Managing Ethical Challenges in
Clinical Work with Children and
Families
Gerald P. Koocher, PhD
April 26, 2013
www.ethicsresearch.com
Psychological work
with families differs
significantly from
work with individuals
in many respects
that have important
ethical implications.
2
Families often include…
• People with non-congruent,
competing, or conflicting interests.
• People who wish to keep secrets from
each other.
• People who do not wish to be totally
candid with each other.
• People with differing levels of
decisional capacity and dependence.
3
People with non-congruent,
competing, or conflicting
interests.
It may surprise you to know that, contrary to your
experience, you’re actually very happily married.
4
People who
want to
keep
secrets
from each
other.
5
People who do not wish to be
totally candid with each other.
• Do I look
fat in this?
• Aren’t my
parent’s
wonderful?
• I’m right,
aren’t I?
“Is this a good time to have a big
fight?”
6
Understanding the Legal Status of
Parents and Children
Grasping the fundamentals and classic court
cases provides a guide to ethical practice by:
• Understanding parental rights
• Understand protections afforded to
children
• Obeying the law.
Parent’s right of control:
Pierce v. Society of Sisters (1925)
• On 7 November 1922, the voters of Oregon passed a
referendum, the Compulsory Education Act. The
referendum was primarily aimed at eliminating
parochial schools, including Catholic schools. Many
Protestants felt that religious schools prevented
assimilation
• Private schools such as those run by the Society of
Sisters of the Holy Names of Jesus and Mary were
concerned about the right of parents to send their
children to such schools as they saw fit, including
religious schools.
Meyer v. Nebraska (1923)
• Robert T. Meyer, the Plaintiff, was tried and
convicted in the district court for Hamilton
county, Nebraska, under an information
which charged that on May 25, 1920, while
an instructor in Zion Parochial School he
unlawfully taught the subject of reading in
the German language to Raymond Parpart, a
child of 10 years, who had not attained and
successfully passed the eighth grade.
Limits on Parental Control:
Prince v. Massachusetts (1944)
• Sarah Prince, aunt and custodian of Betty M.
Simmons, age nine had:
– (1) refused to disclose Betty's identity and age to
a public officer whose duty was to enforce the
statutes;
– (2) furnished Betty with magazines, knowing she
was to sell them unlawfully, that is, on the street;
and
– (3) as Betty's custodian, permitted her to work
contrary to law.
• All plaintiffs were members of the
Jehovah's Witness faith and both Mrs.
Prince and Betty testified they were
ordained ministers.
Mr. Justice Rutledge delivered the
opinion
of the Court’s 5-4 majority
• “Parents may be free to become
martyrs themselves. But it does not
follow they are free, in identical
circumstances, to make martyrs of
their children before they have
reached the age of full and legal
discretion when they can make that
choice for themselves.”
In re: Gault
• The Supreme Court decision which
established that under the
Fourteenth Amendment, juveniles
accused of crimes in a delinquency
proceeding must be accorded many of
the same due process rights as adults
such as the right to timely
notification of charges, the right to
confront witnesses, the right against
self-incrimination, and the right to
counsel.
Mr. Justice Fortas delivered the
opinion
of the Court’s 8-1 majority
• Under our Constitution, the
condition of being a boy does not
justify a kangaroo court.
Tinker v. Des Moines Independent
Community School District (1969)
• In December, 1965, Des Moines, Iowa
residents John Tinker (age 15) and Mary
Beth Tinker (age 13) and their friend
Christopher Eckhardt (age 16) decided
to wear black armbands to their schools
(high school for John and Christopher,
junior high for Mary Beth) in protest of
the Vietnam War. They were suspended.
Mr. Justice Fortas delivered the opinion
of the Court’s 7-2 majority.
• “First Amendment rights, applied in light
of the special characteristics of the
school environment, are available to
teachers and students. It can hardly be
argued that either students or teachers
shed their constitutional rights to
freedom of speech or expression at the
schoolhouse gate.”
How are Child Clients
Different from Adults?
• Legal Status
– Minors and Emancipated Minors
• Example: Dominique Moceanu
• Socialization Influences
– The case of Ricky Ricardo Green
• Time perspective
• Concept manipulation abilities
– Piagetian and other Developmental
Frameworks
16
CHILDREN’S COMPETENCIES
What are you asking for
when you say,
“Is that okay with you?”
• Consent
– Competent, Knowing, Voluntary
• Assent
– Veto Power
– Therapeutic versus nontherapeutic context
• Permission
– Proxy Consent
– Substituted Judgment
18
Let’s clean up the terminology
• “Informed consent” as a tautology
– By definition, consent must be an
affirmative, knowing, voluntary act.
• Passive consent as oxymoron
– Consent cannot occur via inaction.
• Delancy et al. v. Gateway School District
• Gateway settles parents' suit over child
queries;February 13, 2001, Eleanor Chute, PostGazette; parents complained their elementary
children had been asked personal questions without
permission in 1995 settled lawsuit yesterday,
includes $225,000 payment
• People participate in studies, subjects
do not.
Essential Components of
Informed Decision Making
• Information
– Access
• Understanding
– Comprehension
• Competency
• Voluntariness
• Decision Making Ability
– Reasoning Capacity
Children’s Competence to Consent
Ask yourself: Does the child have…
• the ability to understand information
offered about the nature and
potential consequences of the pending
decision?
• the ability to manifest a decision?
• the ability to make an appropriate
decision on reasonable bases?
Important Case Law
on Decision Making and Children
• Prince v. Massachusetts, 321 U.S. 158 (1944)
– Parents may not make martyrs of their
children
• Parham v. J.R., 442 U.S. 584 (1979)
• Fare v. Michael C., 442 U.S. 707 (1979)
22
HOW DO THE APA
STANDARDS GUIDE US?
• Focus on
– Competence
– Confidentiality
– Informed consent
– Role clarity
– Vigilance, monitoring, and active
management as change occurs or
new issues arise
24
Sharing information about
children’s psychotherapy with
their parents
• Basic concept: therapy has to be safe
for all participants and parents need to
know info about their children that
allows them to fulfill parental
responsibilities.
25
Sharing information about
children’s psychotherapy with
their parents
• Children should have consensual
confidentiality rights.
• Parents should have regular progress
reports.
• Therapists may breach a child’s
confidentiality non-consensually to prevent
serious harm, disclosing only info necessary
for parents to protect.
– Clarify meaning of serious harm to avoid
confusion.
26
PRACTITIONER
COMPETENCE
APA Ethics Code Standards
on Competence
• Psychologists provide services, teach,
and conduct research with
populations and in areas only within
the boundaries of their competence,
based on their education, training,
supervised experience, consultation,
study, or professional experience.
28
APA 2010 Code Standards
on Competence
• Where scientific or professional knowledge
in the discipline of psychology establishes
that an understanding of factors associated
with age, gender, gender identity, race,
ethnicity, culture, national origin, religion,
sexual orientation, disability, language, or
socioeconomic status is essential for
effective implementation of their services or
research, psychologists have or obtain the
training, experience, consultation, or
supervision necessary to ensure the
competence of their services, or they make
appropriate referrals…
29
APA Code Standards on
Competence
• Psychologists planning to provide
services, teach, or conduct
research involving populations,
areas, techniques, or
technologies new to them
undertake relevant education,
training, supervised experience,
consultation, or study.
30
Confidentiality in Child
Therapy
31
Who is the client?
• To whom do you believe you owe a
professional duty?
• Who may believe that you owe them a
professional duty?
• What have you done to clarify the nature,
extent, and duration of such obligations?
• What documentation have you retained to
document any of these points?
To whom do I owe a duty of care
and in what hierarchical sequence?
The person in the
room?
The family, guardian,
or attorney?
The agency or
institution?
Society at large?
All of the above?
PRIVACY CONFIDENTIALITY
AND PRIVILEGE
Privacy, Confidentiality &
Privilege Domain Breadth
•Privacy
•A constitutional right
•Confidentiality
•A professional standard
•Privilege
•A narrow legal protection
Excellent confidentiality
source:
http://jaffee-redmond.org/
Privacy
• The Constitutional right of individuals
to choose for themselves whether,
when, and how private information will
be revealed.
• The word privacy does not appear in the
Constitution, but we can infer the
concept in:
–
–
–
–
Amendment 3 – quartering of soldiers in homes
Amendment 4 – search and seizure
Amendment 5 – trial and punishment
Amendment 15 – right to vote regardless of race,
color, or previous servitude
Confidentiality and
Privilege
• Confidentiality: The duty imposed on
professionals to keep information
disclosed in professional relationship
in confidence.
• Privilege: The patient’s right to keep
confidential communications from
being disclosed in a legal proceeding.
Principles underpinning
exceptions to privacy protections
• When there are competing
social policies Parens patriae
doctrine (i.e., the parentalistic state as
the guardian or protector of the
incompetent)
◦ Police powers and confinement may be
used to protect (e.g., Joyce Brown, AKA: Billie
Boggs v. Mayor Koch, 1987).
◦ Legislatures have enacted protective
mandates.
• When a patient’s behavior becomes
inconsistent with social policies
supporting privacy.
No
Yes
No
APA’s fundamental statement on
confidentiality
• Psychologists have a primary
obligation and take reasonable
precautions to protect confidential
information obtained through or
stored in any medium, recognizing
that the extent and limits of
confidentiality may be regulated by
law or established by institutional
rules or professional or scientific
relationship.
40
Limits on Confidentiality
per APA Ethics Code
• Psychologists discuss with persons
(including, to the extent feasible,
persons who are legally incapable of
giving informed consent and their legal
representatives) and organizations with
whom they establish a scientific or
professional relationship
– (1) the relevant limits of confidentiality and
– (2) the foreseeable uses of the information
generated through their psychological
activities.
41
Mandated abuse or
neglect reporting
• 1.03 Conflicts Between Ethics and
Organizational Demands
– If the demands of an organization with which
psychologists are affiliated or for whom they are
working…conflict with this Ethics Code…clarify the
nature of the conflict, make known…commitment to the
Ethics Code, and take reasonable steps to resolve the
conflict consistent with the General Principles and
Ethical Standards… Under no circumstances may this
standard be used to justify or defend violating human
rights…
42
APA’s position regarding
mandated reporting statutes
• If psychologists' ethical responsibilities
conflict with law, regulations, or other
governing legal authority, psychologists
make known their commitment to the
Ethics Code and take steps to resolve the
conflict. If the conflict is unresolvable via
such means, psychologists may adhere to
the requirements of the law, regulations,
or other governing legal authority.
Mandated reporting
variations
• Children
• Elders
• Dependent
persons
– Physically
Disabled
– Mentally
Disabled
• Unsafe
drivers
Ashburn Psychological Services
sued over toddler's death
• February 19, 2013 - 02:21 pm
• WASHINGTON (AP) - The
mother of a 15-month-old boy
who died on a court-ordered
visit to his father has filed a
lawsuit against the
psychologist who sanctioned
the visitation.
• The child died on the fourth
unsupervised visit, and Joaquin
Rams, his father, has been
charged with murder.
• Hera McLeod of Gaithersburg, Md., filed the $20 million
suit Tuesday in Fairfax County against Ashburn
Psychological Services and psychologist Margaret Wong
Alleging professional negligence resulting in wrongful
death.
• McLeod says Wong's report was instrumental in a judge's
decision to grant unsupervised visitation of Prince
McLeod Rams to his father, Joaquin Rams.
• The child, Prince, died on the fourth unsupervised visit,
and Joaquin Rams has been charged with murder.
Authorities say he drowned the boy to collect a life
insurance policy.
• McLeod says the psychologist ignored clear warning signs
that the father was dangerous. The psychology practice
declined comment Tuesday.
Ithaca therapist refuses to turn
over notes, charged with contempt
6:02 PM, Jan 18, 2013 |
• Dianea Kohl spent more than 25 years as a statelicensed marriage and family therapist without
encountering legal troubles. But in 2012, the Ithaca
resident faced court battles in two area counties
involving what she considers a violation of the sanctity
of the therapist-client relationship — a violation she
believes could have a chilling effect on other counselors
and their clients.
• “There are only two exceptions to confidentiality — only
if I have knowledge of child abuse, or if someone is
actively suicidal or homicidal can I breech
confidentiality,” Kohl said.
• Kohl first ran into trouble early last year when she was
called to testify in Steuben County Family Court
regarding a child custody case.
• Both the father involved in the dispute and his 3-yearold child had been to court-ordered therapy sessions
with Kohl. Christine Valkenburg, the law guardian who
represented the child, asked that Kohl provide the
case notes from those sessions. Instead, Kohl
presented a summary of those notes to the court.
• “The law guardian wanted all of my therapy notes. Why
did she want my notes unless she thinks I’m hiding
something?” Kohl said. “She could not give a reason
why she wanted to see the notes. The law guardian
went to the judge, and the judge issued an order.
That’s when I got my own lawyer.
• “I refused to give up my notes. My ethics say I am not
to do that,” she said. “I take lots of fragmented notes.
They would not be helpful to the lawyer.”
• Opposing views
• Valkenburg didn’t see it that way, and neither did
Family Court Judge Joseph Latham. Latham signed a
contempt-of-court order against Kohl in February,
and the next thing Kohl knew, she was under arrest
and in handcuffs.
• “I was arrested June 2. There had been a warrant out
since February, so I thought they decided not to do
anything,” Kohl said. “I was flabbergasted when a
state trooper handcuffed me in broad daylight on
Route 13. I was shocked.”
• Kohl eventually compromised and gave her notes
directly to Latham to review. Kohl had discussed the
order with her client and received the judge’s
promise that only he would see them and that some
text would be redacted.
New York Secure Ammunition and
Firearms Enforcement Act of 2013
(NY SAFE ACT)
• Mental health professionals will be required to
report to local mental health officials when there
is reason to believe a patient is likely to engage in
conduct that will cause serious harm to
themselves or others. This information will then
be crosschecked against the new comprehensive,
and regularly updated, gun registration database.
If the patient possesses a gun, the license will be
suspended and law enforcement will be
authorized to remove the person's firearm.
•
• 9.46 of the Mental Hygiene Law will require
mental health professionals, in the exercise
of reasonable professional judgment, to
report if an individual they are treating is
likely to engage in conduct that will cause
serious harm to him- or herself or others. A
good faith decision about whether to report
will not be a basis for any criminal or civil
liability. When a Section 9.46 report is
made, the Division of Criminal Justice
Services will determine whether the person
possesses a firearms license and, if so,will
notify the appropriate local licensing
official, who must suspend the license. The
person's firearms will then be removed.
Consent to Services
Discussion Topics
• Provide the same basic
information given to individual
clients
• Confidentiality limits
• Access to records
• Normal conflicts of interests in
multiple client therapies
• Children’s rights and limitations in
these situations
52
What principles apply to
informed consent to treatment?
• Inform clients as early as
feasible in the therapeutic
relationship about the nature
and anticipated course of
therapy, fees, involvement of
third parties, and limits of
confidentiality.
• Provide sufficient opportunity
for the client to ask questions
and receive answers.
53
APA Code Comments
on Consent
• For persons who are legally incapable of
giving informed consent, psychologists
nevertheless
– (1) provide an appropriate explanation,
– (2) seek the individual's assent,
– (3) consider such persons' preferences and
best interests, and
– (4) obtain appropriate permission from a
legally authorized person, if such substitute
consent is permitted or required by law.
When consent by a legally authorized person
is not permitted or required by law…take
reasonable steps to protect the individual’s
rights and welfare.
54
APA Code Comments on
Informed Consent
• When psychological services are court
ordered or otherwise mandated,
psychologists inform the individual of
the nature of the anticipated
services, including whether the
services are court ordered or
mandated and any limits of
confidentiality, before proceeding.
• Psychologists appropriately document
written or oral consent, permission,
and assent.
55
How about informed consent
other than treatment?
• Psychologists may dispense with informed
consent only
– (1) where research would not reasonably be
assumed to create distress or harm and
involves
• (a) the study of normal educational practices,
curricula, or classroom management methods
conducted in educational settings;
• (b) only anonymous questionnaires, naturalistic
observations, or archival research for which
disclosure of responses would not place participants
at risk of criminal or civil liability or damage their
financial standing, employability, or reputation, and
confidentiality is protected;
56
Working with Families and Children
Consent Discussion Topics
• Basic information
given individual
clients.
• Confidentiality limits
• Access to records
• Normal conflicts of
interests in multiple
client therapies
• Children’s rights and
limitations on these
• Rules for disclosure
of info across family
• Reminder that no
one can predict the
course of or
changes in human
relationships
• HIPAA rules
57
Who Can Consent to Treatment
for a Minor Child?
• The Child
– Confirm applicability of state laws.
• The Parents
– Joint custody means either parent
may consent unless court decrees
state otherwise.
– With joint custody either parent can
demand an end to therapy of minor
child.
– Resisting parental demand could
result in disciplinary action.
58
Who Can Consent to Treatment
of Minor Child?
• When legal/physical custody is
divided:
– Seek consent from both parents prior
to evaluating or treating.
– Request copy of divorce decree or
letter from parent’s attorney attesting
to their authority.
59
Who Can Consent to Treatment
of Minor Child?
• When a parent is unavailable or when
parental contact might reasonably be
expected to harm the child:
– Seek consultation.
– Note pros and cons of non-contact in
your records.
60
Parental disputes regarding
child’s treatment
• Consent to your services
does not equal acceptance of
payment responsibility.
– Clarify this in advance,
preferably in writing, with the
party accepting responsibility.
61
Who is the client when a
child enters therapy?
• Does a psychotherapist-client relationship
exist when a parent participates in
services only (or chiefly) to aid the child?
– If parent is not considered a client he/she
should be specifically informed before
professional activities begin.
– Information provided in such contexts is
confidential, but may not be privileged.
– Document the parent’s “client” status in writing
62
Who is the client when a
child enters therapy?
• Usual best option:
designate parents
as clients for
limited purposes
in your records
and inform them.
63
Who’s in the record?
• Psychologists create, and to the extent
the records are under their control,
maintain, disseminate, store, retain, and
dispose of records and data relating to
their professional and scientific work…
– (1) facilitate provision of services later by
them or other professionals,
– (2) allow for replication of research,
– (3) meet institutional requirements,
– (4) ensure accuracy of billing and payments,
and
– (5) ensure compliance with law.
64
Involvement of 3rd Parties
• When you agree to provide services to a person or
entity at the request of a third party, attempt to
clarify at the outset of the service the nature of
the relationship with all individuals or organizations
involved. This clarification includes your role (e.g.,
therapist, consultant, diagnostician, or expert
witness), an identification of who is the client, the
probable uses of the services provided or the
information obtained, and the fact that there may
be limits to confidentiality.
65
Multiple Role
Relationships
66
Therapy Involving Couples
or Families
• When psychologists agree to provide
services to several persons who have a
relationship (such as spouses, significant
others, or parents and children), they
take reasonable steps to clarify at the
outset
– (1) which of the individuals are
clients/patients and
– (2) the relationship the psychologist will have
with each person. This clarification includes
the psychologist’s role and the probable uses
of the services provided or the information
obtained.
67
Therapy Involving Couples
or Families
• If it becomes apparent that
psychologists may be called on to
perform potentially conflicting roles
(such as family therapist and then
witness for one party in divorce
proceedings), psychologists take
reasonable steps to clarify and
modify, or withdraw from, roles
appropriately.
68
Remember to discuss…
• Rules for disclosure of information
across the family.
• Reminder that no one can predict the
course of or changes in human
relationships.
69
Isn’t it obvious?
• Do not engage in sexual
intimacies with individuals
known to be close
relatives, guardians, or
significant others of
current clients/patients.
• Do not terminate therapy
to circumvent this
standard.
“You slept with her, didn’t
you?”
70
Jury rules in favor of man suing
therapist for sparking relationship with
his wife during counseling
• Richard Webb’s 25-year marriage was
crumbling so he sought counseling from
Kevin Ragsdale, PhD from September 2007
to January 2008.
• Over a four-month span of counseling,
Webb's wife was brought in to joint
counseling sessions.
• Webb didn't know Ragsdale conducted
private sessions with his wife and later
started a personal relationship with her.
•
http://www.tallahassee.com/article/20111229/NEWS/111228015/Juryrules-favor-man-suing-therapist-sparking-relationship-his-wife-duringcounseling?odyssey=tab|topnews|text|frontpage
• Webb sued Ragsdale, who married Webb's
wife in January 2010, for emotional damages
and a Leon County jury ruled the therapist
violated several ethical standards of the
American Psychological Association.
• The jury held Ragsdale 65 percent
responsible for negligence that caused
"harm or loss" to Webb and attributed 35
percent of the negligence to Webb, awarding
him $107,220 [filed December 15, 2011 in Leon County
(Florida) Circuit Court].
• Webb and his ex-wife had three children
ages 14, 18 and 21. Webb reports having “a
great deal of difficulty on any kind of
parenting issues” now that Ragsdale has
married his ex-wife.
Multiple Relationships
• A multiple relationship occurs when a
psychologist is in a professional role
with a person and
– (1) at the same time is in another role with
the same person,
– (2) at the same time is in a relationship with
a person closely associated with or related
to the person with whom the psychologist
has the professional relationship, or
– (3) promises to enter into another
relationship in the future with the person or
a person closely associated with or related
to the person.
73
Multiple Relationships
• Refrain from entering into a multiple
relationship if that relationship could reasonably
be expected to impair your objectivity,
competence, or effectiveness in performing your
functions as a psychologist, or otherwise risks
exploitation or harm to the person with whom
the professional relationship exists.
• Multiple relationships that would not reasonably
be expected to cause impairment or risk
exploitation or harm are not unethical.
74
Multiple Relationships
• If you find that, due to unforeseen factors, a
potentially harmful multiple relationship has
arisen, take reasonable steps to resolve it
with due regard for the best interests of the
affected person and maximal compliance with
the Ethics Code.
• When required by law, institutional policy, or
extraordinary circumstances to serve in more
than one role in judicial or administrative
proceedings, clarify role expectations and the
extent of confidentiality at the outset and
thereafter as changes occur.
75
Custody Disputes
Child Custody Cases: Key
Advice
• Don’t treat the
system casually!
• Get formal training
and mentored
experience.
• Seek judicial
appointment, if
possible.
• Clarify roles and
expectations with all
parties at the
outset.
Common criticisms of
psychologists in custody disputes
•Deficiencies and abuses in
professional practice.
•Inadequate familiarity with the
legal system and applicable legal
standards.
•Inappropriate application of
assessment techniques.
•Presentation of opinions based on
partial or irrelevant data.
Common criticisms of
psychologists in custody disputes
• Overreaching by exceeding the limits of
psychological knowledge of expert
testimony.
• Offering opinions on matters of law.
• Loss of objectivity through
inappropriate engagement in the
adversary process.
• Failure to recognize the boundaries and
parameters of confidentiality in the
custody context.
Can you believe it?
That idiot took the kids to see
topless dancers at a bar!
Elements of Notification
in a Custody Evaluation
• Provide a statement of adult parties’ legal
rights with respect to the anticipated
assessment
– Give a clear statement regarding the purpose
of the evaluation.
– Identify the requesting entity.
• (Who asked for the evaluation?)
– Describe the nature of anticipated services.
• (What procedures will you follow?)
– Explain the methods to be utilized.
• (What instruments and techniques will you use?)
– Specify whether or not the services are
court ordered.
• Delineate the parameters of confidentiality.
– Will anything be confidential from the court, the
parties, or the public?
– Who will have access to the data and report? How
will access be provided?
• Provide information regarding:
–
–
–
–
–
The evaluator’s credentials;
The responsibilities of evaluator and the parties;
The potential disposition of data
The evaluator’s fees and related policies;
What information provided to the child, and by
whom?
– Any prior relationships between evaluator and
parties;
– Any potential examiner biases (For example:
presumptions regarding joint custody).
• Consent documentation
– Obtain consent to disclose material learned during
evaluation in litigation.
– Obtain waiver of confidentiality from adult
litigants or there legal representatives.
– Provide written documentation of consent.
SCHOOL
DAZE
Psychologists, Kids, and
Schools: Special Ethical Concerns
Who is the Client?
The School Board?
The Principal?
The Parents?
The Child?
Who is most vulnerable?
84
Psychologists, Kids, and
Schools: Special Ethical Concerns
• Organizational Demands versus Child
Client Needs
– Incongruent interests
– Autonomy in the context of
organizational structure
– Service needs and limited budgets
• Forrest v. Ansbach
85
Litigating Intelligence
• LARRY P. v. RILES United States
Court of Appeals, 1984. 793 F.2d 969
(9th Cir.)
• PASE v. Hannon, 506 F. Supp. 831
(N.D. Ill. 1980).
Psychologists, Kids, and Schools:
Special Ethical Concerns within the School
 Legitimacy of
 Pygmalion effects
token economies,  High stakes
rewards, and
testing
aversive controls
 Use of “time out”
 Preventive
exclusion
 Post hoc support
for administrative
decisions
87
Psychologists, Kids, and Schools:
Special Ethical Concerns
• Privacy and Confidentiality
– What goes into school records
– Who has access
– “Need to know: paradigm
• Psychologist as “whistle blower” and
mandated reporter in absence of
administration action
88
Psychologists, Kids, and
Schools: Special Ethical Concerns
• School-based research
– Merriken v. Cressman: “prediction of
drug and alcohol abuse” in Norristown,
PA schools opposed by parent and ACLU
– “Opt-out Consent”
• Delancy et al. v. Gateway School District
– Prediction of school-based violence
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Stigma and Labeling
• Designation as “at risk” creates risk
Psychologists, Kids, and Schools:
Special Ethical Concerns Extending Home
• Substance abuse
• Domestic violence
• Academic
dishonesty
• Disciplinary
actions:
– Detention
– Suspension
– Expulsion
• Attendance
• Misuse of “high
stakes” testing
• Harassment and
bullying (school
violence)
• Social needs
• IEP appeals
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