_______________________________________________________________________ Ethics for Psychologists
In general, psychiatric patients who are involuntarily hospital- ized must be provided with informed consent to treatment. In California, the law also requires that voluntarily hospitalized patients be told specifically of their right not to be treated without their informed consent [15]. For individuals in California who are developmentally delayed and involuntarily hospitalized, the hospital is required to have a patient advocate available to provide informed consent on behalf of the patient and advocate on his or her behalf. PRIVACY AND CONFIDENTIALITY There are distinctions between privacy, confidentiality, and privileged communications. Privacy is an essential part of the professional psychologist’s treating relationship with a patient, consultant, or supervisee. What is revealed in the treatment relationship must remain private so the treatment will be effective. The patient, consultant, or supervisee must feel free to readily disclose information to join into the treat- ment relationship. Examples of privacy issues include: • There is little soundproofing between offices, and discussions between a client and therapist can be over- heard easily in the next room. • A psychologist discusses a client on an online ListServ in ways that make the client identifiable. • A psychologist recognizes a client at a social party, makes eye contact, then immediately leaves, making it obvious there is some relationship between the psy- chologist and client to others in attendance. • A client contacts a psychologist on Facebook requesting to be “friends.” Confidentiality concerns information that is gathered by a psychologist. Federal and state laws govern which records must be kept, and the Ethics Code stipulates that psychologists are to keep records [8]. The nature and extent of the records will vary based on the purpose, setting, and context of the psycho- logical services [16]. Records benefit both the client and the psychologist, allowing a delineated treatment plan, notation of services provided, monitoring of treatment, and assistance in legal or ethical proceedings or when transferring care to another provider. Guidelines for record keeping were set forth by the APA and were approved in February 2007. The guide- lines expired in 2017. As of that date, users are encouraged to contact the APA Practice Directorate to determine whether the guidelines remain in effect [16]: • Responsibility for records: Psychologists generally have responsibility for the maintenance and retention of their records.
• Content of records: A psychologist strives to maintain accurate, current, and pertinent records of professional services as appropriate to the circumstances and as may be required by the psychologist’s jurisdiction. Records include information such as the nature, delivery, prog- ress, and results of psychological services and related fees. • Confidentiality of records: The psychologist takes reasonable steps to establish and maintain the confiden- tiality of information arising from service delivery. • Disclosure of record-keeping procedures: When appro- priate, psychologists inform clients of the nature and extent of record-keeping procedures (including a state- ment on the limitations of confidentiality of the records according to Ethics Code Standard 4.02). • Maintenance of records: The psychologist strives to organize and maintain records to ensure their accuracy and to facilitate their use by the psychologist and others with legitimate access to them. • Security: The psychologist takes appropriate steps to protect records from unauthorized access, damage, and destruction. • Retention of records: The psychologist strives to be aware of applicable laws and regulations and to retain records for the period required by legal, regulatory, institutional, and ethical requirements. • Preserving the context of records: The psychologist strives to be attentive to the situational context in which records are created and how that context may influence the content of those records. • Electronic records: Electronic records, like paper records, should be created and maintained in a way that is designed to protect their security, integrity, confiden- tiality, and appropriate access, as well as their compli- ance with applicable legal and ethical requirements. • Record keeping in organizational settings: Psycholo- gists working in organizational settings (e.g., hospitals, schools, community agencies, prisons) strive to follow the record-keeping policies and procedures of the orga- nization as well as the APA Ethics Code. • Multiple-client records: The psychologist carefully considers documentation procedures when conducting couple, family, or group therapy in order to respect the privacy and confidentiality of all parties. • Financial records: The psychologist strives to ensure accuracy of financial records.
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