Clinical Psychology

sensitive spots in their own personality that could
affect performance, they must guard against the
adverse influence of these problems on their
encounters with patients.
Recently,“toolkits”have been developed to
allow for the assessment of competence in the
practice of clinical psychology (Kaslow, Grus,
Campbell, Fouad, Hatcher, & Rodolfa, 2009).
Such tools include: performance reviews, case pre-
sentation reviews, client outcome data, consumer
surveys, self-assessments, and both oral and written
examinations. By using tools such as these to assess

competence to practice clinical psychology in spe-

cific domains and with specific subpopulations, this

will help ensure that clinicians are expert in areas in

which they are providing services.

Privacy and Confidentiality

Clinicians have a clear ethical duty to respect and

protect the confidentiality of client information.

Confidentiality is central to the client–psychologist

relationship. When information is released without

the client’s consent, the trusting relationship can be

BOX3-5 Focus on Professional Issues

Clinicians Who Participate in Radio Call-In Shows, TV Talk Shows, or Internet Groups:

Are They Ethical?

In 1953, theEthical Standards of Psychologists(Ameri-

can Psychological Association, 1953) stated:

Principle 2.64-1. It is unethical to offer psycholog-

ical services for the purpose of individual diagno-

sis, treatment, or advisement, either directly or

indirectly, by means of public lectures or demon-

strations, newspaper or magazine articles, radio

or television programs, or similar media.

This idea, in 1953, was pretty clear and seemed to

make good sense. Professional advice is an individual

thing. It must be tailored to the individual, and there is

no way a clinician can do this on the basis of a 3-

minute conversation with a radio caller. But in 1953,

there were relatively few radio call-in shows (or TV

shows!) hosted by clinicians. Now, as we all know,

there are surely many more. As in all professions, some

hosts are flip, comedic, and in general, poor clinicians.

Others seem quite skilled, concerned, and sincere while

advising strongly that the caller seek professional help.

Aside from strong media ratings, there are probably

valid reasons now for having good call-in shows. For

many distressed or disadvantaged people, these shows

may be their only route to help or support. The shows

can also sensitize and educate other listeners, helping

to prevent problems from developing or getting

worse. For still others, these shows may provide the

caller with that extra courage or understanding neces-

sary to seek out professional services.

The 2002 APA revision of ethical standards reflects

these points by permitting“advice or comment”—as

opposed to“therapy”—via radio or television

programs, or via the Internet, as long as they take

reasonable precautions to ensure that (a) statements

are based on appropriate psychological literature and

practice, (b) the statements are consistent with this

Ethics Code, and (c) the statements do not cause the

recipient to infer that a professional relationship (i.e.,

therapist–client) has been established with them

personally.

Although these guidelines seem straightforward,

many ambiguities may arise, especially involving

Internet-based mental health groups. For example,

psychologists may adopt many roles when they partic-

ipate in Internet-based groups, including that of pro-

fessional (e.g.,“ask the expert,”group leader) or that

of peer member (i.e., not identified as a psychologist)

(Humphreys, Winzelberg, & Klaw, 2000). Each role may

have different implications for APA Ethical Codes

related to privacy, confidentiality, and personal rela-

tionships (Humphreys et al., 2000). For example, psy-

chologists should not consider confidential or private

any e-mail sent to individuals or to the whole group. E-

mail is a permanent record that can be redistributed to

many, including audiences not targeted for receipt. In

addition, there may be a temptation to enter into an

“electronic”personal therapeutic relationship because

of individual queries from group members. However,

this is strongly discouraged because psychologists can-

not control the situation enough to ensure that ethical

responsibilities are upheld (Humphreys et al., 2000). For

example, there may be extreme limitations on what

actions can be taken if an individual revealed to the

psychologist that he or she is committing child abuse.

CURRENT ISSUES IN CLINICAL PSYCHOLOGY 87