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1
Q

A new client comes for therapy complaining of anxiety and depression. After the therapist provides information about alternative treatment options including medication, the client emphatically states, “I refuse to take medication.” The therapist should NEXT?

A. Acknowledge his right to choose his treatment.

B. Refer him to a psychiatrist.

C. Determine why he’s so against medication.

D. Provide him with research on the benefits of medication.

A

A. Acknowledge his right to choose his treatment.

2
Q

n which of the following situations is a therapist not required by law to break confidentiality?

A. A 4-year-old client is intentionally injured by a 17-year-old brother.

B. A client gives his 78-year-old mother extra medication to keep her sedated.

C. A client reports thoughts of hurting herself.

D. A 14-year-old reports sexual activity with a 13-year-old neighbor.

A

C. A client reports thoughts of hurting herself.

3
Q

A new client wants to receive counseling and informs the therapist that he wants cognitive behavioral therapy. The therapist is not trained in cognitive behavioral therapy. How should the therapist respond to the client:

A. talk about limitations of Cognitive Behavioral Therapy.

B. provide information about the therapist’s orientation.

C. seek consultation from a Cognitive Behavioral therapist.

D. refer to a Cognitive Behavioral therapist.

A

D. refer to a Cognitive Behavioral therapist.

4
Q

A single father’s parental rights were terminated due to neglect of his two young children. After a year of the children being in foster care, the foster care therapist receives a call from the father stating that he has changed his behaviors and would like to have custody of his children returned to him. The therapist should:

A. Empathize with the father but state that the therapist can’t do anything to reinstate parental rights.

B. Discuss the request with the judge who terminated parental rights.

C. Inform the father to speak with a lawyer regarding his appeal.

D. Encourage the father to first re-develop a relationship with his children by setting up weekly home meetings.

A

C. Inform the father to speak with a lawyer regarding his appeal.

5
Q

A 22-year-old woman comes to therapy at the request of her parents. She shares with the therapist that her boyfriend of six months has beat her up a couple times and that her parents want the therapist to convince her to leave him, but she loves him and isn’t going to be told what to do. The therapist should FIRST:

A. obtain a release to speak with her parents.

B. discuss the cycle of violence.

C. acknowledge her right to make decisions about her relationship.

D. help her create a safety plan.

A

C. acknowledge her right to make decisions about her relationship.

6
Q

An 85-year-old client has been living in a nursing home after her husband passed away and she was no longer able to care for herself. The client declines a medical procedure that has the potential to prolong her life. The client is mentally alert and competent and says that she is happy with the life she has lived. The client’s family meets with the therapist, saying that they want the therapist’s help to change their mother’s mind. The therapist should:

A. Determine whether the family’s decision is ethical and oppose it only if it is not.

B. Respect the client’s right to self-determination.

C. Make sure the client understands the consequences behind her choice.

D. Agree to let the family make the choice for the client.

A

B. Respect the client’s right to self-determination.

7
Q

A former client dies and the therapist is notified by the client’s wife. The wife submits a written request to access the client’s therapy records. The therapist must:

A. Assert privilege on behalf of the client.

B. Provide a copy of the records within 15 working days.

C. Deny the request.

D. Request authorization from the client’s legal representative.

A

D. Request authorization from the client’s legal representative.

8
Q

A 14-year-old is brought to therapy by her mother following her parents’ divorce. The mother shares the custody agreement which states that both parents must consent for mental health treatment. When the therapist contacts the father, he refuses to comply stating, “her mother always thinks our daughter is depressed but she’s not.” How should the therapist proceed:

A. Refuse treatment because the father won’t consent.

B. Obtain consent from mother.

C. Obtain consent from mother and daughter.

D. Obtain consent from daughter.

A

D. Obtain consent from daughter.

9
Q

An 18 year old client reports that she was sexually molested by her father repeatedly for five years. She now lives at college, and her two little sisters live at home with her father. She is concerned about living away from home because she doesn’t want him to molest her sisters. The therapist should:

A. Determine if there is suspicion of current molestation.

B. Report immediately, as the abusive father has access to the sisters.

C. Report immediately, as the abuse took place when the client was a minor.

D. Help the client create a safety plan for the sisters.

A

A. Determine if there is suspicion of current molestation.

10
Q

A new client wants to be assured that her sessions are absolutely confidential. When should the possibility of a subpoena for confidential records of a client’s therapy be discussed?

A. in the first session if it appears that the problem might involve court actions.

B. in the first session before the client contracts for services.

C. in the first session after trust and rapport are firmly established.

D. whenever the therapist deems it appropriate.

A

B. in the first session before the client contracts for services.

11
Q

A 13-year-old client reports to his school counselor that he had sex with a 13-year-old girl for the first time yesterday. He met her at his new school three days ago and they had sex behind the school gym after getting high during lunch. The therapist should:

A. process the impact of breaking confidentiality with the client and then report the incident to his parents to keep him safe.

B. process the impact of breaking confidentiality with the client and then report the incident to the school, since the student used drugs on campus.

C. report the incident to CPS, since the student had sex with a minor.

D. maintain confidentiality.

A

D. maintain confidentiality.

12
Q

A therapist should review informed consent with a client:

A. prior to the onset of therapy.

B. prior to the onset of therapy and over the course of the therapeutic relationship.

C. in the early stages of therapy and over the course of the therapeutic relationship.

D. prior to the onset of therapy and whenever a client requests clarification regarding a therapist’s policies.

A

B. prior to the onset of therapy and over the course of the therapeutic relationship.

13
Q

An 11-year-old child is brought to therapy by a single father who claims that the child has been acting differently since he and the child’s mother divorced. He tells the therapist that his former wife has full legal custody because he had been wrongfully accused of mistreating the child, but that the child called him and wanted to see him. Upon meeting the child at an agreed upon time and place, the child told his father that he is very sad and does not want to live anymore. What responsibility does the therapist have in this situation?

A. Treat the child because of the severity of the symptoms.

B. Agree to treat the child only after the father agrees to get permission from the mother.

C. Refuse to treat the child because the law requires that both parents sign consent before treatment begins.

D. Refuse to treat the child because only the parent with legal custody can consent for treatment.

A

D. Refuse to treat the child because only the parent with legal custody can consent for treatment.

14
Q

During a shopping trip to a mall, a therapist witnesses a woman spanking a young child after the child ran away from her. In this situation, the therapist must:

A. file a child abuse report immediately.

B. tell the mother that the therapist is a mandated reporter.

C. provide the mother with a referral to parenting classes.

D. The therapist has no obligation.

A

D. The therapist has no obligation.

15
Q

A 14-year old girl comes to a family service agency for help. She is 4 weeks pregnant, unmarried, and depressed. She lives with her mother who is unaware of her pregnancy. She states she doesn’t want her mother to know she’s getting therapy because she’s a druggie. In order to treat this girl, the therapist should first?

A. Obtain the client’s signed informed consent.

B. Discuss the need for parental involvement with the client.

C. Attempt to contact the client’s mother.

D. Obtain the client’s informed consent and document the reason for not including her parents.

A

D. Obtain the client’s informed consent and document the reason for not including her parents.

16
Q

In their session, a couple talks about their “bad physical fight” last weekend. The therapist notices bruises and abrasions on the wife’s legs. How should the therapist proceed to stop the violence?

A. Refer the husband to a batterers’ group, identify the triggers to the violence, and work with the couple conjointly.

B. Refer the husband to a batterers’ group, work with them conjointly to own their individual responsibility, and increase their understanding of the choices.

C. Refer each to individual therapy to give them a safe place to explore their feelings and continue couples therapy.

D. Refer the husband to a batterers’ group and individual therapy and refer the wife to the local women’s shelter and individual therapy.

A

D. Refer the husband to a batterers’ group and individual therapy and refer the wife to the local women’s shelter and individual therapy.

17
Q

A therapist has been meeting with a client for four months with the expressed goal of addressing the client’s social anxiety. The therapist seeks consultation but the client continues to make no progress. What should the therapist do?

A. Begin termination with client.

B. Discuss referring client to a different therapist.

C. Explore lack of progress directly with client.

D. Refer client for psychiatric evaluation.

A

C. Explore lack of progress directly with client.

18
Q

A 11-year-old is brought to therapy by his mother and stepfather. His mother reports the son has become withdrawn and only wants to hang out with his friends and play video games. After meeting with the son for several sessions, the therapist learns that the son does not like his step-father and feels he is mean toward the mother. The mother requests to access the son’s records. How should the therapist respond?

A. Discuss the request with the client.

B. Allow the mother access to the records since she signed consent to treatment.

C. Allow the mother access to the records if the client consents.

D. Deny the request if it would jeopardize client’s safety and/or the therapeutic relationship.

A

D. Deny the request if it would jeopardize client’s safety and/or the therapeutic relationship.

19
Q

A client is concerned because she is convinced her husband is intending to kill his boss today after work. She knows he has been planning it, and she saw him pack a gun in his briefcase this morning. The therapist should:

A. Initiate a 5150 for the husband, since there is imminent danger to his boss from a credible third party.

B. Call the police and the husband’s boss with the client in the room as per therapist’s duty to warn.

C. Encourage the client to call the police and create a safety plan for the client.

D. Get a release from the client to call the police and boss, and call with the client in the room.

A

C. Encourage the client to call the police and create a safety plan for the client.

20
Q

A family sought therapy after the 36 year-old daughter and her 14 year-old son moved back home with her 66 year-old father and 65-year-old mother. At the start of the eighth session the mother reports that three days ago the daughter relapsed and became violent when they confronted her. What action should the therapist take first?

A. Explore each family members’ perspective of the incident and how they responded.

B. Review the limits of confidentiality with the family members.

C. Recommend that the daughter seek alcohol treatment immediately.

D. Obtain more details about the nature of the violent episode.

A

B. Review the limits of confidentiality with the family members.

21
Q

A married couple meets with a therapist in private practice for an initial session. Afterwards, the wife calls the therapist and states, “I have something I want to talk to you about, but my husband can’t find out.” The therapist’s MOST appropriate response would be to:

A. Reassure the wife that what she says will be kept confidential.

B. Recommend that both husband and wife meet individually before the next couple’s session.

C. Advise the wife of the therapist’s “no secrets” policy.

D. Encourage her to make disclosure at a future couple’s session.

A

C. Advise the wife of the therapist’s “no secrets” policy.

22
Q

A therapist working at a community mental health agency started a group for survivors of domestic violence. While meeting with potential group members, a woman states she is concerned that what she says in the group might be shared with people in her community. How should the therapist respond?

A. Ensure client that all information shared in group will remain confidential.

B. Acknowledge client’s concerns and review importance of group maintaining confidentiality.

C. Acknowledge that information shared in group is not protected by confidentiality laws.

D. Review limits of confidentiality and obtain written agreement from group members.

A

C. Acknowledge that information shared in group is not protected by confidentiality laws.

23
Q

A therapist is treating a 13-year-old girl. In the middle of the third session she shyly discloses that she is 5 weeks pregnant. She states that she is scared to tell her mother for fear of punishment. She shares that she and her boyfriend, who is also 13, want to keep the baby. The therapist should:

A. maintain confidentiality and provide support to the client.

B. make a child protective services report and contact the client’s parents.

C. make a child protective services report and refer the client to an M.D.

D. maintain confidentiality and refer the client to health clinic.

A

D. maintain confidentiality and refer the client to health clinic.

24
Q

A therapist receives a subpoena from the lawyer of a client whom the therapist treated in couples therapy. The couple is getting divorced. The husband signed a release for the records. The therapist should FIRST:

A. release the records to the lawyer once the wife tells you she permits the release.

B. assert privilege on behalf of the clients.

C. contact the wife to determine her wishes.

D. schedule a session with the couple to discuss the matter.

A

C. contact the wife to determine her wishes.

25
Q

A therapist treats a client who reports a desire to kill a former employer who recently laid him off. Upon further questioning, the client says that although this is a desire, it is not a strong one and the client has no plan. The therapist should:

A. notify local law enforcement of the situation.

B. contact the client’s former employer to report the danger.

C. monitor the client’s feelings at future sessions.

D. notify local law enforcement and the client’s former employer of the threat.

A

C. monitor the client’s feelings at future sessions.

26
Q

A therapist is treating a mother who is going through a contentious divorce. She came to session one day very upset and reports that the husband, who has visitation rights every weekend but does not have legal custody, has taken their children to another state without her permission. The therapist should:

A. File a child abuse report for abduction.

B. Encourage mother to consult with her lawyer.

C. Call the police.

D. Determine whether the children are safe.

A

B. Encourage mother to consult with her lawyer.

27
Q

A therapist meets with parents who refuse to provide appropriate medical care to their 6 year-old daughter with a potentially life threatening illness because of their religious beliefs. The child is receiving some care within the guidelines of their church’s ministry but the child’s condition is getting worse. How should the therapist respond to this dilemma?

A. Inform the family that a child neglect report must be filed.

B. Maintain confidentiality because of the family’s right to self-determination.

C. Report the situation to child protective services.

D. Encourage the family to take a different action in the best interests of the child.

A

A. Inform the family that a child neglect report must be filed.

28
Q

An Asian American family seeks family therapy. During the second family therapy session, the 14 year-old angrily states that she is tired of the painful punishment from her father for “trying to fit in with her friends at school.” The father notes that the punishment is necessary to prevent his daughter from imitating the behaviors of her American friends and thus bringing shame to the family. The therapist should initially:

A. explore their cultural beliefs related to parenting and discipline.

B. inform the parents that their behavior requires a report of suspected child abuse.

C. determine the nature and severity of the punishment.

D. help the daughter understand her parents’ behavior as culturally appropriate.

A

C. determine the nature and severity of the punishment.

29
Q

Two therapists are co-facilitating a social skills group for children with ADHD. During one of the sessions one of the children shows a scar on his back that his step dad inflicted because the child would not stay in his room after bedtime. After the group the therapists should FIRST:

A. Both file a child abuse report.

B. Call the child’s mother and schedule a session.

C. Determine which therapist will file a report.

D. Assess the child for recent abuse.

A

C. Determine which therapist will file a report.

30
Q

A therapist has determined his duty to warn has been triggered and he calls the intended victim, who is the ex-wife of his client. She does not believe the therapist and asks for more details, including specific things the client has said. The therapist legally:

A. May not use any direct client statements, as that is not legally permissible.

B. May use any information he chooses in communicating the threat.

C. May use as much information as necessary in communicating the threat.

D. May only state the reasons the therapist believes the threat is credible, without using direct client quotes.

A

C. May use as much information as necessary in communicating the threat.

31
Q

A therapist is seeing two teenage girls and their father. The father reported the girls’ behavioral problems started soon after they returned from a visit with their mother and her new boyfriend. The girls’ parents have been separated for over a year and are in the process of a bitter custody battle. During the initial interview, both girls tell the therapist that their mother’s boyfriend has made them feel uncomfortable by exposing himself and making sexually inappropriate comments. The therapist should first:

A. develop a safety plan with the girls.

B. report the allegations of abuse to child protective services.

C. discuss the allegations with the mother due to the contentious custody fight.

D. further assess for child abuse.

A

B. report the allegations of abuse to child protective services.

32
Q

During a group session with teen moms, one client shares that she’s been fighting with her boyfriend since he took their 4-month-old out in the car without a car seat. She complains, “He just does what he wants with the baby and tells me I worry too much.” The therapist should NEXT:

A. Obtain more details about the boyfriend’s treatment of baby.

B. Inform the group that a child abuse report must be filed.

C. File a report with child protective services immediately after group.

D. Refer boyfriend to a parenting class for teen dads.

A

C. File a report with child protective services immediately after group.

33
Q

In which of the following instances is a mandated report required?

A. A 14-year-old takes pictures of a 9-year-old in her underwear.

B. A 4-year-old was left alone with a 12-year-old and the 4-year-old was harmed.

C. A 13-year-old reports having sex with her boyfriend.

D. A 19-year-old reports sexual abuse by her coach when she was 13-years-old.

A

B. A 4-year-old was left alone with a 12-year-old and the 4-year-old was harmed.

34
Q

A mother seeks therapy for her 8-year-old son after a contentious divorce from the boy’s father. The mother reports that her son is afraid of the father but has to visit him per court orders. During the informed consent, the mother reports that she has full legal custody. How should the therapist proceed?

A. Inform the mother that it is best practice for both parents to consent for treatment.

B. Require a copy of the custody agreement.

C. Obtain signed informed consent from the mother.

D. Determine if the father knows about and approves of treatment for the son.

A

B. Require a copy of the custody agreement.

35
Q

A 9-year-old girl is referred to the therapist because she is being teased for smelly clothes and dirty hair. The girl shares that she wants to take a bath, but the family hasn’t had water or electricity for the past week. Her mother was arrested a month ago and her aunt is supposed to take care of them, but her aunt has been busy with her own family. What should the therapist do FIRST?

A. Assess further for possible neglect.

B. Identify alternative living arrangements for children.

C. File a child abuse report.

D. Assist the child in obtaining clean clothes and a bath.

A

C. File a child abuse report.

36
Q

A therapist has been treating an 8-year-old with Attention-Deficit Hyperactivity Disorder (ADHD) for two months. The focus of treatment has been on reducing his impulsive behavior. One day, he shows up to his therapy appointment with a black eye. He shares that his 17-year-old brother beat him up because he used his computer without asking. How should the therapist proceed?

A. Call the parents and discuss the situation.

B. Discuss the importance of respecting others’ belongings.

C. File a child abuse report.

D. Explore the client’s feelings about the incident.

A

C. File a child abuse report.

37
Q

A 36-year-old single mom is referred by her boss after losing her temper at work. She is raising her 3-year-old and a 20-month-old by herself since leaving her abusive boyfriend. The client shares that she “feels overwhelmed all the time and sometimes loses it with her kids.” What should the therapist assess FIRST?

A. The incident at work.

B. What she means by “sometimes loses it with her kids.”

C. Her trauma history.

D. Her parenting skills.

A

B. What she means by “sometimes loses it with her kids.”

38
Q

A 72-year-old man is transported to a therapy appointment by his daughter-in-law, with whom he lives. The therapist notes that he appears uncomfortable in her presence and becomes increasingly anxious as the session progresses. When the therapist reflects this, he says, “I just don’t want to keep my daughter-in-law waiting. She can get pretty angry.” What should the therapist do NEXT?

A. Suggest a family session to discuss conflicts in the home.

B. File an elder abuse report.

C. Assess for elder abuse.

D. Help the client find alternate means of transportation to future appointments.

A

C. Assess for elder abuse.

39
Q

A therapist is meeting with a 33-year-old client for a second session. The client recently moved from another state where he was receiving treatment at a local mental health center. The client signed a release of information for the therapist to receive the client’s psychological reports from his previous treatment center. The therapist received the reports and noticed that references are made to other treatment centers which the client also previously attended. It is within the principles of confidentiality for the therapist to:

A. ask the staff at the previously attended mental health center to send the reports over.

B. let the client know that other treatment centers have been contacted and reports have been requested.

C. call the other treatment facilities and request treatment reports.

D. talk to the client and obtain a written release for each treatment center previously attended.

A

D. talk to the client and obtain a written release for each treatment center previously attended.

40
Q

A 77-year-old woman arrives for a therapy appointment and reports that she is having trouble coming up with the money to pay for her sessions. When the therapist inquires about this, she reports that her grown son has been “investing” her money for the past 6 months, but she no longer has access to any of her bank accounts. What should the therapist do NEXT?

A. Inform the client that an elder abuse report must be filed.

B. Help the client problem-solve around gaining access to her money.

C. Work with the client to establish a reduced fee for sessions.

D. Schedule a family session to discuss financial matters.

A

A. Inform the client that an elder abuse report must be filed.

41
Q

A 32-year-old man with developmental disabilities comes to an appointment with his case manager and reports that a caregiver in his group home has been refusing to give him his medication and has been locking him in his room at night. What should the case manager do NEXT?

A. Call the man’s group home to validate his story.

B. Reassure the man that the case manager will handle the situation.

C. Report the situation to the police immediately.

D. Call the man’s psychiatrist to report medication changes.

A

C. Report the situation to the police immediately.

42
Q

A therapist is called to the emergency room to evaluate an 83-year-old woman who was brought in by paramedics; the doctor tells the therapist that the woman is bedridden with limited mobility. When she sees the therapist, the woman begins pleading with the therapist saying, “Please don’t make me go home; he never lets me go out or see anyone!” What should the therapist do NEXT?

A. Assess for elder abuse.

B. Consult with the doctor to find out whom the woman is talking about.

C. Reassure the woman that she won’t have to go home.

D. File a report with Adult Protective Services

A

A. Assess for elder abuse.

43
Q

A therapist determines that she must file an elder abuse report. What is the timeline for such report?

A. Call immediately; submit written report within 36 hours.

B. Call immediately; submit written report within 2 days.

C. Call within 24 hrs; submit written report within 2 days.

D. Call within 24 hrs; submit written report within 36 hours.

A

B. Call immediately; submit written report within 2 days.

44
Q

The mother of a three-year-old boy is referred by her doctor. She is in the last month of a second pregnancy, and is experiencing episodes of depression with poor appetite, crying, withdrawal from parenting, and increasing fear that she will harm her child. The client states that she has a history of major depressive disorder with psychotic features following the birth of her first child. The therapist should first:

A. Refer the client for a psychiatric evaluation.

B. Report the situation to the child protection agency.

C. Initiate a 5150.

D. Assess safety of the first child.

A

D. Assess safety of the first child.

45
Q

A therapist receives a letter from a lawyer requesting information about one of the therapist’s clients’ diagnosis and treatment. The letter indicates that the client is the defendant in an upcoming court case. What should the therapist do FIRST?

A. Contact the lawyer and explain that a subpoena will be needed to release information.

B. Contact the lawyer and release selected information from the client’s record.

C. Do not respond to the letter and contact the client to inform them of the request.

D. Send a letter to the lawyer refusing the request.

A

C. Do not respond to the letter and contact the client to inform them of the request.

46
Q

A therapist has been working with a client who is borderline for two years when the client leaves a voicemail that she has found a better therapist and would like a copy of her records sent to her address within the week. The therapist has serious concerns about her seeing his notes. The therapist denies the request and the client gets very upset. The therapist should:

A. Meet with her in person to review her record.

B. Consult a lawyer.

C. Allow another therapist to view the record.

D. Obtain a release to contact the new therapist.

A

C. Allow another therapist to view the record.

47
Q

In which of the following situations does a therapist have a duty to warn?

A. A depressed adult client discusses taking revenge on a sibling who lives next door for abuse that occurred during childhood.

B. A client with bipolar disorder describes feeling out of control during manic episodes and fears hurting a family member.

C. A client with HIV discusses having unprotected sexual relations with a partner without disclosure.

D. A client with a history of physical violence describes a plan to use force to get an ex-spouse back.

A

D. A client with a history of physical violence describes a plan to use force to get an ex-spouse back.

48
Q

A therapist has seen a young adult client for a few months. During a session, the client tells a therapist that he recently participated in the break in of a neighbor’s house and plans to repeat the offense. The therapist should:

A. discuss alternative ways the client can express his aggression.

B. maintain client confidentiality.

C. obtain a written contract that the client will not commit such actions.

D. report the intent to the police and warn the neighbor.

A

B. maintain client confidentiality.

49
Q

A therapist is meeting with a 45-year-old man who came in due to feelings of hopelessness and depression and who says he feels like he “can’t do this anymore.” After further questioning, the client states that he has had some thoughts of suicide. The therapist should NEXT:

A. Determine if the client has a plan.

B. Hospitalize the client.

C. Create a safety plan with the client.

D. Identify social supports for the client.

A

A. Determine if the client has a plan.

50
Q

A therapist meets with a couple for the first time. The couple discloses that the husband is also working with an individual therapist on managing his anger more effectively. The therapist would like to speak with the husband’s individual therapist. The therapist should:

A. Obtain a written release from the husband to speak with his therapist.

B. Obtain a written release from both the husband and wife to speak with the husband’s therapist.

C. Obtain a written release from the husband if only obtaining information about his treatment.

D. Obtain a written release from the husband and wife if planning to work collaboratively with husband’s therapist.

A

B. Obtain a written release from both the husband and wife to speak with the husband’s therapist.

51
Q

A client with paranoia hands his therapist a letter requesting to review his records. He returns the next day at the appointed time and quietly reviews the file. After he finishes, he tells the therapist that he has found several mistakes. Legally the therapist should:

A. Inform the client that amending a record once it is in the file is a violation of the law.

B. Amend the record if the therapist agrees there has been a mistake.

C. Process with the client the effect of reviewing the record and finding mistakes.

D. Inform the client he may submit an addendum to the record that may be included in the file.

A

D. Inform the client he may submit an addendum to the record that may be included in the file.

52
Q

All of the following should be included in an initial evaluation EXCEPT:

A. Assessment of risk.

B. Presenting problem.

C. Mental health history.

D. Expectations of therapy.

A

D. Expectations of therapy.

53
Q

A client with a history of suicide attempts leaves a distraught goodbye message on his therapist’s voicemail. The therapist returns the call but the client does not answer. What should the therapist do next?

A. Initiate a 5150.

B. Call 911.

C. Call his emergency contact.

D. Contact the client’s family.

A

C. Call his emergency contact.

54
Q

A new client calls seeking therapy for depression. She is referred by a former client. On the phone, she reports feelings of hopelessness and expresses doubts that therapy can help. How should the therapist proceed?

A. Validate her feelings.

B. Schedule an appointment.

C. Ask if client has any thoughts of harming herself.

D. Explore her doubts about therapy.

A

C. Ask if client has any thoughts of harming herself.

55
Q

A 33-year-old woman seeks treatment for relationship issues. She reports that since she and her partner married, the partner has become increasingly controlling and occasionally violent. The client begins crying and states angrily, “I can’t take it anymore”. In addition to assisting the client in creating a safety plan, what other legal obligations does the therapist have in this case?

A. Assist the client in locating appropriate shelters and contact the police.

B. Refer the client to a doctor for a medical evaluation and encourage her to contact the police.

C. Assess for suicide risk and danger to others.

D. Refer the client to a doctor for a medical evaluation and assess social supports.

A

C. Assess for suicide risk and danger to others.

56
Q

A new therapist opens her private practice. Before she sees her first client, she sets up her filing system for her new client records. In order to comply with the law, she must do all of the following except:

A. Ensure that there are at least two forms of locks preventing access to the records.

B. Assign a password or lock up her computer if she keeps client information on it.

C. Adhere to the standard of care in keeping her records secure.

D. Ensure her mobile phone is secure if keeping client contact information on it.

A

A. Ensure that there are at least two forms of locks preventing access to the records.

57
Q

A client is in therapy because of problems at work and an inability to concentrate. During the fourth session, she begins to cry uncontrollably. She reveals that her husband has been physically abusive towards her for several years. Which of the following steps should the therapist take to assist the client?

A. File a report with the police.

B. Explore high risk factors of leaving the relationship.

C. Help the client establish a plan of action to escape the abuse.

D. Assess current safety issues and provide referral for DV shelter.

A

D. Assess current safety issues and provide referral for DV shelter.

58
Q

After working with a client for three months, the therapist realizes that the client’s husband works at the same company as the therapist’s husband. What should the therapist do NEXT?

A. Review the importance of boundaries with the client.

B. Share the information with the client and discuss the impact.

C. Seek consultation for countertransference related to information.

D. Refer the client to another therapist.

A

B. Share the information with the client and discuss the impact.

59
Q

A therapist is treating a client with schizophrenia who has an appointed conservator. The client was in an altercation and subsequently sued by the injured party. The therapist receives a subpoena for the client’s records from the client’s lawyer. The therapist should:

A. assert privilege on behalf of the client.

B. contact the client’s conservator.

C. contact the client.

D. consult with a lawyer regarding the subpoena.

A

B. contact the client’s conservator.

60
Q

According to California law, the records of psychotherapy treatment:

A. Are the property of the client.

B. Must be made available to clients upon written request.

C. Must be made available to the client’s representative upon the client’s death.

D. Are the property of the therapist.

A

D. Are the property of the therapist.

61
Q

A therapist is terminating therapy with a 10 year-old-boy. How long must the therapist keep the records?

A. 7 years

B. 8 years

C. 10 years

D. 15 years

A

D. 15 years

62
Q

Following a full day of meeting with clients, a therapist takes home several client files to review them and complete paperwork. The therapist places the documents in a briefcase and locks them in the trunk while stopping for dinner. After dinner, the therapist discovers the car has been broken into and the briefcase was stolen. How should the therapist proceed?

A. Call the police immediately.

B. Call the police and notify all of the affected clients.

C. Notify the affected clients and discuss the issue with them.

D. Consult with a colleague with legal expertise.

A

B. Call the police and notify all of the affected clients.

63
Q

A client in couples therapy calls between sessions and tearfully shares that she discovered child pornography on her fiancé’s computer. The therapist should:

A. maintain confidentiality.

B. suggest they discuss in the next session.

C. remind client of “no secrets” policy.

D. inform her that the therapist must file child abuse report.

A

D. inform her that the therapist must file child abuse report.

64
Q

A client is concerned in session that her obsessive thoughts of suicide might be a result of the antidepressant medication her psychiatrist prescribed. The client agrees to voluntary hospitalization and wants the therapist to call her psychiatrist. The therapist realizes he has no more copies of his release forms in his office. The therapist should:

A. Speak to the psychiatrist without written consent because the client’s level of suicidal ideation constitutes an emergency.

B. Refrain from calling the psychiatrist until the client signs a typed release, as is legally required.

C. Have the client write a release in her own handwriting that is signed and dated.

D. Wait for the psychiatrist to call once the client has been admitted to the hospital.

A

C. Have the client write a release in her own handwriting that is signed and dated.

65
Q

A therapist is required to follow HIPAA in order to:

A. ensure compliance with informed consent.

B. effectively manage privileged information.

C. establish privacy standards related to electronic storage and transmission of patient information.

D. provide clients with reasonable access to their records

A

C. establish privacy standards related to electronic storage and transmission of patient information.

66
Q

A patient being treated for Bipolar I Disorder receives a notice from her insurance that her claims for psychotherapy treatment have been denied. The therapist believes the client is entitled to psychotherapy treatment. The therapist should:

A. Encourage the client to advocate for herself.

B. Advocate on behalf of the client.

C. Adjust the therapist’s fee to see the client at an affordable rate.

D. Refer the client to a low-fee clinic.

A

B. Advocate on behalf of the client.

67
Q

A therapist recently joined an insurance panel as a provider. When working with a third party payer, which of the following is acceptable:

A. Changing a patient’s diagnosis in order to ensure reimbursement.

B. Billing insurance for missed appointments.

C. Waiving a co-payment while billing insurance the full fee.

D. Charging a higher fee because the patient has insurance.

A

B. Billing insurance for missed appointments.

68
Q

A client, who has been missing work, has been referred to a therapist by her Employee Assistance Program for a maximum of four sessions. Any additional sessions would be the client’s financial responsibility. During the initial intake, it becomes clear that the client has many long-standing relationship issues and a trauma history that has not been resolved. She states that she is looking forward to working through her problems. Before developing a treatment plan, the therapist should FIRST:

A. provide education about the therapy process.

B. explore the client’s understanding of the referral and coverage provided.

C. explore the client’s expectations of therapy.

D. discuss fees in case client continues treatment after the EAP sessions end.

A

B. explore the client’s understanding of the referral and coverage provided.

69
Q

A therapist sees a new client referred because of heavy alcohol use. During the initial assessment the client questions the therapist’s credentials and competence. What should the therapist do next?

A. Provide the client with honest information regarding therapist’s credentials.

B. Confront the client about the evasive responses.

C. Ask how the client feels about seeking help.

D. Explain that the therapist has treated a lot of patients like him.

A

A. Provide the client with honest information regarding therapist’s credentials.

70
Q

A recently licensed therapist took one course on emotionally focused therapy during his internship. Now that he is licensed he advertises himself as having an “expertise in emotionally focused couples therapy.” The therapist’s actions are considered:

A. illegal and unethical.

B. legal and ethical as he received training as advertised following graduate school.

C. unethical as he does not have the required training, education, or experience to be considered a specialist.

D ethical only if he explains to clients that he only took one course.

A

A. illegal and unethical

71
Q

A therapist has been working with a 34-year-old woman, who is in treatment for anxiety management. She informs the therapist that she has to go to Colorado on a work trip for 2 weeks. She has asked the therapist whether it would be possible to use Skype and maintain a regular session schedule. Legally the therapist should?

A. Encourage the client to use her anxiety management skills and wait to resume sessions after she comes back.

B. Inform the client that it is illegal to work with clients who reside in a different state if the therapist is not licensed in that state.

C. Obtain a written informed consent and agree to meet the client on Skype during regular session time.

D. Obtain informed consent specific to tele-therapy and document it in the client’s file.

A

D. Obtain informed consent specific to tele-therapy and document it in the client’s file.

72
Q

A low-fee client who has been receiving therapy for several months has failed to make payments for the services provided even though the client was made aware of the therapist’s fees and payment policy. The therapist is considering discontinuing services to the client. What should the therapist do?

A. Terminate services with client and provide at least three referrals.

B. Review payment agreement with client and discuss possible termination.

C. Terminate services immediately until the account is paid by the client.

D. Discuss the possibility of lowering fees once the client takes care of the balance.

A

B. Review payment agreement with client and discuss possible termination.

73
Q

A therapist working in a small agricultural town has been seeing a client for several years when the client reports that he cannot afford to pay for therapy for the next few months because he must make upgrades to his farm. He asks the therapist if, until his financial situation improves, he could offer some of his produce as payment. How should the therapist respond?

A. Determine the worth of the produce the client has offered.

B. Tell client that it would not be appropriate and refer to a low-cost clinic.

C. Agree to barter if it’s determined this is the only way the client can attain necessary services.

D. Tell the client it would not be appropriate and offer a sliding scale.

A

C. Agree to barter if it’s determined this is the only way the client can attain necessary services.

74
Q

A therapist has been meeting with a client who lost her husband a year ago. The client has had trouble maintaining her finances, since her husband was the one who took care of the bills when he was alive. The client is now two months behind in the payment of fees and has no ability to pay soon. Professional ethics allow the therapist to:

A. Suggest the client find a more appropriate therapist who can accommodate a lower fee.

B. Terminate therapy if it is clear that the client is not a danger to self or others.

C. Create a payment plan.

D. Terminate therapy only if it the client’s wishes to do so.

A

B. Terminate therapy if it is clear that the client is not a danger to self or others.

75
Q

A therapist working in a small town has been seeing a client for a few months when the client reports that he lost his job and can no longer afford to pay for therapy. The client offers to provide house repair services for the therapist in exchange for continuing therapy. How should the therapist respond?

A. Refer to low-fee mental health clinic.

B. Consult with colleagues to determine if bartering is common practice.

C. Explain conflict of interest and explore alternative payment arrangements with client.

D. Create a written contract for the exchange of services.

A

C. Explain conflict of interest and explore alternative payment arrangements with client.