Exam #1

Question 1

In which of the following situations is a therapist not required by law to break confidentiality?

Answer 1

A. A 4y/o client is intentionally injured by a 17 y/o brother
B. A client gives his 78 y/o mother extra meds to keep her sedated
C. A client reports thoughts of hurting herself
D. A 14 y/o reports sex activity with 13 y/o neighbor

Question 2

A new client wants to receive counseling and informs the therapist that he wants CBT. The therapist is not trained in CBT. How should the therapist respond to the client?

Answer 2

A. Talk about limitations of CBT
B. Provide information about the therapist’s orientation
C. Seek consultation fro the CBT therapist
D. Refer to the CBT therapist

Question 3

A single parent ‘s rights were terminated due to neglect of his 2 young children. After a year of the children being in foster care, the foster care therapist receives a call from the father stating he has changed his behaviors and would like to have custody of his children returned to him. The therapist should:

Answer 3

A. Empathize with the father but state that the therapist can’t do anything to reinstate parental rights
B. Discuss requests with judge who terminated parental rights
C. Inform father to speak with lawyer regarding his appeal
D. Encourage father to first re-develop a relationship with his children by setting up weekly home meetings

Question 4

A 22 y/o woman comes to therapy at the request of her parents. She shares with therapist that her boyfriend of 6 months has beat her up twice and her parents want therapist to convince her to leave him, but she loves him, and isn’t going to be told what to do. The therapist should first:

Answer 4

A. Obtain a release to speak with her parents
B. Discuss the cycle of violence
C. Acknowledge her right to make decisions about her relationships
D. Help her create a safety plan

Question 5

An 85 y/o client has been living in a nursing home after her husband passed away and she was no longer able to care for herself. Client declines medical procedure that has potential t0 prolong her life. Client is mentally alert and says she’s happy with life she has lived. Client’s family meets with therapist to change client’s mind. The therapist should:

Answer 5

A. Determine whether family’s decision is ethical and oppose only if it’s not
B. Respect client’s right to self-determination
C. Make sure client understands consequences behind her choice
D. Agree to let family make choice for the client

Question 6

A former client dies and the therapist is notified by the client’s wife. The wife submits a written request to access the client’s records. The therapist must:

Answer 6

A. Assert privilege on behalf of the client
B. Provide a copy of records within 15 working days
C. Deny requests
D. Request authorization from client’s legal representative

Question 7

A 14 y/o is brought to therapy by her mother following her parents’ divorce. The mother shared custody agreement which states both parents must consent for mental health treatment. When the therapist contacts the father, he refuses to comply by stating, “her mother thinks our daughter is depressed, but she’s not”. How should the therapist proceed:

Answer 7

A. Refuse treatment because the father won’t consent
B. Obtain consent from mother
C. Obtain consent from mother and daughter
D. Obtain consent from daughter

Question 8

An 18 y/o client reports that she was sexually molested by her father repeatedly for 5 years. She now lives at college, and her 2 little sisters live at home with father. She is concerned about living away from home because she doesn’t want him to molest her sisters. The therapist should:

Answer 8

A. Determine if there’s a suspicion of current molestation
B. Report immediately, as abusive father has access to sisters
C. Report immediately, as abuse took place when client was a minor
D. Help client create a safety plan for her sisters

Question 9

A new client wants to be assured that her sessions are absolutely confidentiality. When should the possibility of a subpoena for confidential records of a client be discussed?

Answer 9

A. 1st session if it appears that the problem might involve court actions
B. 1st session before the client contracts for services
C. 1st session after trust and rapport firmly established
D. Whenever the therapist deems it appropriate

Question 10

A 15 y/o client reports to his school counselor that he had sex with a 13 y/o girl for the first time yesterday. He met her at his new school and 3 days ago and they had sex behind the school gym after getting high during lunch. The therapist should:

Answer 10

A. Process impact of confidentiality with client then report the incident to parents to keep him safe
B. Process impact of confidentiality with client then report incident to school, since the children used drugs on campus
C. Report incident to CPS, since student had sex with a minor
D. Maintain confidentiality

Question 11

A therapist should review informed consent with a client:

Answer 11

A. Prior to the onset of therapy
B. Prior to the onset of therapy and over the course of therapeutic relationship
C. In early stages of therapy and over the course of therapeutic relationship
D. Prior to the onset of therapy and whenever a client requests clarification regarding therapist’s policies

Question 12

An 11 y/o child is brought to therapy by a single father who claims the child is acting differently since he and the child’s mother got divorced. The former wife has full legal custody because he was wrongfully accused of mistreating the child, but that the child called and wanted to see him. Upon meeting the child at agreed time and place, the child told his father that he’s very sad and does not want to live anymore. What responsibility does the therapist have in this situation?

Answer 12

A. The severity of the symptoms
B. Agree to treat the cd only after the father agrees to get permission from the mother
C. Refuse to treat because the law requires both parents to sign consent before treatment begins
D. Refuse to treat because the only parent with legal custody can consent for treatment

Question 13

During a shopping trip to the mall, a therapist witnesses a woman spanking a young child after the child ran away from her. The therapist must:

Answer 13

A. File child abuse report immediately
B. Tell the mother that the therapist is a mandated reporter
C. Provide the mother with referral to parenting classes
D. The therapist has no obligation to

Question 14

A 14 y/o girl comes to a family service agency for help. She’s 4 weeks pregnant, unmarried, and depressed. She lives with her mother, who is unaware of her pregnancy. She states she doesn’t want the mother to know she’s getting therapy because she’s a druggie. The therapist should first:

Answer 14

A. Obtain the client’s signed informed consent
B. Discuss the need for parental involvement with the client
C. Attempt to contact the client’s mother
D. Obtain client’s informed consent and document the reason for not including her parents

Question 15

In their session, a couple talks about their “bad physical fight” last weekend. The therapist notices bruises and abrasions on the wife’s legs. How should the therapist proceed to stop the violence?

Answer 15

A. Refer the husband to batterer’s group, identify triggers of violence, and work with the couple conjointly
B. Refer the husband yo batterer’s group, work with them conjointly to own their individual responsibility, and increase understanding of the choices
C. Refer each to individual therapy to give them a safe space to explore feelings and continue couples therapy
D. Refer husband to batterer’s group and individual therapy and refer wife to woman’s shelter and individual therapy

Question 16

A therapist has been meeting with a client for 4 months and expressed goal of addressing client’s social anxiety. The therapist seeks consultation, but client makes no progress. What should the therapist do?

Answer 16

A. Begin termination with client
B. Discuss referring client to a different therapist
C. Explore lack of progress directly with client
D. Refer client for psych evaluation

Question 17

An 11 y/o brought to therapy by mom and stepdad. Mom reports son became withdrawn and only wants to spend time with friends and play video games. The therapist learns the son does not like his stepdad and feels he is mean to his mom. Mom requests to access son’s records. How should the therapist respond?

Answer 17

A. Discuss request with the client
B. Allow mom access to records since she signed the consent for treatment
C. Allow mom access to records if the client consents
D. Deny the requests if it would jeopardize the client’s safety and/or therapeutic relationship

Question 18

A new client comes for therapy complaining of anxiety and depression. After the therapist provides information about alternative options including medication, the client empathically states, “I refuse to take meds”. What should the therapist do next?

Answer 18

A. Acknowledge his right to refuse treatment
B. Refer to psych
C. Determine why he’s so against meds
D. Provide him with research on the benefit of meds

Question 19

A client is concerned because she is convinced her husband is intending to kill his boss today after work. She knows he has been planning it, and saw him pack a gun in his briefcase this morning. The therapist should:

Answer 19

A. Initiate 5150 for the husband, since there’s imminent danger to his boss from a credible third party
B. Call police and husband’s boss with the CBT in the room as per duty to warn
C. Encourage the client to call the police

Question 20

A family sought therapy after the 36 y/o daughter and her 14 y/o son moved back home with her 66 y/o father and 65 y/o mother. At the start of the eighth session the mother reports that three days ago the daughter relapsed and became violent when they confronted her. What action should the therapist take first?

Answer 20

A. Explore the family members’ perspective of the incident and how they responded
B. Review the limits of confidentiality with family members
C. Recommend that the daughter seek alcohol treatment immediately
D. Obtain more details about the nature of the violent episode

Question 21

A married couple meets with a therapist in private practice for initial session. Afterwards, the wife calls the therapist and says, “I have something I want to talk about, but my husband can’t find out”. The therapist’s MOST appropriate response would be to:

Answer 21

A. Reassure wife that what she says will be kept confidential
B. Recommend that both husband and wife meet individually before the next couple’s session
C. Advise wife of the therapist’s “no secrets” policy *
D. Encourage her to make disclosure at a future couple’s session

Question 22

A therapist working at a community mental health agency started a group for survivors of domestic violence. While meeting with potential group members, a woman states she is concerned that what she says in group might be shared with people in her community. How should the therapist respond?

Answer 22

A. Ensure the client that all information shared in group will remain confidential
B. Acknowledge client’s consents and review importance of group maintaining confidentiality
C. Acknowledge that information shared in group is not protected by confidentiality laws *
D. Review limits of confidentiality and obtain written agreement from group members

Question 23

A therapist is treating a 13 y/o girl. In the middle of session, she discloses that she is 5 weeks pregnant. She states that she is scared to tell her mother for fear of punishment. She shares that she and her boyfriend, who is also 13 want to keep the baby. The therapist should:

Answer 23

A. Maintain confidentiality and provide support to the client
B. Make a CPS report and contact the child’s parent
C. Make a CPS report and refer the client to a medical doctor
D. Maintain confidentiality and refer the client to a health clinic *

Question 24

A therapist receives a subpoena from the lawyer of a client whom the therapist treated in couples therapy. The couple is getting divorced. The husband signed a release for the records. The therapist should FIRST:

Answer 24

A. release the records to the lawyer once the wife tells you she permits the release
B. assert privilege on behalf of the clients
C. contact the wife to determine her wishes *
D. schedule a session with the couple to discuss the matter

Question 25

A therapist treats a client who reports a desire to kill a former employer who recently laid him off. Upon further questioning, the client says that although this is a desire, it is not a strong one and the client has no plan. The therapist should:

Answer 25

A. notify local law enforcement of the situation
B. contact the client’s former employer to report the danger
C. monitor the client’s feelings at future sessions *
D. notify local law enforcement and the client’s former employer of the threat

Question 26

A therapist is treating a mother who is going through a contentious divorce. She came to session one day very upset and reports that the husband, who has visitation rights every weekend but does not have legal custody, has taken their children to another state without her permission. The therapist should:

Answer 26

A. File a child abuse report for abduction
B. Encourage mother to consult with her lawyer *
C. Call the police
D. Determine whether the children are safe

Question 27

A therapist meets with parents who refuse to provide appropriate medical care to their 6 year-old daughter with a potentially life threatening illness because of their religious beliefs. The child is receiving some care within the guidelines of their church’s ministry but the child’s condition is getting worse. How should the therapist respond to this dilemma?

Answer 27

A. Inform the family that a child neglect report must be filed *
B. Maintain confidentiality because of the family’s right to self-determination
C. Report the situation to child protective services
D. Encourage the family to take a different action in the best interests of the child

Question 28

An Asian American family seeks family therapy. During the second family therapy session, the 14 year-old angrily states that she is tired of the painful punishment from her father for “trying to fit in with her friends at school.” The father notes that the punishment is necessary to prevent his daughter from imitating the behaviors of her American friends and thus bringing shame to the family. The therapist should initially:

Answer 28

A. explore their cultural beliefs related to parenting and discipline
B. inform the parents that their behavior requires a report of suspected child abuse
C. determine the nature and severity of the punishment *
D. help the daughter understand her parents’ behavior as culturally appropriate

Question 29

Two therapists are co-facilitating a social skills group for children with ADHD. During one of the sessions one of the children shows a scar on his back that his step dad inflicted because the child would not stay in his room after bedtime. After the group the therapists should FIRST:

Answer 29

A. Both file a child abuse report
B. Call the child’s mother and schedule a session
C. Determine which therapist will file a report *
D. Assess the child for recent abuse

Question 30

A therapist has determined his duty to warn has been triggered and he calls the intended victim, who is the ex-wife of his client. She does not believe the therapist and asks for more details, including specific things the client has said. The therapist legally:

Answer 30

A. May not use any direct client statements, as that is not legally permissible
B. May use any information he chooses in communicating the threat
C. May use as much information as necessary in communicating the threat *
D. May only state the reasons the therapist believes the threat is credible, without using direct client quotes

Question 31

A therapist is seeing two teenage girls and their father. The father reported the girls’ behavioral problems started soon after they returned from a visit with their mother and her new boyfriend. The girls’ parents have been separated for over a year and are in the process of a bitter custody battle. During the initial interview, both girls tell the therapist that their mother’s boyfriend has made them feel uncomfortable by exposing himself and making sexually inappropriate comments. The therapist should first:

Answer 31

A. develop a safety plan with the girls
B. report the allegations of abuse to child protective services *
C. discuss the allegations with the mother due to the contentious custody fight
D. further assess for child abuse

Question 32

During a group session with teen moms, one client shares that she’s been fighting with her boyfriend since he took their 4-month-old out in the car without a car seat. She complains, “He just does what he wants with the baby and tells me I worry too much.” The therapist should NEXT:

Answer 32

A. Obtain more details about the boyfriend’s treatment of baby
B. Inform the group that a child abuse report must be filed
C. File a report with child protective services immediately after group *
D. Refer boyfriend to a parenting class for teen dads

Question 33

In which of the following instances is a mandated report required?

Answer 33

A. A 14-year-old takes pictures of a 9-year-old in her underwear
B. A 4-year-old was left alone with a 12-year-old and the 4-year-old was harmed *
C. A 13-year-old reports having sex with her boyfriend
D. A 19-year-old reports sexual abuse by her coach when she was 13-years-old

Question 34

A mother seeks therapy for her 8-year-old son after a contentious divorce from the boy’s father. The mother reports that her son is afraid of the father but has to visit him per court orders. During the informed consent, the mother reports that she has full legal custody. How should the therapist proceed?

Answer 34

A. Inform the mother that it is best practice for both parents to consent for treatment
B. Require a copy of the custody agreement *
C. Obtain signed informed consent from the mother
D. Determine if the father knows about and approves of treatment for the son

Question 35

A 9-year-old girl is referred to the therapist because she is being teased for smelly clothes and dirty hair. The girl shares that she wants to take a bath, but the family hasn’t had water or electricity for the past week. Her mother was arrested a month ago and her aunt is supposed to take care of them, but her aunt has been busy with her own family. What should the therapist do FIRST?

Answer 35

A. Assess further for possible neglect
B. Identify alternative living arrangements for children
C. File a child abuse report *
D. Assist the child in obtaining clean clothes and a bath

Question 36

A. Assess further for possible neglect.
B. Identify alternative living arrangements for children.
C. File a child abuse report.
D. Assist the child in obtaining clean clothes and a bath

Answer 36

A. Call the parents and discuss the situation
B. Discuss the importance of respecting others’ belongings
C. File a child abuse report *
D. Explore the client’s feelings about the incident

Question 37

A 36-year-old single mom is referred by her boss after losing her temper at work. She is raising her 3-year-old and a 20-month-old by herself since leaving her abusive boyfriend. The client shares that she “feels overwhelmed all the time and sometimes loses it with her kids.” What should the therapist assess FIRST?

Answer 37

A. The incident at work
B. What she means by “sometimes loses it with her kids” *
C. Her trauma history
D. Her parenting skills

Question 38

A 72-year-old man is transported to a therapy appointment by his daughter-in-law, with whom he lives. The therapist notes that he appears uncomfortable in her presence and becomes increasingly anxious as the session progresses. When the therapist reflects this, he says, “I just don’t want to keep my daughter-in-law waiting. She can get pretty angry.” What should the therapist do NEXT?

Answer 38

A. Suggest a family session to discuss conflicts in the home
B. File an elder abuse report
C. Assess for elder abuse *
D. Help the client find alternate means of transportation to future appointments

Question 39

A therapist is meeting with a 33-year-old client for a second session. The client recently moved from another state where he was receiving treatment at a local mental health center. The client signed a release of information for the therapist to receive the client’s psychological reports from his previous treatment center. The therapist received the reports and noticed that references are made to other treatment centers which the client also previously attended. It is within the principles of confidentiality for the therapist to:

Answer 39

A. ask the staff at the previously attended mental health center to send the reports over
B. let the client know that other treatment centers have been contacted and reports have been requested
C. call the other treatment facilities and request treatment reports
D. talk to the client and obtain a written release for each treatment center previously attended

Question 40

A 77-year-old woman arrives for a therapy appointment and reports that she is having trouble coming up with the money to pay for her sessions. When the therapist inquires about this, she reports that her grown son has been “investing” her money for the past 6 months, but she no longer has access to any of her bank accounts. What should the therapist do NEXT?

Answer 40

A. Inform the client that an elder abuse report must be filed *
B. Help the client problem-solve around gaining access to her money
C. Work with the client to establish a reduced fee for sessions
D. Schedule a family session to discuss financial matters

Question 41

A 32-year-old man with developmental disabilities comes to an appointment with his case manager and reports that a caregiver in his group home has been refusing to give him his medication and has been locking him in his room at night. What should the case manager do NEXT?

Answer 41

A. Call the man’s group home to validate his story
B. Reassure the man that the case manager will handle the situation
C. Report the situation to the police immediately *
D. Call the man’s psychiatrist to report medication changes

Question 42

A therapist is called to the emergency room to evaluate an 83-year-old woman who was brought in by paramedics; the doctor tells the therapist that the woman is bedridden with limited mobility. When she sees the therapist, the woman begins pleading with the therapist saying, “Please don’t make me go home; he never lets me go out or see anyone!” What should the therapist do NEXT?

Answer 42

A. Assess for elder abuse *
B. Consult with the doctor to find out whom the woman is talking about
C. Reassure the woman that she won’t have to go home
D. File a report with Adult Protective Services

Question 43

A therapist determines that she must file an elder abuse report for an elderly man who is living in his own home. What is the timeline for such report?

Answer 43

A. Call immediately; submit written report within 36 hours
B. Call immediately; submit written report within 2 days *
C. Call within 24 hrs; submit written report within 2 days
D. Call within 24 hrs; submit written report within 36 hours

Question 44

The mother of a three-year-old boy is referred by her doctor. She is in the last month of a second pregnancy, and is experiencing episodes of depression with poor appetite, crying, withdrawal from parenting, and increasing fear that she will harm her child. The client states that she has a history of major depressive disorder with psychotic features following the birth of her first child. The therapist should first:

Answer 44

A. Refer the client for a psychiatric evaluation
B. Report the situation to the child protection agency
C. Initiate a 5150
D. Assess safety of the first child *

Question 45

A therapist receives a letter from a lawyer requesting information about one of the therapist’s clients’ diagnosis and treatment. The letter indicates that the client is the defendant in an upcoming court case. What should the therapist do FIRST?

Answer 45

A. Contact the lawyer and explain that a subpoena will be needed to release information
B. Contact the lawyer and release selected information from the client’s record
C. Do not respond to the letter and contact the client to inform them of the request *
D. Send a letter to the lawyer refusing the request

Question 46

A therapist has been working with a client who is borderline for two years when the client leaves a voicemail that she has found a better therapist and would like a copy of her records sent to her address within the week. The therapist has serious concerns about her seeing his notes. The therapist denies the request and the client gets very upset. The therapist should:

Answer 46

A. Meet with her in person to review her record
B. Consult a lawyer
C. Allow another therapist to view the record *
D. Obtain a release to contact the new therapist

Question 47

In which of the following situations does a therapist have a duty to warn?

Answer 47

A. A depressed adult client discusses taking revenge on a sibling who lives next door for abuse that occurred during childhood
B. A client with bipolar disorder describes feeling out of control during manic episodes and fears hurting a family member
C. A client with HIV discusses having unprotected sexual relations with a partner without disclosure
D. A client with a history of physical violence describes a plan to use force to get an ex-spouse back *

Question 48

A therapist has seen a young adult client for a few months. During a session, the client tells a therapist that he recently participated in the break in of a neighbor’s house and plans to repeat the offense. The therapist should:

Answer 48

A. discuss alternative ways the client can express his aggression
B. maintain client confidentiality *
C. obtain a written contract that the client will not commit such actions
D. report the intent to the police and warn the neighbor

Question 49

A therapist is meeting with a 45-year-old man who came in due to feelings of hopelessness and depression and who says he feels like he “can’t do this anymore.” After further questioning, the client states that he has had some thoughts of suicide. The therapist should NEXT:

Answer 49

A. Determine if the client has a plan *
B. Hospitalize the client
C. Create a safety plan with the client
D. Identify social supports for the client

Question 50

A therapist meets with a couple for the first time. The couple discloses that the husband is also working with an individual therapist on managing his anger more effectively. The therapist would like to speak with the husband’s individual therapist. The therapist should:

Answer 50

A. Obtain a written release from the husband to speak with his therapist
B. Obtain a written release from both the husband and wife to speak with the husband’s therapist *
C. Obtain a written release from the husband if only obtaining information about his treatment
D. Obtain a written release from the husband and wife if planning to work collaboratively with husband’s therapist

Question 51

A client with paranoia hands his therapist a letter requesting to review his records. He returns the next day at the appointed time and quietly reviews the file. After he finishes, he tells the therapist that he has found several mistakes. Legally the therapist should:

Answer 51

A. Inform the client that amending a record once it is in the file is a violation of the law
B. Amend the record if the therapist agrees there has been a mistake
C. Process with the client the effect of reviewing the record and finding mistakes
D. Inform the client he may submit an addendum to the record that may be included in the file *

Question 52

All of the following should be included in an initial evaluation EXCEPT:

Answer 52

D. Expectations of therapy *

Question 53

A client with a history of suicide attempts leaves a distraught goodbye message on his therapist’s voicemail. The therapist returns the call but the client does not answer. What should the therapist do next?

Answer 53

A. Initiate a 5150
B. Call 911
C. Call his emergency contact *
D. Contact the client’s family

Question 54

A new client calls seeking therapy for depression. She is referred by a former client. On the phone, she reports feelings of hopelessness and expresses doubts that therapy can help. How should the therapist proceed?

Answer 54

A. Validate her feelings
B. Schedule an appointment
C. Ask if client has any thoughts of harming herself *
D. Explore her doubts about therapy

Question 55

A 33-year-old woman seeks treatment for relationship issues. She reports that since she and her partner married, the partner has become increasingly controlling and occasionally violent. The client begins crying and states angrily, “I can’t take it anymore”. In addition to assisting the client in creating a safety plan, what other legal obligations does the therapist have in this case?

Answer 55

A. Assist the client in locating appropriate shelters and contact the police
B. Refer the client to a doctor for a medical evaluation and encourage her to contact the police
C. Assess for suicide risk and danger to others *
D. Refer the client to a doctor for a medical evaluation and assess social supports

Question 56

A new therapist opens her private practice. Before she sees her first client, she sets up her filing system for her new client records. In order to comply with the law, she must do all of the following except:

Answer 56

A. Ensure that there are at least two forms of locks preventing access to the records *
B. Assign a password or lock up her computer if she keeps client information on it
C. Adhere to the standard of care in keeping her records secure
D. Ensure her mobile phone is secure if keeping client contact information on it

Question 57

A client is in therapy because of problems at work and an inability to concentrate. During the fourth session, she begins to cry uncontrollably. She reveals that her husband has been physically abusive towards her for several years. Which of the following steps should the therapist take to assist the client?

Answer 57

A. File a report with the police
B. Explore high risk factors of leaving the relationship
C. Help the client establish a plan of action to escape the abuse
D. Assess current safety issues and provide referral for DV shelter *

Question 58

After working with a client for three months, the therapist realizes that the client’s husband works at the same company as the therapist’s husband. What should the therapist do NEXT?

Answer 58

A. Review the importance of boundaries with the client
B. Share the information with the client and discuss the impact *
C. Seek consultation for countertransference related to information
D. Refer the client to another therapist

Question 59

A therapist is treating a client with schizophrenia who has an appointed conservator. The client was in an altercation and subsequently sued by the injured party. The therapist receives a subpoena for the client’s records from the client’s lawyer. The therapist should:

Answer 59

A. assert privilege on behalf of the client
B. contact the client’s conservator*
C. contact the client
D. consult with a lawyer regarding the subpoena

Question 60

According to California law, the records of psychotherapy treatment:

Answer 60

A. Are the property of the client
B. Must be made available to clients upon written request
C. Must be made available to the client’s representative upon the client’s death
D. Are the property of the therapist *

Question 61

A therapist is terminating therapy with a 10 year-old-boy. How long must the therapist keep the records?

Answer 61

A. 7 years
B. 8 years
C. 10 years
D. 15 years *

Question 62

Following a full day of meeting with clients, a therapist takes home several client files to review them and complete paperwork. The therapist places the documents in a briefcase and locks them in the trunk while stopping for dinner. After dinner, the therapist discovers the car has been broken into and the briefcase was stolen. How should the therapist proceed?

Answer 62

A. Call the police immediately
B. Call the police and notify all of the affected clients *
C. Notify the affected clients and discuss the issue with them
D. Consult with a colleague with legal expertise

Question 63

A client in couples therapy calls between sessions and tearfully shares that she discovered child pornography on her fiancé’s computer. The therapist should:

Answer 63

A. maintain confidentiality
B. suggest they discuss in the next session
C. remind client of “no secrets” policy
D. inform her that the therapist must file child abuse report *

Question 64

A client is concerned in session that her obsessive thoughts of suicide might be a result of the antidepressant medication her psychiatrist prescribed. The client agrees to voluntary hospitalization and wants the therapist to call her psychiatrist. The therapist realizes he has no more copies of his release forms in his office. The therapist should:

Answer 64

A. Speak to the psychiatrist without written consent because the client’s level of suicidal ideation constitutes an emergency
B. Refrain from calling the psychiatrist until the client signs a typed release, as is legally required
C. Have the client write a release in her own handwriting that is signed and dated *
D. Wait for the psychiatrist to call once the client has been admitted to the hospital

Question 65

A therapist is required to follow HIPAA in order to:

Answer 65

A. ensure compliance with informed consent
B. effectively manage privileged information
C. establish privacy standards related to electronic storage and transmission of patient information *
D. provide clients with reasonable access to their records

Question 66

A patient being treated for Bipolar I Disorder receives a notice from her insurance that her claims for psychotherapy treatment have been denied. The therapist believes the client is entitled to psychotherapy treatment. The therapist should:

Answer 66

A. Encourage the client to advocate for herself
B. Advocate on behalf of the client *
C. Adjust the therapist’s fee to see the client at an affordable rate
D. Refer the client to a low-fee clinic

Question 67

A therapist recently joined an insurance panel as a provider. When working with a third party payer, which of the following is acceptable:

Answer 67

A. Changing a patient’s diagnosis in order to ensure reimbursement
B. Billing insurance for missed appointments *
C. Waiving a co-payment while billing insurance the full fee
D. Charging a higher fee because the patient has insurance

Question 68

A client, who has been missing work, has been referred to a therapist by her Employee Assistance Program for a maximum of four sessions. Any additional sessions would be the client’s financial responsibility. During the initial intake, it becomes clear that the client has many long-standing relationship issues and a trauma history that has not been resolved. She states that she is looking forward to working through her problems. Before developing a treatment plan, the therapist should FIRST:

Answer 68

A. provide education about the therapy process
B. explore the client’s understanding of the referral and coverage provided *
C. explore the client’s expectations of therapy
D. discuss fees in case client continues treatment after the EAP sessions end

Question 69

A therapist sees a new client referred because of heavy alcohol use. During the initial assessment the client questions the therapist’s credentials and competence. What should the therapist do next?

Answer 69

A. Provide the client with honest information regarding therapist’s credentials *
B. Confront the client about the evasive responses
C. Ask how the client feels about seeking help
D. Explain that the therapist has treated a lot of patients like him

Question 70

A recently licensed therapist took one course on emotionally focused therapy during his internship. Now that he is licensed he advertises himself as having an “expertise in emotionally focused couples therapy.” The therapist’s actions are considered:

Answer 70

A. illegal and unethical *
B. legal and ethical as he received training as advertised following graduate school
C. unethical as he does not have the required training, education, or experience to be considered a specialist
D ethical only if he explains to clients that he only took one course

Question 71

A therapist has been working with a 34-year-old woman, who is in treatment for anxiety management. She informs the therapist that she has to go to Colorado on a work trip for 2 weeks. She has asked the therapist whether it would be possible to use Skype and maintain a regular session schedule. Legally the therapist should?

Answer 71

A. Encourage the client to use her anxiety management skills and wait to resume sessions after she comes back
B. Inform the client that it is illegal to work with clients who reside in a different state if the therapist is not licensed in that state
C. Obtain a written informed consent and agree to meet the client on Skype during regular session time
D. Obtain informed consent specific to tele-therapy and document it in the client’s file *

Question 72

A low-fee client who has been receiving therapy for several months has failed to make payments for the services provided even though the client was made aware of the therapist’s fees and payment policy. The therapist is considering discontinuing services to the client. What should the therapist do?

Answer 72

A. Terminate services with client and provide at least three referrals
B. Review payment agreement with client and discuss possible termination *
C. Terminate services immediately until the account is paid by the client
D. Discuss the possibility of lowering fees once the client takes care of the balance

Question 73

A therapist working in a small agricultural town has been seeing a client for several years when the client reports that he cannot afford to pay for therapy for the next few months because he must make upgrades to his farm. He asks the therapist if, until his financial situation improves, he could offer some of his produce as payment. How should the therapist respond?

Answer 73

A. Determine the worth of the produce the client has offered
B. Tell client that it would not be appropriate and refer to a low-cost clinic
C. Agree to barter if it’s determined this is the only way the client can attain necessary services *
D. Tell the client it would not be appropriate and offer a sliding scale

Question 74

A therapist has been meeting with a client who lost her husband a year ago. The client has had trouble maintaining her finances, since her husband was the one who took care of the bills when he was alive. The client is now two months behind in the payment of fees and has no ability to pay soon. Professional ethics allow the therapist to:

Answer 74

A. Suggest the client find a more appropriate therapist who can accommodate a lower fee
B. Terminate therapy if it is clear that the client is not a danger to self or others *
C. Create a payment plan
D. Terminate therapy only if it the client’s wishes to do so

Question 75

A therapist working in a small town has been seeing a client for a few months when the client reports that he lost his job and can no longer afford to pay for therapy. The client offers to provide house repair services for the therapist in exchange for continuing therapy. How should the therapist respond?

Answer 75

A. Refer to low-fee mental health clinic
B. Consult with colleagues to determine if bartering is common practice
C. Explain conflict of interest and explore alternative payment arrangements with client *
D. Create a written contract for the exchange of services