Ethics for Psychologists: The Importance of Informed Consent for Psychological Services

By Julie Van Heyningen, Psy.D.
September 25, 2017



Informed Consent Psychological ServicesQ: I am conducting a psychological evaluation that has been ordered by the court. Since the client has no choice but to participate, do I need to gain informed consent for this service?

 A: Per APA’s Ethical Principles of Psychologists and Code of Conduct, informed consent is required for research and most psychological services (Standard 3.10(a). Gaining informed consent not only insures that the client understands the nature and the process of the services being provided, but also the psychologist’s policies on confidentiality, payment and practice. It is the building block of creating a trusting and collaborative process. In regard to psychological evaluations, gaining informed consent insures that the client understands the evaluation process.

Standard 9.03(a) states:

Psychologists obtain informed consent for assessment, evaluations, or diagnostic services, as described in Standard 3.10, Informed Consent, except when (1) testing is mandated by law or government regulations; (2) informed consent is implied because testing is conducted as a routine educational, institutional, or organizational activity (e.g., when participants voluntarily agree to assessment when applying for a job); or (3) one purpose of the testing is to evaluate decisional capacity. Informed consent includes an explanation of the nature and purpose of the assessment, fees, involvement of third parties, and limits of confidentiality and sufficient opportunity for the clients/patient to ask questions and receive answers.

The first exception, when testing is mandated by law or governmental regulations, would apply to court-ordered evaluations. Because the client is ordered to participate in the evaluation and is not there on a voluntary basis, he or she is not consenting to the evaluation. However, these clients do deserve to be told about the evaluation process.

Standard 3.10(c) addresses this issue:

When psychological services are court ordered or otherwise mandated, psychologists inform the individual of the nature of the services, including whether the services are court ordered or mandated and any limits of confidentiality, before proceeding.

Psychologists would be wise to include the four areas of informed consent, outlined in Standard 9.03(a) above (i.e., explanation of the nature and purpose of the evaluation, fees, involvement of third parties and limits of confidentiality) when providing assessment information to the client. Documentation of this discussion would be prudent.

Often when individuals are court-ordered to be evaluated by a psychologist, they do not know the difference between a therapist and evaluator and this should be explained as well. It is especially important to cover the limits of confidentiality given that the evaluation is court-ordered.

The client should explicitly be informed: that information they share and the results of testing, could be included in a report; that the report will be sent to the court and the attorneys, and that these entities may share it with others. Further, the evaluator may be called upon to testify in court about this information.

Finally, in regard to confidentiality, court-ordered clients should also be informed of who will be notified should the client elect to not participate in the evaluation.

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Julie Van Heyningen, Psy.D., is chair of the Colorado Psychological Association’s ethics committee. She is a licensed psychologist with the Colorado Family Center, P.L.L.C., which provides a broad range of services to children, adolescents, couples and families. She may be reached by email at: jvanh@coloradofamilycenter.net

 

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