Langue : ASPPB offre une version française de l’EPPP (le FEPPP) là où un organisme de réglementation l’exige légalement. ASPPB n’a pas encore publié les énoncés de compétence en français : nos questions et nos fiches sont donc en anglais jusqu’à ce qu’il le fasse.

6.C.1

Recognizing the limits of competence and referring well

Énoncé de compétence 6.C.1 d’ASPPB : Engage in ongoing evaluation and identification of one’s limits of professional competence and, when necessary, refer to a more appropriate resource (e.g., another professional, peer support, self-help groups, community elder, spiritual or religious leader)

Competence is bounded by education, training, supervised experience and study, and those boundaries shift with each client's problems, culture, language and setting. Psychologists are expected to keep checking where the limits fall and, when a need lies outside them, to refer: to another professional or to resources outside professional care, such as peer support, self-help groups, community elders or spiritual leaders. A good referral is matched to the need, made with consent and followed up.

Notions clés

Boundaries of competence: APA Standard 2.01(a): provide services only within the boundaries of competence based on education, training, supervised experience, consultation, study or professional experience. Under 2.01(b), where factors such as age, culture, language, religion or disability are essential, obtain the needed training or refer.
Emergencies: Standard 2.02 lets a psychologist provide services outside their competence when no one else is available, so that people are not denied care, and requires ending them once the emergency ends or appropriate services are available.
Personal limits: Standard 2.06 requires appropriate measures, such as consultation or assistance, when personal problems may interfere, and a decision about limiting, suspending or ending work. A systematic review found burnout a concern among applied psychologists, most often linked to workload and work setting (McCormack and colleagues, 2018).
Referral to other professionals: Principle B asks psychologists to consult with, refer to or cooperate with other professionals and institutions as needed to serve clients' best interests, for example a physician when symptoms may have a medical cause.
Resources outside professional care: Peer support, self-help groups, elders and spiritual leaders can offer what therapy cannot. Some have strong evidence: a Cochrane review found manualized Alcoholics Anonymous and Twelve-Step Facilitation more effective than other established treatments for increasing abstinence (Kelly and colleagues, 2020).

Exemple commenté

A psychologist treating a veteran for posttraumatic stress disorder learns that his back pain has been worsening for months, that he is taking a friend's leftover pain pills, and that he feels no one outside the military understands him. He asks the psychologist which pain medicine he should take.

Separate what is within competence from what is not: the trauma treatment is, but advising on medication and evaluating the pain are not (Standard 2.01(a)).
Refer to another professional: with his consent, arrange a prompt visit with his physician about the pain and the borrowed pills, and offer to coordinate care (Principle B).
Offer a resource outside professional care: information about a peer support group for veterans, as an addition to therapy if he wants it.
Follow up in later sessions on whether the referrals happened and how they are going, and adjust the treatment plan.

Know where your competence ends, refer to the right resource, professional or not, and follow through.

Vérifiez vos acquis

Under APA Standard 2.02, a psychologist provides services outside their usual competence in an emergency because no one else is available. When must those services end?

Pratiquer 6.C.1

Sources

American Psychological Association (2017), Ethical Principles of Psychologists and Code of Conduct, Principle B; Standards 2.01, 2.02 and 2.06
McCormack, MacIntyre, O'Shea, Herring and Campbell (2018), The prevalence and cause(s) of burnout among applied psychologists: A systematic review, Frontiers in Psychology 9, 1897 (PMID 30386275), Abstract, results and conclusions: burnout a concern; workload and work setting the most common contributors
Kelly, Humphreys and Ferri (2020), Alcoholics Anonymous and other 12-step programs for alcohol use disorder, Cochrane Database of Systematic Reviews CD012880 (PMID 32159228), Authors' conclusions: high-quality evidence that manualized AA/TSF is more effective than other established treatments for increasing abstinence