California LCSW Law and Ethics Mock 1 Flashcards
A 41-year-old Jewish man comes to an LCSW specializing in anger management. The man informs the LCSW that he has been placed on leave and has been told he will be fired from his job unless he undergoes 24 hours of anger management treatment, after an outburst at work frightened some of his colleagues. The LCSW takes him on as a client. Two weeks later, the client contacts the LCSW to terminate therapy, saying he has found an “anger coach” who is willing to provide 24 hours of treatment in four six-hour sessions. How should the LCSW proceed?
A Inform the client that anger treatment is best accomplished in weekly, one-hour sessions if it is to have lasting positive effects
B Respectfully challenge the idea that the anger coach can provide qualified or effective treatment over such a condensed time span
C Encourage the client to contact the BBS and determine whether the anger coach is a licensed professional
D Offer to provide records to the anger coach if the client wishes to sign a Release of Information
D Offer to provide records to the anger coach if the client wishes to sign a Release of Information
An LCSW has been seeing an individual client for three months. The client is struggling with posttraumatic stress following a military deployment. While the client is in therapy, the LCSW gets to know the client’s spouse, as the client signs a Release of Information allowing the LCSW and the spouse to share information about the client’s symptoms, treatment, and billing. Three months into the therapy, the LCSW and the client’s spouse encounter each other at a bar. They have sex that night. Legally, the LCSW must now:
A Terminate the sexual relationship immediately, terminate the client relationship immediately, and self-report to the BBS
B Terminate the sexual relationship immediately, and immediately disclose the encounter to the client
C Terminate the sexual relationship immediately, encourage the client’s spouse to disclose the encounter to the client, and provide the client a copy of the brochure Therapy Never Includes Sexual Behavior
D Take steps to minimize the emotional harm that may come to the client as a result of the encounter
D Take steps to minimize the emotional harm that may come to the client as a result of the encounter
After years of providing services in the office, an LCSW decides to transition their practice to be exclusively online. The LCSW selects a new videoconferencing platform that advertises itself as being secure and HIPAA-compliant. In a letter, the LCSW informs all existing office clients that their care will be moved online as of roughly one month from the date of the letter. Prior to completing this transition, what must the LCSW do to address their ethical responsibilities?
A Terminate or refer out all in-person clients with serious symptoms
B Allow the clients to choose whether they would like to continue seeing the LCSW in-office rather than moving to telehealth
C Take reasonable steps to identify crisis resources local to each client
D Ensure they are adequately trained on using the videoconference software
D Ensure they are adequately trained on using the videoconference software
An LCSW is working with a 21-year-old client whose treatment is paid for through a family trust, managed by the client’s uncle. The LCSW provides superbills to the client, who submits them tothe trust manager in a similar process to out-of-network care. The client comes to therapy one day confused because the trust returned a pair of superbills without reimbursing them. The thesuperbills appear to have notes on them, but neither the client nor the LCSW can understand what is written. How should the LCSW work with the client toward services being reimbursed?
A Ask the client to complete a Release of Information allowing the LCSW to submit the super bills directly to the trust
B Temporarily waive session fees until the payment issue is resolved
C Ask the client whether there have been similar payment issues with the trust in the past, and if so, how the client was able to navigate them
D Ask the client to provide a Release of Information allowing the LCSW to speak directly to the uncle
C Ask the client whether there have been similar payment issues with the trust in the past, and if so, how the client was able to navigate them
For 15 years, an LCSW has worked extensively with clients who were employed at the same place: A well-known local software company. While the LCSW is not employed by the company, employees of the company often refer their colleagues to the LCSW based on their positive experiences in therapy. The LCSW is interested in highlighting this long-standing relationship with a respected employer in future advertising. How should the LCSW manage their ethical responsibilities?
A Include on the LCSW’s business card and website that the LCSW is “Welcoming employees of” the software company.
B Without claiming any affiliation with the company, place items with the company’s logo visible in the background of photos to be included on the LCSW’s website, to establish a more subtle connection
C Place a print ad in the local newspaper with the employer’s logo and the headline “Thank You, [company], for 15 years of trust.”
D Include on the LCSW’s business card a photo of the company’s building
A Include on the LCSW’s business card and website that the LCSW is “Welcoming employees of” the software company.
A 13-year-old seeks mental health treatment at a nonprofit community clinic and is assigned to an associate CSW. The Associate attempts to engage the 13-year-old in an assessment interview, and while she is not argumentative, the 13-year-old appears easily overwhelmed by the associate CSW’s questions and says very little. When the associate CSW asks the 13-year-old whether she would like the associate CSW to call her parents to pick her up, she simply shakes her head “no.” When the associate CSW asks the 13-year-old whether she understands what therapy is, she shrugs her shoulders. When the Associate asks whether the 13-year-old wants to keep taking with the Associate next week, she shakes her head “yes.” Legally, the LCSW should:
A Schedule a session with the 13-year-old for the following week
B Send a billing statement to the child’s parents
C Ask the 13-year-old to bring her parents to the next session, so that they can provide consent for treatment
D Refer the client to an LCSW
C Ask the 13-year-old to bring her parents to the next session, so that they can provide consent for treatment
After an especially difficult session with a client an LCSW considers to have a personality disorder, the LCSW seeks to consult with a former professor from the LCSW’s graduate degree program, who is now retired. The LCSW plans to call the professor to ask how the professor might handle the case, including asking about specific interventions and asking about whether the LCSW should consider referring the case out. Legally, the LCSW should:
A Share specific information about the session only if they are careful not to mention the client’s name
B Establish a written contract with the professor for the consultation
C Ask the client to sign a Release of Information form
D Document the consultation
C Ask the client to sign a Release of Information form
An LCSW has been treating a man that she finds attractive, but has been able to maintain the integrity of the relationship through consultation with her colleague. The past few weeks she notices that the client has been coming into session cleanly shaved and wearing cologne. The therapist notices that he has been making more jokes, asking her about her personal life, and giving her compliments. How should the LCSW manage this situation?
A Attend her own personal psychotherapy
B Confront the client about her observations and remind him of the legal standards in their relationship
C Tell the client that they can no longer continue treatment and provide him with referrals for other therapists
D Share her observations with the client and discuss his perspective
D Share her observations with the client and discuss his perspective
An LCSW working in an agency setting learns that a child she sees for therapy has been physically abused by the child’s parents. The parents are treated by another therapist at the same agency, and it was that therapist who shared the information about the abuse and is preparing a written report to the local child protective service agency. The LCSW believes she has information from her last meeting with the child that would be relevant to the abuse report. How should the LCSW proceed?
A File her own independent report of suspected child abuse, based on the information she learned from the colleague
B Provide the relevant information to the colleague, and collaborate on the report
C Take no action
D Because the LCSW is the victim’s direct therapist, ask the colleague to provide all the available information and allow the LCSW to determine what will be reported
B Provide the relevant information to the colleague, and collaborate on the report
At a community mental health clinic, an associate CSW finds themselves attracted to their supervisor. The associate informs the supervisor of their attraction, and to the associate’s surprise, the supervisor says that they are also attracted to the associate. Considering their ethical responsibilities, at this time they should:
A Determine whether their attraction will interfere with the supervisory process, and seek consultation
B End the supervisory relationship, and wait at least two years prior to commencing a sexual relationship
C Transfer the associate to a different supervisor at the clinic, and ensure that the associate received no special treatment from the prior supervisor
D End the supervisory relationship, and wait to commence a sexual relationship until at least one of them is no longer employed at that workplace
A Determine whether their attraction will interfere with the supervisory process, and seek consultation
An LCSW has a policy that she will not attend court hearings or testify on a client’s behalf. This policy is written into her treatment contract, which is signed by all clients at the beginning of therapy. The LCSW receives a court order stating that she must testify about a former individual client who is on trial for armed robbery. The LCSW should:
A Assert privilege on the client’s behalf.
B Testify as instructed.
C Refuse the request, citing the clause in the signed treatment contract.
D Contact the client to determine his wishes.
B Testify as instructed.
A court order is different from a subpoena, which can come from a private attorney. If the therapist receives a court order, a judge likely has already determined that privilege does not apply. The LCSW should testify as instructed. A “no-court” policy in a treatment contract is largely unenforceable; it may discourage a client from calling the therapist as a witness, but it does not prevent others from issuing subpoenas or a court from ordering testimony or the production of records.
An LCSW is working as part of a treatment team in a county-run clinic. A colleague who is providing group therapy to clients in need of social skills training voices concern about one of the clients in the group. The LCSW sees this client for individual therapy. The client’s group attendance has become infrequent, and their behavior in group has varied from hyperactive to nearly silent. The client’s case manager notes that medication compliance has sometimes been an issue for this client in the past. The LCSW should:
A Offer to take over the social skills group to better assess the client
B Reconsider the client’s diagnosis
C Ensure that conclusions about the client’s medication compliance are made only by medical professionals
D Share what the LCSW is aware of about the client’s family and social context
D Share what the LCSW is aware of about the client’s family and social context
An LCSW learns from a colleague that Jane, a third LCSW working in the same clinic, developed a sexual relationship with a client when the client was under Jane’s care. Jane says that she terminated the therapy and referred the client to the colleague to resolve the conflict of interests, and Jane considers the matter resolved. Ethically, the LCSW should:
A Immediately report Jane to the BBS
B Demand that Jane report herself to the BBS, and if she does not comply, the LCSW should make the report themselves
C Discuss with Jane that the LCSW is concerned about Jane’s professional boundaries
D Provide all of Jane’s clients the brochure Therapy Never Includes Sexual Behavior, without revealing the nature of the concern
C Discuss with Jane that the LCSW is concerned about Jane’s professional boundaries
It is tempting to report Jane directly, or to take other steps to ensure that a report happens. But this is not the LCSW’s responsibility. In fact, California is among the states that do not have a requirement in law that LCSWs report the ethical or legal violations of colleagues to the state board. Depending on how you learned the information, doing so might actually be a breach of confidentiality. Inserting yourself into the care of other clients (“Provide the colleague’s clients the brochure Therapy Never Includes Sexual Behavior, without revealing the nature of the concern”) is inappropriate, as is threatening the colleague (“Demand that the colleague report herself to the BBS, and if she does not do so.
A client’s doctor has prescribed the client medication to help treat the client’s obsessive-compulsive disorder. In therapy, the client reports that the medication has helped them reduce instances of compulsive behavior, but they find themselves continuing to struggle with patterns of obsessive thought. The client reports some difficulty with taking their medication at the same time every day, as the doctor prescribed. The therapist should:
A Avoid any discussion about the medication or its effects, and focus on symptom reduction
B Encourage compliance with the prescribed medication treatment, and work with the client on ways of managing current symptoms and taking their medication on time
C Refer the client back to their physician to discuss symptoms and medication compliance
D Encourage the client to consider minor adjustments in medication dosage
B Encourage compliance with the prescribed medication treatment, and work with the client on ways of managing current symptoms and taking their medication on time
The therapist cannot give medical advice (ruling out d), but part of coordinated mental health care involves helping clients to comply with the treatment specified by other qualified professionals. In other words, the therapist is not required to completely avoid any discussion of medication (ruling out c), and does not need to immediately refer back to the physician any time the topic of medication comes up (ruling out b). The therapist can remain safely within their scope of practice while discussing how the client has experienced meditation’s impact on their symptoms, and while encouraging medication compliance (a).
An LCSW occasionally encounters her first client of the morning on the subway, as they both live in the same neighborhood and take the same train to the LCSW’s office. One day, the LCSW and the client see each other as they are both about to enter the subway station. The LCSW realizes she left her wallet, which contains her subway card and cash, at home. The client notices this and offers to pay the LCSW’s fare. How should the LCSW address her ethical responsibilities?
A Accept the client’s offer, agreeing in exchange to reduce the client’s fee that day by the amount of the subway fare
B Consider whether the client would expect special treatment in return
C Accept the client’s offer, and once in session, draft a written agreement documenting the payment and the LCSW’s commitment to pay the client back
D Accept the client’s offer, verbally agreeing to pay the client’s fare the following week
B Consider whether the client would expect special treatment in return
An Italian family seeks therapy from an LCSW. The family consists of a mother, father, grandfather, and three teenagers, all of whom share a home. They describe themselves as “tightknit, loud, and boisterous,” and the initial session reflects this -they often talk over one another and occasionally shout, even when talking about topics they agree on. They tell the LCSW they came to therapy because they are concerned about the middle teenager, age 16, who has been fighting with her siblings and parents. They say the 16-year-old recently disavowed her Catholic religion as well. When considering the LCSW’s ethical obligations, how should the LCSW approach treatment?
A Provide the 16-year-old with individual sessions to ensure that her voice and perspective can be fully heard
B Divide the family into subsystems for small-group conversations
C Become louder in session to emulate the family’s style of communicating; observe family interaction patterns to determine impacts and needs
D Use a “talking stick” or other item to ensure that only one family member speaks at a time; process small interactions to help the family see how they are undermining each other in their communication
C Become louder in session to emulate the family’s style of communicating; observe family interaction patterns to determine impacts and needs
A woman who is seeing an LCSW for treatment of depression dies under mysterious circumstances. In therapy, she had discussed her recreational drug use, and her fear that her ex-husband may become violent with her. The LCSW receives a notice from the local coroner investigating the woman’s cause of death that the coroner would like to review the woman’s treatment records. The LCSW should:
A Contact the woman’s next of kin to determine their wishes
B Claim privilege on behalf of the client
C Offer to answer specific questions, but refuse to provide the treatment record
D Provide the requested records
D Provide the requested records
While most attention for exceptions to confidentiality focuses on the “big four” exceptions, there are other exceptions in state law as well – and a coroner’s investigation of the death of a client is one of them. In this case, the LCSW is legally obligated to turn over the records (D). It isn’t up to the client’s next of kin (A). A coroner’s investigation is not a judicial proceeding, so privilege does not apply (B). And it doesn’t make sense (or comply with the law) for the LCSW to serve as a filter of treatment records (C).
An LCSW in private practice becomes seriously ill and is hospitalized, with the expectation that the hospitalization will be long-term. The LCSW is suffering serious pain and difficulty with cognition due to the combination of medications the LCSW is being given. The LCSW has an active caseload of about 20 clients, some of whom are at risk for going into crisis and require regular contact. Under the circumstances, the LCSW should:
A Conduct telehealth sessions from the LCSW’s hospital room until clients can be transferred
B Authorize another qualified clinician to access client records and coordinate continuity of care
C Sell the LCSW’s practice, including its current active caseload, and inform clients in writing that as of the sale date, they will be attending sessions with the new practice owner
D Send a letter to each client releasing them from the LCSW’s care and closing their cases
B Authorize another qualified clinician to access client records and coordinate continuity of care
This is a difficult situation because there is no good solution. The LCSW’s symptoms suggest that the LCSW will not be able to provide minimally competent care, so they should not be conducting sessions (A). And since no one “owns” a client – clients have autonomy to choose their own providers – the LCSW is not in a position to dictate to clients who they will be attending future sessions with (C). To avoid client abandonment, the LCSW must do more than just sending clients a letter closing their cases (D). Option (B) addresses continuity of care needs by essentially doing a professional will, authorizing another therapist to take over while the LCSW is incapacitated.
A client comes to an LCSW and identifies herself as the victim of intimate partner violence. She describes instances of her husband physically assaulting her and threatening her with a gun. She tells the LCSW that her husband is a police officer who is skilled with technology and monitors their bank accounts closely. She asks the LCSW to see her on a cash-only basis with no physical receipts, and to not keep any records of her treatment, as she is worried those records could be used by her husband to discover where she is currently staying and to describe her in future divorce proceedings as mentally unfit for custody of their children. Considering the LCSW’s ethical responsibilities, the LCSW should:
A Agree to the client’s requests
B Agree to the client’s requests surrounding payment, and inform her that clinical records must be kept, but that those records will not include any information about her mental health
C Agree to the client’s requests surrounding payment, and inform the client that records from treatment of intimate partner violence are not subject to subpoena
D Inform the client that neither of her requests can be honored and describe how records are kept safe
D Inform the client that neither of her requests can be honored and describe how records are kept safe
An LCSW is providing individual therapy for a 33-year-old man who is in the process of ending a long-term romantic relationship. The client says that his partner is becoming increasingly erratic and threatening as he has been encouraging her to find another place to live. In session, he plays the LCSW a voicemail from the partner, received that morning, in which the partner threatens to kill him when he comes home that night. How should the LCSW address this situation?
A Notify law enforcement that there is an active Tarasoff situation
B Attempt to contact the partner to assess her for possible involuntary hospitalization
C Develop a safety plan with the client and encourage the client to notify law enforcement
D Direct the client to remove weapons from the home
C Develop a safety plan with the client and encourage the client to notify law enforcement
A 17-year-old who has been participating in family therapy under her parents’ consent asks the LCSW for a copy of treatment records that apply specifically to her. She explains that her school, from which she was recently suspended, is requesting proof that she is receiving mental health care. She says a treatment summary indicating her participation should suffice if the LCSW does not want to provide more detailed records. Considering the LCSW’s ethical responsibilities, how should the LCSW respond to this request?
A Ask the 17-year-old to complete a Release of Information authorizing the release of records directly to the school
B Contact the parents and any other family members involved in treatment to determine whether they will authorize the release of records, and whether they would prefer a treatment summary be provided
C Provide a copy of the client file within 15 working days, with information about the parents and other family members redacted
D Provide the client with a treatment summary letter, addressed to the client, indicating dates of service only, and not naming any other family members participating in treatment
B Contact the parents and any other family members involved in treatment to determine whether they will authorize the release of records, and whether they would prefer a treatment summary be provided
An LCSW has been providing telehealth-based care to a 70-year-old man who lives in a rural area of northern California. The man grows frustrated with the LCSW, and tells the LCSW that he would like to take a break from their work together. The man is diagnosed with Substance Use Disorder and Bipolar I Disorder, and is not consistent in taking his medication. After five weeks go by without contact between the client and the LCSW, the client calls the LCSW and sounds intoxicated. How should the LCSW direct the client?
A Because of the client’s age, the LCSW should report elder abuse to the client’s local adult protective service agency, ensuring that he will be directed to an appropriate level of care
B Because treatment was terminated, the LCSW owes no duty of care, and no action is necessary
C The LCSW should seek to ensure the client’s immediate safety, and either resume treatment or direct the client to alternate service providers who may be able to take over his therapeutic care
D The LCSW should address safety needs and inform the client that he will need to find another provider once he is no longer intoxicated
C The LCSW should seek to ensure the client’s immediate safety, and either resume treatment or direct the client to alternate service providers who may be able to take over his therapeutic care
An LCSW is treating a client for trauma, using exposure-based techniques. During a particularly intense session, the client becomes overwhelmed, and tells the therapist she is ending treatment. She reports that she has become distracted and irritable with her family and at work, and that the treatment is not helping her in the way she hoped. The therapist should:
A Schedule the client for another session as soon as possible, to re-assess the treatment plan and attempt to restore the relationship
B Inform the client that ending therapy at this stage of therapy is potentially dangerous, and trauma therapy is difficult by nature
C Empathize with the client, and remind her of her rights
D While maintaining confidentiality, share with the client stories of other clients who have faced difficulty in trauma treatment, but went on to complete it successfully
C Empathize with the client, and remind her of her rights
A family of six is seeing an LCSW to address issues of discipline and conflict within the family: A 64year-old grandfather, his 38-year old son, the son’s 29-year-old wife, and their three children, ages 11, 8, and 5. The grandfather is skeptical of therapy and concerned about privacy, and asks the LCSW for more information about how records are stored and maintained. Which of the following responses would best capture the LCSW’s legal responsibilities?
A Ask all family members to agree on a records release policy
B Inform the grandfather that records of treatment must be destroyed after therapy is completed if the family requests it
C Inform the client of the limitations of the LCSW’s knowledge as to how record storage works, while reassuring the client that the LCSW will follow all applicable laws
D Inform the grandfather that records of treatment will be maintained for at least 20 years
D Inform the grandfather that records of treatment will be maintained for at least 20 years
An LCSW works routinely with celebrities and other high-profile clients. One way that the LCSW has gained the trust of these clients is by showing them how she keeps records: All on handwritten notepads, with diagnoses and other clinical information but no client names or other identifying information. In this way, she tells the clients, she can maintain accurate records, but if someone were to break into her office, they would have no way of knowing who the clients are, and the records could not be hacked or made public in a way that might embarrass the clients. She also tells the clients that she will never provide these records to anyone else. Legally, this form of record-keeping:
A Would be considered unprofessional conduct
B Would be considered psychotherapy notes under HIPAA
C Does not comply with the federal Open Note standard
D Serves to protect records from subpoena
A Would be considered unprofessional conduct
An LCSW is working with a client who is attending therapy under court order. The client has spent time in therapy discussing their history of trauma and abuse, which included being the victim of childhood sexual abuse. The client has developed insight linking their victimization in childhood to their more recent violent and risk-taking behavior. The judge in the client’s case requires the LCSW to testify in court as to the client’s progress. Knowing that the hearing is coming up, the client expresses concern in a therapy session that the therapist may be called upon to reveal details of the client’s childhood. When called to the witness stand to testify, the LCSW should:
A Provide basic information about the client’s attendance in therapy, but no details about their history or insight
B Claim privilege on behalf of the client
C Refuse to answer any questions unless the client provides specific permission
D Provide opportunities for the client’s attorney to object to specific questions, but otherwise provide testimony in response to whatever questions are asked
D Provide opportunities for the client’s attorney to object to specific questions, but otherwise provide testimony in response to whatever questions are asked
Therapy that is taking place by court order is one of the specific exceptions to privilege in state law, and since the judge has required the LCSW to testify, it is safe to presume that the judge has determined that privilege does not apply. As such, the LCSW cannot claim privilege or refuse to answer questions. They should testify (d).
An LCSW in private practice hires an assistant to address tasks such as marketing, scheduling, and billing. The LCSW gives the assistant training in HIPAA and related privacy requirements. As the LCSW is approaching a vacation, the assistant prepares a mass email to all current clients informing them of the LCSW’s upcoming absence and how they can receive crisis or emergency care if necessary during the vacation. The assistant accidentally includes all client email addresses in the “To:” field of the email, such that each recipient can see the addresses of all other recipients. The assistant informs the LCSW immediately. How should the LCSW proceed?
A Terminate the employment of the assistant, and issue a formal apology to impacted clients
B Contact impacted clients individually to inform them about the issue and the steps the LCSW is taking to ensure it does not happen again, and provide additional training to the assistant
C Re-issue the newsletter email, hiding individual addresses from other recipients
D Because only client email addresses were exposed, and the specific number of impacted clients is known, treat this situation as a Level 3 breach of private information
B Contact impacted clients individually to inform them about the issue and the steps the LCSW is taking to ensure it does not happen again, and provide additional training to the assistant
A client has seen his LCSW twice in the therapist’s office. Before the third session, the client calls the LCSW as the client is running late. The client asks whether the start of the session can be conducted via phone, with the understanding that he will arrive at the office about 20 minutes after the scheduled starting time. The LCSW should:
A Inform the client that the session can begin when he arrives at the office
B Inform the clients of the risks and benefits of engaging in telehealth, and seek the client’s consent for this form of treatment
C Conduct the initial 20 minutes of the session by phone
D Inform the client that while a phone session is prohibited, it would be possible to meet via real-time, two-way videoconferencing, either for the first 20 minutes or for the full session
B Inform the clients of the risks and benefits of engaging in telehealth, and seek the client’s consent for this form of treatment
By state law, clients must specifically consent to the use of telehealth services, after having been informed of the risks (B). It would not be legal to conduct any therapy via telehealth (C) before securing this consent. A phone call is a legally allowed technology for therapy, eliminating both (A) and (D) as response options.
An LCSW is at a concert, and sees a teenage client at the concert with a friend. The client and the friend both appear to be intoxicated. At one point toward the end of the concert, the client notices the LCSW, and quickly puts her head down in embarrassment. How should the LCSW address their ethical responsibilities?
A Walk up to the client, without revealing their relationship, and say something along the lines of, “You’re allowed to have fun.” At the next scheduled session, pretend she did not see the client at all.
B Leave the concert, and consider terminating therapy as the integrity of the therapeutic relationship has been corrupted. The therapist’s judgment is no longer based solely on clinical information.
C Stay at the concert, avoid further contact with the client, and inform the client’s parents of what the LCSW observed.
D Stay at the concert, and allow the client to determine whether they will say hello. Discuss therapeutic boundaries at the next session.
D Stay at the concert, and allow the client to determine whether they will say hello. Discuss therapeutic boundaries at the next session.
During a pandemic that has caused local officials to close schools and businesses, a client tells his therapist by phone that he has been diagnosed with the disease. Further, the client believes he caught it from being in the therapist’s waiting room at the same time as another individual who was coughing. The client tells the therapist to expect a phone call from a county contact tracer, who is working to identify and inform others who may have been exposed to the virus that causes the disease. Indeed, a day later, the therapist receives a call from a contact tracer, who asks the therapist to provide the name and contact information of the person who had been coughing in the waiting room, as well as anyone else that the therapist believes that individual may have been in close contact with. Considering their legal responsibilities, the therapist:
A Must inform the contact tracer that the therapist can neither confirm nor deny whether the diagnosed person was in the therapist’s waiting room, and cannot provide any other information
B May provide the contact tracer with the name and contact information of the person who was coughing, as well as anyone else the person may have been in close contact with
C Cannot provide the contact tracer any information, but should contact the person who had been coughing in the waiting room and seek to have them hospitalized
D Must provide the contact tracer the name and contact information of the person who had been coughing, and also must notify law enforcement, given the imminent risk of the person infecting others
B May provide the contact tracer with the name and contact information of the person who was coughing, as well as anyone else the person may have been in close contact with
A pandemic is a public health emergency, and is one of the instances in state law where a therapist may provide otherwise confidential information, though they are not required to. In this instance, providing names and con-tact information is reasonable, and does not involve sharing any other information about why those individuals were at the therapist’s office (or even that the place of contact was a therapist’s office).
An LCSW working with an individual client notices that the client has not paid for the last four sessions. The LCSW discusses the client’s obligation and the consequences of nonpayment with the client in session, including the possibility that the matter will be referred to a collections agency. The client promises to pay their bill. The client then no-shows for their next three scheduled appointments. To fulfill the LCSW’s ethical responsibilities, the LCSW should:
A Offer the client a payment plan, refer to low-fee services, and provide notice of intent to refer the client to the collection agency
B Offer the client a payment plan, refer to low-fee services, and increase the frequency of contact until the bill is paid
C Refer to low-fee services, and contact a responsible family member who may be able to assist with payment, without revealing any clinical information
D Refer to low-fee services, and contact the client’s employer to request a wage garnishment until the bill is paid, without revealing any clinical information
A Offer the client a payment plan, refer to low-fee services, and provide notice of intent to refer the client to the collection agency
An LCSW is called to testify as a fact witness in the case of a long-term individual client who is suing their former employer. Based on what the client reported in therapy, the therapist believes that the client’s former manager may have bipolar disorder, and that the client was unfairly blamed for the manager’s behavior. The client has waived privilege, allowing the LCSW’s testimony. When testifying, the LCSW should:
A Advocate on behalf of the client, but avoid any specific discussion of the former manager
B Advocate on behalf of the client, and discuss the reported behaviors that lead the LCSW to believe the manager may have bipolar disorder
C Provide facts in regard to only what the therapist directly observed
D Provide specific facts and expert opinions, including the diagnosis of the manager and the limitations associated with that diagnosis, such as that the LCSW has not personally observed the manager
C Provide facts in regard to only what the therapist directly observed
After several sessions of individual therapy focused on anger management, a client becomes visibly angry at his therapist. “I thought you knew what you were doing,” the client says. “You misled me.” The client pulls a brochure from his pocket and slams it on the table. It’s a brochure the LCSW is using to advertise his practice, and it describes the LCSW as providing psychotherapy focused on anger and resentment issues. It also includes recommendations from two colleagues. Legally, the LCSW should:
A Consider whether the client might have reasonably believed the LCSW has more training or experience in anger management than he does
B Revise the brochure to remove the testimonials
C Revise the brochure to remove the word “psychotherapy”
D Consider termination
A Consider whether the client might have reasonably believed the LCSW has more training or experience in anger management than he does
The recommendations from colleagues are not the same as testimonials from clients and do not need to be removed (B). It’s perfectly legal for LCSWs to call themselves psychotherapists and describe their work as psychotherapy (C). And termination here (D) would be premature; this may very well be a rift in the relationship that can be healed. LCSWs have a legal responsibility to not put out any advertising that is false or misleading. In this case, since the client is reporting that they feel they were misled, the LCSW should consider whether that’s a reasonable response to the advertising material (A), and if it is, change the material accordingly.
