LE 1 Flashcards
(100 cards)
To be consistent with the requirements of Business and Professions Code Section 2919, a psychologist must maintain a minor’s therapy records for how many years after the minor reaches the age of 18?
Select one:
A.
As soon as the minor turns 18
B.
3
C.
5
D.
7
The correct answer is D.
B&PC Section 2919 states: “A licensed psychologist shall retain a patient’s health service records for a minimum of seven years from the patient’s discharge date. If the patient is a minor, the patient’s health service records shall be retained for a minimum of seven years from the date the patient reaches 18 years of age.”
Answer A: A minor’s record would not be destroyed immediately when they turn 18.
Answer B: This does not meet the B&PC code requirement.
Answer C: This does not meet the B&PC code requirement.
A physician at a hospital where the psychologist works approaches them and wants their help in determining a diagnosis. The physician says that she is experiencing nightmares and flashbacks related to a traumatic experience. If the psychologist assesses her symptoms and treats her with EMDR therapy, what ethical principle have they violated?
Select one:
A.
Ethical Principle 3.05 - Multiple Relationships
B.
Ethical Principle 3.08 - Exploitative Relationships
C.
Ethical Principle 3.11 - Psychological Services Delivered to or Through Organizations
D.
Ethical Principle 3.12 - Interruption of Psychological Services
The correct answer is A.
Ethical Principle 3.05 states “A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person… 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.” Therefore the diagnosis and treatment of coworkers would be considered a multiple relationship that could reasonably be expected to hinder the psychologist’s objectivity and effectiveness.
Answer B: This principle refers to psychologists avoiding exploiting their power over their students and employees. In this example, a power differential isn’t implied.
Answer C: This principle refers to services delivered through organizations such as when a psychologist sees a company’s employee for an evaluation to determine readiness to return to work.
Answer D: This principle refers to client abandonment.
A psychologist is fired from their position at a training facility for sexually harassing their supervisees. Which of the following statements is true?
Select one:
A.
Their actions constitute an ethical violation.
B.
In order for their actions to constitute an ethical violation, the sexual harrassment needs to have occured more than once.
C.
Their actions are illegal but not unethical.
D.
In order for their actions to be constitute an ethical violation, the sexual harrassment claims must be proven in a court of law.
The correct answer is A.
The Ethics Code (3.02) states “Psychologists do not engage in sexual harassment. Sexual harassment is described as 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.”
Answer B: A single act can constitute an ethical violation if it is severe enough.
Answer C: Sexual harassment can be both illegal and unethical in nature.
Answer D: The Board of Psychology can take disciplinary action against a psychologist separate from a civil lawsuit.
A psychologist believes that their client is not making progress in therapy after six months of treatment. The client tells their psychologist that they would like to continue treatment, in spite of their lack of progress. Which answer below describes the best course of action?
Select one:
A.
Agree to continue seeing the client since they are satisfied with the progress of therapy
B.
Agree to continue seeing the client for an additional period of time but, at the end of that period, insist on terminating therapy
C.
Explain to the client that their wish to stay in therapy can be normal response to ending therapy and set a date for termination
D.
See if additional goals for treatment can be identified but, if not, set a date for termination and, if appropriate, provide them with referrals to other psychologists
The correct answer is D.
Termination of therapy is addressed in Ethics Code Standard 10.10, which states: “Psychologists terminate therapy 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…. Except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists provide pre-termination counseling and suggest alternative service providers as appropriate.”
Answer A: This answer ignores that the psychologist has determined the client is no longer benefitting from treatment.
Answer B: This answer again indicates the client should continue treatment without benefit.
Answer C: While this answer is not entirely incorrect, it is less preferred as it doesn’t explore the possibility that there could be other benefits to treatment.
A psychologist has recently begun supervising a new psychological intern. After beginning their work, the psychologist realizes that the intern was her patient 15 years ago. The psychologist believes that this previous relationship would not “cause impairment or risk exploitation or harm” because the intern does not recognize the psychologist. Which of the following is true?
Select one:
A.
The psychologist can supervise the new intern because more than seven years have passed.
B.
The psychologist can supervise the new intern because the treatment occured when the intern was a minor.
C.
The psychologist may not supervise the intern and must take steps to remove the intern from the training program.
D.
The psychologist cannot supervise the new intern because it is prohibited in the California regulations.
The correct answer is D.
While the APA Ethics Code does not prohibit all multiple relationships, if they would “not reasonably be expected to cause impairment or risk exploitation or harm,” this is not the underlying issue with this question. The California Code of Regulations (1387.1) states that supervisors, “shall not supervise a supervisee who is now or ever has been a psychotherapy client of the supervisor.”
Answer A: The length of time is not an exception.
Answer B: Regardless if the intern was a minor, the psychologist is still prohibited from supervising the intern.
Answer C: Removing the intern from the program isn’t the matter at hand, and there is no law, regulation, or guideline that would suggest that the intern be removed from the program.
Which of the following nondisciplinary actions by the Board of Psychology is considered a matter of public information that is provided to consumers upon request?
Select one:
A.
probation
B.
educational review
C.
citation or fine
D.
letter of warning
The correct answer is C.
Nondisciplinary actions are usually confidential (i.e., not made available to the public). An exception is a citation and fine, which is considered a nondisciplinary action but is also public information.
Answer A: Probation is a disciplinary action.
Answer B: Educational review is a nondisciplinary action that is not considered a matter of public information.
Answer D: A letter of warning is a nondisciplinary action that is not considered a matter of public information.
A police officer presents a psychologist with an arrest warrant for a former patient. What should the psychologist do?
Select one:
A.
Provide the police officer with any relevant records
B.
Provide the police officer with the former clients last known address and telephone number
C.
Attempt to contact the former client while the police officer is in the psychologists office
D.
Neither confirm nor deny that the person in question is a former client
The correct answer is D.
An arrest warrant does not constitute an exception to the psychotherapist-client privilege. The psychologist should not breach a former patient’s confidentiality, including whether or not the person was indeed their patient. A psychologist may only release information about the patient without their consent under the following conditions; 1) only when mandated by law, for instance, when a court order is issued, 2) to protect the client or the public from imminent harm.
Answer A: An arrest warrant does not constitute being “mandated by law” and therefore the psychologist does not need to share the patient’s records.
Answer B: The arrest warrant does not constitute a legal mandate and the patient’s last known address and identifying information are all protected by the APA’s ethical code and HIPAA’s privacy rule.
Answer C: This response does not address how the psychologist should interact with the police officer. It is however common practice to inform the patient a disclosure has been requested regarding their records to see if, in fact, they would like to consent to the disclosure.
A psychologist is seeing a client in a hospice facility due to end-stage cancer. His physician informs the psychologist the client only has a few weeks to live. The client discloses to the psychologist that he has plans to kill himself while staying at the facility. The psychologist should do all of the following except?
Select one:
A.
Document the client’s statements in his medical record.
B.
Assess for ideation, plan, access to means, and intent.
C.
Develop a plan with the client and his hospice team to keep him safe.
D.
Initiate hospitalization beyond the hospice facility.
The correct answer is D.
Many options are available to the psychologist for follow-up. Given that the client is in hospice care, it would not be recommended to initiate hospitalization outside of the facility, therefore documenting, assessing, and developing a plan with the hospice team is the most feasible plan of action to ensure the client’s safety.
Answers A, B, and C: All of these options are appropriate strategies for follow-up and therefore incorrect in answering the question.
During the initial 72-hour involuntary commitment, it is determined that Luis is still at high risk for suicide. According to the California Welfare and Institutions Code, Luis may be detained for an additional 14 days for treatment under certain conditions. One of these conditions is that Luis is informed that he is entitled to a certification review hearing within the first ________ of the 14-day hold.
Select one:
A.
24 hours
B.
48 hours
C.
4 Days
D.
6 Days
The correct answer is C.
Legal requirements for detaining an individual beyond the initial 72-hour hold are described in Sections 5250 to 5259.3 of the Welfare and Institutions Code. Section 5250 states that, after a 72-hour hold, an individual may be held for an additional 14 days if it is determined that he/she is still a danger to self or others or is gravely disabled. However, Section 5254 also requires that the individual be notified that he/she “is entitled to a certification review hearing, to be held within four days of the date on which the person is certified for a period of intensive treatment.”
Answer A, B, and D: These do not meet the time requirement for a certification hearing.
Which of the following individuals meets the criteria for a “grave disability” as defined in California law?
Select one:
A.
A 62-year-old man who is staying at homeless shelter and whose bizarre behavior is perceived as menacing by other people
B.
A 51-year-old woman who, as the result of a psychotic disorder, wanders away from home and sometimes forgets to take her medication but has a sister who is willing to care for her
C.
A 20-year-old man who lives in an abandoned warehouse, is depressed and chronically high on illegal drugs, and has refused offers of help from his family
D.
A 37-year-old woman who lives alone, has a severe bipolar disorder, and refuses to eat or drink because she believes she doesn’t need to in order to survive
The correct answer is D.
As defined in California Welfare and Institutions Code Section 5008(h)(1), a grave disability is a condition that occurs as the result of a mental disorder and involves an inability to provide for one’s “basic personal needs for food, clothing, or shelter.” Of the people described in the answers to this question, only the individual described in answer D clearly meets these criteria.
Answer A: The man has access to shelter through the homeless shelter.
Answer B: The woman has a home and someone responsible for ensuring her needs are met.
Answer C: The man technically has shelter and there is no indication his addiction impairs his ability to access food or clothing.
At the request of an employer, a psychologist conducts a fitness-for-duty evaluation of an employee. If the employee refuses to sign an authorization or waiver form, the psychologist:
Select one:
A.
cannot provide any information derived from the evaluation to the employer.
B.
can only tell the employer whether the employee is fit-for-duty.
C.
can only tell the employer whether the employee is fit-for-duty and describe any relevant functional limitations.
D.
can tell the employer whether the employee is fit-for-duty, describe any relevant functional limitations, identify the medical or psychological cause of those limitations, and provide any other pertinent information.
The correct answer is C.
A fitness-for-duty evaluation is conducted at the request of an employer or supervisor to determine if psychological or psychiatric factors will interfere with a current employee’s ability to perform essential job functions. The employee is ordinarily asked to sign an authorization for release of information or waiver form prior to the evaluation. However, even when the employee refuses to do so, the employer has a right to limited information about the results of the evaluation - i.e., if the employee is able to perform essential job functions, whether any functional limitations will affect the employee’s ability to perform his/her job duties, and whether any accommodations are needed to help the employee perform his/her job duties.
Answer A: The employer is allowed to know some information.
Answer B: The psychologist may also mention any relevant functional limitations.
Answer D: The psychologist cannot provide the medical and psychological causes of the employee’s problems.
A psychologist receives a request from a former client’s current therapist for copies of certain information from the client’s file. The client has not paid for his last three therapy sessions despite several requests from the psychologist to do so. The psychologist is:
Select one:
A.
prohibited from withholding the clients records because of the outstanding fees.
B.
allowed to withhold the client’s records, unless the client is in crisis.
C.
permitted to withhold the records only if she informs the client of her intent to do so and offers an opportunity for a payment plan.
D.
not required to reply to the request as it did not come from the client directly.
The correct answer is A.
Health and Safety Code Section 123110 prohibits health care providers “from withholding patient records or summaries of patient records because of an unpaid bill for health care services.”
Answer B: Even if the client is not in crisis, the psychologist is not permitted to withhold their record because of unpaid bills for healthcare services.
Answer C: Offering a payment plan is not addressed in the Health and Safety Code.
Answer D: Assuming that the new therapist presented the psychologist with an authorization to release records, the request in essence comes from the client themselves.
A psychologist is hired by a company to provide services to employees as part of the company’s employee assistance program. The company has traditionally photocopied standardized psychological tests to save money, and the program director, who is a licensed psychologist, instructs the psychologist to continue using the photocopied tests. The psychologist believes that photocopying the tests violates copyright laws and, consequently, should:
Select one:
A.
report the program director to the Licensing Board immediately.
B.
refuse to administer the tests using photocopies.
C.
reach out to the program director and discussing this issue, and avoid administering the tests using photocopies.
D.
administer the tests using photocopies. The ethical mandate applies only to the program director, not the psychologist administering the tests.
The correct answer is C.
Photocopying copyrighted psychological testing materials is both illegal and unethical. The Ethics Code (1.04) states, “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.”
Answer A: The ethics code suggests that psychologists attempt informal resolution of the ethical violation, and only if the results have been not been resolved properly should they reach out to the state licensing board.
Answer B: This is not the best answer choice because although the Ethics code (1.05) states, “If the demands of an organization with which psychologists are affiliated or for whom they are working conflict with this Ethics Code, psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and to the extent feasible, resolve the conflict in a way that permits adherence to the Ethics Code,” this answer does not address that the psychologist should not only refuse to continue administering tests using photocopies but should also attempt informal resolution with the program director.
Answer D: All psychologists are called to adhere to the ethics code and legal mandates, even when acting on behalf of organizations.
A psychologist was licensed in California for seven years and then moved to Missouri 12 years ago and allowed their California license to expire by not renewing it for over three years. They plan to move back to California and want to renew their California license. In order to be licensed in California again, the psychologist will need to:
Select one:
A.
file a complete application and pay the appropriate fees.
B.
present their Certificate of Professional Qualification, file a complete application, and pay the appropriate fees.
C.
file a complete application, take and pass the CPLEE, and pay the appropriate fees. They will not need to take the EPPP.
D.
pass the EPPP and CPLEE, file a complete application, and pay the appropriate fees.
The correct answer is C.
The situation described in this question is addressed in the California Code of Regulations Section 1388.6. Paragraph (a) of this section states that, “when a California-licensed psychologist has been licensed for at least five years and has allowed his/her license to expire by not renewing the license for at least three years, the psychologist shall not be required to take the EPPP.” And paragraph (f) states that, “although the EPPP is waived under this section, an applicant must file a complete application and meet all current licensing requirements not addressed above, including payment of any fees, take and pass the California Psychology Law and Ethics Examination (CPLEE), and not been subject to discipline.”
Answers A, B, and D: These responses do not capture all of the requirements for renewing a psychologist’s license in California after moving away.
A new client requests to pay for her therapy sessions in cash and requests that the psychologist keep no record of her sessions or her payments. If the psychologist agrees to this arrangement:
Select one:
A.
the psychologist acted ethically as long as you ascertain that her reasons for making this request are valid.
B.
the psychologist has acted ethically since it is up to them to decide what to include in their practice’s records.
C.
the psychologist has acted ethically as long as the psychologist includes the client’s payments as income on their income tax forms.
D.
the psychologist has acted unethically.
The correct answer is D.
Psychotherapists are required to maintain basic records. With regard to ethical obligations, Standard 6.01 of the APA’s Ethics Code requires psychologists to “create, and to the extent the records are under their control, maintain, disseminate, store, retain, and dispose of records and data relating to their professional and scientific work in order to (1) facilitate the provision of services later by them or by other professionals, (2) allow for replication of research design and analyses, (3) meet institutional requirements, (4) ensure accuracy of billing and payments, and (5) ensure compliance with the law.”
Answer A: The reasoning of her request does not supersede the APA ethical code.
Answer B: The psychologist cannot be in contradiction with the APA ethical requirements for record-keeping.
Answer C: A psychologist’s tax forms and payment information are not related to keeping client records.
When a psychologist is faced with a conflict between the provisions of HIPAA’s privacy rule and the requirements of state law, he/she should keep in mind that:
Select one:
A.
state laws always preempt HIPAA regulations.
B.
HIPAA regulations always preempt state laws.
C.
HIPAA regulations preempt state laws when the regulations provide the client with greater privacy or control over his/her health information.
D.
HIPAA regulations preempt state laws when the regulations allow the psychologist to best protect the therapist-client relationship.
The correct answer is C.
State laws are preempted by HIPAA regulations except when the state law provides the client with greater privacy protection or privacy rights or control over individually identifiable health information.
Answer A: State law does not automatically preempt HIPAA privacy law.
Answer B: HIPAA regulations do not always preempt state laws.
Answer D: The client relationship is not a factor when conflicts arise between HIPAA and state law.
Which of the following accurately describes parental rights with regard to reviewing the treatment records of a minor child?
Select one:
A.
Only the parent who has consented to treatment of the child has the right to review treatment records.
B.
Only the parent who is paying for treatment has the right to review treatment records.
C.
Only the custodial parent has the right to review treatment records.
D.
Custodial and noncustodial parents have the right to review treatment records.
The correct answer is D.
This issue is addressed in Family Code Section 3025. It states that “access to records and information pertaining to a minor child … shall not be denied to a parent because such a parent is not the child’s custodial parent.” Note that this statement is somewhat vague since “custodial parent” is not defined in this section or in the immediately preceding sections of the Family Code.
Answer A: A parent’s consent does not give them sole rights over their child’s record.
Answer B: Payment does not determine rights to a minor child’s record.
Answer C: Noncustodial parents also have rights to their child’s record.
Section 5150 of the Welfare and Institutions Code allows an individual to be involuntarily hospitalized for up to _____ without notifying him/her of his right to a certification review hearing.
Select one:
A.
12 days
B.
7 days
C.
72 hours
D.
24 hours
The correct answer is C.
WIC Section 5150 states that when a person is held involuntarily for treatment for 72 hours, a certification review hearing is not required until the individual has been certified for an additional 14-day hold after the initial 72-hour hold.
Answers A, C, and D: These do not meet the criteria for Section 5150.
During a therapy session, a client tells their psychologist that they got into an argument with another customer at a local bar two evenings ago and ended up giving the man “a good beating.” The client is an amateur boxer, and they feel very guilty about their behavior. The psychologist is required to:
Select one:
A.
report the assault to the authorities.
B.
commence involuntary hospitalization of the patient.
C.
assess for risk of future violence towards others.
D.
discuss alternate ways for dealing with conflict with the client.
The correct answer is C.
Per the California Board of Psychology Laws and Regulations - Article 1024., “There is no privilege… if the psychotherapist has reasonable cause to believe that the patient is in such mental or emotional condition as to be dangerous to himself or to the person or property of another and that disclosure of the communication is necessary to prevent the threatened danger.” Answer C is the best answer because the psychologist would need to assess if the patient is at risk of harming others in the future, as the Article 1024 refers to the duty to warn others about potential harm.
Answer A: The Laws and Regulations governing psychologists do not require that psychologists report assaults (unless they occur to a protected class of individuals).
Answer B: Without first assessing, it isn’t clear from the example that hospitalization is warranted.
Answer D: While this may be a good clinical strategy, it doesn’t address that psychologists have a duty to protect the public from harm when they become aware of threats.
A patient reveals to her psychologist that she has been abusing her 9-year-old daughter. The psychologist files a report with Child Protective Services over the phone. The social worker informs the psychologist that further investigation will occur, and that the psychologist must submit a written follow-up report on the online portal. When is the psychologist required to complete the follow-up written report?
Select one:
A.
As long as the psychologist reported over the phone, they do not need to submit a written followup report.
B.
The psychologist has 36 hours from the time they reported the incident to Child Protective Services.
C.
The follow-up written report must be entered immediately after the social worker confirms an investigation will take place.
D.
The psychologist must complete the written followup report within 1 week of learning of the incident.
The correct answer is B.
PC Section 11166(a) states, “The mandated reporter shall make an initial report to the agency immediately or as soon as is practicably possible by telephone and the mandated reporter shall electronically transmit a written follow-up report thereof within 36 hours of receiving the information concerning the incident.”
Answer A: A written follow-up report is required along with an initial phone call.
Answer C: Reports cannot be entered immediately, as they have to be uploaded to the electronic system.
Answer D: The written follow-up is required within 36 hours, not one week.
A psychologist goes to her child’s play at school. While sitting in the audience, she sees a parent strike his child, bloodying the child’s nose. If the psychologist reports child abuse to Child Protective Services, the psychologist is:
Select one:
A.
covered from both civil and criminal liability.
B.
covered from criminal liability but not from civil liability.
C.
covered from civil liability but not from criminal liability.
D.
not covered from either civil or criminal liability.
The correct answer is A.
Mandated reporters have immunity from criminal and civil liability for any report required or authorized under the Child Abuse Reporting Law. This immunity applies even though the knowledge or reasonable suspicion of abuse was acquired outside his or her professional capacity or outside the scope of his or her employment [P.C. 11172 (a)]. If a mandated reporter is sued for making a report, he or she may be able to receive compensation for legal fees incurred in defending against the action [P.C. 11172 (c)].
Answers B, C, and D: Incorrect as both civil and criminal liability are covered in the California Penal Code [P.C. 11172 (c)].
A psychologist is treating a 15-year-old girl with the consent of her parents. The client’s father requests to access their child’s therapy records. The psychologist believes that agreeing to the parent’s request may be psychologically harmful to their child client. The psychologist:
Select one:
A.
must comply with his request because the parent consented to therapy.
B.
must comply with the parent’s request because they are permitted to deny access only when the minor may face physical danger.
C.
can deny access because they believe disclosure may be psychologically harmful to the client.
D.
cannot deny the parent’s request without first asking the client their preference for course of action.
The correct answer is C.
“Parents have a right to access their minor child’s records. This access is restricted, however, by three broad exceptions. Parents cannot access their child’s records if: (1) the minor has access to the records, (2) the release would have a detrimental effect on the provider’s professional relationship with the minor, or (3) the release would have a detrimental effect on the minor’s safety or psychological well-being” (Z. Pelchat, Request for records: How to respond, The California Therapist, May/June, 2001, 14-15).
Answer A: A request to the child’s treatment records does not have bearing on a psychologist’s decision that disclosure would be psychologically harmful.
Answer B: Psychological and physical danger are both potential reasons to deny disclosure.
Answer D: It wouldn’t be recommended for the psychologist to bring the issue to a minor to resolve.
When the court orders a client to receive an assessment, the psychologist conducting the assessment must:
Select one:
A.
have the client sign a consent for treatment before commencing treatment.
B.
discuss the limits to the confidentiality with the client prior to commencing services.
C.
treat the client regardless of the client’s desire or willingness to participate in treatment.
D.
maintain the client’s confidentiality from the court, including information about attendance.
The correct answer is B.
When the court orders a client to receive assessment or therapy services, signed consent for treatment is not required of the client. This circumstance does not relieve the psychologist of the ethical responsibility to explain the limits that may be imposed on confidence. Even when services are court ordered or otherwise mandated, psychologists should inform the client about the nature of the anticipated services, including that the services are court ordered or mandated and any limits on confidentiality.
Answer A: Signing a consent form is different from building informed consent.
Answer C: The client may still choose to not consent to treatment, but there will likely be consequences from the court.
Answer D: When treatment is court-ordered, the psychologist is required to report attendance to the court.
A psychologist is treating a couple to address conflict in their marriage. The husband is bringing a civil suit against the city of San Diego. He would like the psychologist to testify in the trial and have signed an appropriate consent. The wife has refused to sign consent because she does not want the psychologist to disclose anything that was said during their marital therapy. Which of the following is true?
Select one:
A.
The psychologist may testify only about the husband’s portions of treatment.
B.
The psychologist can testify about the husband and the marriage, as long as they use a pseudonym to refer to the wife.
C.
The psychologist should not testify unless they are called to testify as an expert witness.
D.
The psychologist must obtain consent from both the husband and wife in order to testify in court.
The correct answer is D.
The relevant issues are that both clients hold the privilege in this situation, and that waiver of the privilege by one of the clients does not affect the right of the other client to claim the privilege, even when it relates to the same confidential information. When a psychologist treats a couple and is called to testify, they must secure consent to disclose from both clients.
Answers A, B, and C: The psychologist must obtain consent from both the husband and wife to testify.
