Final Exam Flashcards
Tarasoff/Ewing and HIV/AIDS
NOT TARASOFF
No duty to warn or protect, therapists not MDs and cannot diagnose medical disorders
Informed Consent empowers patient to: (3)
Gain information
Ask questions
Assist in own recovery
Empowered Collaboration (3)
Two fully engaged and committed people
Shows respect for client as a person, not a diagnosis
Gives client autonomy and self-determination
Four elements required for valid Informed Consent
Capacity
Comprehension of information
Voluntary
Document
Informed Consent and Empowered Collaboration are…
Ongoing and organic
Four mechanisms of accountability
Licensing boards
Ethics committees
Civil suits of malpractice
Criminal allegations
Four elements of a civil lawsuit
Duty of care
Standard of care
Demonstrable harm
Proximate cause
Skype and HIPPA - three requirements to be a covered entity
Health care provider + transmits information electronically + conducts covered transactions
Skype and HIPPA - three requirements to be a covered entity
Health care provider + transmits information electronically + conducts covered transactions
Delayed Discovery Rule
Statute of limitations begins UPON DISCOVERY of injury, not upon injury
Most common use of Delayed Discovery Rule
Sexual abuse cases
Burden of proof - civil standards
Preponderance of evidence (51%)
Burden of proof - criminal standards
Beyond a reasonable doubt (99%)
What is “take steps”?
Rule of least restrictive treatment requires us to take steps prior to hospitalization
7 steps prior to hospitalization (Rule of Least Restrictive Treatment)
Increase frequency of sessions Phone contact Support system Medication Adjunctive treatment Agreement Hospitalization
Record Keeping (7-year rule)
Retain records for 7 years following discharge AND 7 years from the patient’s 18th birthday (25 years)
Time frame for completion of electronic records
24-48 hours OR by end of week
Multiple Relationship with… (3)
the client OR a person closely associated with client OR promises to enter another relationship
Consequences of Multiple Relationships to patients (7)
Patient suicide Guilt & shame Delayed reaction (PTSD) Increased rage Patient feels (and is) victimized Decreased self-esteem Major depression
Multiple Relationship risk factors
Practicing in isolation No association memberships Rural area Vulnerable due to own issues Need for patient approval Poor self-esteem Low self-assertion Middle-aged or older Male Young female patients
Multiple Relationship risk factors
Practicing in isolation No association memberships Rural area Vulnerable due to own issues Need for patient approval Poor self-esteem Low self-assertion Middle-aged or older Male Young female patients
Title of Sexual Exploitation Brochure
Therapy Never Includes Sexual Behavior
Penalty for sex with patient (2)
Automatic license revocation + criminal felony
When is sex with patient is illegal? (3)
While in therapy
Within two years of termination
Therapeutic deception
Original Tarasoff
CSI
Communicated directly to therapist
Serious threat of physical harm
Identifiable vicitm
Hedlund
Duty to protect potential bystanders
VA
Seek past records - protect in absence of stated threat
Ewing
Communicated to therapy OR immediate family or reliable other FOR the purpose of advancing therapy
Ewing
Communicated to therapy OR immediate family or reliable other FOR the purpose of advancing therapy
Duty to warn vs Duty to protect
Mandated to breach confidentiality (OG Tarasoff) vs Permitted to breach confidentiality (Revised Tarasoff)
Does Tarasoff apply to suicide? (Bellah v Greenson)
Don't know! Case dismissed (no duty to warn in case of suicide, statute of limitations ran out)
Two benefits of Appropriate Therapist self-disclosure
Clients report reduction in symptom distress
Clients like therapist more
T/F Benefits of Therapist self disclosure require a positive therapeutic alliance
True
T/F Benefits of Therapist self disclosure require a positive therapeutic alliance
True
When do you send a client for further evaluation or consultation?
When therapy is threatened or endangered by the patient
Prior to termination, psychologists must provide…(2)
Pre-termination counseling
Recommend alternative services as appropriate
EXCEPT when precluded by the actions of the patient or payor
Four elements of proper termination
Consult/document
No crisis
Reasonable notice (30-90 days)
Proper referrals
Three elements of proper referrals
Available
Similar fee
Theoretical orientation
Results of Menendez Ruling (2)
Threats eliminated legal right to maintain confidentiality
Therapy ends the moment the therapist is threatened or in danger
Jennifer Keeton
Cannot counsel LGBTQ is immoral due to religious beliefs
Public universities can require students to follow Code of Ethics that conflicts with religious beliefs
Code of Ethics > religious freedom/free speech
Julea Ward
CAN ask to refer out LGTBQ clients on religious grounds (Conscience Clause)
Conscience Clause
Relieves a person from compliance on religious grounds
state by state issue
California Conscience Clause case
Pharmacist right to refuse prescribing abortion pill or contraception
Beliefs vs Behaviors
Beliefs are independent of ethics vs Behaviors must abide by ethics
Bracketing
Managing personal values so they do not contaminate therapy
Child must be ____ years old and have a _____ factor to consent to therapy
12 years old; maturity factor
Dire Exemption
Minors may be seen without parental consent if the situation is dire (suicide, homicide, etc)
Two types of custody
Legal (Decisions)
Physical (Location)
8 Required Reports of Elder/Dependent Abuse
Physical/sexual Neglect, even unintentional Abandonment Isolation Financial Self-Neglect Abduction Psychological Abuse
When to report Elder/Dependent Abuse
Therapist observes
Therapist has knowledge
Therapist is told
Therapist has reasonable suspicion
How to report Elder/Dependent abuse
Phone - immediately
Report form - within two working days
4 Required Reports of Child Abuse
Sexual abuse
Neglect
Willful cruelty/unjustifiable punishment
Unlawful corporal punishment or injury
When to report Child Abuse
Reasonable suspicion
How to report Child Abuse
Phone - immediately
Report form - within 36 hours of reasonable suspicion
Old vs New Terms Divorce > Defendant > Plaintiff > Alimony >
Dissolution
Respondent
Petitioner
Spousal Support
Family Code 3151
The child’s counsel appointed by the court may hold privilege
Judge may appoint to pull therapist out of the middle
Two ways judge can rule in conflict between couples or minors/parents
Patient-therapist privilege (no disclosure)
Third party rule (cannot prevent disclosure)
Subpoena (3)
From attorney
Strongly requests recipient to follow
Do not respond without patient consent
Court Order (3)
From presiding judge
Demands/compels recipient to follow
Must respond without patient
T/F A subpoena alone does not override disclosure requirements without consent of the patient
True
T/F HIPAA does not regulate information disclosures to the legal system, but licensing laws still apply with subpoena
True
T/F State laws require a signed patient authorization for disclosure of information with subpoena
True
How to properly handle subpoena (8)
Properly Served Validity Waiver By Patient Failure to Object (NOT a waiver) 15 Days to Release Motion to Quash Court Order In Camera Meeting
What year was the APA Ethics Code updated?
2017 (enforceable and unenforceable)
Intersectionality
Intersecting social identities related to systems of oppression/discrimination
Cultural Humility
Not knowing
Encapsulation
Ignorance of another’s culture
Three Dimensions of Multicultural Competency
Therapist self-awareness
Therapist understanding
Skill in using interventions
Empowered collaboration should be…(2)
ongoing and organic
