APA Ethics Code Standards 9 & 10

Why Standards 9 and 10 Matter: Your Professional GPS

Picture yourself on your first day as a licensed psychologist. A client sits across from you, and suddenly you're making dozens of decisions: What test should I use? Do I need their signature on this form? Can I share these results with their spouse? What if they ask to see the test questions? These aren't hypothetical scenarios – they're daily realities. Standards 9 and 10 of the APA Ethics Code are your professional GPS, guiding you through the complex terrain of assessment and therapy.

These standards aren't just rules to memorize for the EPPP. They're the difference between a career built on solid ethical ground and one riddled with complaints, lawsuits, and sleepless nights. Think of them as the operating system for your practice – everything else runs on top of them.

Standard 9: Assessment – More Than Just Giving Tests

The Foundation: Enough Information Before You Conclude

Imagine your friend asks you to review their resume after you've only glanced at their job title. You'd probably say, "I need more details before I can help." The same principle applies to psychological assessment. Standard 9.01 requires that you have sufficient information before making any conclusions or recommendations about someone.

Here's the key rule: You need to actually examine the person before offering opinions about their psychological characteristics. This seems obvious, but situations get tricky. Maybe you're asked to review another clinician's report and provide an opinion. You can do this, but you must explain the limitations. It's like being a music critic who reviews an album based on someone else's description rather than listening yourself – you need to tell your readers exactly what you did and didn't do.

Real-world example: A forensic psychologist is asked to evaluate someone's competency to stand trial, but the defendant refuses to meet with them. The psychologist reviews records and interviews from other professionals. When writing the report, they must clearly state: "My conclusions are based on collateral information only. I did not personally examine the defendant, which limits the certainty of these findings."

Using Tests Properly: The Right Tool for the Right Job

You wouldn't use a hammer to cut wood or a saw to drive nails. Similarly, Standard 9.02 requires that you use assessment tools only for purposes supported by research evidence. This includes three critical components:

1. Use tests supported by evidence – The test should actually measure what you're trying to assess
2. Follow standardized procedures – Give and score the test the way it was designed
3. Use tests validated for your client's population – The test should have been normed on people similar to your client

But here's where it gets nuanced: What happens when you need to test someone with a disability? The standard allows adaptations when supported by research. Understanding the difference between accommodations and modifications is crucial:

The documentation rule: Whether you use accommodations or modifications, document everything in your report. Explain how the changes might affect score interpretation. Think of it like those warning labels on side mirrors: "Objects may be different than they appear."

The Telepsychology Challenge

Remember when everyone suddenly switched to video calls during the pandemic? Testing via telepsychology creates similar challenges. The 2024 Guidelines for Telepsychology stress that you need to understand how remote administration affects reliability and validity.

Here's a practical tip from Wright and colleagues (2020): Use wider confidence intervals when interpreting remotely-administered test scores. Why? Because any deviation from standardized procedures increases measurement error. It's like trying to measure ingredients for a recipe using measuring cups from different countries – you need bigger margins for error.

Document in your report: "This assessment was conducted via secure video platform. Standard administration procedures were followed to the extent possible, but remote administration may affect score interpretation. Results should be considered within broader clinical context."

Who Can Give Tests? Training Matters

Standard 9.07 is straightforward: Don't let unqualified people use psychological tests unless you're training them with proper supervision. This is like letting someone use your Netflix password versus letting them drive your car – tests are professional tools that require expertise.

Common scenario: Your unlicensed assistant wants to administer an intelligence test to help you. This is only acceptable if they're in training, you're supervising them, and you take responsibility for proper administration and interpretation.

The "Old Test" Dilemma

Standards 9.08(a) and (b) address outdated results and obsolete tests, but here's the surprise: Neither the Ethics Code nor testing standards specify how old is "too old." This requires professional judgment.

Consider these factors:

• Test results: A personality assessment from six months ago is probably fine for most purposes. That same assessment from five years ago? Probably not.
• Test versions: When a new edition comes out, the old one isn't automatically unethical to use.

The nuanced decision: Suppose you're evaluating a Latinx client, and a new test version was just released. The new version has updated norms but doesn't yet include data for Latinx individuals. The previous version does have those norms. Which should you use? Often, the older version is more appropriate because it provides a better comparison group.

This is like choosing between the latest smartphone with bugs versus last year's model that runs perfectly – newer isn't always better.

Automated Scoring: You're Still Responsible

Standard 9.09 allows using computer scoring and interpretation services, but here's the catch: You remain fully responsible for how you apply, interpret, and use the results. The computer is your assistant, not your replacement.

Think of it this way: If you use GPS navigation and it routes you onto a closed road, you're still the driver. You can't blame the app. Similarly, if automated software generates an interpretation that doesn't fit your client, you're responsible for recognizing and addressing that.

Explaining Results: The Feedback Requirement

Standard 9.10 requires that you explain assessment results to clients – with important exceptions. Employment screenings and forensic evaluations often don't require feedback to the person tested. However, you should explain this beforehand.

Best practice example: Before conducting a pre-employment psychological evaluation, tell the candidate: "I'll be writing a report for the police department. You won't receive direct feedback from me, as the department is the client. However, they may share relevant information with you according to their policies."

Test Data vs. Test Materials: Know the Difference

This distinction trips up many students, so let's break it down clearly:

Real scenario: A client's attorney requests "all testing materials." You can provide the test data (scores, responses, your notes), but not the actual test questions or manual. However, if the attorney gets a court order specifically for test materials, you may need to provide them under protective order.

HIPAA allows you to withhold test data when releasing it would reasonably endanger the client or others. This is rare but important. For example, a client with paranoid delusions might misinterpret test results in ways that increase risk to themselves or others.

Informed Consent for Assessment

Standard 9.03 outlines what clients need to know before testing:

• Nature and purpose of the assessment
• Fees involved
• Who else will be involved (third parties)
• Confidentiality limits

The exceptions: You don't need formal consent when testing is mandated by law (court-ordered) or when it's routine institutional activity (like university counseling center intake assessments).

The malingering test dilemma: What if you're giving a test to detect faking? You can't fully explain the test's purpose without compromising its validity. The solution: Tell clients that measures will assess their "honesty and effort to do well" without describing specific malingering detection methods. This balances transparency with test validity.

Using interpreters: When you need an interpreter for assessment, get informed consent for their involvement, ensure they maintain confidentiality, and document in your report how using an interpreter might affect the data. It's like recording a podcast with a translator – the message gets through, but something might be lost or changed in translation.

Standard 10: Therapy – The Ongoing Conversation

Informed Consent: Start Early, Continue Always

Standard 10.01(a) requires obtaining informed consent "as early as feasible" in therapy. Notice it says "feasible," not "immediately." Sometimes a crisis situation means you start therapy first and formalize consent at the next session.

What clients need to know:

• Nature and course of therapy – What will we do, and how long might it take?
• Fees – Including insurance arrangements and late cancellation policies
• Third-party involvement – Who might see information about our work?
• Confidentiality limits – When you might need to break confidentiality

Here's what many students miss: Informed consent isn't a one-time form they sign. It's an ongoing conversation. Think of it like updating your phone's operating system – you need regular updates as circumstances change.

Practical example: You begin individual therapy with a client. Three months later, you recommend adding group therapy. This requires new informed consent addressing the different confidentiality issues in group settings. Six months after that, you consider adding their spouse to some sessions. Another consent conversation.

Experimental or Developing Treatments

Standard 10.01(b) requires extra disclosures when using treatments without established evidence. You must inform clients about:

1. The developing nature of the treatment
2. Potential risks
3. Alternative treatments available
4. That participation is voluntary

Real scenario: You want to use a new virtual reality exposure protocol for social anxiety that has preliminary research but isn't yet established. You explain: "This approach shows promise in early studies, but we don't have long-term data yet. Traditional exposure therapy has more research support. Here are the potential risks with this newer approach. You can decline or switch to traditional therapy at any point."

Trainees in Therapy: Full Disclosure Required

Standard 10.01(c) is crystal clear: If you're a trainee and your supervisor holds legal responsibility, clients must know this and must know your supervisor's name. No exceptions.

The conversation: "I'm a psychology trainee completing my supervised hours toward licensure. Dr. Johnson is my supervisor and holds legal responsibility for the treatment I provide. I meet with her weekly to discuss our work together."

Telepsychology Consent: The Dual Approach

The 2024 Telepsychology Guidelines recommend a "dual consent approach" – get consent for both in-person and telepsychology services. Why? Because they involve different risks and limitations.

Telepsychology-specific issues to address:

• Technology failure might disrupt sessions
• Increased confidentiality risks (someone overhearing, internet security)
• Emergency protocols if you can't reach them
• Where they're physically located during sessions

Switching modes: If you move from in-person to video therapy (or vice versa), provide an addendum to your original consent form addressing the new format's unique considerations.

Serving Clients Already in Treatment

Standard 10.04 says "proceed with caution" when asked to treat someone already receiving services. This requires judgment about the situation.

Scenario 1 – Probably inappropriate: A client says she's seeing another therapist for depression and wants to see you for the same issue because "two therapists might help me faster." Red flag. This likely creates confusion and splitting.

Scenario 2 – Potentially appropriate: A client sees you for recent grief and mentions he's been in a recovery support group for addiction for two years. These are different issues that can be coordinated. With his authorization, consult the group facilitator to ensure you're working together effectively.

The key question: Will concurrent services help or hinder the client's progress?

Sexual Intimacies: Absolute Lines

Standards 10.05, 10.06, 10.07, and 10.08 create clear boundaries around sexual intimacies:

The former client standard (10.08) includes seven factors you must consider before any post-termination relationship, but here's the reality: It's nearly impossible to demonstrate non-exploitation. Even after two years, the power differential from therapy makes truly consensual relationships questionable. The ethics committee takes this extremely seriously.

Remember this metaphor: Sexual boundaries in therapy are like airbags in cars – they're not there for when things are going well. They're there because the potential for harm is so great that we need absolute protection.

Termination: Knowing When to Say Goodbye

Standard 10.10 requires terminating therapy when clients no longer need it or aren't benefiting. But this isn't about rigid rules – it's about ongoing evaluation.

Appropriate termination reasons:

• Client achieved treatment goals
• Client isn't making progress despite reasonable interventions
• Client needs services outside your competence
• Client isn't engaging in treatment (repeatedly misses sessions, doesn't do homework)

The termination process:

1. Provide pretermination counseling (discussing the decision, reviewing progress)
2. Suggest alternative providers if needed
3. Allow client to ask questions and process the ending

The safety exception: If a client or someone related to them threatens or endangers you, you can terminate immediately without pretermination counseling. Your safety comes first.

About those referrals: The Ethics Code doesn't specify how many referrals to provide, but three is a common professional recommendation. Why three? It gives clients options and reduces the appearance that you're steering them to a specific person.

Common Misconceptions That Trip Up Test-Takers

Misconception 1: "Once a new test version comes out, using the old version is unethical."

Reality: Test obsolescence requires professional judgment. Sometimes the older version is more appropriate, like when it has better norms for your client's demographic group.

Misconception 2: "Test data and test materials are the same thing."

Reality: Test data (scores, responses, your notes) must usually be released. Test materials (actual test items, manuals) must be protected to maintain test security.

Misconception 3: "Informed consent is the form clients sign at the first session."

Reality: Informed consent is an ongoing process of communication that continues throughout treatment whenever circumstances change.

Misconception 4: "I can see a former client romantically after two years if I document it was consensual."

Reality: While technically not absolutely prohibited after two years, the burden of proof that it's non-exploitative is so high that it's practically impossible to meet. This is a career-ending risk.

Misconception 5: "I need full written consent every time I administer a test."

Reality: When testing is routine institutional activity or mandated by law, formal informed consent isn't required (though explaining the process is still good practice).

Practice Tips for Remembering These Standards

For Assessment (Standard 9):

• The S.C.O.R.E. system:
  • Sufficient information before concluding
  • Correct use for validated purposes
  • Outdated tests and data require judgment
  • Release test data (not materials) when appropriate
  • Explain results to clients

For Therapy (Standard 10):

• The C.O.N.S.E.N.T. framework:
  • Continuous process, not one-time event
  • Ongoing treatment requires ongoing updates
  • New providers need caution with concurrent treatment
  • Sexual boundaries are absolute with current clients
  • Early informed consent is required
  • Never provide therapy to sexual partners
  • Terminate when no longer beneficial

Memory aid for accommodations vs. modifications:

• Accommodation = Access without Alteration (same construct)
• Modification = Major change (different construct)

For the EPPP: Create flash cards with scenarios, not just definitions. For example: "Client's lawyer requests all testing materials. What do you provide?" This builds application skills, not just recall.

Key Takeaways

• Assessment requires adequate information: Don't offer opinions about someone you haven't personally examined without clearly stating limitations.

• Tests must be used as designed: Follow standardized procedures unless research supports modifications for specific populations. Always document adaptations.

• Know the difference: Test data (must usually release) vs. test materials (maintain security).

• Informed consent is ongoing: Not just a form, but a continuous conversation throughout assessment and therapy.

• Multiple roles require caution: Be very careful seeing clients who are receiving services elsewhere. Coordinate care when appropriate.

• Sexual boundaries are non-negotiable: Never with current clients, their relatives, or significant others. Essentially never with former clients either.

• Terminate thoughtfully: When clients aren't benefiting, provide pretermination counseling and referrals (unless you're in danger).

• Document everything: When you deviate from standard procedures (accommodations, telepsychology, using interpreters), explain how this affects data interpretation.

• Telepsychology requires special consideration: Different consent, wider confidence intervals for test interpretation, documentation of limitations.

• Professional judgment matters: Many situations (outdated tests, test obsolescence, termination timing) require thoughtful analysis rather than rigid rules.

Remember: These standards exist to protect clients and guide your practice. When you're unsure, consult with colleagues, review the full Ethics Code, and document your reasoning. The EPPP tests your ability to apply these principles to realistic scenarios, so practice thinking through the "why" behind each standard, not just memorizing the rules.