Term
| A therapist has moved to small town in which she is one of only a few therapists. She meets one of the therapists and they are discussing how to maintain ethical standards and avoid potentially harmful dual relationships. Which situation is less likely to be an inappropriate dual relationship? |
|
Definition
A small town where a therapist and a cashier (client) see each other at the local store.
The cashier-client would not present an inappropriate dual relationship. This would be an instance, especially in a small town where the number of stores may be limited, where the contact in the community may be unavoidable. |
|
|
Term
| Hank, a 27-year-old stockbroker is referred by his EAP for 6 sessions. In the 5th session Hank tells you that he has recently acknowledged to himself that he is gay and doesn't know how to tell his fiancee. He wants to bring her to the next session and have you tell her for him. The best course of action would be to: |
|
Definition
Decline his request to tell her for him.
Declining his request is the only ethical answer. |
|
|
Term
| All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT: |
|
Definition
Filing a child abuse report.
Child abuse reporting represents a MANDATED reporting responsibility for a therapist. No release is necessary. |
|
|
Term
| Cheryl and Bobby are in joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. It would be appropriate for Cheryl to: |
|
Definition
Engage Bobby in a therapeutic conversation.
The ethical standard is to speak with the colleague to try to rectify the issue first. |
|
|
Term
| How would an LMFT who is conducting a research study avoid compromising the rights of the participants? |
|
Definition
Make sure that the study falls within the therapist's scope of competence.
Any activity that an LMFT engages in while acting in a professional capacity must fall within his/her scope of competence. |
|
|
Term
| A client gives you a small basket of homemade muffins as a gesture of appreciation. You: |
|
Definition
Accept the gift and explore what it means for her to give you the muffins.
Appropriate gifts (inexpensive, non-romantic, etc.) may be accepted by therapists without impairing their judgment or exploiting the client and should be processed to be most ethical. |
|
|
Term
| When writing notes about your client's therapy, which of the following information would not be kept in a client's chart? |
|
Definition
Notes on any peer consultations regarding countertransference issues around the case.
Notes dealing with the therapist's personal issues should not be placed into a client's chart. |
|
|
Term
| Your have been working with a client for six months. The client sometimes forgets her checkbook and tells you that she will bring it at the next session. She has accumulated a debt of $500. What would be your least important consideration when attempting to collect an unpaid bill from the client? |
|
Definition
Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty.
A client's failure to pay does represent a legal "breach of duty" but that is not related to how you would proceed with collections. |
|
|
Term
| Your therapy client just found out that her identity has been stolen on the internet and she is worried that whoever stole her identity will also know that she was in therapy from the online bills and payment confirmations. What should you do to fulfill your scope of competence obligations? |
|
Definition
Maintain computer security, i.e. firewalls, passwords, etc.
The client is worried about a security breach. Even though you are not responsible, you are ethically obligated to make sure that your practice adheres to privacy measures in the age of digital information transfer. |
|
|
Term
| An intern tells his supervisor that he suspects a client is abusing a child. The supervisor asks the intern if the intern made a report, and the intern said that he wanted to discuss it in supervision first. What must the supervisor do now? |
|
Definition
Advise the intern to make a telephone report to Child Protective Services immediately.
The supervisor must tell the intern to make the report immediately. |
|
|
Term
| Audrey, age 32, comes into your office while her father Carl and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father Carl, and she asks, "Can I pay you when my 'ex' pays his overdue child support?" How would you manage the ethical issue of fees? |
|
Definition
If you see Audrey alone, consider working out a fee that she can manage without her father's help.
If you have a sliding scale, Audrey would appear to be a good candidate, given her financial and psychosocial circumstances. |
|
|
Term
| A 40-year-old woman comes for individual therapy to work on panic attacks that are affecting her job performance and attendance. She and her husband see their pastor for marriage counseling. She says that her pastor has encouraged her to do this, so that they can focus on the marital issues. How would you proceed in addressing the referral from the pastor? |
|
Definition
Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together.
Getting a release to speak with the pastor would be the most ethical way to proceed. The pastor may have relevant information impacting your treatment of the wife, and it would be important to establish a working relationship with your client's other counselor. |
|
|
Term
| You have been treatiing Millie for 3 years. Millie has never missed a session and always pays you on time. You have decided to raise your fees to be more competitive with other therapists in your area. Millie is a client you have had since you were newly licensed. You would handle this situation by: |
|
Definition
Giving Millie 1-month advance notice.
Ethics standards do not supply a specific time frame for fee notification, but a one month notice would not violate any protocols. Legal standards require advance notice of fee increases. |
|
|
Term
| Which of the following scenarios describes a therapist's legal duties regarding the use of telemedicine? |
|
Definition
Breaking confidentiality because an internet client is engaging in child abuse.
Breaking confidentiality when making a mandated child abuse report is a legally required obligation, not an ethical decision or responsibility. |
|
|
Term
| John has had many particularly difficult and emotional clients. John comes home after a day of sessions and begins to tell his partner about some of the cases. As John continues the conversation, his partner thinks he recognizes one of the clients because John mentions her name and occupation. This is unethical because: |
|
Definition
John has clearly disclosed patient confidences; specifically the identity of the client.
Mental health professionals do not disclose patient confidences to anyone except under special circumstances when they are mandated or permitted by law. John has clearly broken a patient's confidence. |
|
|
Term
| A therapist has decided to offer telehealth as part of her practice. Ethically, the therapist should: |
|
Definition
Specify any particular limits of confidentiality as they pertain to internet security and privacy.
There are no special mandated "limits of confidentiality" that pertain to telehealth, but privacy and confidentiality could be compromised in telehealth sessions and therapists would have the ethical obligation to clarify those risks. |
|
|
Term
| Your client of six months, Dale, who was referred to you by her wheelchair aerobics instructor, comes to session with her 16-year old daughter Natasha. Dale is worried about abrupt changes in Natasha, who has suddenly become argumentative and secretive. Natasha continues, "I'm sick and tired of helping her get to the bathroom. I want to be out with my friends." How would you manage the legal issue of records? |
|
Definition
Your records may be kept in a locked file cabinet or on a password protected computer file.
There is a legal obligation to keep records confidential, and keeping them in a locked file cabinet or under password protection on a computer is consistent with a professional standard of care. |
|
|
Term
| At your 12-step meeting, you mention that you are a therapist. Some other participants ask if being a therapist makes you a good sponsor. If you tell them that sponsorship is not within your scope of practice you have: |
|
Definition
Ethically fulfilled your responsibility to provide accurate information about your qualifications.
You are legally and ethically required to provide accurate information about the range of services you can provide, given your license. |
|
|
Term
| Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town's only community counseling clinic. In his second week at the clinic, Eli is given a list of new interns he will be supervising, and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do? |
|
Definition
Decline to supervise the intern.
Declining to supervise the intern is the best ethical choice given here. This is an avoidable dual relationship and the ethical standard is that supervisors do not take on current or former therapy clients. |
|
|
Term
| Maria and Juan have been seeing you for couples' counseling for six weeks. In the 7th session, Maria brings you a batch of fresh, hot, home-baked oatmeal raisin cookies. You would: |
|
Definition
Accept the cookies, and explore their meaning with Maria and Juan.
Accepting the cookies and exploring their meaning with Maria and Juan would be the best choice available. The cookies are a small gift which may have a cultural component. It is important, once the decision to accept the gift is made, that the personal meanings behind it are explored. |
|
|
Term
| You are about to start treatment with Mario. What information would be important in obtaining informed consent to conduct internet therapy |
|
Definition
Disclosure of fees; sufficient information for the client to make decisions about treatment.
Law and ethical standards require that there be information about fees for internet and in-person therapy. Informed consent also requires that patients be provided with enough information, in lay terms, to make an informed decision about services being provided. |
|
|
Term
| Laurel, age 28, a corporate fund-raiser, and Marty, age 30, an electrician, are referred to you by Marty's E.A.P. Three weeks ago Marty witnessed the death by electrocution of a co-worker while they were working on a high-power utility line. Since then, Marty says he can't concentrate, is having nightmares, can't sleep, and finds himself reliving the incident over and over again. Laurel says Marty's problems are due to his drinking, not his co-worker's death. How would you handle the ethical responsibilities pertaining to boundaries? |
|
Definition
Set the fee before the first session.
Setting the fee before the first session is both a legal and ethical responsibility. It is one of many things to do when setting boundaries. |
|
|
Term
| You are treating Harold for problems related to his marriage. You have met his wife Sarah once, but she is too busy to come in for couples counseling. After several months, Harold tells you that he has lost several thousand dollars gambling and has covered up the losses so Sarah will not find out. After some exploration, you discover that Harold is on the verge of bankruptcy and that Sarah is unaware of this. He offers to trade you his ticket to Vegas for one more session, as a way of showing that he is giving up gambling. Ethically, you would be required to: |
|
Definition
Maintain confidentiality and do not accept the ticket.
Ethically you are required to maintain Harold's confidentiality and ethically you are obligated to not accept barter for therapy fees. |
|
|
Term
| George has been referred to you by his doctor for anxiety-related issues. He tells you that while he really wants to be in therapy, he can't afford it right now and asks if it would be okay if, instead of your fee, George will give you credit in the amount of your fee at the grocery store he owns in the small rural community where you both live. Ethically this would be: |
|
Definition
Permissible under some circumstances.
Ethical standards say that therapists do not usually barter and are discouraged from doing this, but the standards make allowances for doing business in communities where bartering is standard practice. |
|
|
Term
| You are working as an associate therapist at a non-profit agency. As part of your treatment, you collaborated with a psychologist and conducted some assessment inventories to evaluate your client's progress. Your client asks you how she scored on her depression test after being in therapy for six months. Your ethical responsibility in this case would be to: |
|
Definition
Inform her of the results in language she can understand.
Ethics require that therapists explain all of therapy, including assessments, in terms a client can understand. |
|
|
Term
| You are conducting a research study on divorce. In the informed consent process, what information do you need to provide your clients? |
|
Definition
The client has the right to withdraw from the study at any time.
The client has the right to withdraw from the study at any time, and we are obligated to comply with the client's wishes |
|
|
Term
| A therapist who specializes in the treatment of phobias and anxiety determines that in-home treatment is appropriate for two of her clients. After providing informed consent, what is the therapist's ethical obligation to those two clients? |
|
Definition
Document the time at which their treatment converts to in-home sessions.
Documentation of treatment changes is ethically required. |
|
|
Term
| Don LaMond is the guest speaker at a conference about domestic violence. He is a licensed MFT but also has a PhD in economics. When the announcer introduces him to the audience, he refers to him as Doctor Don LaMond. Don should: |
|
Definition
Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards.
Therapists have a legal and ethical responsibility to correct false, misleading, or inaccurate information and representations of themselves, made by themselves or others concerning their qualifications, education, license, license status, services, products, etc. |
|
|
Term
| A therapist told a colleague how she had bartered with a client; exchanging therapy for having her office painted. How should the therapist who received this information respond? |
|
Definition
Tell the colleague that her actions violate ethical standards.
Therapists do not operate as "snitches" on other therapists. However, it is ethically appropriate for us to confront a therapist who is engaging in unethical practices. |
|
|
Term
| Angelina, a 20-year-old college student, comes to see you complaining that she's having difficulty breathing and concentrating and that she thinks it's "all in her head." Angelina says she was date raped three weeks ago, and says you are the only person who knows. She hasn't told her parents, and doesn't want them to know about it. Angelina says, "Please help me. I can't take this anymore." She tells you that her parents have told her that they will pay for her therapy. How would you clinically manage the ethical issue of Angelina's parents offer to pay for her therapy? |
|
Definition
Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement.
Ethics require that you respect client autonomy. She has told you how the therapy will be paid for, so bill her and let her decide how to manage her relationship with her parents. |
|
|
Term
| You have been seeing Jill and Dan, a couple in their mid-30s, for 2 months. Dan's insurance has been paying a portion of their therapy. Dan informs you that he has been laid off from his job and is looking for work. The two complain of their finances. Jill works from home, running her own catering business. The couple would like to continue seeing you and ask if Jill could trade some services for their therapy. How would you handle this request? |
|
Definition
Inform them that it would be unethical and help them find a way to pay for continued therapy.
It is unethical to enter into bartering dual relationships with clients. It is also important not to abandon clients. This answer provides many opportunities to help the clients, including adjusting your fee. |
|
|
Term
| Dr. Sveda has been treating Carliss for seven years, during which time the fee has been $50. Carliss finally earns his Ph.D. and gets a job for substantially more money than he had been making. Dr. Sveda tells Carliss he'd like to revisit the fee that Carliss has been paying. Carliss becomes quite upset and tells Dr. Sveda that it would be unethical for him to raise the fee. Dr. Sveda calls for consultation and is given the proper answer, which is that therapists are discouraged from increasing a client's fees: |
|
Definition
Without providing adequate notice.
Ethical standards require that clients be given notice of fee increases before they occur. |
|
|
Term
| Which of the following may serve to protect the supervisor if a supervisee engages in an avoidable dual relationship with a client? |
|
Definition
A copy of agency policies regarding dual relationships, signed by the supervisee.
The best way among the four answer choices for a supervisor to protect him/herself from the actions of a supervisee, is to have a signed document of agency policies that regulate the supervisee/supervisor relationship. |
|
|
Term
| Mrs. Bailey sees the photograph of your dogs in your office and brings you a basket of dog treats. How would you respond to her gift? |
|
Definition
Assess the motivation behind the gift.
Assessing the motivation and the value of a gift is very important in determining whether you should accept it or not. What needs to be determined is whether the act of giving the gift supports Mrs. Bailey's needs, as well as her therapeutic process. |
|
|
Term
| What is the expected length of time to keep client records after the client has been terminated? |
|
Definition
Records must be retained for a minimum of 7 years after the date that the client terminates treatment.
Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015). For minors who terminate treatment, records must be retained for a minimum of 7 years after the minor would have been 18 or at least until the minor client would have been 25. |
|
|
Term
| Linda has been a low-fee client for 2 years. Her insurance wouldn't pay for her therapy because you were a registered intern. Now that you are a licensed therapist, you'd like to raise your fee and she'd like to use her insurance to pay you. You can raise your fee as long as: |
|
Definition
The client has been informed about the new fee with reasonable notice of approximately 30 days.
It is ethical to raise fees as long as you disclose the basis for the increase and give reasonable notice. |
|
|
Term
| Karen has been a client of yours for almost six months. One day when you are in church you notice that Karen's name is in the church bulletin welcoming her as a new member of the congregation. You doubt that she knew you went to this church. You should: |
|
Definition
Review dual relationships with your client, and healthy client-therapist boundaries.
Of the answers provided, reviewing dual relationships with your client, and healthy client-therapist boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be too uncomfortable for your client, or create any therapeutic problems. Of the options provided, it is the most reasonable. |
|
|
Term
| Which of the following is NOT a purpose of providing informed consent to supervisees? |
|
Definition
To protect yourself from legal liability.
Reducing legal liability is not a purpose of providing informed consent. Informed consent is primarily an ethical obligation |
|
|
Term
| Mr. Meltzer saw you for ongoing therapy for eleven months, and still has an outstanding balance. You referred him to another therapist for clinical reasons, not related to his debt. He signed a release so that you can forward his record to his new therapist in another city. You proceed to: |
|
Definition
Send his records as requested.
Sending his records is the correct answer. Mental health professionals do not withhold patient records or information solely because the therapist has not been paid for therapy services. |
|
|
Term
| Your client returns from a vacation in France with an expensive bottle of champagne and gives it to you to thank you "for all the wonderful help you've given her." You: |
|
Definition
Refuse the champagne and explore the meaning behind the gift.
Refusing the gift but processing its meaning is the best ethical course of action. If this client were later to become unhappy with your service and file a complaint with the BBS, investigators would construe your acceptance of an expensive gift as a lack of appropriate boundaries. Exploring the meaning and the impact of your refusal would be appropriate and could be therapeutically beneficial as well. |
|
|
Term
| You are working in a group practice and learn that one of your colleagues tends to have "a drink" in his office between clients. How do you handle the situation? |
|
Definition
Discreetly confront your colleague about his drinking.
Ethics standards strongly encourage therapists to intervene when colleagues are risking client care |
|
|
Term
| Wallace wants to sign an authorization to release confidential information so that his therapist can testify in court regarding his anxiety problems. The therapist believes that her testimony is not in Wallace's best interest. What should this therapist do regarding this court proceeding? She should: |
|
Definition
Discuss her concerns, deny Wallace's request and decline to testify.
If a therapist believes that testimony would be contrary to a client's best interests, she should deny such requests, explain why and decline to testify. If the client and the client's attorney want to press the point, they can subpoena and try to compel the therapist's testimony. |
|
|
Term
| The parent of a child on your child's baseball team is a doctor and wants to send a client to you. On the sidelines, you and this parent often talk about the relationship between illness and how family dsyfunctions develop around those illnesses. The doctor is impressed by your insight and asks for your card. You would: |
|
Definition
Agree to see his referral.
Ethically you could agree to see this referral. An acquaintance who refers business to you would not constitute a dual relationship. |
|
|
Term
| In order to tell her clients about how she works with social media, a therapist says that she will only send texts to confirm a cancellation. This agreement between the client and the therapist represents: |
|
Definition
Informed consent.
This type of statement that refers to boundaries and therapist availability represents informed consent. |
|
|
