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Marc > AATBS KERNER WORKSHOP MATERIALS > Flashcards

AATBS KERNER WORKSHOP MATERIALS Flashcards

1
Q

T or F: Failure to maintain adequate records is unprofessional conduct that may result in disciplinary action by the board.

A

True.

If someone makes a complaint against you, you can’t say you didn’t take notes.

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2
Q

T or F: Parents hold privilege for their children.

A

False.
1991 CA Daniels v Daniels. Dad wanted kid’s record. Therapist said no; thought it would be harmful. Minor holds privilege. (BUT USUALLY ISN’T IT THE PARENTS? SO MAYBE IT”S FALSE BC IT SEEMS LIKE AN ABSOLUTE?) Also not true if minor is tx’d w/o parental consent. And therapist can deny access if they think it would interfere w/ patient/ therapist alliance.

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3
Q

By default, I must always assert the therapist-patient privilege on behalf of patient, unless it has been waived. T or F?

A

True

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4
Q

You are providing therapy to your colleague’s intern as part of the training. You think the intern poses a danger to clts. Do you report to the BOP? Maintain confidentiality? Refer? Contact anyone?

A

Maintain confidentiality.

b/c he’s your clt.

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5
Q

You are a supervisor and you think your intern poses a danger to clts. Do you maintain confidentiality?

A

Nope.

not sure what you’d do, but not confidentiality.

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6
Q

Are you permitted to have a sliding scale?
Must you have a sliding scale?
Is this in the ethics code?

A

Yes. As long as they are fair and serve best interests of clts.
No.
No.

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7
Q

T or F: A psychologist in CA is prohibited from using the term PhD candidate.

A

True. bc can be confusing.

But if you were a psychologist, wouldn’t you just say PhD? SO maybe just prohibition against “candidate”?

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8
Q

T or F: Any psychologist in CA can institute a 5150.

A

False. You can’t institute. You can initiate.

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9
Q

What type of abuse is not mandated to report for elders, but “may” be reportable for kids?

A

emotional. (If it’s willful cruelty, unjustifiable)

IS IT “MAY” for elders, too? OR not at all?

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10
Q

T or F: When the Confidentiality of Medical Info Act (CMIA) conflicts w/ the Lanterman-Petris Short Act (LPSA), re. patient records in public health system or inpatient psychiatric facilities, LPSA applies.

A

True.
CMIA guides you in private practice
LPSA: guides you in involuntary holds.

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11
Q

Outpatient health clinics, acute care facilities, adult day health centers, home health agencies: If they stop operating, how long do they have to hold patient records?

A

adults: 7 years min after discharge of patient
minors: 1 year after minor reaches 18 yo
(but not less than 7 years)

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12
Q

Telehealth: what kind of consent do you need?

A

verbal OR written. before initiating services. and document consent in clt record.

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13
Q

In a criminal proceeding, when a plea of not guilty by reason of insanity is entered, what dx’s cannot be the (sole) basis of this finding (guilty bc of insanity)?

A

personality disorder
adjustment disorder
seizure disorder
addiction/ abuse intoxicating substances

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14
Q

How much SPE must be completed post-doctorally?

A

1 year (at least)

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15
Q

How long do you have to complete each “year” of SPE?

A

30 consecutive months.

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16
Q

If you do all of your SPE postdoctorally, how long do you have to complete it?

A

60 month period

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17
Q

What is the conflict about sending records or summaries/ not paying fees in APA Ethics code vs. CA law?

A 
Ethics Code: OK not to send records for nonpayment, as long as it doesn't hurt clt. And not in emergency situation.
CA law (AND HIPAA?): Not OK ever.
(gives clt more access to records, freedom of choice)
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18
Q

T or F: CA laws usually dominate the APA ethics code.

A

T. Usually. Not always.

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19
Q

You’re a psychologist giving a university class. Several weeks after the course starts, you add a new req not listed in the syllabus which you didn’t mention on the 1st day of class. Is this ethical?

A

Yes. As long as you believe it’s necessary and give the students adequate time to complete it.

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20
Q

According to HIPAA, who is/ not a covered entity?

Providers? Business associates? Clearinghouses? health plans?

A

Not business associates (secretary, tax person)

The defs of “covered entity” is providers clearinghouses and health plans.

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21
Q

You have a clt who hasn’t paid you. Emergency room calls you b/c clt has tried to commit suicide. Can you withhold the records? What is the conflict between Ethics code and CA law?

A

No conflict.
You can’t withhold records in emergency tx’ment situation.
(In non-emergency, ethics code says you may, but CA law says no. HIPAA too?)

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22
Q

You want to use a test on an ethnic person, but it hasn’t been validated for that group. What does the Ethics code say you should do?

A

You can use it, but describe the strengths and limitations of results and interpretation.

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23
Q

What should an informed consent include?

A
  1. ) limits of confidentiality
    2) fee structure
  2. ) your title, training, experience
  3. ) nature and extent of your record-keeping
  4. ) probable length of services
  5. ) risks of services
  6. ) emergency access to therapist
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24
Q

Is confidentiality a legal or an ethical issue?

A

both.

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25
Q

If you have an ethical dilemma, what are the 4 Ps in the hierarchy of needs to consider, and in what order?

A

1.) Patient 2.) Public 3.) Profession 4.) Psychologist

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26
Q

If a clt’s relative comes to therapy just 1x, what should you do in order to cover your butt if there is legal blowback?

A

Have person sign something that they came in as a guest.

You can’t mandate signing.

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27
Q

Malpractice: are we more likely to be sued or have board action?

A

board action

malpractice: means someone is suing you.

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28
Q

To determine malpractice, judge must go through 4 steps. What are they?

A
  1. ) professional relationship resulting in a legal duty
  2. ) there must be negligence or breach of duty
  3. ) harm must occur
  4. ) direct link betw. psychotherapist actions and harm
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29
Q

If your clt is pro bono, is the relationship still a professional relationship–like the one established in determining malpractice?

A

Yep.

$ doesn’t determine whether it’s a professional relationship.

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30
Q

When to refer?

A
  1. ) Cultural/ language difficulties
  2. ) Countertransference
  3. ) Patient not benefiting
  4. ) Lack of cooperation from clt.
  5. ) WHAT ABOUT: major dx you’ve never worked w/ before and no training? (pretty sure yes, refer)
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31
Q

When to consult?

A
  1. ) Deterioration
    2) crisis issues
  2. ) medication consult
  3. ) special expertise
  4. ) uncertainty re. dx/ tx
  5. ) new techniques (supervision)
  6. ) burn out
  7. ) legal/ ethical concerns
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32
Q

Standard of care: If anyone is sued, they look at:

A

what would the average therapist have done in the same situation?

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33
Q

Is standard of care subjective or a statute?

A

subjective

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34
Q

Supervision vs. consultation

A

supervision: you want to learn a
1. ) new technique (e.g. sandtray, jungian, harville hendrix) or
2. ) a sophisticated test

consultation: you had it in grad school
(considered supervision)

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35
Q

Informed consent for telehealth. What are the (3) important things to remember?

A
  1. ) verbal OR
  2. ) written AND
  3. ) documented.
36
Q

Do you need to get prior informed consent for recording voices for research participants?

A

Yes. Unless:

  1. ) naturalistic observations in public places solely and won’t be used in a way that can be id’d or cause harm.
  2. ) deception in design. AND get consent during debrief.
37
Q

Are providers a “covered entity”? Examples?

A

Yes. Psychologists, physicians, nursing homes, pharmacies.

38
Q

Are clearinghouses a “covered entity”?

And what do they do?

A

Yes. e.g. billing companies. (Translate health care transactions into HIPAA standard data.)

39
Q

Are business associates “covered entities”? Examples?

A

No. Secretary, tax person, lawyers, medical transcription services, collection agencies.
They are people or entities that perform functions that involve use of disclosed PHI on behalf of covered entities or as a service to them.

40
Q

Is a health plan a “covered entity”? Examples?

A

Yes. insurance companies, HMOs, gov’t programs that pay health care (Medicare, medicaid)

41
Q

If you assign a unique identifier to each user to track their activity, is this a required HIPAA safeguard?

A

Yes.

42
Q

If you establish procedures for accessing ePHI during emergencies, is this req’d HIPAA safeguard?

A

Yes.

43
Q

If you establish and implement procedures to restore lost data, is this a req’d HIPAA safeguard?

A

Yes.

44
Q

If you use a digital signature to ensure that ePHI hasn’t been altered, is this a req’d HIPAA safeguard?

A

No. Not req’d. But allowed.

45
Q

You’re a psych intern at Lomi. Your supervisor gets sick, but her friend, a licensed psych in private practice, can take over for a fee. Is this an OK arrangement?

A

Nope.
They have to work at same place.
Supervisor not allowed to charge for supervision.

46
Q

Primary supervisor’s license must be valid and …?

A

Free from any formal disciplinary action.

47
Q

You can destroy hard copies of files. Is that only when there’s an offsite backup system?

A

no.
But I think there has to be an offsite backup system. MAYBE the rule about destroying is not tied to the OFFSITE BACKUP SYSTEM?

48
Q

Primary supervisor at Lomi needs to go out of town for 2 weeks. Must she
a Supervise over phone?
b. get colleague who meets reqs for primary sup do it?
c. get the delegated sup to do it?
d. tell the interns they’re out of luck.

A

Get a colleague who meets reqs.
Can’t do over the phone. Need 1 hr face to face
Delegated sup might not be a licensed psych. (MFT, LCSW, so can’t do it.)
The interns can accrue hours when she’s out of town, if there’s a qualified primary sup. So not answer d.).

49
Q

If the APA Ethics code and the law conflicts, which one do you follow?

A

Follow the law. B/c it provides a higher standard. (Gives clt more control over records.)

50
Q 
CA law: Where does it require that you include your license #?
a.) ads for services
b.) business cards and stationery
c.) Notice to Consumers posted in office
d.) insurance forms
Who doesn't this apply to?
A

ads for services.
Any ads, public directory, solicitation.
Doesn’t matter if you have a fictitious business name or corp/ group name.
Doesn’t apply to you if you work in govt org, nonprofit research, education services where there is a board.

51
Q

If you’re a psych assistant, what do you need on your biz card?

A

The BOP recommends, but doesn’t require: your reg #, and name and license # of your sup. (CHECK ON THIS! THOUGHT IT WAS REQ’D)

52
Q

If you get a subpoena for a clt’s records, can you release the info w/o clt consent?

A

I think not! (In the BOP/ PSI questions)

53
Q

elder abuse: if it happens anywhere besides long-term care or state facilities, who should you report to?

A

cops or APS

54
Q

If you use electronic record-keeping, you can destroy the hard copies. How do you ensure the safety/integrity of your electronically-stored records?

So what is considered the original? And in what cases?

And are you allowed to destroy the records because you’ve put these things in place?

A
  1. ) employ offsite backup storage system
  2. ) image mechanism able to copy signatures
  3. ) mechanism to ensure that once a record is input, it’s inalterable.

the printout of the computerized version is considered the original. (to give to patients, Division of licensing/ certification, as evidence in administrative or court proceedings.

You are allowed to destroy the records b/c you are. Not related to whether you’ve put these things in place. You must put them in place if you electronically record-keep.

55
Q

Is the destruction of original records contingent upon you employing an offsite backup storage system?

A

No. But you must have an offsite backup storage system if you’re going to electronically store records.

56
Q

You are allowed to make a computer printout of electronically-stored documents. Is this contingent upon you using an image mechanism that can copy signatures?

A

No. But you must have that image mechanism if you’re going to electronically store records.

57
Q

You patient tells you that he plans to slash neighbors’ tires/ spray paint/ key the car. Is this Tarasoff?

He tells you he’s going to destroy the neighbor’s car./ start fire/ blow something up. Is this any different?

A

No. Maintain confidentiality.

Yes. Could create mayhem.

58
Q

Your client says he’s going to the Democratic rally and going to beat up as many democrats as he can. Is this Tarasoff?

A

Yes.

59
Q

Should you ever contact the district attorney in a Tarasoff?

A

No. Never the right answer.

60
Q

Your client’s been taken to the emergency room. The EMT calls you b/c your card was in clt’s pocket. Do you ask the nature of the emergency or just give her the info (related to the emergency) she asks for?

A

Give her the info she asks for.

As long as it’s related to the emergency.

61
Q

You’re treating a minor. Parents have consented. But now they want to know what you’re discussing in sessions, and you think it’s contraindicated. Should you tell them? Do you have a legal right to tell them?

A

Nope. Nope.

I guess it’s the same as records? Don’t have to give (for a minor) as long as you think it’s contraindicated

62
Q

Your colleague is having sex w/ a current therapy clt. (You actually know this clt b/c you both volunteer.) Do you report to the board?

A

No maintain confidentiality.
Even though it’s not your clt.
It’s “public clt.” NOT SURE WHAT THAT MEANS.
ALSO IS IT RELEVANT TO YOUR REPORTING THAT YOU KNOW THE CLT?

63
Q

You’re providing short-term therapy to a clt. In 4 sessions, it doesn’t seem like there’s any progress. What to do? (Address it directly? Seek consultation? Give it more time, since it’s early in tx? Terminate and refer?)

A

Seek consultation.

64
Q

If a question says that you’ve been seeing a clt for 6 mos, would this be considered short- or long-term?

A

long-term

65
Q

If you have an answer (in a multiple choice questions) that says “immediately”, would you rule this choice in or out?

A

rule it out

maybe except in reporting abuse? immediately or as soon as practically possible

66
Q

What (2) services would a therapist never want to barter for? How does the BOP feel about bartering? What stopped BOP from nixing bartering?

A

Housecleaning/ babysitting
BOP doesn’t like bartering.
Rural psych stopped them from nixing it.

67
Q

When would it not be appropriate to “discuss the conflict” with the clt?

A

When it’s something extreme. Like bartering for housecleaning/ babysitting

68
Q

A lawyer requests a clt’s whole record including raw test data, with a signed release from the clt. Can you send a summary? Can you exclude the raw data? Can you just not provide any results?

A

No. You provide it all

We don’t have a ton of info, but this is the best answer (given) to the question.

69
Q

When performing a suicide eval, what should you be most concerned w/? (their age? marital status? coping skills? level of impulse control? something else?)

A

Past history of suicide attempts

plan for committing suicide.

70
Q

If you get a question about who has higher rates of suicide, what do you look for first? (demographics)

A

Men. (White.) White men of all ages have higher rates.

And I wrote: “alcohol=bipolar” and “widowed=divorced.”

71
Q

Violent behavior: What’s the best predictor?

recent provocation? poor impulse control? signs of tension/ agitation? Something else?

A

past violent behavior

72
Q

You get a call from agitated person who says he needs to be seen right away, may be suicidal. You tell him you can’t–you can see him next week–and he gets angry. What to do? (Choices: see him right away, give him next available appt next week, hospitalize him, refer to emergency service.)

A

Refer to local emergency service.
He’s not a patient.
Court wouldn’t be able to say he could sue.

73
Q

“as early as is feasible” applies to what?

A

fee setting

74
Q

You have to make a child abuse report. Do you need to tell the clt in advance? (legally and/ or ethically?)

A

Ethically.

Not legally req’d.

75
Q

Which is more stringent–the CA Family Code? Or the Health and Safety code? How did the introduction of one of these affect the way we can treat minors?

A

Family Code. It was first.
It said that for a 12 yo to get services w/o parental consent, need to be mature enough/ intelligently AND serious danger to self/ others or victim of incest/ abuse.
But Health and safety code took the 2nd part away.
Both still exist, but health and safety code prevails.

76
Q

When would a minor’s parent be responsible for payment?

A

Only if they consented and/or participated in tx.

77
Q

Psych wants kid to take HIV test. Need permission from parents?

A

I think so! B/c question stated that kid was ward of court and needed permission from court. So probably NEED permission from whoever is guardian.

78
Q

45% of every ethical complaint is based on what kind of situation? So what does this tell you about how you should answer this question?

A

custody evals.
Refuse to do evals, opinions about custody arrangements or anything to do w/ custody.
If you are the therapist for any of the parties. (The kid, the parents, etc.)

79
Q

If they give you an age in the question, what must you determine?

A

Minor
Elder or dependent adult
ANYTHING ELSE?

80
Q

Do you need the family’s permission to involuntarily hospitalize a gravely disabled patient?

A

No.

81
Q

Under WIC 5300 (180-day hold), a court hearing is:

  1. ) required
  2. ) initiated only if requested by patient
  3. ) initiated only if requested by family member
  4. ) not required.
A

1.) required!

CHECK ON THIS!

82
Q

All of the following conditions may result in involuntary hospitalization except:

  1. ) grave disability due to dementia
  2. ) grave disability due to intellectual disabilities
  3. ) danger to self due to chronic alcoholism
  4. ) danger to others during loss of judgement during a manic episode
A

2.) grave disability due to intellectual disabilities

GET MORE CLEAR ON THIS.

83
Q

If a 14 yo and an 18 yo have consensual sex, do you need to file a child abuse report? Is this legal?

A

No report.

But not legal.

84
Q

If you hear that children are being disciplined w/ a paddle or another type of incident, what should you do?

A

Instant mandated report.
Not allowed to use an implement.
Explore how they use it.
Give informed consent: Tell them: “once you tell me you use it for discipline, I have to report it.”

85
Q

If your client tells you he killed someone 2 years ago, do you need to report it?

A

only if it’s a minor/ dependent adult/ elder.

No statute of limitations. Report.

86
Q

Do you have to report if 17 yr old tells you she’s having sex w/ her teacher? Clergy?

A

Find out if this is really happening. Could just be ideation.
If it is, mandated report b/c position of authority. (I think this may be ethical not legal mandate.)

87
Q

41 yr old clt tells you he’s sexually attracted to stepdaughter and masturbates to fantasies. Should you report?

A

You can’t report on fantasies alone. You could be sued. Need a behavior. (If he’s walked in to bedroom at night.)
Also, how old is stepdaughter? If shes not a minor, no report.

Marc (1 decks)

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