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Learning and Teaching Ethical Mistakes

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Learning and Teaching Ethical Mistakes: From Consultation Room to Class Room …

Learning and Teaching Ethical Mistakes: From Consultation Room to Class Room

This presentation was part of PPA's Ethics Educators Workshop

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  • 1. Learning and Teaching Ethical Mistakes: From Consultation Room to Class Room John Gavazzi, PsyD, ABPP Richard Small, PhD, ABPP Michele Miele, MA
  • 2. Learning Objectives
    • Understand the importance of teaching ethical mistakes in the classroom
    • Highlight the Acculturation Model
    • List several ideas related to the Consultation Model
    • Describe the importance of modeling vulnerability and openness
  • 3. O verarching goal is to teach errors in order to prevent unfortunate events or harmful behavior Work on avoiding the term “unethical”
  • 4. Why discuss ethical errors?
    • Patient safety issues
    • Appropriate education of students
    • Provide competent supervision for psychologists-in-training
  • 5. Why discuss ethical errors?
    • Understanding risk management
    • Assist practicing colleagues
    • Develop skills to enhance high quality services
  • 6. Why discuss ethical errors?
    • Highlight how licensing boards work to protect the public
    • Discuss pertinent issues, like offering an apology
  • 7. Ethical decision-making is a complex process
    • Knowledge base: APA code, Pennsylvania law, regulations
    • Emotional factors
    • Cognitive biases/situational factors
    • Outcomes are uncertain
  • 8. Ethical decision-making strategies are typically taught in ethics books and classes The APA Ethical Principles and Code of Conduct do not include a model of ethical decision-making
  • 9. Acculturation Model
  • 10. Acculturation
    • A process to change 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.
  • 11. Ethical Culture of Psychology
    • 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.
  • 12. Acculturation as a Process
    • Can be a complex process
    • Some parts of a psychologist’s practice and lifestyle may be easily acculturated while others not
    • Process that may continue throughout the education or career as a psychologist
  • 13. Ethical Acculturation
    • Identification with personal value system
    • (high vs. low)
    • Identification with value system of psychology
    • (high vs. low)
  • 14. Acculturation Model of Ethical Decision-making High Professional Ethics Low Professional Ethics High Personal Ethics Low Personal Ethics Integration Separation Assimilation Marginalization
  • 15. Marginalization
    • Style: Lower focus on professional ethics
    • Lower focus on personal ethics
    • Risks: Greatest risk of harm
    • Lack appreciation for ethics
    • Motivated by self-interest
    • Less concern for patients
  • 16. Separation
    • Style: Lower focus on professional ethics
    • Higher focus on personal ethics
    • Risks: Compassion overrides good professional judgment
    • Fail to recognize the unique role of psychologists
  • 17. Assimilation
    • Style: Higher focus on professional ethics
    • Lower focus on personal ethics
    • Risks: Developing overly legalistic stance
    • Rigidly conforming to individual rules while missing broader issues
  • 18. Integration
    • Style: High focus on professional ethics
    • High focus on personal ethics
    • Reward: Implement values in context of professional roles
    • Reaching for the ethical ceiling
    • Aspirational ethics
  • 19. Memes
    • Meme : a cultural unit (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"
  • 20. Remedial Ethics
    • Mandatory “floor”
    • Minimum standards adopted by the profession
    • Focus on the law or standards to protect the public
  • 21. Remedial Ethics
    • Overemphasis on regulations and enforceable standards
    • Incomplete view of ethics
  • 22. Positive Ethics
    • 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
  • 23. Positive Ethics is NOT
    • An avoidance of ethical codes, case law, regulations, and statutes
    • A rationalization to explain inappropriate behaviors or decisions
  • 24. Benefits of Positive Ethics
    • Broadens a psychologist’s understanding of ethics in a broader context
    • Sensitize psychologists to ethical implications of decisions on a daily basis
  • 25. Benefits of Positive Ethics
    • Assist psychologists in balancing competing ethical demands
  • 26. Student Perspective
  • 27. Ethics in the Classroom
    • Understanding the Ethical Culture of Psychology
    • Developing Professionalism
      • Dress code
      • Language
      • Self Awareness
    • Level of Acculturation – Integration
      • Learning policy and procedure – Ethics Code
      • Internalizing a strong ethical constitution both professionally and personally.
  • 28. Experiences in the field
    • Clients pursuing personal/ friendship/ intimate relations with you.
      • Rejection
      • Generalizations
    • Using your cell phone for work
    • Gift receiving
    • Self -Disclosure
    • Dealing with suicidal patients and crises
    • The role of Supervision
  • 29. Ethics in the Classroom
    • Exercises on personal examination of ones level of acculturation 
    • Exercises on professionalism – appearance, attitude, language, and understanding that you are being watched even in your personal life. 
    • Dilemma setting – mock therapy sessions – role playing 
    • Video sessions of situations and then discussion to follow 
  • 30. Ethics in the Classroom
    • Debate format – ex. confidentiality versus the duty to warn
    • Teacher, being a good role model – as we are to our clients
      • Let it be evident to our clients/students that we practice professional and personal ethics.
    • Understanding the role of the supervisor during internships
    • Understanding their role as a professional
  • 31. Teaching Ethical Errors Vignettes Case Consultation Model
  • 32. Moving beyond ethical versus unethical Some dilemmas do not have a clear solution, especially when there are competing ethical principles in play.
  • 33. Vignettes
    • Insure that the instructor or supervisor can identify the competing ethical principles
    • Provide sufficient clinical detail
    • If actual case, need to disguise identifying information sufficiently
  • 34. Vignettes
    • Usually less threatening or revealing to the instructor or supervisor
    • Many ethics books have vignettes (along with some semblance of an answer)
    • PPA bulletin board has over 35 real life ethical vignettes
  • 35. Case Consultation Model
    • Prepare a clinical case as if you are seeking consultation from a peer
    • Document relevant clinical details and emotional dynamics
    • Highlight ethical issues or conflicts involved
  • 36. Case Consultation Model
    • Outline your possible solutions and decision-making strategy
    • Discuss what you did clinically
    • Address the outcome of the intervention and your emotional reactions
  • 37. Important Highlights
    • Increase awareness of ethical issues
      • Know the code
      • Know the laws, regulations
      • Read The Pennsylvania Psychologist
      • Commonwealth requires 3 credits in ethics per renewal period, so attend CE workshops on ethics
  • 38. Important Highlights
    • Acculturation process
      • Becoming part of the community of psychologists – PPA, APA, Listserv
      • Awareness of ethical issues through ongoing continuing education
      • Develop a network of colleagues or join a peer consultation network – Ethics Committee
  • 39. Important Highlights
    • When teaching ethical errors
      • Teacher can use ethical decision-making as one means to highlight errors
      • Vignettes can be helpful to highlight pertinent issues and can be emotionally safe
      • Case consultation model can be used as a means to role model ethical struggles and acculturation process