Final Exam 4-29-24 Flashcards
1
Q
What is TIPM?
What does each entail?
A
Thoughts = ask directly if they have thoughts of suicide?
Intent = is the person intending on acting on their thoughts?
Plan = does the person have a plan?
Means = do they have the means to carry out their plan?
2
Q
What are some other things we look at when assessing suicidality?
A
what social support do they have? Do they have hope? Are there personal/family history of suicide attempts?
3
Q
What is SAL? What is it used for?
What does each entail?
A
Used to assess the lethality of a suicidal plan
Specific = how specific is the plan?
Available = do they have the available means?
Lethal = what is the likelihood of death?
4
Q
What things do we look at when assessing suicide?
A
TIPM
their thoughts, intent, plan and means
what are their Thoughts?
what is their Intent?
do they have a Plan?
do they have Means to carry out a plan?
5
Q
What things do we ask when we’re assessing the** lethality** of a suicidal plan?
A
SAL
how Specific is the plan?
do they have Available means?
how Lethal is their plan?
6
Q
What test do you use to assess lethality of **prior **suicide attempts?
what do each mean?
A
CARL
what are the Chronological factors? When did the prior attempt take place?
how Aware are they of their method?
do they do it in a way where want to be Rescued?
Lethality of attepmt? (the greater = the higher risk)
7
Q
What is CARL?
What does it entail?
A
Chronological factors = when did previous attempts take place?
Awareness of Lethality = knowledge of the method
Rescue = did they do it in such a way to be rescued?
Lethality = what is the likelihood of death?
8
Q
are you allowed to count all hours of experience if you have supervision in that same week collecting hours?
A
Yes
9
Q
Countertransference
A
when the therapist lets their own feelings shape the way they interact /perceive the client
10
Q
Transference
A
where clients project onto their therapist past feelings/attitudes they had towards significant people in their lives
11
Q
What is the purpose of a diagnosis?
A
advise on treatment options, tells the insurance companies about the clients/you get $ from ins comp.
12
Q
What is privilege in therapy?
A
gives the client the right to prevent the therapist from disclosing confidential information, designed for the clients protection
13
Q
When using email as a communication, what are some things to consider?
A
- make sure your clients understand that there is not a lot of security
- consider the info you are sharing through email and make sure your clients are aware of this
13
Q
What do you have to do in advance before doing therapy through Telehealth?
A
- get informed consent to use Telehealth (verbal or written)
- inform the client of risks/limitations
- Give the client your license # and type
- Document efforts to get contact information for resources of the client
- assess whether the client is a good fit for Telehealth
13
Q
What does it mean when a clients/therapist relationship is covered as Privileged Communication?
A
A right the client has that prevents the counselor from disclosing confidential information in a legal proceeding
- refuse to answer questions or refuse to give records in court
14
Q
What are some things to consider when gift giving in therapy?
A
If a client is gift giving:
consider their intent behind it, is the gift appropriate? Think of clinical implications; accepting, rejecting or giving a gift.
Ask the client why they thought of you when getting the gift?
15
Q
What are the potential consequences with having sexual relations with a client? What are some things you should think about?
A
- If not after 2 years sexual conduct occurred after last meeting, license will be revoked
- first explore that the former client may be vulnerable and at risk of exploitation,
- encourage the former client to seek counseling on the matter
16
Q
Your thoughts on “once a client, always a client”
A
If you were to have sexual relations after the 2 year time frame of therapeutic relationship, you can’t give them therapy anymore
17
Q
What are some things to be aware of when having boundaries with a supervisor
A
- there needs to clear roles of the trainee and supervisor
- does not use the trainee as someone to confide in (no relationship/physical touch)
- have clear feedback about the trainee’s performance
- A supervisor should be able to discuss conflicts when it occurs
18
Q
Sexual relationship with clients or their family member
A
- Do not engage in sexual activity with a client or anybody who is closely related to one of their clients.
- Do not engage in sexual activity with a former client, or anybody who is closely related to one of their former clients (within two years after terminating session)
19
Q
What are the benefits of advertising?
A
helps clients find a therapist
helps raise public awareness of mental health services
20
Q
What are some things to be aware of when someone is advertising your services?
A
Make sure the info is not false/misleading as you will held responsible for any information made about you
21
Q
What are the advertisement requirements?
A
- name of employer/agency that you volunteer @
- full name
- license status
- license #
- title of license
22
Q
Definition of Legal custody (for minors)
A
the right to make the decisions regarding the health, welfare, education of the child
23
What are some things to consider when entering a dual relationship?
1. will this impair the therapist judgement/objectivity?
2. affect the ability to give effective services
3. will this result in harm or exploitation of client
24
What is boundary crossing?
break from normal practices to potentially benefit the client
25
what are dual relationships?
when the relationship between the therapist and the client involve more than one "identity"
26
"not all dual relationships are unethical or avoidable"
True or False
True
27
what are some things to consider when using physical touch on a client?
- motive
- nature of touch
- impact on the client
- length of treatment
- cultural considerations
28
What is the purpose of record keeping/documenting?
- to assess/diagnose clients
- must reference your treatment decisions
- records protect us from legal action
29
What are the
clinical
ethical
legal
risk management perspectives to record keeping?
Clinical= review course of treatment
Ethical = helps provide quality care to clients
Legal = law requires record keeping
RM = standard of care
30
How long do you keep records for adults vs minors?
adults = 7 years (10 recommended)
minors = until they are 25
31
_____ are the owners of their records
Clients
32
What is the time frame for clients to get copies of their records/inspect their records?
1. 15 days
2. 5 days
33
Tarasoff: what actions might you take to manage the therapeutic relationship?
increase session frequency, have a safety plan, telephone contact between sessions, medication, consult with colleague, consider hospitalization of client
34
A written report of suspicion of child abuse must be submitted to…?
Timeframe?
CPS within 36 hrs
35
what actions would you take to manage a therapeutic relationship with domestic violence?
- create a safety plan
- focus on physical/emo safety for survivors
- talk about the power & control wheel
- refer to medical doctor as they can report abuse
36
definition of a crisis?
when an event/circumstance prevents therapy from proceeding until crisis is stabilized
37
What is the family code of treatment of minors?
- include parents in the minors treatment
- parents and minor agree to the informed consent
- parents sign the consent to treat for the minor (most cases)
- parents and minors sign the written authorization to release info
38
What are the characteristics of a culturally skilled counselor?
- recognize our limitations and willingness to seek consultation, participate in continuing education
- do not engage in discrimination or refuse service based on race/gender/religion etc
39
What are the 4 goals of supervision?
- promote growth/development
- protect the welfare of the client
- monitor performance
- empower trainee
40
what are some common issues with problem supervisors?
- boundary violation
- misuse of power
- sexual contact with supervisees
- substance abuse
- extreme burnout
- diminished clinical judgement
41
What are some common errors in advertising?
- misleading email addresses
- claims of effectiveness
- not considering each page of a website as an advertisement
- do not state you provide psychological services
42
What is your therapeutic duty? What does it include?
- do no harm
- you have the responsibility of assessing/diagnosing/treating which
includes legal/ethical standards when assessing/treating
43
what is Direct Liability? How can this look like?
- when actions of supervisors are the cause of harm
Ex: can happen when a supervisor give tasks us that exceed our competence
44
what is Vicarious liability in concern of supervisors?
- responsibilities that sup. have over the actions of the trainee
- sup. are legally expected to carry the decision making responsibility and liability
45
when is your duty to protect triggered?
Must receive communication of a serious threat of physical violence (to a reasonably identifiable victim) from the client or the clients family member
46
Who can assert privilege?
Most often the client or a mental health professional on behalf of client
47
When does the therapeutic duty begin?
as soon as client enters the therapeutic contract
48
How to treat minors w/o parental consent?
- minor must be 12+ and mature enough to participate in counseling + counseling must be an outpatient, therapist needs to state the intent to include parents in the treatment.
- If after consulting with the minor, its determined that involving the parents is detrimental to the health of the minor
49
How to treat emancipated minors?
- they may be seen w/o parental consent and they have the right to make their own legal decisions
50
What are the licensing laws for becoming a trainee?
competing 1300 clinical hours while enrolled in a graduate program (needs to happen your degree)
51
What are the licensing laws for becoming an associate?
completed a graduate degree, in the process of completing postgrad hours (3,000 to be eligible to sit for licensing exam)
52
Licensing laws for becoming licensed?
graduate from a grad program + complete 3000 hours + pass 2 licensing exams
53
what are 3 conditions that need to be met to trigger Tarasoff?
- serious threat made directly to therapist from the client
- in danger now
- reasonably identified victim with intentions to harm
54
Is Standard of Care considered to be a legal or ethical concept?
Legal
55
Physical custody (minors) definition
where the children stay the majority of the time
56
Why is it so important to document?
- if we don't document, it didn't happen
57
For foster kids, who consents to treatment?
the dependecy court
58
who consents if the parents are biological but not married?
either parent may consent as long as paternity has been confirmed
59
What can parents know about their minor's treatment if consented?
parents who have consented to treatment have the right to info about the treatment and well-being of the child
60
what does a minor's privilege look like?
minors are the holders of the privilege but are not permitted to enter legal contracts
61
What is the content of mental health records?
informed consent/signed consent to treat/intake form/DSM 5 diagnosis/treatment plan/progress notes/testing/signed authorization to release form/consultations/discharge summary (even for clients that ghost you)
62
How can clients request their records?
Made in writing
63
How many days do you have to write a summary note for the client?
10 days
64
what must be summarized in the mental health records?
- complaints including pertinent history
- findings from recent physical exam
- findings from consultation and referral to other health care workers
- reports of diagnostic procedures/tests
65
when can you refuse to give records to the client?
if it can be injurious to the client
- therapist can't release records but can disclose info with them
- you must document why and make records available to another therapist if the client wants to go over it with someone else
66
can you advertise for yourself as a trainee?
No
67
When does the therapist need to know where the area that the client lives?
For emergency situations using Telehealth
68
when using emails to contact clients you must?
- get consent to communicate through email since its not secure
- discuss what info will be shared on email
69
What is Scope of Practice?
How do we use it as therapists?
Can't expand this, you have limits
- it's what you as an MFT can legally do
allows us to use training to diagnose mental illness, work with couples, individuals and use techniques to assess/evaluate/and treat relational issues
70
Scope of Competence
You can expand this, determined by your specific education/training/experience
- varies by person
- Assess/diagnose/treat
71
Which one of these does Caldwell say is the best way you can protect your practice?
A) record your sessions
B) refer difficult clients out
C) take a cab if you've been drinking
Take a cab if you’ve been drinking
72
According to Caldwell, what's the best intervention for a client who is little to no risk and possesses little harm
Make a safety plan
73
If elder abuse was outside the care facility:
When do you make a written/verbal report?
W = 2 buisness days to police/APS
V= ASAP to police and APS
74
What would you ask regarding child abuse?
QRMOTHS
Questions - open ended questions (like "How did that happen")
Releases - (may need to talk to school/doctor)
Mental status exam - (what is their appearance/behavrior/memory like)
Observations - (malnourished, how do they act w/parents? therapist?)
Testing - (child behavior assessment)
History - (was CPS involved in the past? substance abuse?)
Social Support - is there family or anyone they can be with instead?
75
All except are useful tools for the assessment process:
A) Observations
B) Diagnosis
C) Termination
Diagnosis and Termination
76
According to CAMFT, sexual contact with a client/patient or a client's/patient's immediate family member, during the therapeutic relationship is prohibited during....?
2 years following the termination of the therapeutic relationship
77
Physical abuse with serious bodily injury in a long term care facility
Who do you make the verbal & written report to? Timeframe?
V: Police within 2 hrs
W: Police/local ombudsman/long term care facility licensing agency within 2 hrs
78
If you have reasonable suspicion of elder abuse and the elder does not live in a care facility/state hospital, you are required to make a verbal report to…
APS within 24 hrs
79
what are the 6 reportable types of elder abuse?
Abduction
Abandonment
Isolation
Financial
Physical
Neglect/self neglect
80
If abuse other than physical occurs in a long term care facility, when do you make a verbal/written report? Timeframe?
V: ASAP to police/local ombudsman
W: 2 business days
81
Who do you make a verbal & written report to when there is no serious bodily injury in a long term facility? Timeframe?
V: Police within 24 hrs
W: to police/local ombudsman/long term care facility agency within 24 hrs
82
a therapist may formally refuse information to the court in a legal proceeding involving the client by...
asserting privilege
83
True or False:
Therapists are mandated to notify the reasonably identifiable victim.
False, you don't have to notify the victim if you know doing so will increase the risk of harm to them
84
If you were to notify a reasonably identifiable victim, the therapist would....
notify them by phone
85
How do you manage a therapeutic relationship when reporting child abuse?
Normalize their feelings
Provide resources to the client
Explain the process: give reassurance, help them understand what is going to happen next
86
what are the 4 reportable types of child abuse?
What may be reported?
Sexual/Physical/Neglect/Willful harm
Emotional abuse may be reported but not mandated (hard to prove)
87
when is the verbal report due when reporting child abuse?
ASAP to CPS/Police
88
a verbal report must be made to _____ when reasonable suspicion of child abuse is seen.
CPS ASAP
89
what is the legal requirement for reporting a reasonable suspicion of child abuse?
Call CPS/Police ASAP and 36 hrs for the written report
90
When do you report consensual sexual activity? What are the age limits?
If they are under 14 w/other under 14 = no report
14-15 with under 14 = report
91
The Scope of Practice of a Marriage and Family Therapist includes:
A) Treat emotional disorders, behavioral problems and alcohol and substance abuse.
B) Assessment, diagnosis and treatment
C) Working with individuals, couples, families and children to achieve more satisfying relationships
D) All of the these.
All the above
92
The law is specific that you must report any instance of elder or dependent adult abuse that is told to the therapist directly by the elder or dependent adult. However, no report is required if all of the following circumstances exist EXCEPT:
A) If the person has been diagnosed with a mental illness or dementia
B) The therapist reasonably believes the abuse did not happen
C) The family members insist that it didn't happen
D) The therapist is aware of no evidence that would support the claim of abuse
The family members insist that it didn't happen
93
Legally, confidentiality must be broken when:
A) The client describes past criminal activity
B) A minor crime is being planned by the client
C) A client under the age of 18 is a victim of child abuse
D) The client is suicidal
A client under the age of 18 is a victim of child abuse
94
In the therapist's first session with a client, age 59, she reveals that she physically abused her 83-year old mother about 12 months ago but hasn’t harmed her mother since then. She tells the therapist that her previous therapist reported the abuse to adult protective services at the time that it occurred, so the therapist doesn't have to make a report. What does the therapist do?
A) Make a report to adult protective services
B Maintain confidentiality but monitor the client for future abuse of her mother
C) Call the client's previous therapist to make sure that the abuse was reported
D) Ask the client to bring her mother to the next therapy session to confirm that she is no longer being abused
Make a report to APS
95
In the event that a therapist trainee has identified red flags of reasonable suspicion of child abuse but is uncertain as to whether a report is mandated, the most important step that the therapist trainee would take is:
A) Consult as soon as possible with their supervisor
B) Consult with CAMFT
C) Document
D) Ask the client for more information
consult with your supervisor
96
The most important component of a therapist's therapeutic duty is:
A) The therapist will do no harm
B) The therapist will maintain confidentiality
C)The therapist will not impose personal values
D) The therapist will report all abuse
Do no harm
97
Which of the following are legally required aspects of informed consent?
A) Stating the license status of the therapist
B) Stating the risks and benefits of therapy
C) Stating the limits of confidentiality
D) All of these
all of these
98
Informed consent is a:
A) Legal obligation
B) Ethical obligation
C) Legal and ethical obligation
D) Requirement of the Board of Behavioral Sciences
Both legal and ethical obligation
99
A therapist can expand their scope of competence in all of the following ways EXCEPT:
A) Consulting with supervisors
B) Attending trainings and seminars in the field
C) Educating themselves in specific modalities
D) Reflecting upon their personal experiences
reflecting on their own personal experiences
100
The holder of privilege is:
A) The client
B) The parent of minor clients
C) The conservator of the client
D) The client and the conservator of the client
the client and the conservator of the client
101
What is the document needed in order to release confidential information to someone outside of the therapeutic relationship?
authorization to release information
102
The therapist recently graduated from his MFT master's program and is now a registered associate. His new client came in distraught and in crisis over the loss of her beloved dog. The therapist was reticent to review informed consent with her and ask her to sign the consent to treatment or establish the fee because he didn't want to upset her. His failure to obtain informed consent and establish the fee is an example of:
A) Countertransference
B) Empathy
C) Unprofessional conduct
D) Good business practice
unprofessional conduct
103
An MFT finds herself lying awake at night thinking about her client who experienced violence as a child. This is an example of:
A) Dedication
B) Empathy
C) Countertransference
D) Unprofessional Conduct
countertransference
104
If you must act to protect a reasonably identifiable victim in accordance with the duty to protect ruling, you would consider which of the following steps...
A) Notify law enforcement
B) Call the PET or other crisis mobile response team to evaluate your client for a 5150.
C) Disclose all information regarding the client's treatment as no confidentiality is required for clients in a duty to protect (Tarasoff) situation
D) Go to all possible lengths to notify the potential victim.
notify the police and call the PET crisis response team/do a 5150
105
When reporting reasonable suspicion of child abuse, the child is legally required to be your client or the child of your client.
True or False
False
106
A therapist can expand their Scope of Practice within the field of Marriage and Family Therapy
True or False
False
107
When an MFT has reasonable suspicion of physical abuse (serious bodily injury) to an elder/dependent adult who resides in a long term care facility, but not a state mental hospital or state developmental center, the MFT is mandated to:
A) Contact law enforcement within 2 hours and follow up with a written report to law enforcement, the licensing agency of the care facility, and the local Ombudsman within 2 hours.
B) Contact law enforcement immediately and follow up with a written report in two working days.
C) Contact law enforcement within 24 hours and follow up with a written report to law enforcement, the long term care facility and the local Ombudsman within two working days.
Contact law enforcement within 2 hours and follow up with a written report to law enforcement, the licensing agency of the care facility, and the local Ombudsman within 2 hours.
108
Privilege may be waived in all of the following situations EXCEPT:
A) If the client raises the client's mental or emotional state as an issue in a court proceeding.
B) If client waives his/her own privilege
C) If a subpoena comes from a judge
D) If the client is incarcerated
if the client is in jail
109
According to the Goldstein v. Ewing ruling, if a client's friend contacts you and reports that your client made a serious threat to physically harm an identifiable victim, you are required to contact the police and make a reasonable effort to notify the intended victim.
True or False
False
110
Your 15-year-old client who has been struggling with issues of feeling lonely and undesirable comes to session and excitedly tells you about her 23-year-old drama teacher asking her out. She lets you know that she hasn't told anybody except you but she had her first sexual experience with him. Your response is to:
A)Reflect her excitement
B) Keep the information confidential from her parents
C) Discuss birth control options with her
D) Report reasonable suspicion of child abuse
report reasonable suspicion of child abuse
111
review age chart
:)
