Fisher, C. And Oransky, M.

Fisher, C. And Oransky, M. (2008). Informed Consent to Psychotherapy: Protecting the Dignity and Respecting the Autonomy of Patients. Journal of Clinical Psychology in Session. 64 (5): 576-88.

Well-implemented and informed consent procedures are consistent with psychology professionals adaptation of medical ethics and consent procedures.

Using robust informed consent procedures in the psychotherapy paradigm engenders a key reflection of engagement, respect, and collaboration between the patient and the professional.

Introductory Findings -- There are several types of expectations when dealing with a patient's privacy. Often, worries about that privacy will impact the quality of therapy, and for certain the trust issues between patient and client. The psychological professional must, however, determine if the client is capable of understanding the consent, and if so, to what degree this impacts therapy. Also, in emergency psychological situations, much like triage, the professional must make the value judgment regarding the length and breadth of consent necessary to perform treatment. There are requirements and limits to the issue based on HMOs and insurance regulations, as well as specific State regulations.

Methodology -- Case study approach; ten cases are analyzed to find ways in which informed consent was used, or could/should have been used. Clinical red flags formed the bulk of the discussion.

Results -- Each of the ten scenarios offered a different result and solution to the issue; the overall view was, however, that the use of informed consent is not a simple matter of HIPPA regulations or insurance paperwork; but a real concern and avenue for trust within the doctor/patient relationship.

Discussion -- Article was more of a basic literature review using scenario/case studies as approach.

Analysis of Article: Transition Stage of a Group; Chapter 6 -- Group Processes: Stages of Development.

Humans tend to be group animals -- they thrive in groups, coalesce into groups, indeed, the very process of moving from hunter-gatherer to cities was part of a group behavior. Within this essay we will first look at group normative behavior, intergroup communication and leadership, and finally the way in which group behaviors influence individuation and specific responses to that group's culture.

Hypothesis -- the transitional stage of the group is marked by feelings of anxiety and defensiveness; fears emerge during this stage; encouragement of honesty and response can improve productivity during this phase.

Introductory Findings -- During this phase, members are testing the leader and environment; struggling with their risk/reward calculation; observing others to determine who is trustworthy; and learning how to express themselves so others may listen.

Methodology -- Text based approach; facts given, examples to buttress arguments.

Results -- Group leaders should be sensitive and encourage positive and proactive dissent; members will trust when put into situations that engender trust; help group members recognize their own patterns of resistance and proactively mitigate; leader should provide a model for positive and proactive behavior.

Discussion -- Textbook approach gives a great deal of theory; value of the article is in taking the material and applying it to situations that are relevant to one's current profession and/or understanding different approaches to conflict.

Review -- the Million Clinical Multiaxial Inventory (MCMI) - the MCMI is a psychological assessment tool that was written to provide information on psychopathology including specifics outlined in the DSM-IV. It is intended for adults over 18 who have at least an 8th grade reading level and who are seeking mental health services. The test was actually developed and standardizes on clinical populations in psychiatric hospitals or individuals with current existing mental health issues. The authors are quite specific about it not being used with the general population or with adolescents, as values will likely not be appropriate for extrapolation (Pearson, 2012).

History -- Published in 1977 by Theodore Millon based on his 1969 book Modern Psychopathology. When SDM-R was published a new version of the MCMI was also created in 1987. Finally, the current version, the MCMI-III, was published in 1994 and is reflected in revisions in the DSM-IV. This new version eliminated the aggressive and self-defeating personality scales and added scales for depression and PRSD. Additional content was added to include child abuse, anorexia and bulimia (Million, 2006).