Psychologists do not solicit testimonials from current clients or solicit business from actual or potential clients. 6. Recordkeeping and Fees: Rules 6.01–6.07 discuss the control, dissemination, and disposal of confidential records, and that records may not be withheld if needed for emergency treatment based on nonpayment. Financial arrangements must be consistent with law, fees must not be misrepresented, limitations in financing must be addressed, and if a collection agency might be used the client must be notified first. Bartering may be used only if not clinically contraindicated or exploitive. Reports to payors must be accurate. When fees are divided with another professional, the division must be based on services provided, not the referral itself. 7. Education and Training: Rules 7.01–7.07 cover the design and content of education and training programs. Limits and boundaries for requiring students to disclose personal information are discussed. If individual or group therapy is mandatory, the student must be allowed to receive services from a provider outside of the program. Assessment of student/trainee performance must be timely and specific, and sexual relationships with students are prohibited. 8. Research and Publication: Rules 8.01–8.15 discuss obtaining informed consent in research and when it may not be required, use of inducements for research participation, boundaries on the use of deception, debriefing, humane use of animals in research, reporting results that are not fabricated or deceptive, avoiding plagiarism, accuracy in publication credit, and the need to share data for verification. 9. Assessment: Rules 9.01–9.11 cover the use of assessments. Psychologists use assessment procedures appropriate for the situation, and they obtain informed consent in assessment. Test data—which include raw and scaled scores, client responses to questions, and psychologist Boundary crossings and violations Professional boundaries are addressed in multiple sections of the Ethics Code. They help guide the psychologist in choosing appropriate behaviors to prevent harm to clients. Boundary crossings are deviations from practice that are harmless to the client and may also be therapeutic. Limited self-disclosure on the part of the therapist as a way of establishing rapport or normalizing a client behavior would be this category. A boundary violation, however, is a deviation from practice that is clearly harmful to or exploitive of the client (Jain & Roberts 2009). The boundary violation usually takes the psychologist out of the professional role, it benefits the psychologist more than the client, there is significant risk in harming the client, and it transgresses an ethical standard. Sexual relationships are an example of a boundary violation, are extremely harmful to clients, and are specifically prohibited (Standard 10.05), as are such relationships with relatives and significant others of current clients (Standard 10.06). Exerting undue influence and taking advantage of a client are other examples of boundary violations. Boundary crossings, on the other hand, are a more common occurrence in daily practice. Consider these situations: Running in to a client at the store, accepting a minor gift from a client, extending the length of a session, or allowing a former client to friend you on social media. All deviate from classical practice but are not necessarily harmful. However, self-reflection by the psychologist is necessary to ensure that the client’s needs are being met and their well-being is not at risk. Dual/multiple relationships A psychologist refrains from entering into a multiple relationship if it could impair the psychologist’s effectiveness or if it could cause harm to the client (Standard 3.05). Entering into a business relationship with a former client, providing therapy to more than one family member, seeing a friend in therapy, and having a social relationship with a former client all constitute a multiple
notes and recordings—may be released to the client with appropriate client consent. Psychologists strive to maintain the security and integrity of test materials, which includes manuals, protocols, test questions, and test stimuli. Interpretation of results takes into account all the various test factors that may affect results. Use of obsolete tests should be avoided, and psychologists retain responsibility for the assessment when using scoring and interpretation services. Results are explained to the client unless clinically contraindicated. 10. Therapy: Rules 10.01–10.10 discuss informed consent to engage in therapy. Roles and responsibilities of all parties are discussed with all parties in couples, family, and group therapy. Sexual relationships with current clients or significant others of current clients are prohibited. Psychologists may not have sexual intimacy with a former client for at least two years following termination of therapy and even then, the psychologist bears the burden of demonstrating that there has been no exploitation. Psychologists terminate therapy when the client no longer needs the services, is not benefitting from services, or is being harmed by services. Psychologists also terminate therapy if they are threatened by a client or someone on behalf of the client. Chenneville and Schwartz-Mette (2020) address considerations in each of these areas which are relevant when providing psychological services during the time of a public health emergency such as COVID-19. Of these broad areas, the most common reasons for licensing board complaints include sexual misconduct and other boundary violations, multiple relationship violations, breaches of confidentiality, and child custody disputes especially when outside the provider’s competence. (Novotney, 2016). Pope and Keith-Spiegel (2008) discuss nine guidelines to consider when making decisions involving boundary crossings and whether they will be helpful or harmful to the client. ● Imagine the best and worst possible outcomes from crossing the boundary and not crossing the boundary. Will doing so involve the risk of negative consequences, or the risk of serious harm in the short or long term? ● Consider any available research regarding the boundary crossing. ● Consider guidance offered by professional guidelines, ethics codes, legislation, case law, and other resources. ● Have at least one colleague you can trust to give honest feedback about boundary crossing issues. ● Pay attention to any uneasy feelings, doubts, or confusion and try to identify what is causing them and what implications they may have for your decision. ● When starting therapy as part of the informed consent discussion, describe to the client exactly what type of therapy you do. If warranted, refer to a colleague who may be better suited for the client. ● Refer to a colleague any client that you feel incompetent to treat or that you do not feel you could work effectively with ● Pay attention to informed consent for any planned or obvious boundary crossing. ● Keep notes on any planned boundary crossing describing why, in your clinical judgment, you feel it is necessary or helpful to the client. relationship. It may not be possible to avoid some multiple relationships; therefore, it is important to note that the standard also states that if the multiple relationship would not reasonably be expected to cause harm or exploitation, it is not unethical.
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