The CAP
Monitor Issue 52 | Fall 2017
The Legalization of Cannabis in Canada Part 2 of the EPPP // Client Testimonials // Legal Assignment & Contingency Fees // Privacy & Regulatory Investigations
Who’s Who Council
Supervision Consultants
President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Paul Jerry President-Elect . . . . . . . . . . . . . . . . . . . . . . . . . . . Kevin Alderson Past-President . . . . . . . . . . . . . . . . . . . . . . . . . . . Lorraine Stewart Treasurer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Roger Gervais Members-at-Large . . . . . . . . . . . . . . . . . . . . . . . . Hanita Dagan Reagan Gale Kerry Mothersill Public Members . . . . . . . . . . . . . . . . . . . . . . . . . . Kenneth Bainey David Ellement Michael McLaws
Supervision consultants are available to advise provisional psychologists and supervisors. They also assist in the resolution of conflicts between provisional psychologists and supervisors. Jon Amundson 403-289-2511 aapsych@telus.net Walter Goos 780-986-7592
Committee Chairs
waltergoos@shaw.ca
Credentials Evaluation Sub-Committee . . . . . . . . Ali AL-Asadi Oral Examinations Committee . . . . . . . . . . . . . . . Erik Wikman Practice Advisory Committee . . . . . . . . . . . . . . . . Christoph Wuerscher Registration Advisory Committee . . . . . . . . . . . . . Christina Rinaldi Registration Approvals Sub-Committee . . . . . . . . Jill Turner Greg Schoepp Substantial Equivalency Sub-Committee . . . . . . . Ali AL-Asadi
College Staff Registrar & CEO . . . . . . . . . . . . . . . . . . . . . . . . . . Richard Spelliscy Deputy Registrar and Complaints Director . . . . . . Troy Janzen Assistant Deputy Registrar and Director of Professional Guidance . . . . . . . . . Deena Martin Finance and Administration Coordinator . . . . . . . Wendy El-Issa Complaints Coordinator and Hearings Director . . Lindsey Bowers Administrative Assistant to the Registrar . . . . . . . Kathy Semchuk Registration Coordinator . . . . . . . . . . . . . . . . . . . Ingrid Thompson Registration Assistant and Oral Examinations Coordinator . . . . . . . . . . . . Danielle Salame Credentials Evaluation Coordinator . . . . . . . . . . . Kymberly Wahoff
Continuing Competence Consultants Consultants are available to provide advice and guidance to members who wish to participate voluntarily in the Continuing Competence Program. The consultants are also available in special circumstances, for example, when a member does not have access to other regulated members who are able to review their plan. Such circumstances would occur on a very limited basis, as psychologists are encouraged to develop a network of professional peers. Dennis Brown 780-441-9844 brown.dennis002@gmail.com Christoph Wuerscher 403-234-7970 wuerscher@shaw.ca
Communications Coordinator . . . . . . . . . . . . . . . . Melanie Rutten
Bonnie Rude-Weisman
Receptionist/Office Assistant . . . . . . . . . . . . . . . . Renetta Geisler
403-526-8116 brudeweisman@shaw.ca
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Issue 52 | Fall 2017
Contents
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24 4 Registrar’s Letter 5 President’s Letter 6 College News 8 AGM 10 Part 2 of the EPPP
14 Client Testimonials and ThirdParty Rating Websites
18 The Legalization of Cannabis in Canada
24 Privacy and Regulatory Investigations
26 Psychologists in Legal
Assignment and Contingency Fees
www.cap.ab.ca
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Registrar’s Letter Thank you to all of those who presented and attended the September 2017 College of Alberta Psychologists’ Annual Meeting. A special thank you to College staff for their hard work leading up to the Annual Meeting and for giving up personal time to make it a success. The all-time high attendance speaks to the value our profession places on continuous learning. Feedback from the Annual Meeting was largely positive. The College values the diverse views of our members and all feedback will be considered in planning next year’s event. Importantly, coming together as a professional community is valuable in and of itself. I hope to see many of you at our 2018 Annual Meeting which will be held jointly with the Psychologists’ Association of Alberta in Calgary. The College continues to address Council’s 2017 strategic planning and communication engagement priorities. Key among these is the recent Registration Review. Council has established a subcommittee that is tasked with implementation of the recommendations and Derek Truscott was appointed as Chair of this subcommittee. Deena Martin has joined the College and will serve as Assistant Deputy Registrar and Director of Professional Guidance. She will play a key role in ensuring Council’s strategic priority that the College continue to be an exemplary employer. In this issue you will find information on the position statements of the College on the highly debated legalization of cannabis in Canada, client testimonials, regulatory investigations and much more. We hope you enjoy this issue and look forward to hearing your feedback which you can provide on page 16. In closing, I am continually inspired by the depth of skills, experience and commitment College members bring to meeting the mental health priorities of Albertans. These range from prevention and early intervention to researching new treatment modalities. This work supports College efforts to raise the profile of psychology and the importance of equal access to regulated mental health services for all Albertans.
Richard J. Spelliscy, PhD, RPsych Registrar & CEO
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Issue 52 | Fall 2017
President’s Letter We begin another College year on the heels of a very successful AGM. As I look out the window, we are buffeted by an unseasonably early snow (for Medicine Hat at least). I’d like to turn this into a metaphor in some way, but I don’t see the forces affecting our profession as necessarily negative, nor challenging. Your Council is filled with strong members, representing the many areas psychologists find themselves practicing in. This past year was one of many changes, very gracefully managed by our now-Past-President, Lorraine Stewart. We saw the entry of a new Registrar, following the departure of one of the grand dames of Canadian psychology. Our Strategic Plan is in place. Our Communications Plan is nearly complete. Our Registrar has been working tirelessly to effect change and growth. His efforts are reflected in the dedication and hard work we see from the staff at the College. We welcome some new faces and expanded roles, bringing energy and excitement (yes, excitement!) to the regulation of our noble profession. We are in a very good position to meet the challenges that face all self-governing professions in the 21st century. I look forward with optimism to serving you and our Council, over this year, and consolidating the many gains we have made during this year of transition.
Paul Jerry, RPsych President
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College News Council Election Results The College held a call in July for nominations for two Member-at-Large positions on Council for the 2017–2018 fiscal year. In accordance with College Bylaws, two members were elected: Reagan Gale and Kerry Mothersill.
Reagan Gale Dr. Reagan Gale completed a PhD in Clinical Psychology at the University of Windsor, with a focus in Neuropsychology. Reagan worked on the Allied Health team at South Health Campus in Calgary before moving into her current position as the Director of Clinical Psychology in the Yukon Government Department of Health and Social Services, Continuing Care Division. In addition to serving on the Council, she is a member of PAA, CPA, the Psychologists in Long Term Care Association (PLTC), as well as the Yukon Capability and Consent Board. In her current role, Reagan works primarily to provide clinical education, coaching, and support to her colleagues in Continuing Care, both facility-based long-term care centers as well as the territorial Home Care program.
Kerry Mothersill Dr. Kerry Mothersill is the Alberta Health Services Psychology Professional Practice Lead (PPL) in the Calgary Zone, the Coordinator of the Cognitive Therapy Group and Program facilitator at the Outpatient Mental Health Program, Coordinator of the Regional Psychological Assessment Service (AHS) and is an Adjunct Professor, Department of Psychology, University of Calgary. He currently provides Cognitive Behavioural Therapy and psychological assessment services in addition to teaching, supervision and research. The College welcomes our new Council members and looks forward to the year ahead. Council ratified that Paul Jerry moves to the position of president, Kevin Alderson to the position of president-elect and Lorraine Stewart to the position of past-president. Roger Gervais remains as treasurer for one term.
College Staff Changes The College is pleased to welcome Deena Martin, PhD (Special Education), RPsych, as the newly appointed Assistant Deputy Registrar and Director of Professional Guidance.
Deena Martin
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Deena Martin, PhD (in Special Education), RPsych has a focus on the professional training and academic preparation of those in the helping professions. As a professor, her academic portfolio included graduate courses on: professional ethics and law, introductory counselling psychology skills, and research methods (including statistics). As past Director of Alberta Counselling Programs for a private American university, Deena refined her international insight into policies and practices informing psychology and regulatory bodies. She offers 25+ years of human services experience supporting individuals accessing support in a variety of settings including: residential treatment, correctional facilities, community/street outreach, and private practice. Administratively, Deena brings a background in human resources and employs contemporary leadership practices. Over the past several years, she has served in a voluntary capacity for both the College as well as the Psychologists’ Association of Alberta.
Issue 52 | Fall 2017
S u p e r v i s i o n Wo r k s h o p Developing Your Personalized Approach to Clinical Supervision: The Contextual-Functional Meta-Framework Facilitated by Jeff Chang, PhD, RPsych Clinical supervision has been increasingly recognized as a distinct professional competency for which psychologists and other mental health professionals require specific training. In this workshop, participants will develop their personalized approach to clinical supervision using the Contextual-Functional MetaFramework (CFM) for clinical supervision. The CFM, comprised of six components and nine relational positions, provides a template to support a supervisor to develop their approach to supervision, and select supervisory interventions and skills to tailor supervision to their setting, interests, and the developmental needs of supervisees.
Date: Friday, January 26, 2018 Time: 9:00 a.m. - 4:30 p.m. Location: Edmonton, AB Audience: Psychologists and other mental health professionals interested in developing or refining their approach to clinical supervision. This workshop is appropriate for both new and experienced supervisors.
FOR MORE INFORMATION OR TO REGISTER PLEASE CLICK HERE
www.cap.ab.ca
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Annual Meeting and Professional Development Day 2017 College Council and staff would like to extend a heartfelt thank you to all registrants and speakers who attended the 2017 Annual Meeting and Professional Development Day on Saturday, September 16, 2017 at the Shaw Conference Centre in Edmonton, Alberta. It was a very successful day with the largest attendance so far with 250 attendees including College members, students, speakers, council members and staff. Council reported on the 2016–2017 fiscal year and looks forward to continued achievement in the year ahead. We were very pleased to have Dr. Gabor Maté from Vancouver, BC join us as our keynote speaker. Dr. Maté presented on the topic of “Compassion Fatigue.” A renowned speaker and bestselling author, Dr. Gabor Maté is highly sought after for his expertise on a range of topics including addiction, stress and childhood development. Dr. Maté also presented on “How can Psychologists Meet the Opioid Crisis Challenge” and “When the Body Says No!” in the afternoon sessions. Further information about Dr. Maté and his work can be found at www.drgabormate.com. Additional professional development sessions in the afternoon focused on a range of topics, including presentations on: • Collaborative Practice Essentials: Knowledge Café - Elaine Greidanus and Bradley Dye • The Psychologist as an Expert Witness - Andrew Haag • Getting Back on the Rails: Managing Supervision Conflict - Lynda Phillips and Greg Schoepp • Psychologists Meeting the Needs of the Refugee Community - Sophie Yohani
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Highlights from the day included a heartfelt welcome from outgoing President Lorraine Stewart. A Plenary Session in which Richard Spelliscy, CAP Registrar & CEO, and Judi Malone, PAA President, presented on the differences between the two bodies and how they plan to work together to benefit psychology in Alberta. The early bird registration prize winner was drawn by Richard Spelliscy and Judi Malone for the Samsung tablet. The winner, Angila Chase, was chosen and presented with the prize at the event. As of October 4, 2017 there were 118 (47%) electronic evaluation forms submitted. The vast majority of respondents were drawn to the event because of the keynote speaker Dr. Gabor Maté and also for the opportunity to network with other psychologists. The feedback was diverse and many respondents appreciated the diversity of the session topics, the venue, and the chance to hear from College staff and PAA’s President. Suggestions for future sessions included but were not limited to: • Technology and its application in psychology • Ethics • Record keeping • Trauma We look forward to the 2018 Annual Meeting and Professional Development Day which will be held in Calgary jointly with PAA. Email updates will be sent out regarding the 2018 AGM next year.
www.cap.ab.ca
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Part 2 of the Enhanced Examination for Professional Practice in Psychology By Emil Rodolfa, PhD, Chair of the EPPP Part 2 Implementation Task Force and Carol Webb, PhD, ASPPB Chief Operating Officer The Association of State and Provincial Psychology Boards (ASPPB) is the association of all of the governmentally regulated licensing boards for psychology in the United States and Canada. ASPPB’s primary mission is to assist its member boards in their mandate of public protection. One of the requirements for licensing boards is to ensure that the professionals they license are competent. Competence is comprised of the integrated use of knowledge, skills, attitudes and values. For over 50 years, candidates’ knowledge of psychology has been assessed successfully with the Examination for Professional Practice in Psychology (EPPP), but psychology licensing boards have had to rely on other mechanisms to provide an assessment of licensure candidates’ skills. What is Part 2 of the EPPP? Part 2 of the EPPP is a skills examination with a computer-based administration. This examination is meant to augment the current EPPP, the test of foundational knowledge needed to practice psychology independently. Part 2 of the EPPP is based on the 2017 ASPPB Competencies Expected of Psychologists at the Point of Licensure. The final competency model was developed based on the 2016 ASPPB Job Task Analysis that included input from licensed psychologists throughout the U.S. and Canada, and that provides the blueprint for Part 2. (The full report of the Job Task Analysis is available here). Why is ASPPB developing a skills portion of the EPPP? ASPPB is developing Part 2 of the EPPP to offer licensing boards a standardized, reliable, and valid mechanism to assess skills, so that along with the EPPP Part 1, licensing boards will have the up-to-date means necessary to assess information
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about a candidate’s competence and readiness for licensure. Thus, the enhanced EPPP will provide licensing boards a snapshot of a candidate’s ability to practice independently. Including a skills portion to the EPPP is part of a natural progression of the evolving nature of psychology education and training, and licensing assessment practices. There are a number of conditions that have occurred, and that are occurring, that have encouraged ASPPB to develop this examination at this time. These conditions include: Competency Models There exists an essential agreement among many professional groups, including the American Psychological Association Commission on Accreditation (CoA), the Mutual Recognition Agreement of the Canadian Colleges and Boards of Psychology (MRA), Canadian Psychological Association Accreditation (CPAA), and ASPPB on what are the necessary competencies to practice independently. These groups have developed different models of competency; but, although there are differences in the structure of these models, there is substantial agreement regarding the foundational and functional elements across these models. With this professional agreement, ASPPB is able to clearly provide guidance to licensing boards regarding the competencies that need to be assessed for independent practice. Technological Advances Advances in affordable technology have made it possible to assess most of the skills in the ASPPB model via a computer-based examination, rather than using a more costly and time-consuming examination using either real patients/clients or standardized patients/clients.
Lack of Standardization of Graduate Education There have been significant concerns expressed about the lack of standardization of graduate education in psychology, including differences in practicum and foundational education. This variability in graduate education results in EPPP pass rates from APA-accredited programs ranging from 13% to 100%. This variability also results in students accruing anywhere from a few hundred hours, to several thousand hours, of practicum experience. Even the APA and Canadian Psychological Association (CPA) accreditation systems do not require a prescribed course of education and training. ASPPB values these accreditation systems, and in fact has endorsed APA or CPA accreditation as a minimum requirement for doctoral level licensure for health service psychologists. It should be noted, however, that accreditation systems accredit training programs, not individuals. Licensing boards license individuals. It is the duty of licensing boards to assure the public that each individual psychologist that is licensed is competent to practice. Further, not all academic programs are APA/CPA accredited, thus some applicants who become licensed are from programs that have not been reviewed by an external agency. Students from these non-accredited academic programs typically underperform on the EPPP when compared to the average student from an accredited doctoral program, supporting the need for these programs to be reviewed. Because of the great variability in the current educational system in psychology at both the doctoral as well as internship levels, ASPPB is developing the Part 2 to help boards better assess students graduating from such a system.
and it has been demonstrated that supervisors tend to overestimate their reports of supervisee competence, perhaps due to an inherent conflict of being in the gatekeeper and mentor roles simultaneously. Part 2 of the EPPP will offer psychology licensing boards a standardized, reliable and valid assessment of many of the skills needed to practice independently. Clearer Understanding of Competency Assessment Thanks to the evolution of the culture of competency in psychology, we have a better idea of how to assess that competency has been achieved. Regarding the assessment of competency, a number of articles have described how to go about assessing competency. Although simple in design, a pyramid model (Knows, Knows How, Shows How, Does) developed by Miller in 1990 has been very helpful in providing a framework to clarify the steps needed to effectively assess competency using computer technology. Doctoral Professions’ View of Competency Assessment All other doctoral level health professions use a skills examination as a step toward determining competency. These other professions have focused on their own cultures of competence for many years. The EPPP Part 2 skills examination is a next step to fully bring the profession of psychology into the culture of competence.
Supervisor Evaluations It has been noted that supervisors experience difficulty in writing critical or constructive letters of evaluation. This issue of the accuracy, or validity of supervisor evaluations, is not new, nor is it particularly debatable. The reliability and validity of supervisors’ assessments has been questioned for years, www.cap.ab.ca
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ASPPB Membership Support The ASPPB membership (psychology licensing boards in the U.S. and Canada) has discussed competence and the need for a skills-based assessment for many years. Each time licensing boards have been asked to respond to surveys indicating their level of support for a skills examination, they have consistently supported such an examination. In Summary As can be seen, there are many factors that have influenced the development of a skills element to be included as Part 2 of the EPPP. Taking these factors into account, Part 2 of the EPPP is being developed to complement Part 1, the current test of knowledge, and this enhanced EPPP will provide licensing boards a more advanced means to assess an applicant’s readiness to practice independently. This advancement in competency assessment will enable licensing boards to better fulfill one of their primary functions: to insure that those they license can practice competently. Developing Part 2 of the EPPP As noted before, Part 2 of the EPPP is based on the 2017 ASPPB Competencies Expected at the Point of Licensure. After the ASPPB 2016 Job Task Analysis, a blueprint for this skills examination was developed. This blueprint describes the percent of test items that will be from each of the ASPPB Competency Model clusters. The blueprint can be found on the ASPPB website here. The goal in developing Part 2 of the EPPP is to offer a test where candidates for licensure will actually have to demonstrate that they “know how” and can “show how” to perform aspects of the competencies listed in this competency model. Writing EPPP Part 2 Items Over 120 psychologists have volunteered to write items for the Part 2 and over 50% of these item writers are early career psychologists. ASPPB is in the process of training these psychologists how to write items that will appear on the test.
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A variety of item types will appear on the EPPP Part 2. Although it is still in development and the item types have not been finalized, it is clear that there will be:
1) traditional multiple choice items, 2) multiple select items (e.g., items where a candidate will have to choose a number of responses, perhaps in the order that they would be done), 3) scenarios and vignettes with scaffolding questions (e.g., questions that build upon answers given previously), 4) test items requiring exhibits (e.g., test protocols), and 5) other non-traditional types of test questions (e.g., mix and match type items).
Through these various item types, the EPPP Part 2 will test a licensure candidate’s ability to display a snapshot that s/he knows how to do the appropriate things when practicing psychology. The content of the items will be drawn from situations that can be encountered when in practice; for instance, how to go about assessing a client or how to intervene in a specific situation. Item content will also be drawn from the ASPPB Disciplinary Data System and the American Psychological Association Insurance Trust, which will provide descriptions of situations where psychologists were disciplined for their professional behaviors. The goal in using these resources is to provide candidates with realistic situations that have caused psychologists difficulty in navigating their professional lives. When Will the EPPP Part 2 be Launched? The current plan is for the EPPP Part 2 to be launched in 2019. During the next two years (20172018), items will be written and each question will be beta tested. ASPPB will need the help of volunteers willing to serve as beta testers during the next 18 months. The beta testing phase requires that psychologists have been licensed no more than two years. Beta testing will begin in mid to late 2018. If you are a licensed psychologist and would like to participate, please fill out this form.
Conclusions ASPPB has received many comments and reactions over the last year about the development of the EPPP Part 2. As the Part 2 moves forward in its development, we welcome the opportunity to communicate with other professional groups about this examination and want to continue what has proven to be a very useful dialog with students and early career psychologists as well as representatives from the education and training community and the practice community. This skills examination will contribute to a licensing board’s ability to ensure that the professionals who are licensed are competent, in a more up-to-date and enhanced manner than before. It is the responsibility of the education and training community to produce qualified, compassionate, curious, earnest, and competent practitioners. Licensing boards, however, need to assess competence to determine minimum entry-level standards for many different areas, including foundational knowledge, ethics, critical thinking and acquisition of basic, functional skills. And, licensing boards need to do so in a legally defensible manner, which means standardization and reliability are critical concepts. It would be irresponsible for ASPPB to not move forward with a skills part of the EPPP when we now have met all of the necessary conditions for such an exam. It would be like going for a driver’s license and only taking the test of knowledge of rules of the road, and not the actual driving test; or like applying to be a licensed physician, dentist, podiatrist, chiropractor, osteopath, optometrist, or pharmacist and only taking a test of knowledge and not a skills exam. The Part 2 of the EPPP will allow psychology licensing boards to better fulfill their mandate to protect the public. Please send any comments or questions about this article or the EPPP Part 2 to erodolfa@alliant.edu.
Provisional Psychologists’ Information Use of Title •
The Psychologists Profession Regulation Section 15(1)(b) states:
“15(1) A regulated member who is registered on the following registers may use the following titles: (b) a regulated member whose name is entered on the provisional register is authorized to use the title provisional psychologist or registered provisional psychologist.” •
The Health Professions Act Schedule 22 Section 2(c) states:
“2 A regulated member of the College of Alberta Psychologists may, as authorized by the regulations, use any of the following titles: (c) provisional psychologist” •
The College Standards of Practice (2013) Section 13.2 states that:
13.2 A psychologist shall only use titles as authorized by the HPA and the Psychologists Profession Regulation. _____________________________ No other title may be used for a registered provisional psychologist other than those stated above. The title must be spelled out in full.
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Client Testimonials and Third-Party Rating Websites By Emilie Lacroix, Keith S. Dobson, PhD, RPsych, & Kristin M. von Ranson, PhD, RPsych Definitions and Guidelines Testimonials are statements from current or previous clients or their family members that comment upon the services of a professional such as a registered psychologist. Testimonials may include comments about the psychologist’s abilities or characteristics or the benefits of received services. Although psychologists may believe that testimonials are harmless or even that they provide useful information, testimonial use and solicitation are prohibited by provincial and national regulatory bodies: College of Alberta Psychologists (CAP) Practice Guideline “Representing Academic and Professional Credentials in Public Communication” (2013), section 4.1:
“The psychologist should not use the testimonials of current or previous clients, in any form, even when such testimonials are offered and not solicited.”
Canadian Psychological Association (CPA) “Practice Guidelines for Providers of Psychological Services” (1989), section III.2.b: “Claims made by psychologists shall be based upon sound research findings, and may not employ testimonials, selective survey results, or misleading or false information.” Notably, these guidelines do not distinguish anonymous testimonials from those that contain identifying information, and thus apply to both types. Ethics of Testimonial Use Although it can be argued that testimonials could inspire potential clients to seek help, or inform the selection of a psychologist, the process
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of gathering and displaying testimonials is inherently biased. Even in the case of unsolicited testimonials, psychologists are unlikely to acquire or display testimonials that are negative or neutral. As a result, testimonials are unlikely to represent the full spectrum of client experiences or the psychologist’s abilities. Testimonial use thus conflicts with the Canadian Code of Ethics for Psychologists (Canadian Psychological Association, 2017), and specifically the principle of accurate representation (Standard III.2). Testimonial use also raises concerns about confidentiality (I.43) and conflicts of interest (III.28). The risks of inaccurate representation and potential harm, particularly when clients are identifiable, arguably outweigh any potential benefits of testimonial use. Do Psychologists Use Testimonials Despite Guidelines? Until recently, no empirical research had examined the scope of testimonial use or solicitation on professional websites of Canadian psychologists. The only estimate of testimonial use came from the United States: Palmiter and Renjilian (2003) found that 6.0% of 204 sampled mental health professionals’ websites displayed client testimonials. To estimate the scope of testimonial use in Canada, we recently examined the websites of 433 registered psychologists from five provinces (Alberta, British Columbia, Manitoba, Ontario, and Quebec) to ascertain how often testimonials appeared (Lacroix, Dobson, & von Ranson, 2017). We found that 2.0% of Alberta psychologists’ websites included testimonials, 2.0% solicited testimonials, 2.0% had empty pages dedicated to client testimonials, 1.0% linked to third-party rating websites, and 4.0% contained any of the above. These rates were similar to the overall observed averages. Of the testimonials displayed on psychologists’ websites, many contained potentially identifying information. Although
only
4.0%
of
sampled
websites
of
“Psychologists should not use the testimonials of current or previous clients in any form, even when such testimonials are offered and not solicited.” Alberta psychologists included testimonial use or solicitation, this practice violates provincial and national standards. With increasing competition, it may be tempting for psychologists to advertise more aggressively. However, it is important that advertising is consistent with ethical standards and regulatory guidelines, and reflects well on the profession of psychology. Recommendations The bounds of testimonial use are not crystal clear. In considering whether to display statements through websites, written materials, or other media, psychologists should ask themselves: •
•
i ) i i)
Is this a statement from a current or past client, or from someone close to them? Does the statement comment on a psychologist, on psychological services received, or on the outcomes of such services?
If the answer to either of these questions is “Yes,” or even if an outsider could perceive the statement as meeting either of these criteria, psychologists are encouraged to refrain from disseminating or associating themselves with the statement. Ambiguous Examples of Potential Testimonial Use 1. Third-party rating websites. Several websites (e.g., RateMDs.com, Yelp.ca) allow clients to rate psychologists and comment on their services. Typically, all that is needed to leave a review on these websites is a valid email address and an internet connection, so there are no safeguards to ensure that reviews are legitimate. Furthermore, there is typically no simple way to remove reviews on such websites, as might be desirable in the case of defamation or if clients reveal identifying
information about themselves. Displaying reviews from third-party websites, linking to these websites, or requesting reviews on such websites, can be perceived as within the bounds of testimonial use and solicitation. Because these activities conflict with provincial and national guidelines, they are discouraged. 2. Testimonials that are passively received. Testimonials received in the absence of active solicitation (e.g., thank-you cards from past clients) should not be disseminated by psychologists to the public or to potential clients, online or otherwise. This practice would constitute testimonial use. 3. Examples to illustrate the therapeutic process. Psychologists may provide information on their websites that gives clients an idea of what to expect in psychotherapy. This information can be conveyed in the form of illustrative case examples or vignettes. However, if psychologists use such examples, they are encouraged to include a statement declaring that cases are fictionalized, use invented names, and do not represent the experiences of actual past clients. Future Directions Further research is needed to determine whether testimonials affect the processes of clients’ help- seeking and provider selection. While it is possible that the display of testimonials on professional websites does not affect these processes, testimonial use could be perceived by clients as unprofessional, and actually have the opposite effect desired by psychologists who seek to expand their client base.
References can be found on page 28.
www.cap.ab.ca
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Check In... CAP Meetings and Exam Dates
Email addresses are mandatory for all members of the College. It is crucial that we have your current email address as all information from the College is sent out via email.
Do we have your current information? Please notify the College of any changes to your postal address, phone and fax numbers or email address. To update your contact information: • Log in to the Member Portal • Go to the “I Want To” box on the left of the screen • Click “Update my Contact Information” If you need any assistance please contact the College at psych@cap.ab.ca.
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HUMAN RESOURCES/ WORKPLACE HEALTH & SAFETY
FENTANYL PERSONAL PROTECTIVE EQUIPMENT (PPE) Exposure to fentanyl particles/aerosols may occur through inhalation, skin contact or absorbed through the eye. The worker must conduct a field level or a point-of-care risk assessment to determine the level of PPE required.
Low Level Risk
Situations such as small amount of drugs present on the user or the street drug trafficker
N95 Respirator (requires fit testing prior to use)
Uniform, steel toed boots and gowns or long sleeve shirts closed at the cuff
Safety glasses with side shields or safety goggles over prescription glasses
Two pairs extended cuff nitrile gloves (e.g.Ensure EC PM6-210X). The inner pair should sit beneath the sleeve cuff, and the outer pair should be overtop the cuff.
Personal Protective Equipment Removal 1. Remove outer glove by grasping the outside edge of the glove near the wrist and peeling away from the hand, turning the glove inside-out.
4. Carefully remove the respirator from your face by touching only the ties or elastic bands, starting with the bottom strap. Place respirator in the disposal bag.
2. Remove gown by grasping the outside of the gown at the back of the shoulders and pulling the gown down over the arms. Turning it inside out. Place gown in the disposal bag.
5. Remove inner glove by grasping the outside edge of the glove near the wrist and peeling away from the hand, turning the glove inside-out.
3. Remove safety glasses.
6. Wash hands with soap and water.
Place all disposable PPE contaminated with fentanyl in sealed double bags. Label the bag ‘Fentanyl contaminated’. For any situation that is outside of your comfort level or poses a higher risk of exposure than described above, remove self from the area and call your supervisor as it may require response by a professional Hazardous Materials team.
14-Jul-2017
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The Legalization of Cannabis in Canada
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A position statement by Troy Janzen, PhD, RPsych, CAP Deputy Registrar and Complaints Director Sent to Alberta Cannabis Secretariat & Minister of Justice and Solicitor General on July 26, 2017
Preamble
3.
In 2001, Canada passed the Marijuana Medical Access Regulation Act. More recently, the Federal Government has introduced legislation including Bill C45 “Cannabis Act” and Bill C46 “An Act to Amend the Criminal Code” which is expected to come into force July of 2018. Some specific things that are proposed in the new legislation would:
4.
•
The College of Alberta Psychologists (CAP) takes no formal position on the proposed legislation itself. CAP is a body with a mandate to serve the interests of the public and advance the profession. It is within the lens of public protection that this statement is offered. Psychologists have a unique training and knowledge base to offer an opinion on the above stated areas. As psychologists we are trained to seek answers to such questions, where possible or available, by the best available scientific evidence in the field. Thus, this position statement is grounded in the available scientific evidence. Where no or limited evidence exists, CAP believes that the onus is on the government for facilitating the systematic collection and analysis of data to make informed decisions on cannabis production, use and treatment in the interest of public safety.
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allow adults to possess up to 30 grams of legally-produced cannabis allow adults to grow up to four cannabis plants per household set the minimum age for purchase and use at 18 years of age, with the option for provinces to increase the age limit enable a regulatory regime for the licensed production of cannabis, which would be controlled by the federal government enable a regulatory regime for the distribution and sale of cannabis, which would be controlled by the provincial government establish new provisions to address drugimpaired driving, as well as making several changes to the overall legal framework to address alcohol-impaired driving
Downloaded from https://www.alberta.ca/ cannabis-legalization-in-canada.aspx. Initial Position Statement Alberta’s response to this new legislation has been to seek input from various stakeholders. Specifically, the Alberta Justice and Solicitor General has requested information on the following four topics related to the legalization of cannabis: 1.
Legal age – should it be older than the federal minimum legal age of 18? 2. Purchasing cannabis – how will it be distributed and where will it be sold?
Using cannabis in public – where can it be consumed and under what circumstances? Safe roads and workplaces – should Alberta create new impaired driving laws and how should it be treated in the workplace?
The following represents an initial position statement in response to this pending legislation and the above specific questions.
1. Should the legal age be older than the federal minimum legal age of 18? Several other organizations have already provided considerable information on the potential negative impact/risks of cannabis use in children and adolescents. We would point readers to the position statements by the Canadian Psychiatric Association (CPA) (Tibbo et al., 2017) the Canadian Paediatric Society (CPS) (Grant & Belanger, 2017), the Centre for Addiction and Mental Health (CAMH, Crepault, Rehm & Fischer, 2014) and the Canadian Centre on Substance Abuse (CCSA) (2015).
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One summative statement that captures the heart of the research evidence on the impact of cannabis with youth is, â&#x20AC;&#x153;All stakeholders agreed that cannabis is not a benign substance and young people are at a higher level of risk for experiencing negative impacts.â&#x20AC;? (p.8, CCSA, 2015). One concerning statistic according to the World Health Organization (2012) is that nearly one third of youth have reported they tried cannabis at least once by age 15. Of particular concern to Alberta is that Health Canada statistics from 2012 suggest that Alberta youth ranked fourth in the country for usage, with a rate of 11.4%. Youth are the highest consumers of cannabis across all age groups with highest rates among First Nations youth (EltonMarshall, Leatherdale & Burkhalter, 2011). Research is also clear that early use (<16 years) is associated with several negative outcomes (Fischer et al., 2011). Thus, CAP echoes the concerns raised by other organizations about the potential impact legalization might have on youth consumption rates and the concomitant impact on cognition, mental health, addiction, and other safety issues. There is substantial and compelling scientific evidence accumulated over the past 15 years or more that indicates cannabis, and delta-9tetrahydrocanniabol (THC), can have deleterious impact on the developing adolescent brain (Porath-Waller, Notarandrea & Voccarino, 2015). When one considers that there is evidence that the THC content in todayâ&#x20AC;&#x2122;s cannabis products is potentially two to four times higher than in typical products used 40 years ago, the risks to adolescent brains rises substantially (Cascini, Aiello, & Di
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Tanna, 2012). Studies using brain scanning devices such as Magnetic Resonance Imaging (MRI) have shown that youth who regularly use cannabis have lower brain volumes, different folding patterns and thinning of the cortex, less neural connectivity, and lower white matter integrity (Lisdahl, et al., 2014). These structural changes have corresponding cognitive impairments which have been documented to impact many of the executive functions of the brain. Executive functions shown to be negatively impacted by cannabis use in youth include short-term memory, working memory, planning, attention, reaction time, judgement, and motor skills. Two concerns that arise from these cognitive impairments include the impact on educational attainment (Brook, Stimmel, Zhang & Brook, 2008) and risks related to driving under the influence of cannabis (Papafotiou, Carter, & Stough, 2005). In addition, there are functional impairments that have been associated with cannabis dependence including reduced academic performance, truancy, reductions in involvement with school and extracurricular activities, and increased family conflict (CCSA, 2015). There is also a greater risk of truancy and lower graduation rates among regular cannabis users. Another concern is the potential risk to adolescents for cannabis dependence, withdrawal symptoms, and use with other substances including tobacco. Current evidence suggests that around 14% of adolescents who use cannabis will meet criteria for dependence and that their rate of dependence is double that of adults (Chen, Kandel, & Davies, 1997). Risk of dependence increases to 1 in 6 with earlier use (Fischer et al., 2011). Withdrawal symptoms can include combinations of psychological and physical symptoms that may impede cannabis cessation and precipitate relapse (Budney & Hughes, 2006). Given that the Alberta Mental Health Review Committee has already identified youth addiction as an area of priority for prevention and treatment in this province, the pending legalization of cannabis could add to the burden on the mental health system. Many users co-use cannabis with tobacco, which has added health risks. There is abundant research on related health risks to cannabis use when smoked. These include cardiovascular, motor problems and sleep problems.
The risk for impaired driving under the influence of cannabis is also a significant concern among youth and young adults. Rates of cannabisimpaired driving exceed rates of alcohol-impaired driving (CAMH, 2014). Mental health research shows that regular cannabis use in adolescence is associated with mental illness and increases the likelihood of mental illness for those with a pre-existing vulnerability. Regular use of cannabis in adolescence can lead to diminished life satisfaction and increased risk of mental health problems like depression. Use prior to age 18 increases the risk of developing psychosis (i.e., breaks from reality) and has been linked to the development of schizophrenia (Lynch, Rabin & George, 2012). In particular, one study showed that there is a 40% increased risk of psychosis for cannabis users and this rose to 50 to 200% increase in frequent users (Moore et al., 2007). Research has also shown that cannabis use does have some positive medical and potential medical benefits. For example, it has been established that THC and/or cannibindiol (CBN) can be effective for reducing spasticity associated with MS, analgesic effects (i.e., pain control), anti-inflammatory effects, and improving appetite (Volkow, 2015). Many other potential medical benefits have been suggested but have yet to be properly researched/ demonstrated. CAP Position Statements Related to #1 Those under age 25 should not use cannabis recreationally due to the many potentially harmful impacts on health, cognition, educational attainment, and mental health. The federal and provincial governments should establish a system of robust data collection to monitor the use and impact of cannabis use before and after legalization with a particular emphasis on tracking use in children and adolescents. Developmental research suggests that cannabis use continues to pose a risk to those up to age 25 given significant brain development up until this age range. Daily or near daily use in those aged 18-25 should be actively discouraged. The Alberta
government would be advised to consider this in their establishment of the legal age for cannabis use. The potency of THC content should be carefully measured and controlled and displayed clearly for users. Individuals with a pre-identified vulnerability to use of cannabis (e.g., individuals with a history of psychosis, cardiovascular problems, pregnant women, individuals under age 25) should abstain from use. Public education regarding health risks should be targeted to those with a pre-identified vulnerability to use of cannabis. 2. How will cannabis be purchased and distributed? From the perspective of CAP, the concern regarding the purchase and distribution of cannabis relates to the access of cannabis to youth or other vulnerable groups, the measurement and control of the potency of the psychoactive components of cannabis, and the revenues that could be generated from sales. CAP Position Statements Related to #2 Safeguards, education, and public policies should be put into place to limit access and raise awareness among vulnerable groups of the above stated risks. There should be federal or national regulation on the access, marketing and advertising of cannabis aimed at youth. Distribution centres for cannabis should not be near or readily accessible to children or adolescents. Distribution centres for recreational cannabis should be clearly differentiated from pharmacies dispensing properly prescribed marijuana. Strict policies should be established to required producers to measure and regulate the potency of cannabis products.
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Appropriate labeling policies outlining the risks associated particularly to those under the age of 25 and specifically to children if products are sold in an edible form. Strict policies should be established on identifying the THC and CBD content in cannabis products. Strict policies should be established to require that distribution centres routinely require identification for anyone under age 30 similar to alcohol or cigarette sales. Strict policies should be established to track and regulate maximum release of cannabis products in any single day or over a period of time. Tax revenues from sale of cannabis products should be directed to fund prevention, research and access to psychological treatment for the mental health and addiction problems known to be associated with cannabis use. This approach currently exists in more than one US jurisdiction. 3. Where should cannabis be consumed and under what circumstances? Should it be allowed in public spaces? In a majority of the states who have legalized cannabis in the US, they have restricted all use of cannabis products in public and many carry fines for public consumption. Given the previously stated risks of cannabis to youth, the concern with permitting public consumption is that it could serve to minimize or normalize use of cannabis for young people who are already among the highest consumers of cannabis. Also, smoked cannabis increases the risk of exposure of non-users to second-hand smoke and vapours. Recent research by Hermann et al. (2015) and Cone et al. (2015) confirms that nonusers exposed to second-hand cannabis smoke can test positive to such exposure and can experience similar behavioural and cognitive effects that mimic direct exposure. Admittedly, these effects are greatest with extreme exposure and are experienced to a lesser extent than with direct consumption. However, the risk of exposing children or adolescents to such second-hand exposure in a public space must be considered.
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Importantly, proper ventilation does reduce such second-hand effects (Hermann et al., 2015). Further, Wang et al (2016) have shown that one minute of exposure to second-hand smoke from cannabis substantially impairs endothelial function and impacts cardiovascular function similar to cigarette smoke. The evidence of cardiovascular risk for exposure to second-hand cigarette smoke is unequivocal. In terms of edible cannabis in public spaces, increased hospital visits for accidental overdose from children or others who have inadvertently consumed such products has been documented in US states where cannabis has been legalized. The delay in behavioural response to consuming edible cannabis also raises the risk of accidental overdose. CAP Position Statements Related to #3 Upon legalization, all cannabis products should be consumed in private. Smoked cannabis products should also be consumed in private and in well ventilated spaces. There should be restriction on smoked cannabis
in public spaces and confined spaces or in vehicles. All edible products should be accompanied with appropriate warning labels regarding the risks to children who may inadvertently consume cannabis related products. 4. a) Should Alberta create new impaired driving laws? In regard to impairment in driving, the research is fairly clear that the cognitive impairments after consumption of cannabis clearly places risks on those who operate motor vehicles and by default the public. Rates of cannabisimpaired driving exceed rates of alcohol-impaired driving for those aged 15 to 29, many of whom admit to cannabis consumption within an hour of driving (CAMH 2014). Additionally, teens aged 16 to 19 may underestimate the dangers of driving under the influence of cannabis compared to alcohol (CPS, 2017). One meta-analysis estimates that use of cannabis more than doubles the risk of being in an accident (Papafotiou et al., 2005). Thus, we submit that risks for impaired driving under the influence of cannabis are still substantial. Another issue for regulators is to determine a clear way to tell when a driver is too impaired by consumption of cannabis to drive. In terms of safe amounts, this is very difficult to test and to determine as THC absorbs into fat tissue and is not distributed into blood in the same way as alcohol. Despite this, there are precedents for what amounts are legal in states that have legalized cannabis. For example, Colorado and Washington State have placed a limit of 5 nanograms/ml of THC in whole blood as the legal limit for driving restrictions. More research is needed on how to detect THC and CBD content and how to determine safest amounts when operating a motor vehicle.
b) How should cannabis use be treated in the workplace? Cannabis consumption is a major concern in safety-sensitive occupations where workers operate vehicles, power tools, heavy machinery or conveyances, or where they are responsible for monitoring personnel or equipment. This concern is raised given the known impairment of cognitive and motor functions following cannabis use. Consumption of cannabis is also a potential safety risk in positions requiring sustained vigilance for the purposes of public safety (e.g., air traffic controllers, safety inspectors, etc.). CAP Position Statements Related to #4 There should be funding for systematic study and review on the impact on driving under the influence of cannabis. The Alberta government should research into effective methods of testing for the presence and impact of THC or CBD in persons suspected of impaired driving prior to implementing new or amending existing driving laws. The Alberta government should build upon the success of effective educational initiatives such as the prevention of sexually transmitted diseases, tobacco cessation and reduction in impaired driving. It should specifically enlist educators to develop effective messaging particularly for highly vulnerable populations. Summation It is recommended that the Alberta Government develop an oversight body to monitor, evaluate and further study the impact of cannabis legislation. This oversight body could act as a hub for collecting research, developing/implementing prevention, education and intervention strategies It could also provide evidence informed regulatory and policy across sectors. If you require further information please do not hesitate to contact the College at psych@cap. ab.ca. References can be found on page 28. Click here for a full copy of the AB Govt framework.
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Your Career May Be An Open Book: Privacy and Regulatory Investigations A Professional Regulatory Alert from Field Law By Jason Kully, Lawyer and Gregory Sim, Partner & Leader of the Professional Regulatory Practice Group
In dismissing an appeal by an Alberta lawyer who alleged that his Charter rights were violated by an order allowing a law society investigator to search his computers, cell phones, and other electronic devices, the Alberta Court of Appeal confirmed that a professional regulator’s statutory investigation powers are broad and that regulated professionals have a low expectation of privacy. Regulatory investigations may permit searches that would otherwise be unauthorized and a breach of an accused’s Charter rights in a criminal investigation. Law Society of Alberta v Sidhu, 2017 ABCA 224, involved an appeal by a lawyer who was investigated by the Law Society of Alberta after he was criminally charged with transporting drugs into a prison. The Law Society investigator met with the lawyer and, after a series of interviews, demanded
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that the lawyer produce all records or property related to the investigation in accordance with s. 55(2) of the Legal Profession Act. Specifically, the lawyer was requested to provide access to his computers, laptops, iPads, cell phones, and other electronic devices. The lawyer refused the request on the basis that s. 55 infringed his section 8 Charter right to be secure against unreasonable search and seizure. The Law Society then obtained an order from the Court of Queen’s Bench upholding s. 55 as constitutionally valid and requiring the lawyer to comply with the investigator’s demand. On appeal of the order, the lawyer again argued that s. 55 was unconstitutional because it violated the Charter. He also argued, at a minimum, that the Law Society should have to satisfy the Court that there were reasonable grounds to believe the search would
find the property/information sought, as well as reasonable grounds to believe that the property/ information would provide evidence of conduct deserving of sanction.
regulatory investigations or to self-report. The level of involvement from the regulator is the trade-off that allows individuals to participate in particular professions.
The Court of Appeal dismissed the appeal. While the Court of Appeal did not rule on whether s. 55 of the Legal Profession Act breached the Charter, the Court found that in the particular case, the investigator’s demand and the Court of Queen’s Bench order met the standards required in a regulatory investigation. The Court of Appeal recognized:
4. The powers of investigation that professional regulators wield extends to aspects of a professional’s personal life that reflect on their integrity, further attenuating any reasonable expectation of privacy a professional may have in either their personal or professional life as both impact on suitability for a profession.
1. The protection of the public is often the most important objective of regulatory statutes and regulators need broad surveillance powers to ensure that their profession is monitored and managed effectively. In the regulatory context, the very purpose of the inspection and production of documents is often to determine whether an offence has been committed. It would thus be impossible for many administrative searches or seizures in a regulated profession to meet the criminal law standard and require reasonable grounds to believe the search would find the property/ information sought and reasonable grounds to believe that the property/information would provide evidence of conduct deserving of sanction. 2. Regulators play an integral role in protecting the public interest, in part because a client may be in a vulnerable position with respect to the client-professional relationship. 3. There is a lower expectation of privacy in the regulatory context because there is an awareness and acceptance that the regulator will be involved in the life and practice of that profession. There are also professional and statutory obligations to comply with
5. The judicial enforcement of the statutory obligation to cooperate with a demand for production provides judicial oversight and an opportunity for a professional to dispute the extent of the order. The Court of Appeal confirmed that relevance is the overarching standard to apply when determining whether a regulator’s demand for information during an investigation is proper. A regulator wanting to demand access to records and information must ensure the demand is to uncover material that would be relevant to the investigation. A regulator need not meet the criminal law standard of “reasonable grounds”. To support a demand it is sufficient for a regulator to have a “rational suspicion” that the demand will uncover evidence the professional has committed unprofessional conduct. Consistent with a number of other decisions released by the courts in the last year, Law Society of Alberta v Sidhu is a strong endorsement of the role that regulators play in protecting the public and is recognition of the broad authority that regulators must be afforded to carry out this role.
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Psychologists in Legal Assignment and Contingency Fees By Jon Amundson, PhD, RPsych, Member of the CAP Practice Advisory Committee Introduction Psychologists often work with files involving lawyers or the courts. This involvement ranges from criminal through civil proceedings and even tribunal or administrative law. In this work there are two principle roles: as neutral forensic evaluator or treating professional. In the first, the psychologist functions in a tri-partite role, formulating opinion upon a primary patient for a second party, i.e., lawyers and/or the court. In the second role, a psychologist is providing treatment or intervention for an individual within the purview of a pending court matter. In either role it is likely they will provide an opinion or treatment summary related to potential court proceedings. As example, a psychologist may be asked to provide an opinion for legal counsel, or the court, on the hedonic loss associated with a motor vehicle accident. They may be asked to speak to the veracity of a claim related to post traumatic stress disorder, or loss related to some violation of a patient’s rights. In these opinions the psychologist is assisting the court in weighing and measuring compensable damages and the validity of a claim. In a treatment role, they may be asked to assist with remedy in similar circumstance. A clinician may work with chronic pain, or acute and chronic stress disorder. With these files, they may be asked to confirm attendance/participation, extent of a given patient’s restrictions, operational diagnosis, treatment applied, outcome or prognosis. In both roles the patient is seeking justice and compensation through legal proceedings and the psychologist employed in service to such outcome. Legal Assignment and Contingency Fees Often lawyers – and apparently other allied health professionals – accept a file on contingency. This means that a lawyer will proceed with a matter
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under the auspices of collecting fees once a final settlement is reached. This arrangement can also be referred to as assignment where the transfer of rights of one party are assigned to another. It is a contractual arrangement where, for our purposes here, a patient would say: •
‘Upon final settlement, I am contracting to cover all costs accrued in any treatment provided or assessment executed, out of that settlement.’
This contractual arrangement exists, as mentioned between lawyers and their clients, and apparently some health care professionals also permit this. Psychologists and Contingency/Assignment This arrangement however is prohibited for psychologists. This prohibition – to accept contingency fees and/or legal assignment – arises from consideration of the inherent conflict in such design. Initially, it should be clear that where a professional opinion upon patient status is linked to a case outcome, it would be reasonable for a third party to question the objectivity or neutrality of the professional. Most simply, the arrangement would appear to sponsor enthusiasm for the patients’ claim, as it’s veracity to the court (or legal counsel) is directly linked to a professionals’ realization of their fees! ‘Is it possible for a psychologist to perform a complex assessment and find the patient malingering or factious, when this would lead to no compensation?’ Treatment is of little difference. While the primary obligation is to the patient, compensation is still linked to a legal outcome. Hence there is an inherent conflictual dual relationship where the psychologist (in either role) has both a professional and a financial relationship with the patient. Though subtle, as a beneficiary to legal outcome, the psychologist has initiated, or is engaged in, a financial relationship which can clearly impact, distort or limit primary role/function. ‘Can I speak
to personality or character issues, or malingering, or secondary gain, which confounds my treatment, and the compensable aspects of a claim?â&#x20AC;&#x2122; As a result, contingency and assignment has been prohibited in the guidelines of many professional organizations, for just such conflict of interest and role interdiction. Conclusions
connection to/with any such circumstance. While it has been argued that indigent or financially compromised individuals are denied service where assignment is prohibited, it is an argument of little weight. Psychologists are enjoined to acceptance files on a pro bono or no fee bias and it is through such remedy that service can be provided where fees for service is not possible.
In any deferred fee arrangement, it must be clear that costs associated with professional services are independent of any other financial circumstance in a patientâ&#x20AC;&#x2122;s life, and that the psychologist has no
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References Page 14-15
Client Testimonials and Third-Party Rating Websites By Emilie Lacroix, Keith S. Dobson, PhD, RPsych, & Kristin M. von Ranson, PhD, RPsych American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association. Retrieved from http://www.apa.org/ethics/. College of Alberta Psychologists. (2013). Representing Academic and Professional Credentials in Public Communication. Edmonton, AB: College of Alberta Psychologists. Retrieved from http://www.cap.ab.ca Canadian Psychological Association. (1989). Practice guidelines for providers of psychological services. Ottawa, ON: Canadian Psychological Association. Retrieved from http://www.cpa.ca/aboutcpa/committees/ethics/resources. Canadian Psychological Association. (2017). Canadian code of ethics for psychologists (4th ed.). Ottawa, ON: Canadian Psychological Association. Lacroix, E., Dobson, K., & von Ranson, K.M. (in press). Scope and ethics of psychologistsâ&#x20AC;&#x2122; use of client testimonials on professional websites. Canadian Psychology. doi:10.1037/cap0000123 Palmiter, D., Jr., & Renjilian, D. (2003). Clinical Web pages: Do they meet expectations? Professional Psychology: Research and Practice, 34(2), 164-169. doi:10.1037/0735-7028.34.2.164
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The Legalization of Cannabis in Canada A position statement by Troy Janzen, PhD, RPsych, CAP Deputy Registrar and Complaints Director Brook, J.S., Stimmel, M.A., Zhang, C., Brook, D.W. (2008). The Association Between Early Marijuana Use and Subsequent Academic Achievement and Health Problems: A Longitudinal Study. The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 17(2), 155-160. doi:10.1080/10550490701860930 Budney, A.J., & Hughes, J.R. (2006). The cannabis withdrawal syndrome. Current Opinion in Psychiatry. 19(3), 233-8. Canadian Centre on Substance Abuse (2015). Cannabis Regulation: Lessons learned in Colorado and Washington State. Author, downloaded from www.ccsa.ca Cascini, F., Aiello, C., & Di Tanna, G. (2012). Increasing delta-9-tetrahydrocannabinol (Î&#x201D;-9 THC) content in herbal cannabis over time: systematic review and meta-analysis. Curr Drug Abuse Rev. 5(1), 32-40. Chen, K., Kandel, D.B., & Davies, M. (1997). Relationships between frequency and quantity of marijuana use and last year proxy dependence among adolescents and adults in the United States. Drug Alcohol Depend. 46(1-2), 53-67.
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Cone, E.J., Bigelow, G.E., Hermann, E.S., Mitchell, J.M., LoDico, C., Flegel, R. & Vandrey, R. (2015). Non-Smoker Exposure to Secondhand Cannabis Smoke. I. Urine Screening and Confirmation Results. Journal Analytical Toxicology. 39(1), 1–12. doi: 10.1093/jat/ bku116 Crepault, J-F., Rehm, J. & Fischer, B. (2014). The Cannabis Policy Framework by the Centre for Addiction and Mental Health (CAMH): A proposal for a public health approach to cannabis policy in Canada. International Journal of Drug Policy, 34, 1–4. Elton-Marshall, T., Leatherdale, S.T., & Burkhalter, R. (2011). Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: results from the Youth Smoking Survey. Canadian Medical Association Journal. 2011 May 17; 183(8): E480–E486. Fischer, B., Jeffries, V., Hall, W., Room, R., Goldner, E., & Rehm, J. (2011). Lower Risk Cannabis Use Guidelines for Canada (LRCUG): A Narrative Review of Evidence and Recommendations. Canadian Journal of Public Health, 102(5), pp. 324-27. Grant, C.N. & Belanger, R.E. (2017). Canadian Paediatric Society Position Statement: Cannabis and Canada’s children and youth. Paediatric Child Health, 22(2), 98-102. Hermann, E.S., Cone, E.J., Mitchell, J.M., Bigelow, G.E., LoDico, C., Flegel, R., & Vandrey, R. (2015). Non-Smoker Exposure to Secondhand Cannabis Smoke II: Effect of Room Ventilation on the Physiological, Subjective, and Behavioral/Cognitive Effects. Drug and Alcohol Dependence. 151, 194–202. doi: 10.1016/j.drugalcdep.2015.03.019 Lisdahl K.M., Wright N.E., Kirchner-Medina C., Maple K.E., Shollenbarger S. (2014). Considering Cannabis: The Effects of Regular Cannabis Use on Neurocognition in Adolescents and Young Adults. Current addiction reports. 1(2), 44-156. doi:10.1007/s40429-014-0019-6. Lynch, M.J., Rabin, R.A., & George, T.P. (2012). The cannabis-psychosis link. Psychiatric Times, 29 (6), 35-35. Moore, T.H.M., Zammitt, S., Lingford-Hughes, A., Barnes, T.R.E., Jones, P.B., Burke, M., & Lewis, G. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 370 (9584), 319-28. Papafotiou, K., Carter, J.D., & Stough, C. (2005). An evaluation of the sensitivity of the Standardised Field Sobriety Tests (SFSTs) to detect impairment due to marijuana intoxication. Psychopharmacology, 180(1), 107-14. Porath-Waller, A., Notarandrea, R., & Voccarino, F. (2015). Young brains on cannabis: It’s time to clear the smoke. Clinical Pharmacology & Therapeutics, 97(6), 551-2. Tibbo, P, Crocker, C.E., Raymond, W.L., Meyer, J., Sareen, J. & Aitchison, K.J. (2017). Implications of cannabis legalization on youth and young adults. Canadian Psychiatric Association. Volkow, N.D. (2015) Cannabidiol: Barriers to Research and Potential Medical Benefits. National Institute on Drug Abuse, downloaded from https://www.drugabuse.gov/about-nida/ legislative-activities/testimony-to-congress/2016/biology-potential-therapeutic-effects cannabidiol Wang, G.S., Le Lait, M.C., Deakyne, S.J., Bronstein, A.C., Bajaj, L., Roosevelt, G. (2016) Unintentional pediatric exposures to marijuana in Colorado, 2009–2015. JAMA Pediatrics, 170(9), e160971. doi:10.1001/jamapediatrics.2016.0971 www.cap.ab.ca
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Harvey Brink, James Canniff and Paul Jerry are members of the Publications Committee who monitor the content of The CAP Monitor to ensure the information being conveyed is consistent with the Collegeâ&#x20AC;&#x2122;s mandate, governing documents and policy. The CAP Monitor is a regular publication of the College of Alberta Psychologists. To the best of our knowledge it is complete and accurate at the time of publication. This issue was created by Melanie Rutten, CAP Communications Coordinator, if you have any questions please email us at communications@cap.ab.ca.