Quizlet LCSW Law & Ethic Practice Test 1 Flashcards
Jessica, age 14, comes to see you with her mother. She appears withdrawn and fatigued and refuses to speak with you. Her mother explains that in the last few months Jessica’s behavior has changed drastically. How would you manage this family’s treatment needs from an ethical perspective?
Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the steps to take in starting treatment with a new family unit.
A. Explain the family systems model.
B. If you are unable to make progress with the family, give them three referrals.
C. Evaluate how willing the mother is to reframe the problem as the “family problem” rather than Jessica as the problem.
D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually.
D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually.
You would need to determine the unit of treatment before doing any of the other actions.
Mike, your 17-year-old client, has a history of fire-setting. He is in therapy as a result of a court order and his parents know he is in treatment. He tells you that he is angry with his ex-girlfriend and says that he plans to set fire to her house tonight. What should you do?
A. Call his parents so they can be sure that he doesn’t go unsupervised.
B. Maintain confidentiality.
C. Call the police immediately and his ex-girlfriend’s family.
D. Call the police immediately.
C. Call the police immediately and his ex-girlfriend’s family.
In the vignette described there is imminent peril and there is a reasonably identified victim(s). The Duty to Protect includes the mandate to notify the police first and a warning to the identified victim is permitted.
A social worker consults with another professional about a particularly challenging case. Has an ethical violation occurred?
A. Yes, if the social worker does not reveal confidential client information to the other professional.
B. No, if the social worker does not reveal identifying information about the client to the other professional.
C. Yes, if the social worker has a signed consent by the client to consult.
D. No, if the other professional agrees to keep the client information confidential.
B. No, if the social worker does not reveal identifying information about the client to the other professional.
According to the National Association of Social Worker’s (NASW) Code of Ethics, section (1.07) (q) Privacy and Confidentiality, “Social workers should not disclose identifying information when discussing clients with consultants unless the client has consented to disclosure of confidential information or there is a compelling need for such disclosure.” This section implies that the client’s direct consent to consult with another professional is required only if identifying information about the client is revealed. Thus, if general aspects of the case are discussed with another professional, permission from the client is not needed.
A client is referred to you by his attorney. The client tells you that he is reluctant to talk to you because he doesn’t want what he says in therapy coming out in court. Choose the statement that could BEST explain privilege to this client:
A. It is an ethical concept involving the right of a social worker to withhold information in a legal proceeding.
B. It is a legal and ethical principle which involves a restriction on the volunteering of information about a client.
C. It is a legal principle that protects client conversations unless there is a court order.
D. Attorney/client privilege extends to the client of a social worker that the attorney uses for referrals.
C. It is a legal principle that protects client conversations unless there is a court order.
Privilege is the legal right of the client not to have confidential information revealed during a legal proceeding. Only a client, judge or court order would challenge privilege.
If a social worker digitally recorded a session with a client and then receives a subpoena for records because the client is claiming emotional distress, the recorded session would be provided to the court if:
A. The client signed a release to record a session.
B. The client signed a waiver of privilege for the records.
C. The client signed a consent form allowing the session to be videotaped.
D. Digital recording must be disclosed with any records in a subpoena.
B. The client signed a waiver of privilege for the records.
No records would be disclosed until the client or the client’s representative waived privilege.
Steven comes to you for help with debilitating anxiety. He says that his anxiety is beginning to interfere with his relationships and his job. He is afraid to drive his car because he thinks that he is going to hit someone. He doesn’t know how he will ever take a girl out on a date or get to work if he doesn’t get control over this. He thinks he should be able to get over this by himself. The therapist should begin by:
A. Teaching him relaxation techniques and pairing those with thoughts and images of driving his car.
B. Explaining the benefits of a behaviorist approach for severe anxiety.
C. Documenting in an initial treatment plan the client’s goals for treatment of anxiety.
D. Assessing whether a medication evaluation would be necessary.
D. Assessing whether a medication evaluation would be necessary.
From an ethical point (safety-minded) of view, a therapist would first need to consider all treatment modalities to help a client. In this case, that would include considering whether his anxiety is so severe that medication would help him benefit from therapeutic interventions.
Which of the following is not considered by law to be unprofessional conduct by a social worker?
A. A conviction after pleading no contest to a DUI.
B. Thanking a friend for a referral by taking her out to dinner.
C. Being arrested for shoplifting.
D. Poor record keeping.
C. Being arrested for shoplifting.
The law (Business and Professions Code 4982(a) says unprofessional conduct addresses licensees or registrants who have been “convicted” of an offense, not just arrested.
A social worker has been working with a client who informs the social worker that he has been living as a woman since he was 35. He is now 45 and wants to begin transitioning into an anatomical woman. The client tells the social worker that he already has confirmed that his insurance will pay for it but he is self-employed so it is going to be very expensive. How should the social worker proceed?
A. Ask if the client would like to be referred to as “he” or “she.”
B. Use a the client’s signed consent form to determine if he signs it as a woman or as a man.
C. Include a diagnosis of “Gender Dysphoria” on any insurance forms if he signs a release to allow this.
D. If the social worker feels that any counter-transference will impact the therapy, refer the client to a specialist.
A. Ask if the client would like to be referred to as “he” or “she”.
From a diversity perspective, the social worker should directly and respectfully ask the client if s/he would like to be referred to as “he” or “she.”
You are working with a 13-year-old client whose parents are going through a divorce. She texts you one day to tell you that even though she lives full-time with her mother, her dad is now hiring a lawyer for her to come live with him. You receive a subpoena for your records for the purpose of a custody hearing. You would:
A. Assert privilege until a guardian ad litem has been appointed for the client.
B. Contact the parent under whose authorization you are treating the 13-year-old and assert or waive privilege, depending on that person’s wishes.
C. Speak to both parents and assert or waive privilege depending on their wishes.
D. Release the records in order to comply with the subpoena and avoid being in contempt of court.
A. Assert privilege until a guardian ad litem has been appointed for the client.
When subpoenas are received for testimony or records involving clients who are minors therapists should assert privilege until the parent(s) or guardians of the child obtain “guardian ad litem” status.
A couple comes in to see you for therapy. They are referred by the wife’s individual therapist. The husband has recently discovered his wife has been cheating on him and he is unsure if he wants to continue the relationship. What is solely an ethical responsibility in treating this couple?
A. Getting a signed release from both the husband and the wife to speak with the wife’s therapist.
B. Designating a fee prior to the commencement of therapy.
C. Informing the couple of your “no secrets” policy.
D. Having the wife sign a release to speak with her therapist.
C. Informing the couple of your “no secrets” policy
Informing the couple of your “no secrets” policy is solely an ethical responsibility.
Toward the end stages of therapy a client asks his social worker if they can use text or email between sessions to communicate as the final sessions get more spread apart. The social worker suggests that texts and emails won’t really get the client used to less contact; they will only be substitutes. The social worker has:
A. Provided ethical informed consent.
B. Legally maintained confidentiality.
C. Legally avoided client abandonment.
D. Avoided a dual relationship.
A. Provided ethical informed consent.
The social worker’s explanation to the client about the clinical effectiveness of texts and emails is a form of informed consent.
You get a call from the emergency room regarding one of your clients who was brought in by the PET team and is incoherent, delusional, and unstable. While they were going through his belongings they found his driver’s license and your card. The psychiatrist on call wants to know if you can give them any information about this person that might be helpful. You would:
A. Assist them with information you deem pertinent to the situation at hand.
B. Inform them that you cannot confirm or deny if this person is your client.
C. Tell them that they will have to obtain a release signed by the client and fax it to you before you can disclose any information.
D. Ask to speak with your client before disclosing any information.
A. Assist them with information you deem pertinent to the situation at hand.
In the event of a medical emergency it is permissible to give information to medical professionals that may be treating the client. Social workers are permitted to speak with other health professionals for purposes of treatment and diagnosis in recognition of situations such as these.
A client joins a social worker’s church congregation. The social worker should:
A. Leave the congregation.
B. Tell the client s/he needs to join a different congregation.
C. Stay in the congregation but avoid direct social interactions.
D. Review dual relationships with your client and healthy boundaries.
D. Review dual relationships with your client and healthy boundaries.
Of the answers provided, reviewing dual relationships with your client and healthy boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be uncomfortable for your client, or create any therapeutic problems. It is the most reasonable of the options provided.
Your client, Liz, is a 17-year-old female who is leaving for college out of town at the end of the month. She was molested by her uncle as a young child and is working through these issues with you. She has developed a close working relationship with you and wants to continue to work only with you. You would:
A. Consult with a colleague about transference/counter-transference issues.
B. Make three referrals out of town.
C. Plan for weekly, hourly phone sessions with you.
D. See her on school breaks.
B. Make three referrals out of town.
Ethically, you need to provide Liz with the containment she needs to work through her early childhood issues. This can best be accomplished by referring her to social workers in her new area rather than concretizing her transference to you, i.e., “you’re the only person who can understand and help me.”
Your client missed a regularly scheduled appointment. Your policy, made clear to the client in your informed consent document, is that clients will be billed for missed appointments. The client asks you to bill the insurance company. What would you do?
A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.
B. Explain that billing insurance for missed sessions is insurance fraud.
C. Let it go, since by law, insurers cannot be billed for missed sessions and clients with insurance are not required to pay out of pocket.
D. Bill the insurance company for the session.
A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.
It is legal and ethical to bill insurers for missed sessions as long as this is clearly indicated in the billing codes.
You are seeing a 52-year-old man who is unable to keep a job. He states that he always ends up fighting with his bosses who then fire him. During a session he makes a derogatory comment about his last boss’ homosexuality. You find yourself becoming angry towards this client. What would you do?
A. Disclose how you feel.
B. Seek consultation.
C. Refer him out.
D. Put your own feelings on the shelf and deal with the client’s issues.
B. Seek consultation.
Of the choices given, seeking consultation is the first step you would take if you are having angry feelings towards this client. It would be important to understand your reaction and to carefully assess how you would proceed.
For several sessions, you have been working with a client who insists that he “will not rest” until he makes his son’s teacher pay for the false child abuse report that the teacher made. He feels that his family has been shamed and anyone who does an internet search on him will think he is a child abuser. He tells you he would never “put hands on a woman, but I will think of something.” The social worker’s early intervention plan should include:
A. Notifying the police and the teacher.
B. Creating a therapeutic environment where the client can speak openly.
C. Direct questions about his revenge plans.
D. Educating the client about the law regarding your mandate to over report child abuse.
C. Direct questions about his revenge plans.
The social worker would need to determine if the client has a specific and imminent plan to warrant breaking confidentiality.
José, a 14-year-old Mexican-American boy, comes to therapy with his mother. He presents with a flat affect and avoids eye contact during the initial assessment session. During the assessment process, José remains quiet as his mother provides a list of José’s symptoms and behaviors that she would like you, as the social worker, to address. Before the initial assessment session comes to an end, José requests that you meet with him individually from now on. After deciding that it would be appropriate to schedule individual sessions, what is your legal obligation?
A. Assess whether the absence of Jose’s father is having an impact on his behavior or this session.
B. Refer his mother for individual therapy to avoid abandoning her as part of the treatment unit.
C. Document your decision to meet individually with José.
D. Ask his mother to sign a new consent form for him to be treated individually.
C. Document your decision to meet individually with José.
An important legal obligation, since you are changing the unit of treatment from a dyad to individual treatment of a minor, is to obtain consent to treat a minor and document it.
After your session with Scott, you decide to buy $10,000 worth of the stock that he was talking about. In a short time the stock tailspins to 10% of its initial price offering. How would you characterize the social worker’s action?
A. It is illegal and unethical.
B. As the social worker did not solicit the information, the social worker was free to purchase the stock.
C. It is unethical.
D. It is unethical if it interferes with the nature of the therapeutic relationship.
C. It is unethical.
LCSW’s do not use their professional relationships with patients to further their own interests.
Hank, a 27-year-old stockbroker, is referred by his EAP for 6 sessions. In the 5th session Hank tells you that he has recently acknowledged to himself that he is gay and doesn’t know how to tell his fiancee. He wants to bring her to the next session and have you tell her for him. The best course of action would be to:
A. Remind him that he only has one more session and that may not be how he wants to use it.
B. Suggest more sessions to clarify his sexual orientation.
C. Ask him how he knows he is gay.
D. Decline his request to tell her for him.
D. Decline his request to tell her for him.
Declining his request is the only ethical answer. You might also say that you will support him while he tells her, if he wishes.
A therapist who performs telehealth advertises that the main advantage of internet therapy is that the client can reach a therapist in real-time. “If crises come up or just a quick question, online therapy can meet your needs right away.” This advertising is:
A. Legal if the therapist’s informed consent information includes emergency contacts in the case that the therapist is unavailable.
B. Legal if telehealth is within the therapist’s scope of practice.
C. Unethical because online therapy cannot be used in a crisis.
D. Unethical because clients will expect a social worker to be available 24/7.
A. Legal if the therapist’s informed consent information includes emergency contacts in the case that the therapist is unavailable.
Information about availability between sessions or in emergencies is an element of safety planning which is both a legal and ethical requirement.
Miranda, a medical social worker, is going through a painful and conflict-ridden custody battle with her ex-husband. She notices that she has a hard time paying attention in rounds and last week became irritated with a patient and another member of her interdisciplinary team. According to professional ethical standards, how should Miranda proceed?
A. Apologize to the patient and colleague.
B. Take a personal day.
C. Take a leave of absence until the custody situation has been resolved.
D. Speak to her supervisor about making adjustments in her workload.
D. Speak to her supervisor about making adjustments in her workload.
NASW ethical standards say that social workers whose personal problems interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action, including making adjustments in workload.
Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town’s only community counseling clinic. In his second week at the clinic Eli is given a list of new interns he will be supervising and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do?
A. Decline to supervise the intern.
B. Ask the client to choose between having Eli as a social worker or a supervisor.
C. Terminate the therapy since it conflicts with Eli’s role as a supervisor as well as the client’s desire for training and career advancement.
D. Proceed as a supervisor since this is a case of an unavoidable dual relationship.
A. Decline to supervise the intern.
Declining to supervise the intern is the best ethical choice given here (it is possible that with the proper ongoing consultation and responsible care, this particular dual relationship could be ethically acceptable). Although some dual relationships are considered unavoidable, particularly when there are limited choices, the ethics are less ambiguous in stating that supervisors do not take on current or former therapy clients.
You are treating a family of four in therapy. The oldest child, age 17, suggested that you do telehealth sessions with him. Legally, in order to do this you must:
A. Obtain written consent-to-treat from him because he is age 12 and older, to change the treatment plan.
B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.
C. Legally obtain informed consent with the whole family to change the treatment plan.
D. Determine your fee schedule for a different medium.
B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.
If he is in family therapy now, but changed to individual therapy, you would need legal consent-to-treat with a minor.
According to the Elder/Dependent Adult Abuse Reporting Law, you are mandated to report all of the following EXCEPT:
A. Mental suffering
B. Self-neglect
C. Financial abuse
D. Physical abuse
A. Mental suffering.
Optional Category. Mental suffering (fear, agitation, confusion, severe depression, serious emotional stress brought on by threats, harassment, or intimidating behavior) are not mandated.
Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women’s make-up and shoes. Legally, what would be your first concern?
A. You would need to get consent from his parents because he is being abused at school.
B. You would need to assess for child abuse.
C. You would need him to sign a release to speak with his school.
D. You would need to assess for possible suicidal ideation.
B. You would need to assess for child abuse.
Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse.
Audrey, age 32, comes into your office while her father, Carl, and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father, Carl, and she asks, “Can I pay you when my ‘ex’ pays his overdue child support?” How would you manage the ethical issue of fees?
A. Review the fee policies outlined in your informed consent document.
B. Disclose your fee prior to providing therapy or as soon as practically possible.
C. If you see Audrey alone and her father is paying, explain that she must collect the fee from him and then pay you.
D. Discuss Audrey’s request that you wait to be paid until the ‘ex’ pays his overdue child support.
A. Review the fee policies outlined in your informed consent document.
Going over relevant fee policies such as the basis on which it is computed, sliding scale polices or fees for late cancellations constitutes sound ethical management.
A social worker wants to speak with a client’s nurse practitioner and brings up the subject of signing a release in order to do so. As part of informed consent, a client begins asking the social worker what she will do with the release. The social worker should explain that:
A. The release will expire in one year.
B. The client is entitled to receive a copy of the release.
C. The social worker will speak only with the person on the release.
D. The social worker will tell the client before speaking with the third party.
C. The social worker will speak only with the person on the release.
This answer provides the client with information to the client so that she can consent or refuse to consent to this part of the treatment.
As a mental health professional, which of the following situations are you mandated to report?
A. Your 30-year-old female client is beating her husband and there are two young children in the home.
B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son.
C. You have suspicions that your 63-year-old client is being beaten by her son-in-law.
D. Your severely depressed client tells you that she wants to die.
B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son.
You must report both known and suspected child abuse to a child protective agency. Since your client tells you that the elementary school swim instructor is molesting her 9-year-old son, you are mandated to report this abuse.
Two years and one day after terminating with your client, Bob, he calls you and says that he has extra tickets to the NBA playoff game tonight and would like to invite you to the game with him and his wife. Under what circumstances might it be ethically appropriate for you to accept?
A. Under no circumstances, since a client is always a client and this could constitute a dual relationship.
B. Under all circumstances, since this post-therapeutic relationship would occur more than two years following termination of treatment.
C. If both you and the former client felt comfortable with meeting in this way.
D. If you were to obtain professional consultation to determine the reasonableness of this post-therapeutic relationship.
A. Under no circumstances, since a client is always a client and this could constitute a dual relationship.
Non-sexual, post-therapy relationships may be ethical depending upon the reasonableness of the post-therapeutic relationship and the reasonableness of the time since therapy. However, the highest ethical standard is to avoid relationships with former clients because they may want to return to therapy.
You are treating a client who discloses that she has had sexual relations with all her prior therapists. You:
A. Consider a diagnosis of Borderline Personality Disorder.
B. Provide her with a copy of “Professional Therapy Never Includes Sex” and answer her questions about it.
C. Provide her with a copy of “Professional Therapy Never Includes Sex” and describe the laws prohibiting therapist sex with clients.
D. Contact the BBS and inform them of the client’s reports.
B. Provide her with a copy of “Professional Therapy Never Includes Sex” and answer her questions about it.
Your legal responsibility is to provide the pamphlet “Professional Therapy Never Includes Sex” and discuss it with the client if he or she informs you of sexual misconduct between him/herself and a therapist.
Laurel, age 28, a corporate fund-raiser, and Marty, age 30, an electrician, are referred to you by Marty’s E.A.P. Three weeks ago Marty witnessed the death by electrocution of a co-worker while they were working on a high-power utility line. Since then, Marty says he can’t concentrate, is having nightmares, can’t sleep, and finds himself reliving the incident over and over again. Laurel says Marty’s problems are due to his drinking, not his co-worker’s death. How would you handle the ethical responsibilities pertaining to boundaries?
A. Avoid membership in gyms or country clubs to which either Marty or Laurel belong.
B. Inform Marty how privilege works in case he is subpoenaed regarding the co-worker’s death.
C. Have Marty sign a release so that you can speak to his E.A.P.
D. Set the fee before the first session.
D. Set the fee before the first session.
Setting the fee before the first session is both a legal and ethical responsibility. It is one of many things to do when setting boundaries.
A lesbian couple that you have been seeing asks you about Emotionally Focused Therapy. One of the partners tells you that she saw it on a daytime talk show and would like to see if it can help them. What should you NOT tell them if you feel competent to do this kind of therapy?
A. That you will need them to sign an agreement to change the treatment plan.
B. The risks and benefits of this type of therapy.
C. How you will help them determine new treatment goals that fit with EFT.
D. Your skills and experience in working with EFT.
A. That you will need them to sign an agreement to change the treatment plan.
Ethics do not require a signature on a treatment plan.
A family with a 16-year-old daughter and a 15-year-old son comes in to see you. The siblings are of equal height and build. The parents report that they have been referred to you by the school counselor because of the children’s frequent squabbles. You discover they both have hit the other hard enough to give each other black eyes. You would:
A. Set up a strict policy of no hitting; teach anger management skills to both siblings; and instruct the parents on recognizing the warning signs that lead to the children’s violence.
B. Report the incidents to a children’s protective agency.
C. Inform the parents that if they don’t contain the violence, you will report the incident to a children’s protective agency.
D. Take steps to contain the violence. Since the violence is between siblings that are close in age and evenly matched, it is not reportable since it is a mutual affray between minors.
B. Report the incidents to a children’s protective agency.
This vignette describes sibling abuse that has been occurring for a while. The parents are not in control of the situation, and you are mandated to report.
The juvenile court refers a family to you. The 14-year-old son has been found guilty of vandalism and recently tested positive for using marijuana. The parents say the boy’s friends are to blame, and they want your help to convince the court that their son was a victim of these older boys pressuring and threatening him. Ethically you:
A. Would explain that you need a release from the parents to communicate to the court.
B. Could tell the court what the parents have told you.
C. Must consult with the boy’s attorney so that you remain in your scope of competence.
D. Make a child abuse report concerning the older boys’ threats.
A. Would explain that you need a release from the parents to communicate to the court.
Even though the court referred this family, the family is your client, and you cannot break confidentiality without a written release.
Your client of six months, Dale, who was referred to you by her wheelchair aerobics instructor, comes to session with her 16-year old daughter Natasha. Dale is worried about abrupt changes in Natasha who has suddenly become argumentative and secretive. Natasha continues, “I’m sick and tired of helping her get to the bathroom. I want to be out with my friends.” How would you manage your ethical obligations as they pertain to diversity?
A. Educate yourself on the psychosocial impact of being in a wheelchair.
B. Refer Dale to a support group for mothers in wheelchairs.
C. Join with the family by acknowledging similarities between Dale and Natasha.
D. Construct equipment, redesign entrances, or otherwise provide adequate wheelchair accessibility to your office.
A. Educate yourself on the psychosocial impact of being in a wheelchair.
A better understanding of the issues Dale and Natasha face as a result of Dale’s disability would certainly be an important aspect of their treatment and would meet your ETHICAL obligations.
John is a client whom you referred to a psychiatrist for an evaluation. He was reluctant to go because he has a history of steroid abuse that he does not like to talk about. He was given a prescription for SSRIs to alleviate his depression that he has been taking for six months. John comes to session this week and tells you that he has stopped taking the medication. You would:
A. Ensure that John takes the medication.
B. Educate John about the impact of terminating the antidepressant medication.
C. Refer John back to the prescribing psychiatrist.
D. Explore the reasons for John’s refusal and suggest that another antidepressant might be more appropriate.
C. Refer John back to the prescribing psychiatrist.
Referring John back to the psychiatrist would be the most appropriate action, as the psychiatrist could explain the benefits of taking the medication and the repercussions of abruptly terminating it.
A client that you treated 3 years ago terminated when her therapy goals had been reached and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office?
A. Tell her if you have raised your fees.
B. Tell her that you must make referrals if her needs are out of your scope of competence.
C. You must open a separate file.
D. She must sign a new release authorization since they expire after one year.
A. Tell her if you have raised your fees.
You must disclose your fee before beginning therapy with a new or returning client.
The court sends Sue and Jerry to you for marital counseling after a domestic violence incident. A month after the referral, the court requests a report on the couple’s attendance and progress. You:
A. Can inform the court of the couple’s attendance, but not progress without a written release signed by Sue or Jerry.
B. Should assert privilege on behalf of the couple.
C. Need a written release signed by both Sue and Jerry before you can communicate with the court.
D. Cannot assert privilege on behalf of the couple.
C. Need a written release signed by both Sue and Jerry before you can communicate with the court.
Since Sue and Jerry are your clients, you must get a written release from both before divulging any information about them.
Court Orders vs. Client Consent: Even though the court referred the couple, a court referral does not automatically waive confidentiality. A release is still required to disclose any information.
A social worker has been treating Mikey, age 12, for the last 8 months. He has been dealing with feelings of depression and tells you that he is not doing well in school. He tells you that his parents recently filed for divorce, and he does not know with which parent he wants to live. A few weeks later, you receive a call from an attorney who tells you that she was appointed to represent Mikey in the divorce proceedings. She is requesting a copy of your records. How do you respond in this situation?
A. Having determined that the lawyer is the child’s counsel, you would release your clinical records to her, and tell your client that you are doing so.
B. Ask Mikey if he would sign a release to allow you to release the records to the attorney because ethically, you must act in his best interests.
C. Release records with both parents’ authorization if it is in Mikey’s best interests to do so.
D. Do not speak with the attorney because your client’s confidentiality is the more important ethical obligation in this instance.
A. Having determined that the lawyer is the child’s counsel, you would release your clinical records to her, and tell your client that you are doing so.
In custody or visitation proceedings, if a child is represented by an attorney, that person has the right to obtain a child’s clinical records or to interview the assessing or treating social worker. Ethically, you would also discuss this confidentiality issue with your client.
Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae’s school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook’s speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night, so that he can drink some sho-chu to unwind. Chong-Wook tells you that “the fee won’t be a problem, the fee is covered under the overall adoption agreement.” What are your ethical obligations?
A. Determine the family’s understanding of the purpose of the therapy.
B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session.
C. Determine the identified patient and refer to a pediatrician.
D. Tell Chong-Wook and Dae-Sup the fee at the first session, and explain that you may need to consult with the school counselor and adoption agency.
A. Determine the family’s understanding of the purpose of the therapy.
Ethically, you would want to clarify the client’s purpose.
Veronica, a 29-year-old coffee store manager, is in counseling because she is very depressed. She reports that she only works and sleeps and has no hope of things improving. She frequently says, “Dying is the only way out.” The case of Bellah v. Greenson would compel you to:
A. Initiate a 5150.
B. Obtain a “self-care plan.”
C. Take reasonable steps to ensure her safety.
D. Contact friends for a 24-hour watch.
C. Take reasonable steps to ensure her safety.
This legal precedent demands that we take reasonable steps to ensure the safety of a suicidal client. It doesn’t say how it must be done.
You have been seeing a 22-year-old gay client for two years and treating him for depression. You get a call from his partner informing you that your client has committed suicide. Your best course of action would be to:
A. Inquire as to whether the partner has legal authority regarding the disposal of your client’s records.
B. Offer to take the partner as a client to help him process his feelings of grief and loss.
C. Hire an attorney regarding the suicide and make sure your notes on treating your client’s depression are up to date.
D. Maintain confidentiality and retain the client’s files for 7 years.
D. Maintain confidentiality and retain the client’s files for 7 years.
It is your legal responsibility to maintain confidentiality even after the death of a client. Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015).
A client you have been treating, who is also a social worker, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation?
A. You indicate to your client that she can give your number to the program coordinator.
B. You thank her for thinking of you, but you refuse the offer to avoid a dual relationship.
C. You tell her that you are interested and ask her to set up a meeting between you and the program coordinator.
D. You wait until you terminate therapy and then remind your former client of her previous offer.
A. You indicate to your client that she can give your number to the program coordinator.
This response is the best choice. By letting the program coordinator contact you, you can avoid exploiting the client in order to advance a relationship with the program coordinator.
Darius is a psychoanalytically-oriented social worker who prefers to be a “blank screen” and who, as a matter of theoretical orientation, prefers not to disclose personal information. When his clients ask him about his experience, education, training, or his ideas about the therapeutic process, Darius finds ways to avoid answering their questions. This way of handling client questions is:
A. Contrary to the spirit and intent of ethical standards.
B. Ethically appropriate but legally questionable.
C. More in tune with postmodern approaches to therapy.
D. A questionable application of psychoanalytic theory.
A. Contrary to the spirit and intent of ethical standards.
Ethical standards encourage social workers to disclose, at the appropriate time and in the context of treatment (such as when clients request the information), information about their education, experience, training, theoretical information, etc.
You have been seeing Jill and Dan, a couple in their mid-30s, for 2 months. Dan’s insurance has been paying a portion of their therapy. Dan informs you that he has been laid off from his job and is looking for work. The two complain of their finances. Jill works from home, running her own catering business. The couple would like to continue seeing you and ask if Jill could trade some services for their therapy. How would you handle this request?
A. Inform them that it would be unethical and help them find a way to pay for continued therapy.
B. Acknowledge their struggle and accept the arrangement.
C. Refer them to a financial counselor and discontinue therapy.
D. Refer them to a couples’ support group.
A. Inform them that it would be unethical and help them find a way to pay for continued therapy.
It is unethical to enter into bartering dual relationships with clients. It is also important not to abandon clients. This answer provides many opportunities to help the clients, including adjusting your fee.
A therapist who takes a Narrative approach begins to explain the risks and benefits of therapy. The client asks if this is part of the therapy, and the therapist agrees that it is. The therapist then asks the client, “what do you understand about how therapy is ‘supposed’ to be?” From an ethical standpoint, the therapist is:
A. Deconstructing the client’s dominant discourse.
B. Providing informed consent.
C. Avoiding cultural bias.
D. Externalizing the client’s ideas about therapy.
B. Providing informed consent.
From an ethical standpoint, the therapist is providing the client with information to help the client assess his/her desire to be in therapy, which is the intent of informed consent.
You have been treating Anita for three sessions for depression and relationship issues. You are considering a diagnosis of Major Depression and other DSM-5 diagnoses. You are not sure which is appropriate yet. Legally:
A. Do not treat the client unless your advertising indicates that you have expertise with depression or mood disorders.
B. Consider whether it is in your scope of competence to work with depressive disorders.
C. Change the diagnosis when you have confirmed it on any insurance forms.
D. Do not submit insurance billing until you have confirmed a diagnosis.
C. Change the diagnosis when you have confirmed it on any insurance forms.
To avoid fraud you would have to code the diagnosis you currently are considering and change it when necessary.
Parents of 7-year-old Todd bring him in because he told them an older kid at school pulled his pants down in the boy’s bathroom and laughed at him. They tell you that they also found harassing texts on their son’s cell phone from the same kid and some others. The parents demand that you evaluate Todd for mental anguish because they want to sue the school for allowing bullying on its premises. Legally, the social worker should:
A. Identify this as a form of sexual harassment but process it as child abuse.
B. Advise the parents to try talking with the school’s representatives before proceeding with any legal action.
C. Tell them that using their son’s “mental anguish” in a lawsuit could compromise their confidentiality in therapy.
D. Consider making a report to an agency designated to receive a child abuse report within 24 hours by phone and within 48 hours in writing.
C. Tell them that using their son’s “mental anguish” in a lawsuit could compromise their confidentiality in therapy.
Although you must avoid giving legal advice, you could tell the parents of the potential risks of introducing their son’s mental state in a legal proceeding, i.e., that it nullifies the privilege of therapy sessions with them and their son.
You are working as an associate therapist at a non-profit agency. As part of your treatment, you collaborated with a psychologist and conducted some assessment inventories to evaluate your client’s progress. Your client asks you how she scored on her depression test after being in therapy for six months. Your ethical responsibility in this case would be to:
A. Inform her of the results in language she can understand.
B. Give her a copy of every test she completed with a summary of scores.
C. Evaluate if telling her the test scores will disrupt the therapy.
D. Explain to her that she has the right to decline an assessment.
A. Inform her of the results in language she can understand.
Ethics require that therapists explain all of therapy, including assessments, in terms a client can understand.
An 18-year-old woman named Claire, states in her first session that she’s thrilled to be out of her home and to be away from “that monster of a father,” whom she says sexually abused her since she was 15. She tells you she has two younger siblings who still live at home. What is your legal obligation?
A. Maintain confidentiality.
B. File a child abuse report for the abuse that Claire suffered since 15.
C. File a report with CPS for reasonable suspicion of abuse for Claire’s younger siblings.
D. Ask Claire to sign an authorization to speak with her siblings to determine if they are safe.
A. Maintain confidentiality.
Claire is 18 and considered an adult. Thus, making a report would be breaching confidentiality. Social workers do not report historical abuse. Your legal obligation is to maintain Claire’s confidentiality.
This answer is very questionable.
As part of his telehealth practice, a social worker offers quick assessment surveys online to help potential clients decide if they want therapy. The surveys do not ask for any identifying information. The social worker has access to the results of the surveys but does not ask for the name of the consumer, to avoid the appearance of solicitation. This is legal if:
A. He provides referrals for any online survey respondents who are in a crisis.
B. He also offers the survey to current clients at no cost.
C. He advertises that the online assessments are consistent with DSM standards.
D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey.
D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey.
If any fees are associated with clinical practice, social workers are legally obligated to disclose them before providing a service.
Mr. Meltzer saw you for ongoing therapy for eleven months and still has an outstanding balance. You referred him to another therapist for clinical reasons, not related to his debt. He signed a release so that you can forward his record to his new therapist in another city. You proceed to:
A. Explain that you will forward his records when he pays the balance.
B. Ask his new therapist to collect the balance for you.
C. Release the records to a collection agency in order to obtain the balance.
D. Send his records as requested.
D. Send his records as requested.
Sending his records is the correct answer. Mental health professionals do not withhold patient records or information solely because the practitioner has not been paid for therapy services.
You are working as an intern at a non-profit agency. Your client of the past year has made substantial progress and the two of you enjoy a close relationship. You are now ready to leave the agency and will not be available to continue treatment with this client. Your ethical responsibility in this case would be to:
A. Make appropriate referrals.
B. Since she knew that you were a registered associate when she started therapy, tell her that this type of termination is part of the licensing process.
C. Explain to your client why you cannot continue treatment with her.
D. Tell her that you will be able to meet her for coffee now that she is no longer officially your client.
A. Make appropriate referrals.
Making appropriate referrals is the ethical course of action when a social worker is unable to provide services.
Before accepting a client for telehealth services, what action should the social worker take?
A. Determine the appropriateness of treating a client remotely.
B. Determine if the client is a resident of California.
C. Describe the risks, such as confidentiality risks, of internet therapy.
D. Provide detailed informed consent about the social worker’s experience or limits of experience with telehealth.
B. Determine if the client is a resident of California.
The social worker must conform with the law, which requires that the client reside in the state of California.
You have been seeing a couple for several months. The therapeutic issues have focused on communication and trust. You receive a call from the husband who tells you that he has bought a gun “to protect my family from all of the violence out there.” Since his wife is firmly against possessing guns, he has decided not tell her. You would:
A. Remind him of your no secrets policy and encourage the husband to tell his wife about the phone call and the gun.
B. Not bring up the content of the phone call since you’ve established that he is not intending to hurt his wife or children. This does not constitute a Tarasoff situation.
C. Focus on the issue of trust in their marriage which will encourage the husband to tell his wife.
D. Inform him that you do not keep secrets. You assume that he wants his wife to know or he would not have told you. Therefore, if he does not tell his wife in the next session, you will inform her of the conversation.
A. Remind him of your no secrets policy and encourage the husband to tell his wife about the phone call and the gun.
Reminding him of your no secrets policy is the only answer that implies that you have informed your clients of a no secrets policy and it focuses clearly and correctly on how to resolve this therapeutic issue.
During a session with a couple in their 70’s, you notice the man has a bruise on his head, and the woman tearfully admits that she loses her temper and hits him with pots and pans. In clinically managing the legal issue of elder abuse, how would you proceed?
A. Call up an agency designated to take such a report, with the two in the room, arrange for respite care, teach anger management, and create a “no violence plan.”
B. When the two are not in the room, call up an agency designated to take such a report, follow it up with a written report within 2 working days, create a “no violence plan,” and refer to a support group.
C. Create a “no violence plan,” teach time-outs, arrange for a support group, and if those interventions don’t work, call an agency designated to take such a report.
D. Call up an agency designated to take such a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a “no violence plan.”
D. Call up an agency designated to take such a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a “no violence plan.”
This answer contains the basic steps you must take when you know of or have reasonable suspicion of elder abuse, and it shows good clinical management in processing any feelings your clients might have about their social worker filing a report.
Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae’s school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook’s speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night so that he can drink some sho-chu to unwind. Chong-Wook tells you that “the fee won’t be a problem; the fee is covered under the overall adoption agreement.” What are your ethical obligations?
A. Determine the family’s understanding of the purpose of the therapy and refer for an academic assessment.
B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session.
C. Determine the identified patient and refer to a pediatrician.
D. Tell Chong-Wook and Dae-Sup the fee at the first session and explain that you may need to consult with the school counselor and adoption agency.
A. Determine the family’s understanding of the purpose of the therapy and refer for an academic assessment.
Ethically, you would want to clarify the client’s purpose. Since the referral was from the school, it could be in the client’s best interests to assess the needs there.
Rhonda, a 22-year-old college student, comes to therapy looking for advice. She says her boyfriend hit her last week and now she knows she should leave him, but it’s very hard to do. In the past she has told him she didn’t want to see him anymore, but she always gives in when he calls to get together again. She finds herself saying, “just one more time.” She hates being alone and ends up seeing him for companionship. At the end of the session, she asks you if therapy is going to be able to help her. What is your next step?
A. Provide a safe holding environment.
B. Explain the pros and cons of therapy.
C. Join with her concerning her fears.
D. Have her join a singles support group.
B. Explain the pros and cons of therapy.
This question is asking you to respond to a client’s inquiry about whether therapy will be helpful. Explaining the costs and benefits of therapy addresses this concern.
