Legal, Ethical, Boundary, & Assessment Issues in Clinical Psychology

Legal, Ethical, Boundary, & Assessment Issues

There are many important areas of clinical psychology but perhaps the some of the most vital are the legal, ethical, and cultural issues associated with the practice. These areas are often the epicenter of legal and litigation problems.

Two Legal Issues in Clinical Psychology

Informed consent and confidentiality are two areas clinical psychology which are legal issues. Informed consent is both an ethical directive as well as a law. According to Pozgar, (2011), informed consent is a:

Legal concept that provides that a patient has the right to know the potential risks, benefits, and alternatives of a proposed procedure prior to undergoing a particular course of treatment. Informed consent implies that a patient understands a particular procedure or treatment, including the risks, benefits, and alternatives; is capable of making a decision; and gives consent voluntarily (Pozgar, 2011).

From a legal perspective, patients who are not provided proper information concerning procedures, have the right to seek legal remedy. Under the law, the patient must provide consent and must understand what she is consenting to having performed. This should be done in writing as well as verbally in many instances.

Another legal issue is confidentiality. Confidentiality is the safeguarding of a person’s personal information concerning treatment. This area of law is governed under many different laws both state and federal. Most notably, the Health Insurance Portability and Accountability Act (HIPAA) protects this information when it is being transmitted (Pozgar, 2011). However, the protection of this information is also lessened by some of the rules in HIPAA such as allowing the information to be shared with other professionals when needed. This presents a situation in which sharing information can be legal but not always ethical.

Two Ethical Issues in Clinical Psychology

Psychologists are mandated by ethical codes to maintain confidentiality and the privacy of their patients. These codes are specifically outlined by the APA and by the American Counseling Association. Despite these codes, psychologists are often placed in positions where they must weigh the value of client confidentiality and privacy against justice. Psychologists have an obligation to obey ethics and law but there are times in which the law is demanding actions which cannot be obeyed. Due to the need for trust counselors must place the client’s privacy above other concerns in order to maintain a focus on the client’s needs. If the counselor were to concern him or herself with needs other than those of the client this would create conflicts of interest. For this reason, the counselor must maintain the interest of the client as his or her primary responsibility. In some cases, this may mean breaking the law in order to maintain ethics by not breaking confidentiality and privacy.

Professional Boundaries, Boundary Crossings, & Boundary Violations

Professional boundaries are the maintaining of professional lines. The relationship between a doctor and the patient exists for the purpose of therapy and when this relationship diverges it is referred to as a boundary crossing. A boundary crossing is a deviation from therapy activity and relationship and is therefore deemed non-therapeutic. This boundary crossing is considered non-therapeutic but it can also be considered a violation depending on how it occurs. When this happens, it is harmful and this is known as a boundary violation. When it is a divergence from the therapeutic relationship it is a boundary crossing and while this may not be harmful it is a violation of ethics because this crossing has the potential to become a violation. Boundaries are designed because they maintain the therapeutic relationship and ensure that patients are not exploited by professional knowledge. For this reason, it is vital to maintain boundaries between patients and psychologists.

Two Cultural Limitations Associated with Assessment & Treatment

Religion and ethnic diversity can be severe limitations in assessment and treatment. Religion presents a serious problem because some religious beliefs can challenge the psychologist due differences in moral ideas. Religious differences can cause misdiagnosis and can lead to poor clinical outcomes. These differences can allow bias to occur such as assessing a person as having a particular disorder based on a difference in religious thinking. Likewise, ethnic diversity presents a similar challenge in which psychologists must look beyond cultural differences. This problem has been apparent for some time through intelligence testing in which language can cause bias in the testing process due to cultural linguistic differences. The creation of bias in the assessment process can lead to misdiagnosis but in other areas it can impact opportunities such as education. School placement and education choices are often made using aptitude tests and these can be biased through language. Professionals must be able to understand their own deficiencies in culture in order to overcome these problems.

References

Pozgar, G. (2011). Legal Aspects of Health Care Administration New York NY

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