law and ethics mock 4

Question 1

A 67-yr-old woman meets with a therapist for the first time. She informs th therapist that her husband is physically abusive toward her and she can’t take it anymore. She shares her plan to finally stand up to him by taking a knive and showing him what it feels like to be hurt. She states she has never harmed him before. How should the therapist manage the legal obligations in this case?

A. create a safety plan and maintain confidentiality
B. create a safety plan and report abuse to police
C. call police to report client’s plan and process it with client
D. call APS and warn her husband of her plan for violence

Answer 1

C. call police to report client’s plan and process it with client

Question 2

A client reports that she recently awoke in the middle of the night to sounds of crying children in the apartment next door. She went to see if everyone was okay and discovered that the parents had left the 8-yr-old, 5-yr-old and 2-yr-old home alone. The client suspects that the parents are using drugs and expresses a desire to help the kids. How should the therapist manage the legal obligations?

A. process client’s feelings about the situation and document the need to file a report in the file
B. discuss ways the client could help the kids
C. inform the client that the therapist must file a child abuse report
D. determine if the children are in danger

Answer 2

C. inform the client that the therapist must file a child abuse report

Question 3

A therapist is meeting with a high school student who states that he is going to take his father’s gun and shoot the members of the football team who are bullying him. He then says he would not really do it. LEGALLY, what should the therapist do?

A. inform boy’s father
B. maintain confidentiality
C. inform members of football team
D. contact police

Answer 3

D. contact police

Question 4

A therapist relocated to another city. Prior to moving, the therapist referred all active clients to appropriate therapists and services. A new therapist of a former client contacts the therapist with a release of information wanting to know about the past treatment and diagnosis of the client. This particular client had multiple suicide attempts and a history of substance use. The therapist should:

A. only answer the new therapist’s questions
B. contact the client before sharing any information
C. answer the new therapist’s questions and include information about suicide and substance history
D. contact the client after sharing the information

Answer 4

C. answer the new therapist’s questions and include information about suicide and substance history

Question 5

A therapist is pulled over by police after attending a happy hour with work colleagues. The therapist is cited with a DUI. At the conviction hearing the therapist agrees to attend Alcoholics Anonymous meetings. What other legal obligation does the therapist have in this case?

A. inform his clients of his DUI and process their reactions
B. inform the BBS of his conviction within 30 days of conviction
C. inform his supervisor of his conviction
D. the therapist has no responsibility due to agreeing to attend AA

Answer 5

B. inform the BBS of his conviction within 30 days of conviction

Question 6

A 7-yr-old child is referred to the school therapist because he is unable to sit still in class. The child exposes a large, red rash on his torso and complains that the lotion his mom puts on makes it worse. The therapist calls the mother who shares that she doesn’t have time to take her son to the doctor and that she had the same thing as a kid and had to learn to be tough. ETHICALLY, the therapist should:

A. inform the mother that she must take the child to the medical doctor
B. process a possible child neglect report with mother
C. schedule a meeting with mom and child
D. schedule an appointment at a community health clinic

Answer 6

B. process a possible child neglect report with mother

Question 7

A therapist has been meeting with a client for several months. During a session, the client informs the therapist she is moving out of the area to a different part of the state. She tells the therapist that she doesn’t want to find a new therapist and would like to continue by receiving therapy by Skype. How should the therapist LEGALLY and ETHICALLY respond to client’s request?

A. terminate services and provide three referrals
B. discuss treatment options in the client’s new community
C. start internet therapy and obtain informed consent
D. refer patient to providers in her new area

Answer 7

B. discuss treatment options in the client’s new community

Question 8

During an initial assessment with a 7-yr-old boy, a therapist observes that the boy is small in stature and appears listless and gaunt. He is difficult to engage in play and mostly unresponsive to questions about school and friends. The therapist notices that he boy is trying to sneak candy from a dish into his pockets. What should the therapist do to LEGALLY handle the situation?

A. comment on the child’s behavior
B. call in the boy’s mother to tell her about the behavior
C. assess for further signs of child neglect
D. make a note of the behavior and intervene if it is repeated

Answer 8

C. assess for further signs of child neglect

Question 9

A therapist receives a call from a local hospital. The therapist’s client has been hospitalized following a psychotic episode. The hospital psychologist requests information regarding the client’s history and diagnosis. How should the therapist LEGALLY respond to the request for information?

A. release the information due to the crisis situation
B. speak with client to receive consent to share information
C. obtain a signed release from client
D. refuse request to protect client’s confidentiality

Answer 9

A. release the information due to the crisis situation

Question 10

During a therapy session, an 18-yr-old client reports that he assaulted his neighbor’s son whom he suspects broke into the client’s car and stole his radio. The client is bragging and showing no remorse. What action should the therapist take to manage the LEGAL responsibilities in this case?

A. file a child abuse report and process it with client
B. determine the age of the victim and file a report if necessary
C. maintain confidentiality and document incident in record
D. identify alternative coping skills and role-play in session

Answer 10

B. determine the age of the victim and file a report if necessary

Question 11

A 29-yr-old female client is referred to therapy by her MD for postpartum depression. She shares that she self-medicated in the past with marijuana and that her newborn had a positive toxicology test at birth. Her doctor recently prescribed antidepressants but the client does not think they are working. What are the therapist’s LEGAL obligations in this case?

A. report the positive toxicology report to CPS and document it in the record
B. obtain a signed release to contact MD and assess for risk
C. refer client to a substance abuse treatment center for an assessment
D. obtain a signed release to contact husband and MD

Answer 11

B. obtain a signed release to contact MD and assess for risk

Question 12

A therapist is referred a woman who was recently discharged from a short-term stay in a mental hospital following a manic episode. The woman is living with her parents and is being seen monthly for medication monitoring by a psychiatrist. LEGALLY, the therapist should:

A. request to meet with client’s family to gather additional information
B. obtain signed consent to speak with client’s psychiatrist
C. ask client to sign a no harm contract
D. identify treatment goals that the client should focus on

Answer 12

B. obtain signed consent to speak with client’s psychiatrist

Question 13

A therapist in private practice works predominantly with adolescents and uses text messaging to remind them of upcoming appointments. The therapist accidentally send a message to a client that was intended for her son that says “I love you”. How should the therapist ETHICALLY manage the situation?

A. acknowledge mistake and discuss the boundary violation
B. explore the impact of texting on the therapeutic relationship
C. stop using texting messaging in clinical practice
D. send a follow-up text apologizing for the mix up

Answer 13

A. acknowledge mistake and discuss the boundary violation

Question 14

A 13-yr-old client with anxiety returns to therapy after a month at summer camp in Nevada. The client reports that his camp counselor exposed himself to the kids in his cabin and fondled the client at night. The client does not want his parents to know about the incident because he is ashamed that he “let it happen” and knows his parents will be angry with him. How should the therapist LEGALLY handle his disclosure?

A. assure him that his parents will understand and need to be told
B. file a report with Nevada child protective services
C. file a report with California child protective services
D. obtain a release to contact the camp and inform them of allegations

Answer 14

C. file a report with California child protective services

Question 15

After meeting with a Japanese-American family for several months, the family has experienced improvements in communication and their children’s behavior has improved. The parents give the therapist a gift card in appreciation of the good work with the family. ETHICALLY, what should you do?

A. acknowledge the parent’s appreciation and accept gift
B. acknowledge the parent’s appreciation and decline gift
C. determine whether “fee for service” is acceptable in area
D. explore cultural importance of providing gift

Answer 15

B. acknowledge the parent’s appreciation and decline gift

Question 16

During a family therapy session, the therapist notices that both the 6-yr-old and 4-yr-old children have bandages on their hands. The mother discloses tearfully that she can’t trust her 16-yr-old stepson to stay alone with her young children because he superglued their hands to his door. The husband shakes his head and says “we already dealt with this. It won’t happen again.” How should the therapist CLINICALLY manage the LEGAL issue in the case?

A. find out how they dealt with it
B. document the incident in the notes
C. inform the family that the therapist must file a child abuse report
D. ask if other incidents like this have happened before

Answer 16

C. inform the family that the therapist must file a child abuse report

Question 17

A therapist runs an anger management group at a community mental health agency. A group member meets with the therapist individually, to complain that another group member shared confidential information outside of the group. ETHICALLY, how should the therapist manage the situation?

A. encourage the client to address concerns during the next group session
B. address the issue with the other group member at next group session
C. remind group members of the importance of maintaining confidentiality
D. meet with the offending group member and discuss concerns

Answer 17

A. encourage the client to address concerns during the next group session

Question 18

A therapist begins an assessment with a mother and her 13-yr-old son. During the course of the assessment, the therapist learns that the mother has previously used a belt to discipline the son for breaking curfew. The mother and son insist that a child abuse report has already been filed and that child protective services has closed their case. How should the therapist LEGALLY and ETHICALLY respond?

A. elicit information form the mother regarding referrals made during contact with CPS
B. contact CPS to ensure that a report has already been made, and if not, make the report
C. explore how the mother and son are handling disciplinary situations now
D. help the mother and son process the emotional aftereffects of CPS involvement

Answer 18

B. contact CPS to ensure that a report has already been made, and if not, make the report

Question 19

A therapist has been meeting with a client for several months. The client has been using his insurance and is struggling financially after his wife lost her job. He asks the therapist to temporarily waive his co-pay, since he can no longer afford to pay it, and bill insurance for the full fee. The therapist submits the request to the insurance company and they deny the waiver. ETHICALLY, what should the therapist do?

A. agree to waive the copay and continue with therapy
B. appeal insurance company’s denial and continue with therapy while in appeal process
C. terminate with client due to inability to afford fees
D. appeal insurance company’s denial and discuss fee options

Answer 19

D. appeal insurance company’s denial and discuss fee options

Question 20

A preschool mental health consultant meets with a teacher who is concerned about one of her 4-yr-old students. The teacher reports that the child has become increasingly aggressive with peers, has started wetting the bed during naptime, and has come to school with bruises that look like belt marks on the backs of her legs. How should the therapist manage the LEGAL issues in this case?

A. discuss the necessity of reporting the suspected abuse immediately
B. meet with the child and attempt to clarify the cause of the bruises
C. call the child’s parents to gather more information
D. make a referral to a pediatrician

Answer 20

A. discuss the necessity of reporting the suspected abuse immediately

Question 21

A therapist is developing a website to promote his new private practice. All of the following are ETHICAL, except:

A. highlight the therapist’s expertise
B. providing information about the therapist’s training and background
C. including information about the therapist’s office policies
D. including client success stories

Answer 21

D. including client success stories

Question 22

A 13-yr-old is referred to therapy by her middle school counselor because she i withdrawn in class and displays signs of anxiety. Her middle-aged mother attends the first session wearing a Muslim headscarf. The therapist is wearing a Jewish Star of David necklace. The mother notices the necklace and inquires whether the therapist is Jewish. How should the therapist manage the ETHICAL issues in this situation?

A. acknowledge the mother’s question and remind her that they are there for her daughter
B. acknowledge the mother’s question and provide an honest answer
C. acknowledge the mother’s question and explore its significance
D. acknowledge the mother’s question and remove the necklace

Answer 22

C. acknowledge the mother’s question and explore its significance

Question 23

A therapist in private practice meets with a client who is working through issues related to his father’s recent death. During one session, the client talks of feeling overwhelmed by his feelings of grief and is unable to deal with his own son’s crying and sadness about the loss. The client reveals becoming so frustrated with his son over the weekend that he grabbed the child forcefully and left bruises on the child’s arm. How should the therapist manage the LEGAL obligations in this case?

A. assess the child
B. let the client know that the child protection agency must be notified about the incident
C. educate the client on stages of grief and provide him with relaxation skills
D. refer the client to a grief support group

Answer 23

B. let the client know that the child protection agency must be notified about the incident

Question 24

A client is the leader of a criminal street gang. he has been seeing a therapist for several years. One day the client shows up to session desperate for a place to hide some guns that could be used as evidence of a gang killing. He brings the guns to the appointment, asking the therapist to conceal them for him. The therapist denies his request. What are the LEGAL issues present in this situation?

A. the therapist must report the client to the police
B. this communication between the therapist and client is not covered by psychotherapist-patient privilege
C. the therapist must assert privilege if the client’s records are ordered by the court
D. the therapist must inform the client that he no longer is covered by psychotherapist-patient confidentiality

Answer 24

B. this communication between the therapist and client is not covered by psychotherapist-patient privilege

Question 25

A therapist has been seeing a 17-yr-old girl for panic attacks who consented for her own treatment because her parents were against therapy. After four sessions, the client emails the therapist and informs her that she told her parents about therapy and they no longer want her to attend because they think she doesn’t need it. The therapist responds that she thinks the client could still benefit from treatment and she hopes she reconsiders. The client does not respond. How should the therapist manage the ETHICAL obligations in this case?

A. provide client with three referrals
B. call client to discuss the need for therapy over the phone
C. document the reason for termination in the client’s record
D. provide client with alternative treatment options for panic disorder

Answer 25

C. document the reason for termination in the client’s record

Question 26

A therapist in a family service agency is working with an 8-yr-old girl who discloses in session that she was sexually molested by an older boy at school. As she is talking, the therapist realizes that the boy is in a therapy group that she facilitates at the school. The therapist should NEXT:

A. obtain more specific details about the abuse
B. questions the other client about the allegation after the next group
C. report the abuse to the appropriate authorities
D. contact the school principal to report the abuse

Answer 26

C. report the abuse to the appropriate authorities

Question 27

During a session, a client informs the therapist that she is concerned for her neighbor who has been behaving strangely since his wife died. The client explains that her neighbor, an elderly man in his 70s, has been doing yard work naked. In addition, the client informs the therapist that she has been the man foraging in the trash can and running the streets shouting profanities. How should the therapist proceed?

A. maintain client’s confidentality
B. encourage the client to make a report to adult protective services
C. request client signs a release prior to contacting adult protective services
D. explain that the therapist must file a report to adult protective services

Answer 27

D. explain that the therapist must file a report to adult protective services

Question 28

A 25-yr-old woman is in treatment for Borderline Personality Disorder following a discharge from a psychiatric hospital due to a suicide attempt. The client has a severe trauma history and a deep fear of abandonment. After 5 months of treatment, the client shares that she i dating someone special and wants the therapist to see them or couples therapy to make sure the relationship works out. Offering concurrent couples therapy to this would be:

A. ethical as long as the risk and benefits are reviews
B. ethical as long as the expectations of couples therapy are addressed
C. unethical because concurrent couples therapy is never acceptable
D. unethical because it is clinically inappropriate with this client

Answer 28

D. unethical because it is clinically inappropriate with this client

Question 29

A 54-yr-old woman seeks therapy for depression. She shares that her 82-yr-old mother with dementia moved in with her 3 months ago and she feels overwhelmed taking care of her. The woman reports, “sometimes I just leave the house all day, because I can’t deal with all her neediness. She’s like a whiny baby.” What should the therapist do NEXT?

A. refer client to a psychiatrist for medication evaluation
B. file an elder abuse report
C. determine who is caring for her mother when client is gone all day
D. refer client to respite care services

Answer 29

C. determine who is caring for her mother when client is gone all day

Question 30

A therapist meets with a 45-yr-old client who has a history of being violence, or an intake assessment. During the intake assessment, the client states that his wife claims to have been visiting family for the past week but he believes she is lying to him. When probed further, he says that he thinks she is actually having an affair with someone. The client says that he plans on hurting her when she gets home so that she doesn’t do this again. What action must the therapist take to fulfill LEGAL obligations in this case?

A. suggest other ways to deal with his anger
B. determine the level of pathological paranoia in the client
C. inform the police of his statement
D. discuss the reasons for his suspicions to help the client with reality testing

Answer 30

C. inform the police of his statement

Question 31

A client mentions she has been having a difficult time with anxiety and depression since she began a lawsuit against the company that fired her. She discussed feeling anxious about how they will treat her as witness in the trial and who else they may end up wanting to bring into the court for the case. The therapist was subpoenaed by the client’s opposing lawyer. The therapist should LEGALLY respond by:

A. asserting privilege
B. consulting with a lawyer regarding the subpoena
C. turning over the client’s record an whatever else is required within the subpoena
D. maintaining confidentiality

Answer 31

A. asserting privilege

Question 32

An 84-yr-old client calls her therapist because she cannot make it to the session. She has been financially and physically dependent upon her daughter who moved out unexpectedly last week. Which of the following actions must the therapist take to assist the client?

A. determine alternative support person(s)
B. refer the client to a social services support agency
C. report possible elder abuse to the appropriate authorities
D. offer to see the client in her home

Answer 32

C. report possible elder abuse to the appropriate authorities

Question 33

A therapist has been seeing a client for over a year. The client is a sales rep for a major hotel company and travels a lot for work, but always makes time for ongoing therapy focused on her depression and anxiety around being single. During the holiday season, the client gave the therapist a card before leaving for a holiday vacation. In the card was a gift certificate for a weekend stay at the same hotel chain in town including meals. The card said “happy holidays, enjoy some relaxation with my free perks”. How should the therapist ETHICALLY respond?

A. call the client thanking her for the card and gift and ask her the best way to schedule the reservation
B. wait until the next session to politely decline the gift and discuss the reasons but also her reaction to that announcement
C. call the hotel and ask the monetary value of the gift before reserving the room or not using it
D. consult with a colleague regarding the issue

Answer 33

B. wait until the next session to politely decline the gift and discuss the reasons but also her reaction to that announcement

Question 34

A 14-yr-old comes to therapy telling her therapist she is pregnant with her 17-yr-old boyfriend’s baby. She is not sure how many months she is. She is scared to tell her parents but is excited about it bringing her closer to her boyfriend. What action should the therapist take to manage the LEGAL and ETHICAL issues?

A. refer the client to appropriate health services and discuss fears about telling parents
B. invite the family in for a family therapy session to discuss the pregnancy and how they will all handle it
C. invite the boyfriend in for a couple’s session to discuss his feelings and reaction to becoming a father
D. tell the client that the therapist will have to file a child abuse report due to the differences in age and the sexual interaction.

Answer 34

A. refer the client to appropriate health services and discuss fears about telling parents

Question 35

A therapist is treating a 68-yr-old woman following the death of her spouse. The patient has no immediate family and reports having been financially exploited by acquaintances following the spouse’s death. In order to address the LEGAL issues in this case, the therapist should:

A. interview the client regarding the specifics of the alleged exploitation
B. call APS immediately and file a written report of elder abuse within 24 hrs
C. seek legal assistance concerning the financial exploitation
D. call APS immediately and file a written report of elder abuse with 2 days

Answer 35

D. call APS immediately and file a written report of elder abuse with 2 days

Question 36

A client seeks therapy after the death of her mother. The client shares that her 82-yr-old mother was living with her family when she died. The client shares that her mother had dementia and would frequently become verbally and physically aggressive to her and her grown children. She tears up when she reports that she would be so desperate for a break that she’d sometimes lock her mom in her bedroom for an entire day. How should the therapist address the LEGAL issues in this case?

A. file an abuse report with APS and document in file
B. assess for child abuse
C. acknowledge her feelings of shame
D. refer her to a grief support group

Answer 36

C. acknowledge her feelings of shame

Question 37

During an intake assessment with a therapist, a client states that he is angry with his ex-girlfriend who, as he recently found out, cheated on him while they were still together. Upon further exploration, the client reports that he has had serious thoughts about harming her so that she “can’t ever hurt me again”. To address the LEGAL issues in this case, the therapist should:

A. determine if the client has a history of violence and access to a weapon
B. explore the nature of his thoughts and determine if he has a plan
C. warn the ex-girlfriend and notify the police
D. provide a referral to an anger management group

Answer 37

B. explore the nature of his thoughts and determine if he has a plan

Question 38

A new client shares that he is also a therapist he discloses that he recently had an affair with a client, but ended it because he knew it was wrong. He indicates feelings of guilt and remorse. How should the therapist proceed considering the LEGAL and ETHICAL issues in this case?

A. explore his feelings of guilt and remorse
B. provide him with the brochure “Professional Therapy Never Includes Sex”
C. encourage him to file a report with the BBS
D. find out if this has happened with other client

Answer 38

A. explore his feelings of guilt and remorse

Question 39

A therapist has been meeting with a client for 7 months with the expressed goal of addressing the client’s social anxiety. The therapist has noticed that the initial progress the client was making has slowed and the client might even be regressing, returning to previous behaviors. ETHICALLY, how should the therapist proceed?

A. discuss termination with client
B. confront client about lack of engagment
C. consult with colleagues
D. refer client to psychiatric evaluation

Answer 39

C. consult with colleagues

Question 40

Which of the following would be considered poor clinical boundaries?

A. a therapist goes to lunch with a client with an eating disorder
B. a therapist visits a client in the hospital after a suicide attempt
C. a therapist brings a child with attachment issues to her home for a play therapy session
D. a therapist goes to the grocery store with a client with agoraphobia

Answer 40

C. a therapist brings a child with attachment issues to her home for a play therapy session

Question 41

A 51-yr-old woman, who has been married for 17 years, comes to therapy complaining that her husband has been having an affair for the last several years. She tells the therapist that she and her husband are in couples therapy together with another therapist, and she would like to start individual work with you as well. How should the therapist ETHICALLY manage this situation?

A. obtain a release from her and her husband to speak with her couple’s therapist to develop a treatment plan
B. begin therapy with her immediately
C. tell her that it is not ethical to see two therapists at the same time
D. begin therapy with her and obtain a signed release from her to speak to the couple’s therapist

Answer 41

D. begin therapy with her and obtain a signed release from her to speak to the couple’s therapist

Question 42

A therapist meets with an 80-yr-old man and his son. The son would like the father to move out of his home and into an assisted living facility. The son states that his father lives alone, ha fallen twice, and he is concerned for his safety. The father disagrees and would like to stay in his home. The son wants the therapist to convince the father that moving would be in his best interest. How should the therapist ETHICALLY manage the issues presented?

A. discuss the importance of self-determination with the son and his father and provide a referral for home assistance services
B. explore the risks of the father staying in his home and his fears of assisted living
C. discuss the pros and cons of assisted living facilities
D. assess for potential self-neglect and discuss expectations of treatment

Answer 42

D. assess for potential self-neglect and discuss expectations of treatment

Question 43

A therapist is measuring the effectiveness of services offered to chronically mentally ill clients at a community clinic. When developing the informed consent for effectiveness study, the therapist is concerned about the clients’ level of competency, which often varies on a daily basis. What should the therapist do to manage the LEGAL and ETHICAL obligation in this case?

A. create a simplified version of the informed consent to ensure understanding
B. obtain consent only when assured of client’s ability to understand
C. design a rubric to determine various levels of understanding
D. verbal consent, not written is sufficient in this situation

Answer 43

B. obtain consent only when assured of client’s ability to understand

Question 44

A therapist is also a supervisor at an agency in a small town. One of his private practice clients has applied to be an intern at the agency. The agency does not employ any other supervisors that can supervise the intern. The client pleads to get the intern position in that agency since there are no other agencies in town. He mentions that it is a far drive to another town with a different agency that he might be interested in. What action should the therapist take in order to address the ETHICAL issue in the case?

A. explain the ethical conflict and encourage the client to seek internship in another town
B. work with the man both as his therapist and supervisor
C. explain the ethical conflict and discuss why the internship is unsuitable for the client
D. terminate therapy and allow the client to intern at the agency

Answer 44

A. explain the ethical conflict and encourage the client to seek internship in another town

Question 45

All of the following are true about authorizations for release of information EXCEPT:

A. it must have the current date
B. it must have an end date
C. it must indicate who will be sharing information with whom
D. it must be written in 12-pt font or larger

Answer 45

D. it must be written in 12-pt font or larger

Question 46

A Hmong couple are referred to therapy by their children’s school. Their 6-yr-old daughter has been sick recently and the school is concerned tat the parents are not getting adequate health care. The parents share that they immigrated here 5 years ago. The therapist knows very little about the Hmong culture. ETHICALLY, the therapist should:

A. research Hmong culture
B. ask the couple to talk abut their culture and immigration story
C. encourage the couple to tell her about their culture and how it may be impacting the current situation
D. consult with a therapist who is an expert on the Hmong culture

Answer 46

C. encourage the couple to tell her about their culture and how it may be impacting the current situation

Question 47

A bilingual therapist working at a community clinic has met with a client for 3 sessions. During the 4th session, the therapist determines that it is necessary to initiate a 5150 because the client presents as a serious danger to himself. After informing the client of the need to initiate a 5150, he becomes agitated and demands to see the clinic’s interpreter, stating the therapist must have misunderstood him. The interpreter meets with the client and reports finding no reason the client should be hospitalized. How should the therapist manage the LEGAL issues in this case?

A. follow the advice of the interpreter and not initiate a 5150
B. explain the concerns to the interpreter
C. meet with the client and the interpreter to reassess
D. initiate a 5150

Answer 47

C. meet with the client and the interpreter to reassess

Question 48

A therapist admits to an intimate relationship with one of his clients whom he has treated for over 2 years. The therapist is the subject of a regulatory board investigation. he tells the investigator that he truly loves this client and would like to marry her. When interviewed, the client reports that she initiated the sexual contact with the therapist. The therapist terminated therapy with the client when she moved in with him. The therapist’s actions are:

A. acceptable because the client initiated the relationship
B. legal but unethical
C. acceptable because the therapeutic relationship was terminated
D. illegal and unethical

Answer 48

D. illegal and unethical

Question 49

A 38-yr-old woman with Borderline Personality Disorder continually engages in scapegoating during a weekly treatment group. After consultation, the therapist facilitating the group decides to dismiss the client from the group due to the destructive nature of her in-group behaviors. How should the therapist ETHICALLY manage the client’s termination from group?

A. inform the client during a group session that she will be leaving the group in 2 weeks
B. ask the group whether the client should be dismissed from the group
C. schedule an individual appointment with the client to discuss the decision
D. refer the client for individual treatment before termination is discussed

Answer 49

C. schedule an individual appointment with the client to discuss the decision

Question 50

A therapist in private practice has a caseload of 15 clients. The therapist is pregnant and is planning on taking at least 6 months of maternity leave. The therapist is not certain when she will return from her leave. The termination process should include?

A. client’s reactions to therapist’s pregnancy
B. client’s progress
C. referrals to other therapists
D. discussion of return date

Answer 50

C. referrals to other therapists

Question 51

A 41-yr-old female has been in therapy for 2 years for anxiety attacks and depression. She is no longer taking medication and is currently symptom-free. During recent therapy sessions, she frequently laughs and enjoys herself. Which of the following actions should the therapist take to address the ETHICAL issues in this case?

A. interpret the client’s behavior as a flight into good health
B. confront the client regarding avoidance of underlying issues
C. develop termination plan with the client to maintain progress made
D. identifying precipitating events leading to the new symptom development

Answer 51

C. develop termination plan with the client to maintain progress made

Question 52

A 15-yr-old girl is sent to the school therapist because she is upset in class. She shares that her 18-yr-old brother was high on crystal meth the night before and hit her multiple times. She adds that she is worried about her 2-yr-old brother who is home alone with her brother today. How should the therapist LEGALLY manage this situation?

A. report the situation to child protective services immediately
B. report the situation to the police immediately
C. create a safety plan for after school
D. contact the client’s parents and inform them of situation

Answer 52

B. report the situation to the police immediately

Question 53

A therapist is meeting with a 68-yr-old woman and suspects elder abuse. However, the therapist is not certain if abuse is actually taking place. The therapist is conflicted on whether or not to make a report because it could be detrimental to the relationship with his client. What should therapist LEGALLY and ETHICALLY do in this situation?

A. report suspected elder abuse immediately and document it in file
B. maintain confidentiality and remind client of therapist’s reporting responsibilities
C. maintain confidentiality and document dilemma in file
D. report suspected elder abuse and process the report with client

Answer 53

D. report suspected elder abuse and process the report with client

Question 54

A therapist begins treatment with a couple. During the intake, the wife discloses that her husband can be very angry and hit her while the children are around. She also mentioned that their 9-yr-old son has tried to protect his mother and get in between the husband and wife causing the son to get hurt at times. The therapist hasn’t experienced many domestic violence clients in his time as a therapist and is feeling unsure of how to handle working with this couple. He should LEGALLY respond by:

A. referring the husband to an anger management group and creating a safety plan with the wife and son if it happens again
B. consulting with supervisor or colleague that specializes in domestic violence work
C. call CPS and make a mandated report for the abuse the son encountered and process it with parents
D. continue to see the couple as long ad they sign a no harm contract

Answer 54

C. call CPS and make a mandated report for the abuse the son encountered and process it with parents

Question 55

A therapist lives and works in a small community. A woman that he dated intimately over 11 years ago gets in touch with him and is seeking therapy. She has recently broken up with her husband and is needing therapy to resolve her issues regarding her divorce. The therapist ETHICALLY should respond by:

A. referring the client to another therapist due to the conflict of interest
B. begin therapy with the client since it was over 2 years that they had a sexual relationship
C. refer the client to another therapist due to the dual relationships
D. receive consultation on the situation and make a decision based on what the colleague suggests

Answer 55

A. referring the client to another therapist due to the conflict of interest

Question 56

A 33-yr-old woman mentions that the home her grandmother has been staying in has not been answering the phone. When she is able to get through on the phone, they do not put her grandmother on the phone. She complains to the therapist that the last time she went to visit her in the home, her grandmother seems gaunt, distraught and had bed sores that weren’t there before. The therapist should ETHICALLY respond by:

A. discussing with the client the need to call APS and file a report
B. calling the home during the session with the client to try an assist her with getting on the phone with her grandmother
C. making a call to a friend who is therapist at the home and seeing if she can check on the client’s grandmother
D. informing the client and discussing with her the feelings around the therapist’s need to call the police

Answer 56

D. informing the client and discussing with her the feelings around the therapist’s need to call the police

Question 57

A therapist has been seeing a client for a few months when the client has been put under a 72 hr hold with a 5150 by his psychiatrist. The therapist is not sure of the reasonings behind the 5150 and would like to find out more about what is happening with his client. The therapist LEGALLY can respond by:

A. calling the client’s mother to find out what happened
B. contacting the psychiatrist treating the client in the hospital to discuss the reasons the client is there and the treatment the client is receiving
C. not speaking to anyone since the therapist does not have a release from the client to do so
D. faxing the client a release form at the hospital so the psychiatrist can be spoken to

Answer 57

B. contacting the psychiatrist treating the client in the hospital to discuss the reasons the client is there and the treatment the client is receiving

Question 58

A 13-yr-old girl would like to seek therapy for issues going on at school and at home. her mother has brought her to the initial session since she would like her daughter to have therapy. her husband, the client’s father, thinks therapy is a waste of time and money and doesn’t want her to be in therapy. LEGALLY, the therapist should:

A. have the teenager sign her own consent for treatment
B. have a family therapy session to discuss the father’s concerns and views on therapy
C. have the mother sign consent for the client to retrieve therapy
D. refuse to see the client until the father signs the consent as well

Answer 58

C. have the mother sign consent for the client to retrieve therapy

Question 59

A therapist has been seeing a client for over a year for substance abuse issues and depression. The client arrives for his session visibly drunk, slurred speech, and refused to sit down on the couch for the session. The client continues to yell at the therapist and tells him he doesn’t want to have therapy anymore and starts to leave the office with his car keys in his hand. The therapist LEGALLY should respond by:

A. close the door and try to talk to the client into sitting down and staying in the office until he sobers up
B. call 911 and have police help him
C. call his emergency contact person and let them know what is happening with the client
D. let the client leave

Answer 59

B. call 911 and have police help him

Question 60

A therapist has been treating an 11-yr-old boy for anxiety and depression after the accidental death of his younger sister. After 2 months of treatment, the boy turns 12-yrs-old. The therapist believes the boy needs 2 sessions a week due to the severity of his symptoms. How should the therapist manage the LEGAL and ETHICAL issues in this case?

A. obtain a new consent for treatment now that the client is 12 and can consent for his own care
B. inform the client and parents of the need for additional sessions and document that need and their response in the chart
C. refer the client to a higher level of care due to the level of risk indicated
D. contact the client’s insurance to see if they will approve additional sessions per your clinical advice

Answer 60

B. inform the client and parents of the need for additional sessions and document that need and their response in the chart

Question 61

A therapist has been seeing a gay couple who have been attending therapy to deal with the issues behind their family accepting them and also one of the partners being HIV+. The client who is HIV+ calls the therapist distraught and crying and informs her that he has just been told he has full blown AIDS and doesn’t want to tell his partner out of fear of upsetting him and scaring him. The therapist should LEGALLY:

A. inform the partner of the “no secrets policy” and let him know that it will have to be discussed at the next session.
B. process what it was like for him to discuss it on the phone and let him know he will need to be reported for putting his partner in danger
C. encourage him to tell his partner and maintain his confidentiality about the issue
D. bring up the situation in the next situation and process with the clients how they are feeling about it

Answer 61

C. encourage him to tell his partner and maintain his confidentiality about the issue

Question 62

A therapist has opened her own practice after spending many years as an event planner for weddings and parties. One of her newer clients expressed concerns that her upcoming wedding planning is costing her fiancee and the client a lot of money and they are looking for the best locations and vendors to use for the wedding. The therapist knows many people in town that offer lower pricing. The therapist ETHICALLY should:

A. give a list of vendors the client should use so her anxiety levels can go down
B. contact her friend who is a florist and give her the client’s info her for her contact with a flower quote
C. do not mention the fact that she was a wedding planner and give assistance because it is out of the scope of practice
D. do not help the client since it is out of the scope of competence

Answer 62

C. do not mention the fact that she was a wedding planner and give assistance because it is out of the scope of practice

Question 63

A therapist is treating a child whose parents are getting a divorce. The child’s mother asks the therapist to do a custody evaluation. The therapist has a history of conducting custody evaluations for the court. How should the therapist manage the ETHICAL issues in this case?

A. conduct the evaluation because it falls within the therapist’s scope of competence and the therapist is familiar with the family
B. conduct the evaluation and discus the implications of it with both parents
C. conduct the evaluation only if both parents agree to it and provide transparency regarding the process
D. decline to provide the evaluation and provide family with referral for a custody evaluation

Answer 63

D. decline to provide the evaluation and provide family with referral for a custody evaluation

Question 64

A therapist begins seeing a new male client. The male client hugs the therapist when he walks in and introduces himself and hugs her when he leaves. The therapist is really uncomfortable with hugs from anyone, especially clients. How should she ETHICALLY handle the situation?

A. seek consultation to manage her countertransference
B. discuss with the client his need or urge to hug and set a boundary with him regarding personal touch
C. hand the client the “Professional Therapy Never Includes Sex” brochure and discuss that personal touch cannot occur in therapy sessions
D. continue to allow the client to hug since ti is how he manages the relationship

Answer 64

B. discuss with the client his need or urge to hug and set a boundary with him regarding personal touch

Question 65

A therapist has been treating a high-conflict unmarried couple for 5 months. The couple decides that they are going to break up and they terminate couple’s therapy. A week after termination, the girlfriend contacts the therapist and requests individual therapy. The therapy agrees to treat girlfriend. After a month of therapy with the girlfriend, the boyfriend contacts the therapist and requests individual therapy as well. How should the therapist manage the ETHICAL issues in this case?

A. provide the boyfriend with a referral to another qualified therapist
B. inform the boyfriend that it would be a conflict of interest to treat him because of the previous couple’s therapy
C. inform the boyfriend that it would be a conflict of interest to treat him because of the girlfriend is currently in individual treatment
D. agree to treat the boyfriend because you agreed to treat girlfriend

Answer 65

A. provide the boyfriend with a referral to another qualified therapist

Question 66

You are a therapist working in a facility for mentally disabled adults. During a session, you notice that one of your clients has a bruise on her arm. You ask her how she received it, and she tells you that she bumped her arm on a door while she was walking with assistance into her room. You review her chart and determine that the staff member who was with her followed the correct procedures for providing assistance to a resident while walking. What is your LEGAL obligation in this case?

A. report the injury to APS because a dependent adult was injured in a care facility
B. report the injury to law enforcement because a dependent adult was injured in a care facility
C. document the incident in your notes, but take no other action because the injury was accidental
D. document the incident in you notes and report the injury to your local ombudsman

Answer 66

C. document the incident in your notes, but take no other action because the injury was accidental

Question 67

Two parents bring their 11-yr-old son to treatment for ADHD. After a few sessions, the father decides the treatment isn’t working and withdraws his consent. The mother asserts that she believes her son needs therapy and that she wants him to continue treatment. LEGALLY, you should:

A. continue treatment because you only need the mother’s consent to treat the child
B. continue treatment, because the child can consent for his own treatment
C. stop treatment, because you need consent from both parents to treat the child
D. stop treatment because the father has determined the treatment isn’t working

Answer 67

A. continue treatment because you only need the mother’s consent to treat the child

Question 68

Your client is a 35-yr-old woman that you have seen for 2 sessions. She came to see you to work through relationshp issues with her husband, and at the 3rd session she tells you that he finally has greed to participate in couple’s counseling. ETHICALLY, you should:

A. refer the couple to another therapist, while you continue to treat the wife as an individual
B. obtain informed consent from the husband, review issues related to confidentiality, and proceed to treat the couple
C. discuss the potential risks and benefits of changing the unit of treatment, obtain informed consent from husband, and proceed to treat the couple.
D. continue to treat the wife individually, while simultaneously providing the couple with couples counselrin

Answer 68

C. discuss the potential risks and benefits of changing the unit of treatment, obtain informed consent from husband, and proceed to treat the couple.

Question 69

A client is being treated by you for generalized anxiety disorder, and discloses after a few sessions that she is also seeing another therapist at school for treatment for a social phobia. The client signs a release and during your conversation with the other therapist, you agree that she will continue to treat the client for social phobia while you continue to treat the client for generalized anxiety disorder. This decision is:

A. ethical because both therapists are treating the client for distinct, unrelated problems
B. ethical because the client has made an informed choice to work with two separate therapists for her problems
C. unethical because the client’s problems are too closely related to each other to be treated separately
D. unethical because the client hasn’t signed a consent form agreeing to receive concurrent treatment from two different therapists

Answer 69

C. unethical because the client’s problems are too closely related to each other to be treated separately

Question 70

You are treating a 28-yr-old client with Borderline Personality Disorder and a history of previous suicide attempts. During one session, she tells you that she frequently argues with her boyfriend, and during the arguments, she often threatens to commit suicide to punish him for disagreeing with her. You ask her if she has a plan to kill herself and she just laughs and refuses to answer your question. You should:

A. continue trying to assess the client for suicide risk, even though she refused to answer your answer
B. review your “no suicide” contract with the client and ask her to sign it
C. discuss the possibility of voluntary hospitalization with the client
D. continue treating the client according to the treatment plan, and reassess for suicide risk at a later time

Answer 70

A. continue trying to assess the client for suicide risk, even though she refused to answer your answer

Question 71

How long must you LEGALLY retain records for a minor client?

A. 7 years from the beginning of treatment
B. 7 years from the end of treatment
C. 7 years after the client turns 18
D. 7 years after the client turns 25

Answer 71

C. 7 years after the client turns 18

Question 72

A therapist has been treating a new client for depression for 3 months. During her session, she reports she is going on vacation for a month. She states that she wants to continue treatment while she is away and asks to continue treatment through the use of phone sessions. LEGALLY, what is your responsibility?

A. verify that she is staying in California and inform her that you can’t treat her if she leaves the state
B. complete a separate informed consent for teletherapy with her, and agreed to provide phone session while she is away
C. refer her to a local therapist near her vacation residence so she can continue face-to-face therapy uninterrupted
D. review the potential risks and benefits of tele-therapy with her, and discuss the possibility of continuing therapy through the use of phone sessions

Answer 72

B. complete a separate informed consent for teletherapy with her, and agreed to provide phone session while she is away

Question 73

A client comes to therapy to process the ending of his marriage. he and his wife are currently engaged in a custody battle over their 3 young children. The client asks you not to bill his insurance for his therapy and requests that you not keep any records of his sessions. He states that he doesn’t want a paper trail that could be subpoenaed and used against him in court. What is your LEGAL obligation in this case?

A. agree that you won’t keep session records because the client has a right to confidentiality
B. agree that you won’t keep session records because HIPAA doesn’t require you to keep them unless you are billing his insurance
C. inform the client that you are required to keep session records, and provide him with information on the type of information you will be documenting
D. inform the client that you are required to keep session records and reassure him that his record is confidential and can’t be accessed by the courts

Answer 73

C. inform the client that you are required to keep session records, and provide him with information on the type of information you will be documenting

Question 74

A licensed therapist with a thriving private practice is diagnosed with cancer. The therapist learns from her doctor that she will need to stop working for 3 months so they can complete chemotherapy, beginning one month from now. What ETHICAL obligations does the therapist have in this case?

A. prepare a professional will, notify clients of her upcoming absence, discuss the options for continuing treatment with each client individually
B. avoid burdening the clients with her personal health information and refer all of clients out to other therapists so they can continue treatment uninterrupted
C. prepare a professional will, inform clients of her diagnosis, and discuss the options for continuing treatment with each client individaully
D. inform clients of her diagnosis, discuss the option for continuing treatment with each client individually, and transfer all records to another therapist for safekeepin

Answer 74

A. prepare a professional will, notify clients of her upcoming absence, discuss the options for continuing treatment with each client individually

Question 75

A 13-yr-old girl is brought into therapy by her parents for symptoms of depression. She shares with the therapist that she is questioning her sexuality, and feels no one will accept her or who she is. She repeats statements about wanting the pain to go away and describes a plan to take her parent’s sleeping pills that evening and “never have to face the pain and loneliness again”. The client has made prior suicide attempt. Which of the following actions should the therapist take to address the LEGAL obligations in this case?

A. maintain confidentiality and make contact with the clinet to prevent a suicide attempt
B. break confidentiality and notify the client’s parents of her comments about dying
C. maintain confidentiality and provide the client with a suicide prevention hotline number
D. break confidentiality and initiate an evaluation for hospitalization

Answer 75

D. break confidentiality and initiate an evaluation for hospitalization