Exam questions Flashcards

1
Q

What are the Canadian Courts’ expectations of therapists? (during a malpractice suit) (S1:A)

w1

A
  1. Act in a way that is expected of you (as per your peers)
  2. To act in good faith (how do you protect client rights?)
  3. To keep documentation that demonstrates your adherence to code of ethics/standards of practice
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2
Q

What are ethics??? (S1:A)

w1

A

Study of standards of conduct and moral judgement

More than rules - a way of reasoning and constructing relationships with others

About:

1) Protecting client
2) Preserving dignity
3) Responsible caring
4) Taking action (using ROLE POWER)

Not just

  • avoiding punishment
  • creating/following/enforcing rules
  • pleasing others to be liked
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3
Q

What is the difference in regulator authority between the Code of Ethics for Psychologists and the CAP standards of practice?

(S12:T1:A)

w1

A

Code of Ethics = aspirational

In court, psychologists will be held to STANDARD OF PRACTICE, not Code of Ethics

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4
Q

How does CAP regulate psychologists? (Based on 3 things)

(S12:T1:A)

w1

A
  1. Credentials
  2. Practice
  3. Knowledge
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5
Q

What section is psychology under the HPA?

(S12:T1:A)

BONUS EXAM question

w1

A

22

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6
Q

Who has an interest in the effectiveness and fairness of the profession itself?

(S12:T1:A)

w1

A

The client, the profession, society

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7
Q

What is the HPA?

(S12:T1:A and page 880)

w1

A

Health Professions Act
(1999)

(SETS STANDARDS, DISCIPLINE, PROTECTS TITLES)

  • Umbrella legislation that governs the admission to practice in health professions (psychology qualifies as health profession).
  • Protects titles (“Psychologist”).
  • For all regulated health professionals.
  • Mandatory reporting: members must report (break confidentiality) if there is a threat to public health.
  • Makes sure colleges (CAP) has set policies to govern standards for members and that they operate within code of ethics and standards of practice.
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8
Q

What is the HIA?

(page 879)

w1

A

Health Information Act

  • Concerns protection of and access to private or confidential information about clients.
  • Says that custodians must release info if it will prevent imminent danger to health and safety of any person/ OR if individual lacks capacity to consent and disclosure is in client’s best interest.
  • The Act applies to psychologists in hospitals.
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9
Q

What is the AHA?

(page 874)

w1

A

Alberta Health Act

  • Provides complaint review system.
  • Ensures all sectors of health system comply w/ health charter.
  • Also seeks to make the health system transparent and efficient.
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10
Q

What is an ethical dilemma? (S1:A)\

w1

A

Results from a situation where outside factors clash with the expectations of the profession

Can be conflict between one or more of:

  • personal issues
  • moral principles
  • workplace policy/expectations
  • code of ethics/standards of practice
  • law
  • clinical knowledge
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11
Q

What are the 3 Levels of Kohlberg’s Moral Development Theory:

w1

How do Kohlberg’s stages of development contrbute to ethilca decision-making?

A

PEROSU

Level 1: Pre-Conventional Morality
Stage 1: Punishment + Obedience
Stage 2: Individualism and Exchange

Level 2: Conventionality Morality
Stage 3: Good Interpersonal Relationships
Stage 4: Maintaining Social Order

Level 3: Post-Conventional Morality
Stage 5: Social Contract and Individual Rights
Stage 6: Universal Principles

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12
Q

What is Level 1 of Kohlberg’s Moral Development theory?

w1

A

Level 1: Pre-Conventional Morality
Stage 1: Punishment + Obedience (person is good to avoid being punished)
Stage 2: Individualism and Exchange (person is good to get what they need e.g. if you’re good you get a cookie)

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13
Q

What is Level 2 of Kohlberg’s Moral Development theory?

w1

A

Level 2: Conventionality Morality
Stage 3: Good Interpersonal Relationships (person is good to get approval of others)
Stage 4: Maintaining Social Order (person is good to uphold law and avoid guilt; focused on rules of society)

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14
Q

What is Level 3 of Kohlberg’s Moral Development theory?

W1

A

Level 3: Post-Conventional Morality
Stage 5: Social Contract and Individual Rights (person does good by obeying laws when they make sense- understanding that they make sense for that majority of people, BUT there are times when they aren’t in everyone’s best interest e.g. when a starving person steals food)
Stage 6: Universal Principles ( persons does good by developing their own moral guidelines that are driven by principles like human rights, justice, equality; person is comfortable defending her principles to the rest of society

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15
Q

Consent does not travel across therapists/agencies, etc. Why not?

A
  • Don’t know if you can trust the other professional/agencies to carry out informed consent process
  • Other person may have used a different code
  • Must ensure comprehension of informed consent
  • Must check does client remember from previous consent they gave?

Should not assume consent because:

  • Power of control - do you really have the power to say no when you really need counseling ? (you don’t know what happened before)
  • When you’re in emotional distress and given a lot of content, how much are you going to remember when your frontal lobe is offline?
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16
Q

What act in Alberta requires the discipline to set a social contract for the society it serves?

Week 2

A

HIA? HPA?

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17
Q

Describe the social contract that psychologists have with society

Week 2

A

Psychologists receive mutual trust and respect IN EXCHANGE for promise that the discipline will do everything possible to ensure that members place the welfare of society(clients) above the welfare of the discipline and its own members

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18
Q

The Code is structured by these three things

Week 2

A

Ethical Principles
Values
Standards

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19
Q

Who is responsible for enforcing the Code of Ethics and how do they do this?

Week 2

A

The College of Alberta Psychologists

They turn the code of ethics into standards of practice; each province is responsible for doing this

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20
Q

Describe the 3 part protocol counsellors should follow when they are requested to release client records (Section 9, p. 663, Hamberger article).

In section 7, p. 373, it states this question will likely be on our exam.

A

Step 1:

  • Verify the requesting person’s signature on the consent form authorizing record release.
  • Determine if written consent contains legally adequate components for release of mental health info.
  • Initial contact with person requesting the release.
  • If contacting a third party: determine the reason for release, describe reason for requesting the release of the entire record, attempt to narrow the request to a summary report (instead of full release)
  • If the psychologist cannot get ahold of the client: write the client a letter outlining rights/responsibilities, release record upon receipt of a letter from the client.

Step 2:
- In-depth discussion with client outlining their rights, responsibilities, and the potential benefits/costs of releasing the entire record. They must have enough information to make an informed decision!

Step 3:
- Clinician-supervised reading of the full record (with the client). Discuss informed consent again. If the client still wants the full record released, the full record will be released.

21
Q

Fight for privilege Question- What are 3 ways to protect client privacy from courts

(Week 12)

A

Wigmore

Compromise - Find out what lawyer wants to know - can you answer the questions without sharing client’s file?

Bill C-46 (see p. 862) Rape Shield Law

Ask if third-party psychologist can view the file and provide sought information

Ask if judge will look at the file and provide sought information

22
Q

What are the three (4) protection tools for victims of DV under the PAFVA act?

Week 11

A

Protection Against Family Violence Act

p. 920

  1. Emergency Protection Order (EPO) - addresses immediate safety of victims of family violence; orders an abuser not to go where the victim regularly goes and not to communicate with the victim.
  2. Queen’s Bench Protection Order - similar to EPO, but for longer term planning and protection. Can also order abuser to reimburse money, order abuser to attend counselling, or authorize counselling for child.
  3. Warrant Permitting Entry - allows a police officer to enter a location to remove a victim for their safety.
  4. Victims of DV are afforded 5 days off work AND can get an interest free loan from the government for rent
23
Q

Who is the data obtained in the process of conducting a child protection evaluation handled?

P. 735 Week 10

A

“All data obtained in the process of conducting a child protection evaluation are properly maintained and stored in accordance with the CAP Standards of Practice. All records, including the raw data and the interview information, are recorded with the understanding that they may be reviewed by other psychologists, the court of the client”.

24
Q

What are some of the questions that psychologists are frequently asked to address in child-at risk situations?

p.730

A
  1. How seriously has the child’s psychological well-being been affected?
  2. What therapeutic interventions would be recommended to assist the child?
  3. Can parent be successfully treated to prevent harm to child in the future? (timeline?)
  4. What is the psych effect on child if they return to parent?
  5. What would be the psych effect on child if separated from parents/PGO?
  6. Can someone else assume responsibility for child?
25
Q

How does the Child, Youth and Family Enhancement Act define a child in need of intervention?

p. 738

Exam?

A

Reasonable and probably grounds to believe that the survival, security and/or development of the child is endangered because of….

-Child is lost
-guardian is dead
-child is neglected by guardian
-risk that child will be abused
-guardian is unwilling to protect child from abuse
-child will be emotionally injured
guardian is unwilling to protect child from emotional injury
-guardian is unwilling to protect/will cause child cruel/unusual punishment

26
Q

How does the Child, Youth and Family Enhancement Act determine if a child is emotionally injured?

p. 739

Exam?

A

Child is

**impaired in mental/emotional functioning/development

***reasonable grounds to suggest that emotional injury is result of:

  • rejection
  • emotional/social/cognitive/physiological neglect
  • deprivation of affection
  • exposure to dv***
  • excessive/inappropriate criticism, threats, humiliation, accusation, exceptions
  • chronic drug/alcohol abuse by guardians or by anyone is same residence
27
Q

What are the 7 components of a session note?

A

Good contact notes should contain:

  1. Themes: What was the main focus of the meeting?
  2. Rapport: What could you record for the next worker to make the meeting more warm
  3. What you did: What did you DO to help the client (e.g. normalize, validate, make referrals, psychoeducational)
  4. Change/progress: What changes occurred? Better/worse
  5. Risk - record in DETAIL, what was done to ensure safety for all
  6. Future - Homework for clients; staff to follow up
  7. Strengths/coping/grounding
28
Q

What is the overall goal of documentation??

A

Main Answer:
to provide substance in your case notes while going the extra mile to protect your client’s dignity and privacy, now and well into the future

How -get major themes, rapport building information, and what you did

  • to assist with providing continuing care
  • to protect yourself against future complaints
29
Q

What is included in Roger’s Test- Taker’s Bill of Rights?

p. 698

A
  1. Respect/Dignity - not affording dignity could impact performance
  2. Fairness - all protocols must be unbiased (admin/interpret, etc) AND should include opportunity for appeal and reevaluation is results are detrimental to test-taker
  3. Informed consent- reasons for testing, types of tests, intended use of results (plus pro/cons)
  4. Explanation of test results - a) actual test results b) interpretation of results c) recommended action
  5. Confidentiality - NO release of data unless explicit permission is given
  6. Professional competence- should be competent as using test, chose appropriate test
  7. Least stigmatizing label - chose label that will cause least potential damage e.g. self-fulfilling prophecies
  8. Linguistic/Handicapping conditions - make appropriate instrument choices (validity, accessibilities, etc)
30
Q

What does Roger’s Test Taker’s Bill of Rights say about Informed Consent?

A

MUST be stated in a language client can understand:

  • reason for testing
  • types of test to be used
  • intended use for results
  • potential consequences of intended use
  • what info will be released and to who

Clients should:

  • have capacity to consent
  • no coercion
  • give consent in writing

Those incapable of giving consent for testing should:
- get an appropriate explanation; obtain assent; get consent from legally appointed guardian

RIGHT to refuse testing in bill of rights - contradicts APA test standards which state the consent is not required when:

-test is mandated by law
-part of regular school activities
when consent is implied (e.g. application for employment)

31
Q

What are the three levels of the Alberta Trustee and Guardianship act?

What are the values of the ATGA?

Week 9

A

Supported decision making –> ‘supporter’ (supporter will interpret info for vulnerable person)

Co-decision-making –> both get a vote

Guardianship and Trusteeship

Values:

  • assume they can make decisions until they prove you otherwise
  • lack of communication
  • least intrusive option
  • how would they make their own decision?
  • what is in their best interest?
32
Q

A forensic psychologist has the obligation to discuss evaluation with each litigant, which should be tailored to the specific circumstances of each evaluation.

What are the steps to ensure ethical evaluation with forensic clients?

Week 9

Foote & Shuman

A
  1. Notify the person of all legal issues to be address in the evaluation
  2. In the situations where right to remain silent pertains, inform client using Miranda language
  3. Advise person of limited confidentiality afforded including
    I) where reports will be sent
    ii) legal proceedings where testimony is anticipated
    iii) Advise of all uses of report
  4. clarify that you are an EVALUATOR, not a therapist
  5. Request person’s participation and advise of penalty of not participating
33
Q

You will be charged with _______ if you work with a child without obtaining the proper consent?

Week 6 ppnt

A

Battery

34
Q

What are the guiding principles of the Alberta Guadrianship and Trustee Act?

A
  1. Lack of VERBAL skills does not mean lack of capacity to make decisions
  2. Assume adult HAS capability to make decisions until evidence proves otherwise
  3. Focus on BEST interest of person and how she would make decisions if capable
  4. Focus on autonomy - offering lease intrusive option
35
Q

Why/how can the consent process be a therapeutic adventure as opposed to solely a business transaction?

A

Staged relational consent!

(4’Es?)

E - empowering - giving client’s power
E - Encouraging - helping them to bond with you
E - engaging - appeals to different learning styles
E- Educational - they see they have rights

36
Q

Which Acts are behind each of the limits to confidentiality?

A
  1. Child, Youth and Family Enhancement Act (Child at risk)
  2. Protections of Persons in Care Act (abuse)
  3. Health Professionals Act - risk to public safety e.g. mass shooting, bomb threat
  4. Public Health Act - report communicable diseases
37
Q

What are five documents that counsellors should have ready to present to a lawyer for pending lawsuit?

A
  1. Proof of informed consent
  2. Session notes
  3. PD records
  4. Consultation record
  5. Client feedback and evaluation proof
38
Q

What should be included in a client’s file/records?

A
  1. Identifying information
  2. Presenting problem (purpose for services)
  3. Fee arrangement
  4. Date and substance of each sesssion including info on:
    - intervention
    - progress
    - informed consent issues
    - issues related to termination
  5. Test results
  6. Consultation notes
39
Q

What are Dawn’s 3 favorite questions to start a client meeting?1.

A
  1. What stood out for you in the last session (write this down as changes/process)
  2. What is a little bit better since you started/last session (write this down as changes/progress)
  3. So we have __ minutes today, what would you like to talk about
  4. After each topic –> so what stood out for you ?
  5. How might this impact your life?
40
Q

What is the difference between consent and informed consent?

What does BRAINS stand for (informed consent)?

A

Consent: gives permission and agrees to something

Informed consent uses BRAINS:

B- Benefits
R- Risks
A-Alternatives
I- Intuition (what does your gut say?)
N- no (your right)
S- Slow down, Stage it, Solicit (don’t just tell client, ASK!)
41
Q

What are meera’s core virtues?

p.40

A

Memory trick: Meera the BIRP (like bird)

Prudence
Integrity
Respectfulness
Benevolence

42
Q

What act in Alberta requires a discipline to set up a social contract for the society it serves?

A

Health Professional Act

43
Q

R v Cuerrier

A

Obligation to disclose HIV status prior to high risk behaviour

not knowing you’re HIV positive is not a defense

44
Q

How can we ensure the client is the most important person in the room?

A
  • The code of ethics –> client first mentality, psychologists duty to care for society above ourselves and the discipline

All of the 5 tests: Especially test of gain, reversibility
Countertransference
Client hired you

45
Q

What are the weaknesses of the CPA?

A

Little guidelines for animals, except for in research.
Doesn’t have enough feminist-based content
May not include personal bias adequately
Doesn’t seem to extend protections to therapists themselves. E.g., stalking!
Vary in preciseness
Lacking in information on dealing with multiple clients
· Multiculturalism
· Incorporate feelings (especially in the pros/cons section)
· Ongoing professional development
· Focus on Western individualism
· Continuation of care
· Assent
· Mature minor
· Interdisciplinary work
· Electronic counselling

46
Q

Consent does not travel. Why?

A

Trusting another person is sketchy
Different person may have used different codes
Gotta ensure comprehension
How much does client remember from previous consent they gave?
Power of control - do you really have the power to say no when you really need counselling?
When you’re in emotional distress and given a lot of content, how much are you going to remember when your frontal lobe executive functioning is offline?

47
Q

Why do we have a code?

A

hold us accountable regardless of client behavior.
to guide our behavior - accountability
Establish ourselves as a profession
Resolve ethical dilemmas
Helps to educate
Principle IV: CoE can really be a catalyst for change.

48
Q

What are the 9 considerations that help determine whether to take on another role ( to adopt a dual role)

A
  • Is this in my client’s best interest?
  • Whose needs are being served?
  • Will this have an impact on the service I am delivering?
  • How would the client’s family or significant other view this?
  • How would I feel telling a colleague about this?
  • Am I treating this client differently than other clients?
  • Does this client mean something “special” to me?
  • Does this action benefit me rather than the client?
  • Am I comfortable in documenting my decision/behaviour in the client file?