, and changing lifestyles are forcing psychologists to reconsider and refine their approach to respecting this important ethical principle. This article review basic concepts on the matter, and discusses these in light of evolving issues in practice, technology, and the law. Some contrasts in legal and ethical aspects of confidentiality between Australia and the United States are discussed. Recommendations for enhancing attention to confidentiality in one's practice are included.     

The Use of Testing Technicians: Critical Issues for Professional Psychology

The controversial practice of using unlicensed individuals to administered psychological tests has been questioned by some psychologists, professional organizations, state and provincial boards of psychology, state governments, departments of education, and third-party health care providers. This article provides an overview of the ethical, legal, and technical issues surrounding the controversy. On the basis of a review of these issues, recommendations are offered that are directed toward state and provincial boards of psychology, developers and publishers of psychological tests, and licensed psychologists.     

ETHICAL STANDARDS of the American Association for Counseling and Development (3rd Revision,AACD Governing Council,March 1988)

The Association is an educational, scientific, and professional organization whose members are dedicated to the enhancement of the worth, dignity, potential, and uniqueness of each individual and thus to the service of society. The Association recognizes that the role definitions and work settings of its members include a wide variety of academic disciplines, levels of academic preparation, and agency services. This diversity reflects the breadth of the Association's interest and influence. It also poses challenging complexities in efforts to set standards for the performance of members, desired requisite preparation or practice, and supporting social, legal, and ethical controls. The specification of ethical standards enables the Association to clarify to present and future members and to those served by members the nature of ethical responsibilities held in common by its members. The existence of such standards serves to stimulate greater concern by members for their own professional functioning and for the conduct of fellow professionals such as counselors, guidance and student personnel workers, and others in the helping professions. As the ethical code of the Association, this document establishes principles that define the ethical behavior of Association members. Additional ethical guidelines developed by the Association's Divisions for their specialty areas may further define a member's ethical behavior.     

Advertised Australian counselling psychologists: A descriptive survey of their practice details and self perceived competence in six counselling psychology practice areas

This survey research in a field setting aimed to describe psychologists who advertised themselves in the Australian Yellow Pages as counsellors, thus providing a snapshot of advertised counselling psychologists in Australia. Data was collected using a multiple mailing survey method and resulted in a 62.2% return rate. The psychologists’ (a) demographic characteristics, (b) training and development, (c) provision of services, (d) professional involvement, and (e) their self perceived competence in working with (i) depression, (ii) anxiety, (iii) substance use, (iv) clients from non English speaking backgrounds and Indigenous and Torres Strait Islander individuals, (v) clients who are same sex attracted (gay, lesbian, and bisexual individuals), and (vi) clients using electronic mail and instant messaging were assessed. Advertised Australian counselling psychologists tend to be female, mature and Caucasian. The majority of the psychologists surveyed live in urban areas. Master and Bachelor level degrees were most often reported, a minority held doctoral degrees. The average psychologist charged $96.32 per hour, less than the Australian Psychological Society (APS) recommended fee for an hour of service. Eclectic and cognitive behaviour therapy were indicated most often as the theoretical orientations guiding psychological work. Psychologists belonged almost exclusively to the Australian Psychological Society as a professional association. Surprisingly, 2.9% of psychologists indicate not following an ethical code in their work and 3.9% failed to ensure that their work was covered by professional indemnity insurance. Advertised psychologists are thus described and suggestions are given for the further development of the profession. Regarding their self perceived competence, Australian advertised psychologists present as having self perceived strengths and areas of weakness regarding their counselling competence. This indicates that they are aware of their varying ability to work with various issues and populations. The self perceived competence of Australian psychologists in six specific counselling practice areas and suggestions for future training and development are provided.     

Sexual Orientation and Human Rights in the Ethics Code of the Psychology and Counseling Organization of the Islamic Republic of Iran (PCOIRI)

The aim of this study is to investigate the necessity of revising the Ethics Code of the Psychology and Counseling Organization of the Islamic Republic of Iran (PCOIRI) with respect to people’s rights and dignity and to avoid unfair discriminations toward sexual orientation and gender identity. It is said that confused diagnoses; wrong decision making; unethical practice; and the subsequent harm caused to lesbian, gay, bisexual, and transgender clients result from the lack of a clear code and relevant guidelines. In addition, certain conditions in Iran (such as religious perspectives, laws, cultural biases, misunderstandings, a lack of local academic and scientific resources, and Western conspiracy theories) lead professional psychologists and researchers to avoid researching sexual minorities and gender identity, which negatively impacts the Ethics Code of the PCOIRI. Iranian and Western researchers have identified four primary sources to which psychologists and counselors can refer when faced with ethical dilemmas: developmental psychology, professional ethics codes, philosophy of psychology literature, and available researches and compilations on professional ethics. Finally it is suggested that, when dealing with homosexual clients and the related ethical dilemmas, Iranian psychologists and counselors need clear and specific guidelines and a professional ethics code developed from more appropriate reference points than legal and religious sources.     

Ethical Issues in Psychologists' Professional Practice: Agreement Over Problematic Professional Behaviors Among Spanish Psychologists

A sample of 703 Spanish psychologists completed an online survey containing 114 behaviors related to professional practice in different areas. The aim of the study was to learn which professional behaviors create ethical dilemmas most often for psychologists and how they respond to these issues. Findings suggest that psychologists who have actually faced a particular dilemma are less strict on judging the inappropriateness of a possible ethical transgression than those psychologists who have not experienced it. Also, four clusters can be identified according to the attitude of respondents toward the dilemmas, namely “rejection,” “aprioristic,” “utilitarian,” and “no conflict.”     

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.     

Better Preparing Sports Psychologists for the Demands of Applied Practice: The Emotional Labor Training Gap

The aim of this article was to investigate the emotional educational–training–practice gap in the professional formation of sport and exercise psychologists in the United Kingdom through the theoretical lens of emotional labor. Twenty semistructured interviews were conducted with 4 participant groups: master’s students (n?=?5), trainees (n?=?5), neophytes (n?=?5), and experienced sport and exercise psychologists (n?=?5). Adopting an interpretive epistemology, an abductive thematic analysis was conducted in relation to the participant groups recruited. Several overarching themes were identified in each participant group: (a) master’s students (emotional labor as theory, practice), (b) trainees (emotional labor to survive, a professional development tool), (c) neophytes (emotional labor as a new professional, self-care), and (d) experienced sport and exercise psychologists (emotional labor as a professional resource, lifelong learning). A synthesized list of applied recommendations to improve the professional formation of sport and exercise psychologists was developed based on the analysis. The themes extend sport and exercise psychology professional development literature, and we make recommendations for educators, professional associations, and regulatory bodies with regard to (a) bridging the emotional labor and experiential gap when transitioning between development phases via collaborative and innovative educational provision, (b) supporting the development of skills relating to the enactment of emotional labor, and (c) considering support mechanisms for student/trainee/neophyte safeguarding and welfare issues as a result of the emotion-laden transactions in professional practice. The implications for future pedagogy, andragogy, and research are discussed.

Lay Summary

Sports psychologists need to manage their emotions when working with athletes and coaches, but this is not often taught during education or training. This study aimed to understand whether sports psychologists were aware of or prepared to manage their emotions and to identify activities that could develop education and training courses.     

What Creates the Dilemma in Ethical Dilemmas? Examples From Psychological Practice

Twenty psychologists were interviewed about an ethical dilemma that they had found to be particularly difficult to resolve. In just under half of the cases the dilemma involved a perceived conflict of ethical principles (e.g., the welfare of the consumer vs. the right to privacy). In the other cases, the psychologists were prevented from following an ethically prescribed course of action by some nonethical consideration such as contractural obligation, legal requirement, or the demands of an employer. We discuss the implications of these two sorts of dilemmas for psychological practice and make some suggestions for proactive approaches to ethical problem solving.     

What creates the dilemma in ethical dilemmas? Examples from psychological practice

Twenty psychologists were interviewed about an ethical dilemma that they had found to be particularly difficult to resolve. In just under half of the cases the dilemma involved a perceived conflict of ethical principles (e.g., the welfare of the consumer vs. the right to privacy). In the other cases, the psychologists were prevented from following an ethically prescribed course of action by some nonethical consideration such as contractual obligation, legal requirement, or the demands of an employer. We discuss the implications of these two sorts of dilemmas for psychological practice and make some suggestions for proactive approaches to ethical problem solving.     

The practice of psychology in rural communities: potential ethical dilemmas

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.     

Psychotropic Medication Consultation in Schools

Abstract

Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the complexity of medication issues for school psychologists. Training programs are encouraged to examine current curricular requirements to insure that graduates are exposed to evidenced-based treatments including pharmacological approaches. It is vital that school psychologists examine their own competencies as they work to ethically and legally consult with families and physicians to improve adaptive functioning in school-aged populations.     

Canaries in the Ethical Coal Mine? Case Vignettes and Empirical Findings for How Psychology Leaders Have Adopted Twitter

Twitter, an online application, allows users to post microblog statements in real time. Have psychologists in leadership positions adopted Twitter? What ethical standards are navigated in doing so? Little research has examined the adoption rate of Twitter within a sample of psychologists. This article outlines a series of case vignettes depicting ethical dilemmas encountered by psychologists who adopt Twitter. Data reviewing Twitter adoption by professional psychologists who served as president within psychology advocacy organizations reveal higher adoption rates from student group leaders than professional organization advocacy presidents. Implications for ethical standards and professional development are discussed.     

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present article analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present article examines ethical issues that (a) should be taken into account before psychologists take a public position on a controversial issue and (b) are in conflict with APA’s Ethics Code or current research.     

Training and Consultation in Psychological Assessment With Professional Psychologists: Suggestions for Enhancing the Profession and Individual Practices

Once central to the identity and practice of clinical psychology, psychological assessment (PA) is currently more limited in professional practice and generally less emphasized in graduate training programs than in the past. Performance-based personality tests especially are taught and used less, even though scientific evidence of their utility and validity has never been stronger. We review research on training in PA and discuss challenges that contributed to its decreased popularity. We then review continuing education requirements for ethical practice in PA and recommend that PA should be reconceptualized as a specialty best practiced by psychologists who have the resources and time to maintain competency. We offer recommendations about how professional organizations concerned with PA can promote its practice and how individual expert clinicians can assist. We conclude by describing a collaborative model for providing group consultation in PA to practicing psychologists. If implemented widely, this model could help promote PA and raise its standard of practice.