“I had ethical momentum, but I was unable to sustain it.”

1. “I had ethical momentum, but I was unable to sustain it.”

2. Ethics for the 21st Century Fred Provenzano, Ph.D., NCSP Private Practice Teaching Associate, University of Washington

3. Ethics v. Morals • Morals: • Universal • Fundamental • Ethics: • Specific to a profession • Make sense within a system

4. Bankers have different ethics.

5. Purpose of Ethical Codes • Protect those who receive services and the broader public • Sensitize professionals about their impact on and responsibility to their clients • Educate professionals about appropriate and acceptable conduct • Provide standards for resolution of complaints of ethical misconduct.

6. Ethics as Evolving • Changing to meet new situations • Adjusting to changing cultural values • Susceptible to “drift” • Value of professional affiliation

9. NASP Ethics: 2010 Revision • Based in evolution in ethical thinking • Originated with revision of Canadian Psychological Association’s Ethics Code

10. NASP Ethics: 2010 Revision • Based on a set of broad values • 4 broad Ethical Themes • 17 Ethical Principles • More elegant, less redundant than former system

11. NASP Ethics: 2010 Revision • Coordinated with other NASP Standards: • Standards for Graduate Preparation of School Psychologists • Standards for the Credentialing of School Psychologists • Model for Comprehensive and Integrated School Psychological Services (formerly Guidelines)

12. NASP Ethics: 2010 Revision • More specific emphasis on ethics in school-based services • Acknowledges the Code does not address all situations; requires individual professional judgment

13. Four Aspirational Ethical Themes • Respecting the Dignity and Rights of All Persons • Professional Competence and Responsibility • Honesty and Integrity in Professional Relationships • Responsibility to Schools, Families, Communities, the Profession, & Society

14. Theme I: Respecting Dignity & Rights of All Persons I.1. Autonomy and Self-Determination - Consent and Assent I.2 Privacy and Confidentiality I.3 Fairness and Justice

15. Theme I: Case Discussion • You’re running a 5th grade social skills group. • Gained prior informed consent from parents and from each student • Students committed to 12-week program • Prior to Week 6, student wants to drop • You tell him we’ll have to discuss with parents whether he can drop out.

16. Theme II: Professional Competence & Responsibility II.1. Competence II.2. Accepting Responsibility for Actions II.3. Responsible Assessment and Intervention Practices II.4. Responsible School-Based Record Keeping II.5. Responsible Use of Materials

17. Theme II: Case Discussion • My district shreds test protocols after the report has been written. Isn’t my report, with scores cited in it, sufficient? Once it is signed, it becomes the official record and makes the protocols superfluous, doesn’t it?

18. Theme III:Honesty & Integrity in Professional Relationships III.1. Accurate Presentation of Professional Qualifications III.2. Forthright Explanation of Professional Services, Roles, & Priorities III.3. Respecting Other Professionals III.4. Multiple Relationships and Conflicts of Interest

19. Theme III: Case Discussion • You’re a State & NCSP-certified specialist-level school psych w/ district & in private practice as a certified Mental Health Counselor. Can you use “NCSP” designation on your private practice business cards?

20. Theme IV: Responsibility to Schools, Families, Communities, the Profession, and Society IV.1. Promoting Healthy School, Family, and Community Environments IV.2. Respect for Law and Relationship of Law and Ethics IV.3. Maintaining Public Trust by Self- Monitoring & Peer Monitoring

21. Theme IV: Responsibility to Schools, Families, Communities, the Profession, and Society, cont’d. IV.4. Contributing to the Profession by Mentoring, Teaching, and Supervision IV.5. Contributing to the School Psychology Knowledge Base

22. Theme IV: Case Discussion • Some students at your high school want to hold a recognition support rally during lunch on the Friday before the local Gay Pride Parade the following day. Some other students are mocking the organizers, and the principal has banned the rally. Do you have a responsibility in this situation?

23. Theme IV: Case Discussion • One of the popular 4th grade teachers is rumored to be a little too friendly with his female students. You enter his room to see one of his students sitting on his lap. • You report this to the principal, but nothing seems to happen. You consult with the district’s legal counsel, who says you’ve done the right thing and says to let the principal handle the matter.

24. 21st Century Issue:FERPA v. HIPAA • Access to records: • FERPA: Access to personally identifiable student educational records by: • parent & adult student • Others in school with “legitimate educational interests” • HIPAA: released to specified individuals with permission

25. FERPA v. HIPAA v. NASP Ethics • NASP ethics recognize FERPA but respect HIPAA: share only on “need to know” basis • Share sensitive information “when necessary in order to benefit the student” (Schwab & Gelfman, 2005)

26. HIPAA v. FERPA: Case Discussion • You’re evaluating a student with severe self-control and anger problems that result in violent behavior. He is seeing a psychiatrist. You gain the parents’ permission to receive the psychiatric records, but the psychiatrist refuses to send them unless you can guarantee that no one else at the school will be allowed to see them. What do you do?

27. 21st Century Issue:Online Transmissions • HIPAA v. FERPA • Security related to • Confidentiality • Electronic Signature • Tamper-resistance

28. 21st Century Issue:Online Communication • Benefits & Risks of: • E-mail • Facebook • Websites • Twitter • Texting

29. 21st Century Issue:Report Software • Issues with Report/IEP Writing Software: • Limiting access • Confusing formats/scales for score reporting • Protecting from data tampering • Unchangeable elements of reporting • Discouraging original thought

30. 21st Century Issue:IDEA v. DSM-IV • Different nomenclatures for different situations • When is a DSM-IV diagnosis required in a school-based situation? • Are school psychologists qualified to determine DSM-IV diagnoses?

31. Old Issue with New Twist:Storage & Destruction of Records • What constitutes identifiable information? • What constitutes personal records? • What needs to be kept? • Do I need to save test protocols?

32. Storage & Destruction of Records, continued • Where/how are they stored? • How long do records need to be kept? • How should records be destroyed? • Do I need to designate a records custodian?

33. Old Issue with New Twist:Outdated Test Materials • When is a test out of date? • Can I sell tests, new or old? • What to do with protocols? • How to destroy old tests?

34. Selling Tests: Case Discussion • A colleague is offering some old versions of tests for sale online. She says she has some interested buyers in Belgium. You suspect that she may have stolen them from district storage. Do you report it to NASP Ethics Committee, and is there anything they can do about it?

35. Evolving Old Issue:Duality of Relationships • It’s a small world, after all! • Awareness of the critical issues in multiple relationships: • Confidentiality • impact on integrity of services • Confusion about expectations • quid pro quo

36. APA & MLA:A Cautionary Tale • Nothing in this act shall be construed to prevent (cite relevant state education authority or statutory provisions) from credentialing individuals to provide school psychological services in those settings that are under the purview of the state educational agency. Such individuals shall be restricted in their practice and the use of the title so conferred, which must include the word “school”, to employment within those settings. (APA Model Licensure Act, adopted 2/20/2010)

37. Issues with MLA • “This provision is not intended to restrict the activities of licensed psychologists.” (MLA) • Opening schools to psychologists not specialized in school practice? • Advisory only: states are not bound to accept as written • A Tale of Trouble in Texas

38. Use of Title: School Psychologist • NASP Position Statement: Necessary Use of the Title “School Psychologist” • Supports use of title for specialist- and doctoral level school psychologists • Chronicles historical precedent, NASP Policy, state & federal mandates, and graduate education standards

39. Necessary Use of the Title “School Psychologist” • Defines “Specialist-level” • “defined as 60 graduate semester hours of the equivalent in school psychology, resulting in institutional documentation of various types. The following are examples of specialist-level documentation: 60+ Master’s degree; Master’s degree plus Certificate of Advanced Study totaling 60 hours (e.g. CAS, CAGS); or an Educational Specialist (EdS) degree of Psychology Specialist (PsyS) degree.” (Footnote 1)

41. References American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073. Available at www.apa.org/ethics/code. American Psychological Association (2007). Record keeping guidelines. American Psychologist, 62, 993-1004. Available at www.apa.org. Canadian Psychological Association (2000). Canadian code of ethics for psychologists 3rd ed.). Available at http://www.cpa.ca.

42. References, continued Family Educational Rights and Privacy Act of 1974, 20 U.S.C.A. Regulations appear at 34 C.F.R. Part 99. Available at http://ecfr.gpoaccess.gov. Jacob, S. & Hartshorne, T. (2007). Ethics and law for school psychologists, 5th ed. Hoboken, NJ: John Wiley & Sons. National Association of School Psychologists. (rev. 2010). Principles for professional ethics. Available at www.nasponline.org.

43. References, continued Schwab, N.C. & Gelfman, M.H. (2005). Legal issues in in school health services: A resource for school administrators, school attorneys, school nurses. New York: Authors Choice Press. U.S. Dept. of Health & Human Services and U.S. Dept. of Education (November 2008). Joint guidance on the application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to student health records. Available at http://www.ed.gov/policy/gen/guid/fpco/doc/ferpa-hipaa-guidance.pdf.

44. Contact Information • Presenter: Fred Provenzano, Ph.D., NCSP 5506 33rd Ave. NE, Suite D Seattle, WA 98105 Office: 206/361-2343 e-mail: fredipro@comcast.net • Dr. Provenzano is the NASP Ethics Committee Western regional representative.