Ethical Decision-making for Clinical Psychologists Faced With Forensic Questions

1. Ethical Decision-making for Clinical Psychologists Faced With Forensic Questions Recognizing cases with potential Legal implications Argosy University, Dallas Texas School of professional psychology Brown bag lunch workshop September 12, 2012

2. Who has been faced with a clinical question related to forensic matters? • Who has or anticipates • Conducting therapy with a child or parent involved in a pre- or post-divorce custodial matter? • Conducting therapy with a child or adult victim who will testify at a criminal trial? • Conducting a psychological evaluation for pre-employment for a candidate for a public safety personnel position? • Conducting evaluations for DARS/DADs referrals?

3. To Whom Do Forensic Practice Rules Apply? • To all practicing psychologists • A licensee who provides services concerning a matter which the licensee knows or should know will be utilized in a legal proceeding….must comply with all applicable Board rules concerning forensic services regardless of whether the licensee is acting as a factual witness or an expert.

4. Testimony = Plague? Most psychologists don’t plan to specialize in forensic casework Many psychologists seek to avoid having to testify in court All psychologists may find themselves in the position of handling cases that involve forensic issues or being called upon, i.e., subpoenaed, to testify

5. Ethics and Regulatory Rules • Regulatory rules, e.g., TSBEP Rules, are the rails that guide the train • Ethical principals are the bed on which that rail is built and serves as cross ties for the rail

6. Staying On Track • The “rails” serve to keep the psychologist “on track” • The mission of a regulatory Board, e.g. TSBEP, is to protect the public, i.e., the consumer of psychological services • And inform practitioners in a manner that will provide guidance and reduce the likelihood of having a complaint filed against them • The “rails” of regulatory rules serve to provide a minimum standard • Ethically informed decision-making determines how well the psychologist engineering the train progresses down the tracks

7. How Psychologists Get Derailed • Most Frequent Rule Violations • Not completing continuing education requirements (55%) • Forensic case violations and child custody related matters (15%) • General therapy violations, e.g. record keeping and release of records, confidentiality (16%)

8. TSBEP – FY 2011 Complaints Cease & Desist 3% Misc 1% Sexual Misconduct 1%

9. Staying On the Regulatory Rails • Know what constitutes forensic practice and “third party” evaluations • Develop relevant policies for your practice • E.g., how informed consent for child therapy is obtained • Develop appropriate statements of informed consent for the service you are providing • Recognize that circumstances change and understand and address the implications • E.g., know when a general therapy case may become a forensic case and how to respond to that

10. Ethical Awareness • Ethical awareness might also be described as “heightened” awareness • Such awareness is informed by foundational ethical principles of the American Psychological Association • Knowledge of current standards of practice and licensing board regulatory rules (think continuing education) • Be proactive, not reactive • Find a good decision-making model and use it

11. Remember Yerkes-Dodson Law(original version) • There’s a curvilinear relationship, inverted u-shape, between arousal/anxiety and performance • As arousal increases so does performance, but too much arousal can interfere with performance (particularly for complex tasks) • Implication? • If you don’t leave a CE workshop on ethics with a little apprehension/arousal you may be headed for trouble • On the other hand, benefit from your apprehension – Don’t let it paralyze you • Learn what you need to know • Practice what you’ve learned • When you’re not sure what to do, consult • When you think you know what to do, consult • When you have done what you think you need to do, step back, observe and see if it’s working • If not, consult, and revise your strategy

12. Case Example • A child’s father who has remarried brings his child in for therapy due to anxiety and behavioral concerns as reported by the father. • What might you want to know? • What rights does the father have to seek therapy for his child? • Does the child’s mother know he is bringing child for therapy? • Will the father provide the mother’s name and contact number as well as written consent to contact her?

13. Case Examples • Child’s step-mother, i.e., married to the child’s father, brings her 10-year-old step-son in for therapy. She completes the necessary information for intake and signs the informed consent. • What concerns might you have? • Additional information • Stepmother has no legal standing to provide informed consent • Father has joint managing conservatorship of the child • Mother, who is primary custodial parent, has objected in past to the father taking child to therapy

14. Case Examples • A 7 year-old child’s mother brings the child to your office for therapy due to behavioral concerns associated with sexualized behaviors. She wants the child treated and assessed for possible sexual abuse. • What concerns might you have? • Additional information • During the third session the mother mentions that she has filed for divorce from the child’s father.