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)     

Contracting for supervision.

The changing job market has increased the demand for psychologists to serve as clinical supervisors of other mental health service provides; however, such supervisory arrangements inevitably increase legal exposure and pose unique ethical challenges for the supervising psychologist. A detailed sample supervision contract incorporating ethical and practice standards of psychology is offered. Although such contracts may not be legally binding, these agreements help facilitate (a) an adherence to these professional and ethical standards, (b) effective supervisory practices, and (c) the quality of care for the persons receiving psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consent, disclosure, and waiver for the forensic psychological evaluation: Rethinking the roles of psychologist and lawyer.

The duty to obtain consent from a litigant before beginning a forensic evaluation has fallen to the forensic psychologist. Guidelines, ethical standards, and commentators have made this assumed duty mandatory. Unfortunately, psychologists are not able to provide accurate and detailed legal information concerning the forensic evaluation. Only a person trained in the law would be qualified, and the litigant's lawyer has the legal duty to properly inform the litigant about the legal parameters of the forensic evaluation. This article discusses the psychological and legal aspects of consent for forensic evaluation and proposes a model in which both the lawyer and the psychologist collaborate in a process initiated by the psychologist to inform the litigant about the evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consultation with primary care physicians: Obstacles and opportunities in the medical setting.

This article discusses the relationship between psychologists and primary care physicians and describes the training and practice of physicians in the areas of mental and behavioral health care. Issues affecting the relationship between psychologists and primary care physicians are then reviewed. Different models of psychological consultation are discussed, and an integrated behavioral systems model of psychological consultation is presented as a potentially effective model for consultation with primary care physicians. This model provides a framework for psychologists to function as coproviders of primary health care services. Practical strategies to enhance collaboration between psychologists and primary care physicians in private practice are discussed. The need for more research on primary care and for the inclusion of psychologists in managed care and health care reform are also highlighted. (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)     

Barriers and enhancements to physician-psychologist collaboration.

Have you ever wondered why it is so difficult to establish and maintain good relationships with physicians who could be good referral sources for you? Physicians in 2 multispecialty practices that include psychologists reveal what they want from psychologists and what most concerns them about working with psychologists. Strategies are outlined that psychologists can adopt to promote physician-psychologist collaboration, including seeing physicians as their customers and marketing services with an eye toward customer satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical pitfalls for managers.

Maintains that psychologists who are American Psychological Association (APA) members and who hold managerial, administrative, or supervisory positions bear responsibility for adhering to APA's ethical principles. These principles bind all of the manager's behavior, not merely those behaviors that can be regarded as psychological in nature. The nature of managerial work is briefly reviewed, and ethical pitfalls encountered by psychologist/managers are analyzed. Examples of psychologist/managers who have violated the APA code are presented, and suggestions for avoiding such problems are offered. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Third party presence during criminal forensic evaluations: Psychologists' opinions, attitudes, and practices.

If you are a psychologist who conducts forensic evaluations, how would you respond to an attorney's or family member's request to be present or to videotape the evaluation? Your answer may be impacted by legal, professional, ethical, and practical issues as addressed in legal and mental health publications. However, there is a dearth of empirical attention, and even the opinions and practices of psychologists in this arena are unclear. The present article addresses the need for empirical data on third party presence by surveying forensic clinicians' perspectives on the topic. A total of 160 forensic practitioners (41% response rate) provided information on their attitudes and practices pertaining to third parties in an evaluation. Overall, most clinicians believe third party presence can negatively impact an evaluation, yet most have conducted examinations under such conditions. The article concludes with speculation as to the impact of third party presence, a call for research and professional standards, and specific guidelines for psychologists who may struggle with these complex issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk evaluations for the courts: Is service quality a function of specialization?

Psychologists are often asked to testify in court. However, concerns have been expressed in both the legal and psychological literatures about the quality of these services. This article presents survey results comparing the practice patterns of generally licensed psychologists with those of specialist forensic diplomates in providing risk evaluations. Results suggest that general clinicians frequently perform these evaluations, but forensic diplomates use more modern risk instruments, are more aware of the scientific literature, and provide the court with more information about the scientific basis of their testimony. The implication of these results for legal professionals, psychologist training, and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accepting forensic case referrals: Ethical and professional considerations.

As psychologists serve the legal system with increasing frequency, it is important to consider a number of critical issues at a case's inception, including the following: Who calls the psychologist? Who is the referral source? Who is the attorney? Who are the various parties involved in the case? What are the facts of the case? Does the psychologist have the expertise to clarify and develop technical issues of the case? Will the psychologist be expected to play an expert role or a consultant role? Who pays the psychologist? How are fees determined? What records should be kept? Answering these questions will help the psychologist avoid ethical, legal, and professional dilemmas and will allow the psychologist to perform an important service in helping the court to understand technical issues in reaching just decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology, spirituality, and end-of-life care: An ethical integration?

With an increased focus on multidisciplinary care, psychologists are being called to work within palliative care teams. Spirituality is often a salient issue for palliative individuals, and has significant implications with respect to psychological functioning. This paper discusses the incorporation of spirituality/religion into psychological end of life care, with a focus on the biopsychosocial-spiritual model of health, and the consideration of spirituality/religion as an aspect of cultural diversity. Discussion also surrounds the ethical integration of spirituality/religion into psychological assessment and treatment, as well as recommendations for clinical training. An overall theme of this article is that attending to the spiritual needs of palliative individuals is important to fulfill one's ethical responsibilities as a psychologist. Thus, seeking ways to ethically integrate these concepts into psychology training and practice remains an essential endeavour. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Privileged communication in the psychologist–client relationship.

Determining the status of privileged communications between psychologists and clients is a complex task. There is considerable variation across states with respect to the scope of psychologist–client privilege, and several sections of state codes directly and indirectly influence its status. An analysis of state laws related to privileged communication in the psychologist–client relationship is presented and prevalent legal exceptions and trends related to client privilege are discussed. Implications for practice to assist psychologists in balancing their ethical and legal obligations also are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perennial ethical quandaries in military psychology: Toward American Psychological Association-Department of Defense collaboration.

Active duty military clinical psychologists occupy dual roles as therapist–clinician and commissioned military officer. Frequently, simultaneous allegiance to professional (ethical guidelines) and military (federal statutes) requirements is not possible, placing the military psychologist in ethical quandaries that lack elegant resolution and create a continuing environment of risk. This article briefly highlights two areas of acute ethical vulnerability to military psychologists and underscores the dangers inherent in current informal strategies for managing dual allegiance. It concludes with recommendations for close and ongoing collaboration between the American Psychological Association and the Department of Defense for the purpose of clarifying the role of the military psychologist and resolution of the more pressing ethical dilemmas common in military settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suggestions for the uses of psychological devices in accord with legal and ethical standards.

Suggests that some traditional psychological practices no longer conform to current legal and ethical requirements and that several ethical standards in the official publications of the American Psychological Association are applicable to the use of psychological devices. In the treatment of problems with possible organic causes, collaborative relationships with physicians may be required. The Food and Drug Administration's recent classification of some psychological devices (e.g., biofeedback equipment) as medical devices is likely to impose new standards upon the distribution and use of psychological devices similar to those now required for medical devices. Failure to conform to these standards may be considered as evidence of negligent treatment under some state laws. Finally, these standards suggest that public statements and announcements about devices should be based upon scientifically acceptable evidence and that psychologists should not participate for personal gain in the commercial promotion of a proprietary or single-source device to the public. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confidentiality, ethics, and informed consent.

Comments on the article Protecting confidentiality rights: The need for an ethical practice model by Mary Alice Fisher (see record 2007-19520-001). In Fisher's excellent and much-needed article, she rightly implied that when discussing ethical dilemmas, psychologists may find themselves saying "consult an attorney" almost as often as they find themselves saying, "consult a fellow psychologist." Fisher's article was meant to turn the ship so to speak, by providing psychologists with a foundation for thinking clearly about confidentiality issues--a foundation that does not use legal arguments as primary building blocks. The above being said, we offer comments about four issues that we hope will add to the fine ideas expressed by Fisher. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical dilemmas in police psychology.

A body of police psychologists was surveyed with regard to the ethical dilemmas that they experienced in providing psychological services to law enforcement organizations. A majority (55%) of the respondents reported that they had encountered an ethical conflict. The most common ethical dilemmas were related to issues of confidentiality, conflicts between the ethical standards of the psychologist and the needs of the agency, and dual relationships. In this article these areas of concern are explored, and suggestions to help resolve these issues are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Policy on insurance.

Comments on the position adopted by APA in negotiating with insurance companies on the subject of reimbursement to psychologists for services rendered under health insurance plans. When outpatient psychotherapy is covered by insurance, a psychologist making an independent determination of the need for psychotherapeutic treatment is, according to the APA resolution, being a "judge of illness in the medical sense" and that the "appropriate inter-professional collaborative relationships" between medicine and psychology is for the medical person to make the determination of psychotherapeutic illness and to decide upon the need for psychological services. We are officially concurring that medicine is within its rights in determining the need for and supervising psychological services, when these services are covered by insurance. The APA position on this insurance issue contravenes previously accepted APA policy which states that, within the scope of ethical practice, a psychologist may function autonomously as a psychotherapist. This has been done without sufficient justification, and certainly without sufficient notice to and discussion by the membership. It behooves APA to defer any further negotiation on this issue until it provides for a full reconsideration of the issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and HMOs: New partnership or new adversary?

Discusses the provision of psychological services in health maintenance organizations (HMOs) with regard to the level of the legal recognition of the autonomous functioning of psychologists. Professional concerns over the role of psychologists in HMOs and over incentives to provide quality mental health care in such organizations are also discussed. The need is stressed for psychologists to be recognized as autonomous providers under the basic federal health programs. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Veterans Administration psychology: A professional challenge for the 1980s.

Discusses the role that psychology has played in the Veterans Administration (VA) since the 1940's, a role that has increased in prominence over the years. Psychologists in the VA's Department of Medicine and Surgery have been involved in the delivery of health and mental health care services, research efforts, and training programs for psychology interns. It is noted that despite psychology's long-standing involvement in the VA, concerns have arisen recently regarding the status of psychology within the VA. Events contributing to these concerns involve decreased administrative visibility, attempts to exclude psychologists from medical staff membership, threats of psychology staff reductions, and proposals to place psychologist practitioners under the direction of physicians. Psychology's legislative and regulatory efforts to address these concerns are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linking psychologists and family physicians for collaborative practice.

This article describes a pilot, demonstration project that linked psychologists and family physicians to improve the care of patients with alcohol and other drug abuse problems. The project facilitated collaborative practice between family physicians and psychologists to enhance treatment of patients with alcohol and other drug abuse and other psychosocial problems in rural America. Ten pairs of psychologists and family physicians in rural Texas and Wyoming participated in the project. The training successfully established linkages between psychologists and family physicians for the care of a broad range of medical and psychological problems. This article discusses the linkage training, factors that facilitated and hindered collaboration, as well as implications for future training and collaborative health care practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)