Term
| During your informed consent discussion, your 13-year-old client tells you that she "sexts" with some of the boys in her school. She does not want to show you what she sends or receives. She asks you if this is the sort of thing you have to report because she wants to keep it from her parents. What must you do? |
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Definition
| Although images could constitute child pornography, which is illegal for children or adults to share, your legal responsibility is to assess further before making a report. |
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Term
| Rachel comes to you after finding out she had been laid off from her job. Rachel reports that she doesn't understand why, except for the possibility that "the boss always had it in for me after I refused to go out with him." Rachel then states, "He needs to watch out, if he knows what's good for him." Upon assessing further, Rachel tells you she has "a way" to keep his car from running; "That'll show him." What is your response in this situation? |
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Definition
| You could legally break confidentiality under Evidence Code 1024 to warn the boss of the client's plan/intent to damage his car. |
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Term
| An LMFT who works primarily with children makes several child abuse reports each month. One month, the therapist receives a subpoena for the records of treatment because one child's mother believes that she was fired as a result of the social worker coming to her home. She is suing the therapist for damages due to lost wages. Which of the following is true regarding the subpoena? |
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Definition
| A child abuse report, per Evidence Code 1027, is a legal exception to privilege. The therapist would always assert privilege, but the judge may determine during the lawsuit that the files are excluded from privilege. If that happened, a therapist would receive a court order. |
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Term
| You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are: |
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Definition
| A therapist is not legally responsible to report a suicidal client, but is legally responsible to take reasonable steps to ensure the safety of a suicidal client, which can be managed in a number of ways. Evidence Code 1024 allows therapists to break confidentiality when a client, due to a mental disorder, is a danger to self or the property of another and breaking confidentiality would prevent the threatened harm. |
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Term
| You get a telephone call from a highly agitated woman who states that her live-in boyfriend has been battering her whenever he drinks, which is at least once a week. She says she is considering leaving but that it is difficult because she has severe cerebral palsy and uses a wheelchair. You: |
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Definition
| Given her severe cerebral palsy and wheelchair use and probable dependence on her boyfriend or others for some assistance, this is the best answer. The report must be made immediately by telephone and a follow-up written report must be made within 2 working days. Note that just being a wheelchair user does not necessarily mean that one is "dependent." |
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Term
| Your client Silvia comes to therapy upset because she overheard her neighbor stating that he plans to shoot the mayor tomorrow evening and owns a gun. She tells you she has tried to calm him down, but he just "keeps blaming the system for his unemployment." What is your legal obligation? |
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Definition
Maintain confidentiality.
YOUR only legal obligation here is to protect your client's confidentiality. |
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Term
| Kevin is 17 years old and tells you that he was upset when, as a small child his father would hit his mother. He tells you that the abuse stopped a few years ago. Kevin says that his father is 70 years old and is "running out of steam." Now when his father "gets out of line," he and his mother simply lock the father in his room until he settles down. He is glad his father has become more manageable. What would you do next? |
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Definition
Call Adult Protective Services and an agency designated to take a child abuse report immediately.
Call Adult Protective Services immediately because there is reasonable suspicion of an elder being isolated. Call an agency designated to take a child abuse report because Kevin is still a minor and he is reporting having witnessed spousal abuse that caused him distress |
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Term
| Who CANNOT initiate a 5150? |
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Definition
| A person who is under age of 18 years cannot initiate a 5150. |
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Term
| A therapist is treating a man who has been in ongoing custody battles with his ex-wife. If the client asks a therapist to provide an evaluation of his own parental "fitness" to the court: |
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Definition
The client should be told that the custody hearing may disclose his and his children's family history.
An exception to privilege is a "defendant-requested" evaluation in court. If the therapist agrees to act in this capacity, any records of individual or family treatment may not be privileged. |
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Term
| Paul, an 11-year-old child, is skinny, has torn pants and in session presents as withdrawn. In observing him you see no signs of marks or bruises and he exhibits no sexualized behavior. His mother tells you that she is "sick and tired" of dealing with "Paul's crap". The mother chose you as her son's therapist because "you're in the neighborhood", and she doesn't want to drive him. She says, "My hands are already full." What do you do? |
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Definition
Call Child Protective Services to report neglect.
Paul's circumstances appear to meet the definition of child neglect. Filing a report to Child Protective Services for neglect would be the best course of action. |
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Term
| For several sessions, you have been working with a client who insists that he "will not rest" until he makes his son's teacher pay for the false child abuse report that the teacher made. He feels that his family has been shamed and anyone who does an internet search him will think he is a child abuser. He tells you he would never "put hands on a woman, but I will think of something." The therapist's early intervention plan should include: |
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Definition
Direct questions about his revenge plans
The therapist would need to determine if the client has a specific and imminent plan to warrant breaking confidentiality. |
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Term
| While doing play therapy with Whitney, a 10-year-old, she plays "car ride" with the Barbie dolls in your office. During the car ride, the Ken doll touches Barbie's little sister's breasts. When you inquire if anyone has ever touched her in that way, she tells you her uncle has when he drives her to school. You proceed to file a child abuse report. In the next session, Whitney says that her uncle was very angry. Whitney says that she has heard her mother yell at him on the phone many times and gets off the phone crying. Whitney thinks that if her mother knew about the "panty thing she would really cry a lot." Your next step is to: |
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Definition
Call Child Protective Services again.
When Whitney discloses there is a "panty thing that would upset her mother more," then an additional report is required. |
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Term
| A former client, who is a disabled adult, calls to tell you that her mother periodically punishes her by withholding food from her. Since she is in a wheelchair and in this instance, cannot protect her own rights, the therapist should: |
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Definition
Report to Adult Protective Services.
Therapists are mandated reporters of physical abuse, abandonment, isolation, neglect, abduction, as well as financial abuse of elders and dependent adults. Since the client in this instance cannot protect herself from her mother withholding food, a report of neglect to APS would be required. |
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Term
| You are seeing a 45-year-old woman in treatment. She lives with her mother, age 71, who has Alzheimer's Disease and lives in a residential facility for ongoing medical care. She tells you in session that at one point, the nursing staff kept her mother in bed for three weeks. You would: |
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Definition
Report by telephone within 24 hours to law enforcement.
If physical abuse occurs in a long-term facility and does NOT result in serious bodily harm, a telephone report must be made to local law enforcement within 24 hours, and a written report within 24 hours to law enforcement, the facility's licensing agency, and the ombudsman. |
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Term
| Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria? |
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Definition
Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.
A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled |
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Term
| Greg, age 29, comes in to see you about relationship problems. He has been in a wheelchair for 10 years as a result of a diving accident. After you have been seeing him for several months, he reports that the female nurse that he needs to care for him has made unwanted sexual advances towards him. Legally you: |
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Definition
Would report the incident to Adult Protective Services immediately.
A dependent adult is legally defined as someone between the ages of 18 and 64 who is emotionally, financially, or physically unable to care for him/herself. Since Greg is in a wheelchair and has a nurse attending to him, he would be considered a dependent adult. Therefore this would be a mandated report to Adult Protective Services immediately by phone, followed by a written report within 2 working days. |
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Term
| An LMFT has been treating a client who has decided to sue his employer for emotional damage. The therapist does not believe that the client has been harmed by the employment situation and further believes that disclosing the therapy records would harm the client's reputation. Putting aside the ethical challenges that may arise from refusing a client's request, the legal circumstances are that: |
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Definition
A therapist may refuse to cooperate if the therapist believes that disclosing treatment information for the purposes of a court evaluation would not be in the client's best interests.
A therapist may refuse to cooperate with a "defendant-requested" evaluation. Doing so may compromise the therapy relationship, but it is within the therapist's legal rights. |
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Term
| Gladys, age 65, reports she has kicked her 67-year-old husband when it looked like he wasn't listening to her. He tells you that his hearing is poor and most of the time, he heard her the first time anyway. What would you do? |
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Definition
Report immediately to Adult Protective Services and make a written report within 2 working days.
There is a mandated responsibility here since you have knowledge or reasonable suspicion of elder abuse. You would report immediately by phone and follow-up with a written report within 2 working days. |
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Term
| Which of the following represents a Tarasoff situation? |
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Definition
A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night.
The threat was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. Although the laws of confidentiality require that we not report an HIV-positive client whose intentional behavior is to infect others through sex, injecting another person with a syringe without their permission constitutes an act of violence. |
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Term
| A family with a 16-year-old daughter and a 15-year-old son comes in to see you. The siblings are of equal height and build. The parents report that they have been referred to you by the school counselor because of the children's frequent squabbles. You discover they both have hit the other hard enough to give each other black eyes. You would: |
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Definition
Report the incidents to a children's protective agency.
This vignette describes sibling abuse which must be reported. The parents are not in control of the situation. |
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Term
| An 18-year-old woman named Claire, states in her first session that she's thrilled to be out of her home and to be away from "that monster of a father," whom she says sexually abused her since she was 15. She tells you she has a two younger siblings who still live at home. What is your legal obligation? |
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Definition
Maintain confidentiality.
Claire is 18 and considered an adult, thus, making a report would be breaching confidentiality. Therapists do not report historical abuse. Your legal obligation is to maintain Claire's confidentiality |
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Term
| During a session with a couple, you notice the man is in a wheelchair and has a bruise on his head. His spouse tearfully admits that she loses her temper and hits him with a wooden spoon. In clinically managing the legal issue of dependent adult abuse, how would you proceed? |
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Definition
Call up an agency designated to take a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a "no violence plan."
This answer contains the basic steps you must take when you know of or have reasonable suspicion of dependent adult abuse, and it shows good clinical management in processing any feelings your clients might have about their therapist filing a report. |
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Term
| Candice, a 15-year-old patient, tells you "that my mother hit me yesterday with a metal hanger six times." You look at Candice and do not see any marks. You would: |
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Definition
Call the police as soon as possible and file a written report within 36 hours.
Calling the police (an agency designated to take child abuse reports) as soon as possible and filing a written report within 36 hours fulfills your mandated reporting responsibility. |
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Term
| You must contact an agency designated to receive a child abuse report because in your third session with the Kane family, you find out that Dad often whips the oldest son, age 12, and once broke his son's arm during a beating. Dad, a military officer, insists his discipline is what his son needs. You decide to: |
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Definition
Make the report with the family in the room and detail to the entire family the process of what will likely happen as a result of your contacting an agency designated to receive a child abuse report.
This is the best choice of those given even though it doesn't address the possible risk of the son being further abused by Dad. You would decide to inform the family (or not) of the child abuse report based on your clinical assessment of how they would react to it. In general, if possible, it is best to be open and demystify the process. |
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Term
| Your client has been accused of a violent crime. He has asked you to testify on his behalf, to assert that he may not have been competent at the time of the event. Which of the following is accurate regarding the therapist's actions? |
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Definition
The therapist must tell the client that competency evaluation is an exception to privilege.
It is part of the standard of care to inform clients of the limits of confidentiality when the confidentiality of their records may be compromised. |
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Term
| Zach comes to his session angry and upset after witnessing a scene at his tennis club, where he observed Ludwig Babcock, a tennis trainer, slap a child several times. Zach says that his son told him Ludwig often hits students, but that this is Ludwig's way of preparing the students for competition. After you hear Zach's story, you would: |
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Definition
Report child abuse.
Mandated reporters must report knowledge or suspicion of the abuse of any child if they hear of it in their professional capacity. The description of an adult who has authority over children regularly hitting them would constitute at the very least a reasonable suspicion of child abuse and would therefore mandate a report to Children's Protective Services |
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Term
| Your client, Sharon, comes into a session with bruises on her arms and knees. Sharon uses a walker due to rheumatoid arthritis and tells you that she often falls down. She lives with her husband and son. Sharon tells you that they try to help her, but they are not always home. What is your legal responsibility in this case? |
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Definition
You must make a mandated report for dependent adult abuse.
A dependent adult who is enduring injuries would constitute a report of dependent adult abuse/neglect. |
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Term
| Mike, your 17-year-old client, has a history of fire-setting. He is in therapy as a result of a court order and his parents know he is in treatment. He tells you that he is angry with his ex-girlfriend and says that he plans to set fire to her house tonight. What should you do? |
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Definition
Call the police immediately and his ex-girlfriend's family.
In the vignette described, there is imminent peril and there is a reasonably identified victim(s). The Duty to Protect includes the mandate to notify the police first and a warning to the identified victim. |
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Term
| A "5150" or involuntary confinement may be invoked by |
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Definition
A peace officer, staff member of an evaluation facility, or other professional person designated by the county.
A peace officer, a staff member of an evaluation facility or other professionals designated by the county, may invoke a 5150. |
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Term
| Mrs. Hancock is a client with a diagnosis of early Major Neurocognitive Disorder. Three weeks ago, Mrs. Hancock reported that a grocery clerk hit her "upside the head". Two months ago, Mrs. Hancock told you that her son-in-law hit her "upside the head". Those two incidents were reported, investigated, and determined to be unfounded. Today Mrs. Hancock tells you that her next-door neighbor hit her "upside the head". How would you proceed? |
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Definition
Maintain confidentiality and proceed with therapy.
Maintaining confidentiality is the only reasonable answer choice. Please see preceding rationales. |
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Term
| How should physical abuse of a dependent adult be reported by a mental health professional? |
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Definition
By telephone as soon as possible, and in writing within two working days.
Mandated reporters must report dependent adult abuse "immediately or as soon as possible by TELEHPHONE, and shall prepare and send a WRITTEN report within two working days." |
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Term
| When a therapist is court-appointed to provide an evaluation of a person's competency, all of the following is true EXCEPT: |
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Definition
Providing expert testimony must be within the therapist's scope of practice.
When a therapist is court-appointed to provide an evaluation, this is an exception to privilege. The court-appointed factor means that it is mandated, and therefore the therapist's decisions about scope of practice (or anything else for that matter) is irrelevant. |
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Term
| Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women's make-up and shoes. Legally, what would be your first concern? |
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Definition
You would need to assess for child abuse.
Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse. |
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Term
| As a mental health professional, which of the following situations are you mandated to report? |
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Definition
Your client tells you the elementary school swim instructor is molesting her nine-year-old son.
You must report both known and suspected child abuse to a child protective agency. Since your client tells you that the elementary school swim instructor is molesting her 9-year-old son, you are mandated to report this abuse. |
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Term
| A 16-year-old, married female client comes in to see you. She tells you that she's been having "problems" with her husband. There are old bruises on her face and a new scratch on her cheek. How do you initially handle the domestic violence? |
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Definition
Report child abuse.
You must report child abuse as your client is still a minor and is being physically abused by her husband |
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Term
| During the week you get a call from a concerned mother. She tells you that her 15-year-old son, Aaron, who is in therapy with you, sometimes talks with a gang member on the phone. Today she accidentally picked up the phone and overheard the gang member saying that he is going to kill Aaron. Legally, how would you proceed? |
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Definition
Maintain Aaron's confidentiality.
Maintaining confidentiality is the only legally correct action of the answers provided here. |
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Term
| Your client Barbara has been unemployed for three months. In her last session she stated that she plans to kill her ex-boss tomorrow because he's the cause of all her unhappiness. You call the police to alert them to Barbara's plan, but they don't seem to take you seriously because there isn't a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would: |
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Definition
Call Barbara's ex-boss and warn him of her plan.
Warning the victim may be done in the interests of protecting the public and protecting the therapist from liability related to breaking the confidentiality of the potentially dangerous client. As of 2014, there is only a legal responsibility to contact law enforcement within 24 hours. After doing that, warning the potential victim is next. |
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Term
| Mollie, age 62, reports that she has been the victim of spousal abuse over the last year by her husband of 40 years, Roland, age 67. You have told her that you will assess for elder abuse. Legally, how should you proceed? |
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Definition
Maintain confidentiality and assess for possible elder abuse.
There are no reporting mandates here since Mollie is not an elder or dependent adult. Assessing further for elder abuse is something you certainly could do, because there is violence in the relationship and Roland is an elder. |
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Term
| Which of the following situations might NOT require your reporting a situation of child abuse? |
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Definition
You regularly see a 6-year-old girl panhandling alone. Your neighbor tells you her name is Felicia and that she lives in the alley.
You are not mandated to report this situation because you did not learn about it in your professional capacity. But this is, in fact, neglect and you MAY report it to an agency designated to receive child abuse reports just like any other citizen could. |
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Term
| A client comes to his session with his 72-year-old father, who uses a walker from a fall, which he reports was caused by a fight with his wife. The father tells you that his wife has been stealing his social security checks each month and gives him only $5.00 a week. At this point you should: |
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Definition
Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse.
Legally you are mandated to report the physical abuse and financial abuse. |
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Term
| Your 52-year-old client returns from visiting his brother in Florida. He explains that his brother, who cares for their 84-year-old father, doesn't take him to his doctor or physical therapy appointments and she occasionally forgets to fill his prescription medication. What is your legal obligation? |
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Definition
Maintain confidentiality.
Mental health professionals licensed in California are only mandated reporters of Elder and Dependent Adult abuse if the victim is a resident of the state of California. Maintaining confidentiality is your legal obligation. |
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Term
| Which of the following is NOT a type of dependent adult and elder abuse? |
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Definition
Self-harm behavior.
Self-harm behavior is not a type of dependent adult and elder abuse. Welfare and Institutions Code defines dependent adult and elder abuse as knowledge or reasonable suspicion of the following: Physical abuse, Abandonment, Isolation, Neglect, Financial abuse, and Abduction. |
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Term
| A therapist is shopping in a mall with his wife. He sees a mother slapping her child. What should he do? |
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Definition
Legally he is not required to report.
There is no legal mandate involved in this scenario, because he is not in his professional capacity when he witnesses the slapping. |
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Term
| Ajax, a 51-year-old former convict, comes to therapy because he tells you he has been depressed ever since he left prison. He just doesn't feel like he fits in anywhere and still feels terribly guilty for the murders he committed that have gone unpunished. He says he is tired of spending every day looking over his shoulder and would be better off dead. What is your legal responsibility in this case? |
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Definition
Consider breaking confidentiality to ensure his safety.
Evidence Code 1024 gives therapists the right to break confidentiality to ensure the safety of a client. This is the best answer of the choices. |
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Term
| Your client, George, tells you that his mother just got remarried. He tells you that he is worried that the new husband's children are going to go after his inheritance. He tells you that he has very little contact with the new family and wants to keep it that way. What is your legal obligation? |
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Definition
Maintain confidentiality as it pertains to your client and his mother.
You would maintain confidentiality, because you do not know his mother's age and you do not have "reasonable suspicion" of elder abuse. |
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Term
| A disabled client reports difficulty getting her medications because her son spends her SSI checks on gambling debts. What is your legal responsibility? |
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Definition
You are legally mandated to contact Adult Protective Services for dependent adult abuse.
This dependent adult client says she's on SSI (Supplemental Security Income), which indicates she has a severe disability, preventing her from gaining income through employment. It is mandated to report financial abuse to APS. |
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Term
| You find out that your 14-year-old client's mother is beating her for not making her bed in the mornings. You have determined you need to make a child abuse report. What is your legal responsibility as a mandated reporter? |
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Definition
To contact an agency designated to take a report and follow-up with a written report within 36 hours
Your responsibility is to contact a designated agency by phone and follow up with a written report within 36 hours |
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Term
| You receive a call in your office from a 67-year-old woman who says she's confined to a wheelchair. She tells you that her daughter is "sick of her" and takes off and leaves her alone. She can't get around by herself in her home. What would you do? |
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Definition
Call Adult Protective Services and inquire if a report is necessary.
There is no indication in this vignette that the 67-year-old woman is your client. However, you have been called in your "professional capacity" and need to attend to this individual's welfare. This could be an instance of elder neglect or abandonment. |
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Term
| What represents a Tarasoff situation? |
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Definition
| A threat that was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. |
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