The Use of Consultation in Psychological Practice: Ethical, Legal, and Clinical Considerations

Abstract

The importance of consulting with other professionals to maintain acceptable standards of care is well documented in many health care professions. However, evidence indicates that many psychologists fail to utilize consultation when needed, and that consultation use varies along dimensions such as the education and training of the consultee, the type of setting, number of years in practice, and proximity to available consultants. In this article, we review the research on the use of consultation by psychologists as well as other health care professionals. We discuss the clinical, ethical, and legal implications of seeking consultation as a professional psychologist. Finally, a detailed and practical model for the regular use of consultation is given to improve the routine use of consultation in clinical practice.

Ethical Issues in Sandplay Therapy Practice and Research

“…Consultation with colleagues can take any one or more of several forms: evaluation of another therapist's client, the provision of assistance to a therapist for the purpose of developing a client's treatment plan or providing general support with respect to the client, or the provision of services at an administrative or organizational level to a private practice or an agency (Clayton and Bongar 1994). Consultation may occur formally as reflected in a written agreement and fee for the consultation service, or on a more informal basis.…”

“…4.06) Accordingly, the psychologist must weigh carefully how much and what information should be disclosed in order to obtain reliable consultative advice while still maintaining the client privacy. Various writers and ethical codes for a number of mental health professions highly recommend and emphasize the importance of discussing the possible need for consultative services at the outset with each client as part of the informed consent process and documenting the client's agreement (American Psychological Association 2010; Clayton and Bongar 1994;Social Workers Registration Board 2014).…”

National survey of psychological practices across rural and urban communities

“…Additionally, there may be times when the psychologist deems it necessary to practice outside her or his areas of competence. Clayton and Bongar (1994) state that competency consists of appropriate training, supervision and consultation, that it is important to consult with peers and continue one's education. Several authors define competence in terms of domains or components such as the knowledge domain (knowing what to do), the skill domain (being able to do it), and the affective domain (attitudes, values, beliefs) (Berven & Scofield, 1987;Haas, 1993;Koocher & Keith-Spiegel, 1998).…”

“…They also identified the affective domain as contributing to the maintenance of competency, though this will be discussed in the next section defining burnout. Clayton and Bongar (1994) assert that many psychologists fail to use consultation when it is in fact one of the better methods to maintain competency. Pope, Tabachnick, and Keith-Spiegel (1987) found that over 70 percent of survey respondents considered consultation with colleagues to be a good or excellent source of information for maintaining competency in their practice.…”

“…However, 25 percent admitted to acting unethically by practicing outside the scope of their competence rather than seeking guidance. Clayton and Bongar (1994) relate that consultation with colleagues can provide suggestions about difficult cases, include discussions regarding professional and ethical issues, be a valuable source of continuing education, as well as provide a source of support and community. These authors summarize that:…”