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CPLEE 2020 > My Deck > Flashcards

My Deck Flashcards

1
Q

What are other terms for upholding privilege?

A
  • Claim
  • Assert
  • Invoke
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2
Q

How should you respond to a subpoena for client records?

A
  1. Determine if the subpoena is valid
  2. Ask client what they want you to do – share info or assert privilege
  3. If asserting privilege, can write a letter to court or have lawyer file a motion to quash the subpoena
  4. Continue asserting privilege until the subpoena is dropped or you get a court order for the records
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3
Q

What is a Letter of Warning/Educational Letter?

A

BOP non-disciplinary action: Such a letter outlines the allegations, informs of the law, and warns the licensee that if the situation is true and repeated, formal action could result.; e.g., not putting license number in communication

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4
Q

What are the requirements for supervision

A
  • Primary supervisor must provide at least 1 hour of individual face-to =-face supervision each week
  • Must have supervision for 10% of time worked each week
  • Supervisors must be employed at place as supervisee for at least half of the time
  • Supervisor must be available to supervisee for 100% of the time they are working
  • Supervisors must complete 6 hours of training in supervision every 2 years (psychiatrists are exempt from this)
  • Primary supervisor can delegate supervision to other licenses (e.g., MFT)
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5
Q

What APA can do in response to unethical behavior

A
  1. Begin an ethics investigation
  2. Impose sanctions (e.g., revoke membership)
  3. Notify governing bodies, like BOP or law enforcement

Note: APA typically only cares about professional behavior, but may get involved when personal issues affect professional work, like when psychologist is convicted of a felony

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6
Q

BOP’s potential responses to serious violations

A 
Letter of Reproval
Probation
Suspension
Interim Suspension Order
Surrender of License
Revocation

Note: All decisions made public

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7
Q

Fitness for Duty Evaluation confidentiality rules

A

You can tell employer:

  • If employee can perform essential job functions
  • Any functional limitations related to the job
  • Any accommodations needed for job
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8
Q

What to do if you have a case that is outside your competence?

A
  • Get supervision and training if it is a completely new area
  • Get consultation if it is adjacent to your competence
  • Refer out if you have no experience in that area and cannot (or do not want to) obtain supervision
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9
Q

What is the opposite of claiming privilege?

A

Waiving it

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10
Q

Who can hold privilege?

A
  • Patient
  • Patient’s guardian or conservator
  • Parent or guardian if patient
  • Patient’s representative if patient is deceased
  • Patient who is 12+ and mature (but an adult claims or waives it on their behalf)
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11
Q

Exemptions to CE requirements

A
  • Active military service

- Prevented from getting CEs for health reasons or “good cause”

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12
Q

What to do if CA Law contradicts HIPAA

A

Go with HIPAA (Federal law trumps state law)

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13
Q

What to do if Ethics Code disagrees with law

A

Go with the higher/most conservative standard, which is the one that most protects the privacy of the client

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14
Q

Letter of Reproval

A

BOP disciplinary action: Used only when no patient harm occurred; negotiated between BOP, licensee, and his/her lawyer; describes allegation and disciplinary actions agreed upon, which could include mandated coursework and cost recovery to BOP for investigation

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15
Q

Probation

A

BOP disciplinary action: Terms/conditions of probation are set forth and the license is technically revoked, but that revocation is stayed; if licensee does not comply with terms, license gets revoked

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16
Q

4 things needed for a valid malpractice lawsuit

A

Dereliction of duty directly causing damages

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17
Q

Registered Psychologist qualifications and rules

A
  • Must have doctorate in psychology and 1500 hours SPE
  • Registration is for 30 months (2.5 years) and is non-renewable
  • Must be employed in non-profit receiving 25% of its funding from government (excluding Medi-Cal/Medi-Care)
  • Must be supervised by licensed psychologist
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18
Q

BOP’s potential responses to complaints of minor violations

A
  • No Action - Close Case: Outside of jurisdiction or complaint not supported by evidence
  • Letter of Warning/Educational Letter
  • Citation and Fine

Note: Kept confidential, with the exception that Citations and Fines are made public

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19
Q

How many registered psychologists can a psychologist have

A

No limit

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20
Q

Citation and Fine

A

BOP non-disciplinary action: $100-$2500 fine per violation, e.g., false advertising or misrepresentaiton; always accompanied by Order of Abatement telling psychologist to cease some action; may follow unheeded letter of warning

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21
Q

Suspension (of license)

A

BOP disciplinary action: Typically used prior to the effective date of probation; during a suspension, licensee cannot practice or refer to themselves as a psychologist

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22
Q

What is PHI?

A

Protected Healthcare Information

Includes any identifying information that is tied to an individual’s past, present, and future healthcare

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23
Q

BOP disciplinary action when incarcerated after conviction of felony

A

Suspension

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24
Q

Psychology internship must be accredited by ______

A

Accredited by APA or member of APPIC or CAPIC

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25
Q

What are some exceptions to confidentiality?

A
  • Medical emergencies
  • Danger to self (suicide)
  • Danger to others (Tarasoff)
  • Mandated abuse reporting
  • Court order (NOT a subpoena)
  • Professional consultation (only share minimum needed info)
  • To obtain payment from insurance (name and diagnosis)
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26
Q

What to do if Ethics Code contradicts the law

A

Make known your commitment to the Ethics Code
Take steps to resolve the conflict
Safeguard human rights and do no harm

Note: Contradict means you cannot do both things

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27
Q

What to do if colleague is unethical

A
  • If there is no substantial harm, try to resolve informally

- If there is substantial harm, or if informal resolution fails, file a formal complaint

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28
Q

Psychological Assistant qualifications and rules

A
  • Must have master’s in psychology or be a doctoral candidate
  • Cannot provide services on their own
  • Must be employed by licensed psychologist (can have 3), board-cert psychiatrist (can have 1), or psychology clinic
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29
Q

In what case(s) can a minor hold privilege?

A

If they are at least 12 y/o and “mature”

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30
Q

What 3 conditions must be met for informed consent to be valid?

A
  1. Patient must have capacity
  2. Information must be comprehensible
  3. It must be voluntarily given
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31
Q

CE requirements

A

Need 36 hours every 2 years
75% can be independent learning; 25% must be in-person
Do not rollover
Must have some training in laws and ethics each renewal cycle; not further specified
Do not need to submit documentation every cycle, but must keep records for 4 years from last renewal in case of audit

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32
Q

Who can claim privilege?

A
  • Patient
  • Patient’s guardian or conservator
  • Minor’s parent or guardian
  • Patient’s personal representative, if patient is dead
  • Psychologist
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33
Q

BOP disciplinary action if outstanding tax obligations

A

License suspended or denied

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34
Q

NGRI requirements

A

Lack the capacity to understand act was wrong
and/or
Unable to behave according to the law

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35
Q

Exceptions to privilege

A
  • If the client waives privilege
  • Legal mandate like abuse reporting
  • If the client has already willingly shared information with a 3rd party, like posting something online
  • When mental status or emotional stability is in question in the legal proceeding (e.g., CST, NGRI)
  • Court appointed evaluation (court gets to know results)
  • Board of Prison Appointed Evaluations
  • When someone seeks psychological services to help them commit a crime (like faking a worker’s comp claim)
  • Client sues therapist for Breach of Duty
  • Patient danger to self or others
  • Patient is under 16 and the victim of a crime
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36
Q

How long do you have to keep CE records?

A

4 years from last license renewal

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37
Q

Interim Suspension Order

A

BOP disciplinary action: Used when there is evidence the licensee is likely to engage in behaviors that present an immediate threat to the public; BOP requests hearing through AG’s office for an expedited suspension; the BOP then has 15 days to file a formal Accusation

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38
Q

Revocation

A

BOP most serious disciplinary action: License taken away; always the response to psychologist sexual conduct with clients; can petition for reinstatement after 3 years

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39
Q

How do you have to inform clients of HIPAA Privacy Rule?

A

Provide in writing to client and post in office

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40
Q

Do group members have to keep information confidential?

A

No, not legally, but they should be encouraged to do so

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41
Q

In what cases is informed consent not needed?

A
  • Court-ordered evaluation
  • Routine educational or institutional activity (e.g., job application)
  • Evaluating decisional capacity

Note: In court-ordered treatment, you do need informed consent from patient, but court may be entitled to treatment summaries or updates

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42
Q

Informed consent includes these aspects

A
  • Nature and course of service
  • Fees
  • Involvement of 3rd parties
  • Limits to confidentiality, including supervisor
  • Risks involved
  • Voluntariness
  • Opportunity for Q and A
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43
Q

When can you practice outside your competence?

A

In an emergency situation when other mental health services are not available – to ensure that services are not denied

These services should stop as soon as the emergence has passed or more appropriate services become available

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44
Q

What to do if CA Law disagrees with HIPAA

A

Go with HIPAA, unless CA Law is more conservative, then go with CA Law

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45
Q

What is a subpoena?

A

A court document requiring someone to appear and give testimony in court

Subpoena duces tecum requires someone to bring specific documents with them

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46
Q

What is the difference between supervision and consultation?

A

In supervision there is a power differential

Consultation is between peers

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47
Q

HIPAA Rules

A
  • Privacy Rule
  • Security Rule
  • Transaction and Code Sets Rule
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48
Q

What is the difference between confidentiality and privilege?

A

Confidentiality is the legal and ethical obligation to keep a client’s PHI private

Privilege is a legal concept that refers to a person’s right have information kept private in a legal proceeding

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49
Q

How many interns can a psychologist have?

A

No limit

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50
Q

Inactive license

A
  • Can ask to put your license on inactive status
  • Do not need to accrue CEs while inactive
  • To make active again, have to pay renewal fee and have 36 hours of CEs in the 2 years prior
  • If inactive for 3+ years, license is delinquent, and need to reapply for licensure and take EPPP
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51
Q

What are the Ethics Code General Principles?

A 
Beneficence and Nonmaleficence
Fidelity and Responsibility
Integrity
Justice
Respect for People's Rights and Dignity
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52
Q

Surrender of License

A

BOP disciplinary action: Action requested by licensee in lieu of going through administrative hearing process; licensee must wait 3 years before they can petition BOP for reinstatement, and if they do, previous allegations will be held to be true

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53
Q

Do clients have the right to their records?

A

Yes, unless the provider determines there is a risk of adverse consequences to the client

54
Q

BOP disciplinary action for sexual contact with client

A

Revocation - no judge can stay revocation

55
Q

Informed consent required format for telehealth services

A

Verbal OR written

56
Q

When should you obtain informed consent?

A

As early as is feasible

57
Q

How long do you have to retain records per CA law?

A
  • 7 years from end date of treatment for adults
  • 7 years after patient turns 18 for minors (i.e., until age 25)
  • 7 years and at least until patient turns 19 for emancipated minors
58
Q

How long do you have to retain records per APA Ethics Code?

A
  • 7 years from end date of treatment for adults

- 7 years or until patient turns 21 for minors

59
Q

HIPAA requirements for electronic records

A
  • Must have back up storage system
  • Must ensure entered info is unalterable (e.g., use pdf instead of .doc)
  • Ensure a way to copy signature documents
60
Q

When can you deny a patient access to their records per CA law?

A

When there is substantial risk of adverse or detrimental consequences (can include physical and emotional/mental)

61
Q

When can you deny a patient access to their records per CA law?

A

When there is substantial risk of adverse or detrimental consequences (can include physical and emotional/mental)

62
Q

When can you deny a patient access to their records per HIPAA?

A

If access is reasonably likely to endanger the physical safety of the patient or another person. The patient is allowed to have the denial reviewed.
- This trumps CA law

63
Q

What do the Ethics Code and HIPAA say about withholding records for non-payment?

A

Ethics Code: Can withhold records except in case of emergency

HIPAA: Cannot withhold records for any reason

64
Q

Under what circumstances do parents have and not have access to a minor’s records?

A

Parents who have legal custody (at least 50%) have a legal right to a minor’s records, UNLESS the psychologist determines that access would have detrimental effect on therapeutic relationship or minor’s physical safety or well-being

65
Q

Who consents to release of records for a minor?

A

Parent or guardian

Minor if they could have lawfully consented to treatment (i.e., 12+ and mature)

66
Q

What are psychotherapy notes?

A

Notes that are kept separate from the patient’s chart, like the psychologist’s process/progress notes

These can be subpoenaed

67
Q

How long do you have to respond to request to inspect records?

A

5 working days

68
Q

How long do you have to respond to request for a copy of records?

A

15 calendar days

69
Q

How long do you have to respond to a request for a summary of records?

A

10 working days

But up to 30 calendar days under special circumstances, like a long chart

70
Q

When to include license number in communications

A

Always – any professional communication that includes your signature, and any advertisement

71
Q

Advertising/communication don’ts

A
  • Do not misrepresent yourself or mislead the public
  • Do not compensate press/media for media publicity
  • Do not solicit testimonials from current therapy patients or persons vulnerable to influence (including personality disordered patients)
  • Do not solicit business from vulnerable persons
72
Q

When should you agree upon fees?

A

As early as is feasible

73
Q

When can you send to a collection agency?

A

For unpaid fees if person is given a warning first and are given a chance to pay within a specified time period

Can only give name, address, and amount owed (not diagnosis)

74
Q

Can you offer free sessions?

A

Not to bring in new clients, but you can offer a free consultation

75
Q

What are some examples of insurance fraud?

A
  • Waiving a copay
  • Billing for no-shows (but can do if patient paying out-of-pocket)
  • Making incorrect diagnosis
76
Q

Is bartering allowed?

A

Yes, unless it is clinically contraindicated or resulting arrangement would be exploitative (for either party)

77
Q

What is fee splitting and is it allowed?

A

Fee splitting means you split the fee the client gives you with someone else.

It is okay if the split is based on the services provided and not the referral itself. You cannot give someone money for making a referral to you. You can give a portion of the fee to cover office rent, marketing, admin/scheduling, etc.

78
Q

When should you terminate services?

A
  • When client no longer needs services; e.g., treatment is not working or there are no treatment goals
  • When client is not benefitting
  • When continuing would cause harm to client

When terminating, you should provide termination counseling and referrals, except you are not obligated to do so if you feel threatened by the client or someone close to the client, or when the client drops out of tx

79
Q

What do you do if a patient has trouble paying?

A
  • Once a relationship has been established, you cannot abruptly terminate tx due to patient’s temporary financial crisis.
  • You can reduce your fee, reduce appointments, or suspend sessions.
  • If the client is in crisis/emergency, you must continue seeing them until the crisis has resolved, regardless of their ability to pay.
80
Q

Can you have a multiple relationship with client?

A

Yes, unless it is harmful to the client or impairs the competency or objectivity of the psychologist.

In general, avoid doing assessment and therapy with the same patient.

Note: Includes relationship with someone close to the client

In some forensic contexts you may be the therapist and assessor.

81
Q

Who can give consent to treatment of a minor?

A

Parent or guardian with legal custody. If one legal guardian refuses consent, cannot proceed.

If minor is 300, court appoints someone to have temporary legal custody.

Emancipated minor

82
Q

Conditions for becoming emancipated minor

A
  • 14+ years old
  • Living apart from parents with the consent of parents (i.e., not a runaway)
  • Managing own finances
  • Income is not obtained illegally
83
Q

In what situations can minors consent to treatment?

A
  • If they are emancipated
  • 12+ and seeking medical care or counseling for drug and EtOH related problems; BUT must have parental consent for narcotic treatment
  • 12+ and “mature enough to participate intelligently”, but treatment should still involve the parents unless there is abuse
  • 12+ and mature and seeking outpatient or residential care (e.g., runaway house, crisis center) and is a serious threat of hard to self or others without services or is alleged victim of incest or child abuse; BUT parental consent is still needed for inpatient treatment, medication, ECT, or psychosurgery
84
Q

What are the consequences for having sexual contact with clients?

A
  • BOP revokes license
  • If incident occurs with one client and psychologist has no priors: Up to 6 months in county jail and/or up to $1000 fine
  • If incident occurs with 2+ clients or with 1 client but psychologist has priors: State prison for 16 mos, 2 yrs, or 3 yrs and up to $10,000 fine
85
Q

What do you do if your colleague has sexual contact with clients?

A
  • Give the client a copy of “Professional Therapy Never Includes Sex” (give to any client who discloses sexual history with a therapist)
  • If client was a minor during encounter and therapist still sees minors, make child abuse report
  • If client is an adult, encourage them to report it, but you cannot confidentiality to do so
86
Q

Can you break confidentiality to report a psychologist’s sexual contact with a client?

A

No, not if client was an adult at the time

Can make child abuse report if client was a minor at the time and the therapist still sees minors

87
Q

With whom is a psychologist prohibited from having sexual relations?

A
  • Client
  • Close relatives, guardians, or significant others of clients (and cannot terminate therapy to start a relationship)
  • Supervisees or students over whom psychologists have evaluative authority
  • Research participants
88
Q

Can psychologists ever have sexual relationships with former clients?

A

Yes, if two years have passed since termination of treatment and only under the “most unusual circumstances”

The burden is on the psychologist to prove that there was no exploitation

Definitely cannot terminate early in order to start a relationship

89
Q

What is the penalty for not reporting abuse?

A

Up to 1 year in jail and/or up to $5000 fine

90
Q

When are you mandated to report abuse?

A
  1. When you learned about it in your professional capacity (not just during work hours; e.g., if you check your work voicemail on the weekend)
  2. When you have a “reasonable suspicion” abuse occurred
  3. When it was abuse of a child, elder, or dependent adult
91
Q

Who is an elder?

A

Age 65+

92
Q

Who is a dependent adult?

A

18-64 years old and physical or mental limitations that impact normal activities or ability to protect their rights

93
Q

Who is a child?

A

Under 18

94
Q

What are the categories of elder and dependent adult abuse?

A
  • Physical
  • Sexual
  • Abandonment
  • Abduction
  • Financial abuse
  • Isolation
  • Neglect
95
Q

What are the mandated report categories of child abuse?

A

Physical abuse
Sexual abuse
Neglect

96
Q

Emotional abuse _____ be reported

A

may

97
Q

What are the categories of neglect?

A

Severe: severe malnutrition; failure to thrive – any time the life or health of the child is endangered
General: inadequate food, clothing, shelter, medical care, or supervision

Note: neglect includes both omissions and actions

98
Q

In what way and in what timeline do you have to make a CPS report?

A

ASAP by phone

W/in 36 hours in writing

99
Q

Do you have to make a CPS report if the abused child is now an adult?

A

Only if the abuser has current exposure/access to children

100
Q

When is sexual intercourse with a minor legal?

A

When the person is married to the minor

101
Q

What counts as statutory rape?

A

Any sex between an adult and a minor

102
Q

This should not be considered child abuse or neglect

A

A mutual affray between minors

103
Q

Reporting rules for abuse that occurs at a long-term care facility (adult or elder)

A

If there was no serious bodily injury:

  • call law enforcement ASAP, at least w/in 24 hours
  • make a written report to law enforcement, ombudsman, and facility licensing agency w/in 24 hours

If there was serious bodily injury:

  • call law enforcement ASAP, w/in 2 hours
  • make a written report to law enforcement, ombudsman, and facility licensing agency w/in 2 hours
104
Q

Reporting rules for adult/elder abuse that occurs at a state hospital or state center

A

If abuse included sexual assault or serious injury:
- call state department of state hospitals and law enforcement

For other reasons, just call law enforcement

105
Q

Reporting rules for adult/elder abuse that occurs at home or other non-facility location

A

Call APS or law enforcement ASAP

Make a written report to APS or law enforcement w/in 2 working days

106
Q

What counts as “danger to others”?

A

Tarasoff

107
Q

When do you have to break confidentiality under Tarasoff? What meets criteria for Tarasoff?

A

There needs to be a serious threat, reported by client or family member of client, that the client (not anyone else) is a danger to others

There needs to be a threat of physical violence

There must be a reasonably identifiable victim or victims (do not have to have a name)

108
Q

What do you have to do in a Tarasoff situation?

A

Notify law enforcement

Notify/warm the victim(s)

Tarasoff is the “Duty to Protect”

109
Q

What does “grave disability” mean?

A

When, as a result of a mental disorder or chronic alcoholism, someone is unable to provide for their food, clothing, or shelter

ID alone does not qualify as grave disability

110
Q

When can an involuntary hold be initiated? What situations?

A

When, as the result of a mental disorder or chronic alcoholism, someone is a danger to self (suicide risk) or others (Tarasoff), or is gravely disabled (unable to care for self)

111
Q

Who can initiate an involuntary hold?

A

Anyone over 18

Initiate meaning ask for it to be looked into

112
Q

Who can institute an involuntary hold?

A

Only qualified individuals, including police, crisis workers, psychologists, etc.

113
Q

What is a 5150?

A

72 hour involuntary hold

At the end, person is either released or certified (held longer)

114
Q

What is a 5250?

A
  • 14 additional days of hold beyond an initial 72-hour hold
  • This is called “certification”
  • Requires 2 professionals to sign off
  • The person is entitled to a review hearing w/in 4 days of certification
  • At the end, either released or put on post-certification hold
115
Q

What is a 5260?

A

Post-certification hold for SI, 14 days max

116
Q

What is a 5270?

A

Post-certification hold for gravely disabled, 30 days max

117
Q

What is a 5300?

A

Post-certification hold for danger to others, 180 days max

118
Q

What happens at the end of a post-certification hold?

A

Either released or a conservator is appointed by the court for 30 days (temporary) to 1+ years

If a conservator is appointed, they create a treatment plan within 10 days, with the goal of helping the person become independent again

119
Q

What is the code for a 72-hour involuntary hold?

A

5150

120
Q

What is the code for an involuntary certification hold?

A

5250

121
Q

What are the codes for post-certification holds?

A

5260 - Danger to self
5270 - Gravely disabled
5300 - Danger to others

122
Q

Supervisors must complete ________ of training in supervision every ________.

A

6 hours, 2 years

123
Q

For how long is a registered psychologist registration?

A

30 months, non-renewable

124
Q

What is required to invoke a 5250?

A

2 professionals must sign off

125
Q

When is a child abuse report mandated in instances of sexual activity between an adult and a minor?

A

When the adult is 21+ and the minor is under 16, or when the sex is non-consensual (rape)

126
Q

The relationship between a supervisor and psychological assistant is one of _________ to _________.

A

Employer to employee

127
Q

Who can be a primary supervisor?

A

Mostly only a licensed clinical psychologist

But, psych assistants can accrue up to 750 hours under the primary supervision of a board certified psychiatrist

128
Q

Who can be a delegated supervisor?

A
  • LCSW
  • MFT

But not to a psych assistant

129
Q

Is documentation of treatment (e.g., progress notes) mandated?

A

Yes, it is both an ethical and legal mandate

130
Q

Are psychotherapists required to interrogate their clients to find out the identity of a potential victim if homicidal ideation is mentioned?

A

No

131
Q

What are the required pre-licensure courses and how many hours of each do you have to complete?

A

Aging and Longterm Care - 10 hours
Spousal and Partner Abuse - 15 hours (used to be 2 hours)
Chemical Dependency - 15 hours (must be completed at educational institution)
Suicide Risk Assessment - 6 hours
Child Abuse Reporting - 7 hours
Human Sexuality - 10 hours

CPLEE 2020 (30 decks)

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