Applying Ethical Decision-Making

Chapter reading for additional reference material: From the chapter reading.

Reerence:

Fisher, C.B. (2017). Decoding the ethics code: A practical guide for psychologists (4th ed.). Sage.

The appropriate use of psychological assessments can benefit individuals, families, organizations, and society by providing information on which educational placements, mental health treatments, health insurance coverage, employee selection, job placement, workers’ compensation, program development, legal decisions, and government policies can be based. The inappropriate use of assessments can lead to harmful diagnostic, educational, institutional, legal, and social policy decisions based on inaccurate and misleading information. Standard 9.02a is concerned with the proper selection, interpretation, scoring, and administration of assessments. It refers to the full range of assessment techniques used by psychologists, including interviews and standardized tests administered in person, through the Internet, or through other media. According to this standard, ethical justification for the use of assessments is determined by research on or evidence supporting the purpose for which the test is administered, the method of administration, and interpretation of scores (AERA, APA, & NCME, 2014). To comply with the standard, psychologists should be familiar with and be able to evaluate the data and other information provided in test manuals detailing (a) the theoretical and empirical support for test use for specific purposes and populations, (b) the test’s psychometric validity, (c) administration procedures, and (d) how test scores are to be calculated and interpreted. Psychologists should also keep themselves apprised of ongoing research or evidence of a test’s usefulness or obsolescence over time (see also Standards 2.03, Maintaining Competence; 2.04, Bases for Scientific and Professional Judgments; 9.08b, Obsolete Tests and Outdated Test Results). The standard also requires that psychologists adhere to standardized test administration protocols to ensure that test scores reflect the construct(s) being assessed and avoid undue influence of idiosyncrasies in the testing process (AERA, APA, & NCME, 2014).Violations of Standard 9.02a occur when psychologists use assessments in a manner or for a purpose that is not supported by evidence in the field (see also this chapter’s Hot Topic “The Use of Assessments in Expert Testimony: Implications of Case Law and the Federal Rules of Evidence”).

To comply with this standard, psychologists, when selecting a test, must be familiar with the specific populations included in the standardization sample and the test’s validity and reliability estimates. At minimum, psychologists should determine the applicability of a test to an individual of a given age group, ethnicity/culture, language, and gender and, where applicable, disability or other population characteristic when scientific or professional evidence suggests that test scores may not be psychometrically, functionally, or theoretically comparable to scores for the reference groups on which the test was normed (Landwher & Llorente, 2012).Psychologists should also be familiar with relevant federal laws on the selection and administration of nondiscriminatory assessment and evaluation procedures (e.g., IDEA, 34 CFR 300.30[c][1][i]).The dynamic and evolving nature of this country’s cultural, political, and economic landscape creates situations in which population-valid and reliable tests of a psychological construct may not be available for the individual or group tested. Psychologists asked to evaluate individuals from such groups should select tests validated on other populations with caution because they may produce results that do not adequately assess the qualities or competencies intended to be measured (AERA, APA, & NCME, 2014). Recommendations based on these assessments in turn may lead to unfair denial of educational or employment opportunities, health coverage, legal rights, or necessary services (Principle D: Justice). According to Standard 9.02b, psychologists who use tests without established norms for the individual or population assessed must describe in their reports the strengths of using the specific test results as well as the limitations the use of such tests places on psychologists’ interpretations and recommendations. Psychologists conducting evaluations with members of racial/ethnic minority or immigrant groups must be particularly sensitive to the lack of cultural consideration inherent in the most popularly used mental health diagnostic and classification tools: the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11). To avoid errors that may be associated with applying these tools, Johnson (2013) recommended that psychologists (a) apply culturally competent skills to understand attitudes toward mental health that may affect the client’s general response to testing; (b) establish an initial trusting relationship with clients; (c) consider including a measure of acculturation; (d) become familiar with cultural conditions that can impact the sharing of personal history information and the presentation of symptoms; and (e), when appropriate, draw on the appendices in the DSM-5 and ICD-11 to proactively use culture as a factor in the diagnostic process.

Language differences are part of the cultural diversity, rich immigration history, and individual differences in hearing and other linguistically relevant disabilities that make up the demographic mosaic of the United States. The validity and applicability of assessment data can be severely compromised when testing is conducted in a language the testee is relatively unfamiliar with or uncomfortable using. Under Standard 9.02c, psychologists should select tests in the language that is most relevant and appropriate to the test purpose (AERA, APA, & NCME, 2014).Whereas the inappropriateness of English-only-based psychological testing is obvious when testees speak little or no English, the hazards of English-only testing for bilingual persons or oral-language-only assessment of persons with hearing disabilities who can read lips and communicate in sign language are often overlooked. The linguistic competencies of individuals who are bilingual often vary with the mode of communication (e.g., oral vs. written language), language function (e.g., social, educational, or job related), and topical domain (e.g., science, mathematics, interpersonal relationships, self-evaluations). In addition, individuals’ language preferences do not always reflect their language competence. Individuals may be embarrassed to reveal that their English, hearing, or oral language is poor; believe non-English or non-hearing testing will negatively affect their evaluations; or misjudge their language proficiency. The following steps are recommended to help psychologists comply with Standard 9.02c (see also AERA, APA, & NCME, 2014):Psychologists can use language tests that assess multiple language domains to determine language dominance and proficiency relevant to different modes of assessment (e.g., written, oral) and topics (e.g., academic, interpersonal).Whenever possible, psychologists should use test translations that have been developed according to accepted methods of test construction (see Standard 9.05, Test Construction).When a test is translated or adapted, test developers and test users must describe the adequacy of theory, evidence, and methods used to establish the validity of test score interpretations for intended use (see Standard 2.04, Bases for Scientific and Professional Judgments).Additional testing or observation may be necessary to determine whether what appears to be eccentric behavior (e.g., short phrases or reticence in response to test questions) reflects differences in cultural communication styles or an individual characteristic. To the extent feasible, psychologists must ensure the language competence of the test administrator (see also Standards 2.05, Delegation of Work to Others; 9.03c, Informed Consent in Assessments).When interpreting assessment results, test norms for native speakers of English should not be used for individuals for whom English is a second language or should be understood in part as reflecting a level of English proficiency.