Orientation: Integration Model

      I wholeheartedly agree with Liberty’s integration model.  I believe that the bible should be consulted before any other material to get a firm foundation as to what the bible teaches about counseling and helping one another.  After the bible, other resources should be considered to find ideas, truths, and to assess what works.   The information gathered from outside resources should then be filtered through the Word of God to make sure that the information is in agreement with scripture.   I also like how Clinton & Ohlschlager (2002) describe counseling as “soul-care” (pg. 32).  This is not about just helping people to cope with tragedies, affliction, and addictions.  It is about caring for their soul, their eternal life, and their freedom.  “It was for freedom that Christ set us free; therefore keep standing firm and do not be subject again to a yoke of slavery” (Galatians 5:1, New American Standard Bible).  I believe that we are not meant to simple cope, but to be set free.  Jesus is described as our Wonderful Counselor (Isaiah 9:6), and He tells us “But I tell you the truth, it is to your advantage that I go away; for if I do not go away, the Helper will not come to you; but if I go, I will send Him to you.”  The work translated to “the Helper” (NASB), “the Comforter”(KJV), and “the Counselor” (NIV), is the Greek word “parakletos.”  It was to our advantage that Jesus left because he was human and could not reside in us, but the Holy Spirit could, and does.  The Father sent the Spirit in the name of Jesus to teach us all things and bring remembrance to us of everything that Jesus said (John 14:26).  As we are counseling others we should be listening to the person’s story, which gives light to their needs (as talked about in the “The Integration Model of the Center for Counseling and Family Studies” presentation).  We should also be listening to the Holy Spirit who will give us further insight and who will come along side of us to minister to that person.

I am also a firm believer that we are supposed to do everything that Christ did, which includes using the authority that Jesus gives us in His name.  “And He called the twelve together, and gave them power and authority over all the demons and to heal diseases. And He sent them out to proclaim the kingdom of God and to perform healing.” (Luke 9:1-2, NASB).  Many Christians do not like to speak of demons or Satan.  While it can be unhealthy to become obsessive, it is important that we are aware that there is a constant battle being wages in the spiritual realm.  Jesus calls us to put on the full armor of God (Ephesians 6:10-17), which includes “taking up the shield of faith with which you will be able to extinguish all the flaming arrows of the evil one” (Ephesians 6:16). 

Liberty’s Integration Model as well as my own integration model may be a challenge for me because I have not read and studied the entire bible.  I became a Christian about three years ago and have spent time studying certain parts, but I do not know the bible in its entirety.  Since I am to use the bible as a filter for all other resources, this may be challenging for me. 

Clinton, T., & Ohlschlager, G. (2002). Competent Christian counseling, (Vol 1) . Colorado Springs, CO: WaterBrook Press

Major Approaches to Clinical Psychology

Obsessive-compulsive disorder will be defined and examined in relation to psychological approaches: psychodynamic, cognitive-behavioral, humanistic, and family systems.  The philosophical origins of each approach will be discussed in addition to identifying the goals of each approach.  The techniques and strategies of each approach will be explained.  The affects of the approaches will be discussed in relation to OCD treatment strategies.  Also, the effectiveness of each approach in relation to OCD, which will be based on treatment outcome research. 

Obsessive-Compulsive Disorder

The International OCD Foundation defines OCD as “a disorder of the brain and behavior. OCD causes severe anxiety in those affected. OCD involves both obsessions and compulsions that take a lot of time and get in the way of important activities the person values” (2012).  OCD can cause uncontrollable fears which causes the person difficulty functioning in everyday life.  An individual suffering from OCD is preoccupied with perfection, control, detail, lists, organization, order, rules, and schedules. 

The Psychodynamic Approach

The psychodynamic approach originated from Sigmund Freud’s work.  The psychodynamic approach is derived from Freud’s psychoanalytic theory.  The approach has since been challenged, broadened, and adapted. The psychodynamic approach to OCD focuses on the anal developmental stage, which consists of the tasks learned during toilet-training such as learning self-control and staying clean (Hansell & Damour, 2008).  There are three defense mechanisms, which are reaction formation, undoing, and isolation of affect.  Reaction formation is when an individual turns a negative impulse into a positive, or more acceptable, reaction.  Undoing is when an individual uses behaviors to counteract his or her inappropriate feelings.  Isolation of affect is when the individual separates his or her thoughts or feelings to distance him or her from negative emotions. 

Freud believed that people with OCD used a defense mechanism known as fixation, which he defined as a “permanent attachment of the libido onto an earlier, more primitive stage of development” (as cited by Feist & Feist, 2009, p. 36).  For example, an individual with a fixation on eating or smoking may have a fixation with the oral stage of development. 

The psychodynamic approach suggests several treatment options, which are free association (talking openly with therapist), resistance (using defense mechanisms), transference (how the client feels about the therapist), countertransference (how the therapist feels about the patient), interpretation (comments from the therapist about the clients emotional conflicts), and working through (the clients progressive mastery over feelings and conflicts from speaking with the therapist) (Hansell & Damour, 2008). 

The Cognitive-Behavioral Approach

The cognitive-behavioral approach originated on the principals of learning and also stems from conditioning research carried out by Skinner, Watson, Hull, Thorndike, James, Pavlov, among others and  academic experimental psychology (Plante, 2011). The cognitive-behavioral approach tends to focus on observable and non-observable behavior learned through conditioning (Plante, 2011).  The goal of the cognitive-behavior approach, unlike the psychodynamic approach, is to focus more on the present behavior rather than pats behaviors to understand and treat OCD. 

There are several techniques used in the cognitive-behavioral approach such as contingency management, counterconditioning, exposure, behavioral contract, participant modeling, behavioral rehearsal, and thought stopping.  Contingency management is changing the behavior by changing the consequence of the behavior.  Counterconditioning is developing a healthy response to stimuli.  Exposure is when the individual exposes themselves, either all-at-once or gradually, to what he or she fears.  Behavioral contract is a document formed between therapist and client outlining behavioral consequences.  Participant modeling is when the patient observes others behaving in the desired way.  Behavioral rehearsal is when the patient practices desired behaviors or reactions until he or she does them automatically.  Thought stopping is using behavioral queues to stop thoughts and insert more positive thoughts in their place. 

The Humanistic Approach

The humanistic approach developed in part from the “reductionistic aspects of early psychodynamic theory, which viewed all psychological symptoms as derived from sexual conflicts” (Plante, 2011, p. 50).  The humanistic approach was also derived from European philosophy and the work of mental health professionals such as Frank, Rogers, May, Maslow, and Perls.  The goals of humanistic approach is to “emphasize the importance of interpersonal connection, human freedom, and personal choice for emotional well-being” (Hansell & Damour, 2008, p. 49). 

Active listening is when the therapist listens intensely to the patient using reflection, summaries, and paraphrasing, in addition to other techniques.  Empathy conveys to the patient that he or she is being heard as well as understood.  Unconditional positive regard is the full acceptance of the thoughts and emotions of the patient.  Congruence gives the patient the sense that the therapist is being genuine.  Self-actualization is progression towards one’s fullest potential.  Peak experiences are points in time where self-actualization has been reached.  Visualization is a technique used during therapy where the patient visualizes an individual in an empty chair to say what they need to say to that individual. 

The Family Systems Approach

The family systems approach attempts to utilize the family as a whole to treat problematic behavior and emotions.  Before the 1950’s the family approach was foreign as psychologist only working with the patient suffering from OCD or other mental health disorders.  The family systems approach is rooted in the Bateson Project  of the 1950s.  Don Jackson founded the Mental Research Institute alongside another Virginia Satir, another family therapist, in 1959.  During the 1970’s especially, the family system approach became increasingly popular among mental health professionals. 

The goal of the family systems approach is to improve communication between family members, and bring attention to the whole family instead of the problems on one individual within the family.  “OCD is clearly a family affair yet many clinicians may not be attentive to family responses to OCD symptoms, how those responses facilitate the disorder and family dynamics that may result due to the impact of OCD on every member of the family” (International OCD foundation, 2012, para. 2).  Families tend to accommodate the rituals of individual’s with OCD, which makes the family systems approach extremely important to the remission and recovery of the individual suffering from OCD. 

Several techniques are using in the family systems approach such as reframing, paradoxical intention, joining, enmeshing, and disengagement.  Reframing is changing how the patient perceives a behavior.  Paradoxical intention is a technique where the patient actually acts out their problematic behavior in order to feel more comfortable with treatment options.  Joining is when the therapist becomes involved and apart of the family unit rather than an observer.  Enmeshment is when the patient suffering from OCD becomes over-involved and critical of other family member’s lives.  Disengagement is the detachment of a family member in an attempt to avoid emotional involvement. 

Conclusion

Obsessive-compulsive disorder is complex and different for each individual suffering from the disorder.  Each of the psychological approaches to OCD has pros and cons, which should be evaluated by the psychologist before beginning treatment.  The psychodynamic approach focuses on childhood development and unconscious causes and effects of the disorder.   The cognitive-behavioral approach focuses on the present behavior displayed and non-displayed by the patient suffering from OCD to better treat the problematic behaviors.  The humanistic approach assumes that the patient is innately good and encourages personal-growth and eventually self-actualization.  The family systems approach includes the family as a whole in the observation and treatment process without focusing directly on the patient suffering from OCD.  All of these treatment approached have good qualities and effective treatment plans.  It is up to the psychologist as to which one or ones he or she will incorporate in the patient’s treatment plan. 

References

Feist, J., & Feist, G. (2009). Theories of personality (7th ed.). New York, NY: McGraw Hill.

Hansell, J. & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.

International ocd foundation. (2012). Retrieved from http://www.ocfoundation.org/

Plante, T. G. (2011). Contemporary clinical psychology (3rd ed.). Hoboken, NJ: John Wiley & Sons.

Clinical Psychology

Clinical psychology will be examined with discussion on the history and evolution of clinical psychology.  The role of research and statistics in clinical psychology will be explained.  The difference between clinical psychology, social work, psychiatry, and school psychology will be examined. 

History and Evolution of Clinical Psychology

Before clinical psychology became a term there were people and events that set the stage for clinical psychology to become a profession.  The Greeks believed that illnesses were related to the gods.  Sigmund Freud developed the connection between body and mind, and the diseases could be brought about by emotional and unconscious influences.  “As more and more scientific discoveries were revealed, theories about the relative importance of biological, psychological, and social factors in behavior and emotions were altered to accommodate the most up-to-date discoveries and thinking.” (Plante, 2011, p. 45).  Clinical psychology was born in 1896 as a specialty with the first ever psychological clinic.  This clinic was located at the University of Pennsylvania and opened by Lightner Witner.  In 1908 the Binet-Simon scale was created by Alfred Binet and Theodore Simon for teachers and schools to assess and identify children with learning disabilities. 

Sigmund Freud had little influence on clinical psychology until his visit to a conference in the United States in 1909.  The conference influenced children’s psychological clinics in the US to adopt Sigmund’s psychoanalytic theories.  In 1917 clinical psychology was implemented into the U.S. Army with the use of verbal and nonverbal intelligence testing.  The military’s use of psychological testing increased the popularity of clinical psychology.  After World War I there was an explosion of psychological tests, making over 500 accessible in the United States by 1940 (Plante, 2011).  Hermann Rorschach developed the now-famous Psychodiagnostik inkblot test in 1921. 

Although the APA did nothing to enforce it, in 1935 the APA Committee on Standards and Training in Clinical Psychology did recommend a PhD as well as one year of internship be required of clinical psychologists (Plante, 2011).  In 1973 the new Vail model was accepted as a new training model, which was an addition to the already practiced Boulder model.  The PsyD was also accepted as an alternative to the PhD degree for practicing clinical psychology.    A major shift in clinical psychology occurred when a major lawsuit in the late 1980s allowed psychologists to perform psychoanalysis on his or her patients.  This testing led to more widespread consultation and therapy among clinical psychologists.  After more than 40,000 men were hospitalized following World War II there was an increase in clinical psychologists and their services. The VA then employed around 4,700 clinical psychologists in 1947. 

Research and Statistics in Clinical Psychology

Research is the core of clinical psychology, and without it clinical psychology would not have progressed like it has.  The scientific method is widely used by clinical psychologist to conduct research.  “The scientific method is a set of rules and procedures that describe, explain, and predict a particular phenomenon” (Plante, 2011, p. 74).  The phenomenon is first observed by the psychologist or group of psychologists.  Then a hypothesis is formed predicting the believed outcome.  The hypothesis is tested, then altered based on the findings of the testing, and then interpreted.  The DSM-IV-TR is a highly used tool published by the APA.  It is a manual of syndromes with specific diagnostic criteria for the syndromes (Plante, 2011).  This manual is used in research to make sure that all criteria match the specifications in the DSM, for best results.  Once a hypothesis is valid is can be used to explain behavior and predict future behavior. 

“All sciences demand results and are aimed at seeking empirical evidence which is favourable toward the hypothesis formulated, in such a way that they ensure predictable results.  Thus, psychological research seeks to obtain empirical evidence which will allow the hypothesis derived from the different theories postulated to be contrasted.  In order to achieve this aim, some good research designs and appropriate statistical methods must be established” (Sesé & Palmer, 2012, p. 97-98).

Statistics also play a key role in clinical psychology.  Statistics are used to support research hypotheses and their findings.  “Statistical significance refers to the very small probability of obtaining a particular finding by error or chance” (Plante, 2011, p. 96).  Statistics are used within the scientific method to help research psychologists to form their hypothesis, but more importantly statistics allow the research to be used in a broader term. Information can be taken from one experiment and, if it is valid, can be incorporated into other experiments.  Statistics also allow for information to be shared with others easily and legibly. 

Clinical Psychology and Other Mental Health Professions

Clinical psychology differs from other mental health professions.  At its core clinical psychology deals with the assessment and treatment of mental disabilities and illnesses.  Other disciplines may touch on the subject, but encompass an array of other topics that do not include mental illness.  “Social work practice is carried out in public, nonprofit, and for profit agencies and includes direct services to individuals, families, groups, and communities, as well as supervision, management, and policy analysis” (Gambrill, 2006, p. 4).  While psychiatrists do have extensive training in mental illness they focus more on behavioral aspects than clinical psychologists do.  Psychiatrists also specialize in medicine for mental and behavioral problems.  School psychology focuses on children and his or her mental abilities pertaining to achievement and interests.  If a student is having a issues with mental illness it is likely that the child would be referred to a clinical psychologist.  The school psychologist would be able to counsel the child, but would be limited in his or her ability to assess and treat the child for non-school related issues.

Conclusion

Clinical psychology has an extensive history and evolution dating back to its birth in 1896.  Other events took place before then leading to the term “clinical psychology” being coined.  Lightner Witner, Hermann Rorschach, Sigmund Freud, Alfred Binet, and Theodore Simon are just a few men who have greatly impacted the evolution of clinical psychology.  Research and statistics are the backbone of clinical psychology and its ever-evolving history.  Although other mental health professions may encompass parts of clinical psychology, it is the only field to deal with only mental disability and illness.  Clinical psychology has greatly improved the information that is now available to mental health professions. 

References

Gambrill, Eileen D.. (2006). Social Work Practice: A Critical Thinker's Guide. Oxford University Press, USA. Retrieved 5 May 2014, from <http://www.myilibrary.com?ID=65551>

Plante, T. G. (2011). Contemporary clinical psychology (3rd ed.). Hoboken, NJ: John Wiley & Sons.

Sesé, A., & Palmer, A. (2012). The current use of statistics in clinical and health psychology under review. Clinica y Salud, 23(1), 97-108. doi: 10.5093/cl2012v23n1a2

Legal and Ethical Issues Associated with Psychological Testing

Ethical Issues Associated with Psychological Testing

One ethical issue associated with psychological testing is informed consent, which means that a patient or client must give his or her consent to be tested on.  He or she can also, at any time, withdraw consent.  The psychologist performing the testing must explain to the subject, in language that he or she can understand, what the test entails.  Informed consent is extremely important in the world of psychological testing.  It is both ethical for the client to be informed, but may also cause legal problems within a psychological institute if informed consent is not obtained. There are exceptions to this issue such legally mandated assessments and job seeker assessments (Hogan, 2007).  This may make it harder for a psychologist because some people may not consent even though it is in his or her best interest.

A second ethical issue is confidentiality, which entails that the test results cannot be shared with anyone unless the client gives consent, and even then the information may only be shared with a qualified professional.  The test results are to only be used for that which the test was purposed for.  Confidentiality is extremely important and gives great credit to the field of psychological testing.  The field would not be where it is today if confidentiality had not been taken seriously.  Clients would not trust psychologists if confidentiality was not upheld.  The only way a psychologist is allowed to break confidentiality is if he or she believes that the client or someone else is in great danger.  

Legal Issues Associated with Psychological TestingA second legal issue associated with psychological testing is discrimination.  A psychologist may not implement psychological testing on an individual if the results will be biased based on the individuals race, gender, national origin, or religion.  Hogan describes the term discriminant validity as “evidence showing that performance on a test has a relatively low correlation with measures of constructs expected to have a low correlation with the trait of interest” (Hogan, 2007, p. 653).  Psychologists have to be careful when dealing with their patients and cover themselves by making sure that they can prove the test to valid and possibly job related. 

Once legal issue associated with psychological testing is disabilities and the accommodations that psychologists must make to ensure that disabled people are being treated fairly.  “Disabled” is a broad term and does not only include physical handicapped.   Psychological testing must be modifiable to accommodate disabilities, which may include larger print text.  One accommodation that has stirred a lot of controversy is the extending of time limits on tests (Hogan, 2007).  This is a matter of the individual and whether or not it is actually making the test fair by extending the time limit.  Hogan (2007) states that accommodations made to tests should render the norms and validity of the test the same for non-disabled and disabled examinees.    Both of these legal issues make the world of psychological testing more complex but only for the better of the examinees.  All people should be treated fairly, which is ultimately what these laws are in place for. 

Civil Rights Act of 1964

In my opinion the Civil Rights Act of 1964 had the largest impact on the field of psychological testing.  This was a turning point for America and psychological testing, which gives all citizens equal protection under the law.  The Civil Rights act has also been popularly called the Equal Employment Opportunity Act.  This was because psychological testing could have been and can still be used to exclude certain races or genders from getting or keeping a job.  The law protects people from psychological testing that may exclude them from certain opportunities such as jobs, property, or liberty.  This law gave minorities ground the stand on when it came to standing up for themselves and making a way for them in the world.  In regards to psychological testing it has put boundaries on the logic behind tests so that they must be standardized to not exclude any race, religion, gender, or nationality.  The Civil Rights Act ensures that psychological testing cannot be used against the best interest of a person, which gives clients confidence that psychological testing will be for their benefit.  Personally, I like the feeling of knowing that I will not be assessed in any way that would show my race or gender.

References

Hogan, T. P. (2007). Psychological testing: A practical introduction (2^nd ed.). Hoboken, NJ: Wiley.

Gun Control Attitude Survey

Gun Control Survey

1.        What is your age? (circle one):  -18    18-28    28-35    35-45    45-55    60+

2.        What is your gender? (circle one):   Male     Female

3.       What is your ethnicity? (Circle all that apply):  Caucasian     African American   Latino     Native American     Asian      Other   

	Please circle one of the following that best describes you.	SA	A	U	D	SD
4	My city or town experiences gun violence	1	2	3	4	5
5	I am a gun owner or interested in owning a gun	1	2	3	4	5
6	The age to own a gun should be raised from 18 to 21	1	2	3	4	5
7	Improved background checks should be required to determine mental instabilities before an individual can purchase a gun	1	2	3	4	5
8	Guns are responsible for many crimes in America	1	2	3	4	5
9	People are responsible for many crimes in America	1	2	3	4	5
10	Citizens should be required to undergo safety training to own a gun	1	2	3	4	5
11	Armed officers or military personnel placed in schools and populated buildings would reduce gun violence	1	2	3	4	5
12	Increased punishment severity for  gun traffickers would reduce gun crime	1	2	3	4	5
13	Increased gun control would reduce gun violence	1	2	3	4	5
14	Teachers and superintendents should be allowed to carry guns if they undergo training and qualifications annually	1	2	3	4	5
15	Gun owners should be randomly drug tested	1	2	3	4	5
16	I am familiar with the 2nd Amendment of Constitution	1	2	3	4	5
17	Trained and qualified citizens should be able to carry his or her gun in public places such as churches, schools, banks, sporting events, etc.	1	2	3	4	5
18	An armed citizen is likely to decrease the amount of causalities during a gun crime	1	2	3	4	5
SA: Strongly Agree  A: Agree  U: Unsure   D: Disagree  SD: Strongly Disagree

Gun Control Attitude Survey

A gun control survey has been prepared for the administration to police officers in several cities across America.  The purpose of the survey will be explained in addition to preliminary design issues such as mode of administration, length, item formal, number of scores, score reports, administrator training, and background research (Hogan, 2007).  Specific instruction will be given in regards to preparation, administration, scoring, and interpretation of the gun control survey. 

Purpose and Preliminary Design

The purpose of the gun control survey is to define if police officers across America are for or against gun control.  The mode of administration for this survey will be group administered.  The individuals taking the survey do not need to be observed during the test and group administration is efficient for this style of survey.  The survey is short and will only take about fifteen minutes to administer per group with very little preparation time.  Preparation time will only include setting up test room to accommodate the group in addition to making the appropriate number of copies.  The gun control survey designed for the police officers includes 18 questions of a broad nature.  This test is not meant to be sensitive or open-ended, but to get a general idea of how police officers in America feel about gun control.  There are three questions asked about the age, gender, and ethnicity of the participant for grouping purposes.  The remaining 15 questions are on a 5-scale agree-disagree format.  The choice range from strongly agree to strongly disagree, with a neutral and unsure option.       

This survey will generate one score per participant.  The three questions asked about the individual’s age, gender, and ethnicity will be used on a per question basis for further analysis.  The 15 agree-disagree questions will each be put into graph form, showing how the majority and minority of police officers voted.  There will be no need for administrator training.  The test is self-explanatory and will not be scored by the administrators.  The tests will be sent back to production team for analysis.  The production team will score each test, entering the data into spreadsheet format.  Once the scores have been entered graphs will be created from the data to display the results to the public.    Background research will be completed on police officers as well as the cities that the survey is administered, which will be several cities across the United States.

 Administration, Scoring, and Interpretation

Administers of the test will schedule a block of time for each group to participate in the survey.  Copies will be made ahead of time and given out to the participants.  There will be no time limit, but it should only take an average of 15 minutes for each participant to complete the survey.  The survey’s will be turned in face-down upon completion.  There will be no discussion aloud during the survey and participants will be allowed to leave the testing room upon completion.  Once all the surveys have been administered to each group, depending on the department’s choice to test officers in small groups or everyone at once, the tests will be placed into a confidential envelope and mailed back to the production team for analysis.  All surveys will be due back to the production team by a specified date.  The company will not be sent results for each individual from that department, but will be invited to see overall results after publication. 

There is no right or wrong answers to this survey.  The number system on the test will be changed after the participants complete the test.  This is so that the participants are not inclined to choose either the lowest or highest numbers based upon his or her predisposition for gun control.  The numbers will be changes from 1 to 5, 1 being not for gun control and 5 being strongly for gun control.  Once the numbers are changed during analysis the participants will be given a number score.  The lower the score the less she or she is for gun control, the higher the score the more he or she is for gun control. 

The scores will be given only to police officers, which is the norm of the test.  After all the tests are scored and entered into graphs each individual question will then be broken down into further norms such as age, race, and gender.  Only some of these norms will be published along with the original graph of all the results.  All of the questions will be formed into graphs and published on a website.  The web address will be sent out to the police departments that participated.  A web address as well as a printed copy of the publication will then be sent to state governors of the participating states.

Conclusion

In conclusion, the gun control survey is to get the opinions of police officers across America on gun control.  The survey is fairly simple and is will not be complicated for police departments to administer to their officers.  The police departments will not be responsible for scoring the agree-disagree formatted surveys.  The production team will score and interpret results in addition to comprising graphs and written presentations of the results for publication, which will be on a website as well as printed for individual distribution. 

References

Hogan, T. P. (2007). Psychological testing: A practical introduction (2^nd ed.). Hoboken, NJ: Wiley.

The Practice of Clinical Psychology Worksheet

1.      What are at least two legal issues associated with clinical psychology? Provide an example of a situation that could be legal but unethical. Explain your response.

Confidentiality is a legal issues associated with clinical psychology.  Psychologists are legally required to keep information between the client and themselves unless the psychologist feels that the patient is going to harm themselves or someone else.  Also, a psychologist is legally required to alert authorities or child protective services if a child is being neglected or abused.  Issues arise when the psychologist either does not inform the patient that there are some cases in which information cannot be kept confidential, or when the psychologist withholds information from authorities.  Problems also occur when a psychologist breaks confidentiality without gaining permission from the patient (Plante, 2011). 

Informed consent is another legal issue dealt with in the field of clinical psychology.  Plante (2011) gives an example of a psychologist who evaluated both parents in custody battle and then used their statements without informing them or acquiring consent.  This doctor broke the law by using confidential information without the permission of his clients. 

As a psychologist it is important to remain professional even when closeness is developed between doctor and patient.  If a woman came in and told her psychologist that she was having an affair and did not know what to do.  It may be legal for the psychologist to advise the patient to continue with the affair, but it certainly would be unethical. 

2.      What are at least two ethical issues associated with clinical psychology? Provide an example of a situation that could be ethical but illegal. Explain your response.

Recordkeeping is an ethical issue associated with clinical psychology.  The method utilized to keep records in addition to the time period they are kept after treatment is terminated are both concerns in the field of clinical psychology.  Online databases may be easily hacked into, which leaves room for worry that a patient’s information may be stolen or destroyed.  It is best to keep records in paper form inside of a locked area within the doctor’s office.  This allows for easy access by the psychologist and privacy from unwanted theft. Competence is another example of an ethical issue. Plante (2011) introduces competence by stating that the psychologist “must provide only services for which they have the appropriate training and experience and remain up-to-date regarding advances in the field to ensure that they maintain state-of-the-art skills (p. 374).  Concern may arise if a psychologist were to offer help that is outside of his or her skill level.  Also, it is important that the psychologist maintain his or her skills by continuing education and staying up-to-date with new methods of treatment. 

The doctor that performed testing on the two parents can be used as an example of a situation that could be ethical but illegal.  The doctor went about the situation illegally by not obtaining informed consent before using confidential information.  The father admitted to the doctor that he did not really want custody of the child, but really just wanted to get back at the child’s mother.  Even though the doctor was acting illegally by using a tape recorder and using information without informed consent, he was still acting in an ethical way considering that the father did not actually want custody of his child. 

3.      Define professional boundaries, boundary crossings, and boundary violations. What effects do boundaries have on the therapeutic relationship?

Professional boundaries are limits and rules of behavior set by the psychologist.  This may include things such as dressing modestly, not talking about his or her own problems, and meeting only at the office.  These boundaries are set to ensure that the doctor and patient maintain a healthy relationship. 

According to Aravind, Krishnaram, and Thasneem (2012) “A boundary crossing is a deviation from classical therapeutic activity that is harmless, non-exploitative, and possibly supportive of the therapy itself. In contrast, a boundary violation is harmful or potentially harmful, to the patient and the therapy. It constitutes exploitation of the patient” (para. 8). 

Boundaries are used to keep a safe distance from the patient and psychologist.  In order for therapy to be successful both psychologist and patient must adhere to such boundaries to keep the relationship from being unhealthy and harmful.  Boundaries against physical touch, sexual innuendos, flirting, and talking of the psychologist’s personal life, keep the relationship professional and ethical.   

4.      What are at least two cultural limitations associated with assessment and treatment? In your response, discuss the use or misuse of assessment instruments, therapy techniques, research results, or any other facet of clinical practice that could have potentially harmful, culture-specific implications.

It is important for the psychologist to have an understanding of the patient’s cultural background to properly treat him or her. Educational background is an example of a cultural limitation associated with assessment and treatment in clinical psychology.  There are thousands of assessments out there, but only a few may be considered among a specific culture because of education limitations.  It would be difficult to give an age appropriate Standards of Learning (SOL) test to a child who has never been to school.  That child would not pass the test because they lack the information and background needed to succeed on the test.  The test may be measuring what it is supposed to, but it does not apply to that individual and cannot be used to assess for treatment.  The understanding and expectation of common interest is also an example of a cultural limitation.  A behavior that is considered abnormal in western cultures may be considered normal in other cultures around the world.  Plante (2011) suggests that “psychologists need to develop appropriate culturally informed intervention strategies and techniques” (p. 254). 

References

Aravind, V. K., Krishnaram, V. D., & Thasneem, Z. (2012, Jan-Mar). Boundary crossings and violations in clinical settings. Indian Journal of Psychological Medicine, 34(1), 21-24.  Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361837/#__ffn_sectitle

Plante, T. G. (2011). Contemporary clinical psychology (3rd ed.). Hoboken, NJ: John Wiley & Sons.