Your client--a distraught mother of two--recounts the story of her husband's alcoholism and abuse. You help her cope as she decides to file for divorce. A week later, you receive a subpoena: The patient's lawyer has summoned you to court, as the father has challenged her custody rights. Eager to aid a good mother and hasten stability to the lives of her children, you testify on her behalf. You deliver an expert opinion about a man you never met and soon find yourself in court--as well as before an ethics committee and licensing board--defending your breach of professionalism.
This very plausible situation could befall any practicing psychologists unfamiliar with how the law should guide professional decisions and is one of many case studies in "Ethics and Risk Management," a new CD-ROM instructional series from the APA Insurance Trust.
The trustees--psychologists and educators in graduate professional psychology--have developed a comprehensive risk-management education in eight CD-ROM modules. The set offers 24 hours of continuing-education course credits, covering topics such as professional liability, suicide and homicide, boundary issues, confidentiality and record-keeping.
These are lessons for any psychologist or student because, explains project director Patricia M. Bricklin, PhD, "people are tempted to do a lot of things on the basis that they feel they are doing good without thinking about all sides of the situation."
Connecting ethics and the law
Ensuring that future psychologists understand their legal and ethical liabilities was one of the Trust's foremost objectives in developing this instructional series. Bricklin, a professor of ethics in psychology, observes that "ethics issues are not often taught in doctoral programs from a risk management perspective, or they aren't taught in the most interesting way."
She believes the greatest fault in graduate school curricula is the failure to connect ethics and law. An understanding of this conjunction is essential to the success of graduate students in professional psychology. To deliver this lesson, the CD-ROM series includes a manual, lesson plan, topic outlines, sample cases, discussion and exam questions, and resources and references appropriate for graduate ethics and professional issues courses,as well as professional development seminars.
"Ethics and Risk Management" will also be made available to psychologists outside university programs, says APA Insurance Trust Executive Director Bruce Bennett, PhD. "They can literally take it home, put it in their computer and get risk management information with continuing-education credits."
The psychologists and professors who created the series have run focus groups, beta tested the format and held informational meetings in which their product has been very well-received. According to Bricklin, "one of the comments from people who have viewed the CD-ROM has been, 'This is just like real life and could have happened to me.' The case studies presented aren't so bad that the average psychologist could say 'I would never do anything like that.'"
Perhaps the program's most valuable feature is its realistic approach to presenting situations that everyday, well-intentioned psychologists could encounter. "So many psychologists get into trouble because of the kinds of records they keep--or don't keep," Bricklin offers an example.
"If you get sued," Bennett pipes in, "the question's going to be in your records. What documentation do you have to support the professional decision you made? It is very important that you document what you did or didn't do, and why."
"Certain things are straightforward black and white," adds Bennett. "Don't sleep with your patient, don't breach confidentiality, avoid a conflict of interest with your patient."
Yet even obeying the law and following a code of professionalism, he says, does not guarantee immunity; there are also many shades of gray. "Practice can get very complicated, and that's what we teach to."