California LCSW Law and Ethics Mock 2 Flashcards
4
A man who recently immigrated to the US comes to therapy at the request of his coworkers. The man is confused about why they asked him to go to therapy, but willing to do so, and completed the informed consent process prior to session. He has signed a release of information allowing the LCSW to communicate with his boss, who explained that the coworkers were concerned and frightened when they observed the man, from their perspective, mumbling incoherently in a corner of the office. The boss and coworkers were concerned that the man may be having a psychotic episode. How should the LCSW proceed with the client?
A Inquire about the client’s cultural and religious background.
B Inquire about the man’s work history and workplace relationships.
C Educate the client about the nature and etiology of psychosis.
D Assess the client for possible acculturation stress and substance use.
A Inquire about the client’s cultural and religious background.
The client’s speech, while perceived as incoherent by others, could simply have been in the client’s native language. The LCSW can demonstrate cultural competence by asking about the client’s cultural and religious background before jumping to any conclusions about the nature or etiology of the client’s behavior at work.
9
An LCSW in private practice is on the phone with a potential client who would like to schedule an initial session. The client is seeking treatment for what they describe as symptoms of depression. They say they have been in therapy before, most recently two years ago, and that while they have health insurance, they intend to pay out of pocket for the LCSW’s services. Legally, which of the following must be disclosed to the prospective client prior to the initial session?
A Common exceptions to confidentiality.
B Because the client has health insurance, a statement noting that insurers are required to cover mental health services at parity with physical conditions, and that the client would save money by using their insurance.
C The LCSW’s credentials, including their license type and number, highest degree earned, and any relevant certifications.
D An estimate of how much the treatment will cost over the next 12 months.
D An estimate of how much the treatment will cost over the next 12 months.
The requirement for clinical social workers to inform clients about exceptions to confidentiality comes from ethics, not from law. The only legal requirement in the options presented is the estimate of costs, otherwise known as a Good Faith Estimate. This must be provided to all cash-pay clients.
15
An LCSW in private practice charges clients for consultations with other professionals involved in the client’s treatment. Which of the following best summarizes the legality of the LCSW charging this fee?
A The LCSW may not charge or collect these fees, as doing so would amount to an illegal kickback.
B The LCSW may charge and collect the fee so long as it is disclosed at the beginning of treatment.
C The LCSW may not charge or collect these fees, as they are not directly related to the provision of clinical care.
D The LCSW may charge and collect the fee so long as it does not exceed $50 per consultation and so long as the client is notified of each new fee within 72 hours of the consultation occurring.
B The LCSW may charge and collect the fee so long as it is disclosed at the beginning of treatment.
The LCSW is required to disclose this fee at the beginning of treatment, but as long as they have done so, they can charge the fee, and there is no cap on how much they can charge.
19
A 16-year-old presents to an LCSW for individual therapy after being encouraged to do so by her mother. The girl’s parents are divorced, and the mother has legal custody, although the girl reports a positive relationship with her father. The girl says she would like to consent to therapy on her own for privacy, since she wants to discuss her parents’ divorce. She asks the LCSW to bill services to the father, who is required under the custody order to pay for the girl’s health care costs. How should the LCSW address their legal responsibilities?
A Request a copy of the custody order to confirm the father’s financial responsibility.
B Discuss with the client what information will need to be shared with the father to facilitate billing.
C Inform the girl that she will either need to pay for services herself, or that one parent must sign paperwork taking financial responsibility for the treatment.
D Inform the girl that the LCSW can only bill the client or the mother for services provided under a minor’s independent consent.
C Inform the girl that she will either need to pay for services herself, or that one parent must sign paperwork taking financial responsibility for the treatment.
When a minor independently consents for treatment, the provider legally cannot force the parents to pay for that treatment. If one parent is willing to voluntarily take financial responsibility, they can do so, but it cannot be forced upon them – even when there is a custody order like the one described here.
20
The long-term client of an LCSW invites the clinical social worker to the client’s wedding. The client expresses gratitude for the work the LCSW has done to help the client reach a point where they are able to function well and feel secure in a romantic relationship. The LCSW learns from the client that about 200 people will be in attendance at the wedding, and the client is hoping to publicly thank the LCSW in a speech during the wedding reception. How should the LCSW respond to the invitation?
A Inform the client that the LCSW can only attend the wedding if the client agrees not to discuss the therapy relationship publicly. Your answer
B Ask the client to first sign a Release of Information authorizing the clinical social worker to acknowledge the therapy relationship to attendees at the wedding, and seek clarity on what specifically the client is planning to say about the therapy.
C Politely decline the invitation, express gratitude for the work the client has done, and if appropriate and desired, send the couple a reasonably-priced wedding gift.
D Plan with the client in advance for how the client would like to address confidentiality concerns, and defer to the client’s wishes.
D Plan with the client in advance for how the client would like to address confidentiality concerns, and defer to the client’s wishes.
Attending the wedding would not be inherently unethical, but does present some obvious risks related
to boundaries and confidentiality. In this case, a conversation about confidentiality before the wedding
21
An LCSW who identifies as cisgender seeks consultation from a trans Psychologist on working with trans clients. The LCSW has begun seeing trans clients in the LCSW’s practice and is wanting to ensure competent and effective care. How should the LCSW approach the consultation in light of the LCSW’s ethical responsibilities?
A Because the Psychologist is bound to the same confidentiality standards as the LCSW, the LCSW may safely provide any necessary details about the clients, including their names.
B The LCSW cannot consult with the Psychologist, even in general terms, without first receiving a Release of Information from each trans client.
C Ask general questions about clinical work with clients who identify as trans, without discussing details of the specific clients currently in the LCSW’s practice.
D Provide detailed information about the clients in the LCSW’s practice so that the consultation will be specific to their care, but do not provide the clients’ names.
C Ask general questions about clinical work with clients who identify as trans, without discussing details of the specific clients currently in the LCSW’s practice.
The LCSW is seeking to improve their overall competence with the trans population, not to resolve concerns specific to each individual client. Therefore, the LCSW should engage in a general consult, for which a Release of Information is not necessary. If the LCSW were to be providing more specific client information, with or without disclosing client names, seeking releases would be appropriate.
25
An LCSW in private practice and a local psychiatrist in private practice have developed a strong working relationship, after the psychiatrist spent extra time working with some of the LCSW’s clients to ensure their medication dosage was appropriate and effective. The psychiatrist asks the LCSW whether the connection between their practices could be highlighted on the LCSW’s web site, with the psychiatrist to be described as the “preferred psychiatrist” of the LCSW. How should the LCSW respond, considering their legal obligations?
A. The LCSW should clarify with the psychiatrist what “preferred provider” means and what expectations on both of them would come with that title.
B. The LCSW cannot promote the psychiatrist’s practice in this way.
C. This is likely to benefit both providers, neither of whom has a financial stake in the outcome. Therefore, the arrangement would be legal.
D. The LCSW can allow the psychiatrist to advertise on the LCSW’s site, and say that they are the “preferred provider” of the LCSW, so long as they are paying fair market value for the advertising space.
B. The LCSW cannot promote the psychiatrist’s practice in this way.
The psychiatrist is now asking for something in return for accepting the referrals from the LCSW. Even if there is no cash involved, this can still be considered a kickback or fee for referrals, which is explicitly prohibited by law. The only determining factor in the referrals an LCSW gives a client should be the
26
An LCSW has been offered a prominent recurring role on a popular podcast devoted to mental health and well-being. The LCSW realizes that one of the show’s co-hosts is the ex-wife of a former client, and the former client felt deeply harmed by the divorce, and grew resentful and angry each time he heard about his ex-wife succeeding professionally. The LCSW last saw the client three years ago. How should the LCSW proceed, considering their ethical obligations?
A. Inform the show of the potential conflict without specifically identifying the former client.
B. Contact the former client to determine their preferences.
C. Decline the offer.
D. Accept the offer, considering how much time has passed since the client was seen for therapy.
C. Decline the offer.
This situation represents a conflict of interests, as the interests of the LCSW run counter to the likely interests and well-being of the former client. Taking on the role with the podcast is potentially harmful to the former client, and the NASW Code of Ethics puts no time limit on the social worker’s duty of loyalty to the former client. Contacting the former client puts the client in an awkward position of making them responsible for the LCSW’s ethical compliance; they may feel pressured to give permission regardless of their actual feelings.
32
Parents bring their adolescent daughter with them to therapy and provide consent for the daughter’s treatment. They express concern over the daughter’s increasingly withdrawn behavior and falling grades at school. They say they want the LCSW to engage in a mix of family therapy with all of them and individual therapy with the daughter, organized around a single treatment plan. They say they want the daughter to have a safe adult to talk to who is not a parent but can offer good judgment. How should the LCSW proceed in light of their ethical obligations?
A. Interview the adolescent individually to fully assess for child abuse and other forms of violence in the home.
B. Establish a clear policy for all family members to sign about how confidentiality will be handled within the family.
C. Establish a clear schedule for which sessions will be individual and which sessions will be family.
D. Inform the family that performing both individual and family therapy with the daughter would present a conflict of interests, and offer referrals for the family therapy.
B. Establish a clear policy for all family members to sign about how confidentiality will be handled within the family.
It would NOT inherently be a conflict of interest to engage in both family and individual therapy, particularly when both are organized around the same overall treatment plan. Interviewing the child individually for assessment and establishing a clear session schedule are clinically useful tasks, but neither fulfills a specific ethical responsibility. Clinical social workers are required to establish a
40
The individual adult client of an LCSW tells the LCSW that the client was recently denied food assistance from a local nonprofit group. The client is not sure of why she was denied the assistance. The LCSW believes that the client’s financial stressors are significantly impacting the client’s mental health and their ability to progress in therapy. How should the LCSW address the issue, considering the LCSW’s ethical obligations?
A. With client permission, contact the nonprofit group to support the client’s request for their assistance.
B. Speak out generally for the expansion of food assistance programs, highlighting the client’s situation as an example of the need.
C. Refer the client back to the nonprofit and encourage them to request assistance again.
D. If possible, provide food directly to the client from excess supplies at the LCSW’s workplace.
A. With client permission, contact the nonprofit group to support the client’s request for their assistance.
The LCSW should advocate on an individual level for the availability of resources that will address the client’s needs. The LCSW is not obligated to provide direct assistance from their own workplace. Using the client’s situation as an example in public discussion raises confidentiality concerns. Simply referring the client back to the nonprofit without taking steps to address the reasons for their initial refusal appears unlikely to produce a different response.
41
An LCSW is working with a 16-year-old client who says that she’s been exchanging sexually explicit messages and photos with an adult online. The client insists the exchanges are consensual and asks the LCSW not to inform her parents. How should the LCSW fulfill their legal obligations?
A. Inquire about the age of the adult with whom the client has been exchanging messages and photos.
B. Share information about the relationship with the minor’s parents if the parents provided initialconsent for the treatment.
C. Report suspected child abuse to the local child protective service agency.
D. Maintain confi dentiality and educate the client about online safety.
C. Report suspected child abuse to the local child protective service agency.
The distribution or downloading of child sexual abuse material (also often referred to as child pornography) is a mandated report under California law; the age of the adult in this scenario does not matter. Even if the parents provided initial consent for treatment, the LCSW does not have an obligation to proactively inform them about the relationship.
49
An LCSW in private practice has a strong track record of success in helping clients with obsessive-compulsive Disorder. Over the past 6 months, all 18 clients who concluded OCD treatment with the LCSW showed marked improvement in their functioning. The LCSW is considering different ways of highlighting her success in her advertising. Which of the following could the LCSW legally say about her work in an advertisement?
A. 100% success in improving OCD symptoms.
B. I will help you or your loved one get better. Functioning with OCD is possible.
C. If you or a loved one is struggling with OCD, therapy with me can help.
D. See me for recovery from OCD.
C. If you or a loved one is struggling with OCD, therapy with me can help.
The LCSW cannot make claims that a reasonable consumer would perceive as guarantees of success. So the phrases “100% success” and “I will help” are out. It is more nuanced, but “recovery from OCD” also suggests a cure, where the LCSW’s own data only has shown consistent improvement, so this too could be considered misleading. “Can” is a better term to use in advertising, precisely because it is less definite.
57
An LCSW in an agency setting has been working with a homeless client who is struggling with methamphetamine addiction. The client attends therapy infrequently and has had several relapses with drug use. In session, the LCSW observes that the client has lost significant weight and has several scratches, burns, and bruises in different stages of healing. The client complains of severe headaches but refuses to seek medical care, saying, “I know they’ll all just tell me to stop using.” He says he sleeps on the streets most nights, “wherever I wind up.” How can the LCSW best fulfill their legal responsibilities?
A. Provide referrals for medical treatment and encourage the client to make use of them.
B. Encourage the client to seek voluntary hospitalization.
C. Initiate the process of involuntary hospitalization.
D. Inquire about the client’s use of other substances and potential mental health conditions to determine whether they qualify for involuntary hospitalization.
C. Initiate the process of involuntary hospitalization.
The legal criteria for involuntary hospitalization due to a person being gravely disabled were expanded in 2024. The client now meets the criteria based solely on the information in the question. They are unable to meet basic needs for shelter and medical care due to a severe substance use disorder. The LCSW should initiate involuntary hospitalization.
60
A single father and his 7-year-old son came to an LCSW for assistance after the son’s school district
refused to provide accommodations for the boy. The father informs the LCSW that the son was
diagnosed by a prior family therapist as having ADHD and Autism Spectrum Disorder, but that the
school did not honor those diagnoses, citing inadequate evidence. The LCSW observes the child and
believes that he meets both sets of diagnostic criteria. How should the LCSW proceed, considering
their ethical responsibilities?
A. Refer the father to a physician to provide a medical diagnosis for the child.
B. Refer the father to a psychologist to obtain testing in support of the diagnosis.
C. Offer to contact the school directly with the father’s permission to advocate on the child’s behalf.
D. Refer the father to legal support services for a potential lawsuit against the school district.
B. Refer the father to a psychologist to obtain testing in support of the diagnosis.
If the school previously would not honor a therapist’s diagnosis, it appears unlikely that another therapist issuing the same diagnosis would change the result. The family would benefit by a referral for the very thing the school is demanding -better evidence in support of these diagnoses, which would most appropriately come from psychological testing.
63
A client who has been very happy with the services of an LCSW is approaching termination. She asks the clinical social worker whether she can provide some kind of quote or rating or other information that the LCSW can use to promote their practice, considering the client’s satisfaction and the positive results from treatment. Ethically, how should the LCSW proceed?
A. Discuss the possible implications for the client were the LCSW to use the client’s quote and name in advertising. If the client gives permission, use the client’s quote and name.
B. Request that the client wait to provide any kind of a quote or rating until after the treatment has fully concluded.
C. Explore the client feelings and experiences in treatment that have led to their satisfactin and desire to help the LCSW. Use this information to advance the termination process.
D. Inform the client that clinical social workers are prohibited from using such statements from current or former clients.
A. Discuss the possible implications for the client were the LCSW to use the client’s quote and name in advertising. If the client gives permission, use the client’s quote and name.
LCSWs cannot solicit testimonials from clients, but this was not solicited. The client proactively offered it. The LCSW can use the testimonial with clear permission, and they do not need to wait until treatment has ended. Discussing the implications first protects the client’s interests.
