Here are a few sets of notes from Week 2 to Week 7
Here are a few sets of notes from Week 2 to Week 7 Posc 100
Long Beach State
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This 11 page Class Notes was uploaded by Laura Pratt on Saturday January 23, 2016. The Class Notes belongs to Posc 100 at California State University Long Beach taught by in Spring 2016. Since its upload, it has received 30 views. For similar materials see Intro to american government in Political Science at California State University Long Beach.
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Date Created: 01/23/16
- Tale from the jail o Fairy vision o Most common hallucination is gustatory o If don’t assess someone or just accept assessment then you are violating an ethics code o Wasn’t having fairy vision – he was arrested for fare evasion (don’t pay for subway and jump without paying) o Need to do more training education - Use of tests o Generic knowledge and skills Core knowledge and skills Context related qualifications (Not fair to use IQ test on someone who is not from this country or is new to this country) o Psychometric and measurement knowledge Descriptive statistics Intelligence Quotient Tests Wechsler Tests – WAIS, WASI o IQ TEST MEAN: 100 Standard deviation: 15 o 1 standard deviation below the mean = 85; 2 standard deviation below the mean = 70 70 used to mean mental retardation Rogers Indicator of Multiple Intelligences Test o Being musical is an IQ o Visual spatial intelligence - artistic Governed under 904 – release test data in appropriate manner When you are reporting to measure something – you have to either limit those items or When choosing a test, make sure you know that it is measuring what you think it measuring o Dual role Covered in several standards Resurfaces in several areas Is it necessary? Is it exploitive (exploiting the client or psychologist)? At any time in present or future 308 – exploitive relationships Section 10 under therapy – section about therapy involving therapy and couples Intimacy with others Who does it benefit? Should benefit the client the most – should not only benefit the psychologist Could it damage the patient/supervisee/student? Can it disrupt the relationship? Am I objective in evaluating this matter? Have I documented adequately? Is there informed consent? SHOULD be used in scrutiny before moving forward – roles extends to the relatives, friends, etc. of the client What happens if the dual role was found out after the fact? Decide how damaging it could be o Competence is not just having the degree of being able to practice If something is interfering with your capacity to treat you are not competent to treat the client (emotional capacity to treat certain things) o Video vignettes Context, not content that defines the boundary Personal, professional values affect your boundaries Gift giving o Not ok to accept gifts from client o Baseball tickets o Bracelet o Mechanic o Baby blanket How do you respect a clients desire to give you a gift? Group with a former client o What if you wanted to go back into therapy with them later on? Alan/Marta o Alan is talking to Marta like she is his daughter o He had a terrible week and was not fit to run the group that week o Between Alan and his co-facilitator She is keeping information away from him (seeing Marta for own individual therapy) Dual role – she is group and individual – stealing client away from other therapist Relationship with co-facilitator and Marta is blurry (Marta is bisexual) Alan had a discriminatory perspective – his competence is compromised Continuing Care – groups coping o $35 co-payment Asking alumni to funnel funds for therapy Need to be careful how they take funds o Dr. Roth comment and gesture (hugged him too often and left on vacation without letting him know who would be the replacement) Increased medication with no good reason o Taking client from agency Have a common culture – stretching for a client Have to check yourself to make sure you don’t steal from agencies (clients) Ethical decision making model (Corey and Corey) Identify the problem Identify potential issues o Gift giving - VCR from alumnus (what if he relapses?) Review codes Know the laws in your state Obtain consultation Consider courses Enumerate consequences Decide on a course of action - Tarasoff o Duty to warn o GD to 5150 Can call hospital, tell them what diagnosis they have and what medications they are using – warning the hospital – minimum information needed for treatment (given that they are not danger to self, others, or grave disability) o In Thompson v. County of Alameda – do you have a duty to warn when you don’t know exactly who the victim can potentially? No according to this case you only have the duty to warn if the person is identifiable o Brady v. Hopper o Bradley Center Inc. v. Wessner o Exemptions In duty to warn you also have the duty to assess risk – risk to others Child abuse/Elder abuse – incapacitated adult In terms of Tarasoff – have duty to warn o IRAC Issue: Is there a duty to warn? Before Tarasoff no, but after yes Review: Revise it What is the application? Now after Tarasoff since someone did die, need to revise and instate the duty to warn Confidentiality applies with these exemptions Week 2 Notes - Bound by ethics when you have a professional relationship - Confidentiality – are you bound to it when it is not during therapy - What is needed if you don’t have an exemption to confidentiality o First rule of confidentiality - consent – need to give informed consent to the client o After obtain consent can report something that occurred in a public setting (jail) Ethics decision making model notes - Nurenberg code- 10 principles of informed consent - Not be unnecessary - Preceded by research on animals - Should not cause harm or suffering - Conducted by qualified professionals - Subject can withdraw at anytime - Stop of subject is in danger - Thalidomide- use of experimental drug w/out informed consent in pregnant women- caused extreme deformities in the fetus - In 1962, the United States Congress enacted laws requiring tests for safety during pregnancy before a drug can receive approval for sale in the U.S. Other countries enacted similar legislation, and thalidomide was not prescribed or sold for decades. - On July 16, 1998, the FDA approved the use of thalidomide for the treatment of lesions associated with Erythema Nodosum Leprosum (ENL). Because of thalidomide’s potential for causing birth defects, the distribution of the drug was permitted only under tightly controlled conditions. The FDA required that Celgene Corporation, which planned to market thalidomide under the brand name Thalomid, establish a System for Thalidomide Education and Prescribing Safety (S.T.E.P.S) oversight program. The conditions required under the program include; limiting prescription and dispensing rights only to authorized prescribers and pharmacies, keeping a registry of all patients prescribed thalidomide, providing extensive patient education about the risks associated with the drug and providing periodic pregnancy tests for women who are prescribed it. - 1974 – Tuskegee Syphilis Study – people were told they were getting treatment and were actually getting placebos o They kept studying syphilis because researchers thought there was a difference between races - 1963 Sloan institute o Studied cancer by injecting older Jewish men with live cancer cells - 1974 National Research Act national commission guarding protection for human subject- in biomedical and behavioral research o IRB established - Belmont report- principles that underlie medical research o 5 principles – 4 came from the Belmont report - The code developed only after considerable debate. - Ethics are needed! Examples of why we need an ethics code: o Maslow’s experiment o Stanford Experiment o Watson’s Little Albert o Stuttering study – 22 orphans, controlled experiment group, wanted to prove he could condition stuttering Controlled group were praised Experimental group was given negative feedback – this group developed anxiety, depression, bedwetting Some of the peers were horrified that this could take place so they hid the study o Experiments – forced sexual reassignment – for homosexuals Aversive conditioning - The ethics initially were provisional and used only for 3 years until the membership of APA voted, principle by principle, to make them permanent. - Edward Tolman suggested that the prep of the ethics code should be research based. “an empirical approach in which ethical principles would be based on the raw data of experience of psychologists in solving ethical problems.” - Six categories from original survey- a. Ethical standards and public responsibility b. client relationship, c. Teaching d. Research e. Writing an publishing f. Professional relationship. - Only in 1979 an explicit bar against sexual relationship w/ present - Pope and Vetter repeated effort in 1992 679 psychologists, most concerns were related to a. confidentiality – 18%; b. Blurred, dual or conflictual rel 17%, payment 14% academia and training 8%, forensic 5% - Pope, Tabachnick survey of 1000 psychologists reveal o 1.9 % reported engaging in sexual contact o 2.6 engaging in “erotic activity” with a client o 2.9 engaging in sex with a clinical supervisee. - Pope and Bajt -3/4 of the sample of psychologists believed that psychologists should sometimes violate formal legal and ethical standards - Ethical Standards o 1. Resolving Ethical Issues o 2. Competence If don’t know how to deal with someone how do you work with the person? Refer them out, get supervised, get additional education o 3. Human Relations When do we divulge things when informed consent comes up o 4. Privacy and Confidentiality o 5. Advertising & other public statements o 6. Record Keeping and Fees o 7. Education and training o 8. Research and publication o 9. Assessment o 10. Therapy 75% would sometimes violate ethical standards Reasons: better results, standards collide, alliance, and protect client - Ethical Decision Making Process o Ethical awareness is a continuous active process which requires critical thinking o Awareness law and evolving research o Question yourself frequently o Question what you are sure of o Know that ethical dilemmas are unavoidable Following 10 step process Identify the problem o Which standard(s) apply; each dilemma – what is the standard? Identify potential issues o What could happen? Threat to others? Review codes o Go back to manual, what fits here? Know the laws in your state o Knowing that consent age is 18 in this state Obtain consultation o Always someone that knows more than you or are more knowledgeable in that subject Consider courses o Different ways to go about it o What can I actually do here? Think differently about the situation Enumerate consequences Decide on a course of action *Revise as needed* - go back to drawing board and start from beginning o Name and describe 4 of the 8 step is the Corey and Corey ethical dilemmas - Competence o Dilemma: you are a psychologist working in private practice, alone Caucasian Referred a 16 year old client (female), Arabic descent, moved here when 3 years old, family is devout Muslims, does use a wrap, came for anxiety and depression Realize there are a lot of restrictions for socializing and dating She jumped off the roof of her house, broke her leg and back in several places and imagined jumping in the arms of her lover Don’t understand the family dynamics, never dealt with someone who is suicidal o What would you do about this dilemma…would you treat her or how would you go about treating her? Refer out Get training Self-harm needs to be addressed first Put them in 5150 with is a 72 hour hold Decide if they need to be held longer – 5250 = 14 days T-con – need to be really sick to get this Obtain consultation from someone else/specialist can consult with you Family meetings Consultation with child protective services Identify the possible issues that could arise if treating this person who comes from a culture you are not familiar with If have built rapport with the client, should continue to treat but not if believe that harm could come from this Consider doing additional diagnostic so there is a broader range of treatment options Anxiety/depression; BPD – or can list t as traits; figure out assessment and diagnose correctly - Eugenics movement started here by Carnegie and Rockefeller o Nuremberg 1933 - Movie Notes o First their experiments were focused on eugenics then they wanted to see how far the human body could go before it died o Twin studies looked at genetics o Sterilization studies o Low clinical knowledge o Had minimal significance and questionable if we can use it Problem 1. Violation of confidentiality (disclosure) - Breach is the sharing of the information with the staf - Code – 4.01: Maintaining Confidentiality and 4.04: Minimizing Intrusions on Privacy (more specific one) 2. reporting the ethical violation (Section 1) – resolving/reporting - knowing of a violation, person has an obligation to report it - 1.04: Informal Resolution of Ethical Violations and 1.05: Reporting Ethical Violations Laws o Privacy (right) /Confidentiality (ethical) Consultation o Supervisor o APA (American Psychological Association) - For ethical vignettes, write it out under problem, laws, and consultation - Scenario: a psychiatrist working at in-patient unit, there is admission to your floor is a daughter of a colleague of yours. The daughter is psychotic, borderline personality disorder, ill (acute), has history of eating disorder and cutting. She is admitted and she is 70 lbs in a 5 foot 5 inch girl. 5150 admission. You are the only psychiatrist working that shift and you are in charge of admissions and what medication you need to put the person on. Also, don’t have experience with eating disorders. o Problem Emergency – can’t refer to another psychiatrist – 2.02 (Providing services during emergencies) 3.05A: Multiple Relationships; 3.06: Conflict of Interest o Lack of objectivity o Dual relationships (or 2.01: Boundaries of Competence since the psychiatrist is not well versed on the problem of eating disorders) Lack of knowledge of E.D. o Laws The law of the 5150 that has already applied to the patient If the girl is 16 years old – Assent – can’t divulge a lot of information because of confidentiality o Consultation Difficult since you are the only psychiatrist on the floor, but can see if there is some sort of teen clinic that is versed with eating disorders - Deception o Can be used if debrief, end justifies means, consultation - Tuskegee o Syphilis study o Didn’t prescribe medications to them o Did it for the sole purpose of studying Syphilis in Blacks o Would be denied medical attention from anywhere else o Deadly deception – movie Poor black sharecroppers in Alabama – taken advantage of just to study the disease Paid for by taxpayer dollars Method was to withhold treatment from men (All Black) People thought that Syphilis was everywhere and it was stigmatized Consequences included blindness, dementia, premature death – but treatment was available Epitome of what modern medicine was about – could find cause and treated immediately Treatment included toxic compounds being administered over the course of a year and a half The funds for the treatment program ran out – had only treated 1400 and many of these had not received the full treatment Not the end of the project Also known as “bad blood” In early syphilis, there were rashes and then later there was a latency period until the relapse time Men were told that spinal taps were treatment when they were not – deception by an authority figure CDC 1969 Ended in 1972 Formal Apology – During Clinton Administration 75A% were in main stage Syphilis Afected others in family Fitness for duty, selection - Examination to see if a person meets the standards for fitness (cognitive, psychological fitness) o If not, what we can we do to make person meet standards? o When you are talking about someone with disabilities – ADA is involved o ADA court decision – can’t subject someone to tests unless there is an objective reason to believe that symptoms would impose on person’s ability to perform duties (psychological condition or impairment) o Conte versus Horcher – law enforcement officers can be contested to fit for duty examination o Employee has to have informed consent to perform examination If the employee does not o Garity versus New Jersey (Supreme court case) – compelled statements cannot be used in the court of law When talking about fit for duty exam – officer is required to given an honest answer – if involves criminal case – can’t use that against him/her Employee would not be at work if there was a criminal case against them (they would be either be terminated or on leave of absence) o Ring of credit card thefts – police would pull people over and steal credit cards and would use these to make numerous charges Started investigation on the person (they can fall into two categories – criminal category and noncriminal category) Each criminal investigation needs to be done within a year o Lybarger versus city of LA Before we question officers – have to grant them their rights (Miranda rights) o Fit for duty examination How do we determine if the officer should go through these Look for red flags (sudden rise in complaints (citizen), complaints about coworkers, rise in force or excessive force, and something like the person’s mood) Jail for women – had deputy who led choir and had a breakdown and was put on a 5150 o Terry versus Ohio – can pat down someone who you pull over - Personality tests, psychopathology, cognitive, specialized (no default battery) - Recommendations: unfit for duty (1. severe pathology, 2. unfit but treatable, and post-evaluation when person returns to duty, and 3. no psychological diagnosis, 4. invalid evaluation from malingering) - Along with red flags – Brownfiield vs City of Yakima (test can be administered preemptively) o High standard based on objective evidence 10.12.15 Under the historical landmark case of Mc’naghten Rule o 1843 – believed he was being targeted by the pope and prime minister – found not guilty o Three criteria need to exist to meet standard of insanity Irresistible Impulse Standard o E.G. Crime of passion o Not as specific o Most states don’t use this rule Durham Rule o Durham v US – unlawful act was product of disease ALI standard (American Law Institute) o Test of cognition Guilty but mentally ill – sentence is the same of insanity sentence
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