Clients Who Stalk Psychologists: Prevalence, Methods, and Motives.

There is emerging recognition that psychologists are susceptible to various forms of intrusiveness by clients, including stalking. Information regarding the contexts in which stalking emerges and the behaviors to which clinicians are subjected is limited. A random sample of Australian psychologists (N = 1,750) was surveyed to ascertain the prevalence, nature, and occupational impact of stalking by clients. Of the 830 respondents, 19.5% had been stalked for 2 weeks or more. Psychologists typically perceived the stalking to be motivated by resentment (42%) or infatuation (19%). Most practitioners altered their professional practice as a consequence of the harassment and 29% considered leaving the profession. Stalking by clients is a salient professional issue that requires greater attention to better manage conduct that is potentially damaging to both therapists and clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethics-based training for nonclinical staff in mental health settings.

Under the Ethics Code of the American Psychological Association (2002), psychologists are responsible for ensuring that delegated tasks are performed competently. For staff members who interact with clients or who have access to confidential client information, technical competence may not suffice. Psychologists who want to provide the best protection for clients can offer staff training that fosters “ethical competence” as well. Setting-specific ethics training is important even for personnel who have previously worked in other mental health sites, because it demonstrates how the profession’s ethical standards will be upheld through specific policies in the current setting. From an ethical perspective, staff training is not an end in itself or a risk-management strategy for protecting psychologists; rather, it is a means of protecting clients and their rights. The goal is to create a culture of safety (S. J. Knapp & L. D. VandeCreek, 2006) in which upholding ethical standards becomes everyone’s shared responsibility. This ethics-based training would be appropriate for nonclinical staff, clinical staff, supervisees, and students. It can be adapted to outpatient, inpatient, research, or academic clinic settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors That Influence Fee Setting by Male and Female Psychologists.

What factors influence how psychologists in private practice set fees for self-pay clients? An anonymous survey in one county showed that male and female clinical psychologists did not differ in fees requested for services to self-pay clients, indicating that they equally value their time and work effort. They felt that their fees were strongly influenced by personal and local factors (i.e., education/qualifications, business experience, and local competition). Female psychologists indicated that local competition had a significantly greater influence on fee setting than did male psychologists. This perception among female psychologists might arise from competition with the larger number of nondoctoral therapists, who are predominately female, or from higher awareness through more active networking. The usefulness of this model for studies of self-employment is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Listening to military members returning from Iraq and/or Afghanistan: A phenomenological investigation.

Some practicing psychologists are seeing an increasing number of returned military members. The primary objective of this research was to describe and understand the experiences of American military members who had been stationed in Iraq and/or Afghanistan since the conflict began in 2003. Phenomenological interviews were conducted with 10 male military members ranging from 23 to 56 years old, who had returned from Iraq and/or Afghanistan sometime during the last 6 years. An overall thematic structure containing a ground and three figural themes, supported by participant quotations, was developed to represent the military members’ experiences. The ground was the military member’s job. The three figural themes that emerged were being there, awareness of others, and a different world. Several subthemes also emerged, including for or against being there, day-to-day basis, and dangerous within the figural theme of being there, and family, Iraqi/Afghani people, bad guys, and misconceptions of the public within the figural theme awareness of others. These findings have implications that may facilitate psychologists’ work with military member clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual-relationship dilemmas of rural and small-community psychologists.

Sixteen licensed psychologists who lived and practiced in rural areas and small communities participated in interviews about ethical dilemmas they faced in daily practice. Dilemmas involving professional boundaries were identified as significant concerns for all of the psychologists. Major themes were the reality of overlapping business relationships, the effects of overlapping relationships on members of the psychologist's own family, and the dilemmas of working with more than 1 family member as clients or with others who have friendships with individual clients. The psychologists knew the content of ethical codes but often struggled in choosing how to apply those codes in the best interest of clients. Ongoing discussions regarding these choices can contribute to the evolution of practice codes applicable to rural areas and other small communities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethics and the invisible psychologist.

Psychologists have historically conducted research, taught, and provided human services directly with and for people who could readily identify the providers as psychologists. Increasingly, psychologists find themselves engaged in supplying consulting services that affect the lives of many people but take place without public scrutiny or identification. In these situations, the client may be a nonprofit agency, corporation, or government entity, but the effects of the psychologist’s work may have rippling consequences that affect many individuals’ lives profoundly. The ethical responsibility of such invisible psychologists may extend to members of the public not typically considered clients of the psychologist and raise particular concerns when the net result has adverse consequences for individuals or society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and the law: Attitudes of police, lawyers, and mental health professionals.

A literature review on the attitudes of police officers, lawyers, and mental health professionals toward the disabled indicates that police officers' attitudes are related to the extent of their formal education and the amount of information they have about relating to persons with various types of disabilities. Lawyers who have disabled clients tend to be more knowledgeable and to have more positive attitudes than lawyers without such clients, but it is not easy to turn lawyers into advocates for disabled clients. Mental health professionals, who may be called on to provide advice to police officers or lawyers or to testify in court cases, have some negative aspects that may impair their helpfulness, but their attitudes are more positive than those of less educated persons. Data also indicate that the attitudes of psychologists are less negative than those of psychiatrists. It is concluded that rehabilitation psychologists need to undertake studies of the attitudes of these groups and to set up programs designed to change the attitudes of members of these professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Levels of training to address religion in clincal practice.

Psychologists routinely work with clients who hold religious beliefs and values, yet there is often the question of whether psychologists are trained and competent to address religion as an aspect of diversity. How do training programs prepare psychologists to address this specific diversity issue? Do training programs equip psychologists to work effectively with religious clients? It is useful for psychologists to consider a 3-tier training system in religion and religious diversity that reflects a commitment to seeing religion as a meaningful expression of diversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with acceptance and decline of client gift giving.

Client gift giving is an interesting interpersonal event, and scholars have considered the ethical and clinical complexities involved in receiving gifts from clients. Attention to the cultural relations of client gift giving invites a more nuanced discussion of psychologists' decisions to accept or decline client gifts. In recognition of how cultural issues affect the therapeutic relationship, the American Psychological Association has instituted guidelines regarding multicultural competence and has urged psychologists to practice in a culture-centered manner. This article reviews the ethical decision making of 40 licensed psychologists to accept or decline gifts from clients. Results indicated that psychologists were more likely to accept gifts from clients when the gift was inexpensive, informed by cultural context, and presented with gratitude for good work at the end of psychotherapy treatment. Psychologists were more likely to decline gifts that were expensive, were presented during treatment rather than at the end of treatment, and had sentimental or coercive value. Two psychologists indicated they would not accept client gifts because they perceived gift acceptance to be a violation of their code of ethics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Important implications for psychologists of the Americans with Disabilities Act: Case in point, the patient who is deaf.

Increased implementation of the Americans With Disabilities Act of 1990 (ADA), which empowered persons who have disabilities, has begun in earnest with recent federal court action. Three legal opinions have far-reaching implications for psychologists whose practices include disabled clients. These implications are especially true for those psychologists who are most likely to work at least occasionally with deaf, hard-of-hearing, or otherwise disabled individuals. However, ADA court decisions also apply to psychologists in group practices and managed care corporations. In this article, these legal opinions are reviewed. The authors consider the implications of the decisions on psychologist practitioners, with special emphasis on their legal responsibilities to deaf clients and on liability and related malpractice concerns. The authors also consider the profound impact of these decisions on deaf and hard-of-hearing individuals in need of psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responses of psychologists to complaints filed against them with a state licensing board.

Psychologists are well aware of the possibility of complaints to licensing boards by clients, interns, employees, and others. As many as 11% of psychologists may have to respond to a complaint during their careers. Data collected by a licensing board from psychologists who had complaints filed against them were analyzed. Those who were found to have committed a violation were compared with those who were found to have committed no violation. The violation group (a) reported many more sequelae, including the expenditure of more time and money and the occurrence of more medical and psychological problems and (b) perceived the process and outcome as less fair. These findings suggest that review and modification of the complaint process are needed and that psychological and professional services may be helpful during and after complaint adjudication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinician's reactions to depressive behavior and ill health.

Psychotherapists are susceptible to prevailing negative stereotypes that exist in society at large. Inappropriate negative attitudes toward depressed and ill patients can adversely affect interactions with such clients. The authors examined the reactions of 410 psychologists to vignettes that described a client who emitted either depressed or nondepressed behavior and who varied in terms of cancer prognosis. Clinicians had negative mood reactions after reading the vignette of the depressed client; they also believed the depressed client possessed many undesirable personal attributes. Practicing psychologists are urged to reflect on their attitudes and beliefs so they do not negatively affect assessment and therapy services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of psychologists' education, knowledge, and experience treating clients with HIV/AIDS.

Practicing psychologists are providing services to persons with HIV infection and those at-risk for AIDS. However, most practitioners have not received formal training about HIV/AIDS. In this study, the majority of psychologists surveyed had treated persons at-risk for the virus but had not received HIV/AIDS information in formal educational programs. Most respondents obtained knowledge through popular media. There is a growing body of specialized knowledge about HIV/AIDS for mental health professionals. In addition to better serving HIV-infected clients, psychologists with current multidisciplinary HIV/AIDS knowledge will be valuable members of health care teams. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of self-help materials for anxiety and depression in mental health services: A national survey of psychologists in Norway.

[Correction Notice: An erratum for this article was reported in Vol 42(3) of Professional Psychology: Research and Practice (see record 2011-11548-002). The author's affiliations were listed incorrectly. The correct affiliations are in the correction.] How do psychologists in clinical practice perceive and use self-help materials for clients with anxiety and depression? The use of self-help materials with guidance from a therapist has been suggested as a way of meeting the increasing need for mental health services. The present study investigated factors relevant to the use of self-help materials for the treatment of anxiety and depression among psychologists employed in mental health services. Among 1863 eligible clinical psychologists in Norway, 815 (43.7%) participated in a national survey. A total of 93.5% of the participants had recommended self-help materials to clients, and approximately half (55.1%) had received requests from their clients regarding self-help materials. Self-help materials were recommended as an adjunct and not as an alternative to therapist contact by 73.0% of respondents, by 16.6% for relapse prevention, and by 1.2% to clients on a waiting list. Internet/computer-based programs were recommended by 2.2% of the participants. The practitioner's previous use of self-help materials to enhance his or her therapy skills and knowledge of self-help materials was related to use of self-help materials with clients. Psychologists working in child mental health services recommended self-help less often than those working in adult services. These results have implications for future efforts to disseminate effective self-help materials through increased attention toward self-help interventions in training and clinical practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Counselor theoretical orientation as related to intake judgments.

Investigated the relation between the predominant theoretical orientations (self-identified) of counselors and intake interview judgments by asking 12 senior staff counseling psychologists to rate the problems of 1,443 university students who presented themselves for an intake interview on a 5-point scale. Results show that counselors who were humanistically oriented judged that their clients presented more severe educational problems and characterized their clients as more anxious than did the cognitively oriented psychologists. The 2 groups of counselors did not differ in how they judged the severity of personal problems or predicted length of treatment. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do therapists address ethnic and racial differences in cross-cultural psychotherapy?

Ethnic and racial differences between client and therapist affect therapy processes and outcomes, but little is known about the extent to which therapists have dialogues about their differences in therapy. A survey on this topic was completed by 689 APA-licensed psychologists with experience conducting cross-cultural therapy. Most psychologists reported having such discussions, but with less than half of their cross-ethnic/racial clients. Therapists and clients were equally likely to initiate discussions. Reasons for discussing differences varied greatly. Therapists consistently described themselves as comfortable with and skilled at these discussions, and reported that discussions facilitated therapy. Therapists who were female, older, nonminority, less experienced with diverse clients, and viewed training as an important factor were more likely to have discussions about differences. Results point to the need to better understand if, when, and how ethnic and racial differences should be addressed in therapy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychologists' knowledge of their states' laws pertaining to Tarasoff-type situations.

This study examined psychologists' knowledge of their legal and ethical responsibilities with imminently dangerous clients. We randomly surveyed 1,000 psychologists from four states and received 300 useable responses (30%). Most psychologists (76.4%) were misinformed about their state laws, believing that they had a legal duty to warn when they did not, or assuming that warning was their only legal option when other protective actions less harmful to client privacy were allowed. Moreover, in spite of the inaccuracy of their knowledge, many respondents were confident that they understood the duty to protect in their own state. Contrary to expectation, we found no significant association between legal knowledge and continuing education in legal and ethical issues, graduate training in ethics, or clinical experience with dangerous clients. These findings suggest that educational experiences during and after graduate school may not be meeting the needs of professionals to understand the complicated array of state laws and ethical duties regarding dangerous clients. We recommend several changes in the provisions of these experiences to better protect psychologists and clients from unintentional risks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes of psychologists in training toward persons with AIDS.

Clinical and counseling graduate students (N?=?266) from 8 different universities read a vignette that described a hypothetical patient as having either AIDS or leukemia. These psychologists in training then completed a scale that measured attitudes toward the hypothetical patient. Results indicated that psychologists in training had some attitudes toward AIDS patients that were less positive than their attitudes toward identically described leukemia patients. However, psychologists in training were more willing to interact with AIDS patients and to accept them as psychotherapy clients than were psychologists studied in earlier research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists' Clinical Evaluations and Attitudes: An Examination of the Influence of Gender and Sexual Orientation.

Becoming aware of factors that may affect differential treatment of clients is necessary for psychologists to practice competently. Scholarly writing and empirical studies have suggested that therapist gender, client gender, and client sexual orientation are 3 such factors. This study examined therapist gender, client gender, and client sexual orientation in relation to psychologists' attitudes and clinical evaluations for clients. Results indicated that female psychologists held more positive attitudes and treatment expectations for clients than did male psychologists and that some psychologists hold inconsistent attitudes toward female clients generally and lesbian, gay, and bisexual clients in particular. Continuing education and consultation are recommended to increase psychologists' awareness of gender and sexual orientation issues and potential influences in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)