NİŞANTAŞI ÜNİVERSİTESİ CLINICAL PSYCHOLOGY ETHICAL STANDARTS IN CLINICAL PSYCHOLOGY İktisadi, İdari ve Sosyal Bilimler Fakültesi iisbf.nisantasi.edu.tr NİŞANTAŞI ÜNİVERSİTESİ ©

What is Ethics? Ethics is derived from the Greek word "ethos" that means that custom. Broadly, ethics are the moral and philosophical system that focuses on the concept of what is right and wrong. An ethical approach to a situation seeks to define what is good (or right) and what is bad (or wrong). In psychology, the ethical guidelines are used in order to ensure research participants or those in therapy do not face any negative consequences from their participation.

Case Study 1: Cln. Psy. A.N., Participates in a Dual Relationship with her client Psy. A.N. is treating a patient who experiences obesity. She is providing a behavioral treatment program to help her patient, decrease food consumption, increase exercise, and change her lifestyle in order to minimize weight problems. Psy. A.N.'s patient works in the printing business. Psy. A.N. needs to order more business cards because she recently moved her office to a new location, so she asks her patient if she would produce the business cards for her at a discounted price. The patient agrees to produce the materials at a 30% discount. Later, Psy. A.N. feels that her patient did only a fair printing job and feels angry and resentful.

Psy. A.N. should have avoided the dual relationship with her client related to business cards. Psy. A.N. shouldn’t try to have both a therapeutic professional relationship and a separate business relationship with her patient. This dual relationship may have made it too difficult for the patient to say no to Psy. A.N., and Psy. A.N.’s dissatisfaction with the printing job may interfere with her ability to relate positively to the patient.

Case Study 2: Psy. B. Breaks Confidentiality with a Client Psy. B. is working with the children of a famous sports celebrity. He is conducting educational and intellectual testing to determine if one or both of his children have learning disabilities. Psy. B. is a big sports fan and is extremely excited about meeting and having the opportunity to work with the family of the sports star. During the course of the evaluation, Psy. B learns a great deal about family including the fact that the sports celebrity has a learning disability and plans on retiring from sports very soon. Psy. B has difficulty keeping this information to himself. He decides to tell his wife as well as several close friends that he is working with celebrity. He asks them not to tell anyone about his learning disability and upcoming retirement from sports.

Case Study 3: Psy. O. uses testing materials for purposes for which they were not developed Psy. O is approached by the board of a computer software company that is interested in hiring a company president. They are hoping that Psy. O will be able to conduct a psychological evaluation to determine which of the three top candidates would make the best company president. The board feels that all three candidates are excellent and that a better understanding of the psychological functioning, personality, and “character” of each person is needed to make the best decision. Psy. O decides to conduct a two-hour interview with each of the three candidates and then ask each to participate in psychological testing. Psy. O decides to use the Rorschach, the MMPI-2, and projective drawings. Based on the testing results, Psy. O recommends one of the candidates as being the most promising company president.

Psy. O. unethically used testing materials for purposes for which they were not intended. These instruments were neither designed nor validated for personnel selection.

*Should a psychologist have lunch with his or her patient? *Should a psychologist date with his/her former patient? *Should a therapist accept gift from his / her clients?

A psychologist who is lonely might be tempted to initiate a friendship or romantic relationship with a highly appealing client. A psychologist with significant financial problems might be tempted to invest in a business deal with a wealthy and successful client. They might be inappropriately break confidentially. Become sexually involved with their patient(s). Falsify research data. Engage in sexual harassment. Encourage their patients to do favors for them such as babysit their child or paint their house, provide ineffective or questionable treatment, or engage in financial fraud. *Many of the principles outlined in these various versions of ethical codes were originally highlighted many centuries ago in the 2500 years old Hippocratic Oath.

ORIGINAL TEXT: Hekim apollon aesculapions, hygia panacea ve bütün tanrı ve tanrıçalar adına!… and içerim, onları tanık ve şahit tutarım ki, bu andımı ve verdiğim sözü gücüm kuvvetim yettiği kadar yerine getireceğim. Bu sanatta hocamı, babam gibi tanıyacağım, rızkımı onunla paylaşacağım. Paraya ihtiyacı olursa kesemi onunla bölüşeceğim. Öğrenmek istedikleri takdirde onun çocuklarına bu sanatı bir ücret veya senet almaksızın öğreteceğim. Reçetelerin örneklerini, ağızdan bilgileri şifahi malumatı ve başka dersleri evlatlarıma, hocamın çocuklarına ve hekim andı içenlere öğreteceğim. Bunlardan başka bir kimseye öğretmeyeceğim. Gücüm yettiği kadar tedavimi hiçbir vakit kötülük için değil, yardım için kullanacağım. Benden ağı ( zehir ) isteyene onu vermeyeceğim gibi, böyle bir hareket tarzını bile tavsiye etmeyeceğim. Bunun gibi gebe bir kadına çocuk düşürmesi için ilaç vermeyeceğim. Fakat hayatımı, sanatımı tertemiz bir şekilde kullanacağım. Bıçağımı mesanesinde taş olan muzdariplerde bile kullanmayacağım. Bunun için yerimi ehline terk edeceğim. Hangi eve girersem gireyim, hastaya yardım için gireceğim. Kasıtlı olan bütün kötülüklerden kaçınacağım. İster hür ister köle olsun erkek ve kadınların vücudunu kötüye kullanmaktan mazarrattan sakınacağım. Gerek sanatımın icrası sırasında, gerek sanatımın dışında insanlarla münasebette iken etrafımda olup bitenleri, görüp işittiklerimi bir sır olarak saklayacağım ve kimseye açmayacağım.”

TARASOFF DECISION - 1976 This relates to a court decision and has meant that if a person is in danger from a person with mental health issues, psychologist must tell the police.

Whether a psychologist is a researcher, teacher, therapist or administrator, he or she is expected to maintain the highest professional ethics in all professional activities at all times. The APA formed an ethics committee in the 1930s, and developed its first set of ethical principles in 1953. (1985, 1992, 1993) The most current version of the Ethics code published by the APA should have read. It is especially important for the field of psychology to focus on professional ethics since psychologist generally have a high degree of responsibility that often significantly impacts the lives of others.

APA’S FIVE GENERAL PRINCIPLES OF ETHICS: 1. Beneficence (fayda sağlama) and non-maleficence (bilerek zarar vermeme) : Psychologists stritive to benefit those they serve and to do no harm. In their professional practice, psychologists must protect the rights and well-being of their clients, those who need help, the animals of research. 2. Fidelity ( vefa, sadakat) and responsibility : Psychologists must have professional and scientific responsibilities characterized by trust. They should continue to spend part of their time for professional development. 3. Integrity (dürüstlük):In all their activities, psychologists strive to be accurate, honest, and truthful. Psychologists do not cheat, swindle, or give promises they can not keep. 4. Justice (adalet) : All persons are entitled to access to and benefit from the profession of psychology; psychologists should recognize their biases and boundaries competence. They should to balance quality of the service. 5. Respect for people’s rights and dignity (haysiyet, itibar): Psychologists must respect the right, privacy and dignity of all people and strive to apply protection of these rights. They must respect differences such as religion, culture, sexual orientation, race and political party, socio-economic status, and should not allow them to influence their therapeutic relationship.

We need these 5 ethical principles in the following areas; 1- Solving ethical issues 2- Determination of Competence and Boundaries 3- Human relationships 4- Protection of confidentiality and privacy 5- Declaration and social explanations 6- Payment 7- Training and internship 8- Research and publication 9- Evaluation 10- Therapy

Other Important Ethical Principles Competence: Psychologists must maintain competence in their area(s) of specialization.They must provide services for which they have the appropriate training and experience and remain up-to-date regarding advances in the field to ensure that they maintain state-of-the-art skills.For example, It has been estimated that about 50% of the material that is learned in graduate school become obsolete 10 to 12 years following graduation. It is important for psychologists to be well aware of their strength and weaknesses, their skill and deficits, and must importantly, their limitations. Confidentiality: Confidentiality is the cornerstone of psychological services. Everything that is mentioned in the consultation room must be kept confidential. Without the assurance of confidentiality, many patients could not comfortably speak about what is on their minds and would be unable to obtain needed assistance. Social Responsibility: Psychologists are expected to contribute some professional time to causes that do not result in financial or other personal gains. For ex. Many psychologists agree to treat at least some patients who are unable to pay for services or can pay only a very small amount of money. Some psychologists agree to provide lectures to schools or civil organizations without financial compensation or expectation that patient referrals will result from their talk. Assessment, or Intervention: Psychologists must use assessment instruments only for the purposes for which they were developed and validated. They must also only use tests they are qualified to administer and interpret and not encourage unqualified persons to use these tests. Informed Consent: When psychologists conduct research or provide assessment, therapy, counseling, or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person.

The most common complaints directed to psychologists are; Inappropriate assessment procedures (%37,3) Lack of professional skills (%13,5) Therapist- client relationship - key issues are confidentiality and border problems (%13) (BC Psychologists Association, 2006)

It is very important that they have knowledge about laws in the countries of psychologists. Limits of confidentiality : For example, it is necessary to report cases of physical abuse and sexual abuse of children. For example, there is a duty to inform the motor vehicles department when it is learned that a motor vehicle is used despite brain spasms or dementia.

The 10 steps of the ethical decision-making process (Canadian Code of Ethics for Psychologists) 1- Determining who may be affected 2. To clarify which ethical principles and solutions can be applied to the existing situation 3- Assessing personal biases 4- Preparing possible action plans 5- To analyze the risks and benefits of these action plans 6- Choosing the most wise action plan 7- Taking action 8- To evaluate the results of action 9- Accepting the responsibilities of the results of action 10- To predict the future, foreseen (ögörülen) situations and take precaution

Case Study: Family therapist D.G. is doing family therapy sessions with a couple. During a solo interview with the couple, the husband mentions that they are constantly arguing, he cannot understand why they are in this situation and he is very sad. However, his wife mentions that she has had a relationship with someone since a year and wants therapist not to tell this to her husband. But nevertheless, she wants to continue therapy sessions because she wants to continue her marriage for her children and other economic reasons. The therapist D.G.has a knowledge that one of the partners is not allowed to know. Should the therapist maintain therapy sessions?

How should the therapist D. G How should the therapist D.G. follow the ethical decision-making process?

REFERENCES NİŞANTAŞI ÜNİVERSİTESİ © American Counseling Association (2005). Code of Ethics. Alexandria, VA: Author. Clinical Psychology: A Modern Health Profession 1st Edition by Wolfgang Linden , Paul Hewitt , Nobel. Haas, L.J. & Malouf, J.L. (1989). Keeping up the good work: A practitioner's guide to mental health ethics. Sarasota, FL: Professional Resource Exchange, Inc. Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. Counseling Psychologist, 12(3), 43-55. Sileo, F. & Kopala, M. (1993). An A-B-C-D-E worksheet for promoting beneficence when considering ethical issues. Counseling and Values, 37, 89-95. Van Hoose, W.H. (1980). Ethics and counseling. Counseling & Human Development, 13(1), 1-12. NİŞANTAŞI ÜNİVERSİTESİ ©