● Emergency procedures : Emergency contact information, availability of emergency sessions
insurance company may also be prudent. Informed consent forms may also include information about office policies and procedures, for example: ● Scheduling policies : Frequency of sessions, session length, availability between session appointments, cancellation and rescheduling policies ● Payment policies : Fee structure, expected copays, expected timeframe for payment, forms of payments accepted, collection policies ● Records : How records are kept, electronic record security, policies regarding access to records, policies about release of records Privacy and confidentiality The Ethics Code states that psychologists have a primary responsibility to protect confidential information obtained through, or stored in, any medium (Rule 4.01). The client has the right to expect that their disclosures during therapy sessions will be kept within the boundaries of the professional relationship. The scope and limits of confidentiality should be discussed at the onset of treatment, as this is central to developing a trusting therapeutic relationship (Rule 4.02). Confidentiality is an issue that spans ethical, therapeutic, and legal areas— and ethical considerations within the realm of confidentiality are numerous. There are situations where the client’s confidential disclosure must be broken, for example, when suicidal intent is expressed (Rule 4.05) or to protect others from harm. If confidentiality must be broken, for example, in mandated reporting of child or elder abuse, if possible the client should be informed or allowed to be part of the process. Competence Achieving competence and being aware of one’s boundaries of competence are crucial to the ethical treatment of clients. CCR Article 8 Section 1396 of the California Code states that a psychologist shall not function outside their particular field or fields of competence as established by their education, training, and experience. Despite the importance of being competent to provide a service, it is not always easy to define what it means. Rule 2.01 of the Ethics Code states that psychologists obtain the training, experience, consultation, and/or supervision necessary to provide competent services or they make an appropriate referral. Rule 2.02 recognizes that there may be emergency situations that, for the safety of the client, require the psychologist to practice outside of their scope but there is the expectation that services will be discontinued as soon as the emergency resolves or appropriate services become available. In addition to competent psychology knowledge and skills, the psychologist must also have emotional competence. Per Rule 2.06, the psychologist must be aware of personal problems that could prevent them from providing services in a competent manner. If that situation occurs, they take appropriate steps to limit or suspend their work duties. This is reinforced in California Code of Regulations CCR Article 8 Section 1396.1, which states that a psychologist shall not knowingly undertake any activity in which temporary or more enduring personal problems of the psychologist would result in inferior professional services or harm to a patient or client. When becoming aware of
It is crucial to recognize that informed consent is a process and does not end with the initial signing of forms at the start of treatment. Certainly, the process begins during intake. However, it is not unusual for a course of treatment to involve changes in the course of therapy, the structure of therapy, or the types of interventions used. All require ongoing discussion with the patient to ensure their understanding and consent. Although the Health Insurance Portability and Accountability Act (HIPAA) specifies that therapy process notes are to be kept separate in the client’s record, third-party payors typically have access to client diagnosis and therapy visits. With advances in technology and the recent pandemic, telehealth has become common. Many clients are not aware of the limits of confidentiality, particularly in situations of mandated reporting. It is generally good practice to a have a written statement about its scope and limits signed by the client at the onset of treatment as part of initial paperwork in order to avoid any later complaint of an ethical violation. In addition, HIPAA requires the more general Notice of Privacy Practices, which details the routine use and disclosure of protected health information and client rights with respect to that information, to be signed by the client and placed in their record. such personal problems, the psychologist seeks professional assistance to determine whether services to the patient should be continued or terminated. In addition, psychology has been increasingly sensitive to the needs of diverse groups that have felt excluded, alienated, or stigmatized. Awareness and understanding of cultural and diversity factors have become an integral part of what is considered competent practice. Diversity in all forms—including cultural differences, ethnic differences, gender, gender orientation, race, sexual orientation, physical disabilities, individual strengths and weaknesses, and community-based differences—is a component of cultural competence. Attending conferences or workshops; completing continuing education courses, periodic literature reviews, and collegial consultation; and engaging in formal or informal supervision with others with more experience in a given area are all ways
to foster and maintain competence. Self-Assessment Quiz Question #5
Accepting a minor gift from a client, running into a client in the store, and extending the length of a session one
time are all examples of: a. Multiple relationships. b. Boundary violations. c. Boundary crossings. d. Breach of confidentiality.
ETHICAL DECISION MAKING
Understanding the laws, regulations, General Principles, and Ethical Standards provides the foundation for navigating the complexities involved in the ethical practice of psychology. Psychology professionals will face many situations during their careers that require them to make judgements about the best course of action. An ethical dilemma occurs when a
decision must be made about a course of action when two or more ethical standards are in conflict and the standards do not provide a clear solution. It is then left up to the psychologist to determine the best course of action to produce the best outcome for the client.
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Book Code: PYCA2725
EliteLearning.com/Psychology
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