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Integrating ethics and values
The document discusses ethics training for psychologists, including reviewing ethical principles, models of ethical decision-making, analyzing vignettes, and increasing awareness of cognitive biases and situational factors that can influence ethical judgments and decisions. Online resources on ethics are recommended for self-education as well as connecting with others on ethics blogs and sites. The goal is for psychologists to thoughtfully integrate ethics into their work through understanding acculturation into the professional culture.
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Integrating ethics and values
- 1. John Gavazzi, PsyDABPP November 1, 2012
- 2. Learning Objectives Online Information: Ethics blog and other sites Structured information sharing Vignette analysis and case discussions
- 3. 1. List at least three ethical principles related to APA’s code 2. Compare and contrast positive ethics and risk management 3. Describe the Acculturation Model 4. Explain one ethical decision-making model 5. Analyze one ethical vignette by identifying conflicting principles
- 4. www.papsyblog.org Where Ethics isMore Than a Code and Positive Ethics is more than a Slogan
- 5. Ethics Blog Self-education Connecting with others: Blogs & other sites Becoming politically active
- 6. Introduction and Applicability Preamble and General Principles (Aspirational and based on principle-based ethics) Ethical Standards (Enforceable and represent minimum standards)
- 7. The ethics code does not include federal laws, such as HIPAA The ethics code does not include case law, though influence is noted The ethics code is distinct and separate from guidelines approved by the APA Council of Representatives Quiz Question: How many are there?
- 8. Autonomy Beneficence Nonmaleficence Fidelity Justice
- 9. Does not mean promoting autonomy (individuation or separation) Means respecting the autonomous decision making ability of the patient
- 10. It encompasses freedomof thought and action. Individuals are at liberty to behave as they chose. - Determining goals in therapy - Making life decisions (e.g., marriage, divorce) - Scheduling appointments and terminating treatment
- 11. The principle of benefiting others and accepting the responsibility to do good underlies the profession. - Providing the best treatment possible - Competency - Referring when needed
- 12. Basis of foundationalstandard 2.01 “Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence. . . “
- 13. The principle isdoing no harm. - Demonstrating competence - Maintaining appropriate boundaries - Not using an experimental technique as the first line of treatment - Providing benefits, risks, and costs
- 14. Foundational Standard 3.04 “Psychologiststake reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients, and others with whom they work, and to minimize harm when it is foreseeable and unavoidable.”
- 15. This principle refersto being faithful to commitments. Fidelity includes promise keeping, trustworthiness, and loyalty. - Avoiding conflicts of interests that could compromise therapy - Keeping information confidential - Adhering to therapeutic contract (e.g., session length, time, phone contacts, etc.)
- 16. Foundational Standard 4.01 “Psychologistshave a primary obligation and take reasonable precautions to protect confidential information.”
- 17. Justice primarily refersto treating people fairly and equally. In their work-related activities, psychologists do not engage in unfair discrimination based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, socioeconomic status, or any basis proscribed by law. (3.01)
- 18. Ethics as a movement away from the punishment and anxiety-producing components of ethics Fulfill their highest ideals A means to help interpret and apply ethics standards
- 19. Broadensa psychologist’s understanding of ethics in a larger context Sensitizepsychologists to ethical implications of decisions on a daily basis
- 20. Heighten awareness related to ethics beyond our offices Assist psychologists in balancing competing ethical demands
- 21. Remedial: Acquiring andmaintaining minimal formal qualifications Positive: Striving for highest standards Includes self-awareness and self-care Emotional competence
- 22. Remedial: Avoiding boundaryviolations Focus on sexual boundaries Adhere to strict interpretation Positive: Striving to enhance quality of all professional relationships Understand issues related to multiple relationships
- 23. Remedial: Fulfilling legalresponsibilities to get consent forms or Privacy Notices signed Positive: Working to maximize client participation with goals and treatment processes
- 24. Remedial: Avoiding prohibiteddisclosure Emphasis legal requirements Positive: Striving to enhance trust Understanding nuances when working with families
- 26. A process tochange the cultural behavior of an individual through contact with another culture. The process of acculturation occurs when there is an adaptation into an organization or society. The process involves developing relationships with those within the culture to learn the traditions, rules, roles, and behaviors to become part of that group or community.
- 27. Our system of common beliefs, shared meanings, norms and traditions that distinguish psychologists as professionals. It is a learned set of skills, bases of knowledge and ethical beliefs, as described in our ethics code.
- 28. Our culture of ethics moves beyond ourselves as individual psychologists. Expands into our ability to become connected with the profession of psychology as well as other professionals. Our ethical culture “happens” everyday when we relate to our patients, peers, or general population.
- 29. Can be a complex process Some parts of a psychologist’s behaviors, practice, and lifestyle may be easily acculturated; while others will not Process that may continue throughout the education or career as a psychologist
- 30. Ethics Autobiography Exploring religious upbringing Exploring interpersonal relationships
- 31. Meme: a culturalunit (an idea or value or pattern of behavior) that is passed from one person to another by non-genetic means (as by imitation); "memes are the cultural counterpart of genes"
- 32. Identification with personalvalue system (high vs. low) Identification with value system of psychology (high vs. low) These are on a continuum more so than boxes.
- 33. Acculturation Model ofEthical Decision-making Higher on Professional Ethics Lower on Professional Ethics Integration Separation Higher on Personal Ethics Assimilation Marginalization Lower on Personal Ethics
- 34. Style: Lower focuson professional ethics Lower focus on personal ethics Risks: Greatest risk of harm Lack appreciation for ethics Motivated by self-interest Less concern for patients
- 35. Style: Lower focuson professional ethics Higher focus on personal ethics Risks: Compassion overrides good professional judgment Fail to recognize the unique role of psychologists
- 36. Style: Higher focuson professional ethics Lower focus on personal ethics Risks: Developing overly legalistic stance Rigidly conforming to individual rules while missing broader issues
- 37. Style: High focuson professional ethics High focus on personal ethics Reward: Implement values in context of professional roles Reaching for the ethical ceiling Aspirational ethics
- 38. Our level ofacculturation and our style of ethical decision-making
- 39. Mandatory “floor” Minimum standards adopted by the profession Focus on the law or standards to protect the public
- 40. Overemphasis on regulations and enforceable standards Incomplete view of ethics Ethics is more than just a code
- 41. A means to reduce risk in an uncertain situation Decision-making strategies to avert problems or liability of the psychologist False risk management strategies (memes, such as the No Suicide Contract)
- 42. No evidence to indicate that it helps reduce suicidal behavior Cannot be used an part of an assessment Contract implies a legal tool to reduce risk May actually harm the therapeutic alliance, not promote it
- 43. What are someoptions?
- 44. Rational Psychologist Learnthe rules Apply the rules Outcomes will follow
- 45. Learn the rules Understand patient Apply the rules dynamics Outcomes will follow Understand the relationship
- 46. Psychologist Patient Variables Therapeutic Alliance
- 47. Looking at how well a psychologist integrates his/her values and behaviors into the ethical culture of psychology Psychology has a set of normative principles and behaviors related to ethical behavior and appropriate conduct
- 48. APA’s Code of Conduct Commonwealth Psychology regulations found in the Psychology Law and Practice Act Federal Regulations, such as HIPAA Court decisions aka case law
- 49. The APA EthicalPrinciples and Code of Conduct do not include a model of ethical decision-making Other resources dictate behavior, but do not highlight how to work through dilemmas
- 51. The means to comply with a standard may not always be readily apparent Two seemingly competing standards may appear equally appropriate Application with of a single standard or set of standards appear consistent with one or more aspirational principle, but not another
- 52. Autonomy Beneficence Nonmaleficence Fidelity Justice
- 53. Often ethical dilemmasinvolve apparent conflicts between respect for patient autonomy versus beneficence or Respect for autonomy versus general or public beneficence
- 54. Identify the competing ethical principles Help to determine which principle has precedence and why The importance of emotion in ethical decision- making and moral judgments
- 55. S Scrutinize H Hypothesize A Analyze P Perform E Evaluate
- 56. 1. Goal isto define the problem by identifying the conflicting ethical principles 2. Generate a wide range of possible solutions and identify pros and cons 3. Merge or knit the possible solutions together in a way that maximizes the benefits and limits the disadvantages 4. Implement 5. Look back or evaluate
- 57. “integrative framework” stepstwo and three generate solutions that maximize your personal values within the context of your professional role
- 58. Avoid dichotomous thinking–either I have to do x or y. For example, either I have to warn the potential victim of a threat or I have to protect confidentiality.
- 59. Malcolm Gladwell’s book “Blink” Jonathan Haidt’s book on Moral Intuition Jay Mills article on emotions in ethical decision- making
- 60. Fear Passion Anxiety Calmness/Centered Empathy Disgust Respect/Sympathy Disrespect Positive emotions related to our good Negative emotions related to ethics decision-making skills and ethical and moral decision-making knowledge
- 61. Why do psychologists(still and continue to) have sex with their patients?
- 62. The Fundamental Attribution Error Availability Heuristic Trait Negativity Bias Confirmation Bias
- 63. Dunning-Kruger Effect: a cognitive bias in which unskilled individuals suffer from illusory superiority, mistakenly rating their ability as much higher than average. Poor performers fail to learn from their mistakes. And, they fail to internalize direct feedback from others.
- 65. Knowledge base: APA code, Pennsylvania law, regulations Become Aware of emotional factors Cognitive biases/situational factors Outcomes are uncertain