Samuel Knapp

Training Ethical Psychologists: An Acculturation Model.

This article presents an approach to graduate (and professional) training that views becoming an ethical psychologist as an acculturation process. J.W. Berrys (1980, 2003) model of acculturation strategies is used as a framework for understanding ethical acculturation, a developmental process during which students can use several types of adaptation strategies. Students enter training with their own moral value traditions and concepts but are confronted with new ethical principles and rules, some of which may be inconsistent with their ethics of origin. The article explores several applications of the framework to ethics courses, practicum supervision, and other areas of training.

Nonrational processes in ethical decision making.

Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasilegal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior, including context, perceptions, relationships, emotions, and heuristics. For example, a large body of behavioral research has demonstrated the importance of automatic intuitive and affective processes in decision making and judgment. These processes profoundly affect human behavior and lead to systematic biases and departures from normative theories of rationality. Their influence represents an important but largely unrecognized component of ethical decision making. We selectively review this work; provide various illustrations; and make recommendations for scientists, trainers, and practitioners to aid them in integrating the understanding of nonrational processes with ethical decision making.

Professional boundaries in nontraditional settings

Summary Home-based services may be the only way for some patients toreceive services because of transportation limitations, mobilityissues, or cultural barriers to office-based treatment. In addition,for some clients, home-based services may be clinically indicated.For example, multisystemic therapy, which occurs largely in thenatural environment of the child, has been an effective treatmentthat can often be used in lieu of hospitalizations or institutionalplacements (Henggeler et al., 2002).Delivering services in nontraditional settings has the potential tobenefit clients. However, services in these settings can also lead tochallenges to helpful therapeutic boundaries. When working in thehomes or residences of clients, we recommend that psychologistsemphasize informed consent, especially about therapeuticboundaries.Whenever possible, the impact of boundary crossings on therapyand the therapeutic relationship should be considered ahead oftime. Effective psychologists balance social amenities that maystrengthen the therapeutic relationship with the need to focus ontreatment goals (Andersen et al., 2001; Knapp & Slattery, 2001).Preparing to handle possible boundary crossings can lead to suc-cessful decision making under difficult situations.Supervisors can minimize problems by training and monitoringsupervisees who work in the residences or homes of clients.Training should emphasize the general rule that some boundariesshould be kept firm, especially when workers feel threatened or

An Overview of the Major Changes in the 2002 APA Ethics Code

This article summarizes the major changes that were made to the 2002 Ethical Principles and Code of Conduct of the American Psychological Association. The 2002 Ethics Code retains the general format of the 1992 Ethics Code and does not radically alter the obligations of psychologists. One goal of the Ethics Committee Task Force was to reduce the potential of the Ethics Code to be used to unnecessarily punish psychologists. In addition, the revised Ethics Code expresses greater sensitivity to the needs of cultural and linguistic minorities and students. Shortcomings of the 2002 Ethics Code are discussed.

Considerations for ethical practice in managed care.

How does one maintain an ethical practice while facing the requirements and limits of a health care system that is dominated by managed care? Psychologists are increasingly raising such questions about ethical issues when working in or contracting with managed care organizations. The authors review the process involved in ethical decision making and problem solving and focus on 4 areas in which ethical dilemmas most commonly arise in a managed care context: informed consent, confidentiality, abandonment, and utilization management-utilization review. The need for sustained and organized advocacy efforts to ensure patient access to quality health care is discussed, as is the impact of managed cares competitive marketplace on professional relationships. Hypothetical examples of typical dilemmas psychologists face in the current practice environment are provided to illustrate systematic ethical decision making.

Thorough Record Keeping: A Good Defense in a Litigious Era

Psychotherapists, like other health professionals, are concerned about the increase in malpracticelitigation and insurance rates. Properly kept records, made in anticipation of future litigation,may be crucial for the psychotherapist who is faced with a malpractice suit. We review cases inwhich records influenced the outcome of malpractice suits, and we make specific recommenda-tions regarding the optimal maintenance of records.

When Laws and Ethics Collide: What Should Psychologists Do?

At times the laws under which psychologists function may appear to contradict generally recognized ethical values and/or good clinical care. When these circumstances arise, psychologists must determine if a conflict really exists and, if so, seek solutions that reconcile respect for the law with their ethical values. At times, psychologists may decide to follow the law despite their ethical concerns. At other times, they may determine that a conscientious objection is warranted. The authors recommend options to consider when these situations arise and offer a decision-making process.

Some principles for ethics education: Implementing the acculturation model

In 2005, the authors (Handelsman, Gottlieb, & Knapp, 2005) proposed that ethics education be conducted based on a model of ethics acculturation. Here, the authors extend that work by offering some principles that support implementation of an ethics acculturation model (EAM) over the full course of professional preparation. The authors argue that ethics education should be life-long and provide students and trainees with positive, ongoing, experiential, and supportive educational environments and activities. After presenting and explaining each principle, the authors offer a detailed example showing how various exercises from the existing literature may be employed to facilitate students’ ethical development.

A PRINCIPLE-BASED ANALYSIS OF THE 2002 AMERICAN PSYCHOLOGICAL ASSOCIATION ETHICS CODE

The authors adopt a position that the Standards in the American Psychological Association (APA; 2002) Ethics Code should be based on or be logically related to some underlying ethical theory. The authors then review the 2002 APA Ethics Code from the standpoint of principle-based (prima facie) ethics. Their analysis shows that almost all of the enforceable standards in the 2002 APA Ethics Code are based on or can be linked logically to the criteria of principle-based ethics.

The ethics of advertising, billing, and finances in psychotherapy.

Psychotherapists must deal with practical business matters such as advertising, billing, collecting fees, and other practice management topics. We review the enforceable standards of the American Psychological Associations (2002) Ethics Code that deal with advertising, fees, billing, and related business matters in psychotherapy. Using a principle-based perspective, we link each of the standards to overarching ethical values and illustrate the concerns with case vignettes. We argue that understanding the moral foundations of ethical standards helps psychotherapists to implement with greater integrity the spirit and the letter of the standards with regard to advertising and business practices.