Potential ethical violations

Know your rights and your psychologist’s responsibilities in several common ethical dilemmas:

Multiple relationships

Your psychologist shouldn't also be your friend, client or sex partner. That’s because psychologists are supposed to avoid relationships that could impair their professional performance or harm their clients.

• Of course, it’s usually impossible for psychologists to avoid all contact with clients outside their offices. Relationships that don’t hinder psychologists’ performance or harm their patients are ethically OK.
• One type of relationship that’s never acceptable is a sexual relationship with a current client. And even though sexual relationships that occur at least two years after therapy ends may be technically acceptable, they can still be harmful.

Confidentiality

Employers, spouses, school administrators, insurance companies and others often ask psychologists to provide information about their clients. APA’s Ethics Code says that psychologists may only share the minimum information necessary.

• Your psychologist should be clear about whether and why he or she is disclosing information. Sometimes, for instance, a law requires psychologists to disclose something, such as possible abuse.
• Your psychologist should let you know the limits of confidentiality and explain how confidential records are stored.

Informed consent

Your psychologist should give you the information you need to give informed consent right from the start. Topics to discuss include:

• Limits of confidentiality
• Nature and extent of your psychologist’s record-keeping
• Expertise , experience and training
• What services your psychologist can’t or won’t provide
• Estimated length of therapy
• Alternative approaches to treatment or service
• Fees and billing practices
• Your right to terminate your treatment and any resulting financial obligations.

Trainees

Sometimes a therapist in training may provide your treatment. The therapist should let you know he or she is a trainee and give you the supervising psychologist's name.

• Keep in mind that bills may be under the supervisor’s name, not the trainee’s. You don’t want to report a billing problem when none exists!

Roles

When psychologists work with organizations or groups, there may be confusion about who the actual client is.

• In court, for instance, it may not be clear whether a psychologist is serving as an expert witness or an advocate for one side. Confusion is also possible when psychologists provide services to one person at the request of another, such as parents requesting therapy for children or police departments requesting evaluations of officers.
• Psychologists should be clear from the start about who the client is and what their own role is.
• They should also discuss limits to confidentiality, what services they’ll provide to whom and how they or others could use the information obtained.

Expertise

Psychologists should only practice in areas where they are competent.

• If you’re in a custody battle, for instance, a psychologist who’s unfamiliar with working with courts could harm your case no matter how well-intentioned he or she is.
• If you ask your psychologist to write a letter to the judge about your child’s relationship with you and your spouse, the psychologist could get in trouble by failing to note something like the fact that she never met the child’s father.

Billing

Your psychologist has an ethical obligation to bill patients and insurers accurately. Your psychologist should explain financial policies at the beginning of treatment.

• Sloppy bookkeeping lands some psychologists in hot water. Others get in trouble because they try to manipulate the system to get clients more benefits than they’re entitled to.
• Don’t ask your psychologist to bill for a service that’s covered rather than what was actually provided. And don’t ask your psychologist to exaggerate your diagnosis to justify more visits or to give you a less damaging diagnosis for fear of what your employer or others will think.
• And, expect your psychologist to bill you rather than your insurance company if you miss an appointment.

End of therapy

You should know the difference between treatment termination and abandonment.

• Psychologists can ethically discontinue treatment when clients aren’t benefiting from therapy, may be harmed by treatment, no longer need therapy or threaten the therapist, themselves or others.
• Your psychologist should explain why the current treatment is no longer appropriate, suggest alternative service providers, address feelings of rejection and resolve any practical issues.
• In contrast, abandonment occurs when a psychologist inappropriately ends treatment.