Professional Ethics in Clinical psychology Mid-term notes

 Introduction to the American Psychological Association (APA) – Focus

on Psychology and Ethics

The American Psychological Association (APA) is the premier professional organization for
psychologists in the United States, playing a vital role in shaping the scientific, educational, and
ethical standards of the field of psychology. Since its founding in 1892, APA has worked to
advance psychology as a science, profession, and means of promoting health, education, and
human welfare.

The American Psychological Association (APA) is the leading scientific and professional
organization representing psychology in the United States. Founded in 1892 at Clark University
in Worcester, Massachusetts, the APA has grown to become one of the largest psychological
associations in the world, with over 130,000 members, including researchers, educators,
clinicians, consultants, and students.

 APA’s Role in Psychology

1. Advancement of Psychological Science:

 APA supports research in psychology by funding studies, publishing scientific journals,

and promoting evidence-based practice.
 It publishes some of the most respected journals in the field, including American
Psychologist, which disseminates innovative research and theoretical insights.

2. Setting Educational Standards:

 APA accredits doctoral-level psychology programs, internships, and postdoctoral

residencies.
 It establishes training guidelines that ensure psychologists are well-prepared to work in
clinical, educational, research, and organizational settings.

3. Supporting Psychological Practice:

 APA provides resources for licensed psychologists to maintain competence, engage in

continuing education, and follow best practices in clinical and applied settings.

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  It addresses important areas in mental health such as trauma, addiction, anxiety,
depression, and cultural competency.
 Mission and Goals

The APA’s mission is to:

 Advance the creation, communication, and application of psychological knowledge to

benefit society and improve lives.
 Promote research-based practice in the field of psychology.
 Set professional standards and ethical guidelines for psychologists.
 Advocate for psychology in public policy, education, and health care.
 Organizational Structure

The APA is governed by:

 A Council of Representatives: The main decision-making body.

 A Board of Directors: Oversees the association’s administrative functions.
 Various Divisions: APA has 54 divisions that focus on subfields of psychology, such as
clinical, developmental, forensic, educational, and industrial-organizational psychology.
 State and territorial psychological associations: These are affiliated with APA and
operate at the local level.
 Functions and Contributions

1. Publication and Research:

 APA is a major publisher of scholarly journals, books, and databases.

 It publishes over 90 scientific and professional journals, including American Psychologist
and Journal of Abnormal Psychology.
 It manages PsycINFO, a comprehensive database of psychological literature.

2. APA Style and Writing Standards:

 APA developed the APA Style, a widely used format for writing academic papers in the
social sciences.
 The Publication Manual of the APA provides guidelines on citation, formatting, and
writing clarity.

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3. Education and Accreditation:

 APA accredits doctoral programs in psychology, internships, and postdoctoral residencies.

 It sets educational and training standards for psychological practitioners and researchers.

4. Ethics and Professional Practice:

 APA maintains the Ethical Principles of Psychologists and Code of Conduct, which
outlines ethical behavior for professionals.
 It investigates complaints and offers guidance on ethical dilemmas.

5. Advocacy and Public Policy:

 APA engages in advocacy efforts to influence public policy on mental health, education,
scientific research, and more.
 It provides psychological insights on national and global issues, such as climate change,
racism, and social justice.

6. Support for Psychologists and Students:

 APA offers resources for career development, licensing information, continuing

education, and grants/funding.
 It provides special support and networking for students and early-career psychologists.
 Global Impact and Collaboration

Though based in the U.S., APA works with international psychological organizations to promote
global mental health, research collaboration, and cultural understanding in psychology.

 Principles of the American Psychological Association (APA)

The APA Ethical Principles of Psychologists and Code of Conduct are divided into:

A. General Ethical Principles (aspirational guidance)

B. Enforceable Ethical Standards (rules for conduct)

A. General Ethical Principles (Divisions, Motives, and Examples)

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These principles guide psychologists toward high ethical ideals. They are not enforceable, but
they provide a moral foundation for professional conduct.

1. Principle A: Beneficence and Nonmaleficence

Division: Human Welfare

Motive:

 Promote well-being (beneficence)

 Avoid causing harm (nonmaleficence)
 Stay aware of how personal or situational factors may affect others.

Example:

A psychologist working with a trauma survivor realizes that one of the therapy techniques is
triggering flashbacks. She discontinues that approach and switches to a gentler intervention (e.g.,
grounding techniques), prioritizing the client's emotional safety.

2. Principle B: Fidelity and Responsibility

Division: Professional Relationships

Motive:

 Build trust in professional relationships

 Uphold standards of conduct
 Take responsibility for ethical behavior
 Promote ethical practices among colleagues

Example:

A clinical supervisor notices that a trainee is breaching client confidentiality. Rather than
ignoring the mistake, the supervisor takes responsibility by providing guidance, correcting the
behavior, and reporting it if necessary to maintain ethical standards.

3. Principle C: Integrity

Division: Honesty and Truthfulness

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Motive:

 Ensure honesty, accuracy, and truthfulness

 Avoid deception unless ethically justified (e.g., research purposes)
 Maintain transparency in communication

Example:

A psychologist conducting a research study informs participants about the use of minor
deception (e.g., a confederate posing as another participant) and ensures a full debrief afterward,
explaining the study’s purpose and reasoning for the deception.

4. Principle D: Justice

Division: Fairness and Equality

Motive:

 Ensure fair access to psychological services and benefits

 Prevent unjust practices, bias, or discrimination
 Recognize limitations in competence to avoid unfair treatment

Example:

A school psychologist avoids using a standardized test that has been shown to be culturally
biased against non-English-speaking students. Instead, they use culturally adapted assessments
and consult with cultural experts to ensure fairness.

5. Principle E: Respect for People’s Rights and Dignity

Division: Individual Rights

Motive:

 Uphold dignity, privacy, and autonomy

 Ensure informed consent and confidentiality
 Respect cultural, individual, and role differences

Example:

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A psychologist working with a deaf client arranges for a professional sign-language interpreter
and ensures all therapy materials are accessible, thus respecting the client’s communication
rights and cultural identity.

II. Enforceable Ethical Standards

These are mandatory and legally binding standards, drawn from the five General Principles
above. They are divided into ten key areas:

1. Resolving Ethical Issues – Reporting misconduct, cooperation with ethics committees

2. Competence – Working within areas of expertise

3. Human Relations – Avoiding discrimination, harassment, or multiple relationships

4. Privacy and Confidentiality – Protecting sensitive client information

5. Advertising and Public Statements – Honest marketing

6. Record Keeping and Fees – Accurate documentation and fair billing

7. Education and Training – Ethical teaching and supervision

8. Research and Publication – Honest, ethical research practices

9. Assessment – Using valid and fair testing tools

10. Therapy – Ethical therapeutic practices and boundaries.

 Core Ethical Principles in Psychotherapies

1. Informed Consent

Definition:

Informed consent means that the client is given clear, accurate, and sufficient information to
make a voluntary decision about participating in therapy.

Importance:

 Respects the client’s autonomy

 Promotes transparency and trust

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  Ensures clients know their rights

Key Elements:

 Nature and purpose of therapy

 Therapist’s qualifications
 Expected duration and frequency of sessions
 Fees and billing information
 Risks and benefits
 Limits of confidentiality
 Client's right to withdraw

Example:

Before starting treatment, a therapist explains to a client how Cognitive Behavioral Therapy
(CBT) works, what outcomes to expect, and that the client can stop at any time. The therapist
provides a written consent form that the client signs after discussion.

2. Confidentiality

Definition:

Confidentiality is the obligation of the therapist to protect the privacy of the client's information.

Importance:

 Builds client trust

 Encourages openness
 Protects client’s personal and sensitive information

Limits to Confidentiality:

Therapists may break confidentiality when:

 A client is a danger to themselves (e.g., suicidal) or others (e.g., threats of violence)

 There is suspected abuse of a child, elder, or vulnerable adult
 Ordered by a court of law

Example:

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A teenager tells the therapist about suicidal thoughts. The therapist explains that they must
inform the parents or appropriate services to ensure the teen's safety, even though it's a breach of
confidentiality.

3. Justice

Definittion:

Justice refers to fairness, equity, and equal access to psychological services. In psychotherapy,
this means treating clients fairly regardless of their background, identity, or socioeconomic
status, and ensuring that no one is unfairly discriminated against or denied care.

🌟 Importance:

 Promotes social equality in mental health care.

 Prevents bias, discrimination, and favoritism in treatment.
 Encourages inclusive therapeutic practices that respect all clients.
 Upholds the idea that all individuals deserve competent psychological help.

🚫 Limits:

 Therapists may still face institutional or systemic limitations (e.g., limited access to
services for rural or low-income clients).
 Therapists may not always be able to provide equal treatment due to time, resources, or
personal competence limitations.
 Fair treatment does not mean identical treatment—clients with different needs require
tailored interventions.

💡 Example:

A therapist offers sliding-scale fees to ensure that clients from low-income backgrounds can still
receive therapy, while maintaining quality and professionalism for all clients regardless of
financial situation.

4. Integrity:

Definition:

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Integrity involves honesty, truthfulness, and transparency in all professional activities. In
psychotherapy, it means being honest about your qualifications, not misleading clients, and
avoiding deception unless ethically justified (such as in rare research contexts).

🌟 Importance:

 Builds trust between therapist and client.

 Ensures that clients are not misled about therapy outcomes, diagnoses, or the therapist's
capabilities.
 Encourages accountability and professionalism in clinical practice.

🚫 Limits:

 Complete honesty must be balanced with therapeutic sensitivity (e.g., disclosing certain
truths too bluntly could harm the client).
 Some limited deception may be ethically permitted in research under strict guidelines and
when it serves a valid scientific purpose, with debriefing afterward.
 Therapists may also need to withhold certain information temporarily if it is in the
client’s best therapeutic interest (e.g., delaying a diagnosis reveal until the client is
ready).

💡 Example:

A therapist avoids guaranteeing success or promising a cure. Instead, they explain that therapy is
a collaborative process and progress depends on multiple factors like participation, time, and
readiness for change.

4. Competence

Definition:

Competence means that a therapist must have the proper education, training, and skills to treat
specific issues.

Importance:

 Ensures effective and safe treatment

 Protects clients from harm

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  Promotes professional integrity

Example:

A therapist trained in general anxiety disorders receives a client with complex PTSD.
Recognizing that trauma therapy requires special expertise, the therapist refers the client to a
trauma specialist.

5. Avoiding Dual or Multiple Relationships

Definition:

A dual relationship occurs when the therapist has another significant relationship with the client
outside of therapy (e.g., friend, teacher, business partner).

Importance:

 Prevents exploitation and bias

 Maintains clear professional boundaries
 Protects the therapeutic alliance

Example:

A therapist refuses to take on their cousin as a client, recognizing that personal involvement
would impair objectivity and potentially harm the relationship and therapy.

6. Cultural Competence and Non-Discrimination

Definition:

Therapists must understand and respect cultural, religious, gender, sexual orientation, and other
individual differences without discrimination.

Importance:

 Ensures inclusive, respectful therapy

 Reduces cultural misunderstandings
 Promotes equality in psychological care

Example:

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A therapist working with a transgender client avoids assumptions, uses correct pronouns, and
adjusts their therapeutic approach to be affirming and respectful of the client's gender identity.

7. Beneficence and Nonmaleficence

Definition:

These principles mean doing good for the client (beneficence) and avoiding harm
(nonmaleficence).

Importance:

 Ensures the client’s welfare is the top priority

 Encourages ethical decision-making, especially in difficult cases

Example:

A client has severe anxiety. The therapist chooses gradual exposure therapy instead of immediate
confrontation of fears to avoid overwhelming the client.

8. Maintaining Professional Boundaries

Definition:

Therapists must maintain emotional and physical boundaries with clients to ensure the
relationship remains professional and safe.

Importance:

 Prevents emotional or physical exploitation

 Preserves therapeutic objectivity

Example:

A therapist avoids meeting clients in private social settings or forming friendships during or after
therapy to maintain professional distance.

9. Ethical Termination of Therapy

Definition:

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Ending therapy must be done responsibly and in the client’s best interest, with planning and
discussion.

Importance:

 Avoids abrupt discontinuation of support

 Ensures client has follow-up care or resources if needed

Example:

If a therapist is relocating, they inform their clients well in advance, offer referrals to new
therapists, and ensure the client’s treatment is transitioned properly.

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