Professionals who use the CAARS 2 are guided by certain ethical and legal principles. Because ethical and legal principles can differ across jurisdictions, especially in a global context, the standards described in this section represent best practices, even if an examiner is not required to follow them according to a given professional association or laws governing licensing/certification. Ethical and legal guidelines for use of the CAARS 2 include obtaining informed consent, explaining limits to confidentiality and local laws governing privileged communication, obtaining a signed release of information before contacting a possible observer, providing feedback upon completion, and complying with copyright laws, along with guidelines pertaining specifically to the use and interpretation of psychological tests.

The process of obtaining informed consent begins by informing the rater about the general purpose of the assessment, including the reason they are being asked to complete the CAARS 2 and the intended use of the results. The rater must be informed of any limits to confidentiality and of the efforts the examiner will take to protect confidential information. The rater must also be instructed that they have the right to stop completing the rating scale at any time for any reason (consistent with the ethical standard of “freedom to withdraw”), but they must be informed of the consequences of this choice and any alternative options. When referring to informed consent, consent means that the rater must agree to complete the test without being forced or coerced into doing so.

Confidentiality is often addressed as part of the informed consent discussion and should include information about two main points: protecting information about the individual being rated and protecting details about the rater’s responses. The examiner should disclose what professionals or staff other than the examiner will have access to the personal information and test results, as well as how and with whom the information will be shared. The rater should be informed about how the information will be secured in order to protect their confidentiality (e.g., on a secured server, in a locked file cabinet, in a locked office). It is particularly critical to explain confidentiality in advance of obtaining ratings in certain circumstances, such as evaluating a young adult whose parents are paying for the evaluation. Furthermore, it is important to clarify how observer data will be shared with the identified client. For example, an observer might be more candid and open if they understand that their specific responses will not be shared but that the overall scores and patterns will be included in the report and feedback session. More often than not, an observer may not receive results from their ratings of an individual. These policies can be described in the email or cover letter that accompanies the rating scale.

It is important to obtain a signed release of information from the identified client before sending an observer rating scale or contacting a potential observer. Otherwise, the examiner may violate confidentiality by revealing that someone is your client. Users of the CAARS 2 may find it helpful to ask clients to list potential observers on a standard release form that can be signed to give permission for correspondence around completing the CAARS 2 and clarifying the responses received. This form might also provide a way to indicate who can and cannot receive results.

The particular setting in which the CAARS 2 is used will impact how results are disseminated. For instance, in clinical settings, mental health professionals are mandated to provide results and recommendations from testing. After obtaining evaluation data, including data from the CAARS 2, the identified client should be given appropriate feedback. In a feedback session, the examiner provides a general explanation of the pattern of CAARS 2 scores and, where indicated, how the results inform a diagnosis and/or treatment plan. It is also important to answer questions the client might have about the rating scale and their overall testing experience. A feedback session requires knowledge of the CAARS 2 scoring and interpretation and should be conducted by a qualified professional.

In addition to these person-centered responsibilities, there are certain test-centered responsibilities. Test users are responsible for protecting the confidentiality and security of test materials (including test items, scales, scoring algorithms, and information provided in test manuals) in accordance with professional standards and applicable laws. MHS test materials are protected by various intellectual property laws, including copyright and trademark laws. Disclosure of copyrighted materials is prohibited by law. The CAARS 2 is a copyrighted test; therefore, it must not be copied or transformed into any medium without explicit written permission from the publisher. The CAARS 2 is also a regulated test; in accordance with the ethical and professional standards of the American Psychological Association and the Standards for Educational and Psychological Testing (American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, 2014), the use and interpretation of CAARS 2 results are restricted to qualified professionals (see Users and User Qualifications in chapter 1, Introduction, for more information). Different global jurisdictions may have different qualification requirements. MHS reserves the right to restrict sales to those deemed qualified by our published guidelines (see https://mhs.com/who-can-order/ for MHS qualification guidelines).

Certain laws (e.g., the United States’ Health Insurance Portability and Accountability Act [HIPAA] and the Canadian Personal Information Protection and the Electronic Documents Act [PIPEDA]) require that individuals must have access to the personal information contained in their files. It is the user’s responsibility to ensure that local laws and regulations be followed for the appropriate storage and release of personal information, test materials, and results. Please visit https://mhs.com/test-disclosure-policy/ to access the MHS Test Disclosure Policy, which includes recommendations for best practices regarding client access to test results, and the release of test materials under legal and ethical obligations. Parts of the digital reports as well as part of this manual contain copyrighted/trade secret material, including test items (see Tables 3.2 to 3.4 in this chapter for information on these report sections). If it is necessary or required by law to provide a copy of the report to anyone other thanرthe examiner, sections containing the copyrighted material must be removed before distribution. Rather than sharing a completed CAARS 2 protocol or report, consider options like offering to send the test scores or raw data to another qualified professional (after obtaining the appropriate release of information).