Ethics

Question 1

What is informed consent?

Answer 1

Informed consent is a procedure that entails providing clients with comprehensive information about the psychological service and gaining their agreement to take part in the service.

Question 2

What are the four elements that are considered to form valid consent?

Answer 2

The client must be considered competent
The consent should be given voluntarily
The consent must be specific
The information must be provided to the client in language that he or she is able to understand

Question 3

Do I need to document that consent has been obtained?

Answer 3

There is no legal requirement to document the provision of consent, the APS Code of Ethics instructs psychologists to document a client’s consent prior to the provision of a service.

Question 4

At what age can someone consent to psychological services?

Answer 4

Psychologists may provide services to a young person without parental consent as long as the young person is deemed to have the capacity to give informed consent. A young person is considered capable of giving informed consent when he or she achieves a sufficient understanding and intelligence to enable full understanding of what is proposed.

Question 5

How do I assess a person’s capacity to provide informed consent (4 things)?

Answer 5

In order for a person to provide informed consent he or she must:
• Understand the information that is provided, including the benefits and risks of proceeding or not with the service
• Understand the limits to confidentiality
• Be able to retain and consider the information and make a decision whether to consent or refuse
• Be able to communicate his or her consent.

Question 6

How do I manage consent when a third party has paid for the service?

Answer 6

The psychologist must discuss this information with all parties to ensure full understanding and agreement with the conditions under which the service will be provided, and have documentation outlining consent to the arrangement.

Question 7

A lawyer has sent me a consent form from a client I have seen in the past and has requested a copy of the client’s file. How should I respond to this?

Answer 7

It is always a good idea to attempt to contact the client directly to ensure that he or she fully understands the implications of giving consent and that the consent has been provided contemporaneously.

Question 8

What does a suicide risk assessment involve?

Answer 8

An examination of the client’s mental state, asking about any previous history of suicidal behaviour and whether he has an actual suicide plan as well as access to the means to do it, and looking for evidence of impulsive behaviour or use of alcohol or drugs.

Question 9

What constitutes ‘notifiable conduct’ under the National Law (Section 140),?

Answer 9

When a practitioner has:

a. practised the practitioner’s profession while intoxicated by alcohol or drugs; or
b. engaged in sexual misconduct in connection with the practice of the practitioner’s profession; or
c. placed the public at risk of substantial harm in the practitioner’s practice of the profession because the practitioner has an impairment; or
d. placed the public at risk of harm because the practitioner has practised the profession in a way that constitutes a significant departure from accepted professional standards.

Question 10

What are the three General Principles in The Code of Ethics?

Answer 10

• Respect for the rights and dignity of people and peoples
• Propriety
• Integrity

Question 11

What are the considerations for seeing clients known to each other (4 things)?

Answer 11

• Impact on psychologist’s objectivity
• Impact on the client’s trust
• Conflicts of interest
• Vulnerability to complaints

Question 12

What are the CPD requirements for registered psychologists?

Answer 12

Developing a learning plan based on objective self-assessment
Completing 10 hours of peer consultation activities annually
Completing 20 hours of other CPD activities annually
Maintaining a CPD portfolio that includes the learning plan, activity log, and reflection, and submitting the portfolio to AHPRA within 28 days if selected for audit.

Question 13

What do you need to know about having a sexual relationship with a past client?

Answer 13

It needs to be 2 years after you cease therapy
Consult with senior psychologist, encourage client to see a psychologist about it too to make sure they are not vulnerable to exploitation.

Question 14

What is a multiple (or dual) relationship (4 things)?

Answer 14

Been:
In a non-professional relationship with the same client;
In a different professional relationship with the same client;
In a non-professional relationship with an associated party;
A recipient of a service provided by the same client.

Question 15

Psychologists who agree to provide psychological services to an individual, group of people, system,
community or organisation at the request of a third party, at the outset explain to all parties concerned… (four things)

Answer 15

(a) the nature of the relationship with each of them;
(b) the psychologist’s role (such as, but not limited to, case manager, consultant, counsellor, expert witness,
facilitator, forensic assessor, supervisor, teacher/educator, therapist);
(c) the probable uses of the information obtained;
(d) the limits to confidentiality;

Question 16

Where the sexualised behaviour of a client is impacting on a psychologist’s ability to provide an appropriate
professional service, or when psychologists experience sexual feelings for their clients, what do you do?

Answer 16

Psychologists take responsibility for maintaining appropriate professional boundaries and seek the support of a senior colleague to assess the potential risks and benefits of continuing to provide a psychological service to the client.

Question 17

If psychologists form a reasonable belief that another

practitioner has engaged in sexual misconduct, they are required to…

Answer 17

Notify AHPRA.
When psychologists are required to make a report to AHPRA which relates to their own client, they are aware of the need to manage the professional relationship with the client, and to attend to the client’s well-being.

Question 18

A 15 year old girl discloses that her step-father sexually assaulted her last night. She wants to go to the hospital for a forensic examination. She is adamant that you do not tell her mother. Do you:

a. Reassure her that you will not tell her mother and arrange an appointment for her;
b. Use your clinical judgement. You assess her as an adult so she is therefore, able to give her own consent to the examination. Encourage her to tell her mother;
c. Take her to the hospital and try to convince the staff not to contact her mother;
d. Tell her you are required to tell her mother because she is too young to consent to the examination;
e. Tell her that she must go to the police and you will go with her.

Answer 18

b. Use your clinical judgement. You assess her as an adult so she is therefore, able to give her own consent to the examination. Encourage her to tell her mother;

Question 19

A client presents actively suicidal and tells you that they have stockpiled their antidepressant medication and plan on taking all the pills tonight.

a. You are due at the movies in an hour, so you give them the number of the crisis team;
b. This client has previously threatened to do the same but has never done so. You tell her to stay with a friend tonight but give her your mobile number in case;
c. You call the mental health crisis team and make a referral for an immediate assessment and possible admission;
d. You enter an anti-suicide contract with her and offer an appointment in the morning.

Answer 19

c. You call the mental health crisis team and make a referral for an immediate assessment and possible admission;

Question 20

Your client reports significant illicit substance use to you and provides details that suggest she / he is also selling illicit substances. You say nothing at the time as you feel the information was given to you in confidence but then you have doubts. You:

a. Do not disclose the illicit substance use or selling to authorities as it does not represent clear, significant risk of harm to a specific person / people;
b. Report it to the police and hope your client does not find out;
c. Discuss with your client in the next session telling them that you have to report it to the police even though this is likely to harm your therapeutic relationship.

Answer 20

a. Do not disclose the illicit substance use or selling to authorities as it does not represent clear, significant risk of harm to a specific person / people;

Question 21

Under what circumstances would you consider sharing client information with a third party?

a. With the consent of the relevant client or a person with legal authority to act on behalf of the client;
b. Where there is a legal obligation to do so;
c. If there is an immediate and specified risk of harm to an identifiable person or persons that can be averted only by disclosing information;
d. When consulting colleagues, or in the course of supervision or professional training, provided the psychologist:
(i) conceals the identity of clients and associated parties involved, or
(ii) obtains the client’s consent and obtain an undertaking from the recipients of the information that they will preserve the client’s privacy;
e. All the above.

Answer 21

e. All the above.

Question 22

You are in private practice and your client requires access to their file and your assessment is that they are likely to be distressed by some of the information in it. The best course of action is:

a. Respectfully tell them that it is not in their interest to see their file and you do not allow them access.
b. You allow them access to the file in your office and hope they will be okay.
c. You arrange an appointment so that you can help them with their adverse reactions and you reserve the right to charge them for the appointment.
d. You recognise their right to see the file and you arrange an appointment so that you can help them with their adverse reactions but you feel you do not have a right to request payment.
e. You allow them access to their file and you remove all the material you think may distress them but explain that this material is better presented verbally.

Answer 22

c. You arrange an appointment so that you can help them with their adverse reactions and you reserve the right to charge them for the appointment.

Question 23

You are in your own sole practice and have a pretty good memory. You are very busy and do not have very much time. Which of the following do you feel it is okay to do?

a. You do not have room to keep files at the office, so you take them home and keep them in a locked cupboard at home.
b. You hire an assistant to do the invoices and accounts and rely on them to keep abreast with the changing requirements for Medicare, etc.
c. You rely on your memory and retrospectively do the accounts just before tax time.
d. None of the above.
e. All of the above.

Answer 23

d. None of the above.

Question 24

You are in your own sole practice and have a pretty good memory. You have to do all your own administrative work and do not have very much time in the practice. Your clients are back to back so you do not have much time in between clients.

a. You take very basic notes as your clients are talking and feel that this is sufficient.
b. You take care with your notes ensuring that they are all legible and professional in case they are subpoenaed.
c. You do a formulation initially and make summaries as you go along if necessary.
d. You shred your notes after five years as you do not have room to keep them all.
e. You do not feel it is necessary to take notes as you have a very good memory and you would rather focus your time and energy on your clients.
f. You write post it notes and put them in the file so that when you have time you can catch up.
g. Write a summary of sessions over a six month period because you have covered the same ground over and over.

Answer 24

b. You take care with your notes ensuring that they are all legible and professional in case they are subpoenaed.

Question 25

You work in a small team and you overhear a colleague making a very negative comment about the professional ability of another colleague. You agree with what they are saying about the other colleague. Choose one or more of the following courses of action:

a. Join the conversation with colleagues stating that you agree with the comments about other colleague’s professional ability.
b. Approach the colleague making the comments in private and discuss the issues and action plans.
c. Do nothing.
d. Take the matter to your supervisor.
e. Approach the colleague whose professional ability is in question directly and discuss your concerns.

Answer 25

d. Take the matter to your supervisor.

Question 26

A mother you have been seeing for 3 months tells you she takes her 4 year old daughter to work with her as she cannot always afford a baby sitter. She is a single mum, attending university part-time and studying to be a teacher. She is working at night as a receptionist at a brothel.

a. You tell her she is doing so well juggling everything.
b. You decide not to do anything about the fact she is taking the child to the brothel.
c. You inform her that you have mandatory reporting obligations in respect of her child and you make the report.
d. You tell her that it is reportable and encourage her to make alternative arrangements.
e. Follow d. but if she fails to make suitable arrangements you report her.

Answer 26

e. Follow d. but if she fails to make suitable arrangements you report her.

Question 27

You are working in a multi-disciplinary team and one of the nurses appears to be coming to work intoxicated by alcohol. You are not quite sure but she is acting as if she is a bit tipsy and some of your clients and colleagues have commented to you. You have approached her and she brushed it off. You decide that:

a. This is “notifiable conduct” under the AHPRA guidelines and you go through the mandatory reporting procedure.
b. This falls under the “voluntary notification” as the behaviour constitutes a risk but does not meet the requirements for “notifiable conduct”.
c. You will watch her carefully and ask your colleagues to do the same, but do not make any report to AHPRA at this stage.

Answer 27

b. This falls under the “voluntary notification” as the behaviour constitutes a risk but does not meet the requirements for “notifiable conduct”.

Question 28

What are grounds for a complaint against a psychologist?

a. Practicing under the influence of drugs/alcohol.
b. Engaged in sexual misconduct in connection with their practice.
c. Place public at risk because of an impairment
d. Placed public at risk because the practitioner practises in a way that constitutes a significant departure from accepted professional standards.
e. Knowledge, skill or judgment is below the standard expected.
f. The practitioner may not be a fit and proper person to be registered in the profession.
g. All of the above.
h. Only a., b., c., and d. above.

Answer 28

g. All of the above.

Question 29

Life is very busy at the moment; you are trying to look for a new work role, attending PD workshops, have extra tasks for your work role and are juggling these demands with family life. Sometimes you don’t make it to supervision and cancel because you are too busy or tired. Which of the following would be best practice?

a. Reflect on your situation in your reflective journal and discuss your struggles with your supervisor, exploring self-care, time management and capacity to practise.
b. Identify barriers and strategies to improve your work life balance that will enable you to attend supervision, such as assertiveness, improved boundaries, work-task delegation, making use of flexitime or annual leave days.
c. Attempt to move your supervision time to something more convenient, even if temporarily, so that you can attend on a weekly basis.
d. If you and your supervisor are unable to arrange your schedules to meet weekly, contact the College about alternative solutions such as a change of supervisor or making use of a secondary supervisor.
e. All of the above.
f. None of the above.

Answer 29

e. All of the above.

Question 30

You should contact the Board when:

a. You change address.
b. You have resigned from your placement and are not currently working.
c. Your registration renewal is due and you have not received a form in the post.
d. Your capacity to practise has changed.
e. You are going on extended leave for more than 8 weeks.
f. All of the above.

Answer 30

f. All of the above.

Question 31

When are young people able to consent to psychology services?

Answer 31

If deemed to be able to consent, sufficient understanding/intelligence to give understanding of what is proposed

Question 32

When is it ok to break confidentiality when working with a young person?

Answer 32

The best interest of child is paramount

Question 33

When psychologists are contracted or engaged to provide a psychological service to a young person, the consent and involvement of both parents is _____, although not _____.

Answer 33

desirable

legally required

Question 34

As part of the process of obtaining informed consent a psychologist determines whether the young person… (5 things)

Answer 34

• can understand the nature of the proposed psychological service;
• can understand the benefits and risks of the proposed psychological service;
• can understand the consequences of receiving or not receiving the proposed psychological service;
• has the capacity to make an informed choice; and
• can understand the limits to confidentiality.

Question 35

What is criterion A for PTSD?

Answer 35

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)

Question 36

What symptoms does criterion B cover for PTSD?

Answer 36

Intrusion symptoms

Question 37

What symptoms does criterion C cover for PTSD?

Answer 37

Avoidance

Question 38

What symptoms does criterion D cover for PTSD?

Answer 38

Negative alterations in cognitions and mood

Question 39

What symptoms does criterion E cover for PTSD?

Answer 39

Marked alternations in arousal and reactivity

Question 40

How long do you have to have symptoms for for dx of PTSD?

Answer 40

1 month

Question 41

How many symptoms do you need for dx depression?

Answer 41

5

Question 42

How many symptoms do you need for dx panic disorder?

Answer 42

5

Question 43

How many intrusion symptoms do you need for dx of PTSD?

Answer 43

1 or more

Question 44

What should you do if you do not have experience in a certain area?

Answer 44

Refer to an expert. If they are not available, notify the client of your inexperience and seek their consent and gain assistance through supervision.

Question 45

What is the problem with delaying a client’s payment of sessions?

Answer 45

A delayed payment would put the client in debt, and possibly add to her stressors.

Question 46

Unless an issue is so serious that it warrants immediate report to the Board, then the first option is….

Answer 46

To speak directly to the professional involved to discuss/seek further information.

Question 47

What are the 3 Notifiable Issues to the Board?

Answer 47

1. Working while impaired (e.g. physically, substance use).
2. Departure from professional standards or ethics (working outside realm of profession).
3. Sexual misconduct.

Question 48

Even if the client agrees to report a notifiable incident, as a health practitioner you should….

Answer 48

Also report what has been disclosed to you

Question 49

If it’s not a mandatory notification matter, then encourage the colleague to…

Answer 49

Talk to the Board themselves about it.

Question 50

If a client is below the age of 14, the client would be…

Answer 50

The mother/father

Question 51

Who do you report ongoing criminal activity to (in a school vs in private practice)?

Answer 51

In a school community, the person you are obliged to report to is – the principal.
If it occurs in private practice, you would report to your supervisor then the police.

Question 52

Every time a question asks about memories, look for the answer that indicates that memories are ____ and it is hard to determine ____.

Answer 52

fallible

whether they are true or false

Question 53

Hypnosis is not one of the interventions that is needed to be studied for AHPRA, therefore it would be a(n) ____ question.

Answer 53

Ethical

Question 54

When you get a subpoena, you have to _____ all of the information (except _____, but including all communications e.g. email and including other psychologists notes in the file). If you are of the belief that releasing information would harm the client, then you can request for the non-release of client notes.

Answer 54

legally release

test forms or raw scores

Question 55

Client psychological records include information that…. (3 things)

Answer 55

1) Identifies the client
2) Documents the nature, delivery, progress, results, or recommendations of psychological services
3) Includes appointment diary entries, working notes, assessment material, information stored in a computer, and “post-it” notes.

Question 56

Psychologists terminate their psychological services with a client, if it is reasonably clear that the client is
_____ .

Answer 56

not benefiting from their services

Question 57

Psychologists avoid _____ for psychological services if clients are unlikely to
be able to pay them in a reasonable period of time or may not be able to pay them at all.

Answer 57

clients’ accumulation of large bills

Question 58

If clients have outstanding accounts or may be unlikely to pay, psychologists engage with clients to find
an acceptable process to settle the account. These may include (5 things):

Answer 58

• adjusting the frequency, nature or extent of services to match the client’s budget or their ability to
pay;
• payment by instalments over an agreed period of time;
• informing the client about lower cost options available through alternative providers of similar or other relevant services;
• an additional fee for ongoing clients to pay as a surcharge on each new session they attend to recover the outstanding balance;
• terminating or withdrawing the service in an appropriate manner to avoid harm to the client.

Question 59

Psychologists _____ a commission

for referring a client on to another psychologist or service provider

Answer 59

do not accept