Enhancing Ethical Practice Through Consultation Eric Griffin-Shelley, Ph.D., Eric Dech, Ph.D. and Michele Saffier, M.F.T.

“Lifelong effort”(A.P.A. Preamble): “The development of a dynamic set of ethical standards for psychologists' work-related conduct requires a personal commitment and lifelong effort to act ethically; to encourage ethical behavior by students, supervisees, employees, and colleagues; and to consult with others concerning ethical problems.” http://www.apa.org/ethics/code/index.aspx, p.2.

Experiences with supervision/consultation: 1. Pre-licensure supervision, e.g., state requirements. 2. Post-licensure supervision, then consultation. 3. Mandated consultation by a licensure board.

Types of Consultations A. Individual meetings: 1. Choosing a consultant, e.g., same profession. Format and frequency of meetings. B. Group Consultation concerns: 1. Membership—who is in the group? 2. Structure—what is the format of the meetings? 3. Content—what is discussed, e.g., cases only, personal issues? 4. Size—often 4-6 members. 5. Schedule, e.g., monthly or as needed.

Additional Types of Consultation A. Using Listservs: Pro’s and Con’s. 1. Pro’s: Quick, Large variety of feedback and resources (e.g., books, groups, programs, screening tools) . 2. Con’s: Confidentiality, Hard to give enough detail. B. Professional Organizations have consultants available, e.g., P.P.A.’s Dr. Sam Knapp and A.P.A.’s Insurance Trust has consultants.

Common Issues Confidentiality: A.P.A. Code of Ethics 4.01: 4.01 Maintaining Confidentiality “Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship. (See also Standard 2.05, Delegation of Work to Others.)”

Common Issues Confidentiality A.P.A. Code of Ethics 4.06 Consultations
”When consulting with colleagues, (1) psychologists do not disclose confidential information that reasonably could lead to the identification of a client/patient, research participant, or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided, and (2) they disclose information only to the extent necessary to achieve the purposes of the consultation.”

Common Issues Counter-transference: Anger, Sexual feelings (ours and theirs), Enabling and Colluding (Karpman’s Triangle), Feelings of Powerlessness. Danger to self, others. 1. Reporting requirements (by state) for sex crimes, violence, child and elder abuse. 2. Suicidality assessment. 3. Battered partners (both can be victims).

Common Issues Boundaries including waiting area, phone and email contacts, records. 1. Patients acting out with other patients. 2. Should you Google your clients? Disclosure. 1. Process, policy, Readiness. 2. To children. Terminating therapy: When and How? Diagnosis.

Common Issues Treatment Strategies. Competence. Communication with other therapists (e.g., group, couples). Self-disclosure (including personal information on the Internet). Questioning the ethical behavior of peers.

Forensic involvement. Communication with lawyers, court. Reports. Training for Sex Offender work. 3. Getting offenders to do deeper work.

Value to the consultant. Sharing the work and burdens. Sharing experience and insights.