AP Syllabus focus:
‘Clinical psychologists must follow APA ethical principles, including nonmaleficence, fidelity, integrity, and respect for people's rights and dignity.’
Ethics in psychological treatment protects clients from harm and supports effective care. AP Psychology emphasizes core APA principles and how they guide real clinical decisions about consent, confidentiality, boundaries, and professional responsibility.
Core APA Ethical Principles in Treatment
Nonmaleficence (do no harm)
Clinical decisions should minimize risk and prevent foreseeable injury, including psychological harm.
Nonmaleficence: The ethical duty to avoid causing harm and to reduce potential harm when it cannot be fully avoided.
In practice, nonmaleficence means:
Using evidence-based interventions appropriate to the client’s needs
Monitoring for worsening symptoms (e.g., suicidality) and adjusting care
Avoiding techniques outside one’s competence or training
Considering side effects of any recommended adjunct services (e.g., referrals)
Fidelity (trust and responsibility)
Fidelity involves keeping commitments, maintaining professional boundaries, and acting in the client’s best interests. It supports a strong therapeutic alliance by ensuring the psychologist is reliable, careful with time and fees, and consistent about roles.
Integrity (honesty and accuracy)
Integrity requires truthfulness in professional relationships:
Accurate representation of credentials, training, and services
Clear, non-deceptive explanations of treatment options and limits
Honest documentation and communication with other providers (with permission)
Avoiding conflicts between what is promised and what is delivered
Respect for rights and dignity
This principle prioritizes client autonomy, privacy, and worth, including attention to culture, identity, and values. Respect is shown by:
Obtaining meaningful informed consent
Protecting confidentiality and explaining its limits
Using respectful, non-stigmatizing language and collaboratively setting goals
Informed Consent and Client Autonomy
In treatment, informed consent is an ongoing process, not a single form.
Psychologists should ensure clients understand:
The nature and goals of therapy, expected time commitment, and likely benefits/risks
Fees, cancellation policies, and how records are handled
Alternatives (including no treatment) and the right to withdraw
Limits of confidentiality (e.g., safety-related exceptions)
Consent must be developmentally and linguistically appropriate (e.g., simpler explanations for adolescents or clients with limited health literacy).
Confidentiality, Privacy, and Required Disclosures
Confidentiality supports fidelity and respect, but it is not absolute. Ethical practice includes:
Explaining what information is kept private and with whom it may be shared
Using secure communication and storage for records
Sharing the minimum necessary information when coordinating care (typically with written permission)
Commonly recognized exceptions include:
Imminent risk of serious harm to self or others (duty to protect/warn procedures vary by jurisdiction)
Suspected abuse or neglect when mandatory reporting applies
Court orders/subpoenas (handled carefully, often with legal consultation)
Professional Boundaries and Multiple Relationships
Ethical treatment requires clear boundaries to prevent exploitation or impaired judgment.
Avoid dual relationships that could bias care (e.g., treating close friends, business partners)
Avoid sexual relationships with current clients; these are prohibited in professional ethics codes
Manage gifts, self-disclosure, and contact outside sessions in ways that prioritize the client’s welfare
Competence, Scope of Practice, and Referrals
Competent care means working within one’s education, training, and supervised experience.
Seek consultation or supervision when cases exceed expertise
Use appropriate referrals (e.g., higher level of care, specialised services)
Practice cultural humility: recognise how culture and context shape symptom expression and help-seeking, and adjust treatment accordingly
Documentation and Professional Responsibility
Ethical practice includes accurate records that support continuity of care and accountability:
Document consent, treatment plans, progress, and risk assessments
Keep records secure and only as long as required by law/standards
Maintain professional behaviour that reduces harm, supports trust, and reflects integrity
FAQ
They consider power imbalance, client vulnerability, intent, timing, and likely impact on treatment.
Would it create obligation, dependence, or altered expectations?
Could it be perceived as favouritism or coercion?
Is there a safer alternative (e.g., thanking without accepting)?
Teletherapy adds risks around privacy and security.
Common issues include verifying client location for emergencies, using encrypted platforms, preventing interruptions, and clarifying whether sessions may be recorded.
They balance legal guardian permissions with the young person’s developing autonomy.
Ethically, they explain what will and will not be shared with caregivers, aim to build trust, and only break confidentiality when required for safety or by law.
They avoid imposing values, seek consultation, and ensure competent, respectful care.
If the conflict risks harming treatment, an ethical referral with appropriate continuity of care may be needed.
Processes vary, but often involve documentation review, consultation, and investigation by an employer, licensing board, or professional body.
Possible outcomes include mandated training, supervision, practice limits, or disciplinary action.
Practice Questions
Outline two APA ethical principles that should guide clinical psychologists during treatment. (2 marks)
1 mark for correctly identifying an APA principle (e.g., nonmaleficence, fidelity, integrity, respect for rights and dignity)
1 mark for a second correct principle
Explain how ethical principles guide a psychologist’s actions when a client discloses thoughts of harming someone else. Refer to confidentiality and at least two APA ethical principles. (6 marks)
1 mark: explains confidentiality is expected but has limits
1 mark: links nonmaleficence to preventing harm (risk assessment/safety steps)
1 mark: links respect for rights and dignity to careful handling of client autonomy/privacy
1 mark: links fidelity or integrity to clear, honest communication about limits of confidentiality
1 mark: describes appropriate action (e.g., consult/supervision, safety planning, contacting relevant services as required)
1 mark: indicates minimum necessary disclosure and documentation consistent with professional standards
