Transcript EBP Kids - ethicsresearch.com

Ethical Challenges in
Serving Families
Gerald P. Koocher, Ph.D., ABPP
DePaul University
www.ethicsresearch.com
Psychological work with
families differs
significantly from work
with individuals in many
respects that have
important ethical
implications.
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
2
Families often include…
• People with non-congruent,
competing, or conflicting interests.
• People who wish to keep secrets
from each other.
• People who do not wish to be totally
candid with each other.
• People with differing levels of
decisional capacity and dependence.
3
People with non-congruent,
competing, or conflicting
interests.
4
People who
want to
keep
secrets
from each
other.
5
People who don’t wish to be
totally candid with each other.
• Do I look fat
in this?
• Aren’t my
parent’s
wonderful?
• I’m right,
aren’t I?
6
People with
differing
levels of
decisional
capacity and
dependence.
7
How are Child Clients
Different from Adults?
• Legal Status
– Minors and Emancipated Minors
• Example: Dominique Moceanu
• Socialization Influences
– The case of Ricky Ricardo Green
• Time perspective
• Concept manipulation abilities
– Piagetian Frameworks
8
Legal Status
9
Socialization Influences
10
Time perspective
11
Concept manipulation
capabilities
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
12
Ability to anticipate
Consequences?
13
Therapy Involving Couples
or Families
• When psychologists agree to provide
services to several persons who have a
relationship (such as spouses, significant
others, or parents and children), they
take reasonable steps to clarify at the
outset
– (1) which of the individuals are
clients/patients and
– (2) the relationship the psychologist will
have with each person. This clarification
includes the psychologist’s role and the
probable uses of the services provided or
the information obtained.
14
Therapy Involving Couples
or Families
• If it becomes apparent that
psychologists may be called on to
perform potentially conflicting roles
(such as family therapist and then
witness for one party in divorce
proceedings), psychologists take
reasonable steps to clarify and
modify, or withdraw from, roles
appropriately.
15
Remember to discuss…
• Rules for disclosure of information
across the family.
• Reminder that no one can predict the
course of or changes in human
relationships.
16
Isn’t it obvious?
• Psychologists do not
engage in sexual
intimacies with individuals
they know to be close
relatives, guardians, or
significant others of
current clients/patients.
Psychologists do not
terminate therapy to
circumvent this standard.
17
Multiple Relationships in the
2010 Code
• A multiple relationship occurs when a
psychologist is in a professional role with a
person and
– (1) at the same time is in another role with the same
person,
– (2) at the same time is in a relationship with a person
closely associated with or related to the person with
whom the psychologist has the professional
relationship, or
– (3) promises to enter into another relationship in the
future with the person or a person closely associated
with or related to the person.
18
Multiple Relationships in the
2010 Code
• A psychologist refrains from entering into a
multiple relationship if the multiple
relationship could reasonably be expected to
impair the psychologist’s objectivity,
competence, or effectiveness in performing
his or her functions as a psychologist, or
otherwise risks exploitation or harm to the
person with whom the professional
relationship exists.
• Multiple relationships that would not
reasonably be expected to cause impairment
or risk exploitation or harm are not
unethical.
19
Multiple Relationships in the
2002 Code
• If a psychologist finds that, due to unforeseen
factors, a potentially harmful multiple
relationship has arisen, the psychologist takes
reasonable steps to resolve it with due regard
for the best interests of the affected person
and maximal compliance with the Ethics Code.
• When psychologists are required by law,
institutional policy, or extraordinary
circumstances to serve in more than one role in
judicial or administrative proceedings, at the
outset they clarify role expectations and the
extent of confidentiality and thereafter as
changes occur.
20
Who’s in the record?
• Psychologists create, and to the extent the
records are under their control, maintain,
disseminate, store, retain, and dispose of
records and data relating to their professional
and scientific work…
– (1) facilitate provision of services later by them or
other professionals,
– (2) allow for replication of research,
– (3) meet institutional requirements,
– (4) ensure accuracy of billing and payments, and
– (5) ensure compliance with law.
21
Involvement of 3rd
Parties
• When psychologists agree to provide services to a
person or entity at the request of a third party,
psychologists attempt to clarify at the outset of
the service the nature of the relationship with all
individuals or organizations involved. This
clarification includes the role of the psychologist
(e.g., therapist, consultant, diagnostician, or
expert witness), an identification of who is the
client, the probable uses of the services provided
or the information obtained, and the fact that
there may be limits to confidentiality.
22
Understanding the
subtleties of confidentiality
APA’s fundamental statement
on 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.
24
Limits on Confidentiality
per 2010 APA Ethics Code
• Psychologists discuss with persons (including, to
the extent feasible, persons who are legally
incapable of giving informed consent and their
legal representatives) and organizations with
whom they establish a scientific or professional
relationship
– (1) the relevant limits of confidentiality and
– (2) the foreseeable uses of the information generated
through their psychological activities.
25
Limits on Confidentiality
per 2010 APA Ethics Code
• Unless it is not feasible or is
contraindicated, the discussion of
confidentiality occurs at the outset
of the relationship and thereafter as
new circumstances may warrant.
26
The challenge of multipleclient therapies
• When considering work that involves more than one
client in the room the therapist should:
– Think through the rationale for who will be included
(i.e., screening in group treatment, rationales for
collateral engagement, planning rules of engagement
and cautions for couple/family work).
– Who (if anyone) is the primary client.
– What rules of conduct or expectations apply.
– What limitations apply (e.g., client for a limited
purpose or contacts outside of the group context).
– What hazards apply (e.g., emotional confrontation
in group treatment or break-up of couple)
27
• When more than one person hold “client”
status the clinician should:
– Clarify the duties owed to each person and the
limitations on those obligations at the outset.
– Document having done so.
Multiple Client Therapies and
Records
• Groups
– No privilege held in relationship to
other group members
• Couples
– What is the couple’s contract?
• Families
– What is the contract?
– What will parents allow?
– What about break-ups?
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
29
Sharing information about
children’s psychotherapy with
their parents
• Basic concept: therapy has to be safe for all
participants and parents need to know info
about their children that allows them to
fulfill parental responsibilities.
30
Sharing information about
children’s psychotherapy with
their parents
• Children should have consensual
confidentiality rights.
• Parents should have regular progress
reports.
• Therapists may breach a child’s
confidentiality non-consensually to prevent
serious harm, disclosing only info necessary
for parents to protect.
– Clarify meaning of serious harm to avoid
confusion.
31
Sharing information about
children’s psychotherapy with their
parents
• Basic concept: therapy has to be safe for all participants
and parents need to know info about their children that
allows them to fulfill parental responsibilities.
• Children should have consensual confidentiality rights.
• Parents should have regular progress reports.
• Therapists may breach a child’s confidentiality nonconsensually to prevent serious harm, disclosing only info
necessary for parents to protect.
– Clarify meaning of serious harm to avoid confusion.
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
32
When the client is a minor
What secrets will parents
allow their children?
Contract at outset; but
minds can change
Long-term issues
◦ When grown children access
their own childhood records.
33
Confidentiality
34
Confidentiality Hazards &
Mandated Reporting
Dealing with Problematic Caretakers
Basic Principles
• police power
– The state’s authority to protect the
community and ensure domestic
tranquility.
• parens patriae
– The state’s authority to act as the
“general guardian of all infants, idiots
and lunatics.”
• William Blackstone, Commentaries, 47
Mandated Reporting
Child abuse/neglect
– “Reasonable cause to believe” or “reasonable suspicion”
– Sexual abuse may require additional actions
Abuse/neglect of dependent persons
– Elderly
• May include financial abuse
– Disabled
• May allow more discretion by practitioner
– Dangerous Driver (including elders and neurologically
impaired)
– Firearm ID laws (Illinois FOID and NY SAFE acts)
37
Mandated reports
• Why: protection of the vulnerable and the
practitioner.
• Who, what, and to whom…
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
38
Illinois Firearm Owners
Identification Act (430 ILCS 65)
•
•
On July 9th 2013, Illinois passed HB 183 (Public Act
098-0063), also known as the Firearm Concealed Carry
Act. The Firearm Concealed and Carry Act expands the
reporting requirements for healthcare facilities and
physicians, clinical psychologists and qualified examiners
to include any person that is: adjudicated mentally
disabled person; voluntarily admitted to a psychiatric
unit; determined to be a "clear and present danger";
and/or determined to be "developmentally
disabled/intellectually disabled".
The Illinois FOID Mental Health Reporting System
website provides mandated reporters with 24-hour and
immediate access to report an individual that is receiving
mental health treatment or is determined to be a clear
and present danger, developmentally disabled or
intellectually disabled.
39
626.5561, Minnesota Statutes 2007:
REPORTING OF PRENATAL EXPOSURE TO CONTROLLED
SUBSTANCES-- “A person mandated to report… shall immediately report to the local welfare agency if
the person knows or has reason to believe that a woman is pregnant and has used a
controlled substance for a nonmedical purpose during the pregnancy, including, but not
limited to, tetrahydrocannabinol, or has consumed alcoholic beverages during the
pregnancy in any way that is habitual or excessive.
 Any person may make a voluntary report if the person knows or has reason to believe
that a woman is pregnant and has used….
 An oral report shall be made immediately by telephone or otherwise. An oral report
made by a person required to report shall be followed within 72 hours, exclusive of
weekends and holidays, by a report in writing to the local welfare agency. Any report
shall be of sufficient content to identify the pregnant woman, the nature and extent of
the use, if known, and the name and address of the reporter.”
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
40
Psychologist Accused of Failing to Report
Child Abuse
•
•
POSTED: 6:35 am EDT April 9, 2009
http://www.theindychannel.com/news
NORTH VERNON, IN -- A psychologist was
arrested in his Jennings County office Wednesday
on a charge of failing to report child abuse or
neglect. Police said Dr. Robert Dailey did not
report a case in which a juvenile suspect in a child
molestation investigation told him of
inappropriately touching another juvenile during an
appointment. The juvenile's case went through the
juvenile justice system.
41
Bottom line: know the
jurisdictional rules that
apply to your practice.
• Including electronic or remote practice!
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
42
Informed Consent
43
Essential Components of
Informed Decision Making
• Information
– Access
• Understanding
– Comprehension
• Competency
• Voluntariness
• Decision Making Ability
– Reasoning Capacity
44
What are you asking for when you
say, “Is that okay with you?”
• Consent
– Competent, Knowing, Voluntary
• Assent
– Veto Power
– Therapeutic versus non-therapeutic
context
• Permission
– Proxy Consent
– Substituted Judgment
45
Informed Consent
Discussion Topics
• Provide the same basic information
given to individual clients.
• Confidentiality limits.
• Access to records.
• Normal conflicts of interests in
multiple client therapies.
• Children’s rights and limitations in
these situations
46
What principles apply to
informed consent to
treatment?
• Inform clients as early as feasible in the
therapeutic relationship about the nature
and anticipated course of therapy, fees,
involvement of third parties, and limits of
confidentiality.
• Provide sufficient opportunity for the
client to ask questions and receive
answers.
47
APA 2010 Code Comments on
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 or persons except when conducting
such activities without consent is mandated by law
or governmental regulation or as otherwise
provided in this Ethics Code.
48
APA 2010 Code Comments
on Informed Consent
• For persons who are legally incapable of giving
informed consent, psychologists nevertheless
– (1) provide an appropriate explanation,
– (2) seek the individual's assent,
– (3) consider such persons' preferences and best
interests, and
– (4) obtain appropriate permission from a legally
authorized person, if such substitute consent is
permitted or required by law. When consent by a legally
authorized person is not permitted or required by law,
psychologists take reasonable steps to protect the
individual’s rights and welfare.
49
APA 2010 Code Comments
on Informed Consent
• When psychological services are court ordered or
otherwise mandated, psychologists inform the
individual of the nature of the anticipated
services, including whether the services are court
ordered or mandated and any limits of
confidentiality, before proceeding.
• Psychologists appropriately document written or
oral consent, permission, and assent.
50
How about informed consent
other than treatment?
• Psychologists may dispense with informed
consent only
– (1) where research would not reasonably be
assumed to create distress or harm and
involves
• (a) the study of normal educational practices,
curricula, or classroom management methods
conducted in educational settings;
• (b) only anonymous questionnaires, naturalistic
observations, or archival research for which
disclosure of responses would not place participants
at risk of criminal or civil liability or damage their
financial standing, employability, or reputation, and
confidentiality is protected;
51
Who Can Consent to Treatment
for a Minor Child?
• The Child
– Confirm applicability of state laws.
• The Parents
– Joint custody means either parent may consent
unless court decrees state otherwise.
– With joint custody either parent can demand
an end to therapy of minor child.
– Resisting parental demand could result in
disciplinary action.
52
Who Can Consent to Treatment
of Minor Child?
• When legal/physical custody is
divided:
– Seek consent from both parents prior
to evaluating or treating.
– Request copy of divorce decree or
letter from parent’s attorney attesting
to their authority.
53
Who Can Consent to Treatment
of Minor Child?
• When a parent is unavailable or when
parental contact might reasonably be
expected to harm the child:
– Seek consultation.
– Note pros and cons of non-contact in
your records.
54
Parental disputes
regarding child’s
treatment
• Consent to your services does not
equal acceptance of payment
responsibility.
– Clarify this in advance, preferably in
writing, with the party accepting
responsibility.
55
Who is the client when a
child enters therapy?
• Does a psychotherapist-client relationship
exist when a parent participates in
services only (or chiefly) to aid the child?
– If parent is not considered a client he/she
should be specifically informed before
professional activities begin.
– Information provided in such contexts is
confidential, but may not be privileged.
– Document the parent’s “client” status in writing
56
Who is the client when a
child enters therapy?
• Usual best option: designate
parents as clients for limited
purposes in your records and
inform them.
57
Understanding the
subtleties of confidentiality
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
58
When the client is a minor
What secrets will parents
allow their children?
Contract at outset; but
minds can change
Long-term issues
◦ When grown children access
their own childhood records.
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
59
Sharing information about
children’s psychotherapy with their
parents
• Basic concept: therapy has to be safe for all participants
and parents need to know info about their children that
allows them to fulfill parental responsibilities.
• Children should have consensual confidentiality rights.
• Parents should have regular progress reports.
• Therapists may breach a child’s confidentiality nonconsensually to prevent serious harm, disclosing only info
necessary for parents to protect.
– Clarify meaning of serious harm to avoid confusion.
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
60
Parent and Child
Relationships
Traditional and
Not so Traditional
Parent/Child Issues
Parental Right of Control
• Pierce v. Society of Sisters
(1925)
– Private school okay
• Meyer v. Nebraska (1923)
– OK to teach German
• Prince v. Massachusetts (1944)
– Betty M. Simmons, age 9
– Sara Prince aunt and custodian
– The issue: Do religious convictions
trump child labor laws?
– “Parents may be free to become
martyrs themselves. But it does not
follow they are free, in identical
circumstances, to make martyrs of
their children before … they can make
that decision for themselves.”
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
Guardianship of Phillip B. (1983)
• Herbert and Patsy H. seek to take
Guardianship from Warren and Patricia B.
• “…substantial evidence adequateley
supports the finding that parental custody
would have resulted in harmful deprivation
of…human needs contrary to Philip’s best
interests.”
Parham v. J. R. (1979)
• The reluctant volunteers (children voluntarily
hospitalized by parents)
• Affirmative duty to release recovered patient?
• Least restrictive treatment?
• “Admissions’ staffs…acted in a neutral and detached
fashion.”
• Georgia met due process requirements
• Contrast with Fare v. Michael C., 442 U.S. 707 (1979)
Roe v. Doe Court of Appeals of New York,
1971. 29 N.Y. 2d 188, 324 N.Y.S. 2d
• 20 year old Roe moves out of dorm at University of
Louisville
– Dad (attorney in NY) finds out and cuts off money
– Daughter sells car against Dad’s wishes and lives of sale
income.
– Daughter seeks continuing support to age 21.
• Dad (NY attorney) was not “unreasonable or
capricious.”
• Daughter subjected herself: “to her father’s lawful
wrath…abandons her home…forfeits her support.
Diehl v. State (1985)
• Daughter of Barbara Diehl (age 11)
gave info to police; police search and
find pot.
• Motion to supress evidence denied.
• Confidentiality of parent-child
relationship?
Judicial Notice of
Child Development:
What do Judges
Think?
What we want to believe:
• Judges care about child welfare.
• Judges believe in good science.
• Judges understand child development
(or want to).
• Going into court and telling judges
what we know will carry the day.
Reality:
• Most judges do care about child welfare,
but they (must) care more about the law.
• Judges often have trouble sorting out
what’s really valid data and what it means.
• Telling judges what you know may not help
accomplish what you want, if you don’t
understand legal issues, context, and
precedent.
– P.S. Don’t forget politics & Zeitgeist (all
politics is local and some judges are elected)
Shelley v. Westbrooke (continued)
• December, 1816 – Harriet commits suicide
by drowning in Hyde Park.
– Percy decides to raise the kids, but MGPs say
“No!”
– Percy marries Mary (to look better in custody
dispute?).
• Though fathers had nearly absolute rights
under then-existing English law, Shelley
became one of the first fathers in English
history to lose custody of his children.
Shelley v. Westbrooke (continued)
• The court articulates the “tender years”
doctrine.
– The court described Percy as “profligate and
dissolute,” but focused on his writings as an
avowed atheist.
– The Court of Chancery mostly relied on this,
not on his infidelity or unreliability.
– Lord Chancellor reasoned: Shelley endorsed
atheism and sexual freedom, and would teach
his children to do the same.
U.S. Origin of Tender Years
• Maryland decision in Helms v.
Franciscus, 2 Bl. Ch. (Md.) 544
(1830).
– While recognizing the general
rights of the father, the court
stated that it would violate the
laws of nature to 'snatch' an infant
from the care of its mother.
Palmore v. Sidoti, 466 U.S. 429 (1984)
• Anthony and Linda Sidoti, both Caucasians, were
divorced and Linda was awarded custody of their
3 year old daughter, Melanie. One year later,
Anthony sought custody of the child after Linda
began cohabitating with Clarence Palmore, an
African-American. The Florida courts awarded
Mr. Sidoti custody of the child, arguing that the
child would be more vulnerable to social
stigmatization in a racially mixed household. No
evidence was introduced that indicated Ms. Sidoti
was unfit to continue the custody of the child.
• In a unanimous decision, the Court held:
“The effects of racial prejudice, however
real, cannot justify a racial classification
removing an infant child from the custody
of its natural mother.”
• "Private biases may be outside the reach
of the law, but the law cannot, directly or
indirectly, give them effect." The Court
thus held that the decision of the lower
courts was an unconstitutional denial of
rights under the Fourteenth Amendment.
Goldstein v. Goldstein (1975). Supreme
Court of Rhode Island. 115 R.I. 165,
341 A.2.d 51.
• In the parties' divorce decree, the father was
awarded custody of the daughter. Shortly after the
decree was entered, the father and the daughter
moved to Israel. They did not return for three years.
The mother filed suit to gain custody of her
daughter. During the hearing, the daughter (age 9)
the trial court judge in chambers she wished to live
with her father in Israel. The trial court awarded
custody to the father and allowed him to return with
her to Israel, but ordered her to visit the mother for
four weeks every summer.
• At the wife's request the trial justice took
judicial notice of the threat of
war/terrorist activity in Israel; he also took
notice, upon his own motion, that this country
has been engaged in more violent wars than
Israel during the past 25 years and that
“There's an awful lot of violence here."
• The wife presented testimony that the child,
although reared in the Jewish religion, would
not be considered a member of that faith
under Jewish law until she had been
converted as had her mother.
• On appeal, the court affirmed. The
court held that the trial court did not
err by giving substantial weight to
the daughter's preference when
awarding custody to the father
because the factors favoring each of
the parents was nearly equal.
• “Ann is a very intelligent 9.5 year-old
girl who has had more burdens placed
on her at a very young age than most
youngsters and (has coped) with
those problems and suffers no
emotional damage as a result.“
Oliver Brown v. Board of
Education of Topeka, Kansas
• The Supreme Court announced its
unanimous decision on May 17, 1954.
It held that school segregation
violated the Equal Protection and Due
Process clauses of the Fourteenth
Amendment. The following year the
Court ordered desegregation "with all
deliberate speed."
Brown v. Board of Education of Topeka,
347 U.S. 483 (1954)
• The decision:
– On 17 May 1954 the Supreme
Court handed down a 9-0 decision
which stated, in no uncertain
terms, that "separate educational
facilities are inherently unequal."
Kenneth B. Clark
& Mamie Phipps Clark
• During the 1940s, the Clarks designed a
test to study the psychological effects of
segregation on black children.
• In 1950 Kenneth Clark wrote a paper for
the White House Mid-Century Conference
on Children and Youth summarizing the
research and attracted the attention of
Robert Carter of the NAACP Legal Defense
Fund.
• Carter believed that Clark's findings could
be effectively used in court to show that
segregation damaged the personality
development of black children.
• The Supreme Court specifically cited
Clark's 1950 paper in the Brown decision.
Naughty Children
Roper v. Simmons
• On Sept. 9, 1993, Christopher
Simmons broke into the St. Louis
home of Shirley Crook intent on
robbing and then killing her,
presumably for the thrill of the crime.
He and a friend tied her with duct
tape and drove to a nearby state park.
He wrapped her in electrical cable,
leather straps and a towel before
pushing her off a bridge into the
Meramac River where she drowned.
Roper v. Simmons
• According to prosecutors, Simmons had
talked about this plan with his friends on
several occasions, assuring them they
wouldn't be punished because they were
juveniles in the eyes of the law. A doctor
who evaluated him years after the incident
added that Simmons had drunk12 beers
and smoked marijuana on the evening of
the murder.
Roper v. Simmons
• APA's Position: APA submitted an amicus
brief together with the MoPA presenting
scientific evidence to assist in resolving
critical empirical questions relevant to the
legal standards governing the death penalty
including whether the recognized purposes of
the death penalty – deterrence and
retribution – apply to 16 and 17-year-olds as a
group:
– Behavioral research on the developmental
characteristics of late adolescents, featuring
recent studies from the MacArthur Foundation’s
Research Network on Adolescent Development and
Juvenile Justice, a collection of experts in
psychology, sociology, public policy, law and legal
practice.
Roper v. Simmons
– Research and expert opinion about the characteristics
of adolescents such as less mature decision-making,
impulsivity, risk-taking, peer orientation, temporal
perspective and vulnerability to coercion and false
confession.
– Recent relevant MRI research on brain function
suggesting that the brain continues to develop through
young adulthood in areas that may bear on adolescent
decision-making.
– Assertions that a categorical exclusion of 16 and 17year-olds from the death penalty is warranted based on
the research and the fact that assessment of character
and likelihood of dangerousness as an adult in the death
penalty context cannot be sufficiently reliable to satisfy
constitutional standards.
Roper v. Simmons
• Result: In a 5-4 opinion delivered by
Justice Anthony Kennedy, in March 2005,
the U.S. Supreme Court ruled:
– Standards of decency have evolved so that
executing juvenile offenders who committed
while younger than 18 is “cruel and unusual”
punishment” prohibited by the Eighth
Amendment.
– The majority opinion used several of APA’s
arguments in reaching its conclusion. In his
dissent supporting the death penalty for
juveniles, Justice Scalia asserted that
research provided by APA in a 1989 case
involving parental consent laws was inconsistent
with APA’s position in Simmons.
School Daze
Psychologists, Kids, and
Schools: Special Ethical Concerns
Who is the Client?
The School Board?
The Principal?
The Parents?
The Child?
Who is most vulnerable?
© Gerald P. Koocher, Ph.D., 2014, All Rights Reserved
89
Psychologists, Kids, and
Schools: Special Ethical Concerns
• Organizational Demands versus Child
Client Needs
– Incongruent interests
– Autonomy in the context of
organizational structure
– Service needs and limited budgets
• Forrest v. Ansbach
90
Psychologists, Kids, and Schools: Special
Ethical Concerns within the School
 Legitimacy of token
economies, rewards,
and aversive controls
 Use of “time out”
 Preventive exclusion
 Post hoc support for
administrative
decisions
 Pygmalion effects
91
Psychologists, Kids, and Schools:Special
Ethical Concerns
• Privacy and Confidentiality
– What goes into school records
– Who has access
– “Need to know: paradigm
• Psychologist as “whistle blower” and
mandated reporter in absence of
administration action
92
Psychologists, Kids, and Schools:
Special Ethical Concerns
• School-based research
– Merriken v. Cressman: “prediction of drug and
alcohol abuse” in Norristown, PA schools
opposed by parent and ACLU
– “Opt-out Consent”
• Delancy et al. v. Gateway School District
– Prediction of school-based violence
93
Psychologists, Kids, and Schools: Special
Ethical Concerns Extending Home
• Substance abuse
• Domestic violence
• Academic
dishonesty
• Disciplinary
actions:
– Detention
– Suspension
– Expulsion
• Attendance
• Harassment and
bullying (school
violence)
• Social needs
• IEP appeals
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