Sproing, 2005

Psychology 6300

S. Golding

PERSONAL NOTES COMPARING THE NEW/OLD EPPCC[1]

INTRODUCTION AND ASPIRATIONAL PRINCIPLES

· “NOT ENFORCEABLE” WEAKENED BY REMOVING “MAY BE CONSIDERED BY ETHICS BODIES IN INTERPRETING”

· NAMED PROFESSIONAL ACTIVITIES AND MODES BROADENED [ E.g., INTERNET]

· The Ethics Code is intended to provide guidance for psychologists and standards of professional conduct that can be applied by the APA and by other bodies that choose to adopt them. The Ethics Code is not intended to be a basis of civil liability. Whether or not a psychologist has violated the Ethics Code does not by itself determine whether the psychologist he or she is legally liable in a court action, whether a contract is enforceable, or whether other legal consequences occur. However, compliance with or violation of the Ethics Code may be admissible as evidence in some legal proceedings, depending on the circumstances.

·RESOLVING ETHICAL ISSUES

· 1.05 Reporting ethical violations. If an apparent ethical violation has substantially harmed or is likely to substantially harm a person or organization and is not appropriate for informal resolution under Standard 1.04, Informal Resolution of Ethical Violations, or is not resolved properly in that fashion, psychologists take further action appropriate to the situation. Such action might include referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities. This standard does not apply when an intervention would violate confidentiality rights or when psychologists have been retained to review the work of another psychologist whose professional conduct is in question. [substantial modification]
COMPETENCE

· 2.01(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or appropriate professional experience.

· 2.01 (f).When assuming performing forensic roles, psychologists are or become reasonably familiar with the judicial or administrative rules governing their roles. [Old 7.06]

· 2.02 New standard allowing services beyond current competence in emergency contexts.

· 2.05 Delegation of Work to Others. Psychologists who delegate work to employees, supervisees, or research or teaching assistants or who use the services of others, such as interpreters, take reasonable steps to (1) avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity; (2) authorize only those responsibilities that such persons can be expected to perform competently, on the basis of their education, training, or experience, either independently or with the level of supervision being provided; and (3) see that such persons perform these services competently.

MULTIPLE RELATIONSHIPS

· 3.05 (a). A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom they have the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person. A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists. Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical.

[substantial clarification]

3.05 (c). In most circumstances, psychologists avoid performing multiple and potentially conflicting roles in forensic matters. When psychologists may be called on are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in a legal proceeding - for example, as consultant or expert for one party or for the court and as a fact witness - judicial or administrative proceedings, at the outset they clarify role expectations and the extent of confidentiality in advance to the extent feasible, and thereafter as changes occur, in order to avoid compromising their professional judgment and objectivity and in order to avoid misleading others regarding their role.

· 3.06 Conflict of Interest. Psychologists refrain from taking on a professional role when personal, scientific, professional, legal, financial, or other interests or relationships could reasonably be expected to (1) impair their objectivity, competence, or effectiveness in performing their functions as psychologists or (2) expose the person or organization with whom the professional relationship exists to harm or exploitation pre-existing relationships would create a risk of such harm. [substantial clarification]

INFORMED CONSENT

· 3.10(a) When psychologists conduct research or provide assessment, therapy, counseling, or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or persons except when conducting such activities without consent is mandated by law or governmental regulation or as otherwise provided in this Ethics Code. [collapsed across services]

· (b) For persons who are legally incapable of giving informed consent, psychologists nevertheless (1) provide an appropriate explanation, (2) seek the individual's assent, (3) consider such persons' preferences and best interests, and (4) obtain appropriate permission from a legally authorized person, if such substitute consent is permitted or required by law. When consent by a legally authorized person is not permitted or required by law, psychologists take reasonable steps to protect the individual’s rights and welfare. [Major wording change]

· (c) When psychological services are court ordered or otherwise mandated, psychologists inform the individual of the nature of the anticipated services, including whether the services are court ordered or mandated and any limits of confidentiality, before proceeding [New]

· (d) Psychologists appropriately document written or oral consent, permission, and assent. [clarification]

· 3.11 Psychological Services Delivered To or Through Organizations (a) Psychologists delivering services to or through organizations provide information beforehand to clients and when appropriate those directly affected by the services about (1) the nature and objectives of the services, (2) the intended recipients, (3) which of the individuals are clients, (4) the relationship the psychologist will have with each person and the organization, (5) the probable uses of services provided and information obtained, (6) who will have access to the information, and (7) limits of confidentiality. As soon as feasible, they provide information about the results and conclusions of such services to appropriate persons. [Major change in light of managed care; also HIPAA]

· b) If psychologists will be precluded by law or by organizational roles from providing such information to particular individuals or groups, they so inform those individuals or groups at the outset of the service. [Same]

PRIVACY AND CONFIDENTIALITY [PRIVILEGE]

· 4.01 Maintaining confidentiality. Psychologists have a primary obligation and take reasonable precautions to protect respect the confidential information obtained through or stored in any medium, rights of those with whom they work or consult, recognizing that the extent and limits of confidentiality may be regulated by law, or established by institutional rules, or professional or scientific relationships. [strengthened]

· 4.02(c) Psychologists who offer services, products, or information via electronic transmission inform clients/patients of the risks to privacy and limits of confidentiality. [new]

ADVERTISING AND PUBLIC STATEMENTS

· 5.01(a) Avoidance of False or Deceptive Statements. Public statements include but are not limited to paid or unpaid advertising, product endorsements, grant applications, licensing applications, other credentialing applications, brochures, printed matter, directory listings, personal resumes or curricula vitae, or comments for use in media such as print or electronic transmission, statements in legal proceedings, lectures and public oral presentations, and published materials. Psychologists do not knowingly make public statements that are false, deceptive, or fraudulent, concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated.

· (b) Psychologists do not make false, deceptive, or fraudulent statements concerning (1) their training, experience, or competence; (2) their academic degrees; (3) their credentials; (4) their institutional or association affiliations; (5) their services; (6) the scientific or clinical basis for, or results or degree of success of, their services; (7) their fees; or (8) their publications or research findings. [clarification?]

TEACHING AND SUPERVISION

· 7.04 Student Disclosure of Personal Information. Psychologists do not require students or supervisees to disclose personal information in course- or program-related activities, either orally or in writing, regarding sexual history, history of abuse and neglect, psychological treatment, and relationships with parents, peers, and spouses or significant others except if (1) the program or training facility has clearly identified this requirement in its admissions and program materials or (2) the information is necessary to evaluate or obtain assistance for students whose personal problems could reasonably be judged to be preventing them from performing their training- or professionally related activities in a competent manner or posing a threat to the students or others. [new]

· Mandatory Individual or Group Therapy (a) When individual or group therapy is a program or course requirement, psychologists responsible for that program allow students in undergraduate and graduate programs the option of selecting such therapy from practitioners unaffiliated with the program. [new]

· (b) Faculty who are or are likely to be responsible for evaluating students’ academic performance do not themselves provide that therapy. [new]

· 7.07 Sexual Relationships with Students and Supervisees. Psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom the psychologists have or are likely to have evaluative or direct authority. [clarification]

DOCUMENTATION

· 6.01 Documentation of Professional and Scientific Work. [old 1.23 (a) and 1.24] Psychologists create, and to the extent the records are under their control, maintain, disseminate, store, retain, and dispose of records and data relating to their professional and scientific work research, practice and other work in accordance with law and in a manner that permits compliance with the requirements of this Ethics Code in order to (1) facilitate provision of services later by them or by other professionals, (2) allow for replication of research design and analyses, (3) meet institutional requirements, (4) ensure accuracy of billing and payments, and (5) ensure compliance with law. [strengthened]

· 1.23 (b) When psychologists have reason to believe that records of their professional services will be used in legal proceedings involving recipients of or participants in their work, they have a responsibility to create and maintain documentation in the kind of detail and quality that would be consistent with reasonable scrutiny in an adjudicative forum. [deleted !]

ASSESSMENT ISSUES

· 9.01 (a) (ba) Psychologists’ base the opinions contained in their assessments, recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, on information and techniques (including personal interviews of the individual when appropriate) sufficient to substantiate provide appropriate substantiation for their findings.[forensic language to replace deleted 7.02]

· (b) Except as noted in 9.01 (c), below, psychologists provide opinions written or oral forensic reports or testimony of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions.

· When, despite reasonable efforts, such an examination is not practical feasible, psychologists document the efforts they made and the result of those efforts, clarify the probable impact of their limited information on the reliability and validity of their opinions reports and testimony, and appropriately limit the nature and extent of their conclusions or recommendations.

· (c) When psychologists conduct a record review or provide consultation or supervision and an individual examination is not warranted or necessary for the opinion, psychologists explain this and the sources of information on which they are based their conclusions and recommendations. [new]

· 9.02 (b) Use of assessments. Psychologists use assessment instruments whose validity and reliability have been established for use with members of the population tested. When such validity or reliability has not been established, psychologists describe the strengths and limitations of test results and interpretation. [new]

· (c) Psychologists use assessment methods that are appropriate to an individual’s language preference and competence, unless the use of an alternative language is relevant to the assessment issues. [new]

· 9.03(a) Informed Consent In Assessments.

Psychologists obtain informed consent for assessments, evaluations, or diagnostic services, as described in Standard 3.10, Informed Consent, except when (1) testing is mandated by law or governmental regulations; (2) informed consent is implied because testing is conducted as a routine educational, institutional, or organizational activity (e.g., when participants voluntarily agree to assessment when applying for a job); or (3) one purpose of the testing is to evaluate decisional capacity. Informed consent includes an explanation of the nature and purpose of the assessment, fees, involvement of third parties, and limits of confidentiality and sufficient opportunity for the client/patient to ask questions and receive answers. [new]

· (c) Psychologists using the services of an interpreter obtain informed consent from the client/patient to use that interpreter, ensure that confidentiality of test results and test security are maintained, and include in their recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, discussion of any limitations on the data obtained [new]

9.04 Release of Test Data.

· 9.04(ab) Release of test data. The term “test data” refers to raw and scaled scores, client/patient responses to test questions or stimuli, and psychologists’ notes and recordings concerning client/patient statements and behavior during examination. Those portions of test materials that include client/patient responses are included in the definition of “test data.” Pursuant to a client/patient release, psychologists provide test data to the client/patient or other persons identified in the release. Psychologists may refrain from misuse of assessment techniques, interventions, results, and interpretations and take reasonable steps to prevent others from misusing the information these techniques provide. This includes refraining from releasing raw test results or raw data to protect a client/patient or others from substantial harm, recognizing that in many instances release of confidential information under these circumstances is regulated by law. [substantially revised]

· (b) In the absence of a client/patient release, psychologists provide test data only as required by law or court order. [new]

· 9.09 (a) [Test Scoring and Interpretation Services.] Psychologists who offer assessment or scoring procedures services procedures to other professionals accurately describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use. [essentially the same; it would be nice to have it enforced]

· 9.09 (b) Psychologists select scoring and interpretation services (including automated services) on the basis of evidence of the validity of the program and procedures as well as on other appropriate considerations. [given the lack of enforcement and availability of (a) how is one to do this?]

THERAPY ISSUES

· 10.01 [Informed Consent] (a) When obtaining informed consent to therapy as required in Standard 3.10, Informed Consent, When obtaining informed consent to therapy as required in Standard 3.10, Informed Consent, psychologists inform clients/ patients as early as is feasible in the therapeutic relationship about appropriate issues, such as the nature and anticipated course of therapy, fees, involvement of third parties, and limits of confidentiality and provide sufficient opportunity for the client/patient to ask questions and receive answers. [informed consent as a process not a static “document”]

· (b) When obtaining informed consent for treatment for which generally recognized techniques and procedures have not been established, psychologists inform their clients/patients of the developing nature of the treatment, the potential risks involved, alternative treatments that may be available, and the voluntary nature of their participation. [new section]

· (c) When the therapist is a trainee and the legal responsibility for the treatment provided resides with the supervisor, the client/patient, as part of the informed consent procedure, is informed that the therapist is in training and is being supervised and is given the name of the supervisor. [clarified]

10.03 Group Therapy.

· 110.03 Group Therapy. When psychologists provide services to several persons in a group setting, they describe at the outset the roles and responsibilities of all parties and the limits of confidentiality [new] [easier said than done!]

· 10.06 Sexual Intimacies with Relatives/Significant Others of Current Therapy Clients/Patients. Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard. [new]

· 10.10 (b) Terminating therapy. Psychologists may terminate therapy when threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship. [new]

· 10.10 (c) Except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists provide appropriate pretermination counseling and suggest alternative service providers as appropriate, and takes steps to facilitate transfer of responsibility to another provider if the client/patient needs one immediately. [accepting managed care regulation]

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[1] Prepared for teaching purposes. This is not a complete comparison, and it reflects subjective reactions to the 2002 EPPCC.