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To those who are or plan to see a psychologist.
Many people have worked with psychologists, or are seeing one now, to improve their mental health. But not every psychologist is able to help you; some even cause harm. As a client, how do you evaluate if a psychologist is professional enough? As helping professionals, psychologists have a code of ethics. I would like to discuss them in this article.
According to the Canadian Psychological Association (CPA), psychologists need to follow four basic principles while providing psychological services:
1、Respect for the Dignity of Persons and Peoples
This is the first and foremost principle; it refers to that we need to see clients as independent human beings instead of means to achieve ends. It includes some specific expectations:
(1) Informed consent, psychologists must explain what they do and obtain clients’ written informed consent. This is an ongoing process rather than going through the motion.
Put it simply, when clients come to the service, psychologists must clearly let the client know about their educational and training background, what the therapy/assessment process is like, what type of approaches they will use, what kinds of topics they may cover, roughly how long it will take, the cost of service, how confidentiality is maintained, what risks are involved in the service, and how to manage it, etc.
In other words, if you disagree with the service, no one can force you to do it (except for court mandate). Also, if you want to terminate the service at any time, psychologists cannot stop you from doing that.
(2) Privacy and confidentiality.
When you are seeing a psychologist, you might be concerned about your secrets being disclosed to others. This is a common and fair concern! Psychologists must respect clients’ privacy and keep their secrets.
Specifically, psychologists cannot collect irrelevant information from you, they cannot ask questions simply due to their personal curiosity. For example, say a client wants to discuss interpersonal challenges at workplace, it would be inappropriate for psychologists to ask about the details of the client’s sex life.
Psychologists cannot disclose clients’ identifying information to anybody else in any situation, unless clients agree with that. For example, psychologists cannot tell their friends or family members the names of their clients, where their clients work at or where their clients come from, etc.
Psychologists also cannot disclose the content of service without clients’ consent. For example, psychologists cannot say things like “I saw a client with a serious issue, she can’t fall asleep, can’t eat well, I think she might have depression.” or “I saw a very strange client today, as a man, he is so insecure” to anyone they know for the purpose of leisure.
At some situations, psychologists may need to include materials from their service for some positive purposes (e.g., case presentation, teaching, educating the general public, etc.). If this is the case, psychologists better obtain written consent from the clients beforehand. If it is not possible, psychologists cannot disclose any identifying information associated with the content. Oftentimes, psychologists aggregate cases and present a composite case, which includes many different clients’ situations.
If psychologists want to audio or video-record the session, they have to obtain consent from the clients beforehand.
However, psychologists may break confidentiality in some circumstances. For example, if psychologists reasonably believe that clients are likely to hurt themselves or others, they may do something about it, such as notifying clients’ emergency contact.
Also, if psychologists discover that the abuse of children is involved, they have to report it to relevant government agencies.
The limitations of confidentiality are more than what I just shared, and it is usually included in the informed consent process before the service starts.
In plain words, it means that psychologists need to ensure that their service is helpful for the clients, at least not harmful. Specifically:
(1) Psychologists’ services must be based on their expertise. They cannot provide services that they don’t have expertise. If they choose to, they need to have appropriate consultation or supervision in place. Otherwise, they need to refer the clients to other colleagues.
Psychologists’ training is long and comprehensive, including both academic and clinical training. Psychologists cannot claim that they have full competency in some areas simply because they take some workshops.
For example, psychologists who never received training in couple’s therapy cannot provide service in this area.
As a client, you need to figure out if the psychologist you are about to see has relevant educational and training background.
(2) Psychologists need to keep learning. Education and training at school are limited; psychologists cannot constantly meet clients’ diverse needs if they stop continued education.
(3) If psychologists’ wellness negatively impacts their professional services; they should take a break. Psychologists have to take good care of themselves first in order to better help their clients.
(4) If psychologists’ service is not helpful for clients anymore; they should terminate or refer to other colleagues. For example, if a client’s goal is not met after quite a few sessions with a psychologist, they need to seriously reflect on the therapy process and see if it would be wiser to refer to other colleagues.
(5) Psychologists cannot use their expertise to harm people, such as interrogating, brainwashing, lying, and etc.
As a client, if psychologists’ statements make you feel very uncomfortable, you should let them know directly or consult a local professional psychology regulatory body. Don’t simple agree with everything psychologists say; some professionals do hurt their clients.
3. Integrity in Professional Relationship
Psychologists need to ensure that the professional relationship between them and clients are ethical, specifically:
(1) psychologists don’t need to be “neutral,” but they need to be aware of the impact of their personal values/backgrounds on their services. For example, psychologists with unfavourable views of the LGBTQ group may feel uncomfortable working with people from that community. This dynamic may sabotage the quality of the service or even harm the clients. If psychologists cannot avoid it, they should seek consultation/supervision or refer to other colleagues.
(2) Psychologists need to accurately present their credentials; they cannot mislead the general public to think that some of their credentials equate to expertise. For example, being a professional member of a professional association doesn’t mean this psychologist has the expertise in that area because they can just pay the membership dues to become a professional member.
(3) Avoid dual relationships. Psychologists cannot develop any other relationships with clients except for professional ones. Some examples include business, romantic, or friendship. Why is it not ok to do it? Because psychologists and clients are usually not in a reciprocal relationship, clients are seeking professional help from psychologists, and clients usually share many personal stories with the psychologists. If psychologists develop dual relationships with clients, it is very easy for them to take advantage of their client’s vulnerability.
Additionally, psychologists should not provide professional services to people they already know in their personal life, such as family members, friends, partners, work colleagues, etc. The reason is that personal relationship is likely to bias psychologists’ professional judgment.
Psychologists can provide some general information to people they know; after all, general information is not a professional service.
4、Responsibility to Society
Psychologists should contribute to the society outside of the therapy room, specifically:
(1) Participating in positive social activities, such as charity, advocacy, social justice movement, etc.
(2) Contributing to professional associations.
(3) Promoting mental health and clarify the general public’s misunderstandings of psychological professionals.
(4) Destigmatizing mental health challenges.
This article is based on the Canadian Code of Ethics for Psychologists (Fourth Edition) published by the Canadian Psychological Association (CPA), and it only applies to Canadian Psychologists.
Canadian Psychologists need to follow four basic ethical principles: Respect for the Dignity of Persons and Peoples, Responsible Caring, Integrity in Relationships and Responsibility to Society.
Each provincial regulatory body also has a Standard of Practice, which is very consistent with the Code of Ethics. If you find out that a psychologist is violating those principles, you can report it to the regulatory body, and the psychologist will be investigated.