CHAPTER 18: E T H I C S C O D E S, R E G U L A T I O N S, A N D E N F O R C E M E N T S Presentation brought to you by: Cristie J. Caruso

(Student from a previous course)

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ETHICS CODES: PURPOSE

 Used to help judge those whose ethical standards or practices have been questioned by defining rules to which they should follow

 Give individuals protection against licensing boards, or other boards who are unsuited to consider a complaint

 To make sure it is known, and understood that mental health professionals can not prevent every potential for harm, or ethical dilemma

 Although not all harm can be avoided, or ethical issue extinguished, it is the purpose of ethics codes to help provide guidelines for making good decisions

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POSITIVE PSYCHOLOGY

 Late 1970s attempted a positive approach to psychology which was based on encouragement, and taking pride in one’s work.

 Code was revised to state how ethical psychologists behave, not what they should avoid doing

 Why didn’t it work?

 There were issues brought up against a positive approach to the ethics code, because although individuals were told what good ethical workers do, do, they were not told what they can not do. This would leave it up to interpretation, and it was decided that it was easier to decide, and enforce what should be avoided, and what was seen as unethical.

 (koocher & Keith-Spiegel, 2016, p. 607) 3

CODES OF ETHICS IN THE MENTAL HEALTH PROFESSION

-American Psychological Association

-American Association for Marriage and Family

Therapy -American Counseling Association -National Association of Social

Workers

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AMERICAN PSYCHOLOGICAL ASSOCIATION: ETHICAL PRINCIPLES AND CODE OF CONDUCT

1. Resolving Ethical Issues: How to deal with and report violations

2. Competence: Practicing within the field of one’s skills, and knowledge

3. Human Relations: Discrimination, harassment, multiple-role relationships, interruption of services, ect.

4. Privacy and Confidentiality

5. Advertising and Other Public Statements: What not to do during self-promoting, and how to conduct workshops, and other educational programs

For more information you can visit

http://www.apa.org/ethics/code/index.aspx

6. Recordkeeping and Fees: How to document, and disposal of confidential material. Bartering and making referrals

7. Education and Training: Teaching accurately, assessing students, and mandating therapy. Relationships between teachers, supervisors, and students, and what is appropriate, and what is not.

8. Research and Publication: Humane care of humans, and animals. Touches on plagiarism, and publication.

9. Assessment: Bases, uses, consent, scoring and interpretation

10. Therapy: Informed consent, Who are not acceptable clients, and unacceptable relationships

(koocher & Keith-Spiegel, 2016, p. 609)

All information is paraphrased, or can be found from the text above.

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THE AMERICAN ASSOCIATION FOR MARRIAGE AND FAMILY THERAPY

1. Responsibility to Clients: Nondiscrimination, multiple-role relationships, unethical conduct, referrals

2. Confidentiality: Written authorization before disclosing information with others, protecting records, client’s access to their records

3. Professional Competence and Integrity: Maintain and develop skills, avoid conflict of interest

4. Responsibility to Students and Supervisees: Avoid sexual intimacies, do not exploit students

5. Research and Publication: Institutional approval, respecting and protecting research, informed consent, confidentiality

For more information you can visit

http://www.aamft.org/iMIS15/AAMFT/Content/legal_ethics/code_o f_ethics.aspx

6. Technology-Assisted Professional Services: Competence to give services through electronical devices

7. Professional Evaluations: Performance of forensic services, legal proceedings, avoiding conflict, separation of custody

8. Financial Arrangements: Make sure agreements are understood by the clients, and others involved

9. Advertising: Do not misrepresent

(koocher & Keith-Spiegel, 2016, p. 609-610)

All information is paraphrased, or can be found from the text above.

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THE AMERICAN COUNSELING ASSOCIATION

1. The Counseling Relationship: Client welfare, informed consent, maintaining boundaries

2. Confidentiality and Privacy: Respect for privacy

3. Professional Responsibility: Improve the lives of who you come in contact with, continuing education, honesty, responsibilities to other professionals

4. Relationships with other Professionals

5. Evaluation, Assessment, and Interpretation: Competency to use assessments, informed consent, release of data, security, data

For more information you can visit

http://www.counseling.org/docs/ethics/2014-aca-code-of- ethics.pdf?sfvrsn=4

6. Supervision, Training, and Teaching: Education, and relationships

7. Research and Publication: Rights of participants, vulnerable individuals, reporting of results, publication

8. Distance Counseling, Technology, and Social Media: Web maintenance, how to maintain distant professional relationships

9. Resolving Ethical Issues: Knowing the law, suspected violations, conflicts between ethics and the law

(koocher & Keith-Spiegel, 2016, p. 610-611)

All information is paraphrased, or can be found from the text above.

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NATIONAL ASSOCIATION OF SOCIAL WORKERS

1. Ethical Responsibilities to Clients: Conflict of interest, privacy, sexual relationships, payment for services

2. Ethical Responsibilities to Colleagues: Respect, disputes, sexual relationships, harassment, incompetent and unethical colleagues

3. Ethical Responsibilities in Practice Settings: Education and training, client records and transfer, labor- management disputes

For more information you can visit

http://www.socialworkers.org/pubs/code/default.asp

4. Ethical Responsibilities as Professionals: Competence, discrimination, misrepresentation, client solicitation

5. Ethical Responsibilities to the Social Work Profession: “Promoting integrity, and ethical issues in evaluation research”

6. Ethical Responsibilities to the broader society: Improve social conditions, uphold human rights, social justice

(koocher & Keith-Spiegel, 2016, p. 610-611)

All information is paraphrased, or can be found from the text above.

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ENFORCEMENT, COMMITTEES AND REPORTING

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ENFORCEMENT

Formal Mechanisms

 “Criminal law applicable to all citizens, including members of any profession”

 “Profession-specific legal controls that emanate from state laws via licensing boards”

 “Civil litigation to process claims of malpractice or other professional liability”

 “Federal and state laws and regulations, such as policies issued on the protection of human participants in social and behavioral science, research, confidentiality of records, civil rights violations, or prescribing medication”

 “Professional review committees to handle misunderstanding or complaints involving third-party payers, institutions, or employers. Professional review committees are rarely used now”

(koocher & Keith-Spiegel, 2016, p. 612)

Relationship between Laws and Ethics

 General laws do not protect individuals from unethical acts performed by mental health professionals

 Morals and laws usually go hand in hand

 “Some conduct specified as unethical in professional ethics codes can also qualify as civilly or criminally actionable (p.613)

 Professionals can lose their license to practice and be kicked out of their professional associations for being found guilty of a felony

 Convictions on a misdemeanor are only handled the same way if the offense was involved in the unethical act

 Some therapists believe that defying the law is a matter of their own conscience (See case 18-3 on p. 614 for an example)

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COMMITTEES

 Members serve without pay, and usually without reimbursement for their expenses

 Ethics Committees:

 Investigate violations at all levels

 Help resolve cases which are too hard, or unable to be taken by others

 Criticisms:

 Bias

 Lack of training

 Lack of experience

 Conflict of interests

 Excessive time taken to adjudicate cases

 Insufficient investigations

 Timid procedures from fear of lawsuits

 Possible harm to the public

(koocher & Keith-Spiegel, 2016, p. 617)

All information is paraphrased, or can be found from the text above.

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COMPLAINTS

 Most complaints have had direct and/or personal interactions with the accused

 Plagiarism is found by academics or by students

 Ethics committees can take on sua sponte

 Ex: Newspaper, local news, service advertisements, court records

 Some complaints are questioned because of the mental state of the individual making the claim

 These complaints are not just swept under the rug, they are most likely still investigated

 Apologizing:

 Some charges are avoided by the therapist simply apologizing to the client about the misunderstanding, or their behavior

 Individuals who make a complaint:

 Make sure the complaint is legit

 Must be willing to have their identities and the complaint shared with the accused subject

 Be prepared to possibly be countercharged

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COMPLAINTS PT. 2

 What if you’re being charged?

 It is advised that you do not try to “beat the system” and/or manipulate evidence in your favor

 Anger is common, but do not let it get out of control

 KNOW YOUR RIGHTS (See p. 621 for tips, photocopy it if you must and keep a record for yourself)

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SANCTIONS, DIRECTIVES, AND LEVELS OF ETHICAL VIOLATIONS

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SANCTIONS

 Reprimand: Appropriate when there has been a violation but the violation was not likely to cause harm to another person, or to the professional

 Censure: Appropriate when there has been a violation, and the violation was likely to cause harm to the person, or profession, BUT was not likely to cause substantial harm

 Expulsion: Appropriate if there has been a violation, and the violation was likely to cause substantial harm to the person, or professional

 Stipulated Resignation: “May be offered after finding the respondent committed a violation of the ethics code or railed to show good cause why he or she should not be expelled, contingent on execution of an acceptable affidavit and approval by the board of directors” (p.626)

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DIRECTIVES

 Cease-and-Desist: Immediately terminate the unethical behavior(s)

 Supervision: Having work monitored

 Education, Training, or Tutorial Required: Engage in learning appropriate to the unethical behavior

 Evaluation: Determine the possibility of treatment, and obtain treatment if needed

 Probation: Monitoring of the individual to make sure they are in compliance with the results

 Other Corrective actions: Potential payment to the APA or the individual in order to protect the interests, and the individuals, or associations

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LEVELS

A

 Level l:

 Behavior or practice was not clearly unethical, but was done in insufficient caution

 Level ll:

 Clearly unethical, but unlikely to harm the public, or profession

 Level lll:

 Continuing misconduct and producing a genuine hazard to clients, the public, and the profession

B

 Level l:

 Minor infraction occurred, but harm was unlikely. May not have been intentional

 Level ll:

 Deliberate or persistent behavior that could lead to substantial harm to the client or public, although little harm may have happened

 Level lll:

 Clients or others who have worked with the are substantially injured, and there are serious thoughts on whether or not the therapist has potential for rehabilitation

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DISCUSSION QUESTIONS Please post your responses to the

following slides in the discussion

board as per the Professor’s

instructions.

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QUESTION

How do you know if an issue is legal or ethical?

Can an issue be both legal and ethical?

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CASE 2: P. 6 1 3

“Sadie Snile, Ph.D., struggled with her own downturns in life. She and her only surviving parent were estranged, a recent divorce left her bitter, and she was drinking too much at night. She became short-tempered with her clients and often mixed up their case narratives from one week to the next.”

Imagine you are the director of the agency that Dr. Snile works for, and you received a complaint from a client about her “attitude.”

 What do you believe should be done about Dr. Snile’s behavior?

 Is she breaking any ethical codes? (Refer to the professional code of MFT or Psychology & use the code number to identify it, if relevant).

 What about violation of any laws? (I realize you might not be fully familiar with laws, but guesses?)

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