All psychologists must uphold the same ethical standards about confidentiality even though each state imposes different legal limits on their ability to protect clients' confidences. The resulting ethical-legal confusion is exacerbated by legally based confidentiality training that treats legal exceptions as if they were the rule and fosters the impression that attorneys are now the only real experts about this aspect of practice. This article provides an ethics-based confidentiality practice model that clarifies the ethical rule and puts its legal exceptions into ethical perspective. Like the Confidentiality section of the American Psychological Association's (2002) Ethical Principles of Psychologists and Code of Conduct, this outline would apply to all psychologists regardless of state laws, but the details of its implementation would vary according to role and setting. It can be used as a universal training outline, a consultation and supervision tool, a guide to professional practice, and a basis for clearer ongoing conversation about the ethics of "conditional confidentiality." Psychologists can use this practice model to regain their status as experts about the confidentiality ethics of their own profession.
Professional Psychology: Research and Practice is published bimonthly (beginning in February) by the American Psychological Association. The journal publishes articles on the application of psychology, including the scientific underpinnings of the profession of psychology. Articles that present assessment, treatment, and practice implications are encouraged. Both data-based and theoretical articles on techniques and practices used in the application of psychology are acceptable. The journal also publishes brief reports on research or practice in professional psychology. For more information, including how to subscribe, please visit the journal's Web site at www.apa.org/journals/pro.
The ethics and standards of practice literature has long focused on the duties that psychotherapists owe their patients. While this has been valuable to the profession, it has created a circumstance in which psychotherapists have focused on their duties and responsibilities to their patients with little understanding or respect for how the conduct of a patient can impact those factors. These articles will review these factors from both an ethical and legal perspective. In addition, all of the articles discuss the premise that, while the psychotherapist has the primary responsibilities when rendering treatment to a patient, the treatment alliance is actually a dynamic that changes depending upon the conduct of both the psychotherapist and the patient.
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.
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