Law + Ethics Comp Exam Flashcards
The __________ is set by law and cannot be expanded.
Scope of Practice
The __________ can be expanded.
Scope of Competence
The __________ is set in state law and specifies what an MFT can legally do.
Scope of Practice
The __________ allows MFTs to work with individuals, couples, families, and groups.
Scope of Practice
The scope of practice for MFTs allows professionals to assess and treat _________.
relational issues.
The scope of practice allows MFTs to use psych tests if 1) the therapist is working with the client in ______ and 2) we have adequate ______ to administer the test.
1) therapy setting
2) training
This question helps an MFT determine if they are working within their ______:
Does the need for treatment stem from issues involving the client’s relationships?
Scope of Practice
This statement helps an MFT determine if they are working within their ______:
If anyone would have something negative to say about what you’re doing, don’t do it.
Scope of Practice
The following questions bring clarity to an MFT’s ______:
- How would your peers (other MFTs) evaluate whether or not you were working within your scope of practice?
- What would your professional association say, if given all the facts, about whether or not you were working within your scope of practice?
- What do you believe would be the position of the ethics committee for your professional association?
- What would the licensing board say, if given all the facts, about whether or not you were working within your scope of practice?
Scope of Practice
The knowledge, skills, and tools that help us practice are ___________.
Scope of Comptence
The scope of competence is determined by _____
education, training, and experience
You can expand your scope of _____, but you can not expand your scope of _____.
competence
practice
The most important piece of the scope of practice is understanding its ________.
limits
The scope of ________ varies by person
competence
A guiding question for __________ is:
What is it you’re being asked to do at that moment? Am I competent to administer this?
Scope of Comptentence
______ is the body of rules that govern the profession.
Laws
Laws define the __________ that the government enforces.
minimum standards
What makes laws important in what we do? Laws are important because of __________. Let’s you know what you can/can’t do.
keeping order, protection, safe
_________ is roughly 40% that will cover you legally in working with the client. Everything else is a grey area of _______.
Informed consent
Ethics
_______ represents the ideal standards for the profession.
Ethics
_______ are established and enforced by professional organizations–AAMFT, CAMFT, ACA…
Ethics
The primary purpose of ethics codes is safeguarding ________.
client welfare
_______ are beliefs and attitudes that provide direction to everyday living.
Values
_______ are ideas of right and wrong based on cultural or religious beliefs
Morality
_______ is a process that involves the psychotherapist sharing sufficient information with the client or prospective client so the client can make an informed decision about participation in the proposed course of treatment.
Informed Consent
Informed consent requires that the client understands the information presented, gives consent voluntarily, and is competent to give ___________.
Consent to treatment
Consent to treat is important for working with all clients but especially ________.
minors
Therapists cannot release information unless the client signs an _______. This dictates what information we can/cannot share.
Authorization to Release Information
When working with couples, therapists are encouraged to have a ____________ where the therapist cannot “hold” sensitive information from one or the other participants.
No Secrets Policy
We legally have to disclose ________ before therapy begins.
Fees
Licensure status & date
Complaint process (BBS)
Privacy Practices
Use of technology as a delivery of services (Telehealth)
The important documents are:
1) Informed Consent
2) Consent to treat
3) Authorization to Release Information
4) No Secrets Policy
With Informed Consent, failure to provide relevant information could mean that a therapist is not meeting the ___________.
“standard of care”
The therapist must obtain the client’s _________ by providing information about the nature of therapy so that the client can make meaningful decisions for or against treatment.
informed consent
The following are legally required elements of ___________:
- Competency of the client – the client must have the sufficient mental ability to reasonably understand the treatment
- Inform the client of the information that a “reasonable” person would want to know before deciding on the proposed treatment
- The therapist’s contract and wording must be worded in a language that a “reasonable” person could understand
- The client must be free of coercion, duress, or fraud when they consent to treatment
Informed Consent
The following are ___________ to include in Informed Consent:
- Risk/benefits of therapy
- Therapists’ education, theoretical orientation, background
- Management of confidentiality
- Mandated Reporting
- Self-harm process
- Cancellation policy, no-show rates
- Client behaviors that may necessitate termination
best practice information
What are the four types of child abuse?
Physical
Willful harm and endangerment
Neglect (general and severe)
Sexual (assault and exploitation)
(PNWS)
Mental/Emotional (optional)
Any situation where any person willfully causes, or permits, injury to a child is ______.
Child abuse - physical
Examples of this kind of child abuse are:
Hitting, grabbing, leaving a mark, etc…. “Are there differences in the child between yesterday and today?”
Child abuse - Physical
_______ is a situation where any person willfully inflicts upon any child any cruel or inhuman corporal punishment or injury resulting in a traumatic condition
Unlawful Corporal Punishment
_________ is when any person causing a child “unjustifiable physical pain or mental suffering, or any caregiver allowing it to happen”. (i.e. sleep depravation)
Willful Harm or Endangerment (Child Abuse)
_______ includes incest, oral sex, anal sex, sexual penetration, lewd and lascivious acts, child molestation, and some forms of statutory rape.
Sexual Assault (Child Abuse)
_______ is when parents or other adults encourage a child to participate in sexually explicit acts, performances, or depictions
Sexual Exploitation (Child Abuse)
The following are other considerations of _______:
- Lewd and Lascivious Acts
- Consensual Sex and Reporting
- Sexting and Digital Media
Sexual Abuse
________ is negligent treatment or maltreatment of a child by a parent or caretaker that could or does result in harm or threatened harm to the child’s health or welfare. (2 Types: General and Severe)
Neglect (Child Abuse)
Who do you report child abuse to?
- Child Protective Services (CPS) - county the child lives in.
- Police/Local law enforcement (if in imminent danger, call 911)
You submit a verbal report for child abuse when:
- When you reasonably suspect abuse, see bruises
- Immediately… as soon as possible
- Due within 24 hours
A written report for child abuse is due:
- Within 36 hours
When reporting abuse, what do you need to get from the agency you reported to?
- Get the name and title of the person in the agency you reported to (CPS, police, etc.)
- Case number
If someone already made a report on child abuse, we _______.
We still report it. We don’t trust every clinician has made the report. If our hands touched it, we see it from start to finish.
While managing the therapeutic relationship in reporting child abuse, the therapist must:
- Explain process
- Normalize feelings
- Provide resources
What is the age range of an elder?
Someone 60 years and older
What is the age range of a dependent adult?
18 to 59 years old
A dependent adult means any person residing in this state between 18-59 years of age, inclusive, who resides in this state, and who has a combination of a ___________ and the inability to protect ___________, or who has the inability to carry out ___________.
1) disability
2) their own interest
3) normal activities
What are the six reportable types of elder abuse?
Physical Abuse
Abandonment
Isolation
Neglect
Financial
Abduction
(PAINFA)
With elder abuse, physical abuse is _______________.
inflicting physical pain or injury upon an older adult.
Different types of physical abuse for elders are:
- Assault
- Battery
- Physical restraint
- Sexual assault
- Deprivation of food or water
The following are examples of _________ that are reportable within elder abuse.
- Failure to assist in personal hygiene or provide food
- Failure to provide proper medical needs
- Leaving an at-risk person unattended
- Soiled linens/clothing
- Untreated skin disorders
- Neglected bedsores
Neglect
With elder abuse, ________ is a reportable abuse when someone prevents elder or dependent adult from receiving their mail, phone calls, meeting with visitors, leaving their home, or telling a visitor that the elder or dependent adult is not available.
Isolation
With elder abuse, _________ is a reportable abuse for the following scenarios:
- The disappearance of papers/checkbooks
- Staff or others assisting with purchases/withdrawals
- Sudden changes in spending habits
- Bills left unpaid
- Telemarketing fraud, identity theft, home improvement scams, etc. Should be reported so that the government can investigate.
Financial
With elder abuse, ________ is a reportable abuse when a caretaker deserts their patient/loved one or gives up on their responsibilities when a reasonable person would not have done so.
Abdandonment
________ is a reportable abuse when the elder or dependent adult must have been taken outside the state of California or prevented from returning to the state, and they must not have the ability to consent.
Abduction
Abduction does not apply if they are moved against their will ________.
within the state
For elder and dependent adult abuse outside of a care facility, therapists report to:
Adult Protective Services (APS)
Local law enforcement
For elder and dependent adult abuse outside of a care facility, when do you make the verbal and written report?
Verbal Report - Within 24 hours
Written Report - Within 48 hours
For elder and dependent adult abuse within a care facility, when do you report physical abuse with a serious bodily injury?
Verbal Report - Within 2 hours
Written Report - Within 24 hours
For elder and dependent adult abuse within a care facility, who do you report physical abuse with a serious bodily injury?
Local ombudsman (advocate) or local law enforcement by phone immediately or as soon as practicably possible
For elder and dependent adult abuse within a care facility, when do you report physical abuse that does not result in serious bodily harm?
Verbal - within 24 hours to contact law enforcement.
Written - within 48 hours (2 working days).
For elder and dependent adult abuse within a care facility, who do you report physical abuse that does not result in serious bodily harm?
Local law enforcement
Local ombudsman
(A phone or internet report and written report to them…)
What are the three requirements that create an exception to reporting elder abuse?
1) The therapist is not aware of any independent evidence that corroborates the alleged abuse
2) The elder or dependent adult has been diagnosed with a mental illness or dementia or is the subject of a court-ordered conservatorship due to mental illness or dementia.
3) In the exercise of clinical judgment, the therapist reasonably believes the abuse did not occur.
When an elder or dependent adult tells the therapist that he or she has been abused, you ________________ if all of the following are true:
1) The therapist is not aware of any independent evidence that corroborates the alleged abuse
2) The elder or dependent adult has been diagnosed with a mental illness or dementia or is the subject of a court-ordered conservatorship due to mental illness or dementia.
3) In the exercise of clinical judgment, the therapist reasonably believes the abuse did not occur.
do not have to report
When is your Duty to Protect triggered?
- A client (or a family member of the client)
- Communicates to the therapist;
- The client’s “serious threat” (which must be imminent in order to be serious);
- Of “physical violence”;
What steps are you to take to carry out your Duty to Protect?
- Consider the hospitalization of the client
- Notify law enforcement
- Make reasonable efforts to warn the intended victim(s) and others who might be in harm’s way
What actions might you take to manage the therapeutic relationship when needing to carry out your Duty to Protect?
Institute a “safety plan”
Increase session frequency
Telephone contact between sessions
Consider the hospitalization of the client
Medication
Consult with a colleague or supervisor
Have the client dispose of the means
Comply with your agency’s policies
Only provide information necessary to meet the legal requirement when contacting law enforcement
Document all steps
For assessment and mandates as a clinician, what is a helpful acronym to utilize?
QRMOTHS
For assessment and mandates as a clinician, what does the acronym QR MOTHS stand for?
Questions
Releases/Referrals
Mental Status Examination (MSE)
Observations
Testing
History
Social Supports
_______ is a legal right to not have confidential information revealed by their therapist during a legal proceeding.
Privilege
Who can waive privilege?
The general rule is the client waives privilege
Who can assert privilege?
- The person who holds privilege (most often the client)
- A mental health professional on behalf of a client
Who is the holder of privilege?
- CLIENT regardless of age, when there is no guardian or conservator
- A GUARDIAN ad litem (guardian for purposes of litigation)
- REPRESENTATIVE of the patient if dead
- All members of a TREATMENT UNIT (individual, couple, family)
The scenarios when we (therapist) legally has to disclose client information and break confidentiality are:
- Ordered by a judge (can say no to an attorney)
- The client files a complaint against the therapist
- Client claims psychological damage in a lawsuit
- Civil Commitment proceedings
Three ways to manage countertransference are:
- Seek personal therapy
- Establish appropriate boundaries
- Consult with your supervisor and colleagues
