Whether you are a first-year practitioner of psychology with your own business or a seasoned professional with a large firm, it is never a bad idea to brush up on ethical principles that could impact you or your practice. If you’re a bit unsure about what constitutes an ethics violation, contact Bowne Barry & Barry, a law office in East Brunswick, NJ, to get answers on which you can rely.
The American Psychological Association (APA) reports that, on average, over a 20-year career, 40% of psychologists will receive a licensing board complaint. Just under 2% of psychologists will have a malpractice suit brought against them. To protect yourself and your practice, you need a clear understanding of ethical principles.
At Bowne Barry & Barry, an East Brunswick, NJ, law office, these four fundamental ethical principles are those most frequently necessitating clarification.
Confidentiality Issues
When thinking through confidentiality issues, there should be no doubt in your mind regarding what you are allowed to disclose and to whom.
The APA’s 2002 Ethics Code states that psychologists may only share the minimum amount of information necessary to provide needed services, obtain appropriate consultations, protect the client, psychologist, or others from harm, or accept payment for services from a client. But it’s important to remember that state laws can vary. You must know your state’s law inside and out, especially concerning your practice. There may be confidentiality exceptions in your state, usually relating to situations where a patient is threatening to self-harm or harm another person.
Maintaining confidentiality requirements are a vital part of ethical practice.
Some common-sense steps to ensure all parties involved understand confidentiality requirements:
- Plainly discuss your confidentiality agreement with your client. Include information about confidentiality limits.
- Safely keep and store records. Notify your clients of your policies – especially if using audio/video recordings. Make sure you receive any necessary consents in writing regarding audio/video documentation. Ensure and explain that rooms in which confidential conversations occur are soundproof.
- Obey all state and federal reporting laws.
If you have doubts about confidentiality in general or specifically regarding New Jersey state law, reach out for professional representation before making any type of disclosure.
Multiple Relationships
Before entering their practices, while still in the classroom learning and discussing the idea of multiple relationships, would-be psychologists often find concern regarding multiple relationships to be over-the-top. Many psychologists-in-training do not believe they will ever find themselves in the middle of a problem regarding multiple relationships. Once in practice, however, issues relating to multiple relationships inevitably rear their heads. Life can be muddy and not always outlined with black and white lines.
The APA’s 2002 Ethics Code states that psychologists should avoid multiple relationships that “could reasonably be expected to impair the psychologist’s objectivity, competence or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”
This language is sound and helpful, but in practice, the situation can be multi-faceted, complex, and challenging to navigate objectively.
It’s incredible to us that even after years of awareness and education, sexual relationships between clients and practitioners are still the most common lawsuit against psychologists/therapists.
Ethical questions surrounding multiple relationships are some of our more prevalent. You may need an expert to help you think through your particular situation. Bowne Barry & Barry has years of experience. Call us for objective expertise.
Document Everything
Good documentation is essential. If ever faced with ethical charges or a lawsuit, the best information available is documentation. In the same way, the wrong kind of documentation – or lack of any documentation – can be ruinous.
The APA’s record keeping guidelines offer the following as examples of what to include in your documentation:
- Identification essentials and notes regarding initial contact
- Relevant history and risks, medical status, all your attempts at obtaining prior treatment records
- Dates of service and fees for that service
- Diagnostic notes including impressions, assessments, treatment plans, consultation, summary, and testing reports, supporting data, progress notes. Be sure to include not only the types of successful treatment but also treatments tried and rejected and considered.
- Informed consent documentation, consent to use audio/video, and release of information documentation
- Relevant phone calls, any out-of-office contact
- Follow-up efforts if the patient is a no-call, no-show, or refuses further treatment
- Any relevant details should another professional take over the delivery of service
If you are unsure about the types of documentation you should be using or the types of documentation you should avoid, please reach out. We are here to help.
One pro-tip: Never, ever change a record after the fact. You will almost always get caught should you try to amend a record. That doesn’t mean you can’t amend the record, but make a straightforward, dated second entry, explaining the reason for the amendment thoroughly.
Bowne Barry & Barry Recommends Accurate Billing
Honesty is always the best policy. Avoid ethical issues in your billing practices by communicating financial policies and procedures at the beginning of a client’s treatment. Don’t be a sloppy bookkeeper. Thoroughly familiarize yourself with procedure codes. Don’t exaggerate diagnosis or treatments.
Set appropriate limits with your client. Should a client stop paying fees, address this issue sooner rather than later. Don’t allow large balances, which can lead to further stresses.
Remember, if billing paperwork is submitted under your name, YOU are responsible. Review documents and keep track of your billing. You cannot afford not to.
Contact Bowne Barry & Barry
At Bowne Barry & Barry, a law firm in East Brunswick, NJ, we are here to support you in your psychology practice. We want you to do what you do best – care for your clients. Call us to help before ethical issues arise in your practice. We are here to help you form, build, and grow your practice – and also to make sure that you are legally protected. Contact us for more information about all the services we provide.
