Midterm Prep

Question 1

What is informed consent?

Answer 1

A document to define boundaries and clarify the nature of the counseling relationship between therapist and client

Question 2

What are the main points included in an informed consent document?

Answer 2

• Purpose of treatment
• Risks and benefits
• Alternatives available
• Voluntary participation
• Confidentiality and limits of confidentiality
• Fees

Question 3

When should the informed consent document be delivered?

Answer 3

As early as feasibly possible, leaving room for discussion

Question 4

What are progress notes?

Answer 4

A means of documenting aspects of a client’s treatment kept in a client’s clinical record

Question 5

What do progress notes typically contain?

Answer 5

• Diagnosis
• Functional status
• Symptoms
• Treatment plan
• Prognosis
• Client progress

Question 6

What are process notes?

Answer 6

Notes that deal with client reactions such as transference and the therapist’s subjective impressions of a client

Question 7

What is a mistake of omission?

Answer 7

An error caused by neglecting or forgetting to do something rather than doing something incorrectly

Question 8

What is a mistake of commission?

Answer 8

An error that occurs when someone takes an action, but it is the wrong action

Question 9

What are some examples of mistakes of omission in online services?

Answer 9

• Failing to obtain clients’ full informed consent
• Limiting clients’ access to personal information on social networking sites
• Failing to comply with HIPAA regarding electronic communications

Question 10

What is the definition of a minor in the context of counseling?

Answer 10

Varies from state to state, typically 18-21; some states authorize 16-year-olds to consent to their own health care in specific circumstances

Question 11

What is necessary for a minor to enter into a counseling relationship in most states?

Answer 11

Informed parental/guardian consent or court order

Question 12

What are some exceptions where parental/guardian consent may not be required?

Answer 12

• Addictions to dangerous drugs
• STIs
• Pregnancy/Birth control
• Examination following sexual assault of a minor over 12 years old

Question 13

What is the duty to warn?

Answer 13

Obligation of a therapist to notify an identifiable potential victim if a client poses a credible threat to their safety

Question 14

What is the duty to protect?

Answer 14

Broader obligation that includes notifying law enforcement and initiating involuntary hospitalization if necessary

Question 15

What landmark case established a therapist’s duty to protect potential victims?

Answer 15

Tarasoff case

Question 16

What does ethical bracketing refer to?

Answer 16

Intentional setting aside of the counselor’s personal values to provide ethical and appropriate counseling

Question 17

What are the 3 Cs in maintaining ethical boundaries?

Answer 17

• Confidentiality
• Consent
• Competence

Question 18

What is HIPAA?

Answer 18

Health Insurance Portability and Accountability Act of 1996, a federal law to protect sensitive patient health information

Question 19

What does the HIPAA Privacy Rule regulate?

Answer 19

The use of Protected Health Information (PHI) and requires safeguards to protect health information

Question 20

What are HIPAA covered entities?

Answer 20

• Healthcare Providers
• Health plans
• Healthcare Clearing Houses

Question 21

What is the legal concept of privileged communication?

Answer 21

Generally bars the disclosure of confidential communications made to a psychotherapist from judicial proceedings

Question 22

What is the counselor’s ethical duty regarding confidentiality?

Answer 22

To protect private client communication

Question 23

What are some limits to confidentiality?

Answer 23

• Suspicion of child abuse
• Suspicion of elder abuse
• Credible and imminent threat to self or others
• Court orders

Question 24

What should therapists do if a client poses a credible threat to themselves or others?

Answer 24

Evaluate and manage suicidal risk, inform clients of limits of confidentiality, and document threats

Question 25

What should be included in the assessment of suicidal behavior?

Answer 25

* Evaluating depression * Suicide ideation * Suicide intention * Risk factors associated with suicide

Question 26

What are some danger signs to watch out for in assessing suicide risk?

Answer 26

* Direct verbal warnings * Previous suicide attempts * Feelings of hopelessness * Access to lethal means

Question 27

What does the term 'values imposition' refer to?

Answer 27

When a counselor attempts to influence a client to adopt their values, attitudes, beliefs, or behaviors

Question 28

What is the purpose of defensive record keeping?

Answer 28

To document sessions and protect the therapist from legal liability

Question 29

What should a therapist do if a client reveals intent to commit suicide?

Answer 29

Mandatory reporting is required if the disclosure of intent, a plan, and the means to carry out the plan are present

Question 30

What should be removed from the home to reduce suicide risk?

Answer 30

Lethal means ## Footnote Work with family members to remove lethal means from the home.

Question 31

What is a key factor that can contribute to suicidal ideation?

Answer 31

Lack of a support system

Question 32

How should counselors assess suicidal ideation?

Answer 32

By asking if the client wants to die or if they want the pain to end

Question 33

What should counselors with limited experience in suicide assessment do?

Answer 33

Seek supervision and/or consultation with experienced professionals

Question 34

What must counselors document regarding suicidal clients?

Answer 34

All assessments, interventions, consultations, and treatment decisions comprehensively

Question 35

What is essential for professional preparedness in suicide prevention?

Answer 35

Ongoing education and training

Question 36

What should a supportive environment for a client include?

Answer 36

A written safety plan with emergency contacts

Question 37

How can counselors manage client risk effectively?

Answer 37

Increase session frequency as needed and secure dangerous items through third parties

Question 38

What role does collaboration play in counseling suicidal clients?

Answer 38

Involves consulting with colleagues and involving family and support networks

Question 39

What should counselors communicate regarding their availability?

Answer 39

Emergency contact procedures

Question 40

What is a key component of a personalized safety plan?

Answer 40

Client lists their reasons for living

Question 41

What may indicate a need for a higher level of care in a safety plan?

Answer 41

Inability to list reasons for living or identify contacts for assistance

Question 42

What is cultural racism?

Answer 42

The belief that one group's history and traditions are superior to others

Question 43

What does social justice work in counseling involve?

Answer 43

Empowerment of individuals and advocacy for addressing injustices

Question 44

Define multicultural counseling.

Answer 44

The working alliance between counselor and client considering personal and cultural dynamics

Question 45

What assumption do many mental health professionals have about self-actualization?

Answer 45

It is a fundamental goal for individuals

Question 46

What should counselors consider when building rapport with clients?

Answer 46

The client's cultural background and how trust is established from their perspective

Question 47

What is a balanced approach to self-actualization in therapy?

Answer 47

Integrating self-actualization with responsibility to the group

Question 48

What is the counselor's responsibility regarding cultural differences?

Answer 48

To initiate conversations about culture and acknowledge differences with respect