Human Relations

CHAPTER 6

Standards on

Human Relations

3. Human Relations

3.01 Unfair Discrimination

In their work-related activities, psychologists do not engage in unfair discrimination based on age,

gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability,

socioeconomic status, or any basis proscribed by law.

Psychologists respect the dignity and worth of all people and appropriately consider

the relevance of personal characteristics based on factors such as age, gender,

gender identity, race, ethnicity, culture, national origin, religion, sexual orientation,

disability, or socioeconomic status (Principle E: Respect for People’s Rights and

Dignity). Much of the work of psychologists entails making valid discriminating

judgments that best serve the people and organizations they work with and fulfilling

their ethical obligations as teachers, researchers, organizational consultants, and

practitioners. Standard 3.01 of the APA Ethics Code (APA, 2002b) does not prohibit

such discriminations.

􀀵 The graduate psychology faculty of a university used differences in standardized test

scores, undergraduate grades, and professionally related experience as selection criteria

for program admission.

􀀵 A research psychologist sampled individuals from specific age, gender, and cultural

groups to test a specific hypothesis relevant to these groups.

􀀵 An organizational psychologist working for a software company designed assessments

for employee screening and promotion to distinguish individuals with the

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92——PART II ENFORCEABLE STANDARDS

Standard 3.01 does not require psychologists offering therapeutic assistance to

accept as clients/patients all individuals who request mental health services. Discerning

and prudent psychologists know the limitations of their competence and accept to

treat only those whom they can reasonably expect to help based on their education,

training, and experience (Striefel, 2007). Psychologists may also refuse to accept

clients/patients on the basis of individuals’ lack of commitment to the therapeutic

process, problems they have that fall outside the therapists’ area of competence, or their

perceived inability or unwillingness to pay for services (Knapp & VandeCreek, 2003).

Psychologists must, however, exercise reasonable judgment and precautions to

ensure that their work does not reflect personal or organizational biases or prejudices

that can lead to injustice (Principle D: Justice). For example, the American

Psychological Association’s (APA’s) Resolution on Religious, Religion-Based, and/or

Religion-Derived Prejudice (APA, 2007d) condemns prejudice and discrimination

against individuals or groups based on their religious or spiritual beliefs, practices,

adherence, or background.

Standard 3.01 prohibits psychologists from making unfair discriminations based

on the factors listed in the standard.

requisite information technology skills to perform tasks essential to the positions from

individuals not possessing these skills.

􀀵 A school psychologist considers factors such as age, English language proficiency, and

hearing or vision impairment when making educational placement recommendations.

􀀵 A family bereavement counselor working in an elder care unit of a hospital regularly

considered the extent to which factors associated with the families’ culture or religious

values should be considered in the treatment plan.

􀀵 A psychologist conducting couples therapy with gay partners worked with clients to

explore the potential effects of homophobia, relational ambiguity, and family support

on their relationship (Green & Mitchell, 2002).

􀀴 The director of a graduate program in psychology rejected a candidate for program

admission because the candidate indicated that he was a Muslim.

􀀴 A consulting psychologist agreed to a company’s request to develop pre-employment

procedures that would screen out applicants from Spanish-speaking cultures based on

the company’s presumption that the majority of such candidates would be undocumented

residents.

􀀴 A psychologist working in a Medicaid clinic decided not to include a cognitive component

in a behavioral treatment based solely on the psychologist’s belief that lowerincome

patients were incapable of responding to “talk therapies.”

􀀴 One partner of a gay couple who recently entered couple counseling called their psychologist

when he learned that he tested positive for the HIV virus. Although when

working with heterosexual couples the psychologist strongly encouraged clients to

inform their partners if they had a sexually transmitted disease, she did not believe such

an approach was necessary in this situation based on her erroneous assumption that

all gay men engaged in reckless and risky sexual behavior (see Palma & Iannelli, 2002).

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Chapter 6 Standards on Human Relations——93

Discrimination Proscribed by Law

Standard 3.01 prohibits psychologists from discriminating among individuals on

any basis proscribed by law. For example, industrial–organizational psychologists

need to be aware of nondiscrimination laws relevant to race, religion, and disability

that apply to companies for which they work (e.g., ADA, www.ada.gov; Title VII of

the Civil Rights Act of 1964, www.eeoc.gov/laws/statutes/titlevii.cfm, archive.eeoc

.gov/types/religion.html; Workforce Investment Act of 1998, www.doleta.gov/

usworkforce/wia/wialaw.txt). Psychologists conducting personnel performance

evaluations should avoid selecting tests developed to assess psychopathology (see

Karraker v. Rent-a-Center, 2005). In addition, under ADA (1990), disability-relevant

questions can only be asked of prospective employees after the employer has made

a conditional offer. In some instances, ADA laws for small businesses also apply to

psychologists in private practice, such as wheelchair accessibility. In addition,

HIPAA prohibits covered entities from discriminating against an individual for filing

a complaint, participating in a compliance review or hearing, or opposing an act or

practice that is unlawful under the regulation (45 CFR 164.530[g]).

3.02 Sexual Harassment

Psychologists do not engage in sexual harassment. Sexual harassment is sexual solicitation,

physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection

with the psychologist’s activities or role as a psychologist, and that either (1) is unwelcome,

is offensive, or creates a hostile workplace or educational environment, and the psychologist

knows or is told this; or (2) is sufficiently severe or intense to be abusive to a reasonable person

in the context. Sexual harassment can consist of a single intense or severe act or of multiple

persistent or pervasive acts. (See also Standard 1.08, Unfair Discrimination Against Complainants

and Respondents.)

It is always wise for psychologists to be familiar with and comply with applicable

laws and institutional policies regarding sexual harassment. Laws on sexual

harassment vary across jurisdictions, are often complex, and change over time.

Standard 3.02 provides a clear definition of behaviors that are prohibited and considered

sexual harassment under the Ethics Code. When this definition establishes

a higher standard of conduct than required by law, psychologists must comply

with Standard 3.02.

According to Standard 3.02, sexual harassment can be verbal or nonverbal

solicitation, advances, or sexual conduct that occurs in connection with the psychologist’s

activities or role as a psychologist. The wording of the definition was

carefully crafted to prohibit sexual harassment without encouraging complaints

against psychologists whose poor judgments or behaviors do not rise to the level of

harassment. Thus, to meet the standard’s threshold for sexual harassment, behaviors

have to be either so severe or intense that a reasonable person would deem

them abusive in that context, or, regardless of intensity, the psychologist was aware

or had been told that the behaviors are unwelcome, offensive, or creating a hostile

workplace or educational environment.

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94——PART II ENFORCEABLE STANDARDS

For example, a senior faculty member who places an arm around a student’s

shoulder during a discussion or who tells an off-color sexual joke that offends a

number of junior faculty may not be in violation of this standard if such behavior

is uncharacteristic of the faculty member’s usual conduct, if a reasonable

person might interpret the behavior as inoffensive, and if there is reason to

assume the psychologist neither is aware of nor has been told the behavior is

offensive.

A hostile workplace or educational environment is one in which the sexual

language or behaviors of the psychologist impairs the ability of those who are the

target of the sexual harassment to conduct their work or participate in classroom

and educational experiences. The actions of the senior faculty member described

above might be considered sexual harassment if the psychologist’s behaviors

reflected a consistent pattern of sexual conduct during class or office hours, if

such behaviors had led students to withdraw from the psychologist’s class, or if

students or other faculty had repeatedly told the psychologist about the discomfort

produced.

􀀴 A senior psychologist at a test company sexually fondled a junior colleague during an

office party.

􀀴 During clinical supervision, a trainee had an emotional discussion with her female

supervisor about how her own experiences recognizing her lesbian sexual orientation

during adolescence were helping her counsel the gay and lesbian youths

she was working with. At the end of the session, the supervisor kissed the trainee

on the lips.

According to this standard, sexual harassment can also consist of a single intense

or severe act that would be considered abusive to a reasonable person.

A violation of this standard applies to all psychologists irrespective of the status,

sex, or sexual orientation of the psychologist or individual harassed.

3.03 Other Harassment

Psychologists do not knowingly engage in behavior that is harassing or demeaning to persons

with whom they interact in their work based on factors such as those persons’ age, gender, gender

identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language,

or socioeconomic status.

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Chapter 6 Standards on Human Relations——95

According to Principle E: Respect for People’s Rights and Dignity, psychologists

should eliminate from their work the effect of bias and prejudice based on factors

such as age, gender, gender identity, race, ethnicity, national origin, religion, sexual

orientation, disability, language, and socioeconomic status. Standard 3.03 prohibits

behaviors that draw on these categories to harass or demean individuals with

whom psychologists work, such as colleagues, students, research participants, or

employees. Behaviors in violation of this standard include ethnic slurs and negative

generalizations based on gender, sexual orientation, disability, or socioeconomic

status whose intention or outcome is lowering status or reputation.

The term knowingly reflects the fact that evolving societal sensitivity to language

and behaviors demeaning to different groups may result in psychologists unknowingly

acting in a pejorative manner. The term knowingly also reflects awareness that

interpretations of behaviors that are harassing or demeaning can often be subjective.

Thus, a violation of this standard rests on an objective evaluation that a psychologist

would have or should have been aware that his or her behavior would be

perceived as harassing or demeaning.

This standard does not prohibit psychologists from critical comments about

the work of students, colleagues, or others based on legitimate criteria. For

example, professors can inform, and often have a duty to inform, students that

their writing or clinical skills are below program standards or indicate when a

student’s classroom comment is incorrect or inappropriate. It is the responsibility

of employers or chairs of academic departments to critically review, report on,

and discuss both positive and negative evaluations of employees or faculty.

Similarly, the standard does not prohibit psychologists conducting assessment or

therapy from applying valid diagnostic classifications that a client/patient may

find offensive.

3.04 Avoiding Harm

Psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees,

research participants, organizational clients, and others with whom they work, and to minimize

harm where it is foreseeable and unavoidable.

As articulated in Principle A: Beneficence and Nonmaleficence, psychologists

seek to safeguard the welfare of those with whom they work and avoid or minimize

harm when conflicts occur among professional obligations. In the rightly practiced

profession and science of psychology, harm is not always unethical or avoidable.

Legitimate activities that may lead to harm include (a) giving low grades to students

who perform poorly on exams; (b) providing a valid diagnosis that prevents a

client/patient from receiving disability insurance; (c) conducting personnel reviews

that lead to an individual’s termination of employment; (d) conducting a custody

evaluation in a case in which the judge determines one of the parents must relinquish

custodial rights; or (e) disclosing confidential information to protect the

physical welfare of a third party.

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96——PART II ENFORCEABLE STANDARDS

Steps for Avoiding Harm

Recognizing that such harms are not always avoidable or inappropriate,

Standard 3.04 requires psychologists to take reasonable steps to avoid harming

those with whom they interact in their professional and scientific roles and to

minimize harm where it is foreseeable and unavoidable.

These steps often include complying with other standards in the Ethics Code,

such as the following:

􀀵 Parents of a fourth-grade student wanted their child placed in a special education

class. After administering a complete battery of tests, the school psychologist’s

report indicated that the child’s responses did not meet established definitions for

learning disabilities and therefore did not meet the district’s criteria for such

placement.

􀀵 A forensic psychologist was asked to evaluate the mental status of a criminal

defendant who was asserting volitional insanity as a defense against liability in

his trial for manslaughter. The psychologist conducted a thorough evaluation

based on definitions of volitional insanity and irresistible impulse established by

the profession of psychology and by law. While the psychologist’s report noted

that the inmate had some problems with impulse control and emotional instability,

it also noted that these deficiencies did not meet the legal definition of volitional

that would bar prosecution (see also Hot Topic “Human Rights and

Psychologists’ Involvement in Assessments Related to Death Penalty Cases” in

Chapter 4).

􀀴 A psychologist conducted therapy over the Internet for clients/patients in a rural area

120 miles from her office. The psychologist had not developed a plan with each client/

patient for handling mental health crises. During a live video Internet session, a client

who had been struggling with bouts of depression showed the psychologist his gun

and said he was going outside to “blow his head off.” The psychologist did not have

the contact information of any local hospital, relative, or friend to send prompt emergency

assistance.

􀀴 A psychologist with prescription privileges prescribed a Food and Drug Administration

(FDA)-approved neuroenhancer to help a young adult patient suffering from performance

anxiety associated with his responsibilities as quarterback for his college varsity

football team. The psychologist failed to discuss the importance of gradual reduction in

dosage, and she was dismayed to learn that her patient had been hospitalized after he

abruptly discontinued the medication when the football season ended (APA, 2011a;

McCrickerd, 2010; I. Singh & Kelleher, 2010).

􀀴 Consistent with Standard 10.10a, Terminating Treatment, a psychologist treating a

client/patient with a diagnosis of borderline disorder terminated therapy when she

realized the client/patient had formed an iatrogenic attachment to her that was clearly

interfering with any benefits that could be derived from the treatment. However, her

failure to provide appropriate pretermination counseling and referrals contributed to

the client’s/patient’s emergency hospitalization for suicidal risk (Standard 10.10c,

Terminating Treatment).

HMO

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Chapter 6 Standards on Human Relations——97

Is Use of Aversion Therapies Unethical?

Aversion therapy involves the repeated association of a maladaptive behavior or

cognition with an aversive stimulus (e.g., electric shock, unpleasant images, nausea)

to eliminate pleasant associations or introduce negative associations with the undesirable

behavior. Aversion therapies have proved promising in treatments of drug

cravings, alcoholism, and pica (Bordnick, Elkins, Orr, Walters, & Thyer, 2004;

Ferreri, Tamm, & Wier, 2006; Thurber, 1985) and have been used with questionable

effectiveness for pedophilia (Hall & Hall, 2007). It is beyond the purview of this

volume to review literature evaluating the clinical efficacy of aversion therapies for

different disorders. However, even with evidence of clinical efficacy, aversion therapies

have and will continue to require ethical deliberation because they purposely

subject clients/patients to physical and emotional discomfort and distress. In so

doing, they raise the fundamental moral issue of balancing doing good against

doing no harm (Principle A: Beneficence and Nonmaleficence).

Psychologists should consider the following questions before engaging in aversion

therapy:

Have all empirically and clinically validated alternative therapeutic approaches

been attempted?

Is there empirical evidence that the aversive therapeutic approach has demonstrated

effectiveness with individuals who are similar to the client/patient in

mental health disorder, age, physical health, and other relevant factors?

(Standard 2.04, Bases for Scientific and Professional Judgments)

􀀵 Clarifying course requirements and establishing a timely and specific process for providing

feedback to students (Standard 7.06, Assessing Student and Supervisee Performance)

􀀵 Selecting and using valid and reliable assessment techniques appropriate to the nature

of the problem and characteristics of the testee to avoid misdiagnosis and inappropriate

services (Standards 9.01, Bases for Assessments, and 9.02, Use of Assessments)

􀀵 When appropriate, providing information beforehand to employees and others who

may be directly affected by a psychologist’s services to an organization (Standard 3.11,

Psychological Services Delivered To or Through Organizations)

􀀵 Acquiring adequate knowledge of relevant judicial or administrative rules prior to

performing forensic roles to avoid violating the legal rights of individuals involved in

litigation (Standard 2.01f, Boundaries of Competence)

􀀵 Taking steps to minimize harm when, during debriefing, a psychologist becomes aware

of participant distress created by the research procedure (Standard 8.08c, Debriefing)

􀀵 Becoming familiar with local social service, medical, and legal resources for clients/

patients and third parties who will be affected if a psychologist is ethically or legally

compelled to report child abuse, suicide risk, elder abuse, or intent to do physical harm

to another individual (Standard 4.05b, Disclosures)

􀀵 Monitoring patient’s physiological status when prescribing medications (with legal

prescribing authority), particularly when there is a physical condition that might complicate

the response to psychotropic medication or predispose a patient to experience

an adverse reaction (APA, 2011a).

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98——PART II ENFORCEABLE STANDARDS

To what extent is the behavior endangering the life or seriously compromising

the well-being of the client/patient?

For this particular patient, will the discomfort and distress of the aversive

treatment outweigh its potential positive effects?

To what extent is the urgency defined by the needs of third parties rather than

the client/patient? (Standards 3.05, Multiple Relationships; 3.07, Third-Party

Requests for Services; and 3.08, Exploitative Relationships)

Am I competent to administer the aversive treatment? (Standards 2.01a,

Boundaries of Competence, and 2.05, Delegation of Work to Others)

If aversive treatment is the only remaining option to best serve the needs of

the client/patient, how can harm be minimized?

Have I established appropriate monitoring procedures and termination criteria?

􀀵 Prescribing psychologists trained in addiction treatments opened a group practice to

provide assessment and individual and group therapy for substance abuse and comorbid

disorders. Occasionally, some clients who were long-term cocaine users could not

overcome their cravings despite positive responses to therapy. In such cases, the team

would offer the client a chemical aversion therapy with empirical evidence of treatment

efficacy. The therapy was supervised by a member of the team who was a prescribing

psychologist and who had acquired additional training in this technique (see

also Standard 2.01, Competence).

􀀵 Prior to initiating the aversion therapy, clients/patients were required to undergo a

physical examination by a physician to rule out those for whom the treatment posed

a potential medical risk. The treatment consisted of drinking a saltwater solution

containing a chemical that would induce nausea. Saltwater was used to avoid creating

a negative association with water. As soon as the client began to feel nauseated,

he or she was instructed to ingest a placebo form of crack cocaine using drug paraphernalia.

A bucket was available for vomiting. Patients were monitored by a physician

assistant and the prescribing psychologist during the process and recovery for

any medical or iatrogenic psychological side effects (Standard 3.09, Cooperation With

Other Professionals). Following the recommended minimum number of sessions,

patients continued in individual psychotherapy, and positive and negative reactions to

the aversion therapy continued to be monitored (see Bordnick et al., 2004).

Need to Know: When HMOs

Refuse to Extend Coverage

When health maintenance organizations refuse psychologists’ request to extend coverage for

clients/patients whose reimbursement quotas have been reached, psychologists may be in

violation of Standard 3.04 if they (a) did not take reasonable steps at the outset of therapy to

estimate and communicate to patients and their insurance company the number of sessions

anticipated, (b) did not familiarize themselves with the insurers’ policy, (c) recognized a need

for continuing treatment but did not communicate with insurers in an adequate or timely

fashion, or (d) were unprepared to handle client/patient response to termination of services.

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Chapter 6 Standards on Human Relations——99

Often, violation of Standard 3.04 will occur in connection with the violation of

other standards in this code that detail the actions required to perform psychological

activities in an ethically responsible manner. For example:

􀀴 Providing testimony on the poor parenting skills of an individual whom the psychologist

has never personally examined that contributed to that individual’s loss of child

custody (Standard 9.01b, Bases for Assessments)

􀀴 Engaging in a sexual relationship with a current therapy client/patient that was a

factor leading to the breakup of the client’s/patient’s marriage (Standard 10.05,

Sexual Intimacies With Current Therapy Clients/Patients)

􀀴 Asking students to relate their personal experience in psychotherapy to past and current

theories on mental health treatment when this requirement was not stipulated in

admissions or program materials, causing some students to drop out of the program

(Standard 7.04, Student Disclosure of Personal Information)

􀀴 Deceiving a research participant about procedures that the investigator expected

would cause some physical pain (Standard 8.07b, Deception in Research)

􀀴 Invalidating the life experience of clients from diverse cultural backgrounds by defining

their cultural values or behaviors as deviant or pathological and denying them culturally

appropriate care (D. W. Sue & Sue, 2003; Standard 2.01b, Boundaries of Competence).

Some contexts require more stringent protections against harm. For example,

psychologists working within institutions that use seclusion or physical restraint

techniques to treat violent episodes or other potentially injurious patient behaviors

must ensure that these extreme methods are employed only upon evidence of their

effectiveness, when other treatment alternatives have failed, and when the use of

such techniques is in the best interest of the patient and not for punishment, for

staff convenience or anxiety, or to reduce costs (Jerome, 1998).

􀀴 The director of psychological services for a children’s state psychiatric inpatient ward

approved the employment of time-out procedures to discipline patients who were disruptive

during educational classes. A special room was set up for this purpose. The director

did not, however, set guidelines for how the time-out procedure should be implemented.

For example, he failed to set limits on the length of time a child could be kept in the room

and not require staff monitoring, did not ensure the room was protected against fire

hazard, and did not develop policies that would permit patients to leave the room for

appropriate reasons. The director was appalled to learn that staff had not monitored

a 7-year-old who was kept in the room for over an hour and was discovered crying and

self-soiled (see, e.g., Dickens v. Johnson County Board of Education, 1987; Goss v. Lopez,

1975; Hayes v. Unified School District, 1989; Yell, 1994).

Psychotherapy and Counseling Harms

Psychologists should also be aware of psychotherapies or counseling techniques

that may cause harm (Barlow, 2010). If psychological interventions are powerful

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100——PART II ENFORCEABLE STANDARDS

enough to improve mental health, it follows that they can be equally effective in worsening

it. In the normative practice of mental health treatment, the diversity of patient/

client mental health needs and the fluid nature of differential diagnosis will mean that

some therapeutic approaches will fail to help alleviate a mental health problem. In such

circumstances, psychologists will turn to other techniques, seek consultation, or offer

an appropriate referral. In other circumstances, negative symptoms are expected to

increase then subside during the natural course of evidence-based treatment (e.g.,

exposure therapy). When treating naturally deteriorating conditions (e.g., Alzheimer’s

disease), a worsening of symptoms does not necessarily indicate treatment harms

(Dimidjian & Hollon, 2010). By contrast, harmful psychotherapies are defined as those

that produce outcomes worse than what would have occurred without treatment

(Dimidjian & Hollon, 2010; Lilienfeld, 2007). Such harmful effects are easiest to detect

for mental health problems whose natural course is constant. In all these circumstances,

failure to terminate treatment when it becomes clear that continuation would

be harmful is a violation of Standard 3.04 and Standard 10.10a, Terminating Therapy.

Need to Know: How to Detect Harm

in Psychotherapy and Counseling

Psychologists should be aware of the evolving body of knowledge on potential contributors

to the harmful effects of psychotherapy and keep in mind the following suggestions

drawn from Beutler, Blatt, Alimohamed, Levy, and Angtuaco (2006), Castonguay, Boswell,

Constantino, Goldfried, and Hill (2010), and Lilienfeld (2007):

Obtain training in and keep up to date on the flexible use of interventions and

treatment alternatives to avoid premature use of clinical interpretations, rigid theoretical

frameworks, and singular treatment modalities.

Be familiar with the degree to which each client/patient and treatment setting match

those reported for a specific EBP and look for multiple knowledge sources as support

for different approaches (readers may also want to refer to the Need to Know section

on “Navigating the Online Search for Evidence-Based Practices” in Chapter 5).

Monitor change suggesting client/patient deterioration or lack of improvement;

continuously evaluate what works and what interferes with positive change.

Attend to treatment-relevant characteristics such as culture, sexual orientation,

religious beliefs, and disabilities and be aware of the possibility of over- or underdiagnosing

these clients’/patients’ mental health needs.

Carefully attend to client’s/patient’s disclosures of frustration with treatment and

use the information self-critically to evaluate the need to modify diagnosis, adjust

treatment strategy, or strengthen relational factors that may be jeopardizing the

therapeutic alliance.

Equipoise and Randomized Clinical Trials

Important questions of treatment efficacy and effectiveness driving the conduct

of randomized clinical trials (RCTs) for mental health treatments raise, by their very

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Chapter 6 Standards on Human Relations——101

nature, the possibility that some participants will fail to respond to experimental

treatment conditions or experience a decline in mental health during the trial. To

comply with Standard 3.04, research psychologists should develop procedures to

identify and address such possibilities. Such steps can include (a) scientifically and

clinically informed inclusion and exclusion criteria for patient participation, (b) the

establishment of a data safety monitoring board to evaluate unanticipated risks that

may emerge during a clinical trial, and (c) prior to the initiation of the research,

establishing criteria based on anticipated risks for when a trial should be stopped to

protect the welfare of participants. For additional information on guidance from the

Office of Human Research Protections, readers can refer to http://www.hhs.gov/

ohrp/policy/advevntguid.html.

􀀵 There is professional and scientific disagreement over the risks and benefits of

prescribing methylphenidate (e.g., brand name Ritalin) for treatment of attentiondeficit/

hyperactivity disorder (ADHD) in children less than 6 years of age. An interdisciplinary

team of behavioral and prescribing psychologists sought to empirically

test the advantage of adding psychopharmaceutical treatment to CBT for 3- to

5-year-old children previously diagnosed with ADHD. To avoid unnecessarily exposing

children to the potential side effects of medication, the team decided that preschoolers

would first participate in a multi-week parent training and behavioral

treatment program and that only those children whose symptoms did not significantly

improve with the behavioral intervention would continue on to the medication

clinical trial.

3.05 Multiple Relationships

(a) A multiple relationship occurs when a psychologist is in a professional role with a person and

(1) at the same time is in another role with the same person, (2) at the same time is in a relationship

with a person closely associated with or related to the person with whom the psychologist

has the professional relationship, or (3) promises to enter into another relationship in the future

with the person or a person closely associated with or related to the person. A psychologist

refrains from entering into a multiple relationship if the multiple relationship could reasonably be

expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his

or her functions as a psychologist, or otherwise risks exploitation or harm to the person with

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