LE 3 Flashcards
(100 cards)
A psychologist’s former client, who has received several notifications regarding their outstanding bill, sends a written request and authorization form to the psychologist for their treatment records. The client indicates that he would like to share these records with his current therapist. The psychologist should:
Select one:
A.
release the records after the cilent pays their bill
B.
release the records
C.
release the records only if it is an emergency
D.
release the records to the current therapist only
The correct answer is B.
Per APA Ethics Code 6.03, “psychologists may not withhold records under their control that are requested and needed for a client’s/patient’s emergency treatment solely because payment has not been received.” However, according to HIPAA, psychologists may not under any circumstances withhold records for nonpayment. Thus, it is technically ethical but actually illegal to withhold the records for nonpayment in non-emergency situations. Therefore, the psychologist should release the records to the client.
Answers A & C: The psychologist cannot withhold treatment records for nonpayment regardless of whether or not it is an emergency or non-emergency.
Answer D: Given that the request is coming from the former client, the psychologist should release the records directly to the client rather than the treating therapist.
A psychologist is treating a minor who was legally authorized to seek treatment by himself. The client’s mother emails the psychologist with a written request for the client’s treatment records. How should the psychologist respond to this request?
Select one:
A.
The psychologist should offer to write a treatment summary rather than release the records.
B.
The psychologist should discuss this request with the client and then release the records.
C.
The psychologist should not release the records, and offer to schedule a phone call with the client’s mother to discuss the treatment plan
D.
The psychologist should not release the records.
The correct answer is D.
If a minor is legally authorized to get treatment by himself or herself, their parent or guardian may be denied access to the treatment records. Also, per California law, when a minor participates in therapy with their parent’s consent, the minor’s parent or guardian may be denied access to the treatment record if the provider determines that this would have a detrimental impact on the therapeutic relationship or the minor’s physical or emotional wellbeing.
Answer A: Although psychologists often offer to write a treatment summary in lieu of the treatment records, this psychologist should not release anything (treatment summary or records) to the minor’s parent, as the client was legally authorized to obtain treatment on their own.
Answer B: The psychologist may decide to discuss this request with the client; however, they should not release the records without the client’s consent.
Answer C: Similarly, in this situation, the psychologist should not review any confidential information during a phone call with the client’s mother.
As a thank you for sending new therapy clients, a psychologist regularly sends a therapist a gift card. This behavior is considered: _______________.
Select one:
A.
unethical
B.
ethical
C.
unethical if the gift card was over $50
D.
ethical if the therapist gave the client other referrals as well
The correct answer is A.
Per APA Ethics Code 6.07, payments or fee-splitting between psychologists and other professionals must be based on services provided (clinical, administrative, etc.). Psychologists cannot pay another professional for a referral, as this may lead to a conflict of interest. In addition, per CA Laws and Regulations, Article 6, “any rebate, refund, commission, preference, patronage dividend, discount, or other consideration, whether in the form of money or otherwise, as compensation or inducement for referring patient, clients, or customers to any person is unlawful.” Thus, sending gifts for referrals, particularly when they are of significant monetary value and/or are sent on a regular basis, is unethical and illegal.
Answer B: This behavior is generally frowned upon and considered unethical.
Answer C: Sending small gifts (under $50) to referral sources during the holidays may be seen as acceptable behavior. However, in this question the psychologist is regularly sending a gift card as a thank you for a referral, which is considered unethical.
Answer D: Regardless of whether or not the therapist also gave the client other referrals, the therapist may have been influenced by the history of gift giving to refer to this psychologist, which is considered unethical.
A psychologist would like to transfer their records to an electronic record keeping system. Upon storing the records electronically, the original copies should be ________________.
Select one:
A.
kept for a minimum of 3 years
B.
kept for a minimum of 5 years
C.
kept for a minimum of 7 years
D.
destroyed
The correct answer is D.
After the records are stored electronically, the original hard copies may be destroyed and there is no requirement to store the original hard copies for a minimum amount of time. Psychologists should ensure that electronic records are kept safe and intact.
Answers A & B are incorrect.
Answer C: California law requires that treatment records are maintained for all patients for a minimum of seven years after the treatment has been completed. For minors, treatment records should be kept until the patient turns 25 years old.
A client, who is the president of a large company, tells their psychologist that they are looking to hire a new director of sales. The psychologist passes on this information to another one of their clients after they mention that they recently lost their job and are looking for employment. Did the psychologist break confidentiality?
Select one:
A.
Yes, this would constitute as a breach of confidentiality.
B.
No, this would not constitute as a breach of confidentiality if the psychologist did not reveal the name of the client.
C.
No, this would not be considered a breach of confidentiality if the information is also posted publicly.
D.
Yes, this would be considered a breach of confidentiality if the source of this information was reasonably identifiable.
The correct answer is A.
Confidentiality refers to a patient’s right to have communications kept within the bounds of the professional patient-therapist relationship. This information cannot be revealed to anyone outside of the professional relationship, unless this is permitted by law or mandated by law. A breach of confidentiality occurs when a psychologist discloses a patient’s confidential information to a third party without a signed authorization. In this question, the psychologist is sharing confidential information that was obtained during their treatment with another client. Thus, this would constitute a breach of confidentiality.
Answers B & D: Even if the psychologist did not reveal the name of their client, they cannot disclose information that was obtained within the bounds of treatment.
Answer C: If the psychologist obtained this information from a public website rather than from their patient, this would not constitute as a breach of confidentiality. However, in this situation, the psychologist obtained the information from their patient, which is a break in confidentiality.
A client tells their psychologist that their previous therapist often discussed his troubled marriage and asked for advice on their personal life. The client also reported that this therapist would stand a bit too close to her and put his hand on her lower back when they were walking out of the therapy office, which made her uncomfortable. The psychologist feels that this therapist made an ethical violation. They should:
Select one:
A.
Report these concerns to the licensing board.
B.
Discuss these concerns with the previous psychologist and attempt to resolve the issue.
C.
Validate the clients experience and discuss coping strategies.
D.
Discuss the rules and guidelines that govern a psychologist’s behavior and the patient’s right to file a complaint.
The correct answer is D.
First and foremost, the psychologist must protect their clients confidentiality. As a result, they should discuss these concerns with the patient and their right to report.
Answer A: The psychologist cannot make a report to the Board unless they have a signed authorization from their patient.
Answer B: Similarly, the psychologist cannot reach out to the previous psychologist, as this would break their patients confidentiality.
Answer C: While the psychologist should validate their patients experience and provide coping skills, they should also review the guidelines and regulations for psychologists and the patient’s right to report this behavior to the ethics committee or state licensing board.
During a session, a client tells their therapist that they are extremely upset with their neighbor who lives across the street. They are planning to smash their neighbors mailbox tomorrow night with a hammer while they are sleeping. The therapist should:
Select one:
A.
Report this to local law enforcement and attempt to warn the neighbor.
B.
Report this to local law enforcement.
C.
Validate their clients experience and discuss coping techniques
D.
Attempt to warn the neighbor.
The correct answer is C.
This question raises the issue of Tarasoff, which refers to a therapists legal duty to warn, protect, and predict when a client (or their family members) communicate to the therapist that there is a serious threat of physical violence against a reasonably identifiable victim(s). If so, the therapist should make reasonable efforts to communicate the threat to the victim or victims and the law enforcement agency. In this situation, the patient is making a threat towards someone’s property, which does not constitute a Tarasoff situation. Thus, the therapist should not break confidentiality by reporting this to local law enforcement or attempting to warn the victims family.
Answers A, B, and D: Instead, the therapist should discuss ways to cope with these negative feelings. Moreover, they may explore the potential adverse consequences associated with smashing in their neighbor’s mailbox. Of note, if the patient made a threat to a person’s property that would also result in someone being harmed, this would be considered a Tarasoff situation and the therapist should report this to local law enforcement and attempt to warn the victims family.
A 17-year-old client tells their psychologist that he got into a physical fight with a classmate at his school and shows him the bruises on his arms. He says that he frequently fights and messes around with this classmate during recess. The psychologist should _____________.
Select one:
A.
report this incident to child protective services
B.
call the clients parents and make a safety plan
C.
further assess the situation to determine if both parties are willingly engaging in this fight
D.
continue to treat the client and keep this information confidential
The correct answer is C.
Per California Laws and Regulations section 11165.6, the term “child abuse or neglect includes physical injury or death inflicted by other than accidental means upon a child by another person, child abuse or neglect does not include a mutual affray between minors.” Thus, it is important to understand whether or not both parties have the intent to fight with one another. For example, two children willingly wrestling with each other during recess is not considered child abuse and reportable, despite one child having bruises. Thus, the psychologist should further assess the situation. Is the child scared or afraid of this other boy? Or, are they both on the wrestling team and practice during recess? More information is needed here.
Answer A: Given the information provided, the psychologist should further assess the situation before filing a report. The psychologist could call child protective services to consult in this situation though.
Answer B: Similarly, it would be important to check in with the parents if the child is unsafe; however, the psychologist should further assess the situation before breaching confidentiality and talking with the parents.
Answer D: Again, depending on the circumstances surrounding this incident, this may be the appropriate choice; however, more information is needed. The client may be sharing this information to get help and thus it would be appropriate for the psychologist to make a safety plan for the client.
A psychologist who is licensed in New York would like to start treating a client who lives in California. In accordance with the California Board of Psychology, the psychologist can provide psychological services in California for up to ___ days in the calendar year.
Select one:
A.
45
B.
30
C.
180
D.
15
The correct answer is B.
Per the California Board of Psychology, a psychologist who is licensed in another state can provide psychological services in California for up to 30 days in the calendar year.
Answers A & D are incorrect.
Answer C: If the psychologist has applied to the board for a California license, they can provide services in California for up to 180 calendar days from when they submitted their application or started living in California, whichever comes first.
A client is in therapy to address symptoms of depression and anxiety related to their recent breast cancer diagnosis. The treating psychologist lost their mother to breast cancer last month and frequently tears up when the client discusses her diagnosis. During the last few sessions, the psychologist has started to deflect the clients conversation away from their breast cancer diagnosis, as it is too painful to discuss. How should the psychologist proceed?
Select one:
A.
Seek consultation to determine if the psychologist can remain objective in treatment.
B.
Continue to treat the client, as these personal difficulties will improve overtime.
C.
Seek their own personal therapy for the loss of their mother.
D.
Refer the patient out to another provider.
The correct answer is D.
Per the APA Ethics Code, 2.06 Personal Problems and Conflicts, “when psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they should take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties.” Moreover, a therapist should refer a patient out when their personal beliefs or issues are interfering with the effectiveness of therapy. In this question, the psychologist’s recent loss of a parent due to breast cancer is impeding their ability to discuss the client’s primary concern in session. Avoiding this topic is likely making the therapy less effective and may even be harmful to the patient. Thus, the psychologist should refer the patient out to another provider.
Answer A: Consultation would help the psychologist determine if they are able to stay objective and effective when treating a client. However, in this instance, it is clear that the psychologist’s history is negatively impacting the treatment as they are unable to devote the therapy time to discuss the client’s main concerns. Thus, referring the patient out is the best option listed.
Answer B: Preventing the client from discussing their main concerns may be harmful to their well-being and overall treatment. The psychologist should therefore take action rather than wait it out.
Answer C: While seeking their own therapy may be helpful, it does not address the primary issue of what a psychologist should do when their personal beliefs are interfering with the treatment.
A psychologist who has been licensed for two years writes an online advertisement that says she has been practicing in the field for ten years, which includes her time in graduate school. Upon sharing this advertisement with a colleague to ensure that they are following the APA Ethics Code, they suggest that the psychologist _____________.
Select one:
A.
remove this statement as it is misleading to the public
B.
include her licensing number in the advertisement
C.
include her licensing number and the date of licensure in the advertisement
D.
keep the ad as written
The correct answer is A.
Per the APA Ethics Code, Advertising and Other Public Statements, 5.01, “psychologists do not make false, deceptive, or fraudulent statements concerning (1) their training, experience, or competence.” Although the psychologist was “practicing in the field for ten years” while she was in graduate school, this statement may be misleading to the public. Specifically, the public may assume that she has been licensed for 10 years. Therefore, the psychologist should remove this statement.
Answer B: Psychologists must include their license number in any advertising, public directory, or solicitation of business. However, this suggestion does not address the underlying issue of making a misleading statement to the public and thus removing that statement.
Answer C: Although providing the date of licensure may help elucidate the number of years the psychologist has been licensed, it is possible that the public may not know how to interpret this date and thus defer to the misleading statement made by the psychologist.
Answer D: As mentioned previously, the psychologist should remove this statement to ensure that she is not making any deceptive statements to the public regarding her training, experience, or competence.
An adult patient tells their psychologist that their father physically abused them as a child. The psychologist should:
Select one:
A.
report this incident if it was a frequent occurrence.
B.
report this incident if it was associated with using an object on bare skin.
C.
encourage the client to report this abuse on their own.
D.
maintain confidentiality and discuss this further in therapy.
The correct answer is D.
If an adult patient reports a history of child abuse, the psychologist should determine if there are any children currently at risk. For example, if the perpetrator has access to children and may be abusing children. If so, the psychologist should file an abuse report. If not, the psychologist should maintain confidentiality. In contrast, if a minor reports a history of child abuse, the psychologist is required to make a report. For this question, given the information provided, the psychologist is not required to report this history of abuse.
Answers A & B: If a minor was reporting the abuse, then the psychologist should report the abuse regardless of whether or not it was a single event or frequent occurrence. In addition, if a minor is reporting an incident or physical injury involving an object on bare skin, a report should be made.
Answer C: Again, child abuse is reported when it is reported by a minor or if there is a risk of this abuse is occurring now. Although the adult patient may decide to report this incident, the psychologist is not obligated to report the abuse. Moreover, it may not be clinically indicated for the psychologist to encourage the client to report their history of child abuse.
A child client informs their psychologist that their mother slapped them in the face after they made a racist comment at the dinner table. The client reports that this is the first time something like this has happened. Is this considered child abuse?
Select one:
A.
Yes, this is considered child abuse.
B.
Yes, this is considered child abuse if the incident left a bruise or mark on their face.
C.
No, if the child is at least 16 years old.
D.
No, a parent is permitted to discipline their child.
The correct answer is B.
Per the California Laws and Regulations, Section 11165.6 Child Abuse or Neglect, “child abuse or neglect includes physical injury or death inflicted by other than accidental means upon a child by another person.” In California, parents are permitted to discipline children with corporal punishment, including spanking; however, this discipline should not include “willful cruelty, unjustifiable or unreasonable punishment, or unlawful corporal punishment or injury. Generally speaking, a child abuse report should be made if the physical insurance is associated with a bruise or mark on the child. Or, if the discipline involves using an object on bare skin (belt buckle on bare skin) or hitting with a closed fist. In this situation, this would be considered child abuse if the incident left a mark or bruise on the child’s face.
Answer A: Given the information provided, it is difficult to determine whether or not this would be considered child abuse or a physical injury. Thus, more information, such as whether or not the incident left a mark or bruise is needed.
Answer C: Per California Laws and Regulations, Section 11165, “child means a person under the age of 18 years.” Thus, a child abuse report could be made for a 16 or 17-year-old.
Answer D: Again, reasonable parental discipline is allowed and slapping a child for using a racial slur may not constitute as child abuse, unless there was a physical injury. Thus, as Answer B indicates a physical injury, this is the best option.
A psychologist who is licensed in California would like to start temporarily treating a patient via telehealth. The psychologist:
Select one:
A.
should obtain verbal or written consent from the patient for use of telehealth prior to delivering these services.
B.
can only obtain written consent from the patient for use of telehealth prior to delivering these services.
C.
does not need to obtain any additional consent forms for telehealth.
D.
should ensure that their telehealth is fully HIPAA-compliant if they are providing services during the coronavirus pandemic.
The correct answer is A.
Per California law, psychologists should obtain verbal or written consent before delivering telehealth or telemedicine services to a patient.
Answers B & C: Psychologists should obtain written OR verbal consent, and make sure that the consent is documented. This is the case regardless of whether or not the services are temporary.
Answer D: In April 2020, a good faith provision of telehealth services during the COVID-19 public health emergency was issued. Per a California executive order, “if you are a covered health care provider subject to HIPAA, your delivery of psychological services via telehealth is not required to be HIPAA compliant, but must be consistent with the notification, and you must give due consideration to the measures encouraged by the notification to safeguard patient privacy.” The order further states that psychologists can use many popular applications, such as Apple Facetime, Facebook Messenger video chat, Google Hangouts, Zoom, and Skype, though they should notify their patients that these third-party applications may introduce privacy risks.
The Board of Psychology (BOP) recognizes a spectrum of actions that are available when dealing with consumer complaints against licensed psychologists. Which of the following is considered a non-disciplinary and public procedure taken by the BOP to address minor violations?
Select one:
A.
Citation and Fine
B.
Order of Abatement
C.
Educational Letter
D.
Probation
The correct answer is A.
Citations and fines are considered a “non-disciplinary” action taken by the BOP to address minor violations, such as false advertising or misrepresentation. They are public record and thus are not kept confidential.
Answer B: Orders of abatement are actually included in all citation and fine cases and specifically requires the cessation of certain activities or behaviors. An order of abatement may follow an educational letter or letter of warning (see below) if the individuals fail to heed the warning.
Answer C: An educational letter or a letter of warning is also considered a non-disciplinary procedure taken by the BOP to address a minor infraction. This letter is kept confidential and is used to educate a licensee of the requirements of the law to avoid future violations or possible disciplinary action.
Answer D: A licensee is placed on probation after they received a formal statement of charges. Probation is considered a disciplinary action taken by the BOP and is public information. More information regarding BOP administrative actions can be found here: https://www.psychology.ca.gov/consumers/spectrum.shtml
Is a psychologist who works in a private practice considered a HIPAA covered entity?
Select one:
A.
Yes, if they are licensed in the state of California.
Incorrect
B.
Yes, all mental health practitioners are required to follow HIPAA.
C.
No, if they do not accept insurance and do not bill electronically.
D.
No, if they do accept third party reimbursement.
The correct answer is C.
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that was signed into effect in 1996. The HIPAA rules are complex and apply to covered entities and business associates. HIPAA covered entities include health plans and certain health care providers. Specifically, health care providers, such as doctors and psychologists, are considered HIPAA covered entities if they transmit any health information in electronic form in connection with a transaction.
Answers A & B: While extremely rare, not every licensed psychologist or mental health practitioner is subject to HIPAA. For example, a psychologist who does not accept insurance or bill electronically is not considered a HIPAA covered entity.
Answer D: Even if a psychologist does not accept third-party reimbursement, they may bill their clients electronically, which would make them a HIPAA covered entity.
As part of an Employee Assistance Program (EAP), a psychologist is providing therapy services to an employee at the expense of the employer. The employer asks the psychologist if their employee, Mark, attended therapy sessions within the past month. Can the psychologist release this information?
Select one:
A.
Yes, the psychologist can release the employees diagnosis(es) and session attendance for billing purposes.
B.
Yes, if Mark is participating in mandatory counseling due to disciplinary problems.
C.
Yes, the psychologist can release information on the employees diagnoses, session attendance, and functional limitations that may impact their ability to perform at work.
D.
No, the psychologist cannot release any information regarding the employee without a signed authorization form.
The correct answer is B.
Confidentiality is the hallmark of an EAP to ensure its success. However, if the employee agrees to participate in counseling as part of disciplinary action or is referred to therapy by their employer, the psychologist can disclose the number of sessions attended to their employer.
Answers A, C, & D: Generally speaking, the psychologist cannot disclose any information related to the employees identity, diagnosis, or treatment plan without a signed authorization form. Exceptions to confidentiality arise when there is an employee who is participating in mandatory counseling sessions as part of disciplinary action, if there is a suspicion of child or elder abuse, and during safety emergencies.
A child client recently started therapy to address symptoms of depression. During a therapy session, the client discloses that their symptoms started after they were raped a few weeks ago. Can the psychologist share this information with the client’s parents without the client’s consent?
Select one:
A.
Yes, if the client requires medical care.
B.
Yes, a health care provider is permitted to inform a minors parent or guardian without the minors consent if the minor alleges that they were raped.
C.
Yes, if the client is younger than 12 years of age.
D.
No, this information can only be released with the client’s consent.
The correct answer is C.
If a child is younger than 12 years old and reports that they have been raped, the psychologist must attempt to contact the child’s parents or guardian. The psychologist should record the date and time of the attempt and whether the attempt was successful or not.
Answer A: A minor of any age that reports that they have been raped can consent to medical care related to diagnosis, treatment, and collection of evidence.
Answer B: If the client is 12 years or older, the psychologist should keep this information confidential and they are not permitted to release this information without the minor’s consent. Thus, health care providers can only release this information if the child is younger than 12 years old.
Answer D: Again, if the client is 12 years or older, the psychologist can only release this information with the minor’s consent.
A psychologist’s treatment records are subpoenaed after their client’s death. The psychologist should:
Select one:
A.
refuse to release the records, as psychotherapist-patient privilege survives the death of a patient.
B.
offer to provide a treatment summary.
C.
release the treatment records if they are needed for a legal proceeding.
D.
release the records if the personal representative of the deceased is authorizing the release.
The correct answer is D.
Per California Laws and Regulations Code 56.11, “an authorization for the release of medical information by a provider of health care, health care service plan, pharmaceutical company, or contractor shall be valid if it is signed and dated by one of the following (4) the beneficiary or personal representative of a deceased patient.” Thus, the holder of privilege is the personal representative of the deceased, which is generally the executor or administrator of the estate. This person can waive or assert privilege on behalf of the deceased patient. Generally speaking, if the treatment records of a deceased client are requested, the psychologist should assert privilege and resist disclosure of the records until the holder of privilege gives them direction. For answer D, the personal representative of the deceased is requesting the records and thus the psychologist should follow their wishes and release the records.
Answer A: While the psychologist should take care in protecting their clients confidentiality following their death, the treatment records can be released if requested by the personal representative of the deceased.
Answer B: The psychologist could offer to provide a treatment summary; however, this does not get at the underlying issue of who holds the privilege following a clients death and thus is not the best answer available.
Answer C: However, treatment records are commonly subpoenaed for legal proceedings and psychologists should follow the proper channels (check-in with the holder of privilege) before releasing any records. Of note, if the treatment records are being requested via a court order, the psychologist should release the records and follow the court order.
A client is participating in court-ordered therapy. A few sessions into this treatment, the court requests information regarding the clients progress. Can the psychologist release this information to the court?
Select one:
A.
Yes, the court has a right to the information and there is no confidentiality.
B.
Yes, though the psychologist should only release the minimum amount of information necessary to answer the questions from the court.
C.
Yes, though only information on the client’s diagnosis and session attendance can be released.
D.
No, the psychologist cannot release any information to the court without a signed release from the client.
The correct answer is D.
In court-ordered therapy, the client hires the psychologist. Therefore, the client has a right to confidentiality and information can only be provided to the court if they have a signed authorization form from the client. Ideally, the psychologist should clarify the nature of the court-ordered treatment and the information that the court may need or request at the onset of treatment. Nevertheless, the psychologist can only release information to the court if the client signs a release form.
Answers A, B & C: Again, for court-ordered therapy, the client hires the psychologist. Therefore, the client is the client and has a right to confidentiality. Of note, for court-ordered evaluations, the client is the court and thus there is no confidentiality.
A psychologist is starting therapy with a new patient. While they obtained verbal informed consent, they forgot to have the patient sign an informed consent form. How should the psychologist proceed?
Select one:
A.
The psychologist can proceed with treatment and should document that they obtained verbal consent.
B.
The psychologist can proceed with treatment if they document that they will obtain written consent at the next available opportunity.
C.
The psychologist should email the patient the consent form and ask them to sign and return the form within 24 hours.
D.
The psychologist should not proceed with treatment until they obtain both verbal and written informed consent.
The correct answer is A.
Per the APA Ethics Code, section 3.10 Informed Consent, when psychologists provide therapy, they should “obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or persons[and psychologists should] appropriately document written or oral consent, permission, and assent.” In other words, while it is considered standard practice to secure verbal and written informed consent, the APA ethics code only requires that informed consent is provided and documented. Thus, the psychologist can proceed with treatment with verbal informed consent and should document this in their notes.
Answers B, C, & D: Although the psychologist may want to obtain written consent, it is not necessary to proceed with treatment.
A patient reports that they were involved in a drunk driving accident five years ago that resulted in the death of a middle-aged woman. They further disclose to their psychologist that they fled the scene of the crime and that the case is likely still open. The psychologist should:
Select one:
A.
report the crime to the authorities, as this is the protocol for open criminal cases.
B.
keep this confidential.
C.
report the crime to the authorities, as it occurred within the past seven years.
D.
report the crime to the authorities, as this will ultimately help the patient move forward.
The correct answer is B.
Generally speaking, all communication between a psychologist and their patient is kept confidential. Thus, if a patient discloses that they have committed a crime, including homicide, this is kept confidential. Of note, there are exceptions to confidentiality, such as if a patient makes a serious threat of future violence to a person or if a patient reports that they are abusing a child, elder, or dependent adult.
Answer A: Regardless of whether or not the case is open or closed, this information is kept confidential.
Answer C: Similarly, there is no time limit for when a case should or shouldn’t be reported to the authorities and this information should be kept confidential.
Answer D: The psychologist should not break confidentially by reporting this crime to the authorities, despite whether or not they think it would help their patients overall treatment.
On three separate occasions, a patient makes sexual advances towards their psychologist. During a recent session, the patient puts his hand on the psychologist’s thigh and laughs after she stands up and moves away. He then tells the psychologist that he always gets what he wants. The psychologist should ____________________.
Select one:
A.
discuss the pamphlet Professional Therapy Never Includes Sex during their next session
B.
discuss how the patients behavior manifests in other relationships during their next session
C.
start the process of pretermination counseling during their next session
D.
terminate the therapy prior to their next session
The correct answer is D.
Per the APA Ethics Code, Section 10.10 Terminating Therapy, “psychologists may terminate therapy when threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship.” As the psychologist is feeling “highly uncomfortable” and likely threatened, they are fully within their rights to terminate the therapy. Of note, the psychologist could break confidentiality and seek a protective order against a client/patient if they suspect that they will threaten or harm them.
Answer A: When a psychologist becomes aware through a patient that they had a sexual relationship with a psychologist during the course of treatment, they should review this pamphlet with their patient. Although the psychologist could review this pamphlet with their patient, this answer does not address the underlying issue of the psychologist’s safety.
Answer B: It would be helpful to address this behavior with the client. However, the behaviors described in the vignette make it difficult to continue with the treatment.
Answer C: Per the APA Ethics Code, “except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists should provide pretermination counseling and suggest alternative services providers as appropriate.” Thus, while psychologists are encouraged to provide pretermination counseling, this is not required by the ethics code and depends on the specific circumstances. As it is likely that this behavior will continue in a future session and possibly even escalate, the psychologist should terminate the therapy and provide appropriate referrals.
During a group therapy session, a client takes out her phone, takes a picture with the group members, and says that she is going to post the photo to her social media account. The psychologist leading the group should:
Select one:
A.
ignore this behavior and praise the client when she is participating in the group discussion.
B.
refer to the group rules which states that the group members will maintain confidentiality and discuss that posting the photo on social media violates this rule
C.
tell the clients that they have legal and ethical responsibility to maintain the confidentiality of the group members and should therefore delete the photo
D.
ask the client to obtain permission from the group members before posting the photo on social media
The correct answer is B.
At the onset of group therapy, psychologists should discuss the unique roles and responsibilities of both the psychologist and the group members. Specifically, the psychologist should discuss their obligation to maintain confidentiality and the limits of confidentiality. Also, the psychologist should clarify that while the clients or group members are not legally or professionally obligated to maintain confidentiality, they can request that all group members maintain confidentiality. Thus, the psychologist should refer to the group rules, which states that the group members will maintain confidentiality, and discuss how posting the photo would violate this rule.
Answer A: Although positive reinforcement can be helpful to decrease disruptive behaviors, this answer does not get at the underlying issue of confidentiality.
Answer C: While the group members should be encouraged to maintain confidentiality, they are not bound by a professional code and do not have a legal obligation to maintain confidentiality.
Answer D: While this is a reasonable request, the other group members may feel pressured into giving their permission to post the photo. Thus, the psychologist should indicate that this behavior would violate the group rules. Ideally, the psychologist should also create group rules regarding social media use so that they can refer to these policies when issues arise.
