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Psychology graduate student attitudes toward ethics training

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Psychology graduate student attitudes toward ethics training
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Klevansky, Robin Deborah Molly
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xiii, 237 leaves : ; 28 cm

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Graduate students -- Attitudes ( lcsh )
Ethics -- Study and teaching (Higher) ( lcsh )
Ethics -- Study and teaching (Higher) ( fast )
Graduate students -- Attitudes ( fast )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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Includes bibliographical references (leaves 232-237).
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Department of Psychology
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by Robin Deborah Molly Klevansky.

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Full Text
PSYCHOLOGY GRADUATE STUDENT ATTITUDES
TOWARD ETHICS TRAINING
by
Robin Deborah Molly Klevansky
B.A., Haverford College, 2002
A thesis submitted to the
University of Colorado at Denver and Health Sciences Center
in partial fulfillment
of the requirements for the degree of
Master of Arts
Psychology
2007


The thesis for the Master of Arts
degree by
Robin Deborah Molly Klevansky
has been approved
by
Mitchell M. Handelsman

/ j z-^ 7
____________
Date
David Albeck


Klevansky, Robin Deborah Molly (M.A. Clinical Psychology)
Psychology Graduate Student Attitudes toward Ethics Training
Thesis directed by Professor Mitchell M. Handelsman
ABSTRACT
This study looked at several aspects of professional psychology ethics and the
ethics training that clinical psychology students must receive before they can earn the
PhD. Are students satisfied with their ethics training, and does ethics training affect
how they respond to ethical situations? Is ethics training preparing them to handle
ethical issues in a variety of areas: clinical work, research, and teaching? The study
also explored ethical acculturation, the process by which students may adapt their
personal ethical beliefs to the culture of professional psychology ethics. Do students
stick to their previous moral values, take on the new ones, or combine the two? How
should researchers study ethical acculturation in the future?
Clinical psychology doctoral students responded to a survey about their
attitudes toward professional ethics and ethics training and how they would respond
to ethical situations. Results indicated that students may be generally satisfied with
their ethics training. However, they may be less satisfied with their training in the
ethics of teaching than with their training in other areas because only a very small


portion of training focuses on preparing students to handle ethical situations in
academia. Thus, instructors of ethics courses and professors who supervise students
who are teaching in the field might want to call more attention to ethical issues that
can arise in teaching so that students who become teachers are more aware of ethical
considerations in teaching.
Based on the responses to the acculturation questions, most students maybe
combining their own moral sense with the ethics of psychology when they make their
ethical decisions. Students who believe ethics to be particularly important and whose
training has better prepared them to handle ethical issues may be more inclined to use
the ethics of psychology in ethical situations than to fall back on their own moral
sense. However, this studys method of approaching acculturation may not have been
ideal.
This abstract accurately represents the content of the candidates thesis. I recommend
its publication.
Signed
Mitchell M. Handelsman


DEDICATION
This thesis is dedicated to Peter, who granted me a lifetimes worth of
patience and leeway in only two years.


ACKNOWLEDGEMENT
Thanks to my committee members, Allison Bashe and David Albeck, for their
help and feedback. Much credit and hearty appreciation go to my advisor, Dr.
Mitchell M. Handelsman, for his commitment to student development, faith in my
ability to handle this project, and unwillingness to allow me to turn in anything less
than the best I could do.


TABLE OF CONTENTS
CHAPTER
Tables.............................................................x
1. INTRODUCTION................................................... 1
Purpose of the Study........................................ 1
Background...................................................1
Ethics in Professional Psychology.....................1
Training in Professional Psychology Ethics............3
Evaluating Ethics Training Efficacy...................9
Student Attitudes Toward Ethics Training............ 13
Ethical Judgment versus Ethical Behavior............ 18
Ethical Acculturation................................26
Hypotheses..................................................30
Attitudes............................................30
Ethical Vignettes................................... 32
Acculturation........................................33
2. METHOD.........................................................36
Participants................................................36
Procedure...................................................36
Measure.....................................................37
vii


Section ADemographics...............................37
Section BAttitudes..................................38
Section CVignettes..................................39
Section DAcculturation..............................41
3. RESULTS AND DISCUSSION........................................44
Demographics...............................................45
Notes on the Demographic Findings....................57
Attitudes..................................................61
Importance...........................................61
Satisfaction.........................................75
Concern..............................................93
The Vignettes.............................................104
Consistency...............................................131
Acculturation............................................ 134
The Open- Ended Questions................................ 155
Limitations and Conclusions.............................. 162
Limitations.........................................162
Conclusions.........................................168
APPENDIX
viii
A. RECRUITING EMAIL
173


B. FOLLOW-UP TO RECRUITING EMAIL............... 178
C. QUESTIONNAIRE............................... 181
D. TABLES.......................................194
E. RESPONSES TO OPEN-ENDED QUESTIONS............210
REFERENCES...........................................232
ix


LIST OF TABLES
Table
Al. Gender...................................................................194
A2. Age......................................................................194
A3. Race/ethnicity...........................................................194
A4. Years of study in clinical psychology....................................195
A5. Taken ethics course......................................................195
A6. Taken course in professional issues......................................195
A7. Knowledge of APA ethics code.............................................195
A8. Hours of clinical experience............................................ 196
A9. Studies worked on as research assistant..................................196
A10. Studies worked on as primary researcher..................................196
All. Had research experience..................................................197
A12. Courses served as teaching assistant....................................197
A13. Courses taught as primary instructor....................................197
A14. Had teaching experience..................................................197
A15. When discussed ethics in clinical experience............................ 198
A16. Discussed ethics in case conferences or in-services.....................198
A17. When discussed ethics in research experience.............................198
A18. When discussed ethics in teaching experience.............................198
x


A19. Percent of career planned to spend performing clinical work...............199
A20. Percent of career planned to spend performing research....................199
A21. Percent of career planned to spend teaching...............................199
Bl. Percent of ethics training focused on clinical work.......................199
B2. Percent of ethics training focused on research............................200
B3. Percent of ethics training focused on teaching............................200
B4. Importance of ethics in general..........................................201
B5. Importance of ethics in clinical work....................................201
B6. Importance of ethics in research.........................................201
B7. Importance of ethics in teaching.........................................201
B8. Satisfaction with ethics training in general..............................202
B9. Satisfaction with ethics training in clinical work........................202
B10. Satisfaction with ethics training in research.............................202
B11. Satisfaction with ethics training in teaching.............................202
B12. Concern about dealing with ethical issues in general..................203
B13. Concern about dealing with ethical issues in clinical work.............203
B14. Concern about dealing with ethical issues in research..................203
B15. Concern about dealing with ethical issues in teaching..................203
C1. Drinking scenariowhat should you do......................................204
xi


C2. Drinking scenariowhat would you do..................................204
C3. Drinking scenariogap between should and would...................204
C4. Sex scenariowhat should you do......................................204
C5. Sex scenariowhat would you do.......................................205
C6. Sex scenariogap between should and would........................205
Dl. Consistency between ones own moral sense
and the ethics of psychology........................................206
D2. When I make ethical decisions in general, I base them on.............206
D3. When I make ethical decisions in clinical work, I base them on.......206
D4. When I make ethical decisions in research, I base them on............206
D5. When I make ethical decisions in teaching, I base them on............207
D6. In an ethical dilemma, my best course of action
is to follow the ethics of psychology...............................207
D7. In an ethical dilemma, my best course of action
is to follow my own moral sense.....................................207
D8. In an ethical dilemma, my best course of action
is to follow both in equal measure..................................207
D9. In an ethical dilemma, my best course of action is to follow
neither the ethics of psychology nor my own moral sense.............208
D10. If I cannot find a middle ground, I need to follow
the ethics of psychology...........................................208
Dll. If I cannot find a middle ground, I need to follow
my own moral sense.................................................208
xii


D12. I need to find some common or middle ground if possible..........................209
D13. If I cannot find a middle ground, I need to find a new solution..................209
xiii


CHAPTER 1
INTRODUCTION
Purpose of the Study
The purpose of this study was to examine clinical psychology graduate
students attitudes toward professional psychological ethics and their own ethics
training, both in general and in different areas of professional activity: clinical work,
research, and teaching. I asked respondents to report (a) their history of ethics training
and what they believed was the most effective aspect of training, (b) how important
they believed ethics to be in general and in clinical work, research, and teaching, (c)
how satisfied they were with their training, and (d) how concerned they were about
dealing with future ethical issues. I was also interested in how their attitudes might
relate to their feelings about what they should versus what they would do in response
to two hypothetical ethical dilemmas. Finally, I attempted to measure respondents
ethical acculturation strategies by asking what they would do when the ethical norms
of professional psychology confront their own longstanding ethical beliefs.
Background
Ethics in Professional Psychology
In every profession a subset of people do not follow the groups agreed-upon
ethical standards. Despite prohibitions against many unethical actions, some members
will lie, cheat, or exploit the vulnerable. Clinical psychology is no exception: In 2003
1


the Ethics Committee of the American Psychological Association (APA) processed
604 active matters at various stages (APA, 2004, p. 436). This number may be
deceptively low, as many consumers, who include not only therapy clients but also
research participants and students, may be unaware of ethical transgressions or
reluctant to report them.
Psychologists may act unethically for a number of reasons. Some
transgressors could be people who remorselessly use others to their own ends, but the
situation could be much more complicated than that. Price, Dake, and Islam (2001)
pointed out that professionals in academia may violate their own beliefs about
research ethics when they face pressure to publish findings or to secure grants without
which they might not attain tenure or secure salary increases. Psychologists in all
areas of professional activity can succumb to basic human impulses, such as when
therapists become sexually involved with clients (Pope & Tabachnick, 1993). Other
ethical lapses can result from ignorance. Psychologists are not raised in the culture of
psychology and must learn the professions ethical values while developing their
professional skills; in some areas they may simply find little guidance, as Matthews
observed in the case of postsecondary teaching (1991).
As Jones (2003) noted, ethical issues in psychology continually evolve as the
profession alters ethics codes and laws and develops new modes of treatment, so even
psychologists who embrace ethics during their studies must keep educating
themselves to stay current. Psychologists may reflect on what was once thought to be
2


ethical or out of the range of ethical considerationfor example, early studies
involving deception and high stressand conclude that a practice was unethical or at
least deserving of more scrutiny (Bersoff & Bersoff, 1999). Thus, ethical violations
may involve complex motivations, including pressure from within or without and
ignorance.
Training in Professional Psychological Ethics
History
Historically, psychology training programs assumed that students learned
about professional ethics by observing supervisors ethical behavior. Some argued,
however, that such ethics training by osmosis was inadequate and potentially
dangerous, partly because it assumed that supervisors always behaved ethically and
that enough of a variety of ethical issues would arise (Handelsman, 1986, p. 371;
Knauss, 1997, p. 290). Having some kind of ethics training separate from supervision
might help students appreciate the importance of ethical behavior, stave off many
violations based on ignorance, and address common concerns before students
encounter ethical situations. In fact, since 1979 the APA has required that doctoral
programs in psychology have some ethics content in their curricula in order to
maintain accreditation (APA, 1979; APA, 2005), so osmosis should no longer be
students primary source of ethics training.
3


How Best to Teach Ethics?
Although ethics training is now required, psychologists who study ethics
training disagree about how best to teach it, as ethics is a seemingly abstract concept
that is yet another subject to be crammed into doctoral programs that are already
bursting with courses covering everything from statistics to counseling diverse
clients. Some programs devote an entire course to ethics, some include it in a seminar
on professional issues, and some attempt to integrate it into the rest of the curriculum
rather than have a separate course (Davidson, Garton, & Joyce, 2003; Knauss, 1997;
Pettifor & Pitcher, 1982; Tymchuk et al., 1979). Other programs combine approaches.
A model created by Adams, Dollahite, Gilbert, and Keim (2001) places different
approaches to ethics training in undergraduate family science programs on a scale
from 0 to 10, with no discussion of ethics in any context at 0, entire course on
ethics as a non-required class at 5, and integration of ethics across curriculum
including one required, thorough course at 10 (p. 44). According to Adams and
colleagues, a combination of integration and formal coursework may be the most
desirable format.
Structure of Ethics Training
To assess how programs were teaching ethics, Jorgensen and Weigel (1973)
surveyed training directors of 106 clinical and counseling psychology doctoral
programs about the state of their ethics training. Of their respondents, only 14% had a
class devoted solely to ethics. Most training directors of programs that did not offer
4


an ethics-only course (79%) stated that their curricula offered sufficient exposure to
ethics through a professional issues course, which 33% of programs reported
teaching, or through other classes. Further, only 79% of programs that included an
ethics course or ethics coverage in other courses required those classes.
Two decades later, 64% of students from 50 counseling psychology programs
reported that their programs taught ethics through formal course work, and 44%
reported that ethics training was integrated with other class work (Wilson & Ranft,
1993, p. 450). Also, with ethics training having been compulsory for accreditation
purposes since 1979, 94% of the students said that they were required to complete
their programs ethics training. These findings indicate that more programs may be
offering courses with a major ethics component.
Philosophy of Ethics Training
Beyond the major structural differences in ethics training, there are also
philosophical ones. Philosophical concepts of ethics lie on a spectrum between seeing
ethics as objective and relying on a set of rules and viewing it as living up to higher
ideals that, in some interpretations, are also personal to the actor and unique to the
situation.
Handelsman, Knapp, and Gottlieb (2002) favored positive ethics in which
psychologists aspire to their highest ethical potential (p. 731) by becoming deeply
aware of their ethical beliefs and attempting to behave in accordance with those
values. They contrasted this with what they saw as the predominant negative (p.
5


732) approach, which merely provides psychologists with lists of what not to do
rather than the means to become their best ethical selves.
Jordan and Meara (1990/2003) saw a distinction between the rational,
universal principles of principle ethics and the mature internal qualities of virtue
ethics (p. 140). In short, it is the difference between asking What shall I do? versus
Who shall I be? (p. 140). Jordan and Meara argued that principle ethics alone are
limiting, as they rely only on ethical standards and principles, and that inevitably in
some cases two rules will conflict and will end up being applied in whatever way
appeals to the person making the decision. Bersoff (1996) disagreed, preferring a
standardized, logical system to the ideals of virtue ethics, which he described as
depending on the character of the individual and therefore both unreliable and
difficult to teach. He also criticized virtue ethics for its reliance on community values,
which he believed could potentially lead to a tyranny of the majority.
ONeill (1998) saw a tension between the overriding principle approach and
the moral dilemma approach to ethics (p. 194). Those who use the overriding
principle approach believe that they can solve any ethical question by applying the
right principles in a consistent hierarchy. The moral dilemma approach holds that in
some cases no principle will clearly override the others, so whatever compromise
they reach, the decision-makers will be left feeling somewhat ethically apprehensive.
Despite the controversies over format and philosophy, psychologists
emphasize that, although we should not count on students simply to absorb ethics
6


from their professors and supervisors, authority figures are obligated to act ethically
and to expect students to do the same (Kitchener, 1992). In accordance with this focus
on ethics, the staff of training clinics where students complete practica and
internships are responsible for making ethics training routine by practicing ethical
decision making, discussing diversity issues, and holding workshops on ethics
(Cellucci & Heffer, 2002; Handelsman, 1989). Thus, even when programs teach
ethics as a separate course, they reaffirm ethical thinking and decision making during
the entire program of study.
Ethics Training Content
Regardless of how instructors view the more conceptual issues in teaching
ethics, the question lingers of how exactly they should talk with their students about
the intangible ideas involved. Many instructors use real or hypothetical cases as
examples of ethical dilemmas. Costanzo and Handelsman (1998) argued that
instructors can present case studies effectively if they use situations that boil down to
recognizable principles, and they offered several examples. They also included
variations on each case to illustrate the ambiguous nature of ethical decision making,
in which small details can alter perceptions of ethicality. Knapp & VandeCreek
(2004) proposed that instructors include actual court cases in their classes. They
suggested three and explained how the cases are relevant to psychologists and what
issues they might raise in class discussion.
7


Beyond specific cases, some psychologists have written articles detailing
particular modules of a course or even entire course outlines (Corey, Corey, &
Callanan, 2005) that others can implement in their own teaching. Brinthaupt (2002)
informally surveyed local faculty members about their positive and negative
experiences with institutional review boards. He shared the results with his students,
who discussed the balance between ethical concerns and research objectives and, in
some cases, argued whether or not the boards decisions were warranted. Brinthaupt
suggested that other ethics instructors might use this technique in their own classes.
Fine and Ulrich (1988) observed that philosophers have discussed ethics at length, so
they created a course taught by both a clinical psychologist and a philosopher with a
background in counseling. Kitchener (1986) did not describe the specifics of a course
but proposed four goals for counselor training in ethics: teaching students to (a)
become sensitive to professional ethical issues and how their behavior affects others,
(b) develop ethical reasoning skills, (c) feel that they have the responsibility and the
ability to behave ethically, and (d) accept that ethical dilemmas are not always black
and white.
Even with all of these optionsfrom detailed course outlines to broad
conceptual goalsethics is still a relatively new topic in psychology, and researchers
are continually investigating the effectiveness of different approaches. The present
study looked at students perspectives of their own ethics training, although it did not
address the fine points of format and content.
8


Evaluating Ethics Training Efficacy
More Is Better
Researchers have used various methods to explore the effectiveness of ethics
training in graduate psychology programs. Baldick (1980), for example, created the
Ethical Discrimination Inventory (EDI) to test 234 clinical and counseling
psychology interns ethical astuteness in response-to 12 vignettes. A panel of
psychologists identified the ethical concerns in these clinical scenarios; interns who
recognized the same issues would earn higher scores. Baldick found no effect of
demographic characteristics such as sex, age, or number of years of graduate
education on EDI scores, but he did find that students who had taken a formal ethics
course scored significantly higher on the EDI than did students in a control group
with no ethics training. The students who had discussed ethics for just five hours or
more scored higher than the control group (students who had discussed ethics for less
than five hours did not differ significantly from controls), and they did not score
significantly differently from the students with the full course.
That Baldick (1980) found no difference in scores on the EDI between
students who had taken an ethics course and those who had discussed ethics for five
hours or more may indicate that academic training can only do so much in preparing
students to respond to ethical situations. Evidence for this view includes the fact that
out of a possible score of 44, even the students who had completed formal
coursework in ethics scored an average of only 19.
9


On the other hand, the results may be partially explained by the fact that
Baldick (1980) surveyed interns from many sites and many graduate programs, so he
could not control the quality or content of their prior ethics training, but only ask
them to categorize their training within the options he presented. This study was
published in 1980; though the APA was strongly recommending that graduate
programs include training in ethics, it was not required until 1979, and 17% of the
interns responding to Baldicks survey reported no ethics training at all. I would
speculate that, because ethics courses were probably not required for many of
Baldicks respondents, instructors at the time would have had less guidance in how to
teach ethics courses than they do now. Further, even students who did take ethics
courses may not have had the benefit of the focused ethics texts and other materials
that students have in todays programs. Thus, current ethics courses may be more
rigorous, and perhaps more effective, than many of those that Baldicks respondents
had taken. Given that Baldicks study had a large sample, and that todays ethics
courses are certainly as good if not better than his respondents courses, his finding
that ethics training does have some effect is probably quite applicable to students
today.
Lecture plus Discussion Is Better than Either Alone
Sapp (1995) measured ethics training efficacy mor e recently and with much
greater control over the experimental conditions, and he focused on the format rather
than the amount of training. He randomly assigned 57 masters level mental health
10


practicum students from one university to four groups: (a) 18 hours of ethics lecture,
(b) 18 hours of student-led ethics discussion, (c) 18 hours total of lecture and student-
led discussion combined, or (d) 18 hours of discussion about non-ethics, practicum-
related issues. Sapp administered a multiple-choice, vignette-based ethics
questionnaire to all participants and found that the lecture, discussion, and control
groups all scored roughly evenly. In contrast, the participants who had experienced
both lecture and discussion scored significantly higher than all three other groups,
indicating that the combination of formats was the most effective in teaching ethics.
In a similar study, Goldie, Schwartz, McConnachie, and Morrison (2001)
investigated the effects of ethics training on two classes of Scottish medical students.
One had taken the programs standard large, lecture-based ethics course. The other
was an experimental group that had attended small, clinician-led ethics discussion
sessions supplemented with interactive but lecture-oriented seminars with experts in
ethics and law. Goldie and colleagues used the Ethics and Health Care Survey
Instrument, a set of vignettes for which a panel of doctors, lawyers, ethicists, and
philosophers had chosen appropriate consensus answers (p. 299). After their
course, participants in the new small discussion and seminar format were more likely
than participants in the lecture class to shift from the non-consensus answers they
chose before taking the class to the consensus responses chosen by the experts.
Goldie, Schwartz, McConnachie, and Morrison (2002) followed the
experimental group through the next two years of their ethics training, which
11


consisted mainly of seminars similar to those the students had attended in their first
year. Upon re-administering the Ethics and Health Care Survey Instrument at the end
of the third year, Goldie and colleagues discovered that the students had moved no
further toward the consensus answers beyond their improvement after the first year.
Again, this could reflect a ceiling effect of academic ethics training, though Goldie
and colleagues suggested several plausible alternate theories or factors. First, the
amount of time the students spent in ethics training had decreased substantially over
time, from 30 hours in the first year to a total of 14 hours in the second and third
years. Second, the format had changed from primarily small-group discussion to
mainly lectures. Third, Goldie and colleagues noted that ethics was a topic on the
students medical board exams after the first year but not after the second or third, so
if the test did motivate students in their ethics training, it might have only contributed
in the first year.
Taken together, Sapps (1995) and Goldie and colleagues (2001; 2002) most
significant finding may have been that students benefit most from a combination of
discussion about ethics and at least some lecture. A closer look may provide some
nuances to this conclusion. For example, although the students in Goldie and
colleagues studies experienced more discussion and fewer lectures in the first, most
effective year, Sapps solely student-led discussion group showed no score increase.
This finding may mean that the ratio of lecture to discussion is variable, but both have
to be included. Or, perhaps, just as Sapps participants benefited from the additional
12


faculty lecture, so did Goldie and colleagues from having their discussions led by an
experienced clinician rather than by fellow students. The results of Goldie and
colleagues follow-up may also provide further insight into Baldicks (1980) results.
Given that approximately seven hours per year of lecture did not increase students
ethical knowledge in Goldie and colleagues study, it may be that Baldick did not
quite pinpoint the threshold of how much training is effective when he asked students
to report whether they had experienced less than five hours or five hours or more of
training. Or, as we can surmise from Sapp, it could be that format contributes far
more than mere time to the effectiveness of ethics training.
Student Attitudes toward Ethics Training
Psychology Students and Psychologists
Want Ethics Training
Soon after the APA began to require ethics training in psychology doctoral
programs, Tymchuk et al. (1982) asked psychologists about their attitudes toward
ethics training. Of these psychologists, only 37% reported having had some
coursework or a seminar in ethics. Unsurprisingly, 58% felt that they were not well
enough informed about ethical issues in psychology (p. 419), and perhaps as a result
of the experience, 89% believed that ethics training should be mandatory for graduate
psychology students.
Tymchuk (1985) asked APA student members the same questions, and found
that, similar to the psychologists, only 36% had taken ethics courses at that point in
13


their graduate education. However, the students responded even more strongly than
the psychologists had to the attitude questions. In fact, 80% endorsed the idea that
most psychology students are not adequately informed about ethical issues in
psychology (p. 225), and 94% felt that that programs should require clinical
psychology students to take an ethics course. Student opinions such as these are
important, because although objective methods of evaluating ethics training provide
important information to those seeking the most benefit for students, it is also crucial
that the students themselves recognize ethical discretion and reasoning as important
skills and feel that their training is worthwhile.
By many accounts, students do appreciate their training in ethics. One student
who attended an undergraduate ethics class taught by Corey, Corey, and Callanan
(2005) noted how important training had been in preparation for later clinical work:
I remember thinking how fortunate I was to have taken the ... ethics course, because
ethical dilemmas occurred much more frequently than I had expected (p. 204).
Roberts et al. (1996) surveyed psychiatry residents and found that 92.3% of the
respondents, some of whom had ethics training and some of whom did not, felt that
ethics training, was helpful in responding to ethical dilemmas in their interactions
with patients.
Ethics Training Might Not Be Addressing All Areas
The ethics training that students are getting may be valuable, but it may not be
enough, or not enough in all settings. Meyers, Reid, and Quina (1998) touched on this
14


idea when they asked doctoral psychology students how important they believed a
number of topics to be in an academic career, and to what degree they felt their
training had covered each topic. On a scale from 0 to 4, their respondents rated
ethical issues a 2.45 level of importancebetween moderate and highbut
only rated their level of training at 1.20, somewhat higher than a little (p. 124). The
students in this study did score importance higher than amount of training for all
five topics, including ethics. Perhaps student desires are more than graduate programs
can fulfill, or maybe programs are not preparing students for any aspect of day-to-day
life in the academic world.
Clinical psychology students may choose to work in a variety of roles in their
careers, as clinicians, researchers, and instructors or supervisors. Thus, they should be
trained to handle ethical situations in each sphere. Tabachnick, Keith-Spiegel, and
Pope (1991) surveyed teaching psychologists about ethics in teaching, and found that
at least 25% were unsure about the ethics of behaviors such as teaching in a setting
lacking adequate ethnic diversity and teaching when too distressed to be effective
(p. 513). In the clinical realm, Pope, Tabachnick, & Keith-Spiegel (1987) found that
at least 20% of psychologists surveyed were unsure of the ethicality of various
clinical situations such as being sexually attracted to a client and avoiding certain
clients for fear of being sued (p. 999). Studies like these show that there are ethical
issues in all areas of clinical psychologists professional lives about which they are
uncertain.
15


Asking Students for Their Perspectives
Tryon (2001) addressed students perspectives on ethics training in clinical
work when she asked school psychology students how prepared they felt to handle
future ethical dilemmas. She tied the idea of preparation closely to students opinions
about their training by defining prepared as the extent to which you believe your
graduate training has positioned you to effectively deal with the following situations
(p. 380). She also asked them how concerned they were, defined as the extent to
which you are bothered or worried about dealing with the following situations (p.
380).
Tryon presented the students with 12 potentially thorny ethical areas in school
psychology, such as requests to falsify test results and child custody cases (p.
380). She had participants rate how prepared and concerned they were about those 12
areas on five-point Likert scales. She then correlated the ratings with various self-
reported demographic characteristics, such as whether students had taken an ethics
course, how many years of graduate study in psychology they had, and how many
hours they had spent in clinical practica or internships.
Tryon (2001) received completed surveys from 233 students and found that
those who had taken an ethics course felt more prepared to deal with all 12 topics,
though they were no more or less concerned about the issues than students who had
not taken an ethics course. She concluded that students who had taken an ethics
course felt more prepared based on the fact that more than half of the participants
16


stated that they felt prepared to deal with 8 of the 12 issues, whereas the same was
true for only 4 of the 12 issues for students who had not taken an ethics course.
Tryon also found that students who had more years of graduate study felt
more prepared, but no less concerned, than students earlier in their studies. This effect
was not solely attributable to the fact that students in later years are more likely to
have had an ethics course. Finally, students who had more hours of practicum
experience, but not internship experience, felt more prepared to handle ethical
dilemmas, and students with more hours of practicum or internship experience felt
less concerned about dealing with ethical issues. In short, Tryons (2001) findings
indicated that students felt most prepared to deal with ethical issues when they had
taken an ethics course, simply spent more time in graduate school, or worked in the
field, although only actual clinical experience assuaged their concern.
What Students Want
If students do value ethics training and feel more prepared for ethical
dilemmas after having taken a course, what do students want in the ethics curriculum?
The psychologists in Tymchuck and colleagues (1982) study, reflecting on their own
ethics education, proposed many methods instructors use today, such as formal
classes in which students discuss case studies and decision-making models.
Tymchuks (1985) student respondents wanted ethics to be incorporated into earlier
classes and, hearkening back to Sapps (1995) and Goldie and colleagues (2001;
2002) studies, to discuss case studies with experts rather than only with other
17


students. Also agreeing with many of the above findings, the psychiatry residents in
Roberts and colleagues' (1996) study rated ethics training techniques and felt that the
most useful included incorporation of ethics issues into other presentations and
discussions, discussions with colleagues and knowledgeable discussion leader, a
lecture course on ethics, and observation of attending physicians as they handle
ethical problems (p. 135). When Pettifor, Estay, and Paquet (2002) asked
participants in an ethics workshop for mental health professionals to rate seven
teaching strategies, the respondents rated group discussion of vignettes as most
helpful, questions/answers following lectures second, and lectures fourth (third
was group discussion of videotapes). Echoing the objective findings, students
learning about ethics clearly prefer that their ethics training (a) include formal classes
with lecture and discussion under expert guidance, (b) be integrated into other courses
rather than separated from their other training, and (c) be bolstered by observing
professors and supervisors acting ethically.
Ethical Judgment versus Ethical Behavior
Easier Learned than Done
Even if academic courses do provide students with much of the information
they need to make ethical decisions, the judgments individuals make in response to
ethical dilemmas may differ from their actual behaviors when faced with the complex
realities of difficult situations. For example, several students in the class Fine and
Ulrich (1988) studied evaluated the course three months later, when they were
18


working in clinical settings. On a scale of 1 to 5, they rated the course at 4.5 in terms
of their understanding of ethics, but they rated applications, reflecting the degree to
which their behavior in clinical situations had changed (p. 545) at only 3.8, still very
positive but lower than their ratings of understanding. In her survey of school
psychology program directors, Tryon (2000) noted that 67.5% of the students the
directors described as having committed ethical transgressions had taken ethics
courses.
Bernard and JaraShould Do versus Would Do
Bernard and Jara (1986) explored this difference between belief and behavior
by presenting clinical psychology students with two hypothetical vignettes that
detailed behavior that the students would clearly find to be unethical. In one case, a
therapist had developed a sexual relationship with a therapy client. In the other, the
individual had a drinking problem that was affecting his or her clinical judgment and
behavior. (They varied the gender of the actor in the study and found it to have no
effect.) To drive home the fact that these were ethical lapses, the researchers included
the relevant standards of the APA ethics code (APA, 1981). They also stated that the
respondent had already confronted the individual and had been rebuffed.
For the participants, the catch in Bernard and Jaras (1986) study was that they
described the individuals who were behaving unethically as fellow students and
friends in the respondents clinical practicum. As Tryon (2001) noted, one of the
more difficult ethical issues is dealing with colleagues unethical behavior. Keeping
19


that idea in mind, Bernard and Jara followed each vignette with two questions:
According to the Ethical Principles, what should you do? and Speaking
pragmatically, and recognizing that he [she] is a friend and a fellow graduate student,
what do you think you probably would do? (p. 314). The two questions had the same
five answer choices, ranging from nothing to tell the Director of Clinical Training
or his [her] clinical supervisor (p. 314).
Bernard and Jara (1986) focused not on the answersthe judgment or
behavior itselfbut on the difference between the two. They found that, in response
to the sex scenario, half of the 170 respondents said they would do what they believed
they should do; that is, their behavior would align with their judgment. The other half,
however, would do less than they believed they should. The results for the drinking
scenario were similar: 45% of the students said they would do what they believed
they should and 55% said they would do less. Bernard and Jara found no correlations
between whether respondents reported that they would or would not do what they
believed they should in the two situations and any demographic characteristics, such
as respondents year in their programs and whether or not they had taken ethics
courses.
Several researchers have replicated Bernard and Jara's (1986) study. Bernard
himself repeated the study with Murphy and Little (1987) in a survey of clinical
psychologists, a population that might react differently to the vignettes than less-
experienced students. Of the 250 clinicians who responded, 63% said they would do
20


what they believed they should in the case of the sex scenario, and 37% would do
less. For the drinking scenario, 74% would do what they believed they should, while
26% would do less. Again, the researchers found no relationships between the
participants choices and any demographic variables. Bernard and colleagues (1987)
noted that the fact that a greater number would do what they believed they should in
response to the drinking than the sex vignette seemed rather strange, given the
stringent prohibition against sexual contact between therapists and clients and the
slightly muddier policies with regard to psychologist impairment.
Varying Transgressions, Varying Actors
Wilkins, McGuire, Abbott, and Blau (1990) may have addressed Bernard and
colleagues (1987) surprising finding by combining the should and would scores
rather than merely looking at the difference between the two. In their survey of
psychologists, they found that respondents reported that they should and would react
more strongly to the sex scenario than to the one involving alcohol. These findings
may suggest that respondents in Bernard and colleagues study felt that they ought to
do more when faced with a sexual relationship than a drinking problem. If, however,
they would act the same way regardless of the situation, that would result in a greater
difference between their beliefs and hypothetical actions.
Wilkins and colleagues (1990) also varied the Person-of-Reference (p. 541)
in the vignettes. Each respondent saw one of four types of scenarios. In one, the
respondent was the one committing the ethical transgression; in the others, it was a
21


good friend, a colleague, or an acquaintance. They did not find that the Person-of-
Reference affected the difference between what respondents believed they should do
in the situation and what they thought they actually would do. However, when they
combined the should and would ratings, they found that the closer the person in
the vignette was to the respondent, the higher the combined score. That is,
respondents who had read vignettes in which they themselves had committed the
transgression had a higher combined score than respondents who had read vignettes
involving someone who was a good friend; respondents who had read vignettes
involving a good friend had a higher combined score than those who had read
vignettes involving a colleague, and those who read about a colleague had a higher
combined score than those who read about an acquaintance. Wilkins and colleagues
findings indicate that how responsible psychologists feel for dealing with others
ethical transgressions may depend on who the others are. They also indicate that
researchers using Bernard and Jaras vignettes might want to examine the individual
should and would scores themselves and not merely the difference between the
two.
Who Would or Would Not Do What They Should?
Looking back at the disparity between should and would scores,
researchers have also extended Bernard and Jaras (1986) findings by attempting to
differentiate between respondents whose should and would ratings agree and
those whose ratings do not. The task of differentiating between those reporting a
22


gap between what they believe they should do and what they think they would do
and those without such a gap was a fairly open field, because Bernard and Jara (1986)
and Bernard and colleagues (1987) found no effect of demographic characteristics on
whether or not respondents reported a gap between the scores. Given that a belief in
an ethical plan of action does not necessarily guarantee ethical behavior, the question
of what might affect that difference between belief and behavior is an important area
of inquiry.
Fox (2002) hypothesized that students who differed in their responses to the
vignettes would also differ in their levels of moral judgment as measured by the
Defining Issues Test-2. Though some of her respondents reported that they would do
what they believed they should and others reported that they would not, Fox found no
difference between the groups in their levels of moral judgment.
Betan and Stanton (1999) looked more closely at how clinical psychology
students made their decisions by adding two other measures (and using only the
drinking scenario). One asked respondents about their emotional reactions, and the
other asked them to what extent factors such as ethics codes and friendship affected
their decisions. The emotion questions addressed two major factors, anxiety and
compassion, the latter of which included feelings of concern for the participants, both
therapist and client, and confidence that the circumstances could improve. They
found that respondents who said they would do what they believed they should
reported less anxiety and greater compassion, and that they rated professional matters
23


such as ethics codes and education as having affected their decisions more than
worries about friendship. Students who reported that they would do less than they
should were more anxious, less compassionate, and more focused on the personal
relationships than the professional concerns. Betan and Stanton noted that these were
only correlations, so it is possible, for example, that students who do act on their
beliefs are less anxious to begin with or that they feel less anxious about the decision
afterward.
The findings regarding the influence of personal versus professional factors
are related to the present studys questions about acculturation (see below), in that
students who report being heavily influenced by the ethics they learned in graduate
school may be more likely to do what they believe they should than students who
report clinging to pre-training ethical beliefs, which are likely to have had more to do
with maintaining friendships than with professional ethical matters. Also, Betan and
Stantons findings may be related to Tryons (2001), if the idea of preparation is
similar to the anxiety factor and the confidence portion of the compassion factor. That
is, students who feel better prepared by their training may then feel less anxious and
more confident in their ethical decisions. Thus, the present study hypothesized that
greater feelings of preparation, here called satisfaction, would correlate with a
smaller gap between what students believe they should do and what they think they
would do in response to the ethical vignettes.
24


Asking about Real, Not Hypothetical, Behaviors
Some studies have asked respondents about their real behaviors rather than
using hypothetical vignettes. For example, Pope, Tabachnick, and Keith-Spiegel
(1987), who surveyed psychologists about the ethics of various behaviors in therapy,
also asked them how often the behaviors had occurred in their practices. They did the
same in their survey of teaching psychologists (Tabachnick et al., 1991). Branstetter
and Handelsman (2000) adapted Pope et al.s and Tabachnick et al.s questionnaires
to ask graduate teaching assistants about actual ethical dilemmas in their positions. A
major advantage of this method, of course, is that it does not rely on participants
conjecture (though in both cases respondents may be unwilling to share self-
incriminating details), and it is particularly useful in studies concerning specific
behaviors.
The present study used Bernard and Jaras (1986) hypothetical vignettes
instead of asking about real behaviors for two major reasons. First, I surveyed
students, who are unlikely to have experienced many ethical dilemmas. Second, like
Wilkins and colleagues (1990), Fox (2002), and Betan and Stanton (1999), I wanted
to look at students should and would scores. For example, respondents who are
more satisfied with their ethics training might feel more confident that they would do
what they believe they should in the scenarios. They may also differ in self-reported
acculturation strategy, as described below.
25


Ethical Acculturation
Students Have Their Own Personalities and Moralities
In their 1987 study, Bernard and colleagues noted that the fact that they found
no demographic effects on the difference between judgment and behavior suggests
that the decision to report the unethical behavior of a colleague is a matter of personal
values to a large extent (p. 491). When we teach psychology ethics to students, we
accept that they are humans with distinct personalities that can affect their ethical
choices. For example, Sankaran and Bui (2003) found that undergraduates who
scored higher on a scale of competitiveness scored lower on a measure of general
ethics. (Both scales were created by the authors.) Further, future psychologists are
raised in disparate ethical environments, and the ethics of psychology are quite
specializedthe role of psychologist is not identical to the commonly experienced
role of friend, for instance. Thus, even excellent general ethics are inadequate;
consequently, students must learn the ethics of psychology during their professional
training.
Entering the Culture of Psychology Ethics
Two Dimensions and Four Strategies
Handelsman, Gottlieb, and Knapp (2005) approached the idea of students
reconciling their long-standing personal and recently-learned professional ethics as a
type of acculturation. They reasoned that just as immigrants find different ways of
adjusting to their new cultures, so do students when they encounter the ethics of
26


psychology. Handelsman and colleagues adapted Berry's (1980, as cited in
Handelsman et al., 2005) model of acculturation, substituting the concept of ethical
acculturation (p. 59) but retaining the same format and definitions. In this
modification of Berrys model, students have four options as they move from their
own moral systems into the ethics of psychology: integration, assimilation,
separation, and marginalization. The four strategies are based on two dimensions,
cultural maintenance and contact and participation.
In the case of ethics training, cultural maintenance is the degree to which
students learning about ethics in psychology want to maintain their previous ethical
identities. For example, psychology students who have worked in other industries
might bring into their psychology programs a system of morality that was appropriate
to their previous job, such as the ethical constraints of the relationship between
attorney and client or retailer and customer. For young students who have not worked
extensively elsewhere, their ethical identities may be made up solely of the ethics of
personal relationships, such as how they treat their family members or friends.
According to the model of ethical acculturation, students with high cultural
maintenance would want to hold onto their previous identities; those with low cultural
maintenance would let them go.
Contact and participation is the degree to which students value the ethics of
professional psychology and thus want to expose themselves to it and adapt to it.
Students who have high contact and participation with psychology ethics believe that
27


it is a valuable way to approach ethics in their future careers, so they are eager to
embrace it. Those with low contact and participation do not see psychology ethics as
valuable and so do not want to adopt it.
Students who employ integration as a strategy of ethical acculturation have
both high cultural maintenance and high contact and participation. They attempt to
merge their own ethical beliefs, based on personal traits and values, with what they
are learning in their psychology programs. Ideally they see many areas of agreement,
but even when the two traditions conflict, those who use an integration strategy make
an effort to integrate the two, with a full understanding of and appreciation for the
reasoning behind psychological ethics. Integration may be the most advantageous
strategy of the four, as these students strive to understand the deeper principles
underlying their own and psychologys ethical cultures.
The other three strategiesassimilation, separation, and marginalization
may be less successful in both the personal and professional senses. Students may feel
detached from one or both ethical ways of life, and they may be more subject to
complaints by consumers.
In assimilation, students have high contact and participation but low cultural
maintenance. They take on the ethics of psychology while jettisoning their ethical
backgrounds, perhaps because they want to immerse themselves completely in their
chosen careers or because they did not begin with a strong ethical viewpoint. Taking
on the ethics of psychology without the foundation of one's own moral sense can be
28


problematic. Students who choose assimilation may follow the letter of the law
without the spirit, potentially becoming overconfident that they will always behave
correctly when they adhere to oversimplified legal and ethical standards.
Those who implement a separation strategy have high cultural maintenance
but low contact and participation. They decide that their established ethical beliefs are
sufficient and reject the tenets of psychology ethics. Some may feel that their own
sense of right and wrong will necessarily result in professional behavior. The role of
psychologist, however, may be different from students previous roles, and behaving
like a friend (for example, hugging a client) may violate professional boundaries.
Others who employ a separation strategy may believe that some aspects of
psychological ethics are unacceptable, such as the practice of not pushing values on
clients even when psychologists disagree with clients values. The actions of
psychologists following a separation strategy can result in discomfort or worse on the
part of the consumer.
Finally, students who adopt a strategy of marginalization have both low
cultural maintenance and low contact and participation. They do not identify with
either a pre-existing moral sense or the ethics they are learning in their psychology
programs. The deficiency in moral guidance may be temporary, as in the situation of
students who will end up assimilating, and have abandoned their longstanding ethical
beliefs but have not yet fully learned or understood professional ethics. It is possible,
however, for psychologists to utilize this strategy long-term, consistently doing what
29


benefits them personally and sticking to ethical standards only when they are
opportune. This strategy is obviously ethically problematic.
Until the present study, Handelsman and colleagues (2005) ethical
acculturation model had not been tested. I attempted to differentiate among students
who responded in different ways to the attitude and judgment/behavior questions
based on their self-reported ethical acculturation strategy, a construct that had never
before been measured. Established measures of acculturation in ethnic groups had
looked at behaviors very specific to the groups the researchers were examining, so I
could not adapt measures for this study such as those used by Barry (2001) and
Leong, Wagner, and Kim (1995). Thus, I devised several groups of questions to
assess the concept. The questions were fairly face valid, but the results pointed out
some deficiencies in the way the questions were worded; I address these limitations in
the Results and Discussion section below. Nevertheless, I found that responses to the
acculturation questions supported other constructs in the survey, so this study did help
establish some construct validity for ethical acculturation.
Hypotheses
Attitudes
Overall, I was interested in how students felt about ethics and their ethics
training; thus, I asked respondents three general questions about their attitudes and
perceptions. I also wanted to learn about how students were learning and feeling
about ethics in three major areas of professional activity: clinical work, research, and
30


teaching. The first general measure of respondents attitudes asked them how
important they believed ethics to be in each of those three areas:
Hypothesis 1: There will be differences in respondents perceived importance of
ethics in therapy, research, and teaching.
The second attitude question asked respondents how satisfied they were with their
ethics training:
Hypothesis 2: There will be differences in respondents perceived satisfaction
with their training in ethics in therapy, research, and teaching.
The third attitude question asked respondents how concerned they were about dealing
with ethical issues:
Hypothesis 3: There will be differences in respondents perceived concern about
dealing with ethics in therapy, research, and teaching.
Other aspects of their trainingethics and otherwisemight affect how
students feel about ethics and their ethics training. 1 hypothesized that respondents
who had more experience in each area, such as in a clinical internship or as a research
or teaching assistant, would gain some applied knowledge of ethics there, and thus
would be (a) more satisfied with their overall ethics training experience and (b) less
concerned about dealing with future ethical issues in that area:
Hypothesis 4: Respondents with more experience in any given areatherapy,
research, or teachingwill feel more satisfied with their training in regard to
ethics in that domain.
31


Hypothesis 5: Respondents with more experience in any given areatherapy,
research, or teachingwill feel less concerned about ethics in that domain.
A specific part of that applied learning experience would probably be when
respondents discussed ethics with their clinical, research, or teaching supervisors;
thus, I hypothesized that the more frequently they discussed ethics with their
supervisors, the more satisfied and less concerned they would feel:
Hypothesis 6: Respondents who have spent more time discussing ethical issues
with their supervisors in any given areatherapy, research, or teachingwill feel
more satisfied and less concerned about ethics in that domain.
Aside from any differences among clinical work, research, and teaching, I
wanted to know what might make students more satisfied with their ethics training
experience. I hypothesized that, on a basic level, simply having more of it, such as
ethics courses, would affect how satisfied respondents were with their ethics training:
Hypothesis 7: Students who have had more training in ethics will feel more
satisfied with their ethics training.
Ethical Vignettes
The second measure of how students felt about ethics was how they might
actually respond to an ethical dilemma. I used hypothetical clinical ethical dilemmas
like those Bernard and Jara (1986) created as a gauge, and hoped to replicate their
results by finding a similar gap between what respondents believed they should and
what they thought they actually would do in a difficult ethical dilemma:
32


Hypothesis 8: There will be a gap between what students believe they should do
and what they feel they would do in response to the ethical dilemmas in the
hypothetical vignettes.
I also had some predictions about what might affect this gap. I thought that
how satisfied respondents were with their ethics training would indicate how well
they had been trained, at least from their perspective. Thus, I hypothesized that the
more satisfied they were, the more likely they would be to actually do what they
thought they should in an ethical dilemma:
Hypothesis 9: Students who are more satisfied with their training will have a
smaller gap between judgment and behavior in response to the vignettes.
Similarly, I thought that how concerned respondents were about dealing with future
ethical issues would indicate their feelings about how they would act in an ethical
dilemma. I hypothesized that the less concerned they were, the more likely they
would be to do what they thought they should:
Hypothesis 10: Students who are less concerned about dealing with ethical
dilemmas will have a smaller gap between judgment and behavior in response
to the vignettes.
Acculturation
My third measure of how students felt about ethics was the experimental
acculturation questions, which assessed how respondents made their ethical decisions.
Respondents who endorsed integration or assimilation would be indicating high
33


contact and participation with the ethics of psychology, so they would probably rate
ethics as more important than those who endorsed separation or marginalization,
indicating low contact and participation:
Hypothesis 11: Students endorsing integration or assimilation as acculturation
strategies will rate ethics as more important than students endorsing separation or
marginalization.
I also predicted that those indicating high contact and participation would be
more satisfied with their ethics training, because it would have done a good job of
convincing them of the importance of professional ethics, and because they might
have been more open to the training in the first place:
Hypothesis 12: Students endorsing integration or assimilation as acculturation
strategies will be more satisfied with their ethics training than students endorsing
separation or marginalization.
Finally, I hypothesized that, no matter what strategy respondents used, they
would probably agree that in an ethical dilemma in psychology, they should turn to
professional ethics. However, those indicating high contact and participation would
probably be more likely to agree to actually do what they thought was required,
whereas those indicating low contact and participation might decide noi to do what
they should, because they would be following their own or some other moral sense:
34


Hypothesis 13: Students endorsing integration or assimilation as acculturation
strategies will have a smaller gap between judgment and behavior in response
to vignettes than students endorsing separation or marginalization.
35


CHAPTER 2
METHOD
Participants
I contacted clinical psychology students through directors of clinical training
programs or, when that was not possible, through departmental chairpersons. I
emailed those contacts at all accredited American programs that offered doctoral
degrees in clinical psychology as listed on the APA website (APA, n.d.a, n.d.b) and
asked them to forward my information and website link to their students. I sent
follow-up emails to the same contacts approximately two weeks later; the first email
and the follow-up both included informed consent information. The two emails are
reprinted in Appendices A and B.
Procedure
In the emails participants received the address of my website, which I
obtained through Zoomerang, a service that hosts internet surveys. Once there, they
encountered a page that asked them to continue only if they had read the informed
consent information contained in the email; if they continued, the survey appeared.
When respondents finished the survey, they submitted it and Zoomerang stored the
results. Approximately three weeks after sending the follow-up emails, I retrieved the
data from Zoomerang and imported it into SPSS for statistical analysis.
36


Measure
Based on my review of the literature and hypotheses, I developed a four-part
questionnaire. Section A included demographic and other questions about factors that
I believed might affect responses to questions in the other sections. Section B covered
the attitudes that I discussed in my hypotheses. Section C included the hypothetical
vignettes, and Section D comprised questions designed to assess the four
acculturation strategies. The entire survey is presented in Appendix C.
Section ADemographics
I started with standard demographic questions about respondents gender, year
of birth, race/ethnicity, and number of years of graduate study in clinical psychology.
I also asked respondents to rank order all the ways they had learned about ethics in
psychology in terms of the time they had spent in each format. Their options were
graduate course devoted to topic, part of course on professional issues, one-time
workshop, integrated into courses on other topics (assessment, psychotherapy,
etc.), discussions with colleagues, and other. For each format type, they could
select a rank number or 1 have not learned about ethics in this format. The next
question provided an open space so that respondents could describe any other
formats in which they had learned about ethics. I also asked them to select which
format, in their experience, they believed to have been best or most effective. Finally,
I asked them to report how much knowledge they had of the 2002 APA Ethical
37


Principles of Psychologists and Code of Conduct on a scale of 1 to 5, with 1 labeled
no knowledge and 5 labeled expert knowledge.
I asked respondents whether they had any clinical experience in a practicum,
internship, or elsewhere, and if so, how many hours of experience they had. Similarly,
I asked them how many studies they had worked on as a research assistant and how
many as the primary researcher, how many courses for which they had served as a
teaching assistant and how many they had taught with full responsibility. For each of
the three types of activity, I then asked respondents how frequently they had
discussed ethical issues with their supervisors, with four answer choices: never,
only when a specific issue had to be dealt with, on a fairly regular basis, and all
the time. Regarding clinical experiences, I also asked whether ethics had been
discussed in case conferences or in-services.
Finally, to better understand responses to the questions about clinical work,
research, and teaching, I wanted to assess how interested respondents were in each
area. Thus, I asked them what percent of time they planned to devote to each of
clinical work, research, and teaching in their future careers.
Section BAttitudes
Section B opened with one more question about respondents ethics training. I
asked them what percent of their ethics training had focused on clinical work, what
percent had focused on research, and what percent had focused on teaching. Because
I wanted to learn about differences in respondents attitudes toward ethics and ethics
38


training in those three areas, it would help to know their perceptions of how their
training had treated ethics in each activity.
I then introduced the three types of attitude questions. I asked respondents
how important they believed ethics to be in general and in each of the three areas of
clinical work, research, and teaching, with answer choices on a five-point Likert scale
from not at all important to extremely important. In the same manner, I asked
respondents how satisfied they were with their ethics training in general, in clinical
work, in research, and in teaching, and how concerned they were about handling
ethical issues in general, clinical work, research, and teaching, with the same five
answer choices for each question. I defined satisfied and concerned for
respondents using Tryons (2001) definition of concerned and her definition of
prepared for satisfied, adapting both slightly for my purposes. I used the word
satisfied rather than prepared simply because prepared appeared to be
objective, whereas the idea of satisfaction seemed to imply a more personal
perspective, which was the focus of the attitudes section.
I rounded out Section B with an open question: Is there anything else youd
like to tell us about your ethics training experience?
Section CVignettes
For Section C, I attempted to secure the original wording of Bernard and
Jaras (1986) vignettes, which they had not included in their published study. I was
unable to contact Jara, and Bernard no longer had any copies of the vignettes. Betan
39


and Stanton (1999) claimed to have used the original version of the scenario about the
colleague with the drinking problem, with minor alterations for their purposes. I
found it in its entirety in Betans dissertation (1997). It looked like the scenario
Bernard and Jara described; thus, I copied it with only slight adjustments to reverse
the ones Betan and Stanton said they had made for their study. For the other vignette,
in which the colleague had developed a sexual relationship with a client, I began with
the version that Fox (2002) created when she herself could not find the original. I
modified it to make it more parallel to the drinking scenario, because that one was
probably fairly close to its original. For example, I added you have expressed some
concern to him/her in the past.. .but it obviously has had no impact, which maintains
the format of the drinking vignette.
Bernard and Jara (1986) noted that they had presented their participants with
ethical standards 2(f) and 6(a) from the then-current version of APA ethics code
(APA, 1981), which were the standards relevant to personal impairment, multiple
relationships, and sexual intimacies with clients. However, these standards had
changed in wording and placement as the code evolved. I included in my survey the
appropriate current (APA, 2002) versions. Standard 2.06 is virtually identical to 2(f),
and 3.05(a) and 10.05, though somewhat different from 6(a), are the closest
approximations.
In Section C, I presented each of the two vignettes along with the relevant
ethical standards. After each, I asked respondents two questions: According to the
40


Ethical Principles of the American Psychological Association, what should you do?
and, Speaking pragmatically, and recognizing that he/she is a friend and a fellow
graduate student, what do you think you probably would do? Bernard and Jara
(1986) listed their answer choices for the drinking scenario, and I used the same ones:
nothing, suggest that he/she get help for this problem, keep trying to get him/her
to stop drinking, tell him/her that if he/she doesnt get his/her drinking under
control you will have to mention it to the Director of Clinical Training or his/her
clinical supervisor, and tell the Director of Clinical Training or his/her clinical
supervisor. They did not describe their answer choices for the sex scenario; thus, I
made them reasonably parallel to the other: nothing, suggest he/she break off the
sexual relationship with the client, advise him/her to terminate the therapeutic
relationship with the client, tell him/her that if he/she des not terminate therapy you
will have to mention it to the Director of Clinical Training or his/her clinical
supervisor, and tell the Director of Clinical Training or his/her clinical supervisor.
Section DAcculturation
In Section D I attempted to assess respondents ethical acculturation
strategies. I tried three different methods of asking about the four strategies. When
facing an ethical dilemma, if respondents chose to follow professional ethics only,
they would be endorsing a strategy of assimilation, whereas if they followed their
own moral sense alone, they would be demonstrating separation. If they combined the
two, that would be integration, and if they chose neither, or something else altogether,
41


they would be endorsing marginalization. To make sure everyone was on the same
page, 1 defined the ethics of psychology as professional ethics, from the ethics
training you have received in graduate school, professional codes and principles, and
other professional sources. 1 defined my own moral sense as your own sense of
right and wrong that you have developed over the course of your life, from parents,
previous jobs, and other experiences before graduate school.
The first set of four questions asked, When 1 make decisions on ethical issues
in general, my decisions are based on .. . The answer choices to each question were
the four decision-making methods: primarily my own moral sense, primarily the
ethics of psychology, both my own moral sense and the ethics of psychology in
equal measure, and neither my own moral sense nor the ethics of psychology. The
second four-question set, by contrast, was hypothetical rather than current, and did
not address the three areas of professional activity: When faced with an ethical
dilemma, my best course of action is ... . Each question stated that one of the four
decision-making methods was best, and allowed respondents to choose from a five
point scale ranging from strongly disagree to strongly agree.
In the third major set of four questions, I asked respondents to imagine a time
when your own moral sense will be in serious conflict with the demands of the ethics
of psychology, and gave a potential example. The decision-making methods in the
questions were slightly different from how they were worded in the other question
sets: If possible, I need to find some common or middle ground between my own
42


moral sense and the ethics of psychology, If I cant find a middle ground, I need to
follow the ethics of psychology, because Im acting as a professional, If I cant find
a middle ground, I need to follow my own moral sense, to be true to myself, and If
I cant find a middle ground, I need to find an entirely new way to solve the
problem. Answer choices were again a five point scale from strongly disagree to
strongly agree. I designed these questions to correspond to the four acculturation
strategies, in this case in the order of integration, assimilation, separation, and
marginalization.
I also asked this question: To what extent are the ethics of psychology
consistent with your own moral sense? I reasoned that how respondents answered
would give me some contextual understanding of their responses to other questions in
this section. For example, respondents who reported that their own moral sense was
extremely consistent with professional ethics might have a much easier time
following an integration or assimilation strategy than would those whose previous
moral sense was very different from what they were learning about ethics in class.
I included one open question adapted from Handelsman and colleagues
(2005): What didnt you expect about being, or becoming, a professional
psychologist? That is, what has been the most counterintuitive, shocking, surprising
issue that you have learned about so far? Handelsman and colleagues have received
many interesting answers to this question, and I wondered what my respondents
might say.
43


CHAPTER 3
RESULTS AND DISCUSSION
These sections generally follow the format of the survey: (1) demographics,
(2) attitudes, (3) vignettes, and (4) acculturation questions. First I present basic
demographic results and the answers to the questions about respondents experiences
in the field, their ethics training, and their career plans. After the general descriptive
analyses, I discuss some issues involving interpretation of the demographic results.
I then report what respondents said about their attitudes toward ethics and
their ethics training: how important they believed ethics to be, how satisfied they
were with their ethics training, and how concerned they were about dealing with
ethical issues in the future. I also address factors, such as their ethics training, that
may have affected respondents' attitudes, and how these attitudes might have affected
other measures, such as how they made their ethical decisions.
Next I discuss the hypothetical ethical vignettes. I report what respondents
said they should and would do in response to each situation, how their responses
differed between the two scenarios, and the gaps between what they believed they
should do and what they thought they actually would do. Then I discuss the factors
that may have influenced responses to the vignettes.
I address many of the findings related to the acculturation questions in earlier
sections. In the section about how consistent respondents' own moral sense was with
44


the ethics of psychology, I recap those responses and discuss the construct of
consistency. In the acculturation section, which covers responses to the other
ethical decision-making questions, I present descriptive statistics and discuss the
hypotheses that involved acculturation. I also discuss flaws in these experimental
questions, and suggest how researchers might study ethical acculturation in the future.
I then argue that, given the responses to various questions throughout the
survey, there are indeed differences in how programs teach about ethics in clinical
work, research, and teaching, and these differences may reflect deficiencies in
teaching students ethical decision-making strategies and responses to ethical
dilemmas. I describe interesting answers to the open questions, including what might
affect how students feel about their ethics training, and perhaps what might
reinforceor undoa training programs good work. Lastly, I discuss the limitations
of the study and present my final conclusions.
Demographics
In addition to the basic demographic questions about their age, race, and
gender, I also asked respondents questions about their graduate studies and ethics
training experiences. I asked them how many years of graduate education they had in
clinical psychology, how they had learned about professional ethics, and how well
they knew the 2002 APA ethics code. I also asked them about their experiences in
clinical work, research, and teaching: how many hours they had spent performing
clinical work, how many research studies they had been involved in as researchers
45


and research assistants, how many classes they had taught as instructors or assistants,
and how frequently they had discussed ethics with their supervisors in each setting.
Finally I asked them what percent of their careers they planned to spend as clinicians,
researchers, and teachers.
This section includes several discussions that go beyond descriptive statistics
from section A of the survey. One covers responses to the question about what
percent of respondents ethics training they believed had focused on each of clinical
work, research, and teaching. Another introduces the question about the consistency
between respondents own moral sense and the ethics of psychology. I reference this
question throughout the discussion before I explore it in depth, and I present the basic
findings here. In the last part of this section, two subsections discuss relationships
among some of the demographic questions. First, respondents age, their number of
years of graduate education, whether or not they had taken an ethics course, their
knowledge of the APA ethics code, and their amount of field experience all appear to
increase (and respondents were more likely to have taken ethics courses) during their
career as students. I discuss the relationships among these measures and how these
factors might affect interpretation of other analyses. Second, I address how
respondents career plans and the focus of their ethics training may have influenced
each other.
In addition to including the descriptive statistics in the text, I also print them
in tables in Appendix D. The tables address nearly all questions, demographic and
46


otherwise.
Gender, Age, Race, and Number of Years in Program
The online survey was submitted 306 times. I discarded 4 of the submissions
because the survey program had not registered any data other than the final
submission. One additional respondent had not been able to access the online version
and contacted me for a Microsoft Word version; I entered that respondents data into
SPSS manually. I ended up with a total of 303 usable responses.
Respondents included 235 (77.6%) women and 68 (22.4%) men. Their ages
ranged from 22 to 58, with a mean of 29.41 years and a median of 28 years. They
reported having from 1 to 9 years of graduate study, with a mean of 3.53 years and a
median of 3 years. The majority of the respondents, 82.2%, were White; another 5.9%
were Hispanic, and 4.0% were Asian; other ethnicities constituted the rest of the
group. (For more on these questions, see Appendix D, Tables A1-A4.)
Ethics Training Formats
Tymchucks student respondents reported in 1985 that clinical psychology
students should be required to take an ethics course, and two decades later my
respondents seemed to feel the same way. As one commented, 1 think everyone who
plans to work in our field needs a full semester course, and some would have liked
even more. One suggested a review or second course once we started practicum so it
was more applicable and hands-on learning. Another echoed the sentiment:
47


As [ethics courses occur] during the second year, a lot of time goes by
in the program without any formal ethics training. [I] wish that there
were ongoing ethics courses so that students could build upon their
knowledge while incorporating experience as the years go on.
My respondents may not have experienced ongoing ethics courses, but most of them
reported having some dedicated ethics instruction. Four out of 5 (79.9%) said that
they had taken a course focusing on ethics (N = 273), and two thirds (67.3%) had
instead or also taken ethics as part of a course on more general professional issues (N
= 263). Only 10.5% (N = 295) had not had either type of course at the time of the
survey. (These statistics are also presented in Appendix D, Tables A5-A6.) What a
difference from what Jorgensen and Weigel found in 1973, when only 14% of
programs offered an ethics course!
In addition to coursework, one-third of respondents (32.7%) reported having
attended a workshop on ethics (N = 275). I did not ask about the content of the
workshops, nor about the kinds of workshops respondents elected to attend or were
required to attend by their teachers or supervisors. Virtually everyone reported that
ethics had been integrated into their non-ethics courses (99.6%, N = 252); one noting
that almost all my course work has included some aspect of ethics. Nearly all said
that they had discussed ethics with colleagues (97.6%, N = 290). About a third of
those respondents who answered the question (37.2%, N = 180) reported also having
had ethics training in some other format. Although I included a separate question in
which those endorsing another format could elaborate, I received no responses. Thus,
48


either no respondent filled in that question, or the survey program erred and did not
record the responses.
Given that nearly everyone said that they had experienced ethics in non-ethics
classes and discussed it with colleagues, clinical psychology training programs seem
to have ethics integrated into at least one and sometimes more of their other classes in
addition to offering dedicated ethics courses. Adams and colleagues (2001) placed the
union of ethics courses and integration into other classes at the highest rung on their
scale of approaches to ethics, and that approach is how many respondents clinical
programs are teaching ethics. Additionally, just as Sapp (1995) found that the most
useful format included both lecture and student-led discussion, most of my
respondents had taken an ethics course and almost all claimed to discuss the topic
with other students. Thus, my respondents, who were exposed to ethics courses,
ethics integrated into their other classes, and ethics discussions with their colleagues,
may be getting a strong ethics education.
There is one caveat to these findings. Each of the questions about ethics
training formats included the answer choice I have not learned about ethics in this
format. Some respondents answered some of the questions while filling in no answer
choice for others. Perhaps they intended to indicate that they had not learned about
ethics in that format, but did not select the relevant answer choice. Thus, some of
these results may overestimate the percent of respondents who endorsed the question.
For example, the question about integration of ethics into other courses only received
49


252 responses out of 303 potential respondents. Thus, some of the missing answers
might have been a response of no, and the 99.6% affirmative response not
completely representative; in this example, only 82.8% of all respondents actually
reported having ethics integrated into their non-ethics courses. Still, more than 4 out
of 5 is a strong majority of respondents.
Regarding the time respondents had spent in each ethics training format,
68.3% of those who reported having taken ethics courses (N = 218) described the
course as the format in which they had spent the most time learning about ethics. In a
distant second place, 17.1% of those who reported having had ethics integrated into
other courses (N = 251) claimed that integration was the format in which they had
spent the most time on ethics. In regard to preferences, 48.8% of all respondents (TV =
303)67.9% of those who had taken ethics coursessaid that, of the formats they
had experienced, the ethics course was their preferred format. Next most popular was
having ethics integrated into other courses: 22.4% of all respondents and 27.1% of
those who reported having had ethics integrated into other courses chose it as their
preferred format.
Knowledge of the APA Ethics Code
Respondents reported that they were fairly familiar with the 2002 APA
Ethical Principles of Psychologists and Code of Conduct. On a scale from 1, no
knowledge, to 5, expert knowledge, 91.1% gave an answer of 3 or 4, with a mean
of 3.57 (SD = .68, N = 303). If we assume that students cannot be expected to have
50


expert knowledge, a 3.57 is fairly positive, as is the fact that almost nobody (1.0%)
reported (or at least admitted) having no knowledge at all. (For more on this question,
see Appendix D, Table A7.)
Field Experience in Clinical Work, Research, and Teaching
Most respondents reported having some experience in clinical work, research,
and teaching. Of all respondents, 86.8% (N = 302) said that they had some clinical
experience, and those with clinical experience had performed in that context for a
median of 850 hours. In regard to their research experience, 89.5% (N = 296) of
respondents said that they had served as a research assistant on a median of 4 studies,
and 90.4% (N= 301) had directed a median of 2 studies as the primary researcher.
Only 7 respondents (2.3%) had not performed research in any capacity (N =301).
Finally, 63.4% (N = 298) of respondents reported having served as a teaching
assistant for a median of 3 classes, and 33.3% (N = 297) had taught a median of 2
classes on their own; 32.0% had not taught at all (N = 300). (For more on field
experience, see Appendix D, Tables A8-A14.)
Respondents with field experience reported that they discussed ethics with
supervisors most frequently in their clinical experience, less in their research
experience, and least in their teaching experience. On a scale of (1) never, (2) only
when a specific issue had to be dealt with, (3) on a fairly regular basis, and (4) all
the time, respondents gave means of 2.54 (SD = .59, N = 259) for how often they
discussed ethics with their clinical supervisors, 2.38 (SD = .57, N = 292) for how
51


often they discussed ethics with their research supervisors, and 1.93 (SD = .57, N =
204) for how often they discussed ethics with their teaching supervisors. A one-way
ANOVA with Bonferroni post-hoc tests indicated that the means were all
significantly different, F(2, 354) = 68.95, all p < .001. (I used Bonferroni tests for all
means comparisons in this study.)
The differences among how frequently respondents discussed ethics with their
supervisors in clinical, research, and teaching situations could have been due to the
fact that ethical issues may have arisen most frequently in clinical work, less often in
research, and least in teaching. However, the data indicate that the incidence of
ethical issues could not be the only factor affecting the disparity in how often
respondents discussed ethics with their supervisors. For example, 70.1% of
respondents reported having discussed ethics in their teaching experience only when a
specific issue arose, while 45.6% reported that they discussed ethics in their clinical
experience on a fairly regular basis.
Let us speculate that it was indeed the case that ethical issues came up more
frequently in clinical work than in teaching. If respondents reported discussing ethics
with their supervisors in both situations only when a specific issue arose, they would
already be discussing ethics more frequently with their clinical supervisors than with
their teaching supervisors. However, nearly half reported discussing ethics with their
clinical supervisors on a fairly regular basis, even more frequently than when specific
issues arose. Thus, if ethical issues do arise more frequently in clinical work than in
52


teaching, the disparity in how often respondents discussed ethical issues with their
clinical versus teaching supervisors is even greater than it might seem based on the
quantitative results above.
It is certainly possible that ethical issues do arise less frequently in teaching
than in other areas, as 19.1% of respondents reported never discussing ethics in
their teaching experience. If issues did occur in the classes for which respondents
served as instructors or teaching assistants, respondents were not identifying them as
ethical, and neither were supervisors, at least not to their supervisees. By way of
comparison, only one respondent (0.3%) reported never having discussed ethics in his
or her clinical experience, and four respondents (1.4%) said they had never discussed
ethics with their research supervisors. The disparity among how frequently
respondents reported having discussed ethics with their supervisors in each area is
disheartening, because supervisors are responsible for helping students bring their
knowledge into the field, and such knowledge is not only the practical how-to of an
activity, but the potential ethical issues as well. As one respondent commented, I
think the best way to learn about [ethics] is when it is integrated to supervision. (For
more on ethics discussion in field experience, see Appendix D, Tables A15-A18.)
Career Plans
I found wide variation in the percents of time respondents planned to devote
to clinical work, research, and teaching in their careers, but on the whole, they wanted
to spend more of their time performing clinical work than either of the other
53


activities, less time performing research, and the least time teaching. They planned to
spend an average of 53.61% (SD = 28.89, N= 300) of their future careers in clinical
work, 27.22% (SD 22.18, N = 299) performing research, and 18.33% (SD = 16.00,
N = 295) teaching. All three means were significantly different from each other, F(2,
604) = 130.82, all p < .001. (For more on career plans, see Appendix D, Tables A19-
A21.)
Respondents who had field experience in an area generally wanted to do more
of that activity in their careers. Those who had clinical experience wanted to do more
clinical work in their careers than those with no clinical experience, F(l, 297) = 4.33,
p < .05, and those who had taught wanted to do more teaching in their careers than
those who had not taught, F(l, 290) = 10.10, p < .01. Almost all respondents had
some research experience, so that factor was not very revealing, but I did find that the
more studies for which respondents had served as a research assistant, the more
research they wanted to do in their careers, r(292) = .251, p < .001. Students may
enter their programs with career plans in mind and seek out experiences in
accordance with those interests. On the other hand, positive experiences in the field
might alter students plans, so that they become more interested in a subject.
Researchers who want to learn about students' experience in choosing a career might
simply ask soon-to-be or recent graduates what influenced their decisions.
Another finding regarding respondents career plans was a difference between
men and women. Though I actually found few divisions along gender lines in this
54


survey, I did find that women planned to do more clinical work than men did (56.01%
versus 45.09%), F( 1, 298) = 7.52, p < .01, and men planned to do more research than
women did (32.55% versus 25.71%), F(l, 297) = 4.95,;? < .05.
Ethics Training ExperiencesContent
Respondents described their ethics training as having focused most on clinical
work, less on research, and least on teaching. Overall, they said that 61.87% (SD =
20.69, iV= 295) of their ethics training had focused on clinical work, 25.13% (SD =
15.81, N = 296) on ethics in research, and 9.58% (SD = 8.65, N.= 294) on ethics in
teaching, with all means being significantly different, F(2, 584) = 625.79, all p <
.001. (For more on ethics training content, see Appendix D, Tables B1-B3.) Paired
samples T-tests indicated that the percentages of time spent on clinical work and
teaching did not correspond with respondents future plans: Although the rankings of
the three areas were the same, programs spent a greater percent of training time on
ethics in clinical work than the percent of time respondents expected to devote to
clinical work in their careers, t(292) = -4.45, p < .001, and a smaller percent of time
on ethics in teaching than respondents planned for their careers, t(286) = 8.27, p <
.001. These discrepancies may have contributed to some of the other differences
among clinical work, research, and teaching that I describe in this discussion.
Regarding ethics courses specifically, respondents who reported that they had
taken ethics courses claimed that a higher percentage of their training had been
related to clinical ethics, F(l, 263) = 7.45, p < .01, and a lower percentage had been
55


related to research ethics, F(l, 264) = 13.28, p < .001, than those who had not taken
ethics courses. These findings indicate that, compared to other forms of ethics
training, ethics courses may have an additional focus on clinical work and include
less research content, notwithstanding the very small amount of teaching content in
either form. Many of my findings point to a wealth of clinical ethics training and a
dearth of ethics training in teaching, with research often falling in the middle.
However, the fact that those who had taken ethics courses indicated that a lower
percentage of their ethics training had been in the ethics of research indicates that
ethics courses may be focusing on areas other than research ethics. Thus, research
might deserve a bit more attention, particularly in ethics courses.
Overall Consistency Ratings
Overall, respondents reported that the ethics of psychology was fairly
consistent with their own moral sense, giving it a mean of 4.19 out of 5 (SD = .62, N
= 299), without much variation. A significant majority, 62.2%, gave it a rating of 4,
and a lucky (or naive) 29.1% rated the consistency between their own moral sense
and the ethics of psychology a 5. A few, 8.0%, rated their level of consistency a 3,
and only 0.7%, two respondents, gave an answer less than 3. (For more on
consistency, see Appendix D, Table Dl.)
56


Notes on the Demographic Findings
Overlap Among Age, Year in Program, Courses,
Experience, and APA Code Knowledge
When analyzing the results, I had to keep in mind that several demographic
measures were obviously related because they increased with the time respondents
spent in their programs: how many years of graduate education they had, their age,
how likely they were to have taken courses in ethics or professional issues, how much
experience they had in the field, and how familiar they were with the APA ethics
code. For example, respondents age correlated with the number of years of graduate
study they had, r(297) = .34, p < .001. Additionally, those who had gone through
more years of graduate study were more likely to have taken an ethics course, F(l,
271) = 10.82, p <.01. Given that age and number of years in the program
corresponded, and so did number of years in the program and the likelihood of having
taken an ethics course, it made sense that older respondents were also more likely to
have taken an ethics course, F(l, 266) = 6.44, p <.05.
In the same vein, a number of these factors corresponded with higher amounts
of field experience, probably because those with more field experience had simply
been in their programs for longer than those with less field experience. I found
significant correlations between the number of years of graduate study that
respondents reported and their degree of field experience in all areas. Specifically, the
longer they had been in the program, the more hours of experience they had in
57


clinical work, r(289) = .63, p < .001; the more studies on which they had assisted,
r(296) = .17,/> < .01; the more studies they had worked on as the primary researcher,
r(301) = .37, p < .001; the more courses for which they had served as teaching
assistant, r(298) = .25, p < .001; and the more courses they had taught, r(297) = .26, p
< .001. Thus, I was not surprised to find that older students, who on average had been
in their programs longer than younger students, had taught more courses as primary
instructors, r(292) = .22, p < .001, or that those who had clinical experience, being
further along in the program than those who did not, were also more likely to have
taken ethics courses, )f(l, N = 272) = 18.33,/? < .001.
Finally, these same factors were often related to how well respondents
reported knowing the APA ethics code; such knowledge presumably comes with
experience dealing with ethics. For example, respondents who reported having taken
an ethics course also reported greater knowledge of the APA ethics code, F(l, 271) =
5.41, p < .05. Similarly, I found significant correlations between how familiar
respondents were with the ethics code and how many years of graduate study they
had, r(303) = .27, p < .001, how much clinical experience they had, r(289) = .20, p <
.01, and how often they reported discussing ethics with their teaching supervisors,
r(204) = .15, /? < .05.
The essential lesson of this confluence of factors is that, in many cases, when
one of these factors correlates with some measure of ethicality, what may actually
be affecting that measure may be one of the other factors that naturally increase with
58


the time students spend in a clinical psychology program. When I discuss these
subjects elsewhere in this discussion, I attempt to account for these factors.
Nonetheless, throughout the discussion readers should remember the close
relationships among various factors that all tend to increase as, for example,
respondents spend more time in their programs or learn more about ethics from their
teachers and supervisors.
How Respondents Career Plans Might Affect
Their Ethics Training
Students plans for their future careers may influence what and how they learn
about clinical work, research, and teaching. For example, respondents who planned to
do more clinical work in their careers were more likely to have had clinical
experience, F(l, 297) = 4.33, p < .05; respondents who planned to do more research
reported having assisted on more research studies, r(296) = .25, p < .001; and
respondents who planned to do more teaching reported having taught more courses,
both as assistants, r(290) = .12, p < .05, and as instructors, r(289) = .23,/? < .001.
Students who perform research might be bitten by the research bug and decide to
make it a larger part of their careers than they otherwise would have. On the other
hand, students who plan to spend a lot of their time performing research in the future
could make an extra effort to become involved in research projects.
By the same token, what students want to do in the future might affect what
they learn about ethics in those areas. I found significant correlations in two of the
59


three areas, clinical work and research: The more clinical work respondents wanted
to do in their careers, they greater the percent of their ethics training they reported to
have focused on clinical work, r(293) = .18, p < .01, and the more research they
wanted to do, the more of their ethics training they said had focused on ethics in
research, r(293) = .18, p < .01. Again, this finding could be interpreted in several
ways. Students whose ethics training focuses heavily on one area over another could
find themselves more interested in that activity than they were before. Alternatively
(or additionally), they might seek out certain ethics training experiences, such as
workshops or classes into which ethics is integrated, that focus on the areas they
already know they find interesting. Further, students with particular interests could
misperceive or misremember the time they had spent on those interests relative to
others, which might call into question the percents of time respondents said they had
spent learning about ethics in each areas. However, the differences among the
amounts of time that they reported their ethics training had spent on clinical work,
research, and teaching were so great that, although respondents may misremember to
some degree, the order of the three in terms of time spent is probably a true depiction
of respondents ethics training.
This study focused on ethics training and, in the section on respondents
attitudes toward ethics and their ethics training, I often discuss disparities among
clinical work, research, and teaching. I have attempted to tease out whether
60


respondents future plans have affected their attitudes, because respondents own
plans can influence what experiences they decide to have and color their perspectives.
Attitudes
I asked three types of attitude questions. The first type asked respondents how
important they believed ethics to be in general and in the three professional activities
of clinical work, research, and teaching. The second asked how satisfied respondents
were with their ethics training in general, and in clinical work, research, and teaching.
I defined satisfied as the extent to which you believe your graduate training has
positioned you to effectively deal with ethical situations. The last type of attitude
question asked respondents how concerned they were about dealing with future
ethical dilemmas in general, and in clinical work, research, and teaching. I defined
concerned as the extent to which you are bothered or worried about dealing with
ethical situations or problems that will arise in your career. In this section on
attitudes, I describe the groups overall attitudes and then illustrate the relationships
among respondents attitudes and between their attitudes and other measures.
Importance
Overall Importance Ratings
Respondents felt ethics to be very important overall, giving it a mean of 4.84
out of 5 (SD = .39, N = 299). They also rated ethics as important or very important in
each of the specific areas of clinical work, research, and teaching. In Hypothesis 1 I
predicted that I would find differences among how important respondents perceived
61


ethics to be in each of the three areas. This hypothesis was confirmed: I found
significant differences among all importance ratings in all three areas, F(2, 596) =
70.25, all p < .001. Respondents reported ethics to be most important in clinical work
(N = 4.93, SD = .28, N = 301), less important in research (N = 4.77, SD = .48, N =
301), and least important in teaching (N = 4.56, SD = .67, N = 301). (For more on
importance, see Appendix D, Tables B4-B7.)
Although all the importance ratings were high, the finding that respondents
considered ethics to be more important in some professional activities than others
might be cause for concern. I would argue that many ethical lapses are no less
harmful in teaching or research situations than in clinical ones, because all three
involve a power differential between the psychologist and the client, research
participant, or student. For example, a sexual relationship between a student and the
professor who grades his exams or writes her recommendations is not rendered any
less harmful by the fact that a similar relationship between a client and therapist is
clearly wrong. On the other hand, some ethical lapses could be qualitatively different
among settings. A therapy client could be very much harmed by relatively mild
unethical behavior by the therapist if he becomes uncomfortable and decides never to
see another therapist to get help for his problem. A student or research participant
may be only slightly harmed by some minor ethical transgressionsstudents will
probably not cease taking classes because of one frustrating experiencebut the
fallout could affect a large group of students or participants who feel that a professor
62


is playing favorites or that researchers have deceived them. Thus, one could argue
that ethical awareness and reasoning is equally important in all areas of professional
functioning. Despite the different ratings, however, I am encouraged that respondents
believed ethics to be important in all areas.
Correlations Among Importance Ratings
Although the group as a whole rated ethics as quite important, some
respondents gave higher ratings than others, and those who rated ethics as more
important in one area also rated it more important in all other areas. I found
significant correlations between how important respondents reported ethics to be in
clinical work and in research, r(300) = .49, p < .001, in clinical work and in teaching,
r(300) = .31, p < .001, and in research and in teaching, r(300) = .59, p < .001. These
results may tell us something about the respondents and thus about psychology
students: If they believe that ethics is important, either because that is how they enter
their programs or because they pick it up there, they may believe that ethics is
important no matter the situation.
Importance Ratings and Knowledge of the APA Ethics Code
I wanted to ascertain whether there might be a relationship between how
important respondents believed ethics to be and other responses that would indicate
that they had both ethical knowledge and the willingness to use it. First I looked at the
question about respondents degree of familiarity with the APA ethics code. I
performed correlations between how important respondents believed ethics to be in
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general, clinical work, research, and teaching, and how familiar they reported
themselves to be with the 2002 APA ethics code, and I found significant correlations
for three of the four importance questions. Specifically, the higher respondents
reported their knowledge of the APA ethics code to be, the more important they rated
ethics to be in general, r(299) = .23, p < .001, research, r(301) = .16, p < .01, and
teaching, r(301) = .16, p < .01.
The relationship between how important respondents believed ethics to be and
how familiar they were with the APA ethics code does appear to be real, and not
actually due to some other factor that happens to increase as their knowledge of the
ethics code also increases. As I discussed in the demographic findings, several factors
appear to increase with the time respondents spend in their programs and as they
experience ethics training. These factors are respondents age, their number of years
of graduate education in clinical psychology, whether or not they have taken an ethics
course, their knowledge of the APA ethics code, and how much experience they have
in the fieldthey all generally increase as respondents go through their programs. I
found no correlation between how important respondents rated ethics to be and how
old they were, how many years they had spent in their programs, whether or not they
had taken ethics courses, or any measure of experience in research or teaching. I did
find that respondents who had clinical experience believed that ethics was more
important in general, F( 1, 296) = 4.19, p < .05, but not in clinical work, and how
64


important they believed ethics to be did not increase with the amount of time
respondents had spent performing clinical work.
Eliminating those other factors strengthens the probability that there is a true
relationship between students knowledge of ethics, as measured by how well they
know the ethics code, and how important they believe ethics to be. Additionally, the
fact that I found correlations between how well respondents knew the APA ethics
code and how important they believed ethics to be in all three areasclinical work,
research, and teachingfurther indicates that the relationship exists. Perhaps students
who believe that ethics is especially important are more likely to attend to and absorb
the information they are taught about professional ethics. On the other hand,
programs that emphasize ethics more, including such basics as the APA ethics code,
might thereby encourage students to see ethics as a more important part of their
professional lives than do programs that do not emphasize ethics as much.
Importance Ratings and Discussing Ethics Outside of Class
Students may then bring what they have learned academically into their
clinical, research, and teaching experiences. Their supervisors in the field become
students instructors in applying what they have learned about ethics in class. How
frequently trainees discuss ethics with their supervisors can depend on both
individuals; hopefully the student will bring up ethical issues and concerns, but the
supervisor certainly must do it. Such discussion in the field may then lead students to
value ethics and see it as important.
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The more frequently respondents reported having discussed ethics when
engaged in research, r(291) = .13, p < .05, and teaching, r(202) = .24, p < .001, the
more important they believed ethics to be in those activities. That is, respondents who
felt that ethics was more important in research reported discussing ethics more
frequently with their research supervisors than did those who believed ethics was less
important in that activity. Similarly, those who believed ethics to be more important
in teaching said that they discussed ethics more frequently with their supervisors
when they were themselves teaching. This pattern could be due to either the
respondents or the supervisors. Students who believe ethics to be particularly
important might then choose to bring up ethical issues with their supervisors. On the
other hand, if supervisors are especially conscientious about discussing ethics with
their supervisees, they might convince the students that ethics is a more important
matter than they might have otherwise believed. If it is even possible that the latter is
true, then supervisors should certainly consider bringing up ethics frequently in their
supervising, if they do not already, because they can influence how important trainees
believe ethics to be.
Ethics Training Content and Importance Ratings
How important students believe ethics to be in clinical work, research, and
teaching may also be related to how those subjects are treated in students ethics
training, academic and otherwise. I asked respondents what percent of their ethics
training had concerned clinical work, what percent had been about research, and what
66


percent had addressed teaching, and correlated those results with the questions about
how important respondents believed ethics to be in each of those areas of professional
activity. I found significant results for research, r{295) = .15, p < .01, and teaching,
r{293) = 17, p < .01, such that the more the ethics training had focused on research,
the more important respondents believed ethics in research to be, and the more the
ethics training had focused on teaching, the more important respondents believed
ethics in teaching to be. I did not find that respondents who wanted to do more
research or teaching in their careers believed ethics to be more important in research
or teaching, so the relationship between ethics training content and how important
respondents believed ethics to be was not affected by respondents career plans.
When students consider ethics to be important in one area of professional
activity, they might seek out ethics training experiences in that field. Students who
especially value research ethics, for example, might choose to attend workshops on
the subject or take research-related courses in which ethics is discussed. One might
also argue that if students value ethics in research over other areas of ethics, they
might focus most on the research portion of their ethics training, and perhaps then
misperceive or misremember the amount of their ethics training that had concerned
research. This is certainly a valid possibility; however, respondents reported quite
large disparities among their ethics training in how it had focused on clinical work,
research, and teaching. Thus, even though many of the figures were estimations and
may have been affected by factors such as how interested respondents were in each
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area, I would argue that the differences among the focus on the three areas are real,
and may be considerable.
Differences in how much programs focus on ethics in various areas of
professional activity may have measurable effects. For example, the more an ethics or
professional issues course focuses on ethics in research, the more students may take
away that convinces them of the importance of ethics in research. Two other findings
seem to support the idea that ethics training content influences students perceptions
of how important ethics is in the various areas. First, the more their ethics training
had focused on research, the more satisfied respondents were with their training in
research ethics, r(295) = .22, p < .001, and the more their ethics training had focused
on teaching, the more satisfied respondents were with their training in the ethics of
teaching, r(287) = .36, p < .001. Second, the more satisfied respondents were with
their training in the ethics of research, the more important they believed research
ethics to be, r(300) = .13, p < .05, and the more satisfied they were with ethics
training in teaching, the more important they believed ethics in teaching to be, r(292)
= .15, p < .05. Thus, ethics training that has a greater focus on research, for example,
may lead students to be more satisfied with their training in the ethics of research, and
that preparation could influence the students to consider ethics in research particularly
important.
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Importance Ratings and Acculturation
Belief in the importance of ethics in any given area may then affect how
students make their ethical decisions: I found correlations between how important
respondents believed ethics to be and how they responded to the acculturation
questions. In one set of questions, I asked respondents what the best course of action
would be in a dilemma: the ethics of psychology, their own moral sense, both the
ethics of psychology and their own moral sense, or neither. The more important
respondents believed ethics to be, the more strongly they agreed, that the ethics of
psychology was the best course of action in an ethical dilemma. This was true for
three of the four importance questions: Those who believed ethics to be more
important in general, r(297) = .21, p < .001, in clinical work, r(299) = .14, p < .05,
and in research, r(299) = 15, p < .05, chose the ethics of psychology as the best
course of action in an ethical dilemma.
I found similar correlations between how important respondents believed
ethics to be and how likely they were to select the ethics of psychology as what one
ought to follow in a dilemma in which professional ethics conflicts with ones own
moral sense. The correlations existed in all areas: The more important respondents
believed ethics to be in general, r(296) = .35, p < .001, in clinical work, r(298) = .25,
p < .001, in research, r(298) = .28, p < .001, and in teaching, r(298) = .24, p < .001,
the more likely they were to choose the ethics of psychology, even when it conflicted
with their own moral sense.
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This conflict series of questions asked not only what respondents ought to
do in an ethical dilemma, but further, how they would handle such an issue if there
was a significant conflict between what the ethics of psychology required and what
their own moral sense told them. Thus, responses to these questions may be more
revealing than responses to the best course of action questions: In a conflict
between their own moral sense and the ethics of psychology, if respondents chose, for
example, ones own moral sense, they were making that choice even given the fact
that by doing so they would be acting against the ethics of psychology.
In most areas of professional activity, students who believe ethics to be more
important may have higher contact and participation with the ethics of psychology
than students who believe ethics to be less important. Then, even in an ethical
dilemma in which professional ethics conflicts with their own morality, they may
choose the ethics of psychology over their own moral sense. Therefore, the more
psychology programs do to encourage their students to see ethics as important, and
important in all areas of professional activity, the more likely the psychologists who
graduate from those programs may be to act consistently with professional ethics in a
variety of real-life ethical situations.
Importance Ratings and Consistency between
Own and Professional Ethics
Conflicts between professional ethics and their own moral sense may be less
likely to happen for some students than others. In one question in the acculturation
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section, I asked respondents about the degree of consistency between their own moral
sense and the ethics of psychology. I found significant correlations between how
consistent respondents reported their own moral sense to be with the ethics of
psychology and how important they believed ethics to be. The more consistent
respondents reported their own moral sense to be with the ethics of psychology, the
more important they believed ethics to be in all areas: in general, r(296) = .16, p <
.01, in clinical work, r(298) = .14, p < .05, in research, r(298) = .23, p < .001, and in
teaching, r(298) = .17, p < .01.
The relationship between how important respondents believed ethics to be and
how close they reported their own moral sense to be to professional ethics indicates
that students who come to clinical psychology programs with a moral sense that is
much like what they begin to learn about ethics will place more value on what they
are learning. By the same token, students whose previous moral sensewhether
based on their views of friendship and caring outside the professional setting or on
previous professional experiences in other industriesis significantly different from
psychologys professional ethics may not value the new version of morality, and not
think that ethics in psychology is particularly important.
Importance Ratings and the Vignettes
Based on the findings about importance ratings and how respondents
answered the acculturation questions, it appears as though how important students
believe ethics to be may affect their ethical decision making. I might have thought
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that respondents who believed ethics to be more important would have responded
differently to the ethical scenarios in the hypothetical vignettes than respondents who
believed ethics to be less important, but that was not the case. I did not find any
correlation between how important respondents believed ethics to be and how much
they thought they should or would do, or the gap between the two, in response to
the ethical dilemmas in the hypothetical vignettes.
The fact that there was no difference in should ratings is not surprising,
given that, like Bernard and Jara (1986), I presented respondents with standards from
the APA ethics code that told them that the behaviors in the scenarios were ethical
transgressions. Thus, they had much of the knowledge about what they ought to do.
(They did not have all of the knowledge, though; see the section on the vignettes for
more). However, the results were not what 1 would have expected regarding how
important respondents believed ethics to be and what they thought they would do in
the scenarios. One possible reason for the fact that I found no relationship between
the two measures is that the more important students believe ethics to be, the higher
the bar they may set for themselves, but they may not follow through on what they
believe they ought to do. This may not have shown up in what respondents believed
they should do in the scenarios because I provided them with the ethical standards,
but I did find relationships between importance ratings and both how well
respondents knew the APA ethics code and what they believed they ought to do in the
acculturation questions, measures of knowledge and obligation but not follow-
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through. These findings support the notion that believing ethics to be important is
related to what students know and what they believe they ought to do in ethical
situations, even if they do not act on those beliefs.
However, the data point to other possibilities. In the section on importance
ratings and the acculturation questions, I only reported what respondents believed
they ought to do; I did not note what few relationships I had found between how
important respondents rated ethics to be and what they actually said they based their
decisions on in their ethical decision making. Although I found no effects of
importance rating on decision making in clinical work or teaching, I did find potential
effects of beliefs of importance on decision making in research. Respondents who
believed ethics to be more important in research were more likely to report making
their ethical decisions in research based on both the ethics of psychology and their
own moral sense than based on their own moral sense alone, F(3, 294) = 4.00, p <
.01, with ethics of psychology differing from own moral sense at p < .05 and
both differing from own moral sense at p < .01. Thus 1 can speculate that, had I
presented hypothetical ethical vignettes dealing with research, I may have found some
relationship between how important respondents believed ethics to be in those areas
and what they thought they would do in an ethical dilemma in research.
Ceiling Effect of Importance of Clinical Ethics?
The fact that I did not find any relationships between how important
respondents believed ethics to be in clinical work and teaching and how they
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responded to the questions about their current ethical decision making or the
hypothetical ethical scenarios may be due to a number of factors. Ethics in teaching
appears to be a complicated issue, and is discussed in depth elsewhere throughout the
Results and Discussion and in the Conclusion. Regarding clinical work, though, in
several of the above analyses I did not find relationships related to respondents
ratings of the importance of ethics in clinical work, even though I found them for
research and teaching. A likely explanation is that there was a ceiling effect for
analyses involving respondents ratings of the importance of ethics in clinical work.
Respondents reported a mean of 4.93 for how important they believed ethics to be in
clinical work, higher than either of the others and very close to the maximum value of
5. To achieve such a mean, a full 94.0% of respondents gave an answer of 5, and
5.3% answered 4, with only .7% (2 respondents) choosing 3 and none selecting a
lower rating. Perhaps respondents answers were so uniform that many analyses
involving this rating simply could not have achieved significance.
Importance of Ethicsthe Overall Student Experience
On the whole, respondents rated ethics as very important. However, they did
feel that ethics in clinical work was the most important, ethics in research less so, and
ethics in teaching least important. Those who rated ethics more important in one area
felt it to be more important in all others, which could be due to an overall positive
ethics training experience. Good ethics training, including discussions of ethics with
supervisors in the field, may help students feel more prepared to handle ethical issues
74


and also encourage them to see ethics as important. Such feelings may lead to greater
contact and participation with professional ethics, so that students are more likely to
choose to follow the ethics of psychology in real-life ethical situations. In the other
direction, students who believe ethics to be important may better attend to and absorb
information about ethics, and also initiate ethical discussions with supervisors.
Likely, both of these patterns occur and make the ethics training experience even
more positive.
There are caveats to such encouraging findings. First, it helps if students own
moral sense is fairly consistent with professional ethics to begin with, so that they
have an easier time valuing the ethics of psychology and thus seeing it as important.
Second, programs do not appear to be focusing as much on ethics in research and
teaching as on ethics in clinical work, which may decrease the degree to which
students see ethics as important in those areas of professional activity. Students may
then be less likely to make their ethical decisions in research and teaching based on
professional ethics. If programs can help students to see ethics as important in all
areas, they may aid future psychologists in choosing the ethics of psychology when
making ethical decisions in all situations.
Satisfaction
Overall Satisfaction Ratings
Overall, respondents were fairly satisfied with their ethics training, rating their
satisfaction in general a 3.89 out of 5 (SD = .83, N = 301). Unlike the ratings for how
75


important respondents believed ethics to be in each area, those for how satisfied they
were with their ethics training were not so consistently high. Partially confirming
Hypothesis 2,1 found that respondents were more satisfied with their training in the
ethics of clinical work and research than with their training in the ethics of teaching,
F(2, 580) = 114.57, both p < .001. Respondents rated their level of satisfaction with
their training in the ethics of clinical work a 4.07 (SD = .86, N = 300), their
satisfaction with their training in the ethics of research a 3.98 (SD = .89, N = 301),
and their satisfaction with their training in the ethics of teaching 3.24 (SD = 1.13, TV =
293). (For more on satisfaction, see Appendix D, Tables B8-B11.)
The fact that respondents were more satisfied with their training in the ethics
of clinical work and research than with their training in the ethics of teaching is
underscored by their having rated ethics least important in teaching: They are less
satisfied with their training in the ethics of teaching despite believing teaching ethics
to be least important. This difference in satisfaction levels could be due to the
disparity between how much training they reported having had in the ethics of
teaching and how much teaching they wanted to do in their future careers, since they
reported wanting to spend a greater percent of their careers teaching, 18.33% (SD =
16.00, N = 295), than the percent of their ethics training they said had focused on
ethics in teaching, 9.58% (SD = 8.65, N = 294), t(286) = 8.27, p < .001. Even though
they believed ethics in teaching to be less important than in the other areas, they still
76


believed it to be quite important, and perhaps felt that their ethics training had not
adequately addressed teaching.
Correlations Among Satisfaction Ratings
As with the importance questions, respondents who reported being more
satisfied with their ethics training in one area were also more satisfied in other areas,
indicating that they had better overall ethics training experiences. I found significant
correlations between respondents satisfaction with their ethics training in the areas of
clinical work and research, r(299) = .44, p < .001, clinical work and teaching, r(291)
= .44, p < .001, and research and teaching, r(293) = .46, p < .001. Although these
respondents are less satisfied with their training in the ethics of teaching than in the
other two areas, programs that teach ethics well on the whole may leave students
feeling reasonably prepared to deal with ethics in all situations. Perhaps such
programs are particularly conscientious about covering all subject areas, or it might
be that they are especially effective in how they teach general principles and decision-
making processes, so students are able to approach various situations with more
confidence.
Ethics Training and SatisfactionCourses
What factors might make students more satisfied with their ethics training, so
that they feel more prepared to face ethical dilemmas and situations? In Hypothesis 7
I predicted that respondents who had more ethics training would feel more satisfied
with that ethics training. Although I did not ask respondents to quantify their ethics
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training experiences (e.g. number of ethics-related workshops), I did ask whether or
not they had taken courses in ethics or professional issues. I found that those who had
taken ethics courses were more satisfied with their ethics training in most areas than
those who had not taken ethics courses. Specifically, respondents who had taken
ethics courses were more satisfied with their ethics training in general, F( 1, 270) =
15.87,/? < .001, in clinical work, F(l, 269) = 14.65,/? < .001, and in research, F(l,
269) = 4.22, /? < .05. By contrast, those who had learned about ethics in a professional
issues course were more satisfied with their training in the ethics of clinical work,
F(l, 258) = 4.14, p < .05, than those who had not taken a professional issues course,
but the courses did not increase satisfaction with ethics training in general or in the
other areas of professional activity.
Ethics courses provide students with more time directly focused on ethics,
which may be one reason that ethics courses increase satisfaction with ethics training
in more areas than do professional issues courses. In fact, this distinction may support
Hypothesis 7, in that those who had taken courses with greater ethics content were
more satisfied with their ethics training. One might ask, however, whether it is the
courses that are causing the increase in satisfaction or the satisfied students who are
seeking out the courses. Because ethics courses are often required now, the choice is
probably not up to the students, satisfied or not. Therefore, I would suggest that ethics
courses, and to a possibly lesser extent, courses in professional issues, may affect
students satisfaction with their ethics training.
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The effect of ethics courses may also be why respondents who were more
knowledgeable about the APA ethics code were more satisfied with their ethics
training in all areas: in general, r(301) = .34,p < .001, in clinical work, r(300) = .32,
p < .001, in research, r(301) = .21 ,p < .001, and in teaching, r(293) = .11, p < .01.
Ethics training experiences such as ethics courses may affect both students ethical
knowledgeevident in the relationship between having taken an ethics course and
familiarity with the APA ethics code, F(l, 271) = 5.41, p < .05and their satisfaction
with their ethics training. Most respondents to this survey, 79.9%, reported having
taken ethics courses, and that figure does not count those respondents who were early
in their programs and would take an ethics course in the future. Thus, a great majority
of students may be benefiting from formal ethics courses.
It is also possible that simply going through the program has its own effect on
how satisfied students are with their ethics training, and that they simply happen to be
more likely to have taken ethics courses as they move along. I did find significant
correlations between the number of years respondents had spent in their programs and
how satisfied they were with their ethics training in general, r(301) = .21, p < .001, in
clinical work, r(300) = .24, p < .001, and in teaching, r(293) = 14, p < .05.
Additionally, among those few who had taken neither an ethics course nor a
professional issues course, the more years of graduate study they had, the more
satisfied they were with their ethics training in general, r(31) = .44, p < .05, and in
clinical work, r(30) = .40, p < .05 Whatever encounters with ethics they might have
79


had, the more time they spent in the programs, the more prepared they felt to face
ethical issues.
Satisfaction and Outside Experience in Each Area
One of those sources of ethics training outside of formal courses may be
experiences outside of the classroom, such as discussing ethics with supervisors and
encountering ethical situations in the field. In Hypothesis 4 I predicted that the more
experience respondents had in each area, the more satisfied they would be with their
ethics training in that area. Thus, I looked at the relationship between how much
experience respondents had in clinical work, research, and teaching and how satisfied
they were with their ethics training.
The results partially supported Hypothesis 4.1 found that students who had
some clinical experience were more satisfied with their training in the ethics of
clinical work than those who had no clinical experience, F(l, 297) = 14.28, p < .001,
and that those who had some teaching experience were more satisfied with their
training in the ethics of teaching than those with no experience teaching, F( 1, 290) =
19.53, p < .001. I also found that the more courses for which respondents had served
as teaching assistants, the more satisfied they were with their training in the ethics of
teaching, r(290) = .20, p < .01.1 did not find a relationship between how many
studies respondents had worked on and how satisfied they were with their training in
the ethics of research; this may have been because almost everyone had some
research experience, and increased experience above that initial research did not
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expose respondents to additional dilemmas or for other reasons did not increase their
satisfaction with their training in the ethics of research.
The potential effects of field experience on respondents satisfaction with their
ethics training could arise from many aspects of field experience. One might be
discussing ethics with supervisors and other interns and assistants. In Hypothesis 6 I
speculated that the more frequently respondents reported discussing ethics with their
clinical, research, and teaching supervisors, the more satisfied they would be with
their ethics training in those areas, and I did find support for this hypothesis. The
more frequently respondents discussed ethics in their clinical experience, the more
satisfied they were with their training in the ethics of clinical work, r(257) = .34, p <
.001; the more they discussed ethics in their research, the more satisfied they were
with their training in research ethics, r(292) = .29, p < .001; and the more they
discussed ethics in their teaching, the more satisfied they were with their training in
the ethics of teaching, r(202) = .25, p < .001).
Encountering ethical situations might also be part of students ethics training,
and I did not ask respondents about their own experiences with ethical issues. In order
to tease out the degree to which students have actually faced ethical dilemmas and
situations in the field, future studies could ask respondents directly about their
encounters with ethical issues in clinical work, research, and teaching. Students may
not have seen many outright ethical dilemmas, but researchers can ask about specific
common ethical situations that respondents might not have remembered or thought
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about as ethical issues at the time. This line of questioning might not only help
researchers, training programs, and ethics instructors understand what aspects of field
experience increase students' knowledge of ethics and satisfaction with ethics
training, but also give them a better idea of what ethical issues students are actually
facing as clinicians, researchers, and teachers.
Many factors contribute to students' overall ethics training; one important
element is their experiences in the field, which may include both ethical discussion
with supervisors and actually encountering ethical situations. Still, the correlations
between how much respondents report discussing ethics and how satisfied they were
with their ethics training could indicate two cause-and-effect relationships. Ethical
discussion is indeed part of ethics training and so may affect student satisfaction, but
more satisfied students, reflecting a more positive and effective training experience,
may bring up ethics more frequently on their own than do those who are less satisfied.
Does Interest in Clinical Work, Research, or Teaching
Lead to Satisfaction with Ethics Training in that Area?
Although it appears that field experiences affect students satisfaction with
their ethics training, it is also possible that both resultswhether or not respondents
had experience in an area and how satisfied they were with their training in that
areawere influenced by how interested respondents were in the subject. For
example, those who are more interested in clinical work may be more likely to seek
out ethics training in that area, such as by attending outside workshops or even just
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taking more clinical-related courses into which ethics is integrated, so they are more
satisfied with their ethics training in clinical work. Additionally, those who are more
interested in clinical work might seek out clinical positions, so that it is an interest in
clinical work that affects both respondents answers to questions about their clinical
experience and their satisfaction with their ethics training in teaching.
To assess if respondents interest in a subject influenced both their experience
in that activity and their satisfaction with their ethics training in that area, I looked at
their interest, field experience, degree of ethics training, and satisfaction with the
ethics training in each area. I viewed respondents career plans as a proxy for how
interested they were in clinical work and teachingthe more clinical work or
teaching they wanted to do in their careers, the more interested they probably were in
clinical work or teaching. If respondents interest in clinical work or teaching was
what caused them to gain clinical or teaching experience, I ought to find relationships
between their career plans and their field experience. If interest in clinical work or
teaching also led respondents to gain more ethics training in that area and thus
become more satisfied with that ethics training, I ought to find relationships between
their plans to do more clinical work or teaching and the percent of ethics training they
had in that area, and also between the percent of ethics training they had in that area
and how satisfied they were with that ethics training.
Regarding clinical work, I found that respondents who wanted to spend more
of their careers as clinicians were more likely to have clinical experience, F(l, 297) =
83


4.33, p < .05, and reported more of their ethics training to have been in the area of
clinical work, r(293) = 18, p < .01. Thus, those who were more interested in
performing clinical work could have been more apt to look for both clinical
experience and training in clinical ethics. However, there was no correlation between
the percent of respondents training that had been in clinical ethics and how satisfied
they were with the portion of their training that had concerned clinical work.
Regarding teaching, I found that respondents who wanted to do more teaching in their
careers were more likely to have teaching experience, F( 1, 290) = 10.10, p < .01, than
those who wanted to do less teaching in their careers. Also, those who reported more
of their ethics training to have been in teaching were more satisfied with their ethics
training in teaching, r(287) = .36, p < .001. However, I did not find any correlation
between respondents career plans in regard to teaching and the degree to which their
ethics training had focused on teaching. These findings do not support the argument
that respondents interest in a subject, as measured by their future plans, affected both
their experience in the field and their satisfaction with their ethics training.
However, these analyses may not be telling the whole story. That I did not
find that the more teaching respondents wanted to do, the more their ethics training
had focused on teaching may not indicate that those who wanted to do more teaching
in their careers would not have wanted additional ethics training in teaching; perhaps
that was simply not an option for them. For example, students who want to perform
psychological research may be required by their institutions review board to
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complete some sort of required training in order to be allowed to work with animals
or humans; depending on the program, a similar training course for teaching may or
may not even exist.
Further, the fact that I found significant correlations between the percent of
training that respondents ethics training had spent in an area and their satisfaction
with ethics training in that same area for teaching but not for clinical work could be
due to diminishing returnsor a ceiling effectin the clinical area, since most of
respondents ethics training focused on clinical work. More ethics training in any area
may be better, but the degree to which clinical work was emphasized over the other
areas may even have been underscored in respondents' minds by the survey, which
compared the time their training had spent on ethics in clinical work to the time spent
on ethics in research and teaching. They might have felt that, relative to the other two
areas, they were pretty satisfied with their training in clinical ethics, and for some,
having had even more of their training in that area did not increase their satisfaction
with it.
In fact, I did find all three relationships in regard to research. First, the more
of their careers respondents planned to spend performing research, the more studies
they had worked on as research assistants, r(292) = .25, p < .001. Second, the more
research respondents wanted to do in their careers, the more their ethics training had
focused on research, r(293) = 18, p < .01. Third, the more respondents ethics
85


training had focused on research, the more satisfied they were with their training in
the ethics of research, r(295) = .22, p < .001.
Perhaps students interests in clinical work, research, or teaching really do
influence the experiences they seek out, including ethics training, and those
experiences affect how satisfied they are with that ethics training. However, ethics
training programs might focus so much on clinical work that they experience
diminishing returns in students feelings of preparation to deal with ethical issues in
clinical work; meanwhile, by increasing the time spent on other areas, they could still
improve such feelings regarding research and teaching. Teaching especially might
deserve more attention, because even those who are very interested in teaching may
not always have the resources to acquire more training in the ethics of teaching.
Students might feel better prepared if they had more opportunities to learn about the
ethics of teaching, and if programs spent more time addressing ethics in both research
and teaching.
Satisfaction and Concern about Dealing with Ethical Issues
Students satisfaction with their ethics training is valuable not only because it
is always a good thing for students to be happy with their programs, but also because
their satisfaction seems to predict other factors, such as how concerned they are about
handling ethical issues. Correlations indicated that the more satisfied respondents
were with their ethics training in general, the less concerned they reported being
about dealing with ethical issues in three of the four areas: in general, r(301) = -.15, p
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< .05, in clinical work, r(300) = -.22, p < .001, and in research, r(298) = -.13, p < .05.
When I looked at satisfaction in each of the three areas, I found similar results for
only the area of clinical work, such that those who were more satisfied with their
ethics training in the area of clinical work were less concerned about dealing with
future ethical issues in clinical work, r(300) = -.24, p < .001. At least in some areas,
the more satisfied respondents were with their ethics training, the less concerned they
were about dealing with ethical issues.
One might see these results in a negative light, preferring that students be
more concerned about dealing with ethical issues. Such a view may be valid if
students who are less concerned develop a false sense of security, believing they
know everything about ethics and not approaching ethical situations with an open and
humble mind. The construct of concern is described in more detail in the next section.
For now, 1 will say that the data support the idea that lower concern is generally
better, as many of my findings indicate that those who were less concerned believed
that they would do more in response to the situations in the hypothetical vignettes,
and were more likely to choose the ethics of psychology when answering the
acculturation questions. Therefore, encouraging student satisfaction with ethics
training and thus lower concern about handling future ethical issues appears to be a
worthy goal.
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