Clinical documentation of patient identities in the electronic health record: Ethical principles to consider.

The American Psychological Association's multicultural guidelines encourage psychologists to use language sensitive to the lived experiences of the individuals they serve. In organized care settings, psychologists have important decisions to make about the language they use in the electronic health record (EHR), which may be accessible to both the patient and other health care providers. Language about patient identities (including but not limited to race, ethnicity, gender, and sexual orientation) is especially important, but little guidance exists for psychologists on how and when to document these identities in the EHR. Moreover, organizational mandates, patient preferences, fluid identities, and shifting language may suggest different documentation approaches, posing ethical dilemmas for psychologists to navigate. In this article, we review the purposes of documentation in organized care settings, review how each of the five American Psychological Association Code of Ethics' General Principles relates to identity language in EHR documentation, and propose a set of questions for psychologists to ask themselves and their patients when making choices about documenting identity variables in the EHR. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"The VA was the first place as a trainee that I felt like I had to hide many parts of myself": Lived experiences and recommendations for empowering transgender, nonbinary, and gender expansive VA psychology supervisors and supervisees.

Psychology trainees are increasingly diverse in terms of gender identity and gender expression (Lund & Thomas, 2022), yet clinical supervision models often overlook the unique needs, strengths, and experiences of transgender, nonbinary, and gender expansive (TNBGE) trainees and supervisors. The Department of Veterans Affairs (VA) remains the largest training network for psychology trainees and many American Psychological Association-accredited VA sites advertise focused training opportunities in lesbian, gay, bisexual, transgender, and queer health at both the internship and postdoctoral levels. As such, VA psychology training programs are uniquely positioned to impact the professional experiences of TNBGE psychology trainees and supervisors. Critical issues in supervision with TNBGE supervisees and supervisors in VA health care settings are reviewed utilizing themes and examples from the authors' lived experiences as TNBGE supervisors and supervisees. Recommendations are provided for supervisees, supervisors, and training directors in VA psychology training programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).