Sometimes a prospective client might be interested in seeing me for both an assessment and therapy. However, this comes with some tricky ethical issues for me as a Psychologist and you as a client.
Explanation of Dual Role: Assessment and Therapy
As your psychologist, I want to be transparent about my professional roles and how they may affect your care. At times, a psychologist may be asked to both conduct an assessment (such as for diagnosis, recommendations, or reports) and provide ongoing therapy. This is known as a “dual role” and it is important to understand the ethical considerations involved.
Why Complete the Assessment First?
To ensure your needs are fully understood, it is best practice to complete the assessment process first. This allows me to gather all relevant information, including input from third parties (such as teachers, employers, family members, or other professionals) if needed. It is important that your informants provide accurate information. For some clients, they may feel uncomfortable with this if they are also engaging in therapy with the same clinician, potentially affective the openness and accuracy of the information provided.
Ethical Issues and How They Are Managed
- Conflicts of Interest:
When a psychologist acts in both roles, there is a risk that the objectivity required for assessment could be affected by the therapeutic relationship, or vice versa. That is, the psychologist may unconsciously interpret assessment results in a way that supports their ongoing therapeutic work, rather than maintaining strict objectivity. To manage this, I keep the assessment and therapy processes clearly separated. The assessment will be completed and feedback provided before any therapy begins. If a client prefers to postpone formal assessment eg querying Autism or ADHD, I am happy to provide my clinical opinion based on our therapeutic work to another assessing clinician. - Transparency:
I will explain each step of the process to you, including what information is being collected, why it is needed, and how it will be used. If third-party information is required, I will discuss this with you and seek your consent before contacting anyone. This is essential to maintain trust and to ensure that clients are making informed decisions about their services. - Maintaining Objectivity:
During the assessment, my focus is on gathering accurate, unbiased information to understand your needs. I will document all information carefully and ensure that any recommendations are based on evidence. If you choose to continue with therapy after the assessment, we will discuss how the assessment results can guide your treatment, but the feedback session will be kept separate from therapy sessions to maintain clarity and objectivity. - Avoiding Harm and Maintaining Trust:
My priority is your wellbeing. I will take steps to ensure that the dual role does not compromise your care or trust. If at any point I believe that continuing in both roles may not be in your best interests, I will discuss this with you and, if needed, help you find another psychologist for therapy or assessment. For example, potential harms could include misdiagnosis (if a therapy client subsequently requests an assessment), inappropriate recommendations. A client may feel pressured to continue therapy with the assessing psychologist, even if it is not in the client’s best interest.
Managing the Process
1. Assessment Phase:
We will complete the assessment first, which may involve interviews, questionnaires, and gathering information from other sources (with your consent).
I will provide you with a clear feedback session, where we discuss the results and recommendations.
2. Transition to Therapy (if you wish):
If you decide to continue with me as your therapist, we will start therapy as a new phase, using the assessment results to guide our work.
The assessment feedback will remain a separate session, and therapy will focus on your goals and ongoing support.
3. Ongoing Review:
Throughout therapy, I will continue to monitor for any potential conflicts of interest or ethical concerns.
You are always welcome to raise any questions or concerns about the process.
Your Choice
You have the right to choose whether you would like to continue with me as your therapist after the assessment, or to seek therapy with another psychologist. My aim is to support you in making the decision that feels most comfortable and safe for you.