Legal and Ethical Standards

Question 0

You receive a letter from a psychotherapist who is currently treating Mark, a former client of yours. The therapist is asking for a copy of Mark’s record, and his letter includes a signed release from Mark. Mark terminated therapy with you several months ago but still owes you for the last two therapy sessions. Although you’ve sent Mark a letter asking that he contact you to discuss his outstanding fees, he has not responded. Consequently, you decide not to send the record to the psychotherapist until Mark has paid his bill. Your decision is:

1. acceptable as long as Mark’s records are not needed for emergency treatment.
2. acceptable since you have no obligation to provide Mark’s current therapist with his records.
3. acceptable only if you notify Mark of your decision and the reason for it.
4. unacceptable since you cannot withhold a client’s record because of an unpaid bill.

Answer 0

4. California Health and Safety Code Section 123 10 (J) applies to this situation. It states that, “this section shall be construed as prohibiting a health care provider from withholding patient records or summaries of patient records because of an unpaid bill for health care services.

Question 1

If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, what should psychologists do?

Answer 1

make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority. However, the Introduction states taht, if the “Ethics code establishes a higher standard of conduct than is required by law, psychologists must meet the higher ethical standard.”

Question 2

California law is more stringent (and therefore preempts HIPPA requirements) with regard to the protection of information related to which topics?

Answer 2

Certain aspects of mental health treatment and HIV/AIDS testing

Question 3

Who must comply with HIPPA regulations?

Answer 3

health care providers, health plans, and health care clearinghouses

Question 4

What is Protected Health Information, as defined by HIPPA?

Answer 4

A type of individually identifiable health information that is maintained or transmitted in any medium and that provides information about (1) the individual’s past, present, or future physical and mental health condition; (2) the provision of health care tot he individual; or (3) past, present, or future payment for health care provided to the individual

Question 5

What is not considered PHI?

Answer 5

Individually identifiable health information in educational records covered by FERBA or in employment records maintained by a covered entities in its role as an employer.

Question 6

According to HIPPA standards, a client has the right to review request a review of the denial by a designated health care professional who did not participate in the original decision to deny access in which circumstances?

Answer 6

1. The licensed health care professional has decided that disclosure of PHI to the client is reasonably likely to endanger the life or physical safety of the client or other person.
2. The PHI refers to another person who is not a health care provider, and the health care provider believes that disclosure will cause substantial harm to that perrson
3. The request was made by the client’s personal representative and the health care professional believes that disclosure to that representative is likely to cause substantial harm to the client or other person (California law does not allow a health care provider to withhold records from a patient’s personal representative because the provider believes that releasing records are contrary to the patients best interests).

Question 7

The client does not have the right to request a review of a denial of the release of records under which circumstances?

Answer 7

1) The information is exempt from the right to access (e.g., the request is for PHI that was compiled for use in a criminal, civil, or administrative hearing)
2) The covered entity is a correctional institution or is acting under the direction of a correctional institution, the requester is an inmate, and the covered entity believes that access will threaten the health or safety of the requester, other inmates, or employees of the institution.
3. The information was obtained as part of an ongoing research study and the requester agreed to denial of access as part of the consent process
4. The PHI was obtained from someone other than a health care provider under a promise of confidentiality

Question 8

Under HIPPA’s privacy rule, clients may be denied access to their protected health information in certain circumstances. Which of the following most accurately describes HIPPA’s requirements?

1. Access may be denied when the psychologist believes that providing the information is reasonably likely to cause emotional distress for the client and the client is given the right to have the denial reviewed.
2. Access may be denied when the psychologist believes that providing the information is reasonably likely too endanger the physical safety of the client or other person and the client is given the right to have the denial reviewed.
3. Access may be denied when the psychologist believes that providing the information is reasonably likely to cause emotional distress for the client or endanger the physical safety of the client, and the psychologist determines whether the client may request that the denial be reviewed.
4. Access may be denied when the psychologist believes that doing so is in the best interest of the client, and the psychologist determines whether the client may request that the denial be reviewed.

Answer 8

HIPPA’s privacy rule generally provides clients with greater access to PHI than does California law and usually sets the standard for determining when access may be denied. The privacy rule states that a provider may deny a patient access to his or her medical records when access is reasonably likely to endanger the life or physical safety of the patient or another person. However, in this situation, the client must be given the right to have the denial reviewed by a health care professional who was not involved in the original decision to deny access.

Question 9

Under HIPPA’s privacy rule, a health care provider may disclose PHI without the client’s consent:

1. only when the disclosure meets the “minimum necessary” standard
2. only when the information is needed to provide the client with emergency health care services
3. when the information will be used for routine treatment, payment, and health care operations purposes
4. when the provider has determined that it is in the client’s best interest to do so

Answer 9

3

Question 10

A licensed psychologist who has just started working in a rural community finds that several of her clients have problems that are outside her training and experience but that there is no other mental health professional in the community who can treat these clients. The psychologist should:

1. continue seeing the clients only if they are experiencing a crisis or other emergency
2. inform the client of her lack of experience and let them decide if they want to continue seeing her
3. continue seeing the clients but obtain appropriate consultation by telephone
4. refuse to see the clients until she receives appropriate training

Answer 10

3. It is acceptable for psychologists to acquire new knowledge and skills during the course of their practice as long as they obtain adequate training, supervision, or consultation.

Question 11

Dr. Bermeister, a licensed psychologist, is asked to provide crisis intervention counseling to individuals who were affected by a tornado that destroyed many homes in the community. Dr. B has not had experience providing assistance to people who have been traumatized by a natural disaster, but there is no one else in the area who has experience and is available to see these individuals. As an ethical psychologist, Dr. B should:

1. refuse to provide counseling to these individuals
2. provide counseling to these individuals but use only strategies and techniques that he has experience using.
3. disclose his lack of experience to these individuals during the informed consent process
4. provide counseling to these individuals but stop when the crisis has ended or when the appropriate services become available

Answer 11

4

Question 12

What information is appropriate to share with an employee’s supervisor in the context of an employee assistance program when the employee was referred by his/her supervisor?

Answer 12

Whether the employee kept appointments, whether the employee needs treatment, and whether the employee accepted the treatment. The supervisor should not be given any other information about the employee without the employee’s consent.

Question 13

True or false: Even when an employee refuses to sign a waiver for or an authorization for release of information prior to an evaluation for fitness for duty, an employer still has the right to limited information about the results off the evaluation.

Answer 13

True. They would be given information related to if the employee is able to perform essential job functions, whether any functional limitations will affect the employee’s ability to perform his/her job duties, and whether any accommodations are needed tto help the employee perform his/her job duties.

Question 14

True or false: Group members are legally obligated to maintain one another’s confidentiality.

Answer 14

False. However, group therapist must stress the importance of doing so and describe at the outset of the group the roles and responsibilities of all parties and the limits of confidentiality.

Question 15

True or false: A therapist should never keep secrets in couple and family therapy.

Answer 15

False. The therapist should clarify at the outset his/her policy regarding this type of information at the outset of treatment

Question 16

A licensed psychologist shall retain a patient’s health service records for a minimum of ____ years form the patient’s discharge date. For minor’s, the patient’s health service records shall be retained for a minimum of _____ years from the date the patient reaches 18 yo.

Answer 16

7, 7

Question 17

Can you deny a patient access to their records due to non-payment?

Answer 17

No, under CA law which supersedes the Ethics code

Question 18

What is the time frame in which a psychologist must respond to a written request for access to records?

Answer 18

Health care provider must permit a client or client representative to inspect the client’s records during business hours within five working days following the receipt of the written request.

Health care provider must ensure that a copy of the client’s record is transmitted to the client representative or client within 15 days after receipt of a written request.

Health care provider can choose to prepare a summary of the record for inspection or copying, but HIPAA permits this only if the client agrees in advance to receiving a summary, which must be available within 10 days. If the record is long, hcp can request more time, but notify the client and have the information no more than 30 days after.

Question 19

Is it deceptive/unethical for a psychologist to identify him/herself as a PhD Candidate?

Answer 19

Yes since this listing may falsely imply an earned degree.

Question 20

Advertising

Answer 20

psychologists who engage others to create or place public statements that promote their professional practice, products, or activities retain professional responsibility for such statements.

Question 21

Compensation of press

Answer 21

Psychologists do not compensate employees of press, radio, television, or other communication media in return for publicity in a news item

Question 22

paid advertisements

Answer 22

a paid advertisement relating to a psychologists’ activities must be identified or clearly recognizable as such

Question 23

Solicitation of testimonials

Answer 23

Psychologists do not solicit testimonials from currentt therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.

Question 24

Solicitation of business

Answer 24

Psychologists do not engage, directly or through agents, in uninvited in-person solicitation of business from actual or potential therapy clients or other persons who because of their particular circumstances are vulnerable to undue influence.

Question 25

Business and Professions Code Section 2936 requires psychology licenses and registrants to post a notice regarding which of the following in a conspicuous location in their place of business?

1. Information on how to contact the psychologist in an emergency
2. Information on how to contact the board concerning questions and complaints
3. the psychologist’s policies regarding fees and insurance reimbursement
4. the potential limits of confidentiality

Answer 25

2

Question 26

Which of the following best describes a psychologist’s legal obligations when providing mental health services over the internet?

1. A licensed psychologist may not provide mental health services over the internet except in emergency situations
2. A licensed psychologist may not provide mental health services over the internet unless he/she has been certified as an internet providerr
3. A licensed psychologist may provide mental health services over the internet but must obtain an informed consent from the client verbally and in writing before doing so
4. A licensed psychologist may provide mental health services over the internet but must provide the client with a standard disclaimer before doing so.

Answer 26

3

Question 27

Section 123149 of the California Health and Safety Code applies to providers of health services that utilize electronic recordkeeping services only. It states that:

1. the original hard copy of patient records must be maintained as a backup for an electronic copy
2. the original copy of any record containing the patient’s signature must be maintained even when the record has been electronically stored.
3. the original hard copy of patient records may be destroyed once the records have been electronically stored.
4. the original hard copy of a patient’s records may be destroyed once the records have been electronically stored only after obtaining the consent of the patient to do so.

Answer 27

3

Question 28

When a therapy client requests a summary of his or her record (rather than a copy of the entire record), a psychologist must provide a summary within _____ working days after receipt of the client’s written request unless the record is of extraordinary length or treatment of the client was terminated within the last 10 days.

1. 6
2. 10
3. 15
4. 20

Answer 28

2

Question 29

You are the only psychologist in a rural community. Your daughter’s Girl Scout leader calls, saying she wants to begin seeing you in therapy to work through feelings related to a recent divorce. As an ethical psychologist, you:

1. refuse to see the woman because doing so would constitute a multiple relationship
2. see the woman because you are the only psychologist in the community and her problem is unrelated to her role as a Girl Scout leader
3. ascertain the seriousness of the woman’s problems and agree to see her only if she appears to be in a crisis situation
4. assess the potential for exploitation or loss of objectivity and base your decision about seeing her on the outcome of the assessment

Answer 29

4. Because you are the only psychologist in the community, you wouldn’t necessarily refuse to see the woman in therapy but would want to consider the potential consequences before agreeing to do so.

Question 30

You are starting a program for parents who are recently divorced. You tell the editor of the local newspaper (who just divorced her husband and has physical custody of their 10-year-old daughter) that she can attend the program for free if she puts an article about the program in the paper. According to the ethics code, this is:

1. unethical because you should not compensate a newspaper employee for publicity in a news item about your services
2. unethical only if you influence the editor’s choice of content for the article
3. ethical as long as the arrangement doesn’t compromise your objectivity when providing services to the editor
4. ethical only if the editor would otherwise be unable to attend the workshop due to her inability to pay the fee

Answer 30

1

Question 31

As defined in the APA’s Ethics Code, uninvited in-person soliciation of business by a psychologist is:

1. acceptable as long as the solicitation is not coercive.
2. acceptable when it involves providing disaster or community outreach services
3. acceptable as long as the person’s best interests are of paramount concern
4. never acceptable

Answer 31

2

Question 32

What two requirements must be met for a minor, age 12 or older, to consent to outpatient mental health treatment or counseling services and to residential shelter services?

Answer 32

1. The mental health professional believes the minor is sufficiently mature to participate intelligently in the services
2. The minor would present serious physical or mental harm to self or others without the services or is the alleged victim of incest or child abuse

Question 33

When a minor does not meet the criteria to consent to treatment, the family code provides several exceptions to this rule. What are these exceptions?

Answer 33

1. Alcohol and Drug-related problems (exception does not apply to replacement narcotic abuse treatment); physiciian shall disclose medical information concerning the care to the minor’s parent or legal guardian upon his or her request, even if the minor child does not consent to the disclosue, without liability for the disclosure
2. Prevention and treatment of pregnancy
3. Victim of Rape
4. Victim f sexual assault
5. Exposure to infectious, contagious, or coommunicable diseases
6. Self-sufficient minors (minor must be 15 or older; living separate from guardian; managing own financial affairs)

Question 34

You are treating 14 year old Samantha with the consent of her parents. One day you receive a phone call from Samantha’s father, who wants access to her therapy records. You believe that agreeing to his request may be psychologically harmful to Samantha. You:

1. must comply with his request because Samantha is a minor
2. must comply with his request because he consented to Samantha’s therapy
3. may deny access because of your concern about the consequences of doing so
4. have no obligation to allow him access to Samantha’s records but may comply as a courtesy

Answer 34

3

Question 35

A nonemancipated minor may receive treatment without parental knowledge and consent in which of the following situations?

1. The minor is at least 12 years of age, is requesting counseling for an alcohol-related proglem, and the provider has determined it would not be appropriate to contact the minor’s parent.
2. The minor is at least 12 years of age and is seeking medical care related to the diagnosis or treatment of a sexually transmitted disease or other disease that is required by law to be reported to a local health officer
3. The minor is of any age, is seeking diagnostic or treatment services related to a sexual assault, and the provider believes that the minor’s parent or guardian is the perpetrator of the assault
4. All of the above

Answer 35

4

Question 36

When a minor cannot legally consent to his or her own mental health treatment, who can provide consent?

Answer 36

1. If parents are married, either parent alone may authorize tx
2. When parents are divorced but share joint legal custody, either parent alone may consent to therapy.
3. If a parent has sole legal custody, that parent may unilaterally make mental health care decisions
4. Unmarried parents, minors who are parents, and legal guardians have authorization to consent to tx
5. Caregivers who meet the appropriate requirements and sign an authorization affidavit may give consent for a minor’s treatment
6. In an emergency, no consent is necessary, and a psychologist may treat a minor regardless of who brought the minor for treatment

Question 37

The duty to warn does not apply to which situations?

Answer 37

1. Someone other than the client is the dangerous party (however, potentially encourage client to report danger)
2. Someone other than a family member reports that a client has threatened to harm someone (psychologist would want to address this issue with the client)
3. There is no reasonably identifiable victim or victims (may not have duty to warn/protect but may need to hospitalize)
4. The client threatens suicide

Question 38

Who can inform when a patient has tested positive for HIV virus?

Answer 38

Physicians and surgeons may inform a patient’s spouse, other sexual partners, needle-sharing partners, and other health care workers when a patient has tested positive for the HIV virus. May not identify the patient but may tell the individual that he/she has been exposed to the HIV virus.

Question 39

What is a psychologists duty when working with a client who is HIV positive?

Answer 39

Encourage client to notify sexual and needle-sharing partners; offer to help them make the disclosure; inform client of client’s legal duty to inform their sexual partners

If client expresses an intent to infect a specific person, psychologist may ave a duty to warn but should consult with a colleague and/or attorney.

Question 40

When should involuntary commitment be considered?

Answer 40

1. The danger that the client poses to self or others is imminent or the client is gravely disabled.
2. The danger or grave disability is the result of a mental disorder or chronic alcoholism.
3. The client has refused or is unable to comply with a recommendation to enter a psychiatric hospital voluntarily.

Question 41

What constitutes a 5150?

Answer 41

It is a 72-hour hold and states that, “when any person, as a result of a mental disorder, is a danger to others, or to himself or herselff, or gravely disabbled, a peace officer, a member of the attending staff of an evaluation facility designated by the county, designated members of a mobile crisis team, or other professional person designated by a county, may upon probable cause, take, or cause to be taken, the person into custody and place him or her in a facility designated by the county and approved by the State Department of Mental Health as a facility for 72 hour treatment and evaluation

Question 42

What is 5230?

Answer 42

Similar to 5250 but individual has same problems as the result of alcohol or drug use

Question 43

Gravely disabled?

Answer 43

A. A condition in which a person, as a result of a mental disorder, is unable to provide for his or her basic personal needs for food, clothing, or shelter.

B.. A condition in which a person has been found mentally incompetent under section 1370 of the penal code and all of the following facts exist: The indictment or information pending against the defendant at the time of commitment charges a felony involving death, great bodily harm, or a serious threat to the physical well-being of another person; The indictment or information has not been dismissed; As a result of a mental disorderr, the person is unable to understand the nature and purpose of the proceedings taken against him or her and to assist counsel in the conduct of his or her defense in a rational manner

C. A condition in which a perrson, as a result of impairment by chronic alcoholism, is unable to provide for his or her basic personal needs for food, clothing, or shelter

IT DOES NOT INCLUDE MENTALLY RETARDED PERSONS BY REASON OF BEING MENTALLY RETARDED ALONE

Question 44

WIC Section 5250 permits a person who has been detained for 72 hours and received an evaluation to be certified for up to an additional _____ days for intensive treatment related to a mental disorder or chronic alcoholism when the following conditions have been met:

Answer 44

14; a) as the result of a mental disorder or chronic alcoholism, the person is a danger to self or others or is gravely disabled and b) the person has been advised that treatment is required but has not voluntarily consented to it.

Question 45

What do Sections 5251 and 5253 require?

Answer 45

That a notice of certification about a 14 ay hold be signed by two people (the professional person or his/her designee in charge of the facility or agency providing evaluation services and a physician or psychologist who participated in the evaluation) and that a copy of the notice be personally delivered to the person certified, the person’s attorney, or other attorney or advocate designated in the certificate. Must inform the person that she is entitled to a certification review hearing to determine if there is sufficient reason to detain her or to a judicial review by writ of habeus corpus to ask for release from the certification

Question 46

What does section 5256 require?

Answer 46

That, unless a person has requested a judicial review regarding their 14 day hold, the certification review hearing/probable cause hearing must be held within 4 days of the date on which the person is certified unless the person or his/her attorney or advocate requests a postponement (for up to 48 hours). Person may waive his or her right to a certification review hearing or the right to be present at the hearing.

Question 47

What does section 5276 address?

Answer 47

The judicial review by writ of habeus corpus. It states: “Judicial review shall be in the superior court for the county in which the facility providing intensive treatment is located or in the county in which the 72 hour evaluation was conducted if the patient or a person acting in his or her behalf informs the professional staff of the evaluation facility in writing that judicial review will be sought. No patient shall be transferred from the county providing evaluation services to a different county for intensive treatment if the staff of the evaluation facility has been informed in writing that a judicial review will be sought, until the completion of the judicial review… the court shall either release the person or order an evidentiary hearing to be held within two judicial days after the petition is filed.

Question 48

True or false: The type off postcertification hold that may follow the initial 14 day hold is that same for all circumstances.

Answer 48

False. Depends on whether the person is suicidal, gravely disabled, or poses a serious danger to others.

Question 49

What is the regulation for a postcertification hold for suicidal behavior?

Answer 49

At the expiration of the 14 day period of intensive treatment any person who, as the result of mental disorder or impairment by chronic alcoholism, during the 14 day period or the 72 hour evaluation period, threatened or attempted to take his own life or who was detained for evaluation and treatment because he threatened or attempted to take his own life and who continues to present an imminent threat of taking his own life, may be confined for an additional period not to exceed 14 days.

A certification review hearing is not required for this hold, but the person may request a habeus corpus hearing at any time during the 14 days.

An authorization for the release of a patient who has been held under 5260 must be provided by the psychiatrist responsible for the treatment or by the psychiatrist or psychologist who worked collaboratively in treating the patient when they agree the patient should be releaseed. If there is a disagreement between these individuals, the decision is made by the facility’s medical director.

Question 50

What is the regulation for a postcertification hold for grave disability?

Answer 50

Upon the completion of a 14 day period of intensive treatment, the person may be certified for an additional period of not more than 30 days of intensive treatment under both of the following conditions: a) the professional staff of the agency or facility treating the person has found that the person remains gravely disabled as a result of a mental disorder or impairment by chronic alcoholism. b) the person remains unwilling or unable to accept treatment voluntarily. An individual under this section HAS THE RIGHT TO A CERTIFICATION REVIEW HEARING AND A HABEUS CORPUS HEARING. At the end of 30 days, facility must release the person, refer the person for voluntary treatment, certify the person for treatment as an imminently dangerous person, or begin the process of appointing a conservator

Question 51

What is the regulation for a postcertification hold for serious danger to others?

Answer 51

Person can be confined for further tx for an additional period, not to exceed 1880 days if one of the following exists: a)the person has attempted, inflicted, or made serious threat of substantial physical harm upon the person of another after having been taken into custody, and while in custody, for evaluation and treatment, and who, as a result of mental disorder or defect, presents a demonstrated danger of inflicting substantial physical harm upon others; b) The person had attempted, or inflicted physical harm upon the person of another, that act having resulted in his or her been taken into custody and who presents, as a result of mental disorder or mental defect, a demonstrated danger of inflicting substantial physical harm upon others; c) the person has made a serious threat of substantial physical harm upon the person of another within seven days of being taken into custody, that threat having at least in part resulted in his or her being taken into custody, and the person presents, as a result of a mental disorder or mental defect, a demonstrated danger of inflicting substantial physical harm upon others.

For this hold, the da must file a petition with the court and a court hearing must take place within four days after the petition is filed or within 10 days when the patient requests a jury trial. The client has the right to request a habeus corpus hearing at any time.

At the end of the 180 days, the facility must release the perrson, refer the person for voluntary treatment, or file a new petition to certify the person for treatment as an imminently dangerous person.

Question 52

During the initial 72 hour involuntary commitment, it is determined that Ravina R. is still at high risk for suicide. According to the CWIC, Ravina may be detained for an additional 14 days for intensive treatment under certain conditions. One of these conditions is that Ravina be informed that she is entitled to a certification review hearing to be held within the first ______ of the 14-day hold:

1. 24 hours
2. 36 hours
3. two days
4. four days

Answer 52

4

Question 53

Section 5350 provides clarification of what constitutes gravely disabled. They state that a person is not “gravely disabled” if what?

Answer 53

That person can survive safely without involuntary detention with the help of responsible family, friends, or others who are both willing and able to help provide for the person’s basic personal needs for food, clothing, or shelter.. and unless they specifically indicate in writing their willingness and ability to help, family, friends, or others shall not be considered willing or able to provide this help.

Question 54

True or false: As legally mandated reporters, psychologists must report known or suspected cases of abusee and neglect of children and adolescents under the age of 18, INDCLUDING minors who are emancipated.

Answer 54

True

Question 55

Within _____ days after conservatorship of a person has been established, there shall be an individualized treatment plan unless treatment is specifically found not to be appropriate by the court. When the progress review determines that the goals of treatment have been reached and the person is no longer gravely disabled, a person designated by the county shall so report to the court and the conservatorship shall be terminated by the court.

Answer 55

10

Question 56

True or false: A child abuse report must only be made if the perpetrator is an adult.

Answer 56

False, perpetrator can be a child

Question 57

Mandated reporter should make an initial report to appropriate agency when? The mandated reporter shall prepare and send, fax, or electronically transmit a written follow up report thereof within ______ of receiving the information concerning the incident.

Answer 57

Immediately or as soon as is practically possible by telephone; 36 hours

Question 58

True or false: The pregnancy of a minor constitutes a basis for reasonable suspicion of sexual abuse and should be immediately reported.

Answer 58

False. It does not, in and of itself, constitute a report

Question 59

What is the punishment for failing to report an incident of known or reasonably suspected child abuse or neglect?

Answer 59

Misdemeanor; punishable by up to six months confinement in a county jail or one thousand dollars or by both that imprisonment and fine.

Question 60

If the abuse or neglect results in death or great bodily injury, the mandated reporter, what is the punishment?

Answer 60

Not more than 1 year in a county jail, $5000, or by both fine and imprisonment

Question 61

How is “elder” defined?

Answer 61

any person residing in CA, 65 years or older

Question 62

What is a “dependent adult?”

Answer 62

Any person between the ages of 18 to 64 years who resides in CA and who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, included, but not limited to, persons who have physical or developmental disabilities, or whose physical or mental abilities have diminished because of age or who is admitted as an inpatient to a 24-hour health facility.

Question 63

When must a mandated reporter report elder or dependent abuse?

Answer 63

in his or her professional capacity, or within the scope of his or her employment, has observed or has knowledge of an incident that reasonably appears to be physical abuse, abandonment, abduction, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that he or she has experienced behavior, including an act or imission, constituting physical abuse, abandonment, abduction, isolation, financial abuse, or neglect, or reasonably suspects that abuse, shall report the known or suspected instance of abuse by telephone immediately or as soon as practicably possible, and by written report sent within two working days.

Question 64

Who does the mandated reporter contact when making a report of elder or dependent adult abuse?

Answer 64

Long term care facility (except a state mental health hospital or a state developmental center)- local ombudsperson or local law enforcement agency

State mental hospital or state developmental center- state department of mental health or the state department of developmental services

Any other place- adult protective services agency or the local law enforcement agency

Question 65

When are psychologists mandated to report cases of spousal/partner abuse?

Answer 65

When they learn about it in the course of their practice and only when the partner being abused is an elder or dependent adult or is under the age of 18. In these circumstances, a psychologist is required to file a report of elder or dependent adult abuse or child abuse.

Question 66

What are the types of Elder/Dependent adult abuse?

Answer 66

1. Physical abuse: assault, battery, assault with a deadly weapon or force likely to produce great bodily injury, unreasonable physical constraint or prolonged or continual deprivation of food or water, sexual assault (which includes rape, spousal rape, incest, sodomy, oral copulation, sexual penetration, and lewd or lascivious acts), and use of a physical or chemical restraint or psychotropic medicaito for punishment for a period beyond that for which the medicaiton was ordered by the physician providing medical care.
2. Abandonment
3. Abduction: means removing an elder or dependent adult from CA or restraining him/her from returning to CA when the elder or dependent adult does not have the capacity to consent to the removal or restraint or when his/her conservator or the court has not consented to the removal or restraint
4. Isolation: not allow elder to get mail or calls; not allowing contact; false imprisonment; physical restraint for the purpose of preventing from meeting with visitors
5. Financial abuse: when a person or entity does any of the following:
   a. assists with or Takes, secretes, appropriates, or retains real or personal property to a wrongful use or with intent to defraud, or both
6. Neglect

Question 67

When is it optional to make a report for elder/dependent adult abuse?

Answer 67

Emotional abuse or that types of elder or dependent adult abuse for which reports are not mandated have been inflicted

Question 68

Liability for failing to make a required report of elder/dependent adult abuse:

Answer 68

misdemeanor, punishable by no more than 6 months in county jail, by a fine of not more than $1000, or by both that fine and imprisonment.

If failure to report results in death or great bodily injury, no more than 1 year in county jail, a fine of no more than $5000, or by both that fine and imprisonment.

Question 69

A psychologist is required to make a report of child abuse in which of the following situations?

1. A 13-year-old client reports having consensual sex with a 12-year-old
2. A 14-year-old client reports having consensual sex with a 15-year-old
3. A 15-year-old client reports having consensual sex with a 20-year old
4. A 17-year-old client reports having consensual sex with a 13-year-old

Answer 69

4. Consensual sex is not reportable when both minors are under the age of 14 and are similar in age, or when a minor is 14 or 15 and his/her partner is over 14 but under 21.

Question 70

As defined in Penal Code…, a psychologist who fails to report a case of known or reasonably suspected child abuse or neglect is guilty of a misdemeanor that is punishable by:

1. a fine up to $500 and/or confinement in county jail for up to 3 months.
2. a fine up to $1000 and/or confinement in county jail for up to 6 months
3. a fine up to $2500 and or confinement in county jail for up to 12 months.
4. a fine up to $3000 and/or confinement in county jail for up to 18 months

Answer 70

2

Question 71

As defined by WIC, mandated reporters must report all of the following types of elder abuse except:

1. abandonment
2. isolation
3. financial abuse
4. emotional abuse

Answer 71

4

Question 72

A report of an incident of elder or dependent adult abuse that has occurred in a private care facility or assisted living faccility is made to the:

1. Department of mental health
2. Department of health services
3. local ombudsperson
4. adult protective services agency

Answer 72

3

Question 73

What is the penalty for sex with clients?

Answer 73

Multiple acts with a Single victim (no prior convictions): up to 6 months and up to $1000
Two or more victims or more than one violation: 16 months, two years, or three years and up to $10000

Question 74

1. In which of the following situations may the BOP revoke a psychologist’s license?

• 1. An accusation has been filed against the psychologist for sexual misconduct.
• 2. The psychologist has been charged with felony drug possession.
• 3. The BOP determines that the psychologist knowingly misrepresented his education in the license application.
• 4. The ethics committee finds the psychologist guilty of violating informed consent procedures while conducting research.

Answer 74

The BOP may revoke, suspend, or restrict a license on the ground that the psychologist secured the license by fraud, deceit, or knowingly misrepresenting information. A psychologist’s license will be revoked if it is determined that sexual misconduct took place, but not simply on the basis of an accusation that is filed (ruling out Response 1). Similarly a charge of felony drug possession (Response 2) does not in fact mean that the psychologist has been found guilty. When a psychologist is sanctioned for an ethics violation (e.g., determined by the APA or CPA ethics committee) this information may be transmitted to the BOP, and the BOP could take disciplinary action, but probably not license revocation for violation of informed consent procedures (ruling out Response 4).

Question 75

2. Dr. English wishes to assess Joe Marquez. He enlists Mr. Marquez’s wife to act as a translator. The actions of Dr. English are:

• 1. ethical, as long as he secures full informed consent from both Mr. Marquez and his wife.
• 2. ethical, as long as Dr. English is alert to possible issues of multiple relationships.
• 3. unethical, because of the issue of harmful multiple relationships.
• 4. unethical, because Dr. English should not assess patients for whom he does not have the necessary language competence.

Answer 75

It would be unethical to get involved in a multiple relationship that is harmful to Mr. Marquez. A situation in which his wife is his translator in the assessment violates his confidentiality and would likely prevent him from gaining the best possible advantage from the assessment. The Ethics Code does allow the use of a translator in assessment and treatment (Response 4), but the translator should not be related to the client.

Question 76

3. Psychologists are required to post in a conspicuous location:

• 1. exceptions to confidentiality.
• 2. the patient bill of rights.
• 3. a copy of the Psychology license.
• 4. the Board of Psychology’s address and phone number.

Answer 76

Psychologists are required to post a notice that states, “The Department of Consumer Affairs receives questions and complaints regarding the practice of psychology.” This notice must include the Board of Psychology’s address and a phone number for questions or complaints (Response 4).

Question 77

4. The 1976 Tarasoff v. The Regents of the University of California decision stated that therapists have a duty to protect when a patient poses a serious threat of danger to others. The California legislature subsequently enacted the Tarasoff Statute (Civil Code 43.92). The Tarasoff Statute accomplished which of the following?

• 1. It extended Tarasoff duties to threats of property damage.
• 2. It extended Tarasoff duties to threats reported by third parties.
• 3. It restricted Tarasoff duties to threats made directly by the patient.
• 4. It restricted Tarasoff duties to threats made against named victims.

Answer 77

The California Tarasoff Statute (Civil Code 43.92) states that psychotherapists are not financially liable, “except where the patient has communicated to the psychotherapist a serious threat of physical violence against a reasonably identifiable victim or victims.” Victims need not be “named” (Response 4), merely reasonably identifiable. The recent Ewing Decision (2004) states that that communications from family members are patient communications within the meaning of Civil Code section 43.92 (Response 2). The therapist does not have a legal duty to warn when the threat is made towards someone’s property (Response 1), unless it is reasonable to believe that the property destruction would result in harm to a person or persons.

Question 78

5. With regard to reporting spousal abuse, which of the following guidelines apply to psychologists?

• 1. Psychologists are not mandated to report spousal abuse.
• 2. Any psychologist who has a “reasonable suspicion” that spousal abuse has occurred must make a report.
• 3. Psychologists working in hospitals and certain other settings are mandated to report spousal abuse.
• 4. A spousal abuse report is always permitted, but never mandated for psychologists.

Psychologists are not mandated to report spousal abuse (Response 2). In addition, the law does not “permit” psychologists to report spousal abuse (Response 4). For a brief period of time, psychotherapists in medical settings were required to make reports of spousal abuse (Response 3) but the law was quickly changed. Health practitioners providing medical services are mandated to report spousal abuse (and other forms of assault).

Answer 78

Psychologists are not mandated to report spousal abuse (Response 2). In addition, the law does not “permit” psychologists to report spousal abuse (Response 4). For a brief period of time, psychotherapists in medical settings were required to make reports of spousal abuse (Response 3) but the law was quickly changed. Health practitioners providing medical services are mandated to report spousal abuse (and other forms of assault).

Question 79

6. As compared to disciplinary action, non-disciplinary action is:

• 1. confidential.
• 2. confidential, except for citation and fine.
• 3. confidential, except for the letter of warning and the citation and fine.
• 4. a matter of public record, except for the voluntary educational review.

Answer 79

Disciplinary action includes letter of reprimand, two-step agreement, probation, suspension, interim suspension order, surrender of license, and license revocation. Non-disciplinary action, which is less severe, includes mediation, educational letter, letter of warning, educational review, and citation and fine. Whereas all disciplinary action is a matter of public record, most non-disciplinary action is kept confidential. The one exception is citation and fine, which is a non-disciplinary action that does become a matter of public record.

Question 80

According to California law, a psychotherapist may not engage in sexual contact with a patient under which of the following conditions?

• 1. During the period the patient was receiving psychotherapy from the therapist and within two years of termination, or by means of therapeutic deception.
• 2. During the period the patient was receiving psychotherapy or by means of therapeutic deception.
• 3. Any time during the period the patient was receiving psychotherapy or at any time after termination.
• 4. Once the patient has entered psychotherapy, unless “most unusual circumstances” prevail.

Answer 80

According to California law, a psychotherapist may never have sexual contact with a current patient, or with a former patient within the first two years after termination of psychotherapy. In addition, a psychotherapist may never have sexual contact with a former patient if it is by means of therapeutic deception. Response 2 is incorrect in that it suggests that a psychotherapist may have sexual contact immediately upon termination of the patient’s therapy. Response 3 is incorrect because the law does not prohibit sexual contact indefinitely after termination, only within the first two years. Response 4 is incorrect in that it suggests that there are circumstances in which sexual contact would be permitted in the course of psychotherapy. In addition, “most unusual circumstances” condition comes from the APA Ethics Code, not California law, and deals with the conditions under which sexual contact may be acceptable, but only if two years have passed since termination.

Question 81

8. An adult who masturbates in front of a child has committed:

• 1. an illegal act that may be reported to the police, but does not constitute sexual abuse.
• 2. a reportable form of sexual assault.
• 3. a form of sexual assault that may be reported, but is not mandated.
• 4. a reportable form of sexual exploitation.

Answer 81

Masturbation in front of a child is considered a form of sexual assault, one of the two categories of sexual abuse (Response 1). As such, a child abuse report is mandated (Response 3). Sexual exploitation (Response 4) typically has to do with involving a minor in some form of prostitution or pornography.

Question 82

9. You have been treating Alice, an 8-year-old, who was brought to treatment by her mother who has physical custody. Both parents share legal custody, although Alice has not spent time with her father for the past two years, as he lives out of state. You receive a written request from Alice’s father for a copy of the records including Alice’s test data. You should:

• 1. release a summary of the records to the father excluding Alice’s test data.
• 2. release the records to the father including Alice’s test data.
• 3. seek consent from Alice’s mother before releasing the records/test data to the father.
• 4. refuse the father’s request.

Answer 82

Any parent who has legal custody is entitled to a copy of his or her child’s treatment record. When test data is part of the record that may be included as well, if requested. A psychologist may always offer a summary of the records (Response 1), put the parent would need to agree to the summary in lieu of the complete records. There is no need to seek the consent of the parent with physical custody (ruling out Response 3), nor any reason indicated in this scenario to refuse the father’s request (ruling out Response 4). A psychologist may refuse to release the records of a minor to a parent if the provider determines that there could be either a detrimental effect on the therapy relationship, or that the minor’s physical or emotional well-being might be jeopardized.

Question 83

10. According to the California Code, one must report a suspected incident of child abuse or elder abuse by phone immediately or as soon as is practically possible, and follow up with a written child abuse report _____________, and follow up with a written report elder abuse report ___________.

• 1. within 24 hours; within 24 hours.
• 2. within 36 hours; within 36 hours.
• 3. within 36 hours; within 48 hours.
• 4. within 36 hours; within two working days.

Answer 83

While both child and elder abuse reports must be made by phone immediately or as soon as practically possible, the guideline for the timeframe for the written follow-up report differs. A written report of child abuse must be made within 36 hours, while a written report of elder abuse must then be made within two working days.

Question 84

58. A minor of any age may consent to medical care and collection of evidence related to a rape. What are the guidelines with regard to contacting the minor’s parent or legal guardian?

• 1. The health care provider must attempt to contact the minor’s parent or legal guardian and must document accordingly.
• 2. The health care provider must attempt to contact the minor’s parent or legal guardian if the minor is under age 12, and must document accordingly.
• 3. The health care provider must attempt to contact the minor’s parent or legal guardian if the minor is under age 14, and must document accordingly.
• 4. The health care provider is not permitted to contact a parent or legal guardian without the minor’s consent.

Answer 84

Feedback: CORRECT! According to the California Family Code, a minor of any age who is alleged to have been raped/sexually assaulted, may consent to medical care related to diagnosis and treatment, as well as collection of medical evidence. With regard to contacting the minor’s parent, if the minor is under age 12, the health care provider must attempt to contact the minor’s parent/guardian, and must document the attempt and whether it was successful. For minors 12 years of age or older, the health care provider is not permitted to inform a parent or guardian without the minor’s consent.

Question 85

In regards to rape of a minor 12 years of age or older, what are the guidelines around informing the parent or guardian?

Answer 85

For minors 12 years of age or older, the health care provider is not permitted to inform a parent or guardian without the minor’s consent.

Question 86

An individual who has a Ph.D. in Psychology from Canada and had practiced there for a number of years asks to work with you in your practice. Under what circumstances may you accept her offer?

• 1. She has been licensed in Canada for at least five years and has not been subject to any discipline. (your response)
• 2. She has been licensed in Canada for less than five years, has not been subject to any discipline, and she passes the California Psychology Supplemental Exam.
• 3. She is approved as a psychological assistant by the California Board of Psychology.
• 4. There is an agreement of reciprocity between the Canadian Province she is licensed in, and the State of California.

Answer 86

A psychologist with a license from another state, Canadian province or U.S. Territory can work for another psychologist either as a psychological assistant (Response 3), or once licensed. Passing the CPSE (Response 2) in and of itself does not warrant automatic licensure. For example, one can pass the CPSE while still having certain outstanding requirements for licensure such as coursework. California does not have any “agreements of reciprocity” with other states or provinces (ruling out Response 4).

Question 87

Which of the following is not included in APA’s Ethical Principles of Psychologists and Code of Conduct (2002) as a guideline for assessments and reports?

• 1. Forensic evaluations must be based on an examination of the person involved.
• 2. Evaluations must be based on techniques that are appropriate and sufficient.
• 3. Psychologists should not base their conclusions on obsolete test data.
• 4. Psychologists should acknowledge limitations to their data or conclusions.

Answer 87

Forensic evaluations should typically be based on an examination of the patient. The APA Ethics Code, however, makes provisions for when such an examination is not feasible. Specifically, the psychologist must explicitly clarify what the effect is likely to be on the validity of the report, and must limit his or her conclusions accordingly. All of the other responses are included in the guidelines for assessments and reports.

Question 88

63. Which of the following is the most accurate statement regarding the ethical use of the media in promoting a psychologist?

• 1. It is acceptable to have a press employee write an article about a psychologist, but it is not acceptable to pay for any kind of publicity.
• 2. It is acceptable to pay for publicity, as long as any paid publicity or advertisement is identified as such.
• 3. It is acceptable to compensate a press employee for writing an article about a psychologist.
• 4. A psychologist retains the responsibility to ensure that any media reporting does not provide any favorable bias toward the psychologist

Answer 88

It is ethically permitted for psychologists to pay for publicity (ruling out Response 1) as long as the promotional material is accurate, not misleading, and is identified as paid advertisement. For example, there are ads in papers that look like regular news articles but at the top, the words “paid advertisement” are printed. It is never ethical to pay a media employee to write an article (Response 3). Although psychologists have the responsibility to ensure the accuracy of all information in an article published about them, they do not have to make sure there is no favorable bias (Response 4).

Question 90

65. You are treating a man for emotional stress related to harassment at work. He has filed a worker’s compensation injury lawsuit. His lawyer calls you and requests a copy of the records to help in your client’s case. You:

• 1. give the lawyer a copy of the records as this situation is an exception to privilege.
• 2. give the lawyer a copy of the records as requested.
• 3. refuse the lawyer a copy of the records. (correct answer)
• 4. base your decision to release the records on what would be in your client’s best interests.

Answer 90

Your patient is a plaintiff in a worker’s compensation lawsuit, claiming emotional damages. The patient’s lawyer has called you to ask for a copy of the records. Without a signed release of information, the lawyer for any patient is not entitled to the records. If the records were to be subpoenaed by the defense attorney, the judge would likely rule this an exception to privilege (Response 1), and the psychologist would need to turn over the records, as no privilege exists in proceedings in which the patient raises his or her mental or emotional condition.

Question 91

In order to work as a forensic psychologist, a psychologist must:

• 1. know the laws about mandated reporting.
• 2. be familiar with judicial and legal procedures.
• 3. be knowledgeable about how to testify in court.
• 4. obtain post-doctoral training in forensic psychology.

Answer 91

In order to work as a forensic psychologist one must be familiar with judicial and legal procedures (Response 2). There is no requirement to obtain post-doctoral training in forensic psychology (ruling out Response 4) in that an intern may graduate from a doctoral program and get a job working as a psychologist in a forensic setting. All psychologists must know the laws related to mandated reporting (Response 1).

Question 92

12. Which of the following is the best statement regarding the status of privilege in lawsuits that involve either the patient or the therapist alleging a breach of duty?

• 1. Privilege exists if the therapist initiates the lawsuit, but not if the patient initiates the lawsuit.
• 2. No privilege exists in legal proceedings based on breach of duty, regardless of whether the therapist or patient initiated the lawsuit.
• 3. No privilege exists in malpractice suits.
• 4. The patient has limited privilege when the therapist sues for nonpayment of fees.

Answer 92

According to Evidence Code 1020, an exception to privilege exists when either the patient alleges a breach of duty (e.g., malpractice) or the therapist alleges a breach of duty (e.g., suing for non-payment of fees). Responses 1 and 4 are therefore inaccurate. Response 3 is not a broad enough response because it doesn’t address the general issue of either party alleging a breach of duty.

Question 93

13. Which of the following accurately states the renewal requirements for the psychology license and the registration for a psychological assistant?

• 1. The psychology license and the registration for a psychological assistant must be renewed every two years.
• 2. The psychology license and the registration for a psychological assistant must be renewed each year.
• 3. The psychology license must be renewed each year, and the registration for a psychological assistant must be renewed every two years.
• 4. The psychology license must be renewed every two years, and the registration for a psychological assistant must be renewed every year.

Answer 93

Psychology licenses are renewed every two years, on the last day of the psychologist’s birth month. The supervisor must renew registration of the psychological assistant annually, on or before its expiration.

Question 94

14. A psychologist advertises her services in intelligence testing of adolescents. As part of her advertisement she includes several questions from the “Information” section of the WISC-IV. She has violated:

• 1. confidentiality.
• 2. privilege.
• 3. the guidelines for duplicating published data.
• 4. copyright law.

Answer 94

Reprinting portions of copyrighted material (the WISC-IV) without permission is a violation of copyright law (Response 4). Reprinting test materials without permission also violates test security, which is considered unethical. Remember that confidentiality (Response 1) and privilege (Response 2) have to do with patient’s rights in therapy and legal proceedings, respectively. Reprinting questions from the WISC-IV does not violated guidelines for duplicating published data (Response 3) because in this situation the test questions are being reprinted rather than data (e.g., information about test demographics, etc.).

Question 95

When a minor seeks treatment for a drug or alcohol-related problem, parental consent:

• 1. is not required.
• 2. is not required if the minor is a danger to self or others.
• 3. is required if the minor is under 12 years of age.
• 4. is required after any acute crisis has passed.

Answer 95

The California Family Code allows minors 12 years of age and older to receive drug or alcohol treatment from a county-approved provider without parental consent. There is no provision in California law that permits a minor less than 12 years of age to obtain drug or alcohol-related treatment without parental consent. Thus, for minors under 12 years of age, parental consent is always required for the treatment of substance-related problems, whether or not there is an acute crisis (Response 4) or the minor is a danger to self or others (Response 2).

Question 96

You have been treating a 14-year-old, Alex, for the past six months. Alex was brought to treatment by his parents. Alex’s father tells you that he can no longer afford the copayment, as he was recently laid off from his job, and asks that you waive it. You should:

• 1. agree to his request.
• 2. offer to provide treatment pro-bono.
• 3. let him know that you can’t waive the co-pay since you are billing insurance.
• 4. let him know that you can’t change the co-pay without agreement from the insurance company.

Answer 96

It is generally illegal to waive a co-pay (ruling out Response 1). In a situation such as described, the psychologist’s best first step should be to contact the insurance company to explain the situation, and request permission from the insurance company to waive the co-pay (Response 4). If the insurance company denies the psychologist’s request, then the patient would need to be told that the co-pay cannot be waived (Response 3). There is no requirement that therapy be offered pro-bono (ruling out Response 2).

Question 97

A patient must be notified when a therapist is unlicensed. Which of the following best summarizes the requirements regarding this notification?

• 1. Notification may be written or verbal, but it must be documented.
• 2. Notification must occur in writing by either the supervisor or the supervisee.
• 3. Notification must occur by the supervisor.
• 4. Notification must occur by the supervisee, but the supervisor retains the ultimate responsibility for insuring that notification occurs.

Answer 97

California law states that prior to the rendering of services, supervisors are responsible for notifying each of the supervisee’s patients that the supervisee is unlicensed (Response 3). The supervisor must also notify each patient that the supervisee is functioning under the direction and supervision of the supervisor, that the primary supervisor shall have full access to the treatment record, and that any fees paid for the services of the supervisee must be paid directly to the primary supervisor (or employer). The notification does not need to be done in person; in practice, the primary supervisor commonly gives the supervisee a letter of notification with all the relevant information to give to the patient on the supervisor’s behalf. Responses 2 and 4 specify the supervisee as the one who may notify the patient, which is incorrect. Response 1 does not specify who must notify the patient, so it is too vague.

Question 98

A patient who owns a marketing company asks to see you in your private practice. He proposes that he exchange his marketing services for treatment. The patient notes he has previously been seen in treatment, and agrees to have his records released to you. As you review his records you note that he is diagnosed with schizophrenia. He was recently released from a one-month inpatient hospitalization, secondary to both suicidal and homicidal ideation. At this point you should:

• 1. refuse to see the patient in your private practice, as his diagnosis and recent hospitalization require a higher level of care.
• 2. accept his request to barter if you believe that it is not clinically contraindicated, nor exploitative.
• 3. refuse his request to barter since it is clinically contraindicated.
• 4. evaluate further before making a determination as to whether a barter would be acceptable.

Answer 98

The ethics code allows for bartering as long as it is not clinically contraindicated and not exploitative. This patient’s diagnosis of schizophrenia in combination with his recent hospitalization secondary to both suicidal and homicidal ideation, is a solid contraindication for bartering.

Question 99

19. A report of elder abuse is mandated:

• 1. any time a reasonable suspicion exists.
• 2. only when the reporter has direct evidence of physical abuse.
• 3. only when the reporter has directly witnessed the physical abuse.
• 4. only when the reporter has directly witnessed the abuse or has been told about it by the elder.

Answer 99

California law on elder abuse mandates that psychologists must make a report when the psychologist: (a) has observed or has knowledge of an incident that reasonably appears to be abuse; or (b) is told by the elder or dependent adult of an instance of abuse. Thus, any time a psychologist reasonably suspects abuse, a report is mandated. This can include seeing direct evidence of abuse (Response 2), directly witnessing the abuse (Response 3) and being told about the abuse (Response 4), however, these are not the only times a report is required. Elder abuse includes physical abuse, abandonment, isolation, financial abuse, or neglect.

Question 100

20. Making a small “thank-you” payment to a colleague when she refers you patients is:

• 1. legal and ethical.
• 2. legal but unethical.
• 3. illegal but ethical.
• 4. illegal and unethical.

Answer 100

It is both illegal and unethical to pay for referrals, which is what is occurring when a small “thank-you” payment is being made. It is also illegal and unethical to engage in fee-splitting based on referrals, for example, paying a referral source 10% of the fees received from patients referred. It is only acceptable to pay a referral source based on services provided. For example, it would be acceptable to pay $100 a month to be listed in an on-line directory, regardless of how many referrals are received in a given month.

Question 101

21. Your individual therapy patient asks that you testify on his behalf in a custody dispute with his ex-wife. Your best course of action would be to:

• 1. agree to testify.
• 2. refuse to testify.
• 3. agree to testify only if it is in the best interests of the child.
• 4. proceed with caution.

Answer 101

It is important to note that this is your individual therapy patient and he has asked you to come to court and testify on his behalf. Even though this is a custody dispute, he is not asking you to conduct a custody evaluation, which would be a prohibited multiple relationship. This patient wants you to testify because he believes it will benefit him. However, it is possible that your testimony may actually hurt his side (e.g., he has had multiple substance abuse relapses in the past six months), or that testifying may impair the therapeutic relationship. Because not enough information is provided, it is unclear whether it would be best to agree (Responses 1) or to refuse (Response 2). The best interests of the child (Response 3) is the principle used to make custody recommendations by evaluators, and custody decisions by judges; it does not apply here because you are in neither of these capacities. In this question, a process of elimination is needed to arrive at the best response, because “proceed with caution” (Response 4) doesn’t initially appear as a terrific response.

Question 102

22. When a minor is lawfully in treatment without parental consent, who holds privilege?

• 1. The minor.
• 2. The therapist.
• 3. The parent or legal guardian.
• 4. The court.

Answer 102

When a minor is legally in treatment without parental consent, the minor is the holder of privilege. In a legal proceeding the therapist may assert privilege on the minor’s behalf, however, the therapist is not the holder of privilege. In this situation, it doesn’t make sense for the parent or legal guardian (Response 3) to be the holder of privilege, since the parent or guardian has not authorized treatment. A minor may be in treatment without parental consent, without involvement of the court (Response 4).

Question 103

23. What are the reporting guidelines when a minor is having consensual sexual contact?

• 1. If it is truly consensual sexual contact, it need not be reported.
• 2. Sexual contact involving a minor must always be reported.
• 3. It is reportable if the minor is more than five years younger than his or her sexual partner.
• 4. It depends upon the ages of both parties.

Answer 103

There are times when a minor is having consensual sexual contact that a report of child abuse is not needed, and other times when a report is mandated. The decision generally hinges on the nature of the sexual contact (e.g., intercourse, lewd and lascivious behavior) as well as the ages of the parties, but not simply whether the minor is five years younger than his or her sexual partner (Response 3).

Question 104

24. A peer review committee requests a psychologist’s records on a patient as part of a review of the medical necessity, level of care, and quality of care provided by the psychologist. The psychologist’s obligation in such a situation is:

• 1. to provide the committee with the requested records.
• 2. to provide the committee with the requested records if the patient consents.
• 3. to acknowledge a conflict between the committee’s request and the Ethics Code, and to work to resolve the conflict.
• 4. to assert privilege.

Answer 104

California law explicitly permits disclosure of confidential information for the purpose of quality of care review. The California Civil Code states that information may be released to “professional standards review organizations . . . or to utilization and quality control peer review organizations . . . if the committees, agents, organizations, or persons are engaged in reviewing the competence or qualifications of health care professionals or in reviewing health care services with respect to medical necessity, level of care, quality of care, or justification of charges.”

Question 105

25. Emancipated minors are treated as adults in terms of:

• 1. confidentiality and privilege.
• 2. consent to treatment.
• 3. confidentiality, but not privilege.
• 4. confidentiality, privilege, and consent to treatment.

Answer 105

Emancipated minors are treated as adults with regard to all aspects of therapy, including confidentiality, privilege, and consent to treatment.

Question 106

26. How many psychological assistants may one licensed psychologist have at a time?

• 1. One.
• 2. Three.
• 3. Five.
• 4. Ten.

Answer 106

A licensed psychologist may have up to three psychological assistants at any time. A board-certified psychiatrist may have only one psychological assistant (Response 1) and a psychology clinic or corporation may have up to ten psychological assistants at a time (Response 4).

Question 107

27. According to the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (2002), a psychologist who is experiencing personal problems should:

• 1. suspend his or her practice until the problems are resolved.
• 2. seek personal therapy.
• 3. seek consultation to determine appropriate action.
• 4. seek supervision of his or her therapy work.

Answer 107

According to the APA Ethics Code, a psychologist experiencing personal problems that may be interfering with his or her professional work should seek consultation about whether to limit, suspend, or terminate practice. Suspending practice, personal therapy, and supervision (Responses 1, 2, and 4) are possibly appropriate actions. Consultation, however, will help determine which action is most appropriate for a particular situation.

Question 108

28. The Welfare and Institutions Code section that permits involuntary confinement of a minor for 72 hours of treatment and evaluation is:

• 1. 5150
• 2. 5585
• 3. 5250
• 4. 1024

Answer 108

Welfare and Institutions Code 5585 permits the involuntary confinement of a minor for 72 hours of evaluation and treatment, when the minor, as a result of a mental disorder, is a danger to self, others, or is gravely disabled. W.I.C. 5585 may only be initiated when authorization for voluntary treatment is not available. W.I.C. 5150 (Response 1) permits the involuntary confinement of adults for 72 hours of evaluation and treatment.