The growing number of older adults in America will result in an increasing demand for psychotherapists familiar with their psychological needs. To treat this population in an ethical manner, practitioners need to be aware of the unique characteristics of the aging process, especially in regards to age-related vulnerabilities, such as cognitive decline. Unfortunately, recent research has shown that those currently in practice do not have sufficient knowledge of the aging process and age specific issues of older adults. To address these (...) deficits the American Psychological Association published a report outlining six general concepts: attitudes, general knowledge about adult development, clinical issues, assessment, intervention, and education. These concepts are described. Furthermore, this article extends the current thinking on ethical issues regarding older adults by addressing their vulnerabilities. In addition, ethical issues such as informed consent, confidentiality, and elder abuse are addressed as they apply to both clinical and research situations. In addition, methods of resolving these important issues are suggested throughout the article. A depiction of the ethical issues of psychologists working with older adults is provided and practical procedures to help psychologists perform with high ethical standards of care for this age group are offered. (shrink)

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

ABSTRACT Engaging in sexting, such as sending or receiving of sexual words, pictures, or videos via technology, is a common behavior in minors and a rising trend. This study aimed to understand the ethical dilemmas that clinicians face when working with minors that engage in sexting under current mandated reporting standards. For this study, 178 graduate students and licensed clinicians who work with minors in the state of California completed an online survey involving vignettes concerning issues of sexting behaviors in (...) adolescents. Participants were asked to read each vignette and answer a series of questions regarding their knowledge and attitudes related to the presented issue and whether or not they would breach confidentiality in each case. Results indicated that participants, who had undergone specific training in issues of social media and technology, were significantly more likely to have more declarative knowledge of mandated reporting requirements, however, their reporting behavior was not significantly different from those, who had not previously had any training. Younger clinicians tended to report less than older clinicians. This study highlights the discrepancy that exists between the knowledge of mandated reporting standards relevant to sexting behaviors and clinicians’ reporting practice. (shrink)

Elder abuse presents difficult ethical considerations that the field of psychology has yet to sufficiently address. As demographics and sociocultural factors shift in the coming decade, this deficit in ethical competence may become an increasingly serious problem. Although legal definitions of elder abuse lack uniformity and clarity, there is much room for improvement in the field of psychology. Ethical considerations most relevant to professionals in psychology draw heavily on the principles of beneficence and nonmaleficence and respect for people's rights and (...) dignity. Professional standards of competence, discrimination, informed consent, privacy and confidentiality, and cooperation with other professionals are also critical in these considerations. A number of recommendations are made, centering around the needs for more education, frank discussion, and empirical examination of the complexities of elder abuse. (shrink)

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analyzed using interpretive content and thematic analysis. Three (...) key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices because psychologists described 5 distinct options. These can be conceptualized on a spectrum of varying degrees of client autonomy, ranging from “no disclosure” to “disclosure without the client’s knowledge or consent”. Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimize potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development. (shrink)

Therapeutic reactivity among psychology trainees was ascertained by their response to 10 clinical vignettes depicting clients with HIV who are sexually active with uninformed partners. This construct accounts for the relative change in decisions to maintain the confidentiality of clients who acknowledge safe versus unsafe sexual behavior. As anticipated, an analysis of variance revealed a significant main effect for safety and a significant 3-way interaction. Subsequent analyses revealed that trainees exhibit the highest level of therapeutic reactivity toward heterosexual male clients, (...) and the lowest reactive stance toward heterosexual female clients. Although the decisional pattern evidenced toward heterosexuals seems congruent with epidemiological estimates of risk, the decisions toward lesbians and gay males appear more likely a function of bias. The ethical implications of these findings are discussed. (shrink)