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<v Speaker 1>Welcome back to our study guide, and today we're going

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<v Speaker 1>to be talking about consent. Inform consent. So it's a

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<v Speaker 1>topic that looks straightforward into the E triple PETE designs

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<v Speaker 1>to test to you on it. The exam usually doesn't

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<v Speaker 1>go in and simply ask you what is informed consent.

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<v Speaker 1>They may give you a scenario. You may encounter a

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<v Speaker 1>fifteen year old requesting therapy without parental knowledge, a client

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<v Speaker 1>with schizophrenia considering a research study, or a court ordered

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<v Speaker 1>client who doesn't want treatment. Your job is determine what

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<v Speaker 1>the psychologist should do first, what the client must understand,

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<v Speaker 1>and when consent is and is not required. So let's

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<v Speaker 1>start at the beginning. Form consent is a process, not

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<v Speaker 1>merely a signature. A signed piece of paper doesn't automatically

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<v Speaker 1>establish valid informed consent. For consent to be truly informed,

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<v Speaker 1>four major elements are important. Disclosure, comprehension, voluntariness, and its capacity.

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<v Speaker 1>And for clinical practice, you also want good documentation. Let's

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<v Speaker 1>break these down. Disclosure means provide the client with the

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<v Speaker 1>information reasonably necessary to make an informed decision. Imagine you're

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<v Speaker 1>beginning CBT with a patient experiencing panic disorder. It isn't

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<v Speaker 1>enough to say we're going to do therapy. You should

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<v Speaker 1>explain the nature and purpose of treatment. You might explain

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<v Speaker 1>that CBT involves identifying patterns of thinking and behavior. It

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<v Speaker 1>may include exposure to feared bodily sensations. You would discuss

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<v Speaker 1>reasonably foreseeable risks or discomfort. For example, exposure exercises may

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<v Speaker 1>temporarily increase anxiety. You discuss expected benefits, reasonable alternatives, including

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<v Speaker 1>declining treatment when applicable, fees, relevant boundaries, and the limits

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<v Speaker 1>of confidentiality. Disclosure is giving information. Comprehension is understanding. Psychologists

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<v Speaker 1>can disclose everything correctly while still failing to obtain meaningful

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<v Speaker 1>and formed consent if the client doesn't understand you. Comprehension

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<v Speaker 1>means the client's ability to understand the information relative to

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<v Speaker 1>this decision. Suppose you're explaining trauma focused therapy using highly

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<v Speaker 1>technical terminology.

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<v Speaker 2>You tell the patient we utilize.

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<v Speaker 1>Extinction extinction procedures to modify conditioned responses. The patient signs

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<v Speaker 1>the form but really has no idea what the heck

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<v Speaker 1>you said, and that's a problem. Instead, psychologists are communicated

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<v Speaker 1>a level appropriate to the client's age and education. Cognitive

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<v Speaker 1>functioning one useful technique is teach back means asking the

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<v Speaker 1>clients to explain the information in their own words. Can

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<v Speaker 1>you tell me what you understand about what we'll be

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<v Speaker 1>doing and what some of.

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<v Speaker 2>The possible difficulties might be.

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<v Speaker 1>This helps determine whether actual understanding occurred. Max's voluntariness, which

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<v Speaker 1>means making the decision freely without inappropriate coercion or undue pressure.

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<v Speaker 1>Corision involves using threats or forced to influence someone's decision.

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<v Speaker 1>Consider a psychologists conducting research and a correctional facility. Telling

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<v Speaker 1>inmates if you participate, I'll tell the parole ball you're

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<v Speaker 1>to parole board, you're cooperating creates serious concerns about voluntariness.

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<v Speaker 1>Why because there's a significant power imbalance. If power imbalance

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<v Speaker 1>exists when one person possesses substantially more authority or control

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<v Speaker 1>than another, apples can involve prisoners, students, employees, mandated clients,

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<v Speaker 1>hospitalize patients. Whenever the scenario of alves someone an independent

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<v Speaker 1>or subordinate position, think is this decision genuinely voluntary? Nex's

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<v Speaker 1>capacity to consent? Now we reach an extremely important distinction.

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<v Speaker 1>Capacity refers to a person's ability to make a particularly

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<v Speaker 1>informed decision.

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<v Speaker 2>Generally, this involves being able to.

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<v Speaker 1>Understand relevant information, appreciate how it applies to one situation,

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<v Speaker 1>consider alternatives and consequences.

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<v Speaker 2>And communicate a choice.

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<v Speaker 1>Diagnosis is not automatically equal incapacity. Suppose a thirty five

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<v Speaker 1>year old client with schizophrenia has invited into a research study.

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<v Speaker 1>The wrong response is they have schizophrenia, so they cannot consent. Instead,

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<v Speaker 1>assess the capacity to consent. A person can have schizophrenia

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<v Speaker 1>bipolar while retaining sufficient capacity for a particular decision. Capacity

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<v Speaker 1>is also not necessarily all or nothing. A person might

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<v Speaker 1>be capable of consenting to routine outpatients psychotherapy but not

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<v Speaker 1>understand it an unusually complicated, higher risk decision. Consent versus assent.

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<v Speaker 1>This becomes especially important with miners. Consent refers to legally

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<v Speaker 1>valid authorization. Assent means a person who may not have

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<v Speaker 1>legal authority to provide full consent nevertheless affirmatively agrees to

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<v Speaker 1>participate in a developmentally appropriate way. For many minders, a

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<v Speaker 1>parent a legal guardian provides cut sense while the child

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<v Speaker 1>provides assent. Imagine you're treating a ten year old for anxiety.

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<v Speaker 1>The pairent may legally consent to treatment, which you still

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<v Speaker 1>explain therapy to the child in language they understand. We're

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<v Speaker 1>going to practice ways of handling scary thoughts and situations.

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<v Speaker 2>Is that okay with you? That's a cent.

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<v Speaker 1>However, laws regarding miners vary by jurisdiction and circumstance. Therefore,

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<v Speaker 1>if an E triple P question asks whether a fifteen

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<v Speaker 1>year old can independently consent to the psychotherapy, be cautious

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<v Speaker 1>about absolute answers. The best response may involve checking applicable

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<v Speaker 1>law determining whether an exception applies. Inform consent for psychological assessment.

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<v Speaker 1>Consent isn't limited to psychotherapy. Before testing, psychologists ordinarily explain

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<v Speaker 1>relevant information such as why testing is being conducted, how

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<v Speaker 1>the results will be used, who may receive the results, fees,

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<v Speaker 1>and relevant confidentiality limits. Here's an important exception. Consent may

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<v Speaker 1>not be required in the usual way when testing is

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<v Speaker 1>mandated by law or governmental regulation. When informed consent is

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<v Speaker 1>implied because testing is conducted as a routine educational, institutional,

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<v Speaker 1>organizational activity, or in certain circumstances evolving evaluation of decision

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<v Speaker 1>making capacity. But don't translate that into no consent means

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<v Speaker 1>no explanation, even when consent isn't required in the ordinary sense,

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<v Speaker 1>psychologists generally provide appropriate information about the nature and purpose

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<v Speaker 1>of the services as early as feasible treatment and informed consent.

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<v Speaker 1>For psychotherapy, psychologists inform clients about the nature and anticipated

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<v Speaker 1>course of therapy, fee involved in a third parties, and

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<v Speaker 1>limits of confidentiality, among others. Suppose you're beginning prolonged exposure

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<v Speaker 1>with someone diagnosed with PTSD. Explain what treatment involves and

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<v Speaker 1>that discussing or confronting trauma related memories and situations may

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<v Speaker 1>temporarily increase to stress. You don't promise this tributable cure

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<v Speaker 1>your PTSD. Instead explained reasonably anticipated benefits and limitations. That's

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<v Speaker 1>another E triple P principle. Informed consent is not a

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<v Speaker 1>guarantee of outcome. Couples in family therapy, couple's therapy creates

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<v Speaker 1>additional ethical complexity at the beginning. Clarify important roles and relationships.

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<v Speaker 1>Who is the client, the couple, one partner of the family,

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<v Speaker 1>What happens to information disclosed individually?

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<v Speaker 2>What happens with the couple divorces.

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<v Speaker 1>Suppose in maury couple interest treatment letter separates one spouse

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<v Speaker 1>demands and psychological records. The psychologists should not automatically hand

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<v Speaker 1>them over. Clarify roles early rather than improvise after a

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<v Speaker 1>conflict develops. Research typically involves additional protections. Participants need information

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<v Speaker 1>about the studies, purpose and procedures, foreseeable risks, potential benefits,

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<v Speaker 1>Confidentiality in setives when applicable. Research also may involve IRB,

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<v Speaker 1>and IRB is a committee that reviews research involving human participants.

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<v Speaker 2>Now consider deception.

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<v Speaker 1>Perception means intentionally withholding or misrepresenting certain information about a study.

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<v Speaker 2>It is an automatically prohibitive. It requires ethical.

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<v Speaker 1>Justification and safeguards, and some types of research deception are permissible.

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<v Speaker 1>Participants generally must be debriefed as early as feasible. Debriefing

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<v Speaker 1>means explaining the true nature and purpose of the research.

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<v Speaker 1>Recording therapy a psychologists obtained permission before recording voices or

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<v Speaker 1>images of people to whom they provide services. You don't

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<v Speaker 1>record first and ask after obtain appropriate permission before releasing

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<v Speaker 1>confidentiality confidential information. Imagine another psychologist calls and says send

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<v Speaker 1>of your patient's therapy records. You don't simply send them

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<v Speaker 1>because another clinician requested them. When authorization is required, it

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<v Speaker 1>should appropriately identify what information can be disclosed and for

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<v Speaker 1>whom and for what The confidentiality isn't absolute confidentiality or

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<v Speaker 1>exceptions are legalized. Legally authorized disclosures may involve circumstances such

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<v Speaker 1>as mandata reporting or valid legal requirements.

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<v Speaker 2>Confidentiality and privilege.

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<v Speaker 1>Confidentiality is primarily the professional and ethical obligation to protect

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<v Speaker 1>client information. Privilege is a legal concept governing whether protect

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<v Speaker 1>the communications may be disclosed in legal proceedings and importantly

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<v Speaker 1>generally belong to the client rather than the psychologist. Involuntary

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<v Speaker 1>and mandata treatment, consider a court order client. The person

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<v Speaker 1>may not have freely chosen to attend therapy. Does a

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<v Speaker 1>form consent disappear. No, The psychologists should explain the nature

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<v Speaker 1>of services, relevant limits on confidentiality and who will receive

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<v Speaker 1>the information. Mandatea participation doesn't eliminate the clients rights. Lastly,

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<v Speaker 1>is the ongoing consent. This is one of the most

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<v Speaker 1>important ideas. Informed consent is ongoing. Suppose you're treated to

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<v Speaker 1>client for six months with supportive therapy. You now recommend

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<v Speaker 1>trauma focused therapy that materially changes treatment.

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<v Speaker 2>Revisit inform consent.

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<v Speaker 1>Perhaps a new third party becomes involved in client's capacity

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<v Speaker 1>changes or treatment moves of telehealth under circumstances introducing new considerations,

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<v Speaker 1>Consent should be revisited. With significant circumstances change new situation

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<v Speaker 1>equals reconsider

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<v Speaker 2>Consent and that's it for now