Legal and Ethical Standards Flashcards

Question

Dr. Ambrose Alvarez has been licensed as a psychologist in Canada for 10 years and has applied for licensure in California. He may provide psychological services in California for a period not to exceed _____ calendar days from the time he submitted his application or from the beginning of his residence in California, whichever occurred first. A. 45 B. 90 C. 120 D. 180

Answer 1

The client or other person has informed the psychologist that a report has already been filed with the appropriate authorities _NOTE:_ Psychologists are NOT required to file a report of elder or dependent adult abuse when _all_ of the following conditions are met: 1. the psychotherapist has been told by an elder or dependent adult that he has experienced behavior constituting physical abuse, abandonment, abduction, isolation, financial abuse, or neglect 2. the psychotherapist is not aware of any independent evidence that corroborates the statement that the abuse has occurred 3. the elder or dependent adult has been **diagnosed with a mental illness of dementia** 4. the elder or dependent adult is the subject of a **court-ordered conservatorship** because of a mental illness or dementia 5. in the exercise of clinical judgment, the **psychotherapist reasonably believes that the abuse did not occur**

Answer 2

Give the summary of Sam's records to his mother _NOTE:_ * You **CANNOT DENY TX RECORDS** (_copy or summary_) just because the parent who requests the records _does not have legal custody_ * **HOWEVER**, _with regards to treatment consent_ for a minor when you bring the minor in, **one of the parents MUST HAVE LEGAL CUSTODY**

Answer 3

Can only tell the employee whether the employee is fit-for-duty and describe any relevant functional limitations NOTE: * A fitness-for-duty evaluation is conducted at the request of an employer or supervisor to determine if psychological or psychiatric factors will interfere with a current employee's ability to perform essential job functions. * The employee is ordinarily asked to sign an authorization for release of information or waiver form prior to the evaluation * However, even when the employee refuses to do so, the employer has the right to limited information about the results of the evaluation * EX: if the employee is able to perform essential job functions, whether any functional limitations will affect the employee's ability to perform his/her job duties, and whether any accommodations are needed to help the employee perfom his or her job duties

Answer 4

Civil and criminal liability when a report is made within or outside of their professional capacity

Answer 5

14 _NOTE:_ * Postcertification holds may follow the initial 14-day hold, with the type of hold depending on the individual's circumstances * When a postcertification hold is being requested due to **continued risk for suicide, the hold cannot exceed 14 days**

Answer 6

The modification eliminated the requirement for direct treatment providers to obtain a written consent prior to disclosing PHI for treatment, payment, or health care operations.

Answer 7

10 _NOTE:_ * If the health care provider chooses to prepare a summary of the record rather than allowing access to the entire record**, he or she shall make the summary of the record available to the patient within 10 working days from the date of the patient's request.** * If more time is needed because the record is of extraordinary length or because the patient was discharged from a licensed health facility within the _last 10 days, the health care provider shall notify the patient of this fact_ and the date that the summary will be completed, but **in no case shall _more than 30 days_ lapse between the request by the patient and the delivery of the summary** * While _California law allows health care providers to provide summaries to clients_ rather than complete records, **_HIPAA allows this only when the client agrees to this alternative_**

Answer 8

Must comply with the therapist's requests for Kyle's records

Answer 9

3 _NOTE:_ * For licenses that have been revoked, the BOP states that the individual must wait three years before petitioning the BOP for reinstatment of licensure

Answer 10

$1,000 _NOTE:_ * Unless a licensed psychologist can demonstrate good cause for failing to release client records tothe BOP as requested, he/she is subject to a $1,000 fine for each day the records are not produced after the 15th day following the receipt of the request

Answer 11

Except when the therapist determines, after consulting with the minor, that their involvement would be inappropriate

Answer 12

Send her a summary of the child's records _NOTE:_ * For parents who are divorced, access to records and inforation pertaining to a minor child, including but not limited to, **medical, dental**, and **school records**, **_shall not be denied_** to a parent because such a parent is _not the child's custodial parent_

Answer 13

Refer her to another therapist who is qualified to treat your client for this disorder _NOTE:_ * Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their compentene, based on their education, training, supervised experience, consultation, study, or professional experience. * Because you have **_no training_** in treating clients wit DID, _a referral is indicated_

Answer 14

Emotional abuse

Answer 15

6 _NOTE:_ Primary supervisors who are licensed by the board shall complete a minimum of (6) hors of supervision coursework every two years

Answer 16

With authorization from the patient or the approval of an Institutional Review Board or Privacy Board NOTE: * The requirements of **HIPAA's Privacy Rule** and **California Civil Code** section are _inconsistent_ with regard to the release of information for _research purposes_ * **HIPAA pre-empts California law because they are more stringent** (i.e. they provide the client with greater privacy protection) * According to HIPAA Privacy rule, a pt's PHI can be released without authorization from the patient for research purposes when: * approval to do so has been granted by an **Institutional Review Board** or **Privacy Board** * the **patient is deceased** * a **limited data set that excludes direct identifiers** is provided under a date use agreement between the health provider and researcher

Answer 17

Covered from both civil and criminal liability _NOTE:_ * Mandated reporters have immunity from criminal and civil liability for any report required or authorized under the Child abuse reporting law * This **immunity applies** even though the knowledge or reasonable suspicion of abuse was acquired **outside his or her professional capacity or outside the scope of his or her employment** * If a _mandated reporter is sued for making a report_, he or _she may be able to receive compensation for legal fees incurred_ in defending against the action

Answer 18

You must make a child abuse report to the county welfare department or other designated authority _NOTE:_ * Bobby's injuries suggest that he is being physically abused by the other student and **_psychologists must make a report of child abuse when, in their professional capacity,_ they know or reasonably suspect that a child has been the victim of abuse** * Mandated reported are not required to report injury resulting from "mutual affray between minors." However, the information provided in this question indicates that Bobby's injuries are NOT the result of mutual fights between him and other other student by that the other student is always the aggressor

Answer 19

Give the EMT information related to the emergency _NOTE:_ * It is unecessary to obtain an authorization when PHI or psychotherapy notes must be disclosed to avert a serious threat to health or safety of the client or other person

Answer 20

15; 10 _NOTE:_ Requirements for continuing education states that one **3-unit _academic_ quarter** course is equivalent to **10 hours of CE credit** and that **one 3-unit _semester_ course** is equivalent to **15 hours of CE credit**

Answer 21

None of the above _NOTE:_ * _California law_ does **NOT permit** a clinical psychologist to provide outpatient mental health services to a child **under the age of 12** **without the consent** of the child's parent or guardian

Answer 22

The supervisor may delegate supervision of the assistant or intern to another licensed psychologist, licensed clinical social worker, licensed marriage and family therapist, or other qualified mental health professional _NOTE:_ **PSYCHOLOGICAL ASSISTANTS :** * **_primary supervisor_** * **must be a licensed psychologist** who is responsible for providing minimum 1 hour (10%) of direct supervision * **_Delegated supervision_** * can be from a ****_q_**ualified licensed psychologists** or **board certified psychiatrists** other than the primary supevisor to whom he/she is registered if the delegated supervisor is **_also employed within the same organization_** **PSYCHOLOGICAL INTERNS**: * **_primary supervisor_** * MUST BE a **licensed psychologist, ** * **_delegated supervisor _** * may be another licensed psychologist, **LCSW, LMFT, or other qualified mental health professional** **REGISTERED PSYCHOLOGIST:** * shall at ALL TIMES by under the primary supervision of a licensed psychologist _REQUIREMENTS FOR SUPERVISORS OF PSYCHOLOGICAL ASSISTANTS & INTERNS:_ * the supervisor must complete **six hours** of supervision coursework **every 2 years** * the supervisor must be employed by the **same facility or agency** as the assistant or intern * the supervisor must provide assistants and interns with supervision for at least **10% of the total time they work each week**

Answer 23

It applies to **_each renewal_** and **_no specific hou_****r** requirement is specified

Answer 24

Appear as requested but claim the privilege

Answer 25

Either parent alone may consent to treatment before treatment begins _NOTE:_ * If the parents have joint legal custody, parents share the right and responsibility to make health care decisions for their child * This means that either parent acting alone may consent to mental health treatment, unless the order of joint legal custody has language to the contrary

Answer 26

A copy of the records within 15 days _NOTE:_ * **HIPAA requires health providers to provide patients with copies of their records (PHI)** when the provider receives a _written request_ for the records and there is _no lawful reason for withholding_ the records * The **15-day requirement** for **providing records** is established by the Health and Safety code section * **HIPAA's requirements with regards to the release of a copy** (_rather than a summary_) of the records _takes precedence over state law_ since HIPAA is more stringent in terms of providing patients with access to their records * The requirement to provide a copy of the records (versus a summary) does NOT apply to psychotherapy notes since **HIPAA does NOT require release of psychotherapy notes to patients;** it permits providing a COPY or SUMMARY of the records

Answer 27

The psychotherapist is appointed by the court to evaluate the defendant at the request of the defendant's attorney so that the attorney can determine the approrpiateness of an insanity plea _NOTE:_ Privilege is NOT waived when a psychotherapist has been appointed by the court to evaluate a defendant at the request of the defendant's attorney to determine the appropriateness of an insanity defense based on the defendant's emotional state PRIVILEGE IS WAIVED IN THE FOLLOWING SITUATIONS: * the services of the **psychologist were sought by the patient** in order to escape detection after committing a crime * the **psychotherapist has been asked by the relative of a patient** **to evaluate the patient** for the purpose of determining the patient's competence * the **patient is suing** the psychotherapist for malpractice

Answer 28

Citation and fine _NOTE:_ * **Nondisciplinary actions are usually confidential** (i.e. not made available to the public) * **An exception is a citation and fine**, which is considered a **nondisciplinary action but is also public information** * Probation is a disciplinary action * Educational review and a letter of warning are both nondisciplinary actions that are not considered a matter of public information

Answer 29

Take precedence over state laws when the state law provides less privacy protection

Answer 30

As long as the advertising does not promote the excessive use of those services

Answer 31

Give advice to the assistant as long as you clarify that you are not creating a therapeutic relationship

Answer 32

Has attempted or threatened suicide _NOTE:_ * At the expiration of the 14 day period of intensive treatment any person, who, as a result of mental disorder or impairment by chronic alcoholism, during the 14 day period or the 72-hour evaluation period, threatened or attempted to take his own life or who was detained for evaluation and treatment because he threatened or attempted to take his own life, may be confined for further intensive treatment pursuant to this article for an additional period not to exceed 14 days

Answer 33

Who should be considered a "family member" _NOTE:_ * California Civil Code Section 43.92 covers a therapist's duty to protect "where the patient has communicated to the psychotherapist a serious threat of physical violence against a reasonably identifiable victims or victims." * Ewing V. Goldstein extended the requirements of this statue to include "immediate family members" * However, it is unclear who is included as a "family member"

Answer 34

Acceptable when it involves providing disaster or community outreach services

Answer 35

HIPAA regulations preempt state laws when the regulations provide the client with greater privacy or control over his/her health information

Answer 36

The court hires you to evaluate a defendant and the purpose of the evaluation is to help the court or the jury determine the defendant's competence to stand trial or state of mind at the time of the crime _NOTE:_ * When the _court hires you to evaluate a defendant_, the **court is your "client,**"and there is **no privilege**. * The purpose of the evaluation is to help the court or the jury determine the defendant's competence to stand trial or state of mind at the time of the crime * As the psychologist, your job is to gather information for the legal proceeding and then share what you learned * Before performing the evaluation as the court-appointed psychologist or disussing any clinical information with the patient, **you must inform the patient that the information he/she discloses to you will be shared in court** * _If you fail to do so, the evalution results CANNOT be submitted in court_ _NOTE:_ * **Exception to privilege does NOT apply when the court orders you to evaluate a defendant** upon the request of the defendant's lawyer in order to provide the lawyer with information needed so that he/she may advise the defendant whether to enter or withdraw a plea based on insanity or to present a defense based on his/her emotional condition * In this situation the purpose of the evaluation is to help the lawyer and defendant plot a legal strategy; privilege is not waived * **This interview is CONFIDENTIAL and you are NOT mandated or permitted to share what you learn with the court,** _you need the patient's permission to do so_

Answer 37

Employed at the same agency as the assistant and be availablle to the assistant 100% of the time he/she is accruing supervised professional experience

Answer 38

Statutory rape has occurred but Dr. Little is not required to file a child abuse report _NOTE:_ * **Statutory rape** (unlawful sexual intercourse) has occurred since **Maggie is under age 18.** * However, _Dr. Little is not required to file a child abuse report_ * because **Maggie is age 16** and the **sexual act was consensual** and noncoercive. * By having "unlawful sexual intercourse" with a child under age 16 when the perpetrator is age 21 year or older is reportable as child abuse

Answer 39

May choose not to encrypt electronically stored or transmitted PHI when it is not reasonable or appropriate to do so NOTE: * HIPAA's Security rules provides regulations related to the creation, storage, and transmission of PHI in any electronic form (e.g., Internet, email, CD, andcomputer drives) and lists several administrative, physical, and technical safeguards forprotecting electronic PHI from unauthorized release * These safeguards are either categorized as either: * "**required implemenation**" specifications * "**addressable implementation specfications**" * "_Required specifications_": * **mandatory** * "_Addressable specifications_" * allow a covered entity flexibility when * (a) it is determined that the specification is not reasonable or appropriate for the covered entity's environment * (b) the covered entity documents why the specification is not reasonable or approrpriate and implements an equivalent alternative measure as approrpriate * Implementing "security measures to reduce risks and vulnerabilities to a reasonable and appropriate level" is a required specification"

Answer 40

Up to 6 months confinement in a county jail; a fine of $1,000 may have license revoked

Answer 41

180 _NOTE:_ * **A psychologist** _certified or licensed in another state or province_ and who has made the application to the board for a license in his state _MAY peform activities and services_ of a psychological nature without a valid license for a period **_not to exceed 180 calendar days_** from the time of submitting his or her application or from the commencement of residency in this state, whichever first occurs

Answer 42

Psychologists should limit the access, disclosure of, and requests for protected health information to the minimum necessary to accomplish the intended purpose

Answer 43

As long as such advertising does not promote the excessive use of those services

Answer 44

10 _NOTE:_ * If the health care provider **chooses to prepare a summary of the record rather than allowing access to the entire record,** he or she shall make the summary of the record available to the client _within 10 working days_ from the date of the patients request * If more time is needed because the record is of extraordinary length, or because the pt was discharged from a licensed health facility within the last 10 days, the health care provider shall notify the patient of this fact and the date that the summary will be completed * BUT in **NO CASE** shall **MORE THAN 30 DAYS elapse** between the request by the patient and the delivery of the summary * While **_California law_** allows health care providers to **provide summaries to clients** rather than complete records, **_HIPAA_ allows this ONLY when the client agrees to the alternative**

Answer 45

7 years after they turn 18

Answer 46

If you are asked to testify about their marital therapy, you should obtain both of their consents _NOTE:_ * Both of clients hold the privilege in this situation * A waiver of privilege by one of the clients does not affect the right of the other client to claim the privilege even when it relates to the same confidential information * **You need to obtain _BOTH_ consents before disclosing any information**

Answer 47

$1,000 _NOTE:_ * Unless a licensed psychologist can demonstrate good cause for failing to release client record to the Board as requested, he/she is subject to a **$1,000 fine** for _each day the records are not produced_ after the **15th day following receipt of the request**

Answer 48

* **NO PRIVILEGE** when the **patient is under 16 y.o.** * EX: The psychotherapist has reason to believe that the patient has been a victim of crime * Psychologist testifies in a court about a 14-year old boy who told her than older teenagers are extorting money from him * **Since the child is under age 16 and the victim of a crime**, there is _an EXCEPTION TO PRIVILEGE_ * The **psychologist may disclose information in court necessary to protect the boy from danger**

Answer 49

1. *_SOMEONE OTHER THAN THE CLIENT IS THE DANGEROUS PARTY_* **duty to protect ONLY applies when the CLIENT is the dangerous party** * EX: Client says coworker threatened to kill a neighbor, psychologist does not need to report, but can encourage client to make a police report or other appropriate action 2. *_SOMEONE OTHER THAN FAMILY MEMBER REPORTS CLIENT THREATENED TO HARM SOMEONE_* * If a **third party who is NOT AN IMMEDIATE FAMILY MEMBER of the client** tells psychologist that client threatened to harm someone, **psychologist doesn't have duty to protect** 3. *_NO REASONABLY IDENTIFIABLE VICTIM(S)_* * Duty to protect covers "reasonably identifiable victims" * This does not mean the psychologist knows the victim's name * If clt seems **generally dangerous, no identifiable victim, no duty to protect,** but _may want to **hospitalize** the patient_ 4. *_CLIENT THREATENS SUICIDE_* * **Bellah v. Greenson:** no duty to protect as defined in Tarasoff decision when a client threatens suicide. * In that case, **Tarasoff covers a third party victim of a psychologist's client, NOT the client him/herself**

Answer 50

Revoke the psychologist's license _NOTE:_ * **NO MINIMUM PENALTY** * When a finding of sexual misconduct occurs, **revocation or surrender** of license/registration and/or **denial of an application for license or registration ** _MUST be the penalty ordered_ * Sexual misconduct includes sexual assault, exploitation and sexual relations with a therapy client or former therapy client within 2 years following termination of therapy

Answer 51

Requesting a habeas corpus hearing _NOTE:_ * Every person detained by certification for intensive treatment shall have a **right to a hearing by writ of habeas corpus** for his or her release after he or she or any person acting onhis or her behalf has made a request for release to either: * the person delivering the copy of the notice of certification to the person certified at the time of the delivery to any member of the treatment staff of the facility providing intensive treatment at any time during the period of intensive treatment pursuant to Section 5250, 5260, 5270 * A **_RIESE HEARING_** is conducted to determine a **person's capacity to consent to psychotropic medication**

Answer 52

The test-taker's anonymity can be maintained _NOTE:_ In most situations, obtaining an informed consent is necessary before administering a psychological test. However, there are (3) exceptions to informed consent: 1. Testing is mandated by law or government regulation 2. Informed consent is implied because testing is routine 3. The purpose of testing is to evaluate competence

Answer 53

1. Testing is mandated by law or government regulation 2. Informed consent is implied because testing is routine 3. The purpose of testing is to evaluate competence

Answer 54

Local ombudsperson or local law enforcement agency _NOTE:_ * The appopriate recipient of a report of elder or dependent adult abuse depends on the type of abuse and where it occurred * For **ALL TYPES OF ABUSE _EXCEPT_ PHYSICAL** ABUSE, when abuse occurred in a "**long-term care facility, except a state mental health hospital or a state developmental center,**" a telephone and a written report shall be made to the **local ombudsperson or the local law enforcement agency**

Answer 55

* similar to Section 5150 but applies to **individuals who are impaired as the result of alcohol or drug use** * a person may be detained for treatment in a facility for **72-hour treatmen**t and evaluation if upon evaluation, the person is found to be in need of treatment because: * **danger to others, self, gravely disabled bc of _chronic alcoholism, narcotic use, use of restricted dangerous drugs_**

Answer 56

A fine up to $5,000 and/or confinment in a county jail for up to 12 months _NOTE:_ * Any **mandated reporter who willfully fails to report abuse or neglect** where t**hat abuse results in death or great bodily injury** shall be punished by not more than **one year in a county jail**, by a fine of not more than **$5,000** or _by both that fine and imprisonment_

Answer 57

* Upon the completion of the _second_ 14-day period the person may be certified for an additional period of **NOT MORE THAN 30 days** of intensive treatment if: 1. Professional staff find the **person remains gravely disabled** as as result of a _mental disorder_ or impairment by _chronic alcoholism_ 2. Person remains **unwilling or unable to accept treatment voluntarily** _NOTE:_ * An individual under this section has the right to a certification review hearing & habeus corpus hearing * If the patient remains gravely disabled at the end of the 30-day hold, they may NOT BE INVOLUNTARILY CONFINED ANY LONGER **_unless a petition for conservatorship has been filed ruing the hold_**

Answer 58

* At the expiration of the initial 14-day hold, a patient who is **_still suicidal, may be confined for an additional 14-days._** * This **hold is _NOT RENEWABLE_** even if the person continues to be suicidal * Can refer person to voluntary treatment, begin process of appointing a conservator

Answer 59

* Any mandated reporter _**who fails to report an incident of known or reasonably suspected** child_ abuse or neglect is: * **GUILTY OF A MISDEMEANOR** * punishable by up to **6 months** of confinement in a **county jail** * or by a fine of **$1,000** * or **BOTH imprisonment & and fine** Failure to report may also lead to CIVIL LIABILITY as well as DISCIPLINARY ACTION by the LICENSING BOARD * Any mandated reported who WILLFULLY FAILS to REPORT ABUSE or NEGLECT, or IMPEDES, INHIBITS a report abuse or neglect where that abuse or neglect **_RESULTS IN DEATH/SERIOUS BODILY INJURY_**: * **1 year in county jail** * **not more than $5,000**

Answer 60

_STATE MENTAL HOSPITAL or STATE DEVELOPMENTAL CENTER:_ * investigator of the State Department of State Hospitals * State Department of Developmental services * local law enforcement agency _LONG-TERM CARE FACILITY (except State mental hospital):_ * local ombudsman * local law enforcement _GENERALLY:_ * Adult Protective Services (APS) * local law enforcement

Answer 61

* ***_Single_* sexual misconduct,** no prior * ***_Multiple*_ sexual misconduct: _*single victim_***, no prior * County jail 6 months * Fine $1,000 _or both_ * _**2 or more *different victims***_*,* prior conviction * **2 or more sexual acts _w/ *single victim*_,** prior conviction * County jail: 1 year * Fine $1,000 _or both_ * _OR_ State prison: 16 months, 2-3 years * Fine $10,000 _or both_

Answer 62

* Professional practice is not necessarily forensic simply because it occurs in a forensic setting * EX: Providing psychological testimony that is solely based on the provision of psychotherapy & does not include psycholegal opinions is NOT ordinarily considered forensic practice * **Offering expert opinion in a legal proceeding represents the practice of forensic psychology**

Answer 63

* In court-mandated psychological services, psychologists inform the individual of: * the **nature of anticipated services** * whether the services are **court-ordered or mandated** * **limits on confidentiality _BEFORE_ proceeding** _NOTE:_ Psychologists are ordinarily asked to inform the court of: * **whether or not a client has attended court-ordered therapy** * provide court with **progress reports** * in _MOST_ circumstances t**he client must have signed a release before the psychologist may do so**

Answer 64

1. _Licensed in another state, **offering** psychological_ _services in CA:_ * May offer psychological services in CA for a period **NOT TO EXCEED 30 days** 2. _Licensed in another state, **applying** for CA_ _ _ _licensure_ * A psychologist certified or licensed in another state or province who has applied to CA licensing board may perform activities & services of a psychological nature **NOT TO EXCEED 180 calendar days** from the _time of submittin_g his or her application OR from the c_ommencement of residency in this state_

Answer 65

* A licensee who renews his or her license for the **1st time** is only required to accrue CEU for the _number of months the license was in effect_, including the month the license was issued * **1.5 hours** of approved CEU per month * CEU earned via **independent learning** shall be no more than: **75% (27 hours)**

Answer 66

* Licensees will earn 1 hour CEU for each hour of approved instruction * One **3 unit** academic **quarter** = **10 hours** of CEU * One **3 unit** academic **semester** = **15 hours** of CEU _NOTE:_ An **approved instructor of a CEU course** may claim the course for his/her own **credit ONLY ONE TIME** that he/she teaches the approved course during a renewal cycle

Answer 67

1. _NONDISCIPLINARY ACTIONS:_ * usually **confidential** (not available to public) * may be imposed for MINOR violation * **failure to communicate a clear tx plan** * **billing misunderstanding** 2. _CONFIDENTIAL NONDISCIPLINARY ACTIONS:_ * letter of warning * educational review * **Citations & fines: only info AVAILABLE TO PUBLIC** 3. _DISCIPLINARY ACTIONS: _ **always public ** * provided to consumers upon request * EX: * **letter of reprimand** * **license probation** * **outstanding tax obligations** * BOP may deny licensure * appears on FTB or BOE's certified list of top 500 tax delinquincies over $100,000 * **license revocation** * **license surrender** * occurs _automatically if incarcerated_ after felony conviction regardless **\*\***Psychologists who have **SURRENDERED** their license or have it **REVOKED** must **_wait THREE YEARS_** before petioning for reinstatement

Answer 68

Can only tell the employer whether the employee is fit-for-duty and describe any relevant functional limitations _NOTE:_ * This evaluation was _requested by the employer_ to determine fitness-for-duty * **Even when the employee refuses to sign** an authorization for release of information, the **_employer has a right to limited information_** about the results of the evaluation, including: * if the employee is **able to perform essential job functions** * whether any **functional limitations** will affect the employee's ability to perform his/her job duties * whether **accommodations** are needed to help the employee perform his/her job duties

Answer 69

A health care provider whohas obtained a signed release from the client

Answer 70

Inform the mother of your duty to report, make a report to the authorities, and refer the girl for a medical evaluation _NOTE:_ Contacting the friend's parents would not be appropriate.

Answer 71

72 hours _NOTE:_ A certification review hearing is not required until the individual has been certified for an additional 14-day hold after the initial 72-hour hold.

Answer 72

The modification eliminated the requirement for direct treatment providers to obtain a written consent prior to disclosing PHI for treatment, payment, or health care operations.

Answer 73

The psychologist should consider the issue of exploitation of the client before making an arrangement for the fee _NOTE:_ * Psychologists may ONLY barter if it is **_not clinically contraindicated_** * The resulting arrangement is **_not exploitative_** **Barter _should be avoided_** when: * it is **likely to impair a psychologist's objectivity** * otherwise **_adversely affect_ the therapist-client relationship** * when it is **not possible to determine the extent to which a bartered service or good is equivalent** in monetary value to the psychologist's fee _Psychologist should consider several factors when contemplating a bartering relationship_ including: * their **theoretical orientation** * the **client's diagnosis** and **dependency needs** * the **expected duration of treatment** * the **nature** of the barter arrangement * When evaluating the potential for exploitation, _the client and the psychologist should both be considered_ * While exploitation for the clients is of greatest concern, the psychologist may also feel exploited if the client does not meet expectations, which may have an adverse impact on the psychologist services provided * Canter et al. (1994) proposes that the exchange of certain services (below) for therapy would be clearly contraindicated because of the potential negative consequences if those services are not performed satisfactorily: * EX: housekeeping or childcare

Answer 74

27 _NOTE:_ * Up to **27 hours** (**75%**) **of CE** **can be accrued through independent learning** * Independent learning refers to "organized and directed learning experiences that occur when the instructor and the student are not in direct visual or auditory contact" * includes instruction delivered via Internet, CD-rom, and corresponding courses

Answer 75

Maintain his confidentiality and refer him to an alcohol treatment program _NOTE:_ * It would be BEST to assess to see if the minister is harming minors and report to CPS if there is abuse, but this is NOT offered * While exposing the children in the youth group to an adult who is under the influence is providing the children with a poor role model, there is not overt abuse reported in this question * **Since assessing for abuse is NOT a choice**, the **_BEST_** course of action is to **maintain confidentiality** and **work with the _client to enter an alcohol treatment program_**. It would be considered negligence if alcohol problems were not addressed

Answer 76

Send the portion of the treatment record that is relevant to Calvin's school behavior _NOTE:_ * Since Calvin's parent have signed a release, you would send requested information to the principal with SOME LIMITATIONS * You would want to send information that is RELEVANT TO CALVIN'S SCHOOL BEHAVIOR

Answer 77

You can get a verbal consent from the mother who is the boy's legal guardian and follow that with a written consent from her _NOTE:_ **LEGAL CUSTODY:** * refers to the **parent's right & responsibility** t**o make decisions** that concern a child's **_physical_**, **_mental health, education, and welfare_** **PHYSICAL CUSTODY:** * refers **_only to living arrangements_** and **_supervision_** of the child * When parents are divorced, but share JOINT LEGAL CUSTODY, EITHER PARENT MAY CONSENT to therapy for their child * **Only a parent with legal custody may consent to a child's treatment** * If the **legal custody of a minor child is disputed** or unclear, a _psychologist should consider the best interests of the child_ and the rights of the parents and _consult an attorney_ and/or _relevant state laws_

Answer 78

Provide the requested test results including the raw test data

Answer 79

Maintain his confidentiality

Answer 80

Revocation or surrender of license

Answer 81

This is unethical and illegal

Answer 82

Give her the pamphlet, Professional therapy NEVER includes sex, and then discuss the pamphlet with her

Answer 83

All of the above

Answer 84

A 15-year client is having consensual sex with her 22 year old boyfriend

Answer 85

File a child abuse report

Answer 86

Not file a child abuse report because this is a consensual sexual relationship

Answer 87

File a child abuse report if the client continues to pose a danger to children

Answer 88

You are mandated to file child abuse report

Answer 89

Report this incident yourself to the appropriate agency

Answer 90

The minor is at least 16

Answer 91

The psychologist should not provide any information to the parents unless the client authorizes its release

Answer 92

File an abuse report because you have reasonable suspicion of isolation

Answer 93

Local law enforcement agency

Answer 94

Discuss the matter with the psychologist

Answer 95

The supervisor and the intern

Answer 96

You telephone the school police department after the session and send a written report the same day _NOTE:_ * You **_DO NOT_** report suspected child abuse to the school's police department in any circumstance * The mandated reporter shall make a report to the agency **immediately** or **as soon as is practically possible by _telephone_** * The mandated reporter shall p**_repare and send a written report thereof within 36 hours_** of receiving the information concerning the incident

Answer 97

A fine up to $5,000 and/or confinement in county jail for up to 12 months

Answer 98

Any significant mental disorder in the current edition of the DSM, though grave disability **_cannot_** be based on **_intellectual disability alone_**

Answer 99

A fine up to $1,000 and/or confinement in county jail for up to 6 months

Answer 100

Imprisonment in a county jail for no more then 6 months, a fine not exceeding $1,000 or both

Answer 101

Citation and fine

Answer 102

3; 12 _NOTE:_ * While California does not have a law governing the retention of records by mental health professionals, many psychologists adhere to the standards provided in the _California Code of Regulations_ (Title 22, Section 70751). * That statute applies to _general acute care hospitals_ _licensed by the Department of Health Services_ and specifies that records should be maintained for a minimum of **_seven years_** **following discharge of the patient**.

Answer 103

$1,000 _NOTE:_ * Unless a licensed psychologist can demonstrate good cause for failing to release client records to the Board as requested, he/she is subject to a **$1,000 fine for each day** _the records are not produced after_ the **15th day** _following receipt of the request._

Answer 104

All of the above _NOTE:_ _Why not Answer A rationale:_ * Unless the provider has determined that it would not be appropriate to contact the minor’s parent or guardian, he/she should attempt to do so * When the attempt is unsuccessful, the provider can provide treatment without the parent’s consent. _Why not Answer B rationale:_ * This issue is addressed in Family Code Section 6926(a). _Why not Answer C rationale:_ * This issue is addressed in Family Code Section 6925. (Note that legal requirements regarding obtaining an abortion without parental consent are provided in Health and Safety Code Section 123450.)

Answer 105

You telephone the school police department after the session and send a written report the same day. _NOTE:_ * You _DO NOT_ make reports of suspected child abuse or neglect to the _SCHOOL'S_ POLICE DEPT or SECURITY DEPARTMENT * Reports of suspected child abuse or neglect shall be made by mandated reporters to: * any **police department** or **sheriff’s department** * **county probation department** **_if designated by the county_** to receive mandated reports * the **county welfare department (CPS, CWS, DFCS in California)** * the mandated reporter shall make a report to the agency immediately or as soon as is practicably possible by telephone * The mandated reporter shall prepare and send a written report thereof within 36 hours of receiving the information concerning the incident

Answer 106

The court hires you to evaluate a defendant and the purpose of the evaluation is to help the court or the jury determine the defendant’s competence to stand trial or state of mind at the time of the crime. _NOTE:_ * When the **court HIRES** (**vs. orders**) you to evaluate a defendant, the court is your "client," and **_there is no privilege_** (E.C. 1017, Court-Appointed Psychotherapist). * The purpose of the evaluation is to help the court or the jury determine the defendant’s competence to stand trial or state of mind at the time of the crime, and your job is to gather information for the legal proceeding and then share what you learned. * Note that before performing an evaluation as a court-appointed psychotherapist or discussing any clinical information with the patient, you must inform the patient that the information he/she discloses to you will be shared in court; if you fail to do so, the evaluation results cannot be submitted in court

Answer 107

Suspend Dr. Fagen's license _NOTE:_ * Given the limited information provided in this question, this is the best response * A **warning letter** or a **fine** is reserved for **_minor infractions_** and would be less likely than suspension to convince Dr. Fagen that he should cooperate with the Board’s request * **Revocation** is ordinarily reserved for **_major infractions_** * (e.g., conviction of a crime substantially related to the practice of psychology).

Answer 108

You should discuss your legal obligations with a knowledgeable colleague or an attorney. _NOTE:_ * Whether you have a duty to warn in this situation is ambiguous * **Your best course of action would be to discuss the situation with a colleague or attorney** to determine the best course of action. * You would also want to **inform Morgan of his duty to inform his girlfriend.** * Permission to inform the spouse or sexual partner of a person who has tested positive for HIV is granted in Health and Safety Code Section 121015. * However, that **this statute applies to physician and surgeons only, not to psychologists.**

Answer 109

Attempt to resolve the conflict but adhere to legal requirements when this is not possible. _NOTE:_ * If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. * If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority. * In other words, psychologists are not required to violate the law in order to fulfill their ethical obligations. * It is **important to determine whether the law or ethical guidelines _provide a higher standard of conduct_** * If it is not clear whether the question is asking about the Ethics code, _you want to look for an answer that is consistent with law because it provides a higher standard in terms of a client's control_ * EX: CA law prohibits witholding of records for an unpaid bill whereas the Ethics code implies psychologists may withhold records for nonpayment of fees except in Emergency situations

Answer 110

27 _NOTE:_ Up to 27 hours of continuing education during each renewal cycle can be accrued through distance learning technologies. Distance learning courses must meet all standards of an approved continuing education course

Answer 111

A fine up to $5,000 and/or confinment in county jail for up to 12 months

Answer 112

Should seek guidance from the court _NOTE:_ * When you perform a _court-ordered evaluation_, the _court would make decisions_ regarding the evaluation * Therefore, **you SHOULD SEEK THE COURT'S GUIDANCE** when you receive a request from the defendant's lawyer

Answer 113

Grave disability due to intellectual disabilities

Answer 114

All of the above

Answer 115

The minor must be mature enough to participate intelligently

Answer 116

A minor may not receive replacement narcotic abuse treatment without the consent of the minor's parent

Answer 117

The therapist may not deny Hannah's parents access to her records under any circumstances if they consented to her treatment _NOTE:_ * A therapist MAY deny parent access to a minor's records even if the parent consented if the therapist determines that such access would have a **detrimental effect on the therapeutic relationship**

Answer 118

local law enforcement agency _NOTE:_ You make the report to the local law enforcement agency because she is staying in a long-term care facility

Answer 119

Not have to take the EPPP but will have to file a complete application, take and pass the CPLEE and pay the appropriate fees _NOTE:_ * When a California-licensed psychologist has been licensed for at least 5 years and has allowed his/her license to expire by not renewing the license for at least 3 years, the psychologist shall NOT be required to take the EPPP or the CPSE * Although the EPPP and the CPSE are waived: * an application must file a complete application * she must meet all the current requirements not addressed above, including payment of any fees * She must take and pass the CPLEE * She must not have been subject to discipline

Answer 120

Evaluate anyway because this circumstance is an exception to privilege (and you have been court-ordered to evaluate)

Answer 121

Suspend or revoke her license _NOTE:_ **Section 821 states that:** "licentiate's failure to comply with the Board's order shall constitute grounds for the supension or revocation of the licentiate's certificate or license."

Answer 122

A patient reports that her neighbor's 17-year old daughter confided in her that she posed naked for a magazine _NOTE:_ * Psychologists are only mandated reporters of child abuse when they learn of child abuse in their "professional capacity." * Learning about child abuse from a third party (e.g., the patient tells the therapist that someone she knows is perpetuating abuse or is the victim of abuse) * A minor posing naked for a magazine constitutes sexual exploitation **_NOT CONSIDERED WITHIN PROFESSIONAL CAPACITY_**: * When a neighbor tells the psychotherapist that the Little League coach molested her eight-year old nephew * At a child's birthday party, the psychotherapist witnesses an adult slapping a child on the face so hard that welts appear **_MAY OR MAY NOT CONSTITUTE CHILD ABUSE_**: * Spanking a child may or may not constitute chil abuse, depending on the circumstances of the spanking and its severity

Answer 123

In all situations, unless the therapist believes access will have a detrimental effect on the therapeutic effect on the therapeutic relationship or the child's physical or emotional well-being _NOTE:_ According to CA law: * a parent or legal guardian _can generally have access_ to a minor's treatment records **_except_:** * **when the minor has lawfully received treatment _without parental consent_** * A minor's assent (*Answer B*) is not required for parental access * A therapist has the _right to refuse to provide the treatment records if_: 1. the therapist believes the **disclosure would be detrimental to the therapeutic relationship** 2. the therapist believes disclosure would be **detrimental to the child's physical or emotional well-being** (*Answer C*) **_According to HIPAA:_** * Providers may deny individual access when the professional has determined that the access requested is "reasonably likely to endanger the life or physical safety of the individual or another person." * When adults want to access their own treatment records, **HIPAA overrides California law** **(**_thus with adults you would have to release records unless there is a threat to life or physical safety_). * **When adults wants to access a minor's treatment records California law overrides HIPAA** (*rules out Answer D*)

Answer 124

Might make a Tarasoff warning and you might hospitalize the patient _NOTE:_ * It is possible for a psychologist to believe that a patient may pose a danger of violence and not be required to make a Tarasoff warning * **For a Tarasoff warning, the patient _must directly communicate_ to the therapist "a _serious threat of physical violence against a reasonably identifiable victim_."** * saying "I am going to take care of the problem once and for all" is not a direct communication of a serious threat of physical violence * This patient may veil her intentions or even deny dangerousness outright, and the therapist may nevertheless believe that she may in fact be a danger. Therefore, it is **possible that a Tarasoff warning would be required** (i.e., **she appears dangerous but _does not make a specific threat_**)

Answer 125

Ethically mandated _NOTE:_ Documental of treatment is _BOTH_ a **legal** and an **ethical** mandate

Answer 126

General neglect This scenario describes general neglect, defined as negligent failure of the caretaker to provide adequate food, clothing, shelter, medical care, or supervision where no physical injury to the child has occurred. _NOTE:_ * An injury need not be sustained in order for reportable abuse to occur * **_SEVERE NEGLECT:_** negligent failure of the caretaker to protect the child from severe malnutrition, or willfully causing or permitting the health of the child to be endangered, including intentional failure to provide adequate food, clothing, shelter or medical care. * Although inadequate supevision has indeed occurred in this scenario, a more specific kind of abuse has occurred and therefore, "general neglect" is the correct response

Answer 127

Maintain confidentiality _NOTE:_ * There is no basis for you to breach confidentiality. * Psychology students, when they are patients, have the same confidentiality rights as everyone else * When an _educational program mandates counseling_, there is _no provision for breaching confidentiality_ * There is also no grounds for terminating therapy * If your strongly negative feelings make it impossible for you to treat this student, then, at best, you should make an appropriate referral

Answer 128

Requires that the primary supervisor and the supervisee prepare and sign an agreement prior to the start of the SPE _NOTE:_ * Effective January 1, 2005, the BOP requires that prior to the start of accrual of SPE the primary supervisor and the supervisee must together prepare and sign the BOP's supervision aggreement * **While the delegated supervisor may be included in the supervision agreement, this is actually _not a legal requirement_** * For example, midway through accruing SPE on internship, the intern may be supervised by a delegated supervisor not included in the original agreement

Answer 129

In all cases, unless precluded by legal or organizational reasons _NOTE:_ * In general practice, a psychologist should always provide information before an evaluation and feedback afterwards and not only when the patient requests feedback * HOWEVER, the Ethics Code recognizes that _there are some situations that preclude such disclosure_: * **assessment for job placement** * **court-ordered assessments** * Feedback can always be tailored in such a manner that it is presented in the best interest of the patient (this is why answer B: "unless it would not be in the best interest of the patient")

Answer 130

Should be breached to the minimum extent necessary _NOTE:_ * When disclosure of confidential information is lawful and ethical * EX: in a mandated reporting situation, confidentiality is frequently breached * The disclosure should always be limited to the information necessary and sufficient to meet the purpose of the disclosure, thus confidentiality must still be considered. * Even if a report is mandated, a patient may consent to the disclosure * EX: the patient calls in an abuse report with the therapist. * For this reason, it is inaccurate to say that confidentiality is always breached

Answer 131

Employer to employee _NOTE:_ * California law is clear that the **relationship between a supervisor and psychological assistant** _must be one of employer to employee_ * By law, **psychological assistants _may not_ be independent contractors**, although some psychological assistantships are unlawfully set up on this basis

Answer 132

Inform your patient that privilege will not be upheld in this situation because she is attempting to use therapy to avoid apprehension _NOTE:_ **PRIVILEGE:** * the patient's right to refuse to disclose and to prevent another from disclosing a confidential communication in a legal proceeding * This scenario presents one exception to privilege. * According to Evidence Code 1018, **_no privilege_ exists if the services of a therapist were sought** or obtained to aid anyone to commit a crime or **_to escape detection_** or apprehension **after commission of a crime** * The **decision about privilege belongs to the judge**, _not to therapists._ We cannot simply tell the police whatever we think is relevant * **Privilege still exists in a Tarasoff situation, although confidential information relevant to the threat may be disclosed** * Commission of a crime in the past is not an exception to confidentiality or privilege

Answer 133

A 10-hour course in aging and long-term care and a 15-hour course in spousal/partner abuse

Answer 134

1. citation & fine 2. mediation 3. educational letter 4. letter of warning 5. educational review

Answer 135

1. letter of reprimand 2. two-step agreement 3. probation 4. suspension 5. surrender of license 6. revocation

Answer 136

1. must be 15 years of age or older 2. must be living apart from the minor's parents or guardian, whether _with or without consent of the parent or guardian_ 3. must be managing his or her own finances, _regardless of the source of the minor's income_

Answer 137

* An **emancipated minor** needs to be _14 years or older,_ _must have_ the parental/guardian’s consent to live apart and their _income cannot come from criminal activity._ * A **self-sufficient minor** needs to be 15 years or older, _does not need_ parental/legal consent to live independently and their _income source does not matter_

Answer 138

1. Marrying legally 2. Enlisting in the military 3. Declaration of emancipation _NOTE:_ Court can declare that a minor is emanicpated The minor must meet several criteria to be declared as emanicipated by the court: 1. must be **14 or older** 2. **living separate** _with the consent_ from his or her parents and/or guardian 3. **managing his or her own finances with income** _not derived from criminal activity_

Answer 139

_**Health practitioners who provide *medical services* (e.g., MD's, RN):**_ * _mandated to report_ when providing *medical services* to a person suffering from a gunshot wound (self or other inflicted) * any wound resulting from assault or abuse **_Providers of mental health services (e.g., psychologists):_** * _Not mandated_ to report assault, _unless the patient gives explicit written consent_ * If a psychologist makes a report without the patient's consent, _serious violation of confidentiality_

Answer 140

Teaching coping strategies to deal with symptoms of high arousal and re-experiencing the trauma NOTE: * The needs of patient vary, but typically they will **initially need psychoeducation** about their symptoms and will **initially need to learn coping skills** to deal with the most problematic sx's (re-experiencing & high arousal). * Not everyone is ready to initially begin processing the trauma, until they feel safe and have reduced their fear of the past * Many patients may not be initially able to face exposure techniques yet, but may be able to later on * Not all patients have family members or need their families to be educated and if so, not always initially

Answer 141

Assessment of current symptoms, daily functioning, and interpersonal functioning _NOTE:_ * A **functional assessment** is a behavioral analysis of _**current** functioning and behavior_ * It makes up only one component of the overall assessment of a patient * A functional assessment would **_NOT_ include:** * **gathering family history** to identify whether MDE runs in the family * **administering psychological tests** * **review of previous** treatment records * **gathering psychosocial history**

Answer 142

A medical evaluation is always important when treatment bipolar I disorder _NOTE:_ * A **medical evaluation is an ESSENTIAL treatment** component for patients with Bipolar I disorder * The vast majority of individual with Bipolar I need to be on some sort of psychotropic medication in their lifetime * therefore _you should NOT just base_ whether individual needs medication on _severity of current symptoms_ * **Medication issues,** such as agreeing to a referral and complying with prescribed medications are an **important aspect of a psychologist's work** * They are not oustide the scope of a psychologist's practice, just prescribing (which is not mentioned here is)

Answer 143

Should you chose to report, you give the name of the colleague, but are prohibited from giving the name of the client _NOTE:_ * The client is public and the public is protected by confidentiality. * **Normally you would report the psychologist, because you witnessed it** (and _what you saw was not told you to you in the context of a confidential patient-therapist relationship_) * **HOWEVER, a psychologist would NOT be able to file a complaint with the BOP if doing so violates confidentiality of the patient which takes precedence over the responsibility to report** the colleague for misconduct * **You would have to report your colleague if the patient is a minor** and you have reasonable suspicion that the therapist is having sex with minor children * Resolving this situation informally is possible, but **a sexual relationship with a client is not appropriate for a formal resolution**

Answer 144

Suicidal intent _NOTE:_ * "Danger to self" specifically refers to suicidal intent and behavior. * **Self-destructive or reckless behavior**, such as prostitution or high-speed auto driving **_would not qualify as "danger to self"_** * The inability to provide for yourself is the definition of "grave disability" * Individuals generally have the right to refuse medical care even if the medical personnel or others might consider the medical treatment necessary

Answer 145

Statutory rape has occurred but a sexual abuse report is not necessarily mandated _NOTE:_ * Any sexual intercourse between an a**dult and a minor _under the age of 18_ is _statutory rape_** * The penal code does NOT require a child abuse report in all instances of statutory rape * A report of child abuse is mandated when sexual intercourse has occurred between a **person 21 years or older** and a partner who is **_under 16_** years of age * If the intercourse was _between the 21 year old and the 16 year old_ and the **sex was consensual** and the **21 year old does not have _evaluative authority_,** and she was **_not coerced_**, a _child abuse report would NOT be required_ * If, however, the intercourse was between a _**21 year old and a 15 year old**, a report WOULD BE mandated regardless of whether it was consensual or not_

Answer 146

Make a report to the Department of Child services _NOTE:_ * This is a situation in which **_a therapist has witnessed child abuse,_** which **requires immediate reporting to the Department of Child services** * Encouraging the family to return to therapy and consult with the Department of child services are insufficient to address the situation * Calling 911 would be excessive under the circumstances, as **911 should only be called in a true emergency (e.g., the father had stabbed the son with a knife)**, _then 911 should be called._

Answer 147

_PSYCHOLOGIST:_ * required to retain for a minimum of **7 years from the patient's discharge date** * If patient a **_minor_**, retained for minimum of **7 years from the date the patient reaches 18 y.o.** (until he/she is 25) _LICENSED OUTPATIENT CLINIC, ACUTE CARE FACILITIES, ADULT DAY HEALTH CARE CTR, HOME HEALTH AGENCIES_ **GENERAL:** * required to retain for a minimum of **7 years from the patient's discharge date** * If patient a **_minor_**, retained for minimum of **7 years from the date the patient reaches 18 y.o**. (until he/she is 25) **_ONLY IF_** LICENSEE AGENCIES (above agencies) **_CEASE OPERATION:_** * required to preserve for a minimum of **7 years** from the patient's **discharge date** * **_unemancipated minor:_** kept **1 year after turning 18, 7 years total** (until he/she is 24)

Answer 148

_CONSULTATION:_ * appropriate when psychologists are **somewhat familiar** with treating a particular disorder, but are **not an expert in the area** * psychologists have **concerns about whether they can remain objective in treating a client** * _no_ power dynamic * _does not have_ to be weekly * consultation can be made with individual _outside of the field_ _SUPERVISION:_ * required when psychologists are **applying a newly learned technique** * required when **beginning to work with a specialized population** the psychologist has _training, but no experience in_ * there _IS power dynamic_ * _supervisor MUST be in the same field_

Answer 149

3; 12 _NOTE: _ * This answer accurately describes the recommended retention period presented in Paragraph 3(a) of the Record Keeping Guidelines * Note that while _California does not have a law governing the retention of records by mental health professionals_, _many psychologists adhere to the standards proved in the California Code of Regulations_ (Title 22, Section 70751). That statute applies to general acute care hospitals licensed by the Department of Health Services and specifies that **records should be maintained for a minimum of _seven years_ following discharge of the patient**.)

Answer 150

36 _NOTE:_ * When it is the psychologist’s first renewal and the initial license was in effect for less than 24 months, you are required to complete **1.5 hours of CEUs per month** including **the same month the license was issued**. * If you take 1.5 X 24 (2 years is 24 months) = 36 * Of the 36 hours, at least **four hours** _must_ address **law and ethics.**

Answer 151

All of the above _NOTE:_ An unemancipated minor **_CAN CONSENT_** to the following: * tx for alcohol or drug related problem * treatment of a sexually transmitted disease or other disease that is required by law to be reported to a local health officer. * tx related to the prevention or treatment of pregnancy (other than an abortion or sterilization) An unemancipated minor **_CANNOT_** consent to: * inpatient mental health treatment * receive psychotropic drugs * convulsive therapy * psychosurgery * replacement narcotic abuse treatment unless the provider has determined that it would not be appropriate to contact the minor’s parent or guardian, he/she should attempt to do so. When the attempt is unsuccessful, the provider can provide treatment without the parent’s consent.

Answer 152

_UNEMANICIPATED MINOR NOT MEDI-CAL:_ * must be mature enough to intelligbly participate * 12 years or older _UNEMANICIPATED MINOR ON MEDI-CAL:_ * _Cannot consent_ to tx if **under the age of 18** * _Cannot consent_ to tx even if mature enough to participate intelligently **_BUT Unemanicipated WITH MEDI-CAL Can consent if:_** * serious or mental harm to self or others without the services * is the alleged victim of incest of child abuse

Answer 153

3 years _ABSENCE OF SPECIFIC LEGAL REQUIREMENTS:_ * **Complete records**: **_minimum of three years_** after the last contact with the client * **Record or a summary**: retained an **_additional 12 years_** * **Minors**, record kept for at least **three years** _after the client reaches the age of majority_ _CALIFORNIA HEALTH & SAFETY CODE SECTION 123145_ * **Minors:** records retained for a minimum of **seven years** and at least **1 year after majority** * This statute _does not,_ however, pertain to psychologists in private practice;

Answer 154

A psychiatrist directly responsible for the patient’s treatment _NOTE:_ * Each person admitted to a facility for 72-hour treatment and evaluation _shall be released before 72 hours have elapsed_ **only if** the psychiatrist believes that the person no longer requires evaluation or treatment. * If any other professional person who is authorized to release the person, believes the person should be released before 72 hours and the psychiatrist directly responsible for the person’s treatment objects, the matter shall be referred to the _medical director of the facility_ for the final decision"

Answer 155

Attempt to resolve the conflict but adhere to legal requirements when this is not possible. _NOTE:_ * If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, _psychologists make known their commitment to the Ethics Code_ and _take steps to resolve the conflict._ * If the conflict is unresolvable via such means, **psychologists may adhere to the requirements of the law, regulations, or other governing legal authority** * In other words, psychologists are not required to violate the law in order to fulfill their ethical obligations

Answer 156

contact the court to determine the appropriate course of action _NOTE:_ Whenever one parent _does **not give consent**_ (or **_withdraws consent_**) for an evaluation in a custody case, the psychologist **should seek guidance from the court** on how to proceed.

Answer 157

Her parents have consented _NOTE:_ * Luz is only 9 years old. If a minor is under the age of 12, a parent’s consent must be obtained * On the other hand, **a minor who is 12 years of age** or older may consent to mental health treatment or counseling on an outpatient basis, or to residential shelter services, if **_both_** of the following **requirements** are satisfied: (1) The minor, in the opinion of the attending professional person, is **mature enough** **to participate** intelligently in the outpatient services or residential shelter services **_AND_** (2) the minor (a) **would present a danger of serious physical or mental harm to self or to others** _without_ the mental health treatment or counseling or residential shelter services or (b) **is** the **alleged victim of incest** or **child abuse** (Family Code 6924).

Answer 158

The best clinical evidence, clinical expertise, and patient characteristics and preferences

Answer 159

Refer Debbie to another child psychologist for the evaluation _NOTE:_ 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

Answer 160

Seek consultation to determine the best course of action and, if you decide to continue seeing Ralph, obtain additional guidance while working with him if needed. _NOTE:_ * Ralph's sexual orientation may be a contributor to his chronic anxiety * **You have been seeing Ralph for eight months**, **_ethically_** you would **_NOT want to abandon him by referring him to another therapist,_** but _you would want to consider the impact of your lack of experience by working with gay clients_ on your ability to provide effective psychological services to him.

Answer 161

Employed at the same agency as the assistant and be available to the assistant 100% of the time he/she is accruing supervised professional experience _NOTE:_ All **_Primary supervisors_** for **_psychological assistants_** must be: * **board certified psychiatrst CAN be a primary supervisor** but can supervise no more than 750 hours maximum of experience out of the 3,000 * complete a minimum of 6 hours of supervision CEU every 2 years * must be **employed by the same agency** * must be **available to 100%** of the time * must provide a minimum of **1 hour of supervision a week** * **supervision must count for at least 10% of total hours** worked by a trainee * **licensed psychologist can only supervise up to 3 psychological assistants at a time** * board certified psychiatrist can only supervise 1 psychological assistant

Answer 162

36 hours _NOTE:_ * For the **INITIAL RENEWAL** of a psychology license a psychologist is only required to accrue continuing education for the _number of months that the license was in effect, including the month the license was issued._ * This would be at the rate of _**1.5 hours of** approved CEU **per month**_ * **_SUBSEQUENT RENEWALS**_ requires that psychologists complete _**36 hours_ of CEU in the _preceding two years_** * **_INDEPENDENT LEARNING_** can be use to meet no more than **_75% (27 hours_)** of CEU in each renewal cycle

Answer 163

offering psychological services from Dec. 10, 2002 to Jan. 20, 2003 _NOTE:_ * According to Business and Professions Code 2912, **a licensed psychologist from _another state_** (_who has not applied for licensure in California_) may offer psychological services in the state of California **for up to 30 days _WITHIN EACH/ 1 CALENDAR YEAR total_** * EX: practice for 29 days in 2015, you can practice for 29 or less in 2016 because it's EACH/ 1 CALENDAR YEAR * From **December 10th -31st** = is **21 days in 1 calendar year** * From **January 1st -20th** = **19 days in a different calendar year** (*which does not count towards the first year*)

Answer 164

Discuss the purpose of the assessment with the client _NOTE:_ Psychologists inform persons with questionable capacity to consent ... about the nature and purpose of the proposed assessment services, using language that is reasonably understandable to the person being assessed

Answer 165

May deny access because you believe disclosure may be psychologically harmful to Valerie. _NOTE:_ * Parents have a right to access their minor child’s records * HOWEVER, this _access is restricted_, however by **3 broad exceptions**. _**Parents CANNOT access** their child’s records if:_ 1. the **minor has access to the records** 2. the release would have a **detrimental effect o**n the provider’s **PROFESSIONAL RELATIONSHIP** with the minor 3. the release would have a **detrimental effect** on the **MINOR'S SAFETY** or **PSYCHOLOGICAL WELL-BEING**

Answer 166

The psychological assistant would bill the client directly _NOTE:_ * A **psychological assistant could get paid by the psychological assistant**, but a supervisor may NOT charge a psychological assistant a fee for being supervised * Psychological assistants can have _no fiduciary interest in their supervisors’ practices _ * **Psychological assistants** are **_NOT allowed to bill patients directly_**

Answer 167

Primary supervisors that are licensed psychologists must have six hours of supervision coursework every two years _NOTE:_ * **Primary supervisors** can be _**EITHER** licensed psychologists_ or, in the case of PSYCHOLOGICAL ASSISTANTS, _board certified psychiatrists_ (who can supervise up to 750 hours of the 3,000 hours towards SPE) * Primary superviors that are l**icensed psychologists** must have **six hours of supervision coursework every two years** * Primary supervisors (including primary supervisors of psychological assistants) do not need any post-licensure experience * **DELEGATED SUPERVISORS** can be _ANY licensed mental health prfessional_

Answer 168

The psychologist may provide psychological services up to 30 days per calendar year _NOTE:_ * A psychologist **licensed in another state**, **U.S. territory, province or in Canada** _may practice_ in California _without a California license_ for no more than **30 days each calendar YEAR** * The 30 days do NOT HAVE TO BE CONSECUTIVE EX: A psychologist licensed in Canada could visit Los Angeles for two weeks twice a year and provide therapy to former patients, do assessments, etc and then leave. * If a psychologist who is **licensed outside of California** has **applied to the BOP for a California license**, the person may _provide psychological services without a California license for up to **180 calendar days total**_ (from either submitting the application or beginning California residency, whichever first occurs)

Answer 169

Submit the appropriate fees and complete 36 CE units prior to having the license activated _NOTE:_ * A psychologist may put his or her license on "inactive status" at any point at which he or she decides not to practice * To change the license status back to active: * the psychologist must **notify the board** * **submit license fees** * submit proof of meeting the **required 36 units** of continuing education credit for **_the 2 year period prior to reactivating the license_** * When the license is on inactive status, a psychologist does not need to earn ongoing CEU's * A psychologist who has been licensed for **at least 5 years in CA** and has _allowed his or her license to **expire**_ must submit the appropriate fees and **take and pass the CPLEE**

Answer 170

She is approved as a psychological assistant by the California Board of psychology _NOTE:_ * A **psychologist with a degree from a foreign country** can work for _another psychologist_ in CA either as a **psychological assistant** _OR_ **once licensed** * Passing the CPSE in and of itself does NOT guarantee licensure * For example, one can pass the CPSE while _still having_ certain **outstanding requirements** for licensure such as **coursework** * California does not have any "agreements of reciprocity" with other states or countries

Answer 171

May result in license revocation and imprisonment in county jail for up to six months, a fine of up to $1,000.000 or both _NOTE:_ * When a psychologist has been **convicted of sexual exploitation**, the BOP will _typically revoke the psychologist's license_ * **A SINGLE ACT** of sexual exploitaion by a psychologist, **OR MULTIPLE ACTS** with a **SINGLE VICTIM** when the offender has **NO PRIOR CONVICTION** for sexual exploitation shall be punishment by imprisonment in _county jail for up to 6 months_, a fine of up to _$1,000.00 or BOTH_ * Sexual exploitation with **TWO OR MORE VICTIMS**, or **TWO OR MORE ACTS with a SINGLE VICTIM** when there **IS A PRIOR CONVICTION** may either result in _COUNTY JAIL for up to 1 year_, a fine up to _$1,000.00 or both_ **_OR_** imprisonment in _STATE prison_ for up to _16 months_, _two years or three years,_ and a fine of up to _$10,000.00 or both_

Answer 172

Wait at least 1 year to petition for modification of probation of less than 3 years _NOTE:_ * When a licensee is placed on probation, the psychology **license is revoked _AND_ the revocation is stayed** * Thus, the _revocation is not actually executed._ * The probationar period, terms and conditions are specified * A person who has been subject to disciplinary action and put on probation may petition for modification of probation after a certain minimum time period has passed * A psychologist who is on probation must wait at least **1 year to petition** for modificationof **_probation of less than 3 years_** * If **_probation is 3 years of more_**, the psychologist must wait at least **2 years to petition** for modification of probation

Answer 173

License suspension _NOTE:_ * While a psychologist is **incarcerated for a felony,** the **_license is suspended_** * Once the psychologist is _released, the license may be reactivated_, *_depending on the felony committed_* * The BOP may also elect to pursue action against the psychologist's license at that time

Answer 174

The board may suspend or revoke the psychologist's license only if the crime is substantially related to the qualifications, functions, or duties of being a psychologist _NOTE:_ * The Business and Professions Code states that the BOP **may suspend or revoke a license** when the licensee has been convicted of a crime **ONLY IF the crime is _substantially related to the qualifications, functions, or duties of the psychologist_** * There is **NO REQUIREMENT** that the BOP must first offer terms and conditions of probation

Answer 175

In violation of the law _NOTE:_ * In order to provide telehealth services, the therapist **MUST BE LICENSED** _**in the state** in which the patient resides_ * Thus, a NY based psychologist providing therapy by phone to a patient in CA must be licensed in CA. * Therefore, this psychologist is in violation of the law When the psychologist is **_IN PHYSICALLY IN CALIFORNIA_** and is **_LICENSED IN CA_**, **_NOT OUTSIDE OF CA_**, provides therapy to a patient who lives in CA, the psychologist is: * not in violation as long as the telehealth sessions are lmited to 30 days per calendar year * not in violation as long as the psychologist has applied for licensure in California

Answer 176

The patient remains a danger to self _NOTE:_ * Although everyone who meets criteria for involuntary hospitalization is eligible for a 72-hour hold and the additional 14-day certification hold, the _duration of the post-certification hold VARIES based on the REASON FOR HOSPITALIZATION_ **_Suicide/danger to self:_** * pt can be held for **additional 14 days** **_Grave disability:_** * after second 14 day hold, the third post-certification hold is **30 days** **_Homicidal:_** * after second 14 day hold, third hod is **180 days**

Answer 177

Notify his parents and assess the situation further _NOTE:_ A Tarasoff duty exists when _3 conditions are met_: 1. **patient** has **communicated to** the **_psychotherapist_:** 2. a **serious** and **imminent threat of physical violence** 3. against a **reasonably identifiable victim or victims** * This is NOT a Tarasoff situation because your patient has only stated that he "feels like" killing his ex-gf * This statment does not express the imminent intent that would be necessary to make a Tarasoff report * Therefore, it would be premature to contact the intended victim and the authorities or hospitalize your patient before assessing the situation further * Given the potential seriousness of the situation, it might also be important to inform the parents, but not before assessing him further to clarify what he means

Answer 178

May be held civilly liable _NOTE:_ * This pt has communicated an imminent threat of violence against his boss, therefore this is a Tarasoff situation and requires a report both to the intended victim and law enforcement * **TARASOFF is a CIVIL STATUTE** and _failure to comply with a civil statue_ will result in the **_psychologist being civilly liable_**, rather than criminally liable

Answer 179

Make a Tarasoff report _NOTE:_ A Tarasoff duty clearly exists when 3 conditions are met: 1. whether the patient has communicated to the psychotherapist: 2. a serious and imminent threat of physical violence 3. against a reasonably identifiable victim or victims * In the EWING decision (2004), the judge declared that **communication from an immediate family member constitutes a "*_patient communication_***" * The scenario described clearly meets the Tarasoff/Ewin requirements, so the therapist should immediatey make a Tarasoff reort rather than assessing futher or seeking consultation * While it may be acceptable to have the mother contact the police, this should ONLY be considered in addition to the therapist's Tarasoff duty

Answer 180

You should call the police and school officials NOTE: A Tarasoff duty clearly exists when 3 conditions are met: 1. whether the patient has communicated to the psychotherapist: 2. a serious and imminent threat of physical violence 3. against a reasonably identifiable victim or victims * Your pt has communicated to you a _plan to shoot other members of his varsity basketball team_, which **constitutes a Tarasoff situation** * In this case, _further assessment before reporting is unwarranted_. * The Tarasoff duty requires that the therapist must **contact both the law enforcement and the intended victims** * To meet this obligation, the therapist would need to notify the police and contact school officials because they are the ones who can identify the varsity team members by name and warn them accordingly * While it is also important to discuss the boy's plans with his parents, the other responses have left out the important step of notifying the police and the school officials

Answer 181

Report sexual abuse _NOTE:_ * A **child abuse is mandated** _whenever a psychologist learns about child abuse in his or her professional capacity_ * This includes a patient informing the therapist about abuse taking place by a **third party** or a **third party informing the therpist of a pt's abuse** * This is a case of sexual abuse because your patient who is **under 16 i**s **having sex** with a partner **21 years or older**. (_doesn't matter if consensual or not_) * If your patient was **16 or older,** _a report would not be mandated._ * If your **15-year-old** patient's sexual **partner was under 21,** a _report would also not be mandated_ If you

Answer 182

You should make a child abuse report _NOTE:_ * **ANYTIME** a **_minor_** engages in sex that is **NON-CONSENSUAL** (e.g., **rape**), a **_child abuse report is mandated_** * _The age of the perpetrator is irrelevant_ when the sexual act was nonconsensual * Age guidelines for consensual relationships between minors do not apply * Once it is established that the sexual contact was non-consensual, this constitutes a reasonable suspicion of child abuse and no further investigation is required

Answer 183

Child abuse includes death inflicted by other than accidental means upon a child by another person _NOTE:_ * According to the California Penal Code, child abuse is defined as physical injury (including death) that is inflicted by other than accidental means on a child by another person * In cases of serious emotional damage, a mandated reporter MAY report child abuse; reporting is optional * Any person who fails to report an instance of child abuse which he or she knows to exist or should reasonably know to exist, is guilty of a misdemeanor, punishable by a county jail term not to exceed 6 months or a fine or not more than $1,000.00 or both * Any mandated reporter who willfully fails to report abuse or neglect, or who impedes or inhibits a report of abuse or neglect where the abuse or neglect _results in death or bodily injury_ shall be punished by a county jail term not to exceed one year, a fine of not more than $5,000.00 or both

Answer 184

A physician may disclose HIV+ status information to a patient only after the physician has attempted to secure the patient's consent _NOTE:_ * **MENTAL HEALTH PROVIDERS** may _N**EVER BREACH CONFIDENTIALITY** of a patient who is HIV+._ * **PHYSICIANS and SURGEONS** _are permitted_, _but not mandated_ to notify partners of HIV+ patients that they have been exposed to the HIV virus **only after they have attempted to secure the patient's consent** * If the patient refuses at this point, the physician may make the decision to notify the patients partner * Disclosing the HIV+ status to a partner may be due to the physician trying to prevent the transmission of the HIV virus and/or because the HIV+ partner has communicated deliberate intent to expose their partner, BUT THEY DO NOT OUTLINE THE PROPER CIRCUMSTANCES (attempting to secure consent) under which such disclosures may be made

Answer 185

call CPS and not report the therapist to the BOP _NOTE:_ * When an adult in treatment reports a history of abuse as a child, there is no mandate to report the previous abuse * However, the therapist must determine whether there are children currently at risk (e.g., whether the perpetrator of the abuse currently has access to children) * If there is reasonable suspicion that abuse is currently occurring, the thearpist is mandated to make a report to the police or to the County Welfare Agency (e.g., CPS) * As there is NO SUSPICION TO THE CONTRARY (e.g., the vignette does not state that the prior therapist is deceased), the therapist who molested the patient as an adolescent, most likely continues to sees children and adolescents, and may be committing sexual abuse, therefore you would report to CPS * Even though the _psychologist's behavior was clearly illegal and unethical,_ **you are _NEVER permitted to breach patient confidentiality_ by making a report to the BOP** * Therefore, you should make a report to CPS, but not to the BOP

Answer 186

Comply with the subpoena _NOTE:_ * When a psychologist receives a subpoena from an attorney: * the **psychologist must generally comply with the subpoena** * _AND_ **appear** at the requested tme and place (with any documents requested) * Alternatively, the _psychologist may request that the subpoena be modified, or quashed/undone_ (but this was not a choice given in this question) * A therapist will typically be subpoenaed to appear either at a deposition or court; in both situations the therapist may assert privilege if that is what the client wishes, **BUT asserting privilege is NOT ALWAYS what a psychologist will do**, as there are times when a client will want the psychologist to disclose the information (ruling out the first response) * In court, the therapist will either be allowed to uphold confidentiality (if that is what the client wishes), or will be required to disclose confidential information when ordered to do so by the court (the judge) * **A subpoena can NEVER BE IGNORED** * A therapist's basis for responding to the subpoena _CAN NEVER_ be based on _whether or not the client authorizes the therapist to respond_

Answer 187

Proceed with the evaluation _NOTE:_ * When an _evaluation is court-ordered_, **consent is NOT REQUIRED** * However, the **psychologist must inform the patient of the limits of confidentiality** * Assuming the psychologist is famiiar with the legal guidelines for court-ordered evaluations, there is no need to seek consultation * There is no need to speak with the boy's attorney * **The psychologist would also probably notify the court of the parent's refusal to consent**

Answer 188

Report the therapist to CPS _NOTE:_ * **Yelling and threatening physical violence constitute a form of child abuse**, specifically "_willful cruelty and unjustifiable emotional suffering_" and **must be reported** regardless of the outcome of treatment * Under the circumstances, **you do not have the otpion of reporting** the previous therapist to the BOP **_because that would be a breach of confidentiality_**

Answer 189

Share information with an employer _NOTE:_ * The psychologist's privacy policy **(HIPAA)** allows the practitioner to disclose PHI for the purposes of: * **treatment** * **payment** * **healthcare operations** (e.g., quality of care review * **For all other disclosures**, (e.g., to an employer, spouse, the court), _a separate patient authorization or relase of information must be obtained_

Legal and Ethical Standards Flashcards

(224 cards)