Psych 593 Collaborative Study Guide for Ethics & Professional Issues PDF

Multiple Choice Questions for Chapter 3 ======================================= Ryan Stewart: Which of the following are types of justice listed in Principle D of the APA code of ethics? (Choose all that apply): 1. 2. 3. 4. Correct Answer: 1, 3, 4. Fisher, pg. 40 (Principle D: Justice) sect...

Multiple Choice Questions for Chapter 3 ======================================= Ryan Stewart: Which of the following are types of justice listed in Principle D of the APA code of ethics? (Choose all that apply): 1. 2. 3. 4. Correct Answer: 1, 3, 4. Fisher, pg. 40 (Principle D: Justice) section lists three types of justice codified in the APA code of ethics. Tiffany Szymanski: Which APA general principle corresponds to the following type of ethical awareness for psychologists?: "Psychologists should be able to identify what is in the best interest of those with whom they work, when a situation threatens the welfare of individuals, and the competencies required to achieve the greatest good and avoid or minimize harm". 1. 2. 3. 4. Correct answer: 3: Beneficence and Nonmaleficence from Fisher, p. 51 table 3.1 lists general principles from the APA code of ethics with corresponding virtues and ethical awareness for each of the general principles. Principle A of the APA code of ethics (beneficence and non-maleficence) is defined by psychologists taking care to promote the wellbeing of those they work with (beneficence) and protecting their rights and welfare from harm (nonmaleficence); if conflicts arise, psychologists have an obligation to resolve it in a responsible way that avoids or mitigates harm (see p. 35 of Fisher for a detailed description of Principle A of the APA code of ethics). **Jelena Simon:** In some settings including, but not limited to research labs, assessment evaluations, and therapy, [informed consent] is conducted to ensure the participant has a full understanding of their rights and given space to make a conscious decision to participate. Which of the following general principles does this procedure intend to uphold? 1. 2. 3. 4. **Correct Answer:** The correct answer is \#4: respect for people's rights and dignity! Informed consent is one method to ensure that the participant/client has a full understanding of their rights and create a safe environment for clients to express autonomy in their decision-making. (This information can be found on p. 42 of the hardcopy textbook) **David Keenan:** The book states that the Ethics Code has explicit standards prohibiting the misrepresentation of facts in some contexts while little guidance is given regarding deception in other contexts. In which of the following contexts is deception prohibited? (Choose all that apply) 1. 2. 3. 4. **Correct answer:** \#1, \#2, and \#4. Deception is prohibited by the Ethics Code in these three contexts but is not prohibited in the context of psychotherapy. Some reasons for deception not being prohibited include the potential necessity to lie or omit truths to protect one's privacy, and the ability to refer the client to another psychologist without making the client aware of a conflict in values. (Information found in the "Need to know" section under Principle C: Integrity, p. 39). **Mariam Shimo:** **Which virtue, as described in Chapter 3, specifically involves the ability to make well-considered decisions in complex or ambiguous ethical situations?** A\) Conscientiousness, which focuses on following rules meticulously. B\) Discernment, which involves contextually sensitive insight and judgment. C\) Prudence, which is concerned with applying practical wisdom to find feasible solutions. D\) Openness, which involves a commitment to understanding and embracing diverse perspectives. **Correct Answer:** C) Prudence, which is concerned with applying practical wisdom to find feasible solutions. **Rationale:** In Chapter 3, Prudence is specifically described as the virtue that involves the application of practical wisdom to navigate complex or ambiguous situations. It is about making well-considered decisions that balance various factors and lead to effective outcomes. Unlike Conscientiousness, which emphasizes strict adherence to rules, or Discernment, which involves judgment and context-sensitive insight, Prudence is directly concerned with the practical aspects of decision-making and problem-solving. This virtue helps individuals weigh options and choose the best course of action in challenging circumstances, making it the most relevant virtue for addressing complex ethical dilemmas (page 46, "Focal Virtues for Psychology"). **Abirami Suthan:** **Which of the following ways can psychologists respect patients' autonomy in treatment and better prioritize patient-centered care?** a. b. c. d. **Correct Answer**: **B.** Support for this question comes from the 'Need to Know' section Giving Voice to the Lived Experiences of Individuals with Mental Disorders, p. 43. One less apparent but critical breach of Principle E that emphasizes a lack of respect for people\'s rights and dignity involves discounting the lived experiences of individuals with mental health disorders. Psychologists may often call for "patient centered care" however fail to incorporate the patient in their development and evaluation of the success of treatment plans. Options A and C is a clear demonstration of this ethical violation as the psychologist fails to put the client at the forefront of their treatment development and is rather centered around the psychologist\'s stereotypes, knowledge and experience. Option D uses a closed as opposed to open ended question that fails to make room for the clients concerns and whether they are truly following along with the session. **Max Kinsey-Kerr** Which of the following actions exemplifies adherence to Principle B: Fidelity and Responsibility in the APA Ethics Code? A\) A psychologist who maintains client slots in their private practice for no cost to accommodate potentially lower income clients. B\) ​A psychologist who actively promotes equal access to psychological services and advocates for fair treatment of all individuals regardless of their background or socioeconomic status. C\) A psychologist who carefully weighs costs and benefits for participants in their upcoming research study to ensure the potential benefits outweigh any possible harm. D\) A psychologist who prioritizes care for a specific client at the expense of other ongoing relationships with current clients. Correct Answer: A) Rationale: Answer choice A directly addresses the last sentence of Principle B: Fidelity and Responsibility that says "Psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage." Choice B, while admirable, represents adherence to Principle: D Justice, choice C, while also admirable, represents Principle A: Beneficence and Nonmaleficence, and choice D is clearly not exemplifying any principle, but rather violating principles D and A. **Oksana Balaban** *Which of the following are true:* The Ethics Committee may issue directives requiring the respondent to: **A) cease and desist from and activity** **B) obtain supervision or additional training or education** **C) be evaluated for an obtain treatment** D\) continue to work with his/her clients **E) agree to probationary monitoring** Correct Answers: A, B, C, E Rationale: Chapter 2; page 21 under Sanctions. " The Ethics Committee may also issue directives requiring the respondent to (a) cease and desist from an activity, (b) obtain supervision or additional training or education, (c) be evaluated for and obtain treatment if appropriate, or (d) agree to probationary monitoring. A psychologist who has been found in violation of the Ethics Code may respond to the recommendation by requesting an independent case review or, in the case of expulsion, an in-person proceeding before a formal hearing committee". **Karla Mishreky** In regards to Principle C, why do psychologists have a greater ethical responsibility than non-health-care professionals when advertising their services? A\) Psychologists, through fidelity and responsibility, are required to obtain and maintain high standards which would be threatened by irresponsible advertising of services. **B) Consumers of psychological services lack the knowledge to evaluate their treatment needs or the legitimacy of claims made through online advertisements.** C\) Psychologists are only allowed to advertise their services in professional journals. D\) Non-health-care professionals are not bound by any ethical guidelines. Explanation: Chapter 3, page 39- Choice B is correct because according to Principle C, Integrity, psychologists should promote honesty, truthfulness, and accurate information without misrepresentation of facts. Mistrust or misrepresentation may result in harm towards clients/patients which may result in persuasion due to the vulnerability of the consumers. Choice A is a considerable choice, however, principle C is Integrity, fidelity, and responsibility in choice A is principle B. **Oksana Balaban** Which of the following describe a conscientious psychologist? A. B. C. D. Correct Answer: D Rationale: A conscientious psychologist that is motivated to do what is right because it is right, diligently tries to determine what is right, makes reasonable attempts to do the right thing, and is committed to lifelong professional growth. The virtues considered most salient by members of a profession will vary between differences in role responsibilities. Discerning psychologist: B; Prudent psychologist: C. Pg. 46 Chp 3. Multiple Choice Questions for Knapp et al., 2013 ================================================ Ryan Stewart: Which acculturation strategy has been demonstrated to be the most effective under the Ethics Acculturation Model? =============================================================================================================================== 1. Assimilation ============ 2. Separation ========== 3. Marginalization =============== 4. Integration =========== Correct answer: 4. Within the Knapp et. al., article (pg. 372), literature was cited (Berry, 2003; Berry & Sam, 1997) that demonstrated acculturation as the most effective acculturation strategy because it allows individuals to take the best parts of both the new culture they are operating within, and allows them to flexibly adopt new norms while maintaining the cultural norms/values that they bring to the environment from their previous experiences. ====================================================================================================================================================================================================================================================================================================================================================================================================================================================================== Tiffany Szymanski: A separation strategy of acculturation is characterized by... 1. 2. 3. 4. Correct answer: 2. From Figure 1 "Ethics viewed from an acculturation model" (from Handelsman, Gottlieb & Knapp, 2005) from p. 372 of the Knapp et al. Article, this figure provides characteristics of integration, separation, assimilation and marginalization strategies in ethics acculturation for psychologists. From p. 373, Separation strategies of acculturation are characterized by relying too little on the standards associated with the APA Code of Conduct (2010) and giving too much emphasis to personal virtues, implementing values that would be appropriate for their personal relationships but not for professional relationships (Knapp et al., 2013). **Jelena Simon** The phenomenon where psychologists place a social cause or their own personal values above the welfare of the patient is referred to as: 1. 2. 3. 4. **Correct Answer:** The correct answer is \#1: intrusive advocacy! An example of intrusive Advocacy may look like a psychologist pushing a client too hard to press charges on a third party situation. (This information can be found on p. 375 of the Knapp Article) David Keenan: ============= A psychologist meeting a new patient places great emphasis on the ethical boundary preventing a potential sexual relationship with said patient. The psychologist makes the patient sign a legal document agreeing to not enter a sexual relationship with the psychologist. Under the Ethics Acculturation Model, which acculturation strategy was this psychologist using? ============================================================================================================================================================================================================================================================================================================================================================================ 1. 2. 3. 4. **Correct Answer:** \#4. This psychologist is placing too much emphasis on explicitly following the professional ethics outlined in the Ethics Code. The psychologist is, in turn, not placing enough emphasis on personal ethics that would have likely helped them to see how this type of behavior could make patients feel confused, uncomfortable, and like the responsibility was on them. (Information taken from an example of assimilation on p. 375). **Mariam Shimo:** **According to the Ethics Acculturation Model (EAM), which of the following scenarios best illustrates the concept of the \"marginalization strategy\" in professional ethics?** A\) A psychology trainee disregards both personal values and professional ethics, failing to follow the APA Code of Conduct and demonstrating a lack of care in their professional practice. B\) A psychologist strictly adheres to the APA Ethical Principles and avoids personal emotional involvement with clients, maintaining an overly rigid professional demeanor. C\) A psychologist integrates personal virtues with professional standards, showing empathy and respect for patient autonomy while adhering to ethical guidelines. D\) A trainee focuses solely on personal values without consideration of professional standards, such as attempting to help clients in ways that would be inappropriate in a professional setting. **Correct Answer:** A) A psychology trainee disregards both personal values and professional ethics, failing to follow the APA Code of Conduct and demonstrating a lack of care in their professional practice. **Rationale:** The \"marginalization strategy\" in the Ethics Acculturation Model (EAM) is characterized by a neglect of both personal values and professional ethical standards. This approach results in inadequate ethical behavior and poor professional practice. Scenario A shows a psychology trainee who ignores both their personal values and the APA Code of Conduct, leading to a lack of care in their professional responsibilities. This contrasts with other scenarios that either emphasize adherence to professional standards or the integration of personal and professional values. By failing to align with both ethical dimensions, the trainee\'s behavior aligns with the marginalization strategy, which is shown as problematic due to its potential to undermine ethical practice and patient welfare (page 372, "Marginalization Strategy"). **Abirami Suthan:** **Which of the following statements is true about the ethics acculturation strategies outlined within Ethical Acculturation Model (EAM) by Knapp et. al (2013)** **Correct Answer:** C. Support for this question comes from Knapp et. al (2013), p. 373. This article supports the idea that the EAM is fluid and both psychologists in training and experienced psychologists are not permanently inducted into one acculturation strategy for their entire career. how Psychologists can slip in and out of different styles depending on the situation, client, and context no matter how professionally informed or guided by personal compassion they are. Option B is incorrect as it provides the definition of a separation strategy as opposed to assimilation which would involve an individual who leans primarily on ethical rules over personal compassion. Similarly, option D provides the definition of a marginalization strategy as opposed to a separation strategy. **Max Kinsey-Kerr** Which of the following is described as a potential risk when personal values override professional standards? A\) Enhanced therapeutic alliance B\) Improved client outcomes C\) Excessive self-disclosure D\) Increased professional recognition Correct answer: C) Rationale: ​Excessive self-disclosure is described as a potential risk when psychologists allow their personal values or experiences to take priority over professional boundaries and standards.​ The article provides an example where a psychologist immediately shared her own assault history with a new patient who had reported a recent sexual assault. This example of self-disclosure, based on personal rather than clinical or professional considerations, is considered ill-considered and potentially harmful to the therapeutic relationship. **Karla Mishreky** Why are modifiers such as \"reasonable\" and \"appropriate\" used in the APA Ethics Code? A\) To allow psychologists to adopt separation strategies, lessening their reliability on laws. B\) To ensure that psychologists are following the rules unnecessarily to distance themselves from clients/patients. C\) To protect psychologists who adopt assimilation strategies. **D) To allow for professional judgment in unique or unusual circumstances.** Explanation: Interpreting rules too rigidly, page 4- Choice D is correct because the Ethics Code acknowledges the necessity for professional judgment in some scenarios that may arise, which is why it includes several qualifiers like \"reasonable,\" \"appropriate,\" \"to the extent possible,\" and so on. Choice C is not correct because when employing assimilation strategies, psychologists may operate as though the modifiers don\'t exist or that abiding by the rules is sufficient to ensure the highest standards of ethical behavior. Choice B also indicates the psychologist is adopting assimilation strategies. **Oksana Balaban** Which of the following may occur if a psychologist chose his/her goals rather than implementing intrusive advocacy? A. B. C. D. Correct answers: A, C, and D Reasoning: A psychologist who focuses on their goals rather than respecting the client\'s values may harm as it places their own personal values and welfare over there\'s. To "advocate intrusively" is to consider his/her own autonomy and letting your client choose his/her goals/values. Pg. 375 of Dark Side of Professional Ethics Multiple Choice Questions for Dubois, 2008 ========================================== Ryan Stewart ============ Which of the following **is not** a major source of uncertainty/disagreements regarding ethical decisions under the "So far no objections" (SFNO) approach to case analysis? 1. 2. 3. 4. **Correct answer:** 1. Under the SFNO model, conflicting interests are addressed at the level of individuals who are involved in the ethical decision (who is impacted), rather than the specific interest motivating the individuals involved (how they are motivated/impacted). Answer 3 is more in line with this model, and can be thought of as "who are the stakeholders/how are they impacted," rather than "what are the stakes." Per the article (DuBois, 2018), specific conflicts of interest are certainly important, but more narrow in scope than the intention of this model. **Jelena Simon** Based on the text from the article "Solving Ethical Problems," by James M. DuBois, which of the following statements is true? 1. 2. 3. 4. **Correct Answer:** The correct answer is \#1! As described on p. 47 of the article, volitional dilemma refers to: *will I actually do what is right*? A cognitive dilemma is *uncertainty around what the right thing to do is*, and a social dilemma is when *stakeholders disagree on what the right thing to do is.* **Abirami Suthan** **Which of the following is true about legitimate values or prima facie norms in the context of psychological practice?** a. b. c. d. **Correct Answer:** C. Support for this answer comes from Dubois, 2008 (p. 53-54) which defines prima facie norms as a norm that respects values that deserve respect and should always be considered. Options B & D are therefore false in the context of psychological practice as certain ethical situations challenge the efficacy of prima facie norms. As one example of a prima facie norm "always obtain informed consent" may not be in the immediate best interest of a client who is suicidal, and they can therefore not always be followed exactly as intended. Dubois (2008) outline 5 criteria that must be considered when prima facie norms conflict with one's proposed actions and displays how complex these norms are within an ethical context. Option C is thus true as it considers the least infringement criteria which is one of 5 criteria that are necessary to consider when the norms conflict with one\'s proposed action. **Tiffany Szymanski** Which of the following is true regarding the proportionality criterion for justifying a proposed action that conflicts with legitimate values or prima facie norms? A. B. C. D. **Correct Answer: D** **Rationale:** The correct answer is D. Support for this answer comes from page 54 of Dubois, 2008, which lists five criteria for justifying proposed actions that conflict with prima facie norms, which comes from the Childress et. al (2002)article titled, "Public Health Ethics: Mapping the Terrain". Options A through C correspond to the criteria of necessity, least infringement and effectiveness, respectively. On page 54 of Dubois (2008), proportionality is the third criterion listed- it asks whether the desired goal is important enough to justify overriding other principles or values. The author provides an example of this criterion with the Willowbrook study, asking whether the proposed benefits of conducting the study, i.e. developing a hepatitis vaccine, was important enough to justify overriding the potential harm to the children who were research subjects. The author states that if the research were to only produce data for something like a dissertation, then conducting the study would not be justified (i.e. the outcome would not be considered important enough). However, since the research could potentially lead to a vaccine for hepatitis (beneficial outcome) and the risks to the children involved in the study were lower (i.e. the conditions at Willowbrook were very unsanitary where the subjects would have contracted hepatitis anyway had they stayed there; research subjects were kept in a more sanitary research unit where they received better care, which mitigated the risks)- and so the criteria for proportionality had been met. **Mariam Shimo:** **Which of the following best describes a situation where ethical norms might conflict in the context of the Willowbrook study?** A\) Balancing the need for informed consent with the desire for a quick research process. B\) Ensuring scientific validity while simultaneously protecting participants from harm. C\) Selecting a research design that minimizes logistical challenges. D\) Deciding between recruiting a larger sample size or ensuring more detailed monitoring of fewer participants. **Correct Answer:** B) Ensuring scientific validity while simultaneously protecting participants from harm. **Rationale:** Ethical norms often conflict when balancing scientific validity (beneficence) with protecting participants from harm (nonmaleficence). In the Willowbrook study, the conflict was between the goal of advancing scientific knowledge and the protection of vulnerable participants. (See page 50 under "*Norms*") **Max Kinsey-Kerr** Take the following scenario: A large manufacturing company is considering implementing a genetic testing program for its employees, claiming it will help identify individuals who may be at higher risk for certain occupational diseases, and thus improve the company's ability to accommodate for these employees. The employees argue that this will lead to discrimination in the workplace, and is thus an effort to cut costs by not hiring people with costly genetic conditions. Which answer best summarizes the most salient type of disagreement in this situation and the two most important things to consider in this type of disagreement according to DuBois? a\) Facts; The cost-benefit analysis for the company and the potential impact on employee health b\) Competing Interests; The list of stakeholders that are invested in this ethical dilemma and the possible solutions that accommodate all stakeholders' interests c\) Competing Interests; The potential reasons for prioritizing certain stakeholders\' interests and who has legitimate decision-making authority d\) Facts; The employees\' right to privacy and the potential for improving workplace safety Correct answer: C While there may be some disagreements of facts in this situation, the scenario is getting at the disagreement involving the competing interests of the company (minimize costs by not hiring people with potentially costly genetic conditions) and the employees (prevent discrimination in the workplace). I think there is certainly an argument that a disagreement of ethical norms is most salient here, so I did not include that in the answers to make it less ambiguous. Page 51 discusses disagreements revolving around competing interests. DuBois explicitly describes two questions that must be asked in the case of competing interests. The first question is whether there are legitimate reasons to prioritize the interests of one stakeholder over another. The second question involves who has the decision-making authority in this scenario. So, while all these questions could be useful in making an ethical decision, C is the most accurate summarization of the type of disagreement and the questions that are most salient in the case of competing interests. **David Keenan:** A proposed study conflicts with legitimate values but is approved by an IRB regardless. The IRB justifies their approval by claiming that the benefits of the research are likely to outweigh any harms it may cause. Under which of the following justification criteria does this reasoning fall? 1. 2. 3. 4. **Correct answer:** \#2. While all of these criteria can be used to justify studies that conflict with legitimate values in some way, proportionality specifically refers to situations in which the ends are argued to justify the means. Effectiveness addresses the question of whether or not the research will actually work toward the desired goal. Necessity deals with whether or not the potential harm is necessary to achieve the desired goal. Least infringement refers to the process of ensuring that harm is minimized. (Information from p. 54 of the DuBois article) **Oksana Balaban** Based on the Willowbrook study, for what reasons would this study have likely not been approved by the IRB nowadays? a. b. c. d. Correct answer: B. Reasoning: Exploitation of vulnerable populations and protections for those that are vulnerable. The children in the Willowbrook study were not only minors but those with disabilities. These children were unable to consent for themselves and have a full understanding of what they were involved in. Page 55 of Solving Ethical Problems; "current regulations require that additional protections be afforded to vulnerable populations (DHS 2001), "highly unlikely that any IRB would permit such research to be conducted today; the reasons concern primarily proportionality and process". **Karla Mishreky** Select the questions that would be asked when disagreements occur when different people have competing interests. **1.Are there reasons for giving priority to one side's interests over the other?** 2.Which party has the more ethical interest? **3.Who has the authority or investment of decision-making authority?** 4.Which group has more authority or power? Explanation: Disagreements involving competing stakeholders page 6- the two questions that should be asked are "do reasons exist for giving priority to the interests of one party over another?" and "who is invested with decision-making authority?". These questions are essential in order to clarify what the goals are and to provide the adequate treatment for the clients/patients. Multiple Choice Questions for Chapter 5 ======================================= Tiffany Szymanski: ================== Under Standard 1.02 of the APA Ethics Code (Conflicts Between Ethics and Law, Regulations, or Other Governing Legal Authority), what should psychologists do when their ethical responsibilities conflict with the law (select all that apply)? A. Follow the law regardless of any conflicts with the ethics code (including human rights violations), in order to avoid legal repercussions. =========================================================================================================================================== B. C. D. **Correct Answers:** B and D; rationale for answer B comes from p. 83 of the textbook (Fisher, 2023) which lists steps that psychologists should take when the ethics code conflicts with the law, which includes taking action by informing appropriate authorities of the conflict and "explaining the rationale for the ethics code standard", which includes upholding one's commitment to the ethics code (Fisher, 2023). For both answers B and D, support can be found in the explanation of Standard 1.02 in the italicized text (p. 83) in that "Psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and take reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics Code." (Fisher, 2023). For answer D, p. 85 also notes that, "Standard 1.02 does *not* require compliance with law."- i.e. when the law conflicts with the ethics code- especially if it pertains to defending human rights violations (Fisher, 2023). A is incorrect as it suggests that psychologists should always follow the law even if it conflicts with the ethics code, even if following the law includes violating human rights; Standard 1.02 prohibits psychologists to justify legal actions that are in violation of human rights, i.e., "Standard 1.02 makes clear that the participation of psychologists in an activity that can be used by others to justify or defend violations of human rights, even when lawful, is a violation of the APA Ethics Code" (Fisher, 2023, p. 85). C is also incorrect as it is unethical for a psychologist to not take any action in the event that the law conflicts with the ethics code; again the textbook states on page 83 that psychologists must take "reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics Code" (Fisher, 2023, p. 83) implying a proactive duty for psychologists to uphold the ethics code and, "when reasonable actions taken by psychologists do not resolve the conflict, they are permitted to make a conscientious decision to comply with the legal or regulatory authority under circumstances in which their actions cannot be used to justify or defend violating human rights" (p. 84) (Fisher, 2023). **Abirami Suthan** **In order to address institutional biases to develop fair and just procedures within organizations, psychologists should consider which of the following actions (select all that apply):** a. b. c. d. **Correct Answers:** B & C. Support for this answer comes from p.91-93 which outlines actions that psychologists must help organizations consider and address institutional biases that meet the needs of all organizational members. B promotes sensitivity and awareness of one's multicultural humility to identify present organizational policies that condone humans' rights violations such that they can identify and alter them. C encourages individuals to consider the impact of organizational changes at the individual and larger community levels rather than solely the executive and directorial level. For this reason, A is incorrect, as it doesn't consider the larger company and community levels. D is incorrect as Standard 1.03 maintains the Ethics Code and human rights at the forefront of a psychologist\'s ethical responsibilities over their organization's policies. **Mariam Shimo:** **What factor contributes to the fallibility of psychological tests in assessing intellectual disability?** A\) Uniformity of testing procedures across all states.\ B) The standardization of IQ tests for all demographics.\ C) Variability in definitions of intellectual disability and test reliability issues.**\ **D) Consistent predictive accuracy of psychological assessments. **Correct Answer:** C) Variability in definitions of intellectual disability and test reliability issues. The fallibility of psychological tests in assessing intellectual disability arises from two issues: the lack of a universal definition of intellectual disability and the variability in the reliability of these tests. **Rationale:** - - **David Keenan:** Standard 1.05 of the APA Ethics Code (Reporting Ethical Violations) requires psychologists to report ethical violations committed by other psychologists under specific circumstances. Which of the following must be true for a report to be required (select all that apply). 1. 2. 3. 4. **Correct answer: \#**1 and \#3. An ethical violation is only required to be reported if both of these conditions are true. As a rule of thumb, violations that may lead to substantial harm include things such as sexual misconduct, insurance fraud, plagiarism, and blatant intentional misrepresentation. Regarding \#2, the decision to report a violation may be left to the decision of the client in some cases, specifically if conditions \#1 and \#3 are not met. If appropriate, the psychologist hearing the disclosed statement should inform their client of reporting options and why the other psychologist's behavior was unethical. \#4 is false because the scope of one's professional practice is irrelevant when it comes to the necessity of reporting violations. (Information from p. 98 under 1.05 Reporting Ethical Violations) **Ryan Stewart** According to Standard 1.01 of the APA Ethics Code, which of the following is NOT listed as a step psychologists could take to remedy the misuse of their work? 1. 2. 3. 4. **Correct answer: 2.** Standard 1.01 describes the steps taken as *reasonable steps.* "\...psychologists may not be in a position to ensure their requests to correct misuse are followed." (Fisher, 2023, pg. 82). A psychologist isn't required to put Herculean effort into seeking out and finding any instance of their work being misrepresented (although likely could if they decided to) - the spirit of this rule is that reasonable and appropriate measures that are accessible should be taken so that research and positions of the psychologist can't be misconstrued for inappropriate means (such as winning a court case, or justifying harmful public policy). It's important that a psychologist document instances of attempts at correcting the record. **Jelena Simon** An ethics committee can require a psychologist's cooperation when a complaint has been brought against a psychologist, even if it requires the violation of their fifth amendment right against self-incrimination. 1. 2. **Correct Answer:** The correct answer is \#2: FALSE! (This information can be found on p. 100 of the hardcopy textbook) The psychologist\'s ability to provide information to an ethics committee may be limited due to their underlying responsibility to maintain the confidentiality of their client. Professional organizations, unlime government agencies, are not able to exercise this requirement (Fisher, 2023, pg. 100). Standard 1.06 discusses this in more detail. **Max Kinsey-Kerr** Which of the following would be the most fair and just reason for a psychologist to be denied a job (assume this is the only information you have). A. The psychologist has a pending ethical complaint filed against them by a previous client. B. The psychologist has a pending sexual harassment complaint filed against them and their references voluntarily expressed corroboration with the pending complaint. C. The psychologist has filed many ethical complaints against multiple previous employers. D. The psychologist is nearing the end of their career and expressed strong political beliefs that you disagree with. Correct Answer: B The answer is clearly B. Even though the complaint is pending and not confirmed, there is enough evidence outside of this to be sufficient for job denial from their references. A would be an unjust reason as 1.08 prevents denying employment based solely on complaints filed against them or by them. This same rule goes for C. D is also an unjust reason as this would be discrimination based on age and political beliefs. **Karla Mishreky** Which of the following does not constitute noncooperation when cooperating with ethics committees? A. B. C. D. Explanation: 1.06 cooperating with ethics committees, page 100. Answer choice D is the correct answer, standard 1.06 allows psychologists to request that an APA or affiliated association ethics committee delay decisions of a complaint awaiting the outcome of litigation of the complaint. **Oksana Balaban** Which of the following can a psychologist do who works for a school district with insufficient funds aid in providing the best care for students? A. B. C. D. Correct Answers: A, C, D Rationale: If a school does not have sufficient funds to purchase the most up to date assessments or tests, the psychologist may refer to standard 9.8 (obsolete tests and outdated test results), include explanations into assessment of strengths and limitations, as well as work with district superintendent to request funds. (Chapter 5, page 90). Multiple Choice Questions for Chapter 6 (Part 1) ================================================ Tiffany Szymanski: ================== According to Standard 2.01(b)of the APA Code of Ethics (pertaining to boundaries of competence), psychologists have an obligation to maintain familiarity with current scientific and professional knowledge within the field. Which of the following examples reflects a psychologist being compliant with this obligation? A. B. C. D. **Correct Answer: A** **Rationale:** A is the correct answer; the book states that for activities in which psychologists engage, they need to be adequately familiar with professional and scientific knowledge "to determine whether an understanding of factors associated with the individual characteristics listed in Standard 2.01b is necessary for effective implementation of their services or research" (Fisher, 2023, p. 115). By the psychologist attending trainings on emerging research for depression treatments for this particular population, they are engaging in professional development and obtaining knowledge in order to maintain competency in their work and treatment with this population. B pertains to the obligation of knowing when to refrain and refer, which occurs when a psychologist is aware of their limitations in competency, knowledge and training in working with a client from a particular population, and so refers them to another psychologist who has specialized knowledge and training necessary for working with that client (Fisher, 2023, p. 118). C pertains to the obligation of appropriate skills- the psychologist is attempting to gain the necessary and appropriate skills in working with refugees in seeking consultation. D is incorrect as it pertains to expanding the scope of competencies (by working with a geriatric population when one is specialized in working with youth)- without getting the necessary training or supervision needed in order to expand competencies in a new area (this is covered under Standard 2.01c) (Fisher, 2023, p. 120). **Ryan Stewart** What process should be used as a clinical feedback mechanism for gauging practitioner competence and enhancing ethical decision making? 1\. So Far No Objections (SFNO) 2\. Routine Outcome Monitoring (ROM) 3\. Responsible Conduct of Research (RCR) 4\. Program for the Education and Evaluation in Responsible Conduct of Research (PEERRS) **Answer: 2, Routine Outcome Monitoring**. ROM is feedback-informed treatment or measurement-based care, and uses the scientific method to gather data about treatment progress and clinical outcomes in order to have an objective measure on efficacy of intervention and practitioner competence besides subjective self-appraisal (Fisher, 2023, pg. 114). SFNO is an approach to exclusively ethical decision making, RCR relates to legal guidelines around federal/institutional research guidelines, and PEERRS is the University of Michigan umbrella program that offers a wide variety of research-related practical guidelines and courses. **Mariam Shimo:** **What is the MOST significant ethical concern related to psychologists providing services to unaccompanied immigrant children (UIC) in the context of trauma-informed care?\ **A) The potential lack of culturally relevant interventions tailored for UIC.\ B) The urgency of providing services, which may lead to inadequate assessments.\ C) The requirement for psychologists to navigate complex legal issues regarding the children's immigration status.\ D) The limited access to evidence-based practices specifically designed for UIC. **Correct Answer:** B) The urgency of providing services, which may lead to inadequate assessments.\ **Rationale:** The urgency of providing services to unaccompanied immigrant children can result in psychologists making hasty/quick decisions that compromise the thoroughness of assessments and the appropriateness of interventions. Psychologists may feel pressured to deliver services quickly due to the urgent nature of the circumstances these children face, including experiences of trauma during migration, potential abuse in detention facilities, and loss of family connections. This may lead to overlooking critical factors that are essential for effective trauma-informed care, ultimately impacting the child\'s well-being and therapeutic outcomes. This concern is emphasized on page 122 under "NEED TO KNOW" where the ethical dilemma between the need for immediate assistance and the importance of comprehensive evaluation is discussed. **Abirami Suthan:** **In alignment with Standard 2.01(d), which two conditions must psychologists abide by when providing service for whom appropriate mental health services are not available and which they have not obtained the competence necessary?** a. b. c. d. **Correct Answers**: **B &D**. Support for this answer comes from Chapter 6 (P. 122) section titled Providing Services Not Otherwise available. It highlights that Standard 2.01d applies to situations in which psychologists without appropriate training or experience are the only professionals available to provide mental health services that are needed (e.g., with rural areas, small multicultural communities, immigrants with unlawful status, and other marginalized groups that require additional competencies). To ensure just treatment is provided and avoid harm to these populations, Standard 2.01d outlines two conditions (answers B and D) that emphasize psychologists need to have training or experience in a *[closely related area]* and make reasonable efforts to gain knowledge necessary to conduct the service effectively in order to avoid providing poor services. As obtaining formal education and supervision experience on the service needed is not always feasible with such populations, option A and C are incorrect. Max Kinsey-Kerr: ================ What does the APA Ethics Code Section 2.02 state regarding psychological services in states of emergencies? A\) Psychologists must never provide services outside their area of training, even in emergencies. B\) Psychologists may provide services to individuals in emergencies when no other mental health services are available, despite lacking necessary training. C\) Psychologists can only provide services to individuals they have previously treated. D\) Psychologists should only provide emergency services if they feel confident in their training. Correct Answer: B) Psychologists may provide services to individuals in emergencies when no other mental health services are available, despite lacking necessary training. Section 2.02 states that in emergencies, it is ok for psychologists to provide services even without the necessary training. This must be to ensure services are not denied, and as soon as the emergency situation is over, the services should be terminated. **Karla Mishreky** Which of the following factors are NOT essential for effective implementation of a psychologist\'s services or research? (Choose all that apply). A. B. C. D. E. F. G. H. I. Explanation: Competence and Individual and Group Differences, 2.01(b) page 114. Correct choices are C, E, and H. The questions ask for what factors are NOT essential. According to the book the factors are age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status are essential for effective implementation of services for a psychologist to ensure competence of their services. These factors are important because understanding how these factors in an individual's life relate to psychological processes is important in understanding how the client/patient feels and how they experienced situations,experiences,or traumas. **Jelena Simon** As mentioned in Standard 2.01c of the APA Code of Ethics, psychologists are able to expand the scope of their practice, or 'move around' in their field as long as they take on the necessary education, training, supervised experience, consullation, or study. **Correct Answer:** The correct answer is \#2: TRUE! (This information can be found on p. 120 of the hardcopy textbook) Psychologists have the unique opportunity to 'move around' the field or acquire new specialites/outreach within the psychology community as long as they undertake the necessary education, training, supervised experience, consultation, or study. (Fisher, 2023, pg. 120). Standard 2.01C discusses this in more detail. This is especially relevant in our program, as we likely will want to pursue more specialized certifications/training as they pertain to our interests (i.e. substance use, therapeutic modalities, couples therapy. etc) **David Keenan:** Under which circumstances is it appropriate for a psychologist not specialized in the field of forensic psychology to serve as a fact witness in court? 1. 2. 3. 4. **Correct answer:** \#3. All psychologists can testify as fact witnesses in court, but they are also all considered responsible for obtaining the knowledge that would be required of a forensic psychologist who would more typically serve in that type of role. (Information from the "Need to Know" section under "Assuming Forensic Roles" as well as the "Ethics Dos" section under "Familiarity with Law, Regulations, and Governing Authorities") Multiple Choice Questions for Chapter 6 (Part 2) ================================================ ### **Mariam Shimo:** Which of the following best defines \"multicultural competence\" in the context of psychology? ============================================================================================== A) The ability to conduct therapy in multiple languages. B) The capacity to understand and respect diverse cultural backgrounds and their influence on psychological practice. ============================================================================================================================================================================== C) The skill to apply universal psychological principles to all clients. D) The awareness and integration of cultural differences in assessment, diagnosis, and treatment. ========================================================================================================================================================================== Correct Answer: D) The awareness and integration of cultural differences in assessment, diagnosis, and treatment. ================================================================================================================= Rationale: Multicultural competence is not just about the ability to communicate in various languages or applying a one-size-fits-all approach to therapy. Rather, it encompasses a psychologist's ongoing commitment to understanding and respecting the unique cultural backgrounds of their clients. This includes recognizing how cultural factors shape an individual\'s worldview, experiences, and responses to psychological interventions. By integrating cultural differences into their assessment, diagnosis, and treatment plans, psychologists can create a more effective therapeutic alliance that respects the client\'s identity and promotes better outcomes. This principle is increasingly important in a globalized society, where diverse cultural interactions are common, making it essential for mental health professionals to be culturally aware and responsive in their practice. *(Page 145, Section on Multicultural Ethical Competence)* ========================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================= **Oksana Balaban** What distinguishes an expert witness from a fact witness in psychology in the legal setting? A. B. C. D. Correct Answer: C Rationale: The correct answer is C; page 127 of Chapter 6. An expert witness (pscyholgoist\_ has specialized training in forensic psychology who educates a court on related topics that the average person may not understand. A fact witness (psychologist) testifies based on knowledge from treating a client w/o prior need for forensic expertise. Fact witnesses only discuss the client\'s psychological functioning. To sum it up, an expert witness provides specialized knowledge while fact witnesses shar information based on prior treatment (w/o intent of legal use). Tiffany Szymanski ================= **According to Standard 2.05 of the Ethics Code (Delegation of Work to Others), which of the following should psychologists ensure when utilizing language interpreters for their services?** A. B. C. D. **Correct Answers: A and B** **Rationale:** Choices A and B are correct; support for these answers comes from pp. 138-139 of the textbook; Standard 2.05 highlights that when psychologists delegate work to others- including interpreters- to assist in psychological services, the psychologist needs to ensure that the interpreter has the skills and knowledge to perform competently in their role, which includes understanding the psychological nature of what they are interpreting as well as ethical obligations, especially as it pertains to confidentiality (Fisher, 2023). Additionally, on p. 139, Fisher also points out that those who do not speak English well or who are hearing impaired may live or socialize in close-knit communities where utilized interpreters are often know on a personal level; psychologists should avoid utilizing interpreters that the client knows personally, as this can create a multiple relationship between client and interpreter that could result in ethical issues such as breaches of confidentiality, exploitation and loss of objectivity (Fisher, 2023). Choice C is incorrect as Standard 2.05 does not explicitly state that those who have been delegated work by psychologists have to be knowledgeable about specific treatment modalities being used to treat the client (the main focus is if the interpreter can translate competently and maintain ethical boundaries), Choice D is also incorrect as it is not a specific requirement under Standard 2.05 for those who have been delegated work to have experience working in behavioral health settings with those of a similar cultural background; again the main focus is on those who have been delegated work to do so competently and ethically while avoiding multiple relationships. Abirami Suthan ============== Which of the following is **[FALSE]** as it pertains to multicultural competence in psychological practice? a. b. c. d. **Correct Answer:** **B)** Support for this answer comes from Chapter 6, P. 148 which highlights that multicultural ethical commitment and ethical awareness are essential but not sufficient to ensure the ethical resolution of multicultural challenges. Psychologists must also consider the dynamic nature of individual, institutional, and sociopolitical concepts of race, culture and ethnicity and how previous approaches to ethical problems may no longer ensure the best ethical practice across cultural contexts. A goodness-of-fit approach to ethics that requires psychologists to consider the answers highlighted in (A, C, and D) is thus the best way to strive for multicultural competence. Psychologists must be alert to biases that may lead them to overestimate the influence of culture over other factors, and engage in lifelong reflection of how to make ethical decisions in a way that respects the values of cultural communities as well as psychology as a discipline. **Max Kinsey-Kerr** A psychologist is learning more about a budding new therapy and wants to implement these techniques into their private practice. The therapy is relatively new and does not have that much research behind it. Which of the following would be the most acceptable way to implement this new therapy? A. The psychologist believes that this new therapy provides skills that would be helpful to their clients, and decides to give it a try with them. B. The psychologist first consults another therapist and they come to an agreement that this therapy could be helpful in the populations they work with. C. The psychologist read a peer-reviewed review paper with best practices involving this new therapy and implements this new therapy only in ways supported by this review. D. The therapy, while not validated in the population to which their clients belong, seems like it could generalize to other populations and also looks very similar to another therapy that has stronger scientific evidence. Correct Answer: C Section 2.04 describes the idea that work is based on scientific and professional knowledge of the discipline. Therefore, the best answer will rely most on these ideas. A and B just rely on the opinions of one or two therapists. Answer D is just a face validity test for a new kind of therapy. Answer C is a peer-reviewed article that describes best practices with the new therapy and fulfils best the requirement of basing practices on knowledge and evidence of the field. **David Keenan:** A psychologist would like to use an evidence-based treatment (EBT) with their client, but the research into the applicability of this EBT with the client's culture is limited. The psychologist considers using a modified version of the EBT. Which of the following questions are important for the psychologist to consider before ultimately deciding to go through with the modified EBT? (Select all that apply) 1. 2. 3. 4. **Correct answer:** \#1, \#2, and \#4. Regarding \#2, in addition to the potential risks and benefits of the modifications, the psychologist should also consider the risks and benefits associated with adaptations made while using the EBT as a result of trial-and-error. \#3 is incorrect because this would be considered "ethnic gloss" in which the psychologist incorrectly assumes that certain cultural groups can be lumped together. The book gives the example of Mexican, Puerto Rican, and Dominican clients being lumped together as hispanic. (Information from the "Need to Know" section under "Practice Concerns Related to Evidence-Based Practice) **Ryan Stewart** A research psychologist and professor has IRB approval to perform an experiment involving children. The psychologist has recruited undergraduate student volunteers for data collection. Which of the following is **not** a factor for important consideration under section 2.05 - delegation of work to others within the APA ethics code? 1. 2. 3. 4. **Correct answer:** 1. Per section 2.05 of the APA ethics code, psychologists should be aware of multiple relationships, and expectation of competency. Additional codes for consideration include 3.05 multiple relationships, 9.03 Informed consent in assessments, and 9.07 assessment by unqualified persons. **Jelena Simon** According to standard 2.06: Personal Problems & Conflicts, which of the following scenarios was not outlined in the textbook that would be considered 'reasonable?' 1. 2. 3. 4. **Correct Answer:** The correct answer is \#3. (This information can be found on p. 141 of the hardcopy textbook) Psychologists are humans too, with their own interpersonal/personal issues that develop unexpectedly. We must take appropriate steps to manage our capacity in working with others through different strategies such as self-care, social interaction, consultations with other psychologists in the community, etc. If our personal life feels too much to carry, to the point that it may lead to a lack of competency in working with a client, it needs to be addressed properly. This is why \#3 is the correct answer, because psychologists are expected to practice under a certain set of guidelines with their clients, and in treating patient in the context of significant personal issues (with the idea that it is required) can lead to negative or harmful outcomes/unethical behavior (Fisher, 2023, pg. 141). Standard 2.06 discusses this in more detail. **Karla Mishreky** In what ways can education and training programs increase the competent conduct of practice and research? (choose all that apply) Explanation: 2.06 (b) Stressors in Graduate and Postdoctoral Training, pages 143-144. A and C are the correct choices. Choice B is not an option because on page 144 it states termination if necessary when a student exhibits signs of impairment. Choice D is not correct because this would go against the privacy of the student as well as trust in the faculty the student spoke with which would be an ethical violation. According to 2.06 (b) psychologists should take the appropriate measures to determine whether they should limit or suspend/terminate their work. As a psychology student, one should also take the appropriate measures when going through life stressors, especially during graduate training programs, and programs can provide students the opportunity to do so by providing the necessary resources. By doing so, we can increase the competent conduct of practice and research during graduate training. Oksana Balaban ============== Which of the following are not responsibilities of the psychologist when delegating work to other employees? ============================================================================================================ A. avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity ============================================================================================================================================================ B. authorize only those responsibilities that such persons can be expected to perform competently on the basis of their education, training, or experience, either independently or with the level of supervision being provided ============================================================================================================================================================================================================================= C. see that such persons perform these services competently. ========================================================= D. Assign tasks that do not require supervision or consultation ============================================================ Correct Answer: D ================= Rationale: Providing responsibilities onto another psychologist w/ delegation requires not only relationships, training, and education but also that one will be supervised during this period of time to ensure competence. Standard 2.05 requires an obligation to protect the rights and welfare with which they work. "To be in compliance with Standard 2.05, psychologists should (a) evaluate whether employees, supervisees, assistants, or others whose services are used have the skills to implement the task independently or under appropriate supervision; (b) assign such individuals only those tasks for which they are qualified; and (c) monitor the activities to ensure competent implementation." (Page 138-139) ====================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================== Multiple Choice Questions for Feldman et al., 2004 ================================================== Jelena Simon According to the article "Suicide and the Law: A Practical Overview for Mental Health Professionals," by Stephen R. Feldman and authors,, which of the following is the most common legal action that is filed against a clinician? 1. 2. 3. 4. The correct answer is **\#4: an unintentional tort: negligence.** This information can be found on page 96 in the article "Suicide and the Law: A Practical Overview for Mental Health Professionals." More specifically, this situation was described as a 'tort of omission,' in which the most common charges pressed against a clinician was described as failing to have acted in accordance with *[reasonable skill and professional standards of care, and thereby to have caused harm to the plaintiff]*. More specifically, this was applied in the context of unreasonably evaluating a client, resulting in their suicide. **David Keenan:** The Feldman article describes two types of causation that can be used to show how a clinician's negligence may have led to a client's injuries, suicide attempt, or completed suicide. Which of the following falls under the definition of proximate cause? 1. 2. 3. 4. **Correct answer:** \#2. The other type of causation discussed in the Feldman article is actual causation. Actual causation matches with \#1 and can also be thought of as "but for" causation just as proximate causation can also be thought of as legal causation. (Information from p. 100 of the Feldman article) **Tiffany Szymanski** According to Feldman et al., (2004), what steps should be taken by a clinician to forestall potential liability resulting from a breach of confidentiality when treating clients who are at risk of suicide (select all that apply)?: A. B. C. D. Correct Answers: A, C and D Rationale: Support for these answers comes from page 98 of Feldman et. al (2004), explaining that the best way of forestalling liability from breach of confidentiality is for clinicians to disclose to clients their policies and laws where breach of confidentiality must occur, which usually would take place during the initial appointment, while the clinician is doing informed consent, which should be given to the client both written (i.e. written disclosure statement) and orally and should be documented after the fact in case of potential liability. The article also mentions that many states have mandatory reporting laws where breach of confidentiality is required to protect the safety of the client. B is incorrect (see page 98) because, while the article does mention that there have been cases where the clinician has been held liable for not informing the client's family members of the client's suicidality (particularly in the cases of when suicidality was associated with medical or psychiatric conditions) (Feldman et. al, 2004) this is not directly related to the specific legal steps that clinicians must take in preventing liability from a breach of confidentiality, including those of informed consent and proper documentation. **Abirami Suthan** According to a case in Feldman et al., (2014), a physician who had been treating a depressed male with antidepressants for 5 months was informed by the client's wife that he attempted suicide. The physician recommended inpatient treatment to which the client and his wife agreed. The physician learned that the client did not admit himself to the hospital, as his wife reported that the client was feeling better. Upon referral from another psychiatrist, the clinician saw the client a week later, to which the client agreed once more to hospitalize himself. The following day the client completed suicide. Upon review of the clinicians' actions for negligence, the court found him to be... a. b. c. d. **Correct answer: C.** Support for this answer comes from P.101. Although it may be reasonable to deduce that but for the clinician's omission of admitting the client into the hospital, harm would not have result to the client, the link between this negligent care and the clients suicide is not strong enough to prove that the suicide was foreseeably caused by this omission. Answer A is incorrect as there is no "correct" professional standard of care, rather reasonable and accepted standards of care that exists across specialties which posit that clinicians must seek peer consultations and document their conversations with the client and consultant(s) about suicidal ideation and behavior. As two clinicians saw this client prior to their completed suicide, this poses the question as to whether they were both follow the same standard of care. In the context of this case, proximate causation was not able to be proven. **Ryan Stewart** Which of the following categories is **not** considered a basic (legal) element of negligence? 1. 2. 3. 4. 5. **Correct answer:** 3. "\... the plaintiff must show that the clinician owed the client the duty of reasonable care; that the clinician breached that duty of care; that the breach of the duty actually and proximately (legally) caused the harm; and that measurable damages have resulted from the harm." (Feldman, 2004). While it's likely the case that some types/forms of disrespect could be framed as a breach of duty (such as damaging the therapeutic alliance in a way that is knowingly harmful), this isn't included in the basic legal elements in the reading. **Max Kinsey-Kerr** According to Feldman (2004), what is the best way to forestall potential liability resulting from confidentiality breaches? A. After going through any informed consent process and agreeing to participate in treatment, the client assumes the risk of participating in therapy, and thus informed consent procedures are sufficient to prevent liability from necessary confidentiality breaches. B. Clinicians should include in the oral and written informed consent process a comprehensive list of policies, laws, and situations that may require the clinician to breach confidentiality. C. Use a decision-making process that is supported by field standards including consulting with colleagues before breaching any confidentiality. D. When the clinician believes the client is at risk for self-harm, any breach of confidentiality becomes acceptable to protect the client. Correct Answer: B On page 98 of Feldman's paper, he says the following: "However, the best way to forestall potential liability resulting from a breach of confidentiality is for clinicians, during the informed consent pro\[1\]cess, to disclose to their clients the clinician's policies and governing laws that require breach of confidentiality ("mandatory reporting" in some states) that serve the interest of protecting the client's safety. It is good professional prac\[1tice for clinicians to include this information in both the oral consent process and in the written disclosure statement that occurs and is provided to the client in the first visit. The client's informed consent to such disclosures and any discussion about potential disclosures is documented in the clinical record." **Karla Mishreky** What important finding on clinician liability came out of the Bellah v. Greenson case in 1978? A\) All cases of suicidality must be reported to the authorities by clinicians. B\) Clinicians who violate patient confidentiality in suicide cases may be held legally responsible. C\) Noting the value of confidentiality, some courts have decided that clinicians have no obligation to disclose suicidality. D\) The case proved that, in order to protect patients, all therapists are required to divulge patient information. Explanation: According to the Feldman article pages 97-98, answer choice C is correct. If a client\'s confidentiality is more completely protected and their speaking out about their behavior is not discouraged by breaches of confidentiality, then such suicide acts are less likely to occur. Some courts, however, have found clinicians accountable for neglecting to alert clients\' families to the possibility of suicidality linked to specific medical or psychological problems. **Oksana Balaban** When suicidality becomes apparent, what are the following steps to take to prevent and assess lethality? A. B. C. D. E. F. G. H. I. Correct Answers: All of the above Rationale: Several steps should be taken by the clinician to determine lethality of the client. These include evaluating the risk/motivation, identifying specific plans or means, coordinating care with other treatment providers and family, developing a safety plan with emergency contacts and clients. Emergency confinement should also be considered, accounting for weapon/drugs, awareness for destabilizing events, recording all treatment/plans, and continuing to assess lethality (Benjamin and Felman 1998). Page 98. **Mariam Shimo:** **What key misunderstanding regarding the nature of suicide risk assessments does Feldman address?** A\) Assessments are only necessary in cases of prior suicide attempts.\ B) A comprehensive assessment requires ongoing engagement rather than a singular evaluation.\ C) Assessments should always prioritize patient confidentiality over risk management.\ D) Mental health conditions are the sole focus of suicide risk assessments. **Correct Answer:** B) A comprehensive assessment requires ongoing engagement rather than a singular evaluation. **Rational:** Feldman argues that many clinicians mistakenly believe that a one-time assessment is sufficient for understanding a patient\'s suicide risk. He emphasizes that risk factors can change over time due to various influences, including life circumstances and mental health status. Therefore, continuous communication and reassessment are critical to effectively managing suicide risk. This ongoing process helps clinicians adapt their interventions based on real-time feedback and changes in the patient's situation, enhancing the overall effectiveness of the assessment (pgs. 100-101). Feldman's discussion stresses the importance of viewing suicide risk assessment as a dynamic and iterative process rather than a static event. Multiple Choice Questions for Fowler, 2012 ========================================== Jelena Simon In the article "Suicide Risk Assessment in Clinical Practice: Pragmatic Guidelines for Imperfect Assessments," by James Christopher Fowler, why did the author suggest that collaboration and negotiation within the context of the therapeutic alliances is central in approaching risk assessment? 5. 6. 7. 8. 9. The correct answer is **\#5: ALL OF THE ABOVE**. This information can be found on page 87 in the article "Suicide Risk Assessment in Clinical Pratice: Pragmatic Guidelines for Imperfect Assessments. The article emphasized the importance of a collaborative environment between the therapist and the client. Some guidelines such as the SAFE-T plan were outlined later in the article on an attempt on how to achieve this. **Tiffany Szymanski** According to Fowler (2012), which of the following are one of the main concerns that pertain to false-positive predictions in assessing suicide risk? A. B. C. D. Correct Answer: B Rationale: Support for answer B comes from page 88 of Fowler (2012), which emphasizes that false positives from suicide risk assessment can result in unnecessary hospitalizations for clients, which can damage the rapport between client and therapist and result in feelings of betrayal for the client as well as early termination of services (by the client) and even create a stressful event for the client that could increase suicide risk, even if it is done as a protective measure by the therapist; "While patient safety is the prime objective, there are unanticipated consequences to suspending another person's basic civil rights when hospitalizing patients (especially when based on inaccurate data from suicide assessments)." (Fowler, 2012, p. 88). A is incorrect as the article does not mention that distal risk factors are overlooked as a result of false positive predictions in suicide risk, rather, distal risk factors are actually a part of the false positive predictions- in that a client could possess a number of static risk factors and not be at risk for suicide, which is one of the reasons why clinicians cannot rely solely on static risk factors for assessing suicide risk (see page 82 of Fowler, 2012), (they should still be assessed as part of the overall risk assessment in conjunction with other factors); additionally, C is incorrect as false positive predictions for suicide risk generally do not lead clinicians to not consider risk factors that are modifiable (these should be part of the overall risk assessment and should be addressed), and D is incorrect as clinicians should be addressing BOTH protective factors and risk factors during suicide assessment (see pp. 85-87 of Fowler, 2012), and again that the main concern with false positive predictions is unnecessary hospitalizations that compromise the patient's civil rights and can damage the therapeutic alliance. **David Keenan:** The Fowler article contains a section describing suicide risk as a complex diathesis-stress phenomenon. Which of the following fall under the diathesis side of this model? 1. 2. 3. 4. **Correct answer:** \#1 and \#3. The diathesis stress model in this context is predicated on the idea that vulnerabilities, also known as diatheses, increase one's risk for suicidal ideation and behavior when presented with current stressors. The cases of \#1 and \#3 involve a genetic vulnerability and an environmental/social vulnerability respectively. \#2 and \#4, in contrast, are only related to current stressors and, therefore, do not fall under the diathesis side of the model. (Information from p. 85 of the Fowler article) **Abirami Suthan** According to Fowler (2012), which of the following does NOT fall under clinically regarded best practices to consider when initiating treatment with a patient who is at high-risk for suicide? a. b. c. d. **Correct Answer:** B. Support for this answer can be found on P. 86, which details best practices to consider when negotiating a collaborative treatment approach to suicidal thoughts and behaviors with high-risk patients. While regular check-ins may be a critical part of one's treatment plan, it is not an appropriate course of action to take at the start of an intake session. Rather, clinicians should strive to explore precipitants and meaning of the client's crisis with curiosity (answer D), create a clear plan for de-escalating a suicidal crisis in the event one occurs during treatment (answer C), and negotiate with the client ways that the clinician and client can assume responsibility to ensure the patients safety (answer A). The primary goal when initiating treatment is to collect information on risk and protective factors, and to establish and maintain a working therapeutic alliance with the client that is centered around curiosity, concern, and calm acceptance of the patient\'s emotional and cognitive state. **Ryan Stewart** What is currently the strongest risk factor for predicting suicide and suicide related behavior? 1. 2. 3. 4. **Correct Answer: 2.** Answers 1, 3, and 4 are considered relevant to suicide risk, but a history of attempt carries a moderate-high risk of false positive (compared to high/extremely high for other categories) (Fowler, 2012). Serious attempts are strongly associated with increased mortality risk and repeated attempts - individuals who had made a previous attempt were 48 more times likely to die by suicide than the "average" person. Mariam Shimo: ============= According to Fowler, what is a significant limitation of standardized suicide risk assessment tools? ==================================================================================================== A) They often incorporate patient-specific factors effectively. B) They can lead to a false sense of security in risk evaluations. C) They are designed to be used only in hospital settings. D) They require a lengthy training process to use correctly. ========================================================================================================================================================================================================================================================== Correct Answer: B) They can lead to a false sense of security in risk evaluations. ================================================================================== Rationale: Fowler highlights that while standardized tools may offer structured guidance in assessing suicide risk, they can create an illusion of comprehensive accuracy. This false sense of security may result in clinicians relying too heavily on the tool\'s outcomes without adequately considering the patient\'s unique circumstances and the complexities of their emotional state. It is important for practitioners to remain vigilant and combine the insights gained from standardized assessments with their clinical intuition and understanding of the individual\'s context (pgs. 86-87, section on \"Pragmatic Approaches to Risk Assessments\"). This awareness is important for making sure that risk evaluations do not overlook critical factors that could inform treatment decisions. =============================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================================== **Max Kinsey-Kerr** Fowler (2012) discusses the problems with self-report when assessing suicidal patients including motivation to be dishonest to avoid being stopped and inability to accurately assess their own emotional state. Which of the following are novel strategies to circumvent this issue that the article discusses? A. Computer based measures that assess implicit psychological processes. B. Interviewing strategies that explicitly avoid reference to suicide and focus on current affective states. C. Using low face validity tests like the Rorschach inkblot test to assess current dimensions of cognitive and affective functioning. D. Administering personality inventories to assess personality factors that are associated with suicidality. Correct Answers: A, B, and C. On page 85 of the article, Fowler says, "Several research teams investigating short-term risk circumvent problems associated with self-report bias by developing computer-based measures that assess implicit psychological processes (Cha, Najmi, Park, Finn, & Nock, 2010; Nock & Benaji, 2007), use interview strategies focusing on current affective states while intentionally avoiding reference to suicide (Hendin et al., 2007; Hendin, Al Jurdi, Houck, Haas, & Turner, 2010), or extract dimensions of cognition and affective functioning using the Rorschach Inkblot Method (Affra, 1982; Exner & Wiley, 1977; Fowler, Piers, Hilsenroth, Holdwick, & Padawer, 2001; Fowler, Hilsenroth & Piers, 2001; Fowler et al., under review; Silberg & Armstrong, 1992). These indirect measures show con\[1\]siderable predictive validity with uncharacteristically low levels of false-positive prediction." Thus, A, B, and C are novel tools being used to assess suicide risk while avoiding much of the risk inherent in self-report measures. **Karla Mishreky** Which of the following statements conveys most accurately the conclusions reached by the literature regarding the diathesis-stress model and its implications for suicide risk? A\) The diathesis-stress model postulates that suicide behavior is only caused by genetic and psychological vulnerabilities, unaffected by environmental variables. B\) Genetic vulnerabilities, like the 5-HTTLPR polymorphism, and environmental stressors interact in a crucial way, with certain combinations raising the risk of suicide in particular populations. C\) Studies reveal a strong correlation between a person\'s risk of suicide and their heightened sensitivity to environmental stresses, which is seen in those who have attempted suicide several times. D\) Research has demonstrated that stress reactions are the same in all people, irrespective of their genetic make-up or past exposure to traumatic situations. Explanation: Fowler article pg 85 under Diathesis-stress models of risk, choice B is correct. The section emphasizes how crucial the relationship is in predicting the risk of suicide between genetic vulnerabilities and environmental stressors. It specifically refers to a 2003 study by Caspi et al. that discovered people with the 5-HTTLPR short variant of the serotonin transporter gene were more prone to suicide thoughts and attempts when they were subjected to a number of stressful life experiences. This provides evidence in favor of the diathesis-stress concept by showing how hereditary variables can heighten susceptibility to the effects of stress. **Oksana Balaban** Which of the following are static risk factors for suicide and suicide attempt? A. B. C. D. Correct Answers: A, C, D Rationale: Status risk factors include past suicide attempts, singles psychiatric (or multiple) diagnoses, and genertic markers. Currently the strongest risk factor is prior suicide attempt/s. Static risk factors are often unchanged over time and are linked to the client/patient background or psychiatric history. Proximal warning signs are often immediate or ones that can fluctuate over time; i.e: life stressors or post hospital transition. (Pages 82-84, Fowler) Multiple Choice Questions for Chapter 7 (Part 1) ================================================ **Tiffany Szymanski:** Which of the following statements are **true** regarding detecting harms in psychotherapy and counseling (Select all that apply)? A. B. C. D. **Correct Answers: B and C** **Rationale:** From pages 166-167 of the textbook. B is correct as it states on page 167, "Harmful effects are easiest to detect for mental health problems whose natural course is constant" that is, it is easier for psychologists to detect whether psychotherapy could be harmful (in that these psychotherapies are defined as those that produce outcomes worse than if the client did not have any treatment (Fisher, 2023, p. 166)), if the course of the mental health problems is more constant or predictable. C is also correct as it is mentioned in the textbook under the "Need to Know" Section on p.167, regarding suggestions on detecting harm in psychotherapy and counseling, "Monitor changes that suggest client/patient deterioration or lack of improvement; continuously evaluate what works and what interferes with positive change" "Carefully attend to a client's/patient's disclosures of frustration with treatment, and use the information self-critically to evaluate the need to modify diagnosis, adjust treatment strategy, or strengthen relational factors that may be jeopardizing the therapeutic alliance" (Fisher, 2023, p. 167). A is incorrect as the textbook states that harms could be more difficult to detect and predict in mental health problems that vary in their temporal course of symptoms, such as in the case of trauma- which can also vary regarding the type of traumatic experience, precipitating factors and client characteristics (Fisher, 2023, p. 167). D is also incorrect as worsening symptoms do not necessarily indicate treatment harm when treating naturally deteriorating conditions (such as Alzheimer's), rather this is likely due to the natural course of the disease (Fisher, 2023, p. 166). **Jelena Simon** Consider a situation where a psychologist is practicing in a rural/small town where mostly everyone is interconnected (i.e. church members, storeowners, etc), which of the following would be most inline with standard 3.05: Multiple Relationships? \#1. Some relationships are unavoidable, thus the psychologist can treat whoever they want. \#2. Psychologists are expected to practice in a different city from which they reside to avoid multiple relationships. \#3. When alternative options are not available, a psychologist may treat a client as long as they take reasonable steps in protecting confidentiality, competency, and effectiveness. \#4. The psychologist may treat any client, regardless of a multiple relationship, as long as the relationship is acknowledged during the informed consent procedure. The correct answer is **\#3: When alternative options are not available, a psychologist may treat a client as long as they take reasonable steps in protecting confidentiality, competency, and effectiveness.** This information can be found on page 181 in the hardcopy textbook. It is reasonably expected that some relationships are unavoidable in rural communities, small insulated religious or immigrant communities, etc. A multiple relationship is not automatically unethical, although steps need to be taken to ensure effectiveness and integrity of the therapeutic relationship (Fisher, 2023, pg. 181). Standard 3.05 discusses this in more detail. **David Keenan:** Standard 3.01 prohibits psychologists from engaging in "unfair discrimination" but recognizes that some cases of discrimination may be valid and necessary. Of the following, which would be considered examples of "valid discrimination?" (Select all that apply) 1. 2. 3. 4. **Correct answer:** \#1, \#2, and \#3. The book states that much of psychologists' work involves making valid discriminatory judgments that serve to better help the people and organizations with which they work. The discrimination in \#1 could provide valuable research that may aid the community of that specific race, the discrimination in \#2 aids the university, and the discrimination in \#3 aids the client by not wasting their time with treatment that would be unlikely to help them. In contrast, the discrimination in \#4 is an ethical violation because it reflects a personal or organizational prejudice that could lead to injustice, something not seen in \#1, \#2, or \#3. (Information from the sections under 3.01: Unfair Discrimination) **Max Kinsey-Kerr** When practitioners encounter a situation in which their religious beliefs conflict with the client in some way, which of the following does the textbook recommend considering? A. Is there established scientific or professional knowledge that says these conflicting values prevent clinicians from delivering effective treatments? B. Are practitioners engaging in financial exploitation if they agree to see clients knowing that they will make a referral if abortion or sexual orientation (topics that are likely to be disagreed upon) come up? C. Will explaining the reason for the referral prior to or during treatment harm the client in some way? D. Even if there is good evidence that you could effectively treat someone who's religious beliefs don't exactly match up with your own, the textbook says it is acceptable and recommended to refer anyone who you think may not match up with your own religious beliefs. Correct Answers: A, B, and C. On page 154, the textbook says that competent practice draws on training and experience that enables therapeutic change, and the delivery of these services does not and should not require sharing or endorsing of each others religious views. It then lists A, B, and C as things to consider when deciding that a referral due to a mismatch of religious views is a possibility. **Mariam Shimo:** **Which of the following scenarios MOST exemplifies a violation of Standard 3.04 on avoiding harm, considering both the subtle and significant potential for unintended negative consequences?** A\) A psychologist uses a new therapeutic method that is still in its early stages of research but gains the client\'s informed consent after explaining both the risks and potential benefits.\ B) A psychologist helps a client with social anxiety by encouraging them to participate in a small, controlled social setting, despite knowing the client is prone to discomfort in such settings.\ C) A psychologist continues a treatment that has shown minimal improvement for a client with chronic depression, as the client insists on continuing despite the lack of significant progress.\ D) A psychologist leads a mindfulness session with a group of trauma survivors without considering that mindfulness practices may trigger dissociative symptoms in individuals with certain trauma histories. **Answer:** D) A psychologist leads a mindfulness session with a group of trauma survivors without considering that mindfulness practices may trigger dissociative symptoms in individuals with certain trauma histories.\ **Rationale:** Option D is the correct answer because the psychologist's failure to consider the potential harm mindfulness exercises could cause to trauma survivors, especially those with a history of dissociation, represents a subtle but significant violation of Standard 3.04. Dissociative symptoms can be severely destabilizing for individuals with trauma, and this oversight could cause substantial harm, even if the psychologist's intentions are good. **Option A** involves informed consent and transparency about the risks, which mitigates ethical concerns. **Option B** reflects discomfort rather than harm, and the psychologist is taking steps to help the client gradually face their fears in a controlled manner, which is not inherently harmful. **Option C** touches on client autonomy, as the psychologist is respecting the client's wishes despite the lack of significant progress. Although it may be a missed opportunity to explore alternative treatments, it doesn\'t rise to the level of harm that ignoring potential trauma triggers in a group setting (as seen in D) (pgs 160-170). **Ryan Stewart** Which of the following behaviors by a psychologist would fall into a category of "ethical harm," which would not violate section 3.04 of avoiding harm in the APA code of ethics? (Choose all that apply) 1. 2. 3. 4. **Correct Answer: 1, 3, 4.** (Fisher, pg. 160) While psychologists must take reasonable steps to avoid harming clients/those whom they work with, principles such as integrity put a prioritization put a value of truthfulness on decision making in situations where there is conflict (such as an employer looking to reduce harm to their business vs. someone attempting to reduce personal financial harm by losing a job). Answer 2 is incorrect because of the words "experimental" and "appears" - more specificity would be needed around ambiguity in the sentence to confirm the best approach to reducing harm in that situation. **Abirami Suthan** ​​ **The textbook defines "minimal risk" research as the procedures for which the probability and magnitude of harm and discomfort anticipated in the research...** **(Select the best two options)** a. b. c. d. **Correct Answer: A & C.** Support for this answer can be found on P.169 "Need to Know" section on minimal research. The textbook specifies that psychologists should be familiar with the definition of minimal risk research (Answer C) in order to propose research projects that are in line with IRB standards. Because the formal definition is ambiguous, the IRB has specified an additional guideline for minimal risk research (Answer A) that psychologists should take to minimize IRB risk overestimations when working with at-risk populations (e.g., illicit drug users, underage college students engaged in alcohol use, etc.). Answers B and D are incorrect as minimal risk research emphasizes the potential harm anticipated in research as opposed to expected benefits. While the anticipated benefits may be important, minimal risk research specifically focuses on ways to minimize harm and discomfort that may arise for research participants. **Karla Mishreky** Which of the following assertions about sexual harassment in the context of psychological practice is true, according Standard 3.02? a\) Job-related threats do not constitute as sexual harassment; only undesired sexual attention does. b\) If a reasonable person in a situation believes a particular behavior to be abusive, it can be considered sexual harassment. c\) A psychologist using sexual language during office hours or with staff/colleagues. d\) Sexual harassment does not happen in the workplace; it only happens in educational settings. Explanation: 3.02 Sexual Harassment pg 158. Answer choices b and c are correct. Job-related threats do constitute as sexual harassment, excluding choice a. Answer choice d is incorrect because sexual harassment does happen in the workplace as well as educational settings, found during supervision, or field research, as well as during class, office hours, etc. Sexual harassment laws are changing over time, and its important to stay up to date with how these laws apply in any setting and with both heterosexual and sexual/gender-minority individuals. **Oksana Balaban** In which ways might a psychologist decide if aversion therapy is appropriate for their client? A. B. C. D. Correct Answer: B, D, D Rationale: Consideration of aversion therapy requires ethical deliberation as this therapy may cause the client emotional harm and/or distress. It is important to consider several factors prior to beginning aversion therapy, including all other approaches (validated approaches) to have been attempted or considered, behavior is endangering the client, and the therapists competency to administer aversion therapy. Other considerations include the positive implications outweighing directions from therapy and monitoring procedures/termination. A client would not simply be seen for aversion therapy based on his/her prior experiences (Reference: p. 174 chapter 7 pt 1) Multiple Choice Questions for Chapter 7 (Part 2) ================================================ Tiffany Szymanski ================= Which of the following actions would NOT be in violation of Standard 3.08 (Exploitative Relationships) of the APA Code of Ethics (select all that apply)? A. B. C. D. **Correct Answer: A** **Rationale:** Choice A is the correct answer. On page 194 of the textbook, it states that Standard 3.08 does not prohibit psychologists using sliding scale fees or payment plans for different types or amounts of services, as long as the fee practices are equitable and applied consistently across clients (Fisher, 2023). Answer choices B through D would all be examples of psychologists exploiting clients in some way (violating Standard 3.08) that also occur in conjunction with other violations of the ethics code, as Fisher (2023) discussed on p. 193 of the textbook; B is also in violation of Standard 6.05 (accepting non monetary gifts from clients, the value of which is greater than the psychological service), C is also in violation of Standard 6.04a, Fees and Financial Arrangements (charging clients for assessments to which they did not initially agree upon and is unnecessary for their treatment goals) (Fisher, 2023); D is also listed on p. 193 under ways in which psychologists could violate the ethics code and relates to Standard 6.04a, "Psychologists exploit patients with limited resources who they know will require long-term treatment plans when the psychologists provide services until the patients' money or insurance runs out and then refer them to low-cost or free alternative treatments" (Fisher, 2023, p. 193). **Mariam Shimo:** **Which scenario best illustrates a potential conflict of interest that could compromise the psychologist's objectivity and professionalism, as outlined in Standard 3.06?**\ A) A psychologist who provides therapy to clients from a local hospital accepts a consulting role with the same hospital, where they are asked to recommend treatment protocols based on their therapeutic experience.\ B) A psychologist serving on the board of a nonprofit organization that advocates for mental health policy also conducts independent research funded by that organization but has no direct involvement with its advocacy efforts.\ C) A psychologist promotes a specific intervention they created and have used successfully in their practice, despite recent studies suggesting it may not be effective for all client demographics.\ D) A psychologist engages in community outreach while actively encouraging their clients to participate in events organized by a local mental health advocacy group, which they also volunteer with regularly. **Correct Answer:** A) A psychologist who provides therapy to clients from a local hospital accepts a cons