Law and Ethics Flashcards
What are the legal and ethical considerations when a client is at risk of suicide?
Therapists are required to ensure safety, but no legal requirement to report suicidal ideation. Therapist may break confidentiality to ensure immediate safety and/or prevent harm or loss of life.
What are the legal and ethical considerations when a client poses a serious, imminent threat of violence to a reasonably identifiable victim?
- Contact law enforcement within 24 hours
- Attempt a no violence plan
- Consider the use of Evidence Code 1024
What is a Tarasoff situation?
The client poses a serious, imminent threat of violence to a reasonably identifiable victim or victims.
Describe the California Evidence Code 1024.
The therapist cannot maintain privilege if (1) there is a reasonable cause to believe that the client is a danger to self, others, or another persons’ property and (2) disclosure of the communication is necessary to prevent the threatened danger.
What is a “5150” and “5585”?
- Both refer to the Welfare and Institutions Code related to 72-hour involuntary psychiatric hospitalizations.
- 5150 refers to an adult being placed on a 72-hour hold.
- 5585 refers to a child being placed on a 72-hour hold.
What is the therapist’s role when a client needs to be placed on a 72-hour hold?
- Can initiate, but not invoke, a 5150 or 5585
- Provide support and referrals for client during the process
- Explain the hospitalization process
- Collateral support
- Obtain releases when possible prior to hospitalization
- Ensure client is fully admitted with appropriate provider (i.e. calling hospital to confirm)
What are the three criteria that can result in a 5150 or 5585?
- Grave disability: The client is unable/unwilling to secure basic needs (food, clothing, shelter, medical treatment)
- Danger to Others: The client has indicated intention to cause harm to a specific person (verbal, behavioral) as a result of a mental disorder.
- Danger to Self: The client has indicated the intention to cause harm to self (verbal, behavioral) as a result of a mental disorder.
What are the legal and ethical considerations for suspected child abuse?
Mandated to report suspicion of abuse/neglect of any person under 18 years old.
- Report incident to CPS immediately
- Written report within 36 hours
Define “elder” and “dependent adult.”
- Elder: Any person over 65 years old
- Dependent Adult: Anyone 18-64 years old who has physical, mental, or financial limitations that restrict the capacity to live independently.
What are the legal and ethical considerations for suspected elder/dependent adult abuse?
Mandated to report suspicion of abuse/neglect of any elder or dependent adult.
- Report incident to APS or law enforcement immediately
- Written report within 2 working days
- Long-term care: Contact law enforcement immediately (if bodily harm) or in 24 hours (if no bodily harm)
What factors should a therapist consider when confronted with an ethical issue?
ACRONYM: B Slice
- Boundaries
- Scope of practice/competence
- Limits of confidentiality
- Informed consent
- Countertransference
- Expectations in therapy
What are the three factors of informed consent?
- Legal capacity to consent to treatment
- Mature/intelligent enough to participate and understand therapeutic discussion
- Ability to understand the right to decline/refuse treatment
By law, informed consent must include what 5 disclosures?
- Fees, including how fees are determined
- Name and license designation of the practice owner
- Fictitious Business Name Statement (if using a fictitious name)
- License is conspicuously displayed
- Associates disclose pre-licensed status
Sandra, a 40 year old Caucasian homemaker, seeks therapy for depression. She comes to her first session with her 31 year old African-American husband, Rick. He seems reluctant to be there. They have three children aged 2, 3 and 4. Sandra reports feeling “old and ugly” due to taking care of children all day, and suspects Rick is cheating on her. Rick avoids eye contact and says he is not interested in other women. What ethical considerations should the therapist consider?
- Assess biases/reactions to working with a bi-racial couple
What are common client expectations therapists should consider during treatment?
ACRONYM: LC DART
- Legal/Ethical concerns
- Client makes decisions, not the therapist
- Duration of treatment
- Advocacy measures therapist can take to promote care
- Role of the therapist
- Theoretical orientations/methods used
