APA Code of Ethics

40 Pages·2014·1.02 MB·English

by  Leo Christie

Title of Course: Ethics & Law in Florida Psychology
CE Credit: 3 Hours
Learning Level: Intermediate
Author: Leo Christie, PhD

Abstract:

The purpose of this course is to ensure that Florida-licensed psychologists are fully aware of the ethical and
legal privileges and constraints under which they are licensed to practice in the State of Florida. It provides
the opportunity for a comprehensive reading of the APA Code of Ethics and the three sets of statutes and
rules governing the practice of psychology in Florida. Completing this course will fulfill the requirement that
licensed psychologists in Florida complete each biennial renewal period three hours of continuing education
on professional ethics and Florida Statutes and rules affecting the practice of psychology. * This course
satisfies the ethics and law requirement for biennial relicensure for Florida psychologists.

Learning Objectives:

1. Distinguish between the concepts of law and ethics
2. Identify ethical courses of action when the law and ethics are in conflict
3. List circumstances under which multiple relationships may not be unethical
4. Identify exceptions to the requirement that psychologists maintain clients’ confidentiality
5. Describe ethical dilemmas for psychologists posed by the Patriot Act
6. Identify legal restrictions placed upon sexual intimacies between psychologists and clients

About the Author:

Leo Christie, PhD, is a licensed Marriage and Family Therapist with a doctorate in Marriage and Family Therapy from
Florida State University, Dr. Christie is President and CEO of Professional Development Resources. He has more than two
decades of experience in private practice, specializing in child behavior disorders, and has led more than 500 live
healthcare-related continuing education seminars across the country. Dr. Christie authored a number of continuing
education courses on a variety of ethics topics.

Course Directions:

This online course provides instant access to the course materials (PDF download) and CE test. Successful completion of
the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of
completion. You can print the test (download test from My Courses tab of your account) and mark your answers on
while reading the course document. Then submit online when ready to receive credit. Email any questions to
[email protected] – we’re here to help!

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Ethics & Law in Florida Psychology

Introduction

This course is intended to serve as a study guide to the four source documents that describe the ethical and legal
practice of Psychology in the State of Florida:

1. The Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association (referred
to herein as “the Code”)
2. The Florida Health Professions and Occupations General Provisions (referred to herein as “456”)
3. The Florida Psychological Services Act (referred to herein as “490”)
4. The Florida Administrative Code (referred to herein as “64B19”)

These documents set forth the licensure requirements, definitions, principles, standards, competencies, limitations, and
guidelines for legal and ethical practice in the areas of privacy and confidentiality, professional boundaries, record
keeping, scope of practice, use of testing instruments, clinical supervision, sexual misconduct, and all aspects of
psychotherapy. Disciplinary actions and guidelines are detailed in the 490 Practice Act and in the 64B19 Administrative
Code.

The purposes of this course are to (1) provide the opportunity for a comprehensive reading of the four documents listed
above, (2) ensure that psychologists in the State of Florida are fully aware of the ethical and legal privileges and
constraints under which they are practicing, and (3) fulfill the requirement that licensed psychologists in Florida
complete each biennial renewal period three hours of continuing education on professional ethics and Florida Statutes
and rules affecting the practice of psychology. While certain specific sections of the four source documents are included
in this study guide, the guide is not intended as a substitute for a complete reading of all four of them.

APA Code of Ethics

The current version of the Code, which was adopted by the American Psychological Association on August 21, 2002, has
been in force since June 1, 2003. APA requests that inquiries concerning the substance or interpretation of the Code be
addressed to the Director, Office of Ethics, American Psychological Association, 750 First Street, NE, Washington, DC
20002-4242.

The standards in this Ethics Code are used to adjudicate complaints brought concerning alleged conduct occurring on or
after June 1, 2003. Complaints regarding conduct occurring prior to that date are adjudicated on the basis of the version
of the Ethics Code that was in effect at the time the alleged conduct occurred.

The Code can be found on the APA web site, http://www.apa.org/ethics. It is available in HTML, PDF, and MS Word
formats. It is suggested that you open or retrieve the Code from the APA site for reading in conjunction with this course.

The Code is comprised of four major sections: an introduction, a preamble, five general principles, and ten categories of
specific ethical standards. The introduction discusses the intent, organization, procedural considerations, and scope of
application of the Code. The preamble and general principles are described as offering “aspirational” goals, which are
intended to encourage psychologists to aspire to the highest ideals of psychology practice. Even though the preamble
and general principles are not themselves enforceable rules, APA suggests that they be considered by psychologists in
arriving at an ethical course of action.

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The five general principles are these:

1. Beneficence and Nonmaleficence. Within this principle, psychologists are urged to strive to benefit individuals
with whom they work, to do no harm, and to safeguard their welfare and rights.

2. Fidelity and Responsibility. Psychologists are urged to uphold professional standards of conduct, clarify their
professional roles and obligations, accept appropriate responsibility for their behavior, and seek to manage
conflicts of interest that could lead to exploitation or harm.

3. Integrity. Psychologists are urged to seek to promote accuracy, honesty, and truthfulness in the science,
teaching, and practice of psychology.

4. Justice. Psychologists are urged to 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.

5. Respect for People's Rights and Dignity. Psychologists are urged to respect the dignity and worth of all people,
and the rights of individuals to privacy, confidentiality, and self-determination.

Each principle includes a descriptive paragraph outlining the specific intent of these aspirational goals.

As opposed to the general principles, the detailed ethical standards are considered to be enforceable rules for the
professional conduct of psychologists. Most of the standards are purposely written in general terms, intended to apply
to psychologists in various roles, although the application of a standard may vary depending on the context. The
standards are not intended to be exhaustive in nature. That is, the fact that a given conduct is NOT specifically addressed
by an ethical standard does not imply that it is necessarily either ethical or unethical.

The ten categories of specific ethical standards are these:

1. Resolving Ethical Issues 6. Record Keeping and Fees
2. Competence 7. Education and Training
3. Human Relations 8. Research and Publication
4. Privacy and Confidentiality 9. Assessment
5. Advertising and Other Public Statements 10. Therapy

Each of the ten categories contains multiple standards containing highly specific behavioral descriptions and frequent
references to related standards and/or exceptions.

Florida Statutes Chapter 456: Health Professions and Occupations: General Provisions

The intent of Chapter 456 is to assure that those individuals who practice in the
health professions in the State of Florida are regulated for the purpose of protecting
the health, safety and welfare of the public. Chapter 456 lays out only very broad
guidelines. Specific responsibilities and powers are delegated to each professional
board, such as the Florida Board of Psychology. The full text of Chapter 456 of the
Florida Statutes can be accessed at the link below. The act can be viewed either in
its entirety or chapter by chapter.

http://www.doh.state.fl.us/mqa/psychology/psy_statutes.html

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Florida Statutes Chapter 490: Psychological Services Act

The intent of the Psychological Services Act is to assure that those individuals who practice psychology and school
psychology in the State of Florida are qualified to do so. The Legislature expresses recognition that society is complex
and that emotional survival is as important as physical survival. The purpose of the licensure regulation is to protect the
public against the dangers of psychological services provided by unqualified persons.

Chapter sections define and describe specific services and aspects of psychological practice, the requirements for
examination and licensure of psychologists, license renewal and continuing education, disciplinary actions for various
offenses like sexual misconduct, specialty practice areas such as hypnosis and sex therapy, provisions for confidentiality
and privileged communications, and requirements for the keeping of psychologist and school psychologist records.

The full text of Chapter 490 can be accessed from: http://www.doh.state.fl.us/mqa/psychology/psy_statutes.html

Florida Administrative Code Chapter 64B19

The laws set forth in the Psychological Services Act provide the
statutory framework for the practice of psychology in the State of
Florida. The Act mandated the creation of the Florida Board of
Psychology, whose initial purpose was to adopt specific rules to
implement the provisions of 490. The function of 64B19 is, therefore,
to describe with greater specificity the rules by which the laws are to
be enforced. The Florida Board of Psychology is charged with the
responsibility for publishing and enforcing the laws and rules.

64B19 provides detailed rules for the following:

1. Criteria for licensure and the processes of application and examination
2. Supervised experience requirements
3. Denial or revocation of licensure
4. Biennial relicensure
5. Continuing education definitions and requirements
6. Sexual misconduct in the practice of psychology
7. Disciplinary guidelines, with penalty ranges for first, second, and third offenses
8. Professional advertising
9. Scope of practice considerations for specialty areas like hypnosis and sex therapy
10. Use of test instruments
11. Requirements for forensic custody evaluations
12. Psychological records and confidentiality
13. Standards for maintenance and retention of records
14. Confidentiality

The full text of Chapter 64B19 can be accessed from: http://www.doh.state.fl.us/mqa/psychology/psy_statutes.html

Publisher’s Note: Be advised that the Florida Statutes and Administrative Code are dynamic documents that are
frequently updated by legislative acts. Any references to 456, 490 and 64B19 in this course are included as a
convenience to readers and are current as of its publication date. We periodically update the course in an effort to
assure that the information is current and consistent with legislative updates. However, such updates can occur at any
time. The only definitive source of information that is always current is the Florida Department of Health Medical
Quality Assurance website, which can be accessed at the links noted above.
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Organization of This Course

There are a great many possibilities for the organizational structure of a course such as this one. Lacking evidence that
any one of them is superior to any other, this material will be organized according to the sequencing of the ten
categories of specific ethical standards in the Code, listed earlier in the introduction. In the interest of convenience,
selected elements of the four core documents noted above are grouped together under each topic heading. Where
relevant, references to certain published literature are included as well.

This study guide is predicated on the assumption that readers will have the four documents available for reading and
reference. While certain topics are highlighted as being of particular interest, and specific excerpts are included in this
text, the points addressed in the study guide do not address all of the points covered in the core documents. Therefore,
a reading of the full text of each is considered to be the foundation of this course.

In the introduction to the Code, there are two qualifying statements that are worthy of note here. First is the statement
regarding the intended scope of the ethical standards:

The Ethical Standards set forth enforceable rules for conduct as psychologists. Most of the Ethical Standards
are written broadly, in order to apply to psychologists in varied roles, although the application of an Ethical
Standard may vary depending on the context. The Ethical Standards are not exhaustive. The fact that a
given conduct is not specifically addressed by an Ethical Standard does not mean that it is necessarily either
ethical or unethical.

The second qualifier is a limiting statement, intended to distinguish professional from personal conduct:

This Ethics Code applies only to psychologists' activities that are part of their scientific, educational, or
professional roles as psychologists. Areas covered include but are not limited to the clinical, counseling, and
school practice of psychology; research; teaching; supervision of trainees; public service; policy
development; social intervention; development of assessment instruments; conducting assessments;
educational counseling; organizational consulting; forensic activities; program design and evaluation; and
administration. This Ethics Code applies to these activities across a variety of contexts, such as in person,
postal, telephone, internet, and other electronic transmissions. These activities shall be distinguished from
the purely private conduct of psychologists, which is not within the purview of the Ethics Code.

1. Resolving Ethical Issues

The first principle in the Code, Beneficence and Nonmaleficence, recognizes that ethical conflicts are inevitable in
the practice of psychology. The principle states that when (not if) conflicts occur among psychologists’ obligations
or concerns, they:

“attempt to resolve these conflicts in a responsible fashion that avoids or minimizes harm. Because
psychologists' scientific and professional judgments and actions may affect the lives of others, they are alert
to and guard against personal, financial, social, organizational, or political factors that might lead to misuse
of their influence. Psychologists strive to be aware of the possible effect of their own physical and mental
health on their ability to help those with whom they work.”

Standard 1 describes steps to be taken by psychologists in dealing with misuse or misrepresentation of their work,
conflicts between ethics, law, and organizational demands, and resolution of ethics violations by other psychologists.

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Conflicts between Ethics and the Law

Psychologists will inevitably encounter blurred boundaries and apparent or real conflicts among 1) the theoretical
orientation of their professional training, 2) published ethical guidelines, and 3) the legal obligations imposed by a
variety of regulatory entities. Where training, ethics, and law seem to violate each other’s boundaries, there are usually
provisions in the code of ethics for resolving these differences.

A useful distinction between what is properly ethics and what is the law is provided by Stephen
Ragusea, Chair of the Florida Psychological Association’s Ethics Committee (2007):

“Laws are rules of conduct established by a community or authority and enforceable by
that entity. The underlying philosophy of the law is called jurisprudence. Certainly, it
may be claimed that ethical concerns are often at the root of our laws but ethics do not
carry the power of law. In order for laws to have real meaning, a system of
punishments is often established and enforced. In the United States, laws are
established and enforced by federal, state, county, and local governments.

“Psychology’s ethical system is promulgated by The American Psychological Association. APA’s current Code of
Ethics was adopted by the Council of Representatives in 2002, and establishes our ethical guideposts. As stated
in the code’s introduction, ‘The Ethics Code is intended to provide guidance for psychologists and standards of
professional conduct that can be applied by the APA and by other bodies that choose to adopt them.’”

Of particular note is standard 1.02: Conflicts between Ethics and Law, Regulations, or Other Governing Legal Authority,
which states:

“If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority,
psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code and take
reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the
Ethics Code. Under no circumstances may this standard be used to justify or defend violating human
rights.”

The introduction section of the Code includes this statement:

“In the process of making decisions regarding their professional behavior, psychologists must consider this
Ethics Code in addition to applicable laws and psychology board regulations. In applying the Ethics Code to
their professional work, psychologists may consider other materials and guidelines that have been adopted
or endorsed by scientific and professional psychological organizations and the dictates of their own
conscience, as well as consult with others within the field. If this Ethics Code establishes a higher standard
of conduct than is required by law, psychologists must meet the higher ethical standard.”

Ragusea adds further interpretation:

“Ultimately, therefore, we may obey a law that conflicts with our ethical code. However, if our ethical
obligations represent a higher moral standard than the law, we are obligated to embrace that higher level.
And, we are bound to consider a variety of sources of guidance, including that found in our own
conscience… We are required to engage in a ‘process’ that can be complex and not always satisfying. An
example of this process may be briefly discussed relative to laws requiring psychologists to report child
abuse. What is to be done if your nearly-18-year-old patient tells you that he was abused by his stepmother
when he was 12? He has had no contact with his stepmother for 5 years, since his father divorced her and
she moved to New Zealand. Therapeutically, is it in the patient’s best interests to report the abuse? If not,
our ethical standards would suggest that it not be done. However, the law requires it.

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“Therefore, law trumps ethics. However, your consultation with peers and a personal examination of
conscience may ultimately lead you to consider not making the report. Yet, to not report the incident is a
violation of the law. What do you do? Nobody said it was going to be easy.”

A contemporary example of such a conflict is the “Patriot Act” and the practice of psychology – an ethical boundary
dilemma that will be addressed in greater detail later in this course. Two sections found in this legislation passed in
October 2001 can be used to require the release of medical and psychological records without notification of the client
whose records are being demanded. This is in direct conflict with professional boundaries and the privacy and
confidentiality guidelines of the Code, which contains a number of guidelines for psychologists to use in protecting
confidentiality and informing clients when a demand has been made for their records.

As is the case with a number of other codes of ethics, the APA Code has a standard that obliges psychologists to disclose
the limits of confidentiality in their verbal and written office policy statements. This is an important practice to be
observed by all psychologists, since most clients (and probably most psychologists) might be surprised to learn that
terrorism has had an impact even on the boundaries of privacy in their therapeutic sessions.

In 2010, in response to potential psychologist involvement in what were known as
“enhanced interrogation techniques” during the last Bush administration, APA
amended two ethical standards in APA’s “Ethical Principles of Psychologists and
Code of Conduct” (2002): standards 1.02 (noted above) and 1.03, which address
situations where psychologists’ ethical responsibilities conflict with law,
regulations, other governing legal authority, or organizational demands. Previously,
it appeared that if psychologists could not resolve such conflicts, they could adhere
to the law or demands of an organization without further consideration. That
language has now been deleted and this new sentence added: “Under no circumstances may this standard be used to
justify or defend violating human rights.” Following are the two ethical standards and the changes adopted. Language
that is underscored was newly adopted.

1.02, Conflicts between Ethics and Law, Regulations, or Other Governing Legal Authority
If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority,
psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code and take
reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics
Code. Under no circumstances may this standard be used to justify or defend violating human rights.

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 are in
conflict with this Ethics Code, psychologists clarify the nature of the conflict, make known their commitment to
the Ethics Code, and take reasonable steps to resolve the conflict consistent with the General Principles and
Ethical Standards of the Ethics Code. Under no circumstances may this standard be used to justify or defend
violating human rights.

Source: http://www.apa.org/news/press/releases/2010/02/ethics-code.aspx retrieved 11/21/2011.

Standard 1.04 Informal Resolutions of Ethical Violations

When a psychologist becomes aware that there may have been an ethical violation by another psychologist, there are
both informal and formal remedies suggested.

“When psychologists believe that there may have been an ethical violation by another psychologist, they
attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution
appears appropriate and the intervention does not violate any confidentiality rights that may be involved.”

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Standard 1.05 provides guidelines for further action if an apparent ethical violation:

“has substantially harmed or is likely to substantially harm a person or organization and is not appropriate
for informal resolution… psychologists take further action appropriate to the situation. Such action might
include referral to state or national committees on professional ethics, to state licensing boards, or to the
appropriate institutional authorities.”

2. Competence

The issue of professional competence in the practice of psychology encompasses such
diverse areas as licensure, education, training, supervised experience, cultural
competency, emerging technologies, emergency services, continuing education,
delegation of work to others, scope of practice, and dealing with one’s own personal
problems. The standard states that psychologists provide services in areas only within
the boundaries of their competence, based on their education, training, supervised
experience, consultation, study, or professional experience. When an understanding
of factors like age, gender, ethnicity, religion or sexual orientation is necessary for
competent practice, psychologists are required to either have or obtain the necessary
training, experience, consultation or supervision. Otherwise, they should make
referrals to other psychologists who hold the appropriate competencies. An exception
that is noted in the Code is the provision of emergency services, in situations in which
essential mental health services are not available and would be otherwise denied.

The Code specifies six areas in which psychologists are required to practice only within
the limits of their own competence.

Standard 2.01 Boundaries of Competence

(a) 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.

(b) 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, except as provided in
Standard 2.02, Providing Services in Emergencies [below].

(c) 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.

(d) When psychologists are asked to provide services to individuals for whom appropriate mental health services
are not available and for which psychologists have not obtained the competence necessary, psychologists with
closely related prior training or experience may provide such services in order to ensure that services are not
denied if they make a reasonable effort to obtain the competence required by using relevant research, training,
consultation, or study.

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(e) In those emerging areas in which generally recognized standards for preparatory training do not yet exist,
psychologists nevertheless take reasonable steps to ensure the competence of their work and to protect
clients/patients, students, supervisees, research participants, organizational clients, and others from harm.

(f) When assuming forensic roles, psychologists are or become reasonably familiar with the judicial or
administrative rules governing their roles.

Standard 2.02 Providing Services in Emergencies

In emergencies, when psychologists provide services to individuals for whom other mental health services are
not available and for which psychologists have not obtained the necessary training, psychologists may provide
such services in order to ensure that services are not denied. The services are discontinued as soon as the
emergency has ended or appropriate services are available.

Licensure of Psychologists in Florida

Florida Statute 490 addresses licensing and competency issues involved in the
practice of psychology in as number of areas: definitions of "doctoral-level
psychological education" and "doctoral degree in psychology," licensure by
examination or endorsement, continuing education requirements, and the
definition of a variety of specialty practices.

Statute 490 provides definitions in s. 490.003(3), effective July 1, 1999, of "doctoral-level
psychological education" and "doctoral degree in psychology" as follows:

Psy.D., an Ed.D. in psychology, or a Ph.D. in psychology from:

1. An educational institution which, at the time the applicant was enrolled and
graduated, had institutional accreditation from an agency recognized and
approved by the United States Department of Education or was recognized as a
member in good standing with the Association of Universities and Colleges of
Canada; and

2. A psychology program within that educational institution which, at the time the
applicant was enrolled and graduated, had programmatic accreditation from an
agency recognized and approved by the United States Department of Education.

It further describes the requirements for any individual who wishes to be licensed as a psychologist in Florida, either by
examination (490.005) or by endorsement (490.006). The latter is intended primarily for psychologists who hold
substantially equivalent licenses in other states.

Exemptions

490.014 lists a number of exemptions to the practice act in order to avoid limiting the practice of physicians, ministers
and rabbis, or other professionals who may provide counseling services, as long as they do not hold themselves
out as psychologists.

Scope of Practice

490 defines the specific professional activities that are within the scope of practice for psychologists.

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490.003 (4) "Practice of psychology" means the observations,
description, evaluation, interpretation, and modification of
human behavior, by the use of scientific and applied
psychological principles, methods, and procedures, for the
purpose of describing, preventing, alleviating, or eliminating
symptomatic, maladaptive, or undesired behavior and of
enhancing interpersonal behavioral health and mental or
psychological health. The ethical practice of psychology includes,
but is not limited to, psychological testing and the evaluation or
assessment of personal characteristics such as intelligence,
personality, abilities, interests, aptitudes, and neuropsychological
functioning, including evaluation of mental competency to manage one's affairs and to participate in legal
proceedings; counseling, psychoanalysis, all forms of psychotherapy, sex therapy, hypnosis, biofeedback, and
behavioral analysis and therapy; psychoeducational evaluation, therapy, remediation, and consultation; and use
of psychological methods to diagnose and treat mental, nervous, psychological, marital, or emotional disorders,
illness, or disability, alcoholism and substance abuse, and disorders of habit or conduct, as well as the
psychological aspects of physical illness, accident, injury, or disability, including neuropsychological evaluation,
diagnosis, prognosis, etiology, and treatment.

(a) Psychological services may be rendered to individuals, couples, families, groups, and the public without regard
to place of service.

(b) The use of specific modalities within the practice of psychology is restricted to psychologists appropriately
trained in the use of such modalities.

(c) The practice of psychology shall be construed within the meaning of this definition without regard to whether
payment is requested or received for services rendered.

490.003 (5) "Practice of school psychology" means the rendering or offering to render to an individual, a group, an
organization, a government agency, or the public any of the following services:

(a) Assessment, which includes psychoeducational, developmental, and vocational assessment; evaluation and
interpretation of intelligence, aptitudes, interests, academic achievement, adjustment, and motivations, or any
other attributes, in individuals or groups, that relate to learning, educational, or adjustment needs.

(b) Counseling, which includes short-term situation-oriented
professional interaction with children, parents, or other adults
for amelioration or prevention of learning and adjustment
problems. Counseling services relative to the practice of school
psychology include verbal interaction, interviewing, behavior
techniques, developmental and vocational intervention,
environmental management, and group processes.

(c) Consultation, which includes psychoeducational,
developmental, and vocational assistance or direct educational
services to schools, agencies, organizations, families, or
individuals related to learning problems and adjustments to those problems.

(d) Development of programs, which includes designing, implementing, or evaluating educationally and
psychologically sound learning environments; acting as a catalyst for teacher involvement in adaptations and
innovations; and facilitating the psychoeducational development of individual families or groups.

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