2- Ethics and professional practices Flashcards
You have developed and administered a reading enrichment program for gifted children. A friend of yours, who happens to be a newspaper reporter, asks you if his 7-year old daughter can enroll in the program. Would it be ethical for you to agree to enroll her?
Select one:
A. Yes, as long as the reporter doesn’t give you any publicity for the program in exchange.
B. Yes, as long as the friend pays the same amount for the program as everybody else and his daughter meets the requirements for enrollment in the program.
C. No, because, if you did, you’d be involved in a dual relationship.
D. No, because the reporter may feel pressured into giving your program free publicity.
Correct Answer is: C
Standard 3.05(a) of the Ethics Code applies here. It states in part that “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.” Here, the risk for such harm is present. For instance, your objectivity might be impaired because of your friendship with the reporter.
Additional Information: Multiple Relationships
A psychologist compliments several of his co-workers on their clothing. One of his female co-workers indicates that she is not comfortable with these type of comments and asks him to stop. He complies with her request. His behavior is: Select one: A. Unacceptable B. Unethical C. Sexual harrassment D. Acceptable
Correct Answer is: D
His behavior is acceptable. According to Standard 3.02 (Sexual Harassment): “Sexual harassment is sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with the psychologist’s activities or roles as a psychologist, and that either (1) is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or (2) is sufficiently severe or intense to be abusive to a reasonable person in the context. Sexual harassment can consist of a single intense or severe act or of multiple persistent or pervasive acts.” In this case the co-worker evidently found the psychologist’s comments offensive. The psychologist upon learning this stopped his behavior.
Additional Information: Discrimination and Harassment
You are treating a family consisting of a father, mother, and their 13-year-old son. The boy comes to therapy limping and his arm is in a splint due to a sprain. Based on the family’s history, you suspect that the boy was beaten by his father but all three family members deny this is the case. In this situation, you should
Select one:
A. remind the family that therapy is most effective when information is not hidden.
B. maintain the family’s confidentiality unless or until you have proof that the boy was beaten.
C. talk to each family member separately.
D. report child abuse to your state child protective agency.
Correct Answer is: D
Every state has child abuse reporting laws that require psychotherapists to report cases of physical or sexual abuse to the state’s child protective agency. Therapists do not need proof that abuse has occurred; the trigger for a mandatory report is a reasonable suspicion.
remind the family that therapy is most effective when information is not hidden.
talk to each family member separately.
These two options may or may not be good ideas, but neither has to do with the major issue at hand, which is your mandatory reporting requirement.
Additional Information: Mandated and Permitted Disclosures of Confidential Information
An article to be published in a psychology research journal is based on doctoral student’s dissertation. The work of the student’s thesis advisor, a well-known expert in the dissertation’s subject area, was cited extensively in the dissertation and the article. The advisor conducted a follow-up study and added the results of it to the results section of the article. He also modified he conclusion, adding an interpretation of the results of the follow-up study, and a few revisions to the student’s wording. In this case, the thesis advisor should be
Select one:
A. listed as the first author of the article.
B. listed as an author of the article.
C. should be credited in a footnote.
D. should be thanked by the student in text of the article.
Correct Answer is: B
According to standard 8.12 of APA’s Code of Conduct, “Except under exceptional circumstances, a student is listed as principal author on any multiple-authored article that is substantially based on the student’s doctoral dissertation.” Nothing in this question describes any exceptional circumstance. Thus, the student should be listed as the first author. However, the advisor substantially contributed to the article by conducting a follow-up study and including the results in the article. This contribution is sufficient to qualify him as one of the authors of the article.
Additional Information: Publication Credit
A psychologist is impressed by an innovative treatment technique presented at a psychological conference. Although it is still an experimental treatment, the psychologist wants to start using it in his practice immediately. An ethical psychologist would:
Select one:
A. initiate the experimental treatment only if there are no alternative options available.
B. not use an experimental treatment until its effectiveness has been well established unless there are no alternative options available.
C. obtain a client’s informed consent before initiating an experimental treatment.
D. obtain a client’s informed consent, discuss with the client the experimental nature of the treatment and the availability of alternative treatments.
Correct Answer is: D
Experimental treatments are not prohibited in the Ethics Code; however psychologists need to be cautious in determining how to use them. According to Ethical Standard 8.02(b), “Psychologists conducting intervention research involving the use of experimental treatments clarify to participants at the outset of the research (1) the experimental nature of the treatment; (2) the services that will or will not be available to the control group(s) if appropriate; (3) the means by which assignment to treatment and control groups will be made; (4) available treatment alternatives if an individual does not wish to participate in the research or wishes to withdraw once a study has begun; and (5) compensation for or monetary costs of participating including, if appropriate, whether reimbursement from the participant or a third-party payor will be sought.”
Additional Information: Informed Consent for Research
After almost two months, Dr. Roberts realizes the woman he’s been dating is the cousin of a client he has been seeing in therapy for six months. The best course of action initially for Dr. Robert’s would be to:
Select one:
A. discuss the matter with the client as soon as possible
B. immediately refer the client to another therapist
C. continue seeing both unless it is evident that the situation is creating a conflict
D. immediately stop seeing the woman
Correct Answer is: A
The Ethics Code does not directly address this particular situation however it warns against becoming involved in multiple relationships. Standard 3.05(b) of the Ethics Code states, “If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.” Consistent with the intent of the Code, the best option would probably be to discuss the matter with the client immediately.
While eventually it may be appropriate to refer the client to another therapist or end the relationship with the woman he is dating, neither would be Dr. Robert’s the best course of action initially. In other words, the correct choice does not mean that these other choices would not be the final outcome of this situation.
Additional Information: Multiple Relationships
In the course of conjoint couple’s therapy, one of the spouses requests an individual appointment with you. According to the American Psychological Association’s Ethical Principles and Code of Conduct,
Select one:
A. seeing the client in individual therapy would not be allowed because it would constitute a prohibited dual relationship.
B. seeing the client in individual therapy would not be allowed because it would cause a conflict of interest.
C. seeing the client individual therapy would be allowed as long as the client’s disclosures in that context are kept confidential from the other spouse.
D. seeing the client in individual therapy would be allowed as long as it were consistent with the therapeutic contract you have with the couple.
Correct Answer is: D
Treating a patient in individual therapy and conjoint couple’s therapy can raise potential problems such as conflict of interest, and many family therapists only do so in rare cases or not at all. However, this practice is not prohibited by APA’s Code of Ethics. Specifically, standard 10.02 states that “When psychologists agree to provide services to several persons who have a relationship…they take reasonable steps to clarify at the outset (1) which of the individuals are clients/patients and (2) the relationship the psychologist will have with each person. “ In other words, it would be permitted to see a client in both conjoint and individual therapy if both parties agree to this arrangement at the outset of therapy. The arrangement would also have to include an agreement on confidentiality of disclosures in individual therapy.
Additional Information: Couple and Family Therapy
A psychologist is seeing a client who is covered under her husband’s insurance policy that he obtained through his employment. As part of the application process for insurance, the husband signed a blanket release of information that permits release of all medical records to the insurer. As a follow-up to a claim the psychologist submitted, the insurer requests all therapy records from the psychologist. The psychologist’s best course of action would be to
Select one:
A. refuse to release any information without contacting the patient first.
B. attempt to determine what information is needed to resolve the claim, and only release that information.
C. release all of the information to the insurer, but take steps to ensure it is transmitted securely and identifying information related to third parties is redacted.
D. release the information without conditions.
Correct Answer is: B
Standard 4.04 of APA’s Ethical Principles and Code of Conduct applies to this question. It states “Psychologists include in written and oral reports”¦only information germane to the purpose for which the communication is made.” In other words, even though the client’s husband has signed a blanket release of information, the psychologist still must take steps to safeguard client privacy.
refuse to release any information without contacting the patient first.
Discussing the situation with the patient, as stated by this choice, might be appropriate, but the wording of the choice is too absolute–there is no need to “refuse” to disclose “any” information.
Additional Information: Maintaining Confidentiality
Which of the following infractions accounts for the largest percentage of malpractice costs? Select one: A. lack of competence B. breach of confidentiality C. sexual contact with clients D. improper billing practices
Correct Answer is: C
The infraction that accounts for the greatest proportion of malpractice claims depends on how the infractions are categorized. However, regardless of the way that malpractice claims are grouped, sex with clients is always the infraction that accounts for the greatest insurance costs, with reported figures ranging from 45 to 50%.
Additional Information: Sexual Intimacies
A 45-year-old Korean man, who speaks limited English, has an appointment for an assessment with a psychologist who doesn’t speak Korean. Since the client speaks limited English, one of his children accompanies him and volunteers to translate for the psychologist. In this situation, the psychologist should:
Select one:
A. not allow the child to translate for the father.
B. allow the child to translate for the psychologist if the father voluntarily consents to this arrangement.
C. allow the child to translate for the psychologist if the child is proficient in both English and Korean.
D. allow the child to translate for the psychologist if the child is an adult.
Correct Answer is: A
The psychologist would not utilize the child to translate given the multiple relationships with the father and consequent potential loss of objectivity. Several biases could influence the child’s translations for his/her father including the difficulty for the child to try to avoid “helping” his/her father during the assessment. [See: Ethical Standard 2.05: “Psychologists … who use the services of others, such as interpreters, take reasonable steps to (1) avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity; (2) authorize only those responsibilities that such persons can be expected to perform competently on the basis of their education, training, or experience, either independently or with the level of supervision being provided; and (3) see that such persons perform these services competently.” ]
Additional Information: Psychologists Acting as Supervisors or Employers
An experimental treatment that has been used successfully with animals only has recently been approved for research with human participants. Which of the following statements regarding the need to inform participants of the experimental status of the treatment is true?
Select one:
A. There is no need to inform participants that the treatment is experimental, since the treatment was shown to be safe in animal research.
B. There is no need to inform participants that the treatment is experimental, because they would not likely understand the connotations of the word “experimental.”
C. There is no need to inform participants that the treatment is experimental as long as the study was approved by an institutional review board.
D. Participants should be informed that the treatment is experimental.
Correct Answer is: D
Ethical Standard 8.02(b) states that “Psychologists conducting intervention research involving the use of experimental treatments clarify to participants at the outset of the research (1) the experimental nature of the treatment; (2) the services that will or will not be available to the control group(s) if appropriate; (3) the means by which assignment to treatment and control groups will be made; (4) available treatment alternatives if an individual does not wish to participate in the research or wishes to withdraw once a study has begun; and (5) compensation for or monetary costs of participating, including if appropriate, whether reimbursement from the participant or a third-party payor will be sought.”
Additional Information: Informed Consent for Research
According to the most recent version of APA’s Ethical Standards and Code of Conduct, bartering goods and services in exchange for psychotherapy
Select one:
A. is prohibited.
B. should be refrained from under ordinary circumstances.
C. is acceptable if it is not clinically contraindicated and not exploitative.
D. is acceptable if the practice is common in the area where the therapist is practicing.
Correct Answer is: C
According to standard 6.05 of APA’s Ethical Standards and Code of Conduct (2002), “Psychologists may barter only if (1) it is not clinically contraindicated, and (2) the resulting arrangement is not exploitative.” The previous version of the standards contained a statement to the effect that psychologists ordinarily refrain from bartering, but that statement was removed in the most recent version, perhaps in recognition of the fact that bartering is a common arrangement in some communities and may be the only option for cash poor clients. Nonetheless, psychologists should proceed cautiously before entering into a bartering arrangement. Issues to consider include whether a fair value for the bartered goods/services can be established, and clinical considerations such as whether the nature of the transference would interfere in arranging a non-exploitative bartering relationship.
Additional Information: Barter
Therapists who become sexually involved with their clients
Select one:
A. usually do so because they believe they are in love with the client as a result of the client’s unique and desirable characteristics.
B. usually do so as a result of a lack of experience and poor judgment.
C. usually do so to fulfill personal needs resulting from events in their own life.
D. do not show any characteristics that distinguish them from therapists who do not become sexually involved with their clients.
Correct Answer is: C
The experts generally agree that therapists who have sexual relationships with their clients are not only exhibiting poor judgment but are also usually suffering from some type of impairment, often related to boundary issues or unfulfilled needs. See J. D. Guy, The Personal Life of the Psychotherapist, New York, John Wiley & Sons, 1987.
Additional Information: Sexual Intimacies
Which of the following terms refers to the right to refuse to have information released in a legal proceeding? Select one: A. privileged communication B. confidentiality C. privacy D. juris secretas
Correct Answer is: A
Privileged communication is the legal term which refers to a patient’s right to refuse to have information, disclosed in psychotherapy, released in a legal proceeding.
Additional Information: Privilege Versus Confidentiality
You belong to a managed-care panel and a client with a 12-session limit was referred to you. Without calling to cancel, she does not show up for her fourth session. How would you bill for the missed session?
Select one:
A. bill the insurance company
B. bill the client according to office policies
C. bill the client for the co-payment and the insurance company for the no-show
D. you cannot bill either the client or insurance company
Correct Answer is: B
The best answer is that you should bill according to your office policies which, presumably, was explained and agreed to by the client at the beginning of treatment (Standard 6.04: Fees and Financial Arrangements). If charging the client for the missed session was not agreed upon in advance, this would be unethical. You cannot bill the insurance company, since you should only bill insurance for services that you actually provide (Standard 6.06: Accuracy in Reports to Payors and Funding Sources). While your financial agreement may or may not require the client to cover the co-payment for missed sessions, Current Procedural Terminology (CPT) codes do not provide a code for no-shows, and billing for services not rendered is unethical.
Additional Information: Fees for Services
In cases of litigation, which of the following is considered the key defense for a psychologist? Select one: A. licensure B. liability insurance C. sufficient record-keeping D. informed consent
Correct Answer is: C
A review of the risk management literature indicates good record-keeping is the best key defense in cases of malpractice. (See: Knapp, S. (1997) Professional liability and risk management in an era of managed care, in D. T. Marsh and R. O. Magee [eds.], Ethical and Legal Issues in Professional Practice with Families, New York, John Wiley and Sons.).
Additional Information: Malpractice
According to the Specialty Guidelines for Forensic Psychologists (APA, 1991), if a psychological evaluation is ordered by a court and the defendant to be evaluated informs the evaluating psychologist that he does not wish to cooperate, the psychologist should:
Select one:
A. conduct the evaluation
B. refuse to conduct the evaluation
C. refuse to conduct the evaluation unless the defendant consents
D. postpone the evaluation and notify the defendant’s attorney
Correct Answer is: D
Although it is not necessary to obtain informed consent for court-ordered evaluations, the subject of the evaluation should be informed of its purpose. Furthermore, if the subject does not want to be evaluated, the subject’s attorney should be contacted before taking further action. If the attorney also objects to the evaluation, the psychologist should then notify the court and respond as directed.
Situations that legally permit a waiver of the privilege:
Select one:
A. differ from state to state.
B. differ from state to state only in situations when clients are involuntarily hospitalized.
C. do not differ from state to state when clients are involuntarily hospitalized.
D. do not differ from state to state
Correct Answer is: A
Legally-defined exceptions to privilege varies from state to state. However, most, if not all, states, waive privilege when a psychologist is acting in a court-appointed capacity; a client initiates a malpractice or other lawsuit against a therapist; a client has introduced a mental condition as a defense in a civil suit; a client has sought the assistance of a therapist solely for the purpose of committing a crime; and a therapist determines that a client is in need of hospitalization for a mental or psychological disorder.
Additional Information: Privilege
A psychologist is working for a company that changes health care providers due to cost-effectiveness. The new provider has a policy that compromises the employee’s future limits to confidentiality. The psychologist should
Select one:
A. refuse to follow the new procedures and leave immediately.
B. outline her points of dissatisfaction and send it to the new provider.
C. make clear with each client the company’s new limits to confidentiality.
D. organize a strike and call CNN.
Correct Answer is: C
According to Standard 3.11 (Psychological Services Delivered To or Through Organizations), “Psychologists delivering services to or through organizations provide information beforehand to clients and when appropriate those directly affected by the services about (1) the nature and objectives of the services, (2) the intended recipients, (3) which of the individuals are clients, (4) the relationship the psychologist will have with each person and the organization, (5) the probable uses of services provided and information obtained, (6) who will have access to the information, and (7) limits of confidentiality. As soon as feasible, they provide information about the results and conclusions of such services to appropriate persons.”
refuse to follow the new procedures and leave immediately.
If you choose this answer and leave abruptly, you are abandoning your client.
outline her points of dissatisfaction and send it to the new provider.
You may also want to do this-outline your points of dissatisfaction-but this wouldn’t be your first or most important consideration.
Additional Information: Discussing the Limits of Confidentiality
You are working as a psychologist in a hospital with a patient suffering from head trauma. In your presence, the patient develops Delirium. In this situation, you should:
Select one:
A. bring more people into the room.
B. find a physician for a medication consultation.
C. stay with the person to provide support and help him remain calm.
D. recommend ECT treatment.
Correct Answer is: C
This is a difficult question because it requires you to know about clinical management of Delirium and then to choose between two choices that are not bad answers. General principles of addressing an episode of Delirium include providing environmental support, manipulating the patient’s environment in order to reduce confusion and disorientation, and giving medication if the patient is agitated, psychotic, or has insomnia.
stay with the person to provide support and help him remain calm.
find a physician for a medication consultation.
Both of these options are good answers to this question. However, “stay with the person to provide support and help him remain calm” is better for the following reasons: 1) Not all Delirium patients require medication; only if the patient is agitated, psychotic, or can’t sleep at night is medication necessary, and 2) “find a physician for a medication consultation” implies that you would leave the patient to go find a physician. You should not leave a patient with Delirium alone, and even if a nurse or somebody else were available to stay with the patient, you should avoid sudden changes in a Delirium patient’s environment.
bring more people into the room.
This choice, as phrased, is not a good idea – bringing strange people into the room could increase the patient’s sense of disorientation and confusion. Having a relative or other familiar person stay with the patient is a good idea, but this option is not specific about what people you would bring into the room.
recommend ECT treatment.
This choice, ECT, is actually used in rare cases for patients who do not respond to environmental manipulation or medication; however, you certainly would not recommend it right away. By the way, the primary treatment of Delirium – addressing the underlying medical or substance-related disorder that is causing the symptom – is not a choice here.
Additional Information: Etiology (Delirium)
From a legal standpoint, a charge of malpractice against a psychologist would be held valid if it were proven that the therapist:
Select one:
A. had a duty of care to the patient, held malevolent intentions toward the patient, and engaged in activity that resulted in harm to the patient.
B. had a duty of care to the patient and held malevolent intentions toward the patient; demonstration of actual harm is not necessary.
C. had a duty of care to the patient and engaged in activity that resulted in harm to the patient; malevolent intentions need not be present.
D. engages in activity that harms a patient; malevolent intentions and a duty of care are not necessary.
Correct Answer is: C
For a malpractice claim against a psychologist to be held valid, three elements must be proven: 1) the psychologist must have had a professional relationship with (and, therefore a duty of care to) the client; 2) the psychologist must have been negligent or failed to live up to that duty; and 3) harm to the patient must have resulted. In other words, the psychologist’s intentions are not an issue.
Additional Information: Malpractice
The mother of a 22-year-old client of yours calls to inform you that your client has died. The mother requests a copy of your client’s therapy records. You should:
Select one:
A. release the records to her
B. refuse to release the records
C. release the records only after obtaining a signed release from the mother
D. release the records only after obtaining a signed release from the executor or administrator of the client’s estate
Correct Answer is: D
Most state laws provide a deceased person’s executor or administrator the right to access confidential records of the client. The deceased person’s executor or administrator must be legally designated as the deceased’s representative, usually by a probate court. Without such a designation, records should not be released.
Which of the following would be least relevant in a malpractice suit brought against a psychologist?
Select one:
A. whether or not the psychologist committed a negligent act or omission.
B. whether or not actual, provable damage or harm to a patient resulted from the psychologist’s actions.
C. whether or not the psychologist’s actions deviated from generally accepted standards of care.
D. whether or not the psychologist intended to cause damage to the patient
Correct Answer is: D
Though the specific rules regarding medical malpractice (which apply to health care professionals including psychologists) vary from state to state, the general definition is agreed upon. Medical malpractice occurs when a negligent act or omission, deviating from generally accepted standards of practice, results in demonstrable damage or harm to a patient. Malpractice does not necessarily mean that the practitioner intended to cause damage or harm.
Additional Information: Malpractice
While attending a staff meeting at a mental health facility where you work, you learn that one of your colleagues, a psychologist, is behaving in an unethical manner toward one of her patients. Despite being advised to do so by several members of the staff, she states that she will not change her behavior. What should you do in this situation?
Select one:
A. Approach the colleague individually and urge her to change her behavior; if she refuses, report her to the appropriate ethics committee.
B. Approach the colleague individually and urge her to change her behavior; if she refuses, recommend to the director of the facility that she be fired.
C. Report the colleague to the appropriate ethics committee immediately, since she has already stated that she will not change her behavior.
D. Announce in the staff meeting that you want to “go on the record” as noting that the psychologist is behaving unethically.
Correct Answer is: A
The Ethics Code states that you should deal with ethical violations by another psychologist in an informal manner, by bringing it to the attention of the psychologist. A report to an ethics committee should be made when the attempt at informal resolution has failed or if the violation is not amenable to informal resolution. Thus, you should speak to the psychologist privately and report her to an ethics committee if she still refuses to change her behavior. You may have thought that, since the psychologist has already stated her refusal to behave ethically, you should go ahead and report her, without bothering to talk to her. This actually makes sense, but the Ethics Code requires that you attempt an informal attempt at resolution first. A staff meeting is a formal setting, and does not personally give you the opportunity to attempt an informal resolution.
Additional Information: Informal Resolution and Reporting of Ethical Violations
A psychologist is undertaking a research project in a high security prison on the effects of certain food additives on behavior. The prison population is surveyed, informed of the purposes of the study, and volunteers are sought. The volunteer participants are again explained the purpose of the study and are asked to give their written consent to be participants. Because of the nature of the study, its importance to the food industry and the governmental regulatory agency, and the need to keep as much control of the participants’ food intake as is feasible, the participants are informed that, once they begin the study, they are expected to remain in it at least until the first evaluation period, six weeks from the beginning of the research program. They are told that they shouldn’t agree to participate unless they are reasonably sure they can complete at least this initial phase. Those participants who then agree and give written consent are included in the study. According to APA’s Ethical Principles, such a study:
Select one:
A. should not be undertaken as the participants are not allowed to freely withdraw.
B. would be allowed only if the participants gave specific acknowledgment of their agreement to abide by the withdrawal arrangements.
C. is probably unethical because the prison research review committee did not also agree to the participation arrangements.
D. meets all research guidelines and can be undertaken.
Correct Answer is: A
The ethical standards require that research participants be allowed to withdraw from a study at any time. Hence the answer must be: “should not be undertaken as the participants are not allowed to freely withdraw”.
Additional Information: Informed Consent for Research
You are working in a clinic as a psychologist and your supervisor, who is working on his Ph.D. in psychology, wants to begin conducting family therapy. Since this is an area which you have expertise in, he asks you to be the consulting supervisor. In this situation:
Select one:
A. you should refer the supervisor to someone else
B. you could only provide the supervision if you first clearly define the roles
C. the ethics code does not apply
D. you could provide the supervision as long as his clients are informed and consent
Correct Answer is: A
The Ethics Code requires that, whenever feasible, psychologists avoid entering into multiple relationships. The best course of action would, therefore, be to refer the supervisor to another qualified professional.
Additional Information: Multiple Relationships
You are working with a couple in marital therapy and are conducting the initial interview. You realize that although the husband doesn’t remember you, the two of you once dated. You should
Select one:
A. speak to the husband alone, explain the situation and ask him if he feels comfortable with proceeding.
B. see the wife in individual therapy only.
C. refer the couple to another therapist.
D. let the couple know the situation and then proceed with therapy.
Correct Answer is: C
This question is fairly easy to answer once you remember you are not obliged to provide services for all your referrals. This is an initial interview and you have a situation that involves a multiple relationship. You need to refer this couple to one of your competent colleagues.
Additional Information: Multiple Relationships
If a psychologist begins treatment with a client knowing that there is a high probability that the records will be subpoenaed, the psychologist should:
Select one:
A. not maintain any records in order to protect the client’s best interests
B. maintain adequate records
C. maintain only information about the client which will not be damaging if disclosed
D. maintain records, but only include the minimal requirements in adherence with the law
Correct Answer is: B
According to APA’s Record Keeping Guidelines (1993, 48(9), 984-986) records should minimally include: identifying data, dates and types of service, fees, any release of information obtained, any assessment, plan for intervention, consultation, summary reports, and/or testing reports.
not maintain any records in order to protect the client’s best interests
It would, therefore, be unethical (and possibly illegal), not to maintain any records.
maintain only information about the client which will not be damaging if disclosed
Although records should be written with an awareness of the risk of the client or others gaining access to them, it would likely be incomplete and, therefore, unethical to include only information that will not be damaging.
maintain records, but only include the minimal requirements in adherence with the law
Patient records should meet the minimal requirements of federal, state, and local laws; however, this option indicates that the psychologist should only meet those minimum requirements. There may be jurisdictions in which the Ethics Code or guidelines have a higher standard than the law; in which case, the psychologist should adhere to the higher standard.
Additional Information: Records
You have been court ordered to complete an evaluation. As you start the evaluation, the client begins sharing information that she obviously would not want shared further. You should:
Select one:
A. Say nothing and remain objective
B. Refer her to a different psychologist
C. Advise her that the information she is giving you is not pertinent
D. Reexplain the limits of confidentiality before proceeding
Correct Answer is: D
Remember, that in this case the client is the court. And you are ethically bound to behave appropriately with all involved parties. You should have already explained the limits of confidentiality before beginning the evaluation; however, it is perfectly appropriate and most ethical to stop and re-clarify the limits of confidentiality.
Additional Information: Discussing the Limits of Confidentiality
A new therapeutic intervention for heroin addiction is tested in a 6-month study, comparing it to existing treatment programs and a control group. At the end of 3 months the researchers find a dramatic success rate for the experimental treatment with over 75% of the clients maintaining abstinence from heroin, compared to 30% for the other treatment groups and 10% for the control group. What should the researchers do?
Select one:
A. inform the other groups of the results and recommend that they begin the new treatment program.
B. inform the other groups of the results and give them the option of receiving the new treatment or continuing with their existing program.
C. not inform the other groups of the results
D. wait until the conclusion of the study and then offer the other groups the new treatment
Correct Answer is: D
Since this study was designed for a duration of 6 months, it should continue as planned before any conclusions regarding the effectiveness are made. Informing any of the groups about the relative effectiveness of any of the treatments prior to the conclusion of the study would likely contaminate the validity of the final results. Of course, the researchers have an obligation to inform the participants of the results and conclusions of the research, but this should not be provided until the conclusions have been made.
Additional Information: Debriefing
The mother of your 8-year-old patient calls to inform you of a meeting being held at the child’s school in 30 minutes to discuss the child’s recent behavioral problems. The child reportedly has had repeated bouts of yelling and hitting other students. The mother requests that you call the school psychologist to discuss your evaluation of the child’s behavior. You should:
Select one:
A. tell the mother that you’re sorry that you can’t release any information until she comes in to sign a release.
B. agree to provide the information and document the mother’s verbal consent to release it in your patient’s file.
C. call the school and provide them with the minimal amount of information that is appropriate.
D. agree to provide the information by phone but follow up with a written report to the school psychologist.
Correct Answer is: B
The Ethics Code states that consent to reveal confidential information must be obtained, however, it does not require the consent to be in writing. Documentation of the mother’s verbal consent in a progress note could be sufficient, particularly under an urgent situation such as this, in which it is not feasible to obtain a written consent.
As suggested in this choice, you should also limit the disclosure to only relevant, though not necessarily “minimal” information.
Additional Information: Informed Consent
A psychologist can kill an animal in research:
Select one:
A. as long as the animal is treated humanely
B. as long as an anesthetic is used, with an effort to minimize pain
C. when it is appropriate and if it is done rapidly, with an effort to minimize pain
D. under no circumstances
Correct Answer is: C
According to Ethical Standard 8.09(g) (Humane Care and Use of Animals in Research), “When it is appropriate that an animal’s life be terminated, psychologists proceed rapidly, with an effort to minimize pain and in accordance with accepted procedures.” In all research with animals, the animals must be treated humanely. If surgical procedures are performed, they are done under appropriate anesthesia with techniques to avoid infection and minimize pain.
Additional Information: Care and Use of Animals in Research
The purpose of APA’s Standards for Educational and Psychological Testing is to
Select one:
A. provide guidelines for establishing the reliability and validity of tests.
B. provide criteria for the evaluation of tests.
C. provide guidelines for the use of tests in various settings such as psychotherapy, the workplace, and the courtroom.
D. offer psychologists instructions and advice regarding the proper way to administer tests.
Correct Answer is: B
The Standards for Educational and Psychological Testing is a set of guidelines published jointly by the American Psychological Association, the American Educational Research Association, and the National Council on Measurement in Education. The most recent version of the Standards, published in 1999, provides 15 sets of guidelines divided into three parts: Test Construction, Evaluation, and Documentation; Fairness in Testing; and Testing Applications. Their purpose, according to the introduction, is to “provide criteria for the evaluation of tests, testing practices, and the effects of test use.”
Additional Information: APA’s Standards for Educational and Psychological Testing
A psychologist working for an Employee Assistance Program (EAP) has seen a client who was referred by her supervisor. The supervisor asks the psychologist if the employee has kept the appointment. The psychologist should
Select one:
A. provide the supervisor only with this information but nothing else.
B. refuse to give the supervisor this information.
C. provide this information as well as any other information about the client the supervisor is interested in.
D. consult with the manager of the company.
Correct Answer is: A
When a mental health professional works as part of an EAP, the potential for confidentiality dilemmas is present. Employers, after all, often feel they have the right to know if employees are benefitting from EAPs, but mental health professionals must understand the importance of confidentiality - including, in most circumstances, the confidentiality of whether a person is or is not a client or patient. In the context of EAPs, however, it is considered acceptable to give the relevant information to relevant people; specifically, it’s OK to tell the supervisor (or the referring person in the organization) if the employee keeps a scheduled appointment, if treatment is needed, and if the employee has agreed to and accepted treatment. All other information should be kept confidential (barring, of course, the employee’s consent to release it).
Although you have extensive experience in administering the WAIS-R, you have not yet administered the WAIS-III. If you would like to administer the WAIS-III you should:
Select one:
A. obtain additional training
B. obtain supervision by a psychologist experienced in the use of the WAIS-III
C. seek consultation to determine the most appropriate action to take
D. be able to administer the WAIS-III since it is very similar to the WAIS-R
Correct Answer is: A
Standard 2.01(c) (Boundaries of competence), requires psychologists who provide services involving populations, areas, techniques, or technologies that are new to them undertake relevant education, training, supervised experience, consultation, or study. When administering a test, or a new version of a test which you are not familiar with, the best course of action would be to obtain the necessary training.
An attorney contacts a psychologist requesting that his client be given a psychological evaluation prior to appearing in court. Following the evaluation the client asks that his records not be released to the court, although his attorney believes that releasing the records would be in his client’s best interest. The psychologist should:
Select one:
A. release the records since there is no privilege regarding forensic evaluations
B. release the records since the attorney requested the evaluation
C. not release the records
D. seek consultation
Correct Answer is: C
Since this does not appear to be a court-ordered evaluation, the examinee remains the holder of the privilege; thus, his records should not be released to the court without his consent.
Additional Information: Maintaining Confidentiality
A psychologist sees clients at a facility where fees are capitated. What does this mean?
Select one:
A. providers are paid a fee each time a service is performed
B. clients are billed according to their ability to pay
C. clients are required to meet a deductible before their insurance will pay
D. providers receive a fixed dollar amount over a specific period of time to cover the service needs of a fixed number of clients
Correct Answer is: D
The term “capitation” refers to a fixed amount of money paid per person, not by the visit or procedure. Managed care companies usually express capitation in terms of cost per member per month.
providers receive a fixed dollar amount over a specific period of time to cover the service needs of a fixed number of clients
As stated in this response, providers are paid a specific dollar amount, for a specific time period, to cover the service needs of a specific number of people. If a provider exceeds his or her capitated payment, he or she may not be able to cover his or her costs and, consequently, may limit his or her services.
You are seeing a 15 year old girl in therapy. Prior to beginning treatment, you, the girl, and her parents agree that you will maintain the girl’s confidentiality and not discuss anything she reveals in therapy with her parents. In the first session you realize that the girl is very depressed, and during the fifth session she tells you that she wants to kill herself. Under these circumstances, you will:
Select one:
A. not contact her parents but have the girl sign a “no-suicide contract.”
B. contact her parents only if they are unaware of the girl’s depressed state.
C. contact her parents if you feel the girl is at high risk for attempting suicide.
D. contact the child protective agency.
Correct Answer is: C
Even though you’ve come to an agreement with the parents and the adolescent, the parents are still the holder of the privilege. Also, whenever someone is a threat to themselves, you have an obligation to take steps to protect them, even when this means violating confidentiality.
Additional Information: Mandated and Permitted Disclosures of Confidential Information
A psychologist sends the MMPI to a client through the mail. The client will complete the test at home and return it to the psychologist by mail. This is:
Select one:
A. acceptable as long as the client has signed a statement saying she will not breach test security.
B. acceptable as long as the psychologist provides adequate instructions over the phone.
C. acceptable as long as the test is sent by certified mail.
D. unacceptable.
Correct Answer is: D
This is pretty clear: As a psychologist, you’re responsible for maintaining test security. In addition, you’d want to administer the MMPI under controlled conditions to obtain valid results. If you sent the test to the client, you’d have no control over testing conditions.
Additional Information: Maintaining Test Security
You have a client who does not want their records released under any circumstances. The attorney has subpoened you. Your best course of action is to:
Select one:
A. Respond in-person, but don’t take the records
B. Take the records, but don’t turn them over
C. Ignore the entire matter
D. Destroy the records
Correct Answer is: B
You should respond to the subpoena by asserting the psychotherapist-client privilege on the client’s behalf. If you cannot be released from the subpoena, you should appear at the legal proceeding with the documents requested; however, you should not actually release any information in the records, unless the judge orders you to do so. Keep in mind that a subpoena duces tecum requires a person to appear at a designated time and place with a copy of the records. It does not necessarily require the person to release those records.
Additional Information: Responding to a Subpoena
Your managed care company denies to pay for further sessions for a client and requests that you do not tell the client of its decision. In this situation, you should
Select one:
A. terminate with the client as requested.
B. continue to provide treatment to the client if you believe the client could benefit from treatment.
C. inform the client of all aspects of this decision that are relevant to treatment.
D. seek the advice of an attorney regarding a possible lawsuit against the managed care company.
Correct Answer is: C
This question is not so much about managed care as it is about informed consent procedures. Whether or not a patient’s treatment is being financed by a managed care company, a psychologist should inform clients of relevant information regarding treatment at the outset of the professional relationship and continue to provide such information as it arises throughout treatment. Due to the nature of managed care companies, there may be more concerns that need to be discussed with managed care patients than with other clients. But the general informed consent requirement applies to this situation as well as many others. The other choices don’t really address the issue raised by the question.
terminate with the client as requested.
continue to provide treatment to the client if you believe the client could benefit from treatment.
These two choices describe two possibly acceptable responses to this situation, but neither are requirements – whether or not you would continue to see the patient would depend on a number of factors, including the patient’s needs and your policies.
seek the advice of an attorney regarding a possible lawsuit against the managed care company.
This choice implies that the managed care company’s actions are illegal and have caused you harm, but the question does not provide enough information for you to reasonably conclude that this is true.
Additional Information: Informed Consent
Of the following, which would not be inconsistent with a psychologist’s ethical obligations?
Select one:
A. Beginning a sexual relationship with a cousin of a former patient who terminated therapy a year earlier.
B. Engaging in a sexual relationship with a patient who ended therapy two years earlier wherein therapy was not terminated for the intention of commencing this relationship.
C. Accepting a new patient with whom the psychologist had been sexually involved four years before.
D. Having a sexual relationship with a psychological assistant that the psychologist is currently supervising.
Correct Answer is: A
Beginning a sexual relationship with a cousin of a former patient who terminated therapy a year earlier.
While there are several types of inappropriate relationships described in this question, the correct response would not be inconsistent with a psychologist’s ethical obligations and is the correct answer. Ethical Standard 10.06 specifically mentions “current” clients or patients, but does not prohibit “former” clients or patients. “Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard.”
Engaging in a sexual relationship with a patient who ended therapy two years earlier wherein therapy was not terminated for the intention of commencing this relationship.
While sexual relationships with former patients are not altogether prohibited after two years in the Ethics Code, they are discouraged, and the psychologist would “bear the burden of demonstrating that there has been no exploitation.” Specifically, Ethical Standard 10.08 states “Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances.”
Accepting a new patient with whom the psychologist had been sexually involved four years before.
This response is incorrect as Ethical Standard 10.07 states, “Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.”
Having a sexual relationship with a psychological assistant that the psychologist is currently supervising.
Ethical Standard 7.07 addresses this response: “Psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority.”
Additional Information: Sexual Intimacies
Which of the following is a mental health service that HMOs must provide under federal requirements?
Select one:
A. pre- and post-pregnancy counseling.
B. psychodynamically oriented psychotherapy.
C. inpatient psychiatric care.
D. short-term outpatient evaluative crisis intervention.
Correct Answer is: D
Federal laws regarding qualification for an HMO requires that the company provide “short-term (not to exceed 20 visits), outpatient evaluative crisis intervention services”, and “medical treatment and referral for alcohol and drug addiction.” These are the only qualifications related to mental health services. Most HMOs provide certain additional services, because doing so reduces their costs in the long-run.
The difference between professional ethics and professional values is best stated by which of the following?
Select one:
A. If a psychologist is ethical, there should be no difference between ethics and values.
B. Ethics are standards for practice set by the profession, while values refer to judgments of right and wrong.
C. Ethics can be stated more specifically than values.
D. Values specifically define appropriate professional conduct, while ethics are a more general code of proper professional conduct.
Correct Answer is: B
The correct response distinguishes between ethics and values. Values are concerned with what is good and desirable and ethics refer to correct or appropriate practice. Values and ethics are related in that the latter are usually derived from the former; for example, privacy is a value that is reflected in the ethical standard requiring psychologists to obtain clients’ informed consent before releasing information about therapy. These two responses (*) are not necessarily true, and this answer (**) is not true since values do not specifically define appropriate professional conduct.
* If a psychologist is ethical, there should be no difference between ethics and values.
This response not necessarily true.
* Ethics can be stated more specifically than values.
This response not necessarily true.
** Values specifically define appropriate professional conduct, while ethics are a more general code of proper professional conduct.
This response is not true since values do not specifically define appropriate professional conduct.
Additional Information: Preamble and General Principles
A defense attorney contacts a psychologist to conduct an assessment of a client who has been charged with assault. Because the client does not have the means to pay, the defense attorney was hired by the family. The psychologist meets the client to perform the assessment however the client appears to lack the capacity to fully understand the reasons for the assessment. The psychologist should:
Select one:
A. refuse to perform the assessment because the results would be invalid.
B. discuss the purpose of the assessment to the client.
C. obtain informed consent from the family.
D. obtain the informed consent from the defense attorney.
Correct Answer is: B
Ethical Standard 9.03(b) states, “Psychologists inform persons with questionable capacity to consent … about the nature and purpose of the proposed assessment services, using language that is reasonably understandable to the person being assessed.”
Additional Information: Informed Consent for Assessment
According to APA’s Ethical Standards, psychologists would be banned under all circumstances from soliciting testimonials from
Select one:
A. anyone.
B. current patients.
C. current and former patients.
D. no one - the Ethical Standards do not deal with the issue of testimonials.
Correct Answer is: B
Ethical Standard 5.05 states that “Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.” So you would be banned under all circumstances from soliciting testimonials from current patients. Certainly, the “vulnerable due to undue influence” language would ban you from soliciting testimonials from former patients in many if not most cases. But this is not an absolute ban from seeking testimonials from former patients, so, due to the wording “under all circumstances” in the question, this choice (“current and former patients”) is not the best answer.
Additional Information: Testimonials
When a psychologist believes that her patient’s records will be used in a legal proceeding, she should:
Select one:
A. rewrite them to meet the higher standards of a forensic setting
B. avoid the use of any psychological terminology in favor of legal terminology
C. maintain them in the same kind and quality as all of her patients’ records
D. maintain them in the kind and quality consistent with reasonable scrutiny in an adjudicative forum
Correct Answer is: D
According to the Specialty Guidelines for Forensic Psychologists (1991), “When forensic psychologists conduct an evaluation or engage in the treatment of a party to a legal proceeding, with foreknowledge that their professional services will be used in an adjudicative forum, they incur a special responsibility to provide the best documentation possible under the circumstances.”
Additional Information: Records
A forensic psychologist is asked to review and make conclusions regarding a defendant’s psychological evaluation that was conducted 4 years ago following a similar crime that the defendant is now accused of. The psychologist should:
Select one:
A. refuse the request
B. comply with the request but interpret the previous findings with caution
C. reevaluate the person and disregard the previous findings
D. reevaluate the person and interpret the previous findings with caution
Correct Answer is: D
According to the Forensic Specialty Guidelines, “Forensic psychologists avoid giving written or oral evidence about the psychological characteristics of particular individuals when they have not had an opportunity to conduct an examination of the individual…” And, according to Ethical Standard 9.08, psychologists also do not base their decisions on outdated results. Thus, the psychologist in this case should make a reasonable effort to reevaluate the person. However, it would probably be inappropriate to completely disregard the previous findings. The best approach would be to reevaluate the person and interpret the previous findings with caution.
Additional Information: Use of Assessments
The purpose of licensure in psychology and other mental health fields is to
Select one:
A. protect the consumer by limiting practice to those who are qualified.
B. provide uniform national standards of minimal competence in the field.
C. protect the public by ensuring that professional have enough knowledge about the field.
D. allow consumers to choose professionals who are the best in the field.
Correct Answer is: A
All 50 states in the U.S., the 10 provinces in Canada, and the territories of Guam, Puerto Rico, U.S. Virgin Islands, and the District of Columbia regulate the practice of psychology and require psychologists to obtain licenses in order to practice professionally. The purpose of licensure and licensure laws are to protect the public by only allowing qualified persons to practice; i.e., persons who have demonstrated that have met minimum standards of competence as defined by state or provincial law.
provide uniform national standards of minimal competence in the field.
Contrary to this option, licensure is a matter of state law, not national standards.
protect the public by ensuring that professional have enough knowledge about the field.
This choice is not complete enough; licensure is intended to ensure that professionals meet standards of competence, which extend beyond just knowledge.
Additional Information: Licensure and the EPPP
You have been retained by the court to make a recommendation concerning custody of a 4 year old girl. You have met with the mother on two occasions and also administered some psychological tests. You have completed a phone interview with the father who lives out of state. In reporting to the court, you should
Select one:
A. explain that you cannot present any data.
B. recommend custody go to the parent you have determined is most competent to parent.
C. present the results of your evaluation but refrain from making a recommendation.
D. make a recommendation, but note that your evaluation of the father was incomplete.
Correct Answer is: C
present the results of your evaluation but refrain from making a recommendation.
This is another question where it is tempting to do more than you are qualified to do. This answer is correct; Standard 9.01(b) states that “psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions. When, despite reasonable efforts, such an examination is not practical, psychologists document the efforts they made and the result of those efforts, clarify the probable impact of their limited information on the reliability and validity of their opinions, and appropriately limit the nature and extent of their conclusions or recommendations.” A phone conversation is not a psychological evaluation.
make a recommendation, but note that your evaluation of the father was incomplete.
You may have chosen this response, but it is pertinent to ask yourself the question that if you could not make a complete evaluation why would you make a recommendation.
Additional Information: Use of Assessments
You have been court-ordered to evaluate a prisoner who is being tried for murder. You explain the purpose of the evaluation and complete it. As you are packing up your testing materials, the prisoner smirks, and says, “I agreed to this but I didn’t sign anything. You are out of luck, doctor.”
Select one:
A. You should go ahead and complete the report, but leave out the prisoner’s comments.
B. The prisoner is correct – you should refer for a new assessment.
C. You should add this verbal comment to the report, noting the prisoner’s passive-aggressive tendencies.
D. You should have read the case file because you would have learned that the accused is also an attorney; this would affect how you would treat this prisoner.
Correct Answer is: A
Because this evaluation was court-ordered you were not actually required to obtain informed consent. However Standard IV.E.1 of the Speciality Guidelines for Forensic Psychologists states that “if the client appears unwilling to proceed after receiving a thorough notification of the purposes, methods, and intended uses of the forensic evaluation, the psychologist should take steps to place the client in contact with his or her attorney for the purpose of legal advice on the issue of participation.” Remember, you always want to take the most careful and conservative approach if possible.
You should add this verbal comment to the report, noting the prisoner’s passive-aggressive tendencies.
While you may be tempted to choose this option and add the client’s comments to your report, this would contradict Standard V.C. of the Forensic Guidelines which states that, “In situations where the right of the client to confidentiality is limited, the forensic psychologist makes every effort to maintain confidentiality with regard to any information that does not bear directly upon the legal purpose of the evaluation.”
You should have read the case file because you would have learned that the accused is also an attorney; this would affect how you would treat this prisoner.
Finally, as a thorough evaluator you should have read the case file closely; however, you would not proceed with an evaluation differently just because your client is an attorney.
Additional Information: Specialty Guidelines for Forensic Psychology
You’ve completed a psychological assessment on a child whose parents are divorced. They have joint custody. The child’s mother doesn’t want the father’s girlfriend present for the debriefing session although the father does want her there. What do you do? (The mother paid for the testing).
Select one:
A. Have only the custodial parents present
B. Have only the mother present
C. Have two sessions, one with the mother, one with the father and his girlfriend
D. Send everyone a copy of the report and only meet if one of the parents needs further clarification
Correct Answer is: A
Having just the custodial parents present is probably your best course of action. You don’t have the right to breach the child’s confidentiality to the girlfriend-that is the father’s call. Both parents do have a right to the results unless you can think of a reason that such access would be harmful to the child. Avoiding the situation by just sending a copy of the report isn’t in line with the Standard 15.10 of Test Administration, Scoring and Reporting that indicates that those responsible for testing programs should provide appropriate interpretations when test score information is released. Finally, who paid for the testing is not pertinent to who has access to the results.
Additional Information: Releasing and Explaining Test Results
A 14-year old is brought to your office. He does not want to be there. His mother notes that they are referred by the school. The only presenting complaint is that his grades are much poorer than last year. Your evaluation indicates no significant other problematic areas in his life. Your best course of action is to:
Select one:
A. schedule ongoing treatment with yourself.
B. continue your assessment to ascertain the presence of hidden pathology.
C. explore the possibility of an educational intervention.
D. not do anything.
Correct Answer is: C
This is a practical, and often realistic, problem. You have a 14-year-old who doesn’t want to come to you. You have a referral from the school that his grades are going down. You made an assessment that there doesn’t appear, now anyway, to be any psychiatric disorder. So, what would you do? There’s no need to suggest treatment since he doesn’t want to come see you. And, besides, you haven’t found any problems. You wouldn’t continue an assessment since, from the information given, you already concluded there isn’t much psychological conflict present. You could do nothing, telling him to come back to you if things get worse. That’s one possibility. Another possibility presented as a choice is to explore some educational intervention, such as talking to his teachers to investigate how his school environment might be optimized. So you could certainly propose intervening with the school. And between suggesting this, and doing nothing, we’d go with exploring a school-based intervention.
The APA’s Record Keeping Guidelines (2007) suggest complete records be retained for:
Select one:
A. seven years post-termination of therapy.
B. 10 years post-termination of therapy.
C. three years post-termination and a summary of the record for at least four more years.
D. three years post-termination and a summary of the record for at least seven more years.
Correct Answer is: A
The APA’s Record Keeping Guidelines (2007) indicates a “psychologist strives to be aware of applicable laws and regulations and to retain records for the period required by legal, regulatory, institutional, and ethical requirements.” And in the case where there is no legal or institutional regulations, “psychologists may consider retaining full records until 7 years after the last date of service delivery for adults or until 3 years after a minor reaches the age of majority, whichever is later. In some circumstances, the psychologist may wish to keep records for a longer period, weighing the risks associated with obsolete or outdated information, or privacy loss, versus potential benefits associated with preserving the records.”
Additional Information: Records
According to the Ethics Code, under what condition is it acceptable to provide therapy to a former sex partner?
Select one:
A. under no condition
B. when the sexual relationship ended at least two years ago
C. when the sexual relationship ended at least two years ago and the therapist has determined that the previous relationship will not affect the ability to provide effective therapy
D. when the therapist determines that the therapeutic relationship will be not be exploitative and is not clinically contraindicated
Correct Answer is: A
This is covered by Standard 10.07 of the Ethics Code, which states that “Psychologists do not accept as therapy patients or clients persons with whom they have engaged in sexual intimacies.”
Additional Information: Sexual Intimacies
In cases of ethical violations investigated by the APA following the loss of a psychologist’s license, which of the following is the most common ethical issue involved?
Select one:
A. multiple relationships (nonsexual)
B. practice outside the boundaries of competence
C. sexual misconduct
D. confidentiality breaches
Correct Answer is: C
Every year, the Ethics Committee files a report on the number and types of ethical complaints against psychologists it has investigated. In cases in which the committee investigated a complaint following a state board’s revocation of a psychologist’s license, sexual misconduct has been the ethical issue involved in the preponderance of cases.
Additional Information: Sexual Intimacies
According to APA’s Ethical Standards and Code of Conduct, when a client makes a credible threat of violence against a specifically identifiable victim, a therapist can breach confidentiality
Select one:
A. only when legally mandated to do so
B. only when legally mandated or legally permitted to do so.
C. only if he has discussed the legal limits of confidentiality at the outset of therapy.
D. only if he has first attempted to resolve any conflict between the law and the ethical requirement to maintain confidentiality in a manner consistent with the latter.
Correct Answer is: B
The majority of states have “duty to protect” laws that require therapists to breach confidentiality when a client makes a credible threat of violence against an identifiable victim. In states where this duty is not a legal mandate, there are laws that permit a therapist to breach confidentiality as necessary to protect others. In this situation, APA’s Ethical Standards allow for a breach of confidentiality whenever the law mandates or permits it. According to Standard 4.05, “Psychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to…protect the client/patient, psychologist, or others from harm.”
Additional Information: Maintaining Confidentiality
Prior to conducting a court-ordered evaluation of a minor, you:
Select one:
A. must obtain informed consent from the minor.
B. must obtain informed consent from the parents or legal guardians of the minor.
C. must insure that the parents or legal guardians are present during the evaluation.
D. should discuss the purpose of the evaluation with the minor.
Correct Answer is: D
APA’s “Specialty Guidelines for Forensic Psychologists” states that “psychologists obtain informed consent unless the service is court ordered.” Thus, regardless of whether the examinee is an adult or a minor, in a court-ordered evaluation, it is not necessary to obtain informed consent. However, the subject of an evaluation should always be informed of the purpose, methods, and intended use of the evaluation.
Additional Information: Informed Consent for Assessment
In a criminal case, the finding “not guilty by reason of insanity” means that the defendant
Select one:
A. did not understand the charges against him.
B. could be retried once the insanity passes.
C. could be held for involuntary treatment for no longer than three months.
D. was legally insane at the time of the crime.
Correct Answer is: D
A finding of not guilty by reason of insanity means that the person was legally insane at the time of the crime. “Legally insane” does not mean the same thing as mentally ill; a person can be mentally ill at the time of a crime and not necessarily be legally insane. The term’s definition will vary from state to state, but in almost all cases, it will be along the lines of not being able to distinguish right from wrong at the time of the crime due to a mental defect or disorder.
Additional Information: Competency to Stand Trial vs. Insanity
A psychologist is asked by the attorney for the father in a divorce procedure to determine, in his expert opinion, which parent is better able to care for the children. The father is in the same state as the psychologist but the mother is in a distant state. The psychologist should
Select one:
A. agree to evaluate the father and give his opinion as requested as long as the conclusions are not influenced by who pays the fee.
B. evaluate the father but not send the report until asked for it by the judge.
C. evaluate the children and both parents before giving such an opinion.
D. refuse to accept this work since there can be no firm predictions made as to which parent would be better able to care for the children.
Correct Answer is: C
The basic principle is that you can’t give an opinion as to which parent will be better able to care for the children unless you interview both parents and the children. Otherwise, all you can attest to is your findings about the psychological health of whomever you evaluate. You can’t, if you only see one of the parents, opine as to which one is better: You’d have no basis to come to such a conclusion.
Additional Information: Use of Assessments
A client of yours has signed up for the same exercise class you attend. You should:
Select one:
A. Terminate the client
B. Change your health club membership
C. Make a decision depending on whether the class has two or 100 participants
D. Ask the client if he can tell that you are losing weight
Correct Answer is: C
This question is about multiple relationships. Ethical Standard 3.05(a) (Multiple Relationships) indicates that, “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”Thus, if there are just two of you in the class, this relationship might impact the therapeutic one, while in a large class, the effects will probably be negligible. The Standard doesn’t tell you how to decide-it just instructs you to determine what is in the best interest of your client.
Additional Information: Multiple Relationships
A psychologist is informed by a new client at the conclusion of an initial therapy session that he/she is also seeing a psychiatrist. In this case, the psychologist should:
Select one:
A. inform the client it would be unethical to continue seeing him/her while under the care of another professional.
B. discuss with the client when to terminate treatment with the psychiatrist.
C. contact the psychiatrist to inform her of the situation and obtain copies of the client’s records.
D. discuss the treatment issues and role of the psychiatrist with the client.
Correct Answer is: D
According to Standard 10.04 of the Ethics Code, “In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare. Psychologists discuss these issues with the client/patient or another legally authorized person on behalf of the client/patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues.”
The Ethics Code does not prohibit the psychologist in this situation from continuing to treat the client* and contacting the psychiatrist* would violate the client’s confidentiality unless it is done with her consent, which is not indicated (* incorrect responses).
Additional Information: Providing Therapy to Clients Served by Others
You receive a subpoena for a current client’s therapy records from a process server hired by the court. This means that you must:
Select one:
A. inform the server that you cannot comply with the subpoena because therapy records are privileged.
B. tell the server to wait while you make a copy of the records.
C. appear at a designated place and time with a copy of the records.
D. leave a copy of the records at the courthouse within 48 hours.
Correct Answer is: C
A subpoena to produce records or documents (known as a subpoena duces tecum) requires a person to appear at a designated time and place with a copy of the records. It does not necessarily require the person to release those records; this is a matter for the court to decide, following a hearing on privilege, if the issue of privilege is being contested. If your client has waived the privilege, however, you would release the records to the court at the time of your appearance.
Additional Information: Responding to a Subpoena
Which of the following client's rights are protected in a court of law? Select one: A. A second opinion B. Tarasoff C. Right of confidentiality D. Right to receive medication.
Correct Answer is: C
A client’s right to confidentiality is protected by a court of law. The client’s right to keep his/her matters confidential is referred to as privilege. The court also determines exceptions to privilege, such as the Tarasoff Statute.
Additional Information: Privilege Versus Confidentiality
A managed care company asks a psychologist to conduct a study on the relative effectiveness of a 10-week therapy program for depression vs. a 20-week therapy program. The company plans to publish the results of the research if no significant difference is found but will not publish the results if the longer therapy program is more effective. The psychologist should:
Select one:
A. agree to conduct the study because it is within the company’s rights to publish or not publish their research findings
B. agree to conduct the study if the psychologist is able to approve any article submitted for publication
C. agree to conduct the study only if all research participants are appropriately debriefed at the conclusion of the study
D. refuse to conduct the study
Correct Answer is: D
Ethical Standard 5.01 states, “Psychologists do not knowingly make public statements that are false, deceptive, or fraudulent, concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated.” Although in this case the psychologist is asked not to publish data, this would still be deceptive. It also is inconsistent with General Principle A of the Ethics Code which states that, “psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons…. Because psychologists’ scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence.”
Additional Information: Public Statements Made by Psychologists and Others
Which of the following best describes the ethical requirements of a licensed clinical psychologist who tests positive for HIV?
Select one:
A. inform clients of his/her medical condition “as early as is feasible”
B. obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties
C. refrain from initiating any professional activities that might be adversely affected by the medical condition
D. there is no obligation to take precautions or special actions in this situation
Correct Answer is: C
Being diagnosed with HIV, when considering the ethical obligations of a psychologist, would be considered a health-related personal issue. Personal problems, including emotional, social, health-related and other personal issues, are addressed in Standard 2.06: Psychologists “refrain from initiating an activity when they know or should know there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.” If a psychologist thinks the condition may impair his/her ability to provide effective services or perform work-related duties then the psychologist would “take appropriate measures.”
However, there is no evidence that this is the case, so “obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties” is not the best answer. Informing clients of the condition is not necessary and may not be in the best interests of some of the clients to do so.
Additional Information: Psychologists with Personal Problems or Conflicts
You are a psychologist at a state mental hospital. One of your colleagues, a psychiatrist, tells you that one of his clients has reported to him that he has sexually abused a child. The perpetrator still has access to the child. The psychiatrist says that he is not going to report the abuse because the client expressed remorse, promised not to do it again, and promised to continue treatment. Furthermore, he is widely-known and highly respected in the community. The psychiatrist adamantly refuses to report the child abuse. You should:
Select one:
A. discuss the matter further with your colleague and encourage him to make a report to the appropriate child abuse reporting agency.
B. file a complaint against your colleague with APA or state licensing board.
C. contact the appropriate child abuse reporting agency and provide them with information about the abuse, but refuse to give the colleague’s name.
D. contact the appropriate child abuse reporting agency and provide them with information about the abuse and with the colleague’s name.
Correct Answer is: D
Psychologists, like most health professionals are mandated reporters. In this instance, since the primary reporter refuses to make the report, you would be mandated to report the suspected child abuse to the appropriate child abuse reporting agency. You would also be obligated to report the identity of the nonreporter to that child abuse reporting agency.
Additional Information: Mandated and Permitted Disclosures of Confidential Information
Your new patient is a 20-year-old gang member who informs you that he has killed a couple of people in the past and that he will probably kill others in the future. He states that he has no intentions of leaving the gang but wants help dealing with his cocaine addiction. You should:
Select one:
A. notify the police of the patient’s previous murders
B. notify the police of the patient’s danger to others
C. provide the patient with substance abuse treatment
D. refuse to provide treatment for this patient unless he agrees to leave the gang
Correct Answer is: C
Many states have laws based on Tarasoff that require psychologists to warn or protect a potential victim from serious harm when there is an imminent threat to an identifiable victim. However, this question does not indicate an imminent threat nor an identifiable victim; therefore, confidentiality should be maintained. The Ethics Code similarly permits a breach of confidentiality without client consent in order to protect others from harm, but without an identifiable victim such a breach would not serve to protect others and would be inappropriate. The best option would be to provide the treatment requested.
Refusing to provide treatment for this patient unless he leaves the gang would be a clinical option, but would probably be ineffective at this stage because he has stated that he has no intentions of leaving the gang. Besides, engaging the patient in treatment for his substance abuse might later lead him to want to leave the gang.
Additional Information: Mandated and Permitted Disclosures of Confidential Information
In the last session, your gorgeous new client complimented you on how nice you look in your red outfit. You noticed you were very happy before this session. You even caught yourself singing, "Oh What a Beautiful Morning" while looking in the mirror to do a final 'visual check' before seeing your client in. Ethically, Select one: A. You need to cancel this session B. You need to consult with a colleague C. You need to behave more appropriately D. You need to get out more
Correct Answer is: B
While no Ethical Standards have been violated at this point; there is a strong indication that you are experiencing some type of “extra attraction” toward this client. You need to seek consultation and determine how to process and handle your countertransference. Cancelling the session may not be in the client’s best interest.
Additional Information: Psychologists with Personal Problems or Conflicts
At the request of an attorney, a psychologist in a rural community agrees to conduct a psychological evaluation and provide treatment for the same person. This would probably be considered:
Select one:
A. ethical, since both services are within the boundaries of a professional relationship
B. ethical, if the psychologist takes reasonable steps to minimize any negative effects
C. unethical, since evaluation and treatment are inherently conflicting
D. unethical, since only a patient, not an attorney can request treatment services
Correct Answer is: B
As a general rule, psychologists should avoid potentially conflicting relationships, which could result when conducting both an evaluation and treatment for a patient. However, according to APA’s Specialty Guidelines for Forensic Psychologists (1991), “When it is necessary to provide both evaluation and treatment services to a party in a legal proceeding (as may be the case in small forensic hospital settings or small communities), the forensic psychologist takes reasonable steps to minimize the potential negative effects of these circumstances on the rights of the party, confidentiality, and the process of treatment and evaluation.” [Law and Human Behavior, 15 (6), p.659].
Additional Information: Multiple Relationships
Which of these studies would be considered most unethical today? Select one: A. Milgram's B. Bandura C. Zimbardo D. BF Skinner's study of his own child
Correct Answer is: A
This is a different twist on a previous question but the answer is still Milgram’s study. You may feel a different study is more unethical, but the Ethical Standards are specifically pertinent to Milgram’s study. This study involved deception and no debriefing about that deception. Ethical Standard 8.07 (Deception in Research) addresses this, indicating that: “(a) Psychologists do not conduct a study involving deception unless they have determined that the use of deceptive techniques is justified by the study’s significant prospective scientific, educational, or applied value and that effective nondeceptive alternative procedures are not feasible. (b) Psychologists do not deceive prospective participants about research that is reasonably expected to cause physical pain or severe emotional distress. (c) Psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection, and permit participants to withdraw their data.”
Additional Information: Use of Deception in Research
During an initial interview with a psychotherapy client, the client tells the psychologist that he wants to pay for his sessions himself without the psychologist releasing any information to his insurance company. He also requests that the psychologist not keep any records of their sessions. Agreeing to this arrangement would be:
Select one:
A. ethical and legal, as long as the psychologist keeps a record of the financial payments and reports those amounts on income tax forms
B. ethical, as long as the psychologist determines that the client’s reasons for the request are valid
C. unethical, because psychologists cannot withhold records from a client’s insurance company
D. unethical and possibly illegal, because psychologists must maintain records
Correct Answer is: D
According to APA’s Record Keeping Guidelines (1993, 48(9), 984-986) records should be maintained and should minimally include: identifying data, dates and types of service, fees, any release of information obtained, any assessment, plan for intervention, consultation, summary reports, and/or testing reports. Although these guidelines are aspirational, they have become a standard of care for psychologists and, therefore, not maintaining any records about a client would be considered unethical. Many states also require the maintenance of client records, and therefore, not keeping records may be illegal.
unethical, because psychologists cannot withhold records from a client’s insurance company
In regards to this option, clients generally have the right not to permit the release of records to their insurance company if the insurance company will not be responsible for payment. However, if the psychologist is a contracted provider for the insurance company, the contract may include restrictions on providing “out-of-pocket” treatment to its members or it may require the client to sign a waiver releasing the insurance company of its financial responsibility.
Additional Information: Records
A psychologist is planning to retire in the next few months and has been decreasing her caseload. One of the psychologist’s former clients, who had terminated a few months earlier, phones the psychologist and reports having suicidal thoughts. The psychologist should:
Select one:
A. inform the client that she is retiring and that she cannot accept any clients
B. refer the client to a colleague immediately
C. meet with the client until the client no longer needs treatment
D. meet with the client until the situation is stabilized and then refer
Correct Answer is: D
Although this question is referring to a former client, due to the potential danger for a suicidal client, the most appropriate action would be to meet with the client until the situation is stabilized and then refer.
You have been working with a couple in marital therapy for four months, with slow but notable progress. After a session one day, the wife pulls you aside and asks to make some individual appointments with you. You should
Select one:
A. refer her to another therapist.
B. wait until the completion of marital therapy and then see her individually.
C. terminate with the couple and see the woman individually.
D. encourage her to discuss any relevant issues within the context of marital therapy.
Correct Answer is: A
There is a potential for role conflict when a client in conjoint therapy asks you to see him or her individually. It’s possible that there may be a conflict between your considerations as a couple’s therapist and as an individual therapist. Thus, although your actions would vary depending on the parameters of the individual case, the best answer in light of the information we have is to refer the woman to another therapist for individual therapy.
Additional Information: Couple and Family Therapy
At the beginning of group therapy, all members signed a contract to maintain confidentiality. If one of the members breaks confidentiality it is:
Select one:
A. an ethical violation
B. a legal violation
C. a moral violation
D. an ethical, moral and possible legal violation
Correct Answer is: C
In the context of group therapy, a moral responsibility to respect confidentiality extends beyond the therapist to each group participant. However, while there may be a moral obligation to maintain confidentiality, there isn’t an ethically enforceable obligation. The Ethics Code, Standard 4.02, addresses the limitations of confidentiality and Standard 10.01, Informed Consent in Therapy, addresses the need to discuss the limits of confidentiality at the beginning of (group) therapy. In group work agreements, therapists clearly define confidentiality and the parameters for the specific group being entered, explain the importance, and discuss the difficulties related to confidentiality involved in group therapy. Since confidentiality cannot be guaranteed by the therapist, group members have provided “implied consent” to the release of the information by voluntarily agreeing to participate. In most states, group members are not legally obligated to maintain confidences.
A managed health care organization decides that additional mental health services for one of your clients are not “medically necessary.” You disagree with this conclusion, because you believe that the client may experience severe and long-term mental distress without at least two or three more counseling sessions. Based on current standards of practice as well as the implications of the court’s ruling in Wickline v. California, your duty in this situation would be to:
Select one:
A. ensure that the client understands why you can no longer provide treatment and refer him to a place where he can obtain low-cost or free services.
B. continue treating the client for a fee that is commensurate with his previous co-payment.
C. appeal the decision of the managed health care organization.
D. file a lawsuit against the managed health care organization.
Correct Answer is: C
In the Wickline case, a patient sued a state-run managed care organization because it did not approve an eight-day post-surgical hospital stay and the patient later developed medical complications. The physician complied with the organization and released the patient without protest. The client lost the case against the organization, in part because the physician never appealed the organization’s decision. The court held that a treating professional who “complies without protest with the limitations imposed by a third-party payor, when his [professional] judgment dictates otherwise, cannot avoid his ultimate responsibility for the patient’s care.” This case suggests that it is the health professional’s obligation to protest in a situation such as the one described in the question, and a number of commentators suggest that advocacy for the patient’s needs in such situations is an ethical obligation.
Additional Information: Terminating Therapy
During the 10th psychotherapy session with a client, you realize that your client has recently started dating your best friend. You should:
Select one:
A. refer the client to another therapist
B. discuss this with your client immediately
C. discontinue your relationship with your friend
D. wait and address the problem with your client if a conflict becomes imminent
Correct Answer is: B
Although the Ethics Code does not specify exactly how to resolve this type of ethical dilemma, it does state, “If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code” (Ethical Standard 3.05[b]). Consistent with the intent of the Code, the best option would probably be to discuss the matter with your client immediately. After discussing it with your client, additional steps, such as referring the client, may be appropriate.
Additional Information: Multiple Relationships
A psychologist who sees a family consisting of a mother, stepfather, and two children from the mother’s first marriage, aged 10 and 14, must
Select one:
A. provide individual therapy as needed to each member.
B. meet with each family member separately at least once.
C. see family members only as a group.
D. provide an understandable explanation of services to the children
Correct Answer is: D
provide an understandable explanation of services to the children
Of the choices listed, only this option describes something the psychologist “must” do. As part of informed consent procedures, the psychologist will explain the nature of the services to the parents. And, according to APA’s Ethics Code, when working with clients who legally cannot give informed consent such as children, psychologists must “provide an appropriate explanation” of the services as well as “seek the individual’s assent” and “consider such persons’ preferences and best interests.”
The other choices may describe good practices depending on the situation; for instance, many family therapists believe that they should not treat family members both individually and as a family, and also many would meet with family members individually at least once. However, these are not absolute requirements and are not required by APA’s Ethics Code.
Additional Information: Informed Consent
You are treating a client, a five-year old girl, with the consent of her father. After five sessions, you receive a call from the girl’s mother, who tells you that she is the custodial parent, that the father is a non-custodial parent, and that she doesn’t want her daughter seeing you for therapy. You believe that it’s in the girl’s best interest to continue treatment. Assuming that the mother’s statement is truthful, you should:
Select one:
A. terminate therapy immediately.
B. refuse to stop therapy, since it’s in the girl’s best interest to continue.
C. urge the mother to consent to a few additional sessions, so you can terminate appropriately with the child.
D. tell the mother to work out the problem with the father, but in the meantime, continue to see the girl for therapy.
Correct Answer is: C
This is a good example of a conflict between ethical and legal obligations. Your ethical obligation is to serve the best interests of the child, but legally, you cannot proceed with treatment if the custodial parent does not give you consent to do so. The Ethics Code is instructive in such situations: Standard 1.02 states that “If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority.” Thus, you could not just terminate without attempting to advocate for the patient; you also could not continue to treat the child without the mother’s consent, because violating the law is not consistent with resolving the conflict in a responsible manner. Thus, your best option is to explain to the mother why you believe that immediate termination could harm the child and urge her to let you continue seeing the girl for a few more sessions.
Additional Information: Conflict Between Ethics and Laws or Organizational Demands
You have been attempting to collect payment from a former patient of yours who did not pay for his final two months of therapy. One day, you get a letter from a state hospital where that former patient is now currently a patient. The letter includes a request for a copy of your records of the patient’s treatment along with a signed release of information. In this situation, you should
Select one:
A. refuse to supply any information to the hospital until the bill is paid.
B. send a summary of the records to the hospital along with a copy of a bill for the unpaid therapy fees.
C. go to the hospital and talk to the patient about the situation.
D. provide the information requested by the hospital.
Correct Answer is: D
The issue here is that you can’t withhold records under your control that are “requested and needed for a client’s/patient’s emergency treatment solely because payment has not been received (Ethical Standard 6.03). Thus, you must provide the requested information in this instance.
Additional Information: Records
Dr. Que has recently started working with a family consisting of a mother, father, and five year old boy. The parents say the boy has become “impossible to manage” and they don’t know what to do to control him. Dr. Que believes he will get a better idea of the family’s dynamics if he is able to observe them at home. When he suggests this, the parents say that, because of their religious beliefs, they cannot allow this. Dr. Que should:
Select one:
A. refer the family to a therapist from the same religious background.
B. impress upon the parents his need to observe them at home in order to best serve the interests of the child.
C. determine if there is an alternative and mutually agreeable location for the observation.
D. contact child protective services immediately.
Correct Answer is: C
This type of situation is covered by ethical requirements related to cross-cultural counseling. (See, for example, APA’s Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations.) There’s certainly not any information given that warrants a call to child protective services. Also, it’s not necessary to make a referral, and it wouldn’t be a good idea to manipulate the parents into doing something they don’t want to do.
Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations
A new client tells you that she recently had sex with her previous therapist. She wants you to “help her put the experience behind her”. You should:
Select one:
A. Report this situation immediately
B. Not report, but counsel her about the process
C. Call the offending party but not give the client’s name
D. Encourage her to recall the event so she doesn’t suffer from repression later
Correct Answer is: B
You are obligated to protect your client’s confidentiality. However you want to educate her about the Ethical Standards regarding this situation and also explain to her avenues of recourse she could take.
Additional Information: Maintaining Confidentiality
The purpose of State Licensing Boards is primarily to Select one: A. educate the public. B. educate the profession. C. protect the public. D. set minimum standards of practice.
Correct Answer is: C
The State Boards derive their authority from the principle of protecting the public. That’s the justification for giving exams, setting requirements for licensure, writing and enforcing regulations, and so on.
Additional Information: Licensure and the EPPP
A patient calls for an appointment and tells you that he is already seeing another psychologist but wants to see you. In this situation, you should
Select one:
A. not allow him to make an appointment.
B. allow him to come in for an initial session and obtain written permission to contact the other psychologist.
C. make an appointment to discuss reasons the patient wants to see another psychologist and explain why doing so might not be in the patient’s best interests.
D. set up an appointment and establish a treatment plan after ensuring that the patient has the financial resources to pay for two therapists.
Correct Answer is: C
Ethical standard 10.04 deals with this situation. The relevant language states that “In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare. Psychologists discuss these issues with the client/patient or another legally authorized person on behalf of the client/patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues.” From the limited information presented, you don’t know if it would be appropriate to contact the client’s current therapist.
Additional Information: Providing Therapy to Clients Served by Others
A psychologist is providing therapy to a client through the client’s Employee Assistance Program at work. The client’s supervisor can be informed by the psychologist that the client is receiving treatment:
Select one:
A. under no circumstances
B. if the client’s problem is affecting her job performance
C. if the supervisor referred the client to the program
D. if that is the only information he reveals to the supervisor
Correct Answer is: C
Generally, in the context of an EAP, information about an employee/client’s condition or treatment should not be disclosed without the employee/client’s consent. However, as the correct answer (“if the supervisor referred the client to the program” ) states, when the employee/client comes to therapy as the result of a referral by his or her supervisor, the supervisor can be given certain limited information: He or she can be told if the employee/client kept the appointment, whether the employee/client needs treatment, and whether the employee/client accepted treatment. The supervisor should not be given any other confidential information unless the psychologist has permission from the employee/client. Confidentiality can also be breached under the same conditions that it can be breached in other contexts (e.g., danger to self, mandated reports).
Records of psychological services should minimally include all of the following except: Select one: A. fees B. process notes C. types of services provided D. plans for treatment interventions
Correct Answer is: B
According to APA’s Record Keeping Guidelines (1993, 48 (9), 984-986) records should minimally include: identifying data, dates and types of service, fees, any release of information obtained, any assessment, plan for intervention, consultation, summary reports, and/or testing reports. Process notes, which contain intimate details of psychotherapy sessions, including the psychotherapist’s personal notes, are generally considered inappropriate for the medical record and are not recommended for minimal inclusion in the Guidelines.
Additional Information: Records
A researcher working in an institutionalized setting wishes to do some research with moderately mentally retarded patients. The researcher has obtained the approval of the institution’s research review committee. Before beginning the research, she should also
Select one:
A. obtain informed consent from the patients’ legal guardians.
B. obtain informed consent from the patients’ legal guardians and the participants.
C. obtain informed consent from the patients’ legal guardians and assent from the participants.
D. not worry about obtaining consent from the participants or their guardians, since she has already obtained the institution’s permission.
Correct Answer is: C
In the context of research, the term “informed consent” implies agreement to participate from a person who has been informed of all relevant information and is competent enough to understand that information. With few exceptions (e.g., where deception is necessary and permissible), the Ethical Principles require researchers to obtain informed consent from all participants who are capable of giving it. If the potential participant is not competent to give informed consent, the Ethics require that informed consent be obtained from his or her legal guardian. In addition, when the potential participant is not competent to give informed consent, the research must be explained to the potential participant in language that he or she can understand, and his or her consent must be obtained.
You see a client for the first time. She is already receiving treatment from another professional, and she is not clear about why she wants additional treatment from you. In this situation, you should
Select one:
A. treat the client and let her discuss what she is doing with the other professional when she is comfortable enough to do so.
B. contact the other professional and attempt to work out a coordinated treatment plan with him or her.
C. attempt to discuss with the client the reason she is seeking the services of a second therapist.
D. inform the client that it would be unethical for you to continue therapy with her.
Correct Answer is: C
In answering ethics questions, it is a good idea to bring to mind the language of the applicable ethical standard and choose the answer that is most consistent with that standard. According to Standard 10.04 (Providing Therapy to Those Served by Others), psychologists should consider treatment issues and the client’s welfare, and discuss these issues with the client, “in order to minimize the risk of confusion and conflict,” and should “proceed with caution and sensitivity to the therapeutic issues.” Of the choices listed, only the correct answer states that you would discuss the issue with the client, and is therefore the best answer.
Additional Information: Providing Therapy to Clients Served by Others
