Truly appreciate the things your company does. It truly helps people with certain deadlines and a hectic life they have.
PART1- Due Thursday Respond to the following in a minimum of 175 words:
Review this week’s course materials and learning activities, and reflect on your learning so far this week. Respond to one or more of the following prompts in one to two paragraphs:
University of Phoenix Material
Case Study Four Worksheet
Respond to the following questions in 1,500 to 1,750 words.
1. Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma?
2. Does this situation meet the standards set by the duty to protect statue? How might whether or not Dr. Yeung’s state includes researchers under such a statute influence Dr. Yeung’s ethical decision making? How might the fact that Dr. Yeung is a research psychologist without training or licensure in clinical practice influence the ethical decision?
3. How are APA Ethical Standards 2.01a b, and c; 2.04; 3.04; 3.06; 4.01; 4.02; and 10.10a relevant to this case? Which other standards might apply?
4. What are Dr. Yeung’s ethical alternatives for resolving this dilemma? Which alternative best reflects the Ethics Code aspirational principle and enforceable standard, as well as legal standards and Dr. Yeung’s obligations to stakeholders?
5. What steps should Dr. Yeung take to ethically implement her decision and monitor its effects?
Fisher, C. B. (2013). Decoding the ethics code: A practical guide for psychologists. Thousand Oaks, CA: Sage.
PART3- I will post part 3 Tuesday, it will consist of two power-point slides.
Psychologists responsible for education and training programs have an obligation to establish relationships of loyalty and trust with their institutions, students, and members of society who rely on academic institutions to provide the knowledge, skills, and career opportunities claimed by the specific degree program (Principle B: Fidelity and Responsibility). This requires knowledge of system change and competencies in academic program management and leadership skills (APA, 2012f; Standard 2.03, Maintaining Competence). Psychologists responsible for administering academic programs must ensure that course requirements meet recognized standards in the relevant field and that students have sufficient practicum, externship, and research experiences to meet the career outcome goals articulated by the program (Wise & Cellucci, 2014).
The term reasonable steps reflects recognition that despite a program administrator’s best efforts, there may be periods during which curriculum adjustments must be made in reaction to changes in faculty composition, departmental reorganizations, institutional demands, modifications in accreditation or licensure regulations, or evolving disciplinary standards.
Interprofessional Training for Practice and Research in Primary Care
Doctoral programs in psychology will increasingly need to equip students with the skills necessary for professional practice, quality improvement and outcomes research, and team management and consulting in the integrated patient care systems of the future. Systems such as patient-centered medical homes (PCMH) and accountable care organizations (ACO) will need psychologists trained in applying patient-centered, accountability-focused, evidence-based, and team-based approaches to enhancing access to quality (Belar, 2014; DeLeon, Sells, Cassidy, Waters, & Kasper, 2015; see also the section on the Patient Protection and Affordable Care Act (ACA) in Chapter 1). Program administrators need to be aware of evolving APA accreditation requirements for externships and internships that provide trainees with opportunities to acquire direct experience and supervision in interprofessional systems of care and when appropriate documentation of specialization as a basic credential for a practicing psychologist once licensed (Standard 7.01, Design of Education and Training Programs). Compliance with Standard 7.01 will also require curricula that foster competencies in the following:
Readers might also refer to Standards 2.04, Bases for Scientific and Professional Judgments; 3.09, Cooperation with Other Professionals; 6.01 Documentation of Professional and Scientific Work and Maintenance of Records as well as Nash et al. (2013) and Rozensky (2014a, 2014 b is not kept pace with the rapid evolution and availability of online education. Distance learning using information technology raises complex questions regarding the adequacy of psychology programs to meet education and training requirements for a diverse student body from across the United States and in different countries. Psychologists administering online distance education might consider the following questions (Anderson & Simpson, 2007; Brey, 2006):
Department and program chairs and psychologists responsible for internship training programs must also ensure that prospective and current students have an accurate description of the nature of the academic and training programs to which they may apply or have been admitted. This standard of the APA Ethics Code (APA, 2010c) requires psychologists responsible for these programs to keep program descriptions up-to-date regarding (a) required coursework and field experiences; (b) educational and career objectives supported by the program; (c) current faculty or supervisory staff; (d) currently offered courses; and (e) the dollar amount of available student stipends and benefits, the process of applying for these, and the obligations incurred by students, interns, or postdoctoral fellows who receive stipends or benefits.
Standard 7.02 specifically obligates teaching psychologists to ensure that prospective and current students, externs, or interns are aware of program requirements to participate in personal psychotherapy or counseling, experiential groups, or any other courses or activities that require them to reveal personal thoughts or feelings. Many program descriptions now appear on university or institutional websites. Psychologists need to ensure to the extent possible that these websites are appropriately updated. The term reasonable steps recognizes that efforts to ensure up-to-date information may be constrained by publication schedules for course catalogs, webmasters not directly under the auspices of the department or program, and other institutional functions over which psychologists may have limited control.
Need to Know: Language-Matching Training Experiences
The increasing language diversity of client/patient populations in the United States sometimes leads to matching bilingual graduate students with externship and internship populations for which their language skills are considered an advantage. Limiting bilingual trainees to work experiences with non-English-speaking clients or to one cultural–language group may deprive students of the broad educational training opportunities promised by the graduate or training program (Fields, 2010; see also Standard 3.08, Exploitative Relationships). Such assignments may also implicitly lead to misconceptions by bilingual and other students in the program that language competence is equivalent to multicultural treatment competence (Schwartz, Rodríguez, Santiago-Rivera, Arredondo, & Field, 2010). Faculty advisers and supervisors should actively assess bilingual students’ training needs as well as their comfort and desire to work with same-language populations to ensure these students are afforded the same quality of education, respect, and autonomy that other trainees enjoy (Schwartz et al., 2010). English-only-speaking supervisors who rely on a trainee’s language translations of sessions should also be aware that they may be providing feedback on clients that they cannot actually work with themselves (Standard 2.01b, Boundaries of Competence), and in some states, this lack of “proper” supervision might mean that the trainee is perceived to be practicing “independently” without a license (Schwartz et al., 2010).
7.03 Accuracy in Teaching
Standard 7.03a requires that teaching psychologists provide students with accurate and timely information regarding course content; required and recommended readings; exams, required papers, or other forms of evaluation; and extra-classroom experiences if required. Psychologists who provide their syllabi via the Internet or who require students to use web-based references need to keep these websites accurate and appropriately updated.
Modifying Course Content or Requirements
This standard also recognizes that syllabi may sometimes include an unintentional error, required readings may become unavailable, changes in institutional scheduling may create conflicts in dates set for exams, and many times, psychologists have valid pedagogical reasons for changing course content or requirements at the beginning or middle of a semester. For example, a professor may find that assigned readings are too difficult or not sufficiently advanced for the academic level of students in the class. In such instances, it would be appropriate for professors to modify course reading requirements as long as materials are available to students and they are given sufficient time to obtain and read the materials. Similarly, in response to constraints imposed by publishers, bookstores, other professors, or the institution, psychologists may rightly need to modify required texts or exam schedules.
Modifications to course content or requirements do not violate this standard as long as students are made aware of such modifications in a clear and timely manner that enables them to fulfill course requirements without undue hardship. However, a professor who has neither discussed nor specified how students will be evaluated until the last week of class or one who fails to update an old syllabus that does not reflect the current content of the course would be in violation of this standard.
Standards prescribing the nature of information that teachers should provide raise legitimate concerns about academic freedom. At the same time, in many ways, teaching is a “process of persuasion” where instructors are in the unique socially sanctioned and desired role of systematically influencing the knowledge base and belief systems of students (Friedrich & Douglass, 1998). Standard 7.03b reflects the pedagogical obligation of psychologists to share with students their scholarly judgment and expertise along with the right of students to receive an accurate representation of the subject matter that enables them to evaluate where a professor’s views fit within the larger discipline.
The narrowness or breadth of information required to fulfill this standard will depend on the nature of the course. For example, a psychologist who presented readings and lectures only on psychodynamic theories of personality would be presenting accurate information in a course by that name but inaccurate information if teaching a general survey course on theories of personality. A professor who has been teaching the same material for 20 years when such material is considered obsolete in terms of the discipline’s recognized standards would be providing students inaccurate information about the current state of the subject matter.
7.04 Student Disclosure of Personal Information
This standard requires psychologists to respect the privacy rights of students and supervisees. In many instances, information about students’ or supervisees’ sexual history; their personal experience of abuse or neglect; whether they have or are currently receiving psychotherapy; and their relationships with relatives, friends, or significant others is outside the legitimate boundaries of academic or supervisory program inquiry.
With two exceptions, Standard 7.04 prohibits psychologists from requiring students or supervisees to disclose such information.
Clear Identification of Requirements
Teaching and supervisory psychologists may require disclosure of information about sexual experiences, history of abuse, psychological treatment, or relationships with significant others only if the admissions and program materials have clearly identified that students or supervisees will be expected to reveal such information if admitted to the program. The requirement for advance notification includes programs that explore countertransference reactions during supervisory sessions if questions about such reactions will tap into any of the categories listed above. Clear and advance notification about the types of disclosures that programs require will allow potential students to elect not to apply to a program if they find such a requirement intrusive or otherwise discomforting.
Interference With Academic Performance or Self-Harm or Other Harm
The standard also recognizes that there are times when students’ personal problems may interfere with their ability to competently perform professionally related activities or pose a threat of self-harm or harm to others. In such instances, psychologists are permitted to require students or supervisees to disclose the personal information necessary to help evaluate the nature of the problem, to obtain assistance for the student or supervisee, or to protect others’ welfare.
Need to Know: Supervision of Trainees With Disabilities
The field of rehabilitation psychology is increasing the discipline’s familiarity with reasonable accommodations and training requirements for students with disabilities (Americans with Disabilities Act [ADA], 1990; Falender, Collins, & Shafranske, 2009). The nascent status of the field leaves unexplored potentially prejudicial beliefs held by supervisors that may unintentionally lead to inequities and inadequacies in the training experiences of graduate students with disabilities enrolled in psychology practitioner programs. For example, there is no empirical support for the assumption that a trainee with disabilities cannot perform the essential functions of a psychologist or that this individual is at a disadvantage in establishing a therapeutic alliance with clients/patients (Taube & Olkin, 2011).
Supervision competencies in the area of disability require familiarity with the ADA, models of ableness, and influence of multiple minority statuses and group histories of oppression on the perspectives of individuals with disabilities. Supervisors will also need to acquire the skills to neither over- nor underattend to a supervisee’s disability, support necessary adaptations to clinical tools, and create a safe environment for supervisees to discuss issues relevant to their disability that may emerge in their clinical or supervisory settings (Cornish & Monson, 2014).
Digital Ethics: Disclosure of Student Personal Information Through Social Media
Teaching psychologists may use Facebook, Twitter, blogs, chat rooms, and other forms of social media to engage students in discussions regarding academic material or university events. However, students may sometimes use these sites to share or link to information about themselves or other students that describes sexual behaviors, family relationships, or other personal information. Faculty access to such information may be inconsistent with the goal of Standard 7.04, which is to protect students from disclosing personal information that may unfairly influence evaluation of their academic performance (Standard 7.06b, Assessing Student and Supervisee Performance). Psychologists who utilize electronic media for instructional purposes should clarify in advance restrictions on the type of information that can be posted on these sites. Instructors should also educate students on their responsibilities and strategies to avoid privacy violations that may emerge when academic sites are linked to other sources of personal information. Furthermore, faculty should develop procedures for removing such information if it appears. If a situation arises and faculty are concerned that becoming aware of such information may bias their evaluation of student performance, they should seek consultation while at the same time protecting the student’s identity (Standards 4.04b, Minimizing Intrusions on Privacy; 4.06, Consultations).
7.05 Mandatory Individual or Group Therapy
Standard 7.05a addresses the privacy rights of psychology students enrolled in programs that require individual or group psychotherapy. During the commenting period for the revision of the current APA Ethics Code, a number of graduate students raised concerns about revealing personal information (a) in the presence of other students in required group therapy or experiential courses and (b) to therapists in required individual psychotherapy if the therapist was closely affiliated with their graduate program. In response to these concerns, this standard requires programs that have such requirements to allow students to select a therapist unaffiliated with the program.
Standard 7.05a does not prevent programs from instituting a screening and approval process for practitioners outside the program whom students may see for required psychotherapy. It is sound policy for programs to ensure that required individual or group therapy is conducted by a qualified mental health professional. In addition, in some programs, the therapeutic experience may be seen as one facet of training about a particular form of psychotherapy, and the program is entitled to require students to select a private therapist who conducts treatment consistent with the program’s training goals.
This standard does not apply to postdoctoral programs, such as postgraduate psychoanalytic programs, that require a training analysis with a member of the faculty. These advanced programs, unlike graduate programs, are optional for individuals who seek specialized training beyond a doctoral degree in psychology, and a decision not to enroll in such programs because of therapy requirements does not restrict opportunities to pursue a career in professional psychology.
This standard is designed to protect the integrity and fairness of evaluations of student academic performance. Whereas Standard 7.05a protects a student’s right to keep personal information private from program-affiliated practitioners, Standard 7.05b protects the student from grading or performance evaluation biases that might arise if a faculty member who serves as the student’s psychotherapist is also involved in judging his or her academic performance. This standard pertains not only to faculty who might teach a course in which a student who is in therapy with them might enroll but also to faculty who may be involved in decisions regarding passing or failing of comprehensive exams, advancement from master’s-level to doctoral-level status, training supervision, and dissertation committees. As indicated by the cross-reference to Standard 3.05, Multiple Relationships, serving in the dual roles of therapist and academic evaluator can impair the therapist’s objectivity when knowledge gained from one role is applied to the other, or it can undermine treatment effectiveness when students are afraid to reveal personal information that might negatively affect their academic evaluations.
Need to Know: Ethical Criteria for Mandatory Personal Psychotherapy (MPP)
The training goal of program-mandated personal psychotherapy (MPP) is to maximize therapeutic efficacy through self-awareness that heightens appreciation of the therapeutic relationship and client/patient vulnerability and minimizes the possibility of harming clients or acting in ways that are not in their best interests (Norcross, 2005). However, due to the diversity of theoretical frameworks for clinical care and the paucity of empirical data to support its efficacy in comparison to other training models, the value of MPP remains contested. One issue is whether imposing psychotherapy on well-functioning trainees who display no pathological behavior and feel no need for treatment is consistent with the ethical practice of psychotherapy, including respect for client/patient autonomy and obligation to terminate treatment when the client/patient does not need health services (Ivey, 2014; Principle E: Respect for People’s Rights and Dignity; Standards 3.10, Informed Consent; 10.01, Informed Consent to Therapy; 10.10, Terminating Therapy). Below are useful guidelines for programs requiring MPP (see Ivey, 2014, for an excellent summary):
7.06 Assessing Student and Supervisee Performance
Psychologists establish academic and supervisory relationships of trust with students and supervisees based on fair processes of evaluation that provide students and supervisees with the opportunity to learn from positive and negative feedback of their work (Principle B: Fidelity and Responsibility). As in other domains of psychological activities, supervisors need to be familiar with the knowledge base for models of enhancing and monitoring the professional functioning of supervisees (APA, 2012f; Standards 2.01, Competence; 2.03, Maintaining Competence). Under Standard 7.06a, psychologists must inform students and supervisees (a) when and how often they will be evaluated, (b) the basis for evaluation (e.g., performance in exams, attendance, implementation of various phases of research, summaries of client/patient sessions, and administration and interpretation of psychological assessments), and (c) the timing and manner in which feedback will be provided.
Providing specific information about student evaluation at the beginning of the process is especially important for the supervision of clinical work, psychological assessment, or research because these supervisory activities are often less uniformly structured than classroom teaching.
Group supervisees can benefit from the multiple input, support, and shared experiences of their peer colleagues while also learning how to provide effective feedback and gain initial competencies required for their own future skills as supervisors. Psychologists engaged in group supervision must develop competencies in creating a safe environment for group discussion and disagreement and for clarifying the roles of supervisor and supervisees. At the beginning of the supervision, they need to clarify the purpose of group supervision and how responsibilities and supervisee evaluation differ from those under individual supervision. For example, most students will be unfamiliar with the unique learning experiences and responsibilities of group supervisees, which include providing feedback to one another, both formally and informally, at specified periods in a respectful manner; preparing case presentations and questions on group materials prior to each meeting; refraining from discussing material about an absent supervisee; and maintaining the confidentiality of group discussions, including information pertaining to other group members, their clients, and specific training sites (see Smith, Cornish & Riva, 2014, for additional details).
Johnson and Kennedy (2010) eloquently described the unique responsibilities of military psychologists supervising trainees in American combat theaters and the need to provide timely and constructive feedback under intense and fast-paced conditions. Military supervisors are often torn between a duty to help trainees meet their active duty responsibilities and concerns that some trainees may not be adequately prepared during the initially agreed-upon time frame. According to the authors, military supervisors need enhanced competencies to address the unique nature of trainee stress produced by almost continuous exposure to life-threatening combat conditions and deceased and severely injured and traumatized service members (Standard 2.01, Boundaries of Competence). They recommended that for each trainee soon to be deployed, supervisors develop “the best mix of training and supervision in psychotherapy, battlefield triage, combat-related psychopathology, treatments for trauma-related disorders, neuropsychology, and ethical decision making” (p. 300) and make sure the trainee is clear about the training components and expectations of the supervised experience, including the physical dangers and stresses of performing their roles in combat situations.
Fairness and justice require that academic and supervisory evaluations should never be based on student personal characteristics that have not been observed to affect their performance or that are outside the established bounds of program requirements.
Additional discussion regarding psychologists’ ethical responsibilities during supervision can be found in the Hot Topic “Ethical Supervision of Trainees” at the end of this chapter.
Digital Ethics: Use of Technology for Supervision
Increasingly, state licensure boards are permitting email, teleconferencing, or other forms of online supervision on their own or as adjuncts to face-to-face supervision to satisfy training requirements. As noted by Dombo et al. (2014), whether or not the use of these modalities fulfills obligations to trainees depends upon how accessible the supervisor is to the trainee, the timeliness of the supervision, the supervisor’s experience with using these technologies, and the trainee’s comfort level. Supervisors should also keep in mind that through their online supervision, they are modeling ethical practice and decision making regarding the use of social media and other technologies (Falender, Shafranske, & Falicov, 2014). Issues to consider include the following:
7.07 Sexual Relationships With Students and Supervisees
Having sexual relationships with students or supervisees is specifically prohibited by Standard 7.07. The student–professor/supervisor role is inherently asymmetrical in terms of power. Teachers and supervisors have the power to affect student careers through grading, research and professional opportunities, letters of recommendation, scholarships and stipends, and reputation among other faculty or staff. Using this power to coerce or otherwise unduly influence a student to enter a sexual relationship is exploitative (Standard 3.08, Exploitative Relationships). The prohibition against sex with students and supervisees applies not only to those over whom the psychologist has evaluative or direct authority but also to anyone who is a student or supervisee in the psychologist’s department, agency, or training center or over whom the psychologist might be likely to have evaluative authority in the program or supervised setting.
Sexual relationships with students and supervisees are a specific example of an unethical multiple relationship (Standard 3.05, Multiple Relationships). When psychologists enter into a sexual relationship with a student or supervisee, their ability to judge the student’s/supervisee’s academic, professional, or scientific performance objectively is impaired. In addition, when other students learn about such relationships, their knowledge can jeopardize the psychologist’s ability to maintain an impression of professional impartiality. Furthermore, the behavior provides students with a model of unethical conduct that jeopardizes the psychologist’s effectiveness as a teacher or supervisor. Such relationships also risk compromising psychologists’ ability to exert appropriate authority or make objective evaluations regarding the student/supervisee and others with whom they work if the sexual partner can manipulate the psychologist through threats of exposure or complaints of misconduct.
In many psychology programs, graduate students serve as teaching or research assistants charged with evaluating undergraduate or graduate students’ academic performance or supervising their research projects. Standard 7.07 applies to sexual relationships between graduate assistants and students when assistants are either student members of the American Psychology Association or their department has adopted the APA Ethics Code in its policies and procedures.
Hot Topic: Ethical Supervision of Trainees in Professional Psychology Programs
Supervision is a primary means by which students in professional psychology programs acquire and develop skills needed to provide effective and ethical mental health services (Shallcross, Johnson, & Lincoln, 2010). Competent and ethical supervision provides a foundation for the attitudes, skills, and commitment supervisees will need to know what is right and the motivation for self-evaluation and lifelong learning necessary to do what is right throughout their careers (see Chapter 3). The American Psychological Association (APA, 2011b), the Health Service Psychology Education Collaborative (2013), and proposed Standards for Accreditation for Health Service Providers (APA, 2015e) now include supervision as an essential competency for psychologists at the highest levels of the profession. Thus, psychology graduate students need to have training in supervisory competencies through classroom lectures and readings as well as learning through modeling the practices of their own supervisors.
Supervisors have a fiduciary obligation to their supervisees, the clients/patients under the supervisees’ care, and the public (Principle B: Fidelity and Responsibility). They must (a) nurture the supervisees’ professional skills and attitudes, (b) ensure that supervisees’ clients/patients are provided appropriate mental health treatment, and (c) serve as gatekeepers who take appropriate actions to prevent supervisees not able to demonstrate the needed professional competence from entering the profession and practicing independently (Principle A: Beneficence and Nonmaleficence; Barnett & Molzon, 2014). Supervision should be marked by mutual respect, with supervisor and supervisee both contributing to the process of establishing goals and role responsibilities (Principle E: Respect for People’s Rights and Dignity; Pettifor, McCarron, Schoepp, Stark, & Stewart, 2011). The goal of this Hot Topic is to describe the competencies needed to provide effective and ethical supervision, desired outcomes on which to fairly evaluate supervisee performance, and how trainees can contribute to their supervisory experience.
Competencies for Effective Supervision
Efforts to provide faculty with the skills necessary for competent supervision have not kept pace with psychology’s growing commitment to a culture of competence in training and supervision (Standard 2.01, Boundaries of Competence; APA, 2011b). Competencies for effective supervision include professional knowledge and expertise and the interpersonal skills necessary to create a trusting supervisory alliance (Falender et al., 2004). A competence-based approach to supervision also requires techniques for successfully monitoring, assessing, and providing feedback to trainees and an emphasis on self-reflection and self-assessment on the part of supervisor and trainee (Kaslow, Falender, & Grus, 2012).
Professional Knowledge and Expertise
Supervisors must have the necessary clinical knowledge and expertise to identify client mental health needs within a diversity-sensitive context, guide supervisees in client-appropriate treatment techniques, and recognize when clients are not responding to supervisee interventions (Accurso, Taylor, & Garland, 2011). They must also be familiar with academic credit or credentialing supervision requirements, on-site institutional policies, and relevant laws as well as appropriate risk management strategies. Adequate preparation includes the following (see Baird, 2014; Barnett & Molzon, 2014; Moffett, Becker & Patton, 2014; Wise & Cellucci, 2014):
The supervisory context should encourage open discussion of treatment challenges and attempt to try new strategies by providing constructive feedback in a manner that minimizes trainee anxiety and decreased feelings of self-efficacy (Barnett et al., 2007; Daniels & Larson, 2001). At the same time, supervisors cannot shy away from providing negative feedback when it is necessary to ensure that clients are receiving adequate care; supervisors’ evaluations of supervisee clinical acumen must be objective and in accord with the standards of the profession.
There is increasing recognition that competent supervision requires sensitivity to the attitudes, values, and sociopolitical experiences of supervisees from diverse racial/ethnic, cultural, sexual minority, disability, social class, immigrant, and other groups, including when multiple identities intersect (Falender, Shafranske, & Falicov, 2014). The dynamic and continuously evolving nature of group identity and experiences requires supervisors to acquire the skills to engage in a collaborative process in which the effect of differing supervisor–supervisee worldviews is respectfully discussed (including targeted self-disclosure when appropriate), and the important role of diversity factors should be clearly introduced and reinforced throughout the supervision (Pettifor, Sinclair, & Falender, 2014). Competent diversity supervision also includes (a) recognizing factors of power, privilege, and personal bias that may be barriers to a trainee’s full participation in the supervisory relationship; (b) being alert to the fact that trainees may be wary of honest engagement in the supervisory process based on previous training experiences that were diversity insensitive; (c) acquiring the skills to help trainees overcome past dignitary harms as well as the consequences of the supervisor’s own actions that may result from diversity misunderstandings; (d) being mindful that through their supervision, they are modeling the ethical practice of diversity sensitivity for supervisees to apply to clinical work and future positions as supervisors (Falender et al., 2014; Fouad & Chavez-Korell, 2014).
Structuring the Supervisory Process
Structuring the supervisory process requires the ability to tailor training to the supervisee’s level of competence, identify appropriate outcome measures for evaluation, and present clear standards for assessment. Both supervisors and supervisees need to be familiar with the APA core benchmark components (APA, 2011b) that their program has designated as appropriate for its training goals (see discussion under Standard 7.01, Design of Education and Training Programs).
Identifying Supervisee’s Competencies
The goals and desired outcomes of a training experience need to be tailored to the supervisee’s current competencies in relation to client needs and institutional requirements. To meet obligations to trainees and the trainees’ clients, supervisors need to evaluate each supervisee’s developing competence and the clinical responsibilities with which he or she can be entrusted (Falender & Shafranske, 2007; Standard 2.05, Delegation of Work to Others).
Identifying Appropriate Training Outcomes
Evaluations must be based on the supervisee’s actual performance on relevant and established requirements (Standard 7.06, Assessing Student and Supervisee Performance). Falender and Shafranske (2007) identified the following general abilities by which the trainee’s professional growth can be evaluated:
The APA also provides a “Competency Remediation Plan” template to assist supervisors and supervisees in planning and evaluating progress (http://www.apa.org/ed/graduate/competency.aspx). The plan begins with an identification of competency weaknesses, when the problem(s) was brought to the trainee’s attention, steps already taken by the supervisor to address the problem(s), and steps already taken by the trainee to rectify the problem(s). This is followed by a written plan identifying the essential competency domain and problem behaviors, expectations for acceptable performance, trainee’s and supervisee’s responsibilities, a time frame for acceptable performance, assessment methods, and consequences for unsuccessful remediation.
Feedback and Evaluation
Standard 7.06 also requires that supervisors establish a timely and specific process for providing feedback to supervisees and explain the process to trainees at the beginning of supervision. This includes delineating setting-specific competencies the supervisee must attain for successful completion of the supervised interval (Falender & Shafranske, 2007).
Meaningful evaluations, scheduled at predetermined intervals, provide trainees with adequate time to improve their skills and the supervisor with opportunity to evaluate the trainee’s responsiveness to constructive feedback. When supervisees are unresponsive, fail to demonstrate needed competence, or exhibit impaired professional competence as a result of personal problems, these issues should be addressed in supervision, and the trainee should be provided reasonable opportunities for remediation or intervention. When necessary, the supervisor must act to prevent inappropriate actions resulting in poor-quality client care, violation of ethical standards, or harm to the institution through the supervisee’s violation of policy or law. When appropriate, supervisors should inform their institution or the students’ academic program and provide a written report documenting the reasons for their concerns (see Gizara & Forest, 2004).
Externships and internships in professional psychology programs are often off-site and supervised by nonfaculty members. Supervisors at practicum, externship, and internship sites need to provide supervisees with copies of the relevant institutional and agency policies and procedural manuals, including mandatory and discretionary reporting policies and steps to be taken in case of an emergency.
When applying for training at these sites, students should obtain the following information:
Responsibilities of Supervisees
Self-reflection, ethical commitment, and the motivation to improve one’s clinical knowledge and skills are fundamental to having a successful supervisory relationship. To help supervisors establish appropriate training experiences and evaluation criteria, supervisees should do the following:
Chapter Cases and Ethics Discussion Questions
Dr. Kekoa is mentoring the dissertation of a psychology student who emails him that she has collected half of her dissertation data. She comes to his office to report that the preliminary analyses support her research hypotheses. He reviews the data and realizes that, in fact, the results are in the opposite direction of her hypotheses. He corrects her confusion about the type of statistical results that would support her thesis. Two months later, the student returns with her completed data collection, and this time the analysis indicates that all the data collected since their last conversation support the hypotheses. Dr. Kekoa is concerned that the student may be fabricating or biasing the data. Drawing on the ethical decision model in Chapter 3, how might Dr. Kekoa best approach this dilemma?
Dr. Braithwaite, a psychologist at a popular externship site, is conducting clinical supervision with Derek, a clinical graduate student with legal blindness. This is the first time Dr. Braithwaite has supervised a student with an apparent disability. She wants to ensure that Derek’s clinical externship is a positive experience for him and his potential clients. She is unsure whether she should disclose Derek’s disability to his potential clients before their first session so that clients who would be uncomfortable have the opportunity to request another therapist. Drawing on the Ethics Code Principles and relevant standards (i.e., Standards 2.01, Boundaries of Competence; 3.01, Unfair Discrimination; 3.04, Avoiding Harm; 7.06 Assessing Student and Supervisee Performance), discuss whether client preferences for practitioner attributes in general (e.g., race/ethnicity, gender, age, religion) and disability specifically should be considered in assigning trainees to clients (see also Taube & Olkin, 2011).
Ethical Principles and Standards That Inform Educational Gatekeeping Practices in Psychology
Kimberly E. Bodner Department of Psychological Sciences University of Missouri–Columbia
Educational gatekeeping functions in psychology serve to assess, remediate, and/or dismiss students and trainees with problematic professional competencies (STPPC). Recently, professional psychology graduate programs have increasingly focused on problems with professional competency, and they have begun to implement formal procedures to intervene with STPPC (Rubin et al., 2007). However, there has been considerably less literature addressing the ethics and ethical considerations of instituting these gatekeeping functions, especially in different stages of education and training in psychology. The American Psychological Association (APA; 2002) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) offers faculty and supervisors ethical principles and obligatory standards that provide guidance about how to implement highly ethical gatekeeping practices.Thepurposeofthisarticleistohighlightthemajorethicalissuesanddilemmasthatfaculty and supervisors may face when intervening with STPPC and provide recommendations for ethical gatekeeping practices that are inspired by the APA Ethics Code. Keywords: ethics, gatekeeping, competence, competence problems, undergraduate, graduate, internship, postdoctoral
Educational gatekeeping practices in psychology are implemented to beneﬁt students and trainees, and the individuals with whom they interact. Faculty and supervisors have a responsibility to assess, remediate, and/or dismiss students and trainees with problematic professional competencies (STPPC). However, faculty and supervisors may receive little guidance on how to implement such procedures in a highly ethical manner and/or how to approach complex and challenging gatekeeping dilemmas, especially in different stages of education and training in psychology. Faculty and supervisors in psychology must consider multiple aspects of the American PsychologicalAssociation(APA;2002)EthicalPrinciplesofPsychologistsandCodeofConduct (hereafter referred to as the Ethics Code) during their professional and educational activities, especially during educational gatekeeping functions with STPPC. The ethical principles provide guidance to faculty and supervisors on how to implement ethical gatekeeping functions (General Principles A–E). Although the ethical principles are not enforceable, the ethical standards identiﬁed in the Ethics Code are obligatory and enforceable. The purpose of this article is to identify the ethical principles that faculty and supervisors should aspire to uphold, the ethical standards
Correspondence should be addressed to Kimberly E. Bodner, University of Missouri–Columbia, Columbia, MO 65211. E-mail: ou.edu
ETHICAL EDUCATIONAL GATEKEEPING IN PSYCHOLOGY 61
thatmustbemet,andtheissuesandethicaldilemmasthatmayarisewheninstitutinggatekeeping practices for undergraduate, graduate, internship, and postdoctoral STPPC. Finally, recommendations are provided on how to implement ethical educational gatekeeping functions in various stagesofeducationandtraininginpsychology,andsuggestionsareprovidedforfuturedirections of this line of work.
Typical gatekeeping functions are put into place to assess acceptable professional competency in students and trainees, and to remediate or dismiss STPPC (Vacha-Haase, Davenport, & Kerewsky, 2004). Remediation may require students and trainees to take further training or coursework; attend therapy; extend practica, internships, or postdoctoral training; and/or even change career focus (Forrest, Elman, Gizara, & Vacha-Haase, 1999). Students and trainees develop professional competency skills at different rates as they progress through their programs, and faculty and supervisors may ﬁnd it difﬁcult to determine if problematic professional competencies are developmental in nature and can be remediated. At times, student and trainee professional competency problems may be so severe that remediation may not be successful. Graduate programs have increasingly focused on problems with professional competency, and they have begun to implement formal procedures to intervene with STPPC (Rubin et al., 2007).
DEFINITION OF STUDENTS AND TRAINEES WITH PROBLEMS OF PROFESSIONAL COMPETENCE (STPPC)
For the purpose of this article, the term “students” refers to undergraduate and graduate students and the term “trainees” refers to internship and postdoctoral trainees. Students and trainees may display problematic professional competency at any stage of education or training. In their Benchmark document, Fouad and colleagues (2009) identiﬁed 15 core competencies, deﬁned their essential components that are necessary for each stage of training and education, and described how to assess these competencies across educational levels (e.g., readiness for practica, internship, and entry to practice). The authors further characterized each core competency through its multiple elements. For example, the core competency of professionalism is characterized by the elements of integrity/honesty, deportment, accountability, concern for the welfare of others, and professional identity. An example of a student or trainee who displays problematic professional competence in professionalism might be cheating on assignments, falsifying information, and/or being disrespectful during interpersonal interactions with clients or colleagues. A description of each core competency and its elements is beyond the scope of this article (see Fouad et al., 2009, for a complete list).Student and trainees that display problems in one or more of the 15 core competencies are identiﬁed as STPPC for the purpose of this article.
Prevalence and Type of Competency Problems
There is little to no research evaluating the prevalence rate of undergraduate students with problematic professional competency. White and Franzoni (1990) evaluated 1st-year counseling
graduate students and found that they had signiﬁcantly higher levels of psychopathology in comparison to the population in general, suggesting that undergraduate students with psychological problems may well advance to graduate training in psychology, where professional competence problems may arise (Vacha-Haase et al., 2004). A few studies have evaluated the presence of problematic professional competency in graduate students (e.g., counseling, clinical, school psychology) through the use of questionnaires (Huprich & Rudd, 2004; Vacha-Haase et al., 2004). In a study of 81 graduate programs, Huprich and his colleague (2004) reported that 65% of programs had at least one or more current students with problematic professional competency, and 60% reported three or more within the past 10 years. In a study of 103 graduate programs, Vacha-Haase and colleagues (2004) reported that 52% of programs terminated at least one student in 3 years, which was typically attributed to clinical work problems. However, faculty and supervisors may not always be able to intervene with all students with problems in professional competence, or foresee students who may have problematic competency in the future. In a study of 118 internship sites, 10% of programs reported knowing of at least one current trainee with professional competency problems and 35% reported three or more over the past 10years(Huprich&Rudd,2004).Thestudyindicatedthatthemostcommonproblemsidentiﬁed during graduate programs and internships were difﬁculties with clinical work due to adjustment disorders, alcohol abuse, anxiety and depression, and personality disorders. At this time, the prevalence rate of competency problems in postdoctoral trainees is unknown.
MAJOR ETHICAL ISSUES OF GATEKEEPING
There are major ethical issues to consider when instituting gatekeeping functions during undergraduate, graduate, internship, and postdoctoral education and training. Ethical gatekeeping issues are highlighted by applying ﬁndings from previous literature and the Ethics Code (APA, 2002). Faculty and supervisors should aspire to uphold the ethical principles of beneﬁcence and nonmaleﬁcence, ﬁdelity and responsibility, integrity, justice, and respect for people’s rights and dignity in their educational and professional interactions with STPPC. Faculty and supervisors mustalsoadheretothestandardsoftheEthicsCode,speciﬁcallythestandardsrelevanttoresolving ethical issues, competence, human relations, privacy and conﬁdentiality, record keeping, and education and training (
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