Final Exam

Question 1

Tarasoff/Ewing and HIV/AIDS

Answer 1

NOT TARASOFF

No duty to warn or protect, therapists not MDs and cannot diagnose medical disorders

Question 2

Informed Consent empowers patient to: (3)

Answer 2

Gain information
Ask questions
Assist in own recovery

Question 3

Empowered Collaboration (3)

Answer 3

Two fully engaged and committed people
Shows respect for client as a person, not a diagnosis
Gives client autonomy and self-determination

Question 4

Four elements required for valid Informed Consent

Answer 4

Capacity
Comprehension of information
Voluntary
Document

Question 5

Informed Consent and Empowered Collaboration are…

Answer 5

Ongoing and organic

Question 6

Four mechanisms of accountability

Answer 6

Licensing boards
Ethics committees
Civil suits of malpractice
Criminal allegations

Question 7

Four elements of a civil lawsuit

Answer 7

Duty of care
Standard of care
Demonstrable harm
Proximate cause

Question 8

Skype and HIPPA - three requirements to be a covered entity

Answer 8

Health care provider + transmits information electronically + conducts covered transactions

Question 9

Skype and HIPPA - three requirements to be a covered entity

Answer 9

Health care provider + transmits information electronically + conducts covered transactions

Question 10

Delayed Discovery Rule

Answer 10

Statute of limitations begins UPON DISCOVERY of injury, not upon injury

Question 11

Most common use of Delayed Discovery Rule

Answer 11

Sexual abuse cases

Question 12

Burden of proof - civil standards

Answer 12

Preponderance of evidence (51%)

Question 13

Burden of proof - criminal standards

Answer 13

Beyond a reasonable doubt (99%)

Question 14

What is “take steps”?

Answer 14

Rule of least restrictive treatment requires us to take steps prior to hospitalization

Question 15

7 steps prior to hospitalization (Rule of Least Restrictive Treatment)

Answer 15

Increase frequency of sessions
Phone contact
Support system
Medication
Adjunctive treatment
Agreement
Hospitalization

Question 16

Record Keeping (7-year rule)

Answer 16

Retain records for 7 years following discharge AND 7 years from the patient’s 18th birthday (25 years)

Question 17

Time frame for completion of electronic records

Answer 17

24-48 hours OR by end of week

Question 18

Multiple Relationship with… (3)

Answer 18

the client OR a person closely associated with client OR promises to enter another relationship

Question 19

Consequences of Multiple Relationships to patients (7)

Answer 19

Patient suicide
Guilt & shame
Delayed reaction (PTSD)
Increased rage
Patient feels (and is) victimized
Decreased self-esteem
Major depression

Question 20

Multiple Relationship risk factors

Answer 20

Practicing in isolation
No association memberships
Rural area
Vulnerable due to own issues
Need for patient approval
Poor self-esteem
Low self-assertion
Middle-aged or older
Male
Young female patients

Question 21

Multiple Relationship risk factors

Answer 21

Practicing in isolation
No association memberships
Rural area
Vulnerable due to own issues
Need for patient approval
Poor self-esteem
Low self-assertion
Middle-aged or older
Male
Young female patients

Question 22

Title of Sexual Exploitation Brochure

Answer 22

Therapy Never Includes Sexual Behavior

Question 23

Penalty for sex with patient (2)

Answer 23

Automatic license revocation + criminal felony

Question 24

When is sex with patient is illegal? (3)

Answer 24

While in therapy
Within two years of termination
Therapeutic deception

Question 25

Original Tarasoff

Answer 25

CSI Communicated directly to therapist Serious threat of physical harm Identifiable vicitm

Question 26

Hedlund

Answer 26

Duty to protect potential bystanders

Question 27

VA

Answer 27

Seek past records - protect in absence of stated threat

Question 28

Ewing

Answer 28

Communicated to therapy OR immediate family or reliable other FOR the purpose of advancing therapy

Question 29

Ewing

Answer 29

Communicated to therapy OR immediate family or reliable other FOR the purpose of advancing therapy

Question 30

Duty to warn vs Duty to protect

Answer 30

Mandated to breach confidentiality (OG Tarasoff) vs Permitted to breach confidentiality (Revised Tarasoff)

Question 31

Does Tarasoff apply to suicide? (Bellah v Greenson)

Answer 31

``` Don't know! Case dismissed (no duty to warn in case of suicide, statute of limitations ran out) ```

Question 32

Two benefits of Appropriate Therapist self-disclosure

Answer 32

Clients report reduction in symptom distress | Clients like therapist more

Question 33

T/F Benefits of Therapist self disclosure require a positive therapeutic alliance

Answer 33

True

Question 34

T/F Benefits of Therapist self disclosure require a positive therapeutic alliance

Answer 34

True

Question 35

When do you send a client for further evaluation or consultation?

Answer 35

When therapy is threatened or endangered by the patient

Question 36

Prior to termination, psychologists must provide...(2)

Answer 36

Pre-termination counseling Recommend alternative services as appropriate EXCEPT when precluded by the actions of the patient or payor

Question 37

Four elements of proper termination

Answer 37

Consult/document No crisis Reasonable notice (30-90 days) Proper referrals

Question 38

Three elements of proper referrals

Answer 38

Available Similar fee Theoretical orientation

Question 39

Results of Menendez Ruling (2)

Answer 39

Threats eliminated legal right to maintain confidentiality | Therapy ends the moment the therapist is threatened or in danger

Question 40

Jennifer Keeton

Answer 40

Cannot counsel LGBTQ is immoral due to religious beliefs Public universities can require students to follow Code of Ethics that conflicts with religious beliefs Code of Ethics > religious freedom/free speech

Question 41

Julea Ward

Answer 41

CAN ask to refer out LGTBQ clients on religious grounds (Conscience Clause)

Question 42

Conscience Clause

Answer 42

Relieves a person from compliance on religious grounds | state by state issue

Question 43

California Conscience Clause case

Answer 43

Pharmacist right to refuse prescribing abortion pill or contraception

Question 44

Beliefs vs Behaviors

Answer 44

Beliefs are independent of ethics vs Behaviors must abide by ethics

Question 45

Bracketing

Answer 45

Managing personal values so they do not contaminate therapy

Question 46

Child must be ____ years old and have a _____ factor to consent to therapy

Answer 46

12 years old; maturity factor

Question 47

Dire Exemption

Answer 47

Minors may be seen without parental consent if the situation is dire (suicide, homicide, etc)

Question 48

Two types of custody

Answer 48

Legal (Decisions) | Physical (Location)

Question 49

8 Required Reports of Elder/Dependent Abuse

Answer 49

``` Physical/sexual Neglect, even unintentional Abandonment Isolation Financial Self-Neglect Abduction Psychological Abuse ```

Question 50

When to report Elder/Dependent Abuse

Answer 50

Therapist observes Therapist has knowledge Therapist is told Therapist has reasonable suspicion

Question 51

How to report Elder/Dependent abuse

Answer 51

Phone - immediately | Report form - within two working days

Question 52

4 Required Reports of Child Abuse

Answer 52

Sexual abuse Neglect Willful cruelty/unjustifiable punishment Unlawful corporal punishment or injury

Question 53

When to report Child Abuse

Answer 53

Reasonable suspicion

Question 54

How to report Child Abuse

Answer 54

Phone - immediately | Report form - within 36 hours of reasonable suspicion

Question 55

``` Old vs New Terms Divorce > Defendant > Plaintiff > Alimony > ```

Answer 55

Dissolution Respondent Petitioner Spousal Support

Question 56

Family Code 3151

Answer 56

The child’s counsel appointed by the court may hold privilege Judge may appoint to pull therapist out of the middle

Question 57

Two ways judge can rule in conflict between couples or minors/parents

Answer 57

Patient-therapist privilege (no disclosure) | Third party rule (cannot prevent disclosure)

Question 58

Subpoena (3)

Answer 58

From attorney Strongly requests recipient to follow Do not respond without patient consent

Question 59

Court Order (3)

Answer 59

From presiding judge Demands/compels recipient to follow Must respond without patient

Question 60

T/F A subpoena alone does not override disclosure requirements without consent of the patient

Answer 60

True

Question 61

T/F HIPAA does not regulate information disclosures to the legal system, but licensing laws still apply with subpoena

Answer 61

True

Question 62

T/F State laws require a signed patient authorization for disclosure of information with subpoena

Answer 62

True

Question 63

How to properly handle subpoena (8)

Answer 63

``` Properly Served Validity Waiver By Patient Failure to Object (NOT a waiver) 15 Days to Release Motion to Quash Court Order In Camera Meeting ```

Question 64

What year was the APA Ethics Code updated?

Answer 64

2017 (enforceable and unenforceable)

Question 65

Intersectionality

Answer 65

Intersecting social identities related to systems of oppression/discrimination

Question 66

Cultural Humility

Answer 66

Not knowing

Question 67

Encapsulation

Answer 67

Ignorance of another's culture

Question 68

Three Dimensions of Multicultural Competency

Answer 68

Therapist self-awareness Therapist understanding Skill in using interventions

Question 69

Empowered collaboration should be...(2)

Answer 69

ongoing and organic