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LMFT TDC Cards > Top 50 Topics > Flashcards

Top 50 Topics Flashcards

Module 3 TDC

1
Q

Child abuse and neglect

In CA, you can hit a kid under what circumstances?

A

Spanking with an open hand that does not leave marks/bruises

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2
Q

Child Abuse and Neglect

An aburpt change in behavior of a child could be a sign of _______

A

sexual abuse

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3
Q

Child abuse and neglect

Homelessness of a family with children is not reportable to CPS unless ____

A

The children’s basic needs are not being met

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4
Q

Child abuse and neglect

T/F: you have to report someone who sexually abused someone who still has access to children currently

Ex. football coach previsouly abused kids, now coaches for new team

A

FALSE, proximity to an accussed abuser does not met criteria to trigger mandated report

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5
Q

Child abuse and neglect

T/F: if abuse happens in another state and is reporting in CA, you must report to the state that the abuse occured in

A

FALSE; always report in CA

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6
Q

Child abuse and neglect

What is the timeline for making a mandated report?

A

phone call ASAP, written report submitted within 36 hours

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7
Q

Elder abuse and neglect

Age criteria to be considered elder/adult abuse?

A

65+ y/o OR 18 y/o who is considered disabled

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8
Q

Elder abuse

What are the major areas of elder abuse reporting that the BBS will test competency for?

A
  1. Med mismanagement
  2. Physical and social isolation
  3. abduction
  4. abandonment
  5. neglect
  6. financial abuse
  7. emotional abuse (optional)
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9
Q

Elder abuse

If abuse of an adult is occuring in a facility or residential setting, who do you report this information to? and what is the timeline?

A

law enforcement or local ombudsman

non-physical abuse is reported immediately and written report in 2 business days.

physical abuse with non-serious injury by another person in the care home with dementia is reported to BOTH law enforvment and ombudsman in writing in 24 hours but verbal statement is not required

physical abuse with serious bodily injury must be verbally reported as soon as
possible with no more than 2 hours passing from observing, obtaining knowledge or suspecting abuse or neglect. A written report must be submitted within 24 hours to the local law enforcement, the long term-care ombudsman, and the corresponding state licensing agencies.

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10
Q

Domestic violence

Why is counseling not advised for couples who are actively in a DV situation?

A

Shame is a pre-cursor to risk and the couple will actually be at increased risk of intimate partner violence. Referrals to outside individual counseling should be provided.

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11
Q

Domestic Violence

When do you file a police or CPS report for DV?

A

when child is bystander victim; or is hurt incidentally by adult violence

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12
Q

If a couple is 65 or older, do you report DV?

A

yes, to APS as elder abuse

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13
Q

Domestic violence

T/F: an acceptable form of harm reduction in a couple that is physically violent is a no-harm contract?

A

False, it is not an acceptable violence prevention measure in couples counseling

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14
Q

Danger to self

What are the 7 steps to risk assessment in order that the BBS is seeking?

A
  1. conducting a BPS to assess stressors or substance use
  2. assess for lethality and immenence of actual danger
  3. build rapport
  4. identify major stressors/problems and preceded the crisis (willingness to engage with support system, coping skills, meaning of the crisis)
  5. Encourage exploration of thoughts and feelings (paraphrasing, reflecting)
  6. explore alternatives to harm and willingness to engage in alterative actions
  7. formulate a plan
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15
Q

danger to self

After a risk assessment has been completed and a person is identifed as low risk, you can….

A

Explore alternatives to violence

Identify supports and/or significant others to decrease isolation

remove lethal means to harm self/others

Implement coping mechanisms
Establish future linkage (events to look forward to)

Provide clinical referrals for outpatient services and medication, if appropriate, and a
24-hour crisis number

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16
Q

danger to self

After a risk assessment has been completed and a person is identifed as high risk, you can….

A

Hospitalization should occur if a specific suicidal plan and intention is in place and the
client is unable to engage in safety planning for their own safety

Client should not be left alone and an ambulance should be called

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17
Q

Danger to others

If a client DOES communicate a
“serious threat of physical violence against a reasonably identifiable victim or victims”, what two things are triggered?

A
  1. Duty to protect (Tarasoff)
  2. Duty to warn
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18
Q

danger to others

What year did Tarasoff come into effect and who enacted it?

A

July 1, 1976

CA Supreme Court

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19
Q

Danger to others

Tarasoff duty to warn means…

A

Requires that therapist may make attemps to warn the intended victim or others likely to apprise the victim of the danger, AND/OR to notify the police, or to take whatever other steps are reasonably necessary under the circumstances.

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20
Q

Danger to others

The purpose of the duty to report in CA is….

A

law that attempts to keep weapons out of the hands of clients who are considered a danger to others, triggered when a clt reports a serious threat of violence against another

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21
Q

danger to others

According to the duty to report threats of violence to another, what are the reporting timelines?

A

The duty to report mandates a therapist report to local law enforcement within 24 hours, the identity of a person subject to the prohibition of weapons

Local law enforcement will notify the Department of Justice
and the client will be prohibited from accessing weapons for 5 years.

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22
Q

Mental Status Exams

What are the 11 elements of a mental status exam (MSE)?

A
  1. Appearance in context
  2. Attitude (cooperative)
  3. Behavior/physicality (mannuerisms)
  4. mood/affect
  5. speech (normal)
  6. thought process (normal vs circumstantial v. tangential)
  7. thought content (Delusion, phobia, obsessions)
  8. perceptions (hallucinations)
  9. cognition (alertness/oriented x4)
  10. insight into their condition
  11. Judgment
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23
Q

Initial phase of treatment

What are some of the key things that the BBS considers an appropriate first intervention?

A
  1. Addressing safety first
  2. rapport building
  3. identifying motivation for tx
  4. making appropriate referrals
  5. psychoeducation
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24
Q

Middle phase of treatment

What are some of the key things that the BBS considers an appropriate middle phase of tx intervention?

A
  1. any theory based interventions
  2. teaching, modeling, practicing skills in session
  3. addressing issues that occuring in the tx process
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25
Q

Termination/end phase of tx

What are 3 things the BBS wants you to do upon termination phase of tx?

A
  1. seeking adequate referrals if ending due to not making progress
  2. processing the ending of tx with the client
  3. creating a plan that support ongoing mental wellness OR plan for sxs re-occuring
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26
Q

Working with elderly

BBS will test for your ability to balance an elderly person’s right to self-determination against BLANK

A

their level of competency, which you cannot assess

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27
Q

Couples counseling

When engaging with a couple for counseling, the BBS wants you to do three things at the outset of therapy

A
  1. be clear about goals and never guarantee anything
  2. be clear about risk of seperation
  3. conduct baseline assessment in how much they actually want to stay together
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28
Q

Emotionally focused couples counseling

What is the role of the therapist in EFCT?

A

The therapist is viewed as a process consultant.

Helps the client(s) not only understand their emotions, but experience the emotions as
well within the safety of a therapy session.

Assists the client(s) becoming aware of and experiencing the emotions that have been
previously dismissed or pushed away.

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29
Q

emotionally focused couples counseling

What is the goal of EFCT?

A

Learn how to be more adaptive with feelings, memories, thoughts, and physical
sensations that have previously been feared or avoided.

Develop new kinds of interactions within the couple system and foster secure bonding
between partners.

forming secure attachment bonds

30
Q

Family Counseling

If the BBS asks about shifting from family counseling to individual counseling with one member of the family, what will they want you to do?

A

process the change in dynamic with the family

31
Q

Group therapy

3 phases of group therapy

A
  1. Forming
  2. Storming
  3. Norming
32
Q

Substance use

Steps in readiness to change:

A
  1. precomtemplation
  2. contemplation
  3. planning
  4. action
  5. maintaining
33
Q

Substance use

If someone shows up to session under the influence, what does the BBS expect you do?

A
  1. Do not engage in session, end immediately
  2. Call police if they intend to drive home and refuse to find alternative way home bc Tarasoff and danger to self
34
Q

Disorders in childhood

In order to ADHD to be dx in children, what do you need to see?

A

Functional impairment in at least two domains of life

35
Q

disorders of childhood

Attachment disorders: reactive attachment vs. disinhibited social engagement disorder?

A

Reactive attachment: the child is aloof when around parent and does not seek comfort like normal child would in distress

Disinhibited social engagement d/o: child knows no boundaries with adults and gets too comfortable too quickly with strangers

36
Q

Childhood disorders

ODD
v.
CD
v.
DMDD

A

ODD: issue is primarily with authority figures

CD: issues typically occur with the law or property destruction

DMDD: Issue with regulating extreme/severe angry moods

37
Q

Psychotic disorders

T/F: you can treat someone who is actively experiencing psychosis?

A

False

38
Q

psychotic disorders

For safety purposes, the BBS will want you to do THIS at the beginning on therapy with people who have a prior dx of a psychotic disorder?

A

get an ROI for their psych team

39
Q

psychotic disorders

what is the first goal of tx planning for someone who experiences psychosis sxs?

A

Sxs stabilization

40
Q

Anxiety disorders

Tx planning for anxiety disorders focuses on these 4 things:

A
  1. focus on sxs reduction
  2. building coping skills
  3. identifying triggers
  4. coping with physiological response
41
Q

Bereavement

Can MDD and bereavement be dx at the same time?

A

yes, but you would need to rule our prolonged bereavement first (new dx in DSM-TR)

42
Q

Eating disorders

What tx method does the BBS recommend for eating disorder tx? and what does it not recomment?

A

Nutritional tx, MD stabilization, CBT

medications do not work

43
Q

Somatic sxs disorders

What is going to be an indicator on the test of a possible somatic sxs disorder?

A

Referral source was from an MD

44
Q

Telehealth

What are the 4 things that need to be done for telehealth clt’s at the beginning of tx?

A

Give an informed consent specific to the risks/benefits of telehealth, does not need to be signed for adult clts

Assess for fit of telehealth services

Identify their specific location prior to services

Emergency contacts for clt

45
Q

Consent to tx w/ minors

What age can a child consent for their own tx? and do they need an informed consent?

A

12+

They need to have a signed informed consent for tx

46
Q

Consent to tx w/ minors

who can consent?

Married parents

A

Either parent can consent, dont need both signatures

47
Q

consent to tx w/ minors

Who can consent?

Never married parents of minor

A

only need one parent to consent

48
Q

consent to tx with minors

who can consent?

Divorced parents of minors

A

You need to check custody agreement to determine who can sign

49
Q

Conservatorship

Who holds confidentiality and privilege when someone has a conservatorship?

A

Conservatee still is entitled to confidentiality in sessions, but the conservatee holds privilege

50
Q

Confidentiality

Is duty to protect/warn triggered when HIV staus comes into play?

A

No, it’s considered protected. Even in couples counseling, you cannot out a client.

51
Q

Consultation

When should you seek clinical consultation for transference related issues v. your own personal therapy?

A

Consultation is indicated when your own thoughts or feelings are distracting in session, or you are unsure of how to process. Therapy is indicated when you are experiencing a high level of emotional distress bc of the transference issues (flashbacks, distressing memories, prolonged emotions after session has ended)

52
Q

Sex between minors

What are the basic age rules for minors who have sex?

A

13> is okay with 13> only

If one person can drink, the partner must be of driving age

53
Q

Sex with clients

Is is a legal or ethical issue to fuck a client?

A

both legal and ethical issue

54
Q

Sex with clients

If a clt tells you that they had sex with their prior therapist, what are your next steps?

A

Mandated to distribute the “professional therpay never includes sex” paphlet and encourage them to file a complaint with the BBS

55
Q

Fees

Can money be exchanged for giving or accepting referrals?

A

No, this is a legal and ethical issue

56
Q

Insurance and EAP

What extra piece of information needs to be included in an informed consent when the client is using their insurance or EAP benefits?

A

You must disclose how their information will be shared and with who, notice of privacy practices

57
Q

Records

If a client asks to inspect their records and you determine that it’s clinically appropriate and will not cause harm, what are the timelines to provide their records

A

They are legally able to inspect records within 5 days of the request in your office

You have 10 working days to provide a summary of the records

15 days to provide a physical copy of the records

58
Q

Records

What must you do if your records are stolen or compromised?

A

Notify police and all affected parties with stolen records

59
Q

HIPAA

What are the rules about the notice of privacy practices?

A

They must be given prior to any tx

must be physically posted in your office

must sign an acknowledgment that it was received by them

60
Q

ROI’s

What the basic rules for an ROI to be valid?

A

Everyone in the tx unit who is old enough must sign

Start and end dates

nature of information allowed to be shared

14pt font

If it’s handwritten, must be in clt’s writing

61
Q

Privilege

Who holds privilege?

A

The client (regardless of age)

All members of the treatment unit

A guardian ad litem or conservator

If the patient is deceased, the personal representative of the patient

62
Q

Privilege

10 exceptions to privilege

A
  1. When the client has introduced their emotional condition in a legal proceeding.
  2. When the client has treated confidential information as though it were not confidential.
  3. When there is a breach of duty: The client sues the therapist for malpractice OR the therapist sues the client for non-payment (content of therapy remains confidential).
  4. When the therapist has been appointed by the court to examine the client.
  5. When the client has sought psychotherapy to commit a crime and/or escape punishment for a crime.
  6. When the client is under 16 years of age and has been the victim of a crime (e.g., extortion, statutory rape).
  7. In a proceeding requested by a defendant to determine sanity.
  8. When the psychotherapist has reasonable cause to believe that the client is in such
    mental or emotional condition as to be dangerous to themselves or to the person or property of another and that disclosure of the communication is necessary to prevent the threatened danger.
  9. In a proceeding brought by or on behalf of a client to establish competence.
  10. When a coroner requests information in the course of an investigation of deaths involving public health concerns, abuse, suicides, poisonings, accidents, SIDS, suspicious deaths, unknown deaths, criminal deaths, or when authorized by the decedent’s representative.
63
Q

Privilege

If a clt wants to waive privilege, you must….

A

Express your concerns to the clt, but ultimately honor their wishes and have them sign something acknowledging they are waiving privilege

64
Q

Advertising

Advertising is considered a legal or ethical issue?

A

Both

65
Q

Advertising

All your ads must include…

A

License #, but it’s best practice to also state your crendentials

66
Q

Advertising

Are testimonials for your services an acceptable form of advertisement?

A

No, unethical.

67
Q

Scope of practice and competence

Scope of practice refers to…

A

The range of services you can provide under your MFT license– legal issue.

68
Q

Scope of practice and competence

Scope of competence refers to…

A

The background, knowledge, training and experience you have working with specific populations – ethical issue

69
Q

Social media

What does the BBS want you to assess for social media use?

A
  1. the impact of the usage on the individual
  2. How the adults monitor and protect the minor
70
Q

Legal system involvement

What does the BBS want you to assess when working with those involved in the criminal justice system?

A
  1. the impact of the legal system involvement on their overal fx
  2. sensitivity to racial injustices
  3. Trauma from arrest or incarceration
  4. assessing social supports upon re-entry into society
71
Q

Motivational interviewing

what is motivational interviewing and who is it used for?

A

Motivational Interviewing is a treatment model that focuses on resolving ambivalence and using
the person’s own values and concerns to elicit change. Substance users primarily. Highlights discrepancy of actions against one’s own values.

72
Q

Motivational interview

Motivational interviewing: 4 key interventions used in modality

A
  1. open ended questions
  2. affirmations
  3. Reflecting
  4. Summarizing

LMFT TDC Cards (4 decks)

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