| Lenore Walker , Ed.D., J.D. | APA DIV 42 ETHICS COMMITTEE REPORT
Chair: Lenore Walker, Ed.D., J.D. Members: Martin Williams, Ph.D., Mae Billet-Ziskin, Ph.D., John Fleer, Ph.D., J.D., Shirley Glass, Ph.D., Richard Saunders, Ph.D., David Shapiro, Ph.D., Melba Vasquez, Ph.D., Jeffrey Youngren, Ph.D. The Division 42 Committee on Ethics has as its mission to study the impact of the APA Ethics Code on practitioners, follow the work of the APA Task Force to Revise the Ethics Code (ECTF), assist the Division in forming its opinions on APA Ethics Code and assist so that the Division input in this process is clearly heard within the APA. To do this we have taken on three separate but interrelated tasks: 1) To review all materials that are put forward by the ECTF. We are on their mailing list and so get the minutes of their meetings and materials that are not published as well as those that are. The committee communicated via E-mail and came to opinions on the various proposals that the ECTF put forward in the APA Monitor and other documents prior to convention. At the time the committee’s report was prepared for the Division 42 Board, it appeared that all members agreed but one member who had not responded to the E-mail, later disagreed with the position that it is unnecessary to extend the prohibition of sex between client and therapist beyond the current standard. Convention was an active time and members of this committee attended the various programs on the proposed revisions Although we originally had two classes of membership on the committee, members and advisors, the advisors became as involved as members, and so we have consolidated to the nine members listed above. I met personally with Celia Fisher, Ph.D., the Chair of the ECTF and Dolf Prince, Ph.D., the new staff person for the APA Ethics Committee replacing Stan Jones, Ph.D. Further, the members of the committee used the convention to meet with other practice divisions who have also formed their own Committees on Ethics to attempt to find where our voice can be unified. Our findings are summarized below. 2) To develop a “Bill of Rights” for those APA members who serve on ethics committees or licensing boards to follow when dealing with allegations against colleagues. The lack of due process in both the ethical and the grievance violation process is a major concern to members of the committee and we are looking at ways to encourage AASPB and APA to develop a model licensing bill that gives us due process when a complaint is filed. Until then, we believe that we should hold APA member psychologists who serve on regulatory boards accountable for their behavior, some of which would be deemed unethical if it were not protected by eminent domain laws which gives them their power and authority. Some of the areas to be included in the Bill of Rights would include a time limit for adjudication if we continue with that function, specific guidelines for the relationship with the psychologist who is charged including “presumed innocence,” only making comments about the psychologist charged when there are data to support the comments, and so on. While it is understood that psychologists who serve on adjudication boards cannot always set the rules, they can make sure they behave in an ethical manner or they are required to follow the same process as would a psychologist who is asked to perform unethical tasks in another setting. 3) To survey our members so that we are aware of the impact that the current ethics code has on their professional and personal lives. Although the number of people who are directly impacted by the Ethics Code appears to be small, the negative impact that it appears to have is so detrimental to their mental and professional health that the effect seems to be to scare and traumatize even those members who do not have a complaint filed against them. We have been collecting personal stories that are quite horrifying. There is a vast difference of opinion about the way the Ethics Committee has functioned among different division members—in general there are three areas where members seem to group: Those members who have served valiantly on the Ethics Committee believe the Committee and the Code protects practitioners and other psychologists. They believe that the problems occur when the Code is misinterpreted or misused by those who are uninformed or those who have their own purpose. In some ways they are “true believers” who are unable to accept that there is something fundamentally wrong with the Code if so many practitioners have the perception that they are unprotected and even in harm’s way no matter what the reality might seem to these members. It is difficult to negotiate with many of these members as they feel they must defend the Code and the Committee and sometimes seem to take the dissatisfaction expressed by members as a personal attack. Those members who have had any contact with the Ethics Committee and the Code have found the process to be so repugnant, whatever the outcome, that they join a different “true believer” group who believe that the ethics committee as it currently functions must go! Not all members in this group agree with each other except that they want change. I have found that they are less able to articulate exactly what would substitute for the Code although some suggestions are put forth by some members of the committee and described below. This group seems to be developing a consensus around the preference for the Code to be used as educative rather than towards enforcement. The third clearly defined group are those members who have had any contact (whether personal or by association) with the state licensing boards who usually use (or misuse) the Code for their enforcement function. They find the entire process so degrading and humiliating and unfair that they too become “true believers” who want to do anything possible to change it. The major complaints stem from the fact that there is no “due process” when members are accused of wrong doing, which is offensive, unfair and limiting to our members in trying to maintain their reputations. Further, there does not appear to be an oversight or appeal process that is effective, which encourages idiosyncratic enforcement and politics in certain states. It may be that the simple addition of legal due process and promulgation of ethical guidelines to strictly govern the behavior of psychologists who serve on the various regulatory boards could help fix this serious problem. Clearly, our members in this Division and in many other practice divisions are dissatisfied with the Ethics process within the APA. This does not appear to center around individuals but rather the process itself. The amount of money the association is spending on enforcement appears to have increased substantially over the past ten years causing the Board of Directors to question whether it would be more cost effective for the association to stop enforcement and adopt an education function for ethic’s violators. Whether the education would be individualized to a member with a complaint or general educative guidelines is unclear. There appears to be a large and growing body of members who believe the Ethics Committee and the Code are ineffective in doing what we hope it will, which is to keep us on the straight and narrow path of goodness and protect us from unwarranted arrows and other restrictions on our good judgment in our practice while also “catching the bad guys” who ruin our profession’s reputation. We intend to do a more random sampling in the next few months to get the views of members on their perceptions of the usefulness vs. the emotional experience of the ethics code. We are attempting to get the insurance companies interested in assisting with this survey but if that is not possible, then we will come back to the board for further instructions about funding. My own personal opinions about the Ethics Code and its related Guidelines for practitioners has dramatically changed over the years—perhaps in response to the proliferation of details that are quite restrictive to good practitioners while seen as necessary to guide those with less internal ethical constraints. It is interesting to see that even in Division 35, where one particular issue—the sexual exploitation of clients by therapists - has been a major issue, members who used to be close to 100% for the strictest possible restrictions, such as the currently proposed ‘no sexual relationship ever,’ are now around a 60/30 split, although still in favor of the strictest guidelines. This appeared in a recent E-mail discussion among those leaders on the Executive Committee listserve and represented approximately 30 responders. Perhaps the closer relationship of psychologists with the legal arena has made us more aware of the lack of due process issues and harm to reputation that even innuendoes and bad faith complaints can due to our practices. Further, there is experience with the current Code’s restrictions that appear to be satisfactory and therefore, it may be unnecessary to protect all women clients forever. In another recent E-mail discussion, on the Division 42 Board’s listserve, members responded to a query concerning preference for an educative rather than the current enforcement mission for the Ethics Committee. There appeared to be an emerging consensus from that discussion our list that:
Obviously, these are unrepresentative and small samples of a discussion on two large division’s leadership E-mail list, in response to queries by other members. It does indicate that such discussions may be able to produce consensus even among disparate groups. Therefore, the Committee is considering participating in E-mail discussions with other divisions or other members who are willing to organize chat and E-mail discussions that include responses to the seven proposals that the ECTF put forward at convention and the other issues already raised here. This may have a purpose beyond gathering information as there appears to be a “body count” going on in the ECTF, where they are actually counting the number of responses they receive for and against the seven proposals. If this continues to be the message, then it may be important for the practice divisions to organize individual members so that each person makes his or her preferences known to the ECTF. Results of Meeting with Dolf Prince and Celia Fisher Dr. Prince had just taken over the Ethics staff position at the time of convention and he appeared to be genuinely interested in the dilemmas the current Ethics Code and Committee’s process posed for practitioners. His prior experience as a practitioner seemed to create more sympathy for the practitioner perceptions than had been expressed to any of us previously. Whether or not this translates into behavior change is still unclear. One of his suggestions was that the Ethics Office begin an education program for psychologists who serve on regulatory boards - both in the interpretation of the Ethics Code and in Guidelines for Psychologists Serving on Regulatory Adjudication Boards. This seems like an important area to be explored. Dr. Fisher said that she was receiving comments about half for and half against the seven proposals that had appeared in the APA Monitor. If this is true, then practitioners are not sending in the comments that are being heard in other meetings. Although I reminded Dr. Fisher that Division 42 represented thousands of practitioners who were not in favor of the proposals as described, her response did not indicate that our concerns were taken seriously. In fact, there was no room for substantive discussions, both because of time constraints and Dr. Fisher’s comments that the seven proposals were among many that were being considered by the ECTF and she had just picked out those seven when requested to discuss some of them. She stated that there would be a meeting in October that would outline the agenda for the ECTF and that no decisions on any of the proposals would be made prior to the January meeting. I left the meeting without any assurance that our concerns would be seriously considered although I did feel that the fact that “practitioners were unhappy” was heard. I still do not have any understanding why the ECTF continues to consider proposals that may become outdated and moot should the Ethics Committee change its focus and direction to become more educational with a short, concise behavioral code and aspirational suggestions. I believe this reflects the tenacity with which those who have served on the Ethics Committee hold on to the status quo - adding more of the same without really reflecting on the possibility of a new way of doing business. It would seem to me that if APA is really interested in revisions to the Ethics Committee process and Code, then perhaps the ECTF needs non-ethics committee members with new visions. Continued Work for the Committee on Ethics for Division 42
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