ABNORMAL PSYCHOLOGY – CHAPTER 15

1. ABNORMAL PSYCHOLOGY – CHAPTER 15 ETHICAL AND LEGAL ISSUES

2. Abnormal psychology – chapter 15 – ethical and legal issues VOCABULARY • Commitment: • An emergency procedure for the involuntary hospitalization of a person who, if not hospitalized, is deemed to be likely to create harm for self or other people as a result of mental illness.

3. Abnormal psychology – chapter 15 – ethical and legal issues • Competency to Stand Trial: • Is the defendant aware of and able to participate in criminal proceedings against him or her? • Confidentiality: • The therapist must safeguard disclosures in therapy in private.

4. Abnormal psychology – chapter 15 – ethical and legal issues • Duty to Warn: • Also called “duty to protect” • The clinician is required to inform the intended victim that the client plans to harm him or her. • Guardian Ad Item: • A person appointed by the court to represent or make decisions for a person who is legally incapable of doing so in a civil legal proceeding.

5. Abnormal psychology – chapter 15 – ethical and legal issues • Informed Consent: • An indication that he or she has participated in setting the treatment goals, understands and agrees to the treatment plan, and knows the clinician’s credentials. • Insanity Defense: • An 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.

6. Abnormal psychology – chapter 15 – ethical and legal issues • Mandated Reporting: • Professionals must report cases of child abuse or neglect. Some states include elder abuse as well. • ParensPatriae: • Legal term that gives authority for commitment based on the principle that the state has a responsibility to protect those who are unable to protect themselves.

7. Abnormal psychology – chapter 15 – ethical and legal issues • Privileged Communication: • The clinician may not disclose any information in a court of law without the client’s expressed permission. *******************************

8. Abnormal psychology – chapter 15 – ethical and legal issues • Roles and Responsibilities of Clinicians: • Therapist Competence: • A license or degree does not necessarily mean that the therapist is competent • Experience dealing with specific issues • Personal struggles at time of treatment • Must constantly self-assess

9. Abnormal psychology – chapter 15 – ethical and legal issues • Informed Consent: • Clinicians are required to give the client information pertaining to his/her therapy • Several key elements: • Discuss Goals of Treatment • Client’s Rights • Therapist’s responsibilities • Treatment Risks • Techniques that will be used • Financial Issues • Limits of Confidentiality

10. Abnormal psychology – chapter 15 – ethical and legal issues • Once those matters have been discussed: • Client is generally given a written statement containing that information • In particular, risks of treatment need to be discussed • Electroshock Therapy • Drug Therapies • Patient has to be given the opportunity to refuse treatment • Sometimes, the patient is incapable of making these kinds of decisions

11. Abnormal psychology – chapter 15 – ethical and legal issues • Confidentiality: • Therapist must safeguard disclosures made in private = privileged communication • Exceptions: • Child custody cases = protect welfare of child • Mental disability defense in a criminal trial • Competency to Stand Trial hearings

12. Abnormal psychology – chapter 15 – ethical and legal issues • More Exceptions to “Confidentiality: • Mandated Reporting: • Clinicians, teachers, and other health professionals are required to reveal any information related to abuse and neglect of children and sometimes elders • Duty to Warn: • Clinician is required to notify the intended victim of his/her client

13. Abnormal psychology – chapter 15 – ethical and legal issues • Relationships with Clients: • Most extreme violations: sexual or romantic relationships • No business relationships • Socializing with clients is a gray area • All of these violations cause the clinician’s objectivity and judgment to be blurred

14. Abnormal psychology – chapter 15 – ethical and legal issues • Commitment of Clients: • An emergency procedure for the involuntary hospitalization of a person who, if not hospitalized, is likely to harm self or others due to mental illness. • Stems from legal principle of parenspatriae • The state has the authority to protect those unable to protect themselves

15. Abnormal psychology – chapter 15 – ethical and legal issues • The Process of Commitment: • Clinicians, physicians, nurse specialists, etc., are authorized to sign commitment papers due to mental illness • If a family member desires commitment, it often goes to a judge for a hearing • Hospitalization is usually limited to 10 days and must be extended legally if a longer term is needed

16. Abnormal psychology – chapter 15 – ethical and legal issues • Ethical Questions surrounding “Involuntary Commitment” • Do we have a right to interfere in another’s decisions? • Whose interpretation do we use? Liberal or stringent? • What about the homeless? • How do we predict the likelihood of injury to oneself or another?

17. Abnormal psychology – chapter 15 – ethical and legal issues • Client Rights: • 1. Right to Treatment • Some hospitals are still inhumane and conditions are detrimental to patient’s mental health • The institution MUST be able to help the patient • If they cannot, it amounts to imprisonment instead of mental health confinement

18. Abnormal psychology – chapter 15 – ethical and legal issues • These rights include the following: • Privacy • Appropriate Clothing • Social Interaction • Mail • Telephone Privileges • Visitors • Adequate Diet

19. Abnormal psychology – chapter 15 – ethical and legal issues • Insanity Defense: • Legal Term • Because of a mental disorder, the client should not be held legally responsible for criminal actions • To be legally insane means that one has a lack of freedom to choose one’s behaviors • Also lack the mental competence to distinguish between right and wrong.

20. Abnormal psychology – chapter 15 – ethical and legal issues • History of Insanity Defense: • Landmark case in 1843: • M’Naghten Rule: • Scottish Woodcutter, Daniel M’Naghten, had a delusional belief that he was commanded by God to kill an official of the English Government. • The argument was that he was incapable of knowing right from wrong.

21. Abnormal psychology – chapter 15 – ethical and legal issues • The M’Naghten Rule was modified 30 years later: • Some disturbed behaviors may result from the person’s inability to inhibit actions they feel compelled to carry out. • This happens even though the person knows “right from wrong”.

22. Abnormal psychology – chapter 15 – ethical and legal issues • The next landmark ruling is known as the “Durham Rule” (1954): • A person is not criminally responsible if the “unlawful act was the product of mental disease or defect” • Allows for the insanity defense to be used in cases involving many forms of mental disorders

23. Abnormal psychology – chapter 15 – ethical and legal issues • Some famous cases: • John Hinckley - 1981 • Attempted assassination of President Ronald Reagan • His obsession with actress Jodie Foster led him to believe that if he killed the President, she would be so impressed with him that she would fall in love with and marry him. • He was ruled insane and was sentenced to a mental hospital.

24. Abnormal psychology – chapter 15 – ethical and legal issues • Jeffrey Dahmer: • Serial murderer • Murdered and dismembered 17 boys and young men • Driven to kill out of a compulsion to have sex with dead bodies • Argument was only someone criminally insane would have committed these crimes • The jury rejected his insanity plea and sentenced him to 16 consecutive life terms

25. Abnormal psychology – chapter 15 – ethical and legal issues • Andrea Yates – June 2001: • Drowned and killed her 5 children in her bathtub • Showed previous episodes of mental illness related to post-partum depression • Once again, the jury rejected her defense and sentenced her to life in prison.

26. Abnormal psychology – chapter 15 – ethical and legal issues • How do we determine “COMPETENCY TO STAND TRIAL”? • We are trying to determine whether a defendant is aware of and able to participate in criminal proceedings against him or her. • THIS IS A LEGAL QUESTION!!! • The defendant must be able to understand the charges and be able to participate in his/her defense.

27. Abnormal psychology – chapter 15 – ethical and legal issues • Steps to this determination: • Judge calls expert witnesses (psychologists or psychiatrists) to conduct an examination of the defendant • These experts testify about defendant’s competency • The quality AND quantity of evidence must point to the conclusion that the defendant is suffering from a serious mental illness or defect.

28. Abnormal psychology – chapter 15 – ethical and legal issues • These are the items to be evaluated: • Mental Health • Emotional Stamina • Ongoing Symptoms • Will the stress of the trial create a psychotic episode? • These are never easy questions and clearly need to be carefully considered for each individual case.