Posted: August 6th, 2022

Discussion

 

Discussion: When Does Personal Empathy-Bias Occur in Professional Settings and What are Effective Ways to Manage it?

 You have been invited throughout this course to explore personal empathy-bias about the legal topics and issues that we have explored and analyzed. Being aware of one’s empathy-bias and setting these aside at work is an important part of abiding by ethical guidelines in our field. When serving the legal system or while in other professional settings, ethical guidelines require that forensic psychology professionals be fair, objective, and unbiased. To do so, being aware of one’s empathy-bias can be an important first step in setting aside personal opinions, beliefs, and viewpoints in order to be faithful to these ethical requirements. 

 

To prepare:

  • Review the Learning Resources, especially content related to empathy-bias and ethical guidelines.
  • Reflect on:

    Topics throughout the course and those in which you had the most trouble managing your empathy-bias
    Other topics or work tasks that are most likely to elicit empathy-bias that might be challenging to manage
    Ethical guidelines that might be at risk if your empathy-bias is not managed
    How management of your empathy-bias could empower you to contribute more effectively to social change
    Strategies to manage your empathy-bias, noting that different strategies might work better for different topics

Behavioral Sciences and the Law
Behav. Sei. Law 28: 585-602 (2010)
Published online 7 September 2010 in Wiley Online Library
(wileyonlinelibrary.com) DOI: 10.1002/bsl.953

Empathy or Objectivity: The Forensic
Examiner’s Dilemma?

Daniel W. Shuman, J.D.* and John A. Zervopoulos, Ph.D., J.D.^

Examiners are ethically bound to manage personal biases tbat may infect their expert
opinions. Empathy-related issues that lead to bias in forensic assessment of adjudica-
tive competence arise in evaluation interactions with defendants (therapeutic empathy)
and from examiners’ personal views of issues that these assessments address (empathy-
bias). This article first summarizes flexible adjudicative competence legal standards
that invite bias by forensic experts. Then, after reviewing the therapeutic empathy
issue, the article examines empathy-bias and its effects on the development of expert
opinions. The authors assert that, properly managed, the often assumed dilemma
between empathy and objectivity is a false one. Using case law, research psychology,
and professional guidelines, the authors first emphasize that examiners must actively
generate plausible alternative explanations of evaluation data as they form their
opinions, not afterwards. Then the authors present a practical model to help experts
develop opinions that best explain the data whUe minimizing empathy-bias. Copyright
© 2010 John Wiley & Sons, Ltd.

In 2009, legal scholars and media commentators ardently debated President Obama’s
wish to choose Supreme Court nominees whose decisions would reflect empathy for the
litigants (Kmiec, 2009). Chief Justice John Roberts, in his 2005 Senate confirmation
hearings, articulated an opposing view when he analogized the judge’s role to a baseball
umpire who dispassionately calls balls and strikes without regard to the batter’s
reputation or the game situation (Marcus, 2009). U.S. Supreme Court Justice Sonya
Sotomayor’s 2009 Senate confirmation hearings centered on this issue. In her opening
statement, Sotomayor responded to critics that “fidelity to the law,” not empathy-
tinged bias, was her approach to deciding cases (Baker & Lewis, 2009). Throughout the
hearings, the meaning of “fidelity to the law” became a dominant question answered
indirectly by her Senate confirmation. In contrast, others claimed that the notion of
objective judges putting aside emotions and issuing opinions based solely on reason was
“a useful falsehood” of the legal system, and that the crucial question was not whether
the judge relied on empathy or emotion, but how the judge did so (Brooks, 2009). Is a
judge’s empathy for litigants an impediment to objective judicial decision-making, or a
useful tool for judges that results in more just decisions?

Judges enjoy no monopoly on the empathy-objectivity conundrum. Forensic
psychologists and psychiatrists often find themselves defending the role of empathy in
gathering information or drawing inferences from it. Whether retained by a party or
court appointed, mental health professionals acknowledge an obligation to act objectively

*Correspondence to: Daniel W. Shuman, J.D., Anderson Foundation Endowed Professor of Health Law,
Dedman School of Law, Southern Methodist University, P.O. Box 750116, Dallas, TX 75275-0116, U.S.A.
E-mail: dshuman@mail.smu.edu
*PsychologyLaw Partners, Dallas, TX, U.S.A.

Copyright © 2010 John Wiley & Sons, Ltd.

586 D, W, Shuman and J, A. Zervopoulos

(Mossman et al., 2007; Committee on Ethical Guidelines for Forensic Psychologists
(CEGFP), 1991). Forensic psychologists and psychiatrists often conduct their work in
cases that tug at the heart strings, if not the purse strings. Child custody cases are an
obvious example of cases that present strong empathy-objectivity tensions, as are many
personal injury claims, particularly in the case of victims of abuse or implanted false
memories of abuse, but perhaps the most vivid tensions between objectivity and empathy
occur in adjudicative competence cases—such as competence to stand trial, competence
to waive counsel, competence to confess, and, particularly, competence to be executed.

The authors maintain that most forensic psychologists and psychiatrist experts have
opinions on adjudicative competence cases but can satisfy both professional and legal
demands for objectivity if they actively challenge their decision-making while they
collect their data and formulate their opinions. To develop this thesis, this analysis first
looks at the fiexible definitions and principles in adjudicative competence case law and
the effects of this fiexibility on the tools that forensic examiners may use in these cases.
Second, empathy-bias and the dilemma that empathy-bias poses for forensic examiners,
this article’s focus, is distinguished from therapeutic empathy, which examiners may
improperly extend to defendants in their evaluation interviews. Third, we shall explore
problems with models that have been proposed to account for the inappropriate use
of empathy or other biases that might infect expert opinions are explored. Finally, a
six-stage model is proposed to manage empathy or the biases that might compromise
the reliability of expert opinions.

Such a model is necessary because, no matter how much forensic psychologists and
psychiatrists try to be fair, they may be unaware of the complexity of empathy-related
issues or even when empathy biases expert opinions (Bonnie, 1990; Goldstein & Stone,
1977). A study of New York competence to stand trial evaluations by experienced
examiners who might be expected to be aware of their obligation to be neutral revealed two
distinct philosophies (biases): “Guardians,” who tended to protect their examinees by
expressing concern that the examinees would be unable to attend to the realities of a
stressful courtroom situation, and “Green-Lighters,” who were more optimistic about the
examinee-defendant’s future performance in court, more inclined toward a “benefit of the
doubt” approach (Goldstein & Stone, 1977). Concern also has been raised about the
“partisan allegiance” of forensic evaluators to parties who retain them. One study
examined 23 cases in sexual offender civil commitment trials in which opposing evaluators
reported PCL-R total scores—a test designed to increase the reliability of psychopathy
from one examiner to another—for the same individual. Differences between scores from
opposing evaluators were usually in a direction that supported the party who retained their
services—greater than would be expected based on the PCL-R’s standard error of
measurement or on rater agreement values reported in previous PCL-R research (Murrie
et al., 2008). These examples fuel concerns about biased testimony of forensic
psychologists and psychiatrists (Applebaum, 2008; Goldyne, 2007; Stone, 1984, 2008).

These concerns become more critical with the seriousness of case outcomes. For
example, we may tolerate contrary “Guardians” versus “Green-Lighters” opinions
when competence to stand trial is at issue in nonhomicide cases, but are such
distinctions acceptable in competence to be executed cases?

Ironically, the issue is highlighted even more when the expert consciously
acknowledges empathy towards a litigant or a litigant’s position. But what is to be
done? Should a psychologist or psychiatrist conduct a competence to be executed
examination if he or she acknowledges a position for or against the death penalty? If the

Copyright © 2010 John Wiley & Sons, Ltd. Behav. Sei, Law 28: 585-602 (2010)
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Empathy or Objectivity 587

expert holds an opinion on the case issue, can this expert testify in a way that satisfies
both ethical demands for objectivity and legal requirements for testimony that will
“assist the trier of fact?”

Case law sets out legal principles of adjudicative competence, but the principles do
not lend themselves to bright-line definitions. For example, the competence to stand
trial question, which courts do not associate with “fixed or immutable signs,”
implicates “a wide range of manifestations and subtle nuances” that are difficult even
for trained forensic examiners entertaining the same facts to evaluate (Drope v. Missouri,
1975, p. 180). These legal requirements and professional issues provide the context to
consider whether forensic professionals can conduct objective evaluations.

ADJUDICATIVE COMPETENCE: FLEXIBLE
DEFINITIONS AND PRINCIPLES

The Legal Backdrop

Adjudicative competence addresses the defendant’s present mental capacity to
understand and participate in the trial process, not the defendant’s past mental
capacity or responsibility for decisions. Many adjudicative competence principles
drawn from competence to stand trial (CST) case law form the basis for many
adjudicatory competence issues. CST implicates constitutional rights essential to a fair
trial. The United States Supreme Court set the CST standard in Dusky v. United States
(1960). The court noted that it is not enough for a trial judge to find that the defendant
is “oriented to time and place and has some recollection of events” in order to be
deemed competent to stand trial. Rather, the defendant must have “sufficient present
ability to consult with his lawyer with a reasonable degree of rational understanding,”
and have “a rational as well as factual understanding of the proceedings against him.”
In Drope v. Missouri (1975), the court added that the competent defendant must be able
to consult with counsel and assist in preparing his defense. In addition, the Drope Court
held that the trial court’s inquiry about the defendant’s competence does not end when
the trial begins. Rather, “A trial court must always be alert to circumstances suggesting
a change that would render the accused unable to meet the standards of competence to
stand trial” (p. 181). There are no “fixed or immutable” indicators that the trial court
may use before or during trial to determine the defendant’s CST. The defendant’s
irrational behavior, trial demeanor, and any prior medical condition are relevant—or
only one of these considerations may be sufficient—when the court considers whether
to inquire further into the defendant’s CST (p. 180).

The Supreme Court emphasized that CST is the foundation upon which other rights
essential to a fair trial are based: the right to effective assistance of counsel; the rights to
summon, confront, and cross-examine witnesses; and the right to testify on one’s own
behalf or to remain silent without penalty for doing so (Riggins v. Nevada, 1992,
Kennedy, J., concurring). The question then arises of whether the CST standard is the
same standard that is required for a defendant to plead guilty or to waive the right to
assistance to counsel. The Supreme Court in Godinez v. Moran (1993) held

In addition to determining that a defendant who seeks to plead guilty or waive counsel is
competent, a trial court must satisfy itself that the waiver of his constitutional rights is
knowing and voluntary. In this sense, there is a ‘heightened’ standard for pleading guilty

Copyright © 2010 John Wiley & Sons, Ltd. Behav. Sei. Law 28: 585-602 (2010)
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588 D. W. Shuman and J. A. Zervopoulos

and for waiving die right to counsel, but is not a ‘heightened’ standard of competence (p.
400).

This clouded Godinez standard echoes the flexibility of Drope’s CST standard,
highlighting a trial court’s discretion when deciding these adjudicative competence
issues.

The Godinez court referenced Johnson v. Zerbst (1938), the seminal case that
addressed the general legal standard for waiving individual rights recognized by the U.S.
Constitution (Rogers & Shuman, 2005, p. 115), to place its ruling in context. Johnson, a
waiver of counsel case, describes a waiver as an intentional relinquishment or
abandonment of a known right or privilege (Johnson, p. 463). The trial court is expected
to protect the defendant’s Sixth Amendment right to counsel—”a serious and weighty
responsibility” that the trial judge bears when determining whether the defendant’s
waiver of counsel is “intelligent and competent” (p. 465).

However, the standards for this judicial determination are not bright-lined. Eor
example, Johnson notes that the decision about whether the defendant’s waiver of
counsel is intelligent “must depend, in each case, upon the particular facts and
circumstances surrounding that case, including the background, experience, and
conduct of the accused” (p. 463). A later waiver of counsel Supreme Court case held
that there was no reason to discard the Johnson standard for an inflexible one (North
Carolina v. Butler, 1979). ;„

In cases following Johnson, the court’s opinions amphfied the flexible knowing,
intelligent, and voluntary criteria and their applications. The Sixth Amendment, which is
the authority on which the right to counsel at all critical stages of a prosecution that might
result in incarceration is grounded (Maine v. Moulton, 1985), correlatively recognizes the
defendant’s right to waive counsel and represent himself. If the defendant chooses to waive
counsel, “he should be made aware of the dangers and disadvantages of self-
representation, so that the record will establish that ‘he knows what he is doing, and
his choice is made with eyes open”‘ (Faretta v. California, 1915). The information a
defendant must possess in order to make an intelligent election depends on a range of case-
specific factors that include the defendant’s education or sophistication, the complex or
easily grasped nature of the charge, and the stage of the proceedings (Iowa v. Tovar, 2004).

The Miranda v. Arizona (1966) line of cases—which estabHshed a defendant’s rights to
remain silent when in police custody and to a lawyer—emphasized that a defendant may
waive these rights “provided the waiver is made voluntarily, knowingly, and intelligently”
(p. 444,475). The Miranda waiver should result from a “firee and deliberate choice rather
than from intimidation, coercion, or deception” (Moran v. Burbine, 1986, p. 421).
Eurther, “only if the ‘totality of the circumstances surrounding the interrogation’ reveals
both an uncoerced choice and the requisite level of comprehension may a court properly
conclude that the Miranda rights have been waived” (p. 421). Invoking the same principle,
Godinez later held that the voluntary inquiry’s purpose is to ensure that the defendant’s
decision to waive the right to counsel is uncoerced (p. 417, n. 12).

Colorado v. Connelly (1986) addressed the question of how mental illness might
impact the voluntary quality of a defendant’s constitutional right waiver. It established a
condition for when a court may consider the “voluntary” prong. In Connolly, the
defendant asked the court to nullify his confession after he waived his Miranda rights
because his mental state at the time interfered with his “rational intellect” and “free
will” (p. 160). The defendant traveled from Boston to Denver to confess to a Denver

Copyright © 2010 John Wiley & Sons, Ltd. Behav. Sei. Law 28: 585-602 (2010)
DOI: 10.1002/bsl

Empathy or Objectivity 589

murder. After he was given his Miranda warnings, the defendant said that he
understood the Miranda rights and wanted to talk about the murder. The next day, the
defendant claimed that “voices” had directed him to go to Denver and confess. At a
preliminary hearing, an examining psychiatrist testified that the defendant was
psychotic and had been experiencing “command hallucinations” that had interfered
with the defendant’s “volitional abilities.” However, the hallucinations had not
significantly impaired the defendant’s cognitive abilities—the defendant had under-
stood his rights when the officers told him that he need not speak (p. 161).

The Connolly Court, in a controversial opinion, held that police coercion is a
necessary predicate to finding that a confession is not “voluntary” within the meaning
of the Due Process Clause of the Fourteenth Amendment (p. 167). The dissent
objected to this strict definition of “voluntary” and insisted that “voluntary” entails the
importance of free will and of reliability and, thus, demanded an inquiry into the
“totality of the circumstances” surrounding the confession (p. 176).

>X île the predicate to finding that a defendant’s confession is not voluntary is police
coercion, cases after Connolly appear unclear about whether internal coercion,
infiuenced by emotional factors, may be exempted when considering “voluntariness”
where external coercion interacts with these emotional factors (Rogers and Shuman,
2005, p. 122). For example, the U.S. Supreme Court in Withrow v. Williams (1993)
noted that courts look to the “totality of circumstances” to determine whether a
confession was voluntary (p. 689). The circumstances may include “the crucial element
of police coercion” as well as the length of the interrogation and its location and
continuity. In addition, the court may consider the defendant’s maturity, education,
physical condition, and mental health (Schneckloth v. Bustamonte, 1973; Withrow v.
Williams, 1993) for characterization of “totality of the circumstances”—of both the
accused and the details of the interrogation—when determining voluntariness in a
waiver to consent to search of a car case.

Although competence to be executed may appear to share similar concerns as the
competencies discussed above, its constitutional grounding is different, and it spotlights
the empathy-objectivity tension. CST throughout the trial and competence to waive the
right to assistance of counsel are based on the U.S. Constitution’s Sixth and Fourteenth
Amendments (Dusky v. United States, 1960; Drope v. Missouri, 1975; Godinez v. Moran,
1993). Miranda’s recognition of the right to remain silent and to have a lawyer is
“indispensable to the protection of the Fifth Amendment privilege” (Miranda v.
Arizona, 1966, p. 469).

Competence to be executed (CE) has a different constitutional basis than CST,
competence to waive counsel, or competence to waive Miranda rights. Death penalty
law is based in the Eighth Amendment’s prohibition of the state imposing cruel and
unusual punishment on defendants (Furman v. Georgia, 1972). In Ford v. Wainwright
(1986), the U.S. Supreme Court held that the Eighth Amendment prohibits the state
from infiicting the death penalty upon an insane prisoner. What emerged as the two-
pronged standard for determining whether the criminal should be executed was
articulated in Justice Powell’s concurring opinion in Ford: “[T]he Eighth Amendment
forbids the execution only of those who are unaware of the punishment they are about to
receive and why they are to suffer it” (Ford, p. 422)—a humanitarian rationale that
preserves the legal system’s values and integrity. Nevertheless, what it means to be
competent to be executed has not been paid much attention in case law and scholarly
writings (Saks, 2009, p. 3). In a recent case, the court acknowledged that “rational

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590 D. W. Shuman and J. A. Zervopoulos

understanding” as a concept in competence to be executed cases is difficult to define
(Panetti V. Quarterman, 2007).

Atkins V. Virginia (2002) highlighted other judgment-related issues in competence to
be executed cases. Like the Ford rationale, Atkins held that executions of mentally
retarded criminals are cruel and unusual punishments prohibited by the Eighth
Amendment (p. 304). The U.S. Supreme Court noted that, while the deficiencies of
mentally retarded persons do not warrant exemptions from criminal sanctions, the
deficiencies diminish the personal culpability of these convicted criminals (p. 305). The
court did not specifically define mental retardation, leaving to the states to draft
legislation to comply with the ruling—states differ in their statutory definitions of
mental retardation for death penalty cases, related strict test cutoff scores, and
mandated assessments (Duvall & Morris, 2006). Nevertheless, the court offered a two-
pronged definition of mental retardation: the defendant’s intellectual functioning
would be “subaverage,” and the defendant would also show significant limitations in
adaptive skills such as communication, self-care, and self-direction, both of which
manifested themselves before the age of 18.

In sum. Supreme Court cases set out important constitutional principles in
adjudicative competence-related cases, but the court’s interpretations of these
principles do not lend themselves to bright-line definitions and applications, leaving
ample room for discretion in each case.

THE FORENSIC EXAMINER BACKDROP

Courts admit expert testimony that will “assist the trier of fact” to weigh the evidence
properly (Fed. R. Evid. 702). This requires that the testimony be relevant (i.e., correct
legal standard) and reliable (i.e., consistency and accuracy). The Federal Rules of
Evidence apply in trials, not in “preliminary matters in criminal cases” (Fed. R. Evid.
1101(d)(3)). In federal courts competence to stand trial is determined by the judge,
although in some states a jury trial may occur at which the rules of evidence apply (Cal
Penal Code §1369 (2010)). It is risky to assume that the same evidentiary demands will
not apply in these trials. The Dauben revolution changed the rules, and judges who
apply Dawèerr principles have learned to ask “Doctor, why should I believe that you can
prove what you say?” Moreover, the forensic examiner’s ethical obligation is triggered
by the examiner-examinee relationship, not by the applicability of the rules of evidence.
To meet this obligation to present relevant and reliable information, forensic mental
health professionals have developed forensic assessment instruments to operationalize
and measure many adjudicative competence legal principles (Grisso, 2003). While the
law does not define these principles by test results, some instruments have proven useful
to support expert opinions. Tom Grisso, a pioneer in the field, cautions that expert
opinions about a person’s capacity to waive Miranda rights should not rest on these
instruments alone (p. 191). The use of these instruments, by itself, to support any
adjudicative competence opinions is not legally sufficient. In sum, experts still must
apply the forensic assessment instrument results, no matter how empirically based, to
the legal standard required in a given examination—inferences that may not avoid the
empathy-bias problem. Can forensic mental health experts put aside this empathy and
conduct their work as objectively as Chief Justice Roberts’s baseball umpires? Or
can these experts acknowledge their empathy for the client and the client’s issues yet

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Empathy or Objectivity 591

set their goal as “fidelity to the law”—analogous to the standard of objectivity that
professional practice guidelines, ethics codes, and rules of evidence require?

EMPATHY AND BIAS

In everyday parlance, empathy is regarded as the ability to identify with another. What is
meant by empathy here differs because it deals with a technique used in psychotherapy
and with an expert’s role in the judicial process. In this article, two ways that empathy
must be managed in forensic practice are addressed. The first aspect of empathy is the
inappropriate use of empathy as a therapeutic technique in a forensic exam to cause the
examinee to forget the purpose of the exam, albeit having been warned. In therapy, this
is evidenced when the therapist conveys to the patient an understanding and emotional
awareness of the patient’s experience “as if I am the other”—beyond merely
sympathetic sharing of another’s feelings or friendly rapport (Greenberg & Elliott,
1997, pp. 167-168). The therapist’s empathie expressions are thought to allow the
patient to trust the therapist and, as a result, to more comfortably express personal
concerns to the therapist (Barrett-Leonard, 1981). This use of empathy is referred to
here as therapeutic empathy.

The second concern is with the effect of empathy on the objectivity of the evaluation.
Can examiners adequately monitor and govern their personal views about cases to ensure
that bias does not improperly infiuence their expert opinions (Bonnie, 1990; Brooks,
2009; Kmiec, 2009)? This use of empathy is referred to here as empathy-bias.

THE USE AND MISUSE OF EMPATHY

Both therapeutic empathy and empathy-bias threaten the forensic evaluation. In this
section the reasons why the authors think that therapeutic empathy has no place in a
forensic evaluation are summarized. In the remainder of the article the threat to forensic
evaluations posed by empathy-bias will be examined in detail and a model to manage it
will be proposed.

During their training, clinical psychologists and psychiatrists learn how to use
therapeutic empathy in psychotherapy. Therapists purposefully apply empathy
techniques in psychotherapy. The therapeutic use of empathy is intended to benefit
the patient, who will as a result feel understood and comfortable making disclosures in
psychotherapy. A private patient who undergoes psychotherapy voluntarily consents to
undergo such treatment, whose sole purpose is to benefit the patient. To encourage this,
as a general rule, the therapist may not disclose or be compelled to disclose information
revealed in therapy. The patient may choose to end the therapy at any time.

That same justification does not exist in forensic examinations. The forensic
examination’s goal is not to benefit the examinee. Rather than a consensual relationship a
patient chooses to begin and end, the choice to begin and end the forensic relationship may
have serious legal consequences, such as dismissing a claim or striking a defense. Because
the forensic examination’s purpose is testimony rather than treatment that benefits the
patient, the same limits on relational privacy do not exist (Perlin, 1991). It is a mistake to
assume that what is done in therapy may also be done in a forensic examination.

There are several irreconcilable confiicts between psychotherapy and forensic
relationships and significant difficulties for both the patient and the legal system when

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592 D. W. Shuman and J. A. Zervopoulos

forensic experts or therapists do not respect relationship boundaries (Greenberg &
Shuman, 1997). Professional guidelines have also tied an examiner’s use of
empathy in forensic interviews to inappropriate role mixing that may harm the examinee
and compromise the reliability of subsequent expert testimony. For example, the
American Psychiatric Association’s Task Force on the Role of Psychiatry in Sentencing
(Psychiatry Task Force) cautioned that “use of empathetic techniques and tools of
clarification and interpretation may lower a subject’s usual defenses” (American
Psychiatric Association, 1984, p. 203). Although the Psychiatry Task Force stated that
a forensic examiner’s empathie techniques could be justified to protect the defendant
from harm in the interview, the Psychiatry Task Force also expressed concern that ifthe
examiner were to employ empathie techniques in a forensic interview the defendant
might reveal information that could damage himself legally in response to an examiner’s
empathetic comments (p. 203). To guard against this potential harm, the examiner,
using her judgment, should consider terminating the interview whenever the subject is
confused about the interview’s purpose. Further, the examiner should remind the
defendant “who appears to be slipping into a therapeutic mindset” that the interview is
not intended to be therapeutic before proceeding with the examination (p. 203).

Research, however, finding that therapists do not accurately assess the level of what we
call therapeutic empathy that patients perceive, suggests that the Psychiatric Task Force’s
expectation that the forensic examiner can distinguish between showing empathy to
protect the defendant versus inappropriately using empathy to gain information from the
defendant is illusory (Shuman, 1993). This presents a professional and ethical concern for
the forensic examiner, beyond what even comprehensive informed consent warnings can
remedy, that could lead the defendant to slip into a therapeutic mindset and,
consequently, compromise the defendant’s legal rights (Shuman, 1993, p. 289).

Empathy-bias, a broader notion of empathy that is defined here as the forensic
examiner’s personal views and mindset towards the examination’s purpose, may also
bias the evaluation findings and subsequent testimony of forensic examiners. This
empathy-bias may compromise the objectivity of the findings and testimony that
professional ethics require of forensic examiners and that the court demands of
testifying experts. When this empathy becomes bias, the forensic examiner puts his or
her thumb on the scale of objectivity and directs the outcome towards a preferred end.
This empathy-bias may occur either in the evaluation, in the report writing, or on the
witness stand (Gutheil & Simon, 2004). Consider a forensic evaluator, personally
against the death penalty, who conducts a competence to be executed examination with
a defendant whose behaviors raise questions about her understanding of the reasons for
her impending execution. In the interview, the evaluator should not use therapeutic
empathy to elicit statements from the defendant. But the evaluator may, nonetheless,
consciously or unconsciously frame his evaluation data interpretations in a manner that
supports his personal stance against the death penalty. Of course, this empathy-bias will
also apply to examiners with pro-death-penalty beliefs.

THE EVALUATOR’S DILEMMA

The evaluator’s dilemma may be particularly evident in capital cases. May a forensic
examiner participate in a case when he or she holds personal views on the death penalty?
It is a fair assumption that the examiner has views on issues of the day, particularly on a

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Empathy or Objectivity 593

high-Stakes issue like the death penalty. However, the administration of justice in capital
cases would be compromised if too many forensic specialists declined to conduct
evaluations in these cases (Bonnie, 1990, p. 78). In this case, the pool of available
experts could be slanted in the direction of those least likely to provide mitigating
testimony, depriving capital defendants of fair opportunities to develop their cases and,
thus, seriously compromising their Eighth Amendment rights (pp. 78, 89). Thus the
standards developed by the U.S. Supreme Court to account for “the diverse frailties of
humankind” (Woodson v. North Carolina, 1976) may not be realized if mental health
professionals decline to participate (Bonnie, 1990, pp. 89-90).

CST hearings cast a different slant on the evaluator’s dilemma. Many of these
hearings are perfunctory exercises during which the court accords the forensic
examiner’s opinion much deference, often with little, if any, testimony that could
illuminate the “black box” from which the opinion arises Q. Bellin, personal
communication, Eebruary 14, 2010). Yet, as noted earlier, empathy-bias in the forms of
“Guardians” and “Green-Lighters” has been shown to steer examiner’s opinions in
routine CST cases (Goldstein & Stone, 1977). The absence of legal oversight in many
CST hearings highlights the ethical imperative that forensic experts actively challenge
biases that may infect their opinions in these cases.

The forensic expert’s ethical requirement for objectivity complements Eederal Rules
of Evidence 7O2’s requirement that only objective testimony can assist the trier of fact.
Rule 702 provides the structure for admissible expert testimony, describing the kind of
testimony that will quahfy (scientific, technical, or other specialized knowledge), the
support on which the expert bases the testimony (knowledge, skill, experience, training,
or education), and the characteristics of the testimony that will ensure its legal
reliability. Rule 702 also emphasizes that the purpose for admitting expert testimony is
to “assist the trier of fact to understand the evidence or to determine a fact in issue….”
Absent this purpose, the court will not qualify a witness to offer expert opinions (Trigon
Ins. Co. V. U.S., 2001, noting “[e]xperts participate in a case because, ultimately, the
trier of fact will be assisted by their opinions, pursuant to Rule 702 Eed. R. Evid.”)
Experts’ opinions can assist the trier of fact only when experts strive to be objective.

Proffering expert opinions on adjudicative competence issues does not differ from
proffering other expert opinions. Any reliable expert opinion is a set of inferences from
data derived from reliable methods (Daubert v. Merrell Dow Pharmaceuticals, Inc., 1993,
p. 590). Eurther, while “[T]rained experts commonly extrapolate from existing data…
[A] court may conclude that there is simply too great an analytical gap between the data
and the opinion proffered” (General Electric Co. v. Joiner, 1997, p. 146). If the inferences
that the expert uses to bridge the analytical gap between the data and the proffered
opinion are too tenuous, the trial court, in ruling on a timely and specific objection, may
judge the opinion as unreliable, and, therefore, inadmissible. It is when experts draw
inferences to develop their opinions that biases may infect testimony and compromise
the testimony’s reliability.

PROPOSALS TO MANAGE EMPATHY-BIAS

Although forensic psychology and psychiatry professional guidelines and literature
emphasize that experts conduct their evaluations objectively and testify fairly and
honestly, other writings also acknowledge experts’ dilemma about how to conduct their

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594 D. W. Shuman and J. A. Zervopoulos

work when they may harbor stances about the subject matter of their work. Gold (2004,
p. 39) notes, in the context of sexual harassment litigation, that examiners are not
required to be devoid of political or social opinions and, in any event, cannot change
their life circumstances. As a result, she maintains, absolute objectivity is unattainable.
The forensic examiner’s ethical obligation, she argues, is to strive for, not guarantee,
objectivity. Gold further notes that even the presence of significant bias regarding a
particular case may not be harmful if the expert recognizes the bias and continues to
strive for objectivity (Gold, 2004, p. 54; Simon, 1996).

Gold’s assertions beg the question of how the forensic expert may develop objective
testimony that will assist the court if the expert harbors a bias towards the client or
case. Gold writes that experts minimize bias infiuences “by honestly evaluating the
degree of their influence and by adhering to standard forensic and psychiatric
methodology” (Gold, 2004, p. 55). While Gold’s answer reflects the prevailing
position among forensic professionals, it provides the examiner with few tools to
actively challenge these biases. The meaning of “honestly evaluating” is in the
examiner’s eye. Moreover, while non-adherence to standard methodology raises “red
flags” about the legal reliability of the expert’s opinion, such adherence, by itself, does
not ensure reliability (Shuman & Greenberg, 1998). By itself. Gold’s bias-checking
method is too passive.

Wills (2008) presents a more active, systematic approach to help the forensic expert
“checkmate” opinion bias. Her CHESS model for developing expert opinions contains
five steps: C, formulating the claim (preliminary opinion) after gathering the data; H,
establishing a hierarchy of supporting evidence; E, examining the evidence for
exposure, or areas of potential vulnerability to cross-examination; S, studying the
evidence to respond to these potential weaknesses and determining whether additional
data are needed to bolster the opinion; and S, synthesizing a revised opinion with
stronger supporting evidence (Wills, 2008, p. 537). Wills notes that her model’s
process—which the expert may repeat until she is satisfied with the product—helps
experts use supporting evidence prudently and acknowledge contrary evidence in order
“to formulate balanced opinions that will withstand cross-examination” (p. 539). The
result of the CHESS model. Wills argues, will be more balanced testimony that will
assist the trier of fact (p. 540). Our analysis is that, while the CHESS model is more
active than Gold’s approach, it is too focused on defending the opinion and not enough
on the opinion’s development.

A more active, assertive approach during the opinion’s development that looks for
the best explanation of the data is required. Relying on self-generated prospective cross-
examination questions to already-formed opinions or admonishing forensic psychol-
ogists and psychiatrists to be aware of empathy-bias are inadequate solutions. Cognitive
psychology research indicates that even experienced professionals are prone to cognitive
biases when they make judgments based on clinical interviews, even when given
informative feedback (Faust, 1986, p. 426). Further, awareness that one makes such
errors does not necessarily protect against those errors (p. 427). The lesson? Forensic
examiners must actively challenge their thinking so that their defendant- or case-based
empathy does not translate into biases that would compromise the objectivity and
reliability of their work product and expert opinions (Goldyne, 2007, p. 63). Following
professional guidelines gives some structure to the inductive-inference gathering
process, and strengthening opinions against cross-examination may highlight
weaknesses in already-formed opinions, but more is required.

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• Empathy or Objectivity 595

A PROPOSED MODEL TO MANAGE EMPATHY-BIASES

Plausible Altemative Explanations: The Foundation

Formal tests for the admissibility of an expert opinion include whether the opinion is
falsifiable, whether the opinion’s known or potential error rate is unacceptably high, and
whether the opinion and its underlying methods are generally accepted in the expert’s
discipline (Dauben, 1993, p . 590; Frye v. United States, 1923). What these tests ask is
why we should accept the expert’s opinion as reliable. Daubert notes that “evidentiary
reliability will be based upon scientific validity” (1993, pp. 5 9 0 – 5 9 1 , n.9). T h e
scientific method is but an aspect of critical thinking—a systematic effort to ensure that
things said about the world are accurate (Pinker, 2007). As the forensic evaluator
examines the data developed in the examination, he or she must determine which
explanations of the data are reasonable, and which are not. The objective of this
inductive, inference-driven process is to arrive at the best explanation of the data that
minimizes the effects of biases (Lipton, 2004). The key to achieving this objective is an
active consideration of plausible altemative explanations for the gathered data
( C E G F P , 1991)—more than merely a cursory process. This essential approach is
required by three sources with which forensic examiners must comply: case law,
research psychology, and forensic professional guidelines.

Case law has emphasized that experts developing their opinions consider plausible
alternative explanations as a condition of admissibility, without regard to research
psychology or professional ethics. The advisory committee note to the 2000 post-
Daubert amendments to Federal Rules of Evidence 702 summarized the collective
wisdom of courts’ applications of Dauben’s pragmatic considerations:

(3) Whether the expert has adequately accounted for obvious alternative explanations.
See Claarv. Burlington N.R.R., 29 F.3d 499 (9th Cir. 1994) (testitnony excluded where the
expert failed to consider other obvious causes for the plaintiffs condition). Ambrosini v.
Labarraque, 101 F.3d 129 (D.C. Cir. 1996) (the possibilitj’ of some uneliminated causes
presents a question of weight, so long as the most obvious causes have been considered and
reasonably ruled out by the expert).

In Claar (1994, p. 502), a federal district court’s decision to exclude affidavits of two
medical experts was upheld by the Ninth Circuit Court of Appeals, whose reasoning
centered on the experts’ failure to rule out other possible causes for the plaintiffs
injuries. In an example taken from a state case, the Texas Supreme Court noted that an
expert trying to find a cause of something should carefully consider alternative causes
(E.I. du Pont de Nemours and Co. v. Robinson, 1995,p. 551, quoúng In re Paoli RR, 1994,
pp. 758-759).

Research psychology points to testing alternative explanations as the basis of
experimental design. In their classic work on experimental research, Campbell and
Stanley (1963, p. 35) assert that the “results of an experiment ‘probe’ but do not ‘prove’
a theory,” and that an adequate hypothesis “repeatedly survived such probing, although
it (the adequate hypothesis) may always be displaced by a new probe”—Dauben (1993,
p. 590) echoes this idea, acknowledging that science does not traffic in certainty. In this
scientific probing process, “varying degrees of ‘confirmation’ are conferred upon a
theory through the number of plausible rival hypotheses available to account for the
data. The fewer such plausible rival hypotheses, the greater the degree of
‘confirmation'” (Campbell & Stanley, 1963, p. 36).

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596 D. W. Shuman and J, A; Zervopoulos

Finally, forensic professional guidelines encourage forensic experts to test plausible
alternative explanations while developing their opinions. The American Academy of
Psychiatry and Law’s (AAPL’s) Fthics Guidelines for the Practice of Forensic Psychiatry (2005,
p. 3) states that psychiatrists “communicate the honesty of their work, efforts to attain
objectivity, and the soundness of their clinical opinion, by distinguishing,, to the extent
possible, between verified and unverified information as well as among clinical ‘facts,’
‘inferences,’ and ‘impressions.'” More explicitly, the American Psychological Association’s
(APA’s) Division 41 Specialty Guidelines for Forensic Psychologists states that “the forensic
psychologist maintains professional integrity by examining the issue at hand from all
reasonable perspectives, actively seeking information that will differentially test plausible
rival hypotheses” (CEGFP, 1991, p. 661). The principle is reiterated in the upcoming
updated guidelines draft (http://www.ap-ls.org/aboutpsychlaw/92908sgfp ).

GENERATING AND TESTING PLAUSIBLE ALTERNATIVE
EXPLANATIONS

Philosophical writings on inference-based thinking (Lipton, 2004) and cognitive
psychology research provide a framework for a model by which mental health
professionals may actively test plausible alternative explanations in their forensic work.
These literatures suggest that forensic examiners apply two key steps to develop reliable
conclusions and expert opinions that minimize biases. First, examiners should generate
plausible or reasonable alternative explanations to their data. Next, examiners should
actively challenge how each plausible explanation squares with the data until an
explanation emerges that best “fits” the data. One step without the other will not likely
cut through biases that may taint an expert opinion.

Step One: Generate Plausible Alternative Explanations

From where do plausible alternative explanations of data arise? How can one determine
what alternative explanations are plausible? As discussed earlier, these questions speak
directly to the legal reliability of expert opinions (Fed. R. Evid.. 702 advisory
committee’s note), and to the forensic expert’s professional, even ethical, obligations
(CEGFP, 1991, p. 661).

To address these key concerns, scientists apply a general inference strategy known to
philosophers as inference to the best explanation (IBE) (Day & Kincaid, 1994; Lipton,
2004). By its name alone, IBE echoes the same process that the ethical forensic
examiner who weighs plausible alternative explanations applies, but on its surface IBE
also begs the same troubling concerns as the forensic examiner’s “plausible alternative
explanations” process: “From where do plausible alternative explanations of data
arise?” and “How does one determine what alternative explanations are plausible?”

Day and Kincaid (1994) address these concerns by emphasizing that the IBE
process, rather than inferring random hypotheses, draws from the context in which IBE
is applied to decide among serious competitors for the best explanation of considered
data. Three features fiesh out the context of a properly applied IBE strategy:
background knowledge; internal vs. external evidence; and purposes.

IBE’s first contextual feature relies on “our best background knowledge” to identify
plausible reasonable explanations of considered data (Day and Kincaid, 1994, p. 286).

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Empathy or Objeetivity 597

Background knowledge of a question’s topic directs the inquirer to pursue data by
asking relevant questions and to develop reasonable explanations of the data (Lipton,
2004). For the forensic mental health professional, the same process applies: research
and professional knowledge of the topic in which the expert will offer an opinion directs
exploration of data, aids in developing plausible alternative explanations of the data,
and provides a basis for the opinion. For example, forensic examiners who conduct
CST evaluations will consider better plausible explanations of their evaluation data if
they are knowledgeable about the research literature in malingering and use that
knowledge to question the data (Rogers, 2008). To emphasize this point, Daubert notes
that permitting experts “wide latitude to offer opinions… is premised on the
assumption that the expert’s opinion will have a reliable basis in the knowledge and
experience of his discipline” (Daubert, 1993, p. 592). In addition, professional ethics
requires that experts provide services only in areas in whieh they are competent (APA,
2002).

IBE’s second contextual feature addresses the kinds of evidence considered in
reaching the best explanation—internal evidence and external evidence. Internal
evidence concerns the data that examiners consider in a case to support their
conclusions. In a CST exam, internal evidence might include a defendant’s responses in
interviews, results from a forensic assessment instrument, and information from
collateral sources. External evidence concerns the adequacy and reliability of the
expert’s methods used to develop the data (Day & Kincaid, 1994). Methodological
reliability is a key concern of the Daubert cases—unreliable methods do not yield
reliable data or lead to reliable conclusions, or inferences in IBE’s parlance (see Joiner,
1997, p. 146). The same principle applies professionally to the forensic examiner:
“(P)sychologists base their opinions…, including forensic testimony, on information
and techniques sufficient to substantiate their findings” (APA, 2002).

IBE’s third contextual feature, IBE’s purpose, overlaps the first two features. The
inference’s purpose relates to the inference’s audience. For example, mental health
colleagues of advanced forensic examiners in a professional conference will likely
understand much of the background knowledge, the kind of evidence considered, and the
reliability of methods used to develop plausible alternative explanations, or IBEs, in a CST
examination—time or energy is not required to educate this audience about the basics.
However, it is because courts and juries do not have this ‘ ‘background knowledge’ ‘ that the
law allows experts to “assist the trier of fact to understand the evidence” (Fed. R. Evid.
702). In this latter case, forensic experts must show the background information that
drives their data collection and hypothesis generation, and also that the data they consider
derives from reliable methods. Without these connections, the court cannot judge a
proffered opinion that claims to represent the most reasonable of plausible alternatives, or
the inference to the best explanation. This makes sense—Joiner (1997) notes that “a court
may conclude that there is simply too great an analytical gap between the data and the
opinion proffered” and, thereby, rule the proffered opinion inadmissible (p. 146).

Step Two: Actively Challenge Plausible Alternative Explanations

The second key step to develop reliable conclusions and expert opinions that minimize
biases is that examiners should actively challenge how each plausible explanation
squares with the data until an explanation emerges that best “fits” the data.

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598 D. W. Shuman and J. A. Zervopoulos

Cognitive psychology research suggests that actively challenging plausible alternative
explanations goes beyond what many forensic examiners may consider adequate. Eor
example, in a study exploring hindsight bias, Eischhoff (1977) found that merely
warning subjects about the bias or exhorting them to work harder to consider alternative
explanations to the information they had failed to undo the effects of the bias. Hirt and
Markman (1995) found evidence for the debiasing effects of a “counter-explanation
task.” Eurther, debiased judgments more likely occur when subjects explain
subjectively plausible alternative outcomes rather than when they explain subjectively
implausible alternative outcomes. In a study on hypothesis generation and confidence,
Koehler (1994) found that subjects appeared better able to judge the accuracy of
hypotheses if they generated the hypotheses themselves than if the hypotheses were only
presented to them to evaluate. Applying these principles to clinical judgments, Eaust
(1986) noted that professionals “should habitually generate possible reasons why their
conclusions may be wrong and possible reasons why another possibility may be
correct.” (p. 427) Goldyne (2007), in his practical approach to minimize the influence
of “unconscious bias,” insists that forensic experts proactively challenge biases “rather
than passively await an inkling of them.” (p. 63) Science writer Sharon Begley (2006),
noting qualities of critical thinking that distinguish reasonable from unreasonable
assertions, summarizes these principles succinctly: “You have to want to think critically.
If you have good critical-thinking skills but for some reason are not motivated to deploy
them, you will reach conclusions and make decisions no more rationally than someone
without those skills” (p. Bl).

APPLYING A MODEL TO MANAGE EMPATHY-BIASES

Our discussion thus far shows that forensic experts must apply two steps to manage
empathy-biases adequately when developing their conclusions and opinions. Eirst,
experts should generate plausible alternative explanations to the data they consider.
Then, they should actively challenge how each plausible explanation squares with the
data until an explanation emerges that best “fits’ the data. To apply these steps, we
suggest a six-stage model that will aid the expert’s obligation to provide objective
testimony on which the court may rely.

Conform the examination to the referral question

The examination’s referral question provides the examination’s focus. A vague or
inadequately phrased referral question may trigger relevance and reliability concerns
that could compromise expert opinions derived from the examination.

Conduct the examination only if one has the expertise to address the
referral question

One key measure of the expertise to address the referral question is familiarity with the
“background knowledge”—including research, professional writings, legal principles,
and professional forensic guidelines and standards—required to address the referral

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Empathy or Objectivity 599

question (IBE’s first contextual feature). Ethical experts use this background
knowledge to orient their search for relevant data (IBE’s internal evidence contextual
feature) that will lead to plausible alternative explanations of the data.

Expertise also enables experts to ensure that the methods they use to evaluate
gathered and generated data are scientifically valid and legally reliable (Daubert, 1993).
This applied “background knowledge” (IBE’s external evidence contextual feature)
will ensure “that the expert’s opinion will have a reliable basis in the knowledge and
experience of his discipline” (p. 592).

Keep in tnind the purpose of one’s expert testimony

This IBE contextual feature overlaps with “background knowledge” and data gathering
and assessment. The trier of fact is the expert’s audience—experts are qualified to assist
the court with reliable testimony “to understand the evidence or to determine a fact in
issue” (Fed. R. Evid. 702). Such assistance is the sine qua non of expert testimony
(Trigon, 2001, p. 295). Courts require experts to “show their work” by demonstrating
that the proffered opinions are adequately connected to data derived from reliable
methods—”A court may conclude that there is simply too great an analytical gap
between the data and the opinion proffered” (Joiner, 1997, p. 146).

Use one’s expertise, background knowledge, and examination data
derived from reliable methods to develop plausible alternative

explanations to explain the data in light of the referral question

Because scientific thinking is inductive, more than one hypothesis will plausibly explain
data that an expert considers in a particular case (Day & ICincaid, 1994)—the case itself
represents conflicting plausible explanations of facts. For example, in a CST
examination, plausible alternative explanations may include the following: the
defendant is competent; the defendant is competent but malingering; the defendant
is incompetent and temporarily lucid; the defendant tests well but does not actually
understand the test questions Q. Bellin, personal communication, February 14, 2010).

Developed hypotheses will more likely be plausible if the expert’s examination
approach conforms to the model stages discussed thus far. In contrast, an expert will
engage in noncritical, biased thinking when she, consciously or unconsciously,
prematurely insists on one hypothesis to explain case data and then looks to other data
to confirm this settled hypothesis (Goldyne, 2007; Tversky & Kahneman, 1974).

Actively challenge each plausible alternative hypothesis by
explaining, orally or in writing, the case data in the context

of each hypothesis

Recall research indicating that merely warning subjects about bias or exhorting them to
work harder to consider alternative explanations of information they had failed to undo
bias (Fischhoff, 1977). Actively generating plausible reasons why certain explanations
may be wrong and plausible reasons why others may be correct helps to cut through

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600 D . W. Shuman and J. A. Zervopoulos

biased notions (Faust, 1986; Koehler, 1994)—”you have to want to think critically”
(Begley, 2006, p. Bl).

If possible, determine the explanation that best fits the considered
data

This final step results in the expert’s conclusions and opinions. However, experts
should recognize that, because scientific inferences may never conclusively explain a
given set of data, an expert may not be able to arrive at a “best” explanation of
examination or case data. For example, more than one “best” plausible explanation
may sufficiently fit the case data. Or, a given set of considered data may not give rise to
any “best” plausible explanations that the court will deem as reliable.

CONCLUSION

Empathy or objectivity: the forensic examiner’s dilemma? Properly managed, this is a
false dilemma—in adjudicative competence cases and in other forensic endeavors. All
forensic examiners hold political or social opinions formed from their own experiences.
Absolute objectivity is unattainable, even under the best of circumstances (Gold, 2004).
Developing forensic opinions does not equate to dispassionately calling balls and strikes
irrespective of context. Rather, the forensic examiner’s ethical obligation is to strive for,
not guarantee, objectivity (Gold, 2004). A practical model is offered here to achieve that
goal.

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Ethical Principles of Psychologists and
Code of Conduct

CONTENTS
INTRODUCTION AND
APPLICABILITY

PREAMBLE

GENERAL PRINCIPLES
Principle A: Beneficence and

Nonmaleficence
Principle B: Fidelity and Responsibility
Principle C: Integrity
Principle D: Justice
Principle E: Respect for People’s Rights

and Dignity

ETHICAL STANDARDS

1. Resolving Ethical Issues

1.01 Misuse of Psychologists’ Work
1.02 Conflicts Between Ethics and

Law, Regulations, or Other
Governing Legal Authority

1.03 Conflicts Between Ethics and
Organizational Demands

1.04 Informal Resolution of Ethical
Violations

1.05 Reporting Ethical Violations
1.06 Cooperating With Ethics

Committees
1.07 Improper Complaints
1.08 Unfair Discrimination Against

Complainants and Respondents

2. Competence

2.01 Boundaries of Competence
2.02 Providing Services in Emergencies
2.03 Maintaining Competence
2.04 Bases for Scientific and

Professional Judgments
2.05 Delegation of Work to Others
2.06 Personal Problems and Conflicts

3. Human Relations

3.01 Unfair Discrimination
3.02 Sexual Harassment
3.03 Other Harassment
3.04 Avoiding Harm
3.05 Multiple Relationships
3.06 Conflict of Interest
3.07 Third-Party Requests for

Services

3.08 Exploitative Relationships
3.09 Cooperation With Other

Professionals
3.10 Informed Consent
3.11 Psychological Services Delivered

to or Through Organizations
3.12 Interruption of Psychological

Services

4. Privacy and Confidentiality

4.01 Maintaining Confidentiality
4.02 Discussing the Limits of

Confidentiality
4.03 Recording
4.04 Minimizing Intrusions on Privacy
4.05 Disclosures
4.06 Consultations
4.07 Use of Confidential Information

for Didactic or Other Purposes

5. Advertising and Other Public
Statements

5.01 Avoidance of False or Deceptive
Statements

5.02 Statements by Others
5.03 Descriptions of Workshops and

Non-Degree-Granting Educational
Programs

5.04 Media Presentations
5.05 Testimonials
5.06 In-Person Solicitation

6. Record Keeping and Fees

6.01 Documentation of Professional

and Scientific Work and
Maintenance of Records

6.02 Maintenance, Dissemination, and
Disposal of Confidential Records
of Professional and Scientific
Work

6.03 Withholding Records for
Nonpayment

6.04 Fees and Financial Arrangements
6.05 Barter With Clients/Patients
6.06 Accuracy in Reports to Payors and

Funding Sources
6.07 Referrals and Fees

7. Education and Training

7.01 Design of Education and Training

Programs
7.02 Descriptions of Education and

Training Programs
7.03 Accuracy in Teaching
7.04 Student Disclosure of Personal

Information
7.05 Mandatory Individual or Group

Therapy
7.06 Assessing Student and Supervisee

Performance
7.07 Sexual Relationships With

Students and Supervisees

8. Research and Publication

8.01 Institutional Approval
8.02 Informed Consent to Research

8.03 Informed Consent for Recording
Voices and Images in Research

8.04 Client/Patient, Student, and
Subordinate Research Participants

8.05 Dispensing With Informed
Consent for Research

8.06 Offering Inducements for
Research Participation

8.07 Deception in Research
8.08 Debriefing
8.09 Humane Care and Use of Animals

in Research
8.10 Reporting Research Results
8.11 Plagiarism
8.12 Publication Credit
8.13 Duplicate Publication of Data
8.14 Sharing Research Data for

Verification
8.15 Reviewers

9. Assessment

9.01 Bases for Assessments
9.02 Use of Assessments
9.03 Informed Consent in Assessments
9.04 Release of Test Data
9.05 Test Construction
9.06 Interpreting Assessment Results
9.07 Assessment by Unqualified

Persons
9.08 Obsolete Tests and Outdated Test

Results
9.09 Test Scoring and Interpretation

Services
9.10 Explaining Assessment Results
9.11 Maintaining Test Security

10. Therapy

10.01 Informed Consent to Therapy
10.02 Therapy Involving Couples or

Families
10.03 Group Therapy
10.04 Providing Therapy to Those

Served by Others
10.05 Sexual Intimacies With Current

Therapy Clients/Patients
10.06 Sexual Intimacies With Relatives

or Significant Others of Current
Therapy Clients/Patients

10.07 Therapy With Former Sexual
Partners

10.08 Sexual Intimacies With Former
Therapy Clients/Patients

10.09 Interruption of Therapy
10.10 Terminating Therapy

1060 December 2002 ● American Psychologist
Copyright 2002 by the American Psychological Association, Inc. 0003-066X/02/$5.00

Vol. 57, No. 12, 1060 –1073 DOI: 10.1037//0003-066X.57.12.1060

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INTRODUCTION AND APPLICABILITY
The American Psychological Association’s (APA’s)

Ethical Principles of Psychologists and Code of Conduct
(hereinafter referred to as the Ethics Code) consists of an
Introduction, a Preamble, five General Principles (A–E),
and specific Ethical Standards. The Introduction discusses
the intent, organization, procedural considerations, and
scope of application of the Ethics Code. The Preamble and
General Principles are aspirational goals to guide psychol-
ogists toward the highest ideals of psychology. Although
the Preamble and General Principles are not themselves
enforceable rules, they should be considered by psycholo-
gists in arriving at an ethical course of action. The Ethical
Standards set forth enforceable rules for conduct as psy-
chologists. Most of the Ethical Standards are written
broadly, in order to apply to psychologists in varied roles,
although the application of an Ethical Standard may vary
depending on the context. The Ethical Standards are not
exhaustive. The fact that a given conduct is not specifically
addressed by an Ethical Standard does not mean that it is
necessarily either ethical or unethical.

This Ethics Code applies only to psychologists’
activities that are part of their scientific, educational, or
professional roles as psychologists. Areas covered include
but are not limited to the clinical, counseling, and school
practice of psychology; research; teaching; supervision of
trainees; public service; policy development; social inter-
vention; development of assessment instruments; conduct-
ing assessments; educational counseling; organizational
consulting; forensic activities; program design and evalu-
ation; and administration. This Ethics Code applies to these
activities across a variety of contexts, such as in person,
postal, telephone, Internet, and other electronic transmis-
sions. These activities shall be distinguished from the
purely private conduct of psychologists, which is not
within the purview of the Ethics Code.

Membership in the APA commits members and
student affiliates to comply with the standards of the APA
Ethics Code and to the rules and procedures used to enforce
them. Lack of awareness or misunderstanding of an Ethical
Standard is not itself a defense to a charge of unethical
conduct.

The procedures for filing, investigating, and resolv-
ing complaints of unethical conduct are described in the
current Rules and Procedures of the APA Ethics Commit-
tee. APA may impose sanctions on its members for viola-
tions of the standards of the Ethics Code, including termi-
nation of APA membership, and may notify other bodies
and individuals of its actions. Actions that violate the
standards of the Ethics Code may also lead to the imposi-
tion of sanctions on psychologists or students whether or
not they are APA members by bodies other than APA,
including state psychological associations, other profes-
sional groups, psychology boards, other state or federal
agencies, and payors for health services. In addition, APA
may take action against a member after his or her convic-
tion of a felony, expulsion or suspension from an affiliated
state psychological association, or suspension or loss of

licensure. When the sanction to be imposed by APA is less
than expulsion, the 2001 Rules and Procedures do not
guarantee an opportunity for an in-person hearing, but
generally provide that complaints will be resolved only on
the basis of a submitted record.

The Ethics Code is intended to provide guidance for
psychologists and standards of professional conduct that
can be applied by the APA and by other bodies that choose
to adopt them. The Ethics Code is not intended to be a basis
of civil liability. Whether a psychologist has violated the
Ethics Code standards does not by itself determine whether
the psychologist is legally liable in a court action, whether
a contract is enforceable, or whether other legal conse-
quences occur.

The modifiers used in some of the standards of this
Ethics Code (e.g., reasonably, appropriate, potentially) are
included in the standards when they would (1) allow pro-
fessional judgment on the part of psychologists, (2) elim-
inate injustice or inequality that would occur without the
modifier, (3) ensure applicability across the broad range of
activities conducted by psychologists, or (4) guard against
a set of rigid rules that might be quickly outdated. As used
in this Ethics Code, the term reasonable means the pre-
vailing professional judgment of psychologists engaged in
similar activities in similar circumstances, given the knowl-
edge the psychologist had or should have had at the time.

This version of the APA Ethics Code was adopted by the American
Psychological Association’s Council of Representatives during its meet-
ing, August 21, 2002, and is effective beginning June 1, 2003. Inquiries
concerning the substance or interpretation of the APA Ethics Code should
be addressed to the Director, Office of Ethics, American Psychological
Association, 750 First Street, NE, Washington, DC 20002-4242. The
Ethics Code and information regarding the Code can be found on the APA
Web site, http://www.apa.org/ethics. The standards in this Ethics Code
will be used to adjudicate complaints brought concerning alleged conduct
occurring on or after the effective date. Complaints regarding conduct
occurring prior to the effective date will be adjudicated on the basis of the
version of the Ethics Code that was in effect at the time the conduct
occurred.

The APA has previously published its Ethics Code as follows:

American Psychological Association. (1953). Ethical standards of psy-
chologists. Washington, DC: Author.

American Psychological Association. (1959). Ethical standards of psy-
chologists. American Psychologist, 14, 279 –282.

American Psychological Association. (1963). Ethical standards of psy-
chologists. American Psychologist, 18, 56 – 60.

American Psychological Association. (1968). Ethical standards of psy-
chologists. American Psychologist, 23, 357–361.

American Psychological Association. (1977, March). Ethical standards of
psychologists. APA Monitor, 22–23.

American Psychological Association. (1979). Ethical standards of psy-
chologists. Washington, DC: Author.

American Psychological Association. (1981). Ethical principles of psy-
chologists. American Psychologist, 36, 633– 638.

American Psychological Association. (1990). Ethical principles of psy-
chologists (Amended June 2, 1989). American Psychologist, 45,
390 –395.

American Psychological Association. (1992). Ethical principles of psy-
chologists and code of conduct. American Psychologist, 47,
1597–1611.

Request copies of the APA’s Ethical Principles of Psychologists and
Code of Conduct from the APA Order Department, 750 First Street, NE,
Washington, DC 20002-4242, or phone (202) 336-5510.

Introduction and Applicability ● 1061December 2002 ● American Psychologist

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In the process of making decisions regarding their
professional behavior, psychologists must consider this
Ethics Code in addition to applicable laws and psychology
board regulations. In applying the Ethics Code to their
professional work, psychologists may consider other ma-
terials and guidelines that have been adopted or endorsed
by scientific and professional psychological organizations
and the dictates of their own conscience, as well as consult
with others within the field. If this Ethics Code establishes
a higher standard of conduct than is required by law,
psychologists must meet the higher ethical standard. If
psychologists’ ethical responsibilities conflict with law,
regulations, or other governing legal authority, psycholo-
gists make known their commitment to this Ethics Code
and take steps to resolve the conflict in a responsible
manner. If the conflict is unresolvable via such means,
psychologists may adhere to the requirements of the law,
regulations, or other governing authority in keeping with
basic principles of human rights.

PREAMBLE
Psychologists are committed to increasing scientific

and professional knowledge of behavior and people’s un-
derstanding of themselves and others and to the use of such
knowledge to improve the condition of individuals, orga-
nizations, and society. Psychologists respect and protect
civil and human rights and the central importance of free-
dom of inquiry and expression in research, teaching, and
publication. They strive to help the public in developing
informed judgments and choices concerning human behav-
ior. In doing so, they perform many roles, such as re-
searcher, educator, diagnostician, therapist, supervisor,
consultant, administrator, social interventionist, and expert
witness. This Ethics Code provides a common set of prin-
ciples and standards upon which psychologists build their
professional and scientific work.

This Ethics Code is intended to provide specific
standards to cover most situations encountered by psychol-
ogists. It has as its goals the welfare and protection of the
individuals and groups with whom psychologists work and
the education of members, students, and the public regard-
ing ethical standards of the discipline.

The development of a dynamic set of ethical stan-
dards for psychologists’ work-related conduct requires a
personal commitment and lifelong effort to act ethically; to
encourage ethical behavior by students, supervisees, em-
ployees, and colleagues; and to consult with others con-
cerning ethical problems.

GENERAL PRINCIPLES
This section consists of General Principles. General

Principles, as opposed to Ethical Standards, are aspirational
in nature. Their intent is to guide and inspire psychologists
toward the very highest ethical ideals of the profession.
General Principles, in contrast to Ethical Standards, do not
represent obligations and should not form the basis for
imposing sanctions. Relying upon General Principles for

either of these reasons distorts both their meaning and
purpose.

Principle A: Beneficence and Nonmaleficence
Psychologists strive to benefit those with whom they

work and take care to do no harm. In their professional
actions, psychologists seek to safeguard the welfare and
rights of those with whom they interact professionally and
other affected persons, and the welfare of animal subjects
of research. When conflicts occur among psychologists’
obligations or concerns, they attempt to resolve these con-
flicts in a responsible fashion that avoids or minimizes
harm. Because psychologists’ scientific and professional
judgments and actions may affect the lives of others, they
are alert to and guard against personal, financial, social,
organizational, or political factors that might lead to misuse
of their influence. Psychologists strive to be aware of the
possible effect of their own physical and mental health on
their ability to help those with whom they work.

Principle B: Fidelity and Responsibility
Psychologists establish relationships of trust with

those with whom they work. They are aware of their
professional and scientific responsibilities to society and to
the specific communities in which they work. Psycholo-
gists uphold professional standards of conduct, clarify their
professional roles and obligations, accept appropriate re-
sponsibility for their behavior, and seek to manage conflicts
of interest that could lead to exploitation or harm. Psychol-
ogists consult with, refer to, or cooperate with other pro-
fessionals and institutions to the extent needed to serve the
best interests of those with whom they work. They are
concerned about the ethical compliance of their colleagues’
scientific and professional conduct. Psychologists strive to
contribute a portion of their professional time for little or
no compensation or personal advantage.

Principle C: Integrity
Psychologists seek to promote accuracy, honesty,

and truthfulness in the science, teaching, and practice of
psychology. In these activities psychologists do not steal,
cheat, or engage in fraud, subterfuge, or intentional mis-
representation of fact. Psychologists strive to keep their
promises and to avoid unwise or unclear commitments. In
situations in which deception may be ethically justifiable to
maximize benefits and minimize harm, psychologists have
a serious obligation to consider the need for, the possible
consequences of, and their responsibility to correct any
resulting mistrust or other harmful effects that arise from
the use of such techniques.

Principle D: Justice
Psychologists recognize that fairness and justice en-

title all persons to access to and benefit from the contribu-
tions of psychology and to equal quality in the processes,
procedures, and services being conducted by psychologists.
Psychologists exercise reasonable judgment and take pre-

1062 ● Preamble–Principle D December 2002 ● American Psychologist

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cautions to ensure that their potential biases, the boundaries
of their competence, and the limitations of their expertise
do not lead to or condone unjust practices.

Principle E: Respect for People’s Rights and
Dignity

Psychologists respect the dignity and worth of all
people, and the rights of individuals to privacy, confiden-
tiality, and self-determination. Psychologists are aware that
special safeguards may be necessary to protect the rights
and welfare of persons or communities whose vulnerabil-
ities impair autonomous decision making. Psychologists
are aware of and respect cultural, individual, and role
differences, including those based on age, gender, gender
identity, race, ethnicity, culture, national origin, religion,
sexual orientation, disability, language, and socioeconomic
status, and consider these factors when working with mem-
bers of such groups. Psychologists 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.

ETHICAL STANDARDS
1. Resolving Ethical Issues

1.01 Misuse of Psychologists’ Work
If psychologists learn of misuse or misrepresenta-

tion of their work, they take reasonable steps to correct or
minimize the misuse or misrepresentation.

1.02 Conflicts Between Ethics and Law,
Regulations, or Other Governing Legal
Authority
If psychologists’ ethical responsibilities conflict

with law, regulations, or other governing legal authority,
psychologists make known their commitment to the Ethics
Code and take steps to resolve the conflict. If the conflict is
unresolvable via such means, psychologists may adhere to
the requirements of the law, regulations, or other governing
legal authority.

1.03 Conflicts Between Ethics and
Organizational Demands
If the demands of an organization with which psy-

chologists are affiliated or for whom they are working
conflict with this Ethics Code, psychologists clarify the
nature of the conflict, make known their commitment to the
Ethics Code, and to the extent feasible, resolve the conflict
in a way that permits adherence to the Ethics Code.

1.04 Informal Resolution of Ethical
Violations
When psychologists believe that there may have

been an ethical violation by another psychologist, they
attempt to resolve the issue by bringing it to the attention of
that individual, if an informal resolution appears appropri-

ate and the intervention does not violate any confidentiality
rights that may be involved. (See also Standards 1.02,
Conflicts Between Ethics and Law, Regulations, or Other
Governing Legal Authority, and 1.03, Conflicts Between
Ethics and Organizational Demands.)

1.05 Reporting Ethical Violations
If an apparent ethical violation has substantially

harmed or is likely to substantially harm a person or orga-
nization and is not appropriate for informal resolution
under Standard 1.04, Informal Resolution of Ethical Vio-
lations, or is not resolved properly in that fashion, psychol-
ogists take further action appropriate to the situation. Such
action might include referral to state or national committees
on professional ethics, to state licensing boards, or to the
appropriate institutional authorities. This standard does not
apply when an intervention would violate confidentiality
rights or when psychologists have been retained to review
the work of another psychologist whose professional con-
duct is in question. (See also Standard 1.02, Conflicts
Between Ethics and Law, Regulations, or Other Governing
Legal Authority.)

1.06 Cooperating With Ethics Committees
Psychologists cooperate in ethics investigations,

proceedings, and resulting requirements of the APA or any
affiliated state psychological association to which they
belong. In doing so, they address any confidentiality issues.
Failure to cooperate is itself an ethics violation. However,
making a request for deferment of adjudication of an ethics
complaint pending the outcome of litigation does not alone
constitute noncooperation.

1.07 Improper Complaints
Psychologists do not file or encourage the filing of

ethics complaints that are made with reckless disregard for
or willful ignorance of facts that would disprove the
allegation.

1.08 Unfair Discrimination Against
Complainants and Respondents
Psychologists do not deny persons employment, ad-

vancement, admissions to academic or other programs,
tenure, or promotion, based solely upon their having made
or their being the subject of an ethics complaint. This does
not preclude taking action based upon the outcome of such
proceedings or considering other appropriate information.

2. Competence

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and con-

duct research with populations and in areas only within the
boundaries of their competence, based on their education,
training, supervised experience, consultation, study, or pro-
fessional experience.

(b) Where scientific or professional knowledge in
the discipline of psychology establishes that an understand-

Principle E–Standard 2.01 ● 1063December 2002 ● American Psychologist

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ing of factors associated with age, gender, gender identity,
race, ethnicity, culture, national origin, religion, sexual
orientation, disability, language, or socioeconomic status is
essential for effective implementation of their services or
research, psychologists have or obtain the training, experi-
ence, consultation, or supervision necessary to ensure the
competence of their services, or they make appropriate
referrals, except as provided in Standard 2.02, Providing
Services in Emergencies.

(c) Psychologists planning to provide services,
teach, or conduct research involving populations, areas,
techniques, or technologies new to them undertake relevant
education, training, supervised experience, consultation, or
study.

(d) When psychologists are asked to provide ser-
vices to individuals for whom appropriate mental health
services are not available and for which psychologists have
not obtained the competence necessary, psychologists with
closely related prior training or experience may provide
such services in order to ensure that services are not denied
if they make a reasonable effort to obtain the competence
required by using relevant research, training, consultation,
or study.

(e) In those emerging areas in which generally rec-
ognized standards for preparatory training do not yet exist,
psychologists nevertheless take reasonable steps to ensure
the competence of their work and to protect clients/pa-
tients, students, supervisees, research participants, organi-
zational clients, and others from harm.

(f) When assuming forensic roles, psychologists are
or become reasonably familiar with the judicial or admin-
istrative rules governing their roles.

2.02 Providing Services in Emergencies
In emergencies, when psychologists provide ser-

vices to individuals for whom other mental health services
are not available and for which psychologists have not
obtained the necessary training, psychologists may provide
such services in order to ensure that services are not denied.
The services are discontinued as soon as the emergency has
ended or appropriate services are available.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop

and maintain their competence.

2.04 Bases for Scientific and Professional
Judgments
Psychologists’ work is based upon established sci-

entific and professional knowledge of the discipline. (See
also Standards 2.01e, Boundaries of Competence, and
10.01b, Informed Consent to Therapy.)

2.05 Delegation of Work to Others
Psychologists who delegate work to employees, su-

pervisees, or research or teaching assistants or who use the
services of others, such as interpreters, take reasonable

steps to (1) avoid delegating such work to persons who
have a multiple relationship with those being served that
would likely lead to exploitation or loss of objectivity; (2)
authorize only those responsibilities that such persons can
be expected to perform competently on the basis of their
education, training, or experience, either independently or
with the level of supervision being provided; and (3) see
that such persons perform these services competently. (See
also Standards 2.02, Providing Services in Emergencies;
3.05, Multiple Relationships; 4.01, Maintaining Confiden-
tiality; 9.01, Bases for Assessments; 9.02, Use of Assess-
ments; 9.03, Informed Consent in Assessments; and 9.07,
Assessment by Unqualified Persons.)

2.06 Personal Problems and Conflicts
(a) Psychologists refrain from initiating an activity

when they know or should know that there is a substantial
likelihood that their personal problems will prevent them
from performing their work-related activities in a compe-
tent manner.

(b) When psychologists become aware of personal
problems that may interfere with their performing work-
related duties adequately, they take appropriate measures,
such as obtaining professional consultation or assistance,
and determine whether they should limit, suspend, or ter-
minate their work-related duties. (See also Standard 10.10,
Terminating Therapy.)

3. Human Relations

3.01 Unfair Discrimination
In their work-related activities, psychologists do not

engage in unfair discrimination based on age, gender, gen-
der identity, race, ethnicity, culture, national origin, reli-
gion, sexual orientation, disability, socioeconomic status,
or any basis proscribed by law.

3.02 Sexual Harassment
Psychologists do not engage in sexual harassment.

Sexual harassment is sexual solicitation, physical advances,
or verbal or nonverbal conduct that is sexual in nature, that
occurs in connection with the psychologist’s activities or
roles as a psychologist, and that either (1) is unwelcome, is
offensive, or creates a hostile workplace or educational
environment, and the psychologist knows or is told this or
(2) is sufficiently severe or intense to be abusive to a
reasonable person in the context. Sexual harassment can
consist of a single intense or severe act or of multiple
persistent or pervasive acts. (See also Standard 1.08, Unfair
Discrimination Against Complainants and Respondents.)

3.03 Other Harassment
Psychologists do not knowingly engage in behavior

that is harassing or demeaning to persons with whom they
interact in their work based on factors such as those per-
sons’ age, gender, gender identity, race, ethnicity, culture,
national origin, religion, sexual orientation, disability, lan-
guage, or socioeconomic status.

1064 ● Standard 2.02–Standard 3.03 December 2002 ● American Psychologist

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3.04 Avoiding Harm
Psychologists take reasonable steps to avoid harm-

ing their clients/patients, students, supervisees, research
participants, organizational clients, and others with whom
they work, and to minimize harm where it is foreseeable
and unavoidable.

3.05 Multiple Relationships
(a) A multiple relationship occurs when a psychol-

ogist is in a professional role with a person and (1) at the
same time is in another role with the same person, (2) at the
same time is in a relationship with a person closely asso-
ciated with or related to the person with whom the psy-
chologist has the professional relationship, or (3) promises
to enter into another relationship in the future with the
person or a person closely associated with or related to the
person.

A psychologist refrains from entering into a multi-
ple relationship if the multiple relationship could reason-
ably be expected to impair the psychologist’s objectivity,
competence, or effectiveness in performing his or her func-
tions as a psychologist, or otherwise risks exploitation or
harm to the person with whom the professional relationship
exists.

Multiple relationships that would not reasonably be
expected to cause impairment or risk exploitation or harm
are not unethical.

(b) If a psychologist finds that, due to unforeseen
factors, a potentially harmful multiple relationship has
arisen, the psychologist takes reasonable steps to resolve it
with due regard for the best interests of the affected person
and maximal compliance with the Ethics Code.

(c) When psychologists are required by law, insti-
tutional policy, or extraordinary circumstances to serve in
more than one role in judicial or administrative proceed-
ings, at the outset they clarify role expectations and the
extent of confidentiality and thereafter as changes occur.
(See also Standards 3.04, Avoiding Harm, and 3.07, Third-
Party Requests for Services.)

3.06 Conflict of Interest
Psychologists refrain from taking on a professional

role when personal, scientific, professional, legal, financial,
or other interests or relationships could reasonably be ex-
pected to (1) impair their objectivity, competence, or ef-
fectiveness in performing their functions as psychologists
or (2) expose the person or organization with whom the
professional relationship exists to harm or exploitation.

3.07 Third-Party Requests for Services
When psychologists agree to provide services to a

person or entity at the request of a third party, psycholo-
gists attempt to clarify at the outset of the service the nature
of the relationship with all individuals or organizations
involved. This clarification includes the role of the psy-
chologist (e.g., therapist, consultant, diagnostician, or ex-
pert witness), an identification of who is the client, the

probable uses of the services provided or the information
obtained, and the fact that there may be limits to confiden-
tiality. (See also Standards 3.05, Multiple Relationships,
and 4.02, Discussing the Limits of Confidentiality.)

3.08 Exploitative Relationships
Psychologists do not exploit persons over whom

they have supervisory, evaluative, or other authority such
as clients/patients, students, supervisees, research partici-
pants, and employees. (See also Standards 3.05, Multiple
Relationships; 6.04, Fees and Financial Arrangements;
6.05, Barter With Clients/Patients; 7.07, Sexual Relation-
ships With Students and Supervisees; 10.05, Sexual Inti-
macies With Current Therapy Clients/Patients; 10.06, Sex-
ual Intimacies With Relatives or Significant Others of
Current Therapy Clients/Patients; 10.07, Therapy With
Former Sexual Partners; and 10.08, Sexual Intimacies With
Former Therapy Clients/Patients.)

3.09 Cooperation With Other Professionals
When indicated and professionally appropriate, psy-

chologists cooperate with other professionals in order to
serve their clients/patients effectively and appropriately.
(See also Standard 4.05, Disclosures.)

3.10 Informed Consent
(a) When psychologists conduct research or provide

assessment, therapy, counseling, or consulting services in
person or via electronic transmission or other forms of
communication, they obtain the informed consent of the
individual or individuals using language that is reasonably
understandable to that person or persons except when con-
ducting such activities without consent is mandated by law
or governmental regulation or as otherwise provided in this
Ethics Code. (See also Standards 8.02, Informed Consent
to Research; 9.03, Informed Consent in Assessments; and
10.01, Informed Consent to Therapy.)

(b) For persons who are legally incapable of giving
informed consent, psychologists nevertheless (1) provide
an appropriate explanation, (2) seek the individual’s assent,
(3) consider such persons’ preferences and best interests,
and (4) obtain appropriate permission from a legally au-
thorized person, if such substitute consent is permitted or
required by law. When consent by a legally authorized
person is not permitted or required by law, psychologists
take reasonable steps to protect the individual’s rights and
welfare.

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

(d) Psychologists appropriately document written or
oral consent, permission, and assent. (See also Standards
8.02, Informed Consent to Research; 9.03, Informed Con-
sent in Assessments; and 10.01, Informed Consent to
Therapy.)

Standard 3.04 –Standard 3.10 ● 1065December 2002 ● American Psychologist

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3.11 Psychological Services Delivered to or
Through Organizations
(a) Psychologists delivering services to or through

organizations provide information beforehand to clients
and when appropriate those directly affected by the ser-
vices about (1) the nature and objectives of the services, (2)
the intended recipients, (3) which of the individuals are
clients, (4) the relationship the psychologist will have with
each person and the organization, (5) the probable uses of
services provided and information obtained, (6) who will
have access to the information, and (7) limits of confiden-
tiality. As soon as feasible, they provide information about
the results and conclusions of such services to appropriate
persons.

(b) If psychologists will be precluded by law or by
organizational roles from providing such information to
particular individuals or groups, they so inform those indi-
viduals or groups at the outset of the service.

3.12 Interruption of Psychological Services
Unless otherwise covered by contract, psychologists

make reasonable efforts to plan for facilitating services in
the event that psychological services are interrupted by
factors such as the psychologist’s illness, death, unavail-
ability, relocation, or retirement or by the client’s/patient’s
relocation or financial limitations. (See also Standard
6.02c, Maintenance, Dissemination, and Disposal of Con-
fidential Records of Professional and Scientific Work.)

4. Privacy and Confidentiality

4.01 Maintaining Confidentiality
Psychologists have a primary obligation and take

reasonable precautions to protect confidential information
obtained through or stored in any medium, recognizing that
the extent and limits of confidentiality may be regulated by
law or established by institutional rules or professional or
scientific relationship. (See also Standard 2.05, Delegation
of Work to Others.)

4.02 Discussing the Limits of Confidentiality
(a) Psychologists discuss with persons (including, to

the extent feasible, persons who are legally incapable of
giving informed consent and their legal representatives)
and organizations with whom they establish a scientific or
professional relationship (1) the relevant limits of confi-
dentiality and (2) the foreseeable uses of the information
generated through their psychological activities. (See also
Standard 3.10, Informed Consent.)

(b) Unless it is not feasible or is contraindicated, the
discussion of confidentiality occurs at the outset of the
relationship and thereafter as new circumstances may
warrant.

(c) Psychologists who offer services, products, or
information via electronic transmission inform clients/pa-
tients of the risks to privacy and limits of confidentiality.

4.03 Recording
Before recording the voices or images of individuals

to whom they provide services, psychologists obtain per-
mission from all such persons or their legal representatives.
(See also Standards 8.03, Informed Consent for Recording
Voices and Images in Research; 8.05, Dispensing With
Informed Consent for Research; and 8.07, Deception in
Research.)

4.04 Minimizing Intrusions on Privacy
(a) Psychologists include in written and oral reports

and consultations, only information germane to the purpose
for which the communication is made.

(b) Psychologists discuss confidential information
obtained in their work only for appropriate scientific or
professional purposes and only with persons clearly con-
cerned with such matters.

4.05 Disclosures
(a) Psychologists may disclose confidential informa-

tion with the appropriate consent of the organizational
client, the individual client/patient, or another legally au-
thorized person on behalf of the client/patient unless pro-
hibited by law.

(b) Psychologists disclose confidential information
without the consent of the individual only as mandated by
law, or where permitted by law for a valid purpose such as
to (1) provide needed professional services; (2) obtain
appropriate professional consultations; (3) protect the cli-
ent/patient, psychologist, or others from harm; or (4) obtain
payment for services from a client/patient, in which in-
stance disclosure is limited to the minimum that is neces-
sary to achieve the purpose. (See also Standard 6.04e, Fees
and Financial Arrangements.)

4.06 Consultations
When consulting with colleagues, (1) psychologists

do not disclose confidential information that reasonably
could lead to the identification of a client/patient, research
participant, or other person or organization with whom they
have a confidential relationship unless they have obtained
the prior consent of the person or organization or the
disclosure cannot be avoided, and (2) they disclose infor-
mation only to the extent necessary to achieve the purposes
of the consultation. (See also Standard 4.01, Maintaining
Confidentiality.)

4.07 Use of Confidential Information for
Didactic or Other Purposes
Psychologists do not disclose in their writings, lec-

tures, or other public media, confidential, personally iden-
tifiable information concerning their clients/patients, stu-
dents, research participants, organizational clients, or other
recipients of their services that they obtained during the
course of their work, unless (1) they take reasonable steps
to disguise the person or organization, (2) the person or

1066 ● Standard 3.11–Standard 4.07 December 2002 ● American Psychologist

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organization has consented in writing, or (3) there is legal
authorization for doing so.

5. Advertising and Other Public
Statements

5.01 Avoidance of False or Deceptive
Statements
(a) Public statements include but are not limited to

paid or unpaid advertising, product endorsements, grant
applications, licensing applications, other credentialing ap-
plications, brochures, printed matter, directory listings, per-
sonal resumes or curricula vitae, or comments for use in
media such as print or electronic transmission, statements
in legal proceedings, lectures and public oral presentations,
and published materials. Psychologists do not knowingly
make public statements that are false, deceptive, or fraud-
ulent concerning their research, practice, or other work
activities or those of persons or organizations with which
they are affiliated.

(b) Psychologists do not make false, deceptive, or
fraudulent statements concerning (1) their training, experi-
ence, or competence; (2) their academic degrees; (3) their
credentials; (4) their institutional or association affiliations;
(5) their services; (6) the scientific or clinical basis for, or
results or degree of success of, their services; (7) their fees;
or (8) their publications or research findings.

(c) Psychologists claim degrees as credentials for
their health services only if those degrees (1) were earned
from a regionally accredited educational institution or (2)
were the basis for psychology licensure by the state in
which they practice.

5.02 Statements by Others
(a) Psychologists who engage others to create or

place public statements that promote their professional
practice, products, or activities retain professional respon-
sibility for such statements.

(b) Psychologists do not compensate employees of
press, radio, television, or other communication media in
return for publicity in a news item. (See also Standard 1.01,
Misuse of Psychologists’ Work.)

(c) A paid advertisement relating to psychologists’
activities must be identified or clearly recognizable as such.

5.03 Descriptions of Workshops and Non-
Degree-Granting Educational Programs
To the degree to which they exercise control, psy-

chologists responsible for announcements, catalogs, bro-
chures, or advertisements describing workshops, seminars,
or other non-degree-granting educational programs ensure
that they accurately describe the audience for which the
program is intended, the educational objectives, the pre-
senters, and the fees involved.

5.04 Media Presentations
When psychologists provide public advice or com-

ment via print, Internet, or other electronic transmission,

they take precautions to ensure that statements (1) are
based on their professional knowledge, training, or experi-
ence in accord with appropriate psychological literature
and practice; (2) are otherwise consistent with this Ethics
Code; and (3) do not indicate that a professional relation-
ship has been established with the recipient. (See also
Standard 2.04, Bases for Scientific and Professional
Judgments.)

5.05 Testimonials
Psychologists do not solicit testimonials from cur-

rent therapy clients/patients or other persons who because
of their particular circumstances are vulnerable to undue
influence.

5.06 In-Person Solicitation
Psychologists do not engage, directly or through

agents, in uninvited in-person solicitation of business from
actual or potential therapy clients/patients or other persons
who because of their particular circumstances are vulner-
able to undue influence. However, this prohibition does not
preclude (1) attempting to implement appropriate collateral
contacts for the purpose of benefiting an already engaged
therapy client/patient or (2) providing disaster or commu-
nity outreach services.

6. Record Keeping and Fees

6.01 Documentation of Professional and
Scientific Work and Maintenance
of Records
Psychologists create, and to the extent the records

are under their control, maintain, disseminate, store, retain,
and dispose of records and data relating to their profes-
sional and scientific work in order to (1) facilitate provision
of services later by them or by other professionals, (2)
allow for replication of research design and analyses, (3)
meet institutional requirements, (4) ensure accuracy of
billing and payments, and (5) ensure compliance with law.
(See also Standard 4.01, Maintaining Confidentiality.)

6.02 Maintenance, Dissemination, and
Disposal of Confidential Records of
Professional and Scientific Work
(a) Psychologists maintain confidentiality in creat-

ing, storing, accessing, transferring, and disposing of
records under their control, whether these are written, au-
tomated, or in any other medium. (See also Standards 4.01,
Maintaining Confidentiality, and 6.01, Documentation of
Professional and Scientific Work and Maintenance of
Records.)

(b) If confidential information concerning recipients
of psychological services is entered into databases or sys-
tems of records available to persons whose access has not
been consented to by the recipient, psychologists use cod-
ing or other techniques to avoid the inclusion of personal
identifiers.

Standard 5.01–Standard 6.02 ● 1067December 2002 ● American Psychologist

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(c) Psychologists make plans in advance to facilitate
the appropriate transfer and to protect the confidentiality of
records and data in the event of psychologists’ withdrawal
from positions or practice. (See also Standards 3.12, Inter-
ruption of Psychological Services, and 10.09, Interruption
of Therapy.)

6.03 Withholding Records for Nonpayment
Psychologists may not withhold records under their

control that are requested and needed for a client’s/patient’s
emergency treatment solely because payment has not been
received.

6.04 Fees and Financial Arrangements
(a) As early as is feasible in a professional or sci-

entific relationship, psychologists and recipients of psycho-
logical services reach an agreement specifying compensa-
tion and billing arrangements.

(b) Psychologists’ fee practices are consistent with
law.

(c) Psychologists do not misrepresent their fees.
(d) If limitations to services can be anticipated be-

cause of limitations in financing, this is discussed with the
recipient of services as early as is feasible. (See also
Standards 10.09, Interruption of Therapy, and 10.10, Ter-
minating Therapy.)

(e) If the recipient of services does not pay for
services as agreed, and if psychologists intend to use col-
lection agencies or legal measures to collect the fees,
psychologists first inform the person that such measures
will be taken and provide that person an opportunity to
make prompt payment. (See also Standards 4.05, Disclo-
sures; 6.03, Withholding Records for Nonpayment; and
10.01, Informed Consent to Therapy.)

6.05 Barter With Clients/Patients
Barter is the acceptance of goods, services, or other

nonmonetary remuneration from clients/patients in return
for psychological services. Psychologists may barter only if
(1) it is not clinically contraindicated, and (2) the resulting
arrangement is not exploitative. (See also Standards 3.05,
Multiple Relationships, and 6.04, Fees and Financial
Arrangements.)

6.06 Accuracy in Reports to Payors and
Funding Sources
In their reports to payors for services or sources of

research funding, psychologists take reasonable steps to
ensure the accurate reporting of the nature of the service
provided or research conducted, the fees, charges, or pay-
ments, and where applicable, the identity of the provider,
the findings, and the diagnosis. (See also Standards 4.01,
Maintaining Confidentiality; 4.04, Minimizing Intrusions
on Privacy; and 4.05, Disclosures.)

6.07 Referrals and Fees
When psychologists pay, receive payment from, or

divide fees with another professional, other than in an

employer– employee relationship, the payment to each is
based on the services provided (clinical, consultative, ad-
ministrative, or other) and is not based on the referral itself.
(See also Standard 3.09, Cooperation With Other
Professionals.)

7. Education and Training

7.01 Design of Education and Training
Programs
Psychologists responsible for education and training

programs take reasonable steps to ensure that the programs
are designed to provide the appropriate knowledge and
proper experiences, and to meet the requirements for
licensure, certification, or other goals for which claims
are made by the program. (See also Standard 5.03,
Descriptions of Workshops and Non-Degree-Granting
Educational Programs.)

7.02 Descriptions of Education and Training
Programs
Psychologists responsible for education and training

programs take reasonable steps to ensure that there is a
current and accurate description of the program content
(including participation in required course- or program-
related counseling, psychotherapy, experiential groups,
consulting projects, or community service), training goals
and objectives, stipends and benefits, and requirements that
must be met for satisfactory completion of the program.
This information must be made readily available to all
interested parties.

7.03 Accuracy in Teaching
(a) Psychologists take reasonable steps to ensure

that course syllabi are accurate regarding the subject matter
to be covered, bases for evaluating progress, and the nature
of course experiences. This standard does not preclude an
instructor from modifying course content or requirements
when the instructor considers it pedagogically necessary or
desirable, so long as students are made aware of these
modifications in a manner that enables them to fulfill
course requirements. (See also Standard 5.01, Avoidance
of False or Deceptive Statements.)

(b) When engaged in teaching or training, psychol-
ogists present psychological information accurately. (See
also Standard 2.03, Maintaining Competence.)

7.04 Student Disclosure of Personal
Information
Psychologists do not require students or supervisees

to disclose personal information in course- or program-
related activities, either orally or in writing, regarding
sexual history, history of abuse and neglect, psychological
treatment, and relationships with parents, peers, and
spouses or significant others except if (1) the program or
training facility has clearly identified this requirement in its
admissions and program materials or (2) the information is

1068 ● Standard 6.03–Standard 7.04 December 2002 ● American Psychologist

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necessary to evaluate or obtain assistance for students
whose personal problems could reasonably be judged to be
preventing them from performing their training- or profes-
sionally related activities in a competent manner or posing
a threat to the students or others.

7.05 Mandatory Individual or Group
Therapy
(a) When individual or group therapy is a program

or course requirement, psychologists responsible for that
program allow students in undergraduate and graduate pro-
grams the option of selecting such therapy from practitio-
ners unaffiliated with the program. (See also Standard 7.02,
Descriptions of Education and Training Programs.)

(b) Faculty who are or are likely to be responsible
for evaluating students’ academic performance do not
themselves provide that therapy. (See also Standard 3.05,
Multiple Relationships.)

7.06 Assessing Student and Supervisee
Performance
(a) In academic and supervisory relationships, psy-

chologists establish a timely and specific process for pro-
viding feedback to students and supervisees. Information
regarding the process is provided to the student at the
beginning of supervision.

(b) Psychologists evaluate students and supervisees
on the basis of their actual performance on relevant and
established program requirements.

7.07 Sexual Relationships With Students and
Supervisees
Psychologists do not engage in sexual relationships

with students or supervisees who are in their department,
agency, or training center or over whom psychologists have
or are likely to have evaluative authority. (See also Stan-
dard 3.05, Multiple Relationships.)

8. Research and Publication

8.01 Institutional Approval
When institutional approval is required, psycholo-

gists provide accurate information about their research
proposals and obtain approval prior to conducting the re-
search. They conduct the research in accordance with the
approved research protocol.

8.02 Informed Consent to Research
(a) When obtaining informed consent as required in

Standard 3.10, Informed Consent, psychologists inform
participants about (1) the purpose of the research, expected
duration, and procedures; (2) their right to decline to par-
ticipate and to withdraw from the research once participa-
tion has begun; (3) the foreseeable consequences of declin-
ing or withdrawing; (4) reasonably foreseeable factors that
may be expected to influence their willingness to partici-
pate such as potential risks, discomfort, or adverse effects;

(5) any prospective research benefits; (6) limits of confi-
dentiality; (7) incentives for participation; and (8) whom to
contact for questions about the research and research par-
ticipants’ rights. They provide opportunity for the prospec-
tive participants to ask questions and receive answers. (See
also Standards 8.03, Informed Consent for Recording
Voices and Images in Research; 8.05, Dispensing With
Informed Consent for Research; and 8.07, Deception in
Research.)

(b) Psychologists conducting intervention research
involving the use of experimental treatments clarify to
participants at the outset of the research (1) the experimen-
tal nature of the treatment; (2) the services that will or will
not be available to the control group(s) if appropriate; (3)
the means by which assignment to treatment and control
groups will be made; (4) available treatment alternatives if
an individual does not wish to participate in the research or
wishes to withdraw once a study has begun; and (5) com-
pensation for or monetary costs of participating including,
if appropriate, whether reimbursement from the participant
or a third-party payor will be sought. (See also Standard
8.02a, Informed Consent to Research.)

8.03 Informed Consent for Recording Voices
and Images in Research
Psychologists obtain informed consent from re-

search participants prior to recording their voices or images
for data collection unless (1) the research consists solely of
naturalistic observations in public places, and it is not
anticipated that the recording will be used in a manner that
could cause personal identification or harm, or (2) the
research design includes deception, and consent for the use
of the recording is obtained during debriefing. (See also
Standard 8.07, Deception in Research.)

8.04 Client/Patient, Student, and Subordinate
Research Participants
(a) When psychologists conduct research with cli-

ents/patients, students, or subordinates as participants, psy-
chologists take steps to protect the prospective participants
from adverse consequences of declining or withdrawing
from participation.

(b) When research participation is a course require-
ment or an opportunity for extra credit, the prospective
participant is given the choice of equitable alternative
activities.

8.05 Dispensing With Informed Consent for
Research
Psychologists may dispense with informed consent

only (1) where research would not reasonably be assumed
to create distress or harm and involves (a) the study of
normal educational practices, curricula, or classroom man-
agement methods conducted in educational settings; (b)
only anonymous questionnaires, naturalistic observations,
or archival research for which disclosure of responses
would not place participants at risk of criminal or civil
liability or damage their financial standing, employability,

Standard 7.05–Standard 8.05 ● 1069December 2002 ● American Psychologist

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or reputation, and confidentiality is protected; or (c) the
study of factors related to job or organization effectiveness
conducted in organizational settings for which there is no
risk to participants’ employability, and confidentiality is
protected or (2) where otherwise permitted by law or fed-
eral or institutional regulations.

8.06 Offering Inducements for Research
Participation
(a) Psychologists make reasonable efforts to avoid

offering excessive or inappropriate financial or other in-
ducements for research participation when such induce-
ments are likely to coerce participation.

(b) When offering professional services as an in-
ducement for research participation, psychologists clarify
the nature of the services, as well as the risks, obligations,
and limitations. (See also Standard 6.05, Barter With
Clients/Patients.)

8.07 Deception in Research
(a) Psychologists do not conduct a study involving

deception unless they have determined that the use of
deceptive techniques is justified by the study’s significant
prospective scientific, educational, or applied value and
that effective nondeceptive alternative procedures are not
feasible.

(b) Psychologists do not deceive prospective partic-
ipants about research that is reasonably expected to cause
physical pain or severe emotional distress.

(c) Psychologists explain any deception that is an
integral feature of the design and conduct of an experiment
to participants as early as is feasible, preferably at the
conclusion of their participation, but no later than at the
conclusion of the data collection, and permit participants to
withdraw their data. (See also Standard 8.08, Debriefing.)

8.08 Debriefing
(a) Psychologists provide a prompt opportunity for

participants to obtain appropriate information about the
nature, results, and conclusions of the research, and they
take reasonable steps to correct any misconceptions that
participants may have of which the psychologists are
aware.

(b) If scientific or humane values justify delaying or
withholding this information, psychologists take reason-
able measures to reduce the risk of harm.

(c) When psychologists become aware that research
procedures have harmed a participant, they take reasonable
steps to minimize the harm.

8.09 Humane Care and Use of Animals in
Research
(a) Psychologists acquire, care for, use, and dispose

of animals in compliance with current federal, state, and
local laws and regulations, and with professional standards.

(b) Psychologists trained in research methods and
experienced in the care of laboratory animals supervise all

procedures involving animals and are responsible for en-
suring appropriate consideration of their comfort, health,
and humane treatment.

(c) Psychologists ensure that all individuals under
their supervision who are using animals have received
instruction in research methods and in the care, mainte-
nance, and handling of the species being used, to the extent
appropriate to their role. (See also Standard 2.05, Delega-
tion of Work to Others.)

(d) Psychologists make reasonable efforts to mini-
mize the discomfort, infection, illness, and pain of animal
subjects.

(e) Psychologists use a procedure subjecting ani-
mals to pain, stress, or privation only when an alternative
procedure is unavailable and the goal is justified by its
prospective scientific, educational, or applied value.

(f) Psychologists perform surgical procedures under
appropriate anesthesia and follow techniques to avoid in-
fection and minimize pain during and after surgery.

(g) When it is appropriate that an animal’s life be
terminated, psychologists proceed rapidly, with an effort to
minimize pain and in accordance with accepted procedures.

8.10 Reporting Research Results
(a) Psychologists do not fabricate data. (See also

Standard 5.01a, Avoidance of False or Deceptive
Statements.)

(b) If psychologists discover significant errors in
their published data, they take reasonable steps to correct
such errors in a correction, retraction, erratum, or other
appropriate publication means.

8.11 Plagiarism
Psychologists do not present portions of another’s

work or data as their own, even if the other work or data
source is cited occasionally.

8.12 Publication Credit
(a) Psychologists take responsibility and credit, in-

cluding authorship credit, only for work they have actually
performed or to which they have substantially contributed.
(See also Standard 8.12b, Publication Credit.)

(b) Principal authorship and other publication cred-
its accurately reflect the relative scientific or professional
contributions of the individuals involved, regardless of
their relative status. Mere possession of an institutional
position, such as department chair, does not justify author-
ship credit. Minor contributions to the research or to the
writing for publications are acknowledged appropriately,
such as in footnotes or in an introductory statement.

(c) Except under exceptional circumstances, a stu-
dent is listed as principal author on any multiple-authored
article that is substantially based on the student’s doctoral
dissertation. Faculty advisors discuss publication credit
with students as early as feasible and throughout the re-
search and publication process as appropriate. (See also
Standard 8.12b, Publication Credit.)

1070 ● Standard 8.06 –Standard 8.12 December 2002 ● American Psychologist

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8.13 Duplicate Publication of Data
Psychologists do not publish, as original data, data

that have been previously published. This does not pre-
clude republishing data when they are accompanied by
proper acknowledgment.

8.14 Sharing Research Data for Verification
(a) After research results are published, psycholo-

gists do not withhold the data on which their conclusions
are based from other competent professionals who seek to
verify the substantive claims through reanalysis and who
intend to use such data only for that purpose, provided that
the confidentiality of the participants can be protected and
unless legal rights concerning proprietary data preclude
their release. This does not preclude psychologists from
requiring that such individuals or groups be responsible for
costs associated with the provision of such information.

(b) Psychologists who request data from other psy-
chologists to verify the substantive claims through reanal-
ysis may use shared data only for the declared purpose.
Requesting psychologists obtain prior written agreement
for all other uses of the data.

8.15 Reviewers
Psychologists who review material submitted for

presentation, publication, grant, or research proposal re-
view respect the confidentiality of and the proprietary
rights in such information of those who submitted it.

9. Assessment

9.01 Bases for Assessments
(a) Psychologists base the opinions contained in

their recommendations, reports, and diagnostic or evalua-
tive statements, including forensic testimony, on informa-
tion and techniques sufficient to substantiate their findings.
(See also Standard 2.04, Bases for Scientific and Profes-
sional Judgments.)

(b) Except as noted in 9.01c, psychologists provide
opinions of the psychological characteristics of individuals
only after they have conducted an examination of the
individuals adequate to support their statements or conclu-
sions. When, despite reasonable efforts, such an examina-
tion is not practical, psychologists document the efforts
they made and the result of those efforts, clarify the prob-
able impact of their limited information on the reliability
and validity of their opinions, and appropriately limit the
nature and extent of their conclusions or recommendations.
(See also Standards 2.01, Boundaries of Competence, and
9.06, Interpreting Assessment Results.)

(c) When psychologists conduct a record review or
provide consultation or supervision and an individual
examination is not warranted or necessary for the opin-
ion, psychologists explain this and the sources of infor-
mation on which they based their conclusions and
recommendations.

9.02 Use of Assessments
(a) Psychologists administer, adapt, score, interpret,

or use assessment techniques, interviews, tests, or instru-
ments in a manner and for purposes that are appropriate in
light of the research on or evidence of the usefulness and
proper application of the techniques.

(b) Psychologists use assessment instruments whose
validity and reliability have been established for use
with members of the population tested. When such va-
lidity or reliability has not been established, psycholo-
gists describe the strengths and limitations of test results
and interpretation.

(c) Psychologists use assessment methods that are
appropriate to an individual’s language preference and
competence, unless the use of an alternative language is
relevant to the assessment issues.

9.03 Informed Consent in Assessments
(a) Psychologists obtain informed consent for as-

sessments, evaluations, or diagnostic services, as described
in Standard 3.10, Informed Consent, except when (1) test-
ing is mandated by law or governmental regulations; (2)
informed consent is implied because testing is conducted as
a routine educational, institutional, or organizational activ-
ity (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 in-
cludes an explanation of the nature and purpose of the
assessment, fees, involvement of third parties, and limits of
confidentiality and sufficient opportunity for the client/
patient to ask questions and receive answers.

(b) Psychologists inform persons with questionable
capacity to consent or for whom testing is mandated by law
or governmental regulations about the nature and purpose
of the proposed assessment services, using language that is
reasonably understandable to the person being assessed.

(c) Psychologists using the services of an interpreter
obtain informed consent from the client/patient to use that
interpreter, ensure that confidentiality of test results and
test security are maintained, and include in their recom-
mendations, reports, and diagnostic or evaluative state-
ments, including forensic testimony, discussion of any lim-
itations on the data obtained. (See also Standards 2.05,
Delegation of Work to Others; 4.01, Maintaining Confi-
dentiality; 9.01, Bases for Assessments; 9.06, Interpreting
Assessment Results; and 9.07, Assessment by Unqualified
Persons.)

9.04 Release of Test Data
(a) The term test data refers to raw and scaled

scores, client/patient responses to test questions or stimuli,
and psychologists’ notes and recordings concerning client/
patient statements and behavior during an examination.
Those portions of test materials that include client/patient
responses are included in the definition of test data. Pur-
suant to a client/patient release, psychologists provide test
data to the client/patient or other persons identified in the
release. Psychologists may refrain from releasing test data

Standard 8.13–Standard 9.04 ● 1071December 2002 ● American Psychologist

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to protect a client/patient or others from substantial harm or
misuse or misrepresentation of the data or the test, recog-
nizing that in many instances release of confidential infor-
mation under these circumstances is regulated by law. (See
also Standard 9.11, Maintaining Test Security.)

(b) In the absence of a client/patient release, psy-
chologists provide test data only as required by law or court
order.

9.05 Test Construction
Psychologists who develop tests and other assess-

ment techniques use appropriate psychometric procedures
and current scientific or professional knowledge for test
design, standardization, validation, reduction or elimina-
tion of bias, and recommendations for use.

9.06 Interpreting Assessment Results
When interpreting assessment results, including au-

tomated interpretations, psychologists take into account the
purpose of the assessment as well as the various test fac-
tors, test-taking abilities, and other characteristics of the
person being assessed, such as situational, personal, lin-
guistic, and cultural differences, that might affect psychol-
ogists’ judgments or reduce the accuracy of their interpre-
tations. They indicate any significant limitations of their
interpretations. (See also Standards 2.01b and c, Bound-
aries of Competence, and 3.01, Unfair Discrimination.)

9.07 Assessment by Unqualified Persons
Psychologists do not promote the use of psycholog-

ical assessment techniques by unqualified persons, except
when such use is conducted for training purposes with
appropriate supervision. (See also Standard 2.05, Delega-
tion of Work to Others.)

9.08 Obsolete Tests and Outdated Test
Results
(a) Psychologists do not base their assessment or

intervention decisions or recommendations on data or test
results that are outdated for the current purpose.

(b) Psychologists do not base such decisions or
recommendations on tests and measures that are obsolete
and not useful for the current purpose.

9.09 Test Scoring and Interpretation Services
(a) Psychologists who offer assessment or scoring

services to other professionals accurately describe the pur-
pose, norms, validity, reliability, and applications of the
procedures and any special qualifications applicable to their
use.

(b) Psychologists select scoring and interpretation
services (including automated services) on the basis of
evidence of the validity of the program and procedures as
well as on other appropriate considerations. (See also Stan-
dard 2.01b and c, Boundaries of Competence.)

(c) Psychologists retain responsibility for the appro-
priate application, interpretation, and use of assessment

instruments, whether they score and interpret such tests
themselves or use automated or other services.

9.10 Explaining Assessment Results
Regardless of whether the scoring and interpretation

are done by psychologists, by employees or assistants, or
by automated or other outside services, psychologists take
reasonable steps to ensure that explanations of results are
given to the individual or designated representative unless
the nature of the relationship precludes provision of an
explanation of results (such as in some organizational con-
sulting, preemployment or security screenings, and forensic
evaluations), and this fact has been clearly explained to the
person being assessed in advance.

9.11 Maintaining Test Security
The term test materials refers to manuals, instru-

ments, protocols, and test questions or stimuli and does not
include test data as defined in Standard 9.04, Release of
Test Data. Psychologists make reasonable efforts to main-
tain the integrity and security of test materials and other
assessment techniques consistent with law and contractual
obligations, and in a manner that permits adherence to this
Ethics Code.

10. Therapy

10.01 Informed Consent to Therapy
(a) When obtaining informed consent to therapy as

required in Standard 3.10, Informed Consent, psychologists
inform clients/patients as early as is feasible in the thera-
peutic relationship about the nature and anticipated course
of therapy, fees, involvement of third parties, and limits of
confidentiality and provide sufficient opportunity for the
client/patient to ask questions and receive answers. (See
also Standards 4.02, Discussing the Limits of Confidenti-
ality, and 6.04, Fees and Financial Arrangements.)

(b) When obtaining informed consent for treatment
for which generally recognized techniques and procedures
have not been established, psychologists inform their cli-
ents/patients of the developing nature of the treatment, the
potential risks involved, alternative treatments that may be
available, and the voluntary nature of their participation.
(See also Standards 2.01e, Boundaries of Competence, and
3.10, Informed Consent.)

(c) When the therapist is a trainee and the legal
responsibility for the treatment provided resides with the
supervisor, the client/patient, as part of the informed con-
sent procedure, is informed that the therapist is in training
and is being supervised and is given the name of the
supervisor.

10.02 Therapy Involving Couples or Families
(a) When psychologists agree to provide services to

several persons who have a relationship (such as spouses,
significant others, or parents and children), they take rea-
sonable steps to clarify at the outset (1) which of the

1072 ● Standard 9.05–Standard 10.02 December 2002 ● American Psychologist

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individuals are clients/patients and (2) the relationship the
psychologist will have with each person. This clarification
includes the psychologist’s role and the probable uses of
the services provided or the information obtained. (See also
Standard 4.02, Discussing the Limits of Confidentiality.)

(b) If it becomes apparent that psychologists may be
called on to perform potentially conflicting roles (such as
family therapist and then witness for one party in divorce
proceedings), psychologists take reasonable steps to clarify
and modify, or withdraw from, roles appropriately. (See
also Standard 3.05c, Multiple Relationships.)

10.03 Group Therapy
When psychologists provide services to several per-

sons in a group setting, they describe at the outset the roles
and responsibilities of all parties and the limits of
confidentiality.

10.04 Providing Therapy to Those Served by
Others

In deciding whether to offer or provide services to
those already receiving mental health services elsewhere,
psychologists carefully consider the treatment issues and
the potential client’s/patient’s welfare. Psychologists dis-
cuss these issues with the client/patient or another legally
authorized person on behalf of the client/patient in order to
minimize the risk of confusion and conflict, consult with
the other service providers when appropriate, and proceed
with caution and sensitivity to the therapeutic issues.

10.05 Sexual Intimacies With Current
Therapy Clients/Patients

Psychologists do not engage in sexual intimacies
with current therapy clients/patients.

10.06 Sexual Intimacies With Relatives or
Significant Others of Current Therapy
Clients/Patients

Psychologists do not engage in sexual intimacies
with individuals they know to be close relatives, guardians,
or significant others of current clients/patients. Psycholo-
gists do not terminate therapy to circumvent this standard.

10.07 Therapy With Former Sexual Partners
Psychologists do not accept as therapy clients/

patients persons with whom they have engaged in sexual
intimacies.

10.08 Sexual Intimacies With Former
Therapy Clients/Patients

(a) Psychologists do not engage in sexual intimacies
with former clients/patients for at least two years after
cessation or termination of therapy.

(b) Psychologists do not engage in sexual intimacies
with former clients/patients even after a two-year interval
except in the most unusual circumstances. Psychologists
who engage in such activity after the two years following
cessation or termination of therapy and of having no sexual
contact with the former client/patient bear the burden of
demonstrating that there has been no exploitation, in light
of all relevant factors, including (1) the amount of time that
has passed since therapy terminated; (2) the nature, dura-
tion, and intensity of the therapy; (3) the circumstances of
termination; (4) the client’s/patient’s personal history; (5)
the client’s/patient’s current mental status; (6) the like-
lihood of adverse impact on the client/patient; and (7)
any statements or actions made by the therapist during
the course of therapy suggesting or inviting the possi-
bility of a posttermination sexual or romantic relation-
ship with the client/patient. (See also Standard 3.05,
Multiple Relationships.)

10.09 Interruption of Therapy
When entering into employment or contractual re-

lationships, psychologists make reasonable efforts to pro-
vide for orderly and appropriate resolution of responsibility
for client/patient care in the event that the employment or
contractual relationship ends, with paramount consider-
ation given to the welfare of the client/patient. (See also
Standard 3.12, Interruption of Psychological Services.)

10.10 Terminating Therapy
(a) Psychologists terminate therapy when it be-

comes reasonably clear that the client/patient no longer
needs the service, is not likely to benefit, or is being harmed
by continued service.

(b) Psychologists may terminate therapy when
threatened or otherwise endangered by the client/patient
or another person with whom the client/patient has a
relationship.

(c) Except where precluded by the actions of clients/
patients or third-party payors, prior to termination psychol-
ogists provide pretermination counseling and suggest alter-
native service providers as appropriate.

Standard 10.03–Standard 10.10 ● 1073December 2002 ● American Psychologist

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