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Dark side of ethics podcast: False Risk management strategies


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In this episode, John talks with Dr. Sam Knapp, Psychologist and Ethics Educator, about false risk management strategies. Using the acculturation model as a guide, Sam and John discuss how some psychologists have learned false risk management strategies. They discuss the possible erroneous rationale for these strategies. John and Sam provide good clinical and ethical reasons as how these strategies can actually hinder high quality of services. They also discuss ethics education in general and why learning about ethics codes do not necessarily enhance ethical practice and two other counterintuitive facts.

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Dark side of ethics podcast: False Risk management strategies

  1. 1. False Risk Management Strategies Slide presentation for Podcast 8 that can be found here By Sam Knapp, EdD ABPP and John Gavazzi, PsyD,ABPP
  2. 2. At the end of the workshop the participants will be able to: 1. Explain the concept of a false risk management strategy, 2. Identify two false risk management strategies, 3. Outline how a false risk management strategy hinders high quality psychological care. Podcast Objectives
  3. 3. Having an ethics code or attending lectures on ethics codes are among the least effective ways to ensure ethical behavior.
  4. 4. People should not act on principle (standing on principle can be an unprincipled stand)
  5. 5. Altruism and empathy can be unethical.
  6. 6. 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.
  7. 7. EthicsAcculturation Model • An outgrowth of positive ethics that integrates personal ethics and professional obligations. • Psychology has a system of shared and distinctive norms, beliefs, and traditions. • This set of beliefs is reflected in our ethics code.
  8. 8. 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 will likely continue throughout the education or career as a psychologist
  9. 9. Ethical Acculturation Identification with personal value system (higher vs. lower) Identification with value system of psychology (higher vs. lower)
  10. 10. Acculturation Model of ethical development Integration Separation Assimilation Marginalization Higher on Professional Ethics Higher on Personal Ethics Lower on Personal Ethics Lower on Professional Ethics
  11. 11. Marginalized Matrix: Lower on professional ethics Lower on personal ethics Risks: Greatest risk of harm/potentially exploitative Lack appreciation for ethics Motivated by self-interest Less concern for patients
  12. 12. Assimilation Matrix: Higher on professional ethics Lower on personal ethics Risks: Adopted professional standards May develop an overly legalistic stance Rigidly conforming to certain rules while missing broader issues There may be a misinterpretation of the rules May lack compassion
  13. 13. Separation Matrix: Lower on professional ethics Higher on personal ethics Risks: Compassion overrides good professional judgment Fail to recognize the unique role of psychologists Motivated moral reasoning
  14. 14. Integrated Matrix: Higher on professional ethics Higher on personal ethics Reward: Implement values in context of professional roles Reaching for the ethical ceiling/aspirational Highly effective psychologist Ethics outside the office (advocacy, public education)
  15. 15. Assimilated Strategies
  16. 16. A False Risk Management Strategy is an action or intervention on the part of psychologist that is meant to reduce liability or harm, but does not. Ironically, some of these actions or interventions likely hinder the psychologist’s ability to provide high quality of care. What is a False Risk Management Strategy?
  17. 17. Memes are ways that information is passed through a culture. Memes are to genes as social information is to genetic information. False Ethical Memes
  18. 18. Listeners may want to self-reflect on how they learn information on ethics and clinical practice. Unsure how exactly some of these memes are spread. Self-reflection
  19. 19. • Informed consent only occurs at the beginning of treatment • Informed consent mainly involves the patient to sign forms for risk management purposes Informed Consent
  20. 20. • Self-disclosure is never appropriate by the psychologist during psychotherapy or assessment • Self-disclosure is clearly a boundary violation that is always wrong Self-disclosure
  21. 21. • Psychologists cannot talk with patients about medication. • Technically, it is practicing medicine without a license. Psychotropic medication
  22. 22. • When dealing with high risk patients, it is better to not document a great deal of information. • If you do not document much detail, then you have greater legal protection from an attorney indicating that you did something wrong. Attorneys can twist words easily, so the less the better. Suicidal & Homicidal Patients
  23. 23. • This is an important risk management strategy • This is the standard of care • This strategy helps the patient from actually harming him or herself. No suicide contract
  24. 24. • It is the standard of care. • Co-pay, insurance, ability to access the referral is immaterial. • Relationship with the patient or referral is not a high priority Always give 3 names when referring a person for treatment
  25. 25. If you know any questions, please contact John at • Follow me on Twitter @johngavazzi • Follow me on Tumblr at