Learning and Teaching Ethical Mistakes
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Transcript of Learning and Teaching Ethical Mistakes
Learning and Teaching Ethical Mistakes:Learning and Teaching Ethical Mistakes:
From Consultation Room to Class RoomFrom Consultation Room to Class Room
John Gavazzi, PsyD, ABPPJohn Gavazzi, PsyD, ABPP
Richard Small, PhD, ABPPRichard Small, PhD, ABPP
Michele Miele, MAMichele Miele, MA
Learning ObjectivesLearning Objectives
Understand the importance of teaching Understand the importance of teaching ethical mistakes in the classroomethical mistakes in the classroom
Highlight the Acculturation ModelHighlight the Acculturation Model
List several ideas related to the Consultation List several ideas related to the Consultation ModelModel
Describe the importance of modeling Describe the importance of modeling vulnerability and opennessvulnerability and openness
OOverarching goal is to teach verarching goal is to teach errors in order to errors in order to preventprevent
unfortunate events or harmful unfortunate events or harmful behaviorbehavior
Work on avoiding the term Work on avoiding the term “unethical”“unethical”
Why discuss ethical errors?
Patient safety issuesPatient safety issues
Appropriate education of studentsAppropriate education of students
Provide competent supervision for Provide competent supervision for psychologists-in-trainingpsychologists-in-training
Why discuss ethical errors?
Understanding risk managementUnderstanding risk management
Assist practicing colleaguesAssist practicing colleagues
Develop skills to enhance high quality Develop skills to enhance high quality servicesservices
Why discuss ethical errors?
Highlight how licensing boards work to Highlight how licensing boards work to protect the publicprotect the public
Discuss pertinent issues, like offering an Discuss pertinent issues, like offering an apologyapology
Ethical decision-making is a Ethical decision-making is a complex processcomplex process
Knowledge base: APA code, Knowledge base: APA code, Pennsylvania law, regulationsPennsylvania law, regulations
Emotional factorsEmotional factors
Cognitive biases/situational factorsCognitive biases/situational factors
Outcomes are uncertainOutcomes are uncertain
Ethical decision-making strategies are typically Ethical decision-making strategies are typically taught in ethics books and classestaught in ethics books and classes
The APA Ethical Principles and Code of The APA Ethical Principles and Code of Conduct do not include a model ofConduct do not include a model of
ethical decision-makingethical decision-making
Acculturation ModelAcculturation Model
Acculturation Acculturation
A process to change the cultural behavior A process to change the cultural behavior of an individual through contact with of an individual through contact with another culture. The process of another culture. The process of acculturation occurs when there is an acculturation occurs when there is an adaptation into an organization or society.adaptation into an organization or society.
Ethical Culture of PsychologyEthical Culture of Psychology
Our system of common beliefs, shared Our system of common beliefs, shared meanings, norms and traditions that meanings, norms and traditions that distinguish psychologists as professionals.distinguish psychologists as professionals.
It is a learned set of skills, bases of It is a learned set of skills, bases of knowledge and ethical beliefs, as knowledge and ethical beliefs, as described in our ethics code. described in our ethics code.
Acculturation as a ProcessAcculturation as a Process
Can be a complex processCan be a complex process
Some parts of a psychologist’s practice Some parts of a psychologist’s practice and lifestyle may be easily acculturated and lifestyle may be easily acculturated while others notwhile others not
Process that may continue throughout the Process that may continue throughout the education or career as a psychologisteducation or career as a psychologist
Ethical AcculturationEthical Acculturation
Identification with personal value systemIdentification with personal value system
(high vs. low)(high vs. low)
Identification with value system of Identification with value system of psychologypsychology
(high vs. low)(high vs. low)
Acculturation Model of Ethical Acculturation Model of Ethical Decision-makingDecision-making
Integration Separation
Assimilation Marginalization
High Professional Ethics Low Professional Ethics
High Personal Ethics
Low Personal Ethics
MarginalizationMarginalization
Style: Style: Lower focus on professional ethicsLower focus on professional ethics
Lower focus on personal ethicsLower focus on personal ethics
Risks: Risks: Greatest risk of harmGreatest risk of harm
Lack appreciation for ethicsLack appreciation for ethics
Motivated by self-interestMotivated by self-interest
Less concern for patientsLess concern for patients
SeparationSeparation
Style: Style: Lower focus on professional ethicsLower focus on professional ethics
Higher focus on personal ethicsHigher focus on personal ethics
Risks: Risks: Compassion overrides good Compassion overrides good professional judgment professional judgment
Fail to recognize the unique role Fail to recognize the unique role of psychologists of psychologists
AssimilationAssimilation
Style:Style: Higher focus on professional ethics Higher focus on professional ethics
Lower focus on personal ethicsLower focus on personal ethics
Risks:Risks: Developing overly legalistic Developing overly legalistic stancestance
Rigidly conforming to individual Rigidly conforming to individual rules rules while missing broader while missing broader issuesissues
IntegrationIntegration
Style: Style: High focus on professional ethicsHigh focus on professional ethics
High focus on personal ethicsHigh focus on personal ethics
Reward: Reward: Implement values in context of Implement values in context of professional roles professional roles
Reaching for the ethical ceilingReaching for the ethical ceiling
Aspirational ethicsAspirational ethics
MemesMemes
MemeMeme: a cultural unit (an idea or value or : a cultural unit (an idea or value or pattern of behavior) that is passed from pattern of behavior) that is passed from one person to another by non-genetic one person to another by non-genetic means (as by imitation);means (as by imitation);
"memes are the cultural counterpart of "memes are the cultural counterpart of genes"genes"
Remedial EthicsRemedial Ethics
Mandatory “floor”Mandatory “floor”
Minimum standards adopted by the Minimum standards adopted by the professionprofession
Focus on the law or standards to Focus on the law or standards to protect the publicprotect the public
Remedial EthicsRemedial Ethics
Overemphasis on regulations and Overemphasis on regulations and enforceable standardsenforceable standards
Incomplete view of ethicsIncomplete view of ethics
Positive EthicsPositive Ethics
Ethics as a movement away from Ethics as a movement away from the punishment and anxiety-the punishment and anxiety-producing components of ethicsproducing components of ethics
Fulfill their highest idealsFulfill their highest ideals
A means to help interpret and apply A means to help interpret and apply ethics standardsethics standards
Positive Ethics is NOTPositive Ethics is NOT
An avoidance of ethical codes, case An avoidance of ethical codes, case law, regulations, and statuteslaw, regulations, and statutes
A rationalization to explain A rationalization to explain inappropriate behaviors or decisionsinappropriate behaviors or decisions
Benefits of Positive EthicsBenefits of Positive Ethics
Broadens a psychologist’s Broadens a psychologist’s understanding of ethics in a broader understanding of ethics in a broader contextcontext
Sensitize psychologists to ethical Sensitize psychologists to ethical implications of decisions on a daily implications of decisions on a daily basisbasis
Benefits of Positive EthicsBenefits of Positive Ethics
Assist psychologists in balancing Assist psychologists in balancing competing ethical demandscompeting ethical demands
Student PerspectiveStudent Perspective
Ethics in the ClassroomEthics in the Classroom Understanding the Ethical Culture of PsychologyUnderstanding the Ethical Culture of Psychology
Developing ProfessionalismDeveloping Professionalism Dress codeDress code LanguageLanguage Self AwarenessSelf Awareness
Level of Acculturation – IntegrationLevel of Acculturation – Integration Learning policy and procedure – Ethics CodeLearning policy and procedure – Ethics Code Internalizing a strong ethical constitution both Internalizing a strong ethical constitution both
professionally and personally.professionally and personally.
Experiences in the fieldExperiences in the field Clients pursuing personal/ friendship/ intimate Clients pursuing personal/ friendship/ intimate
relations with you.relations with you. RejectionRejection GeneralizationsGeneralizations
Using your cell phone for work Using your cell phone for work
Gift receiving Gift receiving
Self -Disclosure Self -Disclosure
Dealing with suicidal patients and crisesDealing with suicidal patients and crises
The role of SupervisionThe role of Supervision
Ethics in the ClassroomEthics in the Classroom Exercises on personal examination of ones level Exercises on personal examination of ones level
of acculturation of acculturation
Exercises on professionalism – appearance, Exercises on professionalism – appearance, attitude, language, and understanding that you attitude, language, and understanding that you are being watched even in your personal life. are being watched even in your personal life.
Dilemma setting – mock therapy sessions – role Dilemma setting – mock therapy sessions – role playing playing
Video sessions of situations and then discussion Video sessions of situations and then discussion to follow to follow
Ethics in the ClassroomEthics in the Classroom Debate format – ex. confidentiality versus the Debate format – ex. confidentiality versus the
duty to warnduty to warn
Teacher, being a good role model – as we are to Teacher, being a good role model – as we are to our clientsour clients Let it be evident to our clients/students that Let it be evident to our clients/students that
we practice professional and personal ethics.we practice professional and personal ethics.
Understanding the role of the supervisor during Understanding the role of the supervisor during internshipsinternships
Understanding their role as a professionalUnderstanding their role as a professional
Teaching Ethical ErrorsTeaching Ethical Errors
VignettesVignettes
Case Consultation ModelCase Consultation Model
Moving beyond ethical versus Moving beyond ethical versus unethicalunethical
Some dilemmas do not have a Some dilemmas do not have a clear solution, especially when clear solution, especially when
there are competing ethical there are competing ethical principles in play.principles in play.
VignettesVignettes
Insure that the instructor or supervisor can Insure that the instructor or supervisor can identify the competing ethical principlesidentify the competing ethical principles
Provide sufficient clinical detailProvide sufficient clinical detail
If actual case, need to disguise identifying If actual case, need to disguise identifying information sufficientlyinformation sufficiently
VignettesVignettes
Usually less threatening or revealing to the Usually less threatening or revealing to the instructor or supervisorinstructor or supervisor
Many ethics books have vignettes (along Many ethics books have vignettes (along with some semblance of an answer)with some semblance of an answer)
PPA bulletin board has over 35 real life PPA bulletin board has over 35 real life ethical vignettesethical vignettes
Case Consultation ModelCase Consultation Model
Prepare a clinical case as if you are Prepare a clinical case as if you are seeking consultation from a peerseeking consultation from a peer
Document relevant clinical details and Document relevant clinical details and emotional dynamicsemotional dynamics
Highlight ethical issues or conflicts Highlight ethical issues or conflicts involvedinvolved
Case Consultation ModelCase Consultation Model
Outline your possible solutions and Outline your possible solutions and decision-making strategydecision-making strategy
Discuss what you did clinicallyDiscuss what you did clinically
Address the outcome of the intervention Address the outcome of the intervention and your emotional reactionsand your emotional reactions
Important HighlightsImportant Highlights
Increase awareness of ethical issuesIncrease awareness of ethical issues
Know the codeKnow the code Know the laws, regulationsKnow the laws, regulations Read Read The Pennsylvania PsychologistThe Pennsylvania Psychologist Commonwealth requires 3 credits in ethics Commonwealth requires 3 credits in ethics
per renewal period, so attend CE workshops per renewal period, so attend CE workshops on ethicson ethics
Important HighlightsImportant Highlights
Acculturation processAcculturation process
Becoming part of the community of Becoming part of the community of psychologists – PPA, APA, Listservpsychologists – PPA, APA, Listserv
Awareness of ethical issues through ongoing Awareness of ethical issues through ongoing continuing educationcontinuing education
Develop a network of colleagues or join a Develop a network of colleagues or join a peer consultation network – Ethics Committeepeer consultation network – Ethics Committee
Important HighlightsImportant Highlights
When teaching ethical errors
Teacher can use ethical decision-making as Teacher can use ethical decision-making as one means to highlight errorsone means to highlight errors
Vignettes can be helpful to highlight pertinent Vignettes can be helpful to highlight pertinent issues and can be emotionally safeissues and can be emotionally safe
Case consultation model can be used as a Case consultation model can be used as a means to role model ethical struggles and means to role model ethical struggles and acculturation processacculturation process