1. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ethical and Legal Issues

2. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ethical Issues Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

3. ROLES and RESPONSIBILITIES OF CLINICIANS Therapist Competence- therapist deliver appropriate psychological treatment Informed Consent- getting permission before conducting a healthcare intervention on a person Confidentiality- keeping information about someone’s health or personal life to yourself Privileged Communication- an exchange of information between two individuals in a confidential relationship

4. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. EXCEPTIONS TO PRIVILEGED COMMUNICATION Mandated Reporting- someone who suspects abuse or neglect is legally bound to report this Duty to Warn- a person will be held liable for injuries caused to another, where the party had the opportunity to warn the other of a hazard and failed to do so

5. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. RELATIONSHIPS WITH CLIENTS The therapist must keep therapeutic boundaries. Most ethical codes forbid romantic and sexual involvement.

6. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. THE BUSINESS OF PSYCHOTHERAPY Payment Issues Paid by client or, more often, third party. Health maintenance organizations and managed care health systems arose to keep insurance affordable. Conflicts arise between managed care and client treatment needs.

7. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SPECIAL ROLES FOR CLINICIANS EXPERT WITNESS- a professional witness or judicial expert is a witness, due to training, education, skill or experience, is to have more knowledge than the average person about something EVALUATION IN CHILD PROTECTION CASES GUARDIAN AD LITEM- a person appointed to be the voice of a child who cannot express themselves and may represent the child in court EVALUATIONS OF PEOPLE WITH COGNITIVE DISORDERS ALL HAVE INHERENT ETHICAL DILEMMAS: SOMEONE OTHER THAN THE ONE THEY ARE EVALUATING IS PAYING FOR THEIR SERVICES.

8. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COMMITMENT OF CLIENTS COMMITMENT: An emergency procedure for the involuntary hospitalization of a person who is deemed likely to create harm for self or other people as a result of mental illness.

9. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COMMITMENT ISSUES BALANCE CLIENT’S RIGHTS WITH CLIENT’S BEST INTERESTS RIGHT TO LEAST RESTRICTIVE TREATMENT RIGHT TO REFUSE MEDICATION

10. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Forensic Issues Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

11. INSANITY DEFENSE Contrary to popular belief, this is a legal term, not a psychological term. The argument, presented by a lawyer acting on behalf of the client, that, because of the existence of a mental disorder, the client should not be held legally responsible for criminal actions.

12. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. INSANITY DEFENSE  Unable to appreciate wrongfulness of their conduct and to control their actions due to a severe mental disturbance.  Generally require DSM-IV-TR diagnosis of psychotic disorder, severe mood disorder, dissociative disorder.  Personality disorder will not be sufficient. In question is the individual’s state of mind at the time of the criminal action.

13. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. M’Naghten Rule- a test applied to determine whether a person accused of a crime was sane at the time when the crime was committed and they are criminally responsible for the wrongdoing. Durham Rule- an accused is not criminally responsible if his unlawful act was the product of mental disease or defect American Law Institute- established in 1923 to promote the clarification and simplification of United States common law and its adaptation to changing social needs Insanity Defense Reform Act- amended the US federal laws governing defendants with mental diseases or defects to make it more difficult to obtain a verdict of not guilty only by reason of insanity INSANITY DEFENSE: HISTORY

14. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COMPETENCY TO STAND TRIAL Whether a defendant is aware of and able to participate in criminal proceedings against him or her.

15. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Mental health professionals play an increasingly important role in the legal system and find they must familiarize themselves with a whole array of forensic issues. The intersection between psychology and law will continue to grow as society looks for interventions that are humane, ethical, and effective.

16. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. http:/ www.mhhe.com/halgin6e For more information on material covered in this chapter, visit our Web site: