LE 2 Flashcards
In a professional capacity, a psychologist learns that a 72-year-old client is having large amounts of money stolen out of her wallet by her sister’s son. The client is currently living with her sister’s family. The psychologist should:
Select one:
A.
encourage the client to call the police.
B.
call the adult protective services or local law enforcement immediately and follow-up with a written report within two working days.
C.
call local law enforcement within 24 hours and send a written report within five working days.
D.
call the state department of state hospitals and follow-up with a written report within two working days.
The correct answer is B.
The client is an elder and appears to be a victim of financial abuse. The psychologist is therefore legally required to make a report of abuse. The recipient of the report depends on where the abuse has occurred. Per the Welfare and Institutions Code Section 15630(b)(1), when any type of reportable abuse occurs in a location other than a long-term care facility, a state mental health hospital, or a state developmental center, a telephone report must be made to the adult protective services agency or local law enforcement agency immediately and a written report must be sent to the adult protective services agency or local law enforcement within two working days.
Answer A: Given that a mandated reporter (the psychologist) knows about a suspected incident of elder abuse, they must make a report.
Answer C: The written report must be made within two working days.
Answer D: A report should only be made to a state hospital if the abuse has occurred within a state hospital.
A 10-year-old client tells his psychologist that his grandfather, who just celebrated his 70th birthday and is in a long-term care facility, “cries a lot” and said that a staff member at his nursing home frequently hits him. The psychologist should:
Select one:
A.
call the client’s parents and request that they make an appointment to discuss these concerns.
B.
wait until they can confirm from another family member that abuse has occurred.
C.
contact local law enforcement to report the abuse.
D.
contact adult protective services to report the abuse.
The correct answer is C.
As the client is reporting that his 70-year old grandfather has been physically abused by a staff member at his long term care facility, the psychologist is legally required to report a suspected incident of elder abuse to the local ombudsman AND local law enforcement, given that the abuse is in a long term care facility. Also, a written report should be made within two hours if there is serious bodily injury and within 24 hours if no serious injury has occurred.
Answer A: While the psychologist will likely discuss these concerns with the client’s parents, this answer does not adequately answer the psychologist’s ethical and legal obligation to report the suspected elder abuse.
Answer B: Similarly, while the psychologist may want to discuss these concerns with the client’s family, this does not preclude the psychologist from making a report of suspected abuse.
Answer D: Given that the abuse has taken place in a long-term care facility, the psychologist must make a report to local law enforcement.
A psychologist whose license has been revoked by the Board of Psychology must wait at least _____ year(s) before petitioning the Board for reinstatement of licensure.
Select one:
A.
one
B.
two
C.
three
D.
five
The correct answer is C.
Per the California Business and Professions Code Section 2962(a)(1), the minimum period for petitioning for reinstatement of a revoked license is three years from the effective date of the revocation decision.
Answers A, B, and D: These all provide incorrect responses.
An 8-year-old boy is brought to therapy by his father. The father says that he and the boy’s mother are divorced. He reports that the mother has 100% legal custody; however, they share joint physical custody. The father would like the boy to start therapy because he is having trouble making friends at school. How should the psychologist proceed?
Select one:
A.
The psychologist should obtain consent for treatment from the father.
B.
The psychologist should obtain consent for treatment from the client’s mother.
C.
The psychologist should obtain the contact information for the boy’s mother and proceed treatment with the father’s consent.
D.
The psychologist should request a copy of the custody arrangement.
The correct answer is B.
When the parents are divorced but share joint legal custody, either parent alone may consent to therapy for their child. Legal custody refers to a parent’s right and responsibility to make decisions that concern a child’s physical and mental health, education, and welfare (FC Section 3003). Physical custody refers only to living arrangements and supervision of the child (FC Sections 3004 and 3007). Thus, since the mother has 100% legal custody, she must consent to a child’s treatment.
Answer A: While the psychologist should also obtain consent from the boy’s father, they must have consent from the boy’s mother to proceed with treatment.
Answer C: Although the psychologist should obtain the contact information for the boy’s mother, they cannot proceed with treatment until they have her consent.
Answer D: Similarly, it would be helpful to review the custody arrangement; however, since the father is stating that he does not have legal custody, the psychologist should obtain consent from the boy’s mother.
A client shows up for his therapy session looking extremely disheveled. He reports that he has been hearing voices in his head telling him that someone is trying to kill him and is desperate to make the voices stop. He says that he hasn’t eaten in over three days and is taking “speed” to keep himself from feeling hungry because he’s afraid someone is trying to kill him by poisoning his food. What should the psychologist do?
Select one:
A.
The psychologist should refer the client to a psychiatrist.
B.
The psychologist should initiate a 5150.
C.
The psychologist should contact a family member who is willing to monitor the client’s safety.
D.
The psychologist cannot take any specific action because the client has not threatened an identifiable victim.
The correct answer is B.
This client appears to meet the requirements for a grave disability as defined in WIC Section 5008. Specifically, as the result of a mental disorder, the client is unable to provide for his or her basic personal needs for food, clothing, or shelter. A useful strategy for determining whether a person’s behavior meets the legal requirements for a grave disability is to consider whether the behavior is due to a mental disorder and, if so, whether the behavior threatens their survival. Per WIC Section 5150, “When any person, as a result of a mental disorder, is a danger to others, or himself or herself, or gravely disabled, a peace officer, a member of the attending staff of an evaluation facility designated by the county, designated members of a mobile crisis team, or other professional person designated by a county, may upon probable cause, take, or cause to be taken, the person into custody for a period of up to 72 hours for assessment, evaluation, and crisis intervention.”
Answer A: The main priority is to keep the patient safe by initiating a 5150.
Answer C: After starting the process of a 5150, the professional person in charge of the facility designated by the county for evaluation and treatment will likely connect with the patient’s family members and other available supports. However, the psychologist should first initiate 5150.
Answer D: As stated above, this client, as the result of a mental disorder, is gravely disabled and thus requires additional evaluation and treatment.
Dorothy and Ira are divorced parents who share joint legal custody of their 10-year-old daughter. What are their rights regarding mental health care decisions?
Select one:
A.
Both parents must consent to treatment before treatment begins.
B.
The child and both of her parents must consent to treatment before treatment begins.
C.
Either parent alone may consent to treatment before treatment begins.
D.
The parents must obtain a court order for their daughter to participate in treatment before treatment begins.
The correct answer is C.
If the parents have joint legal custody, they share the right and responsibility to make health care decisions for their child (Family Code 3003). This means that either parent acting alone may consent to mental health treatment, unless the order outlining their joint legal custody has language to the contrary (B. Benitez, Guidelines for the treatment of minors, The California Therapist, September/October 2012). It is recommended that the therapist request a copy of the custody order to confirm the status of the legal custody of the minor, as well as, review any specific language that may impact the treatment. Generally speaking, it is always best to have the support of both parents for the treatment; however, this question refers to the parent’s rights regarding mental health decisions.
Answer A: Only one parent has to consent to treatment unless stated otherwise in the custody documents.
Answer B: The child should give her assent (rather than consent) to treatment and only one of the parents is required to provide consent.
Answer D: If both parents are unable to agree about the treatment that should be provided, it may be necessary for the parent to obtain a court order resolving the matter before treatment is provided.
A psychologist has been seeing a couple in therapy for marital problems for three weeks but has yet to discuss issues related to limits of confidentiality. At the end of a therapy session, the husband reveals that he has been physically abusing his 13-year-old son. The psychologist should:
Select one:
A.
discuss the abuse in the next session with the couple.
B.
discuss limits to confidentiality in the next therapy session so the couple is aware of the psychologist’s obligation as a mandated reporter.
C.
call the couple to inform them that you will be reporting the abuse and will make the report during the next therapy session.
D.
immediately report the suspected abuse.
The correct answer is D.
Although the psychologist should have discussed the limits to confidentiality upon obtaining informed consent at the onset of therapy, this does not release them from their legal obligation to make a report to the appropriate authorities as soon as possible.
Answer A: While the psychologist may address this abuse during the next session, the main priority is to make a child abuse report.
Answer B: Psychologists are legally required to make a report of known or suspected child abuse immediately or as soon as practically possible by telephone, with a written report to follow within 36 hours.
Answer C: Psychologists are legally required to make a report of known or suspected child abuse immediately or as soon as practically possible by telephone, with a written report to follow within 36 hours.
To ascertain the appropriate procedures for breaching client confidentiality when a client refuses to pay for professional psychological services that they have already received, a psychologist should review the:
Select one:
A.
California Board of Psychology Laws and Regulations
B.
California Board of Psychology Patient Bill of Rights
C.
APA Rules and Procedures
D.
APA Ethical Principles of Psychologists and Code of Conduct
The correct answer is D.
The APA Ethics Code, Standards 4.05 and 6.04, speaks to the use of a collection agency or other legal measures to collect outstanding client fees. Per Standard 6.04, psychologists must “first inform the person that such measures will be taken and provide that person with an opportunity to make prompt payment.” Also per Standard 4.05, psychologists may disclose confidential information to obtain payment for services but must limit their disclosure to “the minimum that is necessary to achieve the purpose.”
Answer A: Laws and Regulations Pertaining to the Practice of Psychology contains California laws relevant to the practice of psychology, with an emphasis on laws related to licensure. Note that regulations related to debt collection practices are provided in the Rosenthal Fair Debt Collections Act (California Civil Code, Title 1.6C, Section 1788). However, this Act does not directly address issues related to breaching confidentiality when a client has an outstanding debt.
Answer B: The Patient Bill of Rights is an informational guide for consumers provided by the California Board of Psychology. It does not address the collection of outstanding client fees.
Answer C: The APA’s Rules and Procedures summarize the procedures of the Ethics Committee for conducting matters within its jurisdiction.
The lights turn off for several minutes during a psychological assessment, and the client stops working on a question. The psychologist should:
Select one:
A.
discontinue testing.
B.
start the test over.
C.
allow the client to finish the test but record information about the interruption in the test report.
D.
allow the client to finish the test.
The correct answer is C.
Ideally, a test should always be administered under standardized conditions using standardized procedures. However, when a deviation from standardized conditions or procedures is unavoidable, the psychologist should include information about this deviation in the assessment report since it may have invalidated the results and limited the conclusions that can be drawn from those results. This is consistent with the requirements of Ethics Code Standard 9.06, which requires psychologists to “indicate any significant limitations of their interpretations [of assessment results].”
Answer A: With the information provided, the best answer is to continue testing and record this deviation in the assessment procedures. However, if the test was a short timed test of visual attention, it may make sense to discontinue the test and then substitute this test with a similar measure.
Answer B: It may make sense to restart the test if this disruption occurred at the beginning of the test. However, if it was towards the end of the testing, restarting the test may inflate the client’s scores as they have already seen the questions.
Answer D: The psychologist could let the client proceed with the administration, though they should make note of this disruption in the report.
A therapist meets with her 27-year-old client who lives with her partner, does not have children, and works as an assistant at a vet clinic. The client reports that her partner recently lost their job and, since then, has become verbally and physically abusive. The client says that, on one occasion, her partner gave her a black eye. The psychologist should:
Select one:
A.
get the client’s permission to file a spousal abuse report and provide her with the phone number of a local shelter.
B.
encourage the client to file a police report herself and discuss her options.
C.
assess the level of dangerousness and help the client develop a safety plan.
D.
recommend that the client bring her partner to the next therapy session.
The correct answer is C.
In cases of spouse abuse, a therapist’s first responsibility is to ensure the victim’s safety, which involves assessing the current level of dangerousness for the client and helping the client develop a safety plan. Note that, in California, a psychologist is only required to file a report of abuse if the victim is a minor, an elder and/or a dependent adult.
Answer A: A spousal report is not required.
Answer B: While a police report may be warranted for the client to make, the more important objective is to create a safety plan. The therapist themselves are not required to make a report.
Answer D: The therapist’s priority is to assess the current level of dangerousness for the client and develop a safety plan. Including the partner in therapy may not be in the client’s best interest.
As defined in the APA’s Ethics Code, uninvited in-person solicitation of business from actual or potential therapy clients by a psychologist is:
Select one:
A.
acceptable when the solicitation is not coercive.
B.
acceptable when the client is contacted through the psychologist’s agent.
C.
acceptable when it involves providing disaster or community outreach services.
D.
never acceptable.
The correct answer is C.
Per Standard 5.06 of the APA Ethics Code, psychologists are prohibited from engaging in uninvited in-person solicitation of business from an actual or potential therapy client. However, the prohibition does not preclude psychologists from “attempting to implement appropriate collateral contacts to benefit an already engaged therapy client/patient” or “providing disaster or community outreach services.”
Answer A: Due to the circumstances and power differential, the client is vulnerable to undue influence.
Answer B: Per the APA ethics code, “psychologists do not engage, directly or through agents, in uninvited in-person solicitation of business.”
Answer D: This type of solicitation is allowed if it is related to implementing collateral contacts for the client or disaster or community outreach services.
A psychologist may deny an adult patient access to their treatment records or protected health information (PHI):
Select one:
A.
when access is reasonably likely to have adverse consequences to the patient.
B.
when access is reasonably likely to endanger the patient’s mental health.
C.
when access is reasonably likely to endanger the patient’s life or physical safety.
D.
under no circumstances.
The correct answer is C.
Per HIPAA, records can only be withheld when a patient’s life or physical safety is endangered. Per California Law, a provider may decline patient access to their records when they believe that there would be adverse consequences to the patient. For adult patients, HIPAA prevails over California Law.
Answer A: Although “adverse consequences” may include endangering a patient’s life or physical safety, this answer is vague and in line with California Law rather than HIPAA.
Answer B: This answer is not in line with HIPAA requirements.
Answer D: This is an incorrect response.
The legal determination of “grave disability” requires the presence of all of the following conditions, EXCEPT:
Select one:
A.
the person, as the result of a mental disorder, is unable to provide for their basic personal needs for food.
B.
the person, as the result of a mental disorder, is unable to survive safely without involuntary detention.
C.
the person can survive safely without involuntary detention with the help of a third party who can provide for their basic personal needs.
D.
the person, as the result of a mental disorder, is unable to provide for their basic personal needs for clothing.
The correct answer is C.
A person is not considered “gravely disabled” as the result of a mental disorder if they can survive safely without involuntary detention due to the help of responsible family, friends, or others who are both willing and able to help provide for the person’s basic personal needs for food, clothing, or shelter.
Answers A, B, and D: A person would be considered “gravely disabled” if they are unable to survive safely and provide for their basic personal needs, including food, clothing, or shelter.
Per the APA Ethics Code, which of the following is true about the use of client testimonials?
Select one:
A.
The use of client testimonials is strictly prohibited.
B.
The use of client testimonials is acceptable, as long as they are not deceptive or false.
C.
The use of client testimonials is acceptable, as long as they have not been solicited from current clients or others who are vulnerable to undue influence.
D.
The use of client testimonials is only acceptable when are unsolicited from former therapy clients.
The correct answer is C.
Per Standard 5.05 of the APA Ethics Code, “psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.”
Answer A: This code does not prohibit psychologists from using unsolicited testimonials or solicited testimonials from former clients or others who are not vulnerable to undue influence.
Answer B: Psychologists are not allowed to solicit testimonials from current therapy clients/patients, regardless of whether they are valid or true.
Answer D: Testimonials can be solicited or unsolicited from former therapy clients.
A psychologist would like to start using a new, innovative, and experimental treatment for symptoms of anxiety. Given the developing nature of this treatment, the psychologist should:
Select one:
A.
use this treatment without informing their clients about the development nature of the treatment.
B.
not use this treatment.
C.
use this treatment with the client’s consent.
D.
not use the treatment until its effectiveness has been firmly established in the literature unless no alternative treatments are available.
The correct answer is C.
Per the Ethics Code Standard 10.01, Informed Consent to Therapy, “when obtaining informed consent for treatment for which generally recognized techniques and procedures have not been established, psychologists should inform their clients/patients of the developing nature of the treatment, the potential risks involved, alternative treatments that may be available, and the voluntary nature of their participation.”
Answer A: The psychologist should inform the client of the experimental nature of the treatment to ensure that they have their informed consent for treatment.
Answer B: The psychologist can use this treatment upon obtaining the client’s consent, which includes informing the patient of the developing nature of the treatment, potential risks, alternative treatments, and the voluntary nature of their participation.
Answer D: The psychologist can use this treatment upon obtaining the client’s consent, which includes informing the patient of the developing nature of the treatment, potential risks, alternative treatments, and the voluntary nature of their participation.
A psychologist who is licensed in another state may offer psychological services in California for a period not exceeding ____ days in any calendar year.
Select one:
A.
90
B.
45
C.
30
D.
15
The correct answer is C.
Per CCR Section 2912, “Nothing in this chapter shall be construed to restrict or prevent a person who is licensed as a psychologist at the doctoral level in another state or territory of the United States or in Canada from offering psychological services in this state for a period not to exceed 30 days in any calendar year.”
Answers A, B, and D: These all provide incorrect responses.
A therapist receives a letter from another provider requesting a copy of a former client’s treatment records. This request includes a signed release from the client. This particular client still owes the therapist for their last four therapy sessions, despite multiple attempts to contact the client to pay their bill. The psychologist:
Select one:
A.
must comply with the client’s request for their records.
B.
may withhold the records until the client pays their outstanding fees.
C.
may withhold the client records, as long as they are not needed immediately.
D.
has no obligation to provide the client’s records to the new therapist.
The correct answer is A.
California Health and Safety Code Section 123110 applies to this situation. It states that “This section shall be construed as prohibiting a health care provider from withholding patient records or summaries of patient records because of an unpaid bill for health care services. Any health care provider who willfully withholds patient records or summaries of patient records because of an unpaid bill for health care services is subject to the sanctions specified in subdivision (i).”
Answer B: The psychologist must comply with the request for the patient’s records.
Answer C: The psychologist must comply with this request within 15 days of receiving the request and authorization.
Answer D: The psychologist must comply with the request for the patient’s records.
A licensed psychologist regularly waives the co-payment for her clients who are covered by insurance. Routinely waiving a co-payment is:
Select one:
A.
unethical, unless the psychologist charges other clients a higher copay to compensate for this loss.
B.
unethical.
C.
ethical.
D.
unethical, unless the insurance company agrees to this arrangement.
The correct answer is D.
Generally speaking, insurance companies agree to pay a specific percentage of a psychologist’s fee. When a co-payment is waived, the insurance company is essentially paying the entire fee. Thus, waiving the co-payment without permission from the insurance company may be considered insurance fraud as the psychologist is misrepresenting their true charges. Importantly, it is ethical to waive the co-payment for a client if this is agreed upon by the insurance company. For example, many insurance companies waived their copays and deductibles for telehealth psychotherapy services for COVID-19 related treatment.
Answer A: The co-payment is decided by the insurance company and cannot be changed by the psychologist without permission from the insurance company.
Answer B: While it is generally unethical to routinely waive co-payments, there are exceptions to this rule (see above).
Answer C: As this question is asking whether or not it is ethical for a psychologist to routinely waive co-payments, this would be considered unethical as the psychologist is misrepresenting their true charges.
Based on complaints filed against a psychologist by a former client, the Board of Psychology determines that the psychologist may have a mental illness that is interfering with their ability to provide competent professional services, and it orders the psychologist to be evaluated. The psychologist notifies the Board of Psychology that the client’s complaint is unfounded, and they refuse to participate in an evaluation. Thus, the Board will likely:
Select one:
A.
suspend or revoke the psychologist’s license.
B.
place the psychologist on probation.
C.
require the psychologist’s work with clients to be supervised.
D.
ask the psychologist to file a formal challenge to the client’s complaint.
The correct answer is A.
Per the Business and Professions Code (Sections 820 and 821), the Board of Psychology has the authority to order a licensed psychologist to be examined by a designated professional when the psychologist may be “unable to practice his or her profession safely because the licentiate’s ability to practice is impaired due to mental illness.” Also, a licentiate’s failure to comply with the Board’s order “shall constitute grounds for the suspension or revocation of the licentiate’s certificate or license.”
Answers B, C, and D: These all provide incorrect responses.
A psychologist would like to use an interpreter for a primarily Spanish-speaking client during an upcoming assessment. The psychologist should:
Select one:
A.
let the client know that they will be using an interpreter.
B.
obtain informed consent from the client to use that interpreter.
C.
proceed with the informed consent process, and there is no need to obtain additional consent for the use of an interpreter.
D.
ensure that the client does not know the interpreter personally.
The correct answer is B.
Per the APA Ethics Code, 9.01 Informed Consent in Assessments, “psychologists using the services of an interpreter [should] obtain informed consent from the client/patient to use that interpreter.” Generally speaking, the psychologist should ask the client which language they feel most comfortable speaking in, which will facilitate their ability to obtain informed consent for the use of an interpreter and make sure that the client does not know the interpreter personally.
Answer A: The psychologist should obtain informed consent from the client to use the interpreter, rather than just “let them know.”
Answer C: The psychologist should seek additional informed consent for the use of an interpreter.
Answer D: While the psychologist should check to make sure that the client does not have a personal relationship with the interpreter, they should also obtain informed consent to use the interpreter. As a result, the correct answer specifies that the psychologist should obtain informed consent from the client for that interpreter.
Per the California Board of Psychology Laws & Regulations, a licensed psychologist who serves as the primary supervisor for interns and psychological assistants is required to complete a minimum of _____ hours of supervision coursework every two years.
Select one:
A.
2
B.
4
C.
6
D.
8
The correct answer is C.
Per the California Code of Regulations Section 1387.1(b), “primary supervisors who are licensed by the board shall complete a minimum of six (6) hours of supervision coursework every two years.”
Answers A, B, and D: These are incorrect responses.
A psychologist is treating a 14-year-old for conduct problems at school. During the past year, the client has made significant gains and has not had any outbursts in several months. Both of her parents are extremely pleased with the success of treatment. As the client’s parents begin divorce proceedings, they ask the psychologist to conduct a child custody evaluation. The psychologist should:
Select one:
A.
refer the client to another child psychologist for the evaluation.
B.
request that the judge decides whether or not they should perform the evaluation.
C.
evaluate if the psychologist has consent from both parents.
D.
evaluate if it is not contraindicated.
The correct answer is A.
According to the Guidelines for Child Custody Evaluations in Divorce Proceedings, “Psychologists generally avoid conducting a child custody evaluation in a case in which the psychologist served in a therapeutic role for the child or his or her immediate family or has had other involvement that may compromise the psychologist’s objectivity.” Generally speaking, the evaluator should maintain objectivity, provide and gather balanced information for both parties, and control for bias. Given the pre-existing relationship with the client, the psychologist should refer the client out for the evaluation.
Answer B: The psychologist should avoid performing the evaluation regardless of the judge’s decision.
Answer C: Even if both parents were to consent, it is not ideal for the psychologist to perform the evaluation.
Answer D: The psychologist would not conduct an evaluation if it’s not ideal to perform the evaluation, but in doing so, should refer the client to another psychologist for the evaluation.
A psychologist based in California receives a request from an adult client to obtain their treatment records. If the psychologist feels that these records should be withheld, they should:
Select one:
A.
document the date of request and indicate why releasing the records would have adverse consequences to the patient’s ongoing therapy treatment.
B.
document the date of request and indicate why releasing the records would lead to the patient’s life or physical safety being endangered.
C.
deny the request and offer to prepare a treatment summary.
D.
deny the request.
The correct answer is B.
Per HIPAA, the treatment records for an adult patient can only be withheld if a patient’s life or physical safety is endangered. Per California law, a provider may decline a patient’s access to their treatment records if they believe that there would be adverse consequences to the patient, such as a detrimental impact on the client’s treatment. For adult patients, HIPAA prevails over California law. Thus, the records can only be withheld if the patient’s life or physical safety is endangered.
Answer A: This answer refers to California law. When adult clients request their treatment records, HIPAA prevails over California law.
Answer C: While a treatment summary can be offered to the client in place of providing the records, the psychologist can only deny the request if the patient’s life or physical safety is endangered.
Answer D: This answer is incomplete. The psychologist should also document why this request was denied.
The case of Tarasoff v. Regents of the University of California is relevant to which of the following?
Select one:
A.
The duty to protect when a client threatens violence against a reasonably identifiable victim.
B.
The exception to the psychotherapist-patient privilege when a client is a danger to self or others.
C.
The right of a psychotherapist to claim the privilege on behalf of a client in a legal proceeding.
D.
The right of an emancipated minor to consent to psychiatric care without parental consent.
The correct answer is A.
The original 1974 court ruling in Tarasoff v. Board of Regents of the University of California established a psychotherapist’s “duty to warn” the intended victim of a client; but, in a rehearing of the case, this was changed to a “duty to protect” the intended victim by warning them, notifying the police, and/or taking other reasonably necessary steps. For example, warning the victim may exacerbate a dangerous scenario, and if a therapist chooses not to warn, but instead pursues an alternative course of action for clinical and ethical reasons, such actions must be proven negligent to find legal liability, as in other areas of malpractice.
Answers B, C, and D: These all provide incorrect responses.
During a session, a client reports that he was recently laid off from his job at a law office downtown. He reports, “Americans are losing their jobs to foreigners and I’m not going to stand for it anymore.” He then makes a fist with his hand. He says that he is planning to go to his old office tomorrow and “go postal.” The psychologist should:
Select one:
A.
contact the client’s employer and the police.
B.
schedule a session with the client tomorrow to further assess the situation.
C.
not breach confidentiality until the client identifies a specific victim.
D.
have him arrested.
The correct answer is A.
This situation refers to the psychologist’s duty to protect, which involves “making reasonable efforts to communicate the threat to the victim or victims and a law enforcement agency” (California Civil Code 43.92). The client’s threat to “go postal” suggests that he has made a “serious threat of physical violence.” Although he has not named the specific victim, “foreigners” and others at his workplace can be considered to be reasonably, or readily, identifiable victims. The psychologist should, therefore, warn the intended victim or victim(s) by contacting the client’s employer and notify the police.
Answer B: Although it may be beneficial to schedule another session with this client, the psychologist has a legal obligation to warn, protect, and predict.
Answer C: Given that the psychologist knows that the client works at a law office downtown and that he is planning an attack against “foreigners” and possible others in this office, the psychologist has enough information to proceed.
Answer D: The psychologist should notify the police and they will determine the next steps, which may or may not include arresting the client.
A psychologist receives a phone call from an attorney who is representing one of their therapy patients, who is the defendant in a court case. The attorney asks the psychologist to send her test data and other information from the patient’s record that is needed to assist with the patient’s defense. The psychologist should:
Select one:
A.
release all of the requested information after confirming that the attorney is, in fact, representing the therapy patient.
B.
release only a narrative summary of the patient’s record after confirming that the attorney is, in fact, representing the therapy patient.
C.
release the requested information to the attorney upon receiving written authorization from the patient.
D.
release only a brief summary of the patient’s record to the attorney upon receiving written authorization from the patient.
The correct answer is C.
Evidence Code Section 1158 applies to this situation. It is consistent with HIPAA requirements and states, “whenever, before the filing of any action or the appearance of a defendant in an action, an attorney at law or his or her representative presents a written authorization therefore signed by an adult patient … [a psychologist] shall make all of the patient’s records under his, her, or its custody or control available for inspection and copying by the attorney at law or his or her representative, promptly upon the presentation of the written authorization.” Moreover, Standard 9.04 of the Ethics Code states that “according to a client/patient release, psychologists provide test data to the client/patient or other persons identified in the release.”
Answer A: Although the attorney is representing the therapy patient, the requested information can not be sent until they receive a signed release from the patient.
Answer B: Although the attorney is representing the therapy patient, the requested information can not be sent until they receive a signed release from the patient.
Answer D: Given the information provided, it is likely that the psychologist can release the test data rather than a brief summary, with a signed authorization form in place.
Which of the following is true about reporting known or suspected cases of spousal abuse?
Select one:
A.
Psychologists should make a report whenever they learn of the abuse while providing professional services to the victim or the perpetrator.
B.
Psychologists must make a report when the victim of spousal abuse is a minor, elder, or dependent adult, otherwise psychologists are not required to report spousal abuse.
C.
Psychologists are only required to report spousal abuse when the abuse has occurred for over a year.
D.
Psychologists are not required to report spousal abuse.
The correct answer is B.
In California, psychologists are not mandated to report spousal abuse. However, psychologists must report suspected abuse against a child, elder, or dependent adult. Thus, depending on the age of the alleged victim/spouse, a psychologist may need to report.
Answer A: Psychologists are only required to report spousal abuse when the victim of the abuse is a minor, dependent adult, or elder.
Answer B: If the victim is a minor, dependent adult, or elder, the psychologist should make a report, regardless of how long the abuse has occurred.
Answer D: Psychologists are only required to report spousal abuse when the victim of the abuse is a minor, dependent adult, or elder.
The requirements of the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA):
Select one:
A.
always takes precedence over state laws.
B.
takes precedence over state laws when it is more stringent and provides more privacy protection.
C.
never takes precedence over state laws.
D.
are enforceable only in the absence of state or other applicable federal laws.
The correct answer is B.
When there is a conflict or inconsistency between the requirements of HIPAA and state laws, a psychologist should follow the law that provides the patient with greater privacy, access, or autonomy.
Answer A: If state law provides the patient with greater privacy, access, or autonomy, then you wouldn’t necessarily go with HIPAA in this instance.
Answer C: If HIPAA provides the patient with greater privacy, access, or autonomy, then you wouldn’t necessarily follow state laws in this instance.
Answer D: HIPAA is enforceable in the absence of California law, and in fact, supersedes California law when HIPAA is stricter.
Section 5260 of the Welfare and Institutions Code provides legal guidelines for initiating a post-certification hold for individuals who are:
Select one:
A.
gravely disabled.
B.
suicidal.
C.
a danger to others.
D.
a danger to self or others.
The correct answer is B.
The legal requirements for a post-certification hold that follows the initial 14-day hold depend on whether the person is a suicidal, gravely disabled, or serious danger to others. WIC Section 5260 contains legal requirements for a second 14-day hold for suicidal behavior.
Answer A: The requirements for individuals who are gravely disabled are provided in Section 5270.
Answer C: The requirements for individuals who pose a serious danger to others are provided in Section 5300.
Answer D: The requirements for individuals who are a danger to self are in Section 5260. The requirements for individuals who are a danger to others are in Section 5300.
Welfare and Institutes Code Section 15610 states that mandated reporters MUST report elder abuse, which includes all of the following except _____________.
Select one:
A.
abandonment
B.
isolation
C.
abduction
D.
emotional abuse
The correct answer is D.
Per California Laws and Regulations, Section 15610, “Abuse of an elder or dependent adult means any of the following: 1) Physical abuse, neglect, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering; 2) the deprivation of a care custodian of goods or services that are necessary to avoid physical harm or mental suffering; 3) Financial abuse.” California law provides that a mandated reporter may make a report when he or she has knowledge of, or reasonably suspects, that types of elder or dependent adult abuse for which reports are not mandated have been inflicted upon an elder or dependent adult, or that his or her emotional well-being is endangered in any other way [Section 15630(c)(1)].
Answers A, B, and C: These all include mandated reportable offenses of elder abuse.
Under HIPAA’s privacy rule, patients can be denied access to protected health information (PHI) in certain circumstances. However, in some of these circumstances, the patient has the right to have the denial reviewed by a designated licensed health care professional. Which of the following is a reviewable ground for denial of access to PHI?
Select one:
A.
The requested information includes psychotherapy notes.
B.
The requested information was compiled for use in a civil or criminal proceeding.
C.
The health care provider believes that access is reasonably likely to cause emotional distress for the patient.
D.
The health care provider believes that access is reasonably likely to endanger the physical safety of the patient or another person.
The correct answer is D.
Per HIPAA’s privacy rule, an individual has a right to have the denial reviewed by a licensed health care professional designated by the covered entity who did not participate in the original decision to deny. There are three reviewable grounds for denying access to PHI. One of them includes when a licensed health care professional has determined that access is likely to endanger the life or physical safety of the individual or another person.
Answer A: Psychotherapy notes compiled for a legal proceeding are excluded from the HIPAA privacy rule, and thus not included as reviewable grounds for denial of a request.
Answer B: Psychotherapy information compiled for a legal proceeding is excluded from the HIPAA privacy rule, and thus not included as reviewable grounds for denial of a request.
Answer C: Endangering the life or physical safety of the individual or another person does not extend to concerns regarding psychological or emotional harm, such as concerns that the individual would not be able to understand or be upset by the information.
Many of the tests that psychologists use as part of their assessment of clients provide computer-generated interpretations. When using these tests, psychologists:
Select one:
A.
can assume that the interpretations have adequate reliability and validity.
B.
can assume that the interpretations have adequate reliability and validity of the tests are published by an APA-approved publisher.
C.
should not rely solely on a computer-generated test interpretation to reach diagnostic or other conclusions about a client.
D.
should never use a computer-generated test interpretation to assist with diagnostic or other decisions about a client.
The correct answer is C.
A psychologist’s responsibilities when using computer-generated test score interpretations are addressed in Standard 9.09 of the APA’s Ethics Code. It states that psychologists “retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.” This includes ensuring that the interpretations have evidence of adequate reliability and validity, as well as, not relying solely on a computer-generated interpretation.
Answer A: The psychologist should ensure (not assume) that they are using tests that have adequate reliability and validity.
Answer B: The psychologist should not assume the test results are reliable and valid based on the publisher alone. Moreover, the psychologist should ensure that the tests are not obsolete and are useful for the current purpose.
Answer D: Psychologists should use computer-generated test interpretation to assist in their interpretation, though they should not use these reports as the sole basis for a diagnosis.
A good friend of a licensed psychologist has asked to see her in therapy to address ongoing marital problems. The psychologist has been practicing for over 20 years. The psychologist can accept her friend as a client under which of the following circumstances?
Select one:
A.
If the psychologist’s areas of expertise match the needs of the client/friend
B.
If the psychologist explicitly states the potential problems that may arise when providing therapy to a good friend, and the friend willingly accepts those risks
C.
If the friend insists that she is not comfortable receiving therapy from any other psychologist
D.
The psychologist should not see the friend for therapy
The correct answer is D.
Per Ethical Standard 3.05(a) Multiple Relationships, “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.” Although not all multiple relationships are prohibited, their close pre-existing relationship would likely impair the psychologist’s objectivity. An analysis of the Ethics Code offers the following recommendation: “We advise that accepting those with close preexisting relationships into a professional relationship be avoided altogether, with the possible exception of short-term emergency support until a suitable referral can be located” (in P. Keith-Spiegel and G.P. Koocher, 1998. Ethics in Psychology: Professional Standards and Cases. New York: Random House).
Answer A: Regardless of the psychologist’s area of specialization or the friend’s request, seeing her for therapy would likely impair the psychologist’s objectivity/competence/effectiveness.
Answer B: Given that the psychologist can identify risks associated with multiple relationships, she should refer the friend out, as this would minimize the “harm to the person with whom the professional relationship exists.”
Answer C: While the friend may not be comfortable seeing another psychologist, it is unethical and constitutes dual/multiple relationships to see her for therapy and should be avoided.
The APA’s Ethics Code identifies three situations in which it is not necessary to obtain informed consent before administering a psychological test. Which of the following is NOT one of these three situations?
Select one:
A.
Testing is mandated by law or government regulation.
B.
Informed consent is implied because testing is conducted as a routine organizational activity.
C.
The purpose of testing is to evaluate decisional capacity.
D.
Informed consent is implied because testing is conducted by the school district.
The correct answer is D.
Per Standard 9.03 of the Ethics Code, psychologists obtain informed consent for assessments, evaluations, or diagnostic services, as described in Standard 3.10, Informed Consent, except when (1) testing is mandated by law or governmental regulations; (2) informed consent is implied because testing is conducted as a routine educational, institutional, or organizational activity (e.g., when participants voluntarily agree to assessment when applying for a job); or (3) one purpose of the testing is to evaluate decisional capacity. Informed consent includes an explanation of the nature and purpose of the assessment, fees, the involvement of third parties, and limits of confidentiality, and sufficient opportunity for the client/patient to ask questions and receive answers.
Answers A, B, and C: These refer to the exceptions outlined above.
In consideration to bartering, the APA’s Ethics Code states that:
Select one:
A.
bartering of goods (but not services) is acceptable.
B.
bartering of services (but not goods) is acceptable.
C.
bartering of goods or services is acceptable under certain conditions.
D.
bartering of goods and services is unethical and clinically contraindicated.
The correct answer is C.
This response is consistent with Standard 6.05 of the APA Ethics Code, which states, “Psychologists may barter only if (1) it is not clinically contraindicated, and (2) the resulting arrangement is not exploitative.”
Answer A: Per the APA Ethics Code, barter is the acceptance of goods, services, or other nonmonetary remuneration from clients/patients in return for psychological services.
Answer B: Per the APA Ethics Code, barter is the acceptance of goods, services, or other nonmonetary remuneration from clients/patients in return for psychological services.
Answer D: Bartering is ethical in some situations (see above).
A psychologist receives a phone call from a 13-year-old female who is interested in starting therapy. She reports that her parents would not support this decision and would like to proceed without their consent. The psychologist ___________________.
Select one:
A.
can proceed with treatment without parental consent only if the client is at risk to self or others or an alleged victim of incest or child abuse
B.
can proceed with treatment without parental consent, though they should involve the clients parents in treatment unless this involvement would be inappropriate
C.
cannot proceed with treatment without parental consent, though they should assess for safety and provide appropriate resources
D.
cannot proceed with treatment without parental consent, though they should offer to reach out to the clients parents to obtain consent
The correct answer is B.
Per the Health and Safety Code (2011), a minor must be at least 12 years old and mature enough to participate in therapy without parental consent. They do not have to be a risk to self or others or an alleged victim of incest or child abuse. This code prevails over the California Family Code, which states that the minor must be at least 12 years old, mature enough to participate, and present as a danger to self or others or have been an alleged victim of incest or child abuse. Generally speaking, mental health treatment should include the minor’s parent or guardian consent and involvement in treatment, unless this involvement is deemed inappropriate. The underlying rationale for treatment without parental consent is that a minor requires treatment and they might not seek treatment if parental consent were required. Therefore, the psychologist should find out more about why the client would like to proceed without their parent’s consent. If they feel that this involvement would be inappropriate, they should proceed with treatment without parental consent. They should document the reasons behind their decision to not contact the parent or guardian. They should also consider including them in the treatment later on unless it’s deemed inappropriate.
Answer A: While these guidelines are outlined in the California Family Code, the Health and Safety Code prevails over this code and does not require the minor to be a risk to self or others or have been an alleged victim of incest or child abuse to proceed with treatment without parental consent.
Answer C: While the psychologist should assess for safety concerns and provide the client with resources, they can proceed with treatment without parental consent.
Answer D: Per the Health and Safety Code, the psychologist can proceed without parental consent and do not have to secure this consent.
A psychologist is conducting family therapy. After 6 sessions, the psychologist realizes that he belongs to the same country club as this family. The psychologist should:
Select one:
A.
terminate therapy with the family immediately.
B.
ask the parents of the family what they would like to do.
C.
determine whether or not they can maintain their objectivity with this family.
D.
ignore this detail, as this situation does not present an ethical dilemma.
The correct answer is C.
“Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical” (Ethical Standard 3.05(a)).
Answer A: The situation presented in this question is not a clear example of an unethical (harmful) multiple relationship. Thus, it does not make sense to “terminate immediately.”
Answer B: It is the psychologist’s responsibility to determine whether or not this situation will likely impair their objectivity, competence, or effectiveness, or risk exploitation or harm to the clients.
Answer D: When presented with possible multiple relationships, a psychologist should carefully consider whether they will be able to maintain objectivity (e.g., will the psychologist closely interact with the clients at the country club?) and if this relationship is potentially harmful to the client.
A psychologist obtains a patient’s oral consent to participate in therapy, though he does not have their written consent. Can the psychologist proceed with treatment?
Select one:
A.
Yes, though he should document that he obtained oral consent in his notes.
B.
No, he needs to obtain written consent only.
C.
No, he needs to obtain both oral and written consent.
D.
No, he needs to obtain both oral and written consent and document this in his notes.
The correct answer is A.
Per California Board of Psychology Laws and Regulations section 3.10, Informed Consent, psychologists should “appropriately document written or oral consent, permission, and assent.” The psychologist can, therefore, proceed with treatment with informed consent obtained orally, though they should document that they obtained informed consent in their notes.
Answer B: The psychologist can obtain either written or oral consent, though it needs to be documented.
Answer C: While it is good practice to obtain both oral and written informed consent, the psychologist can proceed with treatment with only oral consent.
Answer D: While it is good practice to obtain both oral and written informed consent, and document this in your notes, the psychologist can proceed with treatment with only oral consent.
Mandated reporters are legally required to make a report of child abuse by telephone as soon as possible and to send a written follow-up report within _____ hours of learning of the abuse to the appropriate authorities.
Select one:
A.
24
B.
36
C.
48
D.
60
The correct answer is B.
Per PC Section 11166(a), a mandated reporter of child abuse “shall make an initial report to the agency immediately or as soon as is practicably possible by telephone and the mandated reporter shall prepare and send, fax, or electronically transmit a written follow-up report within 36 hours of receiving the information concerning the incident.”
Answers A, C, and D: These all provide incorrect responses.
A patient informs their psychologist that they recently relapsed after being sober for 5 years. They further share that they were drunk while coaching a youth basketball team last week. The psychologist should:
Select one:
A.
report to child protective services.
B.
call his employer and report his alcohol use.
C.
maintain his confidentiality and refer him to an alcohol treatment program.
D.
maintain his confidentiality.
The correct answer is C.
While the psychologist should assess if this incident was associated with harm to others, there is no overt abuse in the information provided. Thus, the psychologist should maintain the patient’s confidentiality and encourage them to enter into an alcohol treatment program.
Answer A: If the psychologist has reasonable suspicion that this incident was associated with harm to minors, they should make a child abuse report. However, the information provided does not warrant a report.
Answer B: There is no reason to call the patient’s employer. The psychologist should maintain confidentiality.
Answer D: While the psychologist should maintain the patient’s confidentiality, they are also obligated to address the patient’s relapse and should refer them to the appropriate support systems.
