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Case Conference > Legal & Ethics > Flashcards

Legal & Ethics Flashcards

1
Q

What is the MFT Scope of Practice?

A

Licensed Marriage and Family Therapists (MFTs) perform clinical services for the
purpose of improving the productivity and satisfaction of interpersonal relationships.
In recent years, this statement has been interpreted more broadly to mean
that MFTs have the responsibility to attend to the general mental health of their clients.

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2
Q

What kinds of clients can MFT serve?

A

These services
may be provided to individuals, couples, families, or groups, and MFT’s may apply various clinical
theories and techniques.

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3
Q

Who can supervise an MFT trainee/associate?

A

Licensed Marriage and Family Therapist (MFT)
Licensed Clinical Social Worker (LCSW)
Licensed Clinical Psychologist (Clinical Psychologist)
Board Certified Psychiatrist (MD)

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4
Q

What are the qualifications for supervisors?

A

Psychotherapists are qualified to be clinical supervisors if they have been licensed for two years,
have training in clinical supervision, have an active practice, and are knowledgeable about the laws
and regulations pertaining to the supervision of trainees.

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5
Q

What is MFT Scope of Competence?

A

Education, Training, & Experience!
Mental Health Professionals (MHPs) do not assess, test, diagnose, treat or
advise on problems beyond the level of their competence as determined by their education, training
and experience.

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6
Q

What services can trainees perform?

A

Trainees perform clinical services that are consistent with his/her quality of training
and the level of experience.

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7
Q

What determines the kinds of methods a trainee can use?

A

The methods of therapy used and the types of clients treated need to be
within the clinical experience of the trainee or the trainee’s supervisor.

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8
Q

What do MHPs keep confidential?

A

MHPs keep confidential the names, identities, and all information disclosed in session of the individuals or family members seen in therapy. This confidence includes the identity of each
person seen as part of the therapeutic relationship.

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9
Q

How is confidential information stored?

A

Confidential information must be recorded and stored in ways that protect confidentiality.

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10
Q

When can a client’s confidence be breached?

A

When mandated or permitted by law, or when authorized by the client.

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11
Q

What does a client have to do if they want their information released?

A

An “Authorization to Release Information” is signed by the client and includes
the agency/person receiving the information, the purpose for releasing the information and a time
frame in which the authorization is effective.

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12
Q

What is privilege?

A

MHPs must maintain the client’s “privilege” to refuse disclosure of confidential communication
in a legal proceeding.

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13
Q

What is the difference between confidentiality and privilege?

A

Privilege is a legal term from the Evidence Code and specifically applies to
legal proceedings whereas confidentiality is a clinical term from the Business and Professional Code.

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14
Q

Who is the holder of the privilege?

A

The client

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15
Q

What is consent for treatment and what do you do?

A

MHPs clarify from the onset of counseling/therapy that the professional and
client(s) are entering into a therapeutic relationship. Consequently, MHPs obtain a written consent
from the client or clients that are participating in the counseling/therapy.

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16
Q

What do you do if you’re going to record audio or video sessions?

A

Get written consent

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17
Q

Unit of Treatment

A

When seeing a family, MHPs need to clarify from the beginning which family
members will be treated as clients and the nature of the relationship the therapist will have with each
member of the family.

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18
Q

Rules for Fees for Treatment

A

(Fairness & Clarity!) MHPs must disclose their fees to clients at the beginning of treatment, and any
charges made for canceled or missed appointments. They also give reasonable notice to clients
regarding changes in their fees, and allow reasonable measures for clients to attend to unpaid
balances.

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19
Q

What is a dual relationship?

A

A dual relationship exists when the therapist and client(s) have a separate
relationship apart from the therapeutic relationship.

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20
Q

Are all dual relationships unethical?

A

No

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21
Q

When do you avoid a dual relationship?

A

MHPs avoid dual relationships that may impair

professional judgment or lead to exploitation of the client(s).

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22
Q

How are MHPs required to keep records?

A

MHPs are required to keep client records in a manner consistent with sound clinical
practice.

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23
Q

What medium can records be kept?

A

These records may be kept in any medium (written, taped, computerized)

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24
Q

What do records need to include?

A

some documentation of the treatment sessions.

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25
Q

What is #1 rule of termination?

A

MHPs do not abandon or neglect clients in counseling/therapy.

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26
Q

What do you do if you have to terminate a client?

A

If the therapist is unable
to continue client treatment, s/he needs to inform the client with reasonable time prior to termination
and must assist the client in finding continuation of counseling/therapy.

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27
Q

Cultural Competence rule

A

MHPs must actively strive to understand the diverse cultural backgrounds of
their clients/families and to develop sensitivity and skills necessary when working with a diverse client
population. Cultural competence is an ethical mandate and includes the awareness of how the therapist’s own cultural background, family values and personal beliefs affect the process of therapy.

28
Q

What are MFTs mandated to report?

A

Child abuse, harm to intended other, elder or dependent adult abuse

29
Q

What is included in child abuse?

A

physical abuse and harm, sexual abuse or inappropriate contact, child
neglect and emotional abuse that causes “unjustifiable mental suffering”.

30
Q

Professional Capacity

A

This mandate applies to information received or observed within the role of a
therapist or clinical supervisor. (You get info from a client or parent)

31
Q

How/when to report child abuse

A

report the known or suspected abuse to a
child protective agency immediately or as soon as practically possible by telephone and shall
prepare and send a written report thereof within 36 hours of receiving the information
concerning the incident…”

32
Q

Reasonably suspects

A

Ideally, trainees should consult with their clinical supervisors when they suspect child
abuse. However, if the supervisor is not immediately available, the trainee is mandated to go ahead
and report.

33
Q

When do you report sex involving minors? (4)

A

I. Sexual intercourse between a minor under 16 years old and an adult 21 years old and over.
II. Any sexual activity between a minor 14 or 15 years old and an adult at least 10 years older than the minor.
III. Any sexual activity between a minor under 14 years old and someone 14 or over. Remember that consensual sexual activity between two similarly aged children, both under 14 years old, does not need to be reported.
IV. Incest or intrafamilial sexual activity, even if consensual.

34
Q

Is statutory rape a reportable crime?

A

NO!

35
Q

Elder ages

A

65+

36
Q

Dependent adult ages and definition

A

18-64, who has physical or mental limitations that restrict his/her ability to carry out normal activities or to protect his/her rights.

37
Q

Is danger to self under mandated reporting?

A

NO! You MAY report, but not required

38
Q

How to assess for suicidal threat

A

the therapist should assess if the client has a plan, has

the means, and has a timetable regarding the suicidal ideation.

39
Q

What is ‘serious danger of violence’?

A

The threat by the client must be imminent and towards an identifiable
person.

40
Q

What is ‘Use reasonable care to protect:’

A

There is a duty to protect the potential victim by taking clinical measures
like “no-violence “contract, intensive therapy or hospitalization and by notifying the intended victim
and a law enforcement agency of the threat.

41
Q

Can you have sex with a client?

A

No! Until it is 2 years following the termination of therapy

42
Q

Can you report domestic violence?

A

No!

43
Q

Therapists ethical responsibilities for domestic violence

A

therapists have ethical responsibilities such as making
appropriate referrals to some or all of the following: a shelter for battered women, the police, legal or
medical services and groups for batterers. Therapists also need to assist their clients in developing
an “escape plan”, mobilize support systems and make ending of the cycle of violence a primary
treatment goal. Therapists may not influence a client’s decision regarding marital status.

44
Q

When do you report something involving domestic violence?

A

When domestic violence between adults physically harms the minors in the home there is then the
legal mandate to report child abuse. There is no mandate to report child abuse if the minors witness
the violence but are not physically harmed. However, DCFS will accept and investigate therapists’
reports of emotional harm to minors because of domestic violence.

45
Q

Confidentiality for Minors

A

Adolescents and children are entitled to a confidential relationship.
Although legally
parents may have access to their children’s records, it is important to educate parents about the
therapeutic need for privacy with children in treatment. Discuss with parents and children that you
will maintain the child’s confidence but that if ever the child’s safety becomes an issue that the parents
may need to be informed.

46
Q

How do minors get consent for treatment?

A

Parents have to sign
This form
should include information regarding confidentiality and reporting obligations so that parents are fully
informed regarding potential issues that may arise in the course of treatment.

47
Q

Consent for treatment for minors in divorced families

A

In divorced families, ALWAYS GET CUSTODY PAPERS, and see who has custody. Main parent gives permission. Customary if the other parent isn’t dangerous to have them sign as well.

48
Q

How can a minor get treatment without parental consent?

A

-the child is 12 years or older and mature enough to intelligently participate in outpatient
treatment
-the therapist determines and documents in the record that it would be “inappropriate” to
contact the parent, parents, or legal guardian of the minor. (Physical or emotional harm, incest, danger to child)
Parents not liable for cost of treatment

49
Q

Can children 12+ without parental consent get medication?

A

Yes, if such

treatment is given at a state or county contracted facility.

50
Q

Can Children 12 years and older (and unmarried) may receive mental health treatment without parental
consent for the prevention of pregnancy?

A

Yes

51
Q

Consent for minors for emancipated children 14+

A

Can consent to their own treatment

52
Q

Can you see someone under 12?

A

NO!!!

53
Q

Steps if you’re seeing a minor (already established they’re eligible)

A

Make a note in the child’s file regarding the specific clinical circumstances, and a clear
rationale for why it would not be appropriate to contact the parents initially
• If the child has been a victim of incest or abuse, then Child Protective Services must be
contacted and the course of treatment may be determined by the child’s social worker.
Although not stated in the law, a good policy is to determine a time limited treatment plan with the
potential goal of contacting the child’s parents as soon as possible. Record in the child’s file all
attempts to contact the child’s parents.

54
Q

Minors release of records rules

A

Confidentiality and what information will be released to parents should be
discussed prior to the onset of therapy. Parents are entitled to have access to their children’s records,
and this access is extended to non-custodial parents as well. However, if it is determined that it would
be detrimental to a child’s treatment or if access will impact the child’s safety in any way, the MHP
may deny access to records. MHPs will typically write reports that summarize the content of the
child’s records.

55
Q

What do you do if you need to consult with a minor’s school/pediatrician?

A

Always have parental consent and a signed written

release of information form prior to contacting any outside source.

56
Q

Ethical Representation

A

Trainees and associates must notify clients that they are pre-licensed
professionals and must provide clients with information about their licensed supervisor. Trainees and
associates do not perform services beyond their training, level of experience and competence.

57
Q

Responsibility to Society

A

MHPs recognize a responsibility to participate in activities that contribute to a
better community and society.

58
Q

Ethics of the Supervisory Relationship

A

MHP supervisors do not exploit the trust and dependency of
supervisees and, therefore, avoid engaging in a separate relationship that may impair professional
judgment or lead to exploitation. Supervisors do not provide therapy to supervisees. MHP supervisors
do not engage in a sexual relationship with supervisees, or any form of harassment or exploitation. An
MFT supervisor may require his/her supervisee to be in therapy.

59
Q

Professional Development:

A

MHPs remain abreast of developments in their field through educational
activities and clinical experiences. MHPs remain accountable to the standards of the profession and are
encouraged to become active members of the state and national associations of family therapy.

60
Q

Can MFT Trainees and Associates be “independent consultants”?

A

NO!!!

61
Q

Regulations Pertaining to MFT Trainees/Associates:

A

MFT Trainees and Associates must be informed of,
abide by, the laws, rules, and regulations governing the practice of marriage, family and child therapy in
California.

62
Q

Where can MFT Trainees train?

A

“in any setting that lawfully

and regularly provides mental health counseling or psychotherapy.”

63
Q

Do sites have to be approved by Phillips for trainee hours?

A

YES!

64
Q

Can you get your hours at a for-profit hospital?

A

Yes! As long as Phillips approves it

65
Q

Can you get your hours at a supervisor’s private practice?

A

NO!

66
Q

Can an Intern get hours at a private practice?

A

YEs!

67
Q

How are Interns employed at private practices?

A

The Intern is an employee of the
supervisor and is paid a salary; the Intern is not an independent consultant, and the Intern cannot be paid
directly by the client in a private practice.

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