Tag Archives: Risk Management

Ethics & Risk Management – New Online CE Course

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Ethics & Risk Management: Expert Tips 10 is a new 3-hour online continuing education (CE) course that addresses a variety of ethics and risk management topics in the form of 26 short articles, written by experts in the field.

Ethics & Risk Management: Expert Tips 10 is a 3-hour online CE course that addresses a variety of ethics and risk topics in the form of 26 short articles.

Topics include:

  • What Happens Next? Confidentiality after Death – Considers the legal and ethical issues of sharing confidential client records after a patient’s death.
  • Out-of-Office Encounters May Be Beneficial – Discusses the importance and benefits of out-of-office therapy sessions and encounters with clients.
  • Court Cases, Market Forces – An overview of court cases that highlight the ways in which regulatory boards may be at risk for an FTC complaint or federal suit.
  • Closing Practice Not for Faint of Heart – Describes the emotional toll that closing a private practice may have on clinicians and offers practical advice on how to prepare for this transition.
  • Fee Splitting is Unethical, and Sometimes Illegal – Describes the ins and outs of fee splitting and how to remain both ethical and legal in practice.
  • 3 Questions to Ask HIPAA Vendors – Offers three important questions to consider when selecting a HIPPA service.
  • Confronting Dissatisfaction with Professional Services – Provides twelve risk management strategies for practitioners to minimize, and hopefully avoid, consumer dissatisfaction and ethical/legal complaints.
  • Advertising Offers Must be Ethical – Explores how to advertise psychological services both ethically and legally.
  • Choosing Interpreter Requires Considerations – Raises points to consider when choosing an interpreter for use in clinical practice.
  • Mass Shootings Unfairly Stigmatizing Mentally Ill – Highlights the issues surrounding media exposure and violent gun crimes, reminding clinicians of the ethical issues regarding mental health and gun violence.
  • Court Ruling Could Affect Psychologists – The author reflects upon the court rulings in the case of Byrne v Avery Center to highlight the difference between privilege and confidentiality when patient records are under subpoena.
  • Employee vs Independent Contractor – Why it Matters – Outlines criteria for determining if a clinician should be designated as an employee or independent contractor.
  • Self-Care is Essential to Risk Management – Explains the importance of self-care, not only for the clinician’s health, but for the good of the practice.
  • Telepsychology Takes Special Training – An overview of essential elements to consider before launching a telepsychology practice.
  • New Lawsuit Revives Issue of Duty to Warn – Reminds practitioners of the Duty to Warn of potential threatening behavior from patients, and recommends keeping up to date with specific state laws.
  • Calling out Microaggressions: An Ethical Obligation – Shares an example of a microaggression and suggests a structured, easy to remember, strategy for intervention.
  • What Kind of Liability Insurance is Best? – Discusses the difference between an Occurrence insurance policy and a Claims-Made policy.
  • Managing Intoxicated Patients – Provides an overview of common situations and factors practitioners should prepare for and to inform their professional decision making when encountering an intoxicated patient.
  • Sexually Kinky Clients Present Ethical Issues – Weighs the ethical issues that accompany treating patients who engage in kinky behaviors.
  • Special Considerations Needed When Working with First Responders – Outlines the difficulties psychologists may encounter in treating first responders and provides suggestions on how to overcome the ethical challenges that may arise during treatment.
  • Touching Not Always a Violation – Examines the need for discrepancy and compassion when supporting clients and lists the Zur Institute’s Risk Management guidelines.
  • Child Porn Poses Ethical Dilemma – Clarifies the conflict that a therapist faces when patients reveal they are watching pornography online.
  • How to Ethically Increase Access to Care During COVID-19 – Considers the importance of thoughtfully navigating the ethics of billing and payment during the pandemic.
  • Therapy in the Time of COVID-19: A Look at One Ethical Issue – Provides a principle-based decision-making model to guide clinicians who are faced with patients who express intent to circumvent public health measures, placing the well-being of others at risk.
  • ‘Please Don’t Tell My Surgeon’: Managing Privacy, Confidentiality in Integrated Healthcare Settings – Discusses the ethical challenges practitioners may face when working in an integrated healthcare setting.
  • Minority IQ Scores Boosted to Enable Execution – Examines the issue of boosting IQ scores for minorities in sentencing and briefly explains the outcomes of relevant court cases.
  • A Guide to Child Custody Evaluations and Expert Testimony – Shares key points to bear in mind before becoming involved with child custody evaluations and expert testimony.
  • Seeing Domestic Violence Through Another Lens – Considers how men, who are victims of domestic violence, are overlooked and underserved.
  • Talk of Risks, Side Effects May Lead to Nocebo Effect – Suggests ways to reduce the frequency and severity of Nocebo Effects.

Course #31-39 | 2022 | 55 pages | 20 posttest questions

Click here to learn more about Ethics & Risk Management

This Ethics & Risk online course provides instant access to the course materials (PDF download) and CE test. The course is text-based (reading) and the CE test is open-book (you can print the test to mark your answers on it while reading the course document).

Successful completion of this course involves passing an online test (80% required, 3 chances to take) and we ask that you also complete a brief course evaluation. Click here to learn more.

Click here to view all ethics & risk courses.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for this program and its content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the Continuing Education Board of the American Speech-Language-Hearing Association (ASHA Provider #AAUM); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Arizona Board of Occupational Therapy Examiners; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology and Office of School Psychology, Speech-Language Pathology and Audiology, Dietetics and Nutrition, and Occupational Therapy Practice; the Georgia State Board of Occupational Therapy; the Louisiana State Board of Medical Examiners – Occupational Therapy; the Mississippi MSDoH Bureau of Professional Licensure – Occupational Therapy; the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists (#PSY-0145), State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135) and marriage and family therapists (#MFT-0100), and the State Board for Social Workers an approved provider of continuing education for licensed social workers (#SW-0664); the Ohio Counselor, Social Worker and MFT Board (#RCST100501) and Speech and Hearing Professionals Board; the South Carolina Board of Examiners for Licensure of Professional Counselors and Therapists (#193), Examiners in Psychology, Social Worker Examiners, Occupational Therapy, and Examiners in Speech-Language Pathology and Audiology; the Tennessee Board of Occupational Therapy; the Texas Board of Examiners of Marriage and Family Therapists (#114) and State Board of Social Worker Examiners (#5678); the West Virginia Board of Social Work; the Wyoming Board of Psychology; and is CE Broker compliant  (#50-1635 – all courses are reported within a few days of completion).

Enjoy 20% off all online continuing education (CE/CEU) courses @pdresources.org! Click here for details.

Earn CE Wherever YOU Love to Be!

Ethics & Risk Management – New Online CE Course

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Ethics & Risk Management: Expert Tips 9 is a new 3-hour online continuing education (CE) course that addresses a variety of ethics and risk management topics in the form of 26 short articles, written by experts in the field.

Ethics & Risk Management: Expert Tips 9 is a new 3-hour online continuing education (CE) course that addresses a variety of ethics and risk management topics in the form of 26 short articles, written by experts in the field.

The articles included in Ethics & Risk Management 9 are:

  • Addressing Boundary Issues – Discusses the risks, benefits, and ethics of boundary crossings and multiple relationships in therapy.
  • Consider Risks When Contracting with Commercial Teletherapy Companies – Highlights the risks and provides suggestions for working in e-therapy.
  • Ethical Considerations in Hospital Settings – Discusses the unique ethical challenges professionals in hospital settings face.
  • What is a Disability, Anyway? – Discusses the legal considerations involved in certifying a patient as “disabled” or having a “disability related need.”
  • Pre-Employment Evaluations for Police and Public Safety – Reviews clinical criteria for completing pre-employment psychological evaluations.
  • Exposure Varies in Alternative Practice Models – Discusses potential risks and benefits of alternative practice models.
  • Confidentiality Limited for Service Members – Provides guidance for civilian clinicians that provide mental health services to members of our military.
  • To Terminate or Not to Terminate? – Offers practice tips for clinicians to use when considering terminating therapy with clients.
  • Investigation Notice Not Cause for Panic – Illuminates steps you can take to prepare yourself and your practice, now and ahead of time, for the inevitable complaint.
  • Duty to Warn: Don’t Get Distracted by Legal Cases – Evaluates that laws may change, but the focus of “duty to warn” stays the same.
  • Taking on a Supervisee – An overview of best practice tips practitioners would be wise to consider before beginning a supervisory role of their own.
  • African American Families, Diversity and Ethics – A navigators’ guide to traversing the complexity of African American diversity with integrity and effective professionalism.
  • Protect Yourself from Ransomware – Explores common cyber-security threats and what can be done to mitigate these risks to your practice.
  • The Importance of Informed Consent – An answer to the question, “When and which elements of informed consent are required in the case of court-ordered evaluation?”
  • Laws/Rules Vary for Telepsychology Practice – Discusses the need for researching the ethical and legal guidelines before offering telepsychology services.
  • Working Ethically with LGBTQ Clients – Explores complications that can arise when treating sexual and gender minority clients and offers suggestions to help the clinician.
  • Deaf or Hard-of-Hearing Clients Require Special Ethical Consideration – Provides a look at why it is important to offer interpreters to HOH or deaf clients and the ethical concerns associated with it.
  • How to Fine Tune Consultations – Offers advice on how to determine when a consultation may be necessary and who may be best equipped to provide you the necessary information.
  • High Quality, Well Documented Patient Care is Risk Management – Explains how developing habits of good practice and judicious competence underlie risk management protocols.
  • Ethics of Technology and Clinician Responsibility – Differentiates between psychological testing and assessment of patients and highlights the importance of the clinician’s expertise in the process.
  • Unique Peer Consultation Issues in Rural Alaska – Highlights the need for developing connections with trusted peers, who can support the clinician living and working in a rural Alaskan community.
  • Therapists Vulnerable to Sexual Misconduct Accusations – Reminds practitioners of the importance of having effective policies, practices, and education in place to protect oneself against allegations of misconduct.
  • When Being Too Helpful Can Backfire – Discusses the difference between ‘good customer service’ and a therapeutic relationship.
  • How to Handle Conflicts of Ethics and the Law – Provides examples of times when the Ethics Code conflicts with the law and offers strategies to resolve these conflicts.
  • Managing Risks of Telepsychology – A brief overview of the possible risks associated with telepsychology.
  • Supervising in the Age of #MeToo, Trigger Warning and Safe Spaces – A look at the nuances of interactions between supervisors and supervisees in light of the current social and political climate.

Course #31-22 | 2019 | 51 pages | 26 posttest questions

Click here to learn more.

Ethics & Risk Management 9 provides instant access to the course materials (PDF download) and CE test. The course is text-based (reading) and the CE test is open-book (you can print the test to mark your answers on it while reading the course document).

Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.

Have a question? Contact us. We’re here to help!

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Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Georgia State Board of Occupational Therapy; the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135); the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

PDR offers over 150 accredited online CE courses for healthcare professionals. 

Target Audience: Psychologists, School Psychologists, Counselors, Social Workers, Marriage & Family Therapists (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), and Teachers

Enjoy 20% off all online continuing education (CE/CEU) courses @pdresources.org! Click here for details.

Earn CE Wherever YOU Love to Be!

Wisconsin Psychologists License Renewal & CE

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Wisconsin psychologists have an upcoming license renewal deadline of September 30, 2019. The following continuing education (CE) requirements must be met in order to renew:

CE Required: 40 hours every 2 years 
Online CE Allowed: No limit if APA approved
License Expiration: 9/30, odd years 
National Accreditation Accepted: APA
Notes: 6 hours in ethics, risk management, or jurisprudence each renewal

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor online CE for Wisconsin psychologists and offers 20% off all courses:

Wisconsin psychologists save 20% on CE @pdresources.org

Use coupon code PDR451 at checkout to redeem. Coupon valid on all future orders thru 12/31/2019.

Click here to view online CE courses for Wisconsin psychologists.

Information obtained from the Wisconsin Psychology Examining Board website on July 30, 2019.

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Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Georgia State Board of Occupational Therapy; the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135); the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

PDR offers over 150 accredited online CE courses for healthcare professionals. 

Target Audience: Psychologists, School Psychologists, Counselors, Social Workers, Marriage & Family Therapists (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), and Teachers

Enjoy 20% off all online continuing education (CE/CEU) courses @pdresources.org! Click here for details.

Earn CE Wherever YOU Love to Be!

When Being Too Helpful Can Backfire

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When Being Too Helpful Can Backfire

When prospective clients call on the phone to ask about your services, some will also tell you a little about their problem. At this point, you may want to listen empathetically. But do not ask probing questions.

After speaking with you for a few minutes, a prospective client may make an appointment and then ask for suggestions on how to cope with their situation until they get in to see you. Resist the urge to give advice.

Why should you not be helpful? Isn’t that just good customer service? Being helpful is good customer service. However, in our business we need to be careful – for risk management reasons – not to engage in diagnostic or therapeutic services until we have the person’s informed consent.

Simply asking questions or giving general advice might erroneously communicate to someone that you have established a professional relationship with them. Most of the time that will be inconsequential; however, in rare cases, it could backfire. Here’s a hypothetical example:

Mrs. V, who is seeking help for her rebellious teenage daughter, calls you in desperation. “You’ve come highly recommended,” she says anxiously, “and I’d like to get her in as soon as possible.”

After checking your calendar, you offer her an appointment for early next week. “Thank you!” she exclaims. “I’ll be there. But can I ask one quick question first? My daughter is grounded for two weeks, but she has a gymnastics competition this weekend. Should we make an exception for that?”

Since you’re not busy, you figure it won’t hurt to spend a few minutes helping Mrs. V with this decision. It’s also an opportunity to establish rapport and to impress her with your expertise. So you ask a couple of questions about her daughter and about the family. Her story sounds like many you’ve heard, and you advise her to keep her daughter home from the gymnastics tournament.

The following Monday, Mrs. V calls to cancel her appointment because her daughter is in the hospital after cutting herself. She also threatens to sue you for malpractice and to report you to your licensing board.

Mrs. V may or may not prevail in a lawsuit or licensing board complaint. However, it is apparent that she did assume, from the way you communicated, that she was already in a professional relationship with you. Even though she had not yet met you in person, you were behaving like a treating psychologist, simply by asking probing diagnostic questions and giving specific advice.

The APA ethics code is silent on exactly when a therapeutic relationship begins. According to experienced ethics instructor Dan Taube JD, PhD, who serves as risk management consultant for The Trust, a professional relationship can be assumed simply from the behavior and intent of both parties. Moreover, intent need not be stated; it can be inferred in the absence of informed consent – as was the case in the hypothetical example of Mrs. V.

There are also good business reasons for not being too helpful at the inquiry stage. Ethical and risk-management considerations aside, giving advice to prospective clients may make them less likely to schedule an appointment right away, especially if they are ambivalent about starting therapy.

People are more motivated to take immediate action when pain or discomfort is involved. Therefore, if your symptom-focused advice to an ambivalent prospective client takes the edge off their distress, it’s quite possible that instead of making an appointment immediately, they promise to call back later. By the time “later” comes around, they may have forgotten your name.

What about giving advice in public education writing and speaking?

Taube recommends against giving specific advice, not only when talking to prospective clients, but also in nonclinical situations, such as presentations to community groups, interviews with news media and written articles for the public.

This does not imply that we should avoid speaking to or writing for public audiences. To the contrary, we have a professional obligation to provide the public with science-based information of general interest.

Section 5.04 of the APA ethics code outlines criteria for providing information to the public, but it does not prohibit nor discourage giving general tips or advice. When psychologists provide public advice or comment via print, internet, or other electronic transmission, they take precautions to ensure that statements:

  • Are based on their professional knowledge, training, or experience in accord with appropriate psychological literature and practice
  • Are otherwise consistent with this Ethics Code; and
  • Do not indicate that a professional relationship has been established with the recipient.

APA’s “Psychology Help Center” (apa.org/helpcenter) has some good examples of how to give general practical tips that are not likely to be interpreted as treatment. In addition, many psychologists add a disclaimer to their public education articles that the information provided is for educational purposes only, and is not intended as a substitute for professional services.

When giving talks to community groups, or when being interviewed by a news reporter, you can give general advice about typical ways to approach a given problem. Depending on the situation, you might qualify your statement by saying something like, “Many people find it helpful to…although it may not work for everyone.” A general rule of thumb is to avoid the word you and its variants when answering “What should I do?” questions.

By Pauline Wallin, PhD

This article is an excerpt from the online continuing education (CE) course:

Therapy Tidbits - May/June 2018Therapy Tidbits – May/June 2018 is a 1-hour online continuing education (CE) course comprised of select articles from the May/June 2018 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep mental health professionals informed about practice issues. The articles included in this course are:

  • New Prepayment Audits Strike Fear in Medicare Providers– Describes the difficulties practitioners are facing with when audited and explains the new method of auditing, ‘Targeted Probe and Education’
  • APA Council Approves Reorganization – Describes the upcoming changes as the American Psychological Association Practice Organization is reorganized.
  • Jail Opens Mental Treatment Unit – A brief look at how a Virginia City Jail is taking initiatives to support inmates’ mental health.
  • APA Practice Guidelines Raise Questions – Identifies concerns for the newly proposed sets of practice guidelines.
  • What is Obamacare Anyway? – An overview of Obamacare to date.
  • When Being Too Helpful Can Backfire – Discusses the difference between ‘good customer service’ and a therapeutic relationship.
  • MedPAC’s Latest Lead Balloon – An overview of the conflict surrounding the proposed change from Merit-based Incentive Payment System (MIPS) to the “Voluntary Value Program” (VVP).
  • What Have We Learned from 30 years of School Shootings?– Highlights the use of amphetamine-based drugs and lack of quality mental health care as factors in school shootings.
  • How to Handle Conflicts of Ethics and the Law – Provides examples of times when the Ethics Code conflicts with the law and offers strategies to resolve these conflicts.
  • Psychologists Should Study Uses of Marijuana – Discusses the importance of seriously considering medical marijuana as a viable treatment for patients.

Course #11-20  | 2018 |  20 pages |  10 posttest questions

Course Directions

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

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Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapist (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Is it Ethics or Law?

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Is it Ethics or Law?

In my position as chair of the Florida Psychological Association’s Ethics Committee, I frequently receive telephone calls from psychologists asking for guidance about ethical concerns. However, the majority of questions I hear actually have nothing to do with ethics, per se. Rather, they are queries about the law and psychologists often seem surprised to find that they are blending the two realms in their minds. I’ll try to clarify how to tell if a dilemma is ethics or law in this column.

Laws are rules of conduct established by a community or authority and enforceable by that entity. The underlying philosophy of the law is called jurisprudence. Certainly, it may be claimed that ethical concerns are often at the root of our laws, but ethics do not carry the power of law. In order for laws to have real meaning, a system of punishments is often established and enforced. In the United States, laws are established and enforced by federal, state, county and local governments.

Psychology’s ethical system is promulgated by The American Psychological Association. APA’s current Code of Ethics was adopted by the Council of Representatives and establishes our ethical guideposts. As stated in the code’s introduction, “The Ethics Code is intended to provide guidance for psychologists and standards of professional conduct that can be applied by the APA and by other bodies that choose to adopt them.”

What follows is 16 pages of “guidance” covering many of the ethical challenges with which psychologists must wrestle on a daily basis. The code is, quite literally, the end product of decades of work by thousands of psychologists who committed their time and energy to carefully considering the relevant issues. However, the code is not law and specifically addresses that point in its introduction by stating:

“The Ethics Code is not intended to be a basis of civil liability. Whether a psychologist has violated the Ethics Code standards does not by itself determine whether the psychologist is legally liable in a court action, whether a contract is enforceable, or whether other legal consequences occur.”

The code provides further clarification in section 1.02, Conflicts Between Ethics and Law, Regulations, or Other Governing Legal Authority: “If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority.”

Ultimately, therefore, we may obey a law that conflicts with our ethical code. However, if our ethical obligations represent a higher moral standard than the law, we are obligated to embrace that higher level. And, we are bound to consider a variety of sources of guidance, including that found in our own conscience.

The instructions continue: “In the process of making decisions regarding their professional behavior, psychologists must consider this Ethics Code in addition to applicable laws and psychology board regulations. In applying the Ethics Code to their professional work, psychologists may consider other materials and guidelines that have been adopted or endorsed by scientific and professional psychological organizations and the dictates of their own conscience, as well as consult with others within the field. If this Ethics Code establishes a higher standard of conduct than is required by law, psychologists must meet the higher standard.”

We are required to engage in a “process” that can be complex and not always satisfying. An example of this process may be briefly discussed relative to laws requiring psychologists to report child abuse.

What is to be done if a nearly 18 year-old patient tells you that he was abused by his stepmother when he was 12? He has had no contact with his stepmother for five years since his father divorced her and she moved to New Zealand. Therapeutically, is it in the patient’s best interests to report the abuse? If not, our ethical standards would suggest that it not be done. However, the law requires it.

Therefore, law trumps ethics. However, your consultation with peers and a personal examination of conscience may ultimately lead you to consider not making the report. Yet, to not report the incident is a violation of the law. What do you do?

Nobody said it was going to be easy.

By Stephen A. Ragusea, PsyD, ABPP

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This article is one of 28 included in the 3-hour online continuing education course Ethics & Risk Management: Expert Tips 8 that addresses a wide variety of ethics and risk management topics, written by experts in the field.

Related Online Continuing Education (CE) Courses:

Ethics & Boundaries in PsychotherapyEthics & Boundaries in Psychotherapy is a 3-hour online continuing education (CE) course intended to give psychotherapists the tools they need to resolve the common and not-so-common ethical and boundary issues and dilemmas that they may expect to encounter in their everyday professional practice in the 21st century. Among the topics discussed are definitions of boundaries; resolving conflicts between ethics and the law; boundary crossings vs. boundary violations; multiple relationships; sexual misconduct; privacy and confidentiality in the age of HIPAA and the Patriot Act; ethics issues with dangerous clients; boundary issues in clinical supervision; ethics and cultural competency; ethical boundaries in use of social media; ethical practice in teletherapy; fees and financial relationships; and a 17-step model for ethical decision making. Course #30-77 | 2017 | 42 pages | 21 posttest questions

*This course satisfies the ethics & boundaries requirement for license renewal of Florida counselors, social workers & MFTs. It also includes teachings from the 2014 ACA Code of Ethics to meet the ethics requirement of West Virginia counselors.

Ethics and Law in Florida PsychologyEthics and Law in Florida Psychology is a 3-hour online continuing education (CE) course that meets the ethics and law requirement for license renewal of Florida psychologists. The purpose of this course is to ensure that Florida-licensed psychologists are fully aware of the ethical and legal privileges and constraints under which they are licensed to practice in the State of Florida. It provides the opportunity for a comprehensive reading of the APA Code of Ethics and the three sets of statutes and rules governing the practice of psychology in Florida. Completing this course will fulfill the requirement that licensed psychologists in Florida complete each biennial renewal period three hours of continuing education on professional ethics and Florida statutes and rules affecting the practice of psychology. Case examples are included in this course for the purpose of illustrating the types of practices errors that occur in real life and their real consequences for clients. They are actual cases found in the official public records of the Florida Department of Health Division of Medical Quality Assurance. Licensing board complaints are a matter of public record. Nevertheless, the case reports outlined are included only for the purpose of illustrating the kinds of errors that occur in the practice of psychology and therefore contain no specifics like names, dates, or case numbers. Course #31-05 | 2018 | 55 pages | 20 posttest questions

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Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapist (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Therapists Vulnerable to Sexual Misconduct Accusations

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Sexual Misconduct Accusations

Between October and November 2017, former film producer and entertainment biz executive, Harvey Weinstein achieved infamy as the poster child for sexual misconduct after more than 80 sexual misconduct allegations covering a 30-year period surfaced in a mere 30-odd days.

In the immediate aftermath of the Weinstein allegations, there was some initial victim-blaming backlash toward Weinstein’s female accusers who were perceived by some, if not many, as using Weinstein to advance their own acting careers as much as he used them for his own sexual gratification – contributory negligence vis a vis the proverbial casting couch.

In the truncated period following the watershed Weinstein unraveling, legions of powerful men in politics, media and entertainment have become targets of sexual misconduct allegations launched against them by primarily female peers, colleagues and subordinates.

The second wave of complaints erased any doubt about the unfolding epidemic reflecting nothing more than the casting couch phenomenon endemic to Hollywood glitterazzis and wannabes.

The seeds of sexual misconduct are planted in gardens of power, and the celebrity status arising in its wake, providing wrongdoers with a cloak of invincibility woven from the threads of power, status and influence – powerful men banking on the fact that they could take sexual liberties with impunity because powerful men could never be taken down by subordinate women. Who would believe them anyway?

Some of these men admitted the wrongfulness of their conduct in its entirety, others accepted partial responsibility for something resembling the complainants’ allegations, and others went into full denial mode.

The only thing that is certain is that victims of workplace sexual misconduct have the stage in this theatrical production. They are coming out in record numbers, and their stories are being believed in large measure, particularly in the face of admissions of culpability by the wrongdoers.

Emboldened and empowered, victims are willing to risk outing individuals perceived as having violated their physical and sexual boundaries.

What does this mean for those of us who practice as psychologists? First, not only are we not immune from being potential targets of sexual misconduct allegations, but our work makes us especially vulnerable in some unique but important ways.

The work of psychotherapy and assessment necessarily takes place “behind closed doors,” often in a relational context of a significant and palpable power imbalance; power dynamics that are exaggerated in the face of gender, race, ethnicity, religious, sexual orientation and ability/disability differences – particularly when the client holds one or more less powerful or more disenfranchised statuses.

Being keenly aware of these power imbalances and insuring that you don’t unwittingly capitalize on any of them is good risk management practice.

Second, many clients seek psychological services precisely because they have been victims of sexual misconduct in childhood and/or adulthood. Vulnerabilities from unhealed childhood sexual trauma can result in both increased risk of adult sexual revictimization and in sexual acting out or other provocative or overly sexualized behaviors. And, those behaviors might be directed toward the service provider by the client because it’s a hauntingly familiar albeit dysfunctional dynamic involving recapitulation of the original harm.

Perhaps more than any other field, we are in a uniquely vulnerable position working with vulnerable individuals entrusted to our care in a relationally charged power imbalance. We must ensure that our actions are not perceived as crossing sexual boundaries even in the most nuanced ways, like commenting on a client’s attractiveness or appearance. We must be IMPECCABLE with our boundaries.

While it might be a newsflash to celebrities, politicians, and high-profile media execs that sexual improprieties committed by the powerful against the disempowered are always verboten, as psychologists we have been taught to honor and respect personal and professional boundaries in our work – ethics that are codified in the APA Ethics Code and in state practice statutes.

Research on the prevalence of therapist sexual misconduct against clients is well documented. As a profession, we are not immune from perpetrating acts of sexual misconduct against those we are obligated to care for. Ethics boards regularly announce the names of suspended or otherwise sanctioned psychologists who have committed sexual and other boundary violations.

Touch, even minor seemingly innocuous touch like patting a client’s shoulder or giving a hug may be potentially misinterpreted as an unwanted action the client doesn’t feel empowered to rebuff. Again, the interpretation of touch is context dependent and is substantially influenced by age, culture, race, ethnicity, and gender.

Good therapeutic practice dictates cautious, limited, and mindful use of touch in the context of therapy and always with awareness of whose interests are being served by the touch.

While therapy and assessment clients and their family members are potential victims of sexual assault, best practices include being mindful and aware of any comments, actions or behaviors that might cross physical or sexual boundaries or might make colleagues, students, mentees or staff feel uncomfortable because of their sexualized nature.

Organizational climate is a significant predictor of sexual harassment. Strive to create a safe space for employees, colleagues, and clients. Prudence would suggest sexual harassment education and the development of sexual harassment policies and practices if you work in an organizational or other institutional setting. If not, develop your own policy and guidelines for a sexual harassment free workplace. There are HR consultants and risk management resources available online to assist in that process if you work as a solo practitioner and don’t have organizational resources available.

To be meaningful in practice, sexual harassment prevention policies need to identify an individual to whom sexual misconduct allegations can be reported – ideally someone in a neutral position, not someone perceived to be aligned with the power hierarchy in an organization.

A process for investigating and responding to any sexual misconduct complaints needs to be in place. In the event that someone in the workplace is found to have engaged in sexual misconduct, corrective actions must follow or the policies and other practices are moot.

Being mindful, aware, and having impeccable boundaries, along with developing effective polices, practices and education are keys to successful risk management.

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Therapy Tidbits – March/April 2018Course excerpt from Therapy Tidbits – March/April 2018 – a 1-hour online continuing education (CE) course comprised of select articles from the March/April 2018 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep psychologists (and other mental health professionals) informed about practice issues. Click here to learn more.

This online CE course is sponsored by:

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapist (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

New Ethics & Risk Management CE Course

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New Online CE Course @pdresources.org

Ethics & Risk Management: Expert Tips 8Ethics & Risk Management: Expert Tips 8 is a new 3-hour online continuing education (CE) course that addresses a wide variety of really interesting ethics and risk management topics, written by experts in the field. Topics include:

Can Confidentiality be Maintained in Group Therapy? – Discusses ethical issues involved in conducting group psychotherapy.

A Short Course on Encryption and Cloud Storage – Provides answers to common questions about encryption, cloud storage, confidentiality, and HIPAA.

Retiring Ethically – Reviews the professional aspects of preparing for retirement and the various tasks and challenges involved.

Coping with Disruptions in Practice Due to Death or Disability – Shares two stories of a practice lost to sudden death, and the steps you can take to prepare for unexpected disruptions.

Informed Consent: Ethical Challenges and Opportunities – Provides an overview of the ethical obligations related to informed consent and outlines three ethical challenges.

Ethical Practice and the Challenge of Vicarious Trauma – Examines how vicarious exposure to traumatic material can dramatically impact clinicians both personally and professionally.

Competence for Execution: the Ethical Binds – Summarizes the complex issues involved in determining if a person is competent for execution.

Sorting through Professional Liability Insurance for Needed Coverage – Offers guidance and considerations for choosing between Occurrence Form Coverage and Claims Made Coverage.
Closing a Practice: Practical, Ethical and Clinical Dimensions – Reviews the tasks and challenges involved in terminating a psychotherapy practice.

Is it Ethics or Law? – Discusses the similarities and differences between ethics and law, and what to do when they conflict.

21st Century Changes Ethics for Private Practice – Shares personal experiences dealing with security breaches and offers guidelines for using technology in your own practice.

Ethical Considerations for Clinical Supervisors – Examines the impact of supervision on supervisees and their clients, including competence, clinical oversight, and informed consent.

Correcting vs. Altering Records – Discusses the importance of keeping good treatment records and offers guidance for what to do (and not to do) when needing to make a correction to your records.

Ethical Considerations for Media Presentations – Offers considerations to keep in mind when using the media for professional purposes (the article focuses on radio and television, but can also be applied to the internet).

‘Ghosting’ May Create Ethics Issue – Discusses the passive-aggressive strategy of “ghosting” and offers guidance for what to do when it happens to you, the therapist.

Reducing Risk in Treating Divorcing Families – Provides an overview of several risk management practices for therapists who work with divorced or divorcing families, particularly the children of divorcing families.

Who Let that Doggie on the Airplane? – Examines the growing trend of Emotional Support Animals (ESA) and what to do when you are asked to provide an ESA support letter.

Informed Consent: Records and Fees – Highlights areas of the treatment relationship and issues related to informed consent in the areas of providing records when requested and in establishing fees.

Cloud-Based File-Sharing Can be HIPAA Secure – Shares several options for storing and sharing information securely through the cloud, so therapists no longer have to rely on the burdensome methods of faxing or sending patient documents via proprietary networks.

Social Media and Ethics – Offers guidance to help clinicians engage in meaningful self-reflection prior to engaging in social media for the purpose of preventing ethical breaches.

Therapists Must Keep Pace as Technology Changes Practice – Discusses the change in the method of creating and maintaining patient files, evidenced by the increased use of electronic records, and the areas of concern involved.

Ethical Ways to Counteract Negative Reviews Online – Explains how to manage your online reputation, including what you can ethically do if you receive a negative review – real or not.

The Wounded Psychologist: Adverse Effects from a Licensing Complaint – Explains why licensing boards were created, how licensing board complaints are dealt with, and the negative effects of complaints on clinicians.

Disclosures for Forensic Evaluations – Discusses the requirements for disclosure in forensic evaluations.

Reimbursement Diagnoses may be Co-Morbid – Reviews the ethical, legal and professional challenges of balancing concern for diagnostic work with insurance reimbursement issues.

Giving Professional Commentary on Public Figures – Offers advice on what you can or shouldn’t say when asked to comment on public figures.

Managing Risk with Alcohol-Abusing Clients – Provides guidance on developing a dual-purposed informed consent agreement with working with special populations such as alcoholics or those characterized by high risk (e.g., suicidal or borderline personality disorder) behaviors.

Direct Secure Messaging is Best Electronic Option for Mental Health Records – Discusses use of Electronic Health Records (EHRs), concerns about the potential unrestricted flow of Protected Health Information (PHI), and how Direct Secure Messaging (DSM) can help.

Course #30-99 | 2017 | 49 pages | 20 posttest questions

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Click here to learn more.

Ethics & Risk Management: Expert Tips 8 is an online course that provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

How to Handle a Licensing Board Complaint

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Course excerpt from Therapy Tidbits – May/June 2017

Investigation Notice Not Cause for Panic –

Investigation Notice Not Cause for Panic Every state regulates the practice of psychology. The simplest regulation is that state licensing is required to call oneself a psychologist. A person may have a PhD or a PsyD, but unless the person has a license or works for an educational institution, he or she is not a psychologist.

With a state license comes board oversight to police unprofessional practices. The purpose of a licensing board is to assure that the public is not harmed.

A psychologist is considerably more likely to receive a board complaint than be sued. The reason is that in order to bring a suit there has to be a demonstrable cause of action, proof of damage to the person who wants to sue and a lawyer who is willing to take the case. It is much easier to file a complaint with the state licensing board.

Most complaints arise out of an outcome that makes the complainant feel wronged and filing a complaint is a means to validate that feeling. That does not make that person right, only angry.

The receipt of a complaint can cause anxiety in the psychologist for many reasons. Significant is the fact that most practitioners take the complaint personally and can’t see the motivation of the complainant, only that they intended to provide quality care. In reality most complaints are dismissed at the investigatory stage and there is no official record that they were even filed.

State boards deal with complaints in three phases. The opening phase is the investigatory stage. This is usually the first notice the practitioner has of a problem. A written response and a copy of the chart being sent to the board is required.

If the board thinks it is warranted, the next phase will be a formal inquiry. This can entail testimony and experts to support the complaint about the care provided. Depending on the state, this may take place at a board hearing or in front of an administrative law judge.

Some states employ another step after the administrative law judge with a formal hearing in front of the board. This process can be time consuming and expensive. This doesn’t even include an appeal to the state judicial system.

As almost all malpractice insurance policies provide some coverage for state board complaints, the first thing a policyholder should do is contact the insurance carrier. Insurers are a source of advice and, if needed, a referral to an attorney who is familiar with the complaint process. It is not advisable to try to face the board alone. Even if the complaint is frivolous, the board must take it seriously.

Many psychologists have tried self-representation and found themselves with some sort of sanction that now has to be explained. Additionally, a lot of boards invite the psychologist to sign a consent agreement to put the matter to rest. This may seem innocuous and a quick and easy means to end the matter, but it means that the practitioner has agreed that he or she has done something wrong.

With this agreement, the complainant can now sue and be fairly assured of winning. So it is very important that the practitioner understand his or her malpractice insurance coverage and feel free to contact the carrier if notified a complaint has been filed.

As with most aspects of claims against psychologists, a lot of board complaints arise out of the fractioning of a family unit – such as in a divorce – and the subsequent intervention of a psychologist. It is not unusual for a “custody evaluator” to be named in a complaint. This is the only way to bring an action against a court-appointed individual. Immunity from litigation will protect against a lawsuit but it won’t stop a board from investigating.

Most states have passed laws that allow regulatory agencies access to patient charts. There is even an exception in HIPPA that allows this. That means the board will be looking at the notes that document a course of treatment. They will be making decisions about the psychologist’s career based upon that documentation. This is another example of where the “less is more” theory of note taking breaks down.

The usual risk management strategies apply. As always, your notes are your main defense. Failure to have them just means you will have another problem. In fact, notes are the only way to survive a board complaint.

State boards are consumer protection organizations. They are there to protect the public from allegedly unqualified practitioners. It is important to recognize that a proper defense comes from a clear and documented clinical process.

So as practicing psychologists, protect yourselves by documenting your treatment of patients. If you receive notice of a complaint, don’t panic. Contact your insurance carrier and follow the advice you will be given.

By Eric. C Marine – vice president of claims and risk management for the American Professional Agency Inc. He has more than 35 years involved in the insurance claims business and more than 20 years in all facets of professional liability claims. He writes and speaks nationally on the subject.

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Therapy Tidbits – May/June 2017Therapy Tidbits – May/June 2017 is a 1-hour online continuing education (CE) course that covers a variety of therapy topics in a succinct and reader-friendly format.

The articles included in this course are:

  • Advocates in Field of Aging Hear Strong Call to Action – Highlights focus points of the ASA conference in March: critical social and political issues affecting older Americans and how the ASA is urging member support to protect them.
  • Cost-Containment Restricts Treatment for PTSD – A warzone PsyD is told her patient is receiving, “entirely too much treatment,” after reimbursement allowances by insurers fall substantially.
  • Hoffman Report Triggers Defamation Suit Against APA – Plaintiffs damaged by Hoffman Report claim bias and “blind-following” in case brought against him and numerous others alleged to be complicit in defaming.
  • Investigation Notice Not Cause for Panic – Illuminates steps you can take to prepare yourself and your practice, now and ahead of time, for the inevitable complaint.
  • Proponent of Internet Tests Contends They Eliminate Bias – Explores how the “human factor” can play a significant role in candidate deception.
  • Psychologists Best to Assess Concussions, Gender Effects – Discusses the importance of including the discipline of psychology when addressing the complex effects of concussions.
  • Brain Hacking: Tech Companies Hijack Your Attention – Focuses on the modern compulsion to keep tabs on our electronic communications and social media as well as tactics to combat such distractions.
  • Duty to Warn: Don’t Get Distracted by Legal Cases – Evaluates that laws may change, but the focus of “duty to warn” stays the same.
  • MMPI-2 Book is Excellent Reference Text – Promotes the many benefits of using the MMPI-2 as a resource material for psychology-based professions.

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Course #11-10 | 2017 | 16 pages | 10 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Ethics & Risk Management Online CE Course

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From The National Psychologist

Ethics and Risk Management: Expert Tips VII is a 3-hour online continuing education (CE/CEU) course that addresses a variety of ethics and risk management topics in the form of 22 archived articles from The National Psychologist and is intended for psychotherapists of all specialties. Topics include:

Ethics & Risk Management: Expert Tips VII

3-Hour Online CE Course

  • Why the Mismatch and What Do I Do?
  • What Malpractice Insurance Isn’t
  • An Ethical Prohibition That Isn’t – And Never Really Was
  • Documentation, Lawyers and Common Sense
  • Hot Topics in Psychological Practice
  • Self-Care Important for Psychologists and Graduate Students
  • I Confess …
  • Forensic Psychology IS a Specialty
  • Ethics with Feeling
  • Patient Access to Records: The Invisible Confidentiality Right
  • The Minefield of Divorce Counseling
  • Ethics, Psychology and the Prison Mess
  • Risks Accompany Benefits of Telecommunications
  • Most Psychologists Misinformed on ‘Duty to Warn’
  • Legal Pitfalls in Treating Borderline Personality Disorder
  • Ethical Issues in Assessing & Treating Elite Athletes
  • Electronic Health Records Raise New Ethical Concerns
  • Legal, Clinical, and Ethical Implications of Legalized Marijuana
  • Test Security Must be Maintained
  • No Thinking Allowed: Ethics in Reverse
  • Employ Spiritual Practices Ethically

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Course #30-81 | 2015 | 43 pages | 34 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account after purchasing) to mark your answers on it while reading the course document. Then submit online when ready to receive credit.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by theTexas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

Multiple Relationships Not Always Bad

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By Ofer Zur, PhD

Entering into dual relationships with psychotherapy patients has been a topic of significant controversy in professional psychology. Although these types of extratherapeutic alliances have generally been considered to be unethical conduct, some authors recently have supported their development as both ethical and, in some cases, even therapeutic.

I was surprised to read the statement of my esteemed colleague, Ed Zuckerman, PhD, in the last issue of The National Psychologist (Nov/Dec, 2011), whereas part of an article on “The Fiduciary Heart of Ethics“ he stated, “We have an ethical obligation to avoid multiple relationships.”

This statement is in contrast to the APA’s code of ethics, (Section 3.05), which clearly states that: “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence or effectiveness in performing his or her functions as a psychologist or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”

Multiple relationships not always badMultiple relationships not reasonably expected to cause impairment or risk exploitation or harm are not unethical.

Zuckerman’s statement and discussion of multiple relationships are not only incorrect, unsupported and outdated, but also are in clear contrast to the standard of care of psychotherapy and counseling. For example, multiple relationships are mandated in military settings where psychologists often have primary loyalty to the Department of Defense and only a secondary loyalty to the person they are treating in the consulting room. Multiple relationships are inherent in some correctional settings, such as prisons, where psychologists have a responsibility to the security of the institution, as well as to the mental health of actual patients.

Zuckerman, who to the best of my knowledge, lives in Pennsylvania, should be aware that multiple relationships are unavoidable in small communities and rural areas, which are quite prevalent in his state. In fact, they are a normal and healthy part of such interconnected communities. Familiarity and multiple relationships between all members of small communities, including health care providers, is how such communities survive and thrive.

Not all multiple relationships are created equal. There are different types of multiple relationships:

  • A social multiple relationship is one in which a therapist and client are also friends, acquaintances or have some other type of social relationship within their community.
  • A professional multiple relationship is where a psychotherapist/counselor and client, are also professional colleagues in colleges or training institutions, presenters in professional conferences, co-authors of a book, or other situations that create professional multiple relationships.
  • Institutional multiple relationships take place in the military, prisons, some police departments and mental hospitals where multiple relationships are an inherent part of the institutional settings.
  • Forensic multiple relationships involve clinicians who serve as treating therapists, evaluators and witnesses in trials or hearings.
  • Supervisory relationships inherently involve multiple relationships and multiple loyalties. A supervisor has a professional relationship and duty to the supervisee and to the client, as well as to the profession.
  • A sexual multiple relationship is where a therapist and client are also involved in a sexual relationship.

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Sexual multiple relationships with current clients are always unethical. A business multiple relationship is generally ill-advised. These are relationships, in which a therapist and client are business partners or have an employer-employee relationship.

Multiple relationships can be ethical or unethical, legal or illegal, and can be avoidable, unavoidable or mandated. They can also be planned and anticipated or unexpected. Then they can be concurrent or sequential and can also very with different levels of involvement, from low/minimal to intense.

In summary:

  • Non-sexual multiple relationships are not necessarily unethical or illegal.
  • Multiple relationships can’t be avoided in many settings and are mandated in others.
  • Multiple relationships are a healthy part of small and rural communities.
  • Sexual multiple relationships with current clients are always unethical.

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Non-sexual multiple relationships do not necessarily lead to exploitation, sex or harm. The opposite can be true. Multiple relationships can reduce isolation and prevent exploitation rather than lead to it. Almost all professional association codes of ethics do not mandate a blanket avoidance of multiple relationships.

Source: Ethics & Risk Management: Expert Tips VI