2- Ethics and professional practices

Question 1

You have developed and administered a reading enrichment program for gifted children. A friend of yours, who happens to be a newspaper reporter, asks you if his 7-year old daughter can enroll in the program. Would it be ethical for you to agree to enroll her?
Select one:
A. Yes, as long as the reporter doesn’t give you any publicity for the program in exchange.
B. Yes, as long as the friend pays the same amount for the program as everybody else and his daughter meets the requirements for enrollment in the program.
C. No, because, if you did, you’d be involved in a dual relationship.
D. No, because the reporter may feel pressured into giving your program free publicity.

Answer 1

Correct Answer is: C
Standard 3.05(a) of the Ethics Code applies here. It states in part that “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.” Here, the risk for such harm is present. For instance, your objectivity might be impaired because of your friendship with the reporter.
Additional Information: Multiple Relationships

Question 2

A psychologist compliments several of his co-workers on their clothing. One of his female co-workers indicates that she is not comfortable with these type of comments and asks him to stop. He complies with her request. His behavior is:
Select one:
A. Unacceptable
B. Unethical
C. Sexual harrassment
D. Acceptable

Answer 2

Correct Answer is: D
His behavior is acceptable. According to Standard 3.02 (Sexual Harassment): “Sexual harassment is sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with the psychologist’s activities or roles as a psychologist, and that either (1) is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or (2) is sufficiently severe or intense to be abusive to a reasonable person in the context. Sexual harassment can consist of a single intense or severe act or of multiple persistent or pervasive acts.” In this case the co-worker evidently found the psychologist’s comments offensive. The psychologist upon learning this stopped his behavior.
Additional Information: Discrimination and Harassment

Question 3

You are treating a family consisting of a father, mother, and their 13-year-old son. The boy comes to therapy limping and his arm is in a splint due to a sprain. Based on the family’s history, you suspect that the boy was beaten by his father but all three family members deny this is the case. In this situation, you should
Select one:
A. remind the family that therapy is most effective when information is not hidden.
B. maintain the family’s confidentiality unless or until you have proof that the boy was beaten.
C. talk to each family member separately.
D. report child abuse to your state child protective agency.

Answer 3

Correct Answer is: D
Every state has child abuse reporting laws that require psychotherapists to report cases of physical or sexual abuse to the state’s child protective agency. Therapists do not need proof that abuse has occurred; the trigger for a mandatory report is a reasonable suspicion.
remind the family that therapy is most effective when information is not hidden.
talk to each family member separately.
These two options may or may not be good ideas, but neither has to do with the major issue at hand, which is your mandatory reporting requirement.

Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 4

An article to be published in a psychology research journal is based on doctoral student’s dissertation. The work of the student’s thesis advisor, a well-known expert in the dissertation’s subject area, was cited extensively in the dissertation and the article. The advisor conducted a follow-up study and added the results of it to the results section of the article. He also modified he conclusion, adding an interpretation of the results of the follow-up study, and a few revisions to the student’s wording. In this case, the thesis advisor should be
Select one:
A. listed as the first author of the article.
B. listed as an author of the article.
C. should be credited in a footnote.
D. should be thanked by the student in text of the article.

Answer 4

Correct Answer is: B
According to standard 8.12 of APA’s Code of Conduct, “Except under exceptional circumstances, a student is listed as principal author on any multiple-authored article that is substantially based on the student’s doctoral dissertation.” Nothing in this question describes any exceptional circumstance. Thus, the student should be listed as the first author. However, the advisor substantially contributed to the article by conducting a follow-up study and including the results in the article. This contribution is sufficient to qualify him as one of the authors of the article.
Additional Information: Publication Credit

Question 5

A psychologist is impressed by an innovative treatment technique presented at a psychological conference. Although it is still an experimental treatment, the psychologist wants to start using it in his practice immediately. An ethical psychologist would:
Select one:
A. initiate the experimental treatment only if there are no alternative options available.
B. not use an experimental treatment until its effectiveness has been well established unless there are no alternative options available.
C. obtain a client’s informed consent before initiating an experimental treatment.
D. obtain a client’s informed consent, discuss with the client the experimental nature of the treatment and the availability of alternative treatments.

Answer 5

Correct Answer is: D
Experimental treatments are not prohibited in the Ethics Code; however psychologists need to be cautious in determining how to use them. According to Ethical Standard 8.02(b), “Psychologists conducting intervention research involving the use of experimental treatments clarify to participants at the outset of the research (1) the experimental nature of the treatment; (2) the services that will or will not be available to the control group(s) if appropriate; (3) the means by which assignment to treatment and control groups will be made; (4) available treatment alternatives if an individual does not wish to participate in the research or wishes to withdraw once a study has begun; and (5) compensation for or monetary costs of participating including, if appropriate, whether reimbursement from the participant or a third-party payor will be sought.”
Additional Information: Informed Consent for Research

Question 6

After almost two months, Dr. Roberts realizes the woman he’s been dating is the cousin of a client he has been seeing in therapy for six months. The best course of action initially for Dr. Robert’s would be to:
Select one:
A. discuss the matter with the client as soon as possible
B. immediately refer the client to another therapist
C. continue seeing both unless it is evident that the situation is creating a conflict
D. immediately stop seeing the woman

Answer 6

Correct Answer is: A
The Ethics Code does not directly address this particular situation however it warns against becoming involved in multiple relationships. Standard 3.05(b) of the Ethics Code states, “If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.” Consistent with the intent of the Code, the best option would probably be to discuss the matter with the client immediately.
While eventually it may be appropriate to refer the client to another therapist or end the relationship with the woman he is dating, neither would be Dr. Robert’s the best course of action initially. In other words, the correct choice does not mean that these other choices would not be the final outcome of this situation.
Additional Information: Multiple Relationships

Question 7

In the course of conjoint couple’s therapy, one of the spouses requests an individual appointment with you. According to the American Psychological Association’s Ethical Principles and Code of Conduct,
Select one:
A. seeing the client in individual therapy would not be allowed because it would constitute a prohibited dual relationship.
B. seeing the client in individual therapy would not be allowed because it would cause a conflict of interest.
C. seeing the client individual therapy would be allowed as long as the client’s disclosures in that context are kept confidential from the other spouse.
D. seeing the client in individual therapy would be allowed as long as it were consistent with the therapeutic contract you have with the couple.

Answer 7

Correct Answer is: D
Treating a patient in individual therapy and conjoint couple’s therapy can raise potential problems such as conflict of interest, and many family therapists only do so in rare cases or not at all. However, this practice is not prohibited by APA’s Code of Ethics. Specifically, standard 10.02 states that “When psychologists agree to provide services to several persons who have a relationship…they take reasonable steps to clarify at the outset (1) which of the individuals are clients/patients and (2) the relationship the psychologist will have with each person. “ In other words, it would be permitted to see a client in both conjoint and individual therapy if both parties agree to this arrangement at the outset of therapy. The arrangement would also have to include an agreement on confidentiality of disclosures in individual therapy.
Additional Information: Couple and Family Therapy

Question 8

A psychologist is seeing a client who is covered under her husband’s insurance policy that he obtained through his employment. As part of the application process for insurance, the husband signed a blanket release of information that permits release of all medical records to the insurer. As a follow-up to a claim the psychologist submitted, the insurer requests all therapy records from the psychologist. The psychologist’s best course of action would be to
Select one:
A. refuse to release any information without contacting the patient first.
B. attempt to determine what information is needed to resolve the claim, and only release that information.
C. release all of the information to the insurer, but take steps to ensure it is transmitted securely and identifying information related to third parties is redacted.
D. release the information without conditions.

Answer 8

Correct Answer is: B
Standard 4.04 of APA’s Ethical Principles and Code of Conduct applies to this question. It states “Psychologists include in written and oral reports”¦only information germane to the purpose for which the communication is made.” In other words, even though the client’s husband has signed a blanket release of information, the psychologist still must take steps to safeguard client privacy.
refuse to release any information without contacting the patient first.
Discussing the situation with the patient, as stated by this choice, might be appropriate, but the wording of the choice is too absolute–there is no need to “refuse” to disclose “any” information.

Additional Information: Maintaining Confidentiality

Question 9

Which of the following infractions accounts for the largest percentage of malpractice costs?
Select one:
A. lack of competence
B. breach of confidentiality
C. sexual contact with clients
D. improper billing practices

Answer 9

Correct Answer is: C
The infraction that accounts for the greatest proportion of malpractice claims depends on how the infractions are categorized. However, regardless of the way that malpractice claims are grouped, sex with clients is always the infraction that accounts for the greatest insurance costs, with reported figures ranging from 45 to 50%.
Additional Information: Sexual Intimacies

Question 10

A 45-year-old Korean man, who speaks limited English, has an appointment for an assessment with a psychologist who doesn’t speak Korean. Since the client speaks limited English, one of his children accompanies him and volunteers to translate for the psychologist. In this situation, the psychologist should:
Select one:
A. not allow the child to translate for the father.
B. allow the child to translate for the psychologist if the father voluntarily consents to this arrangement.
C. allow the child to translate for the psychologist if the child is proficient in both English and Korean.
D. allow the child to translate for the psychologist if the child is an adult.

Answer 10

Correct Answer is: A
The psychologist would not utilize the child to translate given the multiple relationships with the father and consequent potential loss of objectivity. Several biases could influence the child’s translations for his/her father including the difficulty for the child to try to avoid “helping” his/her father during the assessment. [See: Ethical Standard 2.05: “Psychologists … who use the services of others, such as interpreters, take reasonable steps to (1) avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity; (2) authorize only those responsibilities that such persons can be expected to perform competently on the basis of their education, training, or experience, either independently or with the level of supervision being provided; and (3) see that such persons perform these services competently.” ]
Additional Information: Psychologists Acting as Supervisors or Employers

Question 11

An experimental treatment that has been used successfully with animals only has recently been approved for research with human participants. Which of the following statements regarding the need to inform participants of the experimental status of the treatment is true?
Select one:
A. There is no need to inform participants that the treatment is experimental, since the treatment was shown to be safe in animal research.
B. There is no need to inform participants that the treatment is experimental, because they would not likely understand the connotations of the word “experimental.”
C. There is no need to inform participants that the treatment is experimental as long as the study was approved by an institutional review board.
D. Participants should be informed that the treatment is experimental.

Answer 11

Correct Answer is: D
Ethical Standard 8.02(b) states that “Psychologists conducting intervention research involving the use of experimental treatments clarify to participants at the outset of the research (1) the experimental nature of the treatment; (2) the services that will or will not be available to the control group(s) if appropriate; (3) the means by which assignment to treatment and control groups will be made; (4) available treatment alternatives if an individual does not wish to participate in the research or wishes to withdraw once a study has begun; and (5) compensation for or monetary costs of participating, including if appropriate, whether reimbursement from the participant or a third-party payor will be sought.”
Additional Information: Informed Consent for Research

Question 12

According to the most recent version of APA’s Ethical Standards and Code of Conduct, bartering goods and services in exchange for psychotherapy
Select one:
A. is prohibited.
B. should be refrained from under ordinary circumstances.
C. is acceptable if it is not clinically contraindicated and not exploitative.
D. is acceptable if the practice is common in the area where the therapist is practicing.

Answer 12

Correct Answer is: C
According to standard 6.05 of APA’s Ethical Standards and Code of Conduct (2002), “Psychologists may barter only if (1) it is not clinically contraindicated, and (2) the resulting arrangement is not exploitative.” The previous version of the standards contained a statement to the effect that psychologists ordinarily refrain from bartering, but that statement was removed in the most recent version, perhaps in recognition of the fact that bartering is a common arrangement in some communities and may be the only option for cash poor clients. Nonetheless, psychologists should proceed cautiously before entering into a bartering arrangement. Issues to consider include whether a fair value for the bartered goods/services can be established, and clinical considerations such as whether the nature of the transference would interfere in arranging a non-exploitative bartering relationship.
Additional Information: Barter

Question 13

Therapists who become sexually involved with their clients
Select one:
A. usually do so because they believe they are in love with the client as a result of the client’s unique and desirable characteristics.
B. usually do so as a result of a lack of experience and poor judgment.
C. usually do so to fulfill personal needs resulting from events in their own life.
D. do not show any characteristics that distinguish them from therapists who do not become sexually involved with their clients.

Answer 13

Correct Answer is: C
The experts generally agree that therapists who have sexual relationships with their clients are not only exhibiting poor judgment but are also usually suffering from some type of impairment, often related to boundary issues or unfulfilled needs. See J. D. Guy, The Personal Life of the Psychotherapist, New York, John Wiley & Sons, 1987.
Additional Information: Sexual Intimacies

Question 14

Which of the following terms refers to the right to refuse to have information released in a legal proceeding?
Select one:
A. privileged communication
B. confidentiality
C. privacy
D. juris secretas

Answer 14

Correct Answer is: A
Privileged communication is the legal term which refers to a patient’s right to refuse to have information, disclosed in psychotherapy, released in a legal proceeding.
Additional Information: Privilege Versus Confidentiality

Question 15

You belong to a managed-care panel and a client with a 12-session limit was referred to you. Without calling to cancel, she does not show up for her fourth session. How would you bill for the missed session?
Select one:
A. bill the insurance company
B. bill the client according to office policies
C. bill the client for the co-payment and the insurance company for the no-show
D. you cannot bill either the client or insurance company

Answer 15

Correct Answer is: B
The best answer is that you should bill according to your office policies which, presumably, was explained and agreed to by the client at the beginning of treatment (Standard 6.04: Fees and Financial Arrangements). If charging the client for the missed session was not agreed upon in advance, this would be unethical. You cannot bill the insurance company, since you should only bill insurance for services that you actually provide (Standard 6.06: Accuracy in Reports to Payors and Funding Sources). While your financial agreement may or may not require the client to cover the co-payment for missed sessions, Current Procedural Terminology (CPT) codes do not provide a code for no-shows, and billing for services not rendered is unethical.
Additional Information: Fees for Services

Question 16

In cases of litigation, which of the following is considered the key defense for a psychologist?
Select one:
A. licensure
B. liability insurance
C. sufficient record-keeping
D. informed consent

Answer 16

Correct Answer is: C
A review of the risk management literature indicates good record-keeping is the best key defense in cases of malpractice. (See: Knapp, S. (1997) Professional liability and risk management in an era of managed care, in D. T. Marsh and R. O. Magee [eds.], Ethical and Legal Issues in Professional Practice with Families, New York, John Wiley and Sons.).
Additional Information: Malpractice

Question 17

According to the Specialty Guidelines for Forensic Psychologists (APA, 1991), if a psychological evaluation is ordered by a court and the defendant to be evaluated informs the evaluating psychologist that he does not wish to cooperate, the psychologist should:
Select one:
A. conduct the evaluation
B. refuse to conduct the evaluation
C. refuse to conduct the evaluation unless the defendant consents
D. postpone the evaluation and notify the defendant’s attorney

Answer 17

Correct Answer is: D
Although it is not necessary to obtain informed consent for court-ordered evaluations, the subject of the evaluation should be informed of its purpose. Furthermore, if the subject does not want to be evaluated, the subject’s attorney should be contacted before taking further action. If the attorney also objects to the evaluation, the psychologist should then notify the court and respond as directed.

Question 18

Situations that legally permit a waiver of the privilege:
Select one:
A. differ from state to state.
B. differ from state to state only in situations when clients are involuntarily hospitalized.
C. do not differ from state to state when clients are involuntarily hospitalized.
D. do not differ from state to state

Answer 18

Correct Answer is: A
Legally-defined exceptions to privilege varies from state to state. However, most, if not all, states, waive privilege when a psychologist is acting in a court-appointed capacity; a client initiates a malpractice or other lawsuit against a therapist; a client has introduced a mental condition as a defense in a civil suit; a client has sought the assistance of a therapist solely for the purpose of committing a crime; and a therapist determines that a client is in need of hospitalization for a mental or psychological disorder.
Additional Information: Privilege

Question 19

A psychologist is working for a company that changes health care providers due to cost-effectiveness. The new provider has a policy that compromises the employee’s future limits to confidentiality. The psychologist should
Select one:
A. refuse to follow the new procedures and leave immediately.
B. outline her points of dissatisfaction and send it to the new provider.
C. make clear with each client the company’s new limits to confidentiality.
D. organize a strike and call CNN.

Answer 19

Correct Answer is: C
According to Standard 3.11 (Psychological Services Delivered To or Through Organizations), “Psychologists delivering services to or through organizations provide information beforehand to clients and when appropriate those directly affected by the services about (1) the nature and objectives of the services, (2) the intended recipients, (3) which of the individuals are clients, (4) the relationship the psychologist will have with each person and the organization, (5) the probable uses of services provided and information obtained, (6) who will have access to the information, and (7) limits of confidentiality. As soon as feasible, they provide information about the results and conclusions of such services to appropriate persons.”
refuse to follow the new procedures and leave immediately.
If you choose this answer and leave abruptly, you are abandoning your client.
outline her points of dissatisfaction and send it to the new provider.
You may also want to do this-outline your points of dissatisfaction-but this wouldn’t be your first or most important consideration.

Additional Information: Discussing the Limits of Confidentiality

Question 20

You are working as a psychologist in a hospital with a patient suffering from head trauma. In your presence, the patient develops Delirium. In this situation, you should:
Select one:
A. bring more people into the room.
B. find a physician for a medication consultation.
C. stay with the person to provide support and help him remain calm.
D. recommend ECT treatment.

Answer 20

Correct Answer is: C
This is a difficult question because it requires you to know about clinical management of Delirium and then to choose between two choices that are not bad answers. General principles of addressing an episode of Delirium include providing environmental support, manipulating the patient’s environment in order to reduce confusion and disorientation, and giving medication if the patient is agitated, psychotic, or has insomnia.
stay with the person to provide support and help him remain calm.
find a physician for a medication consultation.
Both of these options are good answers to this question. However, “stay with the person to provide support and help him remain calm” is better for the following reasons: 1) Not all Delirium patients require medication; only if the patient is agitated, psychotic, or can’t sleep at night is medication necessary, and 2) “find a physician for a medication consultation” implies that you would leave the patient to go find a physician. You should not leave a patient with Delirium alone, and even if a nurse or somebody else were available to stay with the patient, you should avoid sudden changes in a Delirium patient’s environment.
bring more people into the room.
This choice, as phrased, is not a good idea – bringing strange people into the room could increase the patient’s sense of disorientation and confusion. Having a relative or other familiar person stay with the patient is a good idea, but this option is not specific about what people you would bring into the room.
recommend ECT treatment.
This choice, ECT, is actually used in rare cases for patients who do not respond to environmental manipulation or medication; however, you certainly would not recommend it right away. By the way, the primary treatment of Delirium – addressing the underlying medical or substance-related disorder that is causing the symptom – is not a choice here.

Additional Information: Etiology (Delirium)

Question 21

From a legal standpoint, a charge of malpractice against a psychologist would be held valid if it were proven that the therapist:
Select one:
A. had a duty of care to the patient, held malevolent intentions toward the patient, and engaged in activity that resulted in harm to the patient.
B. had a duty of care to the patient and held malevolent intentions toward the patient; demonstration of actual harm is not necessary.
C. had a duty of care to the patient and engaged in activity that resulted in harm to the patient; malevolent intentions need not be present.
D. engages in activity that harms a patient; malevolent intentions and a duty of care are not necessary.

Answer 21

Correct Answer is: C
For a malpractice claim against a psychologist to be held valid, three elements must be proven: 1) the psychologist must have had a professional relationship with (and, therefore a duty of care to) the client; 2) the psychologist must have been negligent or failed to live up to that duty; and 3) harm to the patient must have resulted. In other words, the psychologist’s intentions are not an issue.

Additional Information: Malpractice

Question 22

The mother of a 22-year-old client of yours calls to inform you that your client has died. The mother requests a copy of your client’s therapy records. You should:
Select one:
A. release the records to her
B. refuse to release the records
C. release the records only after obtaining a signed release from the mother
D. release the records only after obtaining a signed release from the executor or administrator of the client’s estate

Answer 22

Correct Answer is: D
Most state laws provide a deceased person’s executor or administrator the right to access confidential records of the client. The deceased person’s executor or administrator must be legally designated as the deceased’s representative, usually by a probate court. Without such a designation, records should not be released.

Question 23

Which of the following would be least relevant in a malpractice suit brought against a psychologist?
Select one:
A. whether or not the psychologist committed a negligent act or omission.
B. whether or not actual, provable damage or harm to a patient resulted from the psychologist’s actions.
C. whether or not the psychologist’s actions deviated from generally accepted standards of care.
D. whether or not the psychologist intended to cause damage to the patient

Answer 23

Correct Answer is: D
Though the specific rules regarding medical malpractice (which apply to health care professionals including psychologists) vary from state to state, the general definition is agreed upon. Medical malpractice occurs when a negligent act or omission, deviating from generally accepted standards of practice, results in demonstrable damage or harm to a patient. Malpractice does not necessarily mean that the practitioner intended to cause damage or harm.
Additional Information: Malpractice

Question 24

While attending a staff meeting at a mental health facility where you work, you learn that one of your colleagues, a psychologist, is behaving in an unethical manner toward one of her patients. Despite being advised to do so by several members of the staff, she states that she will not change her behavior. What should you do in this situation?
Select one:
A. Approach the colleague individually and urge her to change her behavior; if she refuses, report her to the appropriate ethics committee.
B. Approach the colleague individually and urge her to change her behavior; if she refuses, recommend to the director of the facility that she be fired.
C. Report the colleague to the appropriate ethics committee immediately, since she has already stated that she will not change her behavior.
D. Announce in the staff meeting that you want to “go on the record” as noting that the psychologist is behaving unethically.

Answer 24

Correct Answer is: A
The Ethics Code states that you should deal with ethical violations by another psychologist in an informal manner, by bringing it to the attention of the psychologist. A report to an ethics committee should be made when the attempt at informal resolution has failed or if the violation is not amenable to informal resolution. Thus, you should speak to the psychologist privately and report her to an ethics committee if she still refuses to change her behavior. You may have thought that, since the psychologist has already stated her refusal to behave ethically, you should go ahead and report her, without bothering to talk to her. This actually makes sense, but the Ethics Code requires that you attempt an informal attempt at resolution first. A staff meeting is a formal setting, and does not personally give you the opportunity to attempt an informal resolution.
Additional Information: Informal Resolution and Reporting of Ethical Violations

Question 25

A psychologist is undertaking a research project in a high security prison on the effects of certain food additives on behavior. The prison population is surveyed, informed of the purposes of the study, and volunteers are sought. The volunteer participants are again explained the purpose of the study and are asked to give their written consent to be participants. Because of the nature of the study, its importance to the food industry and the governmental regulatory agency, and the need to keep as much control of the participants' food intake as is feasible, the participants are informed that, once they begin the study, they are expected to remain in it at least until the first evaluation period, six weeks from the beginning of the research program. They are told that they shouldn't agree to participate unless they are reasonably sure they can complete at least this initial phase. Those participants who then agree and give written consent are included in the study. According to APA's Ethical Principles, such a study: Select one: A. should not be undertaken as the participants are not allowed to freely withdraw. B. would be allowed only if the participants gave specific acknowledgment of their agreement to abide by the withdrawal arrangements. C. is probably unethical because the prison research review committee did not also agree to the participation arrangements. D. meets all research guidelines and can be undertaken.

Answer 25

Correct Answer is: A The ethical standards require that research participants be allowed to withdraw from a study at any time. Hence the answer must be: "should not be undertaken as the participants are not allowed to freely withdraw". Additional Information: Informed Consent for Research

Question 26

You are working in a clinic as a psychologist and your supervisor, who is working on his Ph.D. in psychology, wants to begin conducting family therapy. Since this is an area which you have expertise in, he asks you to be the consulting supervisor. In this situation: Select one: A. you should refer the supervisor to someone else B. you could only provide the supervision if you first clearly define the roles C. the ethics code does not apply D. you could provide the supervision as long as his clients are informed and consent

Answer 26

Correct Answer is: A The Ethics Code requires that, whenever feasible, psychologists avoid entering into multiple relationships. The best course of action would, therefore, be to refer the supervisor to another qualified professional. Additional Information: Multiple Relationships

Question 27

You are working with a couple in marital therapy and are conducting the initial interview. You realize that although the husband doesn't remember you, the two of you once dated. You should Select one: A. speak to the husband alone, explain the situation and ask him if he feels comfortable with proceeding. B. see the wife in individual therapy only. C. refer the couple to another therapist. D. let the couple know the situation and then proceed with therapy.

Answer 27

Correct Answer is: C This question is fairly easy to answer once you remember you are not obliged to provide services for all your referrals. This is an initial interview and you have a situation that involves a multiple relationship. You need to refer this couple to one of your competent colleagues. Additional Information: Multiple Relationships

Question 28

If a psychologist begins treatment with a client knowing that there is a high probability that the records will be subpoenaed, the psychologist should: Select one: A. not maintain any records in order to protect the client's best interests B. maintain adequate records C. maintain only information about the client which will not be damaging if disclosed D. maintain records, but only include the minimal requirements in adherence with the law

Answer 28

Correct Answer is: B According to APA's Record Keeping Guidelines (1993, 48(9), 984-986) records should minimally include: identifying data, dates and types of service, fees, any release of information obtained, any assessment, plan for intervention, consultation, summary reports, and/or testing reports. not maintain any records in order to protect the client's best interests It would, therefore, be unethical (and possibly illegal), not to maintain any records. maintain only information about the client which will not be damaging if disclosed Although records should be written with an awareness of the risk of the client or others gaining access to them, it would likely be incomplete and, therefore, unethical to include only information that will not be damaging. maintain records, but only include the minimal requirements in adherence with the law Patient records should meet the minimal requirements of federal, state, and local laws; however, this option indicates that the psychologist should only meet those minimum requirements. There may be jurisdictions in which the Ethics Code or guidelines have a higher standard than the law; in which case, the psychologist should adhere to the higher standard. Additional Information: Records

Question 29

You have been court ordered to complete an evaluation. As you start the evaluation, the client begins sharing information that she obviously would not want shared further. You should: Select one: A. Say nothing and remain objective B. Refer her to a different psychologist C. Advise her that the information she is giving you is not pertinent D. Reexplain the limits of confidentiality before proceeding

Answer 29

Correct Answer is: D Remember, that in this case the client is the court. And you are ethically bound to behave appropriately with all involved parties. You should have already explained the limits of confidentiality before beginning the evaluation; however, it is perfectly appropriate and most ethical to stop and re-clarify the limits of confidentiality. Additional Information: Discussing the Limits of Confidentiality

Question 30

A new therapeutic intervention for heroin addiction is tested in a 6-month study, comparing it to existing treatment programs and a control group. At the end of 3 months the researchers find a dramatic success rate for the experimental treatment with over 75% of the clients maintaining abstinence from heroin, compared to 30% for the other treatment groups and 10% for the control group. What should the researchers do? Select one: A. inform the other groups of the results and recommend that they begin the new treatment program. B. inform the other groups of the results and give them the option of receiving the new treatment or continuing with their existing program. C. not inform the other groups of the results D. wait until the conclusion of the study and then offer the other groups the new treatment

Answer 30

Correct Answer is: D Since this study was designed for a duration of 6 months, it should continue as planned before any conclusions regarding the effectiveness are made. Informing any of the groups about the relative effectiveness of any of the treatments prior to the conclusion of the study would likely contaminate the validity of the final results. Of course, the researchers have an obligation to inform the participants of the results and conclusions of the research, but this should not be provided until the conclusions have been made. Additional Information: Debriefing

Question 31

The mother of your 8-year-old patient calls to inform you of a meeting being held at the child's school in 30 minutes to discuss the child's recent behavioral problems. The child reportedly has had repeated bouts of yelling and hitting other students. The mother requests that you call the school psychologist to discuss your evaluation of the child's behavior. You should: Select one: A. tell the mother that you're sorry that you can't release any information until she comes in to sign a release. B. agree to provide the information and document the mother's verbal consent to release it in your patient's file. C. call the school and provide them with the minimal amount of information that is appropriate. D. agree to provide the information by phone but follow up with a written report to the school psychologist.

Answer 31

Correct Answer is: B The Ethics Code states that consent to reveal confidential information must be obtained, however, it does not require the consent to be in writing. Documentation of the mother's verbal consent in a progress note could be sufficient, particularly under an urgent situation such as this, in which it is not feasible to obtain a written consent. As suggested in this choice, you should also limit the disclosure to only relevant, though not necessarily "minimal" information. Additional Information: Informed Consent

Question 32

A psychologist can kill an animal in research: Select one: A. as long as the animal is treated humanely B. as long as an anesthetic is used, with an effort to minimize pain C. when it is appropriate and if it is done rapidly, with an effort to minimize pain D. under no circumstances

Answer 32

Correct Answer is: C According to Ethical Standard 8.09(g) (Humane Care and Use of Animals in Research), "When it is appropriate that an animal's life be terminated, psychologists proceed rapidly, with an effort to minimize pain and in accordance with accepted procedures." In all research with animals, the animals must be treated humanely. If surgical procedures are performed, they are done under appropriate anesthesia with techniques to avoid infection and minimize pain. Additional Information: Care and Use of Animals in Research

Question 33

The purpose of APA's Standards for Educational and Psychological Testing is to Select one: A. provide guidelines for establishing the reliability and validity of tests. B. provide criteria for the evaluation of tests. C. provide guidelines for the use of tests in various settings such as psychotherapy, the workplace, and the courtroom. D. offer psychologists instructions and advice regarding the proper way to administer tests.

Answer 33

Correct Answer is: B The Standards for Educational and Psychological Testing is a set of guidelines published jointly by the American Psychological Association, the American Educational Research Association, and the National Council on Measurement in Education. The most recent version of the Standards, published in 1999, provides 15 sets of guidelines divided into three parts: Test Construction, Evaluation, and Documentation; Fairness in Testing; and Testing Applications. Their purpose, according to the introduction, is to "provide criteria for the evaluation of tests, testing practices, and the effects of test use." Additional Information: APA's Standards for Educational and Psychological Testing

Question 34

A psychologist working for an Employee Assistance Program (EAP) has seen a client who was referred by her supervisor. The supervisor asks the psychologist if the employee has kept the appointment. The psychologist should Select one: A. provide the supervisor only with this information but nothing else. B. refuse to give the supervisor this information. C. provide this information as well as any other information about the client the supervisor is interested in. D. consult with the manager of the company.

Answer 34

Correct Answer is: A When a mental health professional works as part of an EAP, the potential for confidentiality dilemmas is present. Employers, after all, often feel they have the right to know if employees are benefitting from EAPs, but mental health professionals must understand the importance of confidentiality - including, in most circumstances, the confidentiality of whether a person is or is not a client or patient. In the context of EAPs, however, it is considered acceptable to give the relevant information to relevant people; specifically, it's OK to tell the supervisor (or the referring person in the organization) if the employee keeps a scheduled appointment, if treatment is needed, and if the employee has agreed to and accepted treatment. All other information should be kept confidential (barring, of course, the employee's consent to release it).

Question 35

Although you have extensive experience in administering the WAIS-R, you have not yet administered the WAIS-III. If you would like to administer the WAIS-III you should: Select one: A. obtain additional training B. obtain supervision by a psychologist experienced in the use of the WAIS-III C. seek consultation to determine the most appropriate action to take D. be able to administer the WAIS-III since it is very similar to the WAIS-R

Answer 35

Correct Answer is: A Standard 2.01(c) (Boundaries of competence), requires psychologists who provide services involving populations, areas, techniques, or technologies that are new to them undertake relevant education, training, supervised experience, consultation, or study. When administering a test, or a new version of a test which you are not familiar with, the best course of action would be to obtain the necessary training.

Question 36

An attorney contacts a psychologist requesting that his client be given a psychological evaluation prior to appearing in court. Following the evaluation the client asks that his records not be released to the court, although his attorney believes that releasing the records would be in his client's best interest. The psychologist should: Select one: A. release the records since there is no privilege regarding forensic evaluations B. release the records since the attorney requested the evaluation C. not release the records D. seek consultation

Answer 36

Correct Answer is: C Since this does not appear to be a court-ordered evaluation, the examinee remains the holder of the privilege; thus, his records should not be released to the court without his consent. Additional Information: Maintaining Confidentiality

Question 37

A psychologist sees clients at a facility where fees are capitated. What does this mean? Select one: A. providers are paid a fee each time a service is performed B. clients are billed according to their ability to pay C. clients are required to meet a deductible before their insurance will pay D. providers receive a fixed dollar amount over a specific period of time to cover the service needs of a fixed number of clients

Answer 37

Correct Answer is: D The term "capitation" refers to a fixed amount of money paid per person, not by the visit or procedure. Managed care companies usually express capitation in terms of cost per member per month. providers receive a fixed dollar amount over a specific period of time to cover the service needs of a fixed number of clients As stated in this response, providers are paid a specific dollar amount, for a specific time period, to cover the service needs of a specific number of people. If a provider exceeds his or her capitated payment, he or she may not be able to cover his or her costs and, consequently, may limit his or her services.

Question 38

You are seeing a 15 year old girl in therapy. Prior to beginning treatment, you, the girl, and her parents agree that you will maintain the girl's confidentiality and not discuss anything she reveals in therapy with her parents. In the first session you realize that the girl is very depressed, and during the fifth session she tells you that she wants to kill herself. Under these circumstances, you will: Select one: A. not contact her parents but have the girl sign a "no-suicide contract." B. contact her parents only if they are unaware of the girl's depressed state. C. contact her parents if you feel the girl is at high risk for attempting suicide. D. contact the child protective agency.

Answer 38

Correct Answer is: C Even though you've come to an agreement with the parents and the adolescent, the parents are still the holder of the privilege. Also, whenever someone is a threat to themselves, you have an obligation to take steps to protect them, even when this means violating confidentiality. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 39

A psychologist sends the MMPI to a client through the mail. The client will complete the test at home and return it to the psychologist by mail. This is: Select one: A. acceptable as long as the client has signed a statement saying she will not breach test security. B. acceptable as long as the psychologist provides adequate instructions over the phone. C. acceptable as long as the test is sent by certified mail. D. unacceptable.

Answer 39

Correct Answer is: D This is pretty clear: As a psychologist, you're responsible for maintaining test security. In addition, you'd want to administer the MMPI under controlled conditions to obtain valid results. If you sent the test to the client, you'd have no control over testing conditions. Additional Information: Maintaining Test Security

Question 40

You have a client who does not want their records released under any circumstances. The attorney has subpoened you. Your best course of action is to: Select one: A. Respond in-person, but don't take the records B. Take the records, but don't turn them over C. Ignore the entire matter D. Destroy the records

Answer 40

Correct Answer is: B You should respond to the subpoena by asserting the psychotherapist-client privilege on the client's behalf. If you cannot be released from the subpoena, you should appear at the legal proceeding with the documents requested; however, you should not actually release any information in the records, unless the judge orders you to do so. Keep in mind that a subpoena duces tecum requires a person to appear at a designated time and place with a copy of the records. It does not necessarily require the person to release those records. Additional Information: Responding to a Subpoena

Question 41

Your managed care company denies to pay for further sessions for a client and requests that you do not tell the client of its decision. In this situation, you should Select one: A. terminate with the client as requested. B. continue to provide treatment to the client if you believe the client could benefit from treatment. C. inform the client of all aspects of this decision that are relevant to treatment. D. seek the advice of an attorney regarding a possible lawsuit against the managed care company.

Answer 41

Correct Answer is: C This question is not so much about managed care as it is about informed consent procedures. Whether or not a patient's treatment is being financed by a managed care company, a psychologist should inform clients of relevant information regarding treatment at the outset of the professional relationship and continue to provide such information as it arises throughout treatment. Due to the nature of managed care companies, there may be more concerns that need to be discussed with managed care patients than with other clients. But the general informed consent requirement applies to this situation as well as many others. The other choices don't really address the issue raised by the question. terminate with the client as requested. continue to provide treatment to the client if you believe the client could benefit from treatment. These two choices describe two possibly acceptable responses to this situation, but neither are requirements -- whether or not you would continue to see the patient would depend on a number of factors, including the patient's needs and your policies. seek the advice of an attorney regarding a possible lawsuit against the managed care company. This choice implies that the managed care company's actions are illegal and have caused you harm, but the question does not provide enough information for you to reasonably conclude that this is true. Additional Information: Informed Consent

Question 42

Of the following, which would not be inconsistent with a psychologist's ethical obligations? Select one: A. Beginning a sexual relationship with a cousin of a former patient who terminated therapy a year earlier. B. Engaging in a sexual relationship with a patient who ended therapy two years earlier wherein therapy was not terminated for the intention of commencing this relationship. C. Accepting a new patient with whom the psychologist had been sexually involved four years before. D. Having a sexual relationship with a psychological assistant that the psychologist is currently supervising.

Answer 42

Correct Answer is: A Beginning a sexual relationship with a cousin of a former patient who terminated therapy a year earlier. While there are several types of inappropriate relationships described in this question, the correct response would not be inconsistent with a psychologist's ethical obligations and is the correct answer. Ethical Standard 10.06 specifically mentions "current" clients or patients, but does not prohibit "former" clients or patients. "Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard." Engaging in a sexual relationship with a patient who ended therapy two years earlier wherein therapy was not terminated for the intention of commencing this relationship. While sexual relationships with former patients are not altogether prohibited after two years in the Ethics Code, they are discouraged, and the psychologist would "bear the burden of demonstrating that there has been no exploitation." Specifically, Ethical Standard 10.08 states "Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances." Accepting a new patient with whom the psychologist had been sexually involved four years before. This response is incorrect as Ethical Standard 10.07 states, "Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies." Having a sexual relationship with a psychological assistant that the psychologist is currently supervising. Ethical Standard 7.07 addresses this response: "Psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority." Additional Information: Sexual Intimacies

Question 43

Which of the following is a mental health service that HMOs must provide under federal requirements? Select one: A. pre- and post-pregnancy counseling. B. psychodynamically oriented psychotherapy. C. inpatient psychiatric care. D. short-term outpatient evaluative crisis intervention.

Answer 43

Correct Answer is: D Federal laws regarding qualification for an HMO requires that the company provide "short-term (not to exceed 20 visits), outpatient evaluative crisis intervention services", and "medical treatment and referral for alcohol and drug addiction." These are the only qualifications related to mental health services. Most HMOs provide certain additional services, because doing so reduces their costs in the long-run.

Question 44

The difference between professional ethics and professional values is best stated by which of the following? Select one: A. If a psychologist is ethical, there should be no difference between ethics and values. B. Ethics are standards for practice set by the profession, while values refer to judgments of right and wrong. C. Ethics can be stated more specifically than values. D. Values specifically define appropriate professional conduct, while ethics are a more general code of proper professional conduct.

Answer 44

Correct Answer is: B The correct response distinguishes between ethics and values. Values are concerned with what is good and desirable and ethics refer to correct or appropriate practice. Values and ethics are related in that the latter are usually derived from the former; for example, privacy is a value that is reflected in the ethical standard requiring psychologists to obtain clients' informed consent before releasing information about therapy. These two responses (*) are not necessarily true, and this answer (**) is not true since values do not specifically define appropriate professional conduct. * If a psychologist is ethical, there should be no difference between ethics and values. This response not necessarily true. * Ethics can be stated more specifically than values. This response not necessarily true. ** Values specifically define appropriate professional conduct, while ethics are a more general code of proper professional conduct. This response is not true since values do not specifically define appropriate professional conduct. Additional Information: Preamble and General Principles

Question 45

A defense attorney contacts a psychologist to conduct an assessment of a client who has been charged with assault. Because the client does not have the means to pay, the defense attorney was hired by the family. The psychologist meets the client to perform the assessment however the client appears to lack the capacity to fully understand the reasons for the assessment. The psychologist should: Select one: A. refuse to perform the assessment because the results would be invalid. B. discuss the purpose of the assessment to the client. C. obtain informed consent from the family. D. obtain the informed consent from the defense attorney.

Answer 45

Correct Answer is: B Ethical Standard 9.03(b) states, "Psychologists inform persons with questionable capacity to consent ... about the nature and purpose of the proposed assessment services, using language that is reasonably understandable to the person being assessed." Additional Information: Informed Consent for Assessment

Question 46

According to APA's Ethical Standards, psychologists would be banned under all circumstances from soliciting testimonials from Select one: A. anyone. B. current patients. C. current and former patients. D. no one - the Ethical Standards do not deal with the issue of testimonials.

Answer 46

Correct Answer is: B Ethical Standard 5.05 states that "Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence." So you would be banned under all circumstances from soliciting testimonials from current patients. Certainly, the "vulnerable due to undue influence" language would ban you from soliciting testimonials from former patients in many if not most cases. But this is not an absolute ban from seeking testimonials from former patients, so, due to the wording "under all circumstances" in the question, this choice ("current and former patients") is not the best answer. Additional Information: Testimonials

Question 47

When a psychologist believes that her patient's records will be used in a legal proceeding, she should: Select one: A. rewrite them to meet the higher standards of a forensic setting B. avoid the use of any psychological terminology in favor of legal terminology C. maintain them in the same kind and quality as all of her patients' records D. maintain them in the kind and quality consistent with reasonable scrutiny in an adjudicative forum

Answer 47

Correct Answer is: D According to the Specialty Guidelines for Forensic Psychologists (1991), "When forensic psychologists conduct an evaluation or engage in the treatment of a party to a legal proceeding, with foreknowledge that their professional services will be used in an adjudicative forum, they incur a special responsibility to provide the best documentation possible under the circumstances." Additional Information: Records

Question 48

A forensic psychologist is asked to review and make conclusions regarding a defendant's psychological evaluation that was conducted 4 years ago following a similar crime that the defendant is now accused of. The psychologist should: Select one: A. refuse the request B. comply with the request but interpret the previous findings with caution C. reevaluate the person and disregard the previous findings D. reevaluate the person and interpret the previous findings with caution

Answer 48

Correct Answer is: D According to the Forensic Specialty Guidelines, "Forensic psychologists avoid giving written or oral evidence about the psychological characteristics of particular individuals when they have not had an opportunity to conduct an examination of the individual..." And, according to Ethical Standard 9.08, psychologists also do not base their decisions on outdated results. Thus, the psychologist in this case should make a reasonable effort to reevaluate the person. However, it would probably be inappropriate to completely disregard the previous findings. The best approach would be to reevaluate the person and interpret the previous findings with caution. Additional Information: Use of Assessments

Question 49

The purpose of licensure in psychology and other mental health fields is to Select one: A. protect the consumer by limiting practice to those who are qualified. B. provide uniform national standards of minimal competence in the field. C. protect the public by ensuring that professional have enough knowledge about the field. D. allow consumers to choose professionals who are the best in the field.

Answer 49

Correct Answer is: A All 50 states in the U.S., the 10 provinces in Canada, and the territories of Guam, Puerto Rico, U.S. Virgin Islands, and the District of Columbia regulate the practice of psychology and require psychologists to obtain licenses in order to practice professionally. The purpose of licensure and licensure laws are to protect the public by only allowing qualified persons to practice; i.e., persons who have demonstrated that have met minimum standards of competence as defined by state or provincial law. provide uniform national standards of minimal competence in the field. Contrary to this option, licensure is a matter of state law, not national standards. protect the public by ensuring that professional have enough knowledge about the field. This choice is not complete enough; licensure is intended to ensure that professionals meet standards of competence, which extend beyond just knowledge. Additional Information: Licensure and the EPPP

Question 50

You have been retained by the court to make a recommendation concerning custody of a 4 year old girl. You have met with the mother on two occasions and also administered some psychological tests. You have completed a phone interview with the father who lives out of state. In reporting to the court, you should Select one: A. explain that you cannot present any data. B. recommend custody go to the parent you have determined is most competent to parent. C. present the results of your evaluation but refrain from making a recommendation. D. make a recommendation, but note that your evaluation of the father was incomplete.

Answer 50

Correct Answer is: C present the results of your evaluation but refrain from making a recommendation. This is another question where it is tempting to do more than you are qualified to do. This answer is correct; Standard 9.01(b) states that "psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions. When, despite reasonable efforts, such an examination is not practical, psychologists document the efforts they made and the result of those efforts, clarify the probable impact of their limited information on the reliability and validity of their opinions, and appropriately limit the nature and extent of their conclusions or recommendations." A phone conversation is not a psychological evaluation. make a recommendation, but note that your evaluation of the father was incomplete. You may have chosen this response, but it is pertinent to ask yourself the question that if you could not make a complete evaluation why would you make a recommendation. Additional Information: Use of Assessments

Question 51

You have been court-ordered to evaluate a prisoner who is being tried for murder. You explain the purpose of the evaluation and complete it. As you are packing up your testing materials, the prisoner smirks, and says, "I agreed to this but I didn't sign anything. You are out of luck, doctor." Select one: A. You should go ahead and complete the report, but leave out the prisoner's comments. B. The prisoner is correct -- you should refer for a new assessment. C. You should add this verbal comment to the report, noting the prisoner's passive-aggressive tendencies. D. You should have read the case file because you would have learned that the accused is also an attorney; this would affect how you would treat this prisoner.

Answer 51

Correct Answer is: A Because this evaluation was court-ordered you were not actually required to obtain informed consent. However Standard IV.E.1 of the Speciality Guidelines for Forensic Psychologists states that "if the client appears unwilling to proceed after receiving a thorough notification of the purposes, methods, and intended uses of the forensic evaluation, the psychologist should take steps to place the client in contact with his or her attorney for the purpose of legal advice on the issue of participation." Remember, you always want to take the most careful and conservative approach if possible. You should add this verbal comment to the report, noting the prisoner's passive-aggressive tendencies. While you may be tempted to choose this option and add the client's comments to your report, this would contradict Standard V.C. of the Forensic Guidelines which states that, "In situations where the right of the client to confidentiality is limited, the forensic psychologist makes every effort to maintain confidentiality with regard to any information that does not bear directly upon the legal purpose of the evaluation." You should have read the case file because you would have learned that the accused is also an attorney; this would affect how you would treat this prisoner. Finally, as a thorough evaluator you should have read the case file closely; however, you would not proceed with an evaluation differently just because your client is an attorney. Additional Information: Specialty Guidelines for Forensic Psychology

Question 52

You've completed a psychological assessment on a child whose parents are divorced. They have joint custody. The child's mother doesn't want the father's girlfriend present for the debriefing session although the father does want her there. What do you do? (The mother paid for the testing). Select one: A. Have only the custodial parents present B. Have only the mother present C. Have two sessions, one with the mother, one with the father and his girlfriend D. Send everyone a copy of the report and only meet if one of the parents needs further clarification

Answer 52

Correct Answer is: A Having just the custodial parents present is probably your best course of action. You don't have the right to breach the child's confidentiality to the girlfriend-that is the father's call. Both parents do have a right to the results unless you can think of a reason that such access would be harmful to the child. Avoiding the situation by just sending a copy of the report isn't in line with the Standard 15.10 of Test Administration, Scoring and Reporting that indicates that those responsible for testing programs should provide appropriate interpretations when test score information is released. Finally, who paid for the testing is not pertinent to who has access to the results. Additional Information: Releasing and Explaining Test Results

Question 53

A 14-year old is brought to your office. He does not want to be there. His mother notes that they are referred by the school. The only presenting complaint is that his grades are much poorer than last year. Your evaluation indicates no significant other problematic areas in his life. Your best course of action is to: Select one: A. schedule ongoing treatment with yourself. B. continue your assessment to ascertain the presence of hidden pathology. C. explore the possibility of an educational intervention. D. not do anything.

Answer 53

Correct Answer is: C This is a practical, and often realistic, problem. You have a 14-year-old who doesn't want to come to you. You have a referral from the school that his grades are going down. You made an assessment that there doesn't appear, now anyway, to be any psychiatric disorder. So, what would you do? There's no need to suggest treatment since he doesn't want to come see you. And, besides, you haven't found any problems. You wouldn't continue an assessment since, from the information given, you already concluded there isn't much psychological conflict present. You could do nothing, telling him to come back to you if things get worse. That's one possibility. Another possibility presented as a choice is to explore some educational intervention, such as talking to his teachers to investigate how his school environment might be optimized. So you could certainly propose intervening with the school. And between suggesting this, and doing nothing, we'd go with exploring a school-based intervention.

Question 54

The APA's Record Keeping Guidelines (2007) suggest complete records be retained for: Select one: A. seven years post-termination of therapy. B. 10 years post-termination of therapy. C. three years post-termination and a summary of the record for at least four more years. D. three years post-termination and a summary of the record for at least seven more years.

Answer 54

Correct Answer is: A The APA's Record Keeping Guidelines (2007) indicates a "psychologist strives to be aware of applicable laws and regulations and to retain records for the period required by legal, regulatory, institutional, and ethical requirements." And in the case where there is no legal or institutional regulations, "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. In some circumstances, the psychologist may wish to keep records for a longer period, weighing the risks associated with obsolete or outdated information, or privacy loss, versus potential benefits associated with preserving the records." Additional Information: Records

Question 55

According to the Ethics Code, under what condition is it acceptable to provide therapy to a former sex partner? Select one: A. under no condition B. when the sexual relationship ended at least two years ago C. when the sexual relationship ended at least two years ago and the therapist has determined that the previous relationship will not affect the ability to provide effective therapy D. when the therapist determines that the therapeutic relationship will be not be exploitative and is not clinically contraindicated

Answer 55

Correct Answer is: A This is covered by Standard 10.07 of the Ethics Code, which states that "Psychologists do not accept as therapy patients or clients persons with whom they have engaged in sexual intimacies." Additional Information: Sexual Intimacies

Question 56

In cases of ethical violations investigated by the APA following the loss of a psychologist's license, which of the following is the most common ethical issue involved? Select one: A. multiple relationships (nonsexual) B. practice outside the boundaries of competence C. sexual misconduct D. confidentiality breaches

Answer 56

Correct Answer is: C Every year, the Ethics Committee files a report on the number and types of ethical complaints against psychologists it has investigated. In cases in which the committee investigated a complaint following a state board's revocation of a psychologist's license, sexual misconduct has been the ethical issue involved in the preponderance of cases. Additional Information: Sexual Intimacies

Question 57

According to APA's Ethical Standards and Code of Conduct, when a client makes a credible threat of violence against a specifically identifiable victim, a therapist can breach confidentiality Select one: A. only when legally mandated to do so B. only when legally mandated or legally permitted to do so. C. only if he has discussed the legal limits of confidentiality at the outset of therapy. D. only if he has first attempted to resolve any conflict between the law and the ethical requirement to maintain confidentiality in a manner consistent with the latter.

Answer 57

Correct Answer is: B The majority of states have "duty to protect" laws that require therapists to breach confidentiality when a client makes a credible threat of violence against an identifiable victim. In states where this duty is not a legal mandate, there are laws that permit a therapist to breach confidentiality as necessary to protect others. In this situation, APA's Ethical Standards allow for a breach of confidentiality whenever the law mandates or permits it. According to Standard 4.05, "Psychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to...protect the client/patient, psychologist, or others from harm." Additional Information: Maintaining Confidentiality

Question 58

Prior to conducting a court-ordered evaluation of a minor, you: Select one: A. must obtain informed consent from the minor. B. must obtain informed consent from the parents or legal guardians of the minor. C. must insure that the parents or legal guardians are present during the evaluation. D. should discuss the purpose of the evaluation with the minor.

Answer 58

Correct Answer is: D APA's "Specialty Guidelines for Forensic Psychologists" states that "psychologists obtain informed consent unless the service is court ordered." Thus, regardless of whether the examinee is an adult or a minor, in a court-ordered evaluation, it is not necessary to obtain informed consent. However, the subject of an evaluation should always be informed of the purpose, methods, and intended use of the evaluation. Additional Information: Informed Consent for Assessment

Question 59

In a criminal case, the finding "not guilty by reason of insanity" means that the defendant Select one: A. did not understand the charges against him. B. could be retried once the insanity passes. C. could be held for involuntary treatment for no longer than three months. D. was legally insane at the time of the crime.

Answer 59

Correct Answer is: D A finding of not guilty by reason of insanity means that the person was legally insane at the time of the crime. "Legally insane" does not mean the same thing as mentally ill; a person can be mentally ill at the time of a crime and not necessarily be legally insane. The term's definition will vary from state to state, but in almost all cases, it will be along the lines of not being able to distinguish right from wrong at the time of the crime due to a mental defect or disorder. Additional Information: Competency to Stand Trial vs. Insanity

Question 60

A psychologist is asked by the attorney for the father in a divorce procedure to determine, in his expert opinion, which parent is better able to care for the children. The father is in the same state as the psychologist but the mother is in a distant state. The psychologist should Select one: A. agree to evaluate the father and give his opinion as requested as long as the conclusions are not influenced by who pays the fee. B. evaluate the father but not send the report until asked for it by the judge. C. evaluate the children and both parents before giving such an opinion. D. refuse to accept this work since there can be no firm predictions made as to which parent would be better able to care for the children.

Answer 60

Correct Answer is: C The basic principle is that you can't give an opinion as to which parent will be better able to care for the children unless you interview both parents and the children. Otherwise, all you can attest to is your findings about the psychological health of whomever you evaluate. You can't, if you only see one of the parents, opine as to which one is better: You'd have no basis to come to such a conclusion. Additional Information: Use of Assessments

Question 61

A client of yours has signed up for the same exercise class you attend. You should: Select one: A. Terminate the client B. Change your health club membership C. Make a decision depending on whether the class has two or 100 participants D. Ask the client if he can tell that you are losing weight

Answer 61

Correct Answer is: C This question is about multiple relationships. Ethical Standard 3.05(a) (Multiple Relationships) indicates that, "A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists."Thus, if there are just two of you in the class, this relationship might impact the therapeutic one, while in a large class, the effects will probably be negligible. The Standard doesn't tell you how to decide-it just instructs you to determine what is in the best interest of your client. Additional Information: Multiple Relationships

Question 62

A psychologist is informed by a new client at the conclusion of an initial therapy session that he/she is also seeing a psychiatrist. In this case, the psychologist should: Select one: A. inform the client it would be unethical to continue seeing him/her while under the care of another professional. B. discuss with the client when to terminate treatment with the psychiatrist. C. contact the psychiatrist to inform her of the situation and obtain copies of the client's records. D. discuss the treatment issues and role of the psychiatrist with the client.

Answer 62

Correct Answer is: D According to Standard 10.04 of the Ethics Code, "In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client's/patient's welfare. Psychologists discuss these issues with the client/patient or another legally authorized person on behalf of the client/patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues." The Ethics Code does not prohibit the psychologist in this situation from continuing to treat the client* and contacting the psychiatrist* would violate the client's confidentiality unless it is done with her consent, which is not indicated (* incorrect responses). Additional Information: Providing Therapy to Clients Served by Others

Question 63

You receive a subpoena for a current client's therapy records from a process server hired by the court. This means that you must: Select one: A. inform the server that you cannot comply with the subpoena because therapy records are privileged. B. tell the server to wait while you make a copy of the records. C. appear at a designated place and time with a copy of the records. D. leave a copy of the records at the courthouse within 48 hours.

Answer 63

Correct Answer is: C A subpoena to produce records or documents (known as a subpoena duces tecum) requires a person to appear at a designated time and place with a copy of the records. It does not necessarily require the person to release those records; this is a matter for the court to decide, following a hearing on privilege, if the issue of privilege is being contested. If your client has waived the privilege, however, you would release the records to the court at the time of your appearance. Additional Information: Responding to a Subpoena

Question 64

``` Which of the following client's rights are protected in a court of law? Select one: A. A second opinion B. Tarasoff C. Right of confidentiality D. Right to receive medication. ```

Answer 64

Correct Answer is: C A client's right to confidentiality is protected by a court of law. The client's right to keep his/her matters confidential is referred to as privilege. The court also determines exceptions to privilege, such as the Tarasoff Statute. Additional Information: Privilege Versus Confidentiality

Question 65

A managed care company asks a psychologist to conduct a study on the relative effectiveness of a 10-week therapy program for depression vs. a 20-week therapy program. The company plans to publish the results of the research if no significant difference is found but will not publish the results if the longer therapy program is more effective. The psychologist should: Select one: A. agree to conduct the study because it is within the company's rights to publish or not publish their research findings B. agree to conduct the study if the psychologist is able to approve any article submitted for publication C. agree to conduct the study only if all research participants are appropriately debriefed at the conclusion of the study D. refuse to conduct the study

Answer 65

Correct Answer is: D Ethical Standard 5.01 states, "Psychologists do not knowingly make public statements that are false, deceptive, or fraudulent, concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated." Although in this case the psychologist is asked not to publish data, this would still be deceptive. It also is inconsistent with General Principle A of the Ethics Code which states that, "psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons.... Because psychologists' scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence." Additional Information: Public Statements Made by Psychologists and Others

Question 66

Which of the following best describes the ethical requirements of a licensed clinical psychologist who tests positive for HIV? Select one: A. inform clients of his/her medical condition "as early as is feasible" B. obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties C. refrain from initiating any professional activities that might be adversely affected by the medical condition D. there is no obligation to take precautions or special actions in this situation

Answer 66

Correct Answer is: C Being diagnosed with HIV, when considering the ethical obligations of a psychologist, would be considered a health-related personal issue. Personal problems, including emotional, social, health-related and other personal issues, are addressed in Standard 2.06: Psychologists "refrain from initiating an activity when they know or should know there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner." If a psychologist thinks the condition may impair his/her ability to provide effective services or perform work-related duties then the psychologist would "take appropriate measures." However, there is no evidence that this is the case, so "obtain supervision to ensure that the medical condition does not interfere with the performance of work-related duties" is not the best answer. Informing clients of the condition is not necessary and may not be in the best interests of some of the clients to do so. Additional Information: Psychologists with Personal Problems or Conflicts

Question 67

You are a psychologist at a state mental hospital. One of your colleagues, a psychiatrist, tells you that one of his clients has reported to him that he has sexually abused a child. The perpetrator still has access to the child. The psychiatrist says that he is not going to report the abuse because the client expressed remorse, promised not to do it again, and promised to continue treatment. Furthermore, he is widely-known and highly respected in the community. The psychiatrist adamantly refuses to report the child abuse. You should: Select one: A. discuss the matter further with your colleague and encourage him to make a report to the appropriate child abuse reporting agency. B. file a complaint against your colleague with APA or state licensing board. C. contact the appropriate child abuse reporting agency and provide them with information about the abuse, but refuse to give the colleague's name. D. contact the appropriate child abuse reporting agency and provide them with information about the abuse and with the colleague's name.

Answer 67

Correct Answer is: D Psychologists, like most health professionals are mandated reporters. In this instance, since the primary reporter refuses to make the report, you would be mandated to report the suspected child abuse to the appropriate child abuse reporting agency. You would also be obligated to report the identity of the nonreporter to that child abuse reporting agency. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 68

Your new patient is a 20-year-old gang member who informs you that he has killed a couple of people in the past and that he will probably kill others in the future. He states that he has no intentions of leaving the gang but wants help dealing with his cocaine addiction. You should: Select one: A. notify the police of the patient's previous murders B. notify the police of the patient's danger to others C. provide the patient with substance abuse treatment D. refuse to provide treatment for this patient unless he agrees to leave the gang

Answer 68

Correct Answer is: C Many states have laws based on Tarasoff that require psychologists to warn or protect a potential victim from serious harm when there is an imminent threat to an identifiable victim. However, this question does not indicate an imminent threat nor an identifiable victim; therefore, confidentiality should be maintained. The Ethics Code similarly permits a breach of confidentiality without client consent in order to protect others from harm, but without an identifiable victim such a breach would not serve to protect others and would be inappropriate. The best option would be to provide the treatment requested. Refusing to provide treatment for this patient unless he leaves the gang would be a clinical option, but would probably be ineffective at this stage because he has stated that he has no intentions of leaving the gang. Besides, engaging the patient in treatment for his substance abuse might later lead him to want to leave the gang. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 69

``` In the last session, your gorgeous new client complimented you on how nice you look in your red outfit. You noticed you were very happy before this session. You even caught yourself singing, "Oh What a Beautiful Morning" while looking in the mirror to do a final 'visual check' before seeing your client in. Ethically, Select one: A. You need to cancel this session B. You need to consult with a colleague C. You need to behave more appropriately D. You need to get out more ```

Answer 69

Correct Answer is: B While no Ethical Standards have been violated at this point; there is a strong indication that you are experiencing some type of "extra attraction" toward this client. You need to seek consultation and determine how to process and handle your countertransference. Cancelling the session may not be in the client's best interest. Additional Information: Psychologists with Personal Problems or Conflicts

Question 70

At the request of an attorney, a psychologist in a rural community agrees to conduct a psychological evaluation and provide treatment for the same person. This would probably be considered: Select one: A. ethical, since both services are within the boundaries of a professional relationship B. ethical, if the psychologist takes reasonable steps to minimize any negative effects C. unethical, since evaluation and treatment are inherently conflicting D. unethical, since only a patient, not an attorney can request treatment services

Answer 70

Correct Answer is: B As a general rule, psychologists should avoid potentially conflicting relationships, which could result when conducting both an evaluation and treatment for a patient. However, according to APA's Specialty Guidelines for Forensic Psychologists (1991), "When it is necessary to provide both evaluation and treatment services to a party in a legal proceeding (as may be the case in small forensic hospital settings or small communities), the forensic psychologist takes reasonable steps to minimize the potential negative effects of these circumstances on the rights of the party, confidentiality, and the process of treatment and evaluation." [Law and Human Behavior, 15 (6), p.659]. Additional Information: Multiple Relationships

Question 71

``` Which of these studies would be considered most unethical today? Select one: A. Milgram's B. Bandura C. Zimbardo D. BF Skinner's study of his own child ```

Answer 71

Correct Answer is: A This is a different twist on a previous question but the answer is still Milgram's study. You may feel a different study is more unethical, but the Ethical Standards are specifically pertinent to Milgram's study. This study involved deception and no debriefing about that deception. Ethical Standard 8.07 (Deception in Research) addresses this, indicating that: "(a) Psychologists do not conduct a study involving deception unless they have determined that the use of deceptive techniques is justified by the study's significant prospective scientific, educational, or applied value and that effective nondeceptive alternative procedures are not feasible. (b) Psychologists do not deceive prospective participants about research that is reasonably expected to cause physical pain or severe emotional distress. (c) Psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection, and permit participants to withdraw their data." Additional Information: Use of Deception in Research

Question 72

During an initial interview with a psychotherapy client, the client tells the psychologist that he wants to pay for his sessions himself without the psychologist releasing any information to his insurance company. He also requests that the psychologist not keep any records of their sessions. Agreeing to this arrangement would be: Select one: A. ethical and legal, as long as the psychologist keeps a record of the financial payments and reports those amounts on income tax forms B. ethical, as long as the psychologist determines that the client's reasons for the request are valid C. unethical, because psychologists cannot withhold records from a client's insurance company D. unethical and possibly illegal, because psychologists must maintain records

Answer 72

Correct Answer is: D According to APA's Record Keeping Guidelines (1993, 48(9), 984-986) records should be maintained and should minimally include: identifying data, dates and types of service, fees, any release of information obtained, any assessment, plan for intervention, consultation, summary reports, and/or testing reports. Although these guidelines are aspirational, they have become a standard of care for psychologists and, therefore, not maintaining any records about a client would be considered unethical. Many states also require the maintenance of client records, and therefore, not keeping records may be illegal. unethical, because psychologists cannot withhold records from a client's insurance company In regards to this option, clients generally have the right not to permit the release of records to their insurance company if the insurance company will not be responsible for payment. However, if the psychologist is a contracted provider for the insurance company, the contract may include restrictions on providing "out-of-pocket" treatment to its members or it may require the client to sign a waiver releasing the insurance company of its financial responsibility. Additional Information: Records

Question 73

A psychologist is planning to retire in the next few months and has been decreasing her caseload. One of the psychologist's former clients, who had terminated a few months earlier, phones the psychologist and reports having suicidal thoughts. The psychologist should: Select one: A. inform the client that she is retiring and that she cannot accept any clients B. refer the client to a colleague immediately C. meet with the client until the client no longer needs treatment D. meet with the client until the situation is stabilized and then refer

Answer 73

Correct Answer is: D Although this question is referring to a former client, due to the potential danger for a suicidal client, the most appropriate action would be to meet with the client until the situation is stabilized and then refer.

Question 74

You have been working with a couple in marital therapy for four months, with slow but notable progress. After a session one day, the wife pulls you aside and asks to make some individual appointments with you. You should Select one: A. refer her to another therapist. B. wait until the completion of marital therapy and then see her individually. C. terminate with the couple and see the woman individually. D. encourage her to discuss any relevant issues within the context of marital therapy.

Answer 74

Correct Answer is: A There is a potential for role conflict when a client in conjoint therapy asks you to see him or her individually. It's possible that there may be a conflict between your considerations as a couple's therapist and as an individual therapist. Thus, although your actions would vary depending on the parameters of the individual case, the best answer in light of the information we have is to refer the woman to another therapist for individual therapy. Additional Information: Couple and Family Therapy

Question 75

At the beginning of group therapy, all members signed a contract to maintain confidentiality. If one of the members breaks confidentiality it is: Select one: A. an ethical violation B. a legal violation C. a moral violation D. an ethical, moral and possible legal violation

Answer 75

Correct Answer is: C In the context of group therapy, a moral responsibility to respect confidentiality extends beyond the therapist to each group participant. However, while there may be a moral obligation to maintain confidentiality, there isn't an ethically enforceable obligation. The Ethics Code, Standard 4.02, addresses the limitations of confidentiality and Standard 10.01, Informed Consent in Therapy, addresses the need to discuss the limits of confidentiality at the beginning of (group) therapy. In group work agreements, therapists clearly define confidentiality and the parameters for the specific group being entered, explain the importance, and discuss the difficulties related to confidentiality involved in group therapy. Since confidentiality cannot be guaranteed by the therapist, group members have provided "implied consent" to the release of the information by voluntarily agreeing to participate. In most states, group members are not legally obligated to maintain confidences.

Question 76

A managed health care organization decides that additional mental health services for one of your clients are not "medically necessary." You disagree with this conclusion, because you believe that the client may experience severe and long-term mental distress without at least two or three more counseling sessions. Based on current standards of practice as well as the implications of the court's ruling in Wickline v. California, your duty in this situation would be to: Select one: A. ensure that the client understands why you can no longer provide treatment and refer him to a place where he can obtain low-cost or free services. B. continue treating the client for a fee that is commensurate with his previous co-payment. C. appeal the decision of the managed health care organization. D. file a lawsuit against the managed health care organization.

Answer 76

Correct Answer is: C In the Wickline case, a patient sued a state-run managed care organization because it did not approve an eight-day post-surgical hospital stay and the patient later developed medical complications. The physician complied with the organization and released the patient without protest. The client lost the case against the organization, in part because the physician never appealed the organization's decision. The court held that a treating professional who "complies without protest with the limitations imposed by a third-party payor, when his [professional] judgment dictates otherwise, cannot avoid his ultimate responsibility for the patient's care." This case suggests that it is the health professional's obligation to protest in a situation such as the one described in the question, and a number of commentators suggest that advocacy for the patient's needs in such situations is an ethical obligation. Additional Information: Terminating Therapy

Question 77

During the 10th psychotherapy session with a client, you realize that your client has recently started dating your best friend. You should: Select one: A. refer the client to another therapist B. discuss this with your client immediately C. discontinue your relationship with your friend D. wait and address the problem with your client if a conflict becomes imminent

Answer 77

Correct Answer is: B Although the Ethics Code does not specify exactly how to resolve this type of ethical dilemma, it does state, "If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code" (Ethical Standard 3.05[b]). Consistent with the intent of the Code, the best option would probably be to discuss the matter with your client immediately. After discussing it with your client, additional steps, such as referring the client, may be appropriate. Additional Information: Multiple Relationships

Question 78

A psychologist who sees a family consisting of a mother, stepfather, and two children from the mother's first marriage, aged 10 and 14, must Select one: A. provide individual therapy as needed to each member. B. meet with each family member separately at least once. C. see family members only as a group. D. provide an understandable explanation of services to the children

Answer 78

Correct Answer is: D provide an understandable explanation of services to the children Of the choices listed, only this option describes something the psychologist "must" do. As part of informed consent procedures, the psychologist will explain the nature of the services to the parents. And, according to APA's Ethics Code, when working with clients who legally cannot give informed consent such as children, psychologists must "provide an appropriate explanation" of the services as well as "seek the individual's assent" and "consider such persons' preferences and best interests." The other choices may describe good practices depending on the situation; for instance, many family therapists believe that they should not treat family members both individually and as a family, and also many would meet with family members individually at least once. However, these are not absolute requirements and are not required by APA's Ethics Code. Additional Information: Informed Consent

Question 79

You are treating a client, a five-year old girl, with the consent of her father. After five sessions, you receive a call from the girl's mother, who tells you that she is the custodial parent, that the father is a non-custodial parent, and that she doesn't want her daughter seeing you for therapy. You believe that it's in the girl's best interest to continue treatment. Assuming that the mother's statement is truthful, you should: Select one: A. terminate therapy immediately. B. refuse to stop therapy, since it's in the girl's best interest to continue. C. urge the mother to consent to a few additional sessions, so you can terminate appropriately with the child. D. tell the mother to work out the problem with the father, but in the meantime, continue to see the girl for therapy.

Answer 79

Correct Answer is: C This is a good example of a conflict between ethical and legal obligations. Your ethical obligation is to serve the best interests of the child, but legally, you cannot proceed with treatment if the custodial parent does not give you consent to do so. The Ethics Code is instructive in such situations: Standard 1.02 states that "If psychologists' ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority." Thus, you could not just terminate without attempting to advocate for the patient; you also could not continue to treat the child without the mother's consent, because violating the law is not consistent with resolving the conflict in a responsible manner. Thus, your best option is to explain to the mother why you believe that immediate termination could harm the child and urge her to let you continue seeing the girl for a few more sessions. Additional Information: Conflict Between Ethics and Laws or Organizational Demands

Question 80

You have been attempting to collect payment from a former patient of yours who did not pay for his final two months of therapy. One day, you get a letter from a state hospital where that former patient is now currently a patient. The letter includes a request for a copy of your records of the patient's treatment along with a signed release of information. In this situation, you should Select one: A. refuse to supply any information to the hospital until the bill is paid. B. send a summary of the records to the hospital along with a copy of a bill for the unpaid therapy fees. C. go to the hospital and talk to the patient about the situation. D. provide the information requested by the hospital.

Answer 80

Correct Answer is: D The issue here is that you can't withhold records under your control that are "requested and needed for a client's/patient's emergency treatment solely because payment has not been received (Ethical Standard 6.03). Thus, you must provide the requested information in this instance. Additional Information: Records

Question 81

Dr. Que has recently started working with a family consisting of a mother, father, and five year old boy. The parents say the boy has become "impossible to manage" and they don't know what to do to control him. Dr. Que believes he will get a better idea of the family's dynamics if he is able to observe them at home. When he suggests this, the parents say that, because of their religious beliefs, they cannot allow this. Dr. Que should: Select one: A. refer the family to a therapist from the same religious background. B. impress upon the parents his need to observe them at home in order to best serve the interests of the child. C. determine if there is an alternative and mutually agreeable location for the observation. D. contact child protective services immediately.

Answer 81

Correct Answer is: C This type of situation is covered by ethical requirements related to cross-cultural counseling. (See, for example, APA's Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations.) There's certainly not any information given that warrants a call to child protective services. Also, it's not necessary to make a referral, and it wouldn't be a good idea to manipulate the parents into doing something they don't want to do. Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Question 82

A new client tells you that she recently had sex with her previous therapist. She wants you to "help her put the experience behind her". You should: Select one: A. Report this situation immediately B. Not report, but counsel her about the process C. Call the offending party but not give the client's name D. Encourage her to recall the event so she doesn't suffer from repression later

Answer 82

Correct Answer is: B You are obligated to protect your client's confidentiality. However you want to educate her about the Ethical Standards regarding this situation and also explain to her avenues of recourse she could take. Additional Information: Maintaining Confidentiality

Question 83

``` The purpose of State Licensing Boards is primarily to Select one: A. educate the public. B. educate the profession. C. protect the public. D. set minimum standards of practice. ```

Answer 83

Correct Answer is: C The State Boards derive their authority from the principle of protecting the public. That's the justification for giving exams, setting requirements for licensure, writing and enforcing regulations, and so on. Additional Information: Licensure and the EPPP

Question 84

A patient calls for an appointment and tells you that he is already seeing another psychologist but wants to see you. In this situation, you should Select one: A. not allow him to make an appointment. B. allow him to come in for an initial session and obtain written permission to contact the other psychologist. C. make an appointment to discuss reasons the patient wants to see another psychologist and explain why doing so might not be in the patient's best interests. D. set up an appointment and establish a treatment plan after ensuring that the patient has the financial resources to pay for two therapists.

Answer 84

Correct Answer is: C Ethical standard 10.04 deals with this situation. The relevant language states that "In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client's/patient's welfare. Psychologists discuss these issues with the client/patient or another legally authorized person on behalf of the client/patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues." From the limited information presented, you don't know if it would be appropriate to contact the client's current therapist. Additional Information: Providing Therapy to Clients Served by Others

Question 85

A psychologist is providing therapy to a client through the client's Employee Assistance Program at work. The client's supervisor can be informed by the psychologist that the client is receiving treatment: Select one: A. under no circumstances B. if the client's problem is affecting her job performance C. if the supervisor referred the client to the program D. if that is the only information he reveals to the supervisor

Answer 85

Correct Answer is: C Generally, in the context of an EAP, information about an employee/client's condition or treatment should not be disclosed without the employee/client's consent. However, as the correct answer ("if the supervisor referred the client to the program" ) states, when the employee/client comes to therapy as the result of a referral by his or her supervisor, the supervisor can be given certain limited information: He or she can be told if the employee/client kept the appointment, whether the employee/client needs treatment, and whether the employee/client accepted treatment. The supervisor should not be given any other confidential information unless the psychologist has permission from the employee/client. Confidentiality can also be breached under the same conditions that it can be breached in other contexts (e.g., danger to self, mandated reports).

Question 86

``` Records of psychological services should minimally include all of the following except: Select one: A. fees B. process notes C. types of services provided D. plans for treatment interventions ```

Answer 86

Correct Answer is: B According to APA's Record Keeping Guidelines (1993, 48 (9), 984-986) records should minimally include: identifying data, dates and types of service, fees, any release of information obtained, any assessment, plan for intervention, consultation, summary reports, and/or testing reports. Process notes, which contain intimate details of psychotherapy sessions, including the psychotherapist's personal notes, are generally considered inappropriate for the medical record and are not recommended for minimal inclusion in the Guidelines. Additional Information: Records

Question 87

A researcher working in an institutionalized setting wishes to do some research with moderately mentally retarded patients. The researcher has obtained the approval of the institution's research review committee. Before beginning the research, she should also Select one: A. obtain informed consent from the patients' legal guardians. B. obtain informed consent from the patients' legal guardians and the participants. C. obtain informed consent from the patients' legal guardians and assent from the participants. D. not worry about obtaining consent from the participants or their guardians, since she has already obtained the institution's permission.

Answer 87

Correct Answer is: C In the context of research, the term "informed consent" implies agreement to participate from a person who has been informed of all relevant information and is competent enough to understand that information. With few exceptions (e.g., where deception is necessary and permissible), the Ethical Principles require researchers to obtain informed consent from all participants who are capable of giving it. If the potential participant is not competent to give informed consent, the Ethics require that informed consent be obtained from his or her legal guardian. In addition, when the potential participant is not competent to give informed consent, the research must be explained to the potential participant in language that he or she can understand, and his or her consent must be obtained.

Question 88

You see a client for the first time. She is already receiving treatment from another professional, and she is not clear about why she wants additional treatment from you. In this situation, you should Select one: A. treat the client and let her discuss what she is doing with the other professional when she is comfortable enough to do so. B. contact the other professional and attempt to work out a coordinated treatment plan with him or her. C. attempt to discuss with the client the reason she is seeking the services of a second therapist. D. inform the client that it would be unethical for you to continue therapy with her.

Answer 88

Correct Answer is: C In answering ethics questions, it is a good idea to bring to mind the language of the applicable ethical standard and choose the answer that is most consistent with that standard. According to Standard 10.04 (Providing Therapy to Those Served by Others), psychologists should consider treatment issues and the client's welfare, and discuss these issues with the client, "in order to minimize the risk of confusion and conflict," and should "proceed with caution and sensitivity to the therapeutic issues." Of the choices listed, only the correct answer states that you would discuss the issue with the client, and is therefore the best answer. Additional Information: Providing Therapy to Clients Served by Others

Question 89

A psychologist determines clients' fees based on their current income. This "sliding scale" practice is: Select one: A. explicitly prohibited in the Ethics Code B. explicitly recommended in the Ethics Code C. unacceptable but not explicitly mentioned in the Ethics Code. D. acceptable but not explicitly mentioned in the Ethics Code.

Answer 89

Correct Answer is: D As long as they are fair and serve the best interests of the client, sliding scale fees are generally considered acceptable. The Ethics Code does not explicitly address sliding scale fees. Additional Information: Fees for Services

Question 90

In the first session with a patient referred by a managed health care company, it would be most important to discuss Select one: A. the goals of treatment. B. confidentiality and its limitations. C. fee payment arrangements. D. the potential limitations on treatment.

Answer 90

Correct Answer is: B All of the considerations listed in the choices are important to address early in therapy. However, limitations on confidentiality are generally considered the most important issue to discuss in the first session. This is particularly true in the case of managed care clients, who usually must waive their right to confidentiality with respect to the insurance company. Additional Information: Discussing the Limits of Confidentiality

Question 91

The use of deception in research is acceptable: Select one: A. whenever alternative procedures are not feasible B. if the alternative procedures are too costly C. as long as the deception is not about significant aspects that would affect their willingness to participate D. if is justified by the study's prospective value; if equally effective alternatives are not feasible; and participants are debriefed as soon as possible

Answer 91

Correct Answer is: D if it is justified by the study's prospective value; if equally effective alternatives are not feasible; and participants are debriefed as soon as possible Although the other choices are not incorrect, this choice is the most complete and therefore, the best answer. Additional Information: Use of Deception in Research

Question 92

Based on the description of test fairness in APA's Standards for Educational and Psychological Testing, which of the following is not necessarily an indicator of unfairness in test use? Select one: A. a test measures a construct not relevant to what it purports to measure, resulting in one group consistently scoring lower than another. B. access to the test center is easier to obtain for one subgroup than for another. C. minority group members do not succeed on an employee selection test at the same rate as majority group members. D. on a prediction test, errors in prediction consistently occur for members of a particular minority group.

Answer 92

Correct Answer is: C According to APA's Standards for Educational and Psychological Testing, test fairness is a general social concept, not a psychometric one, and is therefore difficult to describe in precise terms. The Standards provide multiple meanings of the term--for instance, it can refer to equitable treatment of all examinees in terms of testing conditions such as access to a test center and practice materials. In psychometric terms, test unfairness is usually defined as either measurement bias ("a test measures a construct not relevant to what it purports to measure, resulting in one group consistently scoring lower than another") or predictive bias ("minority group members do not succeed on an employee selection test at the same rate as majority group members") systematically lowering the scores of a particular subgroup. In measurement bias, the test measures a construct not relevant to its stated purpose, with the result of lower of scores for a given subgroup. An example would be a math test on which scores are systematically lower for people whose first language is not English, due to the wording of the questions. In predictive bias, errors of prediction consistently occur for a particular subgroup. An example would be an employment selection test on which African-Americans consistently score lower than Caucasians even though both groups perform equally well on the job. The Standards explicitly reject a definition of test fairness based solely on equal outcome (i.e., "minority group members do not succeed on an employee selection test at the same rate as majority group members"). If members of a minority group do not succeed on an employee selection test at the same rate of majority group members, the test would not be unfair unless the job performance of both groups did not reflect this difference in test scores. Additional Information: APA's Standards for Educational and Psychological Testing

Question 93

You work for a university on a panel set up to make personnel decisions. The panel is considering granting tenure to a professor who has an unproven charge of sexual harassment pending. You vote against granting the professor tenure. Your actions are: Select one: A. ethical because the Ethics Code states that psychologists should do whatever they can to prevent sexual harassment. B. ethical because, as a member of this panel, you have the right to vote however you please, regardless of your reasons. C. unethical if the reason for your vote was the allegation of sexual harassment. D. unethical regardless of the reasons for your vote.

Answer 93

Correct Answer is: C The Ethics Code (Standard 1.08) explicitly states that a person cannot be denied tenure solely because he or she has made or is the subject of an ethics complaint. Therefore, it would be unethical for you to vote against tenure in this case if your only reason was that the professor has been accused of sexual harassment. If, however, the allegations had been proven, it would be ethical to vote against tenure. Additional Information: Unfair Discrimination Against Complainants and Respondents

Question 94

A psychologist tests a child from a home in which the parents were divorced at the request of the noncustodial parent. The custodial parent complains that the psychologist acted without her permission. According to accepted professional standards of practice, the psychologist acted Select one: A. unethically because she failed to obtain proper consent. B. ethically but with poor judgment. C. ethically because the noncustodial parent still retains this right. D. unethically because she first should have consulted a lawyer.

Answer 94

Correct Answer is: A In many states, it is illegal to provide assessment or treatment to a child in this situation. Even in states where the non-custodial parent has the right to consent to his or her minor child's psychological treatment, it is not considered ethical to begin treatment (except of course in emergency situations) without the custodial parent's consent. This is because the child's best interests are threatened by such an arrangement. Additional Information: Informed Consent

Question 95

You see an elderly male in therapy. In the first session, he breaks down sobbing and admits that he has recently "helped" his wife, who was suffering from incurable cancer, to die. First you need to Select one: A. comfort him as best you can and make a call to the police. B. get the number of a trusted family member and alert them. C. assess your client's potential for suicide. D. suggest that your client call the police while still in your office.

Answer 95

Correct Answer is: C First of all, this question is not about a Tarasoff situation. You are speaking to the husband after the fact of the wife's death so you do not have a mandated breach of confidentiality, and instead now need to decide what is in the best interest of your client. What you have is a bereaved client who is at a high risk for suicide. With his best interests and welfare in mind, you need to assess his potential for suicide ... and then decide if you want to get the number of a trusted family member and alert them. comfort him as best you can and make a call to the police. suggest that your client call the police while still in your office. You would not be able to breach confidentiality as suggested in these two options for the purpose of "turning in" your client. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 96

Research on therapists who became sexually involved with their clients has shown that: Select one: A. the therapist violated other boundaries before the sexual involvement began B. therapists whose own therapist violated him or her sexually is more likely to have sex with his or her clients C. therapists who have sex with their clients have the same attitude about its inappropriateness as therapists who don't have sex with their clients D. therapists who have completed a personal course of therapy are less likely to become sexually involved with their patients than therapists who have not undergone therapy.

Answer 96

Correct Answer is: A Therapists who have sex with their clients usually suffer from some type of impairment, often related to boundary issues or unfulfilled needs. [See J. D. Guy, The Personal Life of the Psychotherapist, New York, Wiley & Sons, 1987.] therapists who have completed a personal course of therapy are less likely to become sexually involved with their patients than therapists who have not undergone therapy. Contrary to this choice, one study found that psychologists who completed psychotherapy or psychoanalysis were more likely to become sexually involved with a client. Additional Information: Sexual Intimacies

Question 97

According to APA's Record Keeping Guidelines, client records: Select one: A. may not be maintained in electronic media B. may not be exclusively maintained in electronic media C. may be maintained in a variety of media D. may be maintained in electronic media if write-protected software is used which prevents changes from being made after initial data storage.

Answer 97

Correct Answer is: C According to APA's Record Keeping Guidelines, client "records may be maintained in a variety of media, so long as their utility, confidentiality and durability are assured" (1993, 48 (9), 984-986). Additional Information: Records

Question 98

A psychology program requires its students to attend group therapy. This is permissible if: Select one: A. the therapy is only provided by the program's faculty B. the students are given the option of obtaining individual therapy in lieu of group therapy C. the program does not require approval of the therapist's credentials D. the students are given the option of receiving therapy from therapists not affiliated with the program

Answer 98

Correct Answer is: D APA's 2002 Ethics Standard 7.05 permits undergraduate and graduate programs to have individual or group therapy as a program or course requirement. However, the students must be allowed "the option of selecting such therapy from practitioners unaffiliated with the program." the program does not require approval of the therapist's credentials Contrary to this option, programs are not prohibited from approving credentials of the outside therapist. Additional Information: Education and Training Programs

Question 99

You receive a letter from the current therapist of a former client. The therapist wants you to forward a copy of the client's records, and she encloses a signed release from the client. The client still owes you for ten therapy sessions, and you notify the client that you will not release the records until a satisfactory payment arrangement has been made. According to the Ethics Code, this Select one: A. is clearly unethical. B. may be acceptable if the client's records are not "imminently needed." C. may be acceptable if you had informed the client of your policy when he began treatment. D. may be acceptable if you previously attempted to collect the fees and the client was uncooperative.

Answer 99

Correct Answer is: B This issue is covered by Standard 6.03 of the Ethics Code, which states that "Psychologists may not withhold records under their control that are requested and needed for a client's/patient's emergency treatment solely because payment has not been received." Additional Information: Records

Question 100

``` A graduate assistant is working on a research study originally initiated by the psychologist. However, the graduate assistant has contributed throughout the duration of the study on defining the research hypothesis, data analysis and developing conclusions based on the results. With respect to authorship, the graduate assistant would be: Select one: A. listed as co-author. B. listed as first author. C. credited in a footnote. D. given no formal credit. ```

Answer 100

Correct Answer is: A Given the graduate assistant has made a significant contribution to the research study some credit for authorship is due and the graduate assistant would be listed as a co-author. listed as first author. Since the study was the psychologist's original project, it would be appropriate for the psychologist to be listed as the first author. credited in a footnote. The graduate assistant's work extends beyond "Minor or routine professional contributions or extensive nonprofessional assistance (e.g., typing a complicated manuscript, coding data, or helpful ideas offered by a colleague) may be acknowledged in a footnote or in an introductory statement" [See: Keith-Spiegel, P. and Koocher, G. P. (1998). Ethics in psychology: Professional Standards and Cases. New York: Random House]. given no formal credit. The graduate assistant deserves some authorship credit. Additional Information: Publication Credit

Question 101

Your client has moved out of state. She has called and left you a voice mail message requesting that you send her records to a new therapist. She leaves her new therapist's number and address but not her own. You have a current written release from her on file. You note that she has one outstanding balance of $200. You should Select one: A. contact the therapist and try to get the client's number. B. send all the records. C. send a summary along with an invoice. D. send the summary along with an invoice indicating the amount still owed.

Answer 101

Correct Answer is: A This would be your best choice. It never hurts to take the most conservative approach, which in this case would be to try and contact your client and discuss the situation with her. It will be helpful to know the purpose of the request. Your client has a right to a copy of her records and a right to have them sent to where she chooses, but your best course of action would be to discuss the situation with her. You would not send her bill to another therapist. Additional Information: Records

Question 102

When working in a forensic capacity, psychologists must often be careful to Select one: A. acknowledge the limits of their data or conclusions. B. take the time to study the facts of the case so they can arrive at their own conclusion regarding the guilt or innocence of the defendant. C. be present every day of the trial in case the judge requires the psychologist's opinion at some point. D. present their conclusions very forcefully and with confidence, so that the public's confidence in the field of psychology is reinforced.

Answer 102

Correct Answer is: A It's often important for forensic psychologists to acknowledge the limits of their conclusions. This is because forensic psychologists are often asked for opinions on matters (e.g., probability of future violence) that cannot be made with absolute certainty. Additional Information: Focus on Legally Relevant Factors (Specialty Guidelines for Forensic Psychology)

Question 103

The director at the training agency, where you are a supervisor, has promised two new interns that they will have plenty of testing experience as part of their training. In order to meet quota, you are under a great deal of pressure to bill many hours. One intern has a great deal of previous testing experience and the other intern has very little. The majority of the testing cases are given to the more experienced intern, and as a result this intern is given the majority of your time and attention. This situation is: Select one: A. ethical B. unethical C. unethical because you are exploiting the more experienced intern D. unethical because the less experienced intern is not getting the training as it was described to him by the director of the clinic

Answer 103

Correct Answer is: A There is no indication that the more experienced intern is being exploited ("unethical because you are exploiting the more experienced intern" ) and while the interns are not receiving an equal number of testing opportunities, the situation is not unethical solely because the less experienced intern is getting fewer testing cases and/or attention. The director stated the interns would have "plenty of testing experience," not necessarily an equal amount of testing cases, time, or attention. Additionally, the definition of plenty is relative to the individual intern, their previous education, training, and experience. Another relative term in the question to consider is "majority." It would be unethical to have the intern with very little testing experience perform more than his/her current level of competency (Standard 2.05(2): Delegation of Work to Others). Note: this intern is receiving test cases, time, and attention - just not the "majority" of cases and attention. Additional Information: Psychologists Acting as Supervisors or Employers

Question 104

``` Waiving privilege is the right of: Select one: A. the courts B. the client C. the client's therapist D. the client's attorney ```

Answer 104

Correct Answer is: B Privilege is a legal term that refers to a client's right to confidentiality in legal proceedings. The client is the holder of the privilege therefore only the client can waive privilege. Although there are legal exceptions to privilege, the court* or the client's attorney* cannot waive it. The client's therapist* can only "assert" the privilege, not waive it (* incorrect responses). Additional Information: Privilege Versus Confidentiality

Question 105

Which of the following sections of the 2002 Ethical Principles of Psychologists and Code of Conduct "discusses the intent, organization, procedural considerations, and scope of application of the Ethics Code." Select one: A. Introduction only B. Introduction and Preamble C. Preamble only D. General Principles and Ethical Standards

Answer 105

Correct Answer is: A The 2002 Ethics Code is divided into four sections: Introduction, Preamble, General Principles, and Ethical Standards. The Introduction "discusses the intent, organization, procedural considerations, and scope of application of the Ethics Code." The purpose of both the Preamble and General Principles is to provide "aspirational goals to guide psychologists toward the highest ideals of psychology." The Ethical Standards "set forth enforceable rules."

Question 106

A child has been assigned a new legal guardian. His biological parents had a psychological evaluation completed and had received the results. The new legal guardian is requesting a copy of the report. What is the most correct thing to do? Select one: A. Get a signed release from the biological parents B. Provide the legal guardian with a copy of the report C. Send the report to the court mediator D. Keep the evaluation on file until the child is emancipated; then forward to him

Answer 106

Correct Answer is: B As legal guardian he or she has the right to a copy of the report. The key term is "legal". A court has determined legal access in this case so you as the psychologist only need to be guided by the law. Additional Information: Records

Question 107

``` A psychologist's best protection against a charge of malpractice is: Select one: A. insurance. B. informed consent. C. licensure. D. documentation. ```

Answer 107

Correct Answer is: D All of the responses describe things a psychologist would want to do to reduce risk and liability. However, a review of the literature reveals that documentation (keeping records) is considered the most critical by the experts. In malpractice litigation, courts generally take the position "if the psychologist didn't write it down, it didn't happen." Additional Information: Malpractice

Question 108

A psychologist, who is a member of APA, receives a charge letter from the Ethics Committee. The charge against the psychologist is that he cheated on the psychology-licensing exam. This means that the psychologist Select one: A. will be barred from further consideration for licensure. B. will have to retake the exam under supervision. C. must respond to the charge letter within thirty days. D. can request independent adjudication or a formal hearing.

Answer 108

Correct Answer is: C The Ethic Committee's procedures are outlined in APA's Rules and Procedures. When the Committee decides that it is appropriate to pursue a formal case investigation, it sends a charge letter to the complainee. The complainee then has thirty days to file an initial response. can request independent adjudication or a formal hearing. A request for independent adjudication or formal hearing is not made until the Committee has actually found the psychologist to be guilty of an ethical violation.

Question 109

If a client makes a credible threat of violence, the least acceptable course of action would be to Select one: A. initiate involuntary hospitalization procedures in accordance with your state or province's law. B. warn the intended victim. C. provide a safe place for the client to express his anger. D. inform the police.

Answer 109

Correct Answer is: C This question relates to what is commonly called the "Tarasoff rule," or the duty to protect the victim when a client threatens violence against an identifiable victim. In two rulings in the case of Tarasoff v. Regents of the University of California (1974 and 1976), The California Supreme Court ruled that, when a psychotherapy patient makes a specific threat of violence against a reasonably identifiable victim or victims, the therapist must make reasonable efforts to protect the victim(s). Though Tarasoff was a California case, many other states have adopted laws with substantially similar language. The duty to protect is a legal mandate in most states, and in states where it isn't mandated, there are laws the permit psychotherapists to breach confidentiality in order to protect the victim. Thus, the duty to protect has evolved into a standard of care in the field of psychotherapy, and APA's ethics code specifically notes the breaches of confidentiality are permitted "to protect others from harm." Therefore, when a client makes a credible threat of imminent violence against an identifiable victim, a psychologist would need to find an appropriate intervention that meets the duty to protect. provide a safe place for the client to express his anger. Of the choices listed, all but this option are reasonable steps one could take to protect the victim from harm; they perhaps would be performed in combination. This choice seems least likely to protect the safety of the intended victim, and while it may help the client, it fails to address the issue raised by the question. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 110

Dr. Fastbuck has been hired by a for-profit mental health hospital corporation as a supervisor of two psychological interns, Dr. Newbie and Dr. Greenhorn. The hospital has promised both interns that they would receive training in psychological assessment. The agency needs at least one of these interns trained quickly, due to a backlog of work on financially lucrative psychological assessments. Dr. Fastbuck decides that Dr. Newbie will receive extensive experience and training in testing, while Dr. Greenhorn will get very little training, because training one of them can be done more quickly than training both. Dr. Fastbuck has acted: Select one: A. ethically, because finishing the assessments quickly is in the best interests of clients. B. ethically, because, in light of the situation, Dr. Fastbuck does not have any alternative. C. unethically, because decisions such as these cannot be based on financial concerns. D. unethically, because Dr. Fastbuck is failing to meet his responsibility as a supervisor.

Answer 110

Correct Answer is: D Ethical Standard 2.05 applies to this situation. It states in part that "Psychologists who delegate work to employees, supervisees, or research or teaching assistants or who use the services of others, such as interpreters, take reasonable steps to (1) avoid delegating such work to persons who have a multiple relationship with those being served that would likely lead to exploitation or loss of objectivity; (2) authorize only those responsibilities that such persons can be expected to perform competently on the basis of their education, training, or experience, either independently or with the level of supervision being provided; and (3) see that such persons perform these services competently."In this situation, in light of what Dr. Greenhorn was hired for, Dr. Fastbuck is not providing proper supervision. It could be argued that the hospital's policy prevented fulfillment of this obligation, but there is no indication in the question that Dr. Fastbuck has attempted to correct the situation. Additional Information: Psychologists Acting as Supervisors or Employers

Question 111

A psychologist who obtained a Ph.D. in experimental psychology wants to change her specialty to clinical psychology. To meet the requirements set forth by the General Guidelines for Providers, the psychologist must Select one: A. complete an internship in clinical psychology under the supervision of a professional clinical psychologist. B. complete appropriate doctoral-level classes and supervised post-doctoral training. C. obtain a Ph.D. in clinical psychology from an accredited college or university. D. meet her state's requirements for licensure in clinical psychology.

Answer 111

Correct Answer is: B The licensing exam often contains questions such as these, and in approaching them, you should remember these buzzwords: training AND experience. Specifically, the Specialty Guidelines state that "professional psychologists who wish to qualify as clinical psychologists meet the same requirements with respect to subject matter and professional skills that apply to doctoral and postdoctoral education and training in clinical psychology." complete appropriate doctoral-level classes and supervised post-doctoral training. The correct answer is the only one that includes an element of both training and experience, and is therefore the best answer. obtain a Ph.D. in clinical psychology from an accredited college or university. Moreover, unlike as stated by this option, a second Ph.D. would not be necessary -- doctoral level coursework in clinical psychology would be sufficient to meet the academic training aspect of this requirement. Additional Information: General Guidelines for Providers of Psychological Services

Question 112

The difference between the General Guidelines for Providers of Psychological Services and the Ethical Principles of Psychologists is that the former: Select one: A. deals with delivery of services to consumers, and the latter with ethics in general. B. deals with clinical practice, and the latter with ethics in general. C. deals with consumers, and the latter with providers of psychological services. D. is a case analysis of the latter.

Answer 112

Correct Answer is: A This is a fundamental distinction. The Ethical Principles and Code of Conduct covers the actions and responsibilities of all APA members in teaching, research, clinical work, testing, private practice, administration, government, industry, etc. It's the basic standard of ethics for all of us. The General Guidelines, and the spin off known as Specialty Guidelines, apply only to those psychologists who work in clinical, counseling, school, and industrial psychology. Note that these guidelines apply to the work, not to the person. Hence a research social psychologist who finds herself working as the director of a mental health center now finds her work falling under the province of the General Guidelines. deals with clinical practice, and the latter with ethics in general. deals with consumers, and the latter with providers of psychological services. Now if you go back to the question you'll see why the correct option is a better answer than these two options. The General Guidelines refer to all the work of applied psychology and this is subsumed best under correct answer. This choice ("deals with clinical practice, and the latter with ethics in general") mentions only clinical practice, which is only part of what is covered by the Guidelines. And this choice ("deals with consumers, and the latter with providers of psychological services") mentions only consumers, which again isn't quite right: the General Guidelines deal also with agencies, private concerns in industrial areas, third-party payers such as insurance companies, etc. Additional Information: General Guidelines for Providers of Psychological Services

Question 113

A psychologist has a client who is a defendant in a sexual harassment case. The psychologist is served a subpoena duces tenum for the client's psychotherapy records and a notice of deposition to appear in court with those records. The client does not want to release the records to the court or the plaintiff. In this case, the psychologist's best course of action would be to Select one: A. claim the psychotherapist-patient privilege and ignore the subpoena. B. comply with the subpoena and release the records to the plaintiff's attorney. C. comply with the notice to appear in court but refuse to release the records unless ordered to do so by the court. D. contact the plaintiff's attorney to discuss the reasons why the records should not be released.

Answer 113

Correct Answer is: C To answer this question, you have to be familiar with what and what not a subpoena legally compels a psychologist to do, along with the ethical obligation to protect confidentiality. A subpoena duces tenum is an order to appear at a particular place at a particular time with specific documents such as the records requested in this case. It has the force of law, so the psychologist in this question must comply with it and show up in court with the records. However, it does not necessarily require the psychologist to turn over the records. Without the client's consent, the psychologist would not have to release the records unless and until a court orders him to do so. If the client opposes their release, the client's attorney could file a motion to quash the subpoena and the court would rule on whether the psychologist is obligated to release the records. So the best option in this case is to comply with the subpoena but refuse to release the records unless and until ordered to do so by the court. claim the psychotherapist-patient privilege and ignore the subpoena. Regarding this choice, psychotherapist-patient privilege, or the legal right to prevent confidential communications between psychologists and their patients from being released in a legal setting, does apply here. In fact, when the psychologist appears on court with the records, he would claim psychologist-patient privilege on behalf of the client as the grounds for withholding the records. The problem with this option is that the subpoena, the order to appear with the records, cannot be ignored. Additional Information: Responding to a Subpoena

Question 114

A psychological researcher studying the effects of frustrated expectations promises to pay research participants $50.00 for their participation in the study when in reality he does not plan to pay them anything. This deception is Select one: A. ethical as long as it is justified by the subject's prospective scientific value. B. ethical as long as subjects are informed that they have the right to withdraw at any time. C. ethical as long as subjects are wealthy enough to not suffer emotional harm due to not receiving the money. D. unethical.

Answer 114

Correct Answer is: D This question requires you to consider the ethical standards related to both deception and informed consent to research. APA's Ethical Principles and Code of Conduct states that "Psychologists do not deceive prospective participants about research that is reasonably expected to cause physical pain or severe emotional distress." This standard alone would probably bar the research described by the question, though perhaps one can argue that withholding a promised payment of $50.00 would not necessarily cause "severe emotional distress." However, the informed consent requirement states that psychologists must inform research participants about "reasonably foreseeable factors that may be expected to influence their willingness to participate" and "incentives for participation." Therefore, deceiving subjects about how much they will be paid for research participation is unethical. Additional Information: Use of Deception in Research

Question 115

One of your clients with a dependent personality is about to go on an overseas trip. She asks you if she can get anything for you while she's there, and you explain that you could not accept any gifts, but you ask if she could purchase an oriental rug for you (which you would pay her for). This would be: Select one: A. ethical, only if the client feels free to decline B. ethical, and may be clinically helpful as the rug could serve as a transitional object C. ethical, but probably not appropriate since you may not have the same taste in oriental rugs D. unethical under any condition

Answer 115

Correct Answer is: D Asking a client to purchase a rug for you would clearly be exploitative, regardless of whether or not you paid for it, or if the client was willing to do it. Most clients, particularly if they are dependent, would not be "free to decline" their therapist's requests. Additional Information: Exploitative Relationships

Question 116

You have been seeing a female client in therapy for over a year and on your birthday she arrives with a beautifully gift-wrapped sweater and birthday card. You should Select one: A. explain that it is unethical and illegal to accept anything from a client. B. keep the card, but don't accept the sweater. C. explore the meaning of the gift. D. agree to keep the gift if the client will exchange it for a different color "“you have already received quite a few green sweaters.

Answer 116

Correct Answer is: C None of the answers are quite right, but this response ("explore the meaning of the gift") is the best choice. It suggests you first try to explore the clinical transference. However, once investigated, the resolution probably won't include a new sweater. explain that it is unethical and illegal to accept anything from a client. This choice is incorrect because while it is usually unethical to accept gifts, it is not illegal to do so. keep the card, but don't accept the sweater. This is a simple solution, but doesn't demonstrate any clinical exploration of the situation. Additional Information: Multiple Relationships

Question 117

Utilization review, an important component of managed health care, refers to the idea that it is useful to Select one: A. review benefits to eliminate or reduce unnecessary health care resources. B. determine the adequacy of health care standards by comparing them to predetermined standards. C. make decisions on patient care by a team of medical experts rather than an individual physician. D. allow a patient to choose from several insurance plans.

Answer 117

Correct Answer is: A Utilization review is concerned with conserving health care monies. It does this through having a utilization review committee assess the use of benefits and reduce or eliminate inappropriate or unnecessary use of health care resources. determine the adequacy of health care standards by comparing them to predetermined standards. This option is a description of the concept of quality assurance. make decisions on patient care by a team of medical experts rather than an individual physician. This option is describing a medical team management approach to individual health care.

Question 118

You are a small-town psychologist in a rural area and a client comes in and states that she is depressed and is having headaches. She has babysat with your child several times over the last year. She would like you to give her biofeedback sessions. You should first: Select one: A. Complete the biofeedback treatment and not ask her to babysit in the future. B. Refer her to her family physician C. Refer her to a psychologist in another town for therapy; it will be OK for you to complete the biofeedback sessions D. Refer her to a biofeedback specialist in another town

Answer 118

Correct Answer is: B This question is more about an awareness of your limitations than it is about a dual relationship. The first step, whether you decide to take the case or not, should be to refer her to her family physician to rule out medical concerns. Additional Information: Boundaries of Competence

Question 119

In a court-ordered evaluation the evaluator: Select one: A. must obtain informed consent from the evaluatee B. must obtain informed consent from the evaluatee's attorney C. does not need to obtain informed consent but must inform the evaluatee of the intended use of the evaluation D. does not need to obtain informed consent nor inform the evaluatee of the purpose of the evaluation

Answer 119

Correct Answer is: C According to APA's Specialty Guidelines for Forensic Psychologists, "psychologists obtain informed consent unless the service is court ordered." Thus, in a court-ordered evaluation, it is not necessary to obtain informed consent. However, the subject of an evaluation should always be informed of the purpose, methods, and intended use of the evaluation. Additional Information: Specialty Guidelines for Forensic Psychology

Question 120

The California Tarasoff Statute: Select one: A. Changed the Ethics Code in Canada and the United States B. Extended the duty to warn clause C. Was necessary as issues implicated by the Tarasoff case account for a majority of forensic cases D. Applies to everyone working in a public setting

Answer 120

Correct Answer is: B The California Tarasoff statute gives clinicians explicit guidance about when a duty to act arises and tells clinicians what actions fulfill their duty. The first Tarasoff decision established a "duty to warn" ; however, the case was reheard several years later and the Tarasoff II decision modified the duty to warn to a "duty to protect." Was necessary as issues implicated by the Tarasoff case account for a majority of forensic cases This choice contradicts the conclusion by Behnke, Preis and Bates in "The Essentials of California Mental Health Law" Norton and Company, 1998, pg. 9 in which they state, "issues implicated by the Tarasoff case and its legal progeny account for a small percentage of forensic cases." Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 121

Which of the following statements regarding therapy records is most consistent with the Ethics Code? Select one: A. A patient's therapy records must be kept for at least three years after termination. B. A patient's therapy records must be destroyed seven years after termination. C. A therapist can destroy records before the legally required time period to keep them has elapsed if the therapist believes that doing so is necessary to prevent the use of obsolete records. D. Records can be kept longer than is legally required, at the therapist's discretion.

Answer 121

Correct Answer is: D To understand why the correct option is correct, let's go through the other choices. A patient's therapy records must be kept for at least three years after termination. A patient's therapy records must be destroyed seven years after termination. State laws vary regarding how long therapy records must be kept following termination; some states do and some states don't have any laws that identify a minimum time period during which records must be maintained. The Ethics Code states that therapists must follow relevant laws, but they do not lay out any specific time guidelines for maintaining records. Therefore, since state laws vary, any option that identifies a specific time frame for maintaining records (such as these two choice) has got to be wrong. A therapist can destroy records before the legally required time period to keep them has elapsed if the therapist believes that doing so is necessary to prevent the use of obsolete records. This implies that it is ethically permissible to violate the law. This is untrue, even if you believe that a violation of the law serves your client's best interests. Records can be kept longer than is legally required, at the therapist's discretion. This leaves the correct choice. The state laws relating to this issue outline a minimum time period for maintaining records, but they don't identify a maximum. In other words, therapists can keep records as long as they want, as long as they follow other ethical standards related to records, such as preventing the misuse of obsolete records. Additional Information: Records

Question 122

Fee arrangements should be made with clients Select one: A. at the beginning of treatment. B. at the end of the first session. C. on the phone before the first session. D. as soon as possible.

Answer 122

Correct Answer is: D This is an example of a question with more than one good answer. The other choices may all be acceptable, depending on the circumstances. as soon as possible. But because there are a number of acceptable answers to this question, you'd hope to find one general answer, such as this one, that covers most or all of the specific possible options. More importantly, of the choices listed, the correct answer is most consistent with the language of APA's Ethical Standard 6.04(a), which states: "As early as is feasible in a professional or scientific relationship, psychologists and recipients of psychological services reach an agreement specifying compensation and billing arrangements. Additional Information: Fees for Services

Question 123

A psychologist works with a client who is a reputed organized crime boss. The psychologist suspects that that the client has been and will be involved with acts of violence, but the client does not mention the name of any people he intends to harm. In this situation, the psychologist should Select one: A. maintain the client's confidentiality. B. warn the police of the danger to others posed by the client. C. attempt to obtain the name of future victims via indirect questioning. D. explore the childhood roots of the client's behavior.

Answer 123

Correct Answer is: A This question relates to a psychotherapist's "duty to protect" the victim when a client threatens violence against an identifiable victim. In two rulings in the case of Tarasoff v. Regents of the University of California (1974 and 1976), the California Supreme Court ruled that, when a psychotherapy patient makes a specific threat of violence against a reasonably identifiable victim, the therapist must make reasonable efforts to protect the victim. Though this requirement is commonly called the "duty to warn", warning the victim is one of a number of possible ways to discharge this duty. Others include calling the police and hospitalizing the client and of course these steps can be combined. Though Tarasoff was a California case, many other states have adopted laws with substantially similar language, and the duty to protect has evolved into a standard of care in mental health fields. The duty to protect only applies when the client makes a specific, foreseeable, and believable threat of violence; when the victim or victims are identifiable; and when therapist intervention is feasible. In this case, there is no specific threat and no identifiable victim. Therapists are not required to pry threats of violence out of clients. Therefore, of the choices listed, the best option would be to maintain the client's confidentiality. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 124

To testify as an "expert witness" in a court case, you must Select one: A. obtain certification as a forensic psychologist. B. obtain certification in the specific area you are testifying about. C. be recognized by both sides' attorneys as an expert. D. have specialized knowledge in the area about which you are testifying.

Answer 124

Correct Answer is: D There are no special certifications that psychologists must obtain in order to testify as expert witness. Nor do they need to be recognized by both parties in the legal proceeding as an expert -- in fact, in a substantial proportion of cases, the psychologist's expertise is likely to be challenged by one of the parties. From an ethical standpoint, the relevant requirement is that psychologists testifying as experts (like all other psychologists) should not practice outside the scope of their competence. In other words, psychologists representing themselves as experts in a particular area should have specialized knowledge in that area. Additional Information: Expert vs. Fact Witness

Question 125

``` Which of the following is most appropriate for referring to a group of research participants? Select one: A. borderlines B. disabled persons C. individuals confined to a wheelchair D. people who have cerebral palsy ```

Answer 125

Correct Answer is: D According to APA's Publication Manual (2001), authors should avoid perpetuating demeaning attitudes in their writing. It is recommended that people be put before their disabilities and not labeled as their disabilities. Thus, "borderlines" would more accurately and sensitively be referred to as "people diagnosed with borderline personality disorder." Similarly "disabled persons" are better described as "people with (or who have) a disability." The phrase, "individuals confined to a wheelchair" does put the people first; however, it is overly negative and suggests continued helplessness, which should be avoided. Instead, the manual recommends using emotionally neutral expressions, for example, "individuals who use a wheelchair." Additional Information: Reducing Bias in Language

Question 126

You are starting a stop-smoking group and tell a newspaper reporter who smokes that he can participate in the group for free if he'll write an article about it for the local newspaper. This arrangement is Select one: A. unethical. B. ethical as long as you don't tell the reporter what to write about. C. ethical as long as you check to make sure that information about the group is accurate. D. ethical as long as the confidentiality of the group participants is not violated.

Answer 126

Correct Answer is: A This issue is addressed in Standard 5.02(b) of the Ethics Code, which states that "Psychologists do not compensate employees of press, radio, television, or other communication media in return for publicity in a news item." Additional Information: Public Statements Made by Psychologists and Others

Question 127

Which of the following statements regarding informed consent procedures in research is least true? Select one: A. Psychologists should inform research participants, in language that is reasonably understandable, about the nature of the research. B. Research participants should be informed of significant factors that may affect their willingness to participate in the research. C. Informed consent to research must be appropriately documented. D. Informed consent to research must be obtained in all cases

Answer 127

Correct Answer is: D In most cases, informed consent to research must be obtained from participants. However, there are some exceptions, such as research involving anonymous questionnaires or naturalistic observations. Ethical standard 8.05 discusses the circumstances under which research does not require informed consent. Additional Information: Dispensing with Informed Consent for Research

Question 128

Your client is terminating your psychological services by mutual agreement after two years. She's going to be married the following May and would like you to be one of her wedding attendants. You should Select one: A. explain to her that the two of you should have no further contact. B. accept; but under condition that you participate in the wedding only and no other type of friendship can be pursued. C. explain that you cannot have a friendship with her until two years have passed. D. decline the invitation; explaining that this would be a multiple relationship.

Answer 128

Correct Answer is: D The best solution in regard to the ethical standards is to avoid multiple relationships. It is possible that your client could need therapeutic services again and if you become her friend, you will no longer be able to offer her that option. Additional Information: Multiple Relationships

Question 129

A researcher advertises for subjects for an experiment on social facilitation. In the ad, she mentions that the subjects will be paid to participate. According to accepted standards of research with human subjects, this is Select one: A. ethical, because it isn't prohibited. B. unethical, because it is prohibited in the ethics. C. unethical, because advertising for subjects in the popular press is prohibited. D. ethical, because paying subjects is encouraged

Answer 129

Correct Answer is: A Paying subjects to participate in research is not unethical, as long as no coercion is involved. Additional Information: Inducements for Participating in Research

Question 130

A clinical psychologist who teaches courses at a college is approached by a student who wishes to begin therapy with the teacher. The student is already in therapy with another psychologist. In this situation, the psychologist should Select one: A. only accept the case if the psychologist believes that doing so would be beneficial to the patient's welfare. B. take the case if the student signs a release of information so that both psychologists can work together. C. seek consultation from an objective third party before deciding on a course of action. D. advise the student to discuss the situation with his current therapist.

Answer 130

Correct Answer is: D This question seemingly presents two ethical issues: multiple professional relationships and provision of therapy to a client who is already in psychotherapy. However, the first issue takes precedence here because teacher/psychologist is an example of a multiple relationship that should be avoided. Standard 3.05 of APA's Ethical Standards states that "A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists." If a teacher accepts the student as a psychotherapy client, there would be clear risk of potential harm to the client and impairment of the psychologist's objectivity. The boundaries between the two roles could easily become blurred and overlap. Therefore, regardless of the circumstances, the psychologist should not accept the student as a psychotherapy client, and of the choices available, only choice four involves a refusal to accept the case. Because the psychologist should not even consider accepting the case due to the multiple relationship issue, the issue of providing services to a person already undergoing psychotherapy becomes moot. Additional Information: Multiple Relationships

Question 131

A psychologist who is very fearful of getting sued decides for this reason that he will not treat any patients with a diagnosis of Borderline Personality Disorder. The psychologist's actions are: Select one: A. unethical, assuming that the psychologist is competent to treat such patients. B. ethical as long as appropriate referrals are provided. C. ethical regardless of whether appropriate referrals are made. D. unethical, because it is inappropriate to consider the possibility of getting sued in making any clinical or treatment decision

Answer 131

Correct Answer is: B Psychologists and other health professionals have no legal or ethical obligation to enter into a professional relationship. Though they cannot discriminate on the basis of race, gender, sexual orientation, or any basis proscribed by law, they can refuse to enter into a relationship based on a client's diagnosis -- even if they are competent to treat individuals with that diagnosis and even if their reasons for doing so are not valid. However, if they do refuse to take a case, psychologists are required to make appropriate referrals. Additional Information: Discrimination and Harassment

Question 132

If you receive a subpoena to appear in court regarding one of your clients, you should: Select one: A. Recopy all of your notes so they are typed and not handwritten B. Eliminate all referral data from the file C. Eliminate anything from the file regarding anyone other than your client D. Organize the data and discuss it with your client

Answer 132

Correct Answer is: D After receiving a subpoena you should always discuss with your client the implications of providing the requested information and seek their consent. It is certainly appropriate to organize the data, however, it would not be appropriate, nor ethical or legal, to tamper with the records in any way. Additional Information: Responding to a Subpoena

Question 133

You have been asked by your client's attorney to serve as a fact witness in a court proceeding. Your client, the plaintiff, suffered a serious physical injury in the workplace and has since experienced significant emotional problems as a result of the injury. You have been working with the client for the past several months. During your testimony, you are asked by the plaintiff's attorney if, in your opinion, the client's emotional problems are directly related to the injury. You should: Select one: A. provide the information as long as you have sufficient data to support your opinion. B. provide the information only if the plaintiff has waived her right to confidentiality. C. not provide the information unless ordered to do so by the court. D. provide the information, but note any possible limitations to your opinion.

Answer 133

Correct Answer is: C The key term in this question is that you are a "fact witness". Unlike an expert witness who can offer opinions, a fact witness, as its name implies, can only testify about facts. A psychologist, while serving as a fact witness, could give an opinion, but only if ordered by the court and any opinions should be qualified by a statement about its limitations. Additional Information: Expert vs. Fact Witness

Question 134

``` The Security Rule in the Health Insurance Portability and Accountability Act (HIPAA) applies specifically to the privacy of Select one: A. medical information. B. electronic information. C. psychotherapy records. D. insurance records ```

Answer 134

Correct Answer is: B The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. It is a broad law covering both the portability of health insurance coverage for workers when they lose their jobs or change jobs, and also standards, including privacy, of health care related information. HIPAA includes regulations covering all four of the choices in this question, but the Security Rule applies specifically to electronic information. The rule, which took effect in 2006, lays out administrative, physical, and technical safeguards of Protected Health Information which is stored in electronic form. Protected information includes that related to an individual's past, present, or future physical or mental health or condition; the provision of health care to an individual; and payment for health care for an individual. Additional Information: HIPAA

Question 135

The mother of a 9-year old client of yours asks you to testify at an upcoming custody hearing. Since you have been working with the child for the past 6 months she believes you are best suited to make a recommendation regarding the custody arrangements. You should: Select one: A. agree to the request only if both parents sign a consent B. agree to the request only if you are able to evaluate both parents C. agree to the request but base your opinion on the best interests of the child D. refuse to testify

Answer 135

Correct Answer is: D APA's Guidelines for Child Custody Evaluations in Divorce Proceedings state that psychologists must avoid multiple relationships. Since you already have a therapeutic relationship with the child you should avoid assuming an evaluative role in the custody case. Additional Information: Multiple Relationships

Question 136

``` Baumrind in 1964 indicated that whose study was unethical? Select one: A. Bandura's B. Zimbardo's C. Milgram's D. Harlow's ```

Answer 136

Correct Answer is: C Baumrind wrote the article, "Some thoughts on the ethics of research: After reading Milgram's behavioral study of obedience." American Psychologist 19 421-423. Milgram's study would be considered unethical today as would Zimbardo's. It is also doubtful that parents would be keen on having their children watch and imitate aggressive models, and the animal rights people would object to Harry Harlow's techniques. Additional Information: Use of Deception in Research

Question 137

During the course of a research experiment, subjects witness someone who is apparently hurt, needing immediate help, and are unable to help or know if the person is assisted. The subjects become immediately distressed. In this situation: Select one: A. debriefing occurs at the conclusion of participation B. group debriefing occurs at the conclusion of collection of data C. debriefing occurs when subjects become distressed D. debriefing occurs at the conclusion of research

Answer 137

Correct Answer is: A This question involves deception in research, distress and debriefing. Due to the use of deception and the resultant participant distress, debriefing immediately following participation is the best option as described by Standard 8.07(c) Deception in Research: "Psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection." The Ethics Code on Debriefing, Standard 8.08(a), notes, "Psychologists provide a prompt opportunity for participants to obtain appropriate information about the nature, results, and conclusions of the research, and they take reasonable steps to correct any misconceptions that participants may have of which the psychologists are aware," and in Standard 8.08(c) "When psychologists become aware that research procedures have harmed a participant, they take reasonable steps to minimize the harm." Additional Information: Use of Deception in Research

Question 138

A psychologist receives a request for information about treatment for a patient from the patient's insurance carrier. The request for a treatment report includes the appropriate signed authorization from the patient. The psychologist should: Select one: A. not provide the information because this is still an unsettled issue. B. provide only the dates of service and the diagnosis. C. refuse the request unless the patient himself or herself asks that it be sent. D. provide the information requested

Answer 138

Correct Answer is: D This ethics question will have some of you stumped unless you deal with these types of clinical situations regularly. In practice, clinicians often get requests for information, especially with insurance companies using managed-care organizations to approve visits. Similar authorizations are necessary when information is released from a hospital, from a clinic, and so forth. The confidentiality of information belongs to the patient. It is up to him or her to waive that confidentiality, as we assume he or she has done by signing the release. In addition, such authorizations should specify the type and extent of information that the patient authorizes to be released, for what purposes, and to whom. Additional Information: Maintaining Confidentiality

Question 139

As a successfully licensed psychologist, you are supervising your first intern. You need to Select one: A. inform your intern that he should use your name as a pseudonoym. B. inform your intern that he needs to let his clients know he is in supervision. C. let his clients know his limitations as a clinician. D. have the intern get informed assent from the clients; you are responsible for informed consent.

Answer 139

Correct Answer is: B Your intern needs to let his clients know his professional status, just as you as a licensed psychologist would explain your own status. According to Standard 10.01(c) "When the therapist is a trainee and the legal responsibility for the treatment provided resides with the supervisor, the client/patient, as part of the informed consent procedure, is informed that the therapist is in training and is being supervised and is given the name of the supervisor." have the intern get informed assent from the clients; you are responsible for informed consent. Your intern is responsible for getting informed consent, not assent from the clients. Additional Information: Informed Consent for Therapy

Question 140

Question ID #97: In order to provide psychotherapy to clients from diverse ethnic groups, psychologists should obtain adequate cross-cultural training. One of the best approaches to receive this training is through: Select one: A. being monitored by a colleague B. becoming versed in specific cultural rituals such as folk healing C. ongoing training and education D. feedback from clients

Answer 140

Correct Answer is: C APA's Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations recommends that "psychologists seek out educational and training experiences to enhance their understanding to address the needs of these populations more appropriately and effectively." Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Question 141

The APA's position on partner notification in cases of HIV/AIDS is that psychologists: Select one: A. not be required legally to protect the partners of individuals with HIV/AIDS. B. be required legally to protect the partners of individuals with HIV/AIDS. C. be required legally to protect the partners of individuals with HIV/AIDS, provided the psychologist is protected from civil and criminal liability for disclosing. D. be required legally to protect the partners of individuals with HIV/AIDS after obtaining the client's permission to disclose.

Answer 141

Correct Answer is: A The American Psychological Association's position on partner notification is consistent with its emphasis on maintaining client confidentiality. The APA's (1991) position is that "a legal duty to protect third parties from HIV infection should not be imposed." If legislation were to be passed, the APA recommends it should only permit disclosure when: the psychologist knows of an identifiable third party at significant risk for infection; knows that the third party is unaware of the risk; has urged the client to notify the third party but he/she has refused to do so; and the psychologist is legally protected from civil or criminal liability for disclosing. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 142

You have been treating a 14-year-old female for the past year and during her final termination session she reports suicidal intent with a plan. You should: Select one: A. attempt to make a no-suicide contract B. immediately contact the parent(s) C. call the police D. not allow the client to leave your office until the risk has passed

Answer 142

Correct Answer is: B If a client poses an imminent danger to self, a breach of confidentiality, which could prevent the danger, is ethically and legally justified. This holds true for all clients, regardless of age. When the client is a minor, the most appropriate action would usually be to notify the client's parent(s). If they are not immediately available, you should then consider calling the police or PET. Attempting to make a no-suicide contract would not be the most prudent option when there is suicidal intent with a plan, especially during a termination session. Not allowing the client to leave your office until the risk has passed is not a realistic option. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 143

A college psychology instructor gives a battery of psychological tests to some of his students who volunteered to be participants. Based on these tests, he finds that one of the participants is at risk for emotional disturbance. He talks to this student and suggests counseling. At the same time, he informs the director of the college counseling office who is a friend of his. According to APA ethical principles, the professor acted Select one: A. unethically, because he revealed this information to a third party. B. ethically, because he acted in accord with the student's welfare. C. ethically, because he had responsibilities to the college as well as to the student. D. unethically, because he isn't a clinician.

Answer 143

Correct Answer is: A Suggesting counseling to the student is ethical and appropriate. However, barring an emergency situation characterized by imminent danger, informing a third party is unethical. Additional Information: Maintaining Confidentiality

Question 144

You are seeing a client whom you discover, in your third session with him, is the second cousin of your child's barber. In this situation, your ethical obligation is to Select one: A. terminate therapy as soon as possible because multiple relationships are prohibited. B. immediately refer the client to another therapist. C. continue seeing the client for a few more sessions and refer the client out when appropriate. D. continue to see the client.

Answer 144

Correct Answer is: D This question is about multiple relationships, or relationships where a psychologist sees a client professionally but is also involved in some other kind of relationship with him or her, such as a business or personal relationship. The point of this particular question is that not all multiple relationships are unethical. The ethical standard applicable to multiple relationships, standard 3.05, states that psychologists refrain "from entering into a multiple relationship if [it] ...could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness"¦or otherwise risk exploitation or harm." It also states "Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical." Though you would need more information to be certain, it is most reasonable to assume that a professional relationship with the second cousin of your child's barber falls into the latter category of multiple relationships that would not likely cause harm or risk. If the question stated that your client was (for example) your husband's boss, your obligations would be different, because in that situation, you could expect that your objectivity would be impaired. In that situation, you would not take the case to begin with if you knew in advance that the client was your husband's boss. If you found this out in the course of therapy, you would have to, according to the same ethical standard, "take reasonable steps to resolve [the relationship] with due regard for the best interests of the affected person and maximal compliance with the Ethics Code." Additional Information: Multiple Relationships

Question 145

A psychologist working in the prison system is asked to evaluate a prisoner and make a recommendation about his eligibility for parole. The psychologist should Select one: A. refuse to do so since this is outside the scope of a psychologist's work. B. do the evaluation and report its results but refuse to make a specific recommendation. C. make a recommendation as long as it is based on the results of valid standardized tests. D. make a recommendation but point out any possible limitations of the data on which it is based

Answer 145

Correct Answer is: D This answer is most consistent with the requirements of the Ethics Code and the Specialty Guidelines for Forensic Psychologists. For example, Standard 9.06 of the Code requires that psychologists "indicate any significant limitations of their interpretations." make a recommendation as long as it is based on the results of valid standardized tests. Although recommendations should be based on valid assessment techniques, those techniques do not have to be standardized tests. Additional Information: Use of Assessments

Question 146

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 applies to: Select one: A. all health care providers B. only health care providers who transmit patient information by fax and the internet C. only health care providers who employ someone, such as billing services, with access to patient information D. only health care providers who transmit patient information electronically

Answer 146

Correct Answer is: D HIPAA does not apply to all health care providers. It only applies to "cover entities" - health plans, health care clearinghouses and healthcare providers - who transmit health information electronically. A provider who only communicates information by mail, phone, or fax is not a covered entity. Transmitting information electronically refers to use of the internet and includes receiving health information as well as transmitting information. For example, a provider is a covered entity even if she/he never transmits information but receives information, such as a description of benefits e-mail, via the internet. Additionally, a provider employing someone who sends or receives patient information on the provider's behalf via the internet is also a covered entity. Additional Information: HIPAA

Question 147

You notice an advertisement in a local newspaper in which a colleague of yours is listed as a doctorate level psychologist when you know for a fact that he has not completed his doctorate. You discuss the issue with the psychologist and he assures you that he will correct the error immediately. Two months later you see a client who has been previously seen by your colleague and the client hands you a business card that identifies the colleague as a Ph.D. In this situation, your ethical obligation is to Select one: A. meet again with your colleague to discuss the situation. B. file a report with the APA Ethics Committee. C. take no action because of the patient confidentiality issues involved. D. try to find out when the colleague had the business cards printed.

Answer 147

Correct Answer is: B Standards 1.04 and 1.05 of APA's Ethical Standards and Code of Conduct deal with the issue of reporting violations by other psychologists. The first states in part that when psychologists learn of an ethical violation by another psychologist "they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate." According to Standard 1.05 "if an apparent ethical violation...and is not appropriate for informal resolution or is not resolved properly in that fashion", psychologists must take "further action", such as reporting the violation to an ethics committee or state licensing board. In the situation described, you attempted to resolve the matter informally but that did not work, and there is no indication that reporting the matter will violate patient confidentiality. Therefore, you have to take further steps, and of the choices listed, a report to APA's Ethics Committee is the only one that is consistent with this obligation. Additional Information: Informal Resolution and Reporting of Ethical Violations

Question 148

You are completing a court-ordered evaluation in order to determine the person's competency to stand trial and during the administration of the MMPI-2 your client jumps out of his seat and shouts "OK, OK, I killed her!" Now you are Select one: A. obligated to include this information in your report; it is a court-ordered report. B. obligated to include this information; privilege is waived because the mental status is part of the defense. C. obligated to include this information; privilege is waived because you know have a Tarasoff situation. D. not obligated to include the confessional information

Answer 148

Correct Answer is: D Since the question does not indicate that the client has waived consent, the law protects the defendant at this juncture. He is protected by laws that prohibit the use of evaluation data to determine the defendant's guilt. The best course of action is to not include any incriminating evidence in the competency report, but instead only information relevant to the defendant's competence (G.B. Melton, Psychological Evaluations for the Court, New York, Guilford, 1987). Additional Information: Informed Consent

Question 149

A new client comes to see you and you find his political views to be distasteful. In this situation, as an ethical psychologist, you should: Select one: A. refer the client to someone else. B. discuss your feelings with the client and assess to determine if his views are reflective of underlying psychopathology. C. respect the client's political views and proceed with therapy. D. seek consultation.

Answer 149

Correct Answer is: C Principle E (Respect for People's Rights and Dignity) states that "Psychologists are aware of and respect cultural, individual, and role differences, including those based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status and consider these factors when working with members of such groups." respect the client's political views and proceed with therapy. Therefore, this is the best answer, since it is most consistent with this ethical principle. A consultation or even a referral may be necessary if your ability to conduct therapy would be impaired. However, there is no reason why a difference of political opinion alone should interfere with therapy.

Question 150

The legal basis of the Tarasoff decision was that Select one: A. the protective privilege ends when the public peril begins. B. psychologists have a legal and ethical responsibility to uphold the general welfare. C. a psychotherapist's duty to enforce the law supercedes his or her duty to protect a patient's confidentiality. D. a psychotherapy patient's right to confidentiality is absolute

Answer 150

Correct Answer is: A The California Supreme Court's Tarasoff decision established the duty of a psychotherapist to protect the intended victim whenever a patient poses a serious danger of violence to another. In ruling that the need to protect the intended victim supercedes a client's confidentiality rights, the Court wrote that "the protective privilege ends when the public peril begins." Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 151

According to APA's Guidelines for Providers of Services to Ethnic, Linguistic, and Culturally Diverse Populations, which of the following suggestions is most useful when working with a client from a minority background? Select one: A. Therapists should treat the client just like any other client. B. Therapists should remember that culture and ethnicity are significantly related to therapeutic issues. C. Therapists should downplay their own culture and emphasize the client's culture. D. Therapists should assume that the client's problems are due to discrimination and bias.

Answer 151

Correct Answer is: B APA's Guidelines for Providers of Service to Ethnic, Linguistic, and Culturally Diverse Populations were designed to provide suggestions to psychologists working with ethnic, linguistic, and culturally diverse populations. One of the suggestions is to "recognize ethnicity and culture as significant parameters in understanding psychological processes." Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Question 152

A client suspects that she may have been sexually abused as a child, although she has no conscious recollection of the abuse. She asks her psychologist to use hypnosis to help her retrieve any repressed memories she may have of any abuse. The psychologist should: Select one: A. agree to use hypnosis only if he or she has obtained adequate training and experience in it's use. B. agree to use hypnosis but take detailed notes in the event of future legal action and avoid asking the client any leading questions. C. advise against the use hypnosis, but recommend the use of guided imagery, which may be more admissible in court. D. advise the patient that hypnosis may produce false recollections of abuse and is therefore inappropriate.

Answer 152

Correct Answer is: D In a report titled "Final Conclusions of the American Psychological Association Working Group on Investigation of Memories of Childhood Abuse" [Psychology, Public Policy, and Law, 2000, 4 (4), 933-940] the authors acknowledge that "it is possible for memories of abuse that have been forgotten for a long time to be remembered." However, they recommend that "clients who seek hypnosis as a means of retrieving or confirming their recollections should be advised that it is not an appropriate procedure for this goal because of the serious risk that pseudomemories may be created in trance states and of the related risk due to increased confidence in those memories. Clients should also be informed that the use of hypnosis could jeopardize any future legal actions they might want to take." Additional Information: Hypnotherapy

Question 153

You conduct a psychological assessment on a patient and then refer the patient to another psychologist. The new psychologist doesn't understand your assessment and offers to pay you for consultation concerning the assessment. The proposed arrangement is Select one: A. unethical, because it represents a payment for a referral. B. unethical, because it represents a dual relationship. C. ethical, as long as the payment is not for the referral. D. ethical, because the current version of the APA's ethical standards permits payment for referrals.

Answer 153

Correct Answer is: C According to the ethical standards, a referring psychologist can receive payment from the new psychologist, as long as the payment is "based on the services (clinical, consultative, administrative, or other) provided and is not based on the referral itself." In this situation, it appears that the new psychologist is paying for legitimate consultative services, rather than providing you with a "kickback." Therefore, the arrangement appears to be ethical. Additional Information: Referral Fees

Question 154

You are the only provider in a rural community and your spouse's coworker asks if he could schedule an appointment with you. Which of the following is the best course of action? Select one: A. You must refer him. B. You must schedule an appointment with him. C. You should refer him if you believe that treating him would impair your objectivity. D. You should discuss this with your spouse and this coworker to determine if this constitutes a dual relationship.

Answer 154

Correct Answer is: C According to APA's Ethics Code regarding multiple relationships (3.05[a]), "A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists." You must refer him. This choice is too prohibitive. Although it may be necessary to refer this person, if it appears unlikely that entering into a professional relationship would impair your objectivity or would otherwise be harmful to the person, you could treat him. You must schedule an appointment with him. This choice can be eliminated because psychologists and other health professionals have no legal or ethical obligation to enter into a professional relationship. You should discuss this with your spouse and this coworker to determine if this constitutes a dual relationship. This choice can be eliminated because discussing the matter with your spouse would be a breach of confidentiality. Additional Information: Multiple Relationships

Question 155

A former patient and yourself meet at the shopping mall 26 months after she has completed therapy with you. Which is the most unethical choice? Select one: A. You help her choose her fall wardrobe. B. She has started smoking again, so you refer her to a smoking cessation group. C. You pursue a romantic relationship with her. D. She is a physician; describe your current physical symptoms and ask her opinion.

Answer 155

Correct Answer is: C You would never PURSUE a romantic relationship with a former client if you are an ethical psychologist. Standard 10.08 (Sexual Intimacies With Former Therapy Clients/Patients) states, "(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy. (b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient." You help her choose her fall wardrobe. She is a physician; describe your current physical symptoms and ask her opinion. These two choice also involve multiple relationships and are not good choices. However, APA has not dedicated a specific standard to either of these situations. Additional Information: Sexual Intimacies

Question 156

A psychologist has been treating a client in therapy for four months. The client has not shown up for the last two appointments, and is overdue on payment for an additional two sessions. In this situation, the psychologist's best course of action would be to Select one: A. refer the matter to a collection agency. B. terminate treatment. C. contact the client to discuss the situation with him. D. interpret the client's behavior as resistance if and when he shows up for a session.

Answer 156

Correct Answer is: C In this situation, the psychologist must address two issues: the client not showing for two appointments, and the client's failure to pay for two completed sessions. This choice ("refer the matter to a collection agency") does not address the issue of missed sessions, nor is it a really great answer for addressing the payment issue, because it fails to note that a psychologist cannot use a collection agency unless the client was first informed that this could happen and provided an opportunity to pay. This choice ("interpret the client's behavior as resistance if and when he shows up for a session") is a purely clinical response, does not address the issue of non-payment, and isn't that great from the clinical perspective because resistance could be but is not necessarily the issue. This choice ("terminate treatment") is incorrect because a psychologist cannot suddenly terminate therapy without at least making an effort to, according to APA's ethical standards, "provide pretermination counseling and suggest alternative service providers." That leaves the correct choice ("contact the client to discuss the situation with him"), even though very general, as the best answer. The psychologist would certainly want to discuss all aspects of the situation with the client, if possible. Additional Information: Fees for Services

Question 157

You see a client for eight sessions for short-term therapy for depression following an accident at work that left him unable to work. A year later, the client's attorney contacts you and asks you to testify on the client's behalf in his lawsuit against the employer. In this case, you should Select one: A. refer the attorney and his client to a psychologist who specializes in forensic evaluations. B. agree to testify since the attorney will likely compel your testimony via a subpoena. C. clarify that it will be necessary to conduct a new evaluation in order to serve as an expert witness. D. explain that you will be only able to testify as and clarify the role of a fact witness.

Answer 157

Correct Answer is: D According to the APA's Ethical Standards, when asked to provide service at the request of a third party "psychologists attempt to clarify at the outset of the service the nature of the relationship with all individuals or organizations involved." In this question, you need to understand the role of psychologists in forensic settings to know how to explain the nature of your service to this client. In these settings, a psychologist can serve as either an expert or a fact witness. An expert witness is someone who has superior knowledge about a particular psychological issue in a legal case based on her training or experience, and offers that opinion if permitted or asked to do so by the court. A fact witness, on the other hand, is one who testifies about facts relevant to the case; when a psychologist testifies as a fact witness, it would be because he has treated a client and the events or disclosures that occurred in the treatment are relevant to the case. The roles of expert witness and fact witness are contradictory in numerous ways; for instance, an expert witness's client is an attorney, whereas a treating psychologist's client is the patient. Therefore, psychologists should not serve as both fact and expert witnesses in the same case. Additionally, the attorney's request to testify "on behalf of the client" requires clarification; this could be interpreted to mean that your primary role would be to advocate for the client as opposed to testifying truthfully. For these reasons, of the choices listed, the best answer is to explain that you only can testify as a fact witness and to clarify your role as such. Additional Information: Third Party Requests for Services

Question 158

Dr. Bean is a newly licensed clinical psychologist who is practicing in a small rural town. She is the only mental health practitioner in a 150-mile radius. Dr. Bean finds that some of her clients have mental health problems that she has little or no experience treating. Her best course of action is to Select one: A. refuse to treat the clients who have problems that she is unfamiliar with. B. obtain appropriate training before treating the clients who have problems that she is unfamiliar with. C. inform the clients of her lack of experience and let them decide what to do. D. see the clients but obtain supervision or consultation by telephone.

Answer 158

Correct Answer is: D According to Ethics Standard 2.01(d), "When psychologists are asked to provide services to individuals for whom appropriate mental health services are not available and for which psychologists have not obtained the competence necessary, psychologists with closely related prior training or experience may provide such services in order to ensure that services are not denied if they make a reasonable effort to obtain the competence required by using relevant research, training, consultation, or study." Since Dr. Bean is the only mental health professional in town, this is the best course of action of those given in the responses since there is no indication that the clients have problems that Dr. Bean doesn't want to treat or that she would not be able to treat with consultation or supervision. Additional Information: Boundaries of Competence

Question 159

An attorney contacts you and requests the raw test data which you collected from a former patient of yours last year, along with the testing protocols. The attorney explains that the information is needed in an upcoming court case in which your former client is a plaintiff in a personal injury case. The client has signed an informed consent for release of information. You should: Select one: A. release only the information which you believe to be relevant to the case B. refuse to release the raw test data or test protocols C. send the attorney the raw data but not the test protocols D. send the attorney the test protocols but not the raw test data

Answer 159

Correct Answer is: C Ethical Standard 9.04(a) states that "Psychologists may refrain from releasing test data to protect a client/patient or others from substantial harm or misuse or misrepresentation of the data or the test, recognizing that in many instances release of confidential information under these circumstances is regulated by law." Since attorneys would not usually be qualified to use raw data, the best course of action would be to advise the attorney to engage the consultation of another psychologist whom you could send the data to (after getting the appropriate consent). However, since that is not one of the available choices in this question, the best option would be to send the attorney the raw data but not the test protocols. Note that the HIPAA law requires psychologists to release certain information, including test data, to patients upon request. However, test materials including manuals, instruments. protocols, and test questions are not part of the test data and should not generally be released for reasons of test security (Standard 9.11). Additional Information: Releasing and Explaining Test Results

Question 160

A 16-year-old girl tells her therapist that she wants to kill herself and that she's been thinking of using her mother's prescription pain pills to overdose. The therapist then tells her that he will have to tell her parents about her suicide risk. The girl becomes enraged and says that she would not have disclosed the information if she knew that the therapist would tell her parents. The therapist should: Select one: A. agree not to tell the parents if the girl agrees to a no-harm contract B. agree not to tell the parents, but tell them without the girl's knowledge C. tell the parents and refer the girl to another therapist because she will probably not be able to trust the therapist again D. tell the parents and apologize to the girl for having to do so

Answer 160

Correct Answer is: D According to both ethics and law, a psychologist may disclose confidential information without the client's consent to protect the client from harm. This applies to minors and adults alike. In this case, it would most likely be appropriate to inform the girl's parents about her suicide risk. The reasons for this should be explained to the girl and the therapist should apologize for the breach of confidentiality. agree not to tell the parents if the girl agrees to a no-harm contract Given the apparent level of risk involved, it would probably not be sufficient to rely on a no-harm contract. agree not to tell the parents, but tell them without the girl's knowledge It would certainly be inappropriate and countertherapeutic to lie to the client. tell the parents and refer the girl to another therapist because she will probably not be able to trust the therapist again And it may not be necessary to refer the client. If handled empathically, it is likely that the girl will come to understand the therapist's reasons for disclosing to the parents and may come to appreciate that her safety was his overriding concern. Additional Information: Maintaining Confidentiality

Question 161

A therapist whose client has filed an ethics complaint against him receives a request from the APA ethics committee for records pertaining to his work with the complainant. The therapist refuses to supply the committee with the records. Which of the following statements is most true of this situation? Select one: A. the therapist acted ethically. B. the therapist acted ethically unless he possesses a written release of information from the client. C. the therapist should have consulted with an attorney first. D. the therapist is now liable for an additional ethics violation

Answer 161

Correct Answer is: D Standard 1.06 of APA's ethical standards states "Psychologists cooperate in ethics investigations, proceedings, and resulting requirements of the APA or any affiliated state psychological association to which they belong...Failure to cooperate is itself an ethics violation." In other words, failure to release the records is itself an ethical violation. the therapist acted ethically unless he possesses a written release of information from the client. If you chose this option, you were correct to be concerned about confidentiality issues in situations like this. However, the client could not have proceeded with his complaint unless he provided a release of information with it. Additional Information: Cooperating With Ethics Committees

Question 162

According to APA's Standards for Educational and Psychological Testing, test results should be reported Select one: A. only to professionals trained in the interpretation of psychological tests. B. using only raw scores. C. using only confidence intervals or percentile bands. D. in clear and simple language

Answer 162

Correct Answer is: D To reason this one out, you don't really have to be familiar with the language of the applicable standard, but here it is anyway: "Those responsible for testing programs should provide appropriate interpretations when test score information is released to students, parents, legal representatives, teachers, or the media. The interpretations should describe in simple language what the test covers, what scores mean, common misinterpretations of test scores, and how scores will be used" (standard 15.10). using only confidence intervals or percentile bands. Other standards require that the standard error of measurement be reported so confidence intervals or percentile bands can be constructed; however, the word "only" makes this option incorrect. Additional Information: Releasing and Explaining Test Results

Question 163

A therapist routinely waives co-payments for all low income clients. This is Select one: A. unethical, unless the client is on welfare. B. ethical, if the psychologist is doing this in order to create a sliding scale. C. unethical. D. ethical.

Answer 163

Correct Answer is: C This is unethical (and illegal) because it constitutes insurance fraud -- the insurance company thinks it's paying for a portion of the client's treatment when it is really paying for the whole thing. Of course, it would not be unethical if you told the insurance company what you were doing. However, most if not all insurance companies would not accept such an arrangement; instead, the company would lower its own contribution to the fee. Additional Information: Third Party Payors

Question 164

A psychologist has been treating a child in play therapy for several months and is asked to testify in a court case involving custody of the child. The psychologist should: Select one: A. testify only if he can evaluate all involved parties B. testify only about objective facts C. decline to testify D. testify as requested

Answer 164

Correct Answer is: C It is in the child's best interests for the psychologist to refrain from testifying because he has an established therapeutic relationship with the child and his role in this situation should be to provide the child with support during the custody battle. testify only if he can evaluate all involved parties If the psychologist did not have a relationship with one of the involved parties or had a past (rather than present) relationship with an involved party, this response would describe the best response. (See: Bernat, W. (1983). The therapist's role in child custody disputes, "Journal of the American Academy of Child Psychiatry, 22, 180-183.) Additional Information: Couple and Family Therapy

Question 165

According to APA's Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Population, psychologists, when working with a client from an ethnic minority background, should Select one: A. downplay the values of their own culture. B. adopt a culturally neutral stance. C. be aware of their own biases. D. assume that the client's presenting problem can be explained by "healthy paranoia."

Answer 165

Correct Answer is: C APA's Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Population are general principles that are "aspirational in nature" and "provide suggestions" (not binding standards) to psychologists working with ethnic, linguistic, and culturally diverse populations. One of these principles is that "Psychologists recognize ethnicity and culture as significant parameters in understanding psychological processes," and a recommendation stemming from this principle is "Psychologists...are aware of how their own...biases influence psychological processes." Regarding the other choices, the principle that ethnicity and culture are significant parameters contradicts this choice ("adopt a culturally neutral stance"), but, contrary to this choice ("downplay the values of their own culture"), it does not mean that psychologists must downplay their own values. And the guidelines do recommend that psychologists remain aware that healthy paranoia, or defensiveness in response to discrimination and racism, does occur, but, unlike this choice ("assume that the client's presenting problem can be explained by 'healthy paranoia'"), they do not state that psychologists should "assume" it is the cause of the presenting problem. Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Question 166

You see a substance abuser who has been referred to therapy as a condition of probation. The man tells you that he is seeking therapy only to avoid jail time and that he does not think he needs therapy. Regarding informed consent in this situation, which of the following statements is true? Select one: A. You don't have to get informed consent because the judge ordered treatment. B. You don't have to obtain informed consent because convicted criminals don't have the right to refuse treatment. C. You don't have to obtain informed consent because there's no way that consent can truly be informed in this situation. D. You cannot treat the patient unless you obtain his informed consent

Answer 166

Correct Answer is: D In working with court-referred patients, psychologists must obtain informed consent from the patients before proceeding. This may seem ridiculous, since many court-referred clients face serious consequences if they don't comply with the court's recommendation to seek therapy. However, in court-referred cases, the client could, theoretically at least, decline treatment and choose jail time or other consequences instead. By contrast, in court-ordered evaluation or treatment, there is no need to get informed consent because the client is mandated by law to participate. However, in such cases, psychologists have other obligations, such as informing the client of the limits to confidentiality. Additional Information: Informed Consent

Question 167

A psychologist in a rural area is referred a 17-year-old male who has been abusing OxyContin. Although the psychologist is trained and experienced in the treatment of substance abuse, she has not received training in, nor experience with, OxyContin abuse. The psychologist should: Select one: A. refer the patient to a psychologist outside the area who is experienced in the treatment of OxyContin abuse B. agree to treat the patient after attending a workshop on the treatment of OxyContin abuse C. refer the patient for inpatient detoxification D. provide the patient with treatment and read relevant literature

Answer 167

Correct Answer is: D Psychologists have an ethical responsibility to practice within the boundaries of their competence. However, according to APA's Ethics Standard 2.01(d), "When psychologists are asked to provide services to individuals for whom appropriate mental health services are not available and for which psychologists have not obtained the competence necessary, psychologists with closely related prior training or experience may provide such services in order to ensure that services are not denied if they make a reasonable effort to obtain the competence required by using relevant research, training, consultation, or study." It should not, therefore, be necessary to refer the patient to a provider out of the area. It also would not be in the patient's best interest to postpone treatment until the psychologist can attend a workshop on the subject. And, although OxyContin abuse is serious and potentially fatal, it generally would not require inpatient detoxification unless the abuse progressed to dependence. Additional Information: Boundaries of Competence

Question 168

At a supermarket, you overhear a colleague of yours discussing confidential information about a client with a mutual friend whom you know is not a mental health professional. Your best course of action would be to Select one: A. pull the colleague aside and explain to him that he is committing an ethical violation. B. call the colleague later in the day and make an appointment to talk to him. C. report your colleague to the state ethics board. D. do nothing because the colleague has not necessarily violated ethical standards.

Answer 168

Correct Answer is: B According to standard 1.04 of APA's ethical standards, "When psychologists believe that there may have been an ethical violation by another psychologist, they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate and the intervention does not violate any confidentiality rights that may be involved." Here there is good reason to believe that the colleague is in violation of ethical standards involving confidentiality, so your obligation would be to bring the violation to his attention. pull the colleague aside and explain to him that he is committing an ethical violation. This choice also involves bringing the violation to the colleague's attention, but there is no ethical obligation (or common-sense need) to pull the client aside in a public place and address the issue in this setting. Additional Information: Informal Resolution and Reporting of Ethical Violations

Question 169

In which of the following circumstances would a psychologist's behavior most likely be considered unethical? Select one: A. hands out her card to individuals in a tent-city whose homes have been destroyed by a hurricane B. receives payment for reviewing a new book in her field, which is published in a popular lay magazine C. has her name and picture featured in a magazine ad in which it is indicated her favorite scotch is Dewars D. sends out announcements to local businesses that she is available to work as an EAP counselor

Answer 169

Correct Answer is: A The Ethical Principles do not ban all forms of solicitation. However, they do ban the solicitation of individuals who are, for whatever reason, "vulnerable to undue influence." Clearly, individuals who have just had their house destroyed are susceptible to undue influence. hands out her card to individuals in a tent-city whose homes have been destroyed by a hurricane Thus, the psychologist in this choice would be acting unethically. Additional Information: Solicitation of Business

Question 170

A colleague of yours confides to you at a party after having a few drinks that he is involved in a sexual relationship with a current client. In this situation, your best course of action would be to Select one: A. meet with the colleague the next day to inform him you are going to report the violation to the state licensing board. B. meet with the colleague the next day and help him to find options for resolving the problem. C. take no action because of the patient confidentiality issues involved. D. take no action because you did not learn of the issue in a professional setting

Answer 170

Correct Answer is: A Standards 1.04 and 1.05 of APA's Ethical Standards and Code of Conduct deal with the issue of reporting violations by other psychologists. The first states in part that when psychologists learn of an ethical violation by another psychologist "they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate." According to Standard 1.05 "if an apparent ethical violation has substantially harmed or is likely to substantially harm a person...and is not appropriate for informal resolution or is not resolved properly in that fashion", psychologists must take "further action", such as reporting the violation to an ethics committee or state licensing board. In other words, you attempt an informal resolution, such as the one described in this option ("meet with the colleague the next day and help him to find options for resolving the problem") when such a resolution appears appropriate. Sexual misconduct, however, is an example of an ethics violation that is very likely to cause substantial harm and attempting an informal resolution would not go far enough in meeting your obligation under the Ethics Code. Thus, a better course of action would be to report the violation. Additional Information: Informal Resolution and Reporting of Ethical Violations

Question 171

To reduce their liability risk, managed care organizations are most likely to do which of the following? Select one: A. insure their providers are credentialed B. reduce the amount of time between date of claim submission and approval of claim C. utilization review D. pay their providers a reasonable reimbursement rate

Answer 171

Correct Answer is: A Managed care organizations typically require all their providers to be credentialed. This helps to insure that their providers are competent and, consequently, reduces their risk of liability. Utilization Review is a cost containment procedure involving an evaluation of patients' use of services to identify any unnecessary or inappropriate use of health care resources.

Question 172

A psychiatrist sends you a release for information from a former patient of yours requesting records that are seven years old. In this situation, you should Select one: A. send the records as requested. B. send the records with a cover letter explaining the limitations of the records. C. refuse to send the records. D. contact the patient to make sure he or she understands the ramifications of the situation.

Answer 172

Correct Answer is: B It is your responsibility to take steps to prevent the misuse of potentially obsolete data. At the same time, access to these records could facilitate the psychiatrist's work with your client, and the client does have the right to request the records. Thus, a cover letter explaining the limitations of the records (i.e., they are old and probably obsolete at least to some degree) is the way to go here. Additional Information: Records

Question 173

You have been seeing a client for several months and believe that treatment has been a success. When you suggest termination to the client, he expresses a desire to continue therapy. Both you and the client are unable to come up with additional treatment goals; however, the client states that he really looks forward to coming to therapy just to talk. In this situation, you should: Select one: A. terminate treatment immediately. B. terminate treatment after a period of pretermination counseling, in which the client's reasons for not wanting to terminate are explored. C. continue seeing the client until he is ready to end therapy. D. seek consultation

Answer 173

Correct Answer is: B Ethical standard 10.10 requires that a psychologist terminate a professional relationship when it becomes "reasonably clear that the client/patient no longer needs the service, is not likely to benefit, or is being harmed by continued service." Prior to termination, the psychologist must "provide pretermination counseling and suggest alternative service providers as appropriate." Additional Information: Terminating Therapy

Question 174

With parental consent, a psychologist has been providing therapy to a 12-year-old boy for a couple of months. Unexpectedly, both parents suddenly withdraw their consent. The psychologist believes that continuing therapy is in the best interests of the boy. The psychologist's best course of action would be to: Select one: A. seek judicial intervention B. obtain a signed consent from the girl and continue treatment C. stop the treatment because both parents have withdrawn their consent but provide them with referrals to other therapists D. continue to see the girl without the parents' consent

Answer 174

Correct Answer is: A The psychologist's ethical obligation is to serve the best interests of the child, but legally, he/she cannot proceed with treatment if the parents do not give consent to do so. While some states have laws that allow psychologists to provide services without parental consent, no information is given in this question regarding the relevant law or whether the child's problem(s) would be covered by this type of law. The Ethics Code Standard 1.02 states that "If psychologists' ethical responsibilities conflict with law, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict in a responsible manner." Therefore, the psychologist would not just terminate without attempting to advocate for the patient; nor continue to treat the child without the parents consent, as violating the law is not consistent with resolving the conflict in a responsible manner. (See: M. DeKrai and S. D. Sales in Liability in child therapy and research, Journal of Consulting and Clinical Psychology, 59(6), 1991, 853-860.)

Question 175

Your client arrives at the fourth session with a small handgun in his coat. He says that when he leaves the session he is going to go by his ex-wife's house and "shake up her new husband a bit." He assures you that the gun is not loaded. You should Select one: A. insist he remain in your office and try to calm him down. B. ask him to turn over the gun. C. alert the new husband if possible. D. do nothing; this particular client has an odd sense of humor.

Answer 175

Correct Answer is: C The correct answer is referring to a situation in which the Tarasoff law applies. You have a client who is threatening harm to an intended victim. "The discharge of such duty...may call for the therapist to warn the intended victim of the danger..." (Tarasoff vs. Regents of University of California 1976, p. 426). insist he remain in your office and try to calm him down. ask him to turn over the gun. These choices are heroic, but may place you at considerable risk; they also require clinical judgments you cannot make with the limited information available in this question. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 176

``` "Pro bono" services are ________________ by the APA's Ethics Code. Select one: A. not addressed B. prohibited C. required D. encouraged ```

Answer 176

Correct Answer is: D Pro bono services are professional services that are provided at no charge for the public good. While not explicitly mentioned in the Ethics Code, pro bono services are addressed in the Code's aspirational General Principle B, "psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage." Since they are addressed in the Code's aspirational General Principles instead of its mandatory Ethical Standards, pro bono services are recommended - but not required - by the Ethics Code. Additional Information: Preamble and General Principles

Question 177

A psychologist learns from a friend that another psychologist has been revealing confidential information about his patients. Both psychologists live in a small rural community and the information the offending psychologist revealed has apparently spread rapidly around town. The psychologist who learned of this behavior should Select one: A. call the other psychologist's clients to assess the degree of harm that their therapist's behavior caused. B. seek consultation. C. report an ethics violation to a state or national Ethics committee. D. do nothing.

Answer 177

Correct Answer is: C You might have been looking for an answer such as "try to resolve this issue informally by speaking to the other psychologist" , but no such choice was present. Thus, you had to choose the best answer, and as with all ethics questions, the best answer is the one most consistent with the language of APA's Ethical Standards. The following excerpts from Ethical Standards 1.04 and 1.05 apply here:"When psychologists believe that there may have been an ethical violation by another psychologist, they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate and the intervention does not violate any confidentiality rights that may be involved." "If an apparent ethical violation has substantially harmed or is likely to substantially harm a person or organization and is not appropriate for informal resolution ... or is not resolved properly in that fashion, psychologists take further action appropriate to the situation. Such action might include referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities." In a nutshell, these standards say that, when another psychologist commits an ethical violation, your responsibility (assuming no confidentiality rights are violated) is to either bring the matter to the other psychologist's attention, or take action such as making a report to an ethics committee. Since this question does not include the option of addressing the issue informally, the best answer must be to report the matter to an Ethics committee. Additional Information: Informal Resolution and Reporting of Ethical Violations

Question 178

You have been treating a client for six months, and the original problem the client sought treatment for is in remission. The client tells you that he wants to terminate. You, however, are reluctant to terminate because you believe that the client can benefit from further psychotherapy. In this situation, you should: Select one: A. terminate in line with the client's wishes, since the client's presenting problem is solved. B. seek consultation. C. discuss the client's reasons for wanting to terminate. D. discuss the reasons why you feel he shouldn't terminate, and, if he still wants to terminate, allow him to do so.

Answer 178

Correct Answer is: D Even though you might not have too much difficulty handling this situation in real life, this question might have been difficult because none of the choices is clearly "wrong." discuss the reasons why you feel he shouldn't terminate, and, if he still wants to terminate, allow him to do so. This is the best answer -- it's in the client's best interests that you explain why you feel he should not terminate, but, if he chooses to do so, you must respect his right to self-determination. terminate in line with the client's wishes, since the client's presenting problem is solved. This choice does not include your explaining your concerns to the client, so it is not as good. seek consultation. You might have been seduced by this option, because seeking consultation is never a bad thing to do, but it is not necessary in this common and relatively straightforward situation. discuss the client's reasons for wanting to terminate. Similarly, when clients want to terminate, it's always important to discuss their reasons, as stated by this choice. In this case, however, the client's reasons are pretty clear -- the problem for which he sought therapy is solved. Additional Information: Terminating Therapy

Question 179

A psychologist is undertaking a research program in an elementary school on the effect of a new counseling program on enhancing children's self-esteem. The psychologist has received permission from the school's principal, the teachers, and from the parents of each student. However, when she explained the program to the children, some of them objected to being part of the study. The psychologist should Select one: A. not use these children in her study. B. call the parents of these children and ask them to try to convince the children to participate. C. use the children in her study because she has all necessary legal consents. D. re-design the study to eliminate the objection the children have to participating.

Answer 179

Correct Answer is: A The best idea is to just leave out these children. Participants have the right to decline to participate in research, even if they are children. It wouldn't be practical or prudent to ask her to re-design the whole experiment because a handful of children object to being participants. Thus, the best answer is to just do the study without using the children who object to participating. Additional Information: Informed Consent for Research

Question 180

A psychologist is contacted by email by a woman seeking online therapy to become more motivated to make some positive life changes. The psychologist agrees to provide the e-therapy and therefore should do which of the following in terms of charging this client for his services? Select one: A. have the client e-mail her credit card information to him before providing services B. charge per e-mail exchange, based on the fee that the client agrees to beforehand C. charge per minute, based on the fee that the client agrees to beforehand D. establish the fee with the client before providing his services

Answer 180

Correct Answer is: D charge per e-mail exchange, based on the fee that the client agrees to beforehand charge per minute, based on the fee that the client agrees to beforehand Although these two responses are acceptable, only the correct response describes something that any e-therapist "should" do. One practice standard for psychologists offering services online is to state their fee structure clearly - clearly stating the amount of their fee on their Web page and communicating with clients about the fee before providing any services. Many e-therapists do what is described in "charge per e-mail exchange, based on the fee that the client agrees to beforehand" - they charge their hourly fee and charge for the time they spend reading and answering each e-mail from a client. have the client e-mail her credit card information to him before providing services An e-therapist can have clients pay by mail, using a check or money order, or accept payment via a credit card. An e-therapist who accepts credit cards, however, must allow payment via a secure server or give the client a phone or fax number to call with his credit card information - he should never ask a client to send her credit card information in an e-mail, or via in any nonsecure Web form. [Note: Additional practice standards for e-therapy include: Describing clearly and fully what services do and do not consist of; fully and accurately disclosing professional credentials, licensure and experience; fully inform clients about how online services work, the skills they need in order to use online services, reach an agreement on the frequency of service and what the possible benefits and risks are, including breaches of confidentiality; deliver services exactly as advertised; make provisions to ensure the confidentiality and privacy of online communications; maintain records of the services provided according to professional and state-mandated standards; and discuss the procedures to follow in an emergency. Legal issues related to e-therapy most often involve those having to do with regulation (i.e., licensure, malpractice coverage), the therapist-client relationship, quality, and security and privacy. Given the unresolved legal issues associated with e-therapy, it considered by many to be too risky for psychologists to diagnose or treat mental disorders online.] (See: Hsiung, R.C. (2002). Suggested Principles of Professional Ethics for E-Therapy. E-Therapy: Case Studies, Guiding Principles, and the Clinical Potential of the Internet; And: International Society for Mental Health Online (ISMHO) & Psychiatric Society for Informatics (2000). The Suggested Principles for the Online Provision of Mental Health Services. Accessed May 2007. http://www.ismho.org) Additional Information: Fees for Services

Question 181

A patient tells you that he plans to blow up an office building at 3 AM. He chose that time because he just wants to make a political statement, and knows that nobody will be in the building. In this situation, you should Select one: A. not report this threat to anybody because there is no identifiable victim. B. try to get more information about the client's plans. C. remind the client about the limits of confidentiality. D. call the police immediately after the client leaves your office.

Answer 181

Correct Answer is: D This question relates to a psychotherapist's "duty to protect" the victim when a client threatens violence against an identifiable victim. In two rulings in the case of Tarasoff v. Regents of the University of California (1974 and 1976), The California Supreme Court ruled that, when a psychotherapy patient makes a specific threat of violence against a reasonably identifiable victim or victims, the therapist must make reasonable efforts to protect the victim(s). Though this requirement is commonly called the "duty to warn", warning the victim(s) is one of a number of possible ways to discharge this duty. Others include calling the police and hospitalizing the client and of course these steps can be combined. Though Tarasoff was a California case, many other states have adopted laws with substantially similar language, which at the very least allow for a breach of confidentiality in these circumstances. Thus, the duty to protect has evolved into a standard of care in mental health fields, even in those states where it is not a legal mandate. Assuming this threat is credible, it clearly triggers the duty to warn. The victims are identifiable: people in the building at 3 AM. Accepting the client's claim that no one would be in the building at 3 AM would be reckless; even he could not know that for sure and there could be people in surrounding areas. remind the client about the limits of confidentiality. It's true, as stated by this choice, that it is often a good idea to remind clients of the limits of confidentiality in situations where you have to breach it. In this case, however, doing so could be dangerous to you; in addition, this choice does not address the main issue raised by the question. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 182

You are a small town psychologist in private practice and a client has written a letter to the Psychology Board complaining that you have a very unprofessional staff. The Board has now written you to inform you of this matter. You should: Select one: A. Discipline your staff B. Respond to the Board C. Call the client and let them know that you will make the appropriate changes with your staff D. Refer the client to a psychologist in another town

Answer 182

Correct Answer is: B You must respond to the Board. To not do so is itself an ethical violation. While it is possible that this is a clinical issue between yourself and your client it is no longer in the therapeutic realm. Your client has gone to an outside source and that source is concerned enough to begin a preliminary investigation. Additional Information: Cooperating With Ethics Committees

Question 183

Which of the following statements regarding therapist-client sexual relations is, according to research, most correct? Select one: A. Therapists treating clients with a diagnosis of Borderline Personality Disorder, Histrionic Personality Disorder, or who have a history of incest are more likely to become sexually involved with their patients than other therapists. B. Therapists who become sexually involved with their patients are likely to have less formal education or to have received less professional recognition than other therapists. C. Therapists who have completed a personal course of therapy are less likely to become sexually involved with their patients than therapists who have not undergone therapy. D. Therapists who become sexually involved with a patient typically do so with a patient who is significantly younger.

Answer 183

Correct Answer is: D Kenneth Pope, in an appendix of his book Sexual Feelings in Psychotherapy (Washington, DC: APA, 1993), provides a review of the research in the area of client-therapist sexual relations. Only the correct choice reflects research findings -- one study found that the average ages of therapists and clients sexually involved with each other were 43 and 33, respectively; another study found these ages to be 42 and 30. Therapists treating clients with a diagnosis of Borderline Personality Disorder, Histrionic Personality Disorder, or who have a history of incest are more likely to become sexually involved with their patients than other therapists. In contrast to this option, no research supports the notion that a particular diagnosis or history places a patient at greater risk for sexual involvement with a therapist. Therapists who become sexually involved with their patients are likely to have less formal education or to have received less professional recognition than other therapists. This is also incorrect -- in fact, one study found that psychologists who had attained a high level of professional achievement reported a higher rate of sex with patients. Therapists who have completed a personal course of therapy are less likely to become sexually involved with their patients than therapists who have not undergone therapy. Similarly, in regard to this choice, one study found that psychologists who had completed psychotherapy or psychoanalysis were more likely to have become sexually involved with a patient than those therapists who hadn't undergone therapy. According to Pope, the best single predictor of sexual exploitation in therapy is a therapist who has exploited a patient in the past. Additional Information: Sexual Intimacies

Question 184

Which of the following statements regarding the need to obtain informed consent before releasing client information is most true? Select one: A. A psychologist should always obtain informed consent from the client before releasing information. B. Before consulting with a colleague about a case, a psychologist must always obtain informed consent from the client. C. A psychologist must obtain informed consent from a client some of the time before releasing information. D. If a psychologist wants to release information about a case, he or she may do so without obtaining informed consent.

Answer 184

Correct Answer is: C Ordinarily, you need to obtain informed consent from a client before releasing information you've obtained from him or her. However, this is not always the case; for instance, when you reasonably suspect child abuse, you are legally obligated to file a report with the appropriate state agency -- with or without the client's consent. Before consulting with a colleague about a case, a psychologist must always obtain informed consent from the client. As for consulting situations, informed consent from the client is not necessary as long as you adequately disguise the client's identity. Additional Information: Informed Consent

Question 185

When conducting a custody evaluation, a psychologist should: Select one: A. advocate for the party that retained him B. advocate for the party that retained him, unless retained by the court, in which case, he should remain impartial C. remain impartial regardless of whether he is retained by the court or either party in the proceedings D. acknowledge the fallacy of impartiality in an adversarial legal system

Answer 185

Correct Answer is: C According to Guidelines for Child Custody Evaluations in Divorce Proceedings, "The psychologist should be impartial regardless of whether he or she is retained by the court or by a party to the proceedings. If either the psychologist or the client cannot accept this neutral role, the psychologist should consider withdrawing from the case. If not permitted to withdraw, in such circumstances, the psychologist acknowledges past roles and other factors that could affect impartiality" (American Psychologist, 49(7), 1994, 677-680). Additional Information: Therapy Involving Couples or Families

Question 186

The APA's position on notification of partners of clients/patients with HIV/AIDS is consistent with its emphasis on: Select one: A. duty to protect B. confidentiality C. informed consent D. protection from civil or criminal liability

Answer 186

Correct Answer is: B The American Psychological Association's position on partner notification is consistent with the emphasis on maintaining client confidentiality. Specifically, it recommends "a legal duty to protect third parties from HIV infection should not be imposed." In its statement, Legal Liability Related to confidentiality and the Prevention of HIV Transmission, the APA (1991) also addresses the possibility of such legislation passing and recommends disclosure should be permitted only when (1) there is a known identifiable third party at significant risk for infection; (2) the third party is unaware of the risk; (3) the client has been urged to tell the partner and has refused to do so; and (4) the psychologist is protected legally from civil or criminal liability for disclosing. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 187

``` To ensure that providers meet and maintain health plan participation requirements, managed care organizations (MCOs) use _____________________ as a review process. Select one: A. clinical audit B. concurrent review C. credentialing D. quality management ```

Answer 187

Correct Answer is: C The formal process for determining if a provider meets and maintains the standards of qualification, as well as providing some legal protection for the managed care organization, is referred to as credentialing. Clinical audit* is a quality assurance method. Concurrent review* describes the utilization review conducted during the course of treatment. Quality management* is another name for quality assurance (* incorrect options).

Question 188

With regards to psychologists paying a fee to another professional for a referral, APA's Ethical Principles of Psychologists and Code of Conduct states that Select one: A. fees for referrals are prohibited. B. fees must be based on actual services rendered. C. fees may be paid for a referral if the client is made aware of this arrangement as part of the informed consent procedure. D. there are no restrictions on fees for referrals.

Answer 188

Correct Answer is: B According to standard 6.07 of APA's ethical principles, "When psychologists pay, receive payment from, or divide fees with another professional...the payment to each is based on the services provided (clinical, consultative, administrative, or other) and is not based on the referral itself." For instance, payments to referral services to help cover their administrative fees are permitted, as is payment to another mental health professional for consulting services. However, "kickbacks", or payments for the referral itself and nothing else, are not permitted. Additional Information: Referral Fees

Question 189

A woman comes to you who has been put on morphine due to her pain. She is an ex-alcoholic in recovery and does not want to become addicted to the morphine. She asks your assistance in lowering the dosage. You should: Select one: A. Work with her physician to lower the dose but explain that synthetic morphine isn't addicting B. Tell her she needs to speak directly to her physician C. Suggest she give you the extra morphine and you will dispose of it properly D. Support her choice to not get addicted and work with her physician

Answer 189

Correct Answer is: D It is really alright to support your client's idea even if it isn't yours. You would want to get a signed release to speak to the prescribing physician and work with him or her to support your client's choice. Additional Information: Maintaining Confidentiality

Question 190

The difference between insanity and psychosis is that: Select one: A. insanity is a legal term and psychosis is a term used in mental health literature B. insanity is an outdated term and is no longer applied in legal cases, while psychosis is used both in mental health and legal literature C. insanity is legally a broader term, and subsumes the term psychosis D. insanity refers to disturbances in thought and emotion, while a psychotic disturbance, by definition, affects thought only

Answer 190

Correct Answer is: A Insanity is strictly a legal term; it usually means that a person is in such a mental state that he or she cannot distinguish between right or wrong. Psychosis, on the other hand, is a psychiatric term. Additional Information: Competency to Stand Trial vs. Insanity

Question 191

A woman who has been abused by her husband comes to therapy. What would a family systems therapist do first in this case? Select one: A. invite the husband into therapy B. teach her how to manage her husband's anger C. find out if the woman is currently safe from abuse and, if necessary, rehearse an escape plan with her D. explore patterns of abuse in her family of origin

Answer 191

Correct Answer is: C The key word in this question is "first." The first concern in this case -- for a systems therapist as well as any other therapist -- is to ensure the client's safety, and only the correct answer addresses this issue. invite the husband into therapy If the client's safety were not an issue, this would probably be the best answer, since systems therapists would focus on the whole system rather than its constituent parts. In other words, they would want to work with the couple rather than just one of the spouses. explore patterns of abuse in her family of origin This choice sounds like something an extended family systems (Bowenian) therapist would do. Although Bowen's work is based on systems theory, so are many other schools of family therapy. Additional Information: Systems Theory

Question 192

A psychologist gets a call on a Friday night from a current patient who says she's feeling so depressed she is really thinking of suicide. The psychologist believes her and advises her to go to the hospital immediately. The psychologist is concerned and calls the next day and finds out that the patient did commit suicide. The psychologist's intervention was Select one: A. unethical, because he should have consulted a psychiatrist before he suggested hospitalization. B. ethical, since he made a referral for appropriate treatment. C. unethical, because he should have been more active in assuring that the patient's needs were met. D. ethical, since he did all that he could on a weekend

Answer 192

Correct Answer is: C If the psychologist believed that the patient was actively suicidal, it was unrealistic to assume that she'd get herself to the hospital. The psychologist should have been more active; for example, he could have called the police, called someone close to the patient, or gone to the patient's location. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 193

The mother of a 3-year old has been told her daughter is very gifted. She wants to encourage the child's abilities and asks you, a school psychologist, to assess the girl's IQ score level and suggest a plan for her future education. You should: Select one: A. comply with the request. B. comply with the request, but inform the mother that test results at this age are not very valid as predictors of future performance. C. suggest that the test not be given, but agree to help the mother in deciding on the future educational plans for her child. D. inform the mother that there are no standardized valid tests available for children of such a young age.

Answer 193

Correct Answer is: B In this case there is nothing wrong with you testing the child and tests are available. But you should also use your knowledge and judgment to counsel the mother about the use of tests for such a young child. While it's true that there is some predictive validity for intelligence tests starting at about 18 months to 2 years of age, you should still tell the mother that many things will determine her daughter's future school performance and that we can't be so sure she will continue as she presently is. Additional Information: Use of Assessments

Question 194

``` A quality assurance review would likely focus on all of the following except Select one: A. treatment effectiveness. B. access to treatment. C. cost of treatment. D. patient satisfaction. ```

Answer 194

Correct Answer is: C In the health care business, quality assurance reviews are conducted by organizations such as HMOs or independent overseers to review the quality of services provided. Because the cost of services is not directly related to their quality, it would probably not be a focus of a quality assurance review.

Question 195

A woman seeks help from a psychologist in dealing with her 12-year-old daughter who has been misbehaving lately. The mother says that the daughter has not been listening to her and last week cursed at her mother. The mother reacted by slapping her daughter which left a bruise. The mother feels very remorseful about it and says that she has never done anything like that before. The psychologist should: Select one: A. insist that the woman attend anger management classes B. report the incident to a child protective services agency before the end of the session C. monitor the situation and report any further abuse incidents to a child protective services agency D. seek consultation

Answer 195

Correct Answer is: B State laws require mandated reporters to report any reasonable suspicion of child abuse. Abuse generally includes, but is not limited to, physical injury that is inflicted upon a child by other than accidental means. The reporting laws do not provide exceptions for those who are remorseful or first-time offenders. Although the reporting laws do not require the reporter to inform the abuser of the report, or to involve him or her in making the report, it is often clinically useful to do so. insist that the woman attend anger management classes Referral to anger management classes might be appropriate, but the psychologist should not insist upon it and the psychologist must still meet the reporting requirements. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 196

Dr. Emm believes that one of his patients would benefit from in-patient treatment. The patient's HMO (health maintenance organization) is most likely to approve this type of treatment if: Select one: A. Dr. Emm will be providing services at the in-patient facility. B. Dr. Emm is a licensed psychologist. C. the patient's presenting problem has become chronic. D. the patient has recently shown a decline in functioning.

Answer 196

Correct Answer is: D Policies regarding in-patient treatment vary from HMO to HMO. However, most emphasize the patient's level of functioning and consider approval of in-patient treatment when there has been a recent decline in functioning.

Question 197

You are hired by a company to evaluate applicants and current employees for the purposes of hiring, promotion, training, and termination. You are told that the company has applicants and employees sign a waiver of confidentiality prior to seeing you. Which of the following best describes your best course of action in this situation? Select one: A. You should tell the employer that the company's policy violates your ethical obligations and refuse to do the evaluations until the policy is changed. B. You should conduct the evaluations but provide the employer only with information that is directly relevant to the purpose of the evaluation. C. You should discuss the impact of the waiver with applicants and employees and see if they want to continue with the evaluation process. D. You should provide the employer with any requested information since applicants and employees have already signed a waiver of confidentiality

Answer 197

Correct Answer is: C In any situation, a general waiver is not the best approach. Waivers should be specific in terms of the kind of information that will be revealed. You should discuss the impact of the waiver with applicants and employees and see if they want to continue with the evaluation process. You should tell the employer that the company's policy violates your ethical obligations and refuse to do the evaluations until the policy is changed. The best answer to this question would probably be some combination of these two options (you'd want to discuss the issue with the employer). However, it's not necessary to refuse to do the evaluations as long as you discuss the implications of the waiver with the applicants and employees, so the correct response is the best answer. Additional Information: Informed Consent for Assessment

Question 198

The concept of privilege is best described by which of the following statements? Select one: A. the primary purpose of privilege is to protect the professional's right to withhold client information B. privilege is a legal term referring to the client's right to not have confidential information released in court without his or her permission C. privilege refers to the ethical obligation of therapists to protect a client's right to privacy D. privilege refers to the responsibility of the professional to safeguard the confidentiality of his or her clients

Answer 198

Correct Answer is: B The term "privilege" refers to the right of a client to prevent confidential information, such as client records or therapist-client communications, from being released in legal proceedings. The client typically holds the right to claim or waive the privilege as "holder of the privilege." However, a psychologist can claim privilege on the client's behalf when his or her testimony or records are subpoenaed. Additional Information: Privilege Versus Confidentiality

Question 199

Which of the following is not a recommendation of APA's Guidelines for Providers of Service to Ethnic, Linguistic, and Culturally Diverse Populations? Select one: A. Psychologists should downplay their own culture and emphasize the client's culture. B. Psychologists should help clients understand, maintain, and resolve their own sociocultural identification. C. Psychologists should seek to help determine whether a so-called "problem" stems from racism or bias in others so that clients don't inappropriately personalize problems. D. Psychologists should work to eliminate biases, prejudices, and discriminatory practices.

Answer 199

Correct Answer is: A Although these Guidelines do emphasize the need to consider, respect, and understand the client's cultural background, they don't advise psychologists to downplay their own backgrounds. The other choices are all paraphrases of statements contained in these Guidelines. Additional Information: Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations

Question 200

In research, a psychologist can terminate the life of an animal: Select one: A. under no circumstances B. as long as the animal is treated humanely C. as long as an anesthetic is used, with an effort to minimize pain D. when it is appropriate and if it is done rapidly, with an effort to minimize pain

Answer 200

Correct Answer is: D In all research with animals, the animals must be treated humanely. If surgical procedures are performed, they are done under appropriate anesthesia with techniques to avoid infection and minimize pain. According to Ethical Standard 8.09 (Humane Care and Use of Animals in Research), "when it is appropriate that an animal's life be terminated, psychologists proceed rapidly, with an effort to minimize pain and in accordance with accepted procedures." Additional Information: Care and Use of Animals in Research

Question 201

You are having lunch with a colleague, Dr. O. Timer, who has been a clinical psychologist for over 25 years. You and Dr. Timer start talking about the aspects of your work that are most distressful. Like many psychologists, Dr. Timer mentions that, most often, the ethical dilemmas he encounters in his practice are related to: Select one: A. deciding when it is acceptable to breach client confidentiality. B. dealing with the sexual advances of his female clients. C. providing accurate information to insurance companies. D. knowing when to continue versus terminate therapy with a client who doesn't seem to be improving.

Answer 201

Correct Answer is: A Surveys have been conducted to determine what issues psychotherapists have the most difficulty with at work. When asked what ethical/legal issue they encounter most frequently, confidentiality is cited most often.

Question 202

A manufacturing company hires a psychologist to screen job applicants using standardized cognitive ability tests. The company then asks the psychologist to train their human resources staff to administer and score the tests. The psychologist should: Select one: A. agree to do so if the psychologist is able to provide adequate training to the staff B. agree to do so if the psychologist is able to supervise the human resources staff C. refuse to do so because cognitive ability tests are not valid predictors of job performance D. refuse to do so because the human resources staff lacks the appropriate qualifications

Answer 202

Correct Answer is: D Ethical Standard 9.07 states, "Psychologists do not promote the use of psychological assessment techniques by unqualified persons." A human resources staff would be unqualified to use these tests and should not be trained in their use. refuse to do so because cognitive ability tests are not valid predictors of job performance Contrary to this option, cognitive ability tests are considered to be a relatively good predictor of job performance. Additional Information: Use of Assessments

Question 203

According to the ethical standards, fees charged to clients are Select one: A. to be established as early as possible in the professional relationship. B. to be established as a function of experience and expertise of the psychologist. C. to be based on community standards. D. are to be as low as practically possible

Answer 203

Correct Answer is: A to be established as early as possible in the professional relationship. Only this option is stated in the Ethical Principles (see Standard 6.04[a]). Additional Information: Fees for Services

Question 204

A client of yours has recently filed a suit against her employer for sex discrimination. You receive a subpoena from the employer's attorney requesting you to appear at a deposition and to bring the client's file. When you contact the client, she tells you she doesn't want you to provide any information about the things she has talked about in therapy. Your best course of action is to: Select one: A. provide the requested information since privilege is waived in this situation. B. provide only the information you believe is relevant to the case. C. appear at the deposition as requested but refuse to provide information about the woman. D. discuss the situation with the employer's attorney before the date of the deposition.

Answer 204

Correct Answer is: D This situation is a common question on the exam, and resolving the issue is not always simple. Certainly, a psychologist could assert the privilege at a deposition but a better initial step would be to contact the employer's attorney to discuss the possibility of withdrawing the request for information (or limiting the kind of information that is required) before the deposition. Additional Information: Responding to a Subpoena

Question 205

The "slippery slope" argument suggests therapist-patient sexual relationships result from: Select one: A. nonsexual boundary crossings and violations B. confusion about the definition of dual relationships and how to address them C. personal characteristics or life circumstances of the therapist D. previous sexual relation with therapist, supervisor or educator

Answer 205

Correct Answer is: A The "slippery slope" analogy refers to the relationship between sexual and non-sexual boundary-crossing and claims that crossing one boundary makes it easier to cross the next boundary. Research has implicated three factors as influences on the occurrence and continuation of exploitative sexual and nonsexual relationships with clients, supervisees, and students: the connection between sexual and nonsexual professional boundary crossings or violations; the confusion about the definition of dual relationships and how to address them; and personal or contextual characteristics that put psychologists at risk for engaging in such behavior. previous sexual relation with therapist, supervisor or educator Research has not found a significant connection between reported sexual boundary violations as a former client, supervisee, or student and as a practicing professional. (See: Lamb, D., Catanzaro, S., & Moorman, A. (2003). Psychologists reflect on their sexual relationships with clients, supervisees, and students: Occurrence, impact, rationales, and collegial intervention. Professional Psychology: Research and Practice, 34, 102-107; Williams, M. (1997). Boundary violations: Do some contended standards of care fail to encompass commonplace procedures of humanistic, behavioral, and eclectic psychotherapies? Psychotherapy, 34, 238-249; and Pope, K. (1990). Therapist-patient sexual involvement: A review of the research. Clinical Psychology Review, 10, 477-490.) Additional Information: Sexual Intimacies

Question 206

The police inform you that they have a warrant out on one of your clients who is suspected of several felony charges of grand theft auto. They want you to provide them with the client's address and phone number. You should: Select one: A. cooperate with the police B. require them to get a warrant before you release any information C. refuse to provide them with the information and notify your client D. inform them when your next scheduled appointment is with your client

Answer 206

Correct Answer is: C Since there is no indication that your client is in imminent danger to self or others, you would be obligated to protect the confidentiality rights of your client. However, you should notify your client of this information that you received, and discuss the option of turning himself in to the police. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 207

A psychologist is consulted by the parents of a child who was referred by a pediatrician for evaluation. During the interview with the parents, they report the girl suffered a severe head injury which they haven't told the pediatrician about. Assuming appropriate consents have been obtained, the psychologist: Select one: A. should have the parents report this to the pediatrician. B. should report this to the pediatrician. C. should not report this until the parents tell the pediatrician first. D. should keep this information to herself

Answer 207

Correct Answer is: B This question looks like one on confidentiality, and, indeed, there are some aspects of confidentiality embedded here. But, more than that, it's about professional relationships. You're told in the item stem that all consents have been obtained, so the confidentiality issue was already addressed. The question then is, "What should the psychologist do?" Since we're all here to help the patient, the most appropriate thing to do is to let the pediatrician know about your findings. You would call (probably call rather than write since calling is quicker) the pediatrician and report your findings. It was the pediatrician who made the referral in the first place, and you have the parents' consent. Additional Information: Maintaining Confidentiality

Question 208

A researcher who is interested in determining the correct language to use in referring to members of ethnic minorities in a research article should refer to information published by Select one: A. the US Census Bureau. B. the American Psychological Association (APA). C. the research committee in the setting where the research takes place. D. the state licensing board.

Answer 208

Correct Answer is: B The Publication Manual of the American Psychological Association is the authority on questions of style (e.g., word usage, formatting) in research articles. It includes a section on choosing nouns referring to racial and ethnic groups. Additional Information: Reducing Bias in Language

Question 209

A psychologist is hired by the defendant's attorney to serve as an expert witness in a criminal case. The arrangement includes a bonus fee for the psychologist if the client is found not guilty. This arrangement is Select one: A. ethical. B. ethical as long as it is disclosed to the court. C. ethical as long as the fee is not excessive. D. unethical.

Answer 209

Correct Answer is: D An expert witness by definition is supposed to clarify issues of fact in a trial and is not supposed to act as an advocate for one side or the other, even if he is hired by one side. For this reason, APA's Specialty Guidelines for Forensic Psychologist explicitly state that psychologists do not provide services to parties in a legal proceeding on a contingent fee basis when those services involve expert testimony. Although the Specialty Guidelines are aspirational rather than binding, APA's Ethical Principles and Code of Conduct, which is binding, contains standards which clearly apply to this situation, such as the prohibition on assuming roles that involve a conflict of interest. Additional Information: Specialty Guidelines for Forensic Psychology

Question 210

An ethics committee contacts a psychologist regarding the investigation of an alleged ethics violation by another psychologist. How should the psychologist respond? Select one: A. The psychologist has no ethical responsibility to cooperate with the ethics committee. B. The psychologist should cooperate with an ethics committee. C. The psychologist should wait until ordered by the court before cooperating with the ethics committee. D. The psychologist should obtain the other psychologist's consent before cooperating with the ethics committee.

Answer 210

Correct Answer is: B According to Ethical Standard 1.06 [Cooperating With Ethics Committees], "Psychologists cooperate in ethics investigations, proceedings, and resulting requirements of the APA or any affiliated state psychological association to which they belong. In doing so, they address any confidentiality issues. Failure to cooperate is itself an ethics violation. However, making a request for deferment of adjudication of an ethics complaint pending the outcome of litigation does not alone constitute noncooperation." Additional Information: Cooperating With Ethics Committees

Question 211

``` Continuing Education Credits (CE Credits) earned through an APA approved sponsor means that the program is: Select one: A. sanctioned by APA. B. endorsed by APA. C. approved by APA. D. the responsibility of the sponsor ```

Answer 211

Correct Answer is: D An organization is approved by the APA to sponsor continuing education programs. The sponsor then becomes responsible for each program. The APA periodically asks for reports from the sponsor, but the specific program is not endorsed, sanctioned, or approved by the APA. Only the overall sponsorship is approved by the APA.

Question 212

The friend of a psychologist is the owner of a small publishing firm. The friend offers the psychologist substantial compensation if she would lend her name to endorsements for his publications, and at times advise and consult on book acquisitions and marketing plans. The psychologist: Select one: A. could accept this as long as APA affiliation is not mentioned in the endorsements. B. could accept this only if the publications she would be dealing with are in her area of competency. C. could accept this only if the publications she would be dealing with are in her area of competency, and the endorsements will be based on the psychologist's honest opinion of the publications. D. should consult the local ethics committee before making her decision.

Answer 212

Correct Answer is: C The ethical standards say that psychologists cannot make false, deceptive, fraudulent, or misleading statements. Unless the psychologist's endorsements were based on sound expertise and her honest opinion of the publications in question, these standards would be violated. Additional Information: Public Statements Made by Psychologists and Others

Question 213

A psychologist discovers a client is HIV positive, has not informed his/her partner and is having unsafe sex with the partner. Current laws related to the psychologist's obligation is most accurately described by which of the following? Select one: A. Health professionals are legally required to breach confidentiality in this situation. B. Health professionals are legally required to NOT breach confidentiality in this situation. C. Health professionals are legally required to breach confidentiality in this situation in some states and prohibited in others. D. Health professionals are legally allowed to determine whether or not to breach confidentiality in this situation.

Answer 213

Correct Answer is: C In this situation, the laws regarding breach of confidentiality vary from state to state and are inconsistent. Some states have laws that prohibit practitioners from notifying the partners of HIV/AIDS clients, and some state laws require practitioners to inform the partners. Additional Information: Mandated and Permitted Disclosures of Confidential Information

Question 214

Which of the following statements is not contained in APA's Ethical Principles of Psychologists and Code of Conduct? Select one: A. "the purely private conduct of psychologists ... is not within the purview of the Ethics Code. B. "This Ethics Code ... has as its goals the welfare and protection of the individuals and groups with whom psychologists work ..." C. "The fact that a given conduct is not specifically addressed by an Ethical Standard does not mean that it is necessarily either ethical or unethical." D. "A violation of the Ethics Code usually means ... that a psychologist will be legally liable in a court action or face other legal consequences."

Answer 214

Correct Answer is: D To answer this question, you didn't need to have had the Ethics Code memorized. All you needed was a good understanding of what the Code is all about. The correct option is not part of the Ethics Code, since ethical and legal standards, even though they sometimes overlap, are distinct, with the Ethics Code often holding psychologists to more stringent standards. In fact, the Code states that "whether or not a psychologist has violated the Ethics Code does not by itself determine whether he or she is legally liable in a court action." Additional Information: APA's Ethical Principles of Psychologists and Code of Conduct

Question 215

``` A defendant's ability to take part in and understand the proceedings against him in a criminal trial is an issue of: Select one: A. sanity B. competence C. consent D. testamentary capacity ```

Answer 215

Correct Answer is: B The situation described in the question refers to competence to stand trial. Additional Information: Competency to Stand Trial vs. Insanity

Question 216

A 15-year-old boy is referred to the school psychologist by his teacher. The boy has recently been acting out in class, not finishing his coursework, as well as talking and joking during instruction. Although initially apprehensive to speak with the psychologist, the boy reveals that he is upset because his parents have been fighting for a few months as his father is angry at his mother for not working outside the home. His father has also been threatening to leave. The boy tells the psychologist his parents are private people and that he doesn't want anyone else to know about this situation. Following the session, the referring teacher inquires what the boy said so that they can create a plan to help the boy. The psychologist should: Select one: A. inform the teacher of what the boy shared because he referred the boy B. inform the teacher of what the boy shared because he will use it to help the boy C. inform the teacher of what the boy shared because they need to cooperate in helping the boy and both work at the same school D. initially withhold what the boy shared from the teacher and speak to his or her supervisor

Answer 216

Correct Answer is: D Because the question doesn't say anything about the policies or procedures at this school regarding the disclosure of confidential information to school personnel, you need to rely on the APA or CPA Code of Ethics to answer this question correctly. The Code of Ethics requires psychologists to maintain their clients' confidentiality, unless they have appropriate permission to disclose information; the safety of the client or someone else is at risk; or a law mandates them to disclose information; and minors, like adults, are entitled to a confidential relationship with their psychologist. Additionally, this boy has explicitly told the psychologist that he doesn't want anyone else to know about what's going on at home. Therefore, the best answer we have available is that the psychologist should not tell the teacher what the boy disclosed. The psychologist may also want to talk to his or her supervisor to verify that the decision was right and determine what to do next. (Additional information: With a younger, school-age child, a psychologist has greater latitude in making this kind of decision: Under the parens partiae doctrine, a psychologist would have an obligation to act in the child's best interests, meaning that she might decide to share information with the teacher or some other relevant party.) Additional Information: Maintaining Confidentiality

Question 217

An individual comes into your office complaining of recent job stress. He notes a chronic pattern of depressed mood, low energy, and eating and sleeping difficulties. Your best initial intervention is to: Select one: A. begin individual treatment. B. refer to an expert in vocational issues. C. refer for a psychiatric evaluation. D. explore the possibility of a job change.

Answer 217

Correct Answer is: C Whenever you see any symptoms that might have a medical or psychiatric basis, it's always good to recommend a physical examination. The closest alternative here was to refer to a psychiatrist. Maybe medication is indicated to address the eating and sleeping difficulties and what you suspect might be an underlying depression. Additional Information: Boundaries of Competence

Question 218

A man contacts a psychologist via e-mail, asking her to provide him with online therapy advising him about a decision that is weighing heavily on him. The man writes making decisions is often hard for him and he is trying to decide whether to quit his current job and accept an offer from a competing company. The man doesn't want to reveal his name to the psychologist. He wants to keep his identity private. The psychologist should: Select one: A. let the man remain anonymous if he wants and provide him with online therapy B. let the man know that before providing any online therapy to him, she has to have basic contact information in case of an emergency such as suicidality C. let the man know that, by law, she has to have a face-to-face meeting with him before she can provide him with online therapy D. let the man know that, by law, she has to know his name and some basic contact information before she can provide him with online therapy

Answer 218

Correct Answer is: A E-therapy refers to the delivery of mental health services online, usually delivered in the form of email communications, discussion lists, live chat rooms, or live audio or audiovisual conferencing and may include "coaching" , psychoeducation, emotional support, interactive journaling, etc. While many e-therapists like to have their clients' names and contact information in case of an emergency, and some even require this, it is both legal and ethical to allow a client receiving e-therapy to remain anonymous if that's what he or she wants. An example of a parallel would be with an anonymous patient who calls a hotline or an emergency room. Like many e-therapists, this psychologist could start by letting this client remain anonymous if he insists and then, as trust develops between them, gradually convince him to provide his name and contact information. (Practically speaking, the client identity problem will be solved online to a large extent as it is in person: as a byproduct of having to pay for services.) let the man know that, by law, she has to know his name and some basic contact information before she can provide him with online therapy Rule out this option because having a face-to-face meeting with a client before providing e-therapy is acceptable (and required by some e-therapists), but it is not mandated by any law or ethical standard. Note: the current Ethics Code is not specific with regard to telephone therapy or teleconferencing or any electronically provided services as such and has no rules prohibiting such services. "Psychologists considering such services must review the characteristics of the services, the service delivery method, and the provisions for confidentiality. Psychologists must then consider the relevant ethical standards and other requirements, such as licensure board rules." (See: American Psychological Association, 1997: Services by Telephone, Teleconferencing, and Internet; And: Kraus, R., Zack, J., & Stricker, G. (Eds.). (2004). Online counseling: A handbook for mental health professionals. San Diego: Elsevier Academic Press.)

Question 219

``` What is needed for a successful malpractice lawsuit against a psychologist? Select one: A. A stated professional relationship B. Significant neglect C. Severe damage D. Sufficient harm ```

Answer 219

Correct Answer is: D For a successful malpractice suit, according to Behnke, Preis and Bates in their provocative book, California Mental Health Law WW Norton and Company 1998, one must have the four "D's" to win a malpractice suit: "dereliction of a duty directly causing damage." One must show that there was a duty--(which assumes a professional relationship, although it does not need to be explicitly stated as in this choice "a stated professional relationship" ), the duty was not carried out; and one must show, that as a direct result of this, the person suffered damages. Additional Information: Malpractice

Question 220

``` Question ID #282: A psychologist's new patient decides to bring in her 12 year-old daughter to deal with communication and relationship issues after a few sessions. The psychologist is confident in being able to help the mom and the daughter get along better. The patient's insurance won't cover family sessions so the psychologist bills the insurance company as if the mom is coming in alone for Generalized Anxiety Disorder. This is an example of: Select one: A. therapeutic drift B. unconscious fiscal convenience C. countertransference D. insurance fraud ```

Answer 220

Correct Answer is: D Despite the psychologist wanting to assist the patient in getting covered services, any form of collusion or lying to an insurance company is insurance fraud. Therapeutic drift* refers to the deviation from the protocol and gradual alteration of treatment plan, shifting style & approach for a given client. Unconscious fiscal convenience* refers to when a psychologist, unconsciously, overlooks important therapeutic dimensions of sessions because they would conflict with the psychologist's financial self-interest (* incorrect responses). (See: Cummings, N. A. (1995). Unconscious fiscal convenience. Psychotherapy in Private Practice, 14(2), 23-28. And Welfel, E. (2002). Ethics in Counseling and Psychotherapy: Standards, Research & Emerging Issues.) Additional Information: Third Party Payors

Question 221

You are a psychologist in private practice and, due to a heavy case load, you decide to work with another psychologist. The second psychologist will see many of the clients and share office space with you. You agree to give this psychologist 50% of all fees received. This arrangement is Select one: A. unethical, because the ethical standards prohibit fees for referrals. B. unethical, because it threatens the best interests of the clients. C. unethical, because the clients will be misled about their fees. D. ethical.

Answer 221

Correct Answer is: D There is nothing inherently unethical about this arrangement, and it is not barred by APA's ethical standards. The standards do prohibit payment for referrals that are based on the referral itself and not based on services rendered. However, both psychologists in this case will apparently be rendering services, so the arrangement appears acceptable. Additional Information: Referral Fees

Question 222

A father brings his 10-year-old son to a psychologist for therapy due to symptoms of depression. The father states that the boy's symptoms began shortly after the parents separated several months ago. The boy is currently living with his father. The father further states that he only wants help for his son and does not want any report or testimony from the psychologist for the divorce proceedings. The psychologist should: Select one: A. have both parents sign an agreement that neither will require the psychologist to provide a report or testimony about the child's therapy B. contact the parents' attorneys to clarify the psychologist's role C. refuse to treat the child unless you can evaluate both parents D. provide therapy for the child but do not maintain any records that could be subpoenaed

Answer 222

Correct Answer is: B Ethical Standard 10.02(b) states, "If it becomes apparent that psychologists may be called on to perform potentially conflicting roles (such as family therapist and then witness for one party in divorce proceedings), psychologists take reasonable steps to clarify and modify, or withdraw from, roles appropriately." Although the patient's father has indicated that he does not want a report or testimony from the psychologist, it would be more prudent to clarify the psychologist's role with the attorneys of each of the parents. have both parents sign an agreement that neither will require the psychologist to provide a report or testimony about the child's therapy Having the parents sign an agreement as suggested in this option does imply a clarification of the psychologist's role, but it may not be legally binding or in the child's best interests and is not as good a choice as the correct option. refuse to treat the child unless you can evaluate both parents This is incorrect because although it is necessary to evaluate all members of a family before making recommendations regarding child custody, in this case, it is therapy that is requested, not a custody evaluation. provide therapy for the child but do not maintain any records that could be subpoenaed This is incorrect because psychologists must maintain adequate records. Additional Information: Couple and Family Therapy