Tuesday, April 1, 2014

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.

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