Ethics & Psychology – Détails, épisodes et analyse

Suicide is the 10th leading cause of death in the United States and the most frequent crisis encountered by mental health professionals. This podcast reviews basic information about the assessment, management, and treatment of patients at risk to die from suicide. It fulfills Act 74 requirements for Pennsylvania licensed psychologists, social workers, marriage and family therapists, and professional counselors.

Program Learning Objectives:

At the end of this program the participants will learn basic information that will help them to

1. Assess patients who are at risk to die from a suicide attempt;
2. Manage the risks of suicide; and
3. Treat patients who are at risk to die from a suicide attempt.

Resources

Bongar, B., & Sullivan, G. (2013). The suicidal patient: Clinical and legal standards of care. (3rd ed.). Washington, DC: American Psychological Association.

Bryan, C. J. (2015). Cognitive behavior strategies for preventing suicidal attempts. NY: Routledge.

Jamison, K. R. (2000). Night Falls Fast: Understanding suicide. New York: Random House.

Jobes, D. (2016). Managing suicide risk (2nd Ed.). NY: Guilford.

Joiner, T. (2005). The myths of suicide. Cambridge, MA: Harvard University Press.

McKeon, R. (2009). Suicidal behavior. Cambridge, MA: Hogrefe & Huber.

Disclaimer

As an educational program, this podcast/video does not purport to provide clinical or legal advice on any particular patient. Listeners or viewers with concerns about the assessment, management, or treatment of any patient are urged to seek clinical or legal advice. Also, individual psychotherapists need to use their clinical judgment with their patients and incorporate procedures or techniques not covered in this podcast/video, or modify or omit certain recommendations herein because of the unique needs of their patients.

This one-hour video/podcast provides a basic introduction to the assessment, management, and treatment of patients at risk to die from a suicide attempt. This podcast/video may be a useful refresher course for experienced clinicians. However, listeners/viewers should not assume that the completion of this course will, in and of itself, make them qualified to assess or treat individuals who are at risk to die from suicide. For those who do not have formal training in suicide, this podcast/video should be seen as providing an introduction or exposure to the professional literature on this topic.

Proficiency in dealing with suicidal patients, like proficiency in other areas of professional practice, is best achieved through an organized sequence of study including mastery of a basic foundation of knowledge and attitudes, and supervision. It is impossible to give a fixed number of hours of continuing education and supervision that professionals need to have before they can be considered proficient in assessing, managing, and treating suicidal patients. Much depends on their existing knowledge base and overall level of clinical skill. It would be indicated to look at competency standards from noted authorities, such as those developed by the American Association of Suicidology ( http://www.sprc.org/training-events/amsr), by David Rudd and his associates (Rudd et al., 2008), or Cramer et al. (2014).

Click here for the slides associated with this podcast.

Click here to link for CE credits.

Nudge theory has gained popularity in behavioral science, mainly in the field of behavioral economics.  The theory broadly indicates that indirect suggestions or contextual changes can influence choices or compliance with healthy behaviors or decisions.  Nudge theory contrasts its approach with direct suggestions, instructions, and education.  In psychotherapy, we nudge patients frequently.  Sometimes we do it consciously, other times unconsciously.  Because of this potentially powerful influence over our clients, we must remain vigilant about our nudges in the form of soft paternalism or projecting our values onto our patients.  Psychologists must be mindful of the power imbalance in the psychotherapy relationship and our duty to respect client autonomy. 

John’s guest is Dr. Jennifer Blumenthal-Barby, Associate Professor of Medicine and Medical Ethics, Center for Medical Ethics and Health Policy, Baylor College of Medicine, located in Texas.

At the end of the podcast, the participants will be able to:

1. Describe what “Nudge Theory” is;
2. Explain how Nudge Theory applies to ethics in the psychotherapy relationship;
3. Name two ways that psychologists can use nudge theory to promote healthy behaviors.

References

Blumenthal-Barby J.S., Burroughs H. (2012). Seeking better health care outcomes: the ethics of using the "nudge". American Journal of Bioethics. Volume 12(2): 1-10.

Blumenthal-Barby, J.S. McCullough, L.B., Kreiger, H. and Coverdale, J.C. (2013). Methods of Influencing the Decisions of Psychiatric Patients. Harvard Review of Psychiatry, Volume 21 (5), 275-279.

DeAngelis, T. Coaxing Better Behavior. (2014). The Monitor on Psychology. Volume 45(11): 62.

Barkan, R. Ayal, S. and Ariely, D. (2010). Ethical dissonance, justifications, and moral behavior. Current Opinion in Psychology, Volume 6, December 2015, 157-161.

Sunstein, C. R. Fifty Shades of Manipulation. (2015). Journal of Behavioral Marketing.

Sunstein, C. R. The Ethics of Nudging. (2014). Social Science Research Network.

Ethics and Telepsychology involves the rise of technology in the healthcare sector.  There are about 21 states that mandate insurance companies cover telehealth services.  John is joined by Dr. Marlene Maheu, trainer, author, researcher, and the Executive Director of the TeleMental Health Institute, Inc., where she has overseen the delivery of professional training in telemental health to more than 5000 professionals in 39 countries since 2010.  John and Marlene discuss the supporting research for telepsychology and its limitations; practitioner competencies; reimbursable, evidence-based models for telepsychology; and limitations with telepsychology.

At the end of this podcast, the listener will be able to:

1. Outline the general research findings on the usefulness of telepsychology,

2. Describe requirements of competent telepsychology practice,

3. List at least four reimbursable, evidence-based models for legal and ethical telepractice.

Resources for Episode 15

TeleMental Health Institute, Inc.

American Psychological Association Guidelines on Telepsychology

The Mental Health Professional and the New Technologies: A Handbook for Practice Today

by Marlene Maheu, Myron L. Pulier, Frank H. Wilhelm and Joseph P. McMenamin 

Bibliography from TeleMental Health Institute, Inc.

Marlene Maheu SlideShare

Gros, D. F., Yoder, M., Tuerk, P. W., Lozano, B. E., & Acierno, R. (2011). Exposure therapy for PTSD delivered to veterans via telehealth: Predictors of treatment completion and outcome and comparison to treatment delivered in person. Behavior Therapy, 42, 276-283. 

doi: 10.1016/j.beth.2010.07.005

Harris, E., & Younggren, J. N. (2011). Risk management in the digital world.Professional Psychology: Research and Practice, 42, 412-418. doi: 10.1037/a0025139

In Episode 14, John welcomes Dr. Sam Knapp back to the podcast.  Sam was fresh off his Lifetime Achievement Award in Ethics Education from the American Psychological Association.  After John's first attempt at listener mail, the topic moves toward ethics education and ways to contemplate positive ethics.  Rather than looking at remedial ethics or the ethics floor, John and Sam give plenty of examples about striving for the ethical ceiling.  The focus on quality enhancement strategies grew out of risk management strategies.  From a quality enhancement perspective, Sam and John give several examples of what may trigger the need for quality enhancement strategies.  They also review four quality enhancement strategies: 1) consultation, 2) empower collaboration, 3) documentation, and 4) redundant protections.  Sam and John also talk about psychologists' emotional reactions to patients.

At the end of this podcast, the listener will be able to:

1. Outline three quality enhancement strategies,

2. Describe how to prepare for a helpful consultation, and,

3. List the reasons why redundant protections are helpful in clinical practice.

Click here to earn one APA-approved CE credit

Resources for this podcast

Ethical Issues With Patients at a High Risk for Treatment Failure 

Samuel J. Knapp and John Gavazzi

Can Checklist Help to Reduce Treatment Failure?

Sam Knapp and John Gavazzi

Quality Enhancement Strategies - PowerPoint

John Gavazzi, PsyD ABPP

Episode 8: The Dark Side of Ethics - False Risk Management Strategies 

Therapists' Anger, Hate, Fear, and Sexual Feelings: National Survey of Therapist Responses, Client Characteristics, Critical Events, Formal Complaints, and Training

Ken Pope and Barbara G. Tabachnick

Lucky Episode 13 mirrors Episode 6 in that the content is similar.  In the first half of the program, John speaks with Dr. Donald McAleer, psychologist and ethics educator, and his pre-doctoral intern Reneh Karamians about ethics education in graduate programs and at internship sites.  We sprinkle in personal experience and the Acculturation Model focusing on how students and early career psychologists may think about ethical decision-making.  In the second half, the participants discuss Vignette #5, A Tricky Situation from the "Vignette Warehouse" at the Ethics and Psychology site.  Dr. McAleer and Intern Reneh arrive at different conclusions as to how to handle the vignette, which nicely models that there can be more than one right answer when dealing with ethical dilemmas.

At the end of this podcast, the listener will be able to:

1. Outline two important components in ethics education,

2. Identify the competing ethical principles in the vignette, and,

3. Practice integrating personal values with professional ethics.

Click here to earn one APA-approved CE credit 

Information on Dr. Don McAleer's Practice and Associated Pre-Doc Internship

Erie Psychological Consortium

Northshore Psychological Associates

Contact Don McAleer, PsyD, ABPP by email

Relevant Resources for this Podcast

Episode 4: Ethical Decision-making Part 1

Episode 5: Ethical Decision-making Part 2

Nonrational Processes in Ethical Decision-making

Mark Rogerson, Michael C. Gottlieb Mitchell M. Handelsman Samuel Knapp  & Jeffrey Younggren

Beauchamp, T.L. & Childress, J.F. (1994). Principles of biomedical ethics ( 4th ed). New York: Oxford University Press.

Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. Counseling Psychologist, 12(3), 43-55.

Dr. Beth Rom-Rymer from Illinois speaks with John about  the recent RxP success in Illinois. Psychologists passed a law to permit appropriately trained psychologist to prescribe psychotropic agents.  Beth shares many words of wisdom, including reasons for psychologists obtaining prescriptive authority, keys to advocacy, and the details of the prescriptive authority law in Illinois.  While John laments that Pennsylvania may in the Precontemplative stage of change, Beth offers numerous suggestions to any state moving in a forward direction on RxP legislation.

The Skype connection was not the best, so apologies in advance for any technical flaws.

In terms of learning objectives, at the end of the podcast, the listener will be able to:

1. Describe two reasons why psychologists are seeking prescriptive authority;

2. Explain the educational requirements of becoming a prescribing psychologist in Illinois; and,

3. Describe two important components to passing legislation on prescriptive authority.

To earn 1-APA approved Continuing Education Credit, click here.

In this episode, John talks with Pauline Wallin, PhD, expert in marketing, public education, and media as well as a cofounder of The Practice Institute, where she helps clinicians build their practices.  It is important for psychologists need to understand why marketing a psychological practice helps protect the public and raise awareness of how psychotherapy can improve people's lives.  Pauline makes the distinction between marketing and selling.  We also discuss four ethical ways to market psychological services via public education.

The end of this podcast, the listener will be able to:

1. Describe two ways that marketing your practice benefits the public.

2. List four ways to use public education to market your practice.

3. Describe two potential ethical pitfalls in marketing via public education, and how to avoid them.

Click here to purchase 1 APA-approved Continuing Education credit

In this episode, John talks with Dr. David Palmiter about the basics of social media.  They discuss why it is important for psychologists to understand social media as their patients are likely using various forms of social media.  Psychologists also need to know what social media is before they participate. They discuss their use of social media as part of professional development.  Psychologists need to know at least the basics about social media to practice psychotherapy effectively.

At the end of this podcast, the listener will be able to:

1. Explain the concept of social media.

2. List two reasons every psychologist should be on Twitter.

3. Define the concept of branding.

Please read David Palmiter's article: To Tweet or Not to Tweet for an understanding of Twitter.

Click here to purchase 1 APA-approved Continuing Education credit

In this episode, John interviews Lori Gephart, a psychologist from the Greater Pittsburgh area on her work as a collaborative coach.  Collaborative coaching is yet another area of practice for specially trained psychologists. Lori talks about her role as a collaborative coach in the divorce process. Skills related to collaborative coaching include helping clients identify shared interests and engage in interest-based resolution.  The collaborative coach also assists with improving communication, facilitating teamwork, providing information on marital transition, and referring for psychotherapy when needed. Lori also outlines information about training, networking, and becoming more involved in the collaborative coaching arena.

At the end of the podcast, the listener will be able to:

1. Define the role of a Collaborative Coach.

2. Identify the role of the Child Specialist.

3. Explain the additional training needed to be a collaborative coach

Click here to purchase 1 APA-approved Continuing Education credit

In this episode, John talks with Dr. Sam Knapp, Psychologist and Ethics Educator, about false risk management strategies.  Using the acculturation model as a guide, Sam and John discuss how some psychologists have learned false risk management strategies.  They discuss the possible erroneous rationale for these strategies.  John and Sam provide good clinical and ethical reasons as how these strategies can actually hinder high quality of services.  They also discuss ethics education in general and why learning about ethics codes do not necessarily enhance ethical practice.

At the end of the workshop the participants will be able to:

1. Explain the concept of a false risk management strategy,
2. Identify two false risk management strategies,
3. Outline how false risk management strategies hinder high quality psychological care.

Click here to purchase 1 APA-approved Continuing Education credit