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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5739
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have a series of opinion questions that I would like to be

Resolved Question:

I have a series of opinion questions that I would like to be answered by a practicing psychologist. Fundamentally these are ethics questions.

1. Do you believe that it should be required for psychologists to undergo regular therapy in order to prevent issues of burn-out, and in order to maintain the ethical requirement of competence and prevent impairment in the practice of psychology?

2. Do you believe that if consumers of psychological services demand treatment via the internet, psychologists have an ethical requirement to provide this service, and therefore, should current licensing requirements that allow practitioners to practice only in states where they hold licensure be loosened?

3. Do you believe that psychologists have an ethical obligation to provide only evidence based treatments in practice?

4. Do you believe that psychologists have an ethical obligation to undergo routine skills assessment in order to maintain the ethical standards of competence in the field of psychology?

5. Do you believe that it is an ethical duty of psychologists to do a better job of informing the public of alternative interventions (i.e. non-drug therapy) in the treatment of mental illness in order to minimize the risks associated with psychotropic medications? For instance, via direct-to-consumer marketing.

6. Do you believe that it is ethical to enforce involuntary medication among incarcerated populations?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z :

Hello I believe I can help you with your questions today

Dr. Z :

I am a practicing psychologist, so I believe am best able to answer your questions.

Dr. Z :

1. No, it should not be required for every psychologist to undergo regular therapy because while burn-out is a great concern, many psychologists have outside activities like family, hobbies, and many other stress relieving activities to avoid burnout. By forcing psychologists to go to therapy on a regular basis, you are already accusing them that they will not be able to practice good self-care, and that forcing them into therapy would be the best option. I think this runs counter to professional judgment as most psychologists are aware when they need help and many voluntarily seek therapy on their own. In addition, also forcing therapy may run counter to its intended effect because if a psychologist feels they are forced to go to therapy then they may not be motivated in therapy and thus they will not receive the maximum benefits from therapy.

Dr. Z :

2. No I do not believe that if consumers demand services via the internet that the psychologist is required to provide them ethically. A psychologist is only able to provide services that he/she feels are within their skill set and training, and services via the internet may not be a part of that. This is like saying that I should provide hypnotherapy because a consumer asks for it, when hypnotherapy is not my specialty, nor would I want it to be a part of my practice in the future. And no licensing requirements should not loosened because services over the internet are still not regulated and it is possible to get services from individuals faking their credentials or from individuals facing sanctions in other states.

Dr. Z :

3. Yes, psychologists should only provide evidence based treatments in practice. The patient is relying on the psychologist to be a professional and to use the appropriate treatment based on the evidence that will work for the patient’s particular issues. If the treatment is still new, but promising, then the psychologist has a requirement to inform the patient of this and explain the positives and negatives of attempting this treatment method. Evidence based treatment means that the treatment has gone through extensive studies and has been shown to work for treating particular disorders. If psychologists do not use evidence based treatment, then they have nothing to prove that their treatment works for the patient’s particular disorder and may be sued for malpractice.

Dr. Z :

4. Yes I do believe that psychologists should undergo routine skills assessment in the form of continuing education credits because the field of psychology, like the field of medicine, is constantly evolving and new information is being presented each year. If you have been out of school for 5 years, half of the theories, diagnoses, and treatments may be considered obsolete or have adjusted and this requires routine continuing education classes and research to maintain professional competence.

Dr. Z :

5. I think it is important to provide the public and patients of an objective viewpoint on alternative therapies. I have seen some psychologist flat out say that “I do not believe in the use of psychotropic medication” and I think this is unethical. I think by showing them both sides and weighing the positives and negatives of a medical approach and non-medical approach (e.g. therapy) is what a psychologist should do, so that the patient and public have all the information to make an informed decision. Now for the public you can advocate for therapy and say that it is very effective, but you also have to state the negatives when compared to the medical approach (e.g. therapy typically takes longer than the medicine to see maximum benefits because therapy is a gradual treatment approach). In addition, you can state the positives that therapy is the only way to cure most mental health disorder like depression, anxiety, and personality disorders as opposed to the medical approach, which just lessens the symptoms, but does not get at the root cause. For me I usually do a two-pronged approach for treatment and say that the medicine can provide immediate relief right now, and we use the therapy techniques for a while. Then after a set period of time, the patient can choose to wean off the medicines as the therapy techniques are now more firmly established in their mind.

Dr. Z :

6. As a forensic psychologist, I have worked in a state hospital, jail, and prison where forced medications were administered, but not as routinely as thought. In fact, this is typically a last resort and requires an order from a civil court judge, where the treatment staff presents their case and the patient (inmate) presents their case through the use of an advocate typically. In this instance, I feel it is ethical for involuntary medication of the incarcerated populations because typically they require it as the patient (inmate) are a danger to themselves and others, or are grossly disabled and need the medications to function properly. Medications are not forced on a whim in the incarcerated population and go through careful legal steps and procedures to meet the criteria for forcing such medication. Sometimes the medications are forced for the incarcerated population to restore them to competency in the pursuit of justice, this is a legal matter, but I believe that it is in the best interest of the patient, so it is ethical. If a patient is found not competent to stand trial, then that patient can be help incarcerated at a state hospital for indeterminate amount of time, unless the patient is found to be competent at a later date, the patient spends enough time incarcerated that would equal what he/she would be found guilty of for the charges presented, or the charges are dropped. I think being help and incarcerated for possibly the rest of your life without ever facing trial is unethical and not in the best interest of the patient, but does happen and this is why forced medications are necessary.

Dr. Z :

I think that should answer all the questions that you asked. If you have any questions or concerns with what I wrote, please let me know and I will be sure to get back to you as soon as possible.

Customer:

Thank you very much for quick and thoughtful response to the questions I have posed! You have given me much "food for thought" about my own rather strong opinions on these questions. As a student, it is very helpful to receive input from those who are in practice, and have to deal with these issues in one way or another in real world settings!

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5739
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Dr. Z
Dr. Z
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Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.