Ethical Practice in Geropsychology

Working with older clients involves a number of unique ethical challenges, including those related to the array of health concerns psychologists do not often encounter with younger clients, such as Alzheimer's disease. This book presents a decision-making framework and clinical vignettes to help clinicians navigate such complex quandaries.

Perhaps the greatest challenge for geropsychologists is balancing the principles of respecting client autonomy and promoting client welfare, especially when a client's decision-making capacity is in question. Geropsychologists also must negotiate the competing interests and expectations of clients and their relatives, other health care professionals, and the institutions in which many older adults are evaluated and treated.

To help geropsychologists navigate these complex issues, Bush, Allen, and Molinari introduce a structured decision-making process that draws heavily from principle-based and positive ethics, providing practical applications of the APA Ethical Principles of Psychologists and Code of Conduct while also accounting for federal laws and regulations.

Detailed case examples illustrate how to apply this process in a variety of treatment contexts, including hospitals, long-term care facilities, and hospice care. These vignettes review unique considerations for assessment, intervention, consultation, business practices, education and training, and advocating for clients' rights. This book will also help geropsychologists to prepare for the ethics component of the board certification exam.

Shane S. Bush, PhD, ABPP, is a neuropsychologist and member of the APA-accredited geropsychology postdoctoral residency program supervisory staff at the Veterans Affairs New York Harbor Healthcare System. He is also director of Long Island Neuropsychology, PC. He is board certified in Geropsychology, Clinical Psychology, Rehabilitation Psychology, and Clinical Neuropsychology. He is a member of the Board of Directors of the American Board of Geropsychology. Dr. Bush is a fellow of APA (Divisions 12, 18, 20, 22, 40, and 42) and a past president and fellow of the National Academy of Neuropsychology. He has published more than 14 books and special journal issues, including Geriatric Neuropsychology: Practice Essentials (coedited with Thomas A. Martin) and Geriatric Mental Health Ethics: A Casebook. He has also published numerous articles and book chapters related to ethical practice, including the specialty of geropsychology. He has presented on professional ethics at national and international conferences. Dr. Bush is a veteran of both the U.S. Marine Corps and Naval Reserve.

Rebecca S. Allen, PhD, ABPP, is a professor of psychology and has a primary appointment in the Alabama Research Institute on Aging at The University of Alabama. She is an associate editor of Aging and Mental Health. Dr. Allen is a fellow of the Behavioral and Social Sciences section of the Gerontological Society of America and APA (Division 20). She is board certified in geropsychology by the American Board of Professional Psychology (ABGERO) and is an ABGERO board member. Dr. Allen's research and clinical interests focus on interventions to reduce the stress of individuals, family, and professional caregivers for older adults with advanced chronic or terminal illness; the dynamics of health care decision making; and practice and training issues, including ethics. She has published on translation of interventions with older adults near the end of life and their caregivers; diversity in advance care planning; end-of-life issues, including civil capacity, behavioral interventions in long-term care; and mental health among aging prisoners. She teaches clinical psychology of aging intervention, lifespan development, geropsychology practicum, and undergraduate statistics.

Victor Molinari, PhD, ABPP, is a professor in the School of Aging Studies at the University of South Florida. Prior to that, he spent more than 17 years as the director of geropsychology for the Houston Veteran Affairs Medical Center. He is board certified in both clinical psychology and geropsychology. He is past-chair of the Council of Professional Geropsychology Training Programs and current president of the American Board of Geropsychology. He was a member of APA's Task Force on Serious Mental Illness and Severe Emotional Disturbance, and he has served on APA's Committee on Aging. He is the past national coordinator for the Psychologists in Long Term Care and past president of APA's Division 12, Section 2 (Clinical Geropsychology). A former member of the National Institute of Health National Advisory Council on Aging, Dr. Molinari is a fellow of APA's Division 20, the American Academy of Clinical Psychology, and the Behavioral and Social Sciences section of The Gerontological Society of America. He was the major preceptor for a federally funded joint University of South Florida/Tampa Veterans Affairs geropsychology postdoctoral fellowship program, and he is the associate editor for long-term care for the interdisciplinary journal Clinical Gerontologist. He teaches courses in gerontological counseling, care management of older adults, and disruptive behavior in long-term care settings.

Acknowledgments
Introduction
I. Foundational Competencies
1. Integrating Psychology and Gerontology
2. Establishing and Maintaining Competence in Geropsychology
3. Ethical Issues and Decision Making in Geropsychology
II. Functional Competencies and Cases
4. Assessment of Older Adults
5. Intervention in Geropsychology
6. Consultation, Administration, and Business Practices in Geropsychology
7. Education, Training, and Research in Geropsychology
8. Setting-Specific Ethical Challenges in Geropsychology
9. Advocacy in Geropsychology: Promoting Services and Protecting Rights
Afterword
References
Index
About the Authors