Speaker 1: Welcome back to our study guide, and today we're going
Speaker 1: to be talking about consent. Inform consent. So it's a
Speaker 1: topic that looks straightforward into the E triple PETE designs
Speaker 1: to test to you on it. The exam usually doesn't
Speaker 1: go in and simply ask you what is informed consent.
Speaker 1: They may give you a scenario. You may encounter a
Speaker 1: fifteen year old requesting therapy without parental knowledge, a client
Speaker 1: with schizophrenia considering a research study, or a court ordered
Speaker 1: client who doesn't want treatment. Your job is determine what
Speaker 1: the psychologist should do first, what the client must understand,
Speaker 1: and when consent is and is not required. So let's
Speaker 1: start at the beginning. Form consent is a process, not
Speaker 1: merely a signature. A signed piece of paper doesn't automatically
Speaker 1: establish valid informed consent. For consent to be truly informed,
Speaker 1: four major elements are important. Disclosure, comprehension, voluntariness, and its capacity.
Speaker 1: And for clinical practice, you also want good documentation. Let's
Speaker 1: break these down. Disclosure means provide the client with the
Speaker 1: information reasonably necessary to make an informed decision. Imagine you're
Speaker 1: beginning CBT with a patient experiencing panic disorder. It isn't
Speaker 1: enough to say we're going to do therapy. You should
Speaker 1: explain the nature and purpose of treatment. You might explain
Speaker 1: that CBT involves identifying patterns of thinking and behavior. It
Speaker 1: may include exposure to feared bodily sensations. You would discuss
Speaker 1: reasonably foreseeable risks or discomfort. For example, exposure exercises may
Speaker 1: temporarily increase anxiety. You discuss expected benefits, reasonable alternatives, including
Speaker 1: declining treatment when applicable, fees, relevant boundaries, and the limits
Speaker 1: of confidentiality. Disclosure is giving information. Comprehension is understanding. Psychologists
Speaker 1: can disclose everything correctly while still failing to obtain meaningful
Speaker 1: and formed consent if the client doesn't understand you. Comprehension
Speaker 1: means the client's ability to understand the information relative to
Speaker 1: this decision. Suppose you're explaining trauma focused therapy using highly
Speaker 1: technical terminology.
Speaker 2: You tell the patient we utilize.
Speaker 1: Extinction extinction procedures to modify conditioned responses. The patient signs
Speaker 1: the form but really has no idea what the heck
Speaker 1: you said, and that's a problem. Instead, psychologists are communicated
Speaker 1: a level appropriate to the client's age and education. Cognitive
Speaker 1: functioning one useful technique is teach back means asking the
Speaker 1: clients to explain the information in their own words. Can
Speaker 1: you tell me what you understand about what we'll be
Speaker 1: doing and what some of.
Speaker 2: The possible difficulties might be.
Speaker 1: This helps determine whether actual understanding occurred. Max's voluntariness, which
Speaker 1: means making the decision freely without inappropriate coercion or undue pressure.
Speaker 1: Corision involves using threats or forced to influence someone's decision.
Speaker 1: Consider a psychologists conducting research and a correctional facility. Telling
Speaker 1: inmates if you participate, I'll tell the parole ball you're
Speaker 1: to parole board, you're cooperating creates serious concerns about voluntariness.
Speaker 1: Why because there's a significant power imbalance. If power imbalance
Speaker 1: exists when one person possesses substantially more authority or control
Speaker 1: than another, apples can involve prisoners, students, employees, mandated clients,
Speaker 1: hospitalize patients. Whenever the scenario of alves someone an independent
Speaker 1: or subordinate position, think is this decision genuinely voluntary? Nex's
Speaker 1: capacity to consent? Now we reach an extremely important distinction.
Speaker 1: Capacity refers to a person's ability to make a particularly
Speaker 1: informed decision.
Speaker 2: Generally, this involves being able to.
Speaker 1: Understand relevant information, appreciate how it applies to one situation,
Speaker 1: consider alternatives and consequences.
Speaker 2: And communicate a choice.
Speaker 1: Diagnosis is not automatically equal incapacity. Suppose a thirty five
Speaker 1: year old client with schizophrenia has invited into a research study.
Speaker 1: The wrong response is they have schizophrenia, so they cannot consent. Instead,
Speaker 1: assess the capacity to consent. A person can have schizophrenia
Speaker 1: bipolar while retaining sufficient capacity for a particular decision. Capacity
Speaker 1: is also not necessarily all or nothing. A person might
Speaker 1: be capable of consenting to routine outpatients psychotherapy but not
Speaker 1: understand it an unusually complicated, higher risk decision. Consent versus assent.
Speaker 1: This becomes especially important with miners. Consent refers to legally
Speaker 1: valid authorization. Assent means a person who may not have
Speaker 1: legal authority to provide full consent nevertheless affirmatively agrees to
Speaker 1: participate in a developmentally appropriate way. For many minders, a
Speaker 1: parent a legal guardian provides cut sense while the child
Speaker 1: provides assent. Imagine you're treating a ten year old for anxiety.
Speaker 1: The pairent may legally consent to treatment, which you still
Speaker 1: explain therapy to the child in language they understand. We're
Speaker 1: going to practice ways of handling scary thoughts and situations.
Speaker 2: Is that okay with you? That's a cent.
Speaker 1: However, laws regarding miners vary by jurisdiction and circumstance. Therefore,
Speaker 1: if an E triple P question asks whether a fifteen
Speaker 1: year old can independently consent to the psychotherapy, be cautious
Speaker 1: about absolute answers. The best response may involve checking applicable
Speaker 1: law determining whether an exception applies. Inform consent for psychological assessment.
Speaker 1: Consent isn't limited to psychotherapy. Before testing, psychologists ordinarily explain
Speaker 1: relevant information such as why testing is being conducted, how
Speaker 1: the results will be used, who may receive the results, fees,
Speaker 1: and relevant confidentiality limits. Here's an important exception. Consent may
Speaker 1: not be required in the usual way when testing is
Speaker 1: mandated by law or governmental regulation. When informed consent is
Speaker 1: implied because testing is conducted as a routine educational, institutional,
Speaker 1: organizational activity, or in certain circumstances evolving evaluation of decision
Speaker 1: making capacity. But don't translate that into no consent means
Speaker 1: no explanation, even when consent isn't required in the ordinary sense,
Speaker 1: psychologists generally provide appropriate information about the nature and purpose
Speaker 1: of the services as early as feasible treatment and informed consent.
Speaker 1: For psychotherapy, psychologists inform clients about the nature and anticipated
Speaker 1: course of therapy, fee involved in a third parties, and
Speaker 1: limits of confidentiality, among others. Suppose you're beginning prolonged exposure
Speaker 1: with someone diagnosed with PTSD. Explain what treatment involves and
Speaker 1: that discussing or confronting trauma related memories and situations may
Speaker 1: temporarily increase to stress. You don't promise this tributable cure
Speaker 1: your PTSD. Instead explained reasonably anticipated benefits and limitations. That's
Speaker 1: another E triple P principle. Informed consent is not a
Speaker 1: guarantee of outcome. Couples in family therapy, couple's therapy creates
Speaker 1: additional ethical complexity at the beginning. Clarify important roles and relationships.
Speaker 1: Who is the client, the couple, one partner of the family,
Speaker 1: What happens to information disclosed individually?
Speaker 2: What happens with the couple divorces.
Speaker 1: Suppose in maury couple interest treatment letter separates one spouse
Speaker 1: demands and psychological records. The psychologists should not automatically hand
Speaker 1: them over. Clarify roles early rather than improvise after a
Speaker 1: conflict develops. Research typically involves additional protections. Participants need information
Speaker 1: about the studies, purpose and procedures, foreseeable risks, potential benefits,
Speaker 1: Confidentiality in setives when applicable. Research also may involve IRB,
Speaker 1: and IRB is a committee that reviews research involving human participants.
Speaker 2: Now consider deception.
Speaker 1: Perception means intentionally withholding or misrepresenting certain information about a study.
Speaker 2: It is an automatically prohibitive. It requires ethical.
Speaker 1: Justification and safeguards, and some types of research deception are permissible.
Speaker 1: Participants generally must be debriefed as early as feasible. Debriefing
Speaker 1: means explaining the true nature and purpose of the research.
Speaker 1: Recording therapy a psychologists obtained permission before recording voices or
Speaker 1: images of people to whom they provide services. You don't
Speaker 1: record first and ask after obtain appropriate permission before releasing
Speaker 1: confidentiality confidential information. Imagine another psychologist calls and says send
Speaker 1: of your patient's therapy records. You don't simply send them
Speaker 1: because another clinician requested them. When authorization is required, it
Speaker 1: should appropriately identify what information can be disclosed and for
Speaker 1: whom and for what The confidentiality isn't absolute confidentiality or
Speaker 1: exceptions are legalized. Legally authorized disclosures may involve circumstances such
Speaker 1: as mandata reporting or valid legal requirements.
Speaker 2: Confidentiality and privilege.
Speaker 1: Confidentiality is primarily the professional and ethical obligation to protect
Speaker 1: client information. Privilege is a legal concept governing whether protect
Speaker 1: the communications may be disclosed in legal proceedings and importantly
Speaker 1: generally belong to the client rather than the psychologist. Involuntary
Speaker 1: and mandata treatment, consider a court order client. The person
Speaker 1: may not have freely chosen to attend therapy. Does a
Speaker 1: form consent disappear. No, The psychologists should explain the nature
Speaker 1: of services, relevant limits on confidentiality and who will receive
Speaker 1: the information. Mandatea participation doesn't eliminate the clients rights. Lastly,
Speaker 1: is the ongoing consent. This is one of the most
Speaker 1: important ideas. Informed consent is ongoing. Suppose you're treated to
Speaker 1: client for six months with supportive therapy. You now recommend
Speaker 1: trauma focused therapy that materially changes treatment.
Speaker 2: Revisit inform consent.
Speaker 1: Perhaps a new third party becomes involved in client's capacity
Speaker 1: changes or treatment moves of telehealth under circumstances introducing new considerations,
Speaker 1: Consent should be revisited. With significant circumstances change new situation
Speaker 1: equals reconsider
Speaker 2: Consent and that's it for now