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Chapter 5

PSYC31 Chapter 5.docx

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Zachariah Campbell

PSYC31 Chapter 5 Association of state and provincial psychology (ASPPB) • Code of conduct standard for professional behaviour • ASPPB is the association of all licencing boards in Canada and the United States o Board of Psychology/licencing boards are established at state/provincial levels. They enforce the ethics codes.  Composed of psychologists and public members who determine whether a psychologist is eligible for a licence to practice  they can sanction those who violate these ethical principles  At least one member of the Board is from the general public • Designed to protect the public not promote the welfare of psychology • Provides licences to psychologists based on proof by the psychologist of adequate training, education, and supervision in clinical hours • Psychologist must have passed the examination of professional practice in psychology • Continuing education credits (CEUs)  designed to ensure that psychologist remains up-to-date on current psychological theory and research • State psych associations are different in their scope and focus than Boards of Psychology o State associations promote the science of psych and its application o Only have jurisdiction over members of their associations, not all licenses • Original ideas of ethical code came from Hippocrates with his Hippocratic Oath • Ethics code is not equivalent/synonymous with the law  a clinical neuropsychologist must adhere to the law, ethics principles, and the Board Ethics Principles of Psychology • Contains 3 componenets: 1. The preamble & general principles - describes the ethics code and its use 2. General Principles which APA would like its members to adhere include: a) Beneficence and non malfeasance b) Integrity c) Fidelity d) Justice e) Respect for people’s rights and dignities 3. Ethical Stanrds that if Violated can be Sanctioned  10 sections _________________________________ 1. Guidelines for reporting ethical issues 2. Providing services in an area where one is competent So providing services only in an area in which one is trained i. ex. a person not trained a a clinical neuropsychologist attempting to administer neuropsychological tests violates this section and thus can be subject to sanctions ii. Making sure one’s personal problems don’t affect one’s judgements (impaired judgement = biased judgement) iii. Competence is comprised of: knowledge, technical skills, and emotional competence • if a clinician neglects his or her self care, he/she may be more likely to be disrespectful to the client 3. Privacy and confidentiality  except in cases of threats of suicide, homicide child abuse (both when client might have been victim or when he/she might be a perpetrator) and abuse o a vulnerable adult (perpetrator/victim?) . a. If the clinet is under the age of 18 the guardian may have access to content fo therapy b. Mandated reporters: professional must report any physical or sexual abuse of children or vulnerable adults c. Privileged communication: a communication between a patient or client and certain providers of services that ma be withheld from a court of law i. All states have privileged communication but they differ – so clinical neuropsychologists must know the law in the state where he/she practices ii. Neurolaw a synthesis of neuropsych, rehab, and law which relates to medico legal ramification of neurological injuries particularly TBI 4. Ethical Standard 5 is advertising and other public statements  addresses false/deceptive advertising a. Psychologists are limited in their advertising to their highest degree received, their practice specialities, and the insurance companies for whom they are providers 5. Record keeping  protecting the records of clients and their address the conditions of their maintenance a. Fees: issues of payment for services and situations involving non-payment for services b. The Health Insurance Portability and Accountability Act (HIPPA) s a federal law implemented in 2003 to protect the privacy of individuals’ medical and psychological records; it requires various provisions by any provider who uses any electronic medium to send information regarding a patient 6. Education and Training  addresses the content of educational programs and ensures the presentation of materials in classes and other situations is done in an unbiased manner 7. Research and publications  the conditions for conducting research, the consent needed from participants, the care and treatment of both human and animal subjects, and the debriefing after a. Also giving credit where credit is due 8. Current tests need to be used with appropriate norms for the population tested 9. This standard discusses all of the variables involved within therapy a. The structure of therapy with the roles of the therapist and clinets are described.The various forms which therpy can take such as individual, couple etc. Sanctions for Violation of Ethical Principles • The Ethical Principles of Psychologists and Code of Conduct were developed by the APA ; however, the sanctions that can be administered ae imposed by state board of psych • Minor ethical violations my require a discussion with the board of psychology regarding whether the psychologist was cognizant of the violation or not • Lack of awareness or misunderstanding of an ethical standard isn’t legit defence o Usually the individual is required to attend a class or read literature pertaining to the infraction and then explain to the board that he has learned the reason why his behaviour wasn’t appropriate • Next level of severity could cause the psychologist to not be allowed to practice in a particular area until he can prove that he has overcome or worked through the reason for his inappropriate behaviour - restriction of practice: a sanction by the board of psych that restricts a psychologist from practicing within a specific area or with certain individuals who have specific difficulties o Ex. individual who completes testin with brin injured individuals while having a person with a TBI in his or her own extended family  having this background may influence the objectivity of the assessment • Most serious ethical infractions could cause the board to remove the psychologist’s license to practice. o Ex. sexual assault on an individual the psychologist was testing o The board of psychologymay remove a psychologist’s license to practice for any conviction of a felony whether its related to his professional duties or not Availbility of Resources Private Insurance Programs • Insurance carriers must maintain HIPAA compliance • Many insurance companies have a limit to the monetary amount they will authorize to be paid for services • The cost and payment plan of a neuropsychological evaluation can be negotiated 2 o Sometimes the receptionist may deal directly with the insurance company like when the client doesn’t understand his/her coverage Government Plans • There are various government programs which may help finance the cost of services o A social worker is a person who may help the client access resources • The federal programs apply across the country. State and country programs will all vary and are often very dissimilar from locale to locale • The Substance Abuse and Mental Health Service Administration (SAMHSA) is a branch of the dpt of Health and Human Service (DHHS)  The U.S. government’s principal agency for protecting the health of all Americans and for providing essential human services esp. to those who are least able to help themselves  handles grants and other funding for those who meet the criteria for their programs o The Centre for Mental Health Services ( CAMHS) has many programs from which an individual with CNS difficulties could benefit from o Ex. the Comprehensive Community Mental Health Services for Children and Their Families Act  This program pays for assessment and rehab services o There are so many programs available through the DHHS • Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are 2 federal programs that are administered by the Social Security Administration o Delivered through the state and local channels • SSDI: Funds those with CNS difficulty for living expenses if the person has been employed in a job or prefession covered by Social Security o Receive funding if considered disabled under federal guidelines  Might require neuropsych evaluation to determine eligibility – person wouldn’t have to pay for the assessment • SSI is designed to help the aged, blind and/or disabled, and people who have little or no income o Provides basic needs of food and shelter – generally doesn’t cover assessment or rehab service • Worker’s Compensation: program regulated by the state – protects workers in situations where they may develop an illness or suffer from an accident that’s caused by or related to performance in an employment situation o Includes harassment o It’s a right of employment – individual employers must buy workers compensation insurance • UEI: another right of emploement – considered income protection. Money from an individual’s paycheck funds the program in the even that an individual is no longer employed • Short Term Disability Insurance: offered through one’s employer as part of a benefit program – it rplaces lost wages when an employyeee is disabled for a short period o Provide an individual with a portion of one’s salary – usually 50, 60 or 66.66 % for 13-52 weeks • Long Term Disability insurance: an insurance program to replace lost income whenan employye is disabled for a long period o Goes into effect after STD has expired or criteria is not meant o Avg length of absence is 2.5 years • Medicare, Meicaid, Medical Assessment – programs that fund assessment and/or treatment for CNS difficulties • Each Sstates has many programs in place like Waiver Programs which are written to meet federal gudielines. Each program includes eligibility requirements specific to the type of disability, fundivn paramtere, and limits, and whether the services are necessary for the recipent’s health, welfare, and safety Patient Characteristics 3 Gender • Several brain structures are slightly differen b/w males and femals so it’s important to consider this variable in the relationship to CNS damage
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