Ethics and Clinical Psychology 1 Running head: Ethics and Clinical Psychology

Ethics, Ethical issues/dilemmas and Clinical Psychology Francesca Conliffe ID#420060752 Lecturer: Mr. Teddy Leon The University of the West Indies

Ethics and Clinical Psychology 2 Ethics has always been a fundamental issue in Psychology as a profession; it guides decisions and actions in all fields, being the core of the profession itself. In order to do justice to this paper one must first determine what is ethics? Ethics is the general term for attempts to state or determine what is good, both for the individual and for society as a whole (Banks 2009, p.15). In the context of clinical psychology, it would imply understanding the moral principles underlying psychological thought and activity. Philosophers have taken different positions in defining what is good, on how to deal with conflicting priorities of individuals versus the whole, over the universality of ethical procedures versus situation ethics in which what is right depends upon the circumstances rather than on some general law, and over whether goodness is determined by the results of the action or the means by which results are achieved (Cohen, 2006). Clinical psychologists, whether they work in a hospital, psychiatric hospital or private practice encounter a multitude of situations or ethical dilemmas in which they must make choices, which can be judged, after the fact, as ethical or unethical. Thus, the study of ethics enhances ones understanding and enables an appreciation of the complexities of acts that involve ethical issues and dilemmas. An ethical dilemma therefore involves the choice between two apparently correct, and equally appealing decisions (Siegel, 2009). For this assignment there will be an analysis of several ethical issues/dilemmas that clinical psychologists face, along with the application of the Ethical principles of psychologists and the code of conduct. When any ethical issue arises, a clinical psychologist should be equipped with a process by which to make the most ethical decision possible. A common characteristic of professions is the development of a code of ethics that emphasizes devotion to fundamental values, such as service to the public and concern for the welfare of those the profession serves (Bersoff, 2003).

Ethics and Clinical Psychology 3 The American Psychological Association (2002) ethical code features two distinct sections: General principles and Ethical Standards. Each of these sections steers psychologists toward ethical behaviour in a different way. According to Compas & Gotlib (2002), the profession of clinical psychology is based on a set of ethical principles which are based on a set of underlying virtues or metaprinciples. These are used as a guide for psychologists to aid them with their ethical decision making and judgement that goes beyond looking for a solution to a dilemma within the codes itself. In contrast the Ethical standards include enforceable rules of conduct, which are written broadly enough to cover the great range of activity in which psychologists engage (Compas & Gotlib, 2002). According to Ross (1998), beneficence means that there are other beings in the world whose conditions one can make better and nonmaleficence basically asserts an obligation not to inflict harm on others. This definition, which is known as Aspirational Principle A, was violated within the first scenario, as the psychologist sent copies of his clients files to a collection agency because the client refused to pay this debt. Cohen (1979) states, the most frequent legal complaint against psychologists involves fee disputes and included in this category were allegations of harassment by collection agencies retained by psychologists and as a result these individuals may obtain a lawyer, thus a suit can be brought against the therapists (p.10). By involving a collection agency and revealing personal information about ones client, a psychologist would have breached ethical standard 4.01and 4.05a under the section four entitled privacy and confidentiality. According to ethical standard 4.01 (as cited in APA Ethics Code, 2002, p.7), psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship.

Ethics and Clinical Psychology 4 Confidentiality has always been the most frequently described dilemmas. According to Koocher and Spiegel (1998), confidentiality has long been regarded as a cornerstone of the helping relationship and have been a primary obligation of psychologists (p.115). It implies an explicit contract or promise not to reveal anything about a client, except under circumstances agreed by both source and subject (Koocher and Spiegel 1985, p.57). When there is an affirmation of privacy and confidentiality, clients feel a sense of security and are more willing to disclose aspects of themselves that they are unable to address in the context of other relationships out of fear that the information obtained might be misused. For example in the Tarasoff (1976) case, the California Supreme Court found a duty for a psychologist to warn an intended murder victim and permitted recovery from the psychologist for the wrongful death of the victim (Eberlein, 1980). Hence there are limits to confidentiality and it is quite evident that non payment of an account is not a justified situation to reveal vital information on a client, as there was no imminent danger to the client or others in respect to this scenario. Further violating ethical code 6.02, as it states, psychologists maintain confidentiality in creating, storing, accessing, transferring and disposing of records under their control, whether these are written, automated or in any other medium (APA Ethics Code, 2002, p.9). According to principle B (as cited in APA Ethics Code, 2002, p.3), psychologists establish relationships of trust with those with whom they work. They are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. Psychologists need to be aware that releasing a name to a collection agency may cause both physical and psychological harm to a client. For example in cases where there is marital and family conflict significant others may be unaware that the individual was seeing a psychologists and because of the aggressive attempts of the collection agency to obtain payment

Ethics and Clinical Psychology 5 of the debt family/friends may become aware of the use of psychological services, resulting in serious consequences for the client (Faustman, 1982). According to ethical standard 3.04 (as cited in APA Ethics Code, 2002, p.6) psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients and others with whom they work, and to minimize harm where it is foreseeable and unavoidable. While trust is particularly vital to all human relationships, it is especially important to a clientcounsellor relationship and this can be gained when a psychologists protect client confidentiality and use accurate informed consent procedures (Knapp & Vandecreek, 2004). Ethical standard 6.04e (as cited in, APA Ethics Code, p. 9), was breached as the psychologist did not inform the client that he was about to involve a collection agency in respect to her delinquent account, therefore not providing the client with an opportunity to make payment arrangements and according to this code if recipient of services does not pay for services as agreed and if psychologists intend to use collection agencies or legal measures to collects fees, psychologists first must inform the person that such measures will be taken and provide that person an opportunity to make prompt payment. According to ethical standards 3.10a , When a psychologists conduct or provide assessment, therapy, counselling, or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or persons except when conducting such activities without consent is mandated by law or governmental regulation or as otherwise provided in this Ethics Code (APA Ethics Code, 2002, p.6). Hence, psychologists should either verbally inform or obtain written consent (or both), in respect to the limitation of confidentiality and should not release confidential information if this is not done.

Ethics and Clinical Psychology 6 According to principle E (as cited in APA Ethics Code, 2002, p.4), psychologists respect the dignity and worth of all people, and the rights of individual privacy, confidentiality and self determination.As the psychologist failed to seek permission to release his/her clients files and was only interested in recovering the account, they violated principle E, as well as section 4.05a of the ethics code which states, psychologists may disclose confidential information with the appropriate consent of the organizational client, the individual client/patient, or another person on behalf of the client/patient unless prohibited by law (p.8). The psychologist further complicated the situation by accepting an expensive gift from the client, therefore Principle C, which states Psychologists seek to promote accuracy, honesty and truthfulness in the science, teaching and practice of psychology, was violated. Based on the psychologists actions, section 6.04c of the Ethics code, which clearly states Psychologists do not misrepresent their fees was breached (APA Ethics Code, 2002, p.3-9). By acceptance of this gift, by the second session, after allowing the client to know that delinquent accounts will be sent to a collection agency the client would be under the impression that there is no need to pay. This creates the potential for exploitation and distortion of the professional relationship, making the receiving of gifts from clients an ethical concern. For example, accepting a gift may not be in the best physical or psychological interest of the client, as gift giving may be in the picture for individuals who have dependent or borderline personality disorders. Passively doing so may reinforce patterns of manipulative or self debasing behaviours that are symptomatic of the problematic levels of functioning (Gerig, 2004). Zur (as cited in Brown & Trangsrud, 2008 ) states, that there are various forms and types of gifts that psychologists receive from clients which may be categorized as appropriate or inappropriate, in terms of monetary value, timing, content, frequency and intent of the giver. Clinically appropriate gifts, such as showing of

Ethics and Clinical Psychology 7 gratitude, can be viewed as boundary crossing and inappropriate gifts, such as suggestions of indebtedness, are boundary violations. Therefore, it is important for a psychologist to understand and evaluate the meaning of each gift within the context that it is given. Cappa (2001) states, it is far easier to refuse a gift, but one must know how and when to accept a gift. From outset the psychologists should have informed the client, with extreme detail, that failure to pay fees may result in the release of their name and other relevant information. The best way to avoid the risks of resorting to bill collection agencies, is to utilize billing strategies that prevent delinquent payments, such as the requirement of payment at the time of the visit; a method which is commonly used by dentists and physicians. Scenario 2 Psychological assessment can be considered as a complex clinical enterprise where the tools of assessment are used in concert with data from referring providers, such as, clients, families, schools, courts and other influential sources (Passer & Smith, 2007). Students involvement with tools of psychological assessment begin most often in the classroom, as they are exposed to these instruments in the context of a lecture prior to using them in a practicum situation. Instructors of psychological assessment may be confronted with situations that illuminate several ethical dilemmas, such as test feedback, and in the case with scenario two, demonstrating the Rorschach test in the undergraduate Clinical psychology course. Principle A, Beneficence and Nonmaleficence was violated as well as ethics 3.04, Avoiding Harm, which states psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients and others with whom they work, and to minimize harm where it is foreseeable and unavoidable (APA Ethics Code, 2002,p.3-6). In conducting the test the student may produce two contamination responses during the Rorschach

Ethics and Clinical Psychology 8 administration and possible harm may occur simply through the students own embarrassment in realizing that the Lecturer has some information that may be viewed as negative. For example, once a student understands the meaning of the two contamination responses one rendered during the testing, an individual may feel shamed and exposed in ones relationship with the lecturer (Yalof & Brabender, 2001). Experiences like these are always a possibility in psychological assessment; they are of greater consequence when the individual who has been assessed must work with the lecturer. Principle E, Respect for peoples rights and Dignity, was breached in that the response of the student was interpreted in front of the class. Therefore section 4.01 of the ethics code ,which states psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship and section 9.06, Interpreting Assessment Results, When interpreting assessment results, including automated interpretations, psychologists take into account the purpose of the assessment as well as the various test factors, test-taking capabilities and other characteristics of the person being assessed, such as situational, personal, linguistic, and cultural differences that might affect psychologists judgements or reduce the accuracy of their interpretations. They indicate any significant limitations of their interpretations, were breached (APA Ethics Code, 2002,p.4-14). The psychology lecturer should not have taken the response from her student in respect to the demonstration of the test, violating Ethical Standard, 7.04, Student Disclosure of Personal Information, Psychologists do not require students or supervisees to disclose personal information in course or program related activities, either orally or in writing, regarding sexual history, history of abuse and neglect, psychological treatment and relationships with parents,

Ethics and Clinical Psychology 9 peers and spouses or significant others except if (1) the program or training facility has clearly identified this requirement in its admissions and program materials or (2) the information is necessary to evaluate or obtain assistance for students whose personal problems could reasonably related activities in a competent manner or posing a threat to the students or others and 4.07,Use of confidentiality information for Didactic or other Statements, Psychologists do not disclose in their writings, lectures, or other public media, confidential, personally identifiable information concerning their clients/patients, students, research participants, organizational clients, or other recipients of their services that they obtained during the course of their work, unless (1) they take reasonable steps to disguise the person or organization, (2) the person or organization has consent in writing or (3) there is legal authorization for doing so (APA Ethics Code, 2002, p.8-10). Therefore by using her students response as an example for the Rorschach Inkblot demonstration the identity of the student was known. The Rorschach Inkblot test is a projective test and a subjects interpretation will have to come from within, reflecting the projection of inner needs, feelings and ways of viewing the world onto the stimulus (Pervin, Cervone & John, 2005). Further indicating that this type of assessment should be done on a one on one basis contravening Principle B, Fidelity and Responsibility and Ethical Standard, 9.02a, Use of Assessments which states, Psychologists administer, adapt, score, interpret, or use assessment techniques, interviews, tests, or instruments in a manner and for purposes that are appropriate in light of the research on or evidence of the usefulness and proper application of the techniques (APA Ethics Code, 2002, p.10). Informed consent is an important resource for protecting participants in assessment and should be obtained before a prospective participant is enrolled in a research or assessment. Not having made the effort to ensure that the terms, procedures and participant rights had been described, especially when dealing with psychological

Ethics and Clinical Psychology 10 assessments, the psychology lecturer violated Standard 3.10a, informed consent, When a psychologists conduct or provide assessment, therapy, counselling, or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or persons except when conducting such activities without consent is mandated by law or governmental regulation or as otherwise provided in this Ethics Code (APA Ethics Code, 2002, p.6). In the court case Bishop v Shurley (1926) the court ruled that when there is neither informed consent nor assent by an individual, there is no opportunity for the person to consider whether to agree to any particular procedure. Therefore by the student being denied the opportunity to refuse the examination, which given that its psychological and neuropsychological nature could be quite intrusive (Reynods, Hays & Arredondo, 2001), Principle C, Integrity, was violated. The psychology lecturer would have lost the students trust because of the assessment interpretation done in front of the class and the teaching methodology that was used in relation to the Rorschach Inkblot lecture. As articulated Ethical Standard 9.10, Explaining Assessment Results was breached by the lecturer and it states, Regardless of whether the scoring, and interpretation are done by psychologists, by employees or assistants, or by automated or other outside devices, psychologists take reasonable steps to ensure that explanations of results are given to the individual or designated representative unless the nature of the relationship precludes provision of an explanation of results(such as in some organizational consulting, preemployment or security screenings and forensic evaluations) and this fact has been clearly explained to the person being assessed in advance (APA Ethics Code, 2002, p.14). Psychological assessment is one of the major responsibilities of psychologists and in order for a psychological assessment to be carried out individuals would need to be a practicing

Ethics and Clinical Psychology 11 psychologist. Practicing psychologists are adequately trained in the use of projective techniques. If the psychology lecturer was verse in this area she would have been aware of the type of information that Rorschach Inkblot Test can provide and being armed with this knowledge would have avoided possible embarrassment of her student. Scenario 3 Bartering is one solution to the financial problems faced by some clients in paying for professional services. The client may offer to provide goods or services in exchange for psychotherapy or other professional services offered by the psychologist. Within scenario three the psychologist made an agreement with the fisherman for a payment of 1000 filleted flying fish, 20 pounds of dolphin and 20 pounds of bill fish for each therapy session, this is an exchange of goods for services. Bartering for psychological services is extremely problematic in that these types of services are an ongoing process during which sensitive issues are expressed in the interaction between psychologists and client. Based on this type of relationship, which should be based on trust and security, a bartering arrangement can become part of this expression in a manner that can make it difficult for the psychologists to maintain an objective attitude (Woody, 1998). For example an overly dependent client may go well beyond the bartered service agreement, in the hope that this effort will be recognized and will be rewarded by receiving the special attention and reassurance that they feel they deserve. (Gandolfo, 2005) According to Peterson (as cited in Woody, 1998), this technique exposes psychologists to all of the potential problems of any nonsexual relationship. Psychologists who barter with clients risk exploitation of the client by accepting goods and services that may be worth an undetermined amount or much more than the market value of the therapy (p.174). Bartering arrangements such as the one this psychologist is engaged in possess ethical risks which further creates a conflict of

Ethics and Clinical Psychology 12 interest that might compromise the professional services afforded by the client. Violating Principle B, Fidelity and Responsibility as well as ethics code 3.06, Conflict of Interest, which states Psychologists refrain from taking on a professional role when personal, scientific, professional, legal, financial, or other interest or relationships could reasonably be expected to (1) impair their objectivity, competence, or effectiveness in performing their functions as psychologists or (2) expose the person or organization with whom the professional relationship exists to harm or exploitation (APA Ethics Code, 2002, p.6). If either the psychologist or the client senses an unfair expectation or demand from the other exploitation will be the result. For example the magnitude of the payment agreement was great and can be viewed as exploitation of the fisherman, as the fishing industry can be relatively unreliable and to fulfil this requirement may be challenging for the fisherman. Therefore Principle C, Integrity, was violated and standard 6.04c which states Psychologists do not misrepresent their fees (APA Ethics Code, 2002,p.39). Principle A, Beneficence and Nonmaleficence was also breached and ethics standard, 6.05, Barter with clients/patients which states, Barter is the acceptance of goods, services, or other nonmonetary remuneration from clients/patients in return for psychological services. Psychologists may barter only if (1) it is not clinically contraindicated and (2) the resulting arrangement is not exploitative (APA Ethics Code, 2002, p.3-9). Within this scenario the psychologists placed the fishermans job at risk to ensure he/she was paid resulting in exploitation and conflict of interest. Ebert (as cited in Helbok, 2003), provided a decision making model based on conflict of interest. He indicated that the new ethical codes do nothing to alleviate confusion for psychologists, as more emphasis was placed on defining multiple relationships, and on the multiple relationship itself, rather than on the potential for conflict of interest. Further suggesting, that not all multiple-role relationships lead to problems; neither are

Ethics and Clinical Psychology 13 they always unethical, however they have the potential to harm through conflict of interest which leads to ethical violations. As within this scenario, bartering has been portrayed as unethical, but sometimes it is not, especially if culture is a determining factor in which the psychologist practices; socializing with a current or former client may or may not be unethical, but a dual relationship in which one teaches a student and socializes with that student may be encouraged. According to Evert (as cited in Helbok, 2003), it is these gray areas that are troublesome for legal systems such as the courts and license boards and for psychologists especially. Scenario 4 Within many academic settings, graduate teaching and research assistants are an integral part of the learning process. As psychologists and psychologists in training, there is a duty to attend to the possible ramifications of a relationship between two individuals of unequal power in an academic setting (Clipson, 2005). The clinical psychology graduate student told her research supervisor about her fathers Mercedes Benz which he is selling. Armed with this information the research supervisor got in contact with the students father and purchased the automobile. Based on this situation Principle C, Integrity, was violated and ethics code 3.06, Conflict of Interest, which states Psychologists refrain from taking on a professional role when personal, scientific, professional, legal, financial, or other interest or relationships could reasonably be expected to (1) impair their objectivity, competence, or effectiveness in performing their functions as psychologists or (2) expose the person or organization with whom the professional relationship exists to harm or exploitation (APA Ethics Code, 2002, p.6). Conflicts of interest can be created by one's desire to promote one's own interests or the interests of others. They can also be created by one's desire to circumvent the interests of others as the interest within the scenario was the classic car. The research supervisor within this scenario

Ethics and Clinical Psychology 14 created an ethical dilemma by contacting the students father violating section 3.05a, Multiple Relationships, A multiple relationship occurs when a psychologists is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologists has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person (APA Ethics Code, 2002, p.6). The issue of multiple relationships between psychologists and those to whom they owe a professional obligation has received significant attention within professional literature. These types of relationships may occur anytime a psychologist interacts professionally with another person in more than one capacity creating a second set of interest for the psychologist, which can lead to errors in judgment (Oberlander & Barnertt, 2005). For example a psychologist/ research supervisor may feel exploited by the student who seeks to use the friendship or social contact with an individual who is close to the student that the psychologists/research supervisor may know or have been in contact with, to gain access to information about tests or to receive special consideration on grading (Clipson, 2005). Psychologists who socialize with students or vice versa can receive charges of favoritism from peers and the role of professionalism that is portrayed by the psychologists is compromised (Clipson, 2005). Therefore psychologists believe that multiple relationships must either be approached with caution or avoided altogether. As articulated in Principle B, Fidelity and Responsibility, psychologists establish relationships of trust with those with whom they work. They are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. This principle was violated along with Ethical Standard 3.08, Exploitative Relationships, Psychologists do not exploit persons over whom they have

Ethics and Clinical Psychology 15 supervisory, evaluative, or other authority such as clients/patients, students, supervisees, research participants and employees (APA Ethics Code, 2002, p.6). Exploitation occurred as the research supervisor possibly seeing a deal in respect to the sale of the classical car, acted on the information received from the student and bought the car. Students essentially trust their professors with sensitive or personal information, as they might a counsellor, trusting these individuals who have authority over them not to use this information to exploit them. Scenario 5 The importance of advertising is steadily on the increase in modern society. Within scenario five the clinical psychologists private practice was not thriving and allowed his client who was an internationally known celebrity to obtain an advertising firm to aid with his clientele. The ad contained a photo of the psychologist and the celebrity client while making inferences that the psychologist is the Psychologist of the Stars. Based on this advertisement within the Sunday paper Principle C, Integrity was breached, as the psychologist is capitalizing on his relationship with this client in order to boost his clientele, as business is slow. Further violating Ethical Standard 3.08, Exploitative Relationships, which states, Psychologists do not exploit persons over whom they have supervisory, evaluative, or other authority such as clients/patients, students, supervisees, research participants and employees (APA Ethics Code, 2002, p.6). The Ethics Code cautions that some testimonials from former and current patients are forbidden as risks are involved in asking patients to provide testimonials. For example the individual may only agree to give a testimonial to avoid displeasing the psychologist, even though they ordinarily would not want themselves publicly identified as patients. Individuals may also feel obligated to share information that is not entirely reflective of their experiences (Knapp & Vandecreek (2008). As within this scenario the celebrity became aware of the psychologists

Ethics and Clinical Psychology 16 misfortune and possibly felt obligated to assist because of her status providing the advertisement with a testimonial which stated If he can help me he can help you. By allowing this statement to be made the psychologist violated, ethical standard 5.02a, Statement by Others, which states, Psychologists who engage others to create or place public statements that promote their professional practice, products or activities retain professional responsibility for such statements (APA Ethics Code, 2002, p.8). He also violated Ethical Standard 5.05, Testimonials, Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence (APA Ethics Code, 2002, p.8). Therefore psychologists who follow the ethical principles of fidelity or truthfulness ensure that their public representations are accurate. According to section 5.01a, Avoidance of False or Deceptive Statements, public statements include but are not limited to paid or unpaid advertising, product endorsements, grant applications, licensing applications, other credentialing applications, brochures, printed matter, directory listings, personal resumes or curricula vitae, or comments for use in media such as print or electronic transmission statements in legal proceedings, lecturers and public oral presentations, and published materials. Psychologists do not knowingly make public statements that are false, deceptive or fraudulent concerning their research, practice or other work activities or those of persons or organizations with which they are affiliated was also violated (APA Ethics Code, 2002, p.8). For example Case 80-4-1 indicated that several psychologists sent the Committee on Scientific and Professional Ethics and Conduct (CSPEC) an advertising brochure of an APA member which was being circulated due to concern that it was unprofessional. The brochure contained flamboyant testimonials regarding the members clinical assessment, made exaggerated claims not demonstrated by proven findings, created expectations of favorable

Ethics and Clinical Psychology 17 results, and implied other comparable techniques were inferior. CSPEC asked the psychologist to stop disseminating the brochure which violated ethics relating to advertising of services (Continuing Psychology Education, n.d). According to Knapp & Vandecreek (2008), any advertisement may be permitted as long as it is accurate. A psychologists may, for example, refer to their practice as the Center for Effective Psychotherapy if, in fact, data indicates that the service that the individual provides is effective (Knapp & Vandecreek (2008). There are some instances where psychologists fail to think through the implications of their presentations and inadvertently mislead potential consumers. Such was the case within this scenario as the psychologist is referred to as the Psychologists of the Stars, which is plural, although he only treated one internationally known celebrity. This violated Ethical Standard 5.04, Media Presentations, When psychologists provide public advice or comment via print, internet or other electronic transmission, they take precautions to ensure that statements (1) are based on their professional knowledge, training or experience in accord with appropriate psychological literature and practice; (2) are otherwise consistent with this Ethics Code; and (3) do not indicate that a professional relationship has been established with the client (APA Ethics Codem 2002, p.8). Psychologists striving for ethical behaviour led to the development of a code of conduct. This code of conduct governs and ensures the rights of the client and clinician as emphasis is placed on the importance of the individual and providing a competent service. According to Gladding (2000), Ethical codes seldom answer specific questions. They are general, idealistic and do not address possible dilemmas. These codes also have limitations such as conflicts arising between ethical and legal codes. They are unable to address cross cultural issues. Some issues cannot be resolved by a code of ethics and finally the enforcement of ethical codes has

Ethics and Clinical Psychology 18 proven to be difficult. These ethical codes can be viewed as mere guidelines based on values and experiences of how psychologists should behave.

Ethics and Clinical Psychology 19

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Ethics and Clinical Psychology 22 Yalof & Brabender, (2001). Ethical Dilemmas in Personality Assessment Courses: Using the Classroom for In Vivo Training. Journal of Personality Assessment, 77 (2) 203-213. (Sanders & Keith-Spiegel, 1980)