Top 50 Topics Flashcards
Sex between minors
Always report nonconsensual between minors.
13 and below can be with 13 and below.
If one can drink (21+), the other can drive (16+).
Sex with clients
Unethical within 2 years of termination.
Providing brochure to clients who report sex with previous therapist is a LEGAL requirement, but do not report (unless they’re a minor!).
Fees
LEGAL & ETHICAL - must be established before treatment.
UNETHICAL to enter into thx knowing client can’t pay long term.
You should lower fees for current clients who lose their job, etc.
ILLEGAL & UNETHICAL - to receive money for referrals, conflict of interest.
Insurance/EAP
Include in informed consent what will be shared with insurance (treatment plan, diagnosis).
Insurance fraud = giving diagnosis that client doesn’t meet criteria for in order to have insurance cover sessions.
MUST inform insurance if changing fees/copay with client.
SHOULD advocate for services for clients when necessary.
Comply with quality assurance/audits!
Records
Keep separate records for each unit of treatment (couple, family, individual).
Therapist or agency owns records, not client.
When to release: 5 days to inspect, 10 days for summary, 15 days for copy of entire record.
Can legally withhold if detrimental to release to client, but MUST document reason.
Parents of minors: Don’t have to share with them if detrimental to client/therapy; get a release from minor if age 12 or older.
If stolen, file police report & notify clients affected.
Illegal to go back and change records.
HIPAA
MUST comply if you’ve EVER used 3rd party payment service (like insurance).
“Records” = diagnosis, official health info.
“Notes” = process & session details, not shared, kept separate from records.
Notice of Privacy Policy - LEGAL- need to post in office and give to clients prior to onset of treatment.
Releases
LEGAL - need signed authorization from all members of treatment unit age 12 and older.
Need date signed, end date, and nature of what is to be shared.
At least 14pt font or handwritten by client.
Privilege
LEGAL term, only related to sharing client info in legal proceedings.
The client is always the one who holds it.
-If minor, “guardian ad litem” unless 12+ and seeking own treatment.
Subpoenas by a lawyer basically mean nothing, do not have to turn over!
Court/judge ordered, must comply, but can request limited scope of release.
Can always assert privilege immediately because client can waive later (must sign something to waive later though).
Conservator can claim on behalf of conservative (can also claim for themselves).
Supervision & Colleagues
Unethical behavior of peers - 1) address personally and directly, 2) report to agency, 3) report to board.
No dual relationships - wait until supervision/professional relationship is over.
Keep notes on supervision sessions if you’re a supervisor.
Advertising/Marketing
LEGAL & ETHICAL
Include license #, “LMFT” or spelled out.
Accurately represent skill set, be able to back it up.
UNETHICAL to ask for testimonials from clients.
Can’t make claims about success rates.
ETHICAL to correct claims made about you by others.
Scope of Practice/Competency
Scope of Practice:
- LEGAL term, range of services you can provide.
- Keep other professional scopes of practice separate (ex. if you are a lawyer and a thx)
Scope of Competence:
-ETHICAL term, training and background to work with particular population
Standard of Care
LEGAL and ETHICAL: acceptable norm, what a clinically prudent therapist would do
Code of Ethics stuff…
Can’t terminate or withhold records based SOLELY on nonpayment of fees.
Get written consent for video/audio recording or observation.
Cannot continue to practice if no longer competent to do so due to impairment - physical, mental, substance use.
Don’t serve in conflicting roles in court.
Watch your conflicts of interest!
Child Abuse
Physical:
- ONLY open hand is okay - no belts, burns, etc.
- REPORT intentional sibling abuse if close to 5yr age difference.
Neglect:
- REPORT if there’s not adequate supervision, food, etc. (DO NOT report for homelessness.)
- REPORT if life-threatening medical care is refused (even if for religious reasons).
- Parental drug use is not enough, look for detrimental effects on child.
Historical:
- DO NOT report if client is no longer a minor.
- DO NOT report solely on fact that person still has access to kids (need reasonable suspicion it’s still happening).
- If already reported by someone else, call and confirm with CPS in that location.
- Always report to California, no matter where it occurred.
- Call ASAP to make initial report, then fill out form within 36 hrs.
Elder and Dependent Adult Abuse
Elder = 65+
Dependent adult = 18+ and needs care
Reporting: call ASAP, then 2 working days to file form.
- Self-neglect is REPORTABLE!
- Gravely disabled = related to mental health (ex: delusional thinking)
- Caretakers giving medications for off-label use is REPORTABLE as physical abuse.
- Incident between two adults is REPORTABLE if one of them is 65+ and injury occurs.
Financial:
- scammed by stranger = REPORT
- manipulated by family for money = REPORT
Abandonment:
-caregiver disappears without setting up other resources = REPORT
Isolation:
-ex) not allowed to leave house to check mail = REPORT
Abduction:
-taken across state lines without consent
