Final

Question 1

Scope of Practice (definition)

Answer 1

1.Set in state
law: specifies
what an MFT
can legally do
02
Allows us to
work with
individuals,
couples,
families and
groups
03
Allows us to
use “applied
psychothera-
peutic
techniques”,
and to assess,
evaluate and
treat relational
issues.
04
Allows us to
use training
we receive.
MFTs can
independently
diagnose
mental illness
05
Can use
psych tests: 1.
has to be with
client in
therapy with
us and 2. we
have to have
adequate
training to
administer the
test.

Question 2

Scope of Competence (definition)

Answer 2

Determined by 
your specific 
education, training 
and experience
2
You can expand 
your scope of 
competence, but 
you can not 
expand your scope 
of practice
3
Varies by person

Question 3

COUNTERTRANSFERENCE

Answer 3

01The therapist’s 
total emotional 
response to a 
client
02Can be a 
constructive or 
destructive 
element in 
therapeutic 
relationship
03Ways to Manage:
Seek Personal 
Therapy 
Establish 
appropriate 
boundaries
Consult with your 
supervisor and 
colleagues

Question 4

CONFIDENTIALITY

Answer 4

Permissible to break confidentiality in the following situations:
Suicidal client – legally permitted, not legally mandated to
disclose
Client consent: Release of Information
For reimbursement, insurance, 3rd party payers with limits
Managed care personnel
Consultation, supervision, peers
Other mental health providers
Other professionals in treatment team

Ordered by a 
judge (can say 
no to an 
attorney)
Client files a 
complaint 
against 
therapist
Client claims 
psychological 
damage in 
lawsuit
Civil 
Commitment 
proceedings 
(5150/5585)

Question 5

LIMITS OF CONFIDENTIALITY

Answer 5

Mandates require us to breach confidentiality
Duty to protect (Tarasoff)
Child abuse
Elder abuse
Dependent adult abuse

Question 6

Privilege

Answer 6

a legal right 
to not have confidential 
information revealed by 
their therapist during a 
legal proceeding
Who is the holder of 
privilege?
• client regardless of age, when 
there is no guardian or 
conservator
• A guardian ad litem (guardian 
for purposes of litigation)
• Representative of patient if 
dead
• All members of a treatment 
unit (individual, couple, family)

Question 7

PRIVILEGE continued

Answer 7

Who can assert privilege?
Person who holds privilege (most often the client)
A mental health professional on behalf of a client
Who can waive privilege?
General rule is the client waives privilege
A legally designated conservator or guardian ad
litem
If the client is deceased, then the personal
representative of the decedent

Question 8

Therapeutic Duty

Answer 8

First duty to client 
– DO NO HARM
Begins as soon as 
client enters the 
therapeutic 
contract
Legal concept, not 
actual law
Encompasses all 
legal and ethical 
responsibilities 
imposed upon 
MFTs
Therapeutic duty 
includes the 
responsibility of 
assessing, 
diagnosing and 
treating
Must incorporate 
all legal and 
ethical standards 
when assessing, 
diagnosing and 
treating

Question 9

Definition - Standard of Care

Answer 9

Standard of Care – “The average degree of skill, care and diligence exercised by
members of same profession, practicing in the same or similar locality” (Black’s
Law Dictionary)
For therapists, this means the “skill level, knowledge and care in diagnosis and
treatment that other reasonably careful therapists would possess and use in
similar circumstance [California Approved Civil Instructions (CACI) 502]
It’s a legal concept used to defend or prosecute therapists accused of negligence
or incompetence

Question 10

Standard of care

Answer 10

– Examples of maintaining a standard of care
include, but are not limited to:
– Obtaining thorough informed consent
– Completing a thorough diagnosis on a client
– Conducting adequate assessments (e.g.,
personal history, medical history, family history,
presenting problems, mental state, etc.)
– Creating a treatment plan

Question 11

Standard of Care

Answer 11

Taking proper steps 
for consultation with 
referral sources, 
psychiatrists, and 
other client treatment 
providers when any 
scope of competence, 
scope of practice, or 
other clinical issue 
arises which is beyond 
the clinician’s abilities 
or experience.
Making appropriate 
and necessary 
referrals
Taking reasonable 
steps to prevent harm 
to a suicidal client

Question 12

QRMOTHS– Child abuse assessment

assessment of reasonable suspicion of child abuse

Answer 12

Q- Questions
R- Releases/ referrals
M- MSE- mental status exam
O- observations
T- Testing
H- history
S- Social Supports

Question 13

TIPM, SAL– Suicide assessment, CARL

Answer 13

T- Thoughts
I- Intent
P- Plan
M- Means

SAL

• Specific
• Available
• Lethality

C- chronological factors
A- awareness of lethality
R- rescue
L- lethality

Recommended clinician style
FFF
F- Friendly
F-Frank
F- Firm

Question 14

Mandatory ethics
Positive ethics
aspirational ethics
principle ethics
virtue ethics

Answer 14

Mandatory ethics
Positive ethics
aspirational ethics
principle ethics
virtue ethics

Question 15

Ethical decision making

Question 16

Informed Consent

Answer 16

A process where the 
therapist must obtain the 
client’s informed consent 
by providing information 
about the nature of 
therapy so that the client 
can make meaningful 
decisions for or against 
treatment.
Failure to provide relevant 
information could mean 
that a therapist is not 
meeting the “standard of 
care”.