dark side of ethics podcast: false risk management strategies
DESCRIPTION
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 and two other counterintuitive facts.TRANSCRIPT
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False Risk Management Strategies
Slide presentation for Podcast 8 that can be found here
The Dark Side of Ethics
By Sam Knapp, EdD ABPP and John Gavazzi, PsyD, ABPP
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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 a false risk management strategy hinders high quality psychological care.
Podcast Objectives
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Having an ethics code or attending lectures on ethics codes are among the least effective ways to ensure ethical behavior.
Counterintuitive Fact
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People should not act on principle(standing on principle can be an unprincipled stand)
Counterintuitive statement
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Altruism and empathy can be unethical.
Counterintuitive statement
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Acculturation
• A process to change the cultural behavior of an individual through contact with another culture.
• The process of acculturation occurs when there is an adaptation into an organization or society.
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Ethics Acculturation Model
• An outgrowth of positive ethics that integrates personal ethics and professional obligations.
• Psychology has a system of shared and distinctive norms, beliefs, and traditions.
• This set of beliefs is reflected in our ethics code.
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Acculturation as a Process• Can be a complex process
• Some parts of a psychologist’s practice and lifestyle may be easily acculturated while others not
• Process that will likely continue throughout the education or career as a psychologist
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Ethical Acculturation
Identification with personal value system(higher vs. lower)
Identification with value system of psychology
(higher vs. lower)
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Acculturation Model of ethical development
Integration Separation
Assimilation Marginalization
Higher on Professional Ethics
Higher on Personal Ethics
Lower on Personal Ethics
Lower on Professional Ethics
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MarginalizedMatrix: Lower on professional ethics
Lower on personal ethics
Risks: Greatest risk of harm/potentially exploitative
Lack appreciation for ethicsMotivated by self-interestLess concern for patients
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AssimilationMatrix: Higher on professional ethics
Lower on personal ethics
Risks: Adopted professional standardsMay develop an overly legalistic stanceRigidly conforming to certain rules while
missing broader issuesThere may be a misinterpretation of the
rulesMay lack compassion
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SeparationMatrix: Lower on professional ethics
Higher on personal ethics
Risks: Compassion overrides good professional judgment
Fail to recognize the unique role of psychologists
Motivated moral reasoning
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IntegratedMatrix: Higher on professional ethics
Higher on personal ethics
Reward: Implement values in context of professional roles
Reaching for the ethical ceiling/aspirationalHighly effective psychologistEthics outside the office (advocacy, public education)
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Assimilated Strategies
False Risk Management
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A False Risk Management Strategy is an action or intervention on the part of psychologist that is meant to reduce liability or harm, but does not. Ironically, some of these actions or interventions likely hinder the psychologist’s ability to provide high quality of care.
What is a False Risk Management Strategy?
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Memes are ways that information is passed through a culture.
Memes are to genes as social information is to genetic information.
False Ethical Memes
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Listeners may want to self-reflect on how they learn information on ethics and clinical practice.
Unsure how exactly some of these memes are spread.
Self-reflection
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• Informed consent only occurs at the beginning of treatment
• Informed consent mainly involves the patient to sign forms for risk management purposes
Informed Consent
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• Self-disclosure is never appropriate by the psychologist during psychotherapy or assessment
• Self-disclosure is clearly a boundary violation that is always wrong
Self-disclosure
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• Psychologists cannot talk with patients about medication.
• Technically, it is practicing medicine without a license.
Psychotropic medication
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• When dealing with high risk patients, it is better to not document a great deal of information.
• If you do not document much detail, then you have greater legal protection from an attorney indicating that you did something wrong. Attorneys can twist words easily, so the less the better.
Suicidal & Homicidal Patients
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• This is an important risk management strategy
• This is the standard of care
• This strategy helps the patient from actually harming him or herself.
No suicide contract
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• It is the standard of care.
• Co-pay, insurance, ability to access the referral is immaterial.
• Relationship with the patient or referral is not a high priority
Always give 3 names when referring a person for treatment
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If you know any questions, please contact John at [email protected]
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