Midterm Exam Flashcards
4 Elements of a Civil Suit of Malpractice
Duty of Care – Relationship established
Duty to Protect – Reasonable Therapist
Proximate Cause – Harm caused by therapist
Demonstrable Harm – Money damages
2 Parts of APA Ethics Code
Unenforceable – aspirational guidelines
Enforceable – numbered codes, mandates
What is the primary element that resulted from deinstitutionalization with regard to clinical treatment?
The rule of least restrictive treatment
2 Elements of Law
Case Law
Statutes
Higher court ruling that becomes precedent
Case Law
Legislative process codifies case law
Statutes
Four elements of standard of care
Reasonable therapist
Case law
Statutes
Ethics code
Ethics committee and code
APA
Licensing board
BOP
Attorney General
Criminal allegations
Standard of Care
Reasonable therapist
Duty of Care
Established relationship
Proximate Cause
Therapist is cause of harm
Demonstrable Harm
Money damanges
Expert Witness
Gives expert opinion
Fact witness
On case before legal action
Two types of actions BOP can assign when a violation of licensing law occurs
Disciplinary and Public
Nondisciplinary and confidential
Reasons for Disciplinary and Public action (4)
Sex with patient
Breaches of confidentiality
Insurance issues
Failure to keep records
Reason for Nondisciplinary and Confidential action
No public display of licensure on documents or office
CSI requirements for mandated reporting - Tarasoff Original Ruling (3)
Communicated directly to therapist
Imminent danger
Identifiable victim (with a moment’s reflection)
Tarasoff/Ewing Assessment for Threat (8)
Gender - male Plan - specificity Feasibility Previous violence - best predictor Current problem - who is in danger Substance use - increases likelihood Support system - includes insurance
Requirements for mandating reporting (3)
Warm victims (civil code) Notify authorities (civil code) Take steps (Tarasoff)
Revocation stayed
Loss of license stopped
Revocation
Complete loss of license
Stipulation
Agreement between BOP and therapist
Surrender
Voluntarily give up license
Tarasoff Original Ruling
CSI
Veteran’s Administration (2)
Protect even in absence of stated threat
Seek past records
Ewing Decision - 2 primary additions to Tarasoff
Communicated by family or reliable other
For the purpose for advancing therapy
Arson/Peck (2)
Use of arson can be a deadly weapon
Damage to property
Hedlund (2)
Duty to protect potential bystanders
Victim to victims
Does an empirically validated suicide risk assessment procedure exist?
No
What is the strongest predictor of teen suicide attempt?
Non-suicidal self-injury (NSSI)
Difference between Risk Factors and Warning Signs
Risk Factors - static and enduring
Warning Signs - episodic and variable
Risk Factors examples (3)
Age
Demographics
Family history of suicide
Warning Signs examples (2)
Mood
Life events
Is use of a safety agreement a good protective measure for a suicidal client?
No
Age group with highest suicide rate
45-54 years old
SAD PERSONAS suicidality scale
Sex Age Depression Previous attempts Ethanol (substance) use Rational thought loss Social support lacking Organized plan No significant other Access to means Sickness
Which is more serious to assessment of danger to self or other? False Positive or False Negative
False Negative
2 primary elements of malpractice re: suicide (Baerger, Bongar, and Sullivan)
Foreseeability (should clinician have anticipated?)
Causation (did clinician take sufficient steps?)
Privacy
No illegal search and seizure (4th amendment rights)
Confidentiality
Ethical standard of professional conduct
Privilege
Legal protection from disclosure in legal proceedings
When a therapist strongly disagrees with a client on a political topic, the therapist should: (2)
Remain neutral
Seek consultation
Can a lack of diversity training lead to misdiagnosis using the DSM?
Yes
Insurance Diagnosis
Giving clients alternate diagnoses to receive insurance coverage (ILLEGAL AND UNETHICAL)
3 broad dimensions of multicultural counseling
Therapist self-awareness
Therapist understanding
Skill in using culturally appropriate interventions
Cultural encapsulation
Lack of understanding and ignorance of another’s cultural background
Intersectionality (Crenshaw)
The intersection of social categorizations, creating
overlapping and interdependent systems of discrimination or disadvantage
Cultural Humility (3)
Long-term understanding and learning
Humble and respectful attitude
A state of not knowing
4 Bins of ethical decision making
Legal (state, federal, or regulatory)
Clinical (patient welfare)
Ethical (standard of care)
Risk Management (liability)
Difference between confidentiality and privilege
Confidentiality = ethics Privilege = law
4 agencies holding psychologists accountable
Licensing boards (BOP)
Ethics committees (APA, CPA)
Civil suits of malpractice
Criminal allegations
Preponderance of evidence
Burden of proof in a civil suit
