Psychology is a complex field that deals with the human mind and behavior. As such, psychologists and psychological research must uphold strict ethical guidelines to protect clients and research participants. There are six main ethical issues that psychologists face:
1. Informed Consent
Informed consent requires that psychologists provide prospective clients and research participants with adequate information regarding the nature of services or research, potential risks and benefits, and the limits of confidentiality. Individuals must freely give consent without coercion, and they must be considered legally and mentally capable of providing consent. Informed consent upholds individual autonomy and ensures individuals understand what they are getting into before participating in psychology services or research.
2. Confidentiality
Confidentiality involves protecting client and research participant privacy. Psychologists must keep information private to the extent allowed by law and only release confidential information with client consent. However, confidentiality is not absolute – it can be breached in certain extenuating circumstances like mandatory reporting of child or elder abuse. Still, psychologists are expected to discuss the limits of confidentiality with clients and research participants.
3. Competence
Psychologists strive to maintain high standards of competence by only practicing within the boundaries of their education, training, supervised experience, and appropriate professional experience. Psychologists avoid practicing in areas beyond their competence and refer clients to other professionals as appropriate. Psychologists also continually update their skills and knowledge through professional development.
4. Multiple Relationships & Exploitation
Multiple relationships occur when psychologists interact with clients/research participants in more than one relationship such as when a psychologist also becomes a client’s friend or business partner. Multiple relationships can impair psychologist objectivity and increase risk of exploitation. As such, psychologists avoid non-professional relationships with clients/participants whenever possible.
5. Scope of Practice
Psychologists provide services only within their scope of practice based on their training, education, and experience. For example, a psychologist trained as a clinical psychologist should not be providing psychoeducational assessments. Psychologists practice within their legally authorized scope of practice and do not misrepresent their experience, training or competence.
6. Legal and Ethical Adherence
Psychologists must adhere to the Ethical Principles of Psychologists and Code of Conduct set forth by the American Psychological Association. They must practice in accordance with applicable state, federal and institutional laws and regulations. Legal requirements take precedence over ethics codes if the two conflict. Psychologists also consult colleagues and ethics committees when faced with complex ethical dilemmas.
Informed Consent
Informed consent is a critical ethical issue in psychology. It involves providing prospective clients and research participants with adequate information regarding the nature of services or research, potential risks and benefits, and the limits of confidentiality. This allows clients and participants to make an informed decision about whether to proceed. Key aspects of informed consent include:
Disclosing Nature of Services
Psychologists explain what services will involve, such as types of therapy or assessments to be conducted. Clients should understand the general course of treatment or research procedures.
Disclosing Risks and Benefits
Psychologists explain reasonably foreseeable risks, discomforts, adverse effects, and benefits of services or research. For example, a psychologist informs a client that discussing traumatic experiences during therapy may cause emotional distress.
Establishing Limits of Confidentiality
Psychologists communicate the level of confidentiality, including any legal or ethical mandatory disclosures. A psychologist informs clients that confidentiality cannot be maintained if the client expresses intent to seriously harm themselves or others.
Obtaining Voluntary Consent
Consent must be given voluntarily without coercion or under duress. Psychologists do not coerce or use undue influence to obtain consent. They ensure prospective clients and participants understand that consent can be withdrawn at any time.
Ensuring Capacity to Consent
Individuals consenting must have the mental and legal capacity to provide consent. Psychologists assess factors like age, psychological disorder, or intoxication that may impair capacity to consent.
Using Comprehensible Language
Psychologists present information using plain, layperson language understandable to the person providing consent. This may involve adapting consent conversations for minors or individuals with cognitive disabilities or limited English proficiency.
Documenting Consent
Psychologists obtain written consent documenting the client or participant received adequate information and consented voluntarily. Signed consent forms are stored in confidential client or research files.
Overall, informed consent upholds individual autonomy, ensures voluntary participation in psychology services and research, and protects client and participant well-being.
Confidentiality
Confidentiality is another central ethical concern. It involves protecting client and research participant privacy by not disclosing confidential information. Key aspects of confidentiality include:
Avoiding Public Disclosure
Psychologists refrain from releasing identifying client or research participant information to the public, such as through presentations, publications, or social media.
Obtaining Consent for Necessary Disclosures
If confidential client or participant information must be shared with others for professional purposes like consultations or referrals, psychologists obtain consent where possible. They inform clients when confidentiality cannot be maintained.
Limiting Access to Confidential Information
Psychologists protect physical and electronic confidential records through methods like locking filing cabinets, encrypting data, and limiting access with passwords. Only staff members with a need to know should have access.
Disclosing Limits of Confidentiality
Psychologists inform clients and participants of legal exceptions to confidentiality, like mandatory reporting of child abuse, that require disclosure without consent.
Obtaining Consent for Record Sharing
Client authorization is obtained before releasing psychological records like therapy notes or assessment reports to other professionals or agencies, except in certain emergency situations.
Avoiding Non-Essential Disclosures
Psychologists only release confidential information to others when essential. Breaching confidentiality should be avoided if at all possible.
Maintaining Confidentiality After Termination
The duty to maintain confidentiality continues after professional services end. Psychologists continue safeguarding client records and information indefinitely.
Adhering to confidentiality protects privacy, maintains trust, and avoids potential harm resulting from improper disclosure of sensitive psychological information.
Competence
Competence involves possessing and maintaining the necessary skills, knowledge, training, education, and experience required to provide effective psychological services in an ethical manner. Key aspects include:
Practicing Within Established Boundaries
Psychologists provide only those services, use only those techniques, and conduct only research that falls within the boundaries of their competence based on education, training, supervised experience, and professional experience.
Seeking Proficiency Before Extending Services
When extending services into new areas or populations beyond their past experience and expertise, psychologists first obtain proficiency through supervised training and education in those new areas.
Regularly Evaluating Competence
Psychologists continually monitor their work to evaluate their competence. They determine when certain cases or research areas exceed their expertise and require consultation or referrals to avoid incompetent practice.
Obtaining Continuing Education
Psychologists maintain competence by completing continuing education and training to stay up-to-date on scientific and professional advances, new assessment and treatment methods, and evolving ethics and best practices.
Knowing When to Retire or Limit Practice
As psychologists age or experience changes in capability, they adapt their practice accordingly. This may involve retiring, limiting practice to certain areas within their current competence, or obtaining remedial education.
Consulting Other Professionals
When uncertain about their competence in an area of practice or research, psychologists consult with and refer clients or research to other qualified professionals.
Upholding competence ensures psychologists have the requisite expertise to provide effective services and protects clients and research participants from potential harm.
Multiple Relationships & Exploitation
Multiple relationships occur when a psychologist interacts with a client or research participant in more ways than just the professional role. Dual relationships can impair objectivity and increase risk of exploitation. Key issues include:
Avoiding Non-Professional Relationships
Psychologists refrain from non-professional relationships with current clients that are potentially exploitative, such as forming friendships or business partnerships outside the boundaries of the therapeutic relationship.
Considering Potential Harm from Relationships
Psychologists carefully consider whether an additional role with a client or participant has potential for impaired objectivity, exploitation, or other harm before entering any multiple relationship.
Refraining from Sexual Relationships
Sexual relationships with current clients are prohibited due to the inherent imbalance of power that can lead to exploitation. Relationships with previous clients are avoided for a minimum of two years post-termination.
Avoiding Harmful Overlapping Roles
Simultaneously taking on roles like providing therapy while conducting assessments or supervising a student’s research creates problematic multiple relationships.
Considering Impact on Former Clients & Participants
When entering relationships post-discharge, psychologists consider factors like length of prior relationship, time elapsed, and adverse impacts on the former client or research participant.
Clarifying Boundaries
Psychologists discuss the appropriate therapeutic or researcher relationship clearly with clients and participants. They establish relationship boundaries to avoid dual roles.
Avoiding exploitation requires careful management of overlapping relationships and maintenance of appropriate professional boundaries.
Scope of Practice
Scope of practice refers to the services, activities, and specialized knowledge that psychologists are allowed to legally and ethically provide based on their training, education, experience, and authorization. Key issues include:
Practicing Within Legal Limits
Psychologists follow all applicable laws and regulations governing the profession. They only offer services and employ techniques that are legally permitted within their state licensure level and area of competence.
Providing Services Within Areas of Competence
Psychologists restrict services to specialty areas, populations, and techniques for which they have obtained adequate education, training, and experience. For example, a psychologist trained in child clinical psychology does not start practicing couples therapy.
Making Appropriate Referrals
When client needs fall outside their scope of training or legal practice boundaries, psychologists refer clients to other qualified professionals.
Not Misrepresenting Qualifications
Psychologists truthfully represent their qualifications, competencies, education, experience, certification, and abilities when advertising services and charges. They do not mislead others regarding their areas of competence.
Supervising Appropriately
Psychologists adequately supervise trainees and assistants requiring supervision. They do not delegate tasks beyond the scope or abilities of supervisees.
Respecting Boundaries of Other Professions
Psychologists respect the competence, roles, and responsibilities of professionals in other disciplines. They provide only services within the recognized boundaries of psychology.
Practicing within an appropriate scope ensures public protection, competent service delivery, and adherence to the law.
Legal and Ethical Adherence
Psychologists have an obligation to know and follow applicable ethics codes, laws and regulations. Key considerations include:
Knowing Relevant Ethics Codes
Psychologists make reasonable efforts to be familiar with and follow the APA’s Ethical Principles of Psychologists and Code of Conduct as well as other applicable ethics codes for specialty areas and populations.
Acting Legally
Psychologists follow local, state, and federal laws and regulations relevant to the profession and their areas of practice. This includes requirements for licensure, mandatory reporting, informed consent, confidentiality, and record keeping.
Seeking Consultation for Ethical Dilemmas
When faced with an ethical dilemma, psychologists consult available ethics resources and consult colleagues with relevant ethics expertise to determine appropriate resolution of the issue.
Understanding Legal Precedence
If legal requirements conflict with ethics codes, the law takes precedence unless otherwise prohibited by law. Psychologists seek consultation on navigating such dilemmas while also adhering to ethics as much as legally possible.
Making Ethical Decisions
Psychologists thoughtfully analyze ethical dilemmas and aim to resolve them in a way that best protects the welfare of those impacted. Their decisions are consistent with ethics codes and human rights principles.
Seeking Continuing Education on Ethics
Psychologists regularly obtain continuing education on ethics and the law to ensure their knowledge remains up-to-date. Licensing boards often require regular ethics training for license renewal.
Legally and ethically sound practice protects the public and promotes public trust in the field of psychology.
Conclusion
In summary, psychologists face six central ethical issues in their practice and research: informed consent, confidentiality, competence, multiple relationships and exploitation, scope of practice, and legal/ethical compliance. Navigating these issues requires practitioners to make well-reasoned ethical judgments that protect the welfare of those they serve. By upholding stringent ethical standards, the field of psychology maintains integrity and public trust.
