Presentation on theme: "Making Ethical Decisions in Challenging Situations"— Presentation transcript:
1Making Ethical Decisions in Challenging Situations Prepared and Distributed by theEthical and Professional Practices Committeeof the National Association of School Psychologists(Spring, 2008)Kathy McNamara, Ph.D., ChairSusan Jacob, Ph.D., Co-ChairTitle SlideThis presentation package was created by the NASP Ethical and Professional Practices Committee in response to a growing need for accessible training in ethical standards and decision-making.The package is available to state school psychology professional associations as a NASP benefit.It includes the handout materials and discussion activities accompanying this presentation.
2Why is Training Needed?School psychologists’ work with children in schools is especially vulnerable to ethical dilemmas;We serve several populations whose interests may differ from one anotherSchools are government agencies subject to regulation, employment law, etc.Schools’ primary concern is the development of academic skillsSchool psychologists work in an atmosphere in which there are plenty of opportunities for questions about ethical practice to arise:Because we work in schools, we have multiple, sometimes competing, prioritiesCLICKWe serve a number of different populations – administrators, teachers, parents, children, the community (examples: children’s need for services, vs. district’s ability to provide and pay for them; parent’s right to know and give consent for services to children, vs. adolescent’s wish to obtain services without involving/informing parents)Schools are really government agencies subject to regulations, employment and collective bargaining laws, etc., not mental health clinics or private practice settings (therefore, obligations are different, and policies and procedures may not always serve the best interests of children)Schools are primarily concerned with academic skill development (readin’, writin’ and ‘rithmetic), rather than social/emotional development, so “best practice” in areas related to mental health may be treated as less important (especially in current era of “high stakes” testing and accountability)2. Contemporary culture emphasizes the rights of the individual – sort of a “consumer protection” orientation. Society no longer views educators as benign, well-intentioned – but fallible – replacements for parents. So, it is increasingly common for educators to be challenged about their decisions and practices.3. Children, the population with which we are concerned in schools, are particularly vulnerable. They hold very few legal rights; they often can’t, or don’t know how, to speak up for themselves; and they don’t control what happens to them.4. Regulations abound! Whether federal law – Individuals with Disabilities Education Act; Family Educational Rights and Privacy Act; Section 504; or the No Child Left Behind Act – or state administrative rules, or state regulatory and licensure board standards, school psychologists must know and follow requirements established by authorities.
3Most school psychologists don’t feel as if they are fully prepared to handle ethical dilemmas; Ethical issues on the jobAdministrative pressureUnethical conduct by a colleagueVery prepared63%(n = 131)65%(n = 135)38%(n = 79)Somewhat prepared37%(n = 77)30%(n = 63)52%( n = 108)Not at all prepared0%(n = 0)5%( n = 10)10%(n = 20)2. Although a national survey of school psychologists indicates that most of us have received formal training in ethics (Dailor, 2007), many of us don’t feel fully prepared to handle some ethical dilemmas, especially those involving unethical conduct on the part of a colleague or co-workerCLICKOnly 38% of the national sample surveyed feel “very prepared” to respond to unethical conduct by a colleagueThese figures leave plenty of room for uncertainty!(Dailor, 2007)
4Ethical standards may be unclear or ambiguous; For example, what, exactly, does this principle recommend?“School psychologists consider children and other clients to be their primary responsibility, acting as advocates for their rights and welfare” (NASP, IV. A. 1.)Who are “children and other clients?”What are appropriate forms of advocacy?Ethical standards are often difficult to translate or interpret, as pointed out by Jacob and Hartshorne (2007).CLICKHere’s an example.How do you interpret this language? Who are the “other clients” mentioned? What does advocacy look like? Does it include whistle-blowing, despite a recent court decision limiting protection for those who publicize undesirable practices in the workplace? (Supreme Court decision, Garcelli v. Ceballos, 2006)
5Often, situations involve competing ethical principles; “School psychologists understand their obligation to respect the rights of a child to initiate, participate in, or discontinue services voluntarily” (NASP, III. B. 3).vs.“School psychologists respect the wishes of parents who object to school psychological services” (NASP, III. C. 4.)Sometimes, there is an ethical standard that clearly and unambiguously points to the proper course of action.But, as Jacob and Hartshorne (2007) pointed out, often, several standards apply, and these may compete with each other. This creates a “dilemma” that the school psychologist must resolve.CLICKFor example, how should we handle a situation where a student requests services, but a parent doesn’t want services to be provided? One NASP principle states that children have the right to assent* to receiving our services,CLICK … but another states that we should honor a parent’s wish to withhold services.*Note: The term assent refers to the child’s agreement to participate in the proposed service. It is different from consent, which refers to the legal right to agree to participate in services, which is a right held by the parent or guardian.
6Sometimes, ethical principles and legal requirements conflict with one another; Jim Donaldson, the father of a 4th grade student who is being evaluated for a suspected learning disability, has decided to obtain an independent evaluation at his own cost. He called the school and spoke with the secretary, indicating that he would like to come in the following week to pick up a copy of the IQ test protocol used for his son’s evaluation. The secretary relayed this request to the school psychologist.“Right to inspect” doesn’t necessarily require a copy of the record;Courts might likely view the parent’s right of access to supersede the publisher’s copyright, especially if only the face sheet is copied; publishers, not school psychologists, pursue copyright violations.To complicate matters further, there are situations in which following the law would require a violation of ethical standards, or vice versa.CLICKWhat about the debate that surfaces regularly about releasing test protocols to parents? On the one hand, the Family Educational Rights and Privacy Act says that parents have the right to inspect any “educational record” that is used to make decisions about the child, which would seem to include test protocols.On the other hand, ethical principles require us to safeguard the security of tests.What about copyright law? Let’s say we decide to copy protocols, but only send them, with parent consent, to a qualified professional conducting an independent evaluation. This would be consistent with our ethical obligation to cooperate with other professionals providing services to children. But, aren’t we violating copyright law, even if we send just the cover page?We don’t want to leave you hanging: It turns out that, in most states, the “right to inspect” records doesn’t include the right to have a copy of them, unless you haven’t made the record available within 45 days after the parent made the request, or if having a copy is necessary for the parent to truly “inspect” the record, as in the case of a parent who can’t read and needs a copy so that she can take the record to someone who can translate it for her. Also, at least one federal court has ruled that providing a copy of a child’s answers on his or her test protocol to parents is not a violation of federal copyright law, since it represents “fair use” of the copyrighted material (Newport-Mesa Unified School District v. State of California Department of Education, 2005). This court recommended that parents be asked to sign a non-disclosure statement prior to giving parents a copy of a protocol.
7And ...The NSPCB requires ethics training for renewal of the NCSP credential (effective January, 2009); some state regulatory boards also require ethics training.Your state credentialing authorities (Department of Education; Board of Psychology) may require ethics training, as well.The final reason that ethics training is important is a very practical one: Such training is required for NCSP renewal, effective in January of 2009, and renewal of your own state-issued practice credentials also may require such training. (By the way, this program should satisfy that requirement.)
8What ethical dilemmas are most frequently reported by school psychologists? A national survey conducted by Dailor (2007) asked school psychologists to report their “top three” concerns related to professional ethics.This question also had been asked in a survey conducted by Jacob-Timm (1999).
9Top Three Ethics-Related Concerns Reported by School Psychologists (Dailor, 2007)Concern% within Top 3NAdministrative Pressure4389Unsound Educational Practices4186Assessment related concerns2756Confronting unethical colleagues2450Storage and disposal of records2245According to Dailor, 43% of school psychologists surveyed said that “administrative pressure to behave unethically” was among their top three ethics-related concerns. Example of administrative pressure to behave unethically include:Not recommending a particular service that might require additional school resources, despite the school psychologist’s belief that it would be helpful to the child.Not disclosing particular evaluation results that might contradict other evaluation results supporting a decision favored by the schoolThe second most frequently-cited concern among the top three reported by school psychologists was “unsound educational practices.” This term refers to:Awareness that a teacher is not following an intervention plan that the school agreed to provide (i.e., isn’t using the intervention, or has changed it dramatically and inappropriately)Awareness that a teacher or other school personnel are engaging in detrimental or unsafe practices (e.g., unusually harsh punishment of students, humiliating students in front of classmates)Awareness that curriculum and instruction include content and activities that are inconsistent with research-based practice (e.g., widespread use of grade retention, instruction that uses methods that research has shown to be ineffective)Third, school psychologists reported concerns related to assessment practices, which might include:Using only certain tests dictated by the administration, rather than selecting tests on an individual basis to suit the child’s characteristicsUsing tests with outdated norms, or tests that have questionable reliability and validity (e.g., projective tests)Using tests inappropriately: Administering only part of the test and “pro-rating” results; using a test with a child for whom that test might be inappropriate due to cultural or language differencesHaving your test results entered into a team report, without having the opportunity to interpret and explain your results24% of school psychologists surveyed said that having to confront a colleague with concerns about unethical practice was among their top three concerns. This is consistent with other research showing that this is a major concern among psychologists (American Psychological Association, 2006), and especially among supervisors, who have to deal with difficult personalities and conflicts (Hunley, et. al, 2000).Finally, storage and disposal of records presents a challenge, especially for those who use electronic reporting and record-keeping, and web-based reporting. The NASP Ethical and Professional Practices Committee frequently receives inquiries from school psychologists who are worried that unauthorized parties can access or change records that are stored electronically.
10Comparison of “Top Three” Ethics Concerns 1999 - 2007 (Dailor, 2007) Jacob-Timm (1999)Administrative pressureAdministrative PressureUnsound Educational PracticesAssessmentConfidentialityConfronting colleagues about unethical conductDailor (2007) surveyed a national sample using a structured questionnaire. In contrast, Jacob-Timm (1999) asked respondents to describe an incident that created “ethical tugs” for them. Although findings from the two studies are not directly comparable because of differences in methodology, it does appear that there may have been changes in the “top three” ethics-related concerns reported by school psychologists between 1999 and 2007.While “administrative pressure to behave unethically” still tops the list, unsound educational practices have become a greater concern. This is probably related to the increased emphasis on intervention, where school psychologists are engaged in planning and evaluating interventions for children in general education settings.Dailor reports that, while confidentiality was a major concern in the 1999 survey, it ranks 9th in the 2007 results: Only 15% of school psychologists reported it as one of their top three concerns.
11Categories of Ethical Misconduct What ethical dilemmas are most frequently reported by school psychologists?Categories of Ethical Misconduct% YESnAssessment86178Intervention79165Administrative Pressure76157Informed Consent51105Parent Conflicts48100School Records38Job Competence3674Confidentiality3369Conflictual Relationships2042Another way of looking at the ethical dilemmas facing school psychologists is to ask how often certain kinds of problems have been witnessed by the school psychologists themselves, whether the situation happened to them or someone else. Dailor (2007) found that, of her 208 respondents, 178 (or 86%) had witnessed problematic situations related to assessment.According to Dailor, the most commonly witnessed instances of ethical misconduct were: Failing to make recommendations for services because of administrator concerns about their cost; conducting evaluation activities in unsatisfactory locations; and a lack of follow-up on interventions that had been recommended.Dailor,2007
12How do school psychologists decide how to handle ethical dilemmas? %nPeer consultation66137Consulted ethics codes, laws, or other guidelines4288Thought about risks/benefits of actions4185Used systematic decision-making model1633Contacted a state professional organization612Contacted NASP24Now that we have an idea about the kinds of situations that concern school psychologists, and that they have witnessed, let’s take a look at how they report that they handle problem situations.CLICKAs you can see from Dailor’s (2007) survey results, the most commonly reported problem-solving strategy was to consult with peers. Of her 208 survey respondents, Dailor found that 137 (or two-thirds) used peer consultation. The next most commonly-reported strategy was to consult published guidelines, such as the NASP Ethical Principles, and to think about the possible risks and benefits of their actions.Relatively few school psychologists reported using a systematic decision-making model. This isn’t surprising, and mirrors results obtained in other studies (Tryon, 2001), although many school psychologists have learned a model in their training, and many authors recommend the use of a systematic decision-making model.Cottone & Claus (2000) reported that many mental health practitioners rely on their understanding of the values of the institutions in which they work, their own convictions, social influence variables (including “peer pressure”), and practical considerations in making decisions about ethical dilemmas. Of perhaps greatest concern is the fact that practitioners tend to make the poorest decisions when under pressure, according to Cottone & Claus, since many situations encountered by school psychologists require them to make decisions quickly.Dailor,2007
13So, if it’s true that school psychologists will make better decisions in situations involving ethical standards if they employ a systematic decision-making model, what kind of model is recommended?First, let’s distill ethical principles into the four general principles recommended by the Canadian Psychological Association. These principles represent the “knowledge base” required for ethical decision-making.
14Four General Ethical Principles Respect for the Dignity of Persons“School psychologists are committed to the application of their professional expertise for the purpose of promoting improvement in the quality of life for children, their families, and the school community. This objective is pursued in ways that protect the dignity and rights of those involved” (NASP, III. A. 1).Self-determination and autonomyPrivacy and confidentialityFairness and non-discriminationThe four general ethical principles are presented in hierarchical order – that is, the first principle, “respect for the dignity of persons,” is considered to be the most important.CLICKWe can think about this principle in terms of three major issues – self-determination and autonomy, privacy and confidentiality, and fairness and non-discrimination. We’ll provide examples of situations in which these issues are relevant. (Examples are drawn from various sources, including Jacob & Hartshorne’s text on law and ethics in school psychology, and the NASP Casebook describing ethical dilemmas, authored by Williams, Armistead, & Jacob, 2008.)
15Self-Determination and Autonomy A 15 year-old male is experiencing confusion about his sexual orientation, and wants to see the school psychologist for counseling on the condition that his parents are not notified that he is being seen for counseling (From study of ethical dilemmas, Jacob-Timm, 1999).Should the school psychologist agree to provide the requested counseling service without notifying the student’s parents (Jacob-Timm, 1999)?[Facilitate discussion with participants. It isn’t important to arrive at a “correct” answer, but participants should be encouraged to identify all salient considerations]Principles to consider/points to make during discussion:Competing principles and considerations:Parent right to “informed consent” before services are provided to a minor child (both ethical and, in most states, a legal right);School psychologist’s duty to involve parents in matters related to students’ mental health and well-being;If student is gay, he is unlikely to successfully integrate this identity if he can’t count on his parents’ support, so it would actually be better for the parents to be informed while a qualified professional is available to facilitate the process of disclosure/acceptance.VSStudent’s entitlement (as a matter of ethics) to access needed services;The student’s request for help was undoubtedly well thought-out, and indicates real distress to which the school psychologist should respond;The student’s age (15) suggests that he is capable of understanding the possible risks and benefits of receiving services from the school psychologist, so – even though he isn’t legally able to give informed consent – it seems reasonable and appropriate to honor his wishes;The school psychologist may be the only person the student will approach; if s/he refuses to help the student, the student might not seek needed help elsewhere;Disclosure of sexual orientation may not be advisable; in fact, research indicates that decisions about when (and to whom) disclosures should be made require careful thought and will be different for various individuals;School psychologist’s duty (both ethical and, in most states, legal duty) to protect students from harm that might result from disclosure of the student’s sexual orientation.Resolution: The school psychologist believes that, given the student’s age, he is capable of making a sound decision to request psychological services. The school psychologist also considers the rights of the parents to be informed and to give consent for their son to receive services, but knows that, given what is known about sexual minority youth, failure to respond to the student’s request may place the student at risk for harm (i.e., sexual minority youth are at greater risk for substance abuse problems, depression, etc.). The school psychologist also knows that the student’s sexual orientation shouldn’t be disclosed to others without the student’s permission.Ultimately, the school psychologist decides on the following course of action: Agree to see the student on a preliminary basis without parental consent in order to assess the student’s emotional status and needs, the family and home circumstances (i.e., what reaction might be expected from the parents?), and to explore with the student ways in which the school psychologist and student can include the parents in the decision about whether to continue counseling services. (The school psychologist would need to explain to the student the legal requirement to obtain parental consent for services.) If the student is adamantly opposed to including his parents in the process despite the school psychologist’s plan to provide support, especially if the school psychologist is convinced that the student’s fears about his parents’ reaction are well-founded, then the school psychologist should consider referring the student to supportive resources outside of the school setting.An interesting aspect of this situation is the question of whether or when students might be regarded as “capable” of making a decision about seeking services from the school psychologist. Let’s take a look at that issue.
16“Diminished Capacity” and Student Self-Determination (Canadian Psychological Association, 2000) Consider whether right to self determination is developmentally appropriate for this childConsider impact on the child’s welfareSeek willing and adequately informed consent from person of diminished capacityProceed only if service is considered to be of direct benefit to that personLegally, students under the age of 18 are not capable of giving “informed consent;” the term describing their status is “diminished capacity.” This term also is used in reference to persons with mental retardation and mental health problems that prevent them from fully understanding the nature of the service that is being considered, or the consequences of receiving or refusing such service.Laws in various states do give minor students the legal right to seek (and consent to) services, including medical care and substance abuse treatment. But, if your states doesn’t give minor students the right to access services from their school psychologist, then the school psychologist must decide whether how to proceed when a student makes such a request. The Canadian Psychological Association offers a 4-step procedure that can be used in this process.CLICKThe first step is to determine whether the student is developmentally capable of making a good decision – that is, is she old enough, sufficiently mature, and intellectually able to understand the nature of services, possible outcomes of services, and potentially harmful consequences? In our example, the 15-year old student is probably developmentally capable of making this decision.Second, consider how the provision of services might affect the student. Will potentially negative consequences outweigh the perceived positive consequences of receiving services without parental consent, and how likely is it that negative consequences will occur?Our example raises concerns about the possibility that the parents will react angrily if they learn that the student has received counseling services without their consent, and might abruptly terminate services, to the detriment of the student. Moreover, this will violate the trust between the student and his parents, and add a layer to the already-challenging matter of disclosing sexual orientation to one’s parents. It will also eliminate the potentially supportive role that the parents might play.However, it is unlikely that the parents will become aware of the school psychologist’s meeting(s) with the student to conduct a preliminary assessment, and the possible negative consequences are outweighed by the importance and possible urgency of the student’s need for help. The plan to discuss parental involvement with the student is a good compromise that will reduce the possibility of an extremely negative and damaging parental reaction.Third, the school psychologist must have a candid discussion with the student about what the school psychologist can and cannot provide (i.e., clarify the student’s expectations), as well as possible benefits and drawbacks of receiving service. In our example, the school psychologist must also explain that, ultimately, parental consent will be required for services beyond an initial assessment, but that if consent is denied – or the student opposes contact with the parents – there are resources outside the school that can be utilized.Finally, the school psychologist can proceed to meet with the student only if the school psychologist’s services will be of direct benefit to the student. In our example, providing support to the student in sorting through his concerns seems to be of paramount importance, and this would certainly be construed as a direct benefit.
17Privacy and Confidentiality Neither seek nor maintain records of information that is not needed to provide servicesObtain information in a legally and ethically appropriate manner, and from responsible sourcesLimit disclosure of confidential informationA second area in which the ethical principle of “respect for the dignity of persons” applies has to do with privacy and confidentiality.CLICKFirst, school psychologists shouldn’t ask for – or include in their oral and written reports – information that isn’t needed to provide appropriate, professional services to students. If the school psychologist isn’t certain whether information may be helpful, the information can be recorded, but reported only when relevant, to appropriate parties.For example, a student’s remarks about her parents’ unhappy marriage aren’t relevant when the referral for school psychological services was based on concerns about reading and math. These remarks shouldn’t be included in oral or written reports, and the school psychologist should carefully consider whether they should even be included in notes taken during the conversation (which, of course, become part of the educational record, and are thus vulnerable to disclosure as required by the Family Educational Rights and Privacy Act)Second, just as the school psychologist is required to use appropriate tests, he or she also is required to seek and use information only from reliable and responsible sources, using appropriate methods. For example, comments made by another parent, or by a teacher reporting what he has heard from others, would not be considered reliable information. Similarly, information that a student has posted on his or her internet webpage (using MySpace, Facebook, etc.) should not be considered “fair game” for inclusion in the school psychologist’s evaluation – first, because it is unreliable (possibly exaggerated, or even fabricated), and, second, because the school psychologist hasn’t been authorized to access this information as part of his or her professional evaluation.Third, school psychologists must safeguard confidential information, ensuring that it is accessible only by authorized parties. We all are familiar with the provisions of the Family Educational Rights and Privacy Act (FERPA), which gives parents and guardians the right to control disclosure of educational records. We know that the FERPA provisions also are incorporated in the Individuals with Disabilities Education Act (IDEA) in the form of “procedural safeguards.” We also may be familiar with the Buckley Amendment, a provision in federal law that prevents schools from requiring students to disclose various types of information about themselves or their families, without prior parent consent.But, confidentiality of records and limited disclosure can be complicated matters.For example, in ethical terms, “confidentiality” refers to an agreement between the professional and the client that is designed to promote client trust. In this definition, we could consider the communication between a school psychologist and a 12 year-old student as confidential, even though the confidentiality “agreement” isn’t legally binding. For example, a school psychologist conducting a social skills training group should discuss with students the need to agree not to repeat information shared during group sessions. If a parent were to ask about his child’s disclosures, the school psychologist would honor her own ethical standards by explaining to the parent the importance of confidentiality to the success of the group, and offer to share information of a more general nature. However, if the parent insisted, the school psychologist would be legally required to share the requested information, but only about the parent’s own child.“Privilege,” on the other hand, is a legal term that describes a right of the client to limit disclosure of information in legal proceedings (It’s important to reiterate that, in the case of students under the age of 18, the client is the parent or legal guardian, not the student). Information is considered “privileged” if it was revealed in context of a professional communication (that is, not in the produce section of the local grocery store), and the client has a reasonable expectation that the information will not be disclosed to others. (If others are present when the information is disclosed, the client could not claim to have an expectation of privacy.)State laws are very clear about the right of “privilege,” defining which professional relationships are subject to privilege, and outlining the circumstances in which privileged information can be disclosed (that is, the circumstances in which the client can waive privilege).Whenever confidential information is disclosed, the school psychologist must be careful to limit disclosure to only the information that is needed, and only to parties with a legitimate “need to know.”
18Fairness and Non-Discrimination School psychologists “are aware of and respect cultural, individual, and role differences, including those based on age, gender, gender identity, race, ethnicity, national origin, religion, sexual orientation, disability, language, and socioeconomic status, and consider these factors when working with members of such groups … (they) try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone activities of others based upon such prejudices” (APA Ethical Principle E)The American Psychological Association’s Ethical Principles offer a good explanation of our obligation to be fair and non-discriminatory in our professional practices.Notice that this principle requires us to “eliminate the effect on (our) work of biases ...”Too often, we think of “fairness and non-discrimination” in terms of our assessment instruments and practices, but we don’t fully appreciate the importance of becoming aware of our own biases, and how they might affect our work. Our ethical principles require us to learn our own biases, pay attention to them, and ensure that they don’t influence our professional practices and decisions in a manner that is unfair to clients.
19Responsible Caring (Beneficence) Practice within the boundaries of competence“School psychologists recognize the strengths and limitations of their training and experience, engaging only in practices for which they are qualified” (NASP II A. 1.)Accept responsibility for one’s actions and decisions“School psychologists accept responsibility for theappropriateness of their professional practices” (NASP III A. 1.)“School psychologists maintain full responsibility for any technological services used” (NASP IV E. 4.)The second general ethical principle is that of “responsible caring”– the notion that we must behave in ways intended to benefit others, and avoid doing any harm.There are two general corollaries to this principle: First, limit your practice to areas in which possess competence, and, second, accept responsibility for your actions.The first corollary seems pretty simple and straightforward: Don’t do what you haven’t been trained and credentialed to do.The second also seems straightforward, but, with recent developments in technology, it has become more complicated. For example, the NASP Ethical and Professional Practices Committee received at least a half-dozen inquiries in 2007 asking about the school psychologist’s responsibilities when a school district uses an online data reporting and record-keeping system. Concerns included the fact that the confidentiality of records couldn’t be guaranteed, and others might be able to change information the school psychologist had included on a form or report.
20Four General Ethical Principles 3. Integrity in Professional RelationshipsOpenness and honesty with others Faithfulness in carrying out dutiesThe third general principle, “integrity in professional relationships” describes our responsibilities to those with whom we work, including parents, employers, community-based resources, colleagues, and administrators.CLICKThis principle requires us to be open and honest in our dealings with others. For example, we must accurately represent ourselves, our competencies, and our credentials. We acknowledge the contributions that others can make, especially those of other professionals who possess competency in areas in which we lack competence. We respect the information provided by others, and include it in our decision-making. We avoid conflicts of interest (or the appearance of conflicts of interest), and don’t take advantage of clients, students, trainees, or colleagues. We take credit only for work that is ours, and give credit to others for the work they have done.We are called to a high standard in carrying out our responsibilities. A member of the NASP Ethical and Professional Practices committee heard a story about a school psychologist in a district where there had been a much-publicized crisis involving a number of students. When the school psychologist learned that teachers in the school district were told not to report to work the next day, she threatened to file a grievance with the union because school psychologists hadn’t also been given a day off. This would be an example of how not to behave as a professional!
21Four General Ethical Principles Responsibility to Community and Society“School psychologists attempt to resolve suspected detrimental or unethical practices on an informal level. If informal efforts are not productive, the appropriate professional organization is contacted for assistance, and procedures established for questioning ethical practice are followed” (NASP, III. A. 8)The fourth and final of the general ethical principles is “responsibility to community and society.”CLICKFirst, this principle requires us – as school psychologists – to accept responsibility for our profession, to ensure that we are providing responsible and effective services.A code of ethics is designed primarily for the protection of the public. By adopting a code of ethics, a profession is saying to the outside world, “we will maintain high standards for practice; we will police our own”. So, in a way, a code of ethics represents our agreement to uphold practice standards in exchange for the public trust.Consequently, if a school psychologist appears to be violating one of our ethical principles, we have a separate ethical responsibility to bring this to the school psychologist’s attention so the violation can be corrected. Before contacting NASP, a state association, or a state regulatory board or department of education, NASP members have an obligation to attempt to address their concerns with their colleagues. This is never easy! Remember, in Dailor’s (2007) research study, 24% of respondents to her survey included “confronting a colleague with concerns” in their top 3 concerns.How can we increase our comfort level in addressing concerns about their conduct with our colleagues?
22Confronting a Colleague with Concerns Respect for colleague’s autonomyConcern about damage to reputation/imageConcern about compromised working relationshipFear of reprisalRecommendationsView situation as opportunity to assist colleagueAvoid judgmentCite specific behaviorsState expectations for behaviorSeek advice from supervisor/colleaguesDocument conversations and actions takenSince research shows that we are uneasy, and often unwilling, to bring our concerns to the attention of our colleagues, it’s likely that many instances of ethical misconduct are not addressed.CLICKWhy are we hesitant to confront our colleagues? There are several reasons:Respect for autonomy of colleagues – it’s not “our place” to intervene in what our colleagues are doing EG: School psychologist is using outdated assessment techniques because s/he thinks the old tests “did a better job” of identifying learning problems. Who are we to question their professional practices, based on their years of experience?b) We are concerned that the image of our school, department, or profession will be damaged if attention is drawn to the misconduct. EG: Let’s say that school psychologists are seen in your district by some staff as living lives of luxury, with little accountability, and you become aware that a fellow school psychologist comes in late and leaves early, but others don’t notice because he goes back and forth between several buildings. If we bring this to anyone’s attention, the reputation of your psychological services department is likely to suffer.c) Concern that engaging in a difficult interaction may compromise your future working relationship with that colleague. We can’t really expect our colleague to thank us for bringing our concern to his or her attention, and promise to never misbehave again! Chances are, the colleague will feel some resentment toward us for expressing our concerns.d) Fear of reprisal from a defensive or angry colleague. The NASP Ethical and Professional Practices committee has heard this from a number of school psychologists who spoke up about concerns. “Reprisals” can take the form of exclusion from the group, criticism and fault-finding, or subtle forms of sabotage, such as not being notified of meetings.So, how do we recommend that you proceed if you have a concern that you wish to raise with a colleague?First, try to think of the situation as an opportunity to assist colleague to improve performance (that is, your decision to talk with your colleague is motivated by your concern for that colleague). Say so! For example, you might say, “Sam, something’s been bothering me and I thought it would be a good idea to talk to you about it. I’m not sure if my perception is accurate, or if there’s some explanation of which I’m not aware, but I knew that you’d prefer that I bring it to your attention first.”Remember, though, that, if the colleague’s behavior is unacceptable or even harmful, your first priority shouldn’t be their feelings, but to ensure that the unacceptable conduct stops right away!2) Avoid presenting your concerns in a judgmental tone; this will only elicit defensiveness. Don’t use terms like “unethical”, “illegal”, or “wrong”. Instead, use language such as “I wonder if this is the best way for you to ...” or “I know you’re trying to do what’s in the student’s best interest, so it may not have occurred to you that ...”3) Cite specific behaviors and actions; don’t use generalities or labels. This is a basic principle of conflict resolution: Be specific and concrete! For example, when confronting a colleague about a pattern of inappropriately disclosing confidential information to unauthorized parties (such as teachers who don’t work with the student in question), you might say, “Yesterday, you were talking with Ms. Gabbalot, the 4th grade teacher, about some of the 3rd grade students you’ve been seeing in your social skills group. I’m not sure she really should be asking you for information about them” rather than “I don’t think you should be sharing confidential information about students with people who aren’t directly involved with them.”4) Be prepared to state an expectation for the colleague’s behavior. This clearly conveys the notion that his or her current behavior is unacceptable, and must change. For example, you might say, “It’s important to let Ms. Gabbalot know that you can’t discuss other students with her. What would be the best way for you to tell her this?”5) Consult a (third) colleague about how to address concerns with your colleague, and for advice about the parties who should be included in the discussion. Of course, your consultation with a colleague should be carefully considered, so that it isn’t interpreted as gossip or criticism. It’s usually best to speak with a trusted supervisor or colleague whose expertise and discretion you respect. Seeking advice can often provide a perspective that you hadn’t previously considered, and the colleague with whom you consult may be able to offer helpful suggestions.6) Document conversations you hold with your colleague, and keep a record of relevant actions that you’ve taken. If needed at some future time, this will demonstrate that you proceeded cautiously and with appropriate regard for your professional relationship with your colleague. In addition, if you need to take further action by filing a complaint with NASP or another agency about your colleague, it is important for them to know what remedies have been attempted.
23Four General Ethical Principles Responsibility to Community and Society“School psychologists attempt to resolve suspected detrimental or unethical practices on an informal level. If informal efforts are not productive, the appropriate professional organization is contacted for assistance, and procedures established for questioning ethical practice are followed” (NASP, III. A. 8)“School psychologists also are citizens, thereby accepting the same responsibilities and duties as any member of society … (they) may act as individual citizens to bring about social change in a lawful manner … (i)f regulations conflict with ethical guidelines, school psychologists seek to resolve such conflict through positive, respected, and legal channels, including advocacy efforts involving public policy” (NASP, III., D. 1, 2, 5)CLICKThis principle also requires school psychologists to behave as responsible citizens, who have special knowledge and expertise that should be brought to bear on policies and decisions affecting the welfare of children and families.
24Responsibility to Community Ann Evans is a school psychologist who lives in the school district where she works. She is concerned about the failure of the school board to address the problem of school bullying; in fact, she heard a radio interview in which a board member claimed that the district’s bullying problem had been eliminated. Ann knows this isn’t true, since an increasing number of students have reported bullying episodes during recess periods and on school buses. Her co-workers have advised her to keep quiet about the situation, since the board takes a negative view of employees who openly challenge school policies and practices. “Besides,” they suggest, “parents will eventually insist that the district do something about the bullying problem.”The obligation of “responsibility to community” is illustrated in the situation Ann Evans faces in her school district. What should Ann do? Should she speak up at a PTA meeting? Organize parents to approach the district administration about the problem? Publicly reveal information about the increasing frequency of bullying episodes? Keep quiet and hope for the best?[Facilitate discussion with participants. It isn’t important to arrive at a “correct” answer, but participants should be encouraged to identify all salient considerations]Principles to consider/points to make during discussion:Competing principles and considerations:Responsibility as an employee to refrain from public criticism that may interfere with the schools’ ability to operate effectively (cite court decision re: “whistleblowers”???).Greater likelihood of success in securing the administration’s cooperation for remedies to the problem by “going through channels,”, rather than creating defensiveness on their part with public criticismVS“Dual role” as both school employee and school district resident – does this create a greater obligation/more promising opportunity for her to take action in ways that co-workers, who aren’t district residents, cannot?Ann’s responsibility to make others aware of a situation in which students could possibly be endangered or harmed.The school’s (and Ann’s) “duty to protect” students who may be harmed by the bullying that Ann knows to be occurring (and the liability they incur by ignoring a potential danger).Ann’s obligation as a citizen to take action to correct a situation that she knows to be detrimental.
251.0 Become aware of dilemma 2.0 Identify basis of conflict2.1 Conflicting interests of parties2.2 Competing standards2.3 Unclear standards1.0 Awareness (event occurs; feelings and intuition may signal a conflict)2.0 Basis (if not directly addressed in ethics code, what interests/standardsare competing?)(McNamara, 2008)There are many models for ethical decision-making; most include some version of the process outlined on the next few slides.Let’s describe each of these steps as they might apply to a hypothetical situation, where a principal confides to Jerry Owens, the school psychologist, that he is concerned about the questionable performance of a teacher, and needs to decide whether the teacher’s contract should be renewed at the end of the school year. The principal tells Jerry that he knows that the teacher has asked Jerry’s help with classroom management, and the principal would like Jerry to keep the principal informed as to the teacher’s efforts and success in dealing with her students’ behavior problems.The first step is to become aware of the dilemma. What is the basis for the conflict that Jerry feels?Most professionals make decisions on basis of intuition/feelings (“clinical judgment”), but this is not an appropriate standard, as it is subject to biased standards, interpretations, and applications. However, intuition and feelings can be useful in signaling to Jerry that a problem exists. Since there is no clear-cut ethical standard that tells Jerry how to behave in this situation – and, in fact, several ethical standards that may apply – a “dilemma” exists, so Jerry must identify the basis of the conflict.2.1 – Conflicting interests of parties? Yes, there are several parties whose interests may conflict in this situation: The principal, the teacher, the students, and Jerry, the school psychologist. So, as Jerry decides what to do, he has to take into consideration the interests of all of these parties.2.2 – Competing standards? Yes, there are several standards involved here: Confidentiality of the teacher’s communication with Jerry; the welfare of students in the teacher’s class; and Jerry’s professional relationships with both the principal and the teacher.2.3 – Unclear statements? In this case, the dilemma doesn’t seem to be a result of a lack of clarity of a particular standard. If it were, then Jerry would need to seek additional information and guidance.So, let’s move on to the next step for 2.1 (conflicting interests of parties) and 2.2 (competing standards).
262.3.1 Determine: What information is lacking? What do I need to know? 2.1.1 Determine: How might each party’s interests be affected by my action?2.2.1 Determine: What standards are involved? Is there a legal requirement I must consider?2.3.1 Determine: What information is lacking? What do I need to know?Consult supervisor or colleagueConsult written resources2.1.2 Determine: What is my responsibility to each party?3.0 Determine: What are my options for action?– With respect to conflicting interests of parties, how might each party be affected by Jerry’s disclosure or non-disclosure of information about the teacher to the principal?[Facilitate discussion with participants. It isn’t important to arrive at a “correct” answer, but participants should be encouraged to identify all salient considerations]Principles to consider/points to make during discussion:Disclosure of information about the teacher to the principal, while valued by administrator, will expose the teacher to potentially damaging consequences.Disclosure of information about the teacher to the principal will probably terminate Jerry’s consulting relationship with the teacher, thereby depriving students of the benefits derived from the (now disrupted) consultation process.If the teacher’s management of the class is ineffective (and possibly even damaging to students), then withholding information from the principal may only perpetuate the negative impact on students.Part of the school psychologist’s job is to consult with teachers, and consultation is a service that requires a trusting relationship.If Jerry violates the confidentiality of his communication with the teacher, his effectiveness as a consultant to this and other teachers will be compromised.The teacher entered into a professional relationship with Jerry with a reasonable expectation of confidentiality.– Having considered the possible impact that Jerry’s decision may have on all parties, what responsibility does Jerry have to each of them?Jerry has entered into a professional relationship with the teacher by accepting her request for consultation.While it may be true that ineffective teaching practices can be detrimental to students, providing information about a teacher to an administrator is not considered to be the responsibility of the school psychologist.– Having considered how Jerry’s decision might affect various parties, and what his obligations are to each of those parties, let’s consider what ethical standards are involved. Is there a legal requirement involved in this situation?There doesn’t seem to be any legal issue that Jerry must factor into his decision, unless “privilege” applies to the teacher’s communication in context of her professional relationship with Jerry. This would seem to be open to interpretation – is the teacher Jerry’s client?The ethical standard of confidentiality applies: The teacher’s communication with Jerry – even if not subject to privilege – would certainly seem to be governed by confidentiality rules, since she sought Jerry’s professional services as a consultant.Standards regarding relationships with other professionals also apply. Jerry has an obligation to respect the authority and responsibility of the principal for the performance of teachers and the welfare of students. At the same time, Jerry is obliged to treat his relationship with the teacher in a similarly respectful manner.We’re now ready to move to the next step – 3.0 – What are Jerry’s options for action?Jerry could talk with the principal about the teacher’s performance, but only in general terms – commenting on her effort and commitment – without giving an opinion about her competence or the success of her efforts.Jerry could refuse to talk with the principal about the teacher’s performance.Jerry could talk candidly with the principal about the teacher’s performance, sharing details of his recommendations and whether – and how successfully – the teacher followed up on them.2.1 Conflicting Interests: Nature of school psychologist’s responsibility to eachinvolved party2.2 Conflicting Standards: Legal requirements must be observed2.3 Unclear Standards: Options for obtaining clarification
273.2 Can negative impact be ameliorated? How? 3.1 What is likely impact, positive and negative, on all parties (including myself)?3.2 Can negative impact be ameliorated? How?3.3 Consider hierarchy of principles: respect for dignity of person; responsible caring; integrity in relationships; responsibility to society3.1 Likely Impact: Possible negative outcomes must be considered3.2 Amelioration: School psychologist may be able to reduce/eliminatenegative effects3.3 Hierarchy of principles: When multiple principles involved, hierarchicalarrangement should be considered3.1 – What is the likely impact of each of these courses of action on all parties? Will there be negative effects?3.2 – Can these negative effects be ameliorated?[Facilitate discussion with participants. It isn’t important to arrive at a “correct” answer, but participants should be encouraged to identify all salient considerations]Principles to consider/points to make during discussion:If Jerry speaks to the principal, but only in general terms, the principal’s goal would not have been accomplished (i.e., information provided by Jerry would be insufficient for the principal to make a determination about the teacher’s performance). However, the negative consequences of Jerry’s “violation” of the teacher’s trust will occur, insofar as the teacher is likely to view him as untrustworthy, regardless of what Jerry did or did not disclose to the principal. This seems to be an unacceptable course of action – there is nothing to be gained, and the negative effects could probably not be ameliorated.If Jerry refuses to speak with the principal, he will have safeguarded the interests of the teacher and his own professional status as a consultant, but his relationship with the principal might be compromised. Can this effect be ameliorated? Probably – depending on how Jerry handles his response to the principal. He will need to explain to the principal his reasons for refusing, emphasizing the importance of his being viewed by teachers as a trustworthy resource.If Jerry speaks candidly to the principal, he will have violated the confidentiality that the teacher (reasonably) anticipated in her communication with Jerry; Jerry would be viewed by the teacher as untrustworthy; and Jerry would have overstepped a professional boundary in that he would be functioning in more of a supervisory capacity. It is unlikely that the damage done to Jerry’s reputation as a trustworthy consultant could be repaired.3.3: How does the hierarchy of ethical principles apply in this situation?Respect for the dignity of persons – which includes confidentiality standards – is highest on the hierarchy of ethical principles.Integrity in professional relationships, however important it may be, is lower on the hierarchy.EG:Respect for dignity of persons more important than responsibility to community/society, so SP passes up opportunity to discuss change in policy re: disciplinary policies, since discussion likely to include potentially embarrassing info that could be linked to current students3.4: Evaluate, using “scale of conscience”- Is this something I would recommend to someone else?- Is this something I would be comfortable having others know about?D. 4.0: Take action, and monitor results of action- If unforeseen negative consequences occur, SP must try to minimize their harmful effectsEG- Gay adolescent seeks counseling from SP, who follows legal requirements and requests parent consent- But, disclosure of sexual orientation c/result in overt/dramatic rejection by parents- So, whether disclosed by SP or by adolescent, SP would be obligated to work w/student and parents toward satisfactory outcome
284.0 Decide on course of action; evaluate outcome 3.4 Consider: Is this action one I would recommend to a colleague? Am I comfortable with others knowing my decision?4.0 Decide on course of action; evaluate outcome3.4 Scale of Conscience3.5 Decide and Evaluate: Follow-through and reflectionFinally, let’s consider 3.4 – Is the action I am contemplating one that Jerry would recommend to a colleague? Will he be comfortable if others learn of his decision and actions?More than likely, Jerry would not want others to know that he was sharing with the principal information provided to him in confidence by teachers, nor would he feel comfortable recommending this solution to others.4.0 – Decide on a course of action; evaluate outcome.Jerry is satisfied that he has carefully thought through his decision, and tells the principal that he isn’t able to report on the teacher’s progress as a consultee. Mindful of the potential impact of this decision on his working relationship with the principal, Jerry acknowledges the principal’s important role as a supervisor and evaluator of teachers, but explains that he (Jerry) isn’t in a position to help the principal with this issue because of the harmful effect this might have on his efforts with this teacher, and on future consultation with other teachers.Now, let’s apply this decision-making process to other ethical dilemmas that school psychologists might encounter.
29Jack Western was a capable and conscientious intern during his first semester as Pearl Meadow’s supervisee. After winter break, however, Jack was often late to school, sporadically absent due to illness, and appeared disorganized and unprepared for meetings. When Pearl expressed concern about this change in his performance, Jack apologized, attribute his tardiness and disorganization to the stress of completing his master’s thesis, and promised to do better. The following week, however, when reviewing a student assessment he completed, Pearl noticed that Jack failed to record any of the child’s verbatim responses on several WISC subtests, and this his report was poorly written, with little attention to integration and interpretation of findings. Then, after lunch that day, Pearl thought she smelled alcohol on his breath. When Pearl asked Jack about the incomplete WISC protocol and hastily written report during their supervision meeting, Jack disclosed that his wife had left him over Christmas and that he was devastated by their separation. He had never administered all the WISC subtests, and had simply fabricated the scores. When asked whether alcohol was a problem, he confided that he had been drinking heavily (Jacob & Hartshorne, 2007, p. 307).NOTE: Use the “Pearl Meadows – Jack Western” vignette as another example of the use of the decision-making model. Have participants work in small groups through each step of the process, then do a “wrap-up” with small groups reporting to the larger group, while the leader/facilitator guides the discussion.Here, Pearl Meadows is faced with a challenge as the supervisor of Jack Western, an intern.How would you go about applying the ethical decision-making model to help Pearl decide what to do?Small Group Discussion -- Principles to consider/points to make during discussion wrap-up:Pearl has a “double role” here – first, she is responsible for the actions of her intern, Jack, as if she herself were engaging in those actions. Second, Pearl has an obligation to Jack, as his supervisor.2.0 Identify basis of conflict.2.1 Are there conflicting interests of parties? (In a way – Jack clearly needs help with his personal problems; Pearl is responsible for his development as a professional; and students are affected by Jack’s actions.)2.2 Are there competing standards? (While there are several standards involved, they don’t seem to be in competition with one another: Concern about students’ welfare is consistent with Pearl’s concern about Jack’s impairment, which is harmful to students. Also, Pearl’s professional relationship with Jack, as his supervisor, requires her to take steps to correct his harmful pattern of behavior.)2.3 Are the relevant ethical standards unclear about how this situation should be handled? (Not really – it’s pretty clear that Pearl must act to correct the situation.)2.1.1 How might each party’s interests be affected by Pearl’s actions?First, the principles of “Respect for the Dignity of Persons” and “Responsible Caring” requires Pearl to ensure that no harm occurs (to children, parents, etc.) as the result of her supervisee’s actions. If Pearl suspends Jack’s internship, then the interests of clients will be protected. If she doesn’t, then there is a good chance that his performance will continue to deteriorate.Although it may seem that Jack would be negatively affected by Pearl’s decision to suspend his internship until his personal problems have been addressed, he would actually be well-served by this action in the long run. And, as his supervisor, based on the principle of “Integrity in Professional Relationships,” Pearl needs to be concerned about Jack’s competence to serve as a school psychologist after his internship.Finally, Pearl’s performance as a supervisor is also an issue under the principles of “Integrity in Professional Relationships” and “Responsible Caring.” If she fails to take effective action, then her competence and professionalism are likely to be questioned. In addition, as a supervisor, she is responsible for Jack’s actions, so she could be held legally responsible for the consequences. As a supervisor, Pearl has a particular obligation under “Responsibility to Community and Society” to take action when she becomes aware of detrimental practices or irresponsible behavior.3.0 Determine: What are My Options for Action?Pearl should immediately suspend Jack’s internship, contingent on his receiving help for his personal problems, and make a clear agreement with him as to the circumstances under which he will be permitted to complete his internship. Pearl also should notify relevant university and school administrators of Jack’s problems and actions, as well as arrangements to correct errors, and agreements (to which administrators should be a party) about the conditions for Jack to complete his internship. She should correct the errors that Jack has made, and explain to the parent (and student, if appropriate) the need for re-administration of tests, and immediately arrange to do so.3.2 Likely Impact, Positive and Negative, on All Parties?The impact of Pearl’s actions will be positive. In Jack’s case, while the initial impact may seem negative, Pearl will actually assist him in reaching his goal of becoming a capable and responsible school psychologist.3.2 Can negative impact be ameliorated?Not necessary.3.3 Hierarchy of principles?Clearly, “Respect for the Dignity of Persons” requires Pearl to take action in a way that is fair and respectful of Jack’s privacy and autonomy, but “Responsible Caring” (i.e., welfare of students) is of primary concern here, and takes precedence even over Jack’s problems.3.4 Would I recommend this action to a colleague? Am I comfortable with others knowing of my decision?Absolutely!4.0 Decide on a course of action; evaluate outcome.In this case, Pearl would follow the plan described above. It will be important for her to monitor Jack’s compliance with the agreement, and to make a careful judgment about his readiness to return to his internship. She would then need to closely monitor his performance.
30Charlie Maxwell, a school psychologist, overheard a conversation between a fellow school psychologist, Frank Brown, and a guidance counselor in the school district in which they both worked. Frank told the counselor that he didn’t see much point in meeting with parents of students who were chronic behavior problems, since poor parenting skills obviously contributed to the problems of such students, and the parents were unlikely to be of any help in addressing their children’s difficulties. When asked by the counselor how he got around the obligation to consult with parents of students who were referred to him, Frank said that, while he did ensure that he had a signed consent form from the parents, he made notations in his record that he had spoken with the parents, or attempted to contact them by phone, when in fact he had not.Have participants apply the decision-making model to this and the following vignette, or to one of their own choosing.
31Cindy, a troubled 14 year-old whom Hannah has seen previously for counseling, comes to her without an appointment. She is upset because two of her best friends, Tara and Trisha, have made plans to “ambush and beat up” another girl after school because of an argument about a boy. She knows that Tara and Trisha have been in trouble at school before for fighting, and she is worried they will be kicked out of school if they follow through on their plans, and that they may really hurt their intended victim (Jacob & Hartshorne, 2007, p. 228).
32ReferencesAmerican Psychological Association (2002).Ethical Principles of Psychologists and Code of Conduct. American Psychologist, 57, 1060 – 1073.American Psychological Association, Board of Professional Affairs’ Advisory Committee on Colleague Assistance (2006). Advancing colleague assistance in professional psychology (monograph - February).Canadian Psychological Association (2000). Canadian code of ethics for psychologists, third edition. Available atCottone, R. R., & Claus, R. E. (2000). Ethical decision-making models: A review of the literature. Journal of Counseling and Development, 78, 275–283.Dailor, A. N. (2007). A national study of ethical transgressions and dilemmas reported by school psychology practitioners. Unpublished Master’s Thesis: Central Michigan University.Hunley, S., Harvey, V., Curtis, M., Portnoy, L., Chesno Grier, E., & Helffrich, D. (2000). School psychology supervisors: A national study of demographics and professional practices. Communiqué, 28(8).Jacob, S. (in press). Best practices in developing ethical school psychological practice. In A. Thomas & J. Grimes (Eds.), Best Practices in School Psychology V. Bethesda, MD: National Association of School Psychologists.Jacob, S., & Hartshorne, T. S. (2007). Ethics and law for school psychologists (5th ed.). Hoboken, NJ: John Wiley.Jacob-Timm, S. (1999). Ethical dilemmas encountered by members of the National Association of School Psychologists. Psychology in the Schools, 36, 205–217.McNamara, K. (in press). Best practices in the application of professional ethics. In A. Thomas & J. Grimes (Eds.), Best Practices in School Psychology V. Bethesda, MD: National Association of School Psychologists.National Association of School Psychologists. (2000). Professional conduct manual: Principles for professional ethics. Bethesda, MD: Author.Tryon, G. S. (2001). School psychology students’ beliefs about their preparation and concern with ethical issues. Ethics and Behavior, 11, 375–394.Williams, B.B., Armistead, L. & Jacob, S. (2008). Professional ethics for school psychologists: A problem-solving model casebook. Bethesda, MD: National Association of School Psychlogists.