Test 5 Flashcards
What is risk?
Risk is exposure to injury, loss or danger.
What is volatility?
a behavior that might lead to more harm when treated.
What is a risk-benefit analysis?
weighing risks and benefits of txt and no txt
What is the risk associated with more severe or intense problem behaviors?
greater risk of failure of the plan/injury
What is the risk regarding mediators?
not running the protocols properly
What must mediators be?
well trained
How does the setting increase risk?
could be dangers in the setting such as drugs or too many people
How does competence relate to risk?
if BA is not competent or BI is untrained things can go wrong
You are consulting to a group home. The participant is aggressive and often throws
items, ie. Shoes, books, plates, glasses, magazines, etc. You have decided to use a DRO
procedure where if the person does not aggress for 5 minutes, they will earn their chosen
reinforcer. What risks should be discussed?
failure
escalation
risk of doing nothing
What is meant by “buy-in”?
implementers not only agree with it but they will do everything possible to ensure it is implemented accurately
What is meant by personal liability?
can you be sued for mistakes?
What are the 5 benefits of behavioral treatment?
behavior improved environment improved caregivers feel empowered peers change liability reduced (less risk of major problems)
What are the benefits for the BCBA and the field?
relief/confidence
reduced liability to BA
Possible contribution to body of knowledge
What is the general rule in providing the ethics message?
be as good of a communicator as you are a BA
What are the parts of being an effective communicator of the ethical message?
1: identify something that is not quite right
2: know what to say and how to say it
What is the first component of a Declaration of Professional services. (CH18)
Credentials/ areas of expertise
How often should your declaration of expertise be updated?
every year
Why do you list “what I do and how I work”?
so people know we don’t cure and how we work
Why list client responsibilities
We need and expect their full cooperation and their total honesty in dealing with us.
what should be done about gifts from clients?
no - dual relationships, compromise of professional judgement
what is the tarasoff case
a case in which the Supreme Court of California held that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient. The original 1974 decision mandated warning the threatened individual, but a 1976 rehearing of the case by the California Supreme Court called for a “duty to protect” the intended victim. The professional may discharge the duty in several ways, including notifying police, warning the intended victim, and/or taking other reasonable steps to protect the threatened individual.
if you suspect abuse what should you do
report it to police or child protective services
what is hippa
Health Insurance Portability and Accountability Act
what guidelines are suggested for choosing a setting or company
consider ethics (dont go to a company that lures you in to meet some criterea)
why meet your supervisor
essential for strong ethical foundation
learn style and that you wont be asked to do anything unethical, you will have time and support
why are job expectations important to discuss up front
so you dont look dumb asking later
As the new person, many therapists come to you for advice, what is a potential downfall?
negative feedback may be punishing, be sure to reinforce appropriate
Why is IOA so important?
relaibility
What is social validity?
whether the treatment goals and the achieved outcomes are acceptable, socially relevant, and useful to the individual receiving services and to those who care about the individual.
How do you determine if your treatment was in fact responsible for change?
data, exp design
How do you demonstrate that other therapists can implement your program procedures
correctly?
validity checks
What is the gold standard to avoid conflicts of interest?
Why is it important to document your time and billing?
operate in the best interest of client
accountability
Why do
you need to identify a trusted colleague?
It is difficult to make ethical decisions in isolation
What guidelines should be in place if you are working with a client and must “touch” the
client, e.g. hand over hand prompting; high fives, pats on the back, overcorrection, etc.
knowlegeable witness
trained to use restraint
be wary of people who make false claims
avoid cross-sex therapeutic interactions
If you are working with nonbehavioral colleagues and reach an impasse in services
provided, what must you do?
it may be necessary to terminate
What is the verbal rule regarding sexual harassment?
if a camera was there what would you do?
What are stealth dilemmas?
10 ways
xsituations that develop gradually, moving step by small step beyond once-firm professional boundaries. Although each step seemed harmless at the time, many practitioners later realize that they have landed themselves in deep trouble.
What is the central question in any multiple relationship situation?
whose needs are being met here
What are 3 factors to consider in multiple relationships?
power
duration
termination
What is the rule regarding sexual relationships with clients?
never permissable
You are working with a child with autism who attends a youth program at your local
religious program (you attend). The church staff know you provide services to the family
and comes up to you and states the child is very disruptive during the youth program and
asks “What do you and the parents do when Eric refuses to sit on the chair and flops on
the floor and makes all those noises?”. What do you say?
sorry, confidential
When may you disclose client information?
when legally required or permitted to due so due to safety
How do you prevent confidentiality problems?
discuss limits up front
keep confidential stuff safe
know law
obey mandatory reporting law
What is meant by respecting people’s autonomy?
informed consent, give info up front
What is the major responsibility of a supervising psychologist?
Who is responsible for the acts of interns?
supervising psychologists should continually assess their supervisees’ competence and make sure they are managing them appropriately, say experts.
Why is it important to identify your
role?
to avoid role related dilemmas
What is the rule regarding documentation?
more is better
Does being certified as a BCBA make you competent to practice?
no, you need expertise in types of clients
What is meant by abandonment?
leaving before termination criteria are met
abandonment occurs when a psychologist inappropriately ends treatment, such as halting needed therapy with no notice.
How do you avoid “dumping” the client?
involve them in plan
What central theme has emerged from inquiries?
identifying and distinguishing the ethical, legal and clinical aspects of the question posed
What are the 2 common kinds of calls?
mandatory child-abuse reporting and Tarasoff-the duty to protect.
What is meant by determining
whether the legal threshold has been reached?
if it meets criteria for duty to report
What is the difference between a duty to disclose information andpermission to disclose
information?
client can give permission or it can be legally required
What is meant by “ the ethical follows upon the legal which, in turn, follows upon theclinical ” ?
The answer to the ethical question will therefore rest upon a clinical assessment to determine the likelihood that there is an actual threat of harm and a legal determination regarding how the jurisdiction’s law applies to the clinical situation. The clinical assessment will thus provide the foundation for the legal and the ethical response.
Who determines competence?
Psychologists’ work is based upon established scientific and professional knowledge of the discipline. (state board of psych)
Who is responsible for verifying a claim of competence?
State board of Psych.
When expanding you areas of competence what must you do?
get help from pro
You are working with a child with autism who exhibits high levels of anxiety, what must
you do?
consult someone with competence in that area
When may you disclose information without informed consent of the client?
when safety is compromised, or when legally required or allowed to do so for legitimate purpose
You are working with a child with autism and a new staff member wants to see the
programs that have been developed, what is the correct response?
show him provided it is relevant to the training
When presenting information on a particular treatment protocol at a conference what
must you do?
get permission in writing
You are collecting baseline data and notice your IOA is not adequate
, you meet with the
team and decide to videotape a couple of sessions for training purposes, what must
occur?
get permission in writing from staff and parents
Can you release private information?
sometimes, if legally required or allowed for a legit purpose such as safety
A client wants to see your notes and data, what do you say?
Sure thing buddy, go nuts.
When working with a child you notice bruising on
the child’s arm. You talk with the
parents and they say the child fell down. What must you do?
report dat shit to child protective services
You are consulting with parents regarding the treatment of their child and you state you
use VB combined with
pivotal response training. What is wrong with th
is description of
services?
too much jargon
What is the bill of rights of clients?
a form that says the rights of clients that must be displayed prominently on the premises of professional practice
A parent asks you to develop a gluten free diet for their child, what must you do?
tell them its not my area of competence, try to gently discourage
A parent insists in hiring a “therapy dog” for their child and you have severe reservations
regarding this treatment, what must you do?
express concern, but don’t quit over it
What are 2 conditions for terminating a professional relationship?
A. the provider’s objectivity or effectiveness is impaired, unless a resolution can be achieved
B. the client is unlikely to benefit from continued professional services by the provider.
How do you inform a client when terminating services?
promptly inform the client in a manner that minimizes harm. This requirement shall not apply when the termination is due to the successful completion of a predefined service such as an assessment or time-limited therapy.
If you see a psychologist who appears to be in violation of a rule of conduct (with the
exception of sexual contact, failure to report abuse) what must you do?
discuss with them
If you learn that a psychologist has had a sexual relationship with a client what must you
do?
report it to state board
If a psychologist comes to you for help (counseling) and states they have had an ongoing
sexual relationship with a minor, what must you do?
report it to state board
A parent comes to you for services and asks if you have worked with other families who
have children with autism. You indicate you have. The parent then asks if they may
contact a couple of these families to get their o
pinion of your services. What do you say?
nope, confidentiality, unless the families gave explicit consent for reference
You have taken a new job and on the agency web page it notes your degree and credentials and states you have completed the BCBA coursework requirements. How would you handle this?
degree and credentials are fine but no mention of BCBA
How is unprofessional conduct defined?
any conduct that fails to conform to the minimum standards of acceptable and prevailing practice
Why do you keep records?
allows you to monitor work
help protect legally
What is the difference between guidelines and standards?
Guidelines differ from standards in that standards are mandatory and may be accompanied by an enforcement mechanism. Guidelines are aspirational in intent.
What was the finding of COPPS on state laws and regulations regarding record keeping?
vague and to vary substantially across
jurisdictions.
Who is responsible for the maintenance and retention of client records?
psychologists
What are the guidelines in updating client records?
A psychologist strives to maintain accurate,
current, and pertinent records of
professional services as appropriate to the
circumstances and as may be required by
the psychologist’s jurisdiction.
When working with a child who displays various inappropriate behaviors, the father
reports to you that the stress is too much and he has been staying out late at the bar and
thinks he may need counseling. What do you record?
keep it separate
In reviewing progress notes with your staff, you see that a staff member wrote “ The parents have not been consistent in implementing the prescribed procedures. I have talked with the parents about this on numerous times and think they really don’t want to be involved with their child.” Is this appropriate? And what should you do?
nope, just record objectively what happened, not what you think, correct it.
You have set up a behavioral program and ask the parents how things went last week.
The parents state “things are great, Eric had a good week”. Is this sufficient?
not for records, get details
When a client requests that limited records of treatment be maintained, what should you
do?
For a variety of reasons, clients may express a wish that limited records of treatment be maintained. In some situations, the client may require limited record keeping as a condition of treatment. The psychologist then considers whether treatment can be provided under this condition.
In cases of an emergency or natural disaster (hurricane, school shooting, death of a
student) psychologists may provide services, what
is the guideline regarding client
records?
Its OK that they are much less detailed. It is more important that service be provided.
In reviewing progress notes with your staff, you see that a staff member wrote “ The parents have not been consistent in implementing the prescribed procedures. I have talked with the parents about this on numerous times and think they really don’t want to be involved with their child.” You discuss this with a staff member who states that the day was stressful and wasn’t really paying attention when writing the progress notes and then states they will submit an amended progress note removing the last comment. What do you say to the staff person?
many states prohibit alteration or destruction of records
As part of the a child’s IEP, you provide individual services to increase community
participation. The school is interested in how things are going and for the upcoming IEP
meeting the school psychologist has requested that you provide a summary of your work.
You write up a summary including baseline and intervention data and send it to the
school psychologist. Is this correct?
sure as long as it wasn’t made up on the spot, use existing records
When should you discuss record keeping p
rocedures?
up front
Why is re-release of data an ethical concern?
the client may not know it was going to be used for the new purpose
What are the guidelines related to maintenance of client records?
The psychologist strives to organize and
maintain records to ensure their accuracy
and to facilitate their use by the psychologist
and others with legitimate access to them.
What are the guidelines related to access of records?
The psychologist plans for transfer of records
to ensure continuity of treatment and
appropriate access to records when the
psychologist is no longer in direct control
What is the general rule regarding retention of records?
go according to law, or In the absence of a superseding requirement, psychologists
may consider retaining full records until 7 years after the last date of service delivery for adults or until 3 years after a minor reaches the age of majority, whichever is later.
Why is it important to consider the context in which services were delivered?
because they can effect someones life i.e. context of psychotic episode etc.
Why is record keeping in organizational settings a challenge?
Psychologists working in organizational settings
may encounter conflicts between the practices of their organization and established professional guidelines, ethical standards, or legal and regulatory requirements. Additionally, record ownership and responsibility is not always clearly defined. Often, multiple service providers access and contribute to the record.
Why is record keeping of multiple clients a dilemma?
Because records may include information about more than one individual client, legitimate disclosure of information regarding
one client may compromise the confidentiality of other clients.
What is a disposition plan and why is it important?
provisions are made for the control and management of the records by a trained individual or agency
To ensure transfer to other providers who have legit reasons to access it
How do you dispose of client records?
In a way that maintains confidentiality and prevents recovery
