Emotional Support Animal Assessments: Toward a Standard and Comprehensive Model for Mental Health Professionals.

Growth in the presence of Emotional Support Animals (ESAs) in our society has recently garnered a substantial amount of attention, both in the popular media and the professional literature. Public media abounds with stories focusing on the increasing number of animals claimed as ESAs, the impact of this growth on society, the industry claiming to certify ESAs, and the various types of animals described as "certified." The authors propose an assessment model for ESAs certification comprising a four-pronged approach for conducting these types of assessments: (1) understanding, recognizing, and applying the laws regulating ESAs, (2) a thorough valid assessment of the individual requesting an ESA certification, (3) an assessment of the animal in question to ensure it actually performs the valid functions of an ESA, and (4) an assessment of the interaction between the animal and the individual to determine whether the animal's presence has a demonstrably beneficial effect on that individual. This model aligns with professional ethics, standards of professional practice, and the law and seeks to provide clear guidelines for mental health professionals conducting ESA evaluations.

Medical Child Abuse Hidden in Pediatric Settings: Detection and Intervention.

Medical child abuse, sometimes referred to as Munchausen Syndrome by Proxy or childhood factitious disorder, poses significant diagnostic, intervention, and ethical issues for medical and mental health practitioners alike. Psychologists working in pediatric hospitals and medical clinics should remain mindful of the health and ethical risks posed by these conditions, which are challenging to detect and treat. The surreptitious nature of the conditions and hazards they pose require an integrated medical, psychological, and child protective response. This article provides historical and clinical background on the condition along with tabular guides and recommendations to assist in detection and intervention.

Psychometric Properties of the Death Anxiety Scale-Extended among Patients with End-Stage Renal Disease.

This study aimed to evaluate the validity and reliability of the Persian version of Death Anxiety Scale-Extended (DAS-E). A total of 507 patients with end-stage renal disease completed the DAS-E. The factor structure of the scale was evaluated using exploratory factor analysis with an oblique rotation and confirmatory factor analysis. The content and construct validity of the DAS-E were assessed. Average variance extracted, maximum shared squared variance, and average shared squared variance were estimated to assess discriminant and convergent validity. Reliability was assessed using Cronbach's alpha coefficient (α = .839 and .831), composite reliability (CR = .845 and .832), Theta (θ = .893 and .867), and McDonald Omega (Ω = .796 and .743). The analysis indicated a two-factor solution. Reliability and discriminant validity of the factors was established. Findings revealed that the present scale was a valid and reliable instrument that can be used in assessment of death anxiety in Iranian patients with end-stage renal disease.

Historical Analysis: Editors' Reflections on 50 Years of the Journal of Pediatric Psychology.

OBJECTIVE: This article provides an historical perspective on the Journal of Pediatric Psychology (JPP) on the occasion of its 50th anniversary. METHODS: Former and current editors of JPP participated in a symposium at the 2019 Society of Pediatric Psychology Annual Conference (SPPAC), each highlighting prominent types of articles published during their terms, the influence of these papers over time, and their reflections on the next 50 years of the journal. Their presentations were summarized and integrated for this article. Additional data on editorial teams, special issues, and publication metrics over time are included. RESULTS: The data demonstrate changes over time in the growth, scope, and impact of JPP. The article also shows the consistency in areas of emphasis over time. Anticipated topics for the future were quite consistent across editors and included increased use of technology, broader attention to teams and approaches, and methodological advances as the field will continue to grow. CONCLUSIONS: This article provides an unusual collaboration among editors of JPP, providing an historical perspective on the journal's growth over time and anticipation of continued impact into the future.

Perceived Risks and Benefits in a Text Message Study of Substance Abuse and Sexual Behavior.

To inform ethical procedures for human subjects research using mobile health (mHealth), we examined perceived risks and benefits of study participation among emerging adults (N=54) with drug use who completed text message assessments of substance use and sexual behaviors. Most participants reported comfort with participation and some reported perceived benefits, such as improved relationships. Perceived risks were infrequently reported, including negative emotions, and legal or financial concerns. In conclusion, participants from a vulnerable population reported few perceived harms of participation in longitudinal mHealth assessments of sensitive behaviors. Researchers should continue characterizing participants' perspectives on ethical aspects of mHealth research.

Discredited Assessment and Treatment Methods Used with Children and Adolescents: A Delphi Poll.

In the context of intense interest in identifying what works in mental health, we sought to establish a consensus on what doesnot work-discredited psychological assessments and treatments used with children and adolescents. Applying a Delphi methodology, we engaged a panel of 139 experts to participate in a two-stage survey. Participants reported their familiarity with 67 treatments and 35 assessment techniques and rated each on a continuum from not at all discredited to certainly discredited. The composite results suggest considerable convergence in what is considered discredited and offer a first step in identifying discredited procedures in modern mental health practice for children and adolescents. It may prove as useful and easier to identify what does not work for youth as it is to identify what does work-as in evidence-based practice compilations. In either case, we can simultaneously avoid consensually identified discredited practices to eradicate what does not work and use inclusively defined evidence-based practices to promote what does work.

Research ethics and private harms.

This commentary addresses the emotionally powerful account of Nicole Taus Kluemper from the perspective of a psychologist familiar with the administrative operation of the American Psychological Association (APA) and the ethics of the profession. The application of the APA's Ethical Principles of Psychologists and Code of Conduct to the case is discussed, and alternative methods of response that researchers who have concerns about case studies might use are offered. The author concludes that existing ethical principles-the aspirational standards in particular-do bear upon the matter in question. However, the enforceable code of conduct is not sufficiently clear about obligations to those whom psychologists publicly discuss when the psychologist does not have a specific duty of care to an individual.

Ethical and legal considerations for internet-based psychotherapy.

The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.

What does not work? Expert consensus on discredited treatments in the addictions.

Evidence-based practice promotes those research-supported treatments that have proven effective, but it rarely identifies discredited treatments that are to be avoided. We sought to establish a professional consensus on discredited addiction treatments using Delphi methodology. A panel of 75 experts participated in a 2-stage study, reporting familiarity with 65 treatments and rating these on a continuum from "not at all discredited" to "certainly discredited." We report their composite opinions and significant differences that occurred as a function of the panelists' theoretical orientation. The results require careful interpretation, but do offer a cogent first step in identifying a professional consensus of discredited treatments for addictions.

Ethical challenges in mental health services to children and families.

Mental health practitioners working with children and families must attend to several ethical concerns that do not typically come into play with adult clients. The challenges for practitioners usually involve attention to four subsets of concerns that all begin with the letter c: competence, consent, confidentiality, and competing interests. Using the 4-C model, this article focuses on ethical aspects of practitioner competence, consent and assent, confidentiality, and the incongruence of interests that occurs when different people organize and set goals for psychological services. After explicating these issues, I provide recommendations for addressing them in the course of clinical practice.

Twenty-first century ethical challenges for psychology.

Foreseeable social and technological changes will force us to reevaluate our thinking about ethically appropriate ways to fulfill our mission of using psychology to advance human health and welfare in the twenty-first century. Three categories of challenge related to societal and technological changes have become particularly evident. First, increasing patterns of delivering services over substantial distances by electronic means (i.e., telepsychology) demand consideration. Second, we must parse our ethical obligations to individuals, to groups, and to society at large as our influence working behind the scenes as "invisible" psychologists grows. Finally, as we witness the accelerating demise of psychiatry, we must take care not to follow a similar path. As we face new ethical challenges, we must continually ask ourselves where our responsibilities lie as individuals and as a profession. We must learn not to repeat the mistakes of the past and focus instead on optimizing the future for a science and practice of psychology focused on human health and welfare.

Following the money: economic inhibitors of change affecting graduate education in clinical psychology.

C.R. Snyder and T.R. Elliott (this issue, pp. 1033-1054) offer a thoughtful and elaborate model for future training in graduate clinical psychology, couched in visionary optimism. However, they interpret history and present trends in a manner that seems to ignore the realistic demands of economic forces. They propose thoughtful, constructive, pro-social directions, but seem at least partially oblivious to underlying economic forces destined to impede meaningful implementation of their model.

The IRB paradox: could the protectors also encourage deceit?

The efforts of some institutional review boards (IRBs) to exercise what is viewed as appropriate oversight may contribute to deceit on the part of investigators who feel unjustly treated. An organizational justice paradigm provides a useful context for exploring why certain IRB behaviors may lead investigators to believe that they have not received fair treatment. These feelings may, in turn, lead to intentional deception by investigators that IRBs will rarely detect. Paradoxically, excessive protective zeal by IRBs may actually encourage misconduct by some investigators. The authors contend that, by fostering a climate in which investigators perceive that they receive fair and unbiased treatment, IRBs optimize the likelihood of collegial compliance with appropriate participant protections.

Ethical issues in psychotherapy with adolescents.

Treating adolescents in psychotherapy presents a number of unique ethical challenges. Because many adolescents who enter treatment have not yet attained the age of majority, reside in families that include other people with emotional difficulties, attend school, become involved with community agencies (e.g., the courts), and must generally take direction from adult authority figures, the role of the therapist becomes particularly complex. The unique dilemmas include developing specialized clinical competence, treatment contracting, choice of treatment modality, direction of the therapeutic process, and confidentiality. This article discusses the range of ethical concerns involved in treating adolescents and suggests strategies for optimal ethical care.

Pediatric cancer survival and marriage: issues affecting adult adjustment.

Of 36 men and women, now aged 21 or older, who were treated for cancer as children, 20 have married. As part of a long-term follow-up, 13 of their spouses were interviewed about the effects of cancer on the patient and on their marriage. Comparison of patient's physical limitations, visible impairments, and psychiatric adjustment ratings indicated significant differences between patients who have married or become engaged and those who have not married.