Legal Aspects of Psychology

Legal Aspects of Professional Psychology
Heidi Andrews
University of Phoenix – Psych 545
Dr. Meghan Kelley
August 2, 2010

Legal Aspects of Professional Psychology The legal aspects and issues are a large part of the world of psychology. This topic covers a vast area such as assessments, testing, diagnosing, HIPPA, confidentiality, written consent, case studies, and many more. Professionals struggle with making sure they are not breaking any laws every day and still caring for every patient to the best of their abilities. There are various ways of legally mistreating a patient and this will also be covered in this paper. Throughout this paper, the different legal aspects will be covered and some statistics will be brought to light and examined as their relation to the field of psychology.
Legal Issues Related to Informed Consent and Refusal The definition of informed consent is the result of a process of reaching an agreement to work collaboratively. The process of informed consent provides the client and the therapist a chance to get on the same page. The client needs to understand what treatment that the therapist has in mind for them. This also tends to be a recurrent process. The patient can consent to an initial psychological assessment but then months later it should be altered based on the results of reactions of the patients progress. (Rosenfeld, 2010) In 1972, the case of Cobbs v. Grant this was quoted “It is the prerogative of the patient, not the physician, to determine for himself the direction in which he believes his interests lie. To enable the patient to chart his course knowledgeably, reasonable familiarity with the therapeutic alternatives and their hazards becomes essential”. There is case after case with quote after quote giving patients the right to choose their own treatment or refuse their treatment. (Pope and Vasquez, 2007)

Legal Issues Associated with Assessment, Testing, and Diagnosing Assessments, testing, and diagnosing are very important in psychology and can change a client’s life. These tools have deciding factors on custody, a person’s reputation, involuntary hospitalization, employment, and possibly even going to prison. The client must fully understand the nature, purpose, and technique of the assessment. Assuming the client understands the testing is not just a written test. Some simply nod out of being anxious or trying to please the therapist out of fear of looking ignorant. It is the therapist responsibility to explain fully and to decide whether or not the client understands what is being said before they proceed. (Pope and Vasquez, 2007) The legal issues involved with diagnosis are the importance of using the correct diagnosis especially when a client has insurance. Some insurance do not provide coverage and services for certain diagnoses. It has been brought to providers’ attention that some physicians will change the diagnosis so that the client can receive benefits from the provider. This comes back to the physician. The providers have begun to hire investigators and legal teams to stop physicians from doing this with clients. (Psychological Association 1963, 2010)
Importance of Maintaining Confidentiality in Therapy Confidentiality is one of the worst for therapist’s areas of violations. It is not usually out of malicious intent. It is from stress, fatigue, and becoming unaware. There are many things that can happen to therapist that are just easy for them to overlook. They do not even have the luxury of going home and speaking to their spouse about their day in fear of accidentally mentioning a client’s name. They cannot go to the gym to blow off some steam due to the off chance that someone there may know them and may know their patients and put two and two together. They cannot have the luxury of being unorganized and having other client’s charts lying around their office while they have a session with another client with the chance that someone will see that person’s name on the chart. They have to be very careful leaving messages for clients on answering machines due to who could hear the message. It could be someone other than the client. The therapist must also be very careful about what is left on the computer screen for others to see. Once a session is over, they must be sure and close the documents open so that the next client does not see anything that pertains to the client that was there before them. (Pope and Vasquez, 2007)
Another huge problem therapists run into is family members, they sometimes feel like they deserve to know what information the client has told the therapist. The information given to the therapist is confidential especially from the family members. They can sometimes try to persuade or pressure a therapist for information but once they are explained the laws of confidentiality then they usually back off. Confidentiality is a huge factor in therapy and once a client feels that it has been violated, the treatment may then become pointless. (Psychological Association 1963, 2010)
Impact of Legislation Legislation in psychology comes into play when the court system or officers of the law need information. This is information that only the therapist has. This is usually when a complaint of child abuse or neglect has been made and the therapist has some kind of important information that state officials need. Therapists can be made to feel like they have to legally supply this information. (Pope and Vasquez, 2007)
Role of Competence The definition of competence is properly or sufficiently qualified or capable or efficient. (Wikipedia, 2010) Clinical psychologist should always limit their practice to their area of competence. The requirements for competence are in the standards established in the ethical, legal, and professional work of therapists. No therapist is allowed to practice outside their field of competence by which they have education or training. This also refers to therapists knowing about things that they do not know about. They can be educated in adult depression and treatment but that does not mean that they are educated in childhood depression. They can be educated in treating Americans but other cultures can be very different. (Rosenfeld, 2010) Emotional competence is being able to conduct a session of therapy in a professional manner without breaking any of the boundaries that are set by standards. These boundaries would be crying in front of a patient, yelling at a patient, telling a patient how disappointed you are in them, sexual boundaries, physical abuse, raising your voice, or any type of discussion about a fantasy of the therapists. These types of events do happen and unfortunately the patients are the ones to suffer from it. ( Pope and Vasquez, 2007)
Table 4.1. Intense Emotion and Other Reactions in Therapy (in percentages) Behavior | Study 1* | Study 2** | Study 3*** | Crying in the presence of a client | 56.5 | | | Telling a client that you are angry at him or her | 89.7 | 77.9 | | Raising your voice at a client because you are angry at him or her | | | 57.2 | Having fantasies that reflect your anger at a client | | | 63.4 | Feeling hatred toward a client | | | 31.2 | Telling clients of your disappointment in them | 51.9 | | | Feeling afraid that a client may commit suicide | | | 97.2 | Feeling afraid that a client may need clinical resources that are unavailable | | | 86.0 | Feeling afraid because a client 's condition gets suddenly or seriously worse | | | 90.9 | Feeling afraid that your colleagues may be critical of your work with a client | | | 88.1 | Feeling afraid that a client may file a formal complaint against you | | | 66.0 | Using self-disclosure as a therapy technique | 93.3 | | | Telling a sexual fantasy to a client | | | 6.0 | Engaging in sexual fantasy about a client | 71.8 | | | Feeling sexually attracted to a client | 89.5 | | 87.3 | A client tells you that he or she is sexually attracted to you | | | 73.3 |

Conclusion Legal aspects are very important in the field of psychology. These aspects protect the patient’s legal right to confidentiality. These laws also prevent professionals from going outside the law to accommodate some patients. This would not be ethically right. The fact remains that all professionals should always refrain from breaking the laws and watch out for those easy to overlook laws. Patients legally have the right to and deserve the utmost discretion.

References
American Psychological Association. (2010). Ethical Principles of Psychologists and Code of Conduct with the 2010 Amendments. Retrieved from http://www.apa.org/ethics/code/index.aspx#
Pope, K. S. & Vasquez. M. J. T. (2007). Ethics in psychotherapy and counseling (3rd ed.). San Francisco, CA: Jossey-Bass/Wiley.
Psychological Association 1963. (2010). Retrieved August 2, 2010, from Legislation: http://www.ak-pa.org/legislation/index.htm
Rosenfeld, B. (2010). Questia. The Psychology of Competence and Informed Consent .

Wikipedia. (2010). Retrieved August 2, 2010, from Wikipedia: http://en.wikipedia.org/wiki/Competence

References: American Psychological Association. (2010). Ethical Principles of Psychologists and Code of Conduct with the 2010 Amendments. Retrieved from http://www.apa.org/ethics/code/index.aspx# Pope, K. S. & Vasquez. M. J. T. (2007). Ethics in psychotherapy and counseling (3rd      ed.). San Francisco, CA: Jossey-Bass/Wiley. Psychological Association 1963. (2010). Retrieved August 2, 2010, from Legislation: http://www.ak-pa.org/legislation/index.htm Rosenfeld, B. (2010). Questia. The Psychology of Competence and Informed Consent . Wikipedia. (2010). Retrieved August 2, 2010, from Wikipedia: http://en.wikipedia.org/wiki/Competence