Showing papers in "Professional Psychology: Research and Practice in 1994"

Mental health and law enforcement professionals: Trauma history, psychological symptoms, and impact of providing services to child sexual abuse survivors

Abstract: A survey of 558 mental health and law enforcement professionals assessed current and past trauma experiences, exposure to traumatic client material, and the sequelae of both types of personal and professional trauma experiences. Results indicated that 29.8% of therapists and 19.6% of officers reported experiencing some form of childhood trauma.

Changes in supervision as counselors and therapists gain experience: A review.

Abstract: Considerable research relevant to counselor and therapist development has been done since Worthington's (1987) review. Additional support has surfaced for Worthington's conclusions: There is support for general developmental models, perceptions of supervisors and supervisees are consistent with developmental theories, the behaviors of supervisors change as counselors gain experience, and the supervision relationship changes as counselors gain experience. Although the types of research used and the sophistication of data analysis have improved somewhat, too few studies directly address changes over time for trainees in supervision. Suggestions are given for future research in supervision to reflect the level of specificity necessary to investigate developmental models.

Duration and outcome in psychotherapy: An integrative review.

Abstract: Research and practice trends are fueling a vigorous interest in brief therapy, highlighting the question of the relationship between treatment duration and outcome. A number of investigations have reported a weak or nonexistent relation between duration and outcome, yielding the possible conclusion that there are few differences between brief and longer term treatments. A finer-grained analysis, however, based on such methodological factors as the nature, source, and timing of outcome measures, reveals intriguing dose-effect linkages within particular helping modalities. Summarizing process and outcome research, this article identifies potential client, therapist, and contextual mediators of the brevity of treatment.

Multiple relationships: Does the new ethics code answer the right questions?

Abstract: The new "Ethical Principles of Psychologists and Code of Conduct" (American Psychological Association, 1992) presented expanded attempts to clarify the ethical issues regarding multiple relationships and to provide useful guidance for psychologists. This article proposes that the new code fails to address adequately two basic questions necessary to provide psychologists with clear guidance: (a) What are multiple relationships? and (b) When do multiple relationships constitute unethical conduct? The article offers a definition of multiple relationships and identifies several dynamics operating within a professional relationship that are likely to be adversely affected by the imposition of a secondary relationship. Unethical multiple relationships are defined. Finally, the article suggests additions to the new code that would enhance its utility for psychologists.

The management of sexual feelings in therapy.

Abstract: This research project examined the incidence, experience, salient features, and management of sexual attraction between psychologists and clients and assessed 908 American Psychological Association member psychologists who work in university counseling centers (43% return rate).

Clinical supervision practices of licensed psychologists.

Abstract: Licensed psychologists from a midwestern state were surveyed to assess the nature of clinical supervision for experienced practitioners. Data were collected concerning type, frequency, and content of supervision; supervisor goals, techniques, assessment methods, and roles; and most and least helpful aspects of supervision.

Explicit ambiguity: the 1992 ethics code as an oxymoron.

Abstract: The author reviews the major themes emerging from commentators' reactions to the 1992 American Psychological Association ethics code and presents his own views as well. Commentators agreed that the 1992 code is improved by its increased breadth and specific attention to important issues not addressed in the previous code but criticized the code for its lack of clarity, its rampant qualifying language, and for seeming to protect the profession rather than the public. The author, finding the code overly long, detailed, and lawyered, recommends that those who revise the code in the 21st century adhere more closely to fundamental moral principles.

Ethical and Professional Conflicts in Correctional Psychology

Abstract: The role of the mental health professional in a prison setting has changed to reflect the prevailing ideology of the correctional administration that deemphasizes treatment and emphasizes security and custodial concerns. As a consequence, mental health professionals who work in corrections have experienced unique ethical and professional conflicts. Standards were developed to address the conflicts and provide guidelines for professional conduct, but dilemmas continue to exist. The authors believe this can be attributed to (a) the standards being vague and (b) correctional personnel not understanding or supporting the standards or the psychologist's role as a mental health professional. This article examines these propositions in more detail, using vignettes and discussion, and offers other approaches to resolving the dilemmas and improving the delivery of mental health services to incarcerated individuals. Historical Perspective Mental health professionals who work in corrections have experienced ethical and professional conflicts that are unique to these institutions. Appreciating the mental health professional's role within a prison entails an examination of how our society has treated those who violate the law. Historically, most societies have adopted a philosophy that those individuals who commit criminal acts should be punished. Modern Western judicial systems have justified their use of punishment on four major grounds: retribution, deterrence, incapacitation, and rehabilitation (Grilliot, 1983; Kerper, 1972). Retribution has Biblical roots referring to "an eye for an eye." Deterrence operates from the core belief that those who see individuals punished will be less likely to follow the example of offenders because of the fear of punishment. Incapacitation has as its primary goal the protection of society by rendering offenders unable to repeat the offense. Rehabilitation is conceptualized as treating or "correcting" offenders so that they can live in society and not reoffend. The theory of rehabilitation is a relatively new objective used to justify punishment and has undergone many reformulations as our society's attitude toward criminal offenders has changed (Travin, 1989). Early American colonists believed that rehabilitation could be accomplished through severe punishment (e.g., stocks or gallows). It was not until the 18th century that an institution incarcerating offenders was viewed as having correctional properties. Reflecting the largely held Protestant values of the time, it was believed that rehabilitation in such institutions

Testing and Assessment Ethics for All Persons: Beginning and Agenda

Abstract: The previous American Psychological Association (APA) assessment ethics code (APA, 1990) and the new code (APA, 1992) differ in content that is relevant to culturally sensitive practices (i.e., culture-specific assessment technologies, culture-specific service delivery styles, use of clients' first language, and recognition of non-Anglo-American belief systems). The new code falls short in areas that are in the process of development or remain controversial. Suggestions for implementation and supplementation are included.

The client's perspective: Ethical judgments and perceptions of therapist practices.

Abstract: In response to a questionnaire, 96 adults, both with and without experience as clients in therapy, judged the ethical appropriateness of 60 therapist practices. In addition, those who had been clients indicated whether the practices had occurred in their own therapy. The practices were organized into 6 groups that corresponded to major areas of professional ethics in psychology: confidentiality, dual relationships, informed consent and business practices, competence, sensitivity to differences, and interventions. Clients and nonclients alike showed a general understanding of ethical principles but uncertainty about many specific points. Some uncertainty stemmed from a misunderstanding about the nature, and particularly the risks, of therapy. Practices judged clearly appropriate were not reported to have occurred universally by the clients in the sample, and practices judged clearly inappropriate were reported to have occurred with some, albeit low, frequency. The results are discussed with regard to implications for ethics research and ethical practice.

Implications of the 1992 ethics code for diverse groups.

Abstract: Previous renditions of the American Psychological Association's (APA's) code of ethics have clearly espoused psychologists' commitment to the ideal of having respect for the dignity and worth of the individual human being. The endorsement of the goal to protect fundamental human rights has always been highlighted in the Preambles of each revision of the code. The current code (APA, 1992) appears to have retreated from prioritizing this humanitarian stance. Ethnic minorities, women, gay men, and lesbians have reason to be apprehensive about the apparent downgrading in importance of psychologists' declaration of respect for the dignity and worth of the individual. All previous codes seemed to have been formulated from a perspective of protecting consumers. The new code appears to be driven by a need to protect psychologists. This article examines the possible impact of the shift in traditional priorities on diverse populations.

Reconsidering the American Psychological Association's policy on sex with former patients: Is it justifiable?

Abstract: This article invites reconsideration of the American Psychological Association's policy permitting sexual involvement between therapists and their former patients under certain conditions. The article (a) restates 5 major concerns about sex after termination that have not been adequately addressed; (b) examines 9 major arguments set forth in support of allowing posttermination sexual relationships, all of which appear ill-founded, fallacious, or misleading; and (c) describes 6 obstacles that seem to hinder attempts to create sound legal and professional policies in this area.

The commerce of professional psychology and the new ethics code.

Abstract: The 1992 version of the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct brings some changes in requirements and new specificity to the practice of psychology. The impact of the new code on therapeutic contracts, informed consent to psychological services, advertising, financial aspects of psychological practice, and other topics related to the commerce of professional psychology are discussed. The genesis of many new thrusts in the code is reviewed from the perspective of psychological service provider. Specific recommendations for improved attention to ethical matters in professional practice are made.

Provision of confidentiality information and its relation to child abuse reporting.

Abstract: A study of 204 psychologists in Minnesota, Missouri, and Kansas, representing a survey response rate of 59.6%, indicated that respondents were inconsistent in their procedures for informing clients of confidentiality limits. The hypothesis that these procedures are related to child abuse reporting tendencies was partially supported.

Self-discrepancy as an important factor in addressing women's emotional reactions to infertility.

Abstract: Infertility is approached in this article as a personal crisis that is based on a conflict between an ideal self as mother and woman and a real self as infertile. E.T. Higgins (1987) self-discrepancy theory is proposed as a model for understanding the variability in the levels of distress and the types of emotional reactions to infertility.

Morality in group and family therapies: multiperson therapies and the 1992 ethics code.

Abstract: Although virtually every psychotherapeutic approach or orientation has adapted group and family therapy to its conceptions of psychological dysfunctions and how to treat them, levels of training of practitioners in all of these approaches are often insufficient to meet the requirements of ethically as well as technically responsible conduct of treatment for persons in groups and families. The new ethics code (American Psychological Association [APA], 1992) does include a few issues specific to multiperson therapies, but other issues critical to the competent practice of group and family therapy remain unaddressed. The result can be confusing to those applying standards for individual therapy to multiperson therapies. It is argued that the classical ethical concerns of psychotherapists, informed consent, confidentiality, countertransference reactions, aand intrusions of therapist values, require special sensitivity to how they are expressed in mulitperson therapies. Practitioners of group and family therapies must be better sensitized to the technical distinctions and the associated ethical vulnerabilities of the modalities they use. Future planning for revision of the APA ethics code should take these factors into account.

Quantitative evaluation of 26 years of private practice.

Abstract: Of 683 cases seen by a clinical psychologists, 67 came for assessment only, 132 dropped out during intake, and 40 were sy=till in treatmenbt at the time of data analysis. The subjects fell into 86 DSM-III-R diagnostic categories and ranged in age from 6 months to 79 years at intake. Of the 444 treated clients, 75% were improved at termination.

Teaching psychologists and the new APA ethics code: do we fit in?

Abstract: The new American Psychological Association (APA) ethics code (APA, 1992) creates dilemmas of both image and substance for teaching psychologists. Items specific to teaching psychologists reflect housekeeping matters of lesser importance and situations over which teaching psychologists have little control. Teachers of psychology are sometimes inappropriately grouped with other types of psychologists. Freedom of inquiry and communication are curtailed in ambiguous ways, and the standards expected of teachers in the academy are set a mediocre level. Although the new code contains some improvements over the previous code (APA, 1990)--especially in the areas of multiple relationships, prohibitions against sex with students, respect for differences among students, and authorship rights retained by students--numerous recommendations for future revision are strongly recommended.

The not so great divide? Psychologists and psychiatrists take stands on the medical and psychosocial models of mental illness.

Abstract: Mental health practitioners' positions on the etiology and treatment of mental illness have traditionally been studied from a unidimensional perspective, assuming a bipolar attitudinal continuum ranging from psychosocial to medical ideology. This assumption is tested from the responses of 82 psychologists and 69 psychiatrists to the newly developed 63-item, 6-point Likert scale, Mental Health Questionnaire (MHQ). Factor analysis detected 6 distinctive factors: biogenetic psychopathology, psychosocial perspectives, medical ideology, diagnosis, drug treatment, and sociocultural values.