Law & Ethics Final EXAM Flashcards
Malpractice Liability
Scenarios:
1-10
- Failure to obtain or document informed consent
- refusal to counsel clients due to value differences
- client abandonment & premature termination
- sexual misconduct with a client
- marked departure from established therapeutic practice
- Practicing beyond the scope of competency
- Negligent assessment & Misdiagnosis
- repressed or false memory
- unhealthy transference relationship
- Failure to assess & manage dangerous clients
Alleged negligence that results in injury or loss to the client
Malpractice
Importance of recordkeeping
- provide service for clients
- maintain continuity of care when client is transferred
- protects counselors to prove adequate care was provided
What does professional negligence look like?
- sexual/romantic interactions
- failure to practice w/ in boundaries of competence
- improper sharing of confidential material
- failure to make fees & charges clear to clients
- misrepresenting credentials
- altering records
- using false advertising
- practicing while impaired
Malpractice lawsuits
What are reasons we have that?
- procedure used by practitioner was not in realm of accepted professional practice
- practitioner employed a technique that they were not trained
- professional did not follow standard counseling procedures, which resulted in harm
- failure to warn about & protect them from violent crime
- informed consent was not obtained/not documented
- professional did not explain possible consequences of the treatment
What term describes a result from unjustified departure from usual practice or from failing to exercise proper care in fulfilling ones responsibilities?
Professional negligence
What does being an ethical therapist mean?
1-10
- Being interested in the welfare of the client
- practicing within the scope of one’s competence
- Understanding and respecting the cultural value of clients
- avoiding harm & exploitation
- Establishing/maintaining appropriate professional boundaries
- Protecting client’s confidence & privacy
- Practicing with ethical and legal framework
- Avoiding discrimination
- striving for the highest level of ethical practice
- Recognizing the importance of self-care as a basis for competent practice
What term refers to violating code of ethics or laws?
Misconduct
What are examples of misconduct?
- sexual misconduct
- confidentiality violation
- malpractice
- unprofessional conduct
- false advertising
- multiple roles
- abandoning client
Describe the social justice perspective?
To promote empowerment of people who are marginalized & oppressed in our society.
We help them gain tools, confidence, political clout, &skills needed to move away from oppression
Intimate relationships
are unethical & against the law
Supervisors responsibilities 1-5
-Responsible both ethically & legally for actions of trainees
-must check on trainees progress & be familiar with case load
-operate in multiple roles with trainee
-instruct a trainee, consult on a case, give feedback
-responsible for ensuring compliance with legal, ethical & professional standards
Supervisor’s role
1-3
- provide behavior guidelines
- protect supervisees
- ensure quality client care
Licensure statutes
- pass clinical exam
- pass cali law & ethics
- complete 2 years post degree work
- 3,000 hrs of supervised experience
GOVERN PROFESSIONAL PRACTICE
Therapist boundaries
invisible limits that establish a framework for the therapeutic relationship & provide psychological safety for clients
Example of therapist boundaries
- scheduling
- space
- fees
- confidentiality
- social medial
- self-disclosure
- communication channels
- dual relationships
Therapist competence
skills & training required to effectively & appropriately treat clients in a specific area of practice
How to maintain therapist competence?
- ongoing self-assessment & self-reflection
- get anonymous feedback
- get feedback from supervisor and peers
What type of assessments did we go over?
Suicide assessment
Formative assessment
Summative assessment
SOAP assessment
Formative assessment
devlopmentally formed process, training throughout ones professional career
Summative assessment
at the end point of the professional program or when applying for licensure
Client record & Storage
crucial when knowing the contact info, when keeping track of client and is first line of defense when accused of wrongdoing.
Types of Records
psychotherapy notes(HIPPA)
progress notes (different)
Progress notes
SOAP
process notes (psychotherapy notes)
Therapist personal use only
SOAP
Subjective
Objective
Assessment
Plan
HIPAA
Health Insurance Portability and Accountability Act
the federal law that created national standards for protecting sensitive patient health information from being disclosed without the patient’s knowledge or consent
“HIPAA regulations require practitioners who are covered entities under HIPAA to provide prospective clients with a clear written explanation of how health information is used, disclosed, and kept” 222
Mandated reporter requirements
required by law to report any known or suspected cases of child abuse or neglect to the county child welfare department (CPS) or a local law enforcement agency. This includes abuse or neglect of an elder or dependent adult. Mandated reporters must report as soon as possible by phone, and then follow up with a written report within two days. They are not responsible for determining if the allegations are true
Telehealth limitations
-Texting/email/video/skype the danger of a breach of confidentiality
-We need to take extra precautions when working through telehealth and need to disclose the breaches of confidentiality. We need to make sure our liability covers telehealth communications
Advertising
“Ethical practice dictates that practitioners accurately represent their competence, education, training, and experience in couples and family therapy.” 401
Financial or material exploitation is the illegal or improper use of an elder’s funds, property, or assets.
financial abuse
supervision requirements
-licensed experience
-supervisor training
-types: individual and group
-supervisor role
-supervision agreements and verification forms/logs to keep track of hours
tarasoff
WE MUST CALL POTENTIAL VICTIM AND CALL LAW ENFORCEMENT warn and protect
Case where EX GF Got killed
sliding scale fees
charging based off of clients income
business cards
According to the AAMFT California Interest Network and CAMFT, marriage and family therapists (MFTs) in California should not use professional identification like business cards if they include misleading or deceptive statements or claims. This includes other professional identification like office signs, letterhead, and social media. California law considers these forms of public communication to be advertisements.
Advertising
Yes, Licensed Marriage and Family Therapists (MFTs) can advertise, but there are some regulations:
Board of Behavioral Sciences (BBS): Regulates advertising, but not starting a website.
Employer: May have rules about advertising.
License status: Advertisements should list license status.
Trainees: Advertisements should include that the person is a trainee, their employer’s name, and that they are supervised by a licensed person.
Registered Associates: Advertisements should include that the person is a registered associate, their registration number, their employer’s name, and that they are supervised by a licensed person. The abbreviation “AMFT” should not be used unless the title “registered associate marriage and family therapist” is also included.
Psychotherapy or psychotherapist: These terms can be used as long as all other legal requirements are met.
BBS
Licensee and Registrant Advertising Requirements - BBS
If you are an AMFT, you must also state in the advertisement that you are supervised
termination
A successful termination calls for a blending of clinical, practical, and ethical factors that become the foundation for the termination process (Davis & Younggren, 2009).
-have clear goals and reassess them through out the session
authorizing forms
mft hours
s 3,000 hours of supervised professional experience, including 104 supervised weeks,
application process
masters degree
3000 hours of supervised experience
104 weeks of supervision
passing law and ethics exam annually for up to 6 years
Are practitioners liable for failing to render predictions of violent behavior of a client?
no
An example of having potential conflict between legal and ethical standards pertains to breaking confidentiality of a client who:
is HIV-positive by warning third party.
A couple asks an MFT for assistance in preparing their 17-year-old daughter for her college interviews. The MFT should:
Refuse to do so b/c such a service is outside the MFT’s scope of practice.
A therapist has been seeing a middle-aged married couple in treatment for six weeks. In today’s session, the therapist learns that the couple has an extensive history of violence, and that they had a physical altercation three days ago. The therapist should:
Reconsider the method of treatment
The ruling in Tarasoff v. CA Board of Regents established that MFTs must:
Warn an identifiable victim of a threat made by a client and take whatever additional steps may be necessary to protect the victim, such as calling police.
Therese is an MFT whose clients have been increasingly dropping out of treatment. Ethically, she should:
Consult with colleagues or a supervisor, and seek client consent to tape sessions.
Which of the following is an appropriate reason to terminate therapy?
Nonpayment of fees.
_______________ can be incurred when the actions of the supervisors are the cause for harm in clients.
Direct liability
Karla, 37, is an African-American woman who has sought therapy to discuss her concerns around being unmarried. She asks for specific strategies to help her find the right partner who will propose to her, however is not interested in investigating her own behavior in counseling. You should
Consider whether this treatment is outside of your scope of practice.
Your friend Han advertises himself as a “karate family therapist,” and specializes in the integration of self-discipline techniques within a Bowen process to improve family functioning. He has been training students in karate for 12 years and is licensed as an MFT. His advertising most likely:
Is within legal and ethical boundaries.
James and Mary were going to counseling for marital problems. The counselor decided to meet each partner in an individual session before meeting them as a couple. James confided that he was HIV-positive and was not going to tell his spouse because she would know that he had been unfaithful. The counselor decided to break confidentiality after attempts to encourage James to inform his wife of his condition. The counselor’s action:
You Answered
may be considered ethical yet it violates CA legal standard.
Which of the following is appropriate on a business card?
June Johnson, Marriage and Family Therapy Associate 12345, supervised by Jane Jones, LMFT #22334
In an event that a practitioner is sued he should:
contact the malpractice insurance carrier & retain an attorney.
Authorization forms should have all of the following information
- purpose of the requested use or disclosure of information.
- expiration date or expiration event.
- potential redisclosures by receiving party.
The Tarasoff rule states that you have the duty to warn and protect when a patient has communicated:
threat of “serious physical harm” to reasonably identifiable victims.
A former client calls and asks you to send her file to her new therapist in Iowa. You:
Request the client fax or mail you a signed release of information.
Gisele has acquired her 3,000 hours of experience for licensure as an MFT in California. To whom does she send her license application?
Board of Behavioral Sciences
As an MFT trainee, you need one unit of supervision (one hour of individual or two hours of group) for every ___ hours of client contact.
Five hours of client contact and for every week that you see clients even if it is less than 5 hour
legal definition of Advertising for MFTs?
Suspected financial abuse of persons age 65 or older in California is:
A mandated reporting situation.
Which of the following should a therapist do each time he/she provides mental health services via telehealth?
Verbally obtain from client the client’s full name and address of present location
After immediately making a phone report of suspected abuse, you have ___ to follow up with a written report.
36 hours for child abuse; two working days for elder or dependent adult abuse.
A therapist has been seeing her client Willow for six months. Initially the therapy focused on Willow’s depression; over the past month, Willow has been increasingly discussing her job opportunities, her favorite workouts, and new restaurants she is discovering with her fiancée. She no longer appears depressed. The therapist should:
Work with Willa to plan the end of treatment, and then follow the plan.
Lex is a licensed MFT in central California. He had been seeing Insoo and Dennis, a cohabiting couple, for two months at his negotiated fee of $60 an hour. (Locally, the average fee is $70.) Then Dennis lost his job, and the fee was renegotiated to $40 an hour. Recently Dennis was hired to a new job, where he will make substantially more money than he did at his old job. Ethically, how much can the therapist charge for future sessions, assuming he gives the clients appropriate notice of the change in fee?
Any amount Insoo and Dennis are willing and able to pay, so long as it is not
exploitative
HIPAA is ……:
A federal law protecting client privacy.
In a SOAP note, client statements about recent events would be in the ___ section.
Subjective
Which of the following address the client’s transference reactions and the therapist’s subjective impressions of the client?
Process notes, psychotherapy notes
Which of the following is TRUE with regards to client records:
Clients can waive their right to full disclosure of their own records.
According to California Law, the suggested length of time to maintain client records after the end of treatment is:
7 years
The skills and training required to effectively and appropriately treat clients in a specific area of practice, and is both an ethical and legal concept, is the definition for:
therapist competence.
___________ is a developmentally informed process that provides useful feedback during one’s training and throughout one’s professional career.
Formative assessment
When therapists extend the boundaries of their practice, or when they branch out into an area requiring specialty competence, they should:
seek consultation with a competent practitioner
____________ statutes determine and govern professional practice.
Licensure
Susan is in a counselor training program and is infatuated with her supervisor. She has indicated that she is interested in pursuing an intimate relationship. In order to provide adequate supervision for Susan, her supervisor would need to:
clearly define and maintain ethical, professional, and social relationship boundaries with Susan.
Counselors ____________ when they use their skills in helping clients challenge institutional barriers that impede their personal, social, academic, or career goals.
function as advocates
Joyce was hospitalized as a result of an attempted suicide. She tried to call her therapist before taking an overdose of pills, but he could not be reached because he was on vacation and did not make provisions for a replacement therapist while he was gone. This action constitutes the following type of professional negligence:
client abandonment.
Elena, your client of two years, has just received the news that she is losing her insurance coverage; however, she recently had a breakthrough in therapy and needs to continue working on her issues. As an ethical therapist, you should:
determine new payment terms so Elena can continue working with you.
Ignoring evidence of peer misconduct is:
an ethical violation.
records
vital to review the course of treatment. The manner in which you document treatment is likely to determine the outcome of the case.
