Final Flashcards
Describe briefly circumstances under which a therapist MUST break a patient’s
confidence, and circumstances under which breaking confidence is permitted but not
required.
Must: Child abuse, elder/dependent adult abuse, harm to identified other
Can: Danger to self
What is the difference between privilege and confidentiality? Who holds the privilege?
Privilege: Privilege is a specific legal term, and refers to a client’s right to keep information about their therapy
from being shared as part of a court proceeding.
Confidentiality: Confidentiality is a broad term that refers to your responsibility
as a therapist to keep therapy private.
Holder of the privilege: Clients
What are all the different types of child, elder and dependent adult abuse?
Child (Under 18): Physical, Sexual, Willful harm or endangerment, Neglect, Abuse in out-of-home care (emotional abuse is permissive but not required)
Elder (65+)/Dependent Adult (18-64): Physical, Abandonment, Abduction, Isolation, Financial, Neglect
What are the legal mandates when a therapist knows or suspects abuse?
CHILD: Once you have developed reasonable suspicion that abuse has taken place, it must be reported by phone to a local child welfare agency immediately.
The phone report must be followed up with a written report within 36 hours.
ELDER/DEPENDENT ADULT: must be reported by phone or Internet immediately, and in writing within two working days, to law enforcement or your local adult protective services agency.
Explain some important exceptions to the privilege. (Evidence Code 1016 and 1024, at a minimum)
Evidence Code 1016 : there is no privilege protecting communications relevant to the mental or emotional condition of a patient if the patient, or someone acting on their behalf, has made their condition an issue in litigation.
Evidence Code 1024 : There is no privilege under this article if the psychotherapist has reasonable cause to believe that the patient is in such mental or emotional condition as to be dangerous to himself or to the person or property of another and that disclosure of the communication is necessary to prevent the threatened danger.
What is a Tarasoff or Duty to Protect situation, and what mandates are imposed?
Therapists have a duty to protect reasonably identifiable victims of a dangerous or threatening client. The court famously wrote, “The protective privilege ends where the public peril begins.”
Mandates: yours is a DUTY TO PROTECT, not a duty to warn. Therapists must take “reasonable efforts” to notify intended
victims and law enforcement when a client poses a threat to reasonably identifiable victims.
the psychotherapist must notify the local law enforcement agency within 24 hours of the initial threat, and law enforcement is then required to notify the DOJ.
What are the legal and/or ethical considerations when a client is suicidal?
Law: a therapist does have a responsibility to take reasonable steps to prevent a threatened suicide. leaving that
question up to the standards of “good medical practice” – that is, the
standard of care.
State law requires mental health professionals to receive training in suicide assessment and intervention so that such clients can be properly assessed and treated, ensuring that they do not
ultimately hurt themselves.
Ethics: Can report.
Interventions: Assessment, safety planning, increased frequency of contact, care of loved one, voluntary hospitalization, involuntary hospitalization
Under what circumstances may a patient have access to his/her psychotherapy records?
How do the rules differ when the patient is a child?
Clients are typically entitled to review or receive a copy of their
treatment records if they wish. If a client requests their records, you
must comply within five working days if the client simply is asking to
inspect their records, and within 15 days (notably, not working days,
just days) if they are requesting a copy of their records. Requests to
inspect or receive copies of records must be made in writing.
CHILD: If a minor has consented to services on their own, the minor
has a right to access their own records. Their parents do not have the
right to access the minor’s treatment records. Only the minor
themselves can authorize the release of records from their therapy.
On the other hand, if the minor’s parent or guardian provided consent for the minor’s treatment, the parent or guardian has a right
to access those records. This is true even if the parent does not live with the child or is a noncustodial parent.
FAMILY: If you have been working with a minor as part of family
therapy, releasing records to any family member requires consent from
all family members who provided consent for treatment originally.
How does a minor become emancipated in California?
1) Get married with parental consent and permission from the court
2) Join the military
3) Go to court and have the judge declare you emancipated - To get a declaration of emancipation, you have to prove ALL of these things:
You are at least 14 years old.
You do not want to live with your parents. Your parents do not mind if you move out.
You can handle your own money.
You have a legal way to make money.
Emancipation would be good for you.
May a minor ever be seen in therapy without parental knowledge and consent?
any minor age 12 or older can
independently consent for their own psychotherapy, as long as
the therapist determines that the minor is mature enough to
participate intelligently in treatment.
the therapist still must attempt to involve
the parent or guardian unless the therapist can document why doing
so would likely be detrimental
What are the ground(s) for dissolution of marriage in California? On what basis is
spousal support determined? What are the guidelines around child custody?
California is a “no-fault divorce” state, meaning that you do not need to show that your partner did something wrong in
order to end a marriage. You simply need to report to the court that you and your spouse have “irreconcilable differences.”
Child Custody: ethics codes keep the role of evaluator and treatment provider separate
Who may consent to treatment of a child when the parents are divorced or divorcing?
When a minor’s parents are divorced, and they have joint legal custody of the minor, either of the parents may provide consent to treat the minor
if a custody agreement gives
both parents the right to make health care decisions for their child,
then you only need the consent of one parent to provide treatment.
It can be considered a best-
practice standard to obtain a copy of a written custody agreement,
How should a therapist respond to a subpoena?
3 Options:
- Assert privilege
- Object to the subpoena
- Comply with the request for records or court appearance
Unless you know that privilege has been waived or a judge has
determined that privilege does not apply, asserting privilege is an
appropriate default position for a therapist to take.
What you should
NOT do is simply fail to respond to a subpoena.
What is the difference between scope of practice and scope of competence? Give
examples of situations involving each concept.
PRACTICE: A profession’s scope of practice outlines the activities one can
legally do as part of that profession. It helps define the boundaries of a
profession, and the differences between one profession and another.
Ex: MFTs vs LCSWs
COMPETENCE: Your scope of competence consists of those
activities that you have appropriate education, training, and
experience to do on your own.
Ex: Experience with PTSD etc
What is a dual or multiple relationship? Give examples of situations in which multiple
relationships exist and discuss how the therapist should manage them.
Dual relationship occurs when a therapist and his/ her patient engage in a separate and distinct relationship either simultaneously with the therapeutic relationship, or during a reasonable period of time following the termination of the therapeutic relationship.
Other acts that would result in unethical dual relationships include, but are not limited to, borrowing money from a patient, hiring a patient, engaging in a business venture with a patient, or engaging in a close personal relationship with a patient. Such acts with a patient’s spouse, partner or family member may also be considered unethical dual relationships.
Sexual intercourse, sexual contact or sexual intimacy with a patient, or a patient’s spouse or partner, or a patient’s immediate family member, during the therapeutic relationship, or during the two years following the termination of the therapeutic relationship, is unethical. the therapist shall consider the potential harm to or exploitation of the former patient or to the patient’s family.
