Ethical dilemmas in psychologists accessing Internet data: Is it justified?

Many psychologists search the Internet for both personal and professional information. Although various guidelines have been proposed for psychologists regarding therapeutic services provided over the Internet, few address the ethics and efficacy of gathering information about clients, students, or employees on the web. As quickly as guidelines are written, new technologies create new challenges. With the advent of social networking sites and numerous free and paid data search engines, unique dilemmas have arisen. The ready access of voluminous personal information raises perplexing questions for clinician psychologists, instructors, supervisors, and employers. An overarching consideration addressed in this article is whether in the course of one's professional activities it is ethically appropriate to conduct intentional Internet searches for information about patients, students, or employees. We discuss ethical dilemmas such as right to privacy, trust, confidentiality, informed consent, boundary violations, and best interest of the client, student, or employee. Next we provide a list of some extant electronic sources of information and offer case examples. The article concludes with recommendations that we hope will generate further dialogue and research on these perplexing issues and provide guidance on balancing situationally appropriate flexibility with the need for adopting wise parameters of professional behavior in regard to social networking activities and Internet “investigations.” (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychotherapy, professional relationships, and ethical considerations in the myspace generation.

The pervasive use of Internet technologies has created new ethical dilemmas for psychology trainees and professionals. In particular, Web sites that allow users to post personal information have sparked controversy regarding the amount of freedom psychologists should have in placing personal information online and how discovering such information may impact professional relationships, including the therapeutic relationship. Results from a graduate student survey (N = 302) address the prevalence of the use of online social networking sites, security measure efforts that limit public access, incidents of client access to psychotherapists’ personal Web sites and Internet use by psychotherapists to obtain client information, and their subsequent effect on the therapeutic relationship. Using applicable ethical principles and standards, we provide recommendations for the field in an effort to decrease potential harm and maximize areas of opportunity for psychologists and constructive professional relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The intimate connection between antisocial personality and substance abuse

This section of the series introduces the topic of WWW search engines and directory sites; showing you how to find information using a search engine and a directory. It also covers other ways of searching for information on the internet.     

Rights of clients, responsibilities of therapists.

Discusses ways in which ethical principles can be put into practice in the client–therapist relationship. Historically, ethical codes for therapists were drawn up to protect the professions from regulation by external agencies. Implicit in the ethical codes, however, is a model for the client–therapist relationship that fosters the goals of mental health. It is suggested that just as ethical codes have been given specific content in standards for providers of psychological services in human service facilities, ethical codes can be given specific content in the client–therapist relationship. It is recommended that therapists take responsibility for incorporating ethical standards into their practices so that clients' rights will be an integral part of therapy. Four illustrative situations are presented: providing clients with information to make informed decisions about therapy, using contracts in therapy, responding to clients' challenges to therapists' competence, and handling clients' complaints. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trying to beat the system: Misuse of the Internet to assist in avoiding the detection of psychological symptom dissimulation.

Although the Internet may be beneficial to clinical practice, its potential for misuse cannot be overlooked. The current probe identified Internet Web sites that contained information that violated the test security of psychological assessment instruments. Five individuals, using multiple search engines, conducted Internet searches to evaluate samples of Web sites. Sites were classified into 1 of 3 levels according to the degree of threat they posed to test security. A small number (2-5%) appeared to be a direct threat to test security. The findings are discussed and recommendations for promoting more ethical use of the Internet are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual relationships between therapist and client: A national study of psychologists, psychiatrists, and social workers.

4,800 psychologists, psychiatrists, and social workers were surveyed (return rate?=?49%) to examine attitudes and practices regarding dual professional roles, social involvements, financial involvements, and incidental involvements. Half of the Ss rated the degree to which each behavior was ethical; the other half reported how often they engaged in each behavior. A majority believed dual role behaviors to be unethical under most conditions; most reported that they had rarely or never engaged in the behaviors. 10 factors (therapist gender, profession, age, experience, marital status, region of residence, client gender, practice setting, theoretical orientation, and practice locale) were examined for their relation to the beliefs and behaviors. A higher proportion of male than of female therapists were perpetrators of sexual and nonsexual dual relationships. The professions did not differ among themselves in terms of (a) sexual intimacies with clients before or after termination, (b) nonsexual dual professional roles, (c) social involvements, or (d) financial involvements with patients. 10 specific training implications are discussed in light of the exploitive and clinically harmful nature of dual relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapist self-disclosure and transparency in the Internet age.

All psychotherapists engage in self-disclosure with their clients. At times it may be deliberate or nondeliberate, verbal or nonverbal, and avoidable or unavoidable. Yet, modern-day Internet technologies have redefined the meaning and applications of self-disclosure and transparency in psychotherapy. Consumers of mental health services can easily access large amounts of information about their psychologists. Clients' online searches about their psychotherapists may range from normal curiosity to criminal stalking. Following an examination of these issues, three invited experts share their commentaries on the issues raised. A historical review of self-disclosure in the mental health professions and the opposition of many theorists and practitioners to its use are provided. Further, the roles of Internet social networking and online communities for psychotherapists and their clients and prospective clients are explored, along with the clinical meaning of the ever-increasing digital transparencies of psychologists, trainees, and clients. Advice is provided for how to view, understand, and consider web postings by psychotherapists, clients, and others. Implications for clinical practice and training are provided along with recommendations for how to effectively address issues of digital transparency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence tactics in psychotherapy.

Examined the process of psychotherapy within the context of social power theory. Therapist influence acts were classified in terms of the goals or reasons why therapists exercised influence and the strength of the influence attempt. The analysis was based on 22 tapes of psychotherapy sessions, provided by 5 female and 6 male therapists. Each therapist provided a tape of 1 male and 1 female client. Findings indicate that therapists were consistent in their use of tactics from one client to another. Male therapists, compared with female therapists, used significantly more influence tactics and interrupted their clients significantly more often. Therapists of both genders used significantly more passive forms of influence earlier in the session and more active forms later. Therapists of both genders told female clients what to do significantly more often than they did male clients, although they significantly more often explained thoughts, feelings, and behaviors to male clients than to female clients. Therapists used stronger influence attempts—those judged as demanding a response from the client—significantly more frequently with female clients than with male clients. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Studying psychotherapy using the one-with-many design: The therapeutic alliance as an exemplar.

Most psychotherapy research uses a one-with-many design, in which each therapist (the one) treats multiple clients (the many), which raises the challenge of nonindependent data. We present a statistical model for analyzing data from studies that use a one-with-many design. This model addresses the problems associated with nonindependence and can address theoretically relevant questions. To illustrate this model, we analyzed data in which 65 therapists and their 227 clients rated their therapeutic alliance. The primary finding was that both therapist and client alliance ratings were largely relational (i.e., specific to the unique therapist–client combination). There was little consensus among clients treated by the same therapist about the quality of the therapeutic alliance, although some therapists reported forming stronger alliances than other therapists. There was substantial dyadic reciprocity, indicating that if a therapist reported an especially good alliance with a particular client (better than with his or her other clients), then that client was also likely to report an especially good alliance (better than those reported by the therapist’s other clients). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inventory of Problematic Internet Experiences Encountered in Clinical Practice.

People are bringing a variety of Internet-related problems into consultation with mental health professionals. This exploratory study used a systematic sample of mental health professionals and obtained both structured and open-ended information from 1,504 practitioners who reported having at least 1 client with an Internet-related problem. This article proposes an inventory of 11 types of problematic Internet experiences reported by youth and adult clients: (a) overuse; (b) pornography; (c) infidelity; (d) sexual exploitation and abuse; (e) gaming, gambling, and role-playing; (f) harassment; (g) isolative-avoidant use; (h) fraud, stealing, and deception; (i) failed online relationships; (j) harmful influence websites; and (k) risky or inappropriate use, not otherwise specified. The authors discuss the spectrum of cases within each category and implications for clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' anger, hate, fear, and sexual feelings: National survey of therapist responses, client characteristics, critical events, formal complaints, and training.

Therapists reported frequencies of experiencing 24 instances of feeling anger, hate, fear, and sexual attraction or arousal; encountering 16 client events (e.g., client orgasm, client disrobing, client suicide, client assault on therapist or 3rd party); and engaging in 27 behaviors (e.g., avoiding clients with HIV, kissing clients, massaging clients, using weapons or summoning police for protection from clients). Responses differed according to therapist gender (e.g., more male than female therapists experienced patient suicides and faced malpractice, ethics, or licensing complaints), client gender (e.g., more female than male clients were noticed as "physically attractive," hugged, and cradled in therapists' laps), and theoretical orientation. Many participants rated graduate training regarding anger, fear, and sexual arousal as inadequate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

国外常用搜索引擎比较分析

对国外五个著名的搜索引擎Alta vista、Excite、Infoseek、HotBot、Lycos、Yahoo从其搜索类型、搜索选项、检索功能和优缺点几方面进行对比和分析，为用户更好地利用搜索引擎查找网上信息提供有益的启示。     

"I apologize for being late": The courteous psychotherapist.

Psychotherapists may behave discourteously toward clients, often unconsciously and without being aware of it. The effort here is to alert therapists to the simplest ingredient of the positive therapeutic relationship--behaving courteously toward our clients. A limited number of pitfalls are discussed including: tardiness, tiredness and fatigue, in-session electronic interruptions, drinking alone in the presence of the client, checking the clock, and improperly addressing clients by name. This brief list encourages therapists to be alert to these as well as other behaviors that may have the potential to be offensive. When therapist discourteous behavior has taken place, it is important for therapists to do what they can to repair the damage, especially if a rupture has ensued. It is recommended that therapists encourage clients to discuss their feelings about the offending behavior in the presence of the nondefensive therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary development of an interaction matrix for observation of client–therapist relationships in play therapy.

Describes the development of the Carmichael Therapist/Client Interaction Matrix (CTCIM) and presents preliminary findings on its use in supervision of therapists and for empirical study of therapist/client interactions. The purpose of the CTCIM is to graphically depict the relationship between the level of therapist's responses and the client's behaviors in therapy. The CTCIM was used to evaluate 32 sessions in a university play therapy laboratory. Five children (aged 6–10 yrs) were paired with 5 therapists. The 5 children represented a wide range of problems from physical abuse survivors to school adjustment difficulties. The 5 graduate student therapists varied from beginning to moderate counseling experience. A positive correlation was found between therapist's responses and client behavioral outcomes in the preliminary study. Based on the finding that the CTCIM met 4 of the 6 dimensions recommended by P. Howe and L. Silvern (1981) in investigating issues important to therapists and clients, it is concluded that the CTCIM demonstrates potential for empirical studies and for supervision of therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing therapist and client perspectives on reasons for psychotherapy termination.

Examines the extent of agreement on the reasons for psychotherapy termination given by therapists and their clients. 194 client files in a psychology training clinic were reviewed to obtain reasons for termination cited by therapists in treatment termination reports. Telephone interviews were conducted with 87 of these former clients to determine their perspectives on reasons for termination. Consistent with previous research, there was little concordance among the reasons cited by therapists and by clients regarding clients' decisions to terminate therapy. Of the clients identified by therapists as terminating because of the successful attainment of therapeutic goals, three-quarters reported this reason as important in their termination decision; of those clients reporting termination because of attaining therapeutic goals, only half were identified by therapists as having achieved their goals. Dissatisfaction with therapy and/or the therapist were reported by many clients as important in their termination decisions; such factors were rarely cited by therapists as reasons for termination. Attention to discrepancies between client and therapist expectations of therapy and therapy termination is necessary to reduce the high rate of premature termination in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of nonverbal behavior to client reactions.

Sixteen therapists each saw a volunteer client for a single counseling session. During a videotape review the clients recorded their reactions and the therapists recorded their perceptions of client reactions to each therapist intervention. Client nonverbal behaviors (speech hesitancies, vertical and horizontal head movements, arm movements, leg movements, postural shifts, adaptors, illustrators, and smiles) were examined to determine whether they were consistently associated with client reactions. The results indicated that horizontal head movements were associated with client reports of supported and therapeutic work reactions and were also associated with therapist perceptions of therapeutic work reactions; vertical head movements were associated with client reports of supported reactions; and speech hesitancies were associated with therapist perceptions of therapeutic work reactions. The results are discussed in terms of implications for practice and further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapists' attitudes toward clients reporting mystical experiences.

Studied the proportion of therapy clients who report mystical experiences, the diagnostic attitudes of their therapists, and the influence of personal and professional factors on attitudes toward these clients by analyzing the survey responses of 285 32–82 yr old psychotherapists (primarily males). Of the 20,670 clients seen during a 12-mo period, 4.5% reported a mystical experience; 67% of Ss had seen at least one such client during that period. Psychodynamic and behavioral therapists attributed significantly more pathology to such clients than did humanistic/existential therapists. Responses suggested that some therapists were biased in their diagnostic attitudes toward clients reporting mystical experiences. 50% of Ss said they had personally had a mystical experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beneath the surface of long-term therapy: Therapist and client report of their own and each other's covert processes.

Therapists and clients reported on their own and their perceptions of each other's covert processes in long-term therapy. Therapists had a match rate of .45 for client reactions, with therapists rating match on therapeutic work reactions as helpful. Although 65% of clients left somethimg unsaid (primarily because of avoidance), only 27% of therapists were able to match what clients left unsaid. Of the clients, 46% had secrets (often sexual), primarily because of shame or insecurity. Clients had a match rate of .50 for therapist intentions, with therapists rating match on exploratory and restructuring intentions as helpful and both clients and therapists rating match on assessment intentions as not helpful. Thus, awareness of the other's covert processes had an effect on therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)