play. Becoming social friends with a former client deprives them of the psychologist’s professional services if they need therapy in the future and may create unrealistic expectations on the part of the client if they see a new psychologist. Psychologists are encouraged to objectively assess and review their privacy settings on all social media accounts and their motivations for those settings. Bartering is another area that poses a potential multiple relationship. Rule 6.05 defines bartering as the acceptance of goods, services, or other nonmonetary renumeration from Informed consent Psychologists obtain informed consent from clients (Rule 3.10). Treatment without informed consent violates ethical responsibilities and does not meet the minimum standard of care for psychologists. Informed consent involves several factors: ● The psychologist must provide information about proposed services using language that is understandable to the client. ● The client must be able to understand the information in order to make an informed decision about engaging in services. ● If the client is not legally capable of giving informed consent, the psychologist should still provide an explanation of services and attempt to obtain assent. Formal consent must be obtained from a legally authorized person. ● The informed consent process and agreement should be documented in the client’s chart. These factors take into consideration the client’s understanding of the proposed treatment, their legal capacity to make an informed decision to initiate treatment, and the voluntary nature of their decision free from coercion or misunderstanding. A written standardized informed consent form should document the type of treatment, risks and benefits, and limits of confidentiality. It should be signed by the client or person legally able to make informed consent. Given the insurance climate, signatures along with documentation about the length of 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
clients in return for psychological services. It is not specifically prohibited, provided that it is not clinically contraindicated and does not result in an exploitive arrangement. However, entering into a bartering agreement can potentially lead to problems in the therapeutic relationship. What happens if the client does not fulfill their part of the barter? What if services by either party do not meet the other party’s expectations for quality or timeliness? When the affordability of the psychologist’s services is an issue, referral to a lower fee option or use of a sliding scale fee schedule may be better than bartering. treatment, number of sessions, insurance copays, and expected disclosures to the 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 ● Emergency procedures : Emergency contact information, availability of emergency sessions 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. 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 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
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Book Code: PYCA2724
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