American Psychological Association Division of Psychotherapy

Updates from the 2010 Meeting of the APA Council

Internet Editor — Thu, 11 Feb 2010 16:54:48 +0000

By Linda Campbell

Dear Friends and Colleagues,

Norine Johnson and I are your representatives to APA Council of Representatives. We bring you the decisions and direction of APA in our report immediately after the Council meeting. We also want your input and your opinions before we go to Council in order to accurately represent your ideas and thoughts on matters that can affect us. I am listing here the items I think hold importance for us. I have also presented these items to our Board of Directors:

1. Call for language amending Ethical Standards 1.02 and 1.03.

In August 2009, the APA Council asked the APA Ethics Committee to propose revised language for the Ethics Code that would accomplish the following three goals:

Resolve the discrepancy between the Introduction to the Ethics Code and Standard 1.02.
The recommended revision must effectively communicate that Standards 1.02 and 1.03 can never been used to justify or defend a violation of basic human rights.
The revision must be ready to become an action item for the Council meeting of February 2010.

The proposed revision as it now standards is the following. Please note that deletions are indicated by brackets and additions are indicated by underlining:

1.02 Conflicts Between Ethics and Law, Regulations, or Other Governing Legal Authority

If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists clarify the nature of the conduct, make known their commitment to the Ethics Code and take reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics Code. [If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority.] Under no circumstances may this standard be used to justify or defend violating human rights.

1.03 Conflict Between Ethics and Organizational Demands

If the demands of an organization with which psychologists are affiliated or for whom they are working are in conflict with this Ethics Code, psychologists clarify the nature of the conflict, make known their commitment to the Ethics C ode, and [to the extent feasible, resolve the conflict in a way that permits adherence to the Ethics Code.] take reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics Code. Under no circumstances may this standard be used to justify or defend violating human rights.

2. Revision of APA’s Model Act for State Licensure of Psychologists

APA’s Model Act serves as a prototype for state legislation regulating the practice of psychology. State legislatures are encouraged to use the model language as a base for development of state laws and regulations. The reasons for the current revision of the Model Act are that (1) the current Model Act was written 20 years ago and is out of date; (2) Recommendations for prescriptive authority for psychologists needs to be included, (3) Important developments have occurred in the practice of psychology apart from provision of health services such as I/O and consulting psychology such that psychologists may wish to or be required to become licensed; (4) the changes in the recommended sequence of education and training leading to licensure need to be incorporated.

Some of the significant changes in the MLA are as follows:

Definitions: Several terms are created that were not present in the 1987 MLA document. The new term “Applied Psychologist” includes the two categories of Health Service Provider” which is already defined in APA documents and General Applied Psychologist” which may refer to applied psychologists providing services outside of the health and mental health field. Additional definitions include “Board, Institutions of higher education, Practice of psychology, Psychologists, Developed areas of practice, Emerging areas of practice, and Client.”
Requirement or Licensure: The sequence of training lagnauge was added such that two years of supervised experience can be obtained during the doctoral program rather than one year being required post doctoral. Substantial detail about doctoral training programs is included in the MLA.
The Task Force recommends to APA that creation of policy that applies to cross jurisdictional practice particularly telepractice be created. The APA does not currently have policies regarding limitations or guidelines for this practice.
Exemptions: The application of exemption from licensure is recommended to include (a) persons engaged in teaching or research in academic /institutional settings, (b) non-health service provider psychologists not involved in direct service, (c) individuals for whom licensure was previously prohibitive but are now expected to become license should be considered for some form of grandparenting.
The exemption that existed in the 1987 MLA for individuals credentialed by a state agency who did not have a doctoral level credential were entitled school psychologists. In the revised MLA, the term school psychologist is reserved for those who have a doctoral degree in psychology; are certified by the state education agency, and are using the terms only during their practice in the public schools.

3. APA’s Strategic Plan: Core Values

Core values are essential and enduring tenets that have intrinsic value and importance to its members. The Ad Hoc APA Values Committee recommends the following core values statement:

“The American Psychological Association commits to its vision through a mission based upon the following values:

The Continual Pursuit of Excellence
Science-Based Knowledge and Application
Outstanding Service to Its Members and to Society
Social Justice including Diversity and Inclusion
Acting Ethically in All that We Do.”

There are considerable additional items that will be presented, discussed, and for which action will be taken. These items will be fully reported by Linda Campbell and Norine Johnson in their Council report in the next Bulletin. If you have any questions or comments that you would like us to know before the Council meets on February 19^th please contact Linda Campbell at lcampbel@uga.edu or Norine Johnson at NorineJ@aol.com. We can either communicate by e-mail or arrange a time to talk by phone.

Psychotherapy’s New Interactive Online Presence

Christopher Overtree — Thu, 04 Feb 2010 12:47:59 +0000

By Christopher E. Overtree:

When I went to college, all students were required to have a voicemail account, enabling college administrators to send campus wide messages. Voicemail served an important social purpose too; we checked hourly to see whether we would be enjoying burritos at the Wa Wa or foot-longs at Hoagie Haven. But, we had a choice about whether we wanted email, and without realizing what I was doing, I selected one. Thus begins my story of the race for information, constant availability, and the battle for privacy amidst a world of transparency. Sometimes I wish I had that choice back.

But there was no one to email back then, unless I wanted to shoot some computer jock a note about “how cool this is” or a message to Steve Jobs reserving a Newton. Now I am plugged in, and my suspicion is that you are too. If not, you are probably told you are hard to reach, asked for your email rather you’re your name, or have been told that your family’s photos are on Facebook rather than in an album. It’s been a bumpy ride.

For psychotherapists, this has created unique challenges. Our profession understands the role that self-disclosure can play in therapy. But in the Internet age, self-disclosure happens to us as information is gradually absorbed by the searchable Internet. We used to think we could opt out, but now realize that it is often better to manage our information than to keep it hidden. In my view the question is not whether psychotherapists should embrace technology, but rather, how should this be done. Our economy frequently asks what jobs and services can be moved to the Internet. My plumber recently ordered parts for my washing machine on his Blackberry. But what about psychotherapy?

As this question brings positive and negative associations to your mind, ponder additionally where discussions about our field are taking place. Where is the dialogue about modern psychotherapy happening? Where do early career psychologists and psychology students find their information, their mentors, and their outlets for dialogue? Where do critics post their harangues? Where is the role of psychotherapy, its utility, its billability, and its very livelihood being discussed? Why the Internet of course! Shouldn’t the Division of Psychotherapy have a loud voice amidst the cacophony? Our own www.divisionofpsychotherapy.org is this opportunity.

Taking over as the Internet Editor for the Division of Psychotherapy was like knocking down the top floor of a skyscraper and rebuilding the penthouse. Obviously, any discussion of the future of our website begins with gratitude to Abe Wolf, past President and first Internet Editor who built things from the ground up and gave the Division such an outstanding online presence. New changes are not referendums on how things used to be done, but rather opportunities for the evolution of ideas and possibilities. But rebuilding the penthouse is no small task, and requires us to ponder its design, its selling points, and how it will stand out in the very crowded web.

The New Web

The new web is not a place where paper documents are scanned and stored. It is not a redundant back-up of printed content, nor is it a secondary source of information. The new web is a primary source, the place where more and more original content is created, displayed and made searchable. Printed documents have become secondary sources because their information is anchored to their publication date. Sad, but true, your morning Times is already out-of-date when it arrives at your doorstep.

The new web is also extremely interactive, not static. It is an interconnected network of information that evolves in response to its users. In essence, the web is a wiki, which represents the collective wisdom (and interests) of the global online community. A website that does not adapt to user interactions, or update its content in real time, comes to resemble the dusty leaves of a silk plant; attractive maybe, but certainly not alive.

In 2004, Google began an experiment in which flu-related search terms were used to map flu activity in different regions of the United States. By aggregating the data, essentially a collection of users searching flu symptoms and remedies, Google was able to map flu outbreaks roughly two weeks before the CDC. The power of their algorithm was in the interactions between users and the web, not in the web itself. This success reminds us that the web is a primary source, an interactive endeavor, and one that relies on its users to establish its relevance.

Division 29’s growth and influence in the field of psychotherapy is intimately tied to its web presence, perhaps as much as its publications and activities. Our website is a portal for our members, but also for the public, policy makers, our critics and supporters. Our website has the opportunity to play a valuable role in the dissemination of information about psychotherapy, establishing Division 29’s leadership in the field.

If you google the word, “psychotherapy,” our website comes up third in the hit list (Wikipedia is number one). However, if you google the phrase, “psychotherapy bylaws,” we shoot to the number one spot. This says a lot about how our website has been used in the past, but also gives us a clear picture of our future direction. A focus on documenting Division activities can shift to one that plays a vital role in the exchange of information about psychotherapy. It can be a resource for early career psychologists and students seeking colleagues and information. It can be a tool for leadership.

Our New Website

Our new website looks very different from the old, and is built on a different set of design principles which bring unique strengths and weaknesses. The website was built using WordPress, an Open Source, self-hosting blogging tool used by millions of sites to display everything from pictures of puppies engaging in humorous antics to international corporations reporting news and earnings. Our site has a custom-built exterior, backed by a powerful infrastructure that is very stable and feature-rich. For those of you not familiar with the Open Source movement, it is based on the notion of collectively authored software platforms with code made available to the public for editing, troubleshooting, and the incorporation of new features. Open Source software is often more stable, adaptable, and typically faster than commercial platforms, and in case you still need to be convinced, is available free. Our choice of WordPress thus represents a shrewd financial decision as well as a statement of support for Internet freedom and transparency. It also brings some excellent features.

Now first and foremost, forget what you know about “blogging,” as our site does not operate like some of the blogs you may have come to enjoy or despise. A blog-style website simply means a design that highlights and organizes new material as “posts,” placed at center stage to get the viewer’s attention. Posts can be articles, commentaries, announcements, book reviews, or even pictures from social events. Each post is optimized for keyword search, grouped into categories for easy sorting, and also “tagged” with specific keywords that tell readers which topics occur most often (check out the Tag Cloud on the homepage which graphically represents hot topics). So new posts get highlighted on the homepage, categorized and tagged. As a post ages, it fades into the background, but is always ready to be called up by a targeted keyword or category search. A post can be authored by anyone, and readers can respond with comments that are monitored to prevent spam.

Our homepage does lots of other things too. Using widgets, we can display many other items including reminders, hyperlinks, Really Simple Syndication (RSS) feeds to display content from other sites, slide-shows and much more. Currently, we are highlighting the Division’s 40^th Anniversary celebration, Jeffrey Magnavita’s “Re-envisioning the Division” slide show, an events calendar, and an RSS feed coming right from our Psychotherapy Journal showing the latest articles.

Across the top of every page is a selection of static pages, where the informational content of a traditional website is located. These pages are updated less frequently, and are designed to contain information regarding governance activities. New and emerging content will always be showcased on the homepage, but the backbone of the Division’s structure is contained in these permanent pages.

One of the best features of the new website is the ability to add users with different privileges, enabling them to create their own content, manage their own posts, and make changes to the site. One excellent example of this is Jeffrey Barnett’s Ask the Ethicist column, which accepts questions on ethics in psychotherapy, and receives responses directly from Dr. Barnett. Whenever Dr. Barnett responds to a question, readers see a new post highlighted on the home page. A description of the Ask the Ethicist column, a place to post your own questions, and a link to view the archives can be found under the Continuing Education tab. We hope that other Division 29 members will author their own columns, and there are currently plans for an Early Career Psychologist mentoring column, a Technology column, and a column for student members.

What is Different About the New Website

One of the major changes for the new website is its focus. As was mentioned above, much of the previous content was “Division-only” business and paperwork. While the new website still attempts to document these activities, it is not quite as useful for archiving documents given its focus on emerging content. While members will still be able to find these documents, users will find this material well organized, but in the background. There will be fewer PDF files, and more content is viewable directly on the page to improve access.

One of the other shifts our website is making is to be more attractive to web-surfers, particularly members of the public, policy makers, students and non-members with an interest in psychotherapy. We hope to increase membership by expanding our reach throughout the Internet and by providing content that is useful to anyone interested in learning more about our field.

A Few Other Division 29 Internet Resources

For a while there, we watched, wallets in hand, as companies fought the format battle. Vinyl to 8-track to cassettes to CD’s to MP3’s and back to vinyl. VHS to DVD to Blueray to 3D ESPN. But the ubiquitous role of information and the ability of computer code to adapt to any device has slowed these battles, and allowed us to focus on the point of all these formats and devices, the enjoyment and sharing of content. Our online presence is also designed to be adaptable to emerging communication trends. Rather than a one-size-fits all approach, we hope that our Division can be flexible, garnering followers in different venues or devices. Can you believe I can edit our Division’s website from my iPhone? Actually, I could if my fingers were smaller, but I promise you it is possible!

One such example is the Division’s new Facebook Page. Facebook makes room for businesses and educational organizations, allowing them to post information and relying on fans to propagate this information by forwarding or reposting items of interest. On our own homepage, you will see an invitation to become a Fan of the Division’s Facebook page. New posts on the Division website are automatically reposted on Facebook, connecting them to the vast social network of our fans. For those of you who are not Facebook users yet (or will never be), it is important to understand that developing a web presence means adaptability. Our Facebook page reaches an entirely different type of user, one that is generally younger and more apt to follow web trends. Our Facebook page also helps us to benefit from the logarithmic effect of passing information socially as posts are automatically shared with friends once, twice and thrice removed. Facebook is also a great place for members of the Division to share interesting pieces of information that would not necessarily warrant rent space on our own homepage. Shrewd followers of Division 29 will Find Us On Facebook! At press time, we have 47 fans, with a hope that when article hits mailboxes, we will see a spike. I’ll be watching.

You may also notice that the electronic version of our Psychotherapy Bulletin is viewable directly on our website, as well as available for download as a PDF file. This is made possible by a document-hosting site, known as Scribd (pronounced scribe-d). Scribd focuses primarily on complete documents and online publications, but also has a social networking component. Scribd users can choose to subscribe to our publications, receiving notifications when new ones arrive.

Finally, if you saw the photos from the 40^th Anniversary celebration on the website, these were hosted on our Picasa page which displays photos for public, private, or by-invitation-only viewing. This is a popular photo-sharing site, making it easy to upload photos from events, or to establish an archive of our Division’s history.

The Role of Online Publishing

I read an analysis recently on the environmental impact of manufacturing and delivering an Amazon Kindle. The conclusion was that the deleterious environmental consequences of purchasing a Kindle were outweighed in a single year by the reduction in paper use and waste in the print industry. This is an impressive triumph for a new electronic device, which typically places increased pressure on the environment. The proliferation of information devices such as the Kindle, iPhone and Blackberry, and new generation tablet computers such as the iPad tell us to expect considerably more growth in the online readership of our Psychotherapy Journal and Psychotherapy Bulletin.

As such, it makes sense that we discuss the optimal means for adapting publications to the online environment, and that we encourage members to select electronic versions instead of print. As is the case with our website, it is the content that is most important. Our strategy is to promote broad appeal, across many devices and formats. We hope that future publications will be compelling enough and improved enough by electronic dissemination, that members will choose to view documents electronically. More importantly, choosing to reduce paper use and publication cost is an opportunity for us to Go Green, bringing the Division more inline with modern conservation standards for educational and business organizations. As if the above were not enough, we also hope members will choose to opt-out of receiving print documents in order to free up financial resources for improving the benefits of membership in new and exciting ways.

Future Possibilities

There are innumerable opportunities provided by the Internet to strengthen the Division of Psychotherapy. Future growth may see the development of a presence on YouTube or possibly other areas more specifically geared to the field of psychotherapy. As the Internet is a highly interactive environment, wholly dependent on the contributions of its users for growth, I hope the Division of Psychotherapy’s website will be equally participatory and members will feel comfortable coming forward with new ideas for content or strategies for broader dissemination. I will be placing an electronic, hyperlinked copy of this article on our website with a place for comments, questions or suggestions. I hope readers of this article will share their reactions and ideas for the growth of Division 29’s online presence.

New Psychotherapy Research Grant Named in Honor of Charles J. Gelso

Internet Editor — Wed, 03 Feb 2010 18:28:19 +0000

CHARLES J. GELSO, PH.D., PSYCHOTHERAPY RESEARCH GRANT

Division 29 created the annual Charles J. Gelso, Ph.D., Psychotherapy Research Grant to provide annual grants (up to $2000) supporting the advancement of research on psychotherapy process or psychotherapy outcome. Grant eligibility rotates biannually between graduate students/predoctoral interns and doctoral level psychologists/postdoctoral fellows.

The grant program was established in honor of Charles J. Gelso, Ph.D., who has made major contributions to theory and empirical research related to the psychotherapy relationship, including the working alliance, transference, countertransference, and the real relationship. In addition, his research has brought about important advances in our understanding of the research training environment in graduate education, as well as in the application of psychoanalytic concepts to short-term and long-term psychotherapy. He received his M.S. from Florida State University in 1964 and his Ph.D. from Ohio State University in 1970, and is a professor in the Department of Psychology at the University of Maryland, College Park. He has mentored many new investigators in the area of psychotherapy research.

Early Career Credentialing Scholarships From The National Register

Internet Editor — Fri, 15 Jan 2010 13:36:13 +0000

Deadline to Apply for Credentialing Scholarships is 3/15/2010.

Dear Early Career Psychologist:

Are you interested in joining the National Register of Health Service Providers in Psychology? If yes, but the application cost is a barrier, you should apply for a National Register Early Career Psychologist (ECP) Credentialing Scholarship.

Early Career Psychologist credentialing scholarships were developed in conjunction with the APA Committee on Early Career Psychologists. These scholarships help ECPs get credentialed as Health Service Providers in Psychology by covering the cost of the credential review and registration fees. The National Register has awarded 189 scholarships to ECPs, so don’t miss your chance to take advantage of this opportunity.

Before you apply for a scholarship, please spend a few minutes browsing the National Register website (www.NationalRegister.org) to learn more about the benefits of the Health Service Provider in Psychology credential, including:

Credentials Banking
License Mobility
Discounts on Professional Liability Insurance
Free Continuing Education*
Practice Profile on the FindaPsychologist.org Referral Website
Credentials Verification to Healthcare Organizations
Publications and Legal Updates

To apply for an ECP Scholarship, go to http://www.nationalregister.org/ECP_award.html.

Credentialing scholarships are made possible by donations to the National Register scholarship funds.

Regards,

Judy E. Hall, Ph.D.
Executive Officer

Norman Abeles To Receive Award for “Distinguished Senior Career Contributions To Psychology In The Public Interest”

Internet Editor — Sat, 09 Jan 2010 16:13:38 +0000

Norman Abeles, current Science Domain representative from APA’s Division of Psychotherapy (Division 29) will receive the Distinguished Senior Career Contributions to Psychology in the Public Interest Award at the APA convention in San Diego in August 2010. Dr. Abeles is a Professor of Psychology Emeritus at Michigan State University where he served as Director of the Psychological Clinic and Director of Clinical Training. He focuses his work in the area of aging. He was instrumental in creating the Office of Aging at APA when he was President of APA in 1997. He has also been very active in presenting workshops on ethics and has written Journal articles on Aging and on ethics and on psychotherapy research. He is also a Past President of APA’s Division of Psychotherapy. He currently serves on the Geriatiric and Gerontology Advisory Committee to the Secretary of the Veteran’s Administration and has twice been invited to the White House conference on Aging which meets every 10 years. He currently serves on the Publications and Communications Board of APA as well as on the Board of Division 12 (clinical) where he represents the section on Assessment. Division 29 is very proud of his accomplishments.

Go Green! Read the Latest Edition of the Psychotherapy Bulletin Online

Internet Editor — Sat, 09 Jan 2010 14:27:16 +0000

Enjoy the latest edition of the Psychotherapy Bulletin online before it reaches your mailbox! Check it out!

Psychotherapy Division Member Melba Vasquez Elected APA President!

Internet Editor — Fri, 08 Jan 2010 16:04:10 +0000

Melba Vasquez

The provision of psychotherapy is the basis of my work. Providing psychotherapy is an activity that is profound in its meaning and effectiveness as a change process. The evolving evidence base helps us to more fully understand the factors that contribute to therapeutic effectiveness. We must ensure that these services are fully included and funded in the evolving health care reform systems.

Leadership

As a member of the Board of Directors, I have advocated consistently for the Practice Directorate, and the APA Practice Organization. I currently Chair the Task Force to revise the Model Licensing Act, whose charge is to bring the MLA in line with other APA policies including proposing increase in licensure mobility, and ensuring that the doctorate is the level of credential required for the title “psychologist” and the independent practice of psychology.

I served as Chair of the Board of Professional Affairs, and as member of the Committee for the Advancement of Professional Practice. I also served on the Ethics Committee, as member of the Examination Committee for the Association of State and Provincial Psychology Boards, and helped to develop the oral exam for licensure in Texas.

Education and Training

I completed a psychotherapy videotape series as part of the APA DVD Videotape project, focusing on multicultural psychotherapy. These series are available for training students about psychotherapy skills.

I previously worked at two university counseling centers as senior psychologist and as internship training director (Colorado State University and University of Texas at Austin). I’ve taught various doctoral courses in supervision and training of psychotherapy. I helped to plan and coordinate the Supply and Demand Conference and the Competencies Conference, both of which yielded important directions for the training of psychotherapy.

Scholarship

I have authored/coauthored over 30 books, journal articles and chapters in the areas of ethics in psychotherapy, multicultural competency, and psychotherapy with women and with men. I am currently completing a volume, Multicultural Theory as part of the APA Theories of Psychotherapy Series. I have served on the editorial boards of practice journals such as Professional Psychology: Research and Practice, The Counseling Psychologist, and Ethics and Behavior.

Advocacy

I have participated in activities with the Association for the Advancement of Psychology such as raising funds for legislators and in making visits to Congress. Those efforts have included extending the restoration of Medicare outpatient mental health reimbursement cuts, and ensuring that health care reform integrates psychological services. While serving as president of the Texas Psychological Association, I helped ensure that our practice laws remained intact during the 12-year sunset review. I have received an Advocacy Award from the Association for the Advancement of Psychology (2008), and the APA Karl F. Heiser Presidential Award for Advocacy (2007).

I would very much appreciate the #1 vote from members of the Division. Please visit my website www.melbavasquezforapapresident.com.

Melba J T Vasquez, PhD ABPP

Independent Practice
Anderson House at Heritage Square
2901 Bee Cave Road, Box N
Austin, Texas 78746
melvasquez@aol.com

Ask The Ethicist: Phone Therapy

Jeffrey Barnett — Thu, 07 Jan 2010 14:44:39 +0000

Question by Dr. Betty Scott Noble.

I have a female client I have seen for several years (abusive marriage then divorce and a very recent re-marriage). She has moved with her new husband about two hours away and does all her work by computer, so she doesn’t come to Atlanta anymore. She asked if I could do “phone therapy” with her. I am guessing probably every other week (at the most) and once a month (at the least). She doesn’t use insurance. I would prefer that she just come down to Atlanta once a month, but she has two kids and a full time job, so it’s not so easy to do. I am guessing this “phone therapy” wouldn’t be for much longer, maybe just two to three times, but I’m not sure. Thanks for your input on this matter.

Response by Dr. Barnett.

Hi Betty. Good questions. There are a few relevant issues. If this is just for a few sessions to tide her over until she can find a new psychologist in her local area or to help her with the transition to her new situation, and thus is time limited, it is much more appropriate. If this is to be the primary form of treatment over an extended period of time it raises several concerns. Can telephone contacts replace in-person
psychotherapy? A lot of that depends on the client’s treatment issues and needs. For some clients this may actually appropriately meet their clinical needs. For others it may prove insufficient. Doing a careful assessment is important and documenting all options considered and relevant factors, pros and cons, the rationale of your decision, and the actual decision. Then, you will want to be sure to fully address these issues in the informed consent process (an ongoing process where you address any significant changes to the treatment contract). It is also important to familiarize yourself with resources in the clients local area so you can access them or
refer her to them should she experience an emergency. Since she’s two hours away and not 12 hours away for example, this may be less pressing an issue, but still important to address proactively. Also, since the client is still in the same state you don’t need to consider licensure issues; you’re not providing services across state lines. That could be problematic. But, even with that, two phone calls when a client is on vacation or on a business trip is very different than providing ongoing treatment via telephone (telehealth/e-therapy) across state lines.

I suggest discussing with the client her needs and her reasons for wanting this type of continued contact with you. If a call once or twice per month for a couple of months is all that is needed it should be less an issue than if this is ongoing treatment. But, any agreement struck with your client should also include what will happen if her treatment needs change. Initial agreements that sound reasonable at times need to change due to changing circumstances for the client. If she needs more intensive treatment will you provide her weekly telephone sessions for an extended period of time or will the agreement stipulate that she will then accept one of the referrals for in-person treatment in her local area that you provide to her?

These are some issues to consider. As always with ethical dilemmas there is no one right answer, but rather, several issues, factors, and options to consider. Also, closely monitoring the situation and having needed agreements in place are all important. I hope this is of help. If you have additional questions or reactions to this response please let me know.

Thanks and best wishes – Jeff

Click Here to Post A Question.

Click Here to View Previous Questions and Responses

UMass Amherst Offers Unique Mental Health Program for Veterans Returning to College

Internet Editor — Thu, 31 Dec 2009 20:40:45 +0000

Division 29’s Internet Editor, Dr. Christopher Overtree, talks about a new program at the University of Massachusetts-Amherst for Veterans Returning to College.

Ask the Ethicist Blog

Jeffrey Barnett — Thu, 10 Dec 2009 18:10:09 +0000

Ask the Ethicist is a feature on the website of the APA Division of Psychotherapy that provides a forum for asking questions involving ethics and professional practice issues. All psychotherapists face ethically challenging dilemmas and situations in their professional work, whether it be in providing psychotherapy, in conducting research, in supervision or consultation, or in other professional roles. Ask the Ethicist offers Division 29 members the opportunity to ask their questions about ethical challenges and dilemmas they face. Dr. Barnett will provide timely suggestions for responding to these challenges and dilemmas.

Jeffrey Barnett

Jeffrey Barnett, Psy.D., ABPP is a Professor in the Department of Psychology at Loyola Univeristy Maryland and a licensed psychologist in practice in Arnold, Maryland. He is a Diplomate in Clinical Psychology and in Clinical Child and Adolescent Psychology of the American Board of Professional Psychology and a Distinguished Practitioner of Psychology in the National Academies of Practice. He is a recent past chair of the Ethics Committee of the American Psychological Association and has previously been chair of the Maryland Psychological Association Ethics Committee. Dr. Barnett has published numerous articles, chapters, and books on ethics and professional issues in Psychology and has given numerous presentations and continuing education ethics workshops for psychologists and other mental health professionals. His most recently published books include Ethics Desk Reference for Psychologists (APA Books, 2008, with Brad Johnson), Ethics Desk Reference for Counselors ( ACA Books, 2009, with Brad Johnson), and Financial Success in Mental Health Practice (APA Books, 2008 with Steve Walfish).