Confidentiality in psychological practice: a decrepit concept?

Although the principle of confidentiality in the relationship between psychologists and client has been vaunted, and is emphasised in the Australian Psychological Society's Code of Professional Conduct (the APS code; 1994), the confidentiality of this relationship is circumscribed by the absence of legal protections, the ethical beliefs of psychologists, institutional practices, and the provisions of the APS code itself. Lack of privilege in judicial proceedings, and statutory obligations to report certain types of behaviour, mandate breaches of confidentiality in some circumstances. Ethical beliefs of psychologists may support disclosure, especially where it is believed that there is danger of serious physical harm to the client or others. Multidisciplinary teams and institutional settings require the exchange of information for optimal delivery of services. Recent amendments to the APS code may require disclosure without the client's consent when a client is believed to be suicidal. Such developments, when considered at all, are typically regarded as exceptions to a general obligation of confidentiality. However, discussion of exceptions presupposes agreement on fundamental principle: the significance of, and rationale for, confidentiality in the psychologist-client relationship. It is argued in this paper that the obligation of confidentiality has been assumed rather than vigorously analysed and empirically explored. A critical examination of this obligation is the most appropriate starting point for the rehabilitation of contemporary principles of confidentiality in the psychologist-client relationship.     

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).     

How believing in affirmative action quotas protects White men’s self-esteem

We propose that White men derive a psychological benefit from believing that affirmative action is a quota-based policy. Three studies provide evidence that quota beliefs protect White men’s self-esteem by boosting their sense of self-competence. Study 1 found a positive relationship between quota beliefs and self-esteem that was mediated by self-perceived competence. In Studies 2 and 3, the belief in affirmative action quotas—whether measured or experimentally manipulated—protected White men’s self-esteem from self-image threatening feedback. Only participants who did not believe in quotas reported a lower self-esteem after being told they had performed poorly on an intelligence test. As in Study 1, this effect was mediated by self-perceived competence. In all, these studies suggest that the belief that affirmative action is a quota policy may persist, in part, because it benefits White mens’ self-esteem.     

Psychology and modern life challenges: the 2nd Middle East and North Africa Regional Conference of Psychology, Amman, Jordan, 2007

The Second Middle East and North Africa Regional Conference of Psychology was held in Amman from 27 April - 1 May 2007 under the Royal Patronage of Her Majesty Queen Rania Al-Abdullah and the auspices of the International Union of Psychological Science, the International Association of Applied Psychology, and the International Association of Cross-Cultural Psychology. It was hosted by the Jordanian Psychological Association whose President was Dr. Asaad Zuby. The President of the Conference and the Local Organizing Committee was Dr. Adnan Farah, the Chair of the Scientific Program Committee was Dr. Mohammad Rimawi, and the Chair of the Regional Advisory Committee was Dr. Marwan Dwairy. The Conference succeeded in attracting participants from 28 countries, including 15 from the Middle East and North Africa region. The Scientific Program explored ways and means to promote the role of psychology in meeting life challenges at regional and international levels. The Conference concluded with the signing of a formal Declaration which called upon governments, academic and professional institutions and organizations, non-governmental organization and other civil society groups, and the United Nations, to work together and to make every possible effort individually and collectively to achieve these goals.     

The two faces of dominance: The differential effect of ingroup superiority and outgroup inferiority on dominant-group identity and group esteem

The present paper provides evidence that dominant-group members distinguish dominance framed as ingroup superiority from dominance framed as outgroup inferiority, and that ingroup superiority enhances esteem for, and thus identification with, the group more than outgroup inferiority. In Experiment 1, Democrats report higher levels of party identification after being told that Democrats won an election than after being told that Republicans lost the election. These effects are attenuated among dominant group members whose values are in conflict with how dominance was achieved. In Experiments 2a and 2b, unearned dominance framed as ingroup superiority resulted in higher levels of White identification than unearned dominance framed as outgroup inferiority among Whites who did not value meritocracy. In contrast, Whites who valued meritocracy did not increase their levels of identification with the group. In Experiment 2b, this interactive effect on racial identification was mediated by esteem for the group.     

Cognitive-behavior therapy for depressed cancer patients in a medical care setting

Major depression is the most common psychiatric disorder among cancer patients and is associated with decreased quality of life, significant deterioration in recreational and physical activities, relationship difficulties, sleep problems, more rapidly progressing cancer symptoms, and more metastasis and pain relative to nondepressed cancer patients. Although some research has explored the utility of psychological interventions with cancer patients, only one study to date has explored the potential benefits of cognitive-behavior therapy among cancer patients with well-diagnosed depression. Addressing this gap in the literature, this study represents an open clinical trial to assess the effectiveness of a brief Cognitive-Behavioral Treatment for Depression (CBTD) among depressed cancer patients in a medical care setting. Results revealed strong treatment integrity, good patient compliance, excellent patient satisfaction with the CBTD protocol, and significant pre-post treatment gains across a breadth of outcome measures assessing depression, anxiety, quality of life, and medical outcomes. These gains also were associated with strong effect sizes and generally maintained at 3-month follow-up. Behavioral activation interventions, especially when paired with cognitive techniques, may represent a practical medical care treatment that may improve psychological outcomes and quality of life among cancer patients. Study limitations and future research directions are discussed.     

Who's afraid of the big bad wolf: a prospective paradigm to test Rachman's indirect pathways in children.

Rachman's theory [The conditioning theory of fear insition: a critical examination. Behav. Res. Ther. 15 (1977) 375-387] of fear acquisition suggests that fears and phobias can be acquired through three pathways: direct conditioning, vicarious learning and information/instruction. Although retrospective studies have provided some evidence for these pathways in the development of phobias during childhood [see King, Gullone, & Ollendick, Etiology of childhood phobias: current status of Rachman's three pathway's theory. Behav. Res. Ther. 36 (1998) 297-309 for a review], these studies have relied on long-term past memories of adult phobics or their parents. The current study was aimed towards developing a paradigm in which the plausibility of Rachman's indirect pathways could be investigated prospectively. In Experiment 1, children aged between 7 and 9 were presented with two types of information about novel stimuli (two monsters): video information and verbal information in the form of a story. Fear-related beliefs about the monsters changed significantly as a result of verbal information but not video information. Having established an operational paradigm, Experiment 2 looked at whether the source of verbal information had an effect on changes in fear-beliefs. Using the same paradigm, information about the monsters was provided by either a teacher, an adult stranger or a peer, or no information was given. Again, verbal information significantly changed fear-beliefs, but only when the information came from an adult. The role of information in the acquisition of fear and maintenance of avoidant behaviour is discussed with reference to modern conditioning theories of fear acquisition.     

When knowledge is not enough: the phenomenon of goal neglect in preschool children

We argue that the concept of goal neglect can be fruitfully applied to understand children's potential problems in experimental tasks and real-world settings. We describe an assessment of goal neglect developed for administration to preschool children and report data on two measures derived from this task alongside the Dimensional Change Card Sort (DCCS) and an opposite color response inhibition task. The propensity to neglect initial task cues was uniquely linked to response inhibition, whereas neglect of a later cue was uniquely linked to the DCCS. Additional evidence suggests that recovery from neglect can occur and shows that goal neglect varies with the cognitive transparency of the signifying cue. Data demonstrate the importance of, and place constraints on, current theories of information regulation and foreground the notion of graded representations in working memory and executive functioning.     

Brain Recording,Mind-Reading,and Neurotechnology: Ethical Issues from Consumer Devices to Brain-Based Speech Decoding

Science and Engineering Ethics - Brain reading technologies are rapidly being developed in a number of neuroscience fields. These technologies can record, process, and decode neural signals. This...