Quizlet LCSW Law & Ethic Practice Test 2 Flashcards
To prepare clients for termination, a social worker schedules sessions every other week and then once a month. Over time, he finds that clients cancel their monthly sessions. Some clients just stop calling entirely without making a monthly appointment. Which of the following would NOT be an ethical concern related to the termination process?
A. Formally terminate with no-show clients.
B. Provide informed consent before changing the session frequency.
C. Assess whether the infrequent sessions are in the client’s best interests.
D. Offer a sliding fee for the intermittent sessions.
D. Offer a sliding fee for the intermittent sessions.
There is no legal or ethical requirement to slide fees as part of termination.
Guidelines regarding advertising state that social workers must advertise in a way that is honest and not misleading. Which of the following is a true statement regarding advertising policies?
B. The advertisement must indicate the full name of the licensee and the complete license number.
It is a legal requirement that the LCSW’s full name and license number or associate’s registration number be on the advertisement.
The parent of a child on your child’s baseball team is a doctor and wants to send a client to you. On the sidelines, you and this parent often talk about the relationship between illness and how family dsyfunctions develop around those illnesses. The doctor is impressed by your insight and asks for your card. You would:
A. Agree to see his referral.
B. Not see his referral because this constitutes a dual relationship.
C. Assess whether it would affect your child and the doctor’s child.
D. Not see the potential client but refer to a colleague.
A. Agree to see his referral.
Ethically, you could agree to see this referral. An acquaintance who refers business to you would not constitute a dual relationship.
You have been working for seven months with a young adult who has recently become very involved with a Nazi skinhead group. You have strong feelings about the detrimental effects such an affiliation can have and will need to:
A. Address your concerns with the client without contaminating the therapy.
B. Discuss the case with your colleagues and get consultation in order to manage your personal bias.
C. Evaluate whether or not you can continue to work effectively with this client.
D. Refer this client out since your bias will get in the way of her progress.
C. Evaluate whether or not you can continue to work effectively with this client.
The first priority is to determine if you can work effectively with the client.
Maxwell, age 46, is referred to you by his EAP because he is depressed and drinking daily on the job. He witnessed a train wreck 3 weeks ago in which several people were killed. Now he says he is terrified to leave the house without a couple of drinks to calm him down. He says that every time he hears a loud noise he feels faint, and he wakes up sweating and shaking. What action would the social worker take?
A. Determine the client’s ability to respond to anxiety treatment interventions.
B. Evaluate the client’s need for a crisis intervention,
C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions.
D. Tell him that his treatment will be confidential as it pertains to his EAP.
C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions.
Ethically, you cannot avoid informed consent even in a crisis. So it would be ethical to give the client the legally required information and meet any crisis needs immediately.
All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT:
A. Filing a child abuse report.
B. Ensuring safety for a suicidal client.
C. Responding to a CPS caseworker’s request for family history following a child abuse report.
D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle.
C. Responding to a CPS caseworker’s request for family history following a child abuse report.
A social worker is not permitted to respond to a CPS caseworker’s follow-up inquiries without a written request if the request does not specifically pertain to the child abuse report.
A social worker is becoming increasingly concerned that one client, who is acutely suicidal, is not improving. The social worker has suggested that the client speak with people in his life who might be supportive and be able to help, but the client only wants to speak with the social worker. The social worker is concerned about boundaries if she speaks with the client as often as he needs, which is at least once day. The client has threatened to leave therapy entirely if the social worker keeps suggesting outside support. Ethically, the social worker should:
Content Area: Ethics: Therapeutic Relationship/Services
This question pertains to ethical aspects of termination.
A. Tell the client directly the social worker’s concerns if the client does not return to therapy.
B. See the client at least once a day to prevent harm and imminent risk.
C. Terminate with the client and have him involuntarily hospitalized.
D. Allow the client to terminate if the social worker is unable to provide adequate support.
A. Tell the client directly the social worker’s concerns if the client does not return to therapy.
Ethically, the social worker is obligated to have a direct informed consent conversation with a client, even clients who are acutely symptomatic.
Maya, a 15-year-old emancipated minor, comes in to see you without parental consent. She tells you that last week her 20-year-old husband, Oliver, raped her when she refused to have sex with him. She’s been feeling depressed and disoriented ever since this happened. Which of the following would represent the correct legal analysis of this situation?
Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of child abuse reporting laws.
A. Since Maya is depressed and disoriented, you can treat her without parental consent.
B. Since Maya is married the rape would represent spousal abuse and you would have an ethical responsibility to ensure her safety.
C. Since Oliver is only 5 years older than Maya, Oliver’s actions would not constitute lewd and lascivious behavior.
D. Since Maya is 15 years old, the rape would constitute child abuse.
D. Since Maya is 15 years old, the rape would constitute child abuse.
Although Maya is an emancipated minor, she is only considered an adult in certain legal circumstances. As a minor, a social worker is required to report abuse, which rape clearly is.
A male client comes to see you for the first time. As he talks, you begin to realize that he is definitely going to harm someone. He has a plan and is going to act, but he has not identified his intended victim to you yet. Just as he is about to tell you the identity of the name of the intended victim, you realize that you have not explained to him the limits of confidentiality:
A. Tell him to stop and refer him to someone else.
B. Wait until he identifies the intended victim and then explain the limits of confidentiality, as you must do as part of obtaining informed consent.
C. Ask him to stop and explain to him the limits of confidentiality as part of informed consent.
D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.
D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.
This is what you would have to do. At this point, the well-being of the intended victim outweighs the ethical concerns about informed consent.
You are working with a client who has expressed suicidal thoughts. You see the client once every two weeks because he does not have insurance. He uses your sliding scale and sometimes texts you between sessions. Which of the following steps would be considered reasonable in fulfilling the duty to ensure the safety of a suicidal client?
A. Schedule extra sessions with your client.
B. Obtain the client’s promise not to harm him/herself until you meet again and use a “self care” contract to reinforce the promise.
C. Give the client the number of the suicide prevention hotline.
D. Explore your client’s support network.
B. Obtain the client’s promise not to harm him/herself until you meet again and use a “self care” contract to reinforce the promise.
If a client promises, in writing, not to harm him/herself until your next meeting, and the social worker reasonably believes that the client agreed in good faith, this would be a reasonable step to ensure the client’s safety.
Social workers are required by law to comply with certain legal standards in the state in which they are licensed. All of the following are legal issues EXCEPT:
A. Suicide.
B. Asking your client, who is a contractor, for information about drywall.
C. Setting a fee.
D. A dependent adult who states that his prescribed seizure medication has not been dispensed by his care custodian.
B. Asking your client, who is a contractor, for information about drywall.
Engaging in a separate and distinct relationship either spontaneously, within a therapeutic relationship or after a reasonable period of time following the termination of the therapeutic relationship, constitutes a dual relationship. This is an ethical issue.
Lisa, age 43, is going through a bitter divorce. She brings her only child, Jamal, age 8, for therapy at the request of his school counselor. He was caught cheating on a test and lied about it to the teacher, the principal, and his mother. As you gather history, Lisa keeps revisiting the injustices of her having to “pay for HIS bad parenting.” When you question her further, she rails about how her ex-husband spoiled Jamal by giving him everything, never backing her up with discipline, etc. She says, “He’s such a jerk. And now he lives in a nice condo and I’m stuck in this dingy little apartment with this dishonest, ungrateful kid. I just can’t believe I have to do this. I can’t afford therapy and, I don’t want to be schlepping him over here every week.” What is the best way to proceed regarding her concern about paying your fee?
A. Consider offering to see Jamal on a sliding scale or pro bono basis.
B. Ask Lisa if she’d like you to call her ex-husband to get some of the payment from him.
C. Tell Lisa that she doesn’t have to pay for therapy because you’ll see her on a pro bono basis.
D. Have Lisa sign a release for you to confer with her ex-husband regarding the fee.
A. Consider offering to see Jamal on a sliding scale or pro bono basis.
This is the most ethical choice. Considering whether to see Jamal on a sliding scale or pro bono basis would address Lisa’s apparent financial stresses and allow Jamal to get needed treatment.
The Humburgs come to counseling with their 16-year-old son, Cameron, because they found drugs in his room. They don’t want the other two children, ages 9 and 11, to know. They want you to suggest some strategies to help Cameron overcome this problem. Ethically, you would:
A. Give them time to adjust to therapy since this is their first session and see just the three of them.
B. Tell them that you are a Family Systems therapist and the other children should be included.
C. Tell them that it would be outside of your scope of practice as a systems therapist to exclude the other two children.
D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them.
D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them.
Ethically, you have to explain the parameters of therapy.
You have been seeing Marsha, 11, with the consent of her mother, Jan. Jan is requesting a copy of Marsha’s therapy notes because she wants to provide them to the school counselor. Under which of the following conditions can you refuse Jan’s request?
A. Marsha will not sign an authorization to release the information to her mother.
B. The content of the therapy notes may have a harmful effect on Marsha’s psychological well-being.
C. Jan wants you to produce a copy of the records within 3 weeks time.
D. You don’t feel comfortable breaching Marsha’s confidentiality.
B. The content of the therapy notes may have a harmful effect on Marsha’s psychological well-being.
If releasing the content of therapy notes will result in a negative impact on the minor’s physical safety and/or psychological well-being, then the social worker has a right to refuse a parent’s inspection of the records.
Mrs. Moran is referred to you by a former client. On the phone she refers to you as “Dr.,” although you do not possess this degree or license. It is apparent to you that Mrs. Moran is quite depressed. How would you handle this situation?
A. Inform Mrs. Moran of your license status once her mood has stabilized and she is in a better mental state to understand and evaluate this information.
B. Refer Mrs. Moran to a doctor since her statement indicates that she is seeking the services of a psychologist, psychiatrist, or M.D.
C. Give Mrs. Moran your business card which will provide her with your accurate qualifications.
D. Inform Mrs. Moran of your license and qualifications.
D. Inform Mrs. Moran of your license and qualifications.
Ethical standards require social workers to correct inaccurate representations of their licensing status and professional qualifications. There is no reason not to inform Mrs. Moran of your licensing status simply because she is “quite depressed.”
Matthew, age 40, and Delilah, age 27, have been married for 8 months and have been referred to you by the pastor of their church. Delilah says, “It’s like I keep marrying the same man. Just like my 2 ex’s, he flies off the handle at the drop of a pin, and I don’t like the way he disciplines the kids.” Matthew says, “She needs to listen to me about how to raise children and seriously adhere to Biblical teachings.” How would you manage your scope of practice obligations in light of the domestic violence?
Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of working within the scope of practice to assess the safety of clients.
A. Establish your right to break confidentiality to prevent domestic violence.
B. Explain that there are exceptions to confidentiality, including the reporting of child abuse.
C. Question Matthew and Delilah separately about possible domestic violence.
D. Do not confirm nor deny to the pastor that Matthew is or is not your client.
C. Question Matthew and Delilah separately about possible domestic violence.
Scope of practice obligations requires that you conduct therapy and safety assessments in a way that meets the standard of care.
You witness a mother abusing her child in a shopping mall.
A. Ethically, you should report the child abuse.
B. Legally, you do not have to report the abuse.
C. You will be in violation of ethical standards if you do not report to the police or child protective service agency.
D. Legally, you must report the abuse by phone and follow up with a written report within 36 hours.
B. Legally, you do not have to report the abuse.
This answer is the most accurate. You do not have to report child abuse if you learned of it outside your professional capacity.
During your intake interview, you learn that your client is a lawyer. As you discuss the limits of confidentiality, the client asks, “can you plead the Fifth like I can in court?” As you consider your answer, you consider some hypotheticals. Privilege might be waived in which instance?
A. A client is a 13-year-old girl, who you are seeing without parental consent, and has been selling drugs.
B. A client has told you he has been involved in hacking a corporate database under an assumed name.
C. A client accused of assault and battery uses insanity as a defense in court.
D. A 64-year-old woman complains to you that her bank is making automatic withdrawals without permission.
C. A client accused of assault and battery uses insanity as a defense in court.
If insanity is used as a defense for a crime, then the client may have waived his or her right to privilege.
Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed?
A. Maintain Roger’s confidentiality.
B. Warn the manager of the factory because this is analogous to a Tarasoff situation.
C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision.
D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.
D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.
The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a “right” to warn when property is threatened.
Your client, Barbara, has been unemployed for three months. In her last session, she stated that she plans to kill her ex-boss tomorrow because he’s the cause of all her unhappiness. You call the police to alert them to Barbara’s plan, but they don’t seem to take you seriously because there isn’t a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would:
A. Document your phone call outlining your concerns and justifying your actions in order to cover your liability.
B. Have Barbara come in immediately for crisis counseling.
C. Call Barbara’s ex-boss and warn him of her plan.
D. Call Barbara and find out if she has a gun so you can tell the police.
C. Call Barbara’s ex-boss and warn him of her plan.
Warning the victim may be done in the interests of protecting the public and protecting the social worker from liability related to breaking the confidentiality of the potentially dangerous client. As of 2014, there is only a legal responsibility to contact law enforcement within 24 hours. After doing that, warning the potential victim is next.
Jeannie and Chuck Jones and their two children, Brooke and Josh, have been seeing you for family counseling for 6 weeks when they come to see you right after a “big family fight.” You notice a rip in Josh’s clothes and Brooke’s red eyes leads you to believe she has been crying. You separate the family and gather a lot of information about the fight. Which statement would NOT lead to a child abuse report?
A. Josh tells you his father tried to push him into a cold shower, and his clothes ripped pulling away.
B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach.
C. Josh tells you his Dad was also trying to lock him in the closet.
D. Brooke tells you her Dad repeatedly said she was stupid.
Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach.
Jeannie telling you that after the fight with the children, her husband and her got into another fight alone in the bedroom, and he punched her in the stomach, would not be reportable. It is not clear that the children witnessed the spousal abuse since it occurred alone in the bedroom, and/or that they had any emotional distress specific to it.
A client comes to his session with his 72-year-old father, who uses a walker from a fall which he reports was caused by a fight with his wife. The father tells you that his wife has been stealing his social security checks each month and gives him only $5.00 a week. At this point you should:
A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse.
B. Call Adult Protective Services and report the financial abuse and “undue influence.”
C. Explore possibilities for alternative living arrangements with the father and address the feelings both he and your client may be feeling due to this trauma.
D. Report the financial abuse, even though it is optional, since the victim and your client have requested your assistance in this matter.
A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse.
You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are:
A. Legally bound to report.
B. Ethically responsible to notify family or “others responsible for the client’s well-being.”
C. Legally responsible to intervene.
D. Not responsible in any way as the client has a right to make his/her own decision.
C. Legally responsible to intervene.
A clinician is not legally responsible to report a suicidal client, but is legally responsible to take reasonable steps to ensure the safety of a suicidal client which can be managed in a number of ways. Evidence Code 1024 allows clinicians to break confidentiality when a client, due to a mental disorder, is a danger to self or the property of another and breaking confidentiality would prevent the threatened harm.
Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria?
Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions that define a person as being gravely disabled.
A. Command auditory hallucinations telling the client to kill other people.
B. Command auditory hallucinations telling the client to kill him or herself.
C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.
D. Choosing to be homeless.
C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.
A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled.
Your 15-year-old client comes to session extremely agitated because she just found out that a photo she sent to her boyfriend is now circulating all over the school. She is getting harassing comments about her appearance and sexual promiscuity. She is afraid that the school will contact her parents if she reports the harassment to school authorities. How do the laws pertaining to bullying direct your actions as a social worker?
Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate interventions with a minor.
A. You may speak with the school, or they may speak to you without a release.
B. You must report to the school authorities, but you are not required to report to the police.
C. You may advise your client about her reporting requirements.
D. You may tell your client about the laws pertaining to cyberbullying.
D. You may tell your client about the laws pertaining to cyberbullying.
You may tell your client about the laws regarding cyber-bullying. The laws about bullying define bullying (e.g., face-to-face or digital harassment, threats, persecution, etc.) and what the school district is permitted to do. You may not give legal advice because that would be out of your scope of practice.
After completing a three-month course on hypnotherapy, you decide to advertise your new specialty. You receive a call from Christopher, who says he would like to come in for a session, so that you could hypnotize him to stop smoking. He says he’s tried the patch and nicotine gum, but he needs your help to quit once and for all. How would you respond to Christopher’s request for treatment?
Content Area: Law: Legal Standards for Professional Practice. This question deals with scope of practice for mental health professionals.
A. Make an appointment because hypnotherapy is now part of your scope of competence.
B. Inform him of your fee before the commencement of treatment.
C. Refer him to a medical doctor.
D. Tell him that you will not be able to help him quit smoking.
D. Tell him that you will not be able to help him quit smoking.
Using hypnotherapy to help Christopher stop smoking would have to be within the context of therapy, and not as a stand-alone treatment. Otherwise, it is outside the scope of practice.
A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have:
A. Expressed your gratitude in an appropriate and professional manner.
B. Not acted unethically or illegally since you did not solicit the referral.
C. Not acted unethically or illegally since you did not directly pay the colleague for the referral.
D. Acted unethically and illegally.
D. Acted unethically and illegally.
Although the gift is not substantial in value, social workers are prohibited by law and ethical standards from accepting or providing any kind of remuneration for referrals.
Your client has two children and is divorced. She tells you that when she arrived at her ex-husband’s house last night to pick up the children, he had locked the doors and texted her that, “Me and my children are moving across the country.” He has no criminal history, but she is afraid she will never see her children again. Which of the following is the clinician’s first intervention?
Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of when to make referrals for expertise outside of your scope of practice.
A. Advise her to call Child Protective Services for abduction.
B. Explore the events immediately preceding this one.
C. Call the police.
D. Advise her to call her lawyer.
D. Advise her to call her lawyer.
Your only obligation in this situation is to maintain confidentiality and assess for a possibility of a crisis interventions. If the client is not afraid that the father will harm the children, she needs to call her lawyer to pursue legal options.
Your client works as a pilot and often misses appointments because she is called out-of-town at the last minute. When billing her insurance, you:
Content Area: Law: Legal Standards for Professional Practice. This question evaluates your knowledge of appropriate ethical guidelines for insurance billing and insurance fraud.
A. Note carefully which sessions the client actually attended.
B. Must not include missed sessions on the bill since insurance will not pay for these.
C. May not commit insurance fraud by noting which of the sessions were canceled within your 24 hour limit and which were canceled at the last minute.
D. May remind her she will have to pay for missed sessions herself.
A. Note carefully which sessions the client actually attended.
It is vital to clearly note which sessions were missed on the bill (which will be sent to the insurance company), or this is insurance fraud.
Rob, a 27- year-old African American male, and Cynthia, his 24-year-old Mexican American girlfriend, have decided to live together after six months of dating. Cynthia asked Rob to participate in therapy, and Rob agrees to attend one month of therapy in order to “try it out.” During the first session, Cynthia softly reports that Rob cannot control his anger. Rob quickly turns to Cynthia and shouts, “You’re the one that’s too sensitive!” When creating a safety plan with Cynthia, you would do all of the following EXCEPT:
Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal obligations to assess a client’s safety and treat the client within your scope of practice.
A. Make yourself available by phone and increase the frequency of sessions.
B. Provide a list of addresses and phone numbers to local shelters, emergency housing agencies, and crisis centers.
C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them.
D. Advise Cynthia to gather important items in one place (i.e. extra set of car keys, debit and credit cards, medical records and prescription refills, etc.).
C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them.
Including Rob in the creation of the safety plan and possible emergency escape plan would only put Cynthia at risk. Rob’s knowledge of these plans may lead to a violent reaction from Rob.
A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would:
Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist’s boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship.
A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations.
B. Contact the therapist to discuss the legal/ethical consequence of his actions.
C. Assess for further boundary violations.
D. Contact the BBS to report the therapist’s inappropriate actions.
C. Assess for further boundary violations.
Assessing for further boundary violations would be important in order to determine the extent of boundary violations and if there had been any sexual contact between the therapist and your client.
A man calls you to ask about his wife’s therapy bill since she has been using his insurance. He asks if you can provide copies of the previous three months’ bills because the insurance company has lost them. Upon hearing his request, you:
A. Send a copy of the bill since it is his insurance.
B. Call his wife and ask if she would like you to send him a copy or if she would prefer you send it addressed to her.
C. Tell him you cannot confirm or deny that his wife is your client.
D. Give his wife the bill copies at her next session.
C. Tell him you cannot confirm or deny that his wife is your client.
Whenever anyone calls asking about anyone other than themselves, it is vital to not reveal any confidential client information.
A female social worker who is having problems in her own marriage finds that she is consistently siding with the wife in couples therapy. Ethically, the social worker’s primary obligation is to:
Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to meet client needs when negative counter-transference could impact objectivity and client welfare.
A. Obtain supervision to address counter-transference.
B. Discontinue conducting therapy until her own marital problems are resolved.
C. Attempt to balance treatment by siding with the husband.
D. Call in a co-therapist to monitor the therapist’s behavior.
A. Obtain supervision to address counter-transference.
The ethical obligation, when a therapist is unable to maintain objectivity, is to seek supervision or consultation.
Which of the following scenarios describes a social worker’s legal duties regarding the use of telemedicine?
Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of the difference between legal and ethical responsibilities.
A. A social worker bills an internet client the fee before starting therapy.
B. A social works breaks confidentiality because an internet client is engaging in child abuse.
C. A social worker provides a client a copy of the informed consent document to download and return with a signature.
D. Referring a client to a CPS website if the client reports child abuse.
B. A social works breaks confidentiality because an internet client is engaging in child abuse.
Breaking confidentiality when making a mandated child abuse report is a legally required obligation, not an ethical decision or responsibility.
A couple, whose children have all graduated from high school, is considering adopting an elementary school-age child. They believe that a child who has not yet been adopted would do well in their household, and they want to give back to society. How should the social worker approach this couple’s decision?
A. Advise them on the cultural implications of adoption.
B. Assess for a phase of life problem.
C. Obtain consultation about adoption.
D. Refer if the couple has reached the original treatment goals.
C. Obtain consultation about adoption.
Getting consultation is a potentially useful thing to do when client presents a new issue.
A person calls telling you that she is your client’s conservator. Your client is physically disabled and has told you about the challenges associated with being under conservatorship. The client tells you that she hates not being able to make her own decisions. How do you manage your ethical obligations related to informed consent?
A. If you have any concerns for the client’s safety, tell the conservator about the limits of confidentiality related to dependent adults.
B. Determine the type of conservatorship. LPS conservatorships allow the conservator to consent to treatment.
C. Tell the conservator about your mandate to report dependent adult abuse.
D. If you have any concerns for the client’s safety, tell the client about the limits of confidentiality related to dependent adults.
D. If you have any concerns for the client’s safety, tell the client about the limits of confidentiality related to dependent adults.
If you have concerns about a dependent adult’s safety, you are legally and ethically obligated to inform the CLIENT about the limits of confidentiality. Although “Consent To Treat” came from the conservatorship, the client’s rights to confidentiality are still relevant.
Angelina, a 20-year-old college student, comes to see you complaining that she’s having difficulty breathing and concentrating, and that she thinks it’s “all in her head.” Angelina says she was date raped three weeks ago and says you are the only person who knows. She hasn’t told her parents and doesn’t want them to know about it. Angelina says, “Please help me. I can’t take this anymore.” She tells you that her parents have told her that they will pay for her therapy. How would you manage the legal issue of payment?
A. Explain the limits of confidentiality if a third party is paying for therapy.
B. Consider offering Angelina a lower fee so that she can pay for her own therapy.
C. Talk to Angelina about whether she wants her parents to pay for therapy.
D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement.
D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement.
Angelina is an adult in therapy. Your legal obligation is to collect your fee and allow the client to determine how she will get paid.
A client who has been in individual therapy wants to bring her children for therapy. The first thing a social worker must do if the social worker agrees to see the children with their mother is:
A. Change the unit of treatment.
B. Provide informed consent.
C. Talk about the risks and benefits of family therapy.
D. Refer the daughter to an individual therapist.
B. Provide informed consent.
Before changing the unit of treatment, which is including the children in this vignette, the social worker would need to provide informed consent with the primary client.
Cathy is a 28-year-old clerk who works in a department store. A social worker has been seeing Cathy, her 7-year-old son, and her 5-year-old daughter in therapy for a month. She never married her children’s father, Bob, who calls “once in a blue moon” requesting to spend time with the kids or will arrive at the door with presents. She receives no support from him and doesn’t want to ask him for money because she feels that he will want to visit them more if she does. If Bob subpoenas the children’s therapy records, what would be the most appropriate move for the social worker to take?
A. Keep the records confidential and make an appointment with Bob to discuss his concerns.
B. Indicate to Bob that you can only release the records if Cathy signs a release form.
C. Determine whether the subpoena came from an attorney or the court.
D. Keep the records confidential and alert Cathy of the subpoena.
D. Keep the records confidential and alert Cathy of the subpoena.
Since Cathy and the children were seen conjointly, the records include confidential information regarding Cathy. Therefore, the best option would be to keep the records confidential and let Cathy and her attorney decide how to proceed.
During the week you get a call from a concerned mother. She tells you that her 15-year-old son, Aaron, who is in therapy with you, sometimes talks with a gang member on the phone. Today she accidentally picked up the phone and overheard the gang member saying that he is going to kill Aaron. Legally, how would you proceed?
A. Treat the situation as a Tarasoff case.
B. Report the information to the police.
C. Maintain Aaron’s confidentiality.
D. Let Aaron know his mother called.
C. Maintain Aaron’s confidentiality.
Maintaining confidentiality is the only legally correct action of the answers provided here.
A man is in therapy, and he is pleased with the way it is going. He refers his wife to his therapist. What should the therapist do in this situation?
A. Encourage his wife to come in for conjoint therapy.
B. Turn down the referral and suggest other clinicians.
C. Wait until his therapy is done before accepting his wife as a client.
D. See the wife individually until you have established a therapeutic alliance, then if the couple desires, see them conjointly.
B. Turn down the referral and suggest other clinicians.
Because a relationship has already been established with the husband, it is best to refer his wife to another therapist.
A social worker was recently hired at an agency that specializes in work with victims of domestic violence. The agency policy states that the social worker must not include any mandated information in the client’s file because it puts the children at risk of stigma if their files are ever subpoenaed. The social worker is responsible for:
A. Speaking with an outside consultant to determine the best course of action.
B. Reporting the agency to the BBS because other colleagues may act unethically or illegally as a result of this policy.
C. Developing a safety plan with the mother.
D. Including a child abuse report in the file if one is made.
D. Including a child abuse report in the file if one is made.
Whatever the agency policy is, a mandated breach of confidentiality must be included in the client’s file. A child abuse report may be kept separate from the treatment file to preserve the child’s confidentiality, but it cannot be omitted entirely.
A client you have been treating for 3 months is suing you because her online therapist told her that she has undiagnosed Bipolar I Disorder. You did not know that she was also pursuing online treatment from a different therapist. She is claiming emotional distress as a result of your negligence in diagnosing and treating her. Would ethics standards allow you to terminate this client?
A. Yes, because she is seeing another therapist and you must avoid exploitation.
B. No, because you continued to treat her without asking about another therapist.
C. Yes, because she is seeing another therapist who has a better scope of competence.
D. No, because she is suing you and you must avoid negative counter-transference.
A. Yes, because she is seeing another therapist and you must avoid exploitation.
In general, social workers are ethically allowed to terminate if a client who needs care is getting it, and duplication of care would exploit the client.
A reality-oriented, high-functioning client tells you she has been following a company’s stock for a number of years and the company’s stock price is several points below the company’s book value. She tells you the company’s profits should double in the next two quarters due to a return on recent expansion. You would:
Content Area: Ethics: Professional Competence and Preventing Harm. This question reviews the ethics of acting on financial investment information obtained in a therapeutic setting.
A. Legally not be able to purchase the stock because you received the information in confidence.
B. Legally not buy the stock, but you could advise your friends to do so.
C. Not buy the stock because of ethical considerations.
D. Buy the stock, but only without the client’s knowledge.
C. Not buy the stock because of ethical considerations.
Ethically, you would not buy the stock because this information was revealed to you in your professional capacity. Clinically, the potential for powerful counter-transference threatens your therapeutic relationship.
A 13-year old named Colleen leaves you a voicemail asking if you’ll be her social worker. Before treating Colleen without parental consent, you need to determine that all of the following factors are present EXCEPT:
Content Area: Law: Confidentiality, Privilege, and Consent
This question reviews the situations where a minor can receive therapy without parental consent.
A. Colleen has a history self-harm.
B. Colleen is at least 12 years old.
C. There is a good reason not to include Colleen’s parents.
D. Colleen is mature enough to participate in therapy.
A. Colleen has a history self-harm.
Although a history of self-harm may be a valid clinical reason to treat a minor without parental consent, this is not a legal requirement. Social workers may treat a minor 12 or older without parental consent if the minor is mature enough to participate intelligently in therapy. There is no longer a requirement for the minor to be a victim of child abuse or a danger to self or others in order to receive treatment without parental consent.
As part of her telehealth practice, a social worker offers quick online surveys to help clients decide if they want therapy. The surveys ask standard questions for typical diagnoses. One day a client asks for an in-person session because the test suggested that her child has AD/HD. How should the social worker proceed with informed consent?
Content Area: Ethics: Therapeutic Relationship/Services
This question tests how you would provide informed consent from an internet referral.
A. Discuss the fee for a complete AD/HD assessment.
B. Discuss the limits of confidentiality related to an online assessment.
C. Have the client sign a release authorization to discuss the online survey.
D. Explore whether the client wants you to assess her child for AD/HD.
D. Explore whether the client wants you to assess her child for AD/HD.
The client found you due to your online assessment; clarifying its relationship to in-person treatment would be an ethical way to proceed.
Molly brings 13-year-old Marvin to your office and indicates that she believes the boy is depressed and needs therapy. She indicates that she is Marvin’s legal guardian, and that she has consulted with the father, who also wants therapy for Marvin, and says he is willing to cooperate in any way necessary to see that Marvin gets treatment. How would you proceed in obtaining consent to treat Marvin?
Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge about consent to treat a minor.
A. Consent is not necessary since Marvin is over the age of 12 and is depressed.
B. Obtain consent from Marvin’s father since he wants therapy for Marvin and has indicated a willingness to cooperate with his treatment.
C. Obtain consent from Molly since she is the legal guardian.
D. Ask to see the custody papers to determine who should sign for consent to treat Marvin.
C. Obtain consent from Molly since she is the legal guardian.
You would obtain consent from Molly since she is the legal guardian.
A therapist is leaving for vacation and has referred all of her clients to you. On the day before your colleague is set to leave town, one of her clients calls you and says that she is in crisis and needs to be seen tomorrow. She adds, “my therapist told me that I could call you if I thought seriously about killing myself. Well, it feels pretty serious.” Your ethical priority is to:
Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to intervene ethically in a potential crisis.
A. Notify the referring therapist of the client’s treatment needs.
B. Tell the client to call her therapist who is still available in town.
C. Provide the client with a crisis number hotline until you are “on duty” for these clients.
D. Ask her to get you quickly up to date on her general treatment so far.
Ask her to get you quickly up to date on her general treatment so far.
Ethics require an action directed toward the client’s immediate safety. You would need to know how “serious” her situation is before determining the next step.
Zach comes to his session angry and upset after witnessing a scene at his tennis club where he observed Ludwig Babcock, a tennis trainer, slap a child several times. Zach says that his son told him Ludwig often hits students, but that this is Ludwig’s way of preparing the students for competition. After you hear Zach’s story, you would:
Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse and reporting requirements.
A. Support Zach in expressing his feelings of anger and sadness since neither the alleged perpetrator nor the alleged victim is your client.
B. Urge Zach to call Child Protective Services and report child abuse.
C. Maintain confidentiality since there is no evidence that the students are injured by the slaps and hits.
D. Report child abuse to the police.
D. Report child abuse to the police.
Mandated reporters must report knowledge or reasonable suspicion of the abuse of any child if they hear of it in their professional capacity. The description of an adult who has authority over children regularly hitting them would constitute, at the very least, a reasonable suspicion of child abuse and would therefore, mandate a report to the police.
A social worker terminates treatment with a client after six months of therapy. The client files a complaint about this. In order to demonstrate that the social worker had sound reasons for deciding to terminate the treatment, all of the following could be acceptable reasons for terminating EXCEPT:
Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical parameters on treatment termination.
A. The client has failed to pay a debt of $700 in unpaid fees despite warnings from the social worker that termination could result.
B. The social worker wants to change the focus of his or her practice and only treat “high functioning” clients.
C. The social worker realizes that the client is involved in a sexual relationship with the social worker’s ex-partner.
D. The social worker has been unable to resolve strong emotional reactions to the client who reminds the social worker of his/her mother.
B. The social worker wants to change the focus of his or her practice and only treat “high functioning” clients.
Deciding to change the focus of practice would not be sound ethical or clinical reasons for deciding to terminate treatment with an ongoing client.
You negotiate a fee with your new client Chetwyn, who asks if his insurance company will pay for the sessions. You tell him that having worked with this company in the past, you’re certain that they will pay for your work together. When you receive a check from the insurance company, only half the sessions are reimbursed because you have been meeting with Chetwyn twice a week. You would:
Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical standards pertaining to fees and insurance billing.
A. Bill Chetwyn for services provided that the insurance company did not cover.
B. Forego payment because you did not adequately explain the process of fee collection and insurance billing to Chetwyn.
C. Advocate for full coverage of Chetwyn’s mental health treatment with the insurance company.
D. Explain to Chetwyn what happened and inform him that he is responsible for any fees not paid by his insurance company.
B. Forego payment because you did not adequately explain the process of fee collection and insurance billing to Chetwyn.
You would forego payment because you did not adequately explain the process of fee collection and insurance billing to your client.
Don LaMond is the guest speaker at a conference about domestic violence. He is a licensed social worker but also has a Ph.D. in economics. When the announcer introduces him to the audience, he refers to him as Doctor Don LaMond. Don should:
Content Area: Ethics: Business Practices and Policies
This question addresses the ethical and legal necessity to clarify one’s qualifications in the mental health field.
A. Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards.
B. Correct the announcer privately after the presentation.
C. Proceed with his presentation. This sort of thing happens all the time. There is no legal or ethical responsibility to do anything.
D. Clarify immediately any misleading information as to his qualifications, professional status, or education, as required by law.
A. Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards.
Social workers have a legal and ethical responsibility to correct false, misleading, or inaccurate information and representations of themselves, made by themselves or others concerning their qualifications, education, license, license status, services, products, etc.
- A client, who is in court-mandated therapy, tells the social worker that he is going to leave the state because he doesn’t want to be in therapy or go to jail for violating probation. The social worker tries to encourage the client to see the benefits of staying in therapy, but the client becomes visibly angry and agitated. If the social worker is concerned about the client’s potential for violence, the reason for seeking consultation is NOT to:
Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when consultation is required to maintain scope of competence.
A. Meet the legal standard of care.
B. Assess the social worker’s own blind spots to risk.
C. Discuss any suspicions that would validate terminating the client.
D. Reassess the social worker’s scope of competence.
C. Discuss any suspicions that would validate terminating the client.
A client’s potential violence would not be a reason for terminating the client. It might be a reason, however, for breaking confidentiality.
Several of your clients are homosexual, and one client in particular is the leader of a group for a range of gender identity support groups. She refers several clients to you because she is impressed with your ability to stay “open minded about whoever people want to be.” Ethically, what would you want to address first?
Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to maintain ethical standards with diverse populations.
A. You would need to determine if your scope of competence was adequate.
B. Avoid a dual relationship with your client by soliciting referrals.
C. Since these clients might know each other, explain the limits of confidentiality.
D. Explain that if they are in the group for gender identity issues, you cannot treat them for the same issue.
A. You would need to determine if your scope of competence was adequate.
Homosexuality does not capture the range of gender identity issues, so just because your client appreciates your approach with her, your ability to treat other types of issues would be your first concern.
Your 52-year-old client returns from visiting his brother in Florida. He explains that his brother, who cares for their 84-year-old father, doesn’t take him to his doctor or physical therapy appointments and she occasionally forgets to fill his prescription medication. What is your legal obligation?
Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of the parameters of elder abuse reporting and when to maintain confidentiality.
A. Maintain confidentiality.
B. Call Adult Protective Services (APS) in Florida and file a written report within two working days.
C. Encourage your client to file an Elder Abuse Report.
D. Call Adult Protective Services (APS) in California and file a written report within 36 hours.
May not be true.
B may be correct.
A. Maintain confidentiality.
Mental health professionals licensed in California are only mandated reporters of Elder and Dependent Adult abuse if the victim is a resident of the state of California. Maintaining confidentiality is your legal obligation.
A man identifying himself as Lefty calls to set up an appointment for therapy. He tells you that he has a hard time with confrontation and that as a result, he often ends up having to do things he doesn’t want to do, and that other people treat him “like a doormat.” Lefty tells you that specifically, he wants your help in terminating with his current therapist and doesn’t know how to do it. You would:
Content Area: Ethics: Therapeutic Relationship/Services
This item tests your knowledge of ethical standards related to a therapist’s professional competence and integrity.
A. Tell him that you can’t treat him without the the agreement of the other therapist.
B. Tell him that you can’t treat him while he is seeing another therapist, and support Lefty in his efforts to terminate with the other therapist before beginning treatment.
C. Agree to see Lefty, obtain a release to speak to the other therapist and consult about how to best help Lefty.
D. Agree to see Lefty and help him to be assertive and to stand up for himself as he requested.
A. Tell him that you can’t treat him without the the agreement of the other therapist.
Social workers generally do not provide services to a person receiving treatment or therapy from another therapist unless by explicit agreement by or with full termination of the other therapist.
What is the expected length of time to keep client records after the client has been terminated?
Content Area: Ethics: Business Practices and Policies
This question assesses your knowledge of the length of time you are required to keep a client’s records after therapy has been terminated.
A. Records must be retained for a minimum of 7 years after the date that the client begins treatment.
B. At least 7 years after the termination of an adult client and 10 years after the termination of a minor client.
C. At least 7 years after the termination of an adult client or until a minor client turns 21.
D. Records must be retained for a minimum of 7 years after the date that the client terminates treatment.
D. Records must be retained for a minimum of 7 years after the date that the client terminates treatment.
Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015). For minors who terminate treatment, records must be retained for a minimum of 7 years after the minor would have been 18 or at least until the minor client would have been 25.
A recently divorced 40-year-old client tells you that her ex-husband is leaving threatening remarks on her social network pages. She has tried to block him, but he finds ways to get on anyway. He lives out of state so she tells you that she doesn’t really think he is a threat; “he’s just trying to get under my skin, and it is working!” As a mental health professional, what would be your best legal course of action?
A. Report to the police because of the serious threat of violence to an identifiable victim.
B. Provide your client with the numbers of shelters or see if she is willing to stay with friends or family members if the threat is imminent and serious.
C. Ask your client to invite her ex-husband to a session and teach harm reduction techniques.
D. Discuss the situation with your client.
D. Discuss the situation with your client.
A social worker’s legal responsibility in this situation is to maintain confidentiality, so discussing it and working with the client on options to best protect herself would be a reasonable thing to do.
Richard, 38, tells you that he is missing more and more work due to back pain. He tells you that he has been to several doctors who prescribe pain medication because he cannot afford to take time off of work. He tells you that he skips work or leaves early because sometimes the “meds make me so tired and fuzzy in my thinking,that I would be fired if I showed up like that.” As a social worker who is not experienced with substance abuse, what is your next course of action?
A. Refer him to AA.
B. Refer him to an MD.
C. Encourage him to take time off of work to get physical therapy for his back.
D. Obtain consultation to determine the extent of his problem.
B. Refer him to an MD.
Overuse of pain medications and back pain would require a medical referral.
A mediator contacts a social worker requesting that she contribute to an ongoing child-custody decision. If the social worker agrees to provide information, the social worker should:
A. Tell the mediator the fee for conducting custody evaluations before doing so.
B. Advise the clients about the risks of this dual relationship.
C. Determine if custody evaluation is within her scope of practice.
D. Limit information disclosed to the mediator that is related to custody.
B. Advise the clients about the risks of this dual relationship.
Before entering into a dual role, a social worker is ethically obligated to advise the client of the risks.
After seeing Mary in therapy for six months, she reports she can’t afford your fee anymore, and wishes to trade services. She wants to provide all your marketing and printing needs to promote your practice. Since she is already your client you would:
A. Agree to trade services because it would be unethical to terminate at this point in treatment.
B. Not agree to trade services and refer her to a low-fee counseling center immediately.
C. Not agree to trade services and attempt to slide her fee to a rate agreeable to both of you.
D. Agree to trade services if a sliding scale fee could not be agreed upon, but reassess the arrangement in a few months.
C. Not agree to trade services and attempt to slide her fee to a rate agreeable to both of you.
Of the choices provided this is the most ethical, avoiding a dual relationship and attempting to come to an agreeable fee.
Your client works for a local newspaper arranging advertising space. You place an ad in the same newspaper for an upcoming therapy group. The client turns out to be the person who does the ad layout. Ethically:
A. You have every right to place an ad in this newspaper.
B. This is an avoidable dual relationship and you should have advertised in a different newspaper.
C. You are required to withdraw the ad.
D. You should request that the client decline the job if it happens again.
A. You have every right to place an ad in this newspaper.
A social worker, like anyone else, has a right to advertise in the local paper. You did not directly interact with the client nor did you intend for your client to work on your ad. This would be an example of an unavoidable dual relationship.
A social worker working with an individual is becoming convinced that marital therapy would be better for a client. The social worker suggests that the client bring her husband for a session, but the client is afraid her husband will monopolize the session. Scope of competence obligations require the social worker to:
A. Refer the client to a couples therapist.
B. Sign a “no secrets” policy at the first session if the husband does come for a session.
C. Explore her reasons for recommending conjoint therapy.
D. Address the wife’s concerns about her husband’s “monopolizing” the session.
D. Address the wife’s concerns about her husband’s “monopolizing” the session.
Ethics require that you meet the “client where they are”, and addressing her question is one way of clarifying expectations and providing informed consent about a change in the treatment.
After a crisis in her own life, a social worker cancels her appointments with clients for two weeks. What must she do next to meet ethical obligations related to informed consent?
A. Tell clients that she will reassess her ability before returning to work.
B. Tell clients that she will not take calls during that time.
C. Reconsider treatment plans when she returns.
D. Obtain consultation to assess if she is ready to return.
B. Tell clients that she will not take calls during that time.
The ethical obligation related to informed consent is that social workers provide clear information about their availability.
Ronald is a 37-year-old moderately successful artist you have been treating for three years for depression and relationship issues. His income is sporadic, and you bill him monthly, but he had never let his balance get too high. Now he owes you $2,100. He offers to give you a painting whose value is roughly equal to the amount he owes you. How would you proceed?
Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical issues regarding client debt, dual relationships, and bartering and techniques to manage those issues.
A. Decline the painting and tell him that based on his history with you, you trust that he will pay you in full when he gets the money.
B. Accept the painting so that you can eliminate the debtor/creditor dual relationship.
C. Accept the painting but process with Ronald the meaning of exchanging his art for your services and have him sign a statement of mutual agreement.
D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due.
D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due.
Although this may not be a perfect solution to the problem, it does reinforce boundaries, stop the balance from getting higher, and suspend treatment in a situation in which professional judgment may be impaired and in which the client may feel exploited (as a debtor, Ronald may not feel capable of participating openly and honestly in therapy).
Burt, a withdrawn young adult, has been seeing you to help him with debilitating anxiety in social situations. You learn that Burt’s previous therapist used highly questionable methods, including having Burt take her on “dates.” He hints that this social worker encouraged him to have sex with her. What should you do?
A. Call the appropriate licensing board and see if any reports have been made on this other therapist in the past.
B. Continue to see Burt and monitor closely anything he says regarding this social worker, so you can take appropriate action when necessary.
C. Question Burt directly on whether he had sex with the previous social worker and give him the brochure if he says yes.
D. Give Burt the brochure, “Professional Therapy Never Includes Sex” regarding sex and therapy and discuss it with him.
D. Give Burt the brochure, “Professional Therapy Never Includes Sex” regarding sex and therapy and discuss it with him.
“Professional Therapy Never Includes Sex” should be provided for this client as well as a discussion of its contents.
Bridget comes to therapy describing how sad and hopeless she feels. You give her a Beck’s Depression Inventory that reveals that she has a moderately high level of depression. At the end of the session, she asks you for a prescription for Zoloft. What is your initial response to her request?
Content Area: Ethics: Business Practices and Policies
This question probes your understanding of techniques for addressing a client’s expectations of therapy.
A. Suggest to Bridget that she increase her level of physical exercise.
B. Review the nature of your license as it is explained in your informed consent.
C. Refer Bridget to a psychiatrist for a medication evaluation.
D. Discuss with Bridget the pros and cons of taking an antidepressant medication.
B. Review the nature of your license as it is explained in your informed consent.
Explaining the nature of your license by using your general office policy reinforces the therapeutic frame that you would have initiated in an informed consent discussion at the beginning of therapy.
Twelve years ago, the Drake family came to see you for family therapy. At that time Mr. and Mrs. Drake were having problems with their two children, ages 2 and 5. The Drakes are now divorcing and are in court to determine custody of their two children. You receive a subpoena from Mr. Drake’s attorney for therapy records for these sessions. You call both Mr. and Mrs. Drake and they each ask you to release the records and send you waivers to that effect. You still would not release the records because:
Content Area: Law: Confidentiality, Privilege, and Consent
This question explores your knowledge of privilege and how to handle subpoenas in a custody case.
A. The children must sign releases since they are old enough to participate in custody issues.
B. You no longer have the records after 10 years.
C. The court has not appointed guardians ad litem.
D. The judge has not ordered the release of the records.
C. The court has not appointed guardians ad litem.
Until the court appoints guardians ad litem, you cannot release the records for the unit of treatment. A guardian ad litem is appointed by the court to make legal decisions in the best interests of a child. Without guardian ad litem status, parents cannot waive privilege for their children.
Terran came to five couples’ sessions with his wife complaining about how she belittles him and expects him to act more American. Terran had a difficult time listening and compromising because he believed his wife was disrespecting him, and they terminated treatment. You receive a subpoena for his records from an attorney representing his employer and learn that he is suing his employer for discrimination and emotional suffering. When you try to contact Terran about the subpoena, he does not return your calls. You would:
A. Assert privilege.
B. Call his attorney and ask the attorney to ask Teran to call you back.
C. Contact Terran’s wife since she was in session and has a right to confidentiality too.
D. Release the records since he has entered his emotional state into a legal proceeding and this represents an exception to privilege.
A. Assert privilege.
If you are unable to contact your client, you must continue to assert privilege. You do not know what is in the client’s best legal interests so all you can do is continue to assert privilege.
A client that you treated 10 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. Have the client sign a new release authorization.
B. Open a separate file if the client was in family therapy before.
C. Sign a new informed consent form.
D. Refer to another therapist if the client was a minor in therapy before.
B. Open a separate file if the client was in family therapy before.
Maintaining treatment files for different units of treatment is a legal obligation.
