Development and Efficacy of an Ethical Decision-Making Tool for Training Clinical Psychologists

We developed an ethical decision-making tool to assist in training clinical psychologists that had four goals: (a) to mirror the way psychologists naturally think about ethical dilemmas; (b) to facilitate thorough analysis by using a simple, guided checklist format; (c) to provide quick access to intuitively organized explanations and examples of each major domain of ethical challenges and principles; and (d) to facilitate good documentation and record-keeping of the decision-making process. Study 1 surveyed clinical psychologists and asked them to list the top 10-15 ethical considerations they encounter in practice, and then used those categories to help develop the tool. In Study 2, having access to two different versions of the tool significantly improved the quality of analysis of a standardized clinical vignette, particularly for individuals still in training. In Study 3, a streamlined version of the tool significantly improved the quality of graduate trainees' analysis of the standardized clinical vignette and was faster to use. In Study 4, we demonstrated the efficacy of the tool in helping trainees analyze ethical dilemmas they had actually experienced. In Study 5, faculty at doctoral programs who teach graduate ethics courses provided dilemmas and then graded the responses of trainees who analyzed them either with or without the tool. Analyses completed with the tool received far better grades on average than those completed without the tool. This work is the first that we know of to develop an evidence-based, empirically supported tool for training future psychologists in ethical practice. Public Significance Statement This study describes the development of a novel ethical decision-making tool for use in training clinical psychology graduate students. The study shows that the tool helps trainees improve their analysis of complex ethical dilemmas that arise in clinical practice.