during most of which there had been no formal code of ethics, was published in the American Psychologist (“Cases and Inquiries,” 1954). During this period, the ethical principles most frequently violated were:
Invalid presentation of professional qualifications (cited 44 times).
Immature and inconsiderate professional relations (cited 23 times).
Unprofessional advertisement or announcement (cited 22 times).
Unwarranted claims for tests or service offered usually by mail (cited 22 times).
Irresponsible public communication (cited 6 times).
The Empirical Approach to a Code Half a Century Later
APA pioneers provided an array of reasons to use an empirical approach to create the code of ethics for psychologists. But a critical incident survey of APA members could also serve other purposes. For instance, the actuarial data of ethics committees, licensing boards, and civil and criminal courts can reveal trends in ethical or legal violations as established by review agencies, empirical critical incident studies. They can also reveal ethical dilemmas and concerns that are encountered in day-to-day practice by a diverse range of psychologists and not just those who are subject to formal complaint.
The APA critical incident study undertaken in the 1940s was replicated in the 1990s and published in the American Psychologist (Pope & Vetter, 1992). In this study, 1,319 randomly sampled APA members were asked to describe incidents that they found ethically challenging or troubling. Table 3.1 describes 703 incidents in 23 categories provided by 679 psychologists.
Table 3.1. Ethical Problems Reported by a National Sample of APA Members.
| Category | Number | Percentage |
|---|---|---|
| Confidentiality | 128 | 18 |
| Blurred, dual, or conflictual relationships | 116 | 17 |
| Payment sources, plans, settings, and methods | 97 | 14 |
| Academic settings, teaching dilemmas, and concerns about training | 57 | 8 |
| Forensic psychology | 35 | 5 |
| Research | 29 | 4 |
| Conduct of colleagues | 29 | 4 |
| Sexual issues | 28 | 4 |
| Assessment | 25 | 4 |
| Questionable or harmful interventions | 20 | 3 |
| Competence | 20 | 3 |
| Ethics and related codes and committees | 17 | 2 |
| School psychology | 15 | 2 |
| Publishing | 14 | 2 |
| Helping the financially stricken | 13 | 2 |
| Supervision | 13 | 2 |
| Advertising and (mis)representation | 13 | 2 |
| Industrial-organizational psychology | 9 | 1 |
| Medical issues | 5 | 1 |
| Termination | 5 | 1 |
| Ethnicity | 4 | 1 |
| Treatment records | 4 | 1 |
| Miscellaneous | 7 | 1 |
| Source: Adapted with permission from “Ethical Dilemmas Encountered by Members of the American Psychological Association: A National Survey,” by K. S. Pope and V. A. Vetter, 1992, American Psychologist, 47, 397–411, p. 399. Available at http://kspope.com. Copyright 1992 by the American Psychological Association. | ||
Here is a sample of the ethical concerns that the psychologists described in this anonymous survey:
Confidentiality
“The executive director of the mental health clinic with which I’m employed used his position to obtain and review clinical patient files of clients who were members of his church. He was [clerical title] in a … church and indicated his knowledge of this clinical (confidential) information would be of help to him in his role as [clerical title].”
“Having a psychologist as a client who tells me she has committed an ethical violation and because of confidentiality I can’t report it.”
“One of my clients claimed she was raped; the police did not believe her and refused to follow up (because of her mental history). Another of my clients described how he raped a woman (the same woman).”
Blurred, Dual, or Conflictual Relationships
“I live and maintain a … private practice in a rural area. I am also a member of a spiritual community based here. There are very few other therapists in the immediate vicinity who work with transformational, holistic, and feminist principles in the context of good clinical training that ‘conventional’ people can also feel confidence in. Clients often come to me because they know me already, because they are not satisfied with the other services available, or because they want to work with someone who understands their spiritual practice and can incorporate its principles and practices into the process of transformation, healing, and change. The stricture against dual relationships helps me to maintain a high degree of sensitivity to the ethics (and potentials for abuse or confusion) of such situations but doesn’t give me any help in working with the actual circumstances
