mock exam2 Flashcards
A new client comes for therapy complaining of anxiety and depression. After the therapist provides information about alternative treatment options including medication, the client emphatically states, “I refuse to take medication.” The therapist should NEXT?
A. Acknowledge his right to choose his treatment.
B. Refer him to a psychiatrist.
C. Determine why he’s so against medication.
D. Provide him with research on the benefits of medication.
A. Acknowledge his right to choose his treatment.
n which of the following situations is a therapist not required by law to break confidentiality?
A. A 4-year-old client is intentionally injured by a 17-year-old brother.
B. A client gives his 78-year-old mother extra medication to keep her sedated.
C. A client reports thoughts of hurting herself.
D. A 14-year-old reports sexual activity with a 13-year-old neighbor.
C. A client reports thoughts of hurting herself.
A new client wants to receive counseling and informs the therapist that he wants cognitive behavioral therapy. The therapist is not trained in cognitive behavioral therapy. How should the therapist respond to the client:
A. talk about limitations of Cognitive Behavioral Therapy.
B. provide information about the therapist’s orientation.
C. seek consultation from a Cognitive Behavioral therapist.
D. refer to a Cognitive Behavioral therapist.
D. refer to a Cognitive Behavioral therapist.
A single father’s parental rights were terminated due to neglect of his two young children. After a year of the children being in foster care, the foster care therapist receives a call from the father stating that he has changed his behaviors and would like to have custody of his children returned to him. The therapist should:
A. Empathize with the father but state that the therapist can’t do anything to reinstate parental rights.
B. Discuss the request with the judge who terminated parental rights.
C. Inform the father to speak with a lawyer regarding his appeal.
D. Encourage the father to first re-develop a relationship with his children by setting up weekly home meetings.
C. Inform the father to speak with a lawyer regarding his appeal.
A 22-year-old woman comes to therapy at the request of her parents. She shares with the therapist that her boyfriend of six months has beat her up a couple times and that her parents want the therapist to convince her to leave him, but she loves him and isn’t going to be told what to do. The therapist should FIRST:
A. obtain a release to speak with her parents.
B. discuss the cycle of violence.
C. acknowledge her right to make decisions about her relationship.
D. help her create a safety plan.
C. acknowledge her right to make decisions about her relationship.
An 85-year-old client has been living in a nursing home after her husband passed away and she was no longer able to care for herself. The client declines a medical procedure that has the potential to prolong her life. The client is mentally alert and competent and says that she is happy with the life she has lived. The client’s family meets with the therapist, saying that they want the therapist’s help to change their mother’s mind. The therapist should:
A. Determine whether the family’s decision is ethical and oppose it only if it is not.
B. Respect the client’s right to self-determination.
C. Make sure the client understands the consequences behind her choice.
D. Agree to let the family make the choice for the client.
B. Respect the client’s right to self-determination.
A former client dies and the therapist is notified by the client’s wife. The wife submits a written request to access the client’s therapy records. The therapist must:
A. Assert privilege on behalf of the client.
B. Provide a copy of the records within 15 working days.
C. Deny the request.
D. Request authorization from the client’s legal representative.
D. Request authorization from the client’s legal representative.
A 14-year-old is brought to therapy by her mother following her parents’ divorce. The mother shares the custody agreement which states that both parents must consent for mental health treatment. When the therapist contacts the father, he refuses to comply stating, “her mother always thinks our daughter is depressed but she’s not.” How should the therapist proceed:
A. Refuse treatment because the father won’t consent.
B. Obtain consent from mother.
C. Obtain consent from mother and daughter.
D. Obtain consent from daughter.
D. Obtain consent from daughter.
An 18 year old client reports that she was sexually molested by her father repeatedly for five years. She now lives at college, and her two little sisters live at home with her father. She is concerned about living away from home because she doesn’t want him to molest her sisters. The therapist should:
A. Determine if there is suspicion of current molestation.
B. Report immediately, as the abusive father has access to the sisters.
C. Report immediately, as the abuse took place when the client was a minor.
D. Help the client create a safety plan for the sisters.
A. Determine if there is suspicion of current molestation.
A new client wants to be assured that her sessions are absolutely confidential. When should the possibility of a subpoena for confidential records of a client’s therapy be discussed?
A. in the first session if it appears that the problem might involve court actions.
B. in the first session before the client contracts for services.
C. in the first session after trust and rapport are firmly established.
D. whenever the therapist deems it appropriate.
B. in the first session before the client contracts for services.
A 13-year-old client reports to his school counselor that he had sex with a 13-year-old girl for the first time yesterday. He met her at his new school three days ago and they had sex behind the school gym after getting high during lunch. The therapist should:
A. process the impact of breaking confidentiality with the client and then report the incident to his parents to keep him safe.
B. process the impact of breaking confidentiality with the client and then report the incident to the school, since the student used drugs on campus.
C. report the incident to CPS, since the student had sex with a minor.
D. maintain confidentiality.
D. maintain confidentiality.
A therapist should review informed consent with a client:
A. prior to the onset of therapy.
B. prior to the onset of therapy and over the course of the therapeutic relationship.
C. in the early stages of therapy and over the course of the therapeutic relationship.
D. prior to the onset of therapy and whenever a client requests clarification regarding a therapist’s policies.
B. prior to the onset of therapy and over the course of the therapeutic relationship.
An 11-year-old child is brought to therapy by a single father who claims that the child has been acting differently since he and the child’s mother divorced. He tells the therapist that his former wife has full legal custody because he had been wrongfully accused of mistreating the child, but that the child called him and wanted to see him. Upon meeting the child at an agreed upon time and place, the child told his father that he is very sad and does not want to live anymore. What responsibility does the therapist have in this situation?
A. Treat the child because of the severity of the symptoms.
B. Agree to treat the child only after the father agrees to get permission from the mother.
C. Refuse to treat the child because the law requires that both parents sign consent before treatment begins.
D. Refuse to treat the child because only the parent with legal custody can consent for treatment.
D. Refuse to treat the child because only the parent with legal custody can consent for treatment.
During a shopping trip to a mall, a therapist witnesses a woman spanking a young child after the child ran away from her. In this situation, the therapist must:
A. file a child abuse report immediately.
B. tell the mother that the therapist is a mandated reporter.
C. provide the mother with a referral to parenting classes.
D. The therapist has no obligation.
D. The therapist has no obligation.
A 14-year old girl comes to a family service agency for help. She is 4 weeks pregnant, unmarried, and depressed. She lives with her mother who is unaware of her pregnancy. She states she doesn’t want her mother to know she’s getting therapy because she’s a druggie. In order to treat this girl, the therapist should first?
A. Obtain the client’s signed informed consent.
B. Discuss the need for parental involvement with the client.
C. Attempt to contact the client’s mother.
D. Obtain the client’s informed consent and document the reason for not including her parents.
D. Obtain the client’s informed consent and document the reason for not including her parents.
In their session, a couple talks about their “bad physical fight” last weekend. The therapist notices bruises and abrasions on the wife’s legs. How should the therapist proceed to stop the violence?
A. Refer the husband to a batterers’ group, identify the triggers to the violence, and work with the couple conjointly.
B. Refer the husband to a batterers’ group, work with them conjointly to own their individual responsibility, and increase their understanding of the choices.
C. Refer each to individual therapy to give them a safe place to explore their feelings and continue couples therapy.
D. Refer the husband to a batterers’ group and individual therapy and refer the wife to the local women’s shelter and individual therapy.
D. Refer the husband to a batterers’ group and individual therapy and refer the wife to the local women’s shelter and individual therapy.
A therapist has been meeting with a client for four months with the expressed goal of addressing the client’s social anxiety. The therapist seeks consultation but the client continues to make no progress. What should the therapist do?
A. Begin termination with client.
B. Discuss referring client to a different therapist.
C. Explore lack of progress directly with client.
D. Refer client for psychiatric evaluation.
C. Explore lack of progress directly with client.
A 11-year-old is brought to therapy by his mother and stepfather. His mother reports the son has become withdrawn and only wants to hang out with his friends and play video games. After meeting with the son for several sessions, the therapist learns that the son does not like his step-father and feels he is mean toward the mother. The mother requests to access the son’s records. How should the therapist respond?
A. Discuss the request with the client.
B. Allow the mother access to the records since she signed consent to treatment.
C. Allow the mother access to the records if the client consents.
D. Deny the request if it would jeopardize client’s safety and/or the therapeutic relationship.
D. Deny the request if it would jeopardize client’s safety and/or the therapeutic relationship.
A client is concerned because she is convinced her husband is intending to kill his boss today after work. She knows he has been planning it, and she saw him pack a gun in his briefcase this morning. The therapist should:
A. Initiate a 5150 for the husband, since there is imminent danger to his boss from a credible third party.
B. Call the police and the husband’s boss with the client in the room as per therapist’s duty to warn.
C. Encourage the client to call the police and create a safety plan for the client.
D. Get a release from the client to call the police and boss, and call with the client in the room.
C. Encourage the client to call the police and create a safety plan for the client.
A family sought therapy after the 36 year-old daughter and her 14 year-old son moved back home with her 66 year-old father and 65-year-old mother. At the start of the eighth session the mother reports that three days ago the daughter relapsed and became violent when they confronted her. What action should the therapist take first?
A. Explore each family members’ perspective of the incident and how they responded.
B. Review the limits of confidentiality with the family members.
C. Recommend that the daughter seek alcohol treatment immediately.
D. Obtain more details about the nature of the violent episode.
B. Review the limits of confidentiality with the family members.
A married couple meets with a therapist in private practice for an initial session. Afterwards, the wife calls the therapist and states, “I have something I want to talk to you about, but my husband can’t find out.” The therapist’s MOST appropriate response would be to:
A. Reassure the wife that what she says will be kept confidential.
B. Recommend that both husband and wife meet individually before the next couple’s session.
C. Advise the wife of the therapist’s “no secrets” policy.
D. Encourage her to make disclosure at a future couple’s session.
C. Advise the wife of the therapist’s “no secrets” policy.
A therapist working at a community mental health agency started a group for survivors of domestic violence. While meeting with potential group members, a woman states she is concerned that what she says in the group might be shared with people in her community. How should the therapist respond?
A. Ensure client that all information shared in group will remain confidential.
B. Acknowledge client’s concerns and review importance of group maintaining confidentiality.
C. Acknowledge that information shared in group is not protected by confidentiality laws.
D. Review limits of confidentiality and obtain written agreement from group members.
C. Acknowledge that information shared in group is not protected by confidentiality laws.
A therapist is treating a 13-year-old girl. In the middle of the third session she shyly discloses that she is 5 weeks pregnant. She states that she is scared to tell her mother for fear of punishment. She shares that she and her boyfriend, who is also 13, want to keep the baby. The therapist should:
A. maintain confidentiality and provide support to the client.
B. make a child protective services report and contact the client’s parents.
C. make a child protective services report and refer the client to an M.D.
D. maintain confidentiality and refer the client to health clinic.
D. maintain confidentiality and refer the client to health clinic.
A therapist receives a subpoena from the lawyer of a client whom the therapist treated in couples therapy. The couple is getting divorced. The husband signed a release for the records. The therapist should FIRST:
A. release the records to the lawyer once the wife tells you she permits the release.
B. assert privilege on behalf of the clients.
C. contact the wife to determine her wishes.
D. schedule a session with the couple to discuss the matter.
C. contact the wife to determine her wishes.
A therapist treats a client who reports a desire to kill a former employer who recently laid him off. Upon further questioning, the client says that although this is a desire, it is not a strong one and the client has no plan. The therapist should:
A. notify local law enforcement of the situation.
B. contact the client’s former employer to report the danger.
C. monitor the client’s feelings at future sessions.
D. notify local law enforcement and the client’s former employer of the threat.
C. monitor the client’s feelings at future sessions.
A therapist is treating a mother who is going through a contentious divorce. She came to session one day very upset and reports that the husband, who has visitation rights every weekend but does not have legal custody, has taken their children to another state without her permission. The therapist should:
A. File a child abuse report for abduction.
B. Encourage mother to consult with her lawyer.
C. Call the police.
D. Determine whether the children are safe.
B. Encourage mother to consult with her lawyer.
A therapist meets with parents who refuse to provide appropriate medical care to their 6 year-old daughter with a potentially life threatening illness because of their religious beliefs. The child is receiving some care within the guidelines of their church’s ministry but the child’s condition is getting worse. How should the therapist respond to this dilemma?
A. Inform the family that a child neglect report must be filed.
B. Maintain confidentiality because of the family’s right to self-determination.
C. Report the situation to child protective services.
D. Encourage the family to take a different action in the best interests of the child.
A. Inform the family that a child neglect report must be filed.
An Asian American family seeks family therapy. During the second family therapy session, the 14 year-old angrily states that she is tired of the painful punishment from her father for “trying to fit in with her friends at school.” The father notes that the punishment is necessary to prevent his daughter from imitating the behaviors of her American friends and thus bringing shame to the family. The therapist should initially:
A. explore their cultural beliefs related to parenting and discipline.
B. inform the parents that their behavior requires a report of suspected child abuse.
C. determine the nature and severity of the punishment.
D. help the daughter understand her parents’ behavior as culturally appropriate.
C. determine the nature and severity of the punishment.
Two therapists are co-facilitating a social skills group for children with ADHD. During one of the sessions one of the children shows a scar on his back that his step dad inflicted because the child would not stay in his room after bedtime. After the group the therapists should FIRST:
A. Both file a child abuse report.
B. Call the child’s mother and schedule a session.
C. Determine which therapist will file a report.
D. Assess the child for recent abuse.
C. Determine which therapist will file a report.
A therapist has determined his duty to warn has been triggered and he calls the intended victim, who is the ex-wife of his client. She does not believe the therapist and asks for more details, including specific things the client has said. The therapist legally:
A. May not use any direct client statements, as that is not legally permissible.
B. May use any information he chooses in communicating the threat.
C. May use as much information as necessary in communicating the threat.
D. May only state the reasons the therapist believes the threat is credible, without using direct client quotes.
C. May use as much information as necessary in communicating the threat.
