Ethics in clinical psychology is like that time when you wanted to use transparent cellophane tape for whichever reasons-to wrap a present, to reassemble the paper ringgit you tore into pieces during your last couple spat, or to seal the many containers of Chinese New Year cookies. It’s just so darn useful precisely because it is transparent. Now, the part I hate is where inconsiderate users of cellophane tape haphazardly paste the ends of the tape back to the roll and consider their job done. (hellooo…would it hurt to fold the edges back so the next user can pick it up from there? Yes I’m talking to you right there)
Picture yourself, sticking out your tongue and grunting from the effort of peeling back the ends of the tape. The spot you just spent the best part of a minute scraping turned out to be a fluke, because that was just the line signaling the end of the roll through the transparent layers. Frustrated, you move the ridges of your fingers along the roll (twice) until you are confident that it is the correct end of the tape. Yesssss, yesyesyesyesyes it’s unraveling slowly. Triumphantly you tear out a slice of tape to realize…. that you tore it in half.
That, my friends, is ethics. It is inflexible, awkward, frustrating, barely observable from others, difficult to navigate but oh-so-necessary despite the deep desire to “just wing it” (infamously characterized by Ronald Weasley). Which is how you end up with half of the tape still stuck to the roll and one tapering end between your fingers. Let us dig into what clinical psychologists think of ethics, shall we?
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Who governs what?
Locally, we have the Mental Health Act 2001, the Allied Health Professionals Act 2016, Counsellors Act, the MSCP Ethical Code (heavily based on the APA ethical codes) that you should definitely be aware of in the profession. Now, as to which one of these applies specifically to clinical psychologists…I’ll let you look into that yourself. The point is that ethical codes are separate from criminal law by its enforcing authorities. That means, if you commit murder the police will come and getcha; if you amplify your credentials as a clinical psychologist, effectively engaging in a form of fraud, who gets who remains to be observed…at least in Malaysia. Ethics in clinical psychology is at such a state at the current moment, although I hear that it may change soon?
As a non-western country, we remain to have issues with the enforcement of professional acts that is yet to be implemented despite its draft some years earlier. Before you get yourself into a huff, this article is not meant to discuss all that (see how I saved myself from riffraff?), but rather a tantalizing entrée as to how ethics is practiced amongst clinical psychologists trained in Malaysia.
The test
A questionnaire of ten ethical dilemmas were posed to clinical psychologists trained and educated in Malaysia. I’ll put up responses to selected no-brainer ethical situations and a couple of the trickier ones. Now of course I’m well aware that in a research study all the questions have to be discussed, how the questions are correlated alongside the demographics of respondent clinical psychologists…but this is not a research paper. (Wide grin)
Summary line: We (included y’all there!) want to conjure a better (albeit vague) understanding of how ethics is playing out in the real world (or, the real Malaysia).
The responses
13 practicing clinical psychologists and one trainee kindly responded. Permission granted to dwell upon its influence onto the responses. (To the trainee: I am sorry if I am savage in the latter parts, but the questionnaire was meant for practicing clinical psychologists)
Without further ado, let’s get into it shall we?
When seeing a client with suicidal ideation, I have been trained (attended training) on suicide prevention skills.
13: Yes, 1: No.
Okay this was one of the no-brainer questions; please please please get yourself trained on suicide prevention before seeing any client. Let’s play nice and assume that the trainee was the lone ranger who had yet to complete his or her training…
I attend training sessions equivalent to 12 CPD points and above each year.
8: Yes, 6: No.
Now there is no explicit or implicit statement anywhere (other than by word of mouth from another clinical psychologist) that a certain number of CPD points are expected per year in Malaysia. Would you be worried if there was almost a half chance that the clinician you’re seeing is not quite interested in keeping up with professional development?
I can share the name of my patient with consulting psychologists in a team.
12: No, 2: Yes.
Another no-brainer. Always ensure that even the consulting team are not privy to any identifying information of your client. YOU are responsible for your clients’ anonymity. Two respondents said yes; it’s the trainee! Or not…he or she is not alone there you see.
I have an external supervisor (not within the same organization) who oversees my work.
8: No, 6: Yes.
This is a real ethical dilemma as the general perception seems to be that having anyone who oversees your work is good enough, let alone an external supervisor to be hired by yourself or your organization. Most in the psychology field may not even have adequate internal supervision in the first place. As to why having an external supervision is crucial, let’s sum it down to the segregation between professional competency (internal supervision) and personal competency (external supervision). None can quite make up for the other.
The Personal Data Protection Act (PDPA) constitutes a passport picture (without name or NRIC) as personal data to be protected.
11: Yes, 3: No.
Not everyone seems to be aware that even a picture counts as identifying information. Let’s leave it as that. (It’s the trainee! Okay I’ll stop I’ll stop)
I have taken annual leave for matters related to personal conflict at home.
7: Yes, 7: No.
Now this was an interesting one. I drafted the question based on one of the APA and MSCP ethical codes (2.06 Personal Problems and Conflicts; Yes I can put up the codes but where is the fun of looking it up yourself?). As you can see from the results it is split across the middle; I sense that personal conflicts are defined differently, like “My wife slapped me this morning but other than the red handprint across my face I feel complete indifference” or, “My nail broke and I am utterly unable to function today” …who knows? Hence, comment received- “I thought the last question on annual leave for personal conflict at home is a personal issue and I can’t see how it can be scored. One may have personal conflicts at home yet not to the extent of taking leave.”
We want more!
Stop it stop flattering me…nahhh you guys just spoil me too much…alright I have to comply feel-free-to-comment-or-get-in-touch-if-you-want-the-responses-to-the-list-of-ten-questions-HAH! (Also, bear in mind that you’ll only get the bare responses with all respondents’ anonymity retained)
Toodles!
*MSCP: Malaysian Society of Clinical Psychology; APA: American Psychological Association; CPD: Continuing Professional Development; PDPA: Personal Data Protection Act; HAH: me snorting.