Scenario-based Questions

Question 1

Under Minnesota law, what should a therapist do if a teenage client reveals drug experimentation and asks for confidentiality?

Answer 1

Maintain confidentiality unless the client is at risk of harm

This aligns with the ethical obligation to respect client confidentiality while also considering the safety of the client.

Question 2

What is the best ethical response for a therapist asked to provide counseling services to church members?

Answer 2

Decline due to the risk of boundary issues

Dual relationships can complicate professional boundaries and objectivity.

Question 3

What action is required if a client expresses violent thoughts about a coworker but claims they would probably never act on it?

Answer 3

Assess the risk further and determine if a duty to warn applies

This is crucial for evaluating the potential risk to others.

Question 4

How should a therapist respond if a former client asks to meet for coffee six months after therapy has ended?

Answer 4

Consider ethical guidelines regarding post-termination relationships

Maintaining professional boundaries is essential to avoid conflicts of interest.

Question 5

In what situations can a 14-year-old client consent to therapy without parental permission under Minnesota law?

Answer 5

When specific legal criteria are met, such as being a emancipated minor or mature minor or in cases of certain exceptions

The law recognizes minors’ rights in specific circumstances.

Emancipated Minor: living apart from parents and managing their own finances, married, or has born a child.
Mature Minor: based on principle and prior decision of a court - 15 years old, able to consent, proposed treatment is for the minor’s benefit, deemed necessary, and does not involve complex, high risk medical procedures or complex, high risk surgery.

Question 6

What ethical considerations should guide a therapist’s response to a Facebook friend request from a current client?

Answer 6

Maintain professional boundaries and confidentiality

Social media interactions can blur the lines of professionalism.

Question 7

What is ‘Informed Consent’ in the context of therapy?

Answer 7

Clients must understand and agree to treatment voluntarily, risk, treatment, probability of treatment, and prognosis (therapeutic process).

This is a fundamental principle in ethical therapy practice.

Question 8

Define ‘Dual Relationship’ in a therapeutic context.

Answer 8

Any non-therapeutic relationship that may impair professional judgment

Dual relationships can lead to conflicts of interest.

Question 9

What is the ‘Tarasoff Rule’?

Answer 9

Obligation to warn potential victims of a client’s serious threats

This legal precedent is vital in ensuring safety.

Question 10

List some exceptions to confidentiality.

Answer 10

• Child abuse
• Elder abuse
• Danger to self/others

These exceptions are mandated by law to protect vulnerable individuals.

Question 11

What are ‘Supervision Requirements’ for MFTs?

Answer 11

MFTs must have a specific number of supervised hours before licensure

Supervision is essential for developing competent clinical skills.

Question 12

What does ‘Scope of Practice’ define for MFTs?

Answer 12

What MFTs are legally allowed to do in their role

Understanding the scope is critical for ethical practice.

Question 13

What is ‘Mandated Reporting’?

Answer 13

Legal duty to report abuse or neglect of children or vulnerable adults

This duty is crucial for safeguarding at-risk populations.

Question 14

What is therapeutic deception?

Answer 14

A representation by a psychotherapist that sexual contact with the therapist is part of the patient or form patient’s treatment.

Question 15

What is emotional dependency?

Answer 15

State in which the client is vulnerable to the therapist where they are dependent and unable to withhold consent.

Question 16

What is Marriage and Family Therapy?

Answer 16

Form of psychotherapy of individual, family, couples that includes the intrapersonal and interpersonal relationships along with the systems such as racism, sexism, ageism, etc.

Question 17

What is HIPAA?

Answer 17

Health Information Portability and Accountability Act
It is a federal legislation to protect client’s confidential information electronically, and has grown as generally to protect client’s data information.

Question 18

What is sexual contact

Question 19

If a client threatened to harm another person and therapist reported, but the police returns asking for more information. How should the therapist respond?

Answer 19

Before, therapist should make sure to document therapist steps and reasons. The therapist cannot confirm or deny and inform the police that they need a ROI or court order and refer to the police report. The therapist’s duty is maintain confidentiality.

Question 20

A 15 year old has given birth to a baby, but want to see you and wants parental consent? Can the therapist see the 15 year?

Answer 20

Yes, they do not need parental consent due to being Medically Emancipated (minor who is living apart from their parents and managing their own finances, born a baby, and if married).

Question 21

A 14 year old is using Adderoll and is seeking for services, but they don’t want their parents to know. Can the therapist see the minor?

Answer 21

The 14 year old is not a emancipated minor, but based on category of care (drugs, STD, pregnancy, abortion, contraceptions, and history of inpatient treatment) the therapist can see the minor without parental consent.

Question 22

A minor reports being trans, is from a religious community, and is seeking services. They are afraid of being ex-out of their community and letting their parents for the fears of being outted. How should the therapist respond?

Answer 22

It depends. The minor does not meet as being medically emancipated or category of care, but assess whether the child meets for being a mature minor who can consent for their own treatment. If the minor is using the parent’s insurance, the therapist would need to discuss the limits of confidentiality due to info and bills being sent to parent’s home.

Question 23

A client wants to give the therapist a gift. How should the therapist respond?

Answer 23

Depends. The therapist should assess what the gift means and meaning to the therapeutic relationship as the therapist should avoid exploiting the client for the benefit of the therapist.

Question 24

A client is depressed and taking medication, but wants to seek out suppliments as a replacement. They want to get the therapist’s advice. How should the therapist respond?

Answer 24

The therapist should refer to their primary care physician as this is outside of the scope. The therapist can process with the client and be informed of changes, but cannot provide opinions.

Question 25

A client comes to you saying they have a diagnosis you are unfamiliar or haven't heard before, can the therapist work with them?

Answer 25

Yes, as therapist are generalist, so it's the responsibility of the therapist to further their research, however, if there continues to be a lack in knowledge and experience it would be best to refer them out.

Question 26

An angry parent calls you to know what is going on with their child, how should a therapist respond?

Answer 26

The therapist should not confirm or deny about the minor being a client, even if they are a parent. The therapist can prove at a later time that they are the parent.

Question 27

What is the Safe Habor Agreement?

Answer 27

An agreement between parents or coparents that protects the children's sessions from being disclosed in legal remedies. The therapist can say no to disclosing information about the child's sessions.

Question 28

A parent is seeking services for their minor without the other parent, what are considerations the therapist should ask for?

Answer 28

The therapist should ask about who has legal rights (full or partial). The therapist is not an investigator, so the therapist is working in good faith based on the information provided.

Question 29

You have been seeing a couple for some time, but stopped and later learned they are getting a divorce. They want you to speak about who should get the child. How should you respond?

Answer 29

Something factors I would want to consider whether this in my scope, if not, I cannot be switching role as therapist and a evaluator and would need a ROI from both to disclose information to the court.

Question 30

A person has excessive sleeping, what are some factors you'd want to consider?

Answer 30

The therapist should assess the time and length of the symptoms, and request for a full diagnosis assessment.

Question 31

Your 14 year old was raped at an event, how should you respond?

Answer 31

There is no obligation to report, I can encourage the client to make a police report for the assault, but this is not considered abuse if the person was someone who is not a caretaker or responsible for the client.

Question 32

A therapist is treating a married couple. After an individual session, one spouse discloses they are hiding a large amount of debt from their partner. They ask the therapist not to reveal this information. How should the therapist respond?

Answer 32

The therapist must maintain confidentiality but may encourage the client to disclose. However, financial secrecy is not typically grounds for breaking confidentiality unless it involves fraud, harm, or abuse.

Question 33

A therapist discovers that a current client follows them on Instagram and frequently comments on their personal posts. The client also sends a private message about personal questions. How should the therapist respond?

Answer 33

The therapist should maintain professional boundaries and avoid engaging with clients on personal social media. Ethical standards suggest discussing digital boundaries with clients at the beginning of treatment.

Question 34

A 16-year-old client reveals they are in a sexual relationship with a 24-year-old adult. They insist it is consensual and do not want anyone to know. What does Minnesota law require in this case? How should the therapist explain their actions to the client?

Answer 34

In Minnesota, this relationship is statutory rape, and the therapist is a mandated reporter. The therapist must report the situation to child prtoective services while explaining confidentiality limits to the client. Further considerations, consult with others about case if needed.

Question 35

A therapist working in a rural community realizes that a new client is their neighbor. They often see this person at local events and have friendly interactions. Should the therapist continue therapy? What factors should be considered in small communities?

Answer 35

In small communities, dual relationships may be unavoidable. The therapist should evaluate whether objectivity can be maintained and discuss boundaries with the client. If conflict exists, referral may be best.

Question 36

A therapist provides online therapy for a Minnesota-based client. The client decides to move to Wisconsin but wants to continue sessions. What ethical and legal issues arises? Can the therapist continue treating the client?

Answer 36

The therapist must check licensure laws in Wisconsin. If they are not licensed in Wisconsin, they likely cannot continue therapy unless temporary practice rules allows it. The therapist should provide appropriate referrals.

Question 37

You are providing therapy for a 10-year-old whose parents are going through a contentious divorce. One parent request access to the therapy records to use in court. The other parent objects. What are your ethical and legal obligations? When, if ever, can you release the therapy records?

Answer 37

In Minnesota, both legal parents generally have access to their child's records unless restricted by court order. However, releasing therapy notes for legal disputes may not be in the child's best interest.

Question 38

You run a couples therapy group. One partner from a couple privately tells you they are considering divorce but haven't told their spouse. They ask you to keep it confidential. How do you handle confidentiality in group therapy setting? What ethical principles guide your response?

Answer 38

Group therapy confidentiality differs from individual therapy. You should remind participants that confidentiality cannot be guaranteed in group setting, and transparency within the couple may be necessary.

Question 39

A former client, whome you saw for individual therapy two years ago, reaches out and ask if you can supervise them for their required clinical hours. Is this an ethical issue? What guidelines determine whether supervision is appropriate?

Answer 39

The ethical principles of avoiding dual relationships applies. Supervising a former client could create bias and affect professional boundaries. The best course of action may be to refer them to another supervisor.

Question 40

A close family member asks you to provide therapy for their struggling teenager, as they trust you the most. Should you accept them as a client? If you decline, how do you explain your reasoning while maintaining the relationship?

Answer 40

Providing therapy to family members can impair objectivity and create ethical conflicts. It is usually best to refer them to another therapist.

Question 41

A client expresses deep anger toward their former boss and says, "Sometimes, I just want to make them pay for what they did to me." They deny any specific plan or intent to act on it. Do you have a duty to warn in this situation? What steps should you take to assess the level of risk?

Answer 41

A vague statement without a specific threat may not meet the legal threshold for a duty to warn. However, a risk assessment (e.g. intent, means, history of violence) is necessary. Documenting the conversation and consulting a supervisor/colleagues may be wise.

Question 42

A 15-year-old client tells you they are pregnant, and the father is 17. They do not want their parents to know. Are you required to report to this as statutory rape? How do you balance confidentiality with legal obligations?

Answer 42

Minnesota's age of consent laws and mandated reporting requirements should be reviewed. Generally, close-in-age relationships may not be reported, but if coercion or exploitation is suspected, reporting may be necessary.

Question 43

A long-term client experiencing severe anxiety starts sending you text messages between sessions, seeking crisis support. How should you handle therapy-related communication outside of sessions? What ethical risks arise from engaging in text-based counseling?

Answer 43

Therapy should be conducted through secure, HIPAA-compliant platforms. Boundaries around digital communication should be established upfront. If a crisis arises, referral to appropriate emergency services may be needed.

Question 44

A satisfied client asks if they can write a public testimonial for your website or Google Reviews. Can you ethically accept and post their review? How do professional ethics guide your decision?

Answer 44

Ethical codes prohibit soliciting testimonials from current clients due to the risks of undue influence. A therapist should kindly decline and educate the client on ethical guidelines.

Question 45

You are working with a Hmong couple experiencing marital distress. The husband expresses reluctance to engage in therapy, stating that mental health struggles should be addressed within the family and spiritual community. How do you approach this and what ethical guidelines empasize cultural competency and sensitivity?

Answer 45

Ethical practices requires respecting diverse cultural beliefs while ensuring effective care. Exploring their concerns, collaborating with cultural supports (e.g. community leaders), and adapting interventions can promote engagement.

Question 46

A client from a conservative religious background seeks therapy to address their same-sex attraction, expressing a desire to change their orientation due to religious beliefs. What does the MFT code of ethics say about conversion therapy?

Answer 46

MFTs are ethically obligated to avoid conversion therapy, as it is harmful and unethical. However, respecting the client's values and helping them explore their identity in a way that aligns with their well-being is crucial.

Question 47

An undocumented immigrant seeks therapy for trauma but is hesitant due to fears of legal consequences. They ask if their immigration status will be reported. How do you hand their concerns about confidentiality? Are there any legal or ethical obligations?

Answer 47

Therapists should reassure clients that therapy is confidential and that immigration status is not reported. However, ethical considerations include providing culturally sensitive care and connecting them with appropriate legal or community resources.

Question 48

You offer sliding-scale fees for clients with financial difficulties. A long-term client, who was previously paying full price, finds out that another client is paying a lower fee and expresses frustration. How do you ethically respond while maintaining confidentiality? What ethical principles apply to fee structures?

Answer 48

Therapist must ensure fee policies are transparent and consistent. While client payment details are confidential, a general policy explanation (e.g., income-based sliding scale) can address concerns.

Question 49

A client who owns a bakery is struggling financially and offers to provide baked goods weekly in exchange for therapy services. Can you accept this and what factors should you consider?

Answer 49

Bartering can create dual relationships and power imbalances. Ethical decision-making involves considering whether it could impair objectivity, create dependency, or lead to conflicts. If unavoidable, clear agreement should be documented.

Question 50

A client requests that you change the diagnosis on their insurance claim so that their sessions will be covered. They assure you that their symptoms are real but say the insurance only covers certain conditions. What ethical and legal obligations do you have? How do you address this with the client?

Answer 50

Altering diagnoses for insurance reimbursement is fraudulent and unethical. The therapist should educate the client on legal risks and explore other payment or assistance options.

Question 51

You are supervising a pre-licensed therapist and notice that they frequently discuss their personal problems with clients, blurring professional boundaries. How should you address this as a supervisor?

Answer 51

Supervisors have a duty to guide ethical practice and protect clients. Providing direct feedback, reviewing professional boundaries, and documenting concerns are essential. If behavior persists, additional corrective action may be needed.

Question 52

A supervisee is experiencing significant personal distress and asks if they can book therapy sessions with you, as they feel comfortable with you. Can you take them on? What alternative solutions should you offer?

Answer 52

Providng therapy to supervisee creates a dual realtionship and is unethical. The best course of action is to encourage them to seek therapy with another professional while offering support as their supervisor.

Question 53

You are a pre-licensed therapist under supervision, but your supervisor freqently cancels meetings, does not provide meaningful feedback, and fails to document required supervision hours. What steps should you take to protect your professional development? What ethical obligations does the supervisor have?

Answer 53

Supervisees have the right to adequate supervision. Addressing concerns with the supervisor directly and, if necessary, seeking guidance from the licensing board or another supervisor is appropriate.