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1

All of the following are true regarding Standard of Care in the field of mental health EXCEPT :

A. It is the standard of perfection
B. It is a legal concept
C. It is continually changing
D. It is derived from legal-professional-communal principles

All of the following are true regarding Standard of Care in the field of mental health EXCEPT :

A. It is the standard of perfection

2

A licensed therapist is also a certified public accountant. In her therapy practice the therapist is treating a woman with depression and anxiety who has failed to pay her taxes the past two years. One of her goals is to pay her back taxes. The client asks to bring her tax information to the next session to have the therapist help her figure it out. The therapist should:

A. Agree as long as the client would benefit from the assistance.

B. Agree because it is within her scope of practice.

C. Refuse because it is outside of her scope of competence.

D. Refuse because it is outside of her scope of practice.

A licensed therapist is also a certified public accountant. In her therapy practice the therapist is treating a woman with depression and anxiety who has failed to pay her taxes the past two years. One of her goals is to pay her back taxes. The client asks to bring her tax information to the next session to have the therapist help her figure it out. The therapist should:

D. Refuse because it is outside of her scope of practice.

3

A new client seeks treatment for alcohol addiction and depression after a break-up from a therapist in private practice who specializes in relationship issues. The therapist agrees to see the client despite having limited training in substance use treatment. The behavior of the therapist is:

A. Illegal because the therapist working outside his scope of practice.


B. Illegal because the therapist is working outside his scope of competence.


C. Unethical because the therapist is working outside his scope of practice.

D. Unethical because the therapist is working outside his scope of competence.

A new client seeks treatment for alcohol addiction and depression after a break-up from a therapist in private practice who specializes in relationship issues. The therapist agrees to see the client despite having limited training in substance use treatment. The behavior of the therapist is:


D. Unethical because the therapist is working outside his scope of competence.

4

A therapist should honor a client’s self-determination in all of the following scenarios except:

A. When the client is in danger of harming himself.


B. When the client is in a domestic violence relationship.


C. When the therapist knows that a client’s decision is going to cause the client additional problems.


D. When the client is gambling excessively despite lacking money for housing.

A therapist should honor a client’s self-determination in all of the following scenarios except:

A. When the client is in danger of harming himself.

5

In which of the following scenarios would a therapist NOT be required to obtain informed consent prior to the onset of therapy?

A.The therapist was seeing a couple and starts to see the husband for individual therapy.


B. A therapist is contacted by an adult patient who has suicidal ideation and a plan.


C. A therapist is contacted by a former client from the therapist’s internship site.


D. A therapist offers a 6 session premarital counseling package.

In which of the following scenarios would a therapist NOT be required to obtain informed consent prior to the onset of therapy?

B. A therapist is contacted by an adult patient who has suicidal ideation and a plan.

6

A therapist arrives at his office and finds that a client has broken in and is looking through his files. The therapist should:

A. call the police and inform them of the name of the client.


B. call the police but withhold the name of the client.


C. determine what files the client has reviewed.


D. schedule a session with the client to discuss the incident.

A therapist arrives at his office and finds that a client has broken in and is looking through his files. The therapist should:

A. call the police and inform them of the name of the client.

7

In which of the following situations does a client not have privilege?


A. When a client files a malpractice suit against the therapist.


B. During a child custody evaluation.


C. When a client is dead.


D. When a client is unable to provide reliable information.

In which of the following situations does a client not have privilege?

A. When a client files a malpractice suit against the therapist.

8

A therapist works as a consultant in a local preschool. During one of her visits, she notices a three-year-old girl with red marks across the back of her legs. When she asks a teacher about this, she is told that that the child's parents use "switches" to discipline the child; the teachers assert that this is a culturally sanctioned technique, which is why it has not been reported. What should the therapist do NEXT?


A. Set up a meeting with the girl’s parents to discuss disciplinary techniques.


B. Consult with a colleague who is familiar with the family’s culture.


C. Make a child abuse report.


D. Assess the child for other signs of abuse.

A therapist works as a consultant in a local preschool. During one of her visits, she notices a three-year-old girl with red marks across the back of her legs. When she asks a teacher about this, she is told that that the child's parents use "switches" to discipline the child; the teachers assert that this is a culturally sanctioned technique, which is why it has not been reported. What should the therapist do NEXT?

C. Make a child abuse report.

9

In which of the following scenarios is the requirement to file an elder abuse report optional?



A. The son of an 85 year old takes his father to Arizona against his will.


B. The caretaker of a 70 year old refuses to allow her contact with friends or use of phone.


C. A 17 year-old-grandson steals his grandmothers ATM card and takes money out of her account.


D. A 73 year-old woman reports that her daughter is constantly berating her and threatening to lock her in the closet.

D. A 73 year-old woman reports that her daughter is constantly berating her and threatening to lock her in the closet.

10

A client contacts a therapist for help with his anger over his partner’s extramarital affair. During the initial session, the client states he “will do whatever it takes” to get even with his partner. What should the therapist do first?

A. Notify the partner of the verbal threat.


B. Remind the client of the limits of confidentiality.


C. Obtain a history of previous violent behavior.


D. Seek further clarification of the statement.

D. Seek further clarification of the statement.

11

A family is referred for therapy by their minister. The parents report that their 14-year-old son has been found drunk on two occasions. The son responds, “I hate school. I get bullied every day. You guys don’t care. You just pray.” What should the therapist assess NEXT?


A. Family history of substance abuse.


B. Severity of bullying.


C. Family’s religious beliefs.


D. Son’s risk of self harm.

D. Son’s risk of self harm.

12

A woman comes to therapy and informs the therapist that she is being physically abused by her husband. She has marks on her face and shares with you that their kids have seen the husband be violent toward her for the past 2 months. How should the therapist respond?

A. Report abuse to police.


B. Provide her with shelter information and contact CPS.


C. Provide her with shelter info and inform her of her rights.


D. Develop safety plan with client.

D. Develop safety plan with client.

13

A therapist meets with a client diagnosed with schizophrenia who is brought in for the first session by her brother. The brother informs the therapist he was recently appointed conservator by the court. The brother would like to attend therapy sessions with the client to ensure she is providing the therapist with accurate information and benefiting from treatment. He explains that the client has a history of lying to her therapists. The therapist should:



A. invite the brother to attend the sessions.


B. explore pros and cons of including the brother and set appropriate boundaries.


C. deny the request and refuse to include the brother in treatment.


D. review conservatee’s rights to confidentiality with the brother.

B. explore pros and cons of including the brother and set appropriate boundaries.

14

A client submits a written request to access their records. There is not a clinical reason to withhold the record. Which of the following is true?


A. The therapist must provide a copy within 10 days.


B. The client may inspect the record within 5 days, or receive a treatment summary within 10 days, or receive a copy within 15 days.


C. . The client may inspect the record within 2 days, or receive a treatment summary within 5 days, or receive a copy within 10 days.


D. The therapist should consult with a lawyer before producing the records.

B. The client may inspect the record within 5 days, or receive a treatment summary within 10 days, or receive a copy within 15 days.

15

In order to meet the standard of care in the event of the death of a therapist, the therapist should:


A. Provide information about referrals to all clients.


B. Engage in on-going consultation.


C. Create an up-to-date professional will.


D. Contact clients if they develop a terminal illness.

C. Create an up-to-date professional will.

16

A therapist must comply with HIPAA requirements if:


A. the therapist uses multiple offices.


B. the therapist communicates electronically with patients.


C. the therapist communicates electronically with third-party payers.


D. all therapists must comply with HIPAA.

C. the therapist communicates electronically with third-party payers.

17

A couple seeks therapy for relational issues. They want to use the wife’s insurance and request that the therapist bill her insurance for individual treatment of an anxiety disorder. The therapist agrees. The therapist’s decision is:



A. Acceptable as long as the wife has an anxiety disorder.


B. Acceptable as long as the couple agrees.


C. Unacceptable because it is unethical.


D. Unacceptable because it is illegal.

D. Unacceptable because it is illegal.

18

A therapist attends a two-day workshop on treating sexual disorders. Besides this workshop, the therapist has no other training or background in sexual disorders. After attending the workshop, the therapist lists Treating Sexual Disorders as an expertise on his website. This action is:


A. Legal but unethical.


B. Illegal and unethical.


C. Legal and ethical.


D. Ethical as long as he cites the specific training he has had.

B. Illegal and unethical.

19

After working with a client for six months, the client moves to Washington state. Both the therapist and client agree that the client would benefit from continued therapy. The client tries three different therapists in Washington but doesn’t feel they are a good fit and requests to continue therapy with the original therapist over the phone. The therapist agrees and reviews the teletherapy consent for treatment. The therapist’s actions are:


A. Acceptable as long as informed consent is obtained.


B. Unethical.


C. Illegal.


D. Illegal and unethical.

C. Illegal.

20

A therapist receives a phone call from a prospective client. When is the therapist legally obligated to discuss fees?


A. Once client determines the therapist is a good fit and will continue.


B. During the initial phone call with the client.


C. Prior to the onset of therapy.


D. During informed consent.

C. Prior to the onset of therapy.

21

A client diagnosed with schizophrenia has been given a prescription for medication by a psychiatrist. The client has stopped the medication, complaining of unpleasant side effects. The therapist does not notice any improvement in the client’s affect, mood, or cognitions. Which of the following actions should the therapist take?


A. Refer the client back to the psychiatrist.


B. Contact the client’s psychiatrist to report client’s noncompliance with medication.


C. Explain that the client cannot be seen unless the client is taking the prescribed medication.


D. Continue to work with the client since the absence of medication appears not to have had a negative effect.

A. Refer the client back to the psychiatrist.

22

A therapist discovers that she attends the same church as her client. The client, a recent widow with ongoing health issues, asks the therapist to accompany her to weekly church services. The client explains to the therapist that it is difficult for her to get around and she does not have any support nearby. The therapist should first:



A. empower client to build support network.


B. address issues of dependency with client.


C. refer client to support group for widows.


D. clarify professional boundaries.

D. clarify professional boundaries.

23

A therapist’s child requests permission to attend the birthday party of a classmate. The therapist realizes that the parent of this child is a client of the therapist, but the therapist does not think that either child is aware of the fact. The therapist’s BEST response is to:


A. plan an alternative activity with the child.


B. allow the child to attend the party.


C. transfer the client to another therapist.


D. discuss the situation with the client.

D. discuss the situation with the client.

24

A therapist in a mental health agency conducts an initial interview with a lesbian client who seeks treatment for depression and problems in her relationship with her partner. The therapist feels uncomfortable when the client discusses her homosexuality. At the conclusion of the session, the client expresses a desire to continue the therapeutic relationship with the therapist. The therapist should first:



A. refer the client to another therapist in the agency.


B. continue working with the client on a trial basis.


C. consult with colleagues to discuss the discomfort.


D. disclose to client lack of experience working with homosexuals.

C. consult with colleagues to discuss the discomfort.

25

A therapist at a mental health clinic meets with a former client of the center. The client reports that she had an affair with the therapist who treated her who has since left the clinic. The therapist should FIRST?


A. Provide the client with the brochure “Professional Therapy Never Includes Sex.”


B. Recommend that the client report the complaint to the licensing board.


C. Ask the therapist about the relationship with the client.


D. Obtain details about the affair.

A. Provide the client with the brochure “Professional Therapy Never Includes Sex.”

26

A therapist in private practice has seen a client for over three months with no apparent change in the client’s symptoms. At this point, the therapist will best serve the client by:



A. seeking consultation from an experienced colleague about the case.


B. searching the professional literature for discussion of similar case situations.


C. discussing termination with the client.


D. reformulating the client’s goals.

A. seeking consultation from an experienced colleague about the case.

27

With the hopes of publishing a research article in a professional journal, a therapist submits an abstract proposing a study of panic disorders as they have occurred in her practice. What should the therapist do FIRST?


A. Select a matched control group.


B. Obtain informed consent from subjects.


C. Introduce the experimental intervention.


D. Pretest data to establish a baseline.

B. Obtain informed consent from subjects.

28

During supervision, the supervisee invites the supervisor to a dinner party to celebrate the supervisee’s birthday. The supervisor likes the supervisee and would like to attend. The supervisor should:


A. Accept the invitation.


B. Tell the supervisee that the supervisor has other plans.


C. Acknowledge the invitation and the desire to attend, but explain the importance of professional boundaries.


D. Politely decline the offer.

C. Acknowledge the invitation and the desire to attend, but explain the importance of professional boundaries.

29

A Mexican American woman brings her 58-year-old mother in for therapy. She says that she is very concerned about her mother, because she has not been the same since her husband died four weeks ago. She relays that her mother hasn’t been able to get out of bed. The mother reports seeing and hearing her husband everywhere. According to the daughter, her mother never had any type of psychological symptoms previously. What should the therapist do?



A. Refer the mother to an M.D.


B. Refer the mother to a psychiatrist for medication evaluation.


C. Explore their cultural views about grief and dying.


D. Normalize the symptoms as part of the grief process.

C. Explore their cultural views about grief and dying.

30

A 42-year-old woman has been in therapy for two years for depression. She has met the mutually agreed-upon goals. She requests ongoing therapy because she does not want her life to go back to the way it was. What course of treatment is most indicated at this point?



A. Discuss termination issues and maintain regularly scheduled sessions.


B. Discuss termination issues and gradually decrease the frequency of contact.


C. Reformulate goals and address anxiety inhibiting client autonomy.


D. Reformulate goals and normalize client’s fears of independent living.

B. Discuss termination issues and gradually decrease the frequency of contact.