The Practice of Clinical Psychology Worksheet
Answer the following questions. Your response to each question must be at least 150 words in length.
.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.
The first legal issue associated with clinical psychology is confidentiality. Whenever a patient seeks help, everything that is said in the sessions must be held confidential and the patient is encouraged to speak freely. There are times when confidentiality becomes unethical and that is if and when the patient talks about issues that may cause harm or being a serious threat to themselves or someone else. An example of this would be if a patient talks about committing suicide or mentions for example child abuse.
The second legal issue associated with clinical psychology is those of dual relationships. Dual relationships do happen, however psychologists should avoid them at all costs so that the relationship between patient and doctor does not get compromised. Professional boundaries should not be crossed. While it may be appropriate to engage in relationships with others in certain professionals, psychologists must avoid those relationships for ethical reasons. For example, if a psychologist meets a client to treat disorders, it must be for that reason only and not for relationship reasons such as in pursuit of a romantic relationship. An example of when a situation could be legal but unethical is a dual relationship when a psychologist is helping a client with a disorder and hangs out with that person outside of the business such as to be friends with the person.
.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.
A major ethical issue associated with clinical psychology is competence. Psychologists must be competent with their experience, skill, and services that he or she provides. A psychologist has to be competent in their speciality area such as if the psychologist works specifically with children, couples, or even a certain type of therapy. If the psychologist steps over the boundaries that he or she has no idea on how to treat the patient with, it can turn into a legal matter. For example, if the psychologist who works with adults going through a divorce only, takes on a case that involves a teenage depression, it could turn into a legal matter if the teen turns suicidal. In the case of this, the psychologist can be held accountable for the teen’s decision.
A second ethical issue associated with clinical psychology is integrity. Psychologists are expected to be professional and honest at all times with their patients and others around them. When a patient is with the psychologist, the psychologist has to honestly tell the patient of all tests that will be done or what will happen in a session. When a psychologist or any other professional for that matter is not honest, it can result in complications which include legal problems. An example for integrity issues that result in legal matters is if a psychologist tells his or her patient that by telling the truth about anything, it will not be reported. A psychologist has an obligation to report any activities that may result in harm to the patient or someone else such as with child abuse. If the patient admits to child abuse because they assumed they would not get into trouble legally, then the integrity of the psychologist is then compromised. If the psychologist did not report what was said during the session, the psychologist and/or patient can end up getting into legal problems.
.3 Define professional boundaries, boundary crossings, and boundary violations. What effects do boundaries have on the therapeutic relationship?
When a psychologist takes on a patient, certain boundaries have to be maintained. Boundaries are what professionals put into place so that privacy and protection is maintained. Dual relationships sometimes cannot be avoided such as a patient being the psychologist’s dentist. If this is the case, boundaries are placed for outside of the office environment between the psychologist and the patient. “Boundary crossings refer to any deviation from traditional, strict, ‘only in the office,’ emotionally distant forms of therapy or any deviation from rigid risk-management protocols” (Zur, 2013). Boundary violations are what happen when the boundaries are crossed. Psychologists are ethically bound to not violate the boundaries, but if it does occur, the integrity of the psychologist is on the line as well. The psychologist’s behavior will be reviewed by the APA to determine what will happen.
Patients do not understand boundaries and what it may mean. For example, patients may invite their psychologist to a wedding, out to lunch, etc. but the psychologist has to decline due to the code of ethics and boundary crossings. The patient may become upset that he or she has been rejected or confused as to why the psychologist is not willing to meet them. This confusion could put a strain on the professional relationship if the patient does not feel comfortable with the psychologist. If that does happen, the patient may not end up talking anymore and could end up regressing instead of progressing.
.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.
Psychologists have to respect the rights of others, including all cultural needs. Psychologists also have to be “sensitive to individual differences, be aware of gaps in knowledge and areas of bias and prejudice” (Plante, 2011). No discrimination is tolerated at all. The psychologist needs to understand cultural differences and be able to provide whatever is necessary to the patient for the sessions. A psychologist has to “develop culturally informed intervention strategies and techniques for their patients” (Plantes, 2011). What this means is that because each individual’s needs are different, the psychologist should plan out the best approach for treatment based off of the patients cultural preferences. Understanding how cultural influences behavior is the key to developing treatment options. Some cultures have specific beliefs or illnesses that have to be accommodated. For example, in India, dhat is a cultural illness that believes anxiety leads to loss of semen in men. The “APA guidelines suggest psychologists to use organizational change processes to support culturally informed organizational (policy) development and practices and apply culturally appropriate skills” (Plante, 2011). During the time of assessment, the psychologist has to sit down with the patient and figure out what the best approach is so that all cultural factors can be added into the therapy. The psychologist will have to be able to provide whatever materials the patient needs such as written instructions in the patients primary language or even to have a translator present. If the patient participates in any rituals such as prayer or anything else, the psychologist will have to respect the patients wants or needs.
Zur, O (2013). Dual Relationships, Multiple Relationships, Boundaries, Boundary Crossings & Boundary Violations in Psychotherapy, Counseling & Mental Health. Zur Institute. Retrieved from: http://www.zurinstitute.com/dualrelationships.html
Plante, T. G. (2011). Contemporary clinical psychology. (3rd. ed.). Hoboken, NJ: Wiley & Sons