When do you report?
○ If you have a professional/privileged relationship you do not have to report (it is your client) ○ Oregon law-child abuse is required to be reported Ethical code (may) require reporting for welfare
Worldviews
Like sand in a picnic– it gets everywhere
U.S. Legal System (order)
- Federal (U.S. law, HIPAA)
- States (ORS, OARS, state statutes)
- Adjunction (Ethical codes, administrative rules)
HIPAA
Applies to "anyone who provides health care and does electronic transmission of health care information". Domains: -Application -Compliance -Enforcement -History
Consent
Good for 6 years, should include need to report
Oregon Board of Psychological Examiners
An agency of the Oregon state government, goal is to “protect the public”. Advocates change, creates/enforces rules, receives complaints
Ethical Standards (According to APA)
- Resolving ethical issues
- Competence
- Human relations
- Privacy and confidentiality
- Advertising and other public statements
- Record keeping and fees
- Education and training
- Research and publication
- Assessment
- Therapy
Tarsoff duties
“The protective privilege ends where the public peril begins”
Confidentiality with children
- Parental consent required
- Involve child in plan and treatment
- Work with child to determine what problems are disclosed with parents
Multiple relationships
Not all are unethical; prohibited if it impairs objectivity, competence or effectiveness
Therapeutic Contract
“It may get worse before it gets better,” Should discuss: problems, goals, methods, length/frequency, costs, risks, limits of confidentiality, cancellation provisions
Malpractice
“the failure to fulfill the requisite standard of care: whether by omission or commission”, involves: duty, damage, deviaion, or direct link
Privacy
Keep it to yourself
Confidentiality
Limited sharing
Privileged
Not shared in court
General Principles
- Beneficience and non-maleficience
- Fidelity and responsibility
- Integrity
- Justice
- Respect for people’s rights and dignity
Record keeping requirements
- Rx monitoring
- start/stop times
- type of therapy
- frequency, # of sessions
- results of clinical tests
- Summary of Dx, functional status, treatment plans, symptoms, prognosis, & progress to date.
Abuse reporting
Mandatory for public officials with “reasonable cause” to a law enforcement agency; exception- do not have to report if information is privileged
Risk Management Formula
Clinical risk= ((patient risk) x (context) x (disciplinary consequences))/ (therapist factors)
Why is Oregon reporting different?
For a licensed psychologist working in Oregon, it is up to the discretion of the psychologist what would be best for the client’s well-being
“Red Flag”
A rule that applies to “creditors” to signal risks of identity theft
Implementing the “Red Flag” rule
- verify pt identity
- be alert for conflicting info
- have a plan to respond if red flag is detected
- manage service providers
- annually review program’s effectiveness
Enforcement of the “Red Flag” rule
◊Civil fine of $100/ea up to $25,000/yr
◊ Criminal fines up to $250,000 up to 10yrs imprisonment for each violation
There is a move to more vigorous enforcement now
What actions qualify as an abuse report
Professional misconduct
Child Abuse
Elder Abuse
Abuse of mentally ill and developmentally disabled
