Chapter 1: Introduction to Clinical knowledge for the field as a whole or for gaining

Psychology a better understanding of a given individual.

Clinical Psychology ✓ Description
✓ Explanation
• Is the scientific study, diagnosis, and ✓ Prediction
treatment of people who have ✓ Change of human functioning
psychological problems adjusting to
themselves and environment. Clinical Psychologist’s Employee Settings:
Clinical Psychologists ✓ General hospital and medical clinics
✓ Mental health and psychiatric hospital,
• Are on the front line in the treatment of rehabilitation hospitals and clinics and
the mental health problems. community service agencies
• Deal with both normal and abnormal ✓ Private practice
behaviors. ✓ Universities and colleges
• They administer and interpret ✓ Industry
psychological test and assist in the ✓ The military
diagnosis and treatment of mental ✓ Prison and correctional facilities
disorders. ✓ Private and governmental research
• They study the structures and agencies school
development of personality.
• A professional who applies principles and Research in Clinical Psychology Today
procedures to understand, predict, and Areas that Clinical Psychology Investigate
alleviate intellectual, emotional, Includes:
psychological, and behavioral problems.
✓ The role of psychology factors in the
Major Professions in The Mental Health Field development of diseases
Other Than Clinical Psychology Include: ✓ The prevention of violent behavior
✓ Psychiatrists ✓ The long-term consequences of sexual
✓ Counseling psychologists assault, harassment, and rape
✓ Psychiatric social workers ✓ Study of individual differences
✓ Rehabilitation psychologists ✓ Prevention of psychopathology
✓ School psychologists In the work-related activities,
✓ Health psychologists psychologists do not engage in unfair
✓ Psychiatric nurses discrimination based on age, gender, gender
✓ Para professionals identity, race, ethnicity, culture, national origin,
Professional Skills/ Activities of A Clinical religion, sexual orientation, disability, socio-
Psychologist: economic status, or any biases prescribed by
law.
✓ Assessment and diagnosis
✓ Therapy Psychologists do not engage knowingly
✓ Teaching in behavior that is harassing or demeaning to
✓ Clinical supervision person with whom they interact in their work
✓ Research based on factors such as age or gender
✓ Consultation Avoid:
✓ Program development
✓ Administration ✓ Harm
✓ Multiple relationships
How A Clinical Psychologist Thinks: ✓ Conflict of interest
A series of four tasks is central to how ✓ Third party requests for services
clinical psychologists think about people and ✓ Exploitative relationships
problems whether in generating research and
Types of Interviews: Chapter 2: Evolution of Clinical Psychology
✓ The intake/admission interview The infamous “dunking test” for witches.
✓ The case history interview According to the dunking test, if a woman
✓ Mental status examination interview drowned, it meant she wasn’t a witch. In
✓ The crisis interviews contrast, if she floated to the top of the water, it
✓ Diagnostic interview meant she was a witch and needed to be
✓ Structured interview executed.
Behavioral Interviewing:
• Problem identification
• Problem analysis
• Assessment planning
• Treatment evaluation
Advances in clinical health psychology to
include a number of physical disorders and
diseases – psychologists contribute directly to
the prevention and treatment of among other
diseases, cancer, diabetes, hypertensions, and
aids Trephining
Psychotherapy • Also known as Trepanation, it’s a surgical
intervention in which a hole is drilled or
• Is a process of discovery – a learning
scraped into the human skull.
process.
• Invented by Fabricius Aquapendente in
• In it, we can work together to discover 16th century.
what events, situations, and relationship
in your current or earlier life are leaving
you with uncomfortable feelings or ways
of dealing with your world that re not
working as well as you want.

Lobotomy

• A surgical operation involving incision

into the prefrontal lobe of the brain,
formerly used to treat mental illness.
• They believed that cutting certain nerves
in the brain could eliminate excess
emotion and stabilize personality.
Indeed, many people who received
lobotomy
seemed to
lose them to
feel intense
emotions,
appearing
childlike and
 less prone to worry. she saw first hand that many of the
inmates where there as a result of mental
William Tuke (1732-1822) illness or retardation rather than crime.
• An English philanthropist who promoted • Dix devoted the rest of her life to
more humane methods of custody and improving the lives and treatment of the
care for people with mental disorders mentally ill. Typically, she would travel to
using “gentler” methods that came to be a city, collect data on its treatment of the
known as moral treatment. He was a mentally ill, present her data to a local
major figure in founding The Retreat at community leader and persuade them to
Lamel Hill in York for treating mental treat the mentally ill more humanely and
health needs. adequately. Her efforts resulted in over
30 state institutions for the mentally ill
Philippe Pinel (1745-1862) throughout the Unites States and even in
• A French physician who pioneered in the Europe, providing the more decent and
humane treatment of the mentally ill. In compassionate treatment for the
1792 he became the chief physician at mentally ill.
the Paris asylum for men, Bicetre, and Tuke, Pinel, Todd and Dix did not create
made his first bold reforms by unchaining clinical psychology. Their efforts however,
patients, many of whom had been represent a movement that promoted
restrained for 30 to 40 years. He did the fundamental message that people with mental
same for the female inmates of illness deserve respects, understanding and
Salpetriere when he became the director help rather than fear and punishment.
there in 1794.
• Discarding the long-popular equation of Lightner Witmer (1867-1956)
mental illness with demonic possession, • Witmer was an American psychologist.
Pinel regarded mental illness as the He introduced the term clinical
result of excessive exposure to social psychology and is often credited with
and psychological stress and, in some founding the field that it describes.
measure, of heredity and physiological Witmer created the world’s first
damage. psychological clinic at the University of
Eli Todd (1769-1833) Pennsylvania in 1896, including the first
journal of clinical psychology and the first
• A pioneer in the treatment of the mentally clinical hospital school in 1907.
ill. His efforts in the medical field of
mental care and smallpox treatment had • Witmer contributed to the numerous
a significant impact not only the branches of psychology including school
residents of his town, Connecticut, but psychology. He contributed and in the
contributed to the establishment of high field of special education.
standards for the rest of the newly Assessment
formed nation.
Diagnostic Issue
• Todd made sure that the chorus of voices
for humane treatment of the mentally ill Categorizing mental illness has been an
was also heard on the other side of the issue central to clinical psychology since
Atlantic Ocean. Todd ensures that Witmer defined the field.
patients at the Retreat were always
Specifically, mental illness was often
treated in humane and dignified way.
placed in one of two very broad categories:
Dorothea Dix (1802-1887) neurosis and psychosis. Neurotic individuals
were thought to suffer from some psychiatric
• Dorothea Dix was working as Sunday symptoms (including what we call anxiety and
school teacher in a Jail in Boston, where depression) but maintain an intact grasp on
reality. Psychotic individuals on the other • In 1939, David Wechsler filled the need
hands, demonstrated a break from reality in the for a test of intelligence designed
form of hallucinations, delusions or grossly specifically for adults. His test is known
disorganize thinking. as Wechsler Adult Intelligence Scale
(WAIS).
Emil Kreaplin (1855-1926)
• In 1949, Wechsler released a children’s
• He is considered a father of descriptive version of his intelligence test, which he
psychiatry, offered a different two called Wechsler Intelligence Scale for
category system of mental illness. He Children (WISC)
differentiated exogenous disorders and • In 1967, Wechsler added an intelligence
endogenous disorders. test designed for very young children
1. Exogenous disorders (caused by called Wechsler Preschool and Primary
external factors). Scale of Intelligence (WPPSI).
2. Endogenous disorders (caused by
Assessment of Personality
internal factors).
• He suggested that exogenous disorders • In 1921, Hermann Rorschach
were more treatable type. published a test known as Rorschach
• Emil Kraeplin started the term Inkblot Test, a projective test of
dementia praecox to describe one personality based on the assumption
endogenous disorder. Later he also that people will project their personalities
proposed terms such as paranoia, into vague stimuli.
manic depressive, psychosis,
melancholia and autistic personality.
• He set a precedent for the creation of
diagnostic terms that eventually led to
the Diagnostic and Statistical Manual for
Mental Disorders (DSM).
Assessment of Intelligence
The emergence of the field of clinical
psychology around the turn of the 20th century
coincided with a dispute among psychology’s
pioneers about the nature of intelligence.
Edward Lee Thorndike was among those who
promoted the idea that each person possesses
Sample Image of Rorschach Cards
separate independent intelligences, whereas
Charles Spearman led a group of theorists who Thematic Apperception Test
argued for the existence of “g” general
intelligence. • In 1935, Christiana Morgan and Henry
Murray published the Thematic
Alfred Binet and Theodore Simon Apperception Test (TAT). The TAT was
similar to Rorschach in that the test
• In response to French governments’
taker responded to cards featuring
request to determine the student’s
vague stimuli. However instead of
performance in school, Binet and
inkblots, the TAT cards depicted people
Simon created the first Binet-Simon
in scenes or situations that could be
scale in 1905. The test yielded a single
interpreted in a variety of ways.
over-all score, endorsing the concept of
“g”. Sample Thematic Apperception Test
• Lewis Terman revised Binet-Simon
In 1943, Starke Hathaway and J.C.
scale known as Standford-Binet
McKinley published Minnesota Multiphasic
Intelligence Scale in 1937.
Personality Inventory (MMPI). Test consisting 3. California Psychological Inventory
550 true-false statements. (CPI)
• A self report inventory created by
Common Personality Test Used by the
Harrison Gough in 1956.
Psychologist
• This test is made up of 434 true-false
1. Beck Depression Inventory (BDI) questions.
• Created by Aaron T. Beck in 1961.
Scales:
• It consists of 21-question multiple –
choice self-report inventory. Its - dominance - empathy
considered one of the most widely used
psychometric test fro measuring - sociability - sense of well being
depression. - responsibility - tolerance
- flexibility - social preference
- socialization - self-acceptance
- achievement - self-control

Sample BDI Results

2. Big Five Personality Traits
• Also known as the five-factor model
(FFM) developed by Ernst Tupes and Sample CPI Results
Raymond Christal in 1980.
4. Hand Test
The five factors include: • A projective technique made up of 10
1. Openness to experience (curious vs. drawings of single hand that measure
cautious) how the viewer interprets what each
hand is doing.
2. Conscientiousness (organize vs. careless) • This instrument does not necessarily
3. Extraversion (outgoing vs. reserved) measure all major aspects of personality
but does assess the individual’s
4. Agreeableness (friendly vs. challenging) behavioral tendencies.
5. Neuroticism (nervous vs. confident) 5. Rorschach Test
• Created by Hermann Rorschach in
1921.
• This test is a psychological test in which
a subject’s perceptions of inkblots are
recorded and then analyze using
psychological interpretation.
Sample • Clinical psychologists use this test to
BFPT examine a person’s personality
Results
 characteristics and emotional Chapter 3: Current Controversies in Clinical
functioning. Psychology

6. Sixteen Personality Factor Test (16 ✓ Psychiatrists are medical doctors,

PF) psychologists are not.
• A self-report personality test developed ✓ Psychiatrists prescribe medication,
by Raymond Cattell. psychologists can’t.
• 16 PF test provides a measure of ✓ Psychiatrists diagnose illness, and
normal personality and can also be used provide medicinal treatments.
by psychologist, and other mental health ✓ Psychologists focus on providing
professionals, as a clinical instrument to psychotherapy (talk therapy) to help
help diagnose psychiatric disorders and patients.
use in therapy planning.
• This test can also provide information Prescription Privileges
relevant to the clinical and counseling
process such as individuals capacity for • In recent years, clinical psychologists
insight, self-esteem, cognitive style, have actively pursued prescription
openness to change, capacity for privileges around 1990s and 2000s.
empathy, interpersonal trust, • The American Psychological Association
interpersonal needs, attitude toward offered suggestions for training of
authority, frustration tolerance coping psychologists to become proficient in the
style etc. knowledge necessary to prescribe safely
and effectively.
• In addition, several individuals such as
Patrick H, De Leon a former president of
American Psychological Association,
Morgan T. Sammons promoted the
movement towards prescribing.
• The prescription privilege movement
scored notable victories in many
countries but still this topic is being
debated across the world.
Why Clinical Psychologists Should
Prescribe
Seven (7) Reasons why clinical
psychologists should prescribe:
1) Shortage of psychiatrists
2) Non physician professionals having
privileges
3) Convenience for clients
4) Professional autonomy
5) Professional identification
6) Evolution of the profession
7) Revenue of the profession
Why Clinical Psychologists Not Should
Prescribe
Four (4) Reasons why clinical therapy with evidence-based
Psychologists should not prescribe: techniques.
1) Training issues Disadvantages of Evidence-based/
2) Threats to psychotherapy Manualized Therapy
3) Identity confusion
✓ Restrictions on Practice
4) The potential influence of the
• A therapy which is not in the list of EBT
pharmaceutical industry
manuals is unfolded and should be
Evidence-based Treatments/Manualized avoided.
Therapy • Some psychologists have used the term
malpractice in reference to the act of
Therapy treatments
using a therapy that lacks empirical
• For many decades researches in the support.
field of psychology have been ✓ Threats to the Psychotherapy
researching what are the benefits and Relationship
how therapy treatment works. • The manuals do not emphasize the
• In researching, it has been proved that meaningful human connection with the
there is no particular treatment for any clients instead they tend to emphasize
particular mental disorder but the idea techniques (how or what they do with
simply supported that treatment of a their therapists).
disorder including therapy treatment is ✓ Diagnostic Complications
more efficient than treatment without • The manuals target a particular disorder
therapy. and specifies at specific treatment for a
specific disorder.
Advantages of Evidence-based/Manualized
• The clients who are allowed into the
Therapy
study are those with target problem and
✓ Establishing Minimal Levels of without any other complicating factors
Competence but in reality, they might have some
• It reduces the competence among the other personality disorders.
psychologists. Otherwise, the
Payment Methods
psychologists will practice their own
unique brands of therapy. • In earliest days the clients paid directly
✓ Scientific Legitimacy out of pockets.
• The scientific empirical approach helps • As of today, although some clients still
the psychologists to uniformly practice pay for therapy on their own but,
the treatment of any disorder. managed care & insurance benefits
✓ Training Improvements bring therapy to many individuals who
• As a result of manualized therapy, the might not otherwise, be able to pay for it.
upcoming generations of psychologists • The companies who control these
will have educated, that have data benefits and at times their priorities can
supporting their success with particular strongly affect the work of clinical
disorder. psychologists.
✓ Decreased Reliance on Clinical
Judgement Effect on Therapy
• The Evidence-based Therapy (EBT) • The clients should receive the same
lessens the reliance on clinical treatment from psychologists regardless
judgement and enhance the outcome of of how they pay (on their own or by
 health insurance) but in reality, this may Application of Technology in Clinical
not true. Psychology
• Psychologists in private practice
• Clinical psychologist can use video
describe managed care as having a
conference to interview or treat a client.
negative impact on their practices and
• In E-mail to provide psychotherapy to a
the quality of therapy they provide.
client.
• The managed care companies are
• Interactive internet site to educate the
exercising too much control over clinical
public by responding to questions about
decisions.
mental health concerns.
• Self-pay therapy does allow the
• Online psychotherapy program to
therapist and client to make important
diagnose and treat specific diagnoses
decisions such as, establishing the goal
of the therapy, agreeing on treatment • Virtual reality techniques in which clients
method, determining the end of the undergo therapeutic experience.
therapy. • Computer-based self-instructional
• Without the intervention of the third party programs designed as specific
(private companies) with a financial components of a treatment or otherwise
interest. face to face and handheld electronic
communication devices.
Effect of Diagnosis
Emerging Professional Issues
• Psychologists diagnose clients
differently depending on how the clients • Clinical psychologist embraces new
pay for therapy. technology and incorporate them into
their practices, the profession is making
• The specific choice of diagnosis
efforts to ensure that the services
depended on somewhat on payment
provided are safe, effective and ethical.
method as well.
• In 2002 American psychological
• The wide range of problems including
association ethical code includes
symptoms of inattention / hyperactivity
several updates designed to address the
and social phobia or for symptoms that
increasing use of new technological
are clearly below diagnosable levels
tools.
psychologists, diagnostic decisions
depend on whether the client’s • Experts in this field have proposed some
insurance company pays for therapy. ethical guidelines for psychologist
practicing online, via videoconferencing
The Influence of Technology or through other similar means.
• Practice of psychology evolves those
• Health care field, clinical psychology has
providing it should follow some
been significantly affected by
fundamental suggestion and they are:
technological advance in recent years.
✓ Obtain informed consent from
• Psychologist allow to manage new
client about the services they may
technologies in their office differently
receive, the technologies that may
than they had before by handling billing,
be used to provide them, and the
records keeping and administrative task
confidentially of the
in a automated in computerized manner.
communication.
• clinical psychologist can perform
✓ Know and follow any applicable
assessment and treatment, teleheath
laws on telehealth and
means supplement to the traditional face
telemedicine
to face meeting.
✓ Know and follow the most recent Chapter 4: Cultural Issues in Clinical
version of the American Psychology
psychological association ethical
✓ Clinical psychology is a branch
code, especially the portions that
of psychology that focuses on
address technological issues.
diagnosing and treating mental,
✓ Ensure clients confidentially as
emotional, and behavioral disorders.
much as possible by using
✓ Some of the more common disorders
encryption or similar method keep
that might be treated include learning
updated on ways in which clinical
disabilities, substance abuse,
information could not be accessed
depression, anxiety, and eating
by “hackers” and techniques for
disorders.
stopping them.
✓ The field is generally considered to have
✓ Don’t practice outside the scope of
begun in 1896 with the opening of the
your expertise. Merely having
first psychological clinic at the University
license may not. be enough.
of Pennsylvania by Lightner Witmer.
✓ Be knowledgeable about
emergency resource in any The Rise of Multiculturalism in Clinical
community form which your clients Psychology
may seek services.
✓ Stay abreast of changes to the The Diversification of the U.S. Population
law’s ethical codes or technology • Cultural diversity has historically been
relevant to your practice. the hallmark of the US population, but in
recent years, the country has become
much more diverse.
• The number of people in minority
ethnicities, as well as the proportion of
the U.S. population has increased
dramatically.
• In certain parts of the country, the
increasing diversity is even more
pronounced.
• In Miami, for example the Latina
Hispanic residents represents the
majority of the population (U.S Census
bureau 2006)
• In San Francisco, the population of
Asian American represents almost one
third of the population and more than
55% of the Detroit and Washington D.C
are African Americans.
• The clinical psychologist has recognized
that the people who might seek their
professional service represents the
growing variety of cultural backgrounds.
• As individuals and as a professional,
clinical psychology are making efforts to
 sensitivity and competently address • Some books focus on a single
issues of Cultures. population like Asia Americans (Lee,
• As stated by Mcgoldrick and Giordano 1997) or Psychotherapy with Women
(2005) “we must incorporate cultural (Mirkin, 2005).
acknowledgement into theories and to • Collectively, these publications
our therapies, so that clients not of the represent a wealth of cultural knowledge
dominant culture do not have to feel for contemporary clinical psychologists
displaced or mystified. and the importance of the topic.
Multiculturalism as the fourth force Emergence of American Psychological
Association Divisions
• The impact of cultural issues on mental
health Professional in recent years has • Divisions 35 – Society for the
been so extensive so some authors Psychology of Women
have identified multiculturalism as a • Division 36 – Psychology of Religion
defining issue of the current era of the • Division 44 – Society for the
psychology. Psychological Study of lesbian, Gay,
• For example, Pederson (1999) has put and Bisexual issues
forth arguments in the evolution of the • Division 45 – Society for the Study of
Clinical/Counseling field, Ethnic Minority Issues
multiculturalism represents the fourth • Division 51 – Society for the
force. Psychological Study of Men and
• Psychoanalysis is the first force, Masculinity
behaviorism is the second force,
humanism/person-centered is the third APAEC – American Psychological
force. Association Ethical Code

Multiculturalism doesn’t necessarily aim to • Numerous specific standards and

dethrone any of the first three forces, instead it Principle in the most recent edition of
enhances and strengthens existing models by the American Psychological Association
infusing with sensitivity and awareness how Ethical Code compel Psychologists to
they can be best applied to the individual of work with cultural sensitivity and
diverse cultural backgrounds. competence.
• Their inclusion as standards makes it
Recent Professional Efforts to Emphasize clear that awareness of diversity issues
Issues of Culture is a requirement rather than merely an
Clinical psychology has addressed the issue of aspiration for ethical psychologists.
cultural diversity in many tangible ways. • Seal of Approval in other words
accreditation to a graduate program in
Journal and Books: psychology.
• Scholarly journals – Articles on Cultural • Multiculturalism is a primary focus.
Topics • In recent edition, “Cultural and Individual
• Psychology journals – Issues of Culture Differences and Diversity” is one of the
eight Domains must be addressed.
Books • Specifically, including people of diverse
• Offer education and guidance to backgrounds among students and
psychologists working with culturally faculty.
diverse populations.
 • Educating students about the role of • The word client defines the person
culture in the science and practice of who’s receiving services from
Professional Psychology. Therapist and medical doctors.
Cultural Competence Etic Versus and Emic Versus Perspective
Cultural competence begins with • These two terms were coined by
learning about one’s culture – not only on the Kenneth Pike in 1954.
basic facts such as where one’s parents or • ETIC perspective emphasizes the
ancestors came from but also the values, similarities among all people. It assumes
assumptions, and biases that has developed universality among all people and
as a result of all cultural influences. generally do not consider differences
between cultural groups.
When Clinical psychologist attains
cultural self-awareness, he/she must learn to • EMIC perspective differs from the etic
understand that client’s viewpoint is unique and perspective because it recognizes and
conclusions are within reach. emphasizes culture specific norms. A
psychologist employing emic
The process of cultural self-awareness perspective consider multiculturalism-
can be difficult or unpleasant for psychologist, concern with the client’s behavior,
because it may require admitting and coming to thoughts, and feelings within the context
terms with some undesirable, sexism, of clients’ own culture.
heterosexism, racism or similar prejudicial or
discriminatory belief system that sometimes Difference Between Etic and Emic
manifest by the psychologist. Etic Emic
Culturally Appropriate Clinical Skills Emphasizes Emphasizes
similarities between differences between
• Once the psychologist has attained the cultures. cultures.
cultural knowledge of self and the clients Assumes behavior Behavior patterns
the next step is to develop suitable patterns are are unique to a
strategies for assessment and universal. culture.
treatment. Outsider perspective. Insider perspective.
• “Talk therapy” may work well for many, ‘Objective’ ‘Subjective’
but for some cultural groups it may be a Ex: Etoro boys are Ex: Etoro boys
bad fit. sexually abused participate in rituals
• Similarly, clients for some culture may when they are taught that turn them into
place a great value on “insight” into their to fellate elders. men and give them
life force they need
psychological problems obtained over
to be successful.
many months, but clients from other
Using etic concept of Using emic concept
cultures may respond much more
sexual abuse. that their ritual is
positively to action-oriented therapies unique.
with a short-term focus.
Are We All Alike or All Different?
What constitutes a culture?
• The discussion of culture issues brings Culture is the characteristics and
some important and fundamental knowledge of a particular group of people
questions about humans, that are encompassing a languages, religion, social
applicable to psychologists and clients. habits, music and arts. If clinical psychologists
will function in a culturally competent and
sensitive way, it makes sense to consider what Foard and Arrendo (2016) – Identified seven
exactly we refer when we say "culture “. specific “critical elements of a multiculturalism
influenced psychology curriculum”.
Therapists can educate themselves about:
1) Commitment to diversity.
✓ LGBT clients
2) Recruit graduate students from diverse
✓ Disabled clients
population.
✓ Rural clients
3) Recruit and retain a diverse faculty.
✓ Low-income clients
4) Made admission process fair and
✓ Other specific groups
equitable.
Interacting Cultural Variables 5) Awareness of their own culture values
and biases.
Ethnicity and race may be most important 6) Culture-centered approach throughout
for certain clients. the curriculum.
For example: Lots of culture variables may 7) Evaluate student on their competence
interact in unique ways to shape the life on a regular basis.
experience of a client. Hardly and Laszloffy (1992) describe
Training Psychologists in Culture Issues numerous ways in which self-knowledge can
be examined during training like in class
Increasing responsibility to train discussion, class presentation, self-guided
psychologists to become culturally sensitive and assignments, and assigned discussion with
competent. one’s own family of origin.
Educational Alternatives
✓ Graduate programs have variety of
approach.
✓ One or more courses designed to
address culture issues.
✓ Some graduate programs may weave
culture training such as
✓ Psychotherapy, assessment and
research.
✓ Culture issues emphasizes real world
experience with individual of diverse
culture.
✓ Reading different books and discussing
about different culture in class
immersing oneself in that culture.
✓ Some training programs interact directly
with the cultural groups.
✓ “No Best Method” OR consensus
(agreement made by group) has
emerged for training psychologists.
✓ Leaders in this field have to identify
essential components for graduate
training program.
 Chapter 5: Ethical Issues in Psychology whom they work. They are aware of
their professional and scientific
American Psychological Association Code
responsibilities to society and to the
of Ethics
specific communities in which they
• Published the first code of ethics in work.”
1953. 3. Integrity
• Code is applied not only in clinical • Integrity – the quality of being
psychologists but to all psychologists’ honest and having strong moral
specialties. principles; moral uprightness.
• These guidelines are relevant to the • “Psychologists seek to promote
common professional activities of clinical accuracy, honesty, and truthfulness
psychologists, such as therapy, in the science, teaching, and practice
assessment, research and testing. of psychology.”
4. Justice
General Principles (aspirational) and Ethical • Justice – the quality of being or fair,
Standards (enforceable) conformity to truth, fact or reason.
• They describe an ideal level of ethical • “Psychologists recognize that
functioning. fairness and justice entitle all
• They don’t include specific definition of persons to access to and benefit
ethical violation instead; they offer broad from the contributions of psychology
descriptions of the exemplary ethical and to equal quality in the processes,
behavior. procedures, and services being
• 5 General Principles: Beneficence and conducted by psychologists.”
Nonmaleficence, Fidelity and 5. Respect for the People’s Rights and
Responsibility, Integrity, Justice and Dignity
Respect for the People’s Right and • Confidentiality – Psychologist have
Dignity a primary obligation and take
reasonable precautions to protect
American Psychological Association confidential information since our
General Ethical Principles profession is entrusted by the public.
1. Beneficence and Nonmaleficence • “Psychologists respect the dignity
• Beneficence is action that is done and worth of all people, and the
for the benefit of others. rights of individuals to privacy,
• Non-maleficence means to “do no confidentiality, and self-
harm.” determination.”
• “Psychologist strive to benefits those Ethical Standards of the Ethical Code
with whom they work with and take
care to do no harm” Ethical Code should be understood not
2. Fidelity and Responsibility only as a list of rules to follow and mistakes to
• Fidelity – the quality of being faithful avoid but also as a source of inspiration for
and trustworthy. ethical behavior of the highest order.
• Responsibility – having an Two Approaches to Ethics
obligation to do something or having
control over or care for someone as ✓ Remedial Approach – doing just
part of one’s job or role. enough to avoid any trouble or violation
to ethical standards.
• “Psychologists establish
relationships of trust with those with
 ✓ Positive Approach – making every 7. Monitor and evaluate the effectiveness
effort to that one’s professional behavior of your course of action.
was consistent with ethical principles. 8. Modify and continue to evaluate the
ethical plan as necessary.
American Psychological Association
Ethical Standards Confidentiality
1) Resolving Ethical Issues • Confidentiality is specifically mentioned
2) Competence among the General Principles and
3) Human Relationships numerous specific Ethical Standards,
4) Privacy and Confidentiality including Standard “Maintaining
5) Advertising And Other Public Confidentiality” which begins,
Statements “Psychology have a primary obligation
6) Record Keeping and Fees and take reasonable precautions to
7) Education And Training protect confidential information.”
8) Research And Publication • Our profession is entrusted by the public
9) Assessment to provide professional services without
10) Therapy sharing the private, personal details
offered in the process.
Ethical Decision Making
When the client is a child or adolescent…
A clinical psychologist should be
equipped with a process by which to make the • Therapists working with minor clients
most ethical decision possible. often negotiate an arrangement with
Celia Fisher their clients and their parents whereby
the parents will not expect to be
• Decoding the Ethics Code (2003( informed of what the client discloses in
• Proposes an eight- step model for therapy except under specified
ethical decision making. conditions.
• Tarassoff Ruling – some situations
Eight-Step Model for Ethical Decision
demand that the clinical psychologist
Making
primary responsibility sift to the
1. Prior to any ethical dilemma arising, immediate prevention of harm.
make a commitment to doing what is
Psychologist’s Ethical Beliefs
ethically appropriate.
2. Become familiar with the American • The American Psychological
Psychological Association ethical codes. Association’s (APA) ethical code may
3. Consult any law or professional instruct psychologists on how to conduct
guidelines relevant to the situation. themselves ethically.
4. Try to understand the perspectives of • Although the APA’s ethical code serves
various parties affected by the actions as a guiding force, the beliefs of the
you may take. Consult with colleagues psychologists actually hold, which
(always protecting with confidentiality) corresponds strongly with the behaviors
for additional input and discussion. they conduct, may be subject to other
5. Generate and evaluate your influences.
alternatives.
6. Select and implement the course of Informed Consent
action that seems most ethically
appropriate.
 • It is used in research, assessments and • Clinical Psychologist who works and
psychotherapy to inform the clients or live in small communities always
participants. experience ethical challenges,
• Psychologist informs prospective defined by ethnicity, religion or
participants about numerous aspects of sexual orientation, or on military
the study including its purpose, bases, small colleges or similar
procedures, and length of time it may settings.
require, any predictable risks or adverse • Multiple Relationships refers to any
effects, incentives for participation and situation where multiple roles exist
the right to decline or withdraw from between a therapist and a client.
participation. • Multiple Relationships forms when a
• Psychologist inform clients/patients as psychologist knows one person both
early as is feasible in the therapeutic professionally and non-professionally
relationship about the nature and and also when psychologist has a
anticipated course of therapy, fees, relationship with someone closely
involvement of third parties, and limits of associated with or related to the
confidentiality and provide sufficient client.
opportunity for the client/patient to ask
APA Ethical Standards
questions and receive answers (APA,
2002). 1) Multiple Relationships
2) Competence
Contemporary Ethical Issues
3) Ethics in Clinical Assessment
1) Managed Care and Ethics 4) Ethics in Clinical Research
• Manage care companies can put
Multiple Relationships
clinical psychologist in a position of
divided loyalty. • It is unethical for psychologists to
• They may be professionally engage in multiple relationships with
pressured to minimized the services their client or somebody closely related
they provide to limit the cost of to their client.
mental health care. • It is unethical for psychologists to make
• They may be professionally promises to enter another relationship
pressured to minimized the services with their client or somebody closely
they provide to limit the cost of related to their client.
mental health care.
Multiple relationships, as defined by the
2) Technology and Ethics
APA, is:
• In recent years, technological
advances have led to changes in the ✓ the occurrence of both professional and
practice of clinical psychology. non-professional relationship between
• On-line Psychological tests that have the psychologist and the client;
questionable validity or reliability and ✓ the presence of relationship between the
inaccurate feedback and distresses psychologist and somebody related to
the client the client; and
• Clinical Psychologist who creates or ✓ the presence of promises in part of the
uses unscientifically sound tests may psychologist to enter in a non-
be engaging in unethical practice. professional relationship with the client
3) Ethics in Small Communities or somebody related to the client.
What Makes Multiple Relationship • Participants in control group of
Unethical? psychotherapy efficacy research are
most commonly placed in 1 of 3
It is unethical because:
conditions: 1) no treatment, 2) placebo
✓ It negatively affects the psychologist’s treatment, 3) alternate treatment.
objectivity, competence and
effectiveness in doing his/her functions
as a psychologist; and
✓ It gives rise for the opportunity of either
party to exploit or harm the other.
Competence
• It is in ethical standard for all
psychologists to be competent of their
professional tasks.
• They must only provide services,
teachings and conduct research within
their competence boundaries based on
their education, training and experience.
• Psychologists need not only be
competent; they must also remain
competent throughout their professional
career.
• Among the many aspects of
competence, cultural competence is the
one they must demonstrate.
• Psychologists are also suggested to
take actions to prevent or reduce their
professional burnout that affects their
performance.
Clinical Assessment
• Psychologists are obligated to select
test appropriate for the purpose of
assessment and the person being
tested.
• Psychologists are obligated to protect
the security and integrity of the test
materials they use.
• They are also obligated to release test
data to clients on request.
Clinical Research
• Psychologists should be careful not to
mistreat or harm the research
participants in the process.