Psy 622Psy 622: Cross-Cultural : Cross-Cultural CounselingCounseling

Daryl M. Rowe, Ph.D.Daryl M. Rowe, Ph.D.Pepperdine UniversityPepperdine University

Graduate School of Education & PsychologyGraduate School of Education & Psychology

Ethical Standards: Purpose, History & Codes

Ethical Issues: IntroductionEthical Issues: Introduction

Rationale: Since clinical psychology is a human service activity, our capacity to initiate change is contingent on the public’s sanctioning of the efficacy of our influence.

When we undermine the social sanctioning, we diminish our effectiveness.

Ethical guidelines help insure that psychologists do not violate the public’s trust; they insure accountability to behave responsibly

Developing Ethical AttitudesDeveloping Ethical Attitudes

Requires that we see ethical behavior as ongoing concerns requiring deliberation and reflection

Requires clarity concerning values Requires responsible actions

Tennyson & Strom (1986) discuss two levels Mandatory ethics Aspirational ethics

Mabe & Rollin (1986) suggest Codes tend to be conservative by nature

History of APAHistory of APA’’s Standardss Standards

First published in 1953 – began to organize/synthesize examples of good, bad and questionable professional behavior and distilled them into a code of standards for professional behavior

Revised in 1958 Revised again in 1963 Revised again in 1968 Revised again in 1977

Review preamble 9 principles:

responsibility; competence; moral & legal standards; public statements; confidentiality; welfare of consumer; professional relationships; utilization of assessment techniques; and pursuit of research activities

History of APAHistory of APA’’s Standards (cont.)s Standards (cont.)

Revised again in 1979 Revised again in 1981 Revised again in 1990 Revised again in 1992

Major restructuring of the Principles; consisted of 4 elements – introduction; preamble; general principles; and ethical standards (review elements)

Set forth the scope & limits of the Code

Delineated guiding philosophy for professional behavior of psychologists

Set forth aspirational goals for psychologists

Competence Integrity Professional/Scientific

Responsibility Respect for People’s Rights

& Dignity Concern for others’ welfare Social Responsibility

Current APA Principles (2002Current APA Principles (2002))

Introduction/applicability – review changes

Preamble – review changes General Principles – aspirational

principles have been eased; one fewer principle included; expectations are not as high as in 1992

Ethical Standards – emphasis on ethical issues

Current APA Principles (2002Current APA Principles (2002))

Introduction & Applicability “Ensure applicability across the

broad range of activities conducted by psychologists”

Preamble “Psychologists respect and protect

civil and human rights”

APA Principles (2002APA Principles (2002) ) (cont.)(cont.)

Principle A: Beneficence and Nonmaleficence “Because psychologists’ scientific and

professional judgments and actions ay affect the lives of others, they are alert to and guard against personal, financial, social, organizational, and political factors that might lead to misuse of their influence”

APA Code of Ethics (2002):APA Code of Ethics (2002):Selected principles and standards Selected principles and standards relevant to working with culturally relevant to working with culturally

diverse groupsdiverse groups Principle B: Fidelity and Responsibility

Psychologists consult with, refer to, or cooperate with other professionals and institutions to the extent needed to serve the best interests of those with whom they work.

Principle C: Integrity Psychologists seek to promote accuracy,

honesty and truthfulness in the science, teaching and practice of psychology

Selected principles and standards Selected principles and standards relevant to working with culturally relevant to working with culturally

diverse groups diverse groups (cont.)(cont.)

Principle D: Justice Psychologists recognize that fairness and justice

entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists. Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices.

Selected principles and standards Selected principles and standards relevant to working with culturally relevant to working with culturally

diverse groups diverse groups (cont.)(cont.)

Principle E: Respect for People’s Rights and Dignity Psychologists respect the dignity and worth of all people,

and the rights of individuals to privacy, confidentiality, and self-determination.

Psychologists are aware of and respect cultural, individual, and role differences, including those based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status and consider these factors when working with members of such groups.

Psychologists try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone activities of others based upon such prejudices.

AAMFT Code of Ethics AAMFT Code of Ethics (2001)(2001)

Principle 1.1“Marriage and family therapists

provide professional assistance to persons without discrimination on the basis on race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, or sexual orientation.”

AAMFT Code of Ethics AAMFT Code of Ethics (2001)(2001)

Principle 3.8Marriage and family therapists do not

engage in sexual or other forms of harassment of clients, students, trainees, supervisees, employees, colleagues, or research subjects.

Principle 3.11Marriage and family therapists do not

diagnose, treat, or advise on problems outside the recognized boundaries of their competencies.

California Association of Marriage & California Association of Marriage & Family Therapists: Ethical StandardsFamily Therapists: Ethical Standards

Introductiono The practice of marriage, and family

therapy and psychotherapy is both an art and a science. It is varied and often complex in its approach, technique, modality and method of service delivery. These ethical standards are to be read, understood, and utilized as a guide for ethical behavior.

Introduction (cont.)Introduction (cont.)

o The general principles contained in this code of conduct are also used as a basis for the adjudication of ethical issues and/or complaints (both within and outside of CAMFT) that may arise. Ethical behavior, in a given situation, must satisfy not only the judgment of the individual marriage and family therapist, but also the judgment of his/her peers, based upon a set of recognized norms.

CAAMFT Ethical StandardsCAAMFT Ethical Standards

Responsibility to Patients Confidentiality Professional Competence and Integrity Responsibility to Students and Supervisees Responsibility to Colleagues Responsibility to Research Participants Responsibility to the Profession Responsibility to the Legal System Financial Arrangements Advertising

CAAMFT Ethical Standards &CAAMFT Ethical Standards &1977 APA Ethical Standards1977 APA Ethical Standards

Responsibility to Patients Confidentiality Professional Competence and

Integrity Responsibility to Students and

Supervisees Responsibility to Colleagues Responsibility to Research

Participants Responsibility to the Profession Responsibility to the Legal

System Financial Arrangements Advertising

Responsibility Competence Moral & Legal Standards Public Statements Confidentiality Welfare of the Consumer Professional Relationships Utilization of Assessment

Techniques Pursuit of Research

Activities

Guidelines for Providers of Psychological Services toGuidelines for Providers of Psychological Services toEthnic, Linguistic and Culturally Diverse Populations Ethnic, Linguistic and Culturally Diverse Populations

(1993) - 9 Aspirational Guidelines(1993) - 9 Aspirational Guidelines

Educate clients to processes of psychological interventions

Aware of research/practice relevant to populations served

Recognize ethnicity/culture are significant in understanding psychological processes

Respect roles of family members, community structures, and beliefs

Respect religious/spiritual beliefs Interact in preferred language of client or refer Consider social, environmental, political factors in

assessing/intervening Work to eliminate biases, prejudices, discriminatory

practices Document cultural/sociopolitical factors in case records

American Psychologist (1993) American Psychologist (1993) 48(1), pp. 45-4848(1), pp. 45-48

Other Aspirational Ethical GuidelinesOther Aspirational Ethical Guidelines

Guidelines on Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists (2002)

Asian American Psychological Association

Association of Black Psychologists National Latino/a Psychological

Association Society of Indian Psychologists

Ethical DilemmasEthical Dilemmas

Helms & Cook (1999) identify a number of dilemmas, which they call “questions”, that may surface in working with persons from various socio-cultural backgrounds. Although these issues are specifically discussed from an ethical standpoint, there are potential ethical issues involved in each of their dilemmas.

See Handout

Mental Health: Mental Health: Culture, Race, and Ethnicity Culture, Race, and Ethnicity

(2001)(2001) The Surgeon General’s landmark report Mental

Health: A Report of the Surgeon General (1999) documented that effective treatments exist for mental illness but are not equally available to all Americans

Mental Health: Culture Race, and Ethnicity – A supplement to Mental Health: A Report of the Surgeon General was requested by the Surgeon General and developed by SAMHSA (Substance Abuse and Mental Health Services Administration) and CMHS (Center for Mental Health Services) in consultation with NIMH (National Institute of Mental Health) and NIH (National Institutes of Health)

Public health approach; disparities in mental health and mental health services are defined as a public health concern

Mental Health: Mental Health: Culture, Race, & EthnicityCulture, Race, & Ethnicity

Major findings/conclusions: Americans do not share equally in the best

that the mental health profession has to offer

There is inadequate research base on racial/ethnic minority mental health

Persons of color have less access to, lower utilization rates, and receive poorer quality mental health services

Major Findings Major Findings (cont.)(cont.)

Therefore, unmet mental health needs exert a greater disability burden for individuals, families, and communities of color

Prevention of mental illness and promotion of mental health are recommended (vs. our heavy emphasis on treating disorders once they develop)

Rates of mental illness are not significantly different between whites and persons of color