Standard 6: Record Keeping and Fees
6.01 Documentation of Professional and Scientific Work and Maintenance of Records
Psychologists create, and to the extent the records are under their control, maintain, disseminate, store,
retain and dispose of records and data relating to their professional and scientific work in order to (1)
facilitate provision of services later by them or by other professionals, (2) allow for replication of research
design and analyses, (3) meet institutional requirements, (4) ensure accuracy of billing and payments, and
(5) ensure compliance with law. (See also Standard 4.01, Maintaining Confidentiality.)
6.02 Maintenance, Dissemination, and Disposal of Confidential Records of Professional and Scientific
Work
(a) Psychologists maintain confidentiality in creating, storing, accessing, transferring and disposing of
records under their control, whether these are written, automated or in any other medium. (See also
Standards 4.01, Maintaining Confidentiality, and 6.01, Documentation of Professional and Scientific Work
and Maintenance of Records.)
(b) If confidential information concerning recipients of psychological services is entered into databases or
systems of records available to persons whose access has not been consented to by the recipient,
psychologists use coding or other techniques to avoid the inclusion of personal identifiers.
(c) Psychologists make plans in advance to facilitate the appropriate transfer and to protect the
confidentiality of records and data in the event of psychologists'
withdrawal from positions or practice. (See
also Standards 3.12, Interruption of Psychological Services, and 10.09, Interruption of Therapy.)
6.03 Withholding Records for Nonpayment
Psychologists may not withhold records under their control that are requested and needed for a
client'
s/patient'
s emergency treatment solely because payment has not been received.
6.04 Fees and Financial Arrangements
(a) As early as is feasible in a professional or scientific relationship, psychologists and recipients of
psychological services reach an agreement specifying compensation and billing arrangements.
(b) Psychologists'
fee practices are consistent with law.
(c) Psychologists do not misrepresent their fees.
(d) If limitations to services can be anticipated because of limitations in financing, this is discussed with the
recipient of services as early as is feasible. (See also Standards 10.09, Interruption of Therapy, and 10.10,
Terminating Therapy.)
(e) If the recipient of services does not pay for services as agreed, and if psychologists intend to use
collection agencies or legal measures to collect the fees, psychologists first inform the person that such
measures will be taken and provide that person an opportunity to make prompt payment. (See also
Standards 4.05, Disclosures; 6.03, Withholding Records for Nonpayment; and 10.01, Informed Consent to
Therapy.)
6.05 Barter with Clients/Patients
Barter is the acceptance of goods, services, or other nonmonetary remuneration from clients/patients in
return for psychological services. Psychologists may barter only if (1) it is not clinically contraindicated,
and (2) the resulting arrangement is not exploitative. (See also Standards 3.05, Multiple Relationships, and
6.04, Fees and Financial Arrangements.)
6.06 Accuracy in Reports to Payors and Funding Sources
In their reports to payors for services or sources of research funding, psychologists take reasonable steps to
ensure the accurate reporting of the nature of the service provided or research conducted, the fees, charges
or payments, and where applicable, the identity of the provider, the findings and the diagnosis. (See also
Standards 4.01, Maintaining Confidentiality; 4.04, Minimizing Intrusions on Privacy; and 4.05,
Disclosures.)
6.07 Referrals and Fees
When psychologists pay, receive payment from or divide fees with another professional, other than in an
employer-employee relationship, the payment to each is based on the services provided (clinical,
consultative, administrative or other) and is not based on the referral itself. (See also Standard 3.09,
Cooperation with Other Professionals.)
COMMENTARY
Standard 6: Record Keeping and Fees
6.02 Maintenance, Dissemination, and Disposal of Confidential Records of
Professional and Scientific Work (b): Most tribes or bands (as defined in Canada)
believe that they or the individual “Own” the data and do not permit the use of even their
demographic data to anyone other than those whom they consent to use their data.
This is the direct result of what Tribes consider to be systematic abuse of their data (e.g.
the Havasupai DNA case.) Many tribes, such as the Navaho and Mohawk tribes, are very
clear that they have the right to collect raw data from the clinician or researcher and must
give permission for ANYONE else to use it. Psychologists working in Indian Country
must reconcile this example of Tribal sovereignty with the Ethics Code.
Story
(From a Traditional Healer who works at a mental health clinic.) Confidentiality needs to
be practiced at a spiritual level as well. Energy is carried in the words written on paper.
Those energies can be transferred to others and takes on life. That life that has already
been lived. I usually tell my clients to be holy for two days; to not touch the fire, kick
dirt, throw things; to not shake others’ hands or travel and to think positive as part of their
healing. I also tell them to not talk about their issues during that time. Then I leave it to
the Creator to do Its duties. Nowhere do I do extra paperwork or assessment. The only
paperwork is at intake; a very short psychosocial and noting of spiritual symptoms. Then
I do a general progress report afterwards.
Documenting a person’s personal information and issues is counteracting getting well.
When a story is stored on paper there is a prolonging of the illness. In traditional ways,
once a ceremony is done it is dissolved. Once a sand painting does its job it is destroyed.
Accountability should be seen in the final result of the patient’s well being, not by a
tedious paper trail. It is paperwork that turns off clients and providers.
Monetary fees are not expected; just offerings of tobacco, corn pollen, cedar, white corn,
and yellow corn are given to me. Then an offering of smoke and cedar is offered to the
fireplace for their assistance. If money can be given, I allow it. I was told there are not set
prices by my uncle, who ordained me with a ceremony.
6.04 Fees and Financial Arrangements: Particularly on reservations, there is often a
barter system in place that is generally acceptable. This often aligns with cultural values
and social norms. The barter system might trigger multiple relationships. Barter and
multiple relationships should be considered when they align with the cultural values of
the people being served.
Story
My father passed away in 1980 but, in his day, he was a well-respected healer in our
community. Everybody knew my dad. My older sister even wrote a paper in college
about him entitled "Manuahi One." Manuahi means give free or gratis. More than that,
manuahi represented the value of reciprocity, and more so, of giving back and sharing
with the community. My father was even more well known for his habit of manuahi.
His "patients" utterly loved him and I always assumed it was for his healing capabilities.
To this day I'm still not really sure why he was so well loved but I have always
remembered how he would seldom charge people who needed his help and they would
usually return sometime later and reciprocate however they could, mostly with whatever
they had to offer. As a result, he made a modest living but we always had enough. I also
think what endeared him to people so greatly was his way of being manuahi and of barter
for care.
Story
(Clinical Psychology Doctoral Student and Certified Medicine Person). No research has
been done on fees for healing ceremonies. People come to get help and provide their
offering, whatever they feel like giving to the practitioner. It is in our creation story that
First Man was given the sacred elements to perform a ceremony. The initial offering is
given to the person conducting the prayer and using his paraphernalia. It is up to her/him
to share his offering with his helpers. I have sat in my uncle’s ceremonies all night and in
the morning he gives me a yard of material. I hold that and feel honored.
