for her mother, and a potential witness for her father. Clearly, the therapist’s objectivity is threatened! At this point, the therapist must make this conflict known to both adults and explain the importance of limiting access to Margaret’s records.
Therapists can avoid conflicts of interests by asking this question: Who is my client? In most instances, therapists identify the child or the entire family as their client. In these instances, the therapist does not provide services to other members of the family independently. If parents present goals in therapy that are separate from those of their child or the family, the therapist will acknowledge those goals but refer the parent to another provider to avoid a multiple relationship (Koocher & Campbell, 2018).
Review
Ethical practice increases the likelihood that a clinician will help her client (i.e., beneficence) and avoid harm (i.e., nonmaleficence).
The APA Ethics Code consists of broad ethical principles (i.e., aspirational goals) that guide psychologists’ professional activities and specific standards (i.e., rules) they must follow when conducting research, helping clients, or interacting with the public.
Four ethical standards are especially important when working with children and families: (1) competence, (2) consent, (3) confidentiality, and (4) conflicts of interest. They are sometimes called the Four Cs of professional ethics.
Key Terms
APA Ethics Code:A common set of principles and standards upon which psychologists build their professional and scientific work; other professions (e.g., school psychologists, social workers) have similar ethics codesAssent:Agreement to participate in treatment or research provided by a person who is unable to give consent because of his or her age or cognitive abilityCategorical classification:Diagnostic approach in which disorders are divided into mutually exclusive groups based on sets of essential criteriaComorbidity:The presentation of two or more disorders in the same person at the same timeCompetence:The education, training, and professional experience mental health professionals use to deliver evidence-based services; professionals must practice within its boundariesConfidentiality:The expectation that information that children and families provide during the course of treatment will not be disclosed to others without their consentConsent:A person’s informed and free decision to participate in treatmentCulture:Values, knowledge, and practices that people derive from membership in social groupsDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):A compendium of mental disorders and diagnostic criteria adopted by the American Psychiatric Association and used by most mental health professionals in the United StatesDiagnostic specifier:A label that describes a relatively homogeneous subgroup of individuals with a given disorderDimensional classification:Diagnostic approach in which the severity of the individual’s distress and/or impairment is described on a continuumEthical principles:Broad ideals or aspirational goals for the professional practice of psychologyEthical standards:Specific rules that guide professional practice in psychologyEthics:Principles and standards of a profession that ensure high-quality care and protect the rights and dignity of othersEthnicity:A culturally constructed identity that is used to define groups of people and communities; it can be rooted in a common history, geographic location, language, religion, or shared experience that distinguishes that person or group from othersEvidence-based practice:The integration of empirical research with clinical expertise to help children and families in the context of their characteristics, culture, and preferencesEvidence-based treatments:Psychotherapies and medications that have been shown in well-designed research studies to reduce children’s symptoms and improve their functioningHarmful dysfunction:A definition of abnormal behavior characterized by (1) a failure of some internal mechanism to perform a function for which it was naturally selected and (2) the failure causes harmIncidence:The percentage of new cases of a disorder in a discrete period of time, usually 1 yearMental disorder:“A syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning” (DSM-5)Multiple relationship:Occurs when a therapist, who is in a professional role with a client, enters into another relationship with the same individual or a person closely associated with that individual; it can impair the objectivity and quality of carePrevalence:The percentage of individuals in a given population who have a medical or psychological conditionPrototypical classification:Diagnostic approach that is based on the degree to which the individual’s signs and symptoms map onto the ideal picture of the disorderPsychotropic medications:Prescription drugs used to treat psychological disorders, such as anxiety, depression, and schizophreniaRace:A culturally constructed category that can be used to divide people into groups based on superficial physical traitsResearch Domain Criteria (RDoC) initiative:A program supported by NIMH to create a new system of classifying mental disorders based on underlying genetic and biological causesSign:An observable feature of a disorder (e.g., hyperactivity, sluggish movement)Socioeconomic status (SES):A composite variable that reflects three aspects of a child’s environment: (1) parents’ levels of education, (2) parents’ employment, and (3) family incomeStigma:Negative beliefs that can lead to fear, avoidance, and discrimination by others or shame and low self-worth in oneselfSymptom:A subjective experience associated with a disorder (e.g., anxiety, depressed mood)
Critical Thinking Exercises
1 According to DSM-5, a mental disorder is a pattern of behavior characterized by distress or disability that resides within the individual. What might be some limitations to this definition, especially when it is applied to children and adolescents?
2 Approximately 40% of youths in the general population who have a mental disorder have at least one other comorbid condition. However, the prevalence of comorbidity among children referred to mental health clinics is much higher—between 70% and 80%. What might explain this difference?
3 Abdi is a 14-year-old boy who was sent to the emergency department of a hospital following a suicide attempt. Abdi, a recent Somali immigrant, does not speak English. After Abdi was medically stable, the psychologist at the hospital interviewed him through a translator, in order to determine whether he met diagnostic criteria for depression or another mental disorder. If you were the psychologist, what considerations might you keep in mind while interviewing Abdi?
4 Allison is a psychology major who is interested in working with children and families after graduation. Allison does not want to earn a doctoral or medical degree. What are some other career options for her? How might she find more information about those careers?
5 Taylor is a student intern at a community mental health center. During her internship, she suspects that one of her clients, a 9-year-old-boy, may be physically abused by his parents. The boy’s parents engage in “rough discipline” such as hard spanking. The boy has never complained and there have never been any marks on his body. What should Taylor do?
Test Yourself and Extend Your Learning
Videos, flashcards, and links to online resources for this chapter are available to students. Teachers also have access to PowerPoint slides to guide lectures, a case study book (with answers) to prompt classroom discussions, and exam questions. Visit abnormalchildpsychology.org.
Descriptions of Images and Figures
Back to Figure
The details of the graph are as follows:
The horizontal axis shows the different disorders affecting children and adolescents.
The