Sample Questions: Deck 2 Flashcards
Candidates for licensure who began their graduate training on or after January 1, 2004, must complete at a minimum:
A. A one-hour course in spousal/partner abuse and a three-hour course in aging and long-term care.
B. A one-hour course in aging and long-term care and a three-hour course in spousal/partner abuse.
C. A 10-hour course in spousal/partner abuse and a 15-hour course in aging and long-term care.
D. A 10-hour course in aging and long-term care and a 15-hour course in spousal/partner abuse.
D.
The BOP requires that candidates who began their graduate training on or after January 1, 2004, complete at a minimum 10 hours of coursework in aging and long-term care, and 15 hours of coursework in spousal or partner abuse, prior to licensure. The BOP also requires that for licensees who began graduate studies prior to January 1, 2004, that during the first licensure renewal period, the licensee complete a one-time course in spousal or partner abuse, of a minimum of one hour, and a one-time course in aging and long-term care, of a minimum of three hours (Response A).
In terms of Welfare and Institutions Code Section 5150, “danger to self” refers to:
A. Suicidal intent.
B. Suicidal intent, as well as potentially self-destructive or reckless behavior.
C. Suicidal intent, as well as the inability to adequately provide for oneself.
D. Suicidal intent, as well as refusal of necessary medical care.
A.
In terms of WIC 5150, “danger to self” specifically refers to suicidal intent and behavior. Self-destructive or reckless behavior (Response B), such as prostitution or high-speed auto driving would not quality as “danger to self.” The inability to adequately provide for oneself (Response C) is the definition of “grave disability.” Individuals generally have the right to refuse medical care (Response D), even if medical personnel or others might consider the medical treatment necessary.
When a mandated reporting situation exists, confidentiality:
A. Is always breached.
B. No longer applies.
C. Should be breached to the minimum extent necessary.
D. Is not breached.
C.
When disclosure of confidential information is lawful and ethical (e.g., in a mandated reporting situation), confidentiality is frequently breached (ruling out Response D). The disclosure should always be limited to the information necessary and sufficient to meet the purpose of the disclosure. Thus, confidentiality must still be considered (Response B). Even if a report is mandated, a patient may consent to the disclosure (e.g., the pateint calls in an abuse report with the therapist). It is therefore inaccurate to say that confidentiality is always breached (Response A).
A Tarasoff duty would clearly exist in which of the following situations?
A. A patient’s spouse informs the patient’s psychologist that his wife has plans for serious violence against her boss.
B. A patient’s coworker informs the psychologist that the patient has a gun and is planning to shoot her next-door neighbor.
C. A patient tells her psychologist that she can’t stop thinking about killing her ex-husband.
D. A patient reveals to her psychologist imminent homicidal intent toward an unnamed acquaintance.
A.
A Tarasoff duty clearly exists when three conditions are met: (a) where the patient has communicated to the psychotherapist; (b) a serious threat of physical violence; (c) against a reasonably identifiable victim or victims. In the recent Ewing decions (case law), it was determined that a patient communication should be construed to include any communication from an intimate or close relation of a patient (e.g., husband, parent, sibling). Response A meets the three Tarasoff conditions, in that the patient’s husband has told the therapist directly that she has a plan of serious violence against an identifiable person, namely her boss. In Response B, however, the psychotherapist hears the threat from the patient’s coworker, thus Tarasoff does not apply. In Response C, the patient is having thoughts of killing her ex-husband; further assessment is required before a clear threat of physical violence can be established. In Response D, the intended victim is not yet clearly identifiable. Psychotherapists are not required to interrogate patients to learn the identity of the victims.
Which of the following statements best describes the attitude of the American Psychological Association’s “Ethical Principles of Psychologists and Code of Conduct” (2002) toward multiple relationships?
A. Multiple relationships are never permitted.
B. Multiple relationships should be avoided whenever possible, but they may be acceptable if they can’t be avoided.
C. Multiple relationships are only unethical if they impair objectivity or present the possibility for harm or exploitation.
D. Multiple relationships are sometimes acceptable if they are not of a sexual, romantic, or financial nature.
C.
The APA Ethics Code states that multiple relationships are not inherently unethical (ruling out Response A). It does not explicitly single out those of a sexual, romantic, or financial nature (Response D) as being problematic, nor does it state that multiple relationships should be avoided whenever possible (Response B). The Ethics Code states that multiple relationships are acceptable as long as they don’t impair effectiveness and objectivity, and they don’t cause harm or exploitation.
When a psychologist receives a subpoena requesting therapy records, the psychologist should in most cases first:
A. Assert privilege.
B. Turn over the records.
C. Contact the patient whose therapy records are being requested.
D. Contact the attorney who issued the subpoena.
C.
In most situations, when a psychologist receives a subpoena, the psychologist should initially contact the patient to see if the patient wishes to assert privilege or waive privilege. Thus, whether the psychologist should assert privilege (Response A) or turn over the records (Response B) depends upon the patient’s decision in the legal proceedings. Generally, a psychologist should never contact the attorney who issued the subpoena (Respone D), except to ask to be released from the subpoena.
A parent has authorized treatment of a minor. According to CA guidelines, in which of the following situations may the parent access the minor’s treatment records?
A. In all situations.
B. If the minor gives assent.
C. In all situations, unless the therapist believes access will have a detrimental effect on the therapeutic relationship or the child’s physical or emotional well-being.
D. In all situations, unless the therapist believes access is reasonably likely to endanger the life or physical safety of the individual or another person.
C.
This is a very difficult question because CA guidelines and federal guidelines (HIPAA) with regard to patient access to mental health records differ. Additionally, psychologists are supposed to follow different guidelines depending on whether an adult is accessing his/her own treatment records or accessing a minor’s treatment records. According to CA law, a parent or legal guardian can generally access a minor’s treatment records (except when the minor has lawfully received treatment without parental consent). A minor’s assent (Response B) is not required for parental access. A therapist has the right to refuse to provide the treatment records if: (a) the therapist believes disclosure would be detrimental to the therapeutic relationship; or (b) the therapist believes disclosure would be detrimental to the child’s physical or emotional well-being (Response C). According to HIPAA, providers may deny individual access when the professional has determined that the access requested is “reasonably likely to endanger the life or physical safety of the individual or another person.” When adults want to access their own treatment records, HIPAA overrides CA law (thus with adults you would have to release records unless there is a threat to life or physical safety). When adults want to access a minor’s treatment records CA law overrides HIPAA (ruling out Response D).
When an adult 21 years of age has sexual intercourse with a minor of 16 years of age:
A. Statutory rape has occurred, but a sexual abuse report is not necessarily mandated.
B. Statutory rape has occurred, and a sexual abuse report is mandated.
C. Statutory rape has not occurred, and a sexual abuse report is not mandated.
D. A report of sexual abuse is discretionary.
A.
Any sexual intercourse between an adult and a minor under the age of 18 is statutory rape. The penal code, however, does not require a child abuse report in all instances of statutory rape. A report of child abuse is mandated when sexual intercourse has occurred between a person 21 or older and a partner who is UNDER 16 years of age. In the situation described, fi the sexual intercourse was consensual, because the minor is 16 years of age, a child abuse report would not be required. If the intercourse was non-consensual (e.g., rape), a report of child abuse would be required.
A new client confesses to having killed her boyfriend accidentally a few weeks ago. She states that she has come to therapy in order to relieve her guilt and to get help in avoiding getting arrested. What would be your most appropriate response in this situation?
A. If you are interrogated by the police, you should divulge releveant information because no privilege exists in this situation.
B. Explain to your client that there is no privilege because this situation constitutes a Tarasoff situation.
C. Inform your patient that all information will be held confidential.
D. Inform your patient that privilege will probably not be upheld in this situation because she is attempting to use therapy to avoid apprehension.
D.
Privilege is defined as the patient’s right to refuse to disclose and to prevent another from disclosing a confidential communication in a legal proceeding. This scenario presents one exception to privilege: according to Evidence Code 1018, no privilege exists if the services of a therapist were sought or obtained to aid anyone to commit a crime or to escape detection or apprehension after commission of a crime (ruling out response C). However, the decision about privilege belongs to a judge, not you. You may not simply tell the police whatever you think is relevant (Response A). A Tarasoff situation occurs when there is a threat of future violence (ruling out Response B). In addition, privilege still exists in a Tarasoff situation, although confidential information relevant to the threat may be disclosed. Also note that commission of a crime in the past is not an exception to confidentiality or privilege.
Documentation of treatment (e.g., progress notes) is:
A. Ethically preferable.
B. Ethically mandated.
C. A legal, but not an ethical issue.
D. Good clinical practice, but neither a legal nor an ethical issue.
Documentation of treatment is both a legal and an ethical mandate.
A six-year-old child reports that he was left alone in a house with broken windows and unprotected poisons. He appears to be unharmed in any way. The behavior of his parents would constitute:
A. Inappropriate supervision.
B. General neglect.
C. Severe neglect.
D. No form of reportable child abuse because no injury was sustained.
B.
This scenario describes general neglect, defined as the negligent failure of the caretaker to provide adequate food, clothing, shelter, medical care, or supervision where no physical injury to the child has occurred. Clearly then, an injury need not be sustained (Response D) in order for reportable abuse to occur. Severe neglect (Response C) is defined as negligent failure of the caretaker to protect the child from severe malnutrition, or willfully causing or permitting the health of the child to be endangered, including intentional failure to provide adequate food, clothing, shelter or medical care. Although inadequate supervision has indeed occurred in this scenario (Response A), a more specific form of abuse has occurred and therefore “general neglect” is the more accurate response.
The relationship between a supervisor and a psychological assistant who is accruing supervised professional experience (SPE) is best described as:
A. Employer to employee.
B. Teacher to student.
C. Business owner to independent contractor.
D. Partner to partner.
A.
CA law is clear that the relationship between a supervisor and a psychological assistant must be one of employer to employee. By law, psychological assistants may not be independent contractors (Response C), although some psychological assistantships are unlawfully set up on this basis.
Which statement best describes a psychologist’s rights and duties if contacted by emergency room personnel regarding a patient who has made a suicide attempt?
A. Because the suicide attempt has already occurred and there is now no immediate threat to safety, the psychologist must uphold confidentiality.
B. The situation constitutes a treatment emergency and the psychologist may divulge confidential information relevant to the patient’s immediate care.
C. Evidence Code 1024 allows the psychologist to share confidential information in this situation because the patient is a danger to self.
D. The psychologist may divulge confidential information only if the patient either gives consent or if the patient is hospitalized in accordance with WIC 5150.
B.
Treatment emergencies are considered exceptions to confidentiality. In a treatment emergency (e.g., a patient has attempted suicide with a drug overdose), confidential information shared in a treatment emergency is intended to help provide the patient with the most appropriate care. Evidence Code 1024 (Response C) is an exception to privilege that generally applies to legal proceedings; Evidence Code 1024 applies when a patient is a danger to self (others or property) and the disclosure is necessary to prevent the danger.
For up to 750 supervised hours, a supervisee may have a primary supervisor who is a:
A. Board certified psychiatrist.
B. Board certified psychiatrist, or LCSW.
C. Board certified psychiatrist, LCSW, or LMFT.
D. LCSW, or LMFT.
A.
Only psychological assistants may accrue up to 750 hours of supervised professional experience (SPE) under the primary supervision of a board certified psychiatrist. In all other circumstances, the primary supervisor must be a CA licensed psychologist. It is never possible to earn SPE under the primary supervision of a LCSW or LMFT. An LCSW or LMFT may, however, serve as a delegated supervisor (but not to a psychological assistant).
Effective January 1, 2007, what does the law of the State of CA mandate in terms of the maintenance of treatment records for minors?
A. All records must be maintained for seven years after termination.
B. All records must be maintained at least until the minor reaches the age of 18.
C. All records must be maintained at least 7 years after the minor reaches the age of 18.
D. All records must be maintained at least until the minor reaches the age of 19, but for no fewer than 7 years after termination.
C.
Effective January 1, 2007, the Business and Professions Code (2919) requires that for adults treatment records be maintained for at least 7 years after termination (Response A), and for minors, the treatment records be maintained for at least 7 years from the date the patient reaches 18 years of age; in other words, until the person is 25 years old (Response C).
A client you have been seeing in therapy for several weeks tells you that her ex-husband is threatening to kill you because he blames you for her unwillingness to get back together with him. From your conversations with the client, you know that the man has a history of violent behavior and that his threat against you must be taken seriously. As an ethical psychologist:
A. You must not terminate therapy with the client and should contact the police to obtain protection only with the client’s consent to do so.
B. You must not terminate therapy with the client but may contact the police to obtain protection with or without the client’s consent to do so.
C. You may terminate therapy with the client and may contact the police to obtain protection with or without the client’s consent to do so.
D. You may terminate therapy with the client but should contact the police to obtain protection only with the client’s consent to do so.
C.
This situation is addressed in the Ethics Code STandard 10.10(b). The Ethics Code permits psychologists to terminate therapy with a client when the client or a person the client has a relationship with poses a threat to the psychologist. In this situation, the psychologist is not required to provide advanced notification of termination or pretermination counseling to the client. Moreover, prohibitions against breaching client confidentiality do not apply if the psychologist needs to contact the police or others to obtain protection.
Under which of the following conditions would you be mandated to file a child abuse report?
A. Consensual sexual intercourse between a 16 year old and a 21 year old.
B. A 15 year old who is engaging in lewd and lascivious conduct voluntarily with a 23 year old.
C. A 17 year old who is the victim of rape.
D. All of the above.
C.
You must report an incident of rape that involves a minor.
CA law requires that the primary supervisor of psychological interns must:
A. Supervise no more than three interns.
B. Complete six hours of supervision coursework every two years.
C. Be either a licensed psychologist or board certified psychiatrist.
D. Provide a minimum of five hours of individual, face-to-face supervision to each intern each week.
B.
The requirements for supervisors of psychological interns are specified in CA Business and Professions Code Section 2911. It requires supervisors to complete six hours of supervision coursework every two years. However, it does not limit the number of interns; it states that supervisors of psychological interns must be licensed psychologists only; and it states that supervisors must provide a minimum of one hour of individual, face-to-face supervision to each intern each week.
Which of the following does NOT represent a legal exception to the psychotherapist-patient privilege?
A. The psychotherapist is appointed by the court to evaluate the defendant at the request of the defendant’s attorney so that the attorney can determine the appropriateness of the insanity plea.
B. The services of the psychotherapist were sought by the patient in order to escape detection after committing a crime.
C. The psychotherapist has been asked by the relative of a patient to evaluate the patient for the purpose of determining the patient’s competence.
D. The patient is suing the psychotherapist for malpractice.
A.
Privilege is not waived when a psychotherapist has been appointed by the court to evaluate a defendant at the request of the defendant’s attorney to determine the appropriateness of an insanity defense or a defense based on the defendant’s emotional state.
The APA’s Ethics Code states that, when there is a conflict between ethical obligations and legal requirements, a psychologist should attempt to resolve the conflict in a manner that is consistent with:
A. Personal conscience.
B. Legal requirements.
C. Basic principles of human rights.
D. The accepted standard of care.
C.
This answer is the best one because it reflects the actual language of the Introduction and Application section, Standard 1.02, and Standard 1.03 of the APA’s Ethics Code. For example, the Introduction and Applicability section states: “If psychologists’ ethical responsibilities conflict with the law, regulations, or other governing legal authority, psychologists make known their commitment to this Ethics Code and take steps to resolve the conflict in a responsible manner in keeping with basic principles of human rights.”
You have just completed a research study but have not yet published its results. A colleague who is familiar with your study requests the data you have collected. Which of the following best describes the requirements of the APA’s Ethics Code with regard to this situation?
A. You are required to comply with the colleague’s request only if her purpose in requesting the data is to re-analyze it.
B. You are required to provide this information as long as the colleague agress to protect the confidentiality of the study’s participants.
C. You are not required to provide this information since the results of the study have not been published.
D. You cannot provide the data to the colleague unless participants have signed a waiver of confidentiality.
C.
The question states that you have not yet published your results; and, consequently, you are not required by the Ethics Code to share the data with your colleague. After publishing the results, however, you would be required to comply with a request for the data by a “competent professional” as long as the request is for the purpose of re-analyzing the data and the confidentiality of the participants can be protected.
A client asks Dr. Ken Kendall for a copy of her therapy record. Dr. Kendall may provide the client witha summary of the record (rather than the complete record) if:
A. He explains his reasons for doing so to the client.
B. The client’s request was verbal rather than in writing.
C. The client requested a summary and the request from the client was in writing.
D. He believes it is in the best interest of the client to do so and the request from the client was in writing.
C.
Although CA law permits a health care provider to dermine whether to provide a client with a record summary or an entire record, HIPAA’s privacy rule allows this only if the client agrees in advance to receiving a summary. Because HIPAA grants clients greater access to their records, it preempts CA law. In addition, HIPAA and CA law both require that a client’s request for access to his/her records be in writing.
You receive a written request from a former client for a copy of his therapy records. His request does not include your psychotherapy notes. Unless you have a lawful reason for withholding the records, you must respond to the request by sending:
A. A copy or summary of the records within 5 days.
B. A copy or summary of the records within 15 days.
C. A copy of the records within 7 days.
D. A copy of the records within 15 days.
D.
HIPAA requires health providers to provide patients with copies of their records (PHI) when the provider receives a written request for the records and ther is no lawful reason for withholding the records; and the 15 day requirement for providing the records is established by Health and Safety Code Section 1123110(b). Note, that HIPAA’s requirements with regard to the release of a copy (rather than a summary) of records takes precedence over state law, since HIPAA is more stringent in terms of providing patients with access to their records. Also note that the requirement to provide a copy of the records (vs. a summary) does not apply to psychotherapy notes since HIPAA does not require release of psychotherapy notes to patients. Therefore, Health and Safety Code 123110 applies to psychotherapy notes, and it permits providing a copy or a summary of the records.
You have been seeing George Gao, age 23, in therapy for 6 months. However, he has missed his last 3 appointments and his father, who has been paying for his sessions, has not sent you a check for the last two sessions that George attendd. You have already sent George a letter asking that he contact you, but he has not responded. You should:
A. Call George’s father to find out what has happened to George.
B. Send George an e-mail asking him if he plans to come back to therapy and reminding him that he has not paid for two sessions.
C. Send a letter to George’s father informing him that you will contact a collection agency if you do not receive payment within 30 days.
D. Send a letter to George informing him that you will contact a collection agency if he does not contact you within 30 days.
D.
George is an adult and, even though his father has been paying for his sessions, you should contact George directly since he is your client. You would not want to send an e-mail to George because you cannot be certain that he will be the only person to see the e-mail.
