California Law And Ethics Exam Social Work

Question: Confidentiality falls into what three types of issues?
Answer: Therapeutic, legal & ethical issues
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Question: What is a leading cause of ethical complaints? Litigation for malpractice?
Answer: Confidentiality

4th most frequent basis of disciplinary action
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Question: According to the NASW Code of Ethics, social workers should protect confidentiality of all info except for when?
Answer: Compelling professional reasons

As necessary to prevent "serious, foreseeable, and imminent harm" to a client or other identifiable person.
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Question: To what level of detail should confidentiality be broken when necessary?
Answer: In these instances, professionals should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed.
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Question: What type of consent is required in order for mental health professionals to disclose to third parties?
Answer: Written

Verbal - in emergency situations only
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Question: What are the exceptions to confidentiality?
Answer: Under California law, there are several exceptions to the confidentiality of psychotherapy. The primary exceptions to confidentiality concern harm to self or others:

Where there is a reasonable suspicion that a client is likely to harm him or herself unless protective measures are taken.

Where there is a reasonable suspicion of child abuse or elder adult physical abuse (see Mandated Reporting section);

Where there is a reasonable suspicion of the potential for danger of violence to others (see Duty to Warn section);
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Question: What is reasonable suspicion according to Lowenthal Child Abuse Reporting guidelines?
Answer: 1. Reasonable suspicion does not require certainty that child abuse or neglect has occurred;
2. Reasonable suspicion does not require a specific medical indication of child abuse or neglect; any reasonable suspicion is sufficient; and
3. Reasonable suspicion may be based on any information considered credible by the reporter, including statements from other individuals.
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Question: How should a therapist approach treatment confidentiality with families or couples?
Answer: It is important for the provider to be specific with regard to confidentiality issues and to seek agreement among the parties involved concerning each individual's right to confidentiality and obligation to preserve the confidentiality of information shared by others.
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Question: How should a therapist approach treatment confidentiality with groups?
Answer: The mental health provider cannot guarantee that group members will keep information confidential and this information is important to share with all group members in advance of group psychotherapy.
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Question: Can clients access their therapeutic medical record?

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Question: What is privileged communication?

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Question: How many privileges are there in CA?
Answer: 13 recognized
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Question: Who holds the privilege?
Answer: Client if no guardian or conservator

If so, guardian/conservator holds it
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Question: Who holds privilege if client is dead?
Answer: Personal representative
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Question: If you want to release information from a group, family or couple, what must you do?
Answer: • If your identified patient is a group, family, or couple you must receive a waiver from each and every member of the group before you can release any information.
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Question: Do minor children hold privilege?
Answer: Yes - If your patient is a minor child, he or she holds the privilege. A minor's parents do not hold the privilege for the minor. The only time a parent could hold the privilege for the minor is if the court has specifically appointed the parent as a guardian ad litem
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Question: How is privilege asserted for minors with regard to attorneys?
Answer: • If your patient is a minor, you must assert the privilege on his or her behalf. If the minor has an attorney, the attorney can make the decision to waive or assert the privilege.
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Question: What does the NASW Code of Ethics say about when the law orders social workers to break confidentiality without client permission?
Answer: Social workers should protect the confidentiality of clients during legal proceedings to the extent permitted by law. When a court of law or other legally authorized body orders social workers to disclose confidential or privileged information without a client's consent and such disclosure could cause harm to the client, social workers should request that the court withdraw the order or limit the order as narrowly as possible or maintain the records under seal, unavailable for public inspection." Although it is ethically preferable, then, not to reveal treatment information, this may still be required by the court.
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Question: What could happen if a provider receives a subpoena from an attorney to provide copies of clinical records?
Answer: waive privilege and allow the provider to provide the subpoenaed information; or
invoke privilege and refuse to allow the release of information.

In the latter case, the judge will determine whether the treating professional must release information and the judge can issue a court order.
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Question: What is required in order for a social worker to be forced to provide information even though privilege is invoked?
Answer: Court order by the judge
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Question: In CA, how old must minors be to consent to mental health treatment or counseling if 2 requirements are met? What are the requirements?
Answer: 12

a) 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

1) The minor would present a danger of serious physical or mental harm to self or others without the mental health treatment or counseling or residential shelter services

or


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Question: If requirements are met, can minors 12+ consent to medical care and counseling related to dx and tx of a drug or alcohol problem? What about psych meds or inpt hospitalization?
Answer: Yes to subst abuse tx

No to psych meds or inpt hospitalization - both require parental consent
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Question: What is required to share a minor's (12+) information/medical record with others, including parents?
Answer: Minor's written consent
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Question: Should a provider attempt to involve a parent/guardian in a minor's tx?
Answer: Yes - unless inappropriate
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Question: At what age does a person become an "elder" under California Welfare and Institution Code?
Answer: 65
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Question: When should a therapist file a report? How about for APS?
Answer: Immediately by phone and a written report within 36 hours

Immediately by phone and written report within 2 working days
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Question: What do mandated reporters have immunity to?
Answer: Civil & criminal liability
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Question: What is a mandated reporter subject to if they fail to file a report?
Answer: Misdemeanor criminal prosecution & fines

If harm comes to a child through the result of a professional's failure to report abuse, even stiffer penalties may exist.
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Question: What does CA require of social workers applying for a license with regard to child abuse reporting?
Answer: Due to the importance of accurate knowledge of child abuse, all persons applying for a license as a marriage and family therapist or clinical social worker needs to complete at least 7 hours of training in child abuse assessment and reporting. Additionally the BBS will not issue a license to a person who has been convicted of a crime in this or any other state or in a territory of the United States that involves sexual abuse of children or who is required to register pursuant to Section 290 of the Penal Code or the equivalent in another state or territory.
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Question: What is Laura's Law?
Answer: "Laura's Law," was written in response to these concerns. Laura's Law allows California counties to decide whether to opt to implement a community-based, court-monitored outpatient treatment program. These programs require outpatient treatment for a seriously mentally ill person who is unlikely to survive safely in the community without supervision, has a history treatment noncompliance, and presents a serious risk of harm to self or others. At the present time some, but not all, California counties have adopted Laura's Law.
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Question: When can a person be placed in assisted outpatient treatment?
Answer: The person must:
1) Be eighteen years of age or older;
2) Be suffering from a mental illness;
3) Be unlikely to survive safely in the community without supervision
4) Have a history of non-compliance with treatment that has either:
5) Have been offered an opportunity to voluntarily participate in a treatment plan by the local mental health department but continue to fail to engage in treatment;
6) Be substantially deteriorating;
7) Be, in view of his or her treatment history and current behavior, in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would likely result in the person meeting California's inpatient commitment standard, which is being:
A.) A serious risk of harm to himself or herself or others; or
B.) Gravely disabled (in immediate physical danger because unable to meet basic needs for food, clothing, or shelter);
8) Be likely to benefit from assisted outpatient treatment; and
9) Participation in the assisted outpatient program is the least restrictive placement necessary to ensure the person's recovery and stability.
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Question: Who can file a petition for AOT?
Answer: Only the county mental health director may file a petition for AOT, but treatment providers or family members may request that such a petition be filed.
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Question: How may a therapist carry out the "duty to protect?" (Tarasoff)

What is the consequence of not acting?
Answer: - Notify the police
- Warn the intended victim
- And/or take other reasonable steps to protect the individual



Failure to act may also result in potential civil liabilities
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Question: When is Tarasoff required?

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Question: Is there a difference in duty to protect if a pt communicates directly to therapist vs. info relayed by an immediate family member?
Answer: No - duty is the same

*Only if a family member communicates this. Not beyond
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Question: What are some symptoms of compassion fatigue?
Answer: Relational/Work-Related Symptoms (Lombardo & Eyre, 2011)
• Avoidance or dread of working with certain patients

• Boundary issues, such as over-involvement with patients

• Reduced ability to feel empathy towards patients or families

• Frequent use of sick days

Physical/Emotional Symptoms

• Lack of joyfulness/Irritability
• Poor concentration, focus, and judgment
• Sleep disturbances
• Excessive use of substances
Anxiety
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Question: What assessment can be used free of charge to self-monitor compassion fatigue?
Answer: Proquol
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Question: Can social workers consult with colleagues for advice on areas outside their scope of practice?
Answer: Yes - do so with the least amount of information necessary
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Question: What is informed consent?


Includes:
1) a description of the diagnosis, treatment, risk and benefits
2) discussion of other options, 3) clinician's qualifications to perform treatment.
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Question: What should be included in informed consent and how should it be conducted?
Answer: Informed consent may take various forms, such as a client information brochure or a discussion between client and therapist. Whatever format it takes, informed consent should include the following factors:

-Goals of therapy/psychotherapy services
-Risks and benefits of therapy
-Approximate length of the process
-Alternatives to therapy
-Fees and services, including processes if bills are not paid
-Qualifications and background of the counselor
-Treatment procedures, including emergency procedures
-Third party disclosures
-Choices between paying with and without insurance
-Limits of confidentiality
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Question: Is informed consent required for school-based psych services b/w teacher & therapist? What about a psych crisis?
Answer: No - as long as interventions are under the authority of the teacher & w/i scope of typical classroom intervention

Parent consent is required if consultation is extensive or intrudes on student/family privacy; and for mental health screenings

No
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Question: Written informed consent is required when?
Answer: Psychosurgery, ECT, research studies
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Question: LEGAL: Privilege does not apply in the following circumstances
Answer: The client authorizes a release of information
A therapist is legally mandated to breach confidentiality
The client has disclosed a significant part of the information to a third person
The situation represents one of the legally defined exceptions to privilege.
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Question: LEGAL: Privilege and Patient-Litigant Exception
Answer: Legally Defined Exception to privilege
If a patients emotional condition has been raised as an issue by the patient or representative
ex: employee suing boss for sexual harassment claiming it caused emotional distress that led to diagnosis of panic disorder. Information obtained by woman's therapist relevant to her diagnosis is not privileged
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Question: LEGAL: Privilege exceptions in Court-Appointed Psychotherapy
Answer: Legally Defined Exception to privilege Therapist has been appointed by court to examine defendant as long as it wasn't defendants attorney wasn't the one to request. Example: Judge orders man on trial for murder to undergo psychological testing to decide if he is competent to stand trial. Information obtained in eval. relevant to competence is not privileged.
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Question: LEGAL: Proceeding to Establish Competence
Answer: Legally Defined Exception to privilege
Example: daughter of man with suspected cognitive disabilities request conservatorship. Therapist who evaluated man may testify about results of cognitive evaluation.
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Question: LEGAL: Patient under 16 is a Victim of a Crime
Answer: Legally Defined Exception to privilege
Example: Therapist testifies in court on behalf of 14 yr old boy who told her older teenagers were extorting money from him. Exception to privilege to protect boy from harm.
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Question: ETHICAL: NASW Core Values
Answer: Service
Social Justice
Dignity and Worth of the Person
Importance of Human Relationships
Integrety
Competence
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Question: A therapist is treating a mother, step-father, 12-year-old son and 4-year old daughter for family therapy. The mother requests that the therapist speak to the son's teacher because he has been complaining of problems in the classroom. When obtaining a release to speak to the teacher, the therapist must get written consent from the entire family.
Answer: False
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Question: According to HIPAA, psychotherapy notes are released to third-party payers for billing.
Answer: False
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Question: A therapist who was a victim of sexual abuse as a child meets with an 18-year-old client who also experienced childhood sexual abuse from a teacher. The therapist is concerned about working effectively with this client due to her lack of experience in treating sexual abuse. It is appropriate for the therapist to refer the client to someone who specializes in sexual abuse because it is out of the therapists scope of competence.
Answer: True
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Question: A therapist should always support a client's right to self-determination first.
Answer: True
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Question: A safety plan does not include giving the client Domestic Violence resources.
Answer: False
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Question: A client, who is a single mother, informs the therapist that she was offered a better job in another state where she does not know anyone. She requests assistance finding childcare for her 5-year old. She adds that she thinks that it would be easier for her to remain in her present living arrangement with her parents until the child is older. The therapist thinks the client should stay. The therapist should explore the pros and cons of her options.
Answer: True
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Question: During informed consent, the client should always have a good understanding of what services they are receiving.
Answer: True
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Question: A therapist accepts insurance in private practice. The insurance company sends notice to the therapist requesting copies of five client files for an audit. This is a typical practice of the insurance company. The therapist should make sure each file has an authorization and then submit the files.
Answer: True
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Question: A mother of an 11-year-old boy was arrested and subsequently ordered to enter a 90-day detox facility for drug and alcohol abuse. The son was sent to live with a foster family temporarily when the mother went into a detox facility. The child has been court-ordered to attend therapy. The therapist should obtain consent for his treatment from first the lawyer and second the social worker.
Answer: True
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Question: A therapist has been seeing a gay couple for several months for relationship issues. Between sessions, one of the men calls distraught because he learned he has HIV. "I don't know what to do! Please don't tell my partner." The therapist should assure him that you will maintain his confidentiality and explore his reasons for not wanting his partner to know.
Answer: True
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Question: Fees are not a legally required aspect of informed consent.
Answer: False
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Question: A therapist is part of an interdisciplinary team at a residential center for teens. The therapist should make it clear to the residents that confidential disclosures are shared with the treatment team.
Answer: True
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Question: A therapist does not have to accept a subpoena.
Answer: False
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Question: A client seeks therapy for anxiety after a car accident. She also decides to sue the driver of the other car who was at fault claiming that the accident has left her too anxious to drive. The therapist receives a subpoena for the client's records and should accept the subpoena, maintain confidentiality, and assert privilege if the client so directs.
Answer: True
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Question: A therapist treating an EAP client or court ordered client can only provide attendance history when their employer or probation officer contacts the therapist for updates.
Answer: True
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Question: A therapist should never respect a client's beliefs, especially if the therapist has different beliefs.
Answer: False
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Question: A therapist should always respect a client's beliefs unless it is affecting the therapist and not allowing them to do their job appropriately.
Answer: True
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Question: 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. The case manager should report the situation to the police immediately.
Answer: True
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Question: A therapist is allowed to confirm or acknowledge a client at the request of a lawyer.
Answer: False
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Question: If a therapist denies client access to their records and the client becomes angry, the therapist should consult a lawyer.
Answer: False
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Question: A therapist can bill the insurance for a missed client appointment, but they may not pay.
Answer: True
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Answer: False
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Question: 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. It is appropriate for the clinician to accept produce from client's farm as payment if that is client's only source of payment.
Answer: True
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Question: A client 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. The clinician should terminate services if it is clear that the client is not a danger to self or others.
Answer: True
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Question: 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. It is acceptable for the client to provide house repair services for the therapist in exchange for continuing therapy.
Answer: False
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Question: A therapist, who was formerly employed as a financial planner, now treats couples with relationship issues. It is acceptable for the therapist to assist couples he is treating with financial planning when that is one of the sources of their conflict.
Answer: False
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Question: A therapist has been treating a woman for depression in private practice for four months. During an emotional session the client discloses that she was sexually molested when she was eight by her neighbor. Since the therapist has minimal training in treating childhood sexual abuse it is acceptable for the therapist to refer the client to a trained child sexual abuse therapist.
Answer: False
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Question: A therapist has been treating a client with Generalized Anxiety Disorder for five months. The client's symptoms have disappeared and the client is functioning well. The therapist enjoys the sessions with the client so she has been reluctant to bring up termination. Also, the client pays full fee and the therapist is worried about losing the income. It is unethical for the therapist to continue therapy with this client.
Answer: True
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Question: A 13-year-old girl is referred by her teacher for therapy for depression. The therapist determines she is mature enough to consent for her treatment. LEGALLY the therapist should first determine whether her parents should give consent.
Answer: True
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Question: A new client comes to the initial therapy session in crisis. The therapist does not inform the client of the fee prior to the initial session. When the client receives the bill, she refuses to pay. In this situation, the therapist should accept the client's refusal to pay.
Answer: True
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Question: A therapist in a small rural community has decided to consult with a colleague about a client who does not seem to be progressing in therapy. As part of the consultation the therapist should obtain a release from the client since the colleague might know him/her.
Answer: True
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Question: A client wants to see his records. The therapist determines that there is high risk of detrimental consequences to the client if the client were to see the records. The therapist should deny the request to access the records and document why it was denied.
Answer: True
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Question: A therapist is working in a small rural town and is the only provider within the area. A neighbor from a nearby farm requests that her son receive counseling services. The therapist has seen the boy on several occasions in the local store, but has minimal interaction with him or his mother. The therapist should decline to provide therapy to the client.
Answer: False
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Question: A therapist receives an order from the court for a former client's records. The therapist is concerned that the release of the records will cause harm to the client. The therapist advocates to the court to limit the scope of the release. The court declines the request so the therapist must provide a copy of the records immediately.
Answer: True
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Question: During a session, a client makes a vague threat toward his former boss. When the therapist asks what the client means by the statement, the client ignores the question. The therapist should remind client you are a mandated reporter.
Answer: False
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Question: A court-ordered client with a history of violence shares that he is really pissed off at his former boss and is "going to wait for him after work one of these days to make him pay." When the therapist asks the client what he means by the statement, the client tells him angrily to "forget it". Due to client's violent history and the fact that he does not want to discuss it, the therapist should inform the police.
Answer: True
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Question: The informed consent for treatment is not part of the summary of records.
Answer: True
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Question: The purpose of laws and regulations pertaining to psychotherapy advertising is to ensure the public is well-informed and not misled.
Answer: True
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Question: It is unethical for a therapist starting a new practice to advertise in her community.
Answer: False
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Question: A gay couple comes in to see you for the first session. They state that they have been referred by one of the partner's individual therapist. The referring therapist told them that you have extensive experience in working with gay couples. In actuality, you have treated a good number of heterosexual couples, but have seen only a few gay couples. As their therapist you should correct the inaccurate information with both the couple and the referring therapist without divulging your client's identity.
Answer: True
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Question: To what services can minors consent to at any age?
Answer: Pregnancy, contraception, abortion (no parental contact without written consent)

Sexual assault/rape services under 12: med dx, tx & evidence collection (provider must attempt to contact parents & report to CPS)
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Question: Is ECT allowed for minors?
Answer: ♣ 12-15 only if considered life-saving - both child and parent consent required
♣ 16-17 - voluntary consent by minor; share with parents with written consent
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Question: To what services can 12+ consent to?
Answer: Parent comm not permitted without written consent:
- ID/STI prevention, dx, tx
- AIDS/HIV testing & tx
- Rape services

- Outpt mental health services (have to attempt to involve parents; can discuss verbally, but medical records require written consent)
---> minor has to be mature enough & present danger/harm to self or others w/o tx OR is alleged victim of child abuse or incest
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Question: To what services can minors not consent to, even if 12+?
Answer: Psych meds

Inpt psych hospitalization (parents cannot force tho unless 5150)
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Question: If a child is under 14, who are they legally permitted to have sex with? 14/15? 16+?
Answer: Under 14

14 - 21

Any age
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Question: Is emotional abuse required to be reported to CPS?
Answer: No
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Question: How old is an elder?
Answer: 65+
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Question: How soon must verbal and written reports be made for child abuse?
Answer: Immediately

w/i 36 hours for written
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Question: How soon must verbal and written reports be made for elder abuse?
Answer: Immediately (by phone or confidential internet reporting tool)

w/i 2 working days for written
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Question: What form is used for written abuse reports?
Answer: DOJ form
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Question: How many hours of training in child abuse assessment is required of LCSWs?
Answer: 7 hours
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Question: Can a person/agency be at risk for litigation upon a negligent/intentional confidentiality breach even if the person drops charges?
Answer: Yes

A licensing or certifying board may assess an admin fine or civil penalty whether or not the patient suffers any damages (CA confidentiality of medical information act - CMIA)

Lanterman-Petris-Short Act (LPS): civil damages for negligent disclosure
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Question: When is drug use by parents reportable to CPS?
Answer: When parent is manufacturing a controlled substance in the presence under a child of age 16

Other drug use would only be reportable if the father could not care for his child safely as a result of use
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Question: What is required when a baby is born with positive drug tox/withdrawal sxs?
Answer: An assessment of needs for the infant and infant's family and to make a referral for appropriate services
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Question: How should social workers act when they disagree with agency policy or procedure?
Answer: - Advocate & discuss with colleagues & admin first informally
- If necessary, do the above but more formally
- If necessary, involve appropriate outside agencies (governors office, media, advocacy organization)
- Avoid conflicts of interest by informing clients of real or potential conflicts of interests
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Question: How long must medical records be retained after client discharge?
Answer: 7 years (but 10 is recommended)

For minors, at least 7 years after they turn 18
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Question: What is the NASW's position regarding sliding-scale fees?
Answer: Consideration should be given to the client's ability to pay
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Question: What should clients of military therapists be informed of?
Answer: Military therapists have neither control over whom they consult or evaluate nor ways to prevent dual relationships and conflicts of interest. Clients in these settings must be fully informed of the disclosures that may result from the unavoidable dual relationship. Comparable conflicts may arise when non-military therapists are involved in court cases.

- They are legally mandated to the dual roles
- National defense, unit integrity, combat readiness etc are higher than individual welfare in the military
- Sometimes people serve alongside clients in military as officers & also as guards in prisons
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Question: What information are military commanding officers allowed to know about information obtained by a social worker? What about what information is required to be reported to prison authority?
Answer: - Relevant to national security or combat readiness

- Relevant to security & safety
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Question: What disclosures can be made of people in correctional institutions?
Answer: 1) Provision of health care
2) Health and safety of inmate and other inmates; also of correctional institution personnel; personnel responsible for transporting/transferring inmates
3) Law enforcement on the correctional institutions premises
4) the 'administration and maintenance of the safety, security, and good order' of the institution

Fugitive - no restrictions - as it is useful for apprehension of the inmate
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Question: Can prisoners obtain med records copies, billing or other records?
Answer: No - not allowed to obtain a copy. Can inspect records unless they are psychotherapy notes or contain info for criminal/admin proceedings

Can deny if access would put at risk the health, safety, security, custody, or rehabilitation of the inmate or other inmates, or the safety of any officer, employee, or other person at the correctional institution as well as the safety of any person responsible for transporting the inmate
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Question: Under HIPPA do client's have the right to see their psychotherapy notes?
Answer: No - therapists have the right to keep them private (as long as they are kept separate from the medical record)

They can be made available to other providers given client's consent
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Question: What is the CA statute of limitations on civil action?
Answer: Between 1 - 4 years
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Question: What is required for breach of confidentiality with regard to SI?
Answer: Plans, means & intent
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Question: What is the 4th most common disciplinary action?
Answer: lack of keeping client confidentiality
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Question: What is a leading cause of litigation?
Answer: breech of confidentiality
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Question: According to the Code of Ethics, when is the only exception for breeching confidentiality?
Answer: compelling professional reasons
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Question: When is the only time, beside a court subpoena, that a counselor can release protected client information?
Answer: Written consent from client or legal guardian
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Question: T or F? Keeping client information confidential does not include when disclosure is necessary to prevent serious forseeable imminent harm to client or others.
Answer: T
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Question: T or F? Counselors should provide the most amount of information when disclosing confidential information.
Answer: F
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Question: T or F? Verbal consent to disclose client information is never permitted.
Answer: F, verbal consent is ok in emergency situations
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Question: What is informed consent?
Answer: A client is informed in advance, circumstances under which the counselor is allowed to disclose client information
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Question: What are the stipulations of breaking confidentiality?
Answer: 1. when a client is at harm of hurting oneself if protective measures were not taken
2. Reasonable suspicion of child or elder abuse/neglect
3. reasonable suspicion of potential for danger/violence to others
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Question: How does confidentiality work when you are doing psychotherapy with a group/family?
Answer: counselor must be clear and specific as to confidentiality issues and to review each member's right to confidentiality & obligation to preserve the confidentiality of information by others
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Question: T or F? A provider cannot ensure that confidentiality will be kept by other group members.
Answer: T
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Question: What is privilege?
Answer: legal right of keeping clinical records confidential
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Question: How does NASW stand on court order of client records?
Answer: Social workers should protect the confidentiality of clients during legal proceedings to the extent permitted by law. When a court of law or other legally authorized body orders social workers to disclose confidential or privileged information without a client's consent and such disclosure could cause harm to the client, social workers should request that the court withdraw the order or limit the order as narrowly as possible or maintain the records under seal, unavailable for public inspection
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Question: What is the term, "age of consent"?
Answer: laws related to the legal and medical rights of minors and is the age at which a minor can consent to tx without parental authorization
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Question: T or F? Mandated reporters have immunity from civil and criminal liability
Answer: T
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Question: What happens if you know or have suspicion of abuse/neglect and you do not report it?
Answer: punishment of misdemeanor criminal prosecution and fines
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Question: T or F? No client has 100% guarantee of complete confidentiality
Answer: T
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Question: What is the primary goal of social work?
Answer: enhance human well-being and help meet the needs of all people who are vulnerable or oppressed
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Question: T or F? Child abuse is usually found in a combination of types rather than alone.
Answer: T
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Question: What are the five things to take into consideration when looking at child abuse?
Answer: 1. age of child
2. Developmental levels of child
3. severity of action
4. frequency of action
5. contextual=historical/cultural perspectives of family
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Question: What is MBP?
Answer: intentional simulation of physical illness by a parent in his or her child, usually for the purpose of attention. This may include fabricating symptoms or actually inducing symptoms (such as causing a child to have a fever, feeding the child things he or she should not ingest, etc.)
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Question: What constructs child neglect?
Answer: emotional, physical and educational
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Question: What does physical neglect entail?
Answer: Physical neglect includes refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision.
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Question: What does educational neglect entail?
Answer: Educational neglect includes the allowance of chronic truancy, failure to enroll a child of mandatory school age in school, and failure to attend to a special educational need.
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Question: What does emotional neglect entail?
Answer: Educational neglect includes the allowance of chronic truancy, failure to enroll a child of mandatory school age in school, and failure to attend to a special educational need.
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Question: What is the most difficult subset of abuse to prove?
Answer: emotional abuse= emotional injury AND Change in emotional stability of child
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Question: What are signs of physical abuse?
Answer: • Has unexplained burns, bites, bruises, broken bones, or black eyes
• Has fading bruises or other marks noticeable after an absence from
school
• Seems frightened of the parents and cries when it is time to go home
• Shrinks at the approach of adults
• Reports abuse to you or another adult caregiver
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Question: What are signs of child neglect?
Answer: • Is frequently absent from school
• Begs or steals food or money
• Lacks needed medical or dental care, immunizations, or glasses
• Is consistently dirty and has severe body odor
• Lacks sufficient clothing for the weather
• Abuses alcohol or other drugs
• States that there is no one at home to provide care
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Question: What are signs of child sexual abuse?
Answer: • Suddenly refuses to change for gym or to participate in physical activities
• Reports nightmares or bedwetting
• Experiences a sudden change in appetite
• Demonstrates bizarre, sophisticated, or unusual sexual knowledge or
behavior
• Becomes pregnant or contracts a venereal disease, particularly if under
age 14
• Runs away
• Reports sexual abuse by a parent or another adult caregiver
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Question: What are the 3 components of HIPAA?
Answer: 1. Portability standards that ensure the continuity of healthcare
2. Privacy standards that govern the disclosure of protected health information
3. Security standards that protect the development and maintenance of health information
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Question: Why was HIPAA established?
Answer: to protect PHI- protected health information
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Question: T or F? psychotherapy notes are treated differently than health records.
Answer: T, more discretion, clients do not have right to obtain copy under HIPAA
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Question: What is HIPAA's definition of psychotherapy notes?
Answer: That the notes are kept separate from the rest of the client chart
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Question: What would the Notice of Privacy Practices include?
Answer: • Information about treatment issues (e.g., the coordination or management of PHI with a third party
• Submission of PHI for Payment
• Exceptions to Confidentiality
• How Sensitive Health Information is handled
• Right of Access to medical records.
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Question: What is a central issue around advertising?
Answer: potential vulnerability of the client relative to the therapist. Vulnerability may include client insecurities, emotional problems, or lack of information about professional psychology services.
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Question: What does Tarasoff law entail?
Answer: therapist must warn the person whom the threat is advanced toward

-notify police
-warn victim
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Question: What does Ewing law entail?
Answer: The court did not differentiate between threats conveyed directly by the patient and those related by an immediate family member of the patient.
-hear from patient or family member
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Question: What is true of the Standard of Care?
Answer: 1. it is a legal concept
2. it is continually changing
3. it is derived from legal professional-communal principles
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Question: a therapist is seeing a woman for depression and her goal is to pay taxes back. The therapist is also a public accountant. The client asks to bring in her documents to the next session. What should the therapist do?
Answer: Refuse because it is outside her scope of practice
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Question: A new client seeks tx for 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 tx. The bx of the therapist is:
Answer: Unethical because the therapist is working outside her scope of competence
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Question: A therapist should honor a client's self-determination in all of the following scenarios except:
Answer: When the client is in danger of harming himself
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Question: In what situation would a therapist not be required to obtain informed consent?
Answer: the therapist is contacted by an adult patient who has SI and a plan
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Question: A therapist arrives at the office and sees a client has broken in and is looking through files. The therapist should:
Answer: call the police and inform them of the name of the client
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Question: In what situation does a client not have privilege?
Answer: When a client files a malpractice suit against the therapist
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Question: A client seeks tx from a therapist for anger after finding out about his partner's extramarital affair. In the first session he states he will do "whatever it takes" to get even. What should the therapist do?
Answer: Seek further clarification of the statement
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Question: A family comes to therapy and the 14 year old son has been found drunk twice. The son says in session, "I hate school. I get bullied everyday. You guys don't care. You just pray". What should the therapist assess next?
Answer: Son's risk of self harm.
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Question: A woman comes to therapy and discloses that she has been abused by her husband and that her children have been witness to the abuse for last 2 months. How should the therapist respond?
Answer: Develop safety plan with client
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Question: A therapist is contacted by a new client's conservator, which is the brother of the client who is dx with schizophrenia. The brother wants to be present in sessions to make sure the client is not lying and telling accurate information. What should the therapist do?
Answer: explore pros and cons of including the brother and set appropriate boundaries
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Question: A client submits a written request to access their records. There is not a clinical reason to withhold the records. What should the therapist do?
Answer: The client may inspect the records within 5 days, receive a tx summary within 10 days, or receive a copy within 15 days
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Question: in order to meet the standard of care in the event of the death of a therapist, the therapist should:
Answer: create an up-to-date professional will
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Question: A therapist must comply with HIPAA regulations if:
Answer: The therapist communicates electronically with patients
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Question: A couple seeks therapy for relationship issues. They want to use the wife's insurance and request the therapist bills insurance for individual tx of anxiety. The therapist agrees. The therapist's decision is:
Answer: unacceptable because it is illegal
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Question: A therapist attends a 2-day workshop on tx sexual disorders. Besides the workshop the therapist has no other training. After the workshop, he lists the Treating SexualDisorders as expertise. The action is:
Answer: illegal and unethical
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Question: A therapist has been seeing a client for 6 months but the client moves to WA. The client sees other therapists in WA but does not feel its a good fit and wants to continue services with therapist over the phone. The therapist agrees and reviews the tele therapy consent for tx. The action is:
Answer: illegal
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Question: A therapist receives a phone call from a prospective client. When is the therapist legally obligated to discuss fees?
Answer: prior to the onset of therapy.
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Question: a client dx with schizophrenia has been given a prescription for med by psych. the client stopped taking the med because of side effects. What should the therapist do?
Answer: refer the client back to the psychiatrist
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Question: A therapist discovers she attends the same church as a client. The client asks the therapist to accompany her on weekly church services. The client says it is hard for her to get around and does not have support nearby. There therapist should:
Answer: clarify professional boundaries
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Question: If a therapist is in a first session/intake with a client where they feel uncomfortable in working with the client due to sexual orientation. What should the therapist do?
Answer: Seek consultation with colleagues to discuss discomfort.
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Question: What should a therapist do when a client tells them they had a sexual relationship with a previous therapist?

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Question: A therapist in private practice has been seeing a client for three months and has not noticed a change in the client's sx or affect. The therapist should:
Answer: seek consultation from a an experienced colleague about the case
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Question: A therapist wants to submit a research article in a professional journal. The therapist submits an abstract proposing a study of panic disorders. What should the therapist do first?
Answer: Obtain informed consent from subjects
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Question: During supervision, the supervisee invites the supervisor to birthday party. The supervisor likes the supervised and would like to attend. The supervisor should:
Answer: acknowledge the invitation and desire to attend, but explain importance of professional boundaries
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Question: A woman has been in therapy for two years for depression. She would like to continue therapy in fear her life will go back to the way it was. What should the course of tx be?
Answer: discuss termination issues and gradually decrease the frequency of contact
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Question: Type abuse that is optional to report, a permitted report
Answer: Emotional abuse
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Question: Time in which written must be made in the case of suspected child abuse
Answer: 36 hours on Department of Justice forms
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Question: Time in which report of elder abuse, not in a care facility, required, both verbal and written reports
Answer: report must be made by phone ASAP and written report made in 2 working days
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Question: Time in which report of elder physical abuse is required, w/ serious bodily injury, when abuse is occurring in a long term living facility
Answer: 24 hours by phone to law enforcement, written report 24 hours to law enforcement AND local Ombudsman AND Long Term Care facility licensing board
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Question: Time in which report of elder physical abuse is required, with out serious bodily injury, when abuse is occurring in a long term living facility
Answer: ASAP by phone to local law enforcement OR local Ombudsman, written report within 2 business days to law enforcement OR Ombudsman
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Question: Headland vs Orange County
Answer: mental health worker is liable to foreseeable bystanders if worker does not for fill Tarasoff responsibility
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Question: Evidence Code 1024
Answer: gives mental health professionals permission to break confidentiality to prevent Cx harm to self, others or property
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Question: Release of Authorization can be revoked only when
Answer: Clinician receives written notification from the Cx requisition revocation
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Question: Length of time 2015 ruling determines clinicians must retain records after service termination date
Answer: 7 years after termination of service date
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Question: Length of time records of a minor are to be retained after service termination
Answer: Minimum of 7 years after Cx turns 18
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Question: Progress notes are
Answer: legal and held to standard of care
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Question: Process notes are
Answer: subjective and only for the professional to use and should be destroyed when no longer relevant and necessary to cx's Tx
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Question: Authorization to mental health services when parents are in an intact marriage
Answer: each parent can authorize Tx, however it is recommended that both be included
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Question: Authorization to mental health services when parents are divorced and have joint legal custody
Answer: both parents can consent to Tx
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Question: Authorization to mental health services when parents are divorced and one parent has soul legal custody
Answer: only parent with soul legal custody can consent to Tx
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Question: uthorization to mental health services when child is in Foster Care
Answer: the child's attorney can authorize consent to Tx
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Question: Length of time Care Givers Authorization Affidavit is valid
Answer: 1 year after the sign in date and can be revoked if the legal parent decides to consent or revoke Tx
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Answer: consent to their own Tx if the minor is 12+ years of age and mature enough to participate in therapy
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Question: Clinicians responsibility if Cx states that another therapist engaged in sexual activity with Cx
Answer: present the Cx with the brochure about sexual misconduct and therapy
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Question: Amount of continuing education hours a clinician must acquire within the initial license renewal period
Answer: at least 18 hours
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Question: Amount of continuing education hours a clinician must acquire within the 2 year license period
Answer: at least 36 hours, 6 of which obtain to Law and Ethics
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Question: Scope of Practice
Answer: all services defined by education and licensure a mental health professional is allowed to preform
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Question: Special Relationship
Answer: when one person is vulnerable and dependent upon another person ex: Cx/Clinician relationship
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Question: Standard of Care
Answer: average degree of skill, care and diligence practiced by members of the same profession, practicing in the same or similar locality
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Question: Definition of Law
Answer: formal code or decision established by a legislative body and interpreted by the courts, indicating what to do and not to do under a given circumstance
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Question: Three sources of legal obligation
Answer: statues and regulations, boards authorized by legislature, court cases
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Question: Examples of Gross negligence and incompetence
Answer: misrepresentation of a degree, reckless physical or mental harm, wrongful insurance billing, engaging in sexual relationships sooner then two years following termination of services
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Question: Definition of Ethics
Answer: ways considered "best" or "right" by standards established by professional organization
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Question: Patient Bill of Rights allows Cx to
Answer: request and receive information about clinicians background, fees and payment, length of therapy and subsequent care, limits of confidentiality seek 2nd opinion etc.
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Question: Definition of Privilege
Answer: Cx's right not to have confidential information revealed during legal proceedings
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Question: Supine
Answer: request for information
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Question: Court Order
Answer: requiring clinician present information requested
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Question: Quashed Supena
Answer: supena is null and void and no information is required to be turned over by the clinician. Cx asserts privilege and it is granted.
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Question: Waiving Privilege
Answer: Cx signs waiver and information is turned over to courts
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Question: Definition of Confidentiality
Answer: the legal and ethical requirement restricting the provider from giving information about things disclosed in Tx
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Question: Definition of physical abuse
Answer: physical injury or death inflicted by other than accidental means
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Question: Definition of sexual abuse
Answer: sexual assault, exploitation, rape, dude and lascivious acts, oral copulation, sexual penetration and molestation.
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Question: AB1775, law
Answer: law which make digital transmission of minors engaging in sexual activities illegal
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Question: Definition of neglect
Answer: maltreatment of Cx including malnutrition, willful endangerment, failing to protect from dangerous situations, failure to provide supervision
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Question: Definition of willful cruelty
Answer: permitting unjustifiable mental/ physical pain upon a child
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Question: Definition of elder
Answer: any adult 65 or older residing or who intends to reside in the state of California
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Question: Definition of a dependent adult
Answer: any person 18-64 residing in or intending to reside in California with physical, mental or financial limitations which restrict their ability to carry out normal activities of daily life, protect own rights and live independently
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Question: Definition of Tarasoff
Answer: duty to protect
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Question: End of life option Act
Answer: allows people 18 years and older to self administer a lethal dose of an aid in dying drug prescribed by Cx attending physician when a Cx has a terminal illness and will die within 6 months of diagnosis
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Question: Definition of Telehealth
Answer: practice of delivering healthcare, diagnosing, providing Tx and transfer of medical data using audio, video etc.
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Question: Ethical Standards

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Question: Scope of Competence
Answer: areas of skill or expertise a mental heath practitioner possess
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Question: Counter-transference
Answer: when the strong reactions f a therapist prevent practitioner from being able to adequately attending to the Cx needs/Tx
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Question: K1. Knowledge of laws regarding confidential communications within the therapeutic relationship.
Answer: B. Clarify for the family how your therapeutic work differs from religious counseling.

This response addresses your client's expectations about therapy and promotes a better understanding of the process.
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Question: K2. Knowledge of laws regarding the disclosure of confidential information to other individuals, professionals, agencies, or authorities.
Answer: B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case.

It would be important to have peer supervision or a paid supervisor in cases like this where counter-transference issues are bound to arise. An eventual referral for one or both clients might be necessary also.
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Question: K3. Knowledge of laws regarding holder of privilege.
Answer: D. Document your crisis interventions in the first session.

The laws about record-keeping require you to document any and all interventions.
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Question: K4. Knowledge of laws regarding privileged communication.
Answer: C. Maintain confidentiality.

Based on the information given in this question you would maintain confidentiality. Juan's threat is dependant upon the death of another person which eliminates the "imminence" that breaking confidentiality under Tarasoff requires.
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Question: K5. Knowledge of laws regarding the release of privileged information.
Answer: B. Decline to make an appointment and refer her to another therapist.

The woman who wants to become your client has a prior relationship with you as your child's piano teacher. This is an easily avoidable dual relationship since there are many other therapists that could help this woman.
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Question: K6. Knowledge of legal requirements for responding to subpoenas and court orders.
Answer: A. Help Hermoine with her crisis until her therapist returns.

Helping Hermoine with her crisis would be the only ethical way to proceed in this instance since her new therapist cannot be reached, and she has called you for help. Even though you had terminated and were no longer her therapist, when someone calls a social worker in crisis, the law presumes at that point the existence of a special relationship in which the therapist must act in the best interests and welfare of that person.
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Question: K7. Knowledge of legal criteria and requirements for providing therapeutic services to minors.
Answer: C. By telephone as soon as possible and in writing within two working days.


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Question: K8. Knowledge of laws regarding documentation of therapeutic services.
Answer: B. Tell minor clients how you will contact parents if you think there is an emergency.

Discussing the limits of confidentiality is an element of informed consent.
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Question: K9. Knowledge of laws pertaining to the maintenance/disposal of client records.
Answer: D. The client has the right to withdraw from the study at any time.

The client has the right to withdraw from the study at any time, and we as therapists, are to respect the client's wishes.
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Question: K10.Knowledge of laws pertaining to client's access to treatment records.
Answer: B. The client signed a waiver of privilege for the records.

No records would be disclosed until the client or the client's representative waived privilege.
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Question: K11.Knowledge of laws pertaining to the release of client records to other individuals, professionals, or third parties.
Answer: C. It is a legal principle that protects client conversations unless there is a court order.

Privilege is the legal right of the client not to have confidential information revealed during a legal proceeding. Only a client, judge or court order would challenge privilege.
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Question: K12.Knowledge of laws regarding the consent to and delivery of services via information and communication technologies.
Answer: D. Determine if you can deal with this client at this time.


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Question: K13.Knowledge of legal requirements of the Health Information Portability and Accountability Act (HIPAA).
Answer: D. Assessing whether a medication evaluation would be necessary.

From an ethical point (safety-minded) of view, a therapist would first need to consider all treatment modalities to help a client. In this case, that would include considering whether his anxiety is so severe that medication would help him benefit from therapeutic interventions.
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Question: K14. Knowledge of indicators of abuse, neglect, or exploitation of dependent adults.
Answer: C. Being arrested for shoplifting.

The law (Business and Professions Code 4982(a) says unprofessional conduct addresses licensees or registrants who have been "convicted" of an offense, not just arrested.
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Question: K15. Knowledge of laws pertaining to the reporting of known or suspected incidents of abuse, neglect, or exploitation of dependent adults.
Answer: C. Informing the couple of your "no secrets" policy

Informing the couple of your "no secrets" policy is solely an ethical responsibility.
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Question: K16. Knowledge of indicators of abuse, neglect, or exploitation of elderly clients.
Answer: A. Assist them with information you deem pertinent to the situation at hand.

In the event of a medical emergency it is permissible to give information to medical professionals that may be treating the client. Social workers are permitted to speak with other health professionals for purposes of treatment and diagnosis in recognition of situations such as these.
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Question: K17. Knowledge of laws pertaining to the reporting of known or suspected incidents of abuse, neglect, or exploitation of elderly clients.
Answer: B. Accommodate your fee since you've established a bond.

Because you've established a bond, accommodating your fee would be in the best interests of the client. If an accommodated fee cannot be agreed upon, then providing three low-cost therapy referrals would be appropriate.
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Question: K18. Knowledge of indicators of abuse/neglect of children and adolescents.
Answer: C. Engage Bobby in a therapeutic conversation.

The ethical standard is to speak with the colleague to try to rectify the issue first.
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Question: K19. Knowledge of laws pertaining to the reporting of known or suspected incidents of abuse/neglect of children and adolescents.
Answer: B. Make three referrals out of town.


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Question: K20. Knowledge of symptoms of mental impairment that may indicate the need for involuntary hospitalization.
Answer: A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.

It is legal and ethical to bill insurers for missed sessions as long as this is clearly indicated in the billing codes.
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Question: K21. Knowledge of protocols for initiating involuntary hospitalization.
Answer: C. Document your decision to meet individually with José.

An important legal obligation, since you are changing the unit of treatment from a dyad to individual treatment of a minor, is to obtain consent to treat a minor and document it.
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Question: K22. Knowledge of laws regarding confidentiality in situations of client danger to self or others.
Answer: C. It is unethical.

LCSW's do not use their professional relationships with patients to further their own interests.
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Question: K23. Knowledge of methods/criteria for identifying situations where client poses a danger to others.
Answer: C. The fee and the true name and license of the designated owner of the practice.

The fee and the name of the owner of the practice, if using a fictitious business name, are legally required disclosures at the onset of therapy.
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Question: K24. Knowledge of laws pertaining to duty to protect when client indicates intent to cause harm.
Answer: A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable.

Information about availability between sessions or in emergencies is an element of safety planning which is both a legal and ethical requirement.
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Question: K25. Knowledge of situations/conditions that constitute reasonable indicators of client's intent to cause harm.
Answer: A. Decline to supervise the intern.

Declining to supervise the intern is the best ethical choice given here (it is possible that with the proper ongoing consultation and responsible care, this particular dual relationship could be ethically acceptable). Although some dual relationships are considered unavoidable, particularly when there are limited choices, the ethics are less ambiguous in stating that supervisors do not take on current or former therapy clients.
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Question: K26. Knowledge of laws regarding privilege exceptions in litigation involving client's mental or emotional condition as raised by the client or client's representative.
Answer: B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.

If he is in family therapy now, but changed to individual therapy, you would need legal consent-to-treat with a minor.
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Question: K27. Knowledge of laws regarding privilege exceptions where client alleges breach of duty.
Answer: B. You would need to assess for child abuse.

Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse.
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Question: K28. Knowledge of laws regarding privilege exceptions in court-appointed evaluation or therapy.
Answer: A. Review the fee policies outlined in your informed consent document.

Going over relevant fee policies such as the basis on which it is computed, sliding scale polices or fees for late cancellations constitutes sound ethical management.
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Question: K29. Knowledge of laws pertaining to privilege exceptions in defendant-requested evaluation or therapy.
Answer: A. That you will need them to sign an agreement to change the treatment plan.

Ethics do not require a signature on a treatment plan.
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Question: K30. Knowledge of laws pertaining to the reporting of crimes perpetrated against a minor.
Answer: A. Scope of competence.

Anything that interferes with a clinician's ability to perform to the standard of care would be a scope of competence issue.
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Question: K31. Knowledge of laws regarding privilege exceptions in crime or tort involving minors.
Answer: A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you.

Before you take on a new case, you want to consider your level of education, training and experience to determine if you are capable of treating this client or if consultation is needed. Also, you need to consider this client's goals. If the client wants help with relationship issues, this is within your scope of practice, but if the client's needs are not relationship-oriented, then this case would be out of your scope of practice.
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Question: K32.Knowledge of laws regarding sexual conduct between therapist and client.
Answer: C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent.

Joint custody may require one or both parents to consent. You must look over the custody papers to review what the court mandates.
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Question: K33. Knowledge of legal requirements for providing client with the brochure Professional Therapy Never Includes Sex.
Answer: A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so.

In custody or visitation proceedings, if a child is represented by an attorney, that person has the right to obtain a child's clinical records or to interview the assessing or treating social worker. Ethically, you would also discuss this confidentiality issue with your client.
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Question: K34.Knowledge of laws that define the scope of clinical practice.
Answer: A. Determine the family's understanding of the purpose of the therapy.

Ethically, you would want to clarify the client's purpose.
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Question: K35.Knowledge of laws that define professional conduct for licensed practitioners.
Answer: B. Refer the client back to the insurance company.

Clients who are referred by insurance companies should be referred back to the payor to get another referral. This way, they can be more sure that their sessions will be financially covered.
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Question: K36.Knowledge of laws regarding disclosures required prior to initiating therapeutic services.
Answer: A. You indicate to your client that she can give your number to the program coordinator.

This response is the best choice. By letting the program coordinator contact you, you can avoid exploiting the client in order to advance a relationship with the program coordinator.
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Question: K37.Knowledge of laws and regulations regarding third-party reimbursement.
Answer: B. Self-harm behavior.

Self-harm behavior is not a type of dependent adult and elder abuse. Welfare and Institutions Code defines dependent adult and elder abuse as knowledge or reasonable suspicion of the following: physical abuse, abandonment, isolation, neglect, financial abuse, and abduction.
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Question: K38.Knowledge of parity laws regarding the provision of mental health services.
Answer: B. Consult with professional peers regarding your discomfort.

You want to be aware of how your discomfort may impact the therapy and, as an initial step, deal with it through research and consultation with colleagues.
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Question: K39.Knowledge of laws regarding advertisement and dissemination of information of professional qualifications, education, and professional affiliations.
Answer: C. Change the diagnosis when you have confirmed it on any insurance forms.

To avoid fraud you would have to code the diagnosis you currently are considering and change it when necessary.
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Question: K40.Knowledge of legal requirements regarding payment or acceptance of money or other considerations for referral of services.
Answer: B. Notification to the person signing the agreement that they have a right to receive a copy of it.

An Authorization to Release Confidential Information form must contain a statement that the person signing the agreement is entitled to a copy of the agreement.
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Question: 3. A 17-year-old girl, Janet, is referred to you by her school counselor. Janet's nose, eyebrow, and tongue are pierced, and her hair is dyed green and yellow. Janet says that recently her twin brother Michael comes into her room at night and tries to "play sleep-over" with her. Janet tells you that a cute boy she met at a rave last week wants her to move in with him. She asks you not to tell her parents that she's seeing you because they're "extremely religious." How would you manage your ethical responsibilities if you were working with the entire family?

Content Area: Ethics: Therapeutic Relationship/Services
This question test your knowledge of the ethical issues that arise when treating a family unit.

A. Clarify for Janet that, as a victim of abuse, she can consent to her own treatment without her parents' permission.

B. Clarify for the family how your therapeutic work differs from religious counseling.

C. Review your fee policy, especially as this case involves various family members and religious issues.

D. Explain the limits of confidentiality to Janet with regard to sexual abuse.
Answer: A. Maintain confidentiality.

Claire is 18 and considered an adult. Thus, making a report would be breaching confidentiality. Social workers do not report historical abuse. Your legal obligation is to maintain Claire's confidentiality.
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Question: 8. Cherilyn, your client of six months, tells you that she's recently begun having an affair with Tony. As she discusses their affair, you realize that Tony is another one of your clients whom you've been seeing for the past year with his wife and two teenage children. In order not to contaminate the therapeutic relationship with Cherilyn or Tony, what would you do?

Content Area: Ethics: Professional Competence and Preventing Harm. This question checks your ability to make distinctions between difficult ethical choices and tests your understanding of dual relationships.

A. Gently terminate with Cherilyn without telling her why. This preserves confidentiality, and since you've been seeing Tony and his family longer, you owe them more professional allegiance.

B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case.

C. Call an attorney and discuss legal issues around dual relationships so you can determine the best action to take.

D. Continue seeing Cherilyn as usual. Ask Tony in for a private conference so you can ask about his commitment to his marriage and family, being careful not to break any confidences.
Answer: D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey.

If any fees are associated with clinical practice, social workers are legally obligated to disclose them before providing a service.
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Question: 10. Your client comes to a first session in a crisis. You do not have time for a full informed consent conversation, but you tell the client the fee and your license number. What is your legal obligation now?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of informed consent and record-keeping.

A. Document your informed consent conversation within 5 days.

B. Document your informed consent conversation within 10 days.

C. Document your treatment plan now that the crisis has passed.

D. Document your crisis interventions in the first session.


This answer contains the basic steps you must take when you know of or have reasonable suspicion of elder abuse, and it shows good clinical management in processing any feelings your clients might have about their social worker filing a report.
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Question: 12. Your client Juan tells you that his brother, Jose, was stabbed to death a year ago by his cousin in a drug deal gone bad. Juan further states that he told his cousin that he intends to murder him for stabbing Jose, but he is going to wait until his aunt dies because she would be too upset by the death of her only son. He tells you that the cousin lives in another state, but he will find him when the time comes. In this situation, what is your legal responsibility?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a possible Tarasoff situation.

A. Under the Ewing v. Goldstein decision you must contact the aunt and warn her about the threat to kill her son.

B. Under the Tarasoff decision you must call the police and warn the victim.

C. Maintain confidentiality.

D. This is privileged information and may not be disclosed without a subpoena.
Answer: D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.

The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened.
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Question: 17. Your child's piano teacher sees you at a P.T.A. meeting and says she's heard that you are a good psychotherapist and asks if she can make an appointment to see you. She says her mother recently passed away and that she is now her elderly father's caretaker. She says "the situation is bringing up a lot of anger" for her because her father sexually abused her when she was a child. In this situation, you should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical behavior regarding potential dual relationships.

A. Report the abuse to Children's Protective Services.

B. Decline to make an appointment and refer her to another therapist.

C. Report the abuse to Adult Protective Services.

D. Make an appointment and try to help her work through the grief and anger issues.
Answer: A. Tell Mr. Milsap that you cannot honor his request.

Without the permission of the court or the party issuing the subpoena, a social worker may not produce a summary or alter (by omission or any other way) the treatment record subpoenaed.
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Question: 20. After 6 months of treatment with Hermoine, she says that she wants to see a therapist whose sexual orientation is different than yours. After processing this over the next two sessions, you have two additional termination sessions, give her three referrals and terminate the therapeutic relationship. Several weeks later, Hermoine calls you in crisis and says her new therapist is out of town and isn't returning her phone calls. She asks you to help her. What would you do?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your decision-making process.

A. Help Hermoine with her crisis until her therapist returns.

B. It is unethical for you to work with Hermoine once you have terminated treatment with her and she has begun treatment with a new therapist.

C. Tell Hermoine that you will not be able to help her since she has terminated treatment with you.

D. Tell Hermoine that she should find out who is taking calls for her new therapist and speak with that person.
Answer: B. Deny his request.

Given the limited information we have in this scenario, denying the request would be the best course of action until proper authorization could be obtained by the dead woman's legal representative.
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Question: 9. How should physical abuse of a dependent adult be reported by a mental health professional?

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question tests your understanding of the legal issue of reporting dependent adult abuse.

A. If there is serious bodily harm, within 24 hours.

B. By telephone within two working days and in writing as soon as possible.

C. By telephone as soon as possible and in writing within two working days.

D. By telephone as soon as possible and in writing within 36 hours.
Answer: A. Answer Miriam's questions.

Social workers must make a distinction between clinical interventions and ethical responsibilities. Clients have the right to such information as where the social worker went to graduate school, how long the social worker has been licensed, and if there are any areas of expertise and training. Such questions should not be treated as inappropriate or boundary violating and are part of the process of a client determining whether or not the social worker offers the kind of services the client wants or needs.
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Question: *18. When unable to reach a client by phone, a social worker texts the client's mother to tell her that her son is talking seriously about running away from home because of the step-father's abuse. She texts back to tell you that he is home safely but "thanks for the heads-up." What are the social worker's ethical obligations regarding the confidentiality of minors?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to handle informed consent about the limits of confidentiality in the treatment of minors.

A. Obtain written informed consent from the minor that allows texts to parents in an emergency.

B. Tell minor clients how you will contact parents if you think there is an emergency.

C. Tell minor clients that you will show them any texts from parents.

D. Obtain informed consent from parents about your mandates to break confidentiality.
Answer: B. The client.

In this situation, since Jennifer has introduced her emotional condition into the trial, her right to privilege MAY be waived. Since there is no indication that she or the court has waived her privilege, it continues to be held by her.
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Question: 20. You are conducting a research study on divorce. In the informed consent process, what information do you need to provide your clients?

Content Area: Ethics: Business Practices and Policies
This question assesses your knowledge of procedures when conducting research using human participants.

A. The importance of the client remaining in the study until the very end to maintain the validity of the study.

B. That dual relationships may be inevitable due to the nature of the study.

C. That any information obtained may be used in the study.

D. The client has the right to withdraw from the study at any time.
Answer: A. Report by telephone within 24 hours to law enforcement.

If physical abuse occurs in a long-term facility and does NOT result in serious bodily harm, a telephone report must be made to local law enforcement within 24 hours and a written report within 24 hours to law enforcement, the facility's licensing agency, and the ombudsman.
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Question: *21. If a social worker digitally recorded a session with a client and then receives a subpoena for records because the client is claiming emotional distress, the recorded session would be provided to the court if:

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question tests your knowledge of how to respond to a subpoena.

A. The client signed a release to record a session.

B. The client signed a waiver of privilege for the records.

C. The client signed a consent form allowing the session to be videotaped.

D. Digital recording must be disclosed with any records in a subpoena.
Answer: A. Assert client privilege.

By the process of elimination, "A" is the only correct answer. None of the other choices are legal requirements.
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Question: *22. A client is referred to you by his attorney. The client tells you that he is reluctant to talk to you because he doesn't want what he says in therapy coming out in court. Choose the statement that could BEST explain privilege to this client:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of privilege. You must be able to distinguish between confidentiality and privilege as well as between law and ethics.

A. It is an ethical concept involving the right of a social worker to withhold information in a legal proceeding.

B. It is a legal and ethical principle which involves a restriction on the volunteering of information about a client.

C. It is a legal principle that protects client conversations unless there is a court order.

D. Attorney/client privilege extends to the client of a social worker that the attorney uses for referrals.
Answer: A. Specify any particular limits of confidentiality as they pertain to internet security and privacy.

There are no special mandated "limits of confidentiality" that pertain to telehealth, but privacy and confidentiality could be compromised in telehealth sessions, and therapists would have the ethical obligation to clarify those risks.
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Question: *23. A client who was referred by his rabbi comes in to see you for issues of grief related to the loss of his mother two weeks ago. Recently your mother died too. What would you do FIRST?

Content Area: Ethics: Professional Competence and Preventing Harm
This question tests your knowledge of how to manage counter-transference.

A. Talk about this situation in your own therapy.

B. Seek professional consultation.

C. Refer the client to another mental health professional who specializes in grief and loss issues.

D. Determine if you can deal with this client at this time.
Answer: A. Permissible under some circumstances.

Ethical standards say that social workers do not usually barter or are discouraged from doing this but the standards make allowances for doing business in communities where bartering is standard practice.
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Question: *24. Steven comes to you for help with debilitating anxiety. He says that his anxiety is beginning to interfere with his relationships and his job. He is afraid to drive his car because he thinks that he is going to hit someone. He doesn't know how he will ever take a girl out on a date or get to work if he doesn't get control over this. He thinks he should be able to get over this by himself. The therapist should begin by:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical obligations when selecting treatment interventions.

A. Teaching him relaxation techniques and pairing those with thoughts and images of driving his car.

B. Explaining the benefits of a behaviorist approach for severe anxiety.

C. Documenting in an initial treatment plan the client's goals for treatment of anxiety.

D. Assessing whether a medication evaluation would be necessary.
Answer: C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy.

Reasonable notice of termination is required if you plan to terminate because a client has not paid.
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Question: *25. Which of the following is not considered by law to be unprofessional conduct by a social worker?

Content Area: Law: Legal Standards for Professional Practice
This question asks you to identify unlawful unprofessional conduct.

A. A conviction after pleading no contest to a DUI.

B. Thanking a friend for a referral by taking her out to dinner.

C. Being arrested for shoplifting.

D. Poor record keeping.
Answer: B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night.

The threat was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. Although the laws of confidentiality require that we not report an HIV-positive client whose intentional behavior is to infect others through sex, injecting another person with a syringe without their permission constitutes an act of violence.
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Question: 33. A couple comes in to see you for therapy. They are referred by the wife's individual therapist. The husband has recently discovered his wife has been cheating on him and he is unsure if he wants to continue the relationship. What is solely an ethical responsibility in treating this couple?

Content Area: Ethics: Therapeutic Relationship/Services
This question addresses your ethical responsibility in treating a couple.

A. Getting a signed release from both the husband and the wife to speak with the wife's therapist.

B. Designating a fee prior to the commencement of therapy.

C. Informing the couple of your "no secrets" policy.

D. Having the wife sign a release to speak with her therapist.
Answer: B. Charge Andy and have him contact the insurance company.

Billing the client, and letting him seek reimbursement from the insurance company is correct. This choice puts the responsibility on the client, where it belongs.
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Question: *36. You get a call from the emergency room regarding one of your clients who was brought in by the PET team and is incoherent, delusional, and unstable. While they were going through his belongings they found his driver's license and your card. The psychiatrist on call wants to know if you can give them any information about this person that might be helpful. You would:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to protect client safety and confidentiality at the same time.

A. Assist them with information you deem pertinent to the situation at hand.

B. Inform them that you cannot confirm or deny if this person is your client.

C. Tell them that they will have to obtain a release signed by the client and fax it to you before you can disclose any information.

D. Ask to speak with your client before disclosing any information.
Answer: D. Assess the motivation behind the gift.

Assessing the motivation and the value of a gift is very important in determining whether you should accept it or not. What needs to be determined is whether the act of giving the gift supports Mrs. Bailey's therapeutic process and needs.
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Question: *38. You contract with a family for ten sessions, as that is all their insurance would cover. After the ten sessions they want to continue therapy but can't afford your full fee. What would you do next?

Content Area: Ethics: Therapeutic Relationship/Services
This question addresses your management of insurance clients with limited coverage, your sensitivity to the ethical concerns of client abandonment and ethical standards.

A. Refer them to a low-fee clinic.

B. Accommodate your fee since you've established a bond.

C. Terminate with the family since you have met the terms of the contract.

D. Assess their motivation for continuing therapy.
Answer: D. Obtain consultation from each doctor about his case.

The best answer choice from an ethical point of view would be to speak with each doctor. This is a scope of competence question that tests your knowledge of how to utilize consultation.
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Question: *39. Cheryl and Bobby are in joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. It would be appropriate for Cheryl to:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to assess and address other professionals' competence if it endangers clients.

A. Avoid making any referrals to Bobby.

B. Offer to take some of his caseload.

C. Engage Bobby in a therapeutic conversation.

D. Report Bobby to a regulatory body.
Answer: B. The advertisement must indicate the full name of the licensee and the complete license number.

It is a legal requirement that the LCSW's full name and license number or associate's registration number be on the advertisement.
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Question: *44. Your client, Liz, is a 17-year-old female who is leaving for college out of town at the end of the month. She was molested by her uncle as a young child and is working through these issues with you. She has developed a close working relationship with you and wants to continue to work only with you. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the legal issues that pertain to treating clients who are moving.

A. Consult with a colleague about transference/counter-transference issues.

B. Make three referrals out of town.

C. Plan for weekly, hourly phone sessions with you.

D. See her on school breaks.
Answer: C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions.

Ethically, you cannot avoid informed consent even in a crisis. So it would be ethical to give the client the legally required information and meet any crisis needs immediately.



















54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality.

A. Filing a child abuse report.

B. Ensuring safety for a suicidal client.

C. Responding to a CPS caseworker's request for family history following a child abuse report.

D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle.
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Question: *45. Your client missed a regularly scheduled appointment. Your policy, made clear to the client in your informed consent document, is that clients will be billed for missed appointments. The client asks you to bill the insurance company. What would you do?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate billing procedures.

A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.

B. Explain that billing insurance for missed sessions is insurance fraud.

C. Let it go, since by law, insurers cannot be billed for missed sessions and clients with insurance are not required to pay out of pocket.

D. Bill the insurance company for the session.
Answer: C. Responding to a CPS caseworker's request for family history following a child abuse report.

A social worker is not permitted to respond to a CPS caseworker's follow-up inquiries without a written request if the request does not specifically pertain to the child abuse report.
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Question: *50. José, a 14-year-old Mexican-American boy, comes to therapy with his mother. He presents with a flat affect and avoids eye contact during the initial assessment session. During the assessment process, José remains quiet as his mother provides a list of José's symptoms and behaviors that she would like you, as the social worker, to address. Before the initial assessment session comes to an end, José requests that you meet with him individually from now on. After deciding that it would be appropriate to schedule individual sessions, what is your legal obligation?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal obligations that pertain to documentation.

A. Assess whether the absence of Jose's father is having an impact on his behavior or this session.

B. Refer his mother for individual therapy to avoid abandoning her as part of the treatment unit.

C. Document your decision to meet individually with José.

D. Ask his mother to sign a new consent form for him to be treated individually.
Answer: D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.

This is what you would have to do. At this point, the well-being of the intended victim outweighs the ethical concerns about informed consent.
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Question: *52. After your session with Scott, you decide to buy $10,000 worth of the stock that he was talking about. In a short time the stock tailspins to 10% of its initial price offering. How would you characterize the social worker's action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your sensitivity to the issues of professional boundaries and dual relationships.

A. It is illegal and unethical.

B. As the social worker did not solicit the information, the social worker was free to purchase the stock.

C. It is unethical.

D. It is unethical if it interferes with the nature of the therapeutic relationship.
Answer: B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being.

If releasing the content of therapy notes will result in a negative impact on the minor's physical safety and/or psychological well-being, then the social worker has a right to refuse a parent's inspection of the records.
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Question: *53. What is a social worker legally required to disclose to a client at the beginning of treatment as part of the ethical obligation for informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question reviews your knowledge of the legal and ethical aspects of informed consent.

A. The fee, the true name and license of the designated owner of the practice, and the limits of confidentiality.

B. The fee and the type of license held by the social worker and the expiration date of a release authorization.

C. The fee and the true name and license of the designated owner of the practice.

D. The fee, the type of license held by the social worker, and limits of confidentiality.
Answer: C. A client accused of assault and battery uses insanity as a defense in court.

If insanity is used as a defense for a crime, then the client may have waived his or her right to privilege.
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Question: 56. A therapist who performs telehealth advertises that the main advantage of internet therapy is that the client can reach a therapist in real-time. "If crises come up or just a quick question, online therapy can meet your needs right away." This advertising is:

Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of the legal parameters for advertising on the internet.

A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable.

B. Legal if telehealth is within the therapist's scope of practice.

C. Unethical because online therapy cannot be used in a crisis.

D. Unethical because clients will expect a social worker to be available 24/7.
Answer: C. Engage him in a discussion of his motivation and past efforts.

In the initial stages of therapy, the establishment of trust and rapport is a crucial component to successful work, which "C" embodies as it deals with the presenting problem and the underlying emotions associated with it.
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Question: *63. Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town's only community counseling clinic. In his second week at the clinic Eli is given a list of new interns he will be supervising and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge regarding supervision and dual relationships.

A. Decline to supervise the intern.

B. Ask the client to choose between having Eli as a social worker or a supervisor.

C. Terminate the therapy since it conflicts with Eli's role as a supervisor as well as the client's desire for training and career advancement.

D. Proceed as a supervisor since this is a case of an unavoidable dual relationship.
Answer: C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.

A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled.
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Question: *65. You are treating a family of four in therapy. The oldest child, age 17, suggested that you do telehealth sessions with him. Legally, in order to do this you must:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal parameters for the use of telemedicine/telehealth.

A. Obtain written consent-to-treat from him because he is age 12 and older, to change the treatment plan.

B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.

C. Legally obtain informed consent with the whole family to change the treatment plan.

D. Determine your fee schedule for a different medium.
Answer: D. Tell him that you will not be able to help him quit smoking.

Using hypnotherapy to help Christopher stop smoking would have to be within the context of therapy, and not as a stand-alone treatment. Otherwise, it is outside the scope of practice.
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Question: *69. Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women's make-up and shoes. Legally, what would be your first concern?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of legal requirements when treating minors.

A. You would need to get consent from his parents because he is being abused at school.

B. You would need to assess for child abuse.

C. You would need him to sign a release to speak with his school.

D. You would need to assess for possible suicidal ideation.
Answer: D. Advise her to call her lawyer.

Your only obligation in this situation is to maintain confidentiality and assess for a possibility of a crisis interventions. If the client is not afraid that the father will harm the children, she needs to call her lawyer to pursue legal options.
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Question: *73. Audrey, age 32, comes into your office while her father, Carl, and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father, Carl, and she asks, "Can I pay you when my 'ex' pays his overdue child support?" How would you manage the ethical issue of fees?

Content Area: Ethics: Business Practices and Policies
This questions test your knowledge of the ethics that pertain to fees, fee disclosure and fee management.

A. Review the fee policies outlined in your informed consent document.

B. Disclose your fee prior to providing therapy or as soon as practically possible.

C. If you see Audrey alone and her father is paying, explain that she must collect the fee from him and then pay you.

D. Discuss Audrey's request that you wait to be paid until the 'ex' pays his overdue child support.
Answer: D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults.

If you have concerns about a dependent adult's safety, you are legally and ethically obligated to inform the CLIENT about the limits of confidentiality. Although "Consent To Treat" came from the conservatorship, the client's rights to confidentiality are still relevant.
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Question: *82. A lesbian couple that you have been seeing asks you about Emotionally Focused Therapy. One of the partners tells you that she saw it on a daytime talk show and would like to see if it can help them. What should you NOT tell them if you feel competent to do this kind of therapy?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to ethically change the treatment plan, which requires informed consent from clients.

A. That you will need them to sign an agreement to change the treatment plan.

B. The risks and benefits of this type of therapy.

C. How you will help them determine new treatment goals that fit with EFT.

D. Your skills and experience in working with EFT.
Answer: C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary.

Giving clients information about payment is a legal and scope of practice issue.
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Question: 92. Cheryl and Bobby are in a joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. Cheryl tells Bobby that she won't make any more referrals to Bobby. If Bobby decides to get some outside support, he is ethically managing his:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of different ethical principles.

A. Scope of competence.

B. Counter-transference.

C. Dual relationship.

D. Scope of practice.
Answer: D. Maintain confidentiality.

YOUR only legal obligation here is to protect your client's confidentiality.
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Question: 98. You just received a referral from a local psychiatrist. The client suffers from a severe psychotic disorder and must take psychotropic medications. You have never treated anyone with a chronic mental illness in your private practice before so you must:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of standards for ethical client treatment.

A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you.

B. Let the doctor know you appreciate the referral, but you are out of your scope of practice in taking on this particular client.

C. Find a supervisor to assist and guide you in working with this client so that you are covered legally.

D. Tell the doctor that you would like to take this case and are prepared to research this diagnosis and work closely with him so that you might effectively treat the client and expand your capabilities as a clinician.
Answer: C. You are mandated to report this situation to a children's protective agency.

This is a mandated report because the social worker has reasonable suspicion of neglect based on the doctor's medical diagnosis. Although the parents have consulted with a doctor, their decision to not seek care based on the doctor's findings constitutes reasonable suspicion of medical neglect.
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Question: 104. A 6-year-old child has been brought in by his mother for counseling. She wants you to explain to him why he is in therapy because she feels like she doesn't have the right words, and it could scare him. How do you handle obtaining consent for the child?

Content Area: Law: Confidentiality, Privilege, and Consent
This question concerns consent to treat a minor and custody.

A. If the parents are divorced, review the custody papers. Joint custody means both parents must consent.

B. Determine the marital status of the family. If the parents are still married, then both must consent.

C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent.

D. If the parents are divorced, review the custody papers. Either parent may consent if they are the biological parent.
Answer: D. Ask her to get you quickly up to date on her general treatment so far.

Ethics require an action directed toward the client's immediate safety. You would need to know how "serious" her situation is before determining the next step
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Question: *105. A social worker has been treating Mikey, age 12, for the last 8 months. He has been dealing with feelings of depression and tells you that he is not doing well in school. He tells you that his parents recently filed for divorce, and he does not know with which parent he wants to live. A few weeks later, you receive a call from an attorney who tells you that she was appointed to represent Mikey in the divorce proceedings. She is requesting a copy of your records. How do you respond in this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This question involves legal and ethical issues related to the release of clinical records.

A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so.

B. Ask Mikey if he would sign a release to allow you to release the records to the attorney because ethically, you must act in his best interests.

C. Release records with both parents' authorization if it is in Mikey's best interests to do so.

D. Do not speak with the attorney because your client's confidentiality is the more important ethical obligation in this instance.
Answer: C. Discuss any suspicions that would validate terminating the client.

A client's potential violence would not be a reason for terminating the client. It might be a reason, however, for breaking confidentiality.
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Question: *107. Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night, so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem, the fee is covered under the overall adoption agreement." What are your ethical obligations?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical obligations.

A. Determine the family's understanding of the purpose of the therapy.

B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session.

C. Determine the identified patient and refer to a pediatrician.

D. Tell Chong-Wook and Dae-Sup the fee at the first session, and explain that you may need to consult with the school counselor and adoption agency.
Answer: A. Maintain confidentiality.

Mental health professionals licensed in California are only mandated reporters of Elder and Dependent Adult abuse if the victim is a resident of the state of California. Maintaining confidentiality is your legal obligation.
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Question: 110. A social worker works for a managed care panel and receives most of her clients by referrals from the managed care company. A client comes for a first session, and the social worker realizes that the client has treatment expectations that are out of her scope of competence. What should the social worker do?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage your ethical and legal obligations when a client is out of your scope of competence.

A. Speak with the insurance company about her scope of competence.

B. Refer the client back to the insurance company.

C. Refer the client to a colleague who can meet his needs.

D. Collect the co-pay but do not bill for the session.
Answer: B. Refer him to an MD.

Overuse of pain medications and back pain would require a medical referral.
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Question: 112. A client you have been treating, who is also a social worker, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships.

A. You indicate to your client that she can give your number to the program coordinator.

B. You thank her for thinking of you, but you refuse the offer to avoid a dual relationship.

C. You tell her that you are interested and ask her to set up a meeting between you and the program coordinator.

D. You wait until you terminate therapy and then remind your former client of her previous offer.
Answer: D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due.

Although this may not be a perfect solution to the problem, it does reinforce boundaries, stop the balance from getting higher, and suspend treatment in a situation in which professional judgment may be impaired and in which the client may feel exploited (as a debtor, Ronald may not feel capable of participating openly and honestly in therapy).
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Question: 115. Which of the following is NOT a type of dependent adult and elder abuse?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the parameters of elder and dependent adult abuse.

A. Abandonment.

B. Self-harm behavior.

C. Isolation.

D. Abduction.
Answer: A. Assert privilege.

If you are unable to contact your client, you must continue to assert privilege. You do not know what is in the client's best legal interests so all you can do is continue to assert privilege.
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Question: *117. You recently get a new, male client who is visually impaired. You've never worked with a client with a physical disability and are feeling a little uncomfortable with the client when he is sitting in the room. What is the best way to handle your discomfort?



A. Let the client know of your discomfort and ask if he would prefer a different therapist.

B. Consult with professional peers regarding your discomfort.

C. Deal with your counter-transference in your own therapy.

D. Do research on blindness to help you with an understanding of your client's needs.
Answer: B. Open a separate file if the client was in family therapy before.

Maintaining treatment files for different units of treatment is a legal obligation.
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Question: *120. You have been treating Anita for three sessions for depression and relationship issues. You are considering a diagnosis of Major Depression and other DSM-5 diagnoses. You are not sure which is appropriate yet. Legally:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice.

A. Do not treat the client unless your advertising indicates that you have expertise with depression or mood disorders.

B. Consider whether it is in your scope of competence to work with depressive disorders.

C. Change the diagnosis when you have confirmed it on any insurance forms.

D. Do not submit insurance billing until you have confirmed a diagnosis.
Answer: False, limits to confidentiality include suicide, homicide, and child abuse
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Question: *125. Some clients are referred to social workers by other helping agencies and collaboration advances client welfare. Your new client tells you that she signed a release with the agency that referred her to you. You ask her to sign your release as well. Which of the following must appear on the release?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legally required elements of release authorization.

A. A "Notice of Privacy Practices" if the client is a "covered entity" under HIPAA.

B. Notification to the person signing the agreement that they have a right to receive a copy of it.

C. It must include an expiration date established by the client.

D. It must state the client's diagnosis and reason for approving the release authorization.
Answer: True
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Question: *130. An 18-year-old woman named Claire, states in her first session that she's thrilled to be out of her home and to be away from "that monster of a father," whom she says sexually abused her since she was 15. She tells you she has a two younger siblings who still live at home. What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations surrounding confidentiality.

A. Maintain confidentiality.

B. File a child abuse report for the abuse that Claire suffered since 15.

C. File a report with CPS for reasonable suspicion of abuse for Claire's younger siblings.

D. Ask Claire to sign an authorization to speak with her siblings to determine if they are safe.
Answer: True
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Question: 131. As part of his telehealth practice, a social worker offers quick assessment surveys online to help potential clients decide if they want therapy. The surveys do not ask for any identifying information. The social worker has access to the results of the surveys but does not ask for the name of the consumer, to avoid the appearance of solicitation. This is legal if:

Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of legal types of advertising and fee arrangements.

A. He provides referrals for any online survey respondents who are in a crisis.

B. He also offers the survey to current clients at no cost.

C. He advertises that the online assessments are consistent with DSM standards.

D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey.
Answer: False, this would be out of scope of practice
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Question: 147. During a session with a couple in their 70's, you notice the man has a bruise on his head, and the woman tearfully admits that she loses her temper and hits him with pots and pans. In clinically managing the legal issue of elder abuse, how would you proceed?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your ability to balance your reporting responsibilities with your clinical need to maintain a safe therapeutic environment.



B. When the two are not in the room, call up an agency designated to take such a report, follow it up with a written report within 2 working days, create a "no violence plan," and refer to a support group.

C. Create a "no violence plan," teach time-outs, arrange for a support group, and if those interventions don't work, call an agency designated to take such a report.


Answer: false
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Question: 1. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of Section 1024 of the Evidence Code.

A. Maintain Roger's confidentiality.

B. Warn the manager of the factory because this is analogous to a Tarasoff situation.

C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision.

D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.
Answer: The services that a social worker can legally preform under a specific license
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Question: 2. Your lawyer calls you to warn you that you may receive a subpoena for the complete treatment record of Mr. Milsap, who you have been treating for five years. Two months ago, Mr. Milsap received minor injuries in an accident at work in which three people were killed when a fully loaded forklift overturned. Mr. Milsap is suing for negligence and claiming severe emotional damage, including PTSD. When you tell Mr. Milsap about the subpoena, he is frantic since he doesn't want anyone to know about the brief affair he had with his secretary four years ago, which is documented in your treatment records. He asks that you submit a summary of information relevant to the accident and his PTSD or to omit from the records information about the long-ago affair. How should you respond?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to legally retain records.

A. Tell Mr. Milsap that you cannot honor his request.

B. Submit a summary of the records related to the accident and the PTSD.

C. Supply the treatment records as requested, but omit information of the long-ago affair, in accordance with the laws of privilege.

D. Contact the court and seek a waiver to narrow the scope of the subpoena in order to protect your client's confidentiality.
Answer: Their expertise, education, and training.
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Question: 4. Three months after the death of Danielle, whom you treated for several years, you receive a written request from Arthur, her husband of 32-years, asking for access to his late wife's files. You saw them conjointly for a few sessions when Danielle requested he be there. How would you proceed?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge regarding who has access to a client's records after their death.

A. Assert privilege.

B. Deny his request.

C. Allow him to inspect the records.

D. Provide a summary or a copy of the records.
Answer: Competency means you have acquired expertise in an area within LCSW scope of practice. Generally competency is gained through education, training, and experience.
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Question: 11. Miriam, a 52-year-old car saleswoman, is referred for therapy by her doctor after Miriam told him that her boyfriend broke up with her and told her that she has trouble respecting other people's boundaries and is too interpersonally aggressive. From the beginning of treatment, Miriam asks the social worker many questions about the social worker's relationships, family, hobbies and interests, and taste in music and movies. At the fifth session, Miriam asks the social worker where she went to graduate school, how long she has been licensed, and if she has any areas of expertise and training. How should the social worker respond to the questions Miriam is now asking?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent and a social worker's ethical responsibility to obtain informed consent from clients.

A. Answer Miriam's questions.

B. Do not answer Miriam's questions and explore her reaction to the social worker's boundary setting.

C. Ask Miriam if she has concerns about the social worker's competence and experience.

D. Remain silent and allow Miriam to do her own processing as part of learning to respect others' boundaries.
Answer: You should refer the client to another professional. This way you are only providing one type of service to a client (thereby avoiding a dual relationship)
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Question: 12. You have been treating Jennifer who has had difficulties establishing and maintaining intimate relationships with men. Several months into treatment, she was arrested for an attempted murder of a male celebrity. In her trial, Jennifer is pleading not guilty by reason of insanity. Who holds the privilege for Jennifer's therapeutic records?

Content Area: Law: Confidentiality, Privilege, and Consent
This question checks your comprehension of privilege.

A. The social worker.

B. The client.

C. There is no privilege.

D. The judge.
Answer: Whenever it's in the best interest of the client.
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Question: 13. You are seeing a 45-year-old woman in treatment. She lives with her mother, age 71, who has Alzheimer's Disease and lives in a residential facility for ongoing medical care. She tells you in session that at one point, the nursing staff kept her mother in bed for three weeks. You would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. Your knowledge of reporting mandates for elder abuse is being checked.

A. Report by telephone within 24 hours to law enforcement.

B. Report immediately to Adult Protective Services by phone and follow-up with a written report within 36 hours.

C. Report by telephone immediately to law enforcement.

D. Refer her to a support group for caretakers, arrange for respite care, and work with her on issues of grief and loss.
Answer: Refer the client to a doctor to discuss sleep medicine.

scope of practice. LCSW cannot make medicine recommendations.
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Question: 19. Your client, a 19-year-old mechanic, confides to you that he recently participated in a robbery. Two weeks later, you are served with a subpoena for information about this client's treatment. You attempt to reach your client but are unable to do so. Legally, you must:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your legal requirement regarding a subpoena.

A. Assert client privilege.

B. Notify your client of this subpoena.

C. Turn over all records as per the subpoena.

D. Notify the client's attorney that you cannot reach the client.
Answer: Refer to doctor to rule out medical concerns, reframe as communication issue, or refer to sex therapist.

Scope of competency. Therapist does not have expertise is sex therapy
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Question: 23. A social worker has decided to offer telehealth as part of her practice. Ethically, the therapist should:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to ethically manage the limits and risks of telehealth.

A. Specify any particular limits of confidentiality as they pertain to internet security and privacy.

B. Avoid a dual relationship by making clear when she is available on the internet and when she is not.

C. Charge and disclose an equivalent fee for telehealth as for in-person sessions.

D. Anticipate an unavoidable dual relationship that could arise if in-person clients also receive telehealth services.
Answer: False, hypnotherapy is in scope of practice but may not be in scope of competence.
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Question: 24. George has been referred to you by his doctor for anxiety-related issues. He tells you that while he really wants to be in therapy, he can't afford it right now and asks if it would be okay if, instead of your fee, George will give you credit in the amount of your fee at the grocery store he owns in the small rural community where you both live. Ethically this would be:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of dual relationships.

A. Permissible under some circumstances.

B. Inadvisable under all circumstances.

C. A prohibited dual relationship.

D. Bartering, which is prohibited by ethical standards.
Answer: False, that would define scope of competency not scope of practice
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Question: 37. Your new client, Suzanne, age 38, says her life feels out of control, and that she is considering getting a divorce. She is not sure she wants to keep coming to therapy. After a session, her husband Bud leaves a telephone message in which he says if Suzanne leaves him, he will kill himself. He asks that you call him back. How would you clinically manage your ethical responsibilities?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical obligations as they pertain to termination and referrals.

A. Explain to Bud your "no secrets" policy and that you will have to disclose to Suzanne that he called you.

B. Offer to Suzanne that she include Bud in a session but inform her of the risks and benefits first

C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy.

D. Assess Bud for suicide because you are in your professional capacity.
Answer: True, get consultations based on client need.
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Question: 38. Which of the following represents a Tarasoff situation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions that would impose a Tarasoff duty to protect situation.



B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night.

C. A client tells you that her husband is "totally fed up with his supervisor" and is going to disfigure the man's face with a chemical solution.

D. A man, who just bought a semi-automatic rifle, tells you that he is going to go on a freeway overpass and randomly shoot at passing cars.
Answer: Department of Consumer Affairs (DCA)
Board of Behavioral Sciences (BBS)
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Question: 40. Andy, a 42-year-old actor, missed his last session. The Motion Picture Industry Pension and Health Plan pays for a portion of his sessions. How should you go about collecting his missed session fee?

Content Area: Law: Legal Standards for Professional Practice. This test item focuses on legal insurance billing procedures.

A. Bill Andy for the co-payment and indicate the cancelled session code with his insurance.

B. Charge Andy and have him contact the insurance company.

C. Bill the insurance company with the 50-minute code as usual.

D. Bill Andy for the co-payment and indicate the 50-minute code.
Answer: NASW, BBS, and the legal system (either civil or criminal).
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Question: 43. Mrs. Bailey sees the photograph of your dogs in your office and brings you a basket of dog treats. How would you respond to her gift?

Content Area: Ethics: Business Practices and Policies
This ethical question regarding gifts tests your sensitivity to the issue of professional boundaries and dual relationships.

A. Accept the gift in the spirit in which it was given.

B. Take one of the treats as a gesture and return the rest.

C. Thank her for her thoughtfulness and decline the gift.

D. Assess the motivation behind the gift.
Answer: True. BBS has many resources to help you do so.
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Question: 46. A psychiatrist refers you a client with severe anxiety. The day before an intake session, the client calls you to ask if he can see you right away because he is afraid he will take all of the anti-anxiety medication he owns. He tells you that he is actually seeing three different doctors to get as much medication as he can. In collaborating with his doctors, which of the following would be the most ethical approach?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to collaborate and consult according to ethical (rather than legal) standards.

A. File three separate releases in the client's file.

B. Tell him that you plan to speak to all of his doctors with or without a release.

C. Ask him which doctor he would prefer that you talk to.

D. Obtain consultation from each doctor about his case.
Answer: A therapist's responsibility to breach confidentiality if a client threatens an identifiable person.
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Question: 49. Guidelines regarding advertising state that social workers must advertise in a way that is honest and not misleading. Which of the following is a true statement regarding advertising policies?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of advertising principles associated with LCSW practice.

A. A prelicensed social worker may not use the term "psychotherapist" on a business card.

B. The advertisement must indicate the full name of the licensee and the complete license number.

C. It is not permissible for an LCSW to use "Ph.D." if s/he is not a psychologist.

D. A social worker cannot use the term "Psychotherapy" on a business card.
Answer: Tarasoff v. Regents of the University of California
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Question: 53. Maxwell, age 46, is referred to you by his EAP because he is depressed and drinking daily on the job. He witnessed a train wreck 3 weeks ago in which several people were killed. Now he says he is terrified to leave the house without a couple of drinks to calm him down. He says that every time he hears a loud noise he feels faint, and he wakes up sweating and shaking. What action would the social worker take?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your ability to respond to client's needs in an ethical way.

A. Determine the client's ability to respond to anxiety treatment interventions.

B. Evaluate the client's need for a crisis intervention,

C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions.

D. Tell him that his treatment will be confidential as it pertains to his EAP.
Answer: A client told a therapist they were going to kill a woman. The therapist did not warn the woman or her parents and she was killed by the client.
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Question: 54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality.

A. Filing a child abuse report.

B. Ensuring safety for a suicidal client.

C. Responding to a CPS caseworker's request for family history following a child abuse report.

D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle.
Answer: That if a client's family member tells a therapist something that makes the therapist concerned about the client's homocidality; they must warn the person.

Information not source triggers duty to warn.
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Question: 62. A male client comes to see you for the first time. As he talks, you begin to realize that he is definitely going to harm someone. He has a plan and is going to act, but he has not identified his intended victim to you yet. Just as he is about to tell you the identity of the name of the intended victim, you realize that you have not explained to him the limits of confidentiality:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage your ethical and legal obligations when a client might be dangerous.

A. Tell him to stop and refer him to someone else.

B. Wait until he identifies the intended victim and then explain the limits of confidentiality, as you must do as part of obtaining informed consent.

C. Ask him to stop and explain to him the limits of confidentiality as part of informed consent.

D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.
Answer: You should ask about history of violence, other violent thoughts or fantasies, if client has a plan and if they have means/opportunity to carry out plan.
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Question: 68. You have been seeing Marsha, 11, with the consent of her mother, Jan. Jan is requesting a copy of Marsha's therapy notes because she wants to provide them to the school counselor. Under which of the following conditions can you refuse Jan's request?

Content Area: Law: Confidentiality, Privilege, and Consent
This question assesses your knowledge of the laws pertaining to parental request of a minor's records.

A. Marsha will not sign an authorization to release the information to her mother.

B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being.

C. Jan wants you to produce a copy of the records within 3 weeks time.

D. You don't feel comfortable breaching Marsha's confidentiality.
Answer: True
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Question: 75. During your intake interview, you learn that your client is a lawyer. As you discuss the limits of confidentiality, the client asks, "can you plead the Fifth like I can in court?" As you consider your answer, you consider some hypotheticals. Privilege might be waived in which instance?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking you to choose when privilege could be waived.

A. A client is a 13-year-old girl, who you are seeing without parental consent, and has been selling drugs.

B. A client has told you he has been involved in hacking a corporate database under an assumed name.

C. A client accused of assault and battery uses insanity as a defense in court.

D. A 64-year-old woman complains to you that her bank is making automatic withdrawals without permission.
Answer: False
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Question: 77. A second generation Chinese-American man comes into therapy and asks you to help him find a wife because his father is pressuring him to get married. Your FIRST intervention would be to:

Content Area: Ethics: Therapeutic Relationship/Services


A. Indicate that his needs would best be served by an Asian mental health professional.

B. Inform him that this is an inappropriate goal for treatment.

C. Engage him in a discussion of his motivation and past efforts.

D. Address his presenting problem and assist him in finding a wife.
Answer: true
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Question: 85. Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions which define a person as being gravely disabled.

A. Command auditory hallucinations telling the client to kill other people.

B. Command auditory hallucinations telling the client to kill him or herself.

C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.

D. Choosing to be homeless.
Answer: False.
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Question: 87. After completing a three-month course on hypnotherapy, you decide to advertise your new specialty. You receive a call from Christopher, who says he would like to come in for a session, so that you could hypnotize him to stop smoking. He says he's tried the patch and nicotine gum, but he needs your help to quit once and for all. How would you respond to Christopher's request for treatment?

Content Area: Law: Legal Standards for Professional Practice. This question deals with scope of practice for mental health professionals.

A. Make an appointment because hypnotherapy is now part of your scope of competence.

B. Inform him of your fee before the commencement of treatment.

C. Refer him to a medical doctor.

D. Tell him that you will not be able to help him quit smoking.
Answer: 1. Identify risk factors
2. identify protective factors
3. conduct suicide inquiry
4. determine risk level/appropriate intervention
5. document what you did and why
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Question: 89. Your client has two children and is divorced. She tells you that when she arrived at her ex-husband's house last night to pick up the children, he had locked the doors and texted her that, "Me and my children are moving across the country." He has no criminal history, but she is afraid she will never see her children again. Which of the following is the clinician's first intervention?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of when to make referrals for expertise outside of your scope of practice.

A. Advise her to call Child Protective Services for abduction.

B. Explore the events immediately preceding this one.

C. Call the police.

D. Advise her to call her lawyer.
Answer: Identify risk factors (PTSD diagnosis, job loss, intoxication/possible substance abuse, talking about death, past suicidal threats and gestures.)

Ask directly about suicidal ideation, plan, intent and past behaviors).

Decide if client is harm to self or not.

if yes, 5150 and document

if no, go over protective factors, support system, hotline #s, and document.
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Question: 98. A person calls telling you that she is your client's conservator. Your client is physically disabled and has told you about the challenges associated with being under conservatorship. The client tells you that she hates not being able to make her own decisions. How do you manage your ethical obligations related to informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge about the ethical requirements for informed consent.

A. If you have any concerns for the client's safety, tell the conservator about the limits of confidentiality related to dependent adults.

B. Determine the type of conservatorship. LPS conservatorships allow the conservator to consent to treatment.

C. Tell the conservator about your mandate to report dependent adult abuse.

D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults.
Answer: An 72 hour involuntary psychiatric hold.
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Question: 108. George takes care of his wife, Gracie because she is unable to work. George asks you to help him manage his finances so that he is able to pay Gracie's medical bills, the family bills, and afford therapy. How should you respond to George's request and still maintain proper therapeutic boundaries?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to act within your scope of practice.

A. Call a financial planner that you know sometimes works on a sliding scale to explain George's situation and see if she is willing to help.

B. Explain to George that you cannot use therapy time to help him with his finances because it is out of your scope of competence.

C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary.

D. Introduce George to a budget minder book, show him how to create a budget, and provide referrals to websites to find less expensive medication.
Answer: False
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Question: 116. Your client Silvia comes to therapy upset because she overheard her neighbor stating that he plans to shoot the mayor tomorrow evening and owns a gun. She tells you she has tried to calm him down, but he just "keeps blaming the system for his unemployment." What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations related to the Tarasoff ruling.

A. Call the police and notify the mayor.

B. Discuss options that Silvia has to prevent harm to the mayor.

C. Call the police and inform them of the imminent danger.

D. Maintain confidentiality.
Answer: False, one component of 5150 is danger due to mental disorder.
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Question: 117. Mr. and Mrs. Chavez come to see you because they are referred to you by their physician. Their doctor has told them that their youngest son has a kidney disorder that will require surgery in the near future. The couple believes that God will intervene in this situation and refuse surgery based on their religious beliefs. Which of the following statements is the BEST response to this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This is a question concerning medical neglect.

A. The parents have the final right to make critical decisions for their son's medical care.

B. "Cultural competence" is an ethical obligation that requires social workers to avoid imposing their own values on the client.

C. You are mandated to report this situation to a children's protective agency.

D. You are legally required to inform the doctor about the parent's decision
Answer: false, even if child abuse is suspected it must be reported.
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Question: 120. A therapist is leaving for vacation and has referred all of her clients to you. On the day before your colleague is set to leave town, one of her clients calls you and says that she is in crisis and needs to be seen tomorrow. She adds, "my therapist told me that I could call you if I thought seriously about killing myself. Well, it feels pretty serious." Your ethical priority is to:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to intervene ethically in a potential crisis.

A. Notify the referring therapist of the client's treatment needs.

B. Tell the client to call her therapist who is still available in town.

C. Provide the client with a crisis number hotline until you are "on duty" for these clients.

D. Ask her to get you quickly up to date on her general treatment so far.
Answer: False, therapists should explain both verbally and in writing.
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Question: 123. A client, who is in court-mandated therapy, tells the social worker that he is going to leave the state because he doesn't want to be in therapy or go to jail for violating probation. The social worker tries to encourage the client to see the benefits of staying in therapy, but the client becomes visibly angry and agitated. If the social worker is concerned about the client's potential for violence, the reason for seeking consultation is NOT to:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when consultation is required to maintain scope of competence.

A. Meet the legal standard of care.

B. Assess the social worker's own blind spots to risk.

C. Discuss any suspicions that would validate terminating the client.

D. Reassess the social worker's scope of competence.
Answer: false, only give information relevant to report.
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Question: 127. Your 52-year-old client returns from visiting his brother in Florida. He explains that his brother, who cares for their 84-year-old father, doesn't take him to his doctor or physical therapy appointments and she occasionally forgets to fill his prescription medication. What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of the parameters of elder abuse reporting and when to maintain confidentiality.

A. Maintain confidentiality.

B. Call Adult Protective Services (APS) in Florida and file a written report within two working days.

C. Encourage your client to file an Elder Abuse Report.

D. Call Adult Protective Services (APS) in California and file a written report within 36 hours.
Answer: true. your license may also be taken away.
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Question: 133. Richard, 38, tells you that he is missing more and more work due to back pain. He tells you that he has been to several doctors who prescribe pain medication because he cannot afford to take time off of work. He tells you that he skips work or leaves early because sometimes the "meds make me so tired and fuzzy in my thinking,that I would be fired if I showed up like that." As a social worker who is not experienced with substance abuse, what is your next course of action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when to make competent referrals.

A. Refer him to AA.

B. Refer him to an MD.

C. Encourage him to take time off of work to get physical therapy for his back.

D. Obtain consultation to determine the extent of his problem.
Answer: You should inform the client that you need to report this relationship to CPS and then make the CPS report.
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Question: 143. Ronald is a 37-year-old moderately successful artist you have been treating for three years for depression and relationship issues. His income is sporadic, and you bill him monthly, but he had never let his balance get too high. Now he owes you $2,100. He offers to give you a painting whose value is roughly equal to the amount he owes you. How would you proceed?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical issues regarding client debt, dual relationships, and bartering and techniques to manage those issues.

A. Decline the painting and tell him that based on his history with you, you trust that he will pay you in full when he gets the money.

B. Accept the painting so that you can eliminate the debtor/creditor dual relationship.

C. Accept the painting but process with Ronald the meaning of exchanging his art for your services and have him sign a statement of mutual agreement.

D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due.
Answer: false
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Question: 147. Terran came to five couples' sessions with his wife complaining about how she belittles him and expects him to act more American. Terran had a difficult time listening and compromising because he believed his wife was disrespecting him, and they terminated treatment. You receive a subpoena for his records from an attorney representing his employer and learn that he is suing his employer for discrimination and emotional suffering. When you try to contact Terran about the subpoena, he does not return your calls. You would:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to proceed when you receive a subpoena.

A. Assert privilege.

B. Call his attorney and ask the attorney to ask Teran to call you back.

C. Contact Terran's wife since she was in session and has a right to confidentiality too.

D. Release the records since he has entered his emotional state into a legal proceeding and this represents an exception to privilege.
Answer: true
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Question: 148. A client that you treated 10 years ago terminated when her therapy goals had been reached, and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to maintain the standards of practice for documentation of client files.

A. Have the client sign a new release authorization.

B. Open a separate file if the client was in family therapy before.

C. Sign a new informed consent form.

D. Refer to another therapist if the client was a minor in therapy before.
Answer: True
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Question: T or F?

California psychotherapists must maintain client confidentiality at all times.
Answer: 65 and up or a dependent adult between ages 18 and 64 with physical and mental limitations.
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Question: T or F?

Based on California law, California therapists (LCSWs, LMFTs, and LPCCs) are not mandated reporters of domestic violence or intimate partner violence (IPV).
Answer: true
==================================================
Question: T or F?

If a 13-year old has consensual sex with another who is 14 or older, it is a mandated child abuse reporting situation.
Answer: false
==================================================
Question: T or F?

There is generally no problem with therapists providing advice to their clients regarding medication if the therapist is knowledgeable about the medication and it is deemed to be in the client's best interest.
Answer: ASAP after you suspect it
==================================================
Question: T or F?

Research indicates that men are slightly more likely to commit elder abuse than women.
Answer: within two working days.

(children is 36 hours or 1.5 days)
==================================================
Question: Define:
Scope of Practice
Answer: true
==================================================
Question: What defines someone's scope of competency?
Answer: false
==================================================
Question: What is the difference between scope of practice and scope of competency?
Answer: false
==================================================
Question: If you are a LCSW and another type of license (attorney, CPA, medicine, real estate, etc.), what should you do with a client who needs both types of services?
Answer: false
==================================================
Question: According to the NASW code of ethics when should a LCSW seek advice or consultation on a client/case?
Answer: true
==================================================
Question: What should you doand which legal/ethical issue is represented?


A male adult client presents personal and medical problems. The client complains about frequent and continual failures at resolving these problems. He reports trouble sleeping and repeatedly asks the therapist for specific recommendations regarding the best medication to treat insomnia.
Answer: false
==================================================
Question: What should you do and which legal/ethical issue is represented?

The clients, a married couple, initiate therapy regarding communication problems. After three months, the husband reveals that he has had difficulty becoming sexually aroused and that sexual intercourse and intimacy have become a problem. The wife reveals that she has always had low sexual arousal. The couple now requests the therapist work with them regarding the problems in their sex life. The therapist begins to provide sex therapy to the clients, even though she has no specialized training, education, or experience in sex therapy.
Answer: true
==================================================
Question: T or F?

A California LCSW is not permitted by law to practice hypnotherapy.
Answer: false
==================================================
Question: T or F?

A California LMFT's scope of practice is determined by the individual's expertise, education, and training.
Answer: true
==================================================
Question: T or F?

Obtaining one or more consultations may be appropriate if the practitioner's scope of competency is limited for a client's needs.
Answer: consumer protection, managing the supply of available professionals, and promotion of the professionals that it regulates.
==================================================
Question: What are the two state agencies set up to protect consumers?
Answer: false
==================================================
Question: Who can sanction you for doing unethical or illegal work?
Answer: true
==================================================
Question: T or F?
It is your responsibility to keep up with changes in the law and regulations.
Answer: False
==================================================
Question: What does "duty to warn and protect" refer to?
Answer: True
==================================================
Question: What is the court case that established the duty to warn?
Answer: True
==================================================
Question: What happened in the Tarasoff case?
Answer: True
==================================================
Question: What did Ewing v. Goldstein clarify from the Tarasoff ruling?
Answer: True
==================================================
Question: What should you do?

A client tells you they have been daydreaming about killing a co-worker who they tell you the name of. The client describes both the daydream and person in extreme detail.
Answer: False
==================================================
Question: T or F?
Based on Tarasoff and subsequent legislation, a therapist's duty to warn and protect requires that the client present a serious danger of grave physical harm to a reasonably identifiable victim.
Answer: False
==================================================
Question: T or F?
The patient (client) having a history of violent behavior is essential in determining whether there is a duty to warn.
Answer: True
==================================================
Question: T or F?
Based on the Ewing v. Goldstein case, a therapist has a duty to warn an identifiable victim if the therapist receives sufficient information from a family member that leads him or her to believe that a client poses a serious risk of grave bodily injury to an identifiable victim.
Answer: False
==================================================
Question: T or F?

Talking overtly and directly about suicide may put ideas into a client's head and trigger a suicide attempt.
Answer: True
==================================================
Question: What are the 5 steps in SAFE-T (suicide assessment five-step evaluation and triage)?
Answer: True
==================================================
Question: What should you do?

A client who you are seeing for PTSD has recently been fired from their job for showing up intoxicated. The client spends most of the session discussion her father's death by suicide and how she wishes she could join him. The client has made suicidal gestures and threats before but never attempted suicide.
Answer: True
==================================================
Question: What is a 5150?
Answer: True
==================================================
Question: T or F?

A therapist is likely to be held liable for a client's suicide if the therapist failed to assess and intervene in the manner generally followed by expert members of the therapist's profession.
Answer: True
==================================================
Question: T or F?

Joe does not have a mental disorder but reports that he intends to take his life to end the pain and expense of his chronic physical illness. Joe has a plan and the means to carry out his plan; therefore, Joe can be involuntarily held on a 5150.
Answer: False
==================================================
Question: T or F?
LCSWs must report child abuse only if they absolutely know it is happening
Answer: True
==================================================
Question: T or F?
Therapists don't need to explain the limits of confidentiality to clients.
Answer: True
==================================================
Question: T or F?
If a LCSW is making a mandated child abuse report, they should just fax the client's entire file to their county's CPS?
Answer: False
==================================================
Question: T or F?
LCSW can be held criminally and civilly liable if they fail to report suspected abuse and the child dies as a result of abuse?
Answer: True
==================================================
Question: What should you do?

A 13 year client talks to you about a romantic relationship they have just begun with a person from another school. The client talks to you about engaging in sexual behavior. The client mentions that their new partner can drive. When asked how old this person is, the client say 16.
Answer: True
==================================================
Question: T or F?

California LCSWs or LMFTs, as mandated reporters, are required to report a reasonable
suspicion of child abuse only if the practitioner is the child's therapist.
Answer: False
==================================================
Question: T or F?

A report of sexual abuse is required when a therapist learns that a 13-year-old has had consensual sexual relations with a 15-year-old.
Answer: True
==================================================
Question: T or F?

Statutory rape refers to sexual relations between a person age 18 or older with another under the age of 18. Although statutory rape may be illegal, it does not require a child abuse report if, for example, the minor is age 16 or 17 and the partner is 18.
Answer: False
==================================================
Question: How old must someone be to be defined as an "elder"?
Answer: True
==================================================
Question: T or F?
In California, elder abuse can be both a criminal and a civil matter.
Answer: False
==================================================
Question: T or F?
In California, LCSWs do not have to report elder or dependent adult abuse or neglect.
Answer: False
==================================================
Question: How soon should you call to report child or elder abuse?
Answer: False
==================================================
Question: How long do you have to turn a written elder abuse report in?
Answer: False
==================================================
Question: T or F?

Older women are more likely to suffer from abuse than older men.
Answer: True
==================================================
Question: T or F?
Research shows that men are more likely to commit elder abuse than women.
Answer: False
==================================================
Question: T or F?

Elder abuse research indicates that the elder's spouse is most likely to abuse an elder.
Answer: True
==================================================
Question: T or F?

California LCSW are mandated reporters for domestic violence.
Answer: False
==================================================
Question: T or F?

California law requires a report when a health practitioner learns that a patient has suffered domestic violence, but only if the health practitioner provides medical services for a physical condition (the result of domestic violence).
Answer: False
==================================================
Question: T or F?

Domestic violence, also referred to as intimate partner violence, is primarily defined in federal law.
Answer: False
==================================================
Question: T or F?

Domestic violence is about one partner having power and control over the other within an intimate relationship.
Answer: True
==================================================
Question: T or F?
The scope of practice for California LCSWs, LMFTs, and LEPs (educational psychologists) is identical.
Answer: False
==================================================
Question: T or F?
A California LCSW or LMFT may be qualified to treat someone with self-injuring behaviors if the practitioner has obtained appropriate specialized training, education, and/or experience
Answer: False
==================================================
Question: What is the primary purpose of the BBS?
Answer: True
==================================================
Question: T or F?
A mandated report is required when two 16-year-olds consensually engage in oral copulation.
Answer: False
==================================================
Question: T or F?
California LCSWs and LMFTs are not de facto qualified to treat someone with an eating disorder. They must also be competent as a result of having acquired sufficient expertise through education, training, and experience.
Answer: False
==================================================
Question: Ignorance of the law is an acceptable legal defense for injuring clients.
Answer: False
==================================================
Question: Clients have the right to sue their clinician for abandonment.
Answer: True
==================================================
Question: A client is legally entitled to adequate information from the therapist before the client provides consent to treat.
Answer: True
==================================================
Question: Clinicians should take additional steps if necessary to insure a client's comprehension of the informed consent contract.
Answer: True
==================================================
Question: Couples should be informed that both reconciliation and separation are possible outcomes of therapy.
Answer: True
==================================================
Question: Terminating services in order to pursue a social, financial, or sexual relationship with a client is acceptable.
Answer: True
==================================================
Question: If a13 year-old seeks and consents for his own treatment, his parents still have a legal right to access his records.
Answer: False
==================================================
Question: A therapist must obtain signed informed consent prior to treatment.
Answer: True
==================================================
Question: When treating a couple, the clinician only needs informed consent from one of the individuals.
Answer: True
==================================================
Question: Termination rights for both the clinician and the client should be included in the informed consent.
Answer: True
==================================================
Question: Legally, fees must be disclosed before the onset of therapy.
Answer: True
==================================================
Question: A therapist should document that he/she obtained informed consent for treatment from client.
Answer: True
==================================================
Question: The therapist has an ethical and legal duty to inform clients of possible outcomes of treatment in order to remain within the standard of care.
Answer: True
==================================================
Question: A therapist should obtain a distinct and separate informed consent for the use of any challenging or novel modalities including any involving touch.
Answer: False
==================================================
Question: The clinician is responsible for providing appropriate referrals for continuity of care when the client initiates termination.
Answer: True
==================================================
Question: Managing confidentiality is a legal and ethical issue.
Answer: False
==================================================
Question: The only exceptions to confidentiality are by a client's written consent to release information or a legal mandate or legal permission to release information.
Answer: True
==================================================
Question: If a husband calls for information about his wife who is in treatment, the therapist should assert privilege.
Answer: True
==================================================
Question: The term privilege relates to the release of information in a legal setting.
Answer: False
==================================================
Question: A therapist is obligated to break confidentiality if there is reasonable suspicion of child abuse.
Answer: True
==================================================
Question: A therapist is obligated to break confidentiality if the client is suicidal.
Answer: False
==================================================
Question: A therapist is mandated to break confidentiality is there is reasonable suspicion of elder abuse.
Answer: False
==================================================
Question: If a client has a plan to vandalize someone's car, the therapist should warn the victim and warn the police.
Answer: False
==================================================
Question: If a new client indicates signs of hopelessness and depression, a prudent therapist would assess for suicide.
Answer: True
==================================================
Question: If a client makes a serious threat to harm an identifiable other, the therapist must warn the victim.
Answer: True
==================================================
Question: Someone over the age of 60 is considered an elder.
Answer: False
==================================================
Question: Therapists are mandated to report domestic violence.
Answer: True
==================================================
Question: If a 65-year-old woman shares that her husband hit her, the therapist should report domestic violence to the police.
Answer: False
==================================================
Question: When a clinician faces a legal action against them initiated by the client, the BBS or a district attorney, the therapist is permitted to break confidentiality.
Answer: True
==================================================
Question: If another clinician contacts you stating that he/she has a release, you may provide the information requested.
Answer: True
==================================================
Question: A group confidentiality contract is a good way to clarify clients' responsibility and protect the clinician.
Answer: True
==================================================
Question: When treating minors, it is the parent who holds privilege.
Answer: True
==================================================
Question: If an adult client shares they were a victim of child abuse as a minor and the perpetrator still has access to children the therapist must file a child abuse report.
Answer: True
==================================================
Question: Therapists are always required to obtain written consent from a parent or guardian before releasing any confidential information about a minor client.
Answer: True
==================================================
Question: The parent or guardian must provide legal consent for a minor's treatment if the minor is under 12.
Answer: True
==================================================
Question: It is a therapist's legal responsibility to make an effort to learn and understand cultural assumptions of their client.
Answer: False
==================================================
Question: Providing false information to an insurance company for the purpose of obtaining treatment is ethically acceptable.
Answer: True
==================================================
Question: Therapists have an ethical responsibility to take reasonable care in maintaining client confidentiality while using electronic devices.
Answer: False
==================================================
Question: If an HIV+ client discloses intent to have unprotected sex with someone, the therapist has a legal duty to warn that individual.
Answer: True
==================================================
Question: When informed of child abuse, a therapist must make an immediate report and follow up with a written report within 24 hours.
Answer: False
==================================================
Question: When informed of elder or dependent adult abuse, a therapist must make the report immediately and follow up with a written report within 3 working days.
Answer: True
==================================================
Question: When filing a report, the therapist is allowed to share any information about the case that he or she thinks is relevant to report.
Answer: True
==================================================
Question: Therapists should document their reasons for filing an abuse report.
Answer: False
==================================================
Question: Privilege is the right of the client to maintain confidentiality regarding the legal system.
Answer: True
==================================================
Question: If a client initiates a lawsuit claiming emotional injury, attorneys for the opposing side are entitled to said client's records.
Answer: False
==================================================
Question: Privilege is suspended if either client or therapist sues the other.
Answer: False
==================================================
Question: If a lawyer subpoenas a client's records without a release, and the therapist is unable to contact the client, the therapist should turn over the records.
Answer: True
==================================================
Question: Professional duty begins as soon as the client enters into an implicit or explicit therapeutic contract.
Answer: True
==================================================
Question: A therapist may provide services without consent for treatment if the client is in a crisis.
Answer: False
==================================================
Question: Therapists have a professional duty to know when a specialist should be utilized.
Answer: True
==================================================
Question: Therapists have a professional duty to know when hospitalization is required.
Answer: True
==================================================
Question: Authorizations to release information must include an end date.
Answer: False
==================================================
Question: Therapists have an ethical professional duty to collaborate or refer to improve and protect the health and wellbeing of their client.
Answer: True
==================================================
Question: A Tarasoff condition only exists if a client expresses a serious threat to harm an identifiable victim.
Answer: False
==================================================
Question: A therapist is not mandated to report consensual sex between minors when they are between the ages of 14 and 18.
Answer: False
==================================================
Question: If a 16 year old is having consensual sex with her 21-year-old boyfriend, the therapist must file a child abuse report.
Answer: True
==================================================
Question: If a 15 year old is having consensual sex with her 21-year-old boyfriend, the therapist must file a child abuse report.
Answer: True
==================================================
Question: If a 13 year old is having consensual sex with her 15-year-old boyfriend, the therapist must file a child abuse report.
Answer: False
==================================================
Question: If a client makes a threat to an unidentifiable victim, the therapist must warn the police.
Answer: True
==================================================
Question: Therapists must maintain mental health records.
Answer: True
==================================================
Question: If a therapist receives a court order for client records, the therapist should assert privilege.
Answer: True
==================================================
Question: Therapists should investigate child abuse if they have reasonable suspicion.
Answer: False
==================================================
Question: If child abuse occurs in another state, the therapist is mandated to report the child abuse in the state in which it occurred.
Answer: True
==================================================
Question: A therapist should inform couples of their "secret" policy before the onset of treatment.
Answer: True
==================================================
Question: Statements made by a client's immediate family members regarding the client's serious danger to harm someone must be considered in Tarasoff situations.
Answer: True
==================================================
Question: Performing any professional services outside the scope of the license is acceptable if explained to the client.
Answer: False
==================================================
Question: Clinicians should not engage in dual or multiple relationships with clients or former clients where there is a risk of potential harm to the client.
Answer: False
==================================================
Question: When dual or multiple relationships are unavoidable, clients are responsible for setting clear, appropriate boundaries.
Answer: True
==================================================
Question: Therapists should avoid initiating treatment when there is a known dual relationship.
Answer: True
==================================================
Question: When a clinician provides services to two or more people who have a relationship to each other (e.g., couples, family members), the clinician should clarify the nature of his or her professional responsibilities to each individual.
Answer: True
==================================================
Question: Clinicians should under no circumstances engage in sexual activities or sexual contact with current clients, whether such contact is consensual or forced.
Answer: False
==================================================
Question: Clinicians should not engage in sexual activities or sexual contact with clients' relatives or others with whom clients maintain a close personal relationship.
Answer: True
==================================================
Question: Clinicians should not provide clinical services to individuals with
whom they have had a prior sexual relationship.
Answer: False
==================================================
Question: It is considered unprofessional conduct to engage in sexual relations with a client within two years following termination of therapy.
Answer: True
==================================================
Question: When obtaining a release of information, all members of the treatment unit who are old enough to consent should sign the release.
Answer: True
==================================================
Question: A therapist should report to CPS if they find out one of their clients is dealing drugs to junior high students in the area.
Answer: False
==================================================
Question: If a client has not had a complete medical evaluation in the last two years, a reasonable and prudent clinician should refer the client for a complete medical check-up.
Answer: True
==================================================
Question: Clinicians providing any treatment without a psychiatric consultation, when warranted, are considered to be practicing below the standard of care.
Answer: True
==================================================
Question: If the client has a legally designated conservator or guardian ad litem, then that person may exercise privilege on their behalf.
Answer: True
==================================================
Question: Parents may exercise the privilege on behalf of their child simply because they are that child's parents.
Answer: False
==================================================
Question: A clinician who receives a subpoena for the records of a minor client would not look to the parents or guardians for instructions on whether to release the records but would instruct the parents or guardians to petition the court for guardian ad litem status.
Answer: True
==================================================
Question: Clients have the right to revoke or modify release authorizations at will.
Answer: True
==================================================
Question: A therapist has a legal duty to prevent suicide.
Answer: False
==================================================
Question: Clinicians must take "appropriate preventive measures" to avert harm to suicidal clients.
Answer: False
==================================================
Question: Ethically, it is acceptable to wait until middle phase of treatment to determine who the unit of treatment is going to be.
Answer: True
==================================================
Question: Minors may only consent to their own treatment if they are over the age of 12 and are victims of abuse.
Answer: True
==================================================
Question: Clinicians are expected to recognize risk factors that can lead to actions resulting in harm to self or others.
Answer: False
==================================================
Question: Not keeping mental health records that meet the standard of care is considered illegal and unprofessional conduct.
Answer: True
==================================================
Question: A clinician can hospitalize a client when the client's mental or physical state causes him/her to be in imminent danger of harming self or others.
Answer: True
==================================================
Question: Social isolation of an elder or dependent adult is a mandated report.
Answer: False
==================================================
Question: A clinician can be deemed legally negligent when his/her treatment plan neglects or overlooks a client's suicidal tendencies.
Answer: False
==================================================
Question: When a client is over 18 years of age and discloses abuse he/she experienced as a child, the therapist is mandated to report it.
Answer: False
==================================================
Question: A clinician is mandated to report all child abuse, including on children residing outside the state of California.
Answer: False
==================================================
Question: Therapist have 3 working days following a written request from a client to allow the client to inspect records.
Answer: False
==================================================
Question: A therapist should keep records for a minimum of 5 year to meet the standard of the profession.
Answer: True
==================================================
Question: A therapist has 15 days to provide the patient with a copy of the records.
Answer: True
==================================================
Question: A therapist may deny a client access to their records when the therapist determines that there is a high risk of detrimental consequences to the client if the client were to see the records.
Answer: False
==================================================
Question: Client records are the property of the client.
Answer: False
==================================================
Question: The monetary value of the gift should be considered when deciding whether or not to accept a gift from your client.
Answer: True
==================================================
Question: A therapist may deny a parent access to the minor's record if the clinician believes releasing the records would have a detrimental effect on the therapeutic relationship.
Answer: True
==================================================
Question: A therapist may deny a parent access to the minor's record if the minor's wellbeing would be jeopardized by releasing records to a parent.
Answer: False
==================================================
Question: If parents are married, both must sign the informed consent to treat their minor child.
Answer: True
==================================================
Question: If parents were never married, either of them may consent for treatment of a minor child.
Answer: True
==================================================
Question: A 12 year old can consent for treatment if he/she is mature enough to participate intelligently in treatment.
Answer: True
==================================================
Question: If a minor consents to his/her own treatment, he/she is responsible for the fees.
Answer: True
==================================================
Question: Any advertisements must include either the exact title of the practitioner's license or the license number.
Answer: Exceptions to Confidentiality:
1. Reasonable suspicion of self-harm
2. Reasonable suspicion of physical abuse with minor/elder adult (mandated report)
3. Reasonable suspicion of danger to others (Duty to Warn)
==================================================
Question: It is unethical but legal to receive compensation for the referral of clients.

2. Disclose least amount of confidential information directly relevant to current situation.
3. Third party release needs consent, verbal consent accepted in emergency situations only.
==================================================
Question: If a therapist uses the term "psychotherapy" or "psychotherapist" in advertisements, he/she must include his/her license number.
Answer: 1. Patient holds if has no guardian or conservator.
2. Patient is dead, has a personal representative
3. Patient is a group, receive a waiver from all members
4. Patient is minor, minor holds unless court appointed parent as guardian, or if minor has attorney.
==================================================
Question: Clinicians have a professional duty to discuss with their clients how insurance companies will manage their confidential information.
Answer: There is no privileged communication if there is cause to believe the client is in mental/emotional condition as to be dangerous to himself/others, disclosure of communication is necessary to prevent threatened danger.
==================================================
Question: Dual relationships between supervisors and supervisees are considered unprofessional conduct.
Answer: Privileged communication refers to a private statement that must be kept in confidence by the recipient for the benefit of the communicator. Privilege refers to information shared in therapy and information documented in the clinical record. Privilege is a legal right.
==================================================
Question: It is a therapist's legal duty to challenge a 'denial of services' from an insurance company.
Answer: Within lawsuit clinician may be required to reveal details of client's treatment. (Law conflicts with Ethics) If release of information will cause harm to client, clinician should request court WITHDRAW or LIMIT the order or SEAL records from public inspection.
==================================================
Question: The purpose of HIPAA is to standardize electronic patient health, administrative, and financial data.
Answer: Clinician may claim privilege on behalf of the client, the client then either:
1. waives privilege and allows the clinician to provide subpoenaed information, or
2. invokes privilege and refuses to allow release of information.
==================================================
Question: It is unethical to accept gifts from clients.
Answer: Minors are protected by confidentiality when able to consent to treatment
==================================================
Question: When a person is unable to provide food, clothing, and shelter for himself or herself due to a mental disorder, he/she is considered gravely disabled.
Answer: 1. Written consent REQUIRED (even with parents).
2. HIPAA gives parents rights to access child's medical records, exceptions (a) minor alone consented to care, parental consent not required, (b) minor obtains care at direction from court
==================================================
Question: The legal requirements for a 5150 (involuntary hold) include when a person is a danger to self or other due to mental illness or he/she is gravely disabled.
Answer: Minor holds unless court appointed parent as guardian, or if minor has attorney.
==================================================
Question: If a therapist learns that a client had sex with a previous therapist, he/she should file a complaint with the BBS.
Answer: Privileged communication refers to private statements made in therapy that is kept confidential for benefit of client. Minors children hold privilege unless court identifies a guardian, clinician must assert privilege on child's behalf unless minor has attorney.
==================================================
Question: If a therapist learns that a client had sex with a previous therapist, he/she should provide the client with the brochure from the BBS outlining their rights and discuss the brochure's contents.
Answer: 1. In CA, 12 years and older can consent to MENTAL HEALTH TX or COUNSELING if BOTH requirements are met: (A) minor is mature enough to participate in services, AND, would present danger to himself/others without treatment, or(B) is alleged victim of incest or child abuse
2. In CA, 12 years and older can consent to MEDICAL TX AND COUNSELING relating to diagnosis/treatment of AOD problem
3. Minors cannot consent to psychotropic medication or inpatient hospitalization without parental consent.
==================================================
Question: Termination may not be appropriate when a client is hospitalized, in crisis, or actively suicidal.
Answer: HIPAA Privacy standards provide protection for accessing psychotherapy notes that contain content/process/clinical opinions. Psychotherapy notes must be kept separate from client chart/record.
==================================================
Question: When termination is initiated by the therapist, consultation is important to ensure that the therapist's reasons for termination and management of the termination process are consistent with community standards and the standard of care.
Answer: In California, providers have an obligation to preserve records for a minimum of seven years following discharge of the patient, except the records of unemancipated minors shall be kept at least one year after the minor has reached the age of 18 years, and in any case, not less than seven years.
==================================================
Question: A therapist must obtain signed written consent to provide teletherapy.
Answer: Request for medical records (PHI) can be denied if:
1. Access is likely to endanger life/safety of individual or other person.
2. PHI refers to another person, release likely to cause harm to that person
3. PHI is created during research (must be notified in advance.)
4. PHI was obtained from someone other than provider under promise of confidentiality and access would break that confidentiality of the source.
==================================================
Question: A professional will explains who is responsible for a therapist's files and clients if the therapist dies.
Answer: HIPAA privacy rules allow clients to view COPIES of medical records. Does NOT require written request. Privacy rule DOES NOT require access to psychotherapy notes. HIPAA allows clients ability to amend information in medical records they consider inaccurate, clinician has 60 days to refute/accept changes made by client. 30 days to respond to request. Clients can request report of who has accessed records for last 6 years. Clients may designate friend/family member to receive information about treatment.
==================================================
Question: When there is a request for information related to any aspect of psychotherapy, each member of the treatment unit should sign the authorization before the disclosure of information.
Answer: Third party disclosure should only release information on a need to know basis, clients must be told in advance if information will be shared with third parties.
==================================================
Question: A therapist should immediately terminate treatment with a client if the therapist is unable to effectively manage his/her countertransference.
Answer: Requires written OR verbal informed consent prior to delivering services, this becomes a part of medical record. Must be within scope of practice. Must be licensed in state client resides.
==================================================
Question: If a therapist suspects that a colleague is unable to perform his/her professional duties due to personal issues (e.g., substance abuse, mental health problems), the therapist should first report him/her to the BBS.
Answer: HIPAA stands for Health Insurance Portability and Accountability Act. Has 3 components:
1. Portability standards that ensure the continuity of healthcare.
2. Privacy standards that govern the disclosure of protected health information (PHI).
3. Security Standards that protect the development and maintenance of health information.
==================================================
Question: Therapists should refrain from bartering for services.
Answer: To ensure the continuity of healthcare:
1. Limits ability of new employer plan to exclude coverage for pre-existing conditions
2. Provides individuals opportunity to enroll in group health plan with loss of coverage
3. Prohibits discrimination against employees and family members based on medical and genetic information.
==================================================
Question: Therapist should explain how fees will be managed, including in the event that the client has not paid his/her fees.
Answer: The Privacy Rule: To govern the disclosure of PHI
1. Sets boundaries on use and release of health records
2. Enables clients to find out how information may be used, and about certain disclosures of their information.
3. Gives clients the right to examine and obtain a copy of health records and request corrections if needed.
4. Establishes safeguards that providers must achieve to protect PHI.
5. Enforces civil and criminal penalties if there is a violation of clients' privacy rights.
==================================================
Question: A therapist has a legal right to withhold a client's records if he/she has not paid his/her fees.
Answer: Any information about health status, provision of health care, or payment for health care that can be connected to a person. HIPAA standards apply only to PHI.
==================================================
Question: Therapist should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made.
Answer: The Privacy Rule requires activities, such as:
1. Notifying clients about their privacy rights and how information can be used. NOTICE OF PRIVACY PRACTICES during first session.
2. Adopting and implementing privacy procedures.
3. Training any employees on privacy procedures.
4. Designating and individual responsible for monitoring adherence of privacy procedures.
5. Securing client records so they are not readily accessible to those who don't need them.
==================================================
Question: If a therapist's records are stolen, the therapist should file a police report and notify the clients.
Answer: 1. Caregiver not wanting elder to be seen on his/her own.
2. Caregiver providing different account of events than elder
3. Lack of cooperation from caregiver for tx plan.
4. Caregiver attempts to isolate elder from family/friends/activities.
5. Caregiver denying right to make decisions about care, living arrangements, etc.
6. Observable behaviors, such as anger or substance use.
7. Dependence of caregiver on elder for financial support.
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Question: If a therapist observes an act of child abuse while shopping at the mall, the therapist is mandated to make a report.
Answer: Mandated reporters required to report abuse if they observe abuse directly, if child or elder discloses abuse, or if they have reasonable suspicion of abuse. Elder abuse must report suspicions to APS ASAP and if reported by phone submit written report within 48 hours.
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Question: HIPAA standards apply if a therapist communicates electronically.
Answer: 1. Sudden change in behaviors; decreased grooming, staring vacantly, fear, agitation/anxiety, unexplained crying, disorientation, depression, unusual behavior (biting/rocking)
2. Discrepancy with standard of living and financial assets, depletion of assets without explanation, money or items missing, unpaid bills, reports of new will or POA.
3. Withdrawn, apathetic, fearful, anxious bxs around certain persons, not wanting to receive visits from family and friends.
4. Malnourishment (weight loss), dehydration (cracked lips/sunken eyes), poor overall hygiene, over sedation, inappropriate clothing, lack of dentures/eyeglasses.
5. Physical Injuries: bruises, unexplained injuries, multiple ER visits, broken glasses.
6. Urinary Tract Infection, vaginal or anal bleeding
7. Medical needs not attended to
8. Sudden changes in living environment, younger person moving in to care for Elderly soon after meeting.
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Question: It is legal but unethical to advertise false skills and specialties.
Answer: Mandated reporters required to report abuse if they observe abuse directly, if child or elder discloses abuse, or if they have reasonable suspicion of abuse. Elder abuse must report suspicions to APS ASAP and if reported by phone submit written report within 48 hours.
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Question: The font on a authorization to release information must be at least 12 point.
Answer: 1. Physical Abuse: burns, bites, bruises, broken bones, black eyes, fear of caretakers, fading bruises or other marks after absence of school
2. Neglect: frequent absence from school, begs for/steals food/money, needed medical or dental care/immunizations/glasses, consistently dirty/smells, lacks clothing, abuses AOD, states no one is home to provide care.
3. Sexual: difficulty walking or sitting, refuses to change or participate in physical activities, reports nightmares/bedwetting, sudden change in appetite, bizarre/sophisticated/unusual sexual knowledge/behavior, pregnant or venereal disease before 14, runs away.
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Question: Changing a client's diagnosis to ensure payment by insurance is acceptable with client's consent.
Answer: Mandated reporters required to report abuse if they observe abuse directly, if child or elder discloses abuse, or if they have reasonable suspicion of abuse. Required to file report immediately by phone and written report completed within 36 hours.
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Question: I am going to pass this exam.
Answer: 1. Does not require certainty the abuse has occurred
2. Does not require medical indication of abuse
3. Based on any information considered credible, including statements from others.
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Question: A therapist must notify the BBS of change of name or address within 30 days.
Answer: Examples of reasonable safeguards include:
1. Speaking quietly when discussing client's condition in public area.
2. Avoiding using names in public hallways and elevators
3. using passwords on computer files containing PHI.
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Question: An incarcerated client loses their right to privilege.





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Question: A baby who tests positive for drugs at birth would require a mandated child abuse report.

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Question: A therapist must notify the BBS of any convictions, including a DUI, within 30 days.

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Question: A conflict of interest occurs when there is a dual relationship between the therapist and client where the therapist may have personal investment and become biased with treatment.
Answer: Make every effort to avoid relationships with clients that could impair professional judgment and increase risk of exploitation, document precautions taken.

Examples of DUAL ROLES: counseling a friend/family member, providing individual therapy to two members in same household, providing simultaneous individual and group therapy and entering a business relationship with client.
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Question: Parents who are in prison lose their rights to access their minor child's records.
Answer: Duty to Warn key issues to review:
1. Client poses threat to self or others
2. Under what circumstances threat was made
3. How much time has passed since threat
4. Client possesses means and capacity
5. Duty to warn mandatory by state law? (yes in CA)
6. Threat to specific individual or public at large
7. Criteria for involuntary commitment may apply
8. If the state permits disclosure of threat if not mandatory
9. Who needs to be warned to effectively discharge duty to warn (police, victim, DMV, Physician, family member)
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Question: After a client dies, the client's designated personal representative or the legal executor of his or her estate has a right under law to access the records.

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Question: A minor may not consent to convulsive therapy, psychosurgery, or psychotropic medication without the consent of the minor's parent or guardian.
Answer: 1. presence of attitudes that support violence
2. capacity of means to carry out
3. Preparing toward violence (buying gun, breaking a law)
4. presence of an intent to carry out action
5. responses of others to clients plans
6. degree of client compliance with tx recommendations
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Question: During the initial session, informed consent should include a discussion of the risks and benefits of treatment and the purpose of therapy.
Answer: California's Inpatient Commitment Standard:
1. Serious risk of harm to himself/others
OR
2. Gravely disabled (in immediate physical danger because unable to meet basic needs for food, clothing or shelter)
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Question: If a therapist is on an insurance panel, and the insurance conducts an audit requesting client records, the therapist must provide copies of the records.
Answer: Request the confinement after signing a written declaration stating the psychiatric diagnosis that the diagnosing medical professional believes to be the cause or reason why they believe the patient to be "a danger to themselves or others" or the psychiatric disorder that has rendered the patient incapable of making their own medical treatment decisions
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Question: K41.Knowledge of limitations of professional experience, education, and training to determine issues outside scope of competence.

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Question: K42. Knowledge of situations that indicate a need for consultation with colleagues or other professionals.
Answer: If issue of client's mental health or treatment is raised during lawsuit, a clinician might be forced by court to reveal details of client's treatment. Providers can disclose medical information when there is reasonable cause to believe client is a danger to himself/others and disclosure is necessary to prevent danger.
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Question: K43. Knowledge of ethical standards regarding the protection of client rights when engaging in consultation/collaboration with other professionals.
Answer: SEXUAL ASSAULT- Provider must attempt to contact parent/guardian (note date/time/outcome), does not apply if parent/guardian is perpetrator. UNLESS RAPE.

RAPE - Not permitted to inform guardian without consent from minor (12 years or older)

CHILD ABUSE/NEGLECT - patient privilege does not apply to information reported. Child abuse reporting act exempts clinicians from liability if they make a good faith report of abuse.
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Question: K44. Knowledge of ethical methods for developing additional areas of practice or expanding competence.
Answer: A tort is a civil wrong, other than breach of contract, for which the court will provide a remedy in the form of an action for damages.

If client is minor child, he holds privilege. Minor's parents do not hold privilege unless court appoints as guardian. Clinician must assert privilege on behalf of minor. If minor has an attorney, attorney can make decision to waive or assert privilege.
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Question: K45. Knowledge of the ethical responsibility to remain current on developments in the profession.
Answer: Privilege exception when therapist has reasonable cause to believe the patient is in such a mental or emotional condition as to be dangerous to himself or other person or property of another
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Question: K46. Knowledge of problems/impairments that interfere with the process of providing therapeutic services.
Answer: Sexual contact of any kind between a therapist and client is unethical and illegal in the state of California. Legally, sexual contact WITHIN two years of termination is illegal and unethical. (its always unethical)
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Question: K47. Knowledge of referrals and resources to assist in meeting the needs of clients.
Answer: Any therapist in California who becomes aware the client had a sexual relationship with past clinician during treatment is required to give brochure entitled "Professional Therapy Never Includes Sex" and discuss with client.
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Question: K48. Knowledge of methods to facilitate transfer when referrals to other professionals are made.
Answer: Clinicians must be licensed in each state where they provide services within "scope of practice" of that jurisdictions license. Issue when providing telehealth services including E-therapy.
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Question: K49.Knowledge of methods for collaborating with client to determine if referral(s) or other resources are clinically indicated.
Answer: Informed consent Includes: goals of services, risks and benefits, approx. length of process, alternatives to therapy, fees and services incl. processes for unpaid bills, qualifications and background of clinician, treatment and emergency procedures, third party disclosures, limits to confidentiality and choices between paying with/without insurance
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Question: K50.Knowledge of the potential impact of therapist's personal values, attitudes, and/or beliefs on the therapeutic relationship.
Answer: Only give necessary information for reimbursement including diagnosis, fees, and insurance information. Do not include clinical notes or provide any information other that what is required for payment.
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Question: K51.Knowledge of methods for managing the impact of therapist's personal values, attitudes, and/or beliefs on the client or the therapeutic relationship.
Answer: Mental Health Parity Act: strove to resolve the practice of insurance discrimination. Health insurance companies offering mental health/substance abuse benefits will be required to provide equal coverage of mental/physical illnesses. Parity Act applies to group coverage of 51 or more employees.
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Question: K52.Knowledge of conditions/situations that could potentially exploit or cause harm to the client.
Answer: Statutes prohibit mental health providers from "advertising in a manner that is false, fraudulent, misleading or deceptive" Example: Your sxs will improve by 50% with this treatment. Common Example: dishonesty about credentials.
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Question: K53. Knowledge of methods for managing boundaries and/or professional relationships with the client.
Answer: 1.05 Cultural Competence and Social Diversity

Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status and mental or physical disability.
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Question: K54. Knowledge of ethical standards regarding protecting the client's wellbeing in potential conflict of interest situations.
Answer: 4.02 Discrimination

Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability.


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Question: K55.Knowledge of relationships that can be potentially detrimental to the client and/or therapeutic relationship.
Answer: 1. Knowledge: client's culture, communication style, help seeking behaviors.

2. Professional sills: application of techniques that prove effective with diverse populations, ability to discuss racial and ethnic issues, ability to use resources on behalf of minority clients.

3. Personal attributes: Willingness to work with diverse populations and ability to communicate genuine warmth and empathy.
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Question: K56.Knowledge of methods to prevent impairment to clinical judgment and/or harm to the client in situations where multiple relationships are unavoidable.
Answer: 1.05 Cultural Competence and Social Diversity

Social Workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion and mental/physical disability.
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Question: K57.Knowledge of the potential for client harm or exploitation associated with sexual activity or contact between therapist and client.
Answer: 1.03 Informed Consent

Informed consent is an opportunity for the therapist and client to make sure they understand their shared venture. Providing client with the information they need to become active participants in the therapy relationship begins with initial session and continues throughout counseling. Promotes active cooperation of clients.
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Question: K58. Knowledge of ethical standards regarding engaging in sexual activity or contact with client and/or others with whom the client has/had a personal relationship.
Answer: 1.07 Privacy and Confidentiality

Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent harm to self/others. In all instances, social workers should disclose the least amount of information that is directly relevant to the purpose for which the disclosure is made should be revealed.
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Question: K59. Knowledge of ethical standards regarding entering into a therapeutic relationship with former sexual partners.
Answer: 1.02 Self-determination

Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals.
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Question: K60.Knowledge of the ethical responsibility to provide client with information regarding the therapeutic process.
Answer: 2.01 Respect

(a) Social workers should treat colleagues with respect an should represent accurately and fairly the qualifications, views and obligations of colleagues.

(b) Social workers should avoid unwarranted negative criticism of colleagues in communications with clients or with other professionals.

(c) Social workers should cooperate with social work colleagues and with colleagues of other professions when such cooperation serves the wellbeing of clients.
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Question: K61. Knowledge of disclosures that facilitate client's ability to make informed decisions regarding treatment.
Answer: 2.03 Interdisciplinary Collaboration

Social Workers who are members of an interdisciplinary team should participate in and contribute to decisions that affect the well-being of clients by drawing on the perspectives, values, and experiences of the social work profession. professional and ethical obligations of the team as a whole and of its individual members should be clearly established.
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Question: K62. Knowledge of client's right to self-determination in making decisions regarding therapeutic services received.
Answer: ??
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Question: K63. Knowledge of methods for communicating information pertaining to informed consent in a manner consistent with developmental and cultural factors.
Answer: 3.04 Client Records

(a) Social workers should take reasonable steps to ensure that documentation in records is accurate and reflects the services provided.
(b) Social workers should include sufficient and timely documentation in records to facilitate the delivery of services and to ensure continuity of services provided to clients in the future.
(c) Social workers' documentation should protect clients' privacy to the extent that is possible and appropriate and should include only information that is directly relevant to the delivery of services.
(d) Social workers should store records following the termination of services to ensure reasonable future access. Records should be maintained for the number of years required by state statutes or relevant contracts.
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Question: K64. Knowledge of the right and responsibility of legal guardian/representative to make decisions on behalf of clients unable to make informed decisions.
Answer: D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.

The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened.
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Question: K65. Knowledge of methods for protecting client's welfare when client is unable to provide voluntary consent.
Answer: A. Tell Mr. Milsap that you cannot honor his request.

Without the permission of the court or the party issuing the subpoena, a social worker may not produce a summary or alter (by omission or any other way) the treatment record subpoenaed.
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Question: K66.Knowledge of the effects of concurrent mental health treatments on the provision of therapeutic services.
Answer: A. A small town where social worker and cashier (client) see each other at the local store.

The cashier/client would not present an inappropriate dual relationship. This would be an instance, especially in a small town where the number of stores may be limited, where the contact in the community may be unavoidable.
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Question: K67. Knowledge of methods for establishing collaborative professional relationships to improve the welfare of the client.
Answer: B. Deny his request.

Given the limited information we have in this scenario, denying the request would be the best course of action until proper authorization could be obtained by the dead woman's legal representative.
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Question: K68. Knowledge of ethical standards regarding the protection of client rights when engaging in consultation/collaboration with other professionals.
Answer: B. Required to maintain confidentiality.

A social worker is legally obligated to maintain confidentiality in this instance.
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Question: K69.Knowledge of methods for identifying the "client" and the nature of relationships when providing therapeutic services to more than one person.
Answer: B. Explain the nature of dual relationships to her.

Explaining dual relationships to her would be the best way to start, and the question is asking what you would do FIRST. What you decide from this point depends on the size of your town and whether you believe this is an avoidable dual relationship.
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Question: K70. Knowledge of the impact of client unit, therapeutic modality, and involvement of multiple systems on confidentiality.
Answer: B. Maintain confidentiality and process her feelings.

The law is clear that you need to maintain confidentiality when the transmission of HIV is by sexual means.
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Question: K71. Knowledge of the factors that impact the therapeutic relationship.
Answer: C. Make another appointment for both of them since the couple is your client.

In conducting marital therapy, your client is the couple. By asking that both partners be present, you are demonstrating that you do not take sides. This might encourage the wife to attend the next session in order to explore her feelings of being treated unfairly.
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Question: K72. Knowledge of methods for managing confidentiality and privacy issues when providing concurrent therapy.
Answer: C. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex" and discuss the contents with her.

You are legally obligated to give a client, who reports having had sexual contact with a previous mental health provider, the booklet "Professional Therapy Never Includes Sex" as well as discuss the contents of the booklet with her.
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Question: K73. Knowledge of methods for managing confidentiality and privacy issues when treatment involves multiple systems or third parties.
Answer: D. Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty.

A client's failure to pay does represent a legal "breach of duty" but that is not related to how you would proceed with collections.
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Question: K74.Knowledge of ethical standards regarding the management of confidentiality issues that arise in the therapeutic process.
Answer: A. Answer Miriam's questions.

Social workers must make a distinction between clinical interventions and ethical responsibilities. Clients have the right to such information as where the social worker went to graduate school, how long the social worker has been licensed, and if there are any areas of expertise and training. Such questions should not be treated as inappropriate or boundary violating and are part of the process of a client determining whether or not the social worker offers the kind of services the client wants or needs.
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Question: K75.Knowledge of methods for managing the impact of confidentiality issues on the therapeutic relationship.
Answer: B. The client.

In this situation, since Jennifer has introduced her emotional condition into the trial, her right to privilege MAY be waived. Since there is no indication that she or the court has waived her privilege, it continues to be held by her.
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Question: K76.Knowledge of methods for assessing level of potential danger or harm to client or others.
Answer: A. Report by telephone within 24 hours to law enforcement.

If physical abuse occurs in a long-term facility and does NOT result in serious bodily harm, a telephone report must be made to local law enforcement within 24 hours and a written report within 24 hours to law enforcement, the facility's licensing agency, and the ombudsman.
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Question: K77. Knowledge of ethical obligations regarding the management of safety needs.
Answer: C. Indicate that you cannot make life decisions for a client.

Social workers respect the right of patients to make decisions and inform them that their decisions are their own responsibility.
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Question: K78. Knowledge of methods and procedures for managing safety needs.
Answer: A. Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together.

This would be the most ethical and clinically efficacious way to proceed. The pastor may have relevant information impacting your treatment of the wife, and it would be important to establish a working relationship with your client's other counselor.
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Question: K79.Knowledge of the impact of legal and ethical obligations on the therapeutic relationship.
Answer: D. Determine if you can deal with this client at this time.

First you would have to assess the client's best interests; only if you can continue to work with the client would you need to manage your counter-transference.
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Question: K80. Knowledge of methods for protecting the best interest of the client in situations where legal and ethical obligations conflict.
Answer: C. Refer to legal aid for restraining order help or to assist with assault charges.

Eugenia is thinking about a temporary restraining order, and the help a social worker would give would be in directing her to the appropriate resources. It would be out of your scope of practice to give her legal advice yourself.
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Question: K81. Knowledge of methods for protecting the best interest of the client in situations where agency and ethical obligations conflict.
Answer: B. Inform the client that you will be unable to see him until he has terminated with his current therapist.

Informing the client that you will be unable to see him until he has terminated with his current therapist would be the most ethical solution.
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Question: K82.Knowledge of diversity factors that potentially impact the therapeutic process.
Answer: A. Assert client privilege.

By the process of elimination, "A" is the only correct answer. None of the other choices are legal requirements.
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Question: K83. Knowledge of ethical standards regarding nondiscrimination.
Answer: D. Call Adult Protective Services and an agency designated to take a child abuse report immediately.

Call Adult Protective Services immediately because there is reasonable suspicion of an elder being isolated. Call an agency designated to take a child abuse report because Kevin is still a minor, and he is reporting having witnessed spousal abuse that caused him distress.
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Question: K84. Knowledge of ethical standards for providing therapeutic services congruent with client diversity.
Answer: B. When the therapist recognizes that the client is suicidal.

Although being suicidal all by itself may not yet be a crisis, clients who are in potential danger must be referred to services they can access close to where they live.
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Question: K85. Knowledge of methods to gain knowledge, awareness, sensitivity, and skills necessary for working with clients from diverse populations.
Answer: A. Evaluate whether Maria can benefit from therapy if they continue in conjoint therapy.

You are ethically obligated to assess if a client can benefit from treatment. A conjoint unit may not be in this client's best interests.
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Question: K86.Knowledge of the collaborative role between therapist and client in the therapeutic process.
Answer: A. Specify any particular limits of confidentiality as they pertain to internet security and privacy.

There are no special mandated "limits of confidentiality" that pertain to telehealth, but privacy and confidentiality could be compromised in telehealth sessions, and therapists would have the ethical obligation to clarify those risks.
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Question: K87. Knowledge of the client's right to make decisions regarding therapeutic services.
Answer: A. Permissible under some circumstances.

Ethical standards say that social workers do not usually barter or are discouraged from doing this but the standards make allowances for doing business in communities where bartering is standard practice.
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Question: K88. Knowledge of methods to assist client to make decisions and clarify goals.
Answer: C. Consider breaking confidentiality to ensure his safety.

Evidence Code 1024 gives social workers the right to break confidentiality to ensure the safety of their client. This is the best answer of the choices.
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Question: K89. Knowledge of methods for establishing collaborative professional relationships to improve the welfare of the client.
Answer: B. A 12-year-old depressed male whose cultural background strongly discourages therapy.

If a minor is at least 12 years old and is mature enough to participate in outpatient treatment, you may provide treatment without parental consent for various clinical issues if, in your professional opinion, parental involvement would be ill-advised.
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Question: K90. Knowledge of ethical standards for participating as a member of an interdisciplinary team.
Answer: C. Discuss the possibility of trading carpooling in exchange for some of the cost of therapy.

Carpooling in exchange for the cost of therapy is the least appropriate option of the choices given.
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Question: K91.Knowledge of methods for evaluating client's capacity to advocate on own behalf.
Answer: A. Ask him to tell you more about his ideas of therapy and his mistrust of you.

When working with clients who have culturally-based expectations of therapy or who may view the social worker with mistrust, it is important to first form an alliance with the client. Expressing interest in the client's experience and feelings is one way to form an alliance.
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Question: K92. Knowledge of ethical standards pertaining to interacting with third-party payers.
Answer: C. Discuss with Arlen under what circumstances, such as obtaining a new job, you will re-establish his original fee structure.

When making a temporary fee reduction, in order to maintain clear ethical boundaries about fees and payments, you should make certain Arlen knows the expectations about when you will resume charging him his original customary fee.
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Question: K93. Knowledge of ethical standards pertaining to interacting with other service delivery systems.
Answer: A. Ethically responsible to provide her with referrals.

There is no legal obligation to report spousal abuse, but there is an ethical responsibility to ensure client safety. Therapeutically, this may consist of a referral to a shelter, an attorney for a restraining order, and/or the establishment of separate living quarters. This can be followed by long-term interventions such as the implementation of anger management and improved communication skills.
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Question: K94. Knowledge of methods for enhancing client's ability to meet own needs.
Answer: C. Ethically, you could contact the boss under the auspices of Evidence Code 1024.

You may ethically break confidentiality under Evidence Code 1024 to warn the boss of the client's plan/intent to damage his car.
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Question: K95.Knowledge of ethical considerations and conditions for interrupting or terminating therapeutic services.
Answer: D. Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on.

The most ethical way to deal with counter-transference is through journaling, peer consultation and personal therapy, in an attempt to regain perspective.
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Question: K96. Knowledge of referrals/resources to provide consistent care in the event therapeutic services must be interrupted or discontinued.
Answer: B. Do not contact the father and maintain the client's confidentiality.

You would maintain the client's confidentiality because she has the legal right to it, and suicide is not a mandated breach of confidentiality. You might consider breaking her confidentiality if her suicidal ideation includes an imminent plan and time frame, but the vignette does not indicate crisis-level suicide that would warrant a breach of confidentiality.
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Question: K97. Knowledge of methods to facilitate transfer when referrals to other professionals are made.
Answer: B. Tell them how individual therapy will be different from conjoint therapy.

In order to help them make the decision about starting individual therapy, you would provide some parameters so you have informed consent.
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Question: K98.Knowledge of factors and/or conditions that indicate client is ready for termination of therapeutic services.
Answer: B. Obtain confirmation about their benefits before the first session.

You would need to confirm the client's benefits (payment policy set by the insurance company) before starting therapy. This is equivalent to setting the fee before therapy.
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Question: K99. Knowledge of factors and/or conditions that indicate client is not benefiting from treatment.
Answer: B. Honor the original agreement, and if your ability to work with this client feels compromised, discuss your concerns with the client and offer to help her transition to another therapist because of the ethical conflict.

Ethically, a therapist would be obliged to honor the original agreement. If the therapist's feelings were interfering with the ability to do good therapy, then it would be ethically correct to find the client another therapist and to explain to the client the reasons to do so. Ethical standards say that therapists have the right to terminate treatment for reasons including ethical conflicts.
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Question: K100. Knowledge of methods for managing the termination process.
Answer: C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy.

Reasonable notice of termination is required if you plan to terminate because a client has not paid.
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Question: K101. Knowledge of methods to prevent client abandonment and/or client neglect.
Answer: B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night.

The threat was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. Although the laws of confidentiality require that we not report an HIV-positive client whose intentional behavior is to infect others through sex, injecting another person with a syringe without their permission constitutes an act of violence.
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Question: LEGAL: Confidential Communications Therapeutic Relationship
Answer: B. Discuss the situation and attempt to negotiate a fee acceptable to both of you.

This is the best answer of the choices given. Although Roberto thinks you should accept his co-payment as the fee, you still have not attempted to negotiate a mutually acceptable fee. This discussion would be your next step. If you could not agree on a fee, he should be given a lower-cost referral to provide for continuity of treatment.
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Question: LEGAL: Disclosure of Confidential Information to individuals, professionals, agencies and authorities
Answer: B. Charge Andy and have him contact the insurance company.

Billing the client, and letting him seek reimbursement from the insurance company is correct. This choice puts the responsibility on the client, where it belongs.
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Question: LEGAL: Identify Holder of Privilege (age, legal status, content of therapy)
Answer: C. 24 months.

According to the NASW code of Ethics, if a social worker waits a minimum of two years to begin a romantic relationship with a client, that social worker is adhering to the standards. Ideally, social workers do not pursue romantic relationships with clients at all, however.
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Question: LEGAL: Laws regarding Privileged Communication
Answer: D. Offer a sliding fee for the intermittent sessions.

There is no legal or ethical requirement to slide fees as part of termination.
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Question: LEGAL: Privileged COMMUNICATION in Legal/Judicial Matters
Answer: D. Assess the motivation behind the gift.

Assessing the motivation and the value of a gift is very important in determining whether you should accept it or not. What needs to be determined is whether the act of giving the gift supports Mrs. Bailey's therapeutic process and needs.
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Question: LEGAL: Laws regarding RELEASE of privileged information in judicial/legal matters
Answer: A. Must gather as much information as possible and make a report of physical abuse to Adult Protective Services since this woman is a dependent adult.


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Question: LEGAL: Laws regarding privileged information in RESPONDING to subpoenas and court orders.


This is a way of providing informed consent about client's expectations.
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Question: LEGAL: Confidentiality with MINORS
Answer: D. Obtain consultation from each doctor about his case.

The best answer choice from an ethical point of view would be to speak with each doctor. This is a scope of competence question that tests your knowledge of how to utilize consultation.
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Question: LEGAL: Disclosure of Confidential information to other individuals, professionals, agencies or authorities when working with MINORS.
Answer: C. The purpose of the release and the social worker's license number.

The purpose of the release and the social worker's license number would both be on a release of information form.
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Question: LEGAL: Holder of privilege with MINORS
Answer: B. Domestic violence.

Domestic violence does not usually fall under the exceptions to confidentiality unless a child abuse report needs to be filed as a result of the domestic violence or if the abused party is under the protected class of individuals.
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Question: LEGAL: Laws regarding privileged communication with MINORS
Answer: B. The advertisement must indicate the full name of the licensee and the complete license number.

It is a legal requirement that the LCSW's full name and license number or associate's registration number be on the advertisement.
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Question: LEGAL: Legal criteria/requirements for providing services to MINORS
Answer: A. Agree to see his referral.

Ethically, you could agree to see this referral. An acquaintance who refers business to you would not constitute a dual relationship.
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Question: LEGAL: Laws regarding documentation of therapeutic services.
Answer: C. Evaluate whether or not you can continue to work effectively with this client.

The first priority is to determine if you can work effectively with the client.
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Question: LEGAL: Laws regarding maintenance/disposal of records
Answer: B. Maintain confidentiality and assess for possible elder abuse.

There are no reporting mandates here since Mollie is not an elder or dependent adult. Assessing further for elder abuse is something you certainly could do, because there is violence in the relationship, and Roland is an elder.
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Question: LEGAL: Laws pertaining to client's access to tx records, REQUEST CAN BE DENIED IF:
Answer: C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions.

Ethically, you cannot avoid informed consent even in a crisis. So it would be ethical to give the client the legally required information and meet any crisis needs immediately.
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Question: LEGAL: Laws pertaining to client's access to tx records
Answer: C. Responding to a CPS caseworker's request for family history following a child abuse report.

A social worker is not permitted to respond to a CPS caseworker's follow-up inquiries without a written request if the request does not specifically pertain to the child abuse report.
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Question: LEGAL: Laws pertaining to release of records to other individuals, professionals, or third parties.
Answer: A. You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction.

Ethical standards prohibit business ventures or social interactions with a patient, spouse, partner, or family member. Hiring Tom's cousin would be considered an unethical dual relationship.
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Question: LEGAL: Telehealth regulations regarding consent and delivery of services via information and communication technologies
Answer: A. Tell the client directly the social worker's concerns if the client does not return to therapy.

Ethically, the social worker is obligated to have a direct informed consent conversation with a client, even clients who are acutely symptomatic.
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Question: LEGAL: HIPAA legal requirements
Answer: B. Discreetly confront your colleague about his drinking.

Ethics standards strongly encourage social workers to intervene when colleagues are risking client care.
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Question: LEGAL: HIPAA and PORTABILITY standards
Answer: D. Since Maya is 15 years old, the rape would constitute child abuse.

Although Maya is an emancipated minor, she is only considered an adult in certain legal circumstances. As a minor, a social worker is required to report abuse, which rape clearly is.
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Question: LEGAL: HIPAA and PRIVACY standards
Answer: C. It is not legal for her to offer compensation for referrals.

It is illegal for mental health professionals to offer compensation or rewards for referrals.
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Question: LEGAL: Protected Health Information (PHI)
Answer: C. Your fee.

Disclosing your fee is legally required prior to the commencement of therapy.
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Question: LEGAL: The Privacy Rule (implications in practice)
Answer: D. Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session.

This would be the most appropriate response. Ethical standards are guidelines and there are circumstances in which other considerations, such as cultural issues, would allow for accepting a gift of this nature.
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Question: LEGAL: Indicators of abuse, neglect or exploitation of DEPENDENT ADULTS
Answer: D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.

This is what you would have to do. At this point, the well-being of the intended victim outweighs the ethical concerns about informed consent.
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Question: LEGAL: Laws pertaining to reporting known or suspected abuse of DEPENDENT ADULTS
Answer: B. Obtain the client's promise not to harm him/herself until you meet again and use a "self care" contract to reinforce the promise.

If a client promises, in writing, not to harm him/herself until your next meeting, and the social worker reasonably believes that the client agreed in good faith, this would be a reasonable step to ensure the client's safety.
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Question: LEGAL: Indicators of abuse, neglect or exploitation of ELDERLY clients
Answer: B. Asking your client, who is a contractor, for information about drywall.

Engaging in a separate and distinct relationship either spontaneously, within a therapeutic relationship or after a reasonable period of time following the termination of the therapeutic relationship, constitutes a dual relationship. This is an ethical issue.
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Question: LEGAL: Laws pertaining to reporting known or suspected abuse of ELDERLY Clients
Answer: A. Consider offering to see Jamal on a sliding scale or pro bono basis.

This is the most ethical choice. Considering whether to see Jamal on a sliding scale or pro bono basis would address Lisa's apparent financial stresses and allow Jamal to get needed treatment.
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Question: LEGAL: Indicators of abuse, neglect or exploitation of MINOR clients
Answer: D. Maintain confidentiality.

As a social worker you are legally and ethically required to maintain confidentiality when you are aware that your client is HIV positive.
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Question: LEGAL: Laws pertaining to reporting known or suspected abuse of MINOR clients
Answer: D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them.

Ethically, you have to explain the parameters of therapy.
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Question: LEGAL: Reporting "Reasonable Suspicion" with MINORS
Answer: B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being.

If releasing the content of therapy notes will result in a negative impact on the minor's physical safety and/or psychological well-being, then the social worker has a right to refuse a parent's inspection of the records.
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Question: ETHICAL: Confidentiality and "reasonable protection" of client records.
Answer: D. Inform Mrs. Moran of your license and qualifications.


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Question: ETHICAL: Releasing client records upon request
Answer: D. Refer her to a financial planner.

She needs assistance and education about how to manage her and her husband's finances.
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Question: ETHICAL: Assisting clients with interpreting therapeutic records.
Answer: C. Question Matthew and Delilah separately about possible domestic violence.

Scope of practice obligations require that you conduct therapy and safety assessments in a way that meets the standard of care.
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Question: ETHICAL: Clarifying roles when not acting as LCSW
Answer: B. Legally, you do not have to report the abuse.

This answer is the most accurate. You do not have to report child abuse if you learned of it outside your professional capacity.
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Question: ETHICAL: Guidelines when engaging in conflicting or dual roles.
Answer: A. To establish a plan of safety, including shelters and established support systems.

The ethical responsibility is to establish a plan of safety, including shelters and established support systems. Legally, mental health professionals cannot usually break confidentiality due to domestic violence unless the recipient of the abuse falls within a protected class of individuals.
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Question: LEGAL: Identifying situations where client poses danger to others
Answer: C. Refer the client to a career counselor.

Based on the information given, referring the client to a career counselor is the appropriate option.
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Question: LEGAL: Duty to protect when client indicates INTENT to cause harm
Answer: C. A client accused of assault and battery uses insanity as a defense in court.

If insanity is used as a defense for a crime, then the client may have waived his or her right to privilege.
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Question: LEGAL: Situations/conditions that constitute reasonable indicators of client's intent to cause harm
Answer: A. Address the mistake in the next group.

From an ethical point of view, clients' experiences need to be validated, and they all saw this email. It would be important to address the confidentiality breach and assess the participants' reactions.
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Question: LEGAL: Symptoms of impairment that indicate need for involuntary hospitalization
Answer: C. Engage him in a discussion of his motivation and past efforts.

In the initial stages of therapy, the establishment of trust and rapport is a crucial component to successful work, which "C" embodies as it deals with the presenting problem and the underlying emotions associated with it.
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Question: LEGAL: Protocols for initiating involuntary hospitalization
Answer: D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.

The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened.
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Question: LEGAL: laws regarding confidentiality in situations of client danger to self or others
Answer: D. File a child abuse report.

Christine has told you that she was sexually abused and, although, she said a report was already filed, you need to fulfill your mandate to report child abuse.
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Question: LEGAL: Laws regarding privilege exceptions in litigation involving mental condition by client or representative
Answer: A. Report the abuse to CPS immediately by phone and with a written report within 36 hours.

You have reasonable suspicion that the perpetrator could be soliciting minors given your client's history and her report of his activity on the internet.
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Question: LEGAL: Laws pertaining to reporting crimes against a MINOR
Answer: C. Call Barbara's ex-boss and warn him of her plan.

Warning the victim may be done in the interests of protecting the public and protecting the social worker from liability related to breaking the confidentiality of the potentially dangerous client. As of 2014, there is only a legal responsibility to contact law enforcement within 24 hours. After doing that, warning the potential victim is next.
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Question: LEGAL: Laws regarding privilege exceptions in crime or tort involving MINORS
Answer: B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach.

Jeannie telling you that after the fight with the children, her husband and her got into another fight alone in the bedroom, and he punched her in the stomach, would not be reportable. It is not clear that the children witnessed the spousal abuse since it occurred alone in the bedroom, and/or that they had any emotional distress specific to it.
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Question: LEGAL: Laws regarding privilege exceptions in court-appointed evaluation or therapy
Answer: A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse.

Legally you are mandated to report the physical abuse and financial abuse.
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Question: LEGAL: Laws re: sexual conduct between therapist and client
Answer: C. Legally responsible to intervene.

A clinician is not legally responsible to report a suicidal client, but is legally responsible to take reasonable steps to ensure the safety of a suicidal client which can be managed in a number of ways. Evidence Code 1024 allows clinicians to break confidentiality when a client, due to a mental disorder, is a danger to self or the property of another and breaking confidentiality would prevent the threatened harm.
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Answer: C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.

A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled.
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Question: LEGAL: Laws that define SCOPE of clinical practice
Answer: D. You may tell your client about the laws pertaining to cyberbullying.

You may tell your client about the laws regarding cyber-bullying. The laws about bullying define bullying (e.g., face-to-face or digital harassment, threats, persecution, etc.) and what the school district is permitted to do. You may not give legal advice because that would be out of your scope of practice.
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Question: LEGAL: Laws re: disclosures required prior to therapeutic services.
Answer: D. Tell him that you will not be able to help him quit smoking.

Using hypnotherapy to help Christopher stop smoking would have to be within the context of therapy, and not as a stand-alone treatment. Otherwise, it is outside the scope of practice.
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Question: LEGAL: Laws re: third party reimbursement
Answer: D. Acted unethically and illegally.

Although the gift is not substantial in value, social workers are prohibited by law and ethical standards from accepting or providing any kind of remuneration for referrals.
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Question: LEGAL: Parity laws re: provision of mental health services
Answer: D. Advise her to call her lawyer.

Your only obligation in this situation is to maintain confidentiality and assess for a possibility of a crisis interventions. If the client is not afraid that the father will harm the children, she needs to call her lawyer to pursue legal options.
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Question: LEGAL: Laws re: ADVERTISEMENT and DISEMINATION of qualifications
Answer: A. Note carefully which sessions the client actually attended.

It is vital to clearly note which sessions were missed on the bill (which will be sent to the insurance company), or this is insurance fraud.
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Question: ETHICAL: Diversity Factors that affect therapeutic process
Answer: C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them.

Including Rob in the creation of the safety plan and possible emergency escape plan would only put Cynthia at risk. Rob's knowledge of these plans may lead to a violent reaction from Rob.
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Question: ETHICAL: Standards regarding nondiscrimination with re: to diversity
Answer: C. Assess for further boundary violations.

Assessing for further boundary violations would be important in order to determine the extent of boundary violations and if there had been any sexual contact between the therapist and your client.
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Question: ETHICAL: Standards for providing therapeutic services with re: to diversity
Answer: C. Tell him you cannot confirm or deny that his wife is your client.

Whenever anyone calls asking about anyone other than themselves, it is vital to not reveal any confidential client information.
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Question: ETHICAL: Methods to gain knowledge, awareness, sensitivity and skills necessary for working with diverse populations
Answer: A. Obtain supervision to address counter-transference.

The ethical obligation, when a therapist is unable to maintain objectivity, is to seek supervision or consultation.
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Question: ETHICAL: Clients right to make decisions re: therapeutic services
Answer: B. A social works breaks confidentiality because an internet client is engaging in child abuse.

Breaking confidentiality when making a mandated child abuse report is a legally required obligation, not an ethical decision or responsibility.
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Question: ETHICAL: Ethical standards re: protection of client rights when engaging with other professionals.
Answer: C. Obtain consultation about adoption.

Getting consultation is a potentially useful thing to do when client presents a new issue.
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Question: ETHICAL: Methods to assist client to make decisions and clarify goals
Answer: B. Deanne.

Privilege resides with all clients unless the ability to exercise (i.e., assert or waive) privilege has been adjudicated away from them.
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Question: ETHICAL: methods for establishing collaborative professional relationships to improve welfare of client
Answer: D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults.

If you have concerns about a dependent adult's safety, you are legally and ethically obligated to inform the CLIENT about the limits of confidentiality. Although "Consent To Treat" came from the conservatorship, the client's rights to confidentiality are still relevant.
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Question: ETHICAL: ethical standards for participating as a member of an interdisciplinary team.
Answer: D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement.

Angelina is an adult in therapy. Your legal obligation is to collect your fee and allow the client to determine how she will get paid.
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Question: LEGAL: Legal requirements re: payment/barter for referrals
Answer: B. Acknowledge the coincidence, explore your client's reactions and discuss how you will both act should you see each other at school functions.

This demonstrates proper clinical management for several reasons: this is an unavoidable dual relationship, you are addressing the coincidence, you are being sensitive to your client's reactions and planning how you will handle seeing one another in a public setting.
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Question: ETHICAL: Documentation of therapeutic services
Answer: B. Provide informed consent.

Before changing the unit of treatment, which is including the children in this vignette, the social worker would need to provide informed consent with the primary client.
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Question: *1. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of Section 1024 of the Evidence Code.

A. Maintain Roger's confidentiality.

B. Warn the manager of the factory because this is analogous to a Tarasoff situation.

C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision.

D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.
Answer: D. Keep the records confidential and alert Cathy of the subpoena.

Since Cathy and the children were seen conjointly, the records include confidential information regarding Cathy. Therefore, the best option would be to keep the records confidential and let Cathy and her attorney decide how to proceed.
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Question: *2. Your lawyer calls you to warn you that you may receive a subpoena for the complete treatment record of Mr. Milsap, who you have been treating for five years. Two months ago, Mr. Milsap received minor injuries in an accident at work in which three people were killed when a fully loaded forklift overturned. Mr. Milsap is suing for negligence and claiming severe emotional damage, including PTSD. When you tell Mr. Milsap about the subpoena, he is frantic since he doesn't want anyone to know about the brief affair he had with his secretary four years ago, which is documented in your treatment records. He asks that you submit a summary of information relevant to the accident and his PTSD or to omit from the records information about the long-ago affair. How should you respond?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to legally retain records.

A. Tell Mr. Milsap that you cannot honor his request.

B. Submit a summary of the records related to the accident and the PTSD.

C. Supply the treatment records as requested, but omit information of the long-ago affair, in accordance with the laws of privilege.

D. Contact the court and seek a waiver to narrow the scope of the subpoena in order to protect your client's confidentiality.
Answer: C. Maintain Aaron's confidentiality.

Maintaining confidentiality is the only legally correct action of the answers provided here.
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Question: *3. Which situation is less likely to be an inappropriate dual relationship?

Content Area: Law: Confidentiality, Privilege, and Consent
You must identify which choice would be the least likely to constitute an INAPPROPRIATE dual relationship.

A. A small town where social worker and cashier (client) see each other at the local store.

B. A small town where social worker and next-door neighbor (client) see each other in the neighborhood watch meetings.

C. A small town where a social worker's brother-in-law's sibling comes to therapy for couple's counseling.

D. A small town where a social worker's CPA seeks couple's counseling with the social worker.
Answer: B. Turn down the referral and suggest other clinicians.

Because a relationship has already been established with the husband, it is best to refer his wife to another therapist.
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Question: 4. Three months after the death of Danielle, whom you treated for several years, you receive a written request from Arthur, her husband of 32-years, asking for access to his late wife's files. You saw them conjointly for a few sessions when Danielle requested he be there. How would you proceed?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge regarding who has access to a client's records after their death.

A. Assert privilege.

B. Deny his request.

C. Allow him to inspect the records.

D. Provide a summary or a copy of the records.
Answer: A. Ascertain their level of acculturation.

A family's acculturation status is an important factor in assessing for treatment, helping the social worker determine the family's level of adjustment to this culture, their current worldview, family values, and level of comfort with U.S. norms and values.
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Question: 5. Your client Maurice tells you that he was involved in a bank robbery and "got away with it." He says the money is stashed in a safety deposit box at a local bank. You are:

Content Area: Law: Confidentiality, Privilege, and Consent
This question deals with a social worker's legal responsibilities related to past crimes.

A. Required to report this to the bank and to the police.

B. Required to maintain confidentiality.

C. Obligated to advise your client of the legal requirement to break confidentiality.

D. Permitted to break confidentiality to protect the public at large.
Answer: C. Help them problem solve but not give them any personal opinions.

Ethical standards regarding boundaries require that therapists avoid giving opinions and remind the client that they are responsible for their own choices.
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Question: 6. You have been participating in the town's bowling league for six months when one of the clients you have been treating joins the league. While speaking to your client about it in the next session, you find out she loves it and plans to stay in the league. First you would:

Content Area: Ethics: Professional Competence and Preventing Harm. This question of ethics asks you what your FIRST step would be in this dual relationship scenario.

A. Switch leagues.

B. Explain the nature of dual relationships to her.

C. Ask her to switch leagues.

D. Give her bowling tips to build rapport.
Answer: D. Including a child abuse report in the file if one is made.

Whatever the agency policy is, a mandated breach of confidentiality must be included in the client's file. A child abuse report may be kept separate from the treatment file to preserve the child's confidentiality, but it cannot be omitted entirely.
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Question: 7. Mimi tells you that her brother is HIV+ and has recently sero-converted to full-blown AIDS. She is terrified because she overheard her brother talking about passing on "The Gift." She informs you that he wants to have sex with his new partner with the purpose of giving him the HIV virus. She thinks it's terrible that her brother plans to knowingly give someone HIV. In this case you would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a case where the transmission of HIV is probable.

A. Call the person he plans to have sex with in accordance with the Tarasoff decision.

B. Maintain confidentiality and process her feelings.

C. Ask Mimi to have her brother set up an appointment.

D. Call the public health service in the area and report what you have heard in an unofficial capacity.
Answer: C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary.

Giving clients information about payment is a legal and scope of practice issue.
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Question: *8. You've been seeing a couple for marital therapy. The husband arrives for their weekly session alone and reports that his wife is staying in the car. He says that she refuses to come to your office because you are always taking his side. He wants to go ahead with the session without her. You decide to:

Content Area: Ethics: Therapeutic Relationship/Services
This question asks you how to proceed in a marital therapy scenario.

A. Proceed with the session, seeing him alone.

B. Terminate the therapy and give him a referral to another mental health professional.

C. Make another appointment for both of them since the couple is your client.

D. Go down to the car and ask the wife to come in so that you can explore this issue.
Answer: A. Yes, because she is seeing another therapist and you must avoid exploitation.

In general, social workers are ethically allowed to terminate if a client who needs care is getting it, and duplication of care would exploit the client.
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Question: 9. You have seen Abby, age 24, four times. In her fifth session, she discloses to you that her previous mental health provider fondled her while he was conducting hypnosis with her. Your legal obligation is to:

Content Area: Law: Legal Standards for Professional Practice. This question assesses your knowledge of your legal obligation regarding clients who have had sexual contact with a previous mental health provider.

A. Inform Abby of the reporting options that are available to her.



C. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex" and discuss the contents with her.

D. Refer Abby to the BBS which will send her a copy of the booklet "Professional Therapy Never Includes Sex" and file the report with their Ethics Committee.
Answer: C. Not buy the stock because of ethical considerations.

Ethically, you would not buy the stock because this information was revealed to you in your professional capacity. Clinically, the potential for powerful counter-transference threatens your therapeutic relationship.
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Question: *10. You have been working with a client for six months. The client sometimes forgets her checkbook and tells you that she will bring it at the next session. She has accumulated a debt of $500. What would be your least important consideration when attempting to collect an unpaid bill from the client?

Content Area: Ethics: Business Practices and Policies
This question reviews proper management of collections, knowing what constitutes a breach of duty and asks you to identify the strategy you would not use.

A. Having the client pay at the beginning of each new session.

B. Providing a collection agency with only the client's name, address and amount owed.

C. Establishing with the client a satisfactory payment plan to pay off the bill.

D. Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty.
Answer: A. Colleen has a history self-harm.

Although a history of self-harm may be a valid clinical reason to treat a minor without parental consent, this is not a legal requirement. Social workers may treat a minor 12 or older without parental consent if the minor is mature enough to participate intelligently in therapy. There is no longer a requirement for the minor to be a victim of child abuse or a danger to self or others in order to receive treatment without parental consent.
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Question: 11. Miriam, a 52-year-old car saleswoman, is referred for therapy by her doctor after Miriam told him that her boyfriend broke up with her and told her that she has trouble respecting other people's boundaries and is too interpersonally aggressive. From the beginning of treatment, Miriam asks the social worker many questions about the social worker's relationships, family, hobbies and interests, and taste in music and movies. At the fifth session, Miriam asks the social worker where she went to graduate school, how long she has been licensed, and if she has any areas of expertise and training. How should the social worker respond to the questions Miriam is now asking?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent and a social worker's ethical responsibility to obtain informed consent from clients.

A. Answer Miriam's questions.

B. Do not answer Miriam's questions and explore her reaction to the social worker's boundary setting.

C. Ask Miriam if she has concerns about the social worker's competence and experience.

D. Remain silent and allow Miriam to do her own processing as part of learning to respect others' boundaries.
Answer: D. Explore whether the client wants you to assess her child for AD/HD.

The client found you due to your online assessment; clarifying its relationship to in-person treatment would be an ethical way to proceed.
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Question: *12. You have been treating Jennifer who has had difficulties establishing and maintaining intimate relationships with men. Several months into treatment, she was arrested for an attempted murder of a male celebrity. In her trial, Jennifer is pleading not guilty by reason of insanity. Who holds the privilege for Jennifer's therapeutic records?

Content Area: Law: Confidentiality, Privilege, and Consent
This question checks your comprehension of privilege.

A. The social worker.

B. The client.

C. There is no privilege.

D. The judge.
Answer: B. Reach an agreed-upon fee arrangement prior to the commencement of therapy.

This would be a legal obligation.
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Question: *13. You are seeing a 45-year-old woman in treatment. She lives with her mother, age 71, who has Alzheimer's Disease and lives in a residential facility for ongoing medical care. She tells you in session that at one point, the nursing staff kept her mother in bed for three weeks. You would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. Your knowledge of reporting mandates for elder abuse is being checked.

A. Report by telephone within 24 hours to law enforcement.

B. Report immediately to Adult Protective Services by phone and follow-up with a written report within 36 hours.

C. Report by telephone immediately to law enforcement.

D. Refer her to a support group for caretakers, arrange for respite care, and work with her on issues of grief and loss.
Answer: B. Yes, but only with informed consent.

With adequate training and informed consent, social workers are permitted to introduce new modalities to new and existing clients.
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Question: 14. Mary is a married 17-year-old who was recently raped by her husband's best friend. She doesn't want to tell her husband because she feels that she may have inadvertently encouraged him and is feeling ashamed. Tearfully, she tells you that she is pregnant and doesn't know what to do. Her best girlfriend has told her to get an abortion. She is conflicted about this because of strong religious beliefs. She says she's very confused and asks you what you would do if you were in her position. How would you ethically respond to this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This question assesses your knowledge of the ethical boundaries that are necessary for effective therapy.

A. Advise her to discuss this situation with her husband.

B. Indicate that you have a "no secrets" policy and invite her husband into the session.

C. Indicate that you cannot make life decisions for a client.

D. Refer her to Planned Parenthood.
Answer: D. Consider the client's cultural values and his expectations of therapy.

The client comes from a culture where therapy may be foreign to him. It is important to establish with the client the objectives of therapy and to understand his emotional style that may have been derived from his cultural background.
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Question: 15. A 40-year-old woman comes for individual therapy to work on panic attacks that are affecting her job performance and attendance. She and her husband see their pastor for marriage counseling. She says that her pastor has encouraged her to do this, so that they can focus on the marital issues. How would you proceed in addressing the referral from the pastor?

Content Area: Ethics: Business Practices and Policies
This question addresses managing a client's concurrent relationship with other providers of care to the client.

A. Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together.

B. Get a release to speak with the pastor and help him to see that the panic attacks and her marriage are directly related.

C. Maintain your client's confidentiality and proceed with treatment.

D. Do not begin treatment with the woman until it is clear that you and the pastor are not working on the same issues, which would be unethical.
Answer: D. Maintain confidentiality.

YOUR only legal obligation here is to protect your client's confidentiality.
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Question: 16. Recently your mother died and a client comes in grieving the loss of his mother. What would you do FIRST?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your ability to recognize the influence of counter-transference and when your functioning is impaired.

A. Talk about this situation in your own therapy.

B. Seek consultation.

C. Refer the client to another therapist.

D. Determine if you can deal with this client at this time.
Answer: C. You are mandated to report this situation to a children's protective agency.

This is a mandated report because the social worker has reasonable suspicion of neglect based on the doctor's medical diagnosis. Although the parents have consulted with a doctor, their decision to not seek care based on the doctor's findings constitutes reasonable suspicion of medical neglect.
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Question: *17. Eugenia, a 36-year-old massage therapist from Brazil, is referred by a former client. She presents in a highly agitated manner and occasionally slurs her words as she tells you that her ex-husband is stalking her and her 16-year-old daughter. She is considering obtaining a temporary restraining order against him. Eugenia has no health insurance and wants to know if you can extend credit to her or receive massages in exchange for therapy. What is your legal course of action?

Content Area: Law: Legal Standards for Professional Practice. This question tests your ability to differentiate legal from ethical issues.

A. Inform Eugenia that if she enters her emotional state into the proceeding to obtain the restraining order, her right to privilege will be waived.

B. Refrain from giving legal advice regarding the restraining order due to scope of competence.

C. Refer to legal aid for restraining order help or to assist with assault charges.

D. Avoid dual relationships regarding becoming a massage client.
Answer: C. Obtain consent from Molly since she is the legal guardian.

You would obtain consent from Molly since she is the legal guardian.
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Question: *18. A self-referred client comes to you wanting therapy for work problems. During the intake, the client reveals he has been going to another therapist for the last four months but states, "I'm planning to leave her anyway." The client admits he has not discussed this with his current therapist and says, "I'm seeing her for a different issue anyway." What is your ethical responsibility in this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This question assesses your knowledge of how to handle concurrent therapies.

A. Accept the new client, as he intends to terminate with his current therapist.

B. Inform the client that you will be unable to see him until he has terminated with his current therapist.

C. Contact the other therapist to discuss the treatment goals before deciding whether to take on the client.

D. Accept the new client, as he reports his goals with the other therapist differ from the goals he wants to explore with you.
Answer: D. Talk about this issue with a colleague in consultation or with your own therapist.

Journaling, consulting, psychotherapy, or other processes that help a social worker to resolve strong emotional reactions to a client constitute appropriate ethical conduct in such situations.
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Question: *19. Your client, a 19-year-old mechanic, confides to you that he recently participated in a robbery. Two weeks later, you are served with a subpoena for information about this client's treatment. You attempt to reach your client but are unable to do so. Legally, you must:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your legal requirement regarding a subpoena.

A. Assert client privilege.

B. Notify your client of this subpoena.

C. Turn over all records as per the subpoena.

D. Notify the client's attorney that you cannot reach the client.
Answer: D. Ask her to get you quickly up to date on her general treatment so far.

Ethics require an action directed toward the client's immediate safety. You would need to know how "serious" her situation is before determining the next step.
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Question: *20. Kevin is 17-years-old and tells you that he was upset when, as a small child, his father would hit his mother. He tells you that the abuse stopped a few years ago. Kevin says that his father is 70-years-old and is "running out of steam." Now when his father "gets out of line," he and his mother simply lock the father in his room until he settles down. He is glad his father has become more manageable. What would you do next?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question reviews your mandated reporting responsibilities.

A. Assess the whole family further in the next session.

B. Call Adult Protective Services immediately because the father is being unlawfully detained.

C. Call an agency designated to take a child abuse report because Kevin lives in a household in which there has been spousal abuse.

D. Call Adult Protective Services and an agency designated to take a child abuse report immediately.
Answer: D. Report child abuse to the police.

Mandated reporters must report knowledge or reasonable suspicion of the abuse of any child if they hear of it in their professional capacity. The description of an adult who has authority over children regularly hitting them would constitute, at the very least, a reasonable suspicion of child abuse and would therefore, mandate a report to the police.
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Question: 21. A therapist offers telehealth services for a slightly reduced fee for clients who cannot afford transportation or do not have a car. At what point during the provision of telehealth with a client would it be legally required to refer the client for crisis care?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal standard of care when providing telehealth.

A. When the client tells you that she is actually 12, not 18.

B. When the therapist recognizes that the client is suicidal.



D. The client tells you that she does not have health insurance and has not been to a doctor in five years.
Answer: B. The social worker wants to change the focus of his or her practice and only treat "high functioning" clients.

Deciding to change the focus of practice would not be sound ethical or clinical reasons for deciding to terminate treatment with an ongoing client.
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Question: *22. Maria, age 27, comes to treatment with her husband Juan. Maria had a miscarriage 3 months ago and she tells you that she just can't get over it and doesn't know if she can go on. Juan says that he has tried everything to cheer her up, but that he's getting sick of her moping around. What action would the therapist take to fulfill ethical obligations?

Content Area: Ethics: Therapeutic Relationship/Services
Social workers are ethically obligated to determine the client's best interests which includes assessing whether they will benefit from therapy.

A. Evaluate whether Maria can benefit from therapy if they continue in conjoint therapy.

B. Tell them your experience and expertise in working with families who have trouble having children.

C. Suggest a few individual sessions to get full informed consent from each client.

D. Answer any question that they have about couple's therapy.
Answer: C. Discuss any suspicions that would validate terminating the client.

A client's potential violence would not be a reason for terminating the client. It might be a reason, however, for breaking confidentiality.
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Question: 23. A social worker has decided to offer telehealth as part of her practice. Ethically, the therapist should:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to ethically manage the limits and risks of telehealth.

A. Specify any particular limits of confidentiality as they pertain to internet security and privacy.

B. Avoid a dual relationship by making clear when she is available on the internet and when she is not.

C. Charge and disclose an equivalent fee for telehealth as for in-person sessions.

D. Anticipate an unavoidable dual relationship that could arise if in-person clients also receive telehealth services.
Answer: B. Forego payment because you did not adequately explain the process of fee collection and insurance billing to Chetwyn.

You would forego payment because you did not adequately explain the process of fee collection and insurance billing to your client.
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Question: *24. George has been referred to you by his doctor for anxiety-related issues. He tells you that while he really wants to be in therapy, he can't afford it right now and asks if it would be okay if, instead of your fee, George will give you credit in the amount of your fee at the grocery store he owns in the small rural community where you both live. Ethically this would be:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of dual relationships.

A. Permissible under some circumstances.

B. Inadvisable under all circumstances.

C. A prohibited dual relationship.

D. Bartering, which is prohibited by ethical standards.
Answer: A. Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards.

Social workers have a legal and ethical responsibility to correct false, misleading, or inaccurate information and representations of themselves, made by themselves or others concerning their qualifications, education, license, license status, services, products, etc.
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Question: 25. Ajax, a 51-year-old former convict, comes to therapy because he tells you he has been depressed ever since he left prison. He just doesn't feel like he fits in anywhere and still feels terribly guilty for the murders he committed that have gone unpunished. He says he is tired of spending every day looking over his shoulder and would be better off dead. What is your legal responsibility in this case?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of confidentiality laws.

A. Call the police because you have knowledge of a murder.

B. Initiate an involuntary hospitalization because he is suicidal.

C. Consider breaking confidentiality to ensure his safety.

D. Notify his next of kin.
Answer: A. You would need to determine if your scope of competence was adequate.

Homosexuality does not capture the range of gender identity issues, so just because your client appreciates your approach with her, your ability to treat other types of issues would be your first concern.
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Question: *26. Which of the following is a legally allowable scenario in which a social worker may treat a minor without parental consent?

Content Area: Law: Confidentiality, Privilege, and Consent
This question focuses on knowing when you may legally treat a minor without parental consent.

A. A 10-year-old suicidal female whose twin brother recently died in a boating accident.

B. A 12-year-old depressed male whose cultural background strongly discourages therapy.

C. A 15-year old having consensual sexual intercourse with a 20-year-old.

D. A 16-year-old having consensual sexual intercourse with a 25-year old.
Answer: A. Maintain confidentiality.

Mental health professionals licensed in California are only mandated reporters of Elder and Dependent Adult abuse if the victim is a resident of the state of California. Maintaining confidentiality is your legal obligation.
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Question: 27. A social worker chooses a preschool for his daughter and enrolls her. One month after she started school, the social worker discovers that a client's child is in the same class. What would be the social worker's least appropriate action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question is assessing your knowledge of how to manage possible dual relationships. Pay careful attention to the way this question is worded.

A. Begin looking for another preschool for his daughter.

B. Discuss with the client how she feels about the situation.

C. Discuss the possibility of trading carpooling in exchange for some of the cost of therapy.

D. Immediately take his daughter out of the school.
Answer: A. Tell him that you can't treat him without the the agreement of the other therapist.

Social workers generally do not provide services to a person receiving treatment or therapy from another therapist unless by explicit agreement by or with full termination of the other therapist.
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Question: 28. LeDoux is an African-American client who tells you he doesn't like the idea of therapy and doesn't trust you. He says he is only coming because his social worker said if he didn't get therapy to work on his anger issues, he would have a harder time getting his kids back. In establishing an alliance with LeDoux, you would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of human diversity issues.

A. Ask him to tell you more about his ideas of therapy and his mistrust of you.

B. Refer LeDoux to another therapist since he indicates that he does not trust you.

C. Establish a highly structured therapy focusing on problem-solving.

D. Take a thorough family history looking for patterns of mistrust and anger.
Answer: D. Records must be retained for a minimum of 7 years after the date that the client terminates treatment.

Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015). For minors who terminate treatment, records must be retained for a minimum of 7 years after the minor would have been 18 or at least until the minor client would have been 25.
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Question: 29. You were working with Arlen for six months when he lost his job working with an internet start-up company. At that time you agreed to use your sliding scale to reduce your fee to accommodate Arlen since after six months a solid therapeutic bond was in place. From the perspective of professional conduct, which is most important to do at this time?

Content Area: Law: Legal Standards for Professional Practice. This question pertains to professional conduct as it pertains to fees.

A. Establish a target date with Arlen for when he will have a new job.

B. Examine Arlen's feelings about you reducing your fee for him.

C. Discuss with Arlen under what circumstances, such as obtaining a new job, you will re-establish his original fee structure.

D. Make sure Arlen is aware of community resources for job seekers.


Ethically, you would need to determine the client's expectations to then determine if you can meet them.
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Question: 30. You are seeing Roger and his wife, Rose, in conjoint therapy. You have been working on helping Rose and Roger communicate better during arguments. In today's session, you learn that over the past few years Roger has physically abused Rose when he loses his temper. You are:

Content Area: Ethics: Therapeutic Relationship/Services
This question reviews the ethics surrounding spousal abuse.

A. Ethically responsible to provide her with referrals.

B. Legally bound to report spousal abuse.

C. Appalled at his behavior and tell him so.

D. Ethically bound to call the police.
Answer: C. Refuse the champagne and explore the meaning behind the gift.

Refusing the gift but processing its meaning is the best ethical course of action. If this client were later to become unhappy with your service and file a complaint with the BBS, investigators would construe your acceptance of an expensive gift as a lack of appropriate boundaries. Exploring the meaning and the impact of your refusal would be appropriate and could be therapeutically beneficial as well.
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Question: 31. Rachel comes to you after finding out she had been laid off from her job. Rachel reports she doesn't understand why, except for the possibility that "the boss always had it in for me after I refused to go out with him." Rachel then states, "He needs to watch out, if he knows what's good for him." Upon assessing further, Rachel tells you she has "a way" to keep his car from running, "That'll show him." What is your response in this situation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of your ethical responsibilities under Evidence Code 1024.

A. Legally, you must contact the police and warn the boss under the Tarasoff ruling.

B. Ethically, you should warn the boss under the Tarasoff ruling.

C. Ethically, you could contact the boss under the auspices of Evidence Code 1024.

D. You have no legal or ethical obligations.
Answer: D. Discuss the situation with your client.

A social worker's legal responsibility in this situation is to maintain confidentiality, so discussing it and working with the client on options to best protect herself would be a reasonable thing to do.
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Question: 32. In your private practice you see mostly adults. The one child that you treat was removed from his parents by Social Services after they were reported for child neglect. During your sessions with Mark, you find yourself becoming more and more attached and wanting to take care of Mark yourself. What is the appropriate way to deal with your feelings?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to deal with your counter-transference.

A. Recognize that your attachment is normal, as you feel sympathy for Mark's situation.

B. Discuss your counter-transference in supervision.

C. Let Mark know about your feelings to show him he still is a lovable little boy, and any issues about having him removed from the home is about his parents and not about Mark.

D. Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on.
Answer: B. Refer him to an MD.

Overuse of pain medications and back pain would require a medical referral.
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Question: 33. You recently began treating a 16-year-old female without parental consent. The client has been feeling suicidal and feels unable to discuss her problems with her parents. You receive a voicemail message from her father, angrily wanting to know why you're treating his daughter. What would be your responsibility?

Content Area: Law: Confidentiality, Privilege, and Consent
This question deals with the legalities pertaining to the confidentiality of a minor client whom you are seeing without parental consent.

A. Obtain consent from the father in order to continue therapy with appropriate consent.

B. Do not contact the father and maintain the client's confidentiality.

C. Process the message with the client and invite the client's father to join in a future session.

D. Obtain consent from both her parents to continue seeing the client.
Answer: B. Advise the clients about the risks of this dual relationship.

Before entering into a dual role, a social worker is ethically obligated to advise the client of the risks.
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Question: *34. Albert and Frank are referred to a social worker for conjoint counseling. Albert does not like it that Frank is so controlling, and Frank's problem is that he considers Albert to be lazy. In one session, their arguing becomes so aggressive that you consider seeing them separately. Albert says it would be a good idea, and Frank says that he will do whatever is best. Ethically, how should the social worker proceed if individual therapy is agreed upon?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to provide informed consent as you learn you client's expectations of therapy.

A. Close the conjoint file and tell them that you will not be able to see them together once individual therapy starts.

B. Tell them how individual therapy will be different from conjoint therapy.

C. Tell them how you plan to utilize "no secrets" policies.

D. Ask them for revised treatment goals.
Answer: C. Not agree to trade services and attempt to slide her fee to a rate agreeable to both of you.

Of the choices provided this is the most ethical, avoiding a dual relationship and attempting to come to an agreeable fee.
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Question: 35. The O'Rourkes have been married for 4 years. Tina says that she and her husband are worried that Megan may be anorexic since they found her internet searches on anorexic websites. Megan's biological mother died 2 years ago. If they want to pay with insurance, you would:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of fee negotiations that must occur before therapy starts

A. Tell them the name of the billing service you use if you have one.

B. Obtain confirmation about their benefits before the first session.

C. Explain the risks to their confidentiality if they want to use third-party payors.

D. Establish a co-pay that is equivalent to cash payments before the first session.
Answer: A. You have every right to place an ad in this newspaper.

A social worker, like anyone else, has a right to advertise in the local paper. You did not directly interact with the client nor did you intend for your client to work on your ad. This would be an example of an unavoidable dual relationship.
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Question: *36. At an initial intake, a client discloses that she recently left her husband and does not have the means to pay your standard fee. The client notices that your waiting room is shabby and offers to paint it in exchange for your therapy. You agree to four sessions in exchange for the work. You proceed with therapy, but when she is finished, you realize she has ruined the carpet, spilled paint on a lamp and the woodwork, and didn't use the color you had asked. You realize that you feel foolish and ripped off. How would you address the situation?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships.

A. Discuss your concerns about the paint with the client and ask her to either repaint the office or work out a plan for her to pay for the four sessions so that your judgment of her will not impair your ability to work with her.

B. Honor the original agreement, and if your ability to work with this client feels compromised, discuss your concerns with the client and offer to help her transition to another therapist because of the ethical conflict.

C. Honor the original agreement, consult to manage your counter-transference, and continue with therapy.

D. Without disclosing your personal reactions, explain that you'd like her to pay you for the therapy because you weren't satisfied with her work, tell her you'll be unable to work with her further, and help her to transition to another therapist.
Answer: D. Address the wife's concerns about her husband's "monopolizing" the session.

Ethics require that you meet the "client where they are", and addressing her question is one way of clarifying expectations and providing informed consent about a change in the treatment.
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Question: *37. Your new client, Suzanne, age 38, says her life feels out of control, and that she is considering getting a divorce. She is not sure she wants to keep coming to therapy. After a session, her husband Bud leaves a telephone message in which he says if Suzanne leaves him, he will kill himself. He asks that you call him back. How would you clinically manage your ethical responsibilities?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical obligations as they pertain to termination and referrals.

A. Explain to Bud your "no secrets" policy and that you will have to disclose to Suzanne that he called you.

B. Offer to Suzanne that she include Bud in a session but inform her of the risks and benefits first

C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy.

D. Assess Bud for suicide because you are in your professional capacity.
Answer: B. Explain that terminating therapy to pursue another relationship is unethical.

The first thing to do is inform the client of the guiding ethical standard which will guide your behavior.
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Question: 38. 38. Which of the following represents a Tarasoff situation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions that would impose a Tarasoff duty to protect situation.



B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night.

C. A client tells you that her husband is "totally fed up with his supervisor" and is going to disfigure the man's face with a chemical solution.

D. A man, who just bought a semi-automatic rifle, tells you that he is going to go on a freeway overpass and randomly shoot at passing cars.
Answer: D. Take the client's lead in the treatment plan to minimize the effects of negative counter-transference.

Taking the client's lead may not be in the client's best interests from a legal, ethical or clinical point of view.
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Question: 39. You have been treating Roberto in individual therapy for 6 months. In session, he gets angry with you for not telling him his insurance only authorized 20 sessions. He thinks you should simply accept his co-payment of $30.00 in the future because it is "your fault." What would you do in this case?

Content Area: Ethics: Therapeutic Relationship/Services
This question concerns your ethical management of a client's changing financial circumstances.

A. Apologize and accept his $30 co-payment.

B. Discuss the situation and attempt to negotiate a fee acceptable to both of you.

C. Inform Roberto that he is now responsible for your full fee or he will have to be terminated.

D. Tell Roberto your personal finances prevent you from accepting such a low fee.
Answer: A. Decline to see Pat because professional ethics forbid social workers from treating former sex partners.

Professional ethics forbid social workers from treating former sex partners.
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Question: 40. Andy, a 42-year-old actor, missed his last session. The Motion Picture Industry Pension and Health Plan pays for a portion of his sessions. How should you go about collecting his missed session fee?

Content Area: Law: Legal Standards for Professional Practice. This test item focuses on legal insurance billing procedures.

A. Bill Andy for the co-payment and indicate the cancelled session code with his insurance.

B. Charge Andy and have him contact the insurance company.

C. Bill the insurance company with the 50-minute code as usual.

D. Bill Andy for the co-payment and indicate the 50-minute code.
Answer: B. Tell clients that she will not take calls during that time.

The ethical obligation related to informed consent is that social workers provide clear information about their availability.
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Question: *41. A social worker becomes attracted to a client. The social worker deals with his/her feelings appropriately and the client feels s/he is ready to terminate. Upon termination, the social worker realizes s/he still has sexual feelings for the client and would like to pursue a relationship. Ethically, how long should the social worker wait before pursuing such a relationship with this client?

Content Area: Ethics: Professional Competence and Preventing Harm. This question asks for the NASW information about sex with a client.

A. 6 months.

B. 12 months.

C. 24 months.

D. An indefinite time, because post-therapy relationships are prohibited by law.
Answer: B. Clarify your scope of competence before agreeing to treat her.

Depending upon your license, you may or may not be skilled with "inner conflicts." As part of your ethical scope of competence obligations, you are ethically obligated to determine if you are competent to treat this client.
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Question: 42. To prepare clients for termination, a social worker schedules sessions every other week and then once a month. Over time, he finds that clients cancel their monthly sessions. Some clients just stop calling entirely without making a monthly appointment. Which of the following would NOT be an ethical concern related to the termination process?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to handle termination in a competent way.

A. Formally terminate with no-show clients.

B. Provide informed consent before changing the session frequency.

C. Assess whether the infrequent sessions are in the client's best interests.

D. Offer a sliding fee for the intermittent sessions.
Answer: D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due.

Although this may not be a perfect solution to the problem, it does reinforce boundaries, stop the balance from getting higher, and suspend treatment in a situation in which professional judgment may be impaired and in which the client may feel exploited (as a debtor, Ronald may not feel capable of participating openly and honestly in therapy).
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Question: *43. Mrs. Bailey sees the photograph of your dogs in your office and brings you a basket of dog treats. How would you respond to her gift?

Content Area: Ethics: Business Practices and Policies
This ethical question regarding gifts tests your sensitivity to the issue of professional boundaries and dual relationships.

A. Accept the gift in the spirit in which it was given.

B. Take one of the treats as a gesture and return the rest.

C. Thank her for her thoughtfulness and decline the gift.

D. Assess the motivation behind the gift.
Answer: D. Give Burt the brochure, "Professional Therapy Never Includes Sex" regarding sex and therapy and discuss it with him.

"Professional Therapy Never Includes Sex" should be provided for this client as well as a discussion of its contents.
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Question: 44. You get a telephone call from a highly agitated woman who states that her live-in boyfriend has been battering her whenever he drinks, which is at least once a week. She says she is considering leaving but that it is difficult because she has severe cerebral palsy and uses a wheelchair. You:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question addresses dependent adult abuse.

A. Must gather as much information as possible and make a report of physical abuse to Adult Protective Services since this woman is a dependent adult.

B. Are not yet this woman's social worker, so you give her the number to Adult Protective Services and encourage her to call them and/or the police to make a report.

C. Set up an appointment for as soon as possible and assist her by giving her numbers for battered women's shelters that are wheelchair accessible.

D. May choose to make a report because you have not witnessed the injuries or the abuse yourself.
Answer: B. Review the nature of your license as it is explained in your informed consent.

Explaining the nature of your license by using your general office policy reinforces the therapeutic frame that you would have initiated in an informed consent discussion at the beginning of therapy.
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Question: *45. The Baker family comes to counseling referred by their pastor. Derek, their 14-year-old son, has been hanging out with a "bad crowd." He isn't doing his homework, is sloppy doing chores, and has failed to show up for choir practice at the church. Their other child, Sarah, who is 12 years old, not only doesn't want to go to choir practice, she doesn't want to go to church at all. Sarah says, "I don't care if I go to hell; at least I'll be able to sleep in on Sundays!" Mr. and Mrs. Baker say they don't want to "do anything rash." "Please help," says Mrs. Baker. How would you proceed with managing your ethical responsibilities?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage family treatment from an ethical perspective.

A. Have the couple tell you what they have attempted to do to manage this conflict thus far.

B. Tell the family that you work from a systems perspective, and that you will be "reframing" the children.

C. Clarify for the family your role with the pastor.


Answer: C. The court has not appointed guardians ad litem.

Until the court appoints guardians ad litem, you cannot release the records for the unit of treatment. A guardian ad litem is appointed by the court to make legal decisions in the best interests of a child. Without guardian ad litem status, parents cannot waive privilege for their children.
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Question: 46. A psychiatrist refers you a client with severe anxiety. The day before an intake session, the client calls you to ask if he can see you right away because he is afraid he will take all of the anti-anxiety medication he owns. He tells you that he is actually seeing three different doctors to get as much medication as he can. In collaborating with his doctors, which of the following would be the most ethical approach?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to collaborate and consult according to ethical (rather than legal) standards.

A. File three separate releases in the client's file.

B. Tell him that you plan to speak to all of his doctors with or without a release.

C. Ask him which doctor he would prefer that you talk to.

D. Obtain consultation from each doctor about his case.
Answer: A. Assert privilege.

If you are unable to contact your client, you must continue to assert privilege. You do not know what is in the client's best legal interests so all you can do is continue to assert privilege.
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Question: 47. You are obtaining a release of information from a client to confer with the client's psychiatrist. The client tells you that she is thinking of finding a new psychiatrist because this one never listens to her. She is concerned that if you talk to the psychiatrist, you will develop a negative opinion of her. Which of the following would you find on a release of information form?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your understanding of what information is included on a release of information form.

A. The client's name and diagnosis.

B. The client's social security number and diagnosis.

C. The purpose of the release and the social worker's license number.

D. The length of time the client has been in treatment and the social worker's license number.
Answer: B. Open a separate file if the client was in family therapy before.

Maintaining treatment files for different units of treatment is a legal obligation.
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Question: 48. When discussing exceptions to confidentiality with a client, which of the following would not be considered such an exception?

Content Area: Ethics: Therapeutic Relationship/Services
This question assesses your knowledge of limits of confidentiality.

A. Suicidal thoughts.

B. Domestic violence.

C. Grave disability.

D. Threats to destroy another's property.
Answer: A. Not see the client.

This is a situation in which you are confronted with a possible avoidable dual relationship; avoid it by not seeing the client.
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Question: *49. Guidelines regarding advertising state that social workers must advertise in a way that is honest and not misleading. Which of the following is a true statement regarding advertising policies?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of advertising principles associated with LCSW practice.

A. A prelicensed social worker may not use the term "psychotherapist" on a business card.

B. The advertisement must indicate the full name of the licensee and the complete license number.

C. It is not permissible for an LCSW to use "Ph.D." if s/he is not a psychologist.

D. A social worker cannot use the term "Psychotherapy" on a business card.
Answer: ETHICAL ISSUE: Privacy + Confidential
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Question: *50. The parent of a child on your child's baseball team is a doctor and wants to send a client to you. On the sidelines, you and this parent often talk about the relationship between illness and how family dsyfunctions develop around those illnesses. The doctor is impressed by your insight and asks for your card. You would:

Content Area: Ethics: Business Practices and Policies
This question asks how you would manage your ethical responsibilities when you receive a referral from someone you know.

A. Agree to see his referral.

B. Not see his referral because this constitutes a dual relationship.

C. Assess whether it would affect your child and the doctor's child.

D. Not see the potential client but refer to a colleague.
Answer: LEGAL and ETHICAL
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Question: *51. You have been working for seven months with a young adult who has recently become very involved with a Nazi skinhead group. You have strong feelings about the detrimental effects such an affiliation can have and will need to:

Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how to handle counter-transference issues with a client.

A. Address your concerns with the client without contaminating the therapy.

B. Discuss the case with your colleagues and get consultation in order to manage your personal bias.

C. Evaluate whether or not you can continue to work effectively with this client.

D. Refer this client out since your bias will get in the way of her progress.
Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: *52. Mollie, age 62, reports that she has been the victim of spousal abuse over the last year by her husband of 40 years, Roland, age 67. You have told her that you will assess for elder abuse. Legally, how should you proceed?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question reviews your knowledge of reporting responsibilities.

A. Make an elder abuse report to Adult Protective Services.

B. Maintain confidentiality and assess for possible elder abuse.

C. Make a report to law enforcement within 2 working days.

D. Make a physical abuse report to Adult Protective Services.
Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: *53. Maxwell, age 46, is referred to you by his EAP because he is depressed and drinking daily on the job. He witnessed a train wreck 3 weeks ago in which several people were killed. Now he says he is terrified to leave the house without a couple of drinks to calm him down. He says that every time he hears a loud noise he feels faint, and he wakes up sweating and shaking. What action would the social worker take?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your ability to respond to client's needs in an ethical way.

A. Determine the client's ability to respond to anxiety treatment interventions.

B. Evaluate the client's need for a crisis intervention,

C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions.

D. Tell him that his treatment will be confidential as it pertains to his EAP.
Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: 54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality.

A. Filing a child abuse report.

B. Ensuring safety for a suicidal client.

C. Responding to a CPS caseworker's request for family history following a child abuse report.

D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle.
Answer: LEGAL and ETHICAL
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Question: 55. You are seeing a client, Tom, for six months. Tom occasionally mentions his cousin, who specializes in installation of landscaped ponds. You've always wanted a landscaped pond with koi. Which of the following represents an ethical course of action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of dual relationships.

A. You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction.

B. You call your client's cousin, along with several other landscapers, to gather price quotes.

C. You call your client's cousin and mention that you are an acquaintance of Tom's hoping that he'll give you a break on the price.

D. You ask Tom how he would feel if you hired his cousin to install a pond.
Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: 56. A social worker is becoming increasingly concerned that one client, who is acutely suicidal, is not improving. The social worker has suggested that the client speak with people in his life who might be supportive and be able to help, but the client only wants to speak with the social worker. The social worker is concerned about boundaries if she speaks with the client as often as he needs, which is at least once day. The client has threatened to leave therapy entirely if the social worker keeps suggesting outside support. Ethically, the social worker should:

Content Area: Ethics: Therapeutic Relationship/Services
This question pertains to ethical aspects of termination.

A. Tell the client directly the social worker's concerns if the client does not return to therapy.

B. See the client at least once a day to prevent harm and imminent risk.

C. Terminate with the client and have him involuntarily hospitalized.

D. Allow the client to terminate if the social worker is unable to provide adequate support.
Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: *57. You are working in a group practice and learn that one of your colleagues tends to have "a drink" in his office between clients. How do you handle the situation?

Content Area: Ethics: Business Practices and Policies
You must choose the best way to address your colleague's apparent drinking problem.

A. Tell your other colleagues in the group and perform a group intervention.

B. Discreetly confront your colleague about his drinking.

C. Contact the BBS.

D. Encourage your colleague to contact an ethics board for advice.
Answer: LEGAL and ETHICAL
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Question: 58. Maya, a 15-year-old emancipated minor, comes in to see you without parental consent. She tells you that last week her 20-year-old husband, Oliver, raped her when she refused to have sex with him. She's been feeling depressed and disoriented ever since this happened. Which of the following would represent the correct legal analysis of this situation?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of child abuse reporting laws.

A. Since Maya is depressed and disoriented, you can treat her without parental consent.

B. Since Maya is married the rape would represent spousal abuse and you would have an ethical responsibility to ensure her safety.

C. Since Oliver is only 5 years older than Maya, Oliver's actions would not constitute lewd and lascivious behavior.

D. Since Maya is 15 years old, the rape would constitute child abuse.
Answer: LEGAL and ETHICAL
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Question: 59. A newly licensed social worker wants to establish her practice. She goes to several neighborhood psychiatrists and doctors advertising her practice and offering small tokens of appreciation in return. What is the problem here?

Content Area: Law: Legal Standards for Professional Practice. This question concerns the practice of purchasing referrals.

A. A social worker must be licensed for a period of two years before s/he can advertise door to door.

B. It is not ethical for her to go door-to-door to advertise her practice.

C. It is not legal for her to offer compensation for referrals.

D. Advertising is restricted to business cards and association literature.
Answer: Failure to keep records consistent with clinical judgment, standards, nature of services = unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: 60. You are meeting with a client in your private practice for the first time. She tells you that she found you with an internet search with the search term "expert in eating disorders." Which of the following must, by law, be disclosed prior to beginning the session?

Content Area: Law: Confidentiality, Privilege, and Consent
This question is testing your knowledge of ethical and legal requirements of an informed consent.

A. Explaining the limits of confidentiality.



C. Your fee.

D. Your full name and license designation.
Answer: 1-Termination or interruption of services w/o notifying ct promptly + arranging transfer/ referral as needed . 2- Failure to take reasonable steps to avoid abandoning cts who are still in need of services 3-Failure to terminate when services no longer serve ct's needs 3- = ETHICAL VIOLATIONS
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Question: 61. Ponciano and Berta are a Guatemalan couple who have been in treatment with you. They are moving back to Guatemala this week. They come to session and present you with some freshly baked sweetbread that Berta says she made especially for you because of all you have done for them. She tells you that it is a custom in her country to make a parting gift when friends are separating. How would you respond?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the ethics that pertain to gifts from clients.

A. Accept the gift but explain that gift giving is not usually a part of a therapeutic relationship.

B. Refuse the sweetbread because, ethically, social workers should not accept gifts from clients.

C. Further explore their customs but do not accept the sweetbread because it is unethical.

D. Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session.
Answer: Prior to the commencement of treatment, failing to disclose to ct or prospective ct the fee to be charged for the profess.services, or the basis upon which fee to be computed = ILLEGAL
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Question: *62. A male client comes to see you for the first time. As he talks, you begin to realize that he is definitely going to harm someone. He has a plan and is going to act, but he has not identified his intended victim to you yet. Just as he is about to tell you the identity of the name of the intended victim, you realize that you have not explained to him the limits of confidentiality:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage your ethical and legal obligations when a client might be dangerous.

A. Tell him to stop and refer him to someone else.

B. Wait until he identifies the intended victim and then explain the limits of confidentiality, as you must do as part of obtaining informed consent.

C. Ask him to stop and explain to him the limits of confidentiality as part of informed consent.

D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.
Answer: Misrepresentation re type or status of a license/reg., or other misrepresentation or permitting misrepresentation of his or her education, qualifications, profess affiliations= ILLEGAL
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Question: *63. You are working with a client who has expressed suicidal thoughts. You see the client once every two weeks because he does not have insurance. He uses your sliding scale and sometimes texts you between sessions. Which of the following steps would be considered reasonable in fulfilling the duty to ensure the safety of a suicidal client?

Content Area: Ethics: Business Practices and Policies
This question addresses your knowledge of a social worker's responsibilities to ensure the safety of a suicidal client.

A. Schedule extra sessions with your client.

B. Obtain the client's promise not to harm him/herself until you meet again and use a "self care" contract to reinforce the promise.

C. Give the client the number of the suicide prevention hotline.

D. Explore your client's support network.
Answer: Termination based on failure to pay overdue balance w/o following: payment policies were made clear, ct not in imminent risk, consequences of nonpayment addressed =
ETHICAL VIOLATION
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Question: 64. Social workers are required by law to comply with certain legal standards in the state in which they are licensed. All of the following are legal issues EXCEPT:

Content Area: Ethics: Therapeutic Relationship/Services
This question requires that you discriminate between legal and ethical issues.

A. Suicide.

B. Asking your client, who is a contractor, for information about drywall.

C. Setting a fee.

D. A dependent adult who states that his prescribed seizure medication has not been dispensed by his care custodian.
Answer: Failure to ensure fees are fair, reasonable. + commensurate w services. Failure to consider ct's ability to pay= ETHICAL VIOLATION:
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Question: 65. Lisa, age 43, is going through a bitter divorce. She brings her only child, Jamal, age 8, for therapy at the request of his school counselor. He was caught cheating on a test and lied about it to the teacher, the principal, and his mother. As you gather history, Lisa keeps revisiting the injustices of her having to "pay for HIS bad parenting." When you question her further, she rails about how her ex-husband spoiled Jamal by giving him everything, never backing her up with discipline, etc. She says, "He's such a jerk. And now he lives in a nice condo and I'm stuck in this dingy little apartment with this dishonest, ungrateful kid. I just can't believe I have to do this. I can't afford therapy and, I don't want to be schlepping him over here every week." What is the best way to proceed regarding her concern about paying your fee?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your sensitivity to client needs and ethical fee setting.

A. Consider offering to see Jamal on a sliding scale or pro bono basis.

B. Ask Lisa if she'd like you to call her ex-husband to get some of the payment from him.

C. Tell Lisa that she doesn't have to pay for therapy because you'll see her on a pro bono basis.

D. Have Lisa sign a release for you to confer with her ex-husband regarding the fee.
Answer: Accepting barter w/o all of the following:it's an accepted practice among profs locally, essential for provision of services, +initiated by ct + w ct's consent = ETHICAL VIOLATION
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Question: 66. Your client, Jordan, has just tested positive for HIV. He is in a relationship and is convinced that if he tells his partner, Julian, he will leave him. What are your ethical responsibilities in this situation?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical considerations regarding confidentiality and clients' HIV status.

A. Refuse to treat Jordan further unless he tells Julian of his HIV-positive status.

B. Tell Jordan that he should tell Julian.

C. Call Julian.

D. Maintain confidentiality.
Answer: Soliciting private fee/ remuneration for services to cts who are entitled to them thru your employer or agency= ETHICAL VIOLATION: NASW 1.13 Payment for Services
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Question: 67. The Humburgs come to counseling with their 16-year-old son, Cameron, because they found drugs in his room. They don't want the other two children, ages 9 and 11, to know. They want you to suggest some strategies to help Cameron overcome this problem. Ethically, you would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to explain the parameters of therapy with clients.

A. Give them time to adjust to therapy since this is their first session and see just the three of them.

B. Tell them that you are a Family Systems therapist and the other children should be included.

C. Tell them that it would be outside of your scope of practice as a systems therapist to exclude the other two children.

D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them.
Answer: 1-Not providing cts w/ reasonable access to records.2- Not assisting ct to interpret them if access to records might lead to serious misunderstanding or harm3- not limiting access + documenting rationale when there is compelling evidence that serious harm would result = ETHICAL VIOLATIONS
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Question: 68. You have been seeing Marsha, 11, with the consent of her mother, Jan. Jan is requesting a copy of Marsha's therapy notes because she wants to provide them to the school counselor. Under which of the following conditions can you refuse Jan's request?

Content Area: Law: Confidentiality, Privilege, and Consent
This question assesses your knowledge of the laws pertaining to parental request of a minor's records.

A. Marsha will not sign an authorization to release the information to her mother.

B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being.

C. Jan wants you to produce a copy of the records within 3 weeks time.

D. You don't feel comfortable breaching Marsha's confidentiality.
Answer: 1-Failure to provide the brochure re the rights of, and remedies for, patients who have been involved sexually with their psychotherapist. 2- Failure todiscuss with the patient the brochure prepared by the department= ILLEGAL.
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Question: 69. Mrs. Moran is referred to you by a former client. On the phone she refers to you as "Dr.," although you do not possess this degree or license. It is apparent to you that Mrs. Moran is quite depressed. How would you handle this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical standards regarding the obligation to accurately represent licensing status.

A. Inform Mrs. Moran of your license status once her mood has stabilized and she is in a better mental state to understand and evaluate this information.

B. Refer Mrs. Moran to a doctor since her statement indicates that she is seeking the services of a psychologist, psychiatrist, or M.D.

C. Give Mrs. Moran your business card which will provide her with your accurate qualifications.

D. Inform Mrs. Moran of your license and qualifications.
Answer: Sex with a ct or a former ct w/in 2yrs from termination, soliciting sex from a ct, or committing sexual abuse or sex.misconduct w/ct or committing act punishable as sex crime, if it's subst.related to qualifications, functions, duties of a clinical social worker.= ILLEGAL
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Question: 70. A 56-year-old woman that you have been treating has just experienced the death of her husband. His was the primary income, and she was not aware of all of the financial responsibilities. She tells you that she has been getting calls from bankers, real estate planners, and lawyers offering to provide assistance. If you become concerned for her welfare, you should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how and for whom to make appropriate referrals.

A. Refer her to a lawyer.

B. File an elder abuse report: financial abuse.

C. File an elder abuse report: undue influence.

D. Refer her to a financial planner.
Answer: Clarify who is considered ct and the nature of professional obligations to various individuals ETHICS
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Question: *71. Matthew, age 40, and Delilah, age 27, have been married for 8 months and have been referred to you by the pastor of their church. Delilah says, "It's like I keep marrying the same man. Just like my 2 ex's, he flies off the handle at the drop of a pin, and I don't like the way he disciplines the kids." Matthew says, "She needs to listen to me about how to raise children and seriously adhere to Biblical teachings." How would you manage your scope of practice obligations in light of the domestic violence?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of working within the scope of practice to assess the safety of clients.

A. Establish your right to break confidentiality to prevent domestic violence.

B. Explain that there are exceptions to confidentiality, including the reporting of child abuse.

C. Question Matthew and Delilah separately about possible domestic violence.

D. Do not confirm nor deny to the pastor that Matthew is or is not your client.
Answer: Failure to comply with child abuse reporting requirements (call asap, f/u in writing w/in 36 hours)= Unprofessional conduct (conditions for Suspension, Revocation of license)
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Question: 72. You witness a mother abusing her child in a shopping mall.

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse reporting laws.

A. Ethically, you should report the child abuse.

B. Legally, you do not have to report the abuse.

C. You will be in violation of ethical standards if you do not report to the police or child protective service agency.

D. Legally, you must report the abuse by phone and follow up with a written report within 36 hours.
Answer: ETHICS/ NASW
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Question: 73. When working with a female client who is being abused by her partner, what is your ethical responsibility?

Content Area: Ethics: Therapeutic Relationship/Services
This question assesses your knowledge of your ethical responsibilities when you become aware that a client is being abused by her partner.

A. To establish a plan of safety, including shelters and established support systems.

B. To make an optional dependent adult abuse report to protect the client if she is pregnant.

C. To report child abuse if children were witnesses to the abuse which negatively impacted them.

D. To refer the client to a divorce lawyer.
Answer: LEGAL + ETHICAL
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Question: 74. An HMO refers a client dealing with depression. When the client arrives at her first session she explains that she's not depressed but is seeking vocational counseling, intellectual testing, and information regarding her desire to change careers. She states that she didn't believe the insurance company would authorize treatment for such a "lame reason." What would you do?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice.

A. Inform her that she will have to pay out of pocket.

B. Proceed with treatment.

C. Refer the client to a career counselor.

D. Call the insurance company and inform them that you will be seeing her for reasons other than depression.
Answer: ETHICS
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Question: *75. During your intake interview, you learn that your client is a lawyer. As you discuss the limits of confidentiality, the client asks, "can you plead the Fifth like I can in court?" As you consider your answer, you consider some hypotheticals. Privilege might be waived in which instance?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking you to choose when privilege could be waived.

A. A client is a 13-year-old girl, who you are seeing without parental consent, and has been selling drugs.

B. A client has told you he has been involved in hacking a corporate database under an assumed name.

C. A client accused of assault and battery uses insanity as a defense in court.

D. A 64-year-old woman complains to you that her bank is making automatic withdrawals without permission.
Answer: LEGAL + ETHICAL
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Question: *76. A social worker who is running a therapy group receives an email from one member of the group, describing some personal issues that she does not feel comfortable discussing in the group setting. The social worker has all group members on a contact list and in his reply to this individual he accidentally does a "reply all" to the members of the group: "Please bring that up in the group if you feel comfortable doing so; if not, I can give you some referrals." What should the social worker do to fulfill ethical obligations?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to respond in an ethical and competent way when confidentiality has been compromised.

A. Address the mistake in the next group.

B. Refer to any "no secrets" policies that allow the social worker to bring up an individual's issues.

C. Nothing needs to be done; no one's confidentiality was breached..

D. Send a private email to the client who sent the first email with an apology for the breach of confidentiality.
Answer: LEGAL (Tarasoff decision)
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Question: 77. A second generation Chinese-American man comes into therapy and asks you to help him find a wife because his father is pressuring him to get married. Your FIRST intervention would be to:

Content Area: Ethics: Therapeutic Relationship/Services


A. Indicate that his needs would best be served by an Asian mental health professional.

B. Inform him that this is an inappropriate goal for treatment.

C. Engage him in a discussion of his motivation and past efforts.

D. Address his presenting problem and assist him in finding a wife.
Answer: LEGAL
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Question: 78. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of Section 1024 of the Evidence Code.

A. Maintain Roger's confidentiality.

B. Warn the manager of the factory because this is analogous to a Tarasoff situation.

C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision.

D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.
Answer: LEGAL + ETHICAL
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Question: 79. Christine is a 14-year-old ward of the court. During the first session she says that her group home counselor is not helping her. Christine says that another child in the group home has sexually molested her, but no one believes her. She says that an abuse report was filed, but nothing came of it. She wants therapy to help her manage her feelings. Legally the next step would be to:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to report child abuse when the abuse happens out of the child's home.

A. Get consent from her court-appointed attorney.

B. Get consent from her group home counselor.

C. Have her terminate with her group home counselor.

D. File a child abuse report.
Answer: LEGAL
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Question: 80. Your 17-year-old client tells you that she was molested on many occasions as a younger child. She tells you that she was taken from the home in which it occurred and has never returned. She tells you that she found the perpetrator on a social networking site that makes her think he is still looking for under-age victims. She shows you his posts and you concur. What would be the most important legal requirement that you would have in such a case?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse reporting requirements.

A. Report the abuse to CPS immediately by phone and with a written report within 36 hours.

B. Inform her of her rights about reporting him now that she is an adult.

C. Advise her to make a police report about a sexual predator.

D. Develop a safety plan if he responds to her posts.
Answer: LEGAL
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Question: 81. Your client, Barbara, has been unemployed for three months. In her last session she stated that she plans to kill her ex-boss tomorrow because he's the cause of all her unhappiness. You call the police to alert them to Barbara's plan, but they don't seem to take you seriously because there isn't a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question involves a Tarasoff situation.

A. Document your phone call outlining your concerns and justifying your actions in order to cover your liability.

B. Have Barbara come in immediately for crisis counseling.

C. Call Barbara's ex-boss and warn him of her plan.

D. Call Barbara and find out if she has a gun so you can tell the police.
Answer: LEGAL and ETHICAL
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Question: 82. Jeannie and Chuck Jones and their two children Brooke and Josh, have been seeing you for family counseling for 6 weeks when they come to see you right after a "big family fight." You notice a rip in Josh's clothes and Brooke's red eyes leads you to believe she has been crying. You separate the family and gather a lot of information about the fight. Which statement would NOT lead to a child abuse report?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. The focus of this question is child abuse reporting mandates.

A. Josh tells you his father tried to push him into a cold shower, and his clothes ripped pulling away.

B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach.

C. Josh tells you his Dad was also trying to lock him in the closet.

D. Brooke tells you her Dad repeatedly said she was stupid.
Answer: LEGAL and ETHICAL
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Question: 83. A client comes to his session with his 72-year-old father, who uses a walker from a fall which he reports was caused by a fight with his wife. The father tells you that his wife has been stealing his social security checks each month and gives him only $5.00 a week. At this point you should:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question continues to test your knowledge of reporting elder abuse.

A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse.



C. Explore possibilities for alternative living arrangements with the father and address the feelings both he and your client may be feeling due to this trauma.

D. Report the financial abuse, even though it is optional, since the victim and your client have requested your assistance in this matter.
Answer: LEGAL
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Question: 84. You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the law pertaining to suicidal clients.

A. Legally bound to report.



C. Legally responsible to intervene.

D. Not responsible in any way as the client has a right to make his/her own decision.
Answer: Failure to provide services only w/ valid inf. consent incl. purpose, risks + limits of services costs, alternatives,right to refuse/withdraw consent, time frame covered by consent = ETHICAL VIOLATION
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Question: 85. Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions which define a person as being gravely disabled.

A. Command auditory hallucinations telling the client to kill other people.

B. Command auditory hallucinations telling the client to kill him or herself.

C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home.

D. Choosing to be homeless.
Answer: Failure to provide information about the nature and extent of services and about the extent of clients' right to refuse service= ETHICAL VIOLATION
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Question: 86. Your 15-year-old client comes to session extremely agitated because she just found out that a photo she sent to her boyfriend is now circulating all over the school. She is getting harassing comments about her appearance and sexual promiscuity. She is afraid that the school will contact her parents if she reports the harassment to school authorities. How do the laws pertaining to bullying direct your actions as a social worker?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate interventions with a minor.

A. You may speak with the school, or they may speak to you without a release.

B. You must report to the school authorities, but you are not required to report to the police.

C. You may advise your client about her reporting requirements.

D. You may tell your client about the laws pertaining to cyberbullying.
Answer: Failure to inform recipients of the limitations and risks associated with such services = ETHICAL VIOLATION
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Question: *87. After completing a three-month course on hypnotherapy, you decide to advertise your new specialty. You receive a call from Christopher, who says he would like to come in for a session, so that you could hypnotize him to stop smoking. He says he's tried the patch and nicotine gum, but he needs your help to quit once and for all. How would you respond to Christopher's request for treatment?

Content Area: Law: Legal Standards for Professional Practice. This question deals with scope of practice for mental health professionals.

A. Make an appointment because hypnotherapy is now part of your scope of competence.

B. Inform him of your fee before the commencement of treatment.

C. Refer him to a medical doctor.

D. Tell him that you will not be able to help him quit smoking.
Answer: Engaging in dual or multiple relationships w/clients or former clients in which there is a risk of exploitation or potential harm to the client = ETHICAL VIOLATION
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Question: 88. A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal and ethical standards in dealing with referrals.

A. Expressed your gratitude in an appropriate and professional manner.

B. Not acted unethically or illegally since you did not solicit the referral.

C. Not acted unethically or illegally since you did not directly pay the colleague for the referral.

D. Acted unethically and illegally.
Answer: Soliciting private infor from cts unless it is essential to provide services or conduct evaluation/ research. Once private information is shared, not complying w/ standards of confidentiality = ETHICAL VIOLATION
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Question: *89. Your client has two children and is divorced. She tells you that when she arrived at her ex-husband's house last night to pick up the children, he had locked the doors and texted her that, "Me and my children are moving across the country." He has no criminal history, but she is afraid she will never see her children again. Which of the following is the clinician's first intervention?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of when to make referrals for expertise outside of your scope of practice.

A. Advise her to call Child Protective Services for abduction.

B. Explore the events immediately preceding this one.

C. Call the police.

D. Advise her to call her lawyer.
Answer: sex w/ a client or former ct w/in 2years from termination, soliciting sex, or committing act of sexual abuse or misconduct w/ a ct, or committing an act punishable as a sex crime, if its subst. related to qualifications, functions, duties of clinical SW = ILLEGAL <Unprofessional conduct >
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Question: *90. Your client works as a pilot and often misses appointments because she is called out-of-town at the last minute. When billing her insurance, you:

Content Area: Law: Legal Standards for Professional Practice. This question evaluates your knowledge of appropriate ethical guidelines for insurance billing and insurance fraud.

A. Note carefully which sessions the client actually attended.

B. Must not include missed sessions on the bill since insurance will not pay for these.

C. May not commit insurance fraud by noting which of the sessions were canceled within your 24 hour limit and which were canceled at the last minute.

D. May remind her she will have to pay for missed sessions herself.
Answer: Failure to discuss nature of confidentiality + limitations of clients' right to confidentiality as soon as possible in SW-client relationship= ETHICAL VIOLATION
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Question: *91. Rob, a 27- year-old African American male, and Cynthia, his 24-year-old Mexican American girlfriend, have decided to live together after six months of dating. Cynthia asked Rob to participate in therapy, and Rob agrees to attend one month of therapy in order to "try it out." During the first session, Cynthia softly reports that Rob cannot control his anger. Rob quickly turns to Cynthia and shouts, "You're the one that's too sensitive!" When creating a safety plan with Cynthia, you would do all of the following EXCEPT:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal obligations to assess a client's safety and treat the client within your scope of practice.

A. Make yourself available by phone and increase the frequency of sessions.

B. Provide a list of addresses and phone numbers to local shelters, emergency housing agencies, and crisis centers.

C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them.

D. Advise Cynthia to gather important items in one place (i.e. extra set of car keys, debit and credit cards, medical records and prescription refills, etc.).
Answer: 1-Failure to seek agreement re each person's right to confid. +obligation to preserve the confidentiality of others.2- Failure to inform you cant guarantee all participants will honor such agreements= ETHICAL VIOLATION
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Question: *92. A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would:

Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist's boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship.

A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations.

B. Contact the therapist to discuss the legal/ethical consequence of his actions.

C. Assess for further boundary violations.

D. Contact the BBS to report the therapist's inappropriate actions.
Answer: Failure to keep all info confid. except for compelling prof.reasons- e.g. when disclosure needed to prevent serious, foreseeable,+imminent harm to a client or other identifiable person=ETHIC. VIOLATION
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Question: 93. A man calls you to ask about his wife's therapy bill since she has been using his insurance. He asks if you can provide copies of the previous three months' bills because the insurance company has lost them. Upon hearing his request, you:

Content Area: Law: Confidentiality, Privilege, and Consent
This question asks for the confidentiality rules in regard to third party callers. The issue of the insurance statements is secondary to the confidentiality issue.

A. Send a copy of the bill since it is his insurance.

B. Call his wife and ask if she would like you to send him a copy or if she would prefer you send it addressed to her.

C. Tell him you cannot confirm or deny that his wife is your client.

D. Give his wife the bill copies at her next session.
Answer: Failure to inform clients, to extent possible, re disclosing confid. info +potential consequences, when feasible beforehand (whether SW disclosing on basis of a legal requirement or ct consent)=ETHIC. VIOL.
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Question: *94. A female social worker who is having problems in her own marriage finds that she is consistently siding with the wife in couples therapy. Ethically, the social worker's primary obligation is to:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to meet client needs when negative counter-transference could impact objectivity and client welfare.

A. Obtain supervision to address counter-transference.

B. Discontinue conducting therapy until her own marital problems are resolved.

C. Attempt to balance treatment by siding with the husband.

D. Call in a co-therapist to monitor the therapist's behavior.
Answer: Failure to limit cts' right to self-determin. when, in your professional judgment, cts' actions or potential actions pose a serious, foreseeable,+imminent risk to themselves or others. =ETHIC. VIOLATION
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Question: *95. Which of the following scenarios describes a social worker's legal duties regarding the use of telemedicine?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of the difference between legal and ethical responsibilities.

A. A social worker bills an internet client the fee before starting therapy.

B. A social works breaks confidentiality because an internet client is engaging in child abuse.

C. A social worker provides a client a copy of the informed consent document to download and return with a signature.

D. Referring a client to a CPS website if the client reports child abuse.
Answer: 1-Not consulting w/ colleagues when it's in ct's best interests. 2-When consulting, disclosing more ct info than necessary =ETHIC. VIOLATION
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Question: 96. A couple, whose children have all graduated from high school, is considering adopting an elementary school-age child. They believe that a child who has not yet been adopted would do well in their household, and they want to give back to society. How should the social worker approach this couple's decision?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to respond to clients' treatment needs.

A. Advise them on the cultural implications of adoption.

B. Assess for a phase of life problem.

C. Obtain consultation about adoption.

D. Refer if the couple has reached the original treatment goals.
Answer: Giving or receiving payment for a referral (when no professional service is provided by the referring party)=ETHIC. VIOLATION
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Question: 97. Deanne is a 13-year-old who is in therapy with you without her parents' consent. In this case, who is the holder of the privilege?

Content Area: Law: Confidentiality, Privilege, and Consent
The issue presented in this vignette is whether a minor can be the holder of privilege.

A. You, due to client privilege.

B. Deanne.

C. The state because Deanne is a minor.

D. Deanne's parents because parents hold privilege for minors.
Answer: 1-sex w/supervisees/ students. 2- Failure to avoid sex w/ colleagues; failure to transfer professional responsibilities, when necessary, to avoid a conflict of interest, if having or anticipating sexual relationship w/ colleague.
=ETHIC. VIOLATIONS
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Question: *98. A person calls telling you that she is your client's conservator. Your client is physically disabled and has told you about the challenges associated with being under conservatorship. The client tells you that she hates not being able to make her own decisions. How do you manage your ethical obligations related to informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge about the ethical requirements for informed consent.

A. If you have any concerns for the client's safety, tell the conservator about the limits of confidentiality related to dependent adults.

B. Determine the type of conservatorship. LPS conservatorships allow the conservator to consent to treatment.

C. Tell the conservator about your mandate to report dependent adult abuse.

D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults.
Answer: 1-Failure to discuss concerns directly w/ colleague when feasible +when such discussion is likely to be productive. 2- Failure to proceed, when necessary, to take actions through formal channels = =ETHIC. VIOLATIONS
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Question: 99. Angelina, a 20-year-old college student, comes to see you complaining that she's having difficulty breathing and concentrating, and that she thinks it's "all in her head." Angelina says she was date raped three weeks ago and says you are the only person who knows. She hasn't told her parents and doesn't want them to know about it. Angelina says, "Please help me. I can't take this anymore." She tells you that her parents have told her that they will pay for her therapy. How would you manage the legal issue of payment?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of the legal issues that pertain to fees.

A. Explain the limits of confidentiality if a third party is paying for therapy.

B. Consider offering Angelina a lower fee so that she can pay for her own therapy.

C. Talk to Angelina about whether she wants her parents to pay for therapy.

D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement.
Answer: 1-Failure to consult w/ the colleague when feasible+ assist in taking remedial action. 2- Failure, If problem persists +colleague hasnt taken steps to address it, to take action thru appropriate channels established by employers, agencies, NASW, licensing + regulatory bodies =ETHIC. VIOLATIONS
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Question: 100. You have been seeing a client for 3 months. You learn she has a daughter who attends the same pre-school as your son. How do you ethically handle this dual relationship?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of ethical management of dual relationships.


A. Refer your client out since the therapy relationship is still fairly new.

B. Acknowledge the coincidence, explore your client's reactions and discuss how you will both act should you see each other at school functions.

C. Transfer your son to another pre-school to avoid a dual relationship.

D. Do not acknowledge the coincidence in session since it is a large pre-school and unlikely you will encounter one another.
Answer: Establish + maintain billing practices that accurately reflect nature + extent of services provided and that identify who provided the service in the practice setting. ETHICS
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Question: 101. A client who has been in individual therapy wants to bring her children for therapy. The first thing a social worker must do if the social worker agrees to see the children with their mother is:

Content Area: Ethics: Therapeutic Relationship/Services
This questions tests your knowledge of the ethical steps required for changing a treatment unit or plan.

A. Change the unit of treatment.

B. Provide informed consent.

C. Talk about the risks and benefits of family therapy.

D. Refer the daughter to an individual therapist.
Answer: Failure to be a diligent steward of the resources of employing organization =ETHIC. VIOLATIONS
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Question: *102. Cathy is a 28-year-old clerk who works in a department store. A social worker has been seeing Cathy, her 7-year-old son, and her 5-year-old daughter in therapy for a month. She never married her children's father, Bob, who calls "once in a blue moon" requesting to spend time with the kids or will arrive at the door with presents. She receives no support from him and doesn't want to ask him for money because she feels that he will want to visit them more if she does. If Bob subpoenas the children's therapy records, what would be the most appropriate move for the social worker to take?

Content Area: Law: Confidentiality, Privilege, and Consent
This question checks your knowledge on confidentiality and privilege.

A. Keep the records confidential and make an appointment with Bob to discuss his concerns.

B. Indicate to Bob that you can only release the records if Cathy signs a release form.

C. Determine whether the subpoena came from an attorney or the court.

D. Keep the records confidential and alert Cathy of the subpoena.
Answer: 1-Failure to discuss w/ client benefits/risks of transferring care. 2- Failure to discuss w/ ct whether consultation w/ previous service provider would be in ct's best interests. =ETHIC. VIOLATIONS
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Question: 103. During the week you get a call from a concerned mother. She tells you that her 15-year-old son, Aaron, who is in therapy with you, sometimes talks with a gang member on the phone. Today she accidentally picked up the phone and overheard the gang member saying that he is going to kill Aaron. Legally, how would you proceed?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of Tarasoff laws.

A. Treat the situation as a Tarasoff case.

B. Report the information to the police.

C. Maintain Aaron's confidentiality.

D. Let Aaron know his mother called.
Answer: To practice, condone, facilitate, or collaborate w/ any form of discrimination =ETHIC. VIOLATIONS
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Question: *104. A man is in therapy, and he is pleased with the way it is going. He refers his wife to his therapist. What should the therapist do in this situation?

Content Area: Ethics: Professional Competence and Preventing Harm. This question explores the ethics of initiating therapy with the spouse of an established client.

A. Encourage his wife to come in for conjoint therapy.

B. Turn down the referral and suggest other clinicians.

C. Wait until his therapy is done before accepting his wife as a client.

D. See the wife individually until you have established a therapeutic alliance, then if the couple desires, see them conjointly.
Answer: Soliciting testimonial endorsements (incl. consent to use ct's prior statement as a testimonial endorsement) from current clients or others vulnerable to undue influence=ETHIC. VIOLATIONS
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Question: 105. How would you assess an immigrant family at a first session?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of assessment techniques when working with immigrant families.

A. Ascertain their level of acculturation.

B. Determine that the father is in accord with therapy.

C. Reassure the family that seeking treatment is not a sign of weakness.

D. Refer the family to an immigrant support group.
Answer: 1-To allow own personal problems, psych.soc.distress, legal probs, SA, or MH difficulties to interfere w/ prof. judgment +performance. 2- If it occurs, failure to seek immediate consultation +take immed. remedial action. =ETHIC. VIOLATION
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Question: *106. You have been seeing Terrie and Jennifer, a gay couple. Terrie and Jennifer want at least one child, but they strongly disagree about whether they should adopt a child or have one by artificial insemination. In their next session, they say they need your help to solve this quandary. You should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question evaluates your understanding of appropriate therapeutic boundaries regarding important client decisions.

A. Ethically, not give your opinion on this subject.

B. Use applied therapeutic techniques to help them evaluate both options before you decide if it would be therapeutically useful to state your opinion.

C. Help them problem solve but not give them any personal opinions.

D. Refer them to specialists in adoption and artificial insemination so that they can get more information which would allow them to better decide.
Answer: Allowing one's private conduct to interfere w/ ability to fulfill profess.responsibilities. =ETHIC. VIOLATION
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Question: 107. A social worker was recently hired at an agency that specializes in work with victims of domestic violence. The agency policy states that the social worker must not include any mandated information in the client's file because it puts the children at risk of stigma if their files are ever subpoenaed. The social worker is responsible for:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to proceed legally when an agency policy conflicts with the law.

A. Speaking with an outside consultant to determine the best course of action.

B. Reporting the agency to the BBS because other colleagues may act unethically or illegally as a result of this policy.

C. Developing a safety plan with the mother.

D. Including a child abuse report in the file if one is made.
Answer: Faiure to act to prevent the unauthorized and unqualified practice of social work =ETHIC. VIOLATION
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Question: *108. George takes care of his wife, Gracie because she is unable to work. George asks you to help him manage his finances so that he is able to pay Gracie's medical bills, the family bills, and afford therapy. How should you respond to George's request and still maintain proper therapeutic boundaries?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to act within your scope of practice.

A. Call a financial planner that you know sometimes works on a sliding scale to explain George's situation and see if she is willing to help.

B. Explain to George that you cannot use therapy time to help him with his finances because it is out of your scope of competence.

C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary.

D. Introduce George to a budget minder book, show him how to create a budget, and provide referrals to websites to find less expensive medication.
Answer: Legal
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Question: 109. A client you have been treating for 3 months is suing you because her online therapist told her that she has undiagnosed Bipolar I Disorder. You did not know that she was also pursuing online treatment from a different therapist. She is claiming emotional distress as a result of your negligence in diagnosing and treating her. Would ethics standards allow you to terminate this client?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethics that regulate termination.

A. Yes, because she is seeing another therapist and you must avoid exploitation.

B. No, because you continued to treat her without asking about another therapist.

C. Yes, because she is seeing another therapist who has a better scope of competence.

D. No, because she is suing you and you must avoid negative counter-transference.
Answer: Ethical
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Question: 110. A reality-oriented, high-functioning client tells you she has been following a company's stock for a number of years and the company's stock price is several points below the company's book value. She tells you the company's profits should double in the next two quarters due to a return on recent expansion. You would:

Content Area: Ethics: Professional Competence and Preventing Harm. This question reviews the ethics of acting on financial investment information obtained in a therapeutic setting.

A. Legally not be able to purchase the stock because you received the information in confidence.

B. Legally not buy the stock, but you could advise your friends to do so.

C. Not buy the stock because of ethical considerations.

D. Buy the stock, but only without the client's knowledge.
Answer: EThical
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Question: 111. A 13-year old named Colleen leaves you a voicemail asking if you'll be her social worker. Before treating Colleen without parental consent, you need to determine that all of the following factors are present EXCEPT:

Content Area: Law: Confidentiality, Privilege, and Consent
This question reviews the situations where a minor can receive therapy without parental consent.

A. Colleen has a history self-harm.

B. Colleen is at least 12 years old.

C. There is a good reason not to include Colleen's parents.

D. Colleen is mature enough to participate in therapy.
Answer: Legal and Ethical
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Question: *112. As part of her telehealth practice, a social worker offers quick online surveys to help clients decide if they want therapy. The surveys ask standard questions for typical diagnoses. One day a client asks for an in-person session because the test suggested that her child has AD/HD. How should the social worker proceed with informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests how you would provide informed consent from an internet referral.

A. Discuss the fee for a complete AD/HD assessment.

B. Discuss the limits of confidentiality related to an online assessment.

C. Have the client sign a release authorization to discuss the online survey.

D. Explore whether the client wants you to assess her child for AD/HD.
Answer: Legal
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Question: 113. 14-year-old Athena and her mother, Voula, moved here from Greece one year ago and were referred by Athena's school counselor. Athena has been cutting school and her grades have been dropping. Tearfully, Voula says, "I don't know what I've done wrong. I just want to sleep all the time." Voula asks, "Can I pay for therapy when I get a job?" How would you clinically manage the legal issue of fees?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal issues that pertain to fees.

A. Manage any counter-transference reactions about the suggested fee arrangement.

B. Reach an agreed-upon fee arrangement prior to the commencement of therapy.

C. Offer Voula a sliding scale fee before beginning therapy and document your agreement.

D. Tell Voula you cannot let her run up a debt because it could create a dual relationship.
Answer: provide access except when there is compelling evidence that serious physical injury or death would result.
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Question: 114. After completing a series in "mindfulness," a social worker wants to use new interventions with ongoing clients. From an ethical point of view, can the social worker use this new modality?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to proceed ethically with a change in treatment plan which requires informed consent.

A. Yes, but only with new clients.

B. Yes, but only with informed consent.

C. No, because it represents a change to the treatment plan.

D. No, because it represents a change to treatment goals.
Answer: provide access except when there is "compelling evidence" that "serious harm" would result
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Question: 115. You have been treating a client who has just immigrated from China. The client does not want to discuss his emotions and wants you to give him advice regarding how to have a successful business in America. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question pulls for your treatment strategies when managing diverse populations.

A. Share your ideas about viable business opportunities.

B. Confront the client regarding his resistance to talking about his emotions.

C. Empathize with him regarding the stress that accompanies acculturation.

D. Consider the client's cultural values and his expectations of therapy.
Answer: you must keep adequate clinical records consistent with the standards of your profession
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Question: 116. Your client Silvia comes to therapy upset because she overheard her neighbor stating that he plans to shoot the mayor tomorrow evening and owns a gun. She tells you she has tried to calm him down, but he just "keeps blaming the system for his unemployment." What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations related to the Tarasoff ruling.

A. Call the police and notify the mayor.

B. Discuss options that Silvia has to prevent harm to the mayor.

C. Call the police and inform them of the imminent danger.

D. Maintain confidentiality.
Answer: consent by just one member of couple
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Question: 117. Mr. and Mrs. Chavez come to see you because they are referred to you by their physician. Their doctor has told them that their youngest son has a kidney disorder that will require surgery in the near future. The couple believes that God will intervene in this situation and refuse surgery based on their religious beliefs. Which of the following statements is the BEST response to this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This is a question concerning medical neglect.

A. The parents have the final right to make critical decisions for their son's medical care.

B. "Cultural competence" is an ethical obligation that requires social workers to avoid imposing their own values on the client.

C. You are mandated to report this situation to a children's protective agency.

D. You are legally required to inform the doctor about the parent's decision.
Answer: need consent from each individual prior to releasing
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Question: *118. Molly brings 13-year-old Marvin to your office and indicates that she believes the boy is depressed and needs therapy. She indicates that she is Marvin's legal guardian, and that she has consulted with the father, who also wants therapy for Marvin, and says he is willing to cooperate in any way necessary to see that Marvin gets treatment. How would you proceed in obtaining consent to treat Marvin?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge about consent to treat a minor.

A. Consent is not necessary since Marvin is over the age of 12 and is depressed.

B. Obtain consent from Marvin's father since he wants therapy for Marvin and has indicated a willingness to cooperate with his treatment.

C. Obtain consent from Molly since she is the legal guardian.

D. Ask to see the custody papers to determine who should sign for consent to treat Marvin.
Answer: can keep joint or separate records. The law requires you to keep adequate clinical records consistent with the standards of your profession, but the law allows you to keep records for a couple either separately or conjointly.
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Question: *119. There's something about your client, Zohar, that reminds you of your brother, and you often find yourself thinking about your brother during sessions and having strong reactions to Zohar because of associations with your brother. Once you accidentally called him by your brother's name. In such a situation, a social worker should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical behavior when dealing with counter-transference.

A. Make the situation transparent by explaining to Zohar that he reminds you of your brother and process the meaning of this with him.

B. Explain the situation to Zohar and tell him that in order to ensure treatment unclouded by personal reactions, you need to refer him to another mental health professional.

C. Explain the situation to Zohar and ask how he wants to deal with it.

D. Talk about this issue with a colleague in consultation or with your own therapist.
Answer: Do not use derogatory language in written or verbal communications to or about cts. Use accurate + respectful language.
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Question: *120. A therapist is leaving for vacation and has referred all of her clients to you. On the day before your colleague is set to leave town, one of her clients calls you and says that she is in crisis and needs to be seen tomorrow. She adds, "my therapist told me that I could call you if I thought seriously about killing myself. Well, it feels pretty serious." Your ethical priority is to:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to intervene ethically in a potential crisis.

A. Notify the referring therapist of the client's treatment needs.

B. Tell the client to call her therapist who is still available in town.

C. Provide the client with a crisis number hotline until you are "on duty" for these clients.

D. Ask her to get you quickly up to date on her general treatment so far.
Answer: Legal
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Question: *121. Zach comes to his session angry and upset after witnessing a scene at his tennis club where he observed Ludwig Babcock, a tennis trainer, slap a child several times. Zach says that his son told him Ludwig often hits students, but that this is Ludwig's way of preparing the students for competition. After you hear Zach's story, you would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse and reporting requirements.

A. Support Zach in expressing his feelings of anger and sadness since neither the alleged perpetrator nor the alleged victim is your client.

B. Urge Zach to call Child Protective Services and report child abuse.

C. Maintain confidentiality since there is no evidence that the students are injured by the slaps and hits.

D. Report child abuse to the police.
Answer: legal principle requiring professionals to engage in the standard of care that is practiced by reasonable and prudent members of their own profession in their own locality
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Question: 122. A social worker terminates treatment with a client after six months of therapy. The client files a complaint about this. In order to demonstrate that the social worker had sound reasons for deciding to terminate the treatment, all of the following could be acceptable reasons for terminating EXCEPT:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical parameters on treatment termination.

A. The client has failed to pay a debt of $700 in unpaid fees despite warnings from the social worker that termination could result.

B. The social worker wants to change the focus of his or her practice and only treat "high functioning" clients.

C. The social worker realizes that the client is involved in a sexual relationship with the social worker's ex-partner.

D. The social worker has been unable to resolve strong emotional reactions to the client who reminds the social worker of his/her mother.
Answer: Ethical
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Question: 123. A client, who is in court-mandated therapy, tells the social worker that he is going to leave the state because he doesn't want to be in therapy or go to jail for violating probation. The social worker tries to encourage the client to see the benefits of staying in therapy, but the client becomes visibly angry and agitated. If the social worker is concerned about the client's potential for violence, the reason for seeking consultation is NOT to:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when consultation is required to maintain scope of competence.

A. Meet the legal standard of care.

B. Assess the social worker's own blind spots to risk.

C. Discuss any suspicions that would validate terminating the client.

D. Reassess the social worker's scope of competence.
Answer: needs and best interests
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Question: *124. You negotiate a fee with your new client Chetwyn, who asks if his insurance company will pay for the sessions. You tell him that having worked with this company in the past, you're certain that they will pay for your work together. When you receive a check from the insurance company, only half the sessions are reimbursed because you have been meeting with Chetwyn twice a week. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical standards pertaining to fees and insurance billing.

A. Bill Chetwyn for services provided that the insurance company did not cover.

B. Forego payment because you did not adequately explain the process of fee collection and insurance billing to Chetwyn.

C. Advocate for full coverage of Chetwyn's mental health treatment with the insurance company.

D. Explain to Chetwyn what happened and inform him that he is responsible for any fees not paid by his insurance company.
Answer: act to prevent the actions, do not maint
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Question: *125. Don LaMond is the guest speaker at a conference about domestic violence. He is a licensed social worker but also has a Ph.D. in economics. When the announcer introduces him to the audience, he refers to him as Doctor Don LaMond. Don should:

Content Area: Ethics: Business Practices and Policies
This question addresses the ethical and legal necessity to clarify one's qualifications in the mental health field.

A. Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards.

B. Correct the announcer privately after the presentation.

C. Proceed with his presentation. This sort of thing happens all the time. There is no legal or ethical responsibility to do anything.

D. Clarify immediately any misleading information as to his qualifications, professional status, or education, as required by law.
Answer: no more than 4 years from date
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Question: *126. Several of your clients are homosexual, and one client in particular is the leader of a group for a range of gender identity support groups. She refers several clients to you because she is impressed with your ability to stay "open minded about whoever people want to be." Ethically, what would you want to address first?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to maintain ethical standards with diverse populations.

A. You would need to determine if your scope of competence was adequate.

B. Avoid a dual relationship with your client by soliciting referrals.

C. Since these clients might know each other, explain the limits of confidentiality.

D. Explain that if they are in the group for gender identity issues, you cannot treat them for the same issue.
Answer: when a SW or client acts in a way outside of their agreed upon duties/role
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Question: 127. Your 52-year-old client returns from visiting his brother in Florida. He explains that his brother, who cares for their 84-year-old father, doesn't take him to his doctor or physical therapy appointments and she occasionally forgets to fill his prescription medication. What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of the parameters of elder abuse reporting and when to maintain confidentiality.

A. Maintain confidentiality.

B. Call Adult Protective Services (APS) in Florida and file a written report within two working days.

C. Encourage your client to file an Elder Abuse Report.

D. Call Adult Protective Services (APS) in California and file a written report within 36 hours.
Answer: 1. at least 12 years old
2. clinical judgment that they are mature enough to participate in and benefit from the therapy AND
3. clinical judgment that without the therapy they would be at serious risk of harm to self or others OR
4. They are an alleged victim of abuse or incest
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Question: *128. A man identifying himself as Lefty calls to set up an appointment for therapy. He tells you that he has a hard time with confrontation and that as a result, he often ends up having to do things he doesn't want to do, and that other people treat him "like a doormat." Lefty tells you that specifically, he wants your help in terminating with his current therapist and doesn't know how to do it. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This item tests your knowledge of ethical standards related to a therapist's professional competence and integrity.

A. Tell him that you can't treat him without the the agreement of the other therapist.

B. Tell him that you can't treat him while he is seeing another therapist, and support Lefty in his efforts to terminate with the other therapist before beginning treatment.

C. Agree to see Lefty, obtain a release to speak to the other therapist and consult about how to best help Lefty.

D. Agree to see Lefty and help him to be assertive and to stand up for himself as he requested.
Answer: When working with a family or couple as a unit, the unit is considered the 'client' rather than each individual. Therefore therapists may assert that they may need to share information learned in individual sessions with the other members of the unit.
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Question: *129. What is the expected length of time to keep client records after the client has been terminated?

Content Area: Ethics: Business Practices and Policies
This question assesses your knowledge of the length of time you are required to keep a client's records after therapy has been terminated.

A. Records must be retained for a minimum of 7 years after the date that the client begins treatment.

B. At least 7 years after the termination of an adult client and 10 years after the termination of a minor client.

C. At least 7 years after the termination of an adult client or until a minor client turns 21.

D. Records must be retained for a minimum of 7 years after the date that the client terminates treatment.
Answer: Maintain confidentiality and do not report
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Question: 130. You schedule a couples' counseling session, but when a 29-year-old female comes to the initial session she apologizes for her husband and explains that he refuses to attend couples' counseling. She is concerned about his drinking and drug use and thought counseling might get him the help he needs. She states that her husband will never admit he has a substance abuse problem, and that she is fed up. She asks you to help her. Ethically, you would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical obligations that pertain to clients' expectations of treatment.

A. Inform her of your "no secrets" policy now, in case couples therapy does occur later.

B. Since she apologized for him and wants couples counseling to help him, assess for co-dependency and whether individual therapy might be more effective.



D. Inform her that it would be a dual relationship if you began therapy with her individually and then saw both of them concurrently.
Answer: must assess the ct's motivation for giving the gift. IF giving the gift supports the ct's therapeutic process and needs, it may be ok to accept
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Question: *131. Your client returns from a vacation in France with an expensive bottle of champagne and gives it to you to thank you "for all the wonderful help you've given her." You:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical conduct in the area of client gift-giving.

A. Accept the champagne in the spirit in which it was offered.

B. Accept the champagne and explore the meaning behind the gift.

C. Refuse the champagne and explore the meaning behind the gift.

D. Accept the champagne but tell her you're going to give it to a colleague so as not to create a dual relationship with her.
Answer: provide info directly pertaining to child abuse allegations, otherwise request must be in writing for anything else
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Question: *132. A recently divorced 40-year-old client tells you that her ex-husband is leaving threatening remarks on her social network pages. She has tried to block him, but he finds ways to get on anyway. He lives out of state so she tells you that she doesn't really think he is a threat; "he's just trying to get under my skin, and it is working!" As a mental health professional, what would be your best legal course of action?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of a social worker's legal responsibilities concerning confidentiality when a client is threatened.

A. Report to the police because of the serious threat of violence to an identifiable victim.

B. Provide your client with the numbers of shelters or see if she is willing to stay with friends or family members if the threat is imminent and serious.

C. Ask your client to invite her ex-husband to a session and teach harm reduction techniques.

D. Discuss the situation with your client.
Answer: youth under 14 with consensual partner 14 yo+
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Question: 133. Richard, 38, tells you that he is missing more and more work due to back pain. He tells you that he has been to several doctors who prescribe pain medication because he cannot afford to take time off of work. He tells you that he skips work or leaves early because sometimes the "meds make me so tired and fuzzy in my thinking,that I would be fired if I showed up like that." As a social worker who is not experienced with substance abuse, what is your next course of action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when to make competent referrals.

A. Refer him to AA.

B. Refer him to an MD.

C. Encourage him to take time off of work to get physical therapy for his back.

D. Obtain consultation to determine the extent of his problem.
Answer: sexual activity with youth 14-15, consensual partner 10+ yrs older (24/25+)
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Question: 134. A mediator contacts a social worker requesting that she contribute to an ongoing child-custody decision. If the social worker agrees to provide information, the social worker should:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge about how to provide informed consent regarding dual relationships.

A. Tell the mediator the fee for conducting custody evaluations before doing so.

B. Advise the clients about the risks of this dual relationship.

C. Determine if custody evaluation is within her scope of practice.

D. Limit information disclosed to the mediator that is related to custody.
Answer: consenual intercourse with minor under 16 and adult 21+, 16+ no report
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Question: 135. After seeing Mary in therapy for six months, she reports she can't afford your fee anymore, and wishes to trade services. She wants to provide all your marketing and printing needs to promote your practice. Since she is already your client you would:

Content Area: Ethics: Business Practices and Policies
Your knowledge of dual relationships and the ethics of bartering for therapeutic services is tested here.

A. Agree to trade services because it would be unethical to terminate at this point in treatment.

B. Not agree to trade services and refer her to a low-fee counseling center immediately.

C. Not agree to trade services and attempt to slide her fee to a rate agreeable to both of you.

D. Agree to trade services if a sliding scale fee could not be agreed upon, but reassess the arrangement in a few months.
Answer: any forced or coerced sexual activity w/ youth under 18, perpetrator any age
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Question: *136. Your client works for a local newspaper arranging advertising space. You place an ad in the same newspaper for an upcoming therapy group. The client turns out to be the person who does the ad layout. Ethically:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your ability to recognize your role in a dual relationship.

A. You have every right to place an ad in this newspaper.

B. This is an avoidable dual relationship and you should have advertised in a different newspaper.

C. You are required to withdraw the ad.

D. You should request that the client decline the job if it happens again.
Answer: NO
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Question: *137. A social worker working with an individual is becoming convinced that marital therapy would be better for a client. The social worker suggests that the client bring her husband for a session, but the client is afraid her husband will monopolize the session. Scope of competence obligations require the social worker to:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to proceed ethically when conjoint therapy may be in the best interests of the client.

A. Refer the client to a couples therapist.

B. Sign a "no secrets" policy at the first session if the husband does come for a session.

C. Explore her reasons for recommending conjoint therapy.

D. Address the wife's concerns about her husband's "monopolizing" the session.
Answer: Use is impairing their ability to care for their child
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Question: 138. After seven sessions, your client tells you that she just started seeing another therapist. She explains that she knows that therapists cannot be friends with their clients so she figured she would take the first step and find another therapist. She tells you she would like this to be your last session, and she will text you in a couple of months. You:

Content Area: Ethics: Therapeutic Relationship/Services
This question addresses the ethics of the therapist/client relationship, including client abandonment.

A. Since the client initiated the termination, you should terminate.

B. Explain that terminating therapy to pursue another relationship is unethical.

C. Do not return her texts when it appears.

D. Should seek consultation to avoid the appearance of client abandonment.
Answer: Parent drug use will impair ability to care for the child
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Question: *139. José, a 49-year-old single Mexican-American surgeon, is abusing prescription medication. He was referred to therapy by his lawyer and is thirty minutes late for his first session. José says he doesn't want you to take notes, "Because my patient is suing me and I don't want more evidence against me in court." José declines a referral to a 12-step group because he fears he might be recognized. He asks you to teach him to stop using drugs. Which of the following is NOT an ethical obligation that would affect your ongoing treatment of Jose?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to assess whether the client will benefit from therapy.

A. Assess whether your treatment plan will require 12-step participation now or at some time in the future.

B. Because 12-step programs do not duplicate individual therapy, tell the client that concurrent treatment is advisable.

C. Explain the risks and benefits of 12-step programs.

D. Take the client's lead in the treatment plan to minimize the effects of negative counter-transference.
Answer: You can be subject to civil penalties
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Question: 140. You receive a phone call from Pat, a former high school sweetheart and first sex partner. You and Pat have not spoken in 20 years, and now Pat asks if you will provide treatment for some life adjustment issues. Pat says you would be perfect because there is already trust between you from the old days. How would you proceed?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your ethical information regarding therapy with former sexual partners.

A. Decline to see Pat because professional ethics forbid social workers from treating former sex partners.

B. Make an appointment with Pat since there are no laws or ethics about treating someone with whom a social worker has previously had sex.

C. Agree to treat Pat since it has been more than two years since there was a sexual relationship.

D. Decline to see Pat because social workers cannot have sex with former clients.
Answer: Release all records with the exception of psychotherapy notes (private notes kept separate from medical record)
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Question: 141. After a crisis in her own life, a social worker cancels her appointments with clients for two weeks. What must she do next to meet ethical obligations related to informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question pertains to providing clients with information about your availability which is part of informed consent.

A. Tell clients that she will reassess her ability before returning to work.

B. Tell clients that she will not take calls during that time.

C. Reconsider treatment plans when she returns.

D. Obtain consultation to assess if she is ready to return.
Answer: assert privilege b/c making that decision is outside a SW's scope of practice, only the court can decide that
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Question: *142. A potential client says she wants to work on "inner conflicts." You would:

Content Area: Ethics: Professional Competence and Preventing Harm. This is an informed consent and scope of competence question.

A. Refer her to a psychologist or psychiatrist.

B. Clarify your scope of competence before agreeing to treat her.

C. Suggest that working on her relationship issues could work out her inner conflicts.

D. Initially explore her inner conflicts to determine your treatment plan.
Answer: -client has introduced his or her emotional condition in a legal proceeding
-client has treated privileged information as though it were not confidential
• breach of duty
• The therapist sues the client for non-payment (content of therapy remains confidential).
• The client sues the therapist for malpractice.
• therapist appointed by court to examine client
• If the client has sought psychotherapy to commit a crime and/or escape punishment for a crime.
• client is under 16 and victim of a crime (e.g. extortion, statutory rape)
• In a proceeding requested by a defendant to determine sanity.
• client brings proceeding to establish competence.
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Question: *143. Ronald is a 37-year-old moderately successful artist you have been treating for three years for depression and relationship issues. His income is sporadic, and you bill him monthly, but he had never let his balance get too high. Now he owes you $2,100. He offers to give you a painting whose value is roughly equal to the amount he owes you. How would you proceed?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical issues regarding client debt, dual relationships, and bartering and techniques to manage those issues.

A. Decline the painting and tell him that based on his history with you, you trust that he will pay you in full when he gets the money.

B. Accept the painting so that you can eliminate the debtor/creditor dual relationship.

C. Accept the painting but process with Ronald the meaning of exchanging his art for your services and have him sign a statement of mutual agreement.

D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due.
Answer: 1. document attempts to connect with parents and involve them in the treatment unless clinical judgment that this would be inappropriate/detrimental to minor
2. remember that parents are NOT responsible for payment if minor receives tx w/o their permission
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Question: *144. Burt, a withdrawn young adult, has been seeing you to help him with debilitating anxiety in social situations. You learn that Burt's previous therapist used highly questionable methods, including having Burt take her on "dates." He hints that this social worker encouraged him to have sex with her. What should you do?

Content Area: Law: Legal Standards for Professional Practice. This addresses therapist/client sexual contact and unethical social worker behavior.

A. Call the appropriate licensing board and see if any reports have been made on this other therapist in the past.

B. Continue to see Burt and monitor closely anything he says regarding this social worker, so you can take appropriate action when necessary.

C. Question Burt directly on whether he had sex with the previous social worker and give him the brochure if he says yes.

D. Give Burt the brochure, "Professional Therapy Never Includes Sex" regarding sex and therapy and discuss it with him.
Answer: 1. SW should maintain minor's confidentiality in tx and clearly outline policies about this in writing during initial consents

2. SW can deny parent access to minor's records if you think it will have a detrimental effect on your therapeutic rx with minor, their physical or psychological safety/wellbeing

3. Parents legally have right to see minor's tx info and assert privilege on their behalf if they are deemed a guardian ad litem
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Question: 145. Bridget comes to therapy describing how sad and hopeless she feels. You give her a Beck's Depression Inventory that reveals that she has a moderately high level of depression. At the end of the session, she asks you for a prescription for Zoloft. What is your initial response to her request?

Content Area: Ethics: Business Practices and Policies
This question probes your understanding of techniques for addressing a client's expectations of therapy.

A. Suggest to Bridget that she increase her level of physical exercise.

B. Review the nature of your license as it is explained in your informed consent.

C. Refer Bridget to a psychiatrist for a medication evaluation.

D. Discuss with Bridget the pros and cons of taking an antidepressant medication.
Answer: Person's mental/psychiatric condition prevents him/her from being able to provide for:
-food
-clothing
-and/or shelter AND
-there is no indication that anyone is willing or able to assist him/her in procuring these needs
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Question: *146. Twelve years ago, the Drake family came to see you for family therapy. At that time Mr. and Mrs. Drake were having problems with their two children, ages 2 and 5. The Drakes are now divorcing and are in court to determine custody of their two children. You receive a subpoena from Mr. Drake's attorney for therapy records for these sessions. You call both Mr. and Mrs. Drake and they each ask you to release the records and send you waivers to that effect. You still would not release the records because:

Content Area: Law: Confidentiality, Privilege, and Consent
This question explores your knowledge of privilege and how to handle subpoenas in a custody case.

A. The children must sign releases since they are old enough to participate in custody issues.

B. You no longer have the records after 10 years.

C. The court has not appointed guardians ad litem.

D. The judge has not ordered the release of the records.
Answer: Minor's mental/psychiatric condition prevents him/her from being able to provide for:
-food
-clothing
-and/or shelter
EVEN IF they are supplied for them directly (i.e. paranoia/depression)
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Question: 147. Terran came to five couples' sessions with his wife complaining about how she belittles him and expects him to act more American. Terran had a difficult time listening and compromising because he believed his wife was disrespecting him, and they terminated treatment. You receive a subpoena for his records from an attorney representing his employer and learn that he is suing his employer for discrimination and emotional suffering. When you try to contact Terran about the subpoena, he does not return your calls. You would:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to proceed when you receive a subpoena.

A. Assert privilege.

B. Call his attorney and ask the attorney to ask Teran to call you back.

C. Contact Terran's wife since she was in session and has a right to confidentiality too.

D. Release the records since he has entered his emotional state into a legal proceeding and this represents an exception to privilege.
Answer: •social workers can provide via phone, video, fax, email
•only SWs licensed in CA can provide telecare to clients in CA
•Medi-Cal only reimburses for video conferencing
•Verbal consent is sufficient
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Question: *148. A client that you treated 10 years ago terminated when her therapy goals had been reached, and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to maintain the standards of practice for documentation of client files.

A. Have the client sign a new release authorization.

B. Open a separate file if the client was in family therapy before.

C. Sign a new informed consent form.

D. Refer to another therapist if the client was a minor in therapy before.
Answer: 1) information about the nature, extent, and duration of the participation requested
2) disclosure of the risks and benefits of participation in the research
3) must be written
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Question: 149. You discover that you are dating a potential client's ex-husband. You would:

Content Area: Ethics: Business Practices and Policies
This question checks your knowledge of ethical, transference, and counter-transference issues.

A. Not see the client.

B. Discuss with the client how she feels about your relationship with her ex-husband.

C. Begin to see the new client and seek consultation.

D. Break off the relationship with the man and begin the therapeutic relationship with the client.
Answer: C. Obtain written authorization from the entire family to contact their lawyers and waive/assert privilege as the family sees fit.

You would be required to obtain written authorizations from the family in order to contact their lawyers who would determine whether to waive or assert privilege.
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Question: 150.
Answer: A. Call Adult Protective Services and report physical abuse.

Social workers are mandated to report physical injury to an elder, inflicted by another person, that occurs by other than accidental means.
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Question: Soliciting private info beyond what is essential for providing services: ethical or legal?
Answer: B. Clarify for the family how your therapeutic work differs from religious counseling.

This response addresses your client's expectations about therapy and promotes a better understanding of the process.
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Question: Maintaining clinical records: ethical or legal?
Answer: C. Do not accept the gift, explain to Melissa how the gift giving could negatively impact the therapeutic relationship, and process Melissa's reaction.

Not accepting this expensive gift is the ethical course of action. Additionally, explaining your reasoning to Melissa and processing her reaction demonstrates good ethical management.
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Question: Securing a license/registration by fraud: ethical or legal?
Answer: C. Only to those qualified to interpret them.

Psychological evaluation test scores should only be released to people who are able to interpret them appropriately. However, if a client insists on seeing his/her test scores, the therapist must release them but must also provide interpretation of the scores in a way that the client can understand.
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Question: Incompetence in performance of clin SW: ethical or legal?
Answer: A. Fetal abuse.

Fetal abuse is optional under the mandated reporting laws.
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Question: Act or omission that falls sufficiently below standard of conduct as to constitute gross negligence: ethical or legal?
Answer: B. Determine who has been assigned by the court as the guardian ad litem for the minor and inform him/her of the subpoena.

It would be important to determine who is your client's guardian ad litem and inform him/her of the subpoena so a decision about privilege can be made in the best interest of the child.
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Question: Sexual relationships: ethical or legal?
Answer: B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case.

It would be important to have peer supervision or a paid supervisor in cases like this where counter-transference issues are bound to arise. An eventual referral for one or both clients might be necessary also.
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Question: Performing, acting as if able to perform, offering to perform any professional services beyond scope of license: ethical or legal?
Answer: B. Acknowledge the effects of racism and listen to his perspective.

Acknowledging that racism exists is a supportive and immediately genuine response. Allowing this client to share his experiences will build trust and rapport.
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Question: Failure to maintain confidentiality: ethical or legal?
Answer: D. Document your crisis interventions in the first session.

The laws about record-keeping require you to document any and all interventions.
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Question: Fee disclosure: ethical or legal?
Answer: A. Respect her wishes to terminate and explain that you will not respond to emails or social network posts that invite your friendship.

You may terminate a client if they want to end therapy, but if they want to terminate in order to pursue a friendship, you would need to process how this will occur before the therapy ends.
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Question: Paying, accepting payment/ remuneration for referrals: ethical or legal?
Answer: C. Maintain confidentiality.

Based on the information given in this question you would maintain confidentiality. Juan's threat is dependant upon the death of another person which eliminates the "imminence" that breaking confidentiality under Tarasoff requires.
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Question: Keeping records (LEGAL)
Answer: B. Thank you for your acknowledgement of our work together. Let's discuss the implications.

Having a discussion about therapeutic boundaries and dual relationships minimizes the chances for misunderstandings and clarifies your role at this ceremony.
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Question: Termination of services -arranging transfer (ETHICAL)
Answer: C. Megan is a danger to herself or others without treatment.

As of January 1, 2011 (SB543; Leno), mental health professionals, including LCSW's and ASW's, may treat a minor 12 or older without parental consent if the minor is mature enough to participate intelligently in therapy, and there is no longer a requirement for the child to be a victim of child abuse or a danger to self or others.
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Question: Fees (LEGAL)
Answer: D. Invite them to explain how their different cultural backgrounds impact their relationship.

Having clients educate you about the impact of human diversity issues on their own experience conveys respect, builds rapport, and helps them to clarify and gain insight into the impact it has on their lives.
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Question: Misrepresenting education/license/registration/ qualifications
Answer: D. Tell her about the husband's phone call and any fee changes that might result from a change in her insurance coverage.

Any changes to fee policies must be discussed before they occur, as directed by legal and ethical standards.
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Question: Termination based on failure to pay (ETHICAL)
Answer: B. Decline to make an appointment and refer her to another therapist.

The woman who wants to become your client has a prior relationship with you as your child's piano teacher. This is an easily avoidable dual relationship since there are many other therapists that could help this woman.
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Question: Payment for Services: Fees (ETHICAL)
Answer: D. Clarify Darren and Samantha's expectations about therapy.

Clarifying a client's expectations would begin to answer a client's inquiries about the therapeutic process.
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Question: Payment for Services: Accepting barter (ETHICAL)
Answer: A. Call Adult Protective Services immediately to file a neglect report.

Reasonable suspicion of neglect exists and it would be up to Adult Protective Services to investigate further.
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Question: Payment for Services: private practice by agency employee (ETHICAL)
Answer: A. Help Hermoine with her crisis until her therapist returns.

Helping Hermoine with her crisis would be the only ethical way to proceed in this instance since her new therapist cannot be reached, and she has called you for help. Even though you had terminated and were no longer her therapist, when someone calls a social worker in crisis, the law presumes at that point the existence of a special relationship in which the therapist must act in the best interests and welfare of that person.
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Question: Access to Records (ETHICAL)
Answer: C. Stop the discussion and do not talk about these clients again.

The rules of confidentiality would require the social workers to stop the discussion and not talk about these clients.
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Question: Alleged sexual misconduct of ct's former therapist (LEGAL)
Answer: B. The BBS found that the therapist terminated therapy in order to pursue a sexual relationship.

Terminating therapy in order to pursue a sexual relationship with a client is prohibited.
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Question: Sexual conduct (LEGAL)
Answer: C. Maintain confidentiality because you do not know the age of the mother.

You would maintain confidentiality because you do not know his mother's age and you do not have "reasonable suspicion" of elder abuse.
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Question: When providing services to couples/ family members (ETHICAL)
Answer: C. Inform Ki that the risks and benefits of therapy may be that he "finds himself" but may change some of his family values.

Informing a client about the risks and benefits of therapy which includes altering their sense of self and their family, is an ethical obligation.
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Question: Child abuse reporting (LEGAL)
Answer: B. Give her the brochure "Professional Therapy Never Includes Sex" and discuss her options.

Therapist sex with a client is prohibited. When a client reveals that s/he has had sex with a former therapist, the treating mental health professional is required to give her/him the brochure "Professional Therapy Never Includes Sex," as well as discuss it with them.
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Question: Seeking consult when needed: ethical or legal?
Answer: A. Without providing adequate notice.

Ethical standard standards require that clients be given notice of fee increases before they occur.
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Question: Informed consent to tx: ethical or legal?
Answer: C. Recommend individual therapy if there are any regressive symptoms in any individual.

If the family wants to terminate but one person might still be in need of individual treatment, it would be ethical to recommend this.
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Question: Client self determination: ethical or legal?
Answer: B. The court may appoint an attorney to represent the best interests of the child.

The courts can assign a guardian ad litem, if needed, to represent the best interests of the child.
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Question: COnflict of interest: ethical or legal?
Answer: C. By telephone as soon as possible and in writing within two working days.


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Question: Duty to Warn: ethical or legal?
Answer: D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually.

You would need to determine the unit of treatment before doing any of the other actions.
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Question: Scope of Practice: ethical or legal?
Answer: C. Inform the supervisor that it is unethical to split fees.

It is not ethical for LCSW's to split fees. NASW's ethical standards state that Licensed Clinical Social Workers do not offer or accept payment for referrals.
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Question: Scope of Competence: ethical or legal?
Answer: B. Evaluate what would be in the client's best interests and how accepting or rejecting the gift might affect treatment.

Depending on the clinical issues, cost of the gift, length of time you've been seeing the client etc. this answer would allow you to act according to the client's needs.
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Question: Standard of care: ethical or legal?
Answer: B. Hypnotherapy.

Hypnotherapy needs specific additional training beyond the education required to obtain a mental health professional license.
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Question: Privileged Communication: ethical or legal?
Answer: B. Indicate that you assessed her risk as "low" and suggested that she call her therapist

Although the client has terminated, you still have an ethical obligation that pertains to crisis management. If her crisis were acute, you would have to do more than simply refer her back to her therapist.
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Question: Misrepresentation: ethical or legal?
Answer: A. Contact your client to determine if she wants you to waive or assert privilege.

Clients hold their own privilege and a social worker must consult with the client to determine whether privilege is to be waived or asserted.
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Question: Fee disclosure: ethical or legal?
Answer: C. Call the police immediately and his ex-girlfriend's family.

In the vignette described there is imminent peril and there is a reasonably identified victim(s). The Duty to Protect includes the mandate to notify the police first and a warning to the identified victim is permitted.
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Question: Elder/ Dep Adult Abuse Reports: ethical or legal?
Answer: B. No, if the social worker does not reveal identifying information about the client to the other professional.

According to the National Association of Social Worker's (NASW) Code of Ethics, section (1.07) (q) Privacy and Confidentiality, "Social workers should not disclose identifying information when discussing clients with consultants unless the client has consented to disclosure of confidential information or there is a compelling need for such disclosure." This section implies that the client's direct
consent to consult with another professional is required only if identifying information about the client is revealed. Thus, if general aspects of the case are discussed with another professional, permission from the client is not needed.
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Question: Informed consent (ETHICAL)
Answer: B. Tell minor clients how you will contact parents if you think there is an emergency.

Discussing the limits of confidentiality is an element of informed consent.
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Question: Involuntary clients (ETHICAL)
Answer: A. Accept the cookies and explore their meaning with Maria and Juan.

Accepting the cookies and exploring their meaning with Maria and Juan would be the best choice available. The cookies are a small gift which may have a cultural component. It is important, once the decision to accept the gift is made, that the personal meanings behind it are explored.
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Question: Providing services via electronic media ETHICAL
Answer: D. The client has the right to withdraw from the study at any time.

The client has the right to withdraw from the study at any time, and we as therapists, are to respect the client's wishes.
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Question: Dual / Multiple relationships ETHICAL
Answer: B. The client signed a waiver of privilege for the records.

No records would be disclosed until the client or the client's representative waived privilege.
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Question: Right to privacy (ETHICAL)
Answer: C. It is a legal principle that protects client conversations unless there is a court order.

Privilege is the legal right of the client not to have confidential information revealed during a legal proceeding. Only a client, judge or court order would challenge privilege.
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Question: Sexual misconduct/ abuse <LEGAL>
Answer: D. Determine if you can deal with this client at this time.


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Question: Explaining limits of confidentiality (ETHICAL)
Answer: D. Assessing whether a medication evaluation would be necessary.

From an ethical point (safety-minded) of view, a therapist would first need to consider all treatment modalities to help a client. In this case, that would include considering whether his anxiety is so severe that medication would help him benefit from therapeutic interventions.
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Question: Confidentiality w/ couples, families, groups (ETHICAL)
Answer: C. Being arrested for shoplifting.

The law (Business and Professions Code 4982(a) says unprofessional conduct addresses licensees or registrants who have been "convicted" of an offense, not just arrested.
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Question: Right to confidentiality (ETHICAL)
Answer: A. Ask if the client would like to be referred to as "he" or "she".


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Question: Disclosure of confidential info (ETHICAL)
Answer: A. To contact an agency designated to take a report and follow up with a written report within 36 hours.

Your responsibility is to contact a designated agency and follow up with a written report within 36 hours.
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Question: Self-determination (ETHICAL)
Answer: C. The social worker should not make this type of referral yet as the client is still in a vulnerable condition.

EMDR can be especially effective when a person is suffering from a recent trauma. In addition, you have already determined the client's need for this referral.
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Question: Consulting with colleagues (ETHICAL)
Answer: A. Assert privilege until a guardian ad litem has been appointed for the client.

When subpoenas are received for testimony or records involving clients who are minors therapists should assert privilege until the parent(s) or guardians of the child obtain "guardian ad litem" status.
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Question: Referrals (ETHICAL)
Answer: B. Outline the process of treatment.

Engaging in the process of informed consent, for example, explaining the therapeutic process at the beginning of therapy is an ethical obligation.
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Question: Sex with colleagues (ETHICAL)
Answer: A. Disclose any fees which are different from in-person sessions.

Fee disclosures are legally required before changes to treatment occur.
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Question: Unethical actions by colleagues (ETHICAL)
Answer: C. Counsel both of them.

As social workers, it is important for us not to impose our values and beliefs on our clients.
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Question: Incompetent or Impaired colleague (ETHICAL)
Answer: C. Informing the couple of your "no secrets" policy

Informing the couple of your "no secrets" policy is solely an ethical responsibility.
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Question: Billing (ETHICAL)
Answer: A. Report immediately to Adult Protective Services and make a written report within 2 working days.

There is a mandated responsibility here since you have knowledge or reasonable suspicion of elder abuse. You would report immediately by phone and follow up with a written report within 2 working days.
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Question: Responsibilities towards employer (ETHICAL)
Answer: A. Provided ethical informed consent.

The social worker's explanation to the client about the clinical effectiveness of texts and emails is a form of informed consent.
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Question: Client transfer (ETHICAL)
Answer: A. Assist them with information you deem pertinent to the situation at hand.

In the event of a medical emergency it is permissible to give information to medical professionals that may be treating the client. Social workers are permitted to speak with other health professionals for purposes of treatment and diagnosis in recognition of situations such as these.
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Question: Discrimination (ETHICAL)
Answer: A. Complete class as usual without acknowledging the client unless he/she acknowledges you and explore his/her reactions in your next session.

Maintaining confidentiality means not acknowledging clients without their permission when you see them outside of therapy. It would be important to discuss the client's feelings about seeing you outside the therapeutic setting.
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Question: Solicitations (ETHICAL)
Answer: B. Accommodate your fee since you've established a bond.

Because you've established a bond, accommodating your fee would be in the best interests of the client. If an accommodated fee cannot be agreed upon, then providing three low-cost therapy referrals would be appropriate.
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Question: Impairment (ETHICAL)
Answer: C. Engage Bobby in a therapeutic conversation.

The ethical standard is to speak with the colleague to try to rectify the issue first.
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Question: Private conduct (ETHICAL)
Answer: B. A peace officer, staff member of an evaluation facility, or other professional person designated by the county.

A peace officer, a staff member of an evaluation facility or other professionals designated by the county, may invoke a 5150.
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Question: Integrity of profession (ETHICAL)
Answer: D. Review dual relationships with your client and healthy boundaries.

Of the answers provided, reviewing dual relationships with your client and healthy boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be uncomfortable for your client, or create any therapeutic problems. It is the most reasonable of the options provided.
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Question: Minor consent: ethical or legal?
Answer: A. Journaling, peer consultation and individual therapy.

Journaling, peer consultation and individual therapy are the appropriate steps in which you would ethically deal with counter-transference.
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Question: "No secrecy" rule: ethical or legal?
Answer: C. You have sufficient reason to treat Brianna without parental consent.

This scenario indicates that Brianna meets all the legal requirements for being treated without parental consent: she is mature enough to participate intelligently in therapy, she meets the minimum age requirement of 12-years-old, treatment will occur in an outpatient setting and she is responsible for the fee. The only criterion that remains is to determine if there is a clinical reason to exclude her parents.
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Question: Professional boundaries: ethical or legal?
Answer: B. Make three referrals out of town.


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Question: Explain your privacy practices (incl. privileged communication)
Answer: A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.

It is legal and ethical to bill insurers for missed sessions as long as this is clearly indicated in the billing codes.
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Question: Protecting privileged communcation
Answer: C. Legally fulfilled your responsibility to provide accurate information about your qualifications.

You are legally required to provide accurate information about the range of services you can provide, given your license.
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Question: Access to records (legal)
Answer: B. Seek consultation.

Of the choices given, seeking consultation is the first step you would take if you are having angry feelings towards this client. It would be important to understand your reaction and to carefully assess how you would proceed.
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Question: Access to records (ethical)
Answer: C. Direct questions about his revenge plans.

The social worker would need to determine if the client has a specific and imminent plan to warrant breaking confidentiality.
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Question: Keeping records (legal)
Answer: B. The social worker and client both agree that it seems as if no further progress can be made.

This is the best answer since it takes into account both social worker and client and the very important concern of client progress.
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Question: Access to couple therapy records by 3rd party (legal)
Answer: C. Document your decision to meet individually with José.

An important legal obligation, since you are changing the unit of treatment from a dyad to individual treatment of a minor, is to obtain consent to treat a minor and document it.
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Question: Access to couple therapy records by 3rd party (ethical)
Answer: B. Notes on any peer consultations regarding counter-transference issues around the case.

Notes dealing with the social worker's personal issues should not be placed into a client's chart.
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Question: Keeping records of couple (legal)
Answer: C. It is unethical.

LCSW's do not use their professional relationships with patients to further their own interests.
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Question: Derogatory language (ethics)
Answer: C. The fee and the true name and license of the designated owner of the practice.

The fee and the name of the owner of the practice, if using a fictitious business name, are legally required disclosures at the onset of therapy.
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Question: Involuntary hold (ethical or legal?)
Answer: D. Decline his request to tell her for him.

Declining his request is the only ethical answer. You might also say that you will support him while he tells her, if he wishes.
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Question: standard of care (meaning)
Answer: B. You are legally mandated to contact Adult Protective Services for dependent adult abuse.

This disabled client says she's on SSI (Supplemental Security Income) which indicates she has a severe disability preventing her from gaining income through employment. Chances are she would be considered a dependent adult and it is important to report financial abuse of dependent adults to APS.
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Question: Seeking consultation when needed (ethical or legal)
Answer: A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable.

Information about availability between sessions or in emergencies is an element of safety planning which is both a legal and ethical requirement.
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Question: In making decisions about ethics, always put the clients' ___________ first
Answer: A. She must submit to you a request in writing.

Clients must submit in writing any request to see their records.
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Question: Evidence Code 1024: client threatens danger to self, others, or property. What should a SW do?
Answer: B. You may practice EMDR if you are properly trained.

A therapist may utilize EMDR as long as s/he has the appropriate education, training and experience.
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Question: Civil court statue of limitation for how long a SW can be sued for liability for a client's suicide
Answer: A. At the commencement of treatment.

At the beginning of the first session is the best answer. You would want to have an ongoing review of policies, as needed, throughout the course of treatment.
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Question: 'Breach of Duty' is
Answer: C. Informed consent.

This type of statement that refers to boundaries and social worker availability represents informed consent.
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Question: Requirements to treat a minor without parental consent
Answer: D. Explore with the client what he means by "psychoanalysis." Educate him on your theoretical approach and inform him of your limitations regarding psychoanalysis. Let him decide if he would like to continue therapy with you or receive referrals.

It would be important to explore with the client what he means by "psychoanalysis," as he may be referring to psychotherapy in a more general way. As part of informed consent, it is also important to explain to him about your theoretical approach so that he is informed about the service you do offer. This puts him in a position to make an educated decision about continuing therapy with you or receiving referrals for other mental health professionals.
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Question: 'No Secrets' policy
Answer: D. Speak to her supervisor about making adjustments in her workload.

NASW ethical standards say that social workers whose personal problems interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action, including making adjustments in workload.
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Question: Legal requirement if HIV+client reports intentions to infect other via sex
Answer: A. Decline to supervise the intern.

Declining to supervise the intern is the best ethical choice given here (it is possible that with the proper ongoing consultation and responsible care, this particular dual relationship could be ethically acceptable). Although some dual relationships are considered unavoidable, particularly when there are limited choices, the ethics are less ambiguous in stating that supervisors do not take on current or former therapy clients.
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Question: Rules for deciding wherther to accept a gift from a client
Answer: A. Provide Joyce with safety information.

As Joyce appears to be the victim of abuse by John's son, it is important that you provide her with safety information.
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Question: CPS worker requests information about a client following a child abuse report, what do you do?
Answer: B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.

If he is in family therapy now, but changed to individual therapy, you would need legal consent-to-treat with a minor.
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Question: When mandated report is required for consensual sexual touching/intercourse
Answer: D. Ask each family member to explain to you from their point of view the meaning this religious ceremony has to them and their family.

The most inclusive and culturally considerate answer would be to have each family member represent their own views on religion and expand their perspectives by discussing the impact of religion on the family as a whole.
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Question: Mandated report required for Lewd/lascivious acts with ages:
Answer: A. Mental suffering.

Optional Category. Mental suffering (fear, agitation, confusion, severe depression, serious emotional stress brought on by threats, harassment, or intimidating behavior) are not mandated.
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Question: Mandated report required for sexual abuse when:
Answer: D. Acted unethically and illegally.

Although the gift is not substantial in value, social workers are prohibited by law and ethical standards from accepting or providing any kind of remuneration for referrals.
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Question: Mandated report required for sexual assault when:
Answer: B. You would need to assess for child abuse.

Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse.
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Question: Is there a mandated reporting requirement for emotional abuse?
Answer: A. Tell the client it would be a dual relationship to act as a social worker and sponsor.

Social workers are obligated to tell clients that if a dual relationship is avoidable, that it must be avoided.
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Question: Mandated report required for parent alcohol/marijuana use only required when:
Answer: C. Assess for further boundary violations.

Assessing for further boundary violations would be important in order to determine the extent of boundary violations and if there had been any sexual contact between the therapist and your client.
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Question: Mandated report required for newborn testing positive or illicit drugs only when:
Answer: A. Call Child Protective Services.

It is possible that the consensual sexual activity between the older sister and her boyfriend may be reportable but the exposure of Patricia to it definitely triggers a mandated report.
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Question: What can happen if you don't comply with a subpoena?
Answer: A. Review the fee policies outlined in your informed consent document.

Going over relevant fee policies such as the basis on which it is computed, sliding scale polices or fees for late cancellations constitutes sound ethical management.
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Question: When client gives consent to release their records to court, social workers are legally obligated to:
Answer: C. The social worker will speak only with the person on the release.

This answer provides the client with information to the client so that she can consent or refuse to consent to this part of the treatment.
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Question: If a SW receives a subpoena that they believe is an 'exception to privilege' circumstance, they should FIRST:
Answer: D. This would be considered outside of your scope of competence.


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Question: primary circumstance where privilege of a client's information can be waived in court:
Answer: C. Not disclose to John's mother that John is your client.

Given the choices available, not disclosing to the mother John is your client is the legal course of action because we don't know if the woman on the telephone is actually John's mother. In order to speak to her, a release would be required.; therefore, the social worker's initial obligation is to maintain John's confidentiality.
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Question: What is a therapist required to do regarding parents when treating a minor without consent? (2 things)
Answer: D. Rowene violated ethical standards, but not the law.

Both the law and ethical standards clearly state that sexual relationships between social worker and client are prohibited during therapy and in the two year period following termination. The sexual relationship started more than two years following termination, so the relationship is not illegal. However it violates NASW Ethical code 1.09 (c) which states that social workers do not have sexual relationships with former clients.
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Question: Important rules of confidentiality when treating minors: (3 things)
Answer: B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son.

You must report both known and suspected child abuse to a child protective agency. Since your client tells you that the elementary school swim instructor is molesting her 9-year-old son, you are mandated to report this abuse.
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Question: "Gravely disabled" criteria for 5150 forcible hospitalization of an adult:
Answer: A. Under no circumstances, since a client is always a client and this could constitute a dual relationship.

Non-sexual, post-therapy relationships may be ethical depending upon the reasonableness of the post-therapeutic relationship and the reasonableness of the time since therapy. However, the highest ethical standard is to avoid relationships with former clients because they may want to return to therapy.
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Question: "Gravely disabled" criteria for 5150 forcible hospitalization of a minor:
Answer: B. Provide her with a copy of "Professional Therapy Never Includes Sex" and answer her questions about it.

Your legal responsibility is to provide the pamphlet "Professional Therapy Never Includes Sex" and discuss it with the client if he or she informs you of sexual misconduct between him/herself and a therapist.
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Question: Rules for providing telemedicine
Answer: D. Set the fee before the first session.

Setting the fee before the first session is both a legal and ethical responsibility. It is one of many things to do when setting boundaries.
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Question: SW research informed consent must include what?
Answer: A. That you will need them to sign an agreement to change the treatment plan.

Ethics do not require a signature on a treatment plan.
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Question: 1. You are treating a family consisting of Sharon, 33, Mike, 36, Carol, 15, and Billy, 12. You receive a subpoena from a lawyer, regarding a lawsuit over an inheritance, for which another family member is suing your clients. The subpoena requests all records for the purpose of showing that this family is not mentally competent to receive the inheritance. How would you manage this situation?

Content Area: Law: Confidentiality, Privilege, and Consent
This question looks at your legal responsibility when receiving a subpoena for an entire family, not just an individual client.

A. Get a release from the parents since the parents hold the children's privilege.

B. Contact the lawyer to assert privilege on behalf of the family.

C. Obtain written authorization from the entire family to contact their lawyers and waive/assert privilege as the family sees fit.

D. Comply with the subpoena since their mental condition has been entered into a legal proceeding and send a copy of the records.
Answer: C. The 14-year-old client.

The client is always the holder of his or her own privilege, unless the court assigns a guardian ad litem or conservator.
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Question: 2. Sidney comes to his session with his 80-year-old mother, who uses a walker following a bad fall, that she reports was caused by a fight with her husband. The mother tells you that the fight was her fault, and she knew that if she kept goading her husband, he would explode. A social worker in this situation must:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of laws regarding elder abuse.

A. Call Adult Protective Services and report physical abuse.

B. Call law enforcement within 24 hours and follow-up with a written report to local law enforcement, licensing agency, and ombudsman.

C. Explore possibilities for alternative living arrangements and address the feelings both she and Sidney are experiencing.

D. Report domestic violence since the victim was an elder.
Answer: B. Report the incidents to a children's protective agency.

This vignette describes sibling abuse that has been occurring for a while. The parents are not in control of the situation, and you are mandated to report.
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Question: *3. A 17-year-old girl, Janet, is referred to you by her school counselor. Janet's nose, eyebrow, and tongue are pierced, and her hair is dyed green and yellow. Janet says that recently her twin brother Michael comes into her room at night and tries to "play sleep-over" with her. Janet tells you that a cute boy she met at a rave last week wants her to move in with him. She asks you not to tell her parents that she's seeing you because they're "extremely religious." How would you manage your ethical responsibilities if you were working with the entire family?

Content Area: Ethics: Therapeutic Relationship/Services
This question test your knowledge of the ethical issues that arise when treating a family unit.

A. Clarify for Janet that, as a victim of abuse, she can consent to her own treatment without her parents' permission.

B. Clarify for the family how your therapeutic work differs from religious counseling.

C. Review your fee policy, especially as this case involves various family members and religious issues.

D. Explain the limits of confidentiality to Janet with regard to sexual abuse.
Answer: A. Would explain that you need a release from the parents to communicate to the court.

Even though the court referred this family, the family is your client, and you cannot break confidentiality without a written release.
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Question: 4. Your client Melissa comes in at Christmas time, gives you an expensive watch, and expresses how thankful she is for the help you have given her. How would you best ethically proceed?

Content Area: Ethics: Business Practices and Policies
This question assesses your knowledge of the ethical management of gift-giving by clients.

A. Review your informed consent document with Melissa specifically discussing boundaries.

B. Accept the watch since Melissa very rarely gives you gifts, and you suspect there may be an element of cultural diversity to heed.

C. Do not accept the gift, explain to Melissa how the gift giving could negatively impact the therapeutic relationship, and process Melissa's reaction.

D. Do not accept the gift since ethical standards prohibit accepting gifts from clients.
Answer: A. Educate yourself on the psychosocial impact of being in a wheelchair.

A better understanding of the issues Dale and Natasha face as a result of Dale's disability would certainly be an important aspect of their treatment and would meet your ETHICAL obligations.
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Question: 5. Psychological evaluation test scores should be released to:

Content Area: Ethics: Business Practices and Policies
This question deals with the ethics involved in the release of test scores.

A. Clients always.

B. Only the parents of children.

C. Only to those qualified to interpret them.

D. Only to other therapists who have the proper training to interpret them.
Answer: A. Only accept referrals within his scope of competence.

Robert should only accept referrals within his scope of competence as determined by education, training and experience. While developing new areas of practice, mental health workers take steps to ensure competence through appropriate education, training, consultation, supervision, etc.
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Question: 6. Which of the following constitutes an optional reporting (rather than a mandated) situation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question asks you to identify the situation in which reporting would be an option rather than a requirement.

A. Fetal abuse.

B. Neglect.

C. Undue influence of an elder.

D. Willful cruelty.
Answer: C. Refer John back to the prescribing psychiatrist.

Referring John back to the psychiatrist would be the most appropriate action, as the psychiatrist could explain the benefits of taking the medication and the repercussions of abruptly terminating it.
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Question: 7. A 6-year-old girl who,se parents are involved in a longstanding custody trial, is in treatment with you. She is in therapy with the consent of both parents. You receive a subpoena from the father's attorney for your session notes to bolster the father's claim that he should have sole custody. What is your legal responsibility?

Content Area: Law: Confidentiality, Privilege, and Consent
This question addresses your knowledge of what to do when you receive a subpoena.

A. Inform your client's mother of the subpoena to determine whether to assert or waive privilege.

B. Determine who has been assigned by the court as the guardian ad litem for the minor and inform him/her of the subpoena.

C. Do not respond to the subpoena in order to protect the confidentiality and privilege of your client.

D. Ask the client whether she wants to assert or waive privilege.
Answer: D. Ask her what her goals have been with the other therapist and request a release to speak with that therapist.

Asking her what her goals have been with the other therapist and requesting a release to speak with that therapist is the best course of action at this time. It is only unethical to have two therapists, if the therapists are working on the same material. It must be clarified what this client is working on in therapy with this other therapist before proceeding.
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Question: 8. Cherilyn, your client of six months, tells you that she's recently begun having an affair with Tony. As she discusses their affair, you realize that Tony is another one of your clients whom you've been seeing for the past year with his wife and two teenage children. In order not to contaminate the therapeutic relationship with Cherilyn or Tony, what would you do?

Content Area: Ethics: Professional Competence and Preventing Harm. This question checks your ability to make distinctions between difficult ethical choices and tests your understanding of dual relationships.

A. Gently terminate with Cherilyn without telling her why. This preserves confidentiality, and since you've been seeing Tony and his family longer, you owe them more professional allegiance.

B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case.

C. Call an attorney and discuss legal issues around dual relationships so you can determine the best action to take.

D. Continue seeing Cherilyn as usual. Ask Tony in for a private conference so you can ask about his commitment to his marriage and family, being careful not to break any confidences.
Answer: D. Call your client.

You must call Cynthia to proceed. You cannot confirm or deny that Cynthia is your client until she signs a statement allowing you to assert or waive privilege on her behalf.
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Question: 9. A 25-year-old African-American male client tells you that he can't find a job, and he blames it on racism. He believes that he is qualified for the jobs he applies to but does not have a college diploma. He tells you that he was told that a high school education would open doors. How would you respond to this?

Content Area: Ethics: Therapeutic Relationship/Services
This tests your knowledge of human diversity issues.

A. Encourage him to consider actual shortcomings he may have.

B. Acknowledge the effects of racism and listen to his perspective.

C. Challenge his irrational thinking and refer him to a vocational counselor.

D. Validate his perspective until he is ready to take responsibility for his failures.
Answer: C. Suggest Janet take anti-depressants.

As an LCSW, you would refer the client to a psychiatrist but you would not suggest a client take medication.
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Question: 10. Your client comes to a first session in a crisis. You do not have time for a full informed consent conversation, but you tell the client the fee and your license number. What is your legal obligation now?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of informed consent and record-keeping.

A. Document your informed consent conversation within 5 days.

B. Document your informed consent conversation within 10 days.

C. Document your treatment plan now that the crisis has passed.

D. Document your crisis interventions in the first session.
Answer: A. Scope of competence.

Anything that interferes with a clinician's ability to perform to the standard of care would be a scope of competence issue.
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Question: 11. A client announces a desire to terminate therapy at the beginning of your fifth session. The client would like to become friends and tells you that the two of you could have the same kind of conversations but they could go on longer. She tells you that she is already interviewing other therapists which is "better for me because they take insurance." You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical standards as they pertain to dual relationships and termination.

A. Respect her wishes to terminate and explain that you will not respond to emails or social network posts that invite your friendship.

B. Attempt to process her desire to terminate as clinical material.

C. Seek consultation in case your counter-transference conveyed to your client that you wanted to be friends.

D. Tell her you cannot terminate therapy under these circumstances.
Answer: D. Waive your "no secrets" policy and call the wife to assess whether she is currently in danger.

Ethically, the clinician would be best advised to assess as soon as possible whether the wife is in imminent danger and to plan accordingly. Perhaps the wife needs an immediate referral to a domestic violence shelter and assistance in making a safety plan. Waiting until the next appointment may place the wife in danger.
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Question: 12. Your client Juan tells you that his brother, Jose, was stabbed to death a year ago by his cousin in a drug deal gone bad. Juan further states that he told his cousin that he intends to murder him for stabbing Jose, but he is going to wait until his aunt dies because she would be too upset by the death of her only son. He tells you that the cousin lives in another state, but he will find him when the time comes. In this situation, what is your legal responsibility?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a possible Tarasoff situation.

A. Under the Ewing v. Goldstein decision you must contact the aunt and warn her about the threat to kill her son.

B. Under the Tarasoff decision you must call the police and warn the victim.

C. Maintain confidentiality.

D. This is privileged information and may not be disclosed without a subpoena.
Answer: D. Review dual relationships with your client, and healthy client-social worker boundaries.

Of the answers provided, reviewing dual relationships with your client, and healthy client-social worker boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be too uncomfortable for your client, or create any therapeutic problems. Of the options provided, it is the most reasonable.
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Question: 13.You have been seeing Amber and John as a couple when they announce their upcoming wedding plans and invite you to attend. They warmly thank you for your help and say they want you to be included in their special day. Your best response would be:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to manage dual relationships.

A. Thank you, but social workers are not allowed to have interaction with clients outside of therapy.

B. Thank you for your acknowledgement of our work together. Let's discuss the implications.

C. My policy is that I will attend the wedding, but not the reception.

D. I will attend, but because of confidentiality, I must be introduced as a friend or teacher rather than your social worker.
Answer: A. Maintain computer security, i.e. firewalls, passwords, etc.

The client is worried about a security breach. Even though you are not responsible, you are ethically obligated to make sure that your practice adheres to privacy measures in the age of digital information transfer.
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Question: 14. While checking messages at the end of the day, you listen to a voicemail from a girl named Megan. She states that she got your number from her friend Claire whom you "helped a lot a couple of years ago." Megan says she's having a hard time getting used to high school and feels like she "doesn't fit in anywhere." Megan asks if she can see you tomorrow and says she doesn't want her parents to know. Before treating Megan without parental consent, you need to determine that all of the following factors are present EXCEPT:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to proceed with consent to treat a minor.

A. Megan is at least 12 years old.

B. Megan is mature enough to participate in therapy.

C. Megan is a danger to herself or others without treatment.

D. There is a good reason not to include Megan's parents.
Answer: D. A 17-year-old client.

A person who is under age 18 cannot initiate a 5150.
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Question: 15. Felix, a 30-year-old Caucasian, has been placed on administrative leave for excessive absences and is referred to you by his EAP. His partner Pablo, a 32-year-old Peruvian-American, joins him in the session. Lately they have been "fighting all the time," and at work nobody knows that they are a couple because Felix fears they'll be fired. Felix begins to cry and says, "I saw Pablo staring at another man, and I'm worried because I've been hurt in past relationships, and I'm sad because it's happening again." How would you incorporate the cultural diversity issue of a gay, bi-cultural relationship into your treatment plan?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to assess the impact of cultural diversity on the counseling relationship.

A. Create gay-friendly goals that consider each of their cultural backgrounds.

B. Refer Pablo to a 12-step group for gay men.

C. Manage your counter-transference if you have a negative reaction to any of the presenting issues (e.g., gay relationship, substance abuse, staying in the closet, etc.) that are impacting your objectivity.

D. Invite them to explain how their different cultural backgrounds impact their relationship.
Answer: C. Need a written release signed by both Sue and Jerry before you can communicate with the court.

Since Sue and Jerry are your clients, you must get a written release from both before divulging any information about them.
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Question: *16. You are treating a woman in therapy for mid-life issues. A month into treatment her husband calls to discuss her progress and the expected length of treatment because his insurance only covers 18 sessions of mental health. She told you that he might call and gave you his name so you are not surprised. Legally:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal issues that pertain to treatment.

A. You could speak with him because she told you his name and you expect the phone call.

B. Before the insurance runs out, negotiate a cash fee with the client.

C. Provide informed consent if you plan to adjust her treatment to end within 18 sessions.

D. Tell her about the husband's phone call and any fee changes that might result from a change in her insurance coverage.
Answer: A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you.

Before you take on a new case, you want to consider your level of education, training and experience to determine if you are capable of treating this client or if consultation is needed. Also, you need to consider this client's goals. If the client wants help with relationship issues, this is within your scope of practice, but if the client's needs are not relationship-oriented, then this case would be out of your scope of practice.
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Question: 17. Your child's piano teacher sees you at a P.T.A. meeting and says she's heard that you are a good psychotherapist and asks if she can make an appointment to see you. She says her mother recently passed away and that she is now her elderly father's caretaker. She says "the situation is bringing up a lot of anger" for her because her father sexually abused her when she was a child. In this situation, you should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical behavior regarding potential dual relationships.

A. Report the abuse to Children's Protective Services.

B. Decline to make an appointment and refer her to another therapist.

C. Report the abuse to Adult Protective Services.

D. Make an appointment and try to help her work through the grief and anger issues.
Answer: D. Evaluate the seriousness of her depression to determine if you can treat her.

The social worker's ethical obligation is to determine if the client will benefit from treatment, which requires an assessment of the presenting problem.
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Question: 18. Darren and Samantha are referred to you by Samantha's psychiatrist. Samantha's psychiatrist has diagnosed Samantha with Schizophrenia. Darren says that he hasn't been sleeping and can't concentrate at work, and that he's afraid to do the shopping himself because when he goes out his heart pounds, he thinks he's going crazy, and it would be embarrassing to him. Darren says he's at the end of his rope and isn't sure he can take Samantha's behavior much longer. When he asks how therapy will help, you would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to provide clients with information about the social worker's training and experience.

A. Have Darren authorize the consent form for Samantha as her dependent adult care custodian.

B. Refer to a support group for families dealing with mental illness.

C. Ensure that Samantha and Darren understand and sign your informed consent document.

D. Clarify Darren and Samantha's expectations about therapy.
Answer: A. Tell her if you have raised your fees.

You must disclose your fee before beginning therapy with a new or returning client.
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Question: *19. You have been seeing Nathan, age 70, for 5 months. He has been managing on his own with some help from his daughter, Pat, who visits frequently. For the past month you have been working with Nathan on his relationship with Pat. She has been frustrated with him because he has complained of being bored, but he won't do anything about it. In your next session he comes in with bruises on his forearms. He states that he fell while walking up the rickety front steps to his house. You would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your ability to differentiate elder abuse from other safety concerns for the elderly and to make the appropriate referrals.

A. Call Adult Protective Services immediately to file a neglect report.

B. Suggest a home improvement company specializing in safety for the elderly.

C. Suggest respite care.

D. Suggest a Senior Citizens' Center.
Answer: A. Refer them to a social worker who has experience with domestic violence issues.

The couple needs help with domestic violence issues. It should not be presumed that lesbian clients need lesbian social workers, or that social workers are uncomfortable working with gay and lesbian clients unless proven otherwise.
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Question: 20. After 6 months of treatment with Hermoine, she says that she wants to see a therapist whose sexual orientation is different than yours. After processing this over the next two sessions, you have two additional termination sessions, give her three referrals and terminate the therapeutic relationship. Several weeks later, Hermoine calls you in crisis and says her new therapist is out of town and isn't returning her phone calls. She asks you to help her. What would you do?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your decision-making process.

A. Help Hermoine with her crisis until her therapist returns.

B. It is unethical for you to work with Hermoine once you have terminated treatment with her and she has begun treatment with a new therapist.

C. Tell Hermoine that you will not be able to help her since she has terminated treatment with you.

D. Tell Hermoine that she should find out who is taking calls for her new therapist and speak with that person.
Answer: C. Legally responsible to intervene.

A clinician is not legally responsible to report a suicidal client, but is legally responsible to take reasonable steps to ensure the safety of a suicidal client which can be managed in a number of ways. Evidence Code 1024 allows clinicians to break confidentiality when a client, due to a mental disorder, is a danger to self or the property of another and breaking confidentiality would prevent the threatened harm.
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Question: 21.
Answer: A. Discuss with Shelly the nature of the therapeutic relationship and explore her feelings and assumptions.

Shelly is beginning to view the therapeutic relationship differently than the social worker views it. It would be your ethical obligation to explore with Shelly her assumptions, so that corrective work can be accomplished, and at the same time, the relationship can be strengthened.
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Question: 22.
Answer: C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent.

Joint custody may require one or both parents to consent. You must look over the custody papers to review what the court mandates.
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Question: 1. Two social workers are dating. They are at dinner and they are talking about their clients. They discover that each of them is seeing a different member of the same couple for individual therapy. What should these social workers do?

Content Area: Law: Confidentiality, Privilege, and Consent
This question is about the legal responsibility of social workers outside of the therapeutic setting discussing a client.

A. No action is necessary since licensed health professionals may consult for purposes of diagnosis and treatment without a release.

B. Stop the discussion and obtain releases so that such discussions in the future do not breach confidentiality.

C. Stop the discussion and do not talk about these clients again.

D. There are no legal or ethical guidelines requiring social workers in such situations to do anything.
Answer: A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so.

In custody or visitation proceedings, if a child is represented by an attorney, that person has the right to obtain a child's clinical records or to interview the assessing or treating social worker. Ethically, you would also discuss this confidentiality issue with your client.
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Question: 2. Revocation of a LCSW's license after having been found to have engaged in sexual misconduct with a client would occur after:

Content Area: Ethics: Professional Competence and Preventing Harm
This question tests your knowledge of the penalties for social workers having sex with a client.

A. A social worker filed a complaint with the BBS on behalf of a client.

B. The BBS found that the therapist terminated therapy in order to pursue a sexual relationship.

C. The social worker gives the client the pamphlet "Professional Therapy Never Includes Sex" and discusses it with the client.

D. The BBS cites the offending social worker within 10 years of the statute of limitations.
Answer: A. Discuss a new fee arrangement before changing the fee.

Legally, you must discuss and agree to any fees or changes in fees before treatment at that fee begins.
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Question: 3. Your client, George, tells you that his mother just got remarried. He tells you that he is worried that the new husband's children are going to go after his inheritance. He tells you that he has very little contact with the new family and wants to keep it that way. What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question tests your knowledge of how to proceed when you may need to assess for or report elder abuse.

A. You must asses for elder abuse, considering "undue influence" regarding the mother's estate.

B. You should refer the client to an attorney to determine if he has a case.

C. Maintain confidentiality because you do not know the age of the mother.

D. Report elder abuse, considering "abandonment" because he has "very little contact" with his mother.
Answer: A. Determine the family's understanding of the purpose of the therapy.

Ethically, you would want to clarify the client's purpose.
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Question: 4. Ki is a 26-year-old Korean who immigrated to the U.S. with his father 10 years ago. Ki wants to be an artist but his father has saved his money and demands that Ki goes to medical school like his grandfather. Ki says he's depressed and he would rather die than become a doctor. He says he's too stupid to pass the classes in medical school anyway. He doesn't know how to tell his father. The social worker determines that Ki is not suicidal. The most appropriate ethical intervention is to:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical obligations that pertain to cultural competence.

A. Recognize the importance of cultural considerations and acknowledge that Ki may have to follow his father's wishes.

B. Ask Ki to bring his father in for a family session because of cultural values that encourage respect for elders.

C. Inform Ki that the risks and benefits of therapy may be that he "finds himself" but may change some of his family values.

D. Ask to see Ki's artwork to reframe him as an individual and your alliance as a place where he can be an individual.
Answer: C. Take reasonable steps to ensure her safety.

This legal precedent demands that we take reasonable steps to ensure the safety of a suicidal client. It doesn't say how it must be done.
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Question: 5. June discloses that she had been molested by a step-brother when she was 15. She is now 28 and was divorced from her husband three years ago. Before seeing you, she saw another therapist and she has just told you that she had sex with him. She wants therapy to focus on the stormy relationship issues that led to her divorce, not on past sexual molestation or exploitation. You would:

Content Area: Law: Legal Standards for Professional Practice, tests your understanding of the legal responsibilities of therapists who learn that a client has had sex with a previous therapist.

A. Respect her wishes and continue to focus on resolving the issues on which she wants to work.

B. Give her the brochure "Professional Therapy Never Includes Sex" and discuss her options.

C. Report the therapist to the BBS to protect the other therapist's present and future clients.

D. Work on the sexual exploitation in therapy.
Answer: C. Call Barbara's ex-boss and warn him of her plan.

Warning the victim may be done in the interests of protecting the public and protecting the social worker from liability related to breaking the confidentiality of the potentially dangerous client. As of 2014, there is only a legal responsibility to contact law enforcement within 24 hours. After doing that, warning the potential victim is next.
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Question: 6. Dr. Sveda has been treating Carliss for seven years during which time the fee has been $50. Carliss finally earns his Ph.D. and gets a job for substantially more money than he had been making. Dr. Sveda tells Carliss he'd like to revisit the fee that Carliss has been paying. Carliss becomes quite upset and tells Dr. Sveda that it would be unethical for him to raise the fee. Dr. Sveda calls for consultation and is given the proper answer which is that social workers are discouraged from increasing a client's fees:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical considerations in raising client fees.

A. Without providing adequate notice.

B. To avoid exploitation of the client.

C. Unless all client fees are increased.

D. According to strict ethical standards for the mental health profession.
Answer: B. Refer the client back to the insurance company.

Clients who are referred by insurance companies should be referred back to the payor to get another referral. This way, they can be more sure that their sessions will be financially covered.
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Question: 7. Joe and Marcie Green and their three children ages 12, 15 and 17, have been in family therapy with you for about 9 months on a regular basis. Joe says that they are getting along much better. Marcie says that the children seem to be willing to spend more time at home and are arguing less with each other. They think that things are so much better that they are ready to end treatment. What is your ethical obligation after deciding to terminate family therapy?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical obligations that pertain to provide clients with information about the therapeutic process, which includes termination.

A. Recommend staying in therapy if there are any regressive symptoms in any individual.

B. Document your agreement with them that they are ready to terminate.

C. Recommend individual therapy if there are any regressive symptoms in any individual.

D. Terminate because ethically you are not permitted to extend treatment beyond a client's ability to benefit.
Answer: D. Maintain confidentiality and retain the client's files for 7 years.

It is your legal responsibility to maintain confidentiality even after the death of a client. Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015).
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Question: 8. Which of the following is true in a court custody case?

Content Area: Law: Confidentiality, Privilege, and Consent
This question examines the parameters of privilege.

A. A minor does not hold his/her own privilege.

B. The court may appoint an attorney to represent the best interests of the child.

C. The parents can waive their child's privilege.

D. The parents' attorney can waive privilege on behalf of the child.
Answer: A. You indicate to your client that she can give your number to the program coordinator.

This response is the best choice. By letting the program coordinator contact you, you can avoid exploiting the client in order to advance a relationship with the program coordinator.
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Question: 9. How should physical abuse of a dependent adult be reported by a mental health professional?

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question tests your understanding of the legal issue of reporting dependent adult abuse.

A. If there is serious bodily harm, within 24 hours.

B. By telephone within two working days and in writing as soon as possible.

C. By telephone as soon as possible and in writing within two working days.

D. By telephone as soon as possible and in writing within 36 hours.
Answer: A. Contrary to the spirit and intent of ethical standards.

Ethical standards encourage social workers to disclose, at the appropriate time and in the context of treatment (such as when clients request the information), information about their education, experience, training, theoretical information, etc.
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Question: 10. Jessica, age 14, comes to see you with her mother. She appears withdrawn and fatigued and refuses to speak with you. Her mother explains that in the last few months Jessica's behavior has changed drastically. How would you manage this family's treatment needs from an ethical perspective?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the steps to take in starting treatment with a new family unit.

A. Explain the family systems model.

B. If you are unable to make progress with the family, give them three referrals.

C. Evaluate how willing the mother is to reframe the problem as the "family problem" rather than Jessica as the problem.

D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually.
Answer: A. Inform them that it would be unethical and help them find a way to pay for continued therapy.

It is unethical to enter into bartering dual relationships with clients. It is also important not to abandon clients. This answer provides many opportunities to help the clients, including adjusting your fee.
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Question: 11. Your former supervisor refers a client to you and suggests that you split the client fee as you did while under her supervision. You would:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to manage referrals that meets ethical obligations.

A. Report this unethical behavior to the BBS.

B. Negotiate a new split fee arrangement.

C. Inform the supervisor that it is unethical to split fees.

D. Inform the supervisor that since you are now a licensed social worker she can only get 25% of the client's total fee.
Answer: B. Self-harm behavior.

Self-harm behavior is not a type of dependent adult and elder abuse. Welfare and Institutions Code defines dependent adult and elder abuse as knowledge or reasonable suspicion of the following: physical abuse, abandonment, isolation, neglect, financial abuse, and abduction.
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Question: *12. You are given an unwrapped book of inspirational religious poetry by one of your clients as a holiday gift. This book strongly contradicts your personal religious beliefs. You decide to:

Content Area: Ethics: Professional Competence and Preventing Harm
This question tests your ability to deal with the therapeutic alliance and potential counter-transference in light of gift-giving.

A. Accept the gift in the spirit in which it was given and say nothing about your spiritual beliefs.

B. Evaluate what would be in the client's best interests and how accepting or rejecting the gift might affect treatment.

C. Gently explain to your client that you cannot accept such a personal gift.

D. Thank the client for her thoughtfulness but let her know that your policy is that you don't accept gifts from clients.
Answer: B. Providing informed consent.

From an ethical standpoint, the therapist is providing the client with information to help the client assess his/her desire to be in therapy, which is the intent of informed consent.
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Question: 13. Which of the following techniques would be considered out of a mental health professional's scope of competence if they did not receive the needed specialized training?

Content Area: Law: Legal Standards for Professional Practice
This question focuses on your knowledge of a mental health professional's scope of competence.

A. Couples therapy

B. Hypnotherapy

C. Psychotherapy

D. Adolescent therapy
Answer: B. Consult with professional peers regarding your discomfort.

You want to be aware of how your discomfort may impact the therapy and, as an initial step, deal with it through research and consultation with colleagues.
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Question: 14. You terminated therapy with Margaret after 3 years because she wanted to work with a therapist with her same sexual orientation. You gave her a referral to a new therapist who she has seen a few times. Several weeks later Margaret leaves you a message saying that she is having a conflict at work and wants to speak with you because only you can help her. When documenting this call you would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to document your care for a client, even a former client.


A. Note that you told her that you cannot ethically treat her because she is already in treatment with another therapist.

B. Indicate that you assessed her risk as "low" and suggested that she call her therapist

C. Confirm that you had a signed termination agreement.

D. Get a release to speak with her other therapist to coordinate care.
Answer: B. Give the doctor the information he needs.

Give the doctor the information he needs. Civil Code 56.10 (The California Medical Information Act) gives licensed health professionals the ability to consult for purposes of diagnosis and treatment without a release authorization.
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Question: *15. You've been treating a woman who is in the midst of a divorce. You receive a subpoena in the mail from her husband's lawyer asking for your client's records. You:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to respond to a subpoena.

A. Contact your client to determine if she wants you to waive or assert privilege.

B. Would contact the husband's lawyer and assert privilege.

C. Ignore the subpoena since there is no one to whom you can assert privilege.

D. Must comply with the subpoena since it is an official court document and you would otherwise be in contempt of court.
Answer: C. Tell the client what you plan to tell the school.

The best ethical approach before speaking with the school, even if your disclosure is narrow, is to discuss it with the client first.
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Question: 16. Mike, your 17-year-old client, has a history of fire-setting. He is in therapy as a result of a court order and his parents know he is in treatment. He tells you that he is angry with his ex-girlfriend and says that he plans to set fire to her house tonight. What should you do?

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question is assessing your ability to determine a Tarasoff situation.

A. Call his parents so they can be sure that he doesn't go unsupervised.

B. Maintain confidentiality.

C. Call the police immediately and his ex-girlfriend's family.

D. Call the police immediately.
Answer: C. Change the diagnosis when you have confirmed it on any insurance forms.

To avoid fraud you would have to code the diagnosis you currently are considering and change it when necessary.
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Question: 17. A social worker consults with another professional about a particularly challenging case. Has an ethical violation occurred?
Content Area: Ethics: Professional Competence and Preventing Harm
This question assesses your ability to collaborate with other professionals when issues arise outside the social worker's expertise.

A. Yes, if the social worker does not reveal confidential client information to the other professional.

B. No, if the social worker does not reveal identifying information about the client to the other professional.

C. Yes, if the social worker has a signed consent by the client to consult.

D. No, if the other professional agrees to keep the client information confidential.
Answer: C. Accept the gift and explore what it means for her to give you the muffins.

Appropriate gifts (inexpensive, non-romantic, etc.) may be accepted by social workers without impairing their judgment or exploiting the client and should be processed to be most ethical.
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Question: *18. When unable to reach a client by phone, a social worker texts the client's mother to tell her that her son is talking seriously about running away from home because of the step-father's abuse. She texts back to tell you that he is home safely but "thanks for the heads-up." What are the social worker's ethical obligations regarding the confidentiality of minors?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to handle informed consent about the limits of confidentiality in the treatment of minors.

A. Obtain written informed consent from the minor that allows texts to parents in an emergency.

B. Tell minor clients how you will contact parents if you think there is an emergency.

C. Tell minor clients that you will show them any texts from parents.

D. Obtain informed consent from parents about your mandates to break confidentiality.
Answer: A. Refer the client to another therapist and disclose the reasons.

Treating a client who was dating a member of the social worker's family would constitute a dual relationship, and the most ethical way to proceed would be to give the client some referrals.
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Question: *19. Maria and Juan have been seeing you for couples' counseling for six weeks. In the 7th session, Maria brings you a batch of fresh, hot, home-baked oatmeal raisin cookies. You would:

Content Area: Ethics: Business Practices and Policies
This ethical question, with a flair of human diversity, reviews ethical policy as it relates to gift giving.

A. Accept the cookies and explore their meaning with Maria and Juan.

B. Refuse the cookies and explore their meaning with Maria and Juan.

C. Accept the cookies and eat one immediately.


Answer: C. Tell them that using their son's "mental anguish" in a lawsuit could compromise their confidentiality in therapy.

Although you must avoid giving legal advice, you could tell the parents of the potential risks of introducing their son's mental state in a legal proceeding, i.e., that it nullifies the privilege of therapy sessions with them and their son.
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Question: 20. You are conducting a research study on divorce. In the informed consent process, what information do you need to provide your clients?

Content Area: Ethics: Business Practices and Policies
This question assesses your knowledge of procedures when conducting research using human participants.

A. The importance of the client remaining in the study until the very end to maintain the validity of the study.

B. That dual relationships may be inevitable due to the nature of the study.

C. That any information obtained may be used in the study.

D. The client has the right to withdraw from the study at any time.
Answer: C. Return the sweater and encourage the man to bring it up in session.

Returning the sweater and encouraging him to bring up the topic in session allows for the agreed-upon payment arrangement to be maintained and avoids collusion with the husband.
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Question: *21. If a social worker digitally recorded a session with a client and then receives a subpoena for records because the client is claiming emotional distress, the recorded session would be provided to the court if:

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question tests your knowledge of how to respond to a subpoena.

A. The client signed a release to record a session.

B. The client signed a waiver of privilege for the records.

C. The client signed a consent form allowing the session to be videotaped.

D. Digital recording must be disclosed with any records in a subpoena.
Answer: B. Notification to the person signing the agreement that they have a right to receive a copy of it.

An Authorization to Release Confidential Information form must contain a statement that the person signing the agreement is entitled to a copy of the agreement.
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Question: *22. A client is referred to you by his attorney. The client tells you that he is reluctant to talk to you because he doesn't want what he says in therapy coming out in court. Choose the statement that could BEST explain privilege to this client:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of privilege. You must be able to distinguish between confidentiality and privilege as well as between law and ethics.

A. It is an ethical concept involving the right of a social worker to withhold information in a legal proceeding.

B. It is a legal and ethical principle which involves a restriction on the volunteering of information about a client.

C. It is a legal principle that protects client conversations unless there is a court order.

D. Attorney/client privilege extends to the client of a social worker that the attorney uses for referrals.
Answer: A. Inform her of the results in language she can understand.

Ethics require that therapists explain all of therapy, including assessments, in terms a client can understand.
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Question: *23. A client who was referred by his rabbi comes in to see you for issues of grief related to the loss of his mother two weeks ago. Recently your mother died too. What would you do FIRST?

Content Area: Ethics: Professional Competence and Preventing Harm
This question tests your knowledge of how to manage counter-transference.

A. Talk about this situation in your own therapy.

B. Seek professional consultation.

C. Refer the client to another mental health professional who specializes in grief and loss issues.

D. Determine if you can deal with this client at this time.
Answer: C. Talk with the client about the risks of dual relationships.

No matter how a dual relationship emerges, on the internet or in a session, the social worker's ethical obligation is to discuss the risks and avoid it if possible.
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Question: *24. Steven comes to you for help with debilitating anxiety. He says that his anxiety is beginning to interfere with his relationships and his job. He is afraid to drive his car because he thinks that he is going to hit someone. He doesn't know how he will ever take a girl out on a date or get to work if he doesn't get control over this. He thinks he should be able to get over this by himself. The therapist should begin by:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical obligations when selecting treatment interventions.

A. Teaching him relaxation techniques and pairing those with thoughts and images of driving his car.

B. Explaining the benefits of a behaviorist approach for severe anxiety.

C. Documenting in an initial treatment plan the client's goals for treatment of anxiety.

D. Assessing whether a medication evaluation would be necessary.
Answer: A. Ask them to educate you about important differences and to tell you how these relate to their presenting problem.

A policy where you model appropriate communication skills will allow your clients to feel more comfortable and facilitate discussion of diversity issues.
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Question: *25. Which of the following is not considered by law to be unprofessional conduct by a social worker?

Content Area: Law: Legal Standards for Professional Practice
This question asks you to identify unlawful unprofessional conduct.

A. A conviction after pleading no contest to a DUI.

B. Thanking a friend for a referral by taking her out to dinner.

C. Being arrested for shoplifting.

D. Poor record keeping.
Answer: C. Tell the colleague that her actions violate ethical standards.

Social workers do not operate as "snitches" on other social workers. However, it is ethically appropriate for us to confront a social worker who is engaging in unethical practices.
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Question: 26. A social worker has been working with a client who informs the social worker that he has been living as a woman since he was 35. He is now 45 and wants to begin transitioning into an anatomical woman. The client tells the social worker that he already has confirmed that his insurance will pay for it but he is self-employed so it is going to be very expensive. How should the social worker proceed?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage diversity from an ethical point of view.



B. Use a the client's signed consent form to determine if he signs it as a woman or as a man.

C. Include a diagnosis of "Gender Dysphoria" on any insurance forms if he signs a release to allow this.

D. If the social worker feels that any counter-transference will impact the therapy, refer the client to a specialist.
Answer: A. Maintain confidentiality.

Claire is 18 and considered an adult. Thus, making a report would be breaching confidentiality. Social workers do not report historical abuse. Your legal obligation is to maintain Claire's confidentiality.
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Question: 27. You find out that your 14-year-old client's mother is beating her for not making her bed in the mornings. You have determined you need to make a child abuse report. What is your legal responsibility as a mandated reporter?

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This test item addresses your responsibility as a mandated reporter.

A. To contact an agency designated to take a report and follow up with a written report within 36 hours.

B. To contact an agency designated to take a report and follow up with a written report within forty-eight hours.

C. To contact an agency designated to take a report and follow up with a written report within two working days.

D. To contact an agency designated to take a report and follow up with a written report within seventy-two hours
Answer: D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey.

If any fees are associated with clinical practice, social workers are legally obligated to disclose them before providing a service.
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Question: 28. After working with a rape survivor for 3 weeks, the social worker determines that the client would benefit from an adjunctive referral to a therapist who specializes in EMDR. All of the following would be clinical considerations in making such a referral except?

Content Area: Ethics: Professional Competence and Preventing Harm
This question addresses issues related to using concurrent social workers.

A. It would be necessary to obtain a release in order to work collaboratively with the EMDR therapist.

B. The treatment plan may need to be modified, as the trauma-related symptoms may begin to shift and lead to other issues that need processing.

C. The social worker should not make this type of referral yet as the client is still in a vulnerable condition.

D. There may be an impact on your therapeutic relationship with this client who may compare or feel torn between two therapists.
Answer: A. Allow the client to inspect the records, receive a copy, or receive a summary.

Allowing the client to inspect the records, receive a copy, or receive a summary is what the law requires social workers to do. Social workers may also, under limited circumstances, refuse the client any access to the records at all if they feel that the release of the records will be harmful to the client.
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Question: 29. You are working with a 13-year-old client whose parents are going through a divorce. She texts you one day to tell you that even though she lives full-time with her mother, her dad is now hiring a lawyer for her to come live with him. You receive a subpoena for your records for the purpose of a custody hearing. You would:

Content Area: Law: Confidentiality, Privilege, and Consent
This question evaluates your understanding of how to respond to a subpoena.

A. Assert privilege until a guardian ad litem has been appointed for the client.

B. Contact the parent under whose authorization you are treating the 13-year-old and assert or waive privilege, depending on that person's wishes.

C. Speak to both parents and assert or waive privilege depending on their wishes.

D. Release the records in order to comply with the subpoena and avoid being in contempt of court.
Answer: C. You've taken a practical course on EMDR and have obtained certification.

Taking courses and obtaining certification demonstrates a minimum level of competence to be able to use EMDR in your own practice. Continual education will keep you current on EMDR practices.
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Question: *30. In her first session, Shannon, who is highly anxious, asks you how long therapy will last. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question is checking your understanding of developing a therapeutic alliance and the importance of explaining the process of therapy at the outset of treatment (informed consent).

A. Interpret her question as an anxiety reaction.

B. Outline the process of treatment.

C. Encourage her to explore the concerns that brought her to therapy.

D. Explore past therapy experiences.
Answer: A. If you have a sobriety contract in place, terminate any session at which Pablo comes in intoxicated.

If a client is unable to benefit from therapy, it is ethical to end the session.
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Question: *31. After being in weekly therapy for 9 months, the client asks if she and the social worker can use telehealth to have sessions on an as-needed basis. If the social worker determines that this is clinically appropriate, what does the social worker need to do to make sure that online sessions are legal?

Content Area: Law: Legal Standards for Professional Practice
This question tests your knowledge about the legalities associated with fee negotiations.

A. Disclose any fees which are different from in-person sessions.

B. Tell the client about confidentiality protections she must have on her computer.

C. Maintain separate files for the different modalities.

D. Get her consent for video recording in writing.
Answer: C. Ethically working within your scope of competence.

Ethically and legally, you may tell your clients about laws which affect their treatment as long as you don't give legal advice.
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Question: 32. In your first session with Peter and Veronica, they disclose to you that although they have a five year relationship, Veronica is married to someone else. You should:

Content Area: Ethics: Professional Competence and Preventing Harm
This question pertains to issues impacting conjoint therapy.

A. Refuse to see Veronica but counsel Peter.

B. Refuse to counsel either of them until Veronica tells her husband about this affair.

C. Counsel both of them.

D. Counsel Veronica and her husband.
Answer: C. Only share information with those providers that advance the welfare of the client.

Ethics codes are primarily designed to assure that therapists balance the best interests of the client in their sociocultural context with clinical competence. Sharing information with other providers, if it is confidential and clinically appropriate, fulfills this ethical obligation.
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Question: 33. A couple comes in to see you for therapy. They are referred by the wife's individual therapist. The husband has recently discovered his wife has been cheating on him and he is unsure if he wants to continue the relationship. What is solely an ethical responsibility in treating this couple?

Content Area: Ethics: Therapeutic Relationship/Services
This question addresses your ethical responsibility in treating a couple.

A. Getting a signed release from both the husband and the wife to speak with the wife's therapist.

B. Designating a fee prior to the commencement of therapy.

C. Informing the couple of your "no secrets" policy.

D. Having the wife sign a release to speak with her therapist.
Answer: B. A provisional diagnosis.

Informed consent would NOT include a provisional diagnosis. The main purpose of informed consent is to give your client information about your services and the process of psychotherapy so that they may make an informed decision about treatment.
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Question: *34. Gladys, age 65, reports she has kicked her 67-year-old husband when it looked like he wasn't listening to her. He tells you that his hearing is poor and most of the time he heard her the first time anyway. What would you do?

Content Area: Law: Limits to Confidentiality/Mandated Reporting
This question addresses the parameters involved in reporting elder abuse.

A. Report immediately to Adult Protective Services and make a written report within 2 working days.

B. Refer him to an MD for possible improvements in his hearing.

C. Since they are spouses, do conjoint work pertaining to anger management.

D. Maintain confidentiality since you are not mandated to report since both spouses are 65 and older.
Answer: D. Send his records as requested.

Sending his records is the correct answer. Mental health professionals do not withhold patient records or information solely because the practitioner has not been paid for therapy services.
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Question: *35. Toward the end stages of therapy a client asks his social worker if they can use text or email between sessions to communicate as the final sessions get more spread apart. The social worker suggests that texts and emails won't really get the client used to less contact; they will only be substitutes. The social worker has:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to respond ethically to clients' requests about changing treatment.

A. Provided ethical informed consent.

B. Legally maintained confidentiality.

C. Legally avoided client abandonment.

D. Avoided a dual relationship.
Answer: A. Make appropriate referrals.

Making appropriate referrals is the ethical course of action when a social worker is unable to provide services.
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Question: *36. You get a call from the emergency room regarding one of your clients who was brought in by the PET team and is incoherent, delusional, and unstable. While they were going through his belongings they found his driver's license and your card. The psychiatrist on call wants to know if you can give them any information about this person that might be helpful. You would:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to protect client safety and confidentiality at the same time.

A. Assist them with information you deem pertinent to the situation at hand.

B. Inform them that you cannot confirm or deny if this person is your client.

C. Tell them that they will have to obtain a release signed by the client and fax it to you before you can disclose any information.

D. Ask to speak with your client before disclosing any information.
Answer: B. Determine if the client is a resident of California.

The social worker must conform with the law, which requires that the client reside in the state of California.
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Question: *37. You have attended a yoga class every Saturday morning for the last 5 years. Today when you arrive you notice your client signing in at the counter for the class you attend. What are your ethical responsibilities?

Content Area: Ethics: Professional Competence and Preventing Harm
This question tests your knowledge of ethical responsibilities regarding dual relationships and techniques to manage this responsibility.

A. Complete class as usual without acknowledging the client unless he/she acknowledges you and explore his/her reactions in your next session.

B. Leave immediately before the client sees you.



D. Say hello to your client, complete the class as usual, and incorporate yoga and body movement in your treatment plan.
Answer: B. No, because this is financial exploitation and does not demonstrate a clinically sound reason to terminate therapy.

This is not ethically sound because ethical standards state that mental health professionals do not financially exploit their clients or refer (i.e., abandon) for financial reasons. She is already paying by insurance, and you cannot change your payment policies without advance notice and a chance for the client to renegotiate.
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Question: *38. You contract with a family for ten sessions, as that is all their insurance would cover. After the ten sessions they want to continue therapy but can't afford your full fee. What would you do next?

Content Area: Ethics: Therapeutic Relationship/Services
This question addresses your management of insurance clients with limited coverage, your sensitivity to the ethical concerns of client abandonment and ethical standards.

A. Refer them to a low-fee clinic.

B. Accommodate your fee since you've established a bond.

C. Terminate with the family since you have met the terms of the contract.

D. Assess their motivation for continuing therapy.
Answer: B. Keep your opinions to yourself.

Deciding what to do with a pregnancy is a decision the couple must live with, not the social worker.
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Question: *39. Cheryl and Bobby are in joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. It would be appropriate for Cheryl to:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to assess and address other professionals' competence if it endangers clients.

A. Avoid making any referrals to Bobby.

B. Offer to take some of his caseload.

C. Engage Bobby in a therapeutic conversation.

D. Report Bobby to a regulatory body.
Answer: D. Questionable at best and unethical since it is close to paying for referrals.

Setting up this type of incentive for making referrals is close to paying for them and is unethical and illegal.
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Question: 40. A "5150" or involuntary confinement may be invoked by:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question pertains to your knowledge of who can invoke a 5150.

A. Any licensed mental health professional.

B. A peace officer, staff member of an evaluation facility, or other professional person designated by the county.

C. Family members of persons to be confined.

D. All of the above.
Answer: B. Would report the incident to Adult Protective Services immediately.

A dependent adult is legally defined as someone between the ages of 18 and 64 who is emotionally, financially, or physically unable to care for him/herself. Since Greg is in a wheelchair and has a nurse attending to him, he would be considered a dependent adult. Therefore, this would be reportable to Adult Protective Services immediately by phone, followed by a written report within 2 working days.
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Question: *41. A client joins a social worker's church congregation. The social worker should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how you would handle a situation involving a potential dual relationship and boundaries.

A. Leave the congregation.

B. Tell the client s/he needs to join a different congregation.

C. Stay in the congregation but avoid direct social interactions.

D. Review dual relationships with your client and healthy boundaries.
Answer: A. Remind him of your no secrets policy and encourage the husband to tell his wife about the phone call and the gun.

Reminding him of your no secrets policy is the only answer that implies that you have informed your clients of a no secrets policy and it focuses clearly and correctly on how to resolve this therapeutic issue.
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Question: 42. You are working with a family and learn that the father is neglecting the child. After making a report to CPS, you feel anger towards the father. What is/are the best way(s) to deal with your counter-transference?

Content Area: Ethics: Professional Competence and Preventing Harm
This question looks at your knowledge of appropriately handling counter-transference issues.

A. Journaling, peer consultation and individual therapy.

B. Journaling, progressive muscle relaxation, and diaphragmatic breathing.

C. Individual therapy, as you already know your anger won't be resolved through independent measures.

D. Refer the family to another therapist who specializes in victimized children and has her counter-transference issues resolved around these issues
Answer: A. Obtain a written agreement about the fees for therapy.

Although her text response could imply her agreement, it would be more legally sound to obtain her agreement to the fees in writing. The "K" does not necessarily prove that she read anything you sent.
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Question: 43. 13-year-old Brianna comes to the clinic where you are doing intakes and asks if she can get a social worker. You assess that Brianna is mature enough to participate intelligently in therapy and Brianna says she can pay for therapy if there is a low fee. In order for Brianna to be seen without parental consent, what other information would you need to know?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal requirements for treating a minor without parental consent.

A. That Brianna's uncle began to molest her a month ago.

B. That Brianna has daydreams of harming herself and no one in whom to confide.

C. You have sufficient reason to treat Brianna without parental consent.

D. That Brianna is in the process of petitioning the court for emancipation.


This answer contains the basic steps you must take when you know of or have reasonable suspicion of elder abuse, and it shows good clinical management in processing any feelings your clients might have about their social worker filing a report.
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Question: *44. Your client, Liz, is a 17-year-old female who is leaving for college out of town at the end of the month. She was molested by her uncle as a young child and is working through these issues with you. She has developed a close working relationship with you and wants to continue to work only with you. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the legal issues that pertain to treating clients who are moving.

A. Consult with a colleague about transference/counter-transference issues.

B. Make three referrals out of town.

C. Plan for weekly, hourly phone sessions with you.

D. See her on school breaks.
Answer: A. Determine the family's understanding of the purpose of the therapy and refer for an academic assessment.

Ethically, you would want to clarify the client's purpose. Since the referral was from the school, it could be in the client's best interests to assess the needs there.
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Question: *45. Your client missed a regularly scheduled appointment. Your policy, made clear to the client in your informed consent document, is that clients will be billed for missed appointments. The client asks you to bill the insurance company. What would you do?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate billing procedures.

A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.

B. Explain that billing insurance for missed sessions is insurance fraud.

C. Let it go, since by law, insurers cannot be billed for missed sessions and clients with insurance are not required to pay out of pocket.

D. Bill the insurance company for the session.
Answer: B. Explain the pros and cons of therapy.

This question is asking you to respond to a client's inquiry about whether therapy will be helpful. Explaining the costs and benefits of therapy addresses this concern.
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Question: *46. At your 12-step meeting you mention that you are a social worker. Some other participants ask if being a social worker makes you a good sponsor. If you tell them that sponsorship is not within your scope of practice you have:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to respond when clients want a service that is beyond your licensure to provide.

A. Failed to provide informed consent.

B. Fulfilled your ethical obligation to restore boundaries.

C. Legally fulfilled your responsibility to provide accurate information about your qualifications.

D. Legally failed to fulfill your responsibility to provide referrals.
Answer: D. Maintain confidentiality.

In this case, maintaining confidentiality is the best of the answer choices. If you subsequently had reason to suspect that the perpetrator had abused a person who is a minor, you would then be mandated to report to CPS.
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Question: *47. You are seeing a 52-year-old man who is unable to keep a job. He states that he always ends up fighting with his bosses who then fire him. During a session he makes a derogatory comment about his last boss' homosexuality. You find yourself becoming angry towards this client. What would you do?

Content Area: Ethics: Professional Competence and Preventing Harm. You must choose which course to pursue in response to your becoming angry at the client.

A. Disclose how you feel.

B. Seek consultation.

C. Refer him out.

D. Put your own feelings on the shelf and deal with the client's issues.
Answer: Codes devloped by mental health practioners for the purpose of setting professional standards for approproate behaviors, defining professional expectations and preventing harm to clients
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Question: *48. For several sessions, you have been working with a client who insists that he "will not rest" until he makes his son's teacher pay for the false child abuse report that the teacher made. He feels that his family has been shamed and anyone who does an internet search on him will think he is a child abuser. He tells you he would never "put hands on a woman, but I will think of something." The social worker's early intervention plan should include:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This questions tests your knowledge of how to assess for danger and the need to break confidentiality in a potential crisis situation.

A. Notifying the police and the teacher.

B. Creating a therapeutic environment where the client can speak openly.

C. Direct questions about his revenge plans.

D. Educating the client about the law regarding your mandate to over report child abuse.
Answer: Enhance human well being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed and living in poverty
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Question: 49. A social worker has been working with a difficult and resistant client for several months. The social worker might make some referrals to other social workers because:

Content Area: Ethics: Therapeutic Relationship/Services
This question checks your understanding of reasons to refer a client to a different social worker.

A. The social worker is having a counter-transference reaction.

B. The social worker and client both agree that it seems as if no further progress can be made.

C. The client probably needs a more directive and confrontational approach.

D. The client begins to miss sessions.
Answer: Social workers should protect the confidentiality of all information obtained in the course of professional service, except compelling professional reasons
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Question: *50. José, a 14-year-old Mexican-American boy, comes to therapy with his mother. He presents with a flat affect and avoids eye contact during the initial assessment session. During the assessment process, José remains quiet as his mother provides a list of José's symptoms and behaviors that she would like you, as the social worker, to address. Before the initial assessment session comes to an end, José requests that you meet with him individually from now on. After deciding that it would be appropriate to schedule individual sessions, what is your legal obligation?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal obligations that pertain to documentation.

A. Assess whether the absence of Jose's father is having an impact on his behavior or this session.

B. Refer his mother for individual therapy to avoid abandoning her as part of the treatment unit.

C. Document your decision to meet individually with José.

D. Ask his mother to sign a new consent form for him to be treated individually.
Answer: 1. Suspension of hurting one self
2. Suspensions of child abuse
3. Suspension of hurting others
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Question: 51. When writing notes about your client's therapy, which of the following information would not be kept in a client's chart?

Content Area: Ethics: Business Practices and Policies
This question addresses the parameters of record keeping.

A. The client's diagnosis.

B. Notes on any peer consultations regarding counter-transference issues around the case.

C. The informed consent signed by the client.

D. The treatment plan.
Answer: 1. Reasonable suspicion does not require certainity the child abuse or neglect has occured
2. Reasonable suspicion does not require a specific medical indication of child abuse or neglect; any reasonable suspesion is suffeciant
3. Reasonable suspicion may be based on any information considered credible by reporter, including statements by others
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Question: *52. After your session with Scott, you decide to buy $10,000 worth of the stock that he was talking about. In a short time the stock tailspins to 10% of its initial price offering. How would you characterize the social worker's action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your sensitivity to the issues of professional boundaries and dual relationships.

A. It is illegal and unethical.

B. As the social worker did not solicit the information, the social worker was free to purchase the stock.

C. It is unethical.

D. It is unethical if it interferes with the nature of the therapeutic relationship.
Answer: An entity with a legitimate need to know. I.e teachers, school counselors, primary care physcians, members of hospital treatment team, agency personal, insurance companies, gatekeepers to services
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Question: *53. What is a social worker legally required to disclose to a client at the beginning of treatment as part of the ethical obligation for informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question reviews your knowledge of the legal and ethical aspects of informed consent.

A. The fee, the true name and license of the designated owner of the practice, and the limits of confidentiality.

B. The fee and the type of license held by the social worker and the expiration date of a release authorization.

C. The fee and the true name and license of the designated owner of the practice.

D. The fee, the type of license held by the social worker, and limits of confidentiality.
Answer: Refers to a private statement that must be kept in confidence by the recepient for thr benefit of the communicator
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Question: 54. Hank, a 27-year-old stockbroker, is referred by his EAP for 6 sessions. In the 5th session Hank tells you that he has recently acknowledged to himself that he is gay and doesn't know how to tell his fiancee. He wants to bring her to the next session and have you tell her for him. The best course of action would be to:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to manage client expectations and boundaries.

A. Remind him that he only has one more session and that may not be how he wants to use it.

B. Suggest more sessions to clarify his sexual orientation.

C. Ask him how he knows he is gay.

D. Decline his request to tell her for him.
Answer: Privilege refers to information shared verbally by the client in psychotherapy sessions and information documented in the clincsl records
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Question: 55. A disabled client reports difficulty getting her medications because her son spends her SSI checks on gambling debts. What is your legal responsibility?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of your responsibilities as a mandated reporter.

A. You have no reporting mandate for domestic violence.

B. You are legally mandated to contact Adult Protective Services for dependent adult abuse.

C. You are legally mandated to contact Adult Protective Services for elder abuse.

D. You are ethically responsible to put the client's son on a 5150 for danger to others, as his mother could die without the medications.
Answer: Is established by ca evidence code 1014
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Question: 56. A therapist who performs telehealth advertises that the main advantage of internet therapy is that the client can reach a therapist in real-time. "If crises come up or just a quick question, online therapy can meet your needs right away." This advertising is:

Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of the legal parameters for advertising on the internet.

A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable.

B. Legal if telehealth is within the therapist's scope of practice.

C. Unethical because online therapy cannot be used in a crisis.

D. Unethical because clients will expect a social worker to be available 24/7.
Answer: 1: The patient is the holder of the privilege when he or she has no guardian or conservator. If the patient has a guardian or conservator, then the guardian or conservator holds the privilege.

2 If the patient is dead, the personal representative of the decedent holds the privilege.

3 If your identified patient is a group, family, or couple you must receive a waiver from each and every member of the group before you can release any information.
4 If your patient is a minor child, he or she holds the privilege. A minor's parents do not hold the privilege for the minor. The only time a parent could hold the privilege for the minor is if the court has specifically appointed the parent as a guardian ad litem.
5 If your patient is a minor, you must assert the privilege on his or her behalf. If the minor has an attorney, the attorney can make the decision to waive or assert the privilege.
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Question: 57. As you arrive to work in the morning you notice your office has been broken into and your client, Matilda, who has been diagnosed with Borderline Personality Disorder, has pried open your locked file cabinet, has her file under her arm, and is about to leave the premises. She tells you she knows that she has a legal right to her own records. You tell her that this is true but that legally, in order for her to see the records:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal protocols for a client requesting to see her records.

A. She must submit to you a request in writing.

B. She must sign a release authorization because after she leaves the office with her records it is possible that unknown third parties will see the records.

C. You must first inspect the records to make sure that there is nothing in them that would be detrimental to her mental condition or to the therapeutic process.

D. Fill out the appropriate HIPAA forms to insure the privacy of her protected health information.
Answer: 1. Service
2. Social justice
3. Dignity and worth of the person
4. Importance of human relationships
5. Integrity
6. Competence
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Question: 58. You are a newly licensed social worker. You would like to incorporate EMDR into your practice. Which of the following statements is CORRECT?

Content Area: Ethics: Professional Competence and Preventing Harm. Awareness of when EMDR can be incorporated into your practice is being tested here.

A. EMDR is not within the scope of practice for a mental health professional.

B. You may practice EMDR if you are properly trained.

C. You are legally required to inform a client in the first session that you use EMDR.

D. You may practice EMDR only if you are certified by your state licensing board.
Answer: Privilege is not absolute, if there is a issue of a clients mental health or psychological treatment is raised during the course of a lawsuit, a ,metal health provider might be forced by the court to reveal the details of the clients treatment
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Question: *59. The best time to establish your office policies with a client is:

Content Area: Ethics: Therapeutic Relationship/Services
This question assesses your knowledge of the ethical standards in establishing office policies.

A. At the commencement of treatment.

B. Within the first couple of sessions.

C. On an ongoing need-to-know basis.

D. When your client asks.
Answer: may claim privilege on behalf of the client (per CA Evidence Code 1015). The client may then:
1.waive privilege and allow the provider to provide the subpoenaed information;
or 2 invoke privilege and refuse to allow the release
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Question: 60. In order to tell her clients about how she works with social media, a social worker says that she will only send texts to confirm a cancellation. This agreement between the client and the social worker represents:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of the contents of informed consent.

A. A Treatment plan.

B. A waiver of privilege.

C. Informed consent.

D. Limits of confidentiality.
Answer: California, minors who are 12 years of age or older may consent to mental health treatment or counseling if both of the following requirements are met: a) 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 1) The minor would present a danger of serious physical or mental harm to self or others without the mental health treatment or counseling or residential shelter services or 2) is an alleged victim of incest or child abuse
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Question: 61. A potential client was referred to you by a former client. He is specifically requesting "psychoanalysis," is willing to pay cash and wants to see you 2-3 times a week. You work from an Existential theoretical orientation. You know a supervisor who works psychoanalytically and you believe you would receive good supervision from him if you were to see this client. What will you do?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical responsibility to clarify expectations of therapy and work within your scope of competence.

A. Inform the client of your theoretical orientation and let him decide what he would like to do.

B. Tell the client you would be willing to see him but only one time a week and start educating yourself regarding psychoanalysis.

C. Tell the client you cannot see him because you're not a psychoanalyst and offer three referrals.

D. Explore with the client what he means by "psychoanalysis." Educate him on your theoretical approach and inform him of your limitations regarding psychoanalysis. Let him decide if he would like to continue therapy with you or receive referrals.
Answer: minor who is 12 years of age or older may consent to medical care and counseling relating to the diagnosis and treatment or a drug or alcohol problem. Minors cannot consent to psychotropic medication or inpatient hospitalization without parental
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Question: 62. Miranda, a medical social worker is going through a painful and conflict-ridden custody battle with her ex-husband. She notices that she has a hard time paying attention in rounds and last week became irritated with a patient and another member of her interdisciplinary team. According to professional ethical standards, how should Miranda proceed?

Content Area: Ethics: Professional Competence and Preventing Harm. This question reviews your knowledge of managing social worker's issues and conflicts that interfere with the ability to deliver professional services.

A. Apologize to the patient and colleague.

B. Take a personal day.

C. Take a leave of absence until the custody situation has been resolved.

D. Speak to her supervisor about making adjustments in her workload.
Answer: , which pertains to child abuse, requires that mandated reporters, make a report of child abuse whenever a "reasonable suspicion" of abuse exists. An abuse report is required whenever a mental health provider learns about the abuse in his or her professional capacity.
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Question: *63. Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town's only community counseling clinic. In his second week at the clinic Eli is given a list of new interns he will be supervising and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge regarding supervision and dual relationships.

A. Decline to supervise the intern.

B. Ask the client to choose between having Eli as a social worker or a supervisor.

C. Terminate the therapy since it conflicts with Eli's role as a supervisor as well as the client's desire for training and career advancement.

D. Proceed as a supervisor since this is a case of an unavoidable dual relationship.
Answer: Elder is over 65 years age
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Question: 64. You find out that your client Joyce has been living with John for one year. John has a son who has become violent with Joyce on several occasions. She states that she really cares for John but doesn't know what to do about his son. How would you handle this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This question pertains to a social worker's ethical responsibility to provide for a client's safety.

A. Provide Joyce with safety information.

B. Obtain Joyce's informed consent.

C. Refer Joyce to a woman's support group.

D. Refer the son to a high-risk teen group.
Answer: Is one whose physical or mental health that puts them at increased risk of abuse
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Question: *65. You are treating a family of four in therapy. The oldest child, age 17, suggested that you do telehealth sessions with him. Legally, in order to do this you must:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legal parameters for the use of telemedicine/telehealth.

A. Obtain written consent-to-treat from him because he is age 12 and older, to change the treatment plan.

B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.

C. Legally obtain informed consent with the whole family to change the treatment plan.

D. Determine your fee schedule for a different medium.
Answer: Financial abuse
Abandonment
Neglect
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Question: *66. Isaac and Fanny want their son Adam to have his Bar Mitzvah ceremony at the Orthodox synagogue that they belong to. Adam will only agree to study for his Bar Mitzvah at the local youth-oriented Hillel Temple that is less traditional. As a social worker, the most helpful initial step would be to:

Content Area: Ethics: Therapeutic Relationship/Services
This question asks you to clinically evaluate diversity of religious beliefs within a family.

A. Suggest a compromise and see how they respond.

B. Ask permission to speak with both Rabbis for their input.

C. Ask the family members individually to share with you their thoughts about religion.

D. Ask each family member to explain to you from their point of view the meaning this religious ceremony has to them and their family.
Answer: Refers to the assumption that the reporter to the best of their knowledge had reason to believe the child in question was being subjected to abuse or neglect. Even if the allegations are false the reporter is provided with immunity
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Question: 67. According to the Elder/Dependent Adult Abuse Reporting Law, you are mandated to report all of the following EXCEPT:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the Elder/Dependent Adult Abuse Reporting Law.

A. Mental suffering

B. Self-neglect

C. Financial abuse

D. Physical abuse
Answer: Laura's Law allows California counties to decide whether to opt to implement a community-based, court- monitored outpatient treatment program. These programs require outpatient treatment for a seriously mentally ill person who is unlikely to survive safely in the community without supervision, has a history treatment noncompliance, and presents a serious risk of harm to self or others. At the present time some, but not all, California counties have adopted Laura's Law.
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Question: 68. A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal and ethical standards in dealing with referrals.

A. Expressed your gratitude in an appropriate and professional manner.

B. Not acted unethically or illegally since you did not solicit the referral.

C. Not acted unethically or illegally since you did not directly pay the colleague for the referral.

D. Acted unethically and illegally.
Answer: (1) the presence of attitudes that support violence, (2) the client's capacity of means to carry out violence, (3) the crossing of a threshold toward violence such as purchasing a gun or breaking a law, (4) the presence of an intent to carry out an action, (5) the responses of others to the client's plans, and (6) the degree of client compliance with professional recommendations to reduce risk.
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Question: *69. Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women's make-up and shoes. Legally, what would be your first concern?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of legal requirements when treating minors.

A. You would need to get consent from his parents because he is being abused at school.

B. You would need to assess for child abuse.

C. You would need him to sign a release to speak with his school.

D. You would need to assess for possible suicidal ideation.
Answer: Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.
b) Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques.
c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm.
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Question: 70. A social worker who works from a Humanistic model tells a few of her clients that she has been sober for 10 years. She finds that clients feel safer with a social worker who is in recovery like themselves. What is a LCSW's ethical obligation to a client if a client wants the social worker to be his sponsor after one year of sobriety and participation in AA?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to ethically manage a client's request that you participate in a dual relationship.

A. Tell the client it would be a dual relationship to act as a social worker and sponsor.

B. Wait at least two years to begin any type of relationship concurrent with therapy.

C. Agree to be the sponsor only after the client terminates therapy and if the client initiates the termination.

D. Assess for any counter-transference that would encourage the social worker to become the sponsor.
Answer: Informed consent involves providing clients with information necessary to make educated decisions about treatment.
Can be in writing or by conversation
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Question: *71. A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would:

Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist's boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship.

A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations.

B. Contact the therapist to discuss the legal/ethical consequence of his actions.

C. Assess for further boundary violations.

D. Contact the BBS to report the therapist's inappropriate actions.
Answer: Goals of therapy/psychotherapy services
- Risks and benefits of therapy
- Approximate length of the process
- Alternatives to therapy
- Fees and services, including processes if bills are not paid
- Qualifications and background of the counselor
- Treatment procedures, including emergency procedures
- Third party disclosures
- Choices between paying with and without insurance
-limits of confidentiality
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Question: 72. Patricia, a 12-year-old client, tells you that she hates it when her older sister lets her boyfriend sneak into her room at night. The older sister is 15 and the boyfriend is 18. Patricia says they continue to do "nasty stuff" even though she tells them to stop. What would be your next step?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of laws that differentiate between reportable sexual abuse and non-reportable consensual sex involving minors.

A. Call Child Protective Services.

B. Tell the parents.

C. Have a session with the sisters.

D. Find out if they are having intercourse.
Answer: Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries.
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Question: *73. Audrey, age 32, comes into your office while her father, Carl, and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father, Carl, and she asks, "Can I pay you when my 'ex' pays his overdue child support?" How would you manage the ethical issue of fees?

Content Area: Ethics: Business Practices and Policies
This questions test your knowledge of the ethics that pertain to fees, fee disclosure and fee management.

A. Review the fee policies outlined in your informed consent document.

B. Disclose your fee prior to providing therapy or as soon as practically possible.

C. If you see Audrey alone and her father is paying, explain that she must collect the fee from him and then pay you.

D. Discuss Audrey's request that you wait to be paid until the 'ex' pays his overdue child support.
Answer: -Counseling a friend, family member or someone known to the therapist - Providing individual therapy to two members of the same household
- Providing simultaneous individual and group therapy
- Entering a business relationship with a client
Entering a social relationship with a client
- Hiring a patient to do work for the therapist
- Bartering goods or services to pay for therapy
- Supporting the patient's isolation from social support systems - Increasing dependency on the therapist.
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Question: *74. A social worker wants to speak with a client's nurse practitioner and brings up the subject of signing a release in order to do so. As part of informed consent, a client begins asking the social worker what she will do with the release. The social worker should explain that:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to talk with clients about the impact of their signing a release authorization.

A. The release will expire in one year.

B. The client is entitled to receive a copy of the release.

C. The social worker will speak only with the person on the release.

D. The social worker will tell the client before speaking with the third party.
Answer: The California Business and Professional Code and the Civil Code (Section 43.93) discuss sexual relationships between of clients by therapists. In California, it is illegal for a psychotherapist to engage in sexual contact with a patient or former patient under any of the following circumstances: a. during therapy; b. within two years of termination of therapy; and c. by means of therapeutic deceptio
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Question: *75. You have been working at your agency for 8 months and you have observed a colleague using EMDR. You are very impressed with the results she is having. You read an article about EMDR in a professional magazine. You also register with an EMDR council on the Internet. You begin using this technique with your clients. In this instance:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to assess your ability to treat a client within your scope of competence.

A. You may use this technique with your clients because you are registered on the Internet with the EMDR site.

B. This would be considered outside of your scope of practice.

C. Since you have studied the technique, it is ethical to practice with your clients.

D. This would be considered outside of your scope of competence.
Answer: -When a client accrues a large bill and cannot pay for services
-When a client who has previously paid in full for services now requires a sliding scale
-When there is a role change (e.g., an agency therapist is promoted to a non-clinical role)
-When the therapist does not see continued need for treatment When there is a lack of treatment progress
-When there is a threat to the clinician
-When a client's issues exceed the clinician's scope of competence
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Question: 76. John, 15, has lived with his father since his parents divorced. When expelled from school, his father brought him to you for counseling. The following week you get a call from Clara who identifies herself as John's mother. She says that her son needs to live with her if he is ever going to "be a better man than his father." Your initial step would be to:

Content Area: Law: Confidentiality, Privilege, and Consent
This test item addresses procedures to protect client confidentiality.

A. Get a release from John's father to talk to his mother.

B. Get a release signed by both John and his father.

C. Not disclose to John's mother that John is your client.

D. Invite John's mother to the next session.
Answer: Health insurance companies offering mental health benefits will be required to provide equal coverage of mental and physical illnesses.
requires health insurers to guarantee that the mental health and substance use benefits they offer are consistent with coverage offered for physical disorders or diseases.
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Question: 77. During the course of therapy, a very strong emotional bond develops between Rowene and her client, Artie. Three years after the therapy terminates, Rowene and Artie run into each other at a delicatessen and decide to share a pastrami sandwich. One thing leads to another and several dill pickles later, Rowene and Artie begin a sexual relationship. One year later they break up. Artie, hurt and vengeful, files a complaint with the BBS claiming Rowene engaged in an unethical dual relationship with Artie by virtue of the relationship they entered into after therapy. Regarding this claim, which of the following responses is true? Revocation of a LCSW's license after having been found to have engaged in sexual misconduct with a client would occur after:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of legal and ethical standards involving post therapy sexual relationships.

A. Rowene violated neither legal nor ethical standards.

B. Rowene violated both legal and ethical standards.

C. Rowene violated the law, but not ethical standards.

D. Rowene violated ethical standards, but not the law.
Answer: California's statute mandates that health insurance plans offered in the state provide coverage for a list of nine mental health conditions: schizophrenia, schizoaffective disorder, bipolar disorder, major depression, panic disorder, obsessive- compulsive disorder, pervasive developmental disorder or autism, anorexia nervosa, and bulimia nervosa. The state law also has broader scope than the federal parity statutes, covering all group insurance plans as well as individual insurance plans.
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Question: 78. As a mental health professional, which of the following situations are you mandated to report?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking for the situation that you are mandated to report.

A. Your 30-year-old female client is beating her husband and there are two young children in the home.

B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son.

C. You have suspicions that your 63-year-old client is being beaten by her son-in-law.

D. Your severely depressed client tells you that she wants to die.
Answer: Request for domestic violence restraining order (DV-100) And the California telecommunications systems (CLETS) information form
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Question: *79. Two years and one day after terminating with your client, Bob, he calls you and says that he has extra tickets to the NBA playoff game tonight and would like to invite you to the game with him and his wife. Under what circumstances might it be ethically appropriate for you to accept?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge regarding dual relationships.

A. Under no circumstances, since a client is always a client and this could constitute a dual relationship.

B. Under all circumstances, since this post-therapeutic relationship would occur more than two years following termination of treatment.

C. If both you and the former client felt comfortable with meeting in this way.

D. If you were to obtain professional consultation to determine the reasonableness of this post-therapeutic relationship.
Answer: makes protection orders enforceable against state lines. If a victim believes that an order of protection has been violated, he or she should call police immediately. In many states, violators of protective orders are immediately arrested and jailed.
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Question: *80. You are treating a client who discloses that she has had sexual relations with all her prior therapists. You:

Content Area: Law: Legal Standards for Professional Practice. This question involves your legal responsibility in treating a client who has had sexual relations with prior therapists.

A. Consider a diagnosis of Borderline Personality Disorder.

B. Provide her with a copy of "Professional Therapy Never Includes Sex" and answer her questions about it.

C. Provide her with a copy of "Professional Therapy Never Includes Sex" and describe the laws prohibiting therapist sex with clients.

D. Contact the BBS and inform them of the client's reports.
Answer: Are community based services that assist and support parents in their role as caregivers
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Question: *81. Laurel, age 28, a corporate fund-raiser, and Marty, age 30, an electrician, are referred to you by Marty's E.A.P. Three weeks ago Marty witnessed the death by electrocution of a co-worker while they were working on a high-power utility line. Since then, Marty says he can't concentrate, is having nightmares, can't sleep, and finds himself reliving the incident over and over again. Laurel says Marty's problems are due to his drinking, not his co-worker's death. How would you handle the ethical responsibilities pertaining to boundaries?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to manage boundaries.

A. Avoid membership in gyms or country clubs to which either Marty or Laurel belong.

B. Inform Marty how privilege works in case he is subpoenaed regarding the co-worker's death.

C. Have Marty sign a release so that you can speak to his E.A.P.

D. Set the fee before the first session.
Answer: Are short term, family focused and community based services designed to help families cope with significant stresses or problems that interfere with their ability to nurture their children
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Question: *82. A lesbian couple that you have been seeing asks you about Emotionally Focused Therapy. One of the partners tells you that she saw it on a daytime talk show and would like to see if it can help them. What should you NOT tell them if you feel competent to do this kind of therapy?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to ethically change the treatment plan, which requires informed consent from clients.

A. That you will need them to sign an agreement to change the treatment plan.

B. The risks and benefits of this type of therapy.

C. How you will help them determine new treatment goals that fit with EFT.

D. Your skills and experience in working with EFT.
Answer: Health insurance portability and accountability act 1996
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Question: *83. Who holds the privilege for a 14-year-old client in a custody case?

Content Area: Law: Confidentiality, Privilege, and Consent
This question reviews your knowledge of privilege.

A. The parents of the minor.

B. The lawyer overseeing the client's case.

C. The 14-year-old client.

D. The social worker.
Answer: Known as the administrative simplification (AS) provisions requires the establishment of national standards for electronic health care transactions and addresses the security and privacy of health data
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Question: *84. A family with a 16-year-old daughter and a 15-year-old son comes in to see you. The siblings are of equal height and build. The parents report that they have been referred to you by the school counselor because of the children's frequent squabbles. You discover they both have hit the other hard enough to give each other black eyes. You would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. The question relates to reporting requirements for sibling abuse.

A. Set up a strict policy of no hitting; teach anger management skills to both siblings; and instruct the parents on recognizing the warning signs that lead to the children's violence.

B. Report the incidents to a children's protective agency.

C. Inform the parents that if they don't contain the violence, you will report the incident to a children's protective agency.

D. Take steps to contain the violence. Since the violence is between siblings that are close in age and evenly matched, it is not reportable since it is a mutual affray between minors.
Answer: Portability standards that ensure the continuity of healthcare
1.Privacy standards that govern the disclosure of protected health information
2. Security standards that protect the development and maintenance of health
information
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Question: *85. The juvenile court refers a family to you. The 14-year-old son has been found guilty of vandalism and recently tested positive for using marijuana. The parents say the boy's friends are to blame, and they want your help to convince the court that their son was a victim of these older boys pressuring and threatening him. Ethically you:

Content Area: Ethics: Therapeutic Relationship/Services
This question assesses your knowledge of how to act in an ethical manner with a client who has been referred by the juvenile court.

A. Would explain that you need a release from the parents to communicate to the court.

B. Could tell the court what the parents have told you.

C. Must consult with the boy's attorney so that you remain in your scope of competence.

D. Make a child abuse report concerning the older boys' threats.
Answer: 1. Limits the ability of a new employer plan to exclude coverage for preexisting conditions
2. Provides individuals with the opportunity to enroll in a group health plan if they lose other coverage or experience certain life events
3. Prohibits discrimination against employees and their dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information
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Question: 86. Your client of six months, Dale, who was referred to you by her wheelchair aerobics instructor, comes to session with her 16-year old daughter Natasha. Dale is worried about abrupt changes in Natasha who has suddenly become argumentative and secretive. Natasha continues, "I'm sick and tired of helping her get to the bathroom. I want to be out with my friends." How would you manage your ethical obligations as they pertain to diversity?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to incorporate diversity issues into the therapy from an ethical perspective.

A. Educate yourself on the psychosocial impact of being in a wheelchair.

B. Refer Dale to a support group for mothers in wheelchairs.

C. Join with the family by acknowledging similarities between Dale and Natasha.

D. Construct equipment, redesign entrances, or otherwise provide adequate wheelchair accessibility to your office.
Answer: Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. The law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to that individual's enrollment date in the plan.
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Question: 87. Due to economic constraints, Robert has decided to broaden his practice and is willing to accept types of clients with whom he has not previously worked. Which ethical principle best characterizes what he should do? Robert should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of scope of competence.

A. Only accept referrals within his scope of competence.

B. Accept all referrals and get proper consultation and training as necessary.

C. Not accept any referrals outside of his experience.

D. Not accept any referrals for which he has had no formal training.
Answer: Protected health information is any information about health status, provision of health care, or payment for health care that can be connected to a person
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Question: *88. John is a client whom you referred to a psychiatrist for an evaluation. He was reluctant to go because he has a history of steroid abuse that he does not like to talk about. He was given a prescription for SSRIs to alleviate his depression that he has been taking for six months. John comes to session this week and tells you that he has stopped taking the medication. You would:

Content Area: Law: Legal Standards for Professional Practice. This question focuses on the issue of scope of practice.

A. Ensure that John takes the medication.

B. Educate John about the impact of terminating the antidepressant medication.

C. Refer John back to the prescribing psychiatrist.

D. Explore the reasons for John's refusal and suggest that another antidepressant might be more appropriate.
Answer: Any information about a person's past, present or future mental health status
Names
All client address information other than their state of residence
Dates (except year) related to an individual, including birth date, admission date,
discharge date
Client phone or fax numbers
E-mail address
Social Security numbers
Client photographs
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Question: *89. Michelle, a 52-year-old car saleswoman, has been seeing you for individual counseling. She has a history of stormy relationships and affairs with married men. In one session, after discussing her tendency to avoid intimacy with any one man by juggling too many men at once, she tells you she's been seeing another therapist on the side. Ethically you:

Content Area: Ethics: Therapeutic Relationship/Services
This item reviews the ethics of a client having two separate therapists.

A. Tell her it is unethical to have two therapists and encourage her to pick between you and the other therapist.

B. Tell her it is unethical, and you can't see her again until she terminates with the other therapist.

C. Explore the similarity between what she is doing in her relationships and with her therapy.

D. Ask her what her goals have been with the other therapist and request a release to speak with that therapist.
Answer: A key component of HIPAA is the Privacy Rule. The HIPAA Privacy Rule creates national standards to protect individuals' medical records and other personal health information.
1. It sets boundaries on the use and release of health records.
2. It enables clients to find out how information may be used, and about certain disclosures of their information that have been made.
3. It gives patients the right to examine and obtain a copy of their health records and to request corrections if data is incorrect.
4. It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information.
5. It enforces civil and criminal penalties if there is a violation of clients' privacy rights
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Question: *90. Cynthia, a 42-year-old, divorced mother of two children, is your client. She has been seeing you to work on overwhelming feelings of anxiety. Her children are being seen in therapy by a well-respected child psychologist to deal with the upset of the divorce. Her husband is suing her for custody of the children. You have been contacted by his lawyer who has subpoenaed your records. You would:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of your legal obligations as they pertain to privilege.

A. Release your records.

B. Tell the lawyer you refuse to release Cynthia's records.

C. Release only a summary of your records.

D. Call your client.
Answer: If you are an individual mental health provider or work for a hospital, health plan or health care clearinghouse that transmits information electronically you are affected by HIPAA.
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Question: *91. Your client, Janet, 25 years old, reports being tired all the time, spending less time doing activities that she used to enjoy and crying often for no apparent reason. Janet reports losing weight and spending less time with family and friends. You assess for suicide and judge the risk to be low. You may use all of the following interventions, EXCEPT:

Content Area: Law: Confidentiality, Privilege, and Consent
This question assesses your understanding of interventions used with suicidal clients.

A. Talk with Janet about the problems in her life and her lack of interest.

B. Mobilize external and internal resources.

C. Suggest Janet take anti-depressants.

D. Offer empathy and emotional support and contracting for ongoing contact with you as necessary.
Answer: The term "covered entity," includes any mental health provider who submits billing information to managed care companies or other third parties. Please note that if there is even a single electronic transmission to an insurance carrier or other third party, the HIPAA requirement states that you must immediately become compliant with all guidelines
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Question: 92. Cheryl and Bobby are in a joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. Cheryl tells Bobby that she won't make any more referrals to Bobby. If Bobby decides to get some outside support, he is ethically managing his:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of different ethical principles.

A. Scope of competence.

B. Counter-transference.

C. Dual relationship.

D. Scope of practice.
Answer: --If access is reasonably likely to endanger the life or physical safety of the individual or another person
--The PHI refers to another person (except for a health care provider) and access is reasonably likely to cause substantial harm to that person; or
--If PHI is created during research, the access to PHI may be temporarily suspended if the individual is notified in advance
--If the PHI was obtained from someone other than a health care provider under a promise of confidentiality and the access requested would reveal the source of the information
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Question: 93. You are a social worker at a private agency funded by a religious charitable organization. You are assigned to work with a couple that initially reported communication problems. You explain the limits of confidentiality and your "no secrets" policy at the first session. After the first session, you receive a message on your voicemail from the wife that says her husband has been physically abusing her. What is the most ethical course of action?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical management of your "no secrets" policy.

A. Call the wife and remind her of your "no secrets" policy, and that you will disclose her message to the husband at their next session.

B. Call the wife and remind her of your "no secrets" policy, and that you expect her to disclose her message to the husband at their next session.

C. Waive your "no secrets" policy and assess for physical abuse at the next session by interviewing the couple separately.

D. Waive your "no secrets" policy and call the wife to assess whether she is currently in danger.
Answer: ---When the minor is the one who consents to care and the consent of the parent is not required under State or other applicable law.
--When the minor obtains care at the direction of a court or a person appointed by the court.
---When, and to the extent that, the parent agrees that the minor and the health care provider may have a confidential relationship.
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Question: *94. Karen has been a client of yours for almost six months. One day when you are in church you notice that Karen's name is in the church bulletin welcoming her as a new member of the congregation. You doubt that she knew you went to this church. You should:

Content Area: Ethics: Business Practices and Policies
This question reviews your knowledge of dual relationship protocol.

A. Leave the congregation.

B. Tell the client she needs to join a different congregation.

C. Stay in the congregation but avoid direct social interactions.

D. Review dual relationships with your client, and healthy client-social worker boundaries.
Answer: Notes recorded in any medium by a mental Heath professional documenting or analyzing the contents of conversation during a private counseling session
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Question: 95. Your client just found out that her identity has been stolen on the internet and she is worried that whoever stole her identity will also know that she was in therapy from the online bills and emails she paid to you, her social worker. What should you do to fulfill your scope of competence obligations?

Content Area: Ethics: Business Practices and Policies
This question relates to general scope of competence issues-any issue related to your ability to provide treatment in a competent manner.

A. Maintain computer security, i.e. firewalls, passwords, etc.

B. Refer the client to a new mental health professional.

C. Destroy records in a confidential manner.

D. Assure that you are competent to provide internet therapy.
Answer: Requires mental health providers to anticipate threats to, or inappropriate uses of confidential information. It only applies to electronic protected health information or ephi
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Question: 96. Which of the following people CANNOT initiate a 5150?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge about initiating a 5150 (an involuntary 72-hour-hold). Initiating a 5150 is making the request for a formal 5150 evaluation to take place.

A. A parent.

B. A social worker.

C. A paramedic.

D. A 17-year-old client.
Answer: Health care claims
Health care payment and remittance advice
Electronic requests for coordination of benefits
Electronic treatment request forms
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Question: *97. The court sends Sue and Jerry to you for marital counseling after a domestic violence incident. A month after the referral, the court requests a report on the couple's attendance and progress. You:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of how to respond to a court request.

A. Can inform the court of the couple's attendance, but not progress without a written release signed by Sue or Jerry.

B. Should assert privilege on behalf of the couple.

C. Need a written release signed by both Sue and Jerry before you can communicate with the court.

D. Cannot assert privilege on behalf of the couple.
Answer: 1.HIPAA standards apply to protected health information: "information about health status, provision of health care, or payment for health care that can be connected to a person." This broadly includes any part of a client's medical record or payment history.
2. HIPAA sets boundaries on the use and release of health records.
3. HIPAA patients the right to examine and obtain a copy of their own health records and request corrections.
4. It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information.
5. Providers must notify clients about their privacy rights and how their information can be used.
6. Mental health practitioners must adopt and implement privacy procedures
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Question: 98. You just received a referral from a local psychiatrist. The client suffers from a severe psychotic disorder and must take psychotropic medications. You have never treated anyone with a chronic mental illness in your private practice before so you must:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of standards for ethical client treatment.

A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you.

B. Let the doctor know you appreciate the referral, but you are out of your scope of practice in taking on this particular client.

C. Find a supervisor to assist and guide you in working with this client so that you are covered legally.

D. Tell the doctor that you would like to take this case and are prepared to research this diagnosis and work closely with him so that you might effectively treat the client and expand your capabilities as a clinician.
Answer: Text based forms of communication include email chat rooms text messages and listservs. Forms of communication that aren't text based include telephone and videoconferencing
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Question: *99. A social worker receives a phone call from a young woman who asks if they can talk before she makes an appointment. In an initial phone call, the woman introduces herself and asks how long you have been a social worker. Missie tells you that she is depressed and that there is no pleasure or joy in anything she does. She doesn't have a lot of time or a lot of money but wants to know if you can help her to feel better. What is the social worker's obligation?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical obligations.

A. Tell her how long you have been licensed and how many clients you have.

B. Ask her how many sessions she can afford and use a therapy model that suits her needs.

C. Before making her a client, perform informed consent about what to expect from therapy.

D. Evaluate the seriousness of her depression to determine if you can treat her.
Answer: Synchronous communication is most easily facilitated through instant messaging, chat rooms, telephone, and videoconference. Synchronous communication provides immediate feedback, since both the practitioner and client are engaged in conversation during the same time frame
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Question: 100. A client that you treated 3 years ago terminated when her therapy goals had been reached and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal requirements when starting therapy.

A. Tell her if you have raised your fees.

B. Tell her that you must make referrals if her needs are out of your scope of competence.

C. You must open a separate file.

D. She must sign a new release authorization since they expire after one year.
Answer: Asynchronous communication allows for correspondence without simultaneous connection (Maheu, et al., 2005). Examples include postal mail, e-mail, facsimile, and voicemail. These forms of contact generally do not allow for immediate feedback or a consistent flow of conversatio
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Question: *101. In making a referral for a lesbian couple dealing with domestic violence issues, the social worker should:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your sensitivity to human diversity issues.

A. Refer them to a social worker who has experience with domestic violence issues.

B. Not consider their sexual orientation since this is irrelevant to the domestic violence issues.

C. Refer them to a lesbian social worker.

D. Refer them to a gay and lesbian community center.
Answer: --The treatment process or procedure
--Benefits associated with the treatment or procedure;
--- Risks associated with the treatment procedure;
--Actions taken to prevent client risk
-- Procedures for emergencies.
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Question: 102. You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the law pertaining to suicidal clients.

A. Legally bound to report.



C. Legally responsible to intervene.

D. Not responsible in any way as the client has a right to make his/her own decision.
Answer: to prevent hackers from accessing patient records and to prevent computer viruses from corrupting electronic data (Zack, 2004). Several different security options are available to practitioners and clients for maintaining a secure computer network. For a licensed therapist practicing E-therapy, experts recommend securing clients' electronic records by utilizing password protection programs, computer network firewalls, wiping software, and document encryption.
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Question: 103. You have been seeing Shelly, 54, for two years. During one session, Shelly expresses the wish that the two of you could get together for coffee, since she likes you as a person, and she has been feeling very lonely lately. You would:

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of the impact of the therapeutic relationship on a client and the necessity to review the relationship with a client on occasion.

A. Discuss with Shelly the nature of the therapeutic relationship and explore her feelings and assumptions.

B. Agree to conduct therapy while the two of you walk in the neighborhood around your office.

C. Give Shelly homework to ask a friend to go out for coffee.

D. Inform Shelly that going out for coffee is a boundary violation, and that you would not think of violating this boundary.
Answer: Medicare deemed online videoconference billable in October 2001
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Question: 104. A 6-year-old child has been brought in by his mother for counseling. She wants you to explain to him why he is in therapy because she feels like she doesn't have the right words, and it could scare him. How do you handle obtaining consent for the child?

Content Area: Law: Confidentiality, Privilege, and Consent
This question concerns consent to treat a minor and custody.

A. If the parents are divorced, review the custody papers. Joint custody means both parents must consent.

B. Determine the marital status of the family. If the parents are still married, then both must consent.

C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent.

D. If the parents are divorced, review the custody papers. Either parent may consent if they are the biological parent.
Answer: provides several means for reducing medical errors, such as:
1) Establishing a national focus to create leadership, research, tools, and protocols to enhance the knowledge base about safety;
2) Identifying and learning from errors by developing a nationwide public mandatory reporting system and by encouraging health care organizations and practitioners to develop and participate in voluntary reporting systems;
3) Raising performance standards and expectations for improvements in safety through the actions of oversight organizations, professional groups, and group purchasers of health care, and
4) Implementing safety systems in health care organizations to en-sure safe practices at the delivery level.
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Question: *105. A social worker has been treating Mikey, age 12, for the last 8 months. He has been dealing with feelings of depression and tells you that he is not doing well in school. He tells you that his parents recently filed for divorce, and he does not know with which parent he wants to live. A few weeks later, you receive a call from an attorney who tells you that she was appointed to represent Mikey in the divorce proceedings. She is requesting a copy of your records. How do you respond in this situation?

Content Area: Ethics: Therapeutic Relationship/Services
This question involves legal and ethical issues related to the release of clinical records.

A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so.

B. Ask Mikey if he would sign a release to allow you to release the records to the attorney because ethically, you must act in his best interests.

C. Release records with both parents' authorization if it is in Mikey's best interests to do so.

D. Do not speak with the attorney because your client's confidentiality is the more important ethical obligation in this instance.
Answer: Professionals make mistakes such as incorrectly diagnosis someone
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Question: *106. A couple is in sex therapy. The sex therapy has focused on differences in their sexual desires. As they begin to make progress, one of the partners asks if they can come every other week, and if they do, if they can they pay a lower fee. What is your legal obligation?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to legally negotiate fees.

A. Discuss a new fee arrangement before changing the fee.

B. Document a new fee arrangement in your files.

C. Refer the client to a lower-fee therapist.

D. Self-assess any counter-transference that causes you to feel manipulated.
Answer: When the clinician fails to act in someway
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Question: *107. Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night, so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem, the fee is covered under the overall adoption agreement." What are your ethical obligations?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical obligations.

A. Determine the family's understanding of the purpose of the therapy.

B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session.

C. Determine the identified patient and refer to a pediatrician.

D. Tell Chong-Wook and Dae-Sup the fee at the first session, and explain that you may need to consult with the school counselor and adoption agency.
Answer: Unexpected occurrences involving death or serious physical or psychological injury or the risk thereof
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Question: 108. Veronica, a 29-year-old coffee store manager, is in counseling because she is very depressed. She reports that she only works and sleeps and has no hope of things improving. She frequently says, "Dying is the only way out." The case of Bellah v. Greenson would compel you to:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the legal parameters when a client is suicidal.

A. Initiate a 5150.



C. Take reasonable steps to ensure her safety.

D. Contact friends for a 24-hour watch.
Answer: Suggests that should event recur it would carry a significant chance of an adverse outcome
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Question: 109. Your client, Barbara, has been unemployed for three months. In her last session she stated that she plans to kill her ex-boss tomorrow because he's the cause of all her unhappiness. You call the police to alert them to Barbara's plan, but they don't seem to take you seriously because there isn't a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question involves a Tarasoff situation.

A. Document your phone call outlining your concerns and justifying your actions in order to cover your liability.

B. Have Barbara come in immediately for crisis counseling.

C. Call Barbara's ex-boss and warn him of her plan.

D. Call Barbara and find out if she has a gun so you can tell the police.
Answer: What happened
Why did it happen
What to do to prevent it happening again
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Question: 110. A social worker works for a managed care panel and receives most of her clients by referrals from the managed care company. A client comes for a first session, and the social worker realizes that the client has treatment expectations that are out of her scope of competence. What should the social worker do?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage your ethical and legal obligations when a client is out of your scope of competence.

A. Speak with the insurance company about her scope of competence.

B. Refer the client back to the insurance company.

C. Refer the client to a colleague who can meet his needs.

D. Collect the co-pay but do not bill for the session.
Answer: Physical cause
Human cause
Organizational cause
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Question: 111. You have been seeing a 22-year-old gay client for two years and treating him for depression. You get a call from his partner informing you that your client has committed suicide. Your best course of action would be to:

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of confidentiality issues after the death of a client.

A. Inquire as to whether the partner has legal authority regarding the disposal of your client's records.

B. Offer to take the partner as a client to help him process his feelings of grief and loss.

C. Hire an attorney regarding the suicide and make sure your notes on treating your client's depression are up to date.

D. Maintain confidentiality and retain the client's files for 7 years.
Answer: Tangible causes such as material items failing in some way. An example of this would be if a psychiatric medication caused an adverse reaction
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Question: *112. A client you have been treating, who is also a social worker, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships.

A. You indicate to your client that she can give your number to the program coordinator.

B. You thank her for thinking of you, but you refuse the offer to avoid a dual relationship.

C. You tell her that you are interested and ask her to set up a meeting between you and the program coordinator.

D. You wait until you terminate therapy and then remind your former client of her previous offer.
Answer: People did something wrong or did not do something that was needed. An example of this would be a therapist failing to take precautions to ensure the safety of a suicidal patient
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Question: 113. Darius is a psychoanalytically-oriented social worker who prefers to be a "blank screen" and who, as a matter of theoretical orientation, prefers not to disclose personal information. When his clients ask him about his experience, education, training, or his ideas about the therapeutic process, Darius finds ways to avoid answering their questions. This way of handling client questions is:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical standards related to informed consent.

A. Contrary to the spirit and intent of ethical standards.

B. Ethically appropriate but legally questionable.

C. More in tune with postmodern approaches to therapy.

D. A questionable application of psychoanalytic theory.
Answer: A system, process, or policy that people use to make decisions or do their work is defective. An example of this would be an organization policy that delays the reporting of child or elder abuse
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Question: *114. You have been seeing Jill and Dan, a couple in their mid-30s, for 2 months. Dan's insurance has been paying a portion of their therapy. Dan informs you that he has been laid off from his job and is looking for work. The two complain of their finances. Jill works from home, running her own catering business. The couple would like to continue seeing you and ask if Jill could trade some services for their therapy. How would you handle this request?

Content Area: Ethics: Business Practices and Policies
This question asks you to choose the best way to proceed in a situation in which your client wants to barter for therapeutic services. A potential dual relationship is involved.

A. Inform them that it would be unethical and help them find a way to pay for continued therapy.

B. Acknowledge their struggle and accept the arrangement.

C. Refer them to a financial counselor and discontinue therapy.

D. Refer them to a couples' support group.
Answer: 4.01 Competence
(a) Social workers should accept responsibility or employment only on the basis of existing competence or the intention to acquire the necessary competence.
(b) Social workers should strive to become and remain proficient in professional practice and the performance of professional functions. Social workers should critically examine and keep current with emerging knowledge relevant to social work. Social workers should routinely review the professional literature and participate in continuing education relevant to social work practice and social work ethics.
(c) Social workers should base practice on recognized knowledge, including empirically based knowledge, relevant to social work and social work ethics.
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Question: 115. Which of the following is NOT a type of dependent adult and elder abuse?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the parameters of elder and dependent adult abuse.

A. Abandonment.

B. Self-harm behavior.

C. Isolation.

D. Abduction.
Answer: 4.05 Impairment
(a) Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility.
(b) Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others.
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Question: 116. A therapist who takes a Narrative approach begins to explain the risks and benefits of therapy. The client asks if this is part of the therapy, and the therapist agrees that it is. The therapist then asks the client, "what do you understand about how therapy is 'supposed' to be?" From an ethical standpoint, the therapist is:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of ethical conceptualizations of interventions.

A. Deconstructing the client's dominant discourse.

B. Providing informed consent.

C. Avoiding cultural bias.

D. Externalizing the client's ideas about therapy.
Answer: 1.05 cultural competence and social diversity
A)Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.
(b) Social workers should have a knowledge base of their clients' cultures and be able to demonstrate competence in the provision of services that are sensitive to clients' cultures and to differences among people and cultural groups.
(c) Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.
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Question: *117. You recently get a new, male client who is visually impaired. You've never worked with a client with a physical disability and are feeling a little uncomfortable with the client when he is sitting in the room. What is the best way to handle your discomfort?



A. Let the client know of your discomfort and ask if he would prefer a different therapist.

B. Consult with professional peers regarding your discomfort.

C. Deal with your counter-transference in your own therapy.

D. Do research on blindness to help you with an understanding of your client's needs.
Answer: Social workers should avoid unwarranted negative criticism of colleagues in communications with clients or with other professionals. Unwarranted negative criticism may include demeaning comments that refer to colleagues' level of competence or to individuals' attributes such as race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability
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Question: 118. When you check your messages you find a message from an emergency room doctor who says that he is treating a man who overdosed, and that this man had your business card in his pocket. You recognize the name as a client you have been treating, and whom you know has a history of substance abuse. The doctor wants information from you. How would you proceed?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge about when a mental health worker may speak to a medical professional regarding a client.

A. Tell the doctor you will need him to fax a release authorization signed by the client in order to speak to him.

B. Give the doctor the information he needs.

C. Do not acknowledge that you know the man.

D. Do not return the phone call.
Answer: Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability.
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Question: *119. Your 15-year-old client is using a false email and social network page to bully other students at school. He tells you he does it so that the school won't catch him. He is in therapy with the consent of his parents, and you have a release to speak with the school. If the school calls, and you decide to speak with the school, how do you fulfill your ethical obligations for informed consent?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to manage a breach of confidentiality in an ethical way.

A. Only disclose information pertinent to the school's questions.

B. Tell his parents that you plan to speak with the school before doing so.

C. Tell the client what you plan to tell the school.

D. Speak to his parents before you talk to the school.
Answer: Social workers should act to prevent and eliminate domination of, exploitation of, and discrimination against any person, group, or class on the basis that of race, ethnicity, national origin, color, sex,sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability.
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Question: *120. You have been treating Anita for three sessions for depression and relationship issues. You are considering a diagnosis of Major Depression and other DSM-5 diagnoses. You are not sure which is appropriate yet. Legally:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice.

A. Do not treat the client unless your advertising indicates that you have expertise with depression or mood disorders.

B. Consider whether it is in your scope of competence to work with depressive disorders.

C. Change the diagnosis when you have confirmed it on any insurance forms.

D. Do not submit insurance billing until you have confirmed a diagnosis.
Answer: Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Social workers should use clear and understandable language to inform clients of the purpose of the services, risks related to the services, limits to services because of the requirements of a third-party payer, relevant costs, reasonable alternatives, clients' right to refuse or withdraw consent, and the time frame covered by the consent. Social workers should provide clients with an opportunity to ask questions.
(b) In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients' comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible.
(c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients' interests by seeking permission from an appropriate third party, informing clients consistent with the clients' level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients' wishes and interests. Social workers should take reasonable steps to enhance such clients' ability to give informed consent.
(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients' right to refuse service.
(e) Social workers who provide services via electronic media (such as computer, telephone, radio, and television) should inform recipients of the limitations and risks associated with such services.
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Question: 121. A client gives you a small basket of homemade muffins as a gesture of appreciation. You:

Content Area: Ethics: Business Practices and Policies
This item assesses the ethical protocol in accepting/declining gifts from clients.

A. Decline the muffins and explain that ethical social workers don't accept gifts from clients.

B. Refuse or accept the gift based on cultural considerations and the meaning of gift giving in the client's culture-of-origin.

C. Accept the gift and explore what it means for her to give you the muffins.

D. Accept the gift in the spirit in which it was intended and move on.

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Question: *122. During a 5th session with a client, Keesterman realizes the client is dating his daughter. How should Keesterman proceed?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge about how to proceed when an ethical conflict develops during the process of therapy.

A. Refer the client to another therapist and disclose the reasons.

B. Disclose to the client the ethical conflict and discuss whether to continue treatment or refer to another therapist.

C. Continue treatment to avoid abandoning the client.

D. Terminate treatment and do not disclose the reasons.
Answer: ---Portability standards that ensure the continuity of healthcare
--Privacy standards that govern the disclosure of protected health
information
--Security standards that protect the development and maintenance of
health information
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Question: *123. Parents of 7-year-old Todd bring him in because he told them an older kid at school pulled his pants down in the boy's bathroom and laughed at him. They tell you that they also found harassing texts on their son's cell phone from the same kid and some others. The parents demand that you evaluate Todd for mental anguish because they want to sue the school for allowing bullying on its premises. Legally, the social worker should:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question probes your knowledge of the clinical and legal consequences of bringing one's mental status into a legal proceeding.

A. Identify this as a form of sexual harassment but process it as child abuse.

B. Advise the parents to try talking with the school's representatives before proceeding with any legal action.

C. Tell them that using their son's "mental anguish" in a lawsuit could compromise their confidentiality in therapy.

D. Consider making a report to an agency designated to receive a child abuse report within 24 hours by phone and within 48 hours in writing.
Answer: The HIPAA Privacy Rule creates national standards to protect individuals' medical records and other personal health information.
It sets boundaries on the use and release of health records.
It gives patients the right to examine and obtain a copy of their health records and to request corrections if data is incorrect.
Clients needed to be notified about privacy practices during first session
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Question: 124. A social worker is seeing a couple on a sliding fee basis. They are having difficulty paying at this rate. When the social worker goes out to the waiting room, she discovers a cashmere sweater with a note pinned to it. The note says, "Don't tell my wife about this." What should the social worker do about this?

Content Area: Ethics: Therapeutic Relationship/Services
This question pertains to the issues of secrets, dual relationships, and appropriate means of payment for therapy.

A. Thank him for the sweater and tell his wife.

B. Thank him for the sweater and not tell his wife.

C. Return the sweater and encourage the man to bring it up in session.

D. Return the sweater and maintain the man's confidentiality.
Answer: B. Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client.
(c) Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed. information germane to the purpose for which the communication is made.
(d) Social workers should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. This applies whether social workers disclose confidential information on the basis of a legal requirement or client consent.
I. Social workers should protect the confidentiality of clients' written and electronic records and other sensitive information. Social workers should take reasonable steps to ensure that clients' records are stored in a secure location and that clients' records are not available to others who are not authorized to have access.
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Question: *125. Some clients are referred to social workers by other helping agencies and collaboration advances client welfare. Your new client tells you that she signed a release with the agency that referred her to you. You ask her to sign your release as well. Which of the following must appear on the release?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the legally required elements of release authorization.

A. A "Notice of Privacy Practices" if the client is a "covered entity" under HIPAA.

B. Notification to the person signing the agreement that they have a right to receive a copy of it.

C. It must include an expiration date established by the client.

D. It must state the client's diagnosis and reason for approving the release authorization.
Answer: 1.04 Competence
(c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm.
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Question: *126. You are working as an associate therapist at a non-profit agency. As part of your treatment, you collaborated with a psychologist and conducted some assessment inventories to evaluate your client's progress. Your client asks you how she scored on her depression test after being in therapy for six months. Your ethical responsibility in this case would be to:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of how to clinically and ethically discuss assessment tests with clients.

A. Inform her of the results in language she can understand.

B. Give her a copy of every test she completed with a summary of scores.

C. Evaluate if telling her the test scores will disrupt the therapy.

D. Explain to her that she has the right to decline an assessment.
Answer: a) When setting fees, social workers should ensure that the fees are fair, reasonable, and commensurate with the services performed. Consideration should be given to clients' ability to pay.
B. Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary.
(c) Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client.
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Question: 127. A social worker is surprised to learn in session that a client did a "google" search and found out that the social worker has another job in another field. The social worker is also a personal trainer and yoga teacher. The client asks which career the social worker likes better and says that she always wanted to try yoga. The social worker feels like the client is interrogating her and is concerned that the client may show up in a yoga class. How should the social worker proceed?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to manage possible dual relationships and the ethics of having a digital and social media presence.

A. Address any counter-transference about the potential dual relationship.

B. Block the client from the website that allows people to enroll in the yoga class.

C. Talk with the client about the risks of dual relationships.

D. Tell the client that you would prefer to know in advance if a client is doing a search, and that you will also tell the client in advance if you search them on the internet.
Answer: Self- determination
Informed consent
Preserving professional boundaries
Safeguarding confidentiality
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Question: *128. A professional couple, who moved here from India two years ago, begins therapy with you. You know little about their culture. In your work together you:

Content Area: Ethics: Therapeutic Relationship/Services
This question ascertains your knowledge of cross-cultural issues.

A. Ask them to educate you about important differences and to tell you how these relate to their presenting problem.

B. Do your own research on upper-class Indians to have a better understanding of your clients.

C. Ask them if they feel comfortable working with you since you are unfamiliar with their native culture.

D. Recommend an Indian therapist who will better understand their concerns.
Answer: What an ordinary reasonable and prudent professional with the same or similar training would have done under the same or similar circumstances
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Question: 129. A social worker told a colleague how she had bartered with a client, exchanging therapy for having her office painted. How should the social worker who received this information respond?

Content Area: Ethics: Business Practices and Policies
This question looks at your familiarity with dual relationships and the appropriate response to a colleague exhibiting poor boundaries.

A. Report to the BBS.

B. Report to an ethics committee.

C. Tell the colleague that her actions violate ethical standards.

D. Do nothing because there is no reporting requirement for this type of situation.
Answer: If parents are the one who consented to therapy they have the right to clinical records
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Question: *130. An 18-year-old woman named Claire, states in her first session that she's thrilled to be out of her home and to be away from "that monster of a father," whom she says sexually abused her since she was 15. She tells you she has a two younger siblings who still live at home. What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations surrounding confidentiality.

A. Maintain confidentiality.

B. File a child abuse report for the abuse that Claire suffered since 15.

C. File a report with CPS for reasonable suspicion of abuse for Claire's younger siblings.

D. Ask Claire to sign an authorization to speak with her siblings to determine if they are safe.
Answer: Refers to the right to withhold information from court. Privilege exists to benefit of the client and belongs to the client
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Question: 131. As part of his telehealth practice, a social worker offers quick assessment surveys online to help potential clients decide if they want therapy. The surveys do not ask for any identifying information. The social worker has access to the results of the surveys but does not ask for the name of the consumer, to avoid the appearance of solicitation. This is legal if:

Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of legal types of advertising and fee arrangements.

A. He provides referrals for any online survey respondents who are in a crisis.

B. He also offers the survey to current clients at no cost.

C. He advertises that the online assessments are consistent with DSM standards.

D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey.
Answer: ---Portability standards that ensure the continuity of healthcare
--Privacy standards that govern the disclosure of protected health
information
--Security standards that protect the development and maintenance of
health information
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Question: 132. Your client of five years asks to see a copy of his treatment records and submits the request to you in writing. How should a social worker respond?

Content Area: Law: Confidentiality, Privilege, and Consent
This question probes your knowledge of how to respond to client requests of access to their treatment records.

A. Allow the client to inspect the records, receive a copy, or receive a summary.

B. Inform the client that the records belong to the social worker, and that there is no right to client access to treatment records.

C. Explain that clients are only entitled to summaries of the treatment record.

D. Assert the privilege unless the request is accompanied by a court order.
Answer: The HIPAA Privacy Rule creates national standards to protect individuals' medical records and other personal health information.
It sets boundaries on the use and release of health records.
It gives patients the right to examine and obtain a copy of their health records and to request corrections if data is incorrect.
Clients needed to be notified about privacy practices during first session
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Question: 133. A new client, Susan, comes into your office reporting difficulties making presentations during staff meetings and has another big presentation in three weeks. Susan says, "I've heard of some technique called EMDR which is supposed to help with things like this. Can you help me?" Under what circumstances would you be allowed to perform EMDR with a client?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of scope of practice and competence.

A. You've read a book on the subject which includes step-by-step instructions.

B. You consulted with a colleague who shows you how to do EMDR.

C. You've taken a practical course on EMDR and have obtained certification.

D. Your personal therapist used EMDR with you so you know how it works.
Answer: B. Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client.
(c) Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed. information germane to the purpose for which the communication is made.
(d) Social workers should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. This applies whether social workers disclose confidential information on the basis of a legal requirement or client consent.
I. Social workers should protect the confidentiality of clients' written and electronic records and other sensitive information. Social workers should take reasonable steps to ensure that clients' records are stored in a secure location and that clients' records are not available to others who are not authorized to have access.
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Question: *134. Felix, a 30-year-old Caucasian, has been placed on administrative leave for excessive absences and is referred to you by his EAP. His partner, Pablo, a 32-year-old Peruvian-American, joins him in the session. Lately they have been "fighting all the time," and at work nobody knows that they are a couple because Felix fears they'll be fired. Pablo shoots an angry glance at Felix and says, "You worry too much. I can't take you moping around all the time, and the reason I drink so much is because you stopped having sex with me." What is your ethical obligation pursuant to Pablo's drinking?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of the ethical assessments and actions you can take to determine a client's ability to benefit from treatment.

A. If you have a sobriety contract in place, terminate any session at which Pablo comes in intoxicated.

B. Establish long-term sobriety as a treatment goal for Pablo.

C. If you have a no secrets policy in place, ask Felix to come for an individual session if Pablo is intoxicated.

D. Sign a self-care contract with Pablo that includes the provision that he will attend AA concurrent with couples' counseling.
Answer: 1.04 Competence
(c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm.
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Question: *135. Your 17-year-old client is the head of Parents, Families, and Friends of Lesbians and Gays (PFLAG) group at school. She tells you that some of the students blog about "conversion therapy" and she wants your "expert opinion" so she can share it with her group. If you explain the law prohibiting sexual orientation change therapy, you are:

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge about informed consent and what you are required to discuss.

A. Illegally acting outside of your scope of practice.

B. Ethically fulfilling informed consent.

C. Ethically working within your scope of competence.

D. Ethically managing your counter-transference.
Answer: a) When setting fees, social workers should ensure that the fees are fair, reasonable, and commensurate with the services performed. Consideration should be given to clients' ability to pay.
B. Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary.
(c) Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client.
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Question: *136. In working with a treatment team that consists of a therapist, medical doctor, and a nurse practitioner, the therapist has a release to speak with all of the client's health providers. The therapist should do which of the following to adhere to ethical standards?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to ethically retain confidentiality when working with a team of providers.

A. Provide the client with a copy of the release.

B. Avoid a dual relationship with any of the health care providers.

C. Only share information with those providers that advance the welfare of the client.

D. Only share information with those providers if the client is a danger to self or others.
Answer: Self- determination
Informed consent
Preserving professional boundaries
Safeguarding confidentiality
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Question: 137. You are seeing a client who has been in therapy before. As you begin your informed consent discussion, she asks you to "skip this part, I have heard it all before. I want to just start telling you what is going on. We are on the 50-minute clock." You tell her that you are required to provide at least the basics of informed consent. Informed consent should include all of the following EXCEPT:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent.

A. Excerpts of general therapy ethical standards.

B. A provisional diagnosis.

C. Information regarding the benefits and drawbacks of therapy.

D. The expected length of sessions and treatment.
Answer: What an ordinary reasonable and prudent professional with the same or similar training would have done under the same or similar circumstances
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Question: 138. Mr. Meltzer saw you for ongoing therapy for eleven months and still has an outstanding balance. You referred him to another therapist for clinical reasons, not related to his debt. He signed a release so that you can forward his record to his new therapist in another city. You proceed to:

Content Area: Ethics: Business Practices and Policies
This question reviews ethical guidelines and how they relate to patients who leave treatment with an outstanding balance.

A. Explain that you will forward his records when he pays the balance.

B. Ask his new therapist to collect the balance for you.

C. Release the records to a collection agency in order to obtain the balance.

D. Send his records as requested.
Answer: If parents are the one who consented to therapy they have the right to clinical records
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Question: 139. You are working as an intern at a non-profit agency. Your client of the past year has made substantial progress and the two of you enjoy a close relationship. You are now ready to leave the agency and will not be available to continue treatment with this client. Your ethical responsibility in this case would be to:

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to proceed when an interruption or termination of your services will occur.

A. Make appropriate referrals.

B. Since she knew that you were a registered associate when she started therapy, tell her that this type of termination is part of the licensing process.

C. Explain to your client why you cannot continue treatment with her.

D. Tell her that you will be able to meet her for coffee now that she is no longer officially your client.
Answer: Refers to the right to withhold information from court. Privilege exists to benefit of the client and belongs to the client
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Question: *140. Before accepting a client for telehealth services, what action should the social worker take?

Content Area: Law: Confidentiality, Privilege, and Consent
This question tests your knowledge of the laws that pertain to telehealth.

A. Determine the appropriateness of treating a client remotely.

B. Determine if the client is a resident of California.

C. Describe the risks, such as confidentiality risks, of internet therapy.

D. Provide detailed informed consent about the social worker's experience or limits of experience with telehealth.
Answer: -Supervision, consultation, TX team meetings, staff meetings
--Client waivers
--privileged communication
--danger to self or others
--suspicion of child/elder abuse
---subpoena
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Question: 141. You have been seeing your client, Anne, for seven months, who pays through her insurance company. She goes on vacation for three weeks and calls to schedule her next appointment. You explain to Anne that her insurance takes a long time to reimburse you. You give Anne the option to pay your full fee or to be given several referrals to other therapists. Is this ethically sound?

Content Area: Ethics: Therapeutic Relationship/Services
This question tests your knowledge of how to proceed with collecting payment.

A. Yes, because you are offering her either continued treatment at your usual and customary fee or referrals to other therapists.

B. No, because this is financial exploitation and does not demonstrate a clinically sound reason to terminate therapy.

C. Yes, because Anne went on an extended vacation thus causing a disruption in treatment.

D. No, because you are obligated to take insurance.
Answer: therapist obligation to keep information given in the therapeutic relationship free from unauthorized disclosures
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Question: *142. You have been seeing Juan and Lucita, a young unmarried couple, for a few months when they announce that they are expecting a baby for which they do not feel prepared. They want to use the therapy time to discuss their options of having the baby and keeping it, giving it up for adoption, or having an abortion. You have very strong feelings about abortion. You would:

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of handling situations that can potentially conflict with the social worker's values.

A. Tell them of your bias.

B. Keep your opinions to yourself.

C. Tell them you can't help them deal with this crisis because of your strong feelings and refer to another mental health professional.

D. Tell them it would be best if they talked to their priest about this matter.
Answer: Evidence Code 1010-1027: The legal right not to have confidential communication revealed in a legal setting.
Is a rule of evidence that allows one party in a legal proceeding (the client) to limit the admissibility of statements originally communicated in confidence, thus rendering the witness (therapist) incompetent to testify regarding a particular matter
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Question: *143. You, a social worker, and the attorney in your office building agree to work together and make referrals back and forth. You each commit to making three referrals monthly and that the person making the most referrals that actually turn into paying clients over the next three months will "win" a weekend for two in Las Vegas. This arrangement is:

Content Area: Law: Legal Standards for Professional Practice. This checks your understanding of business practices regarding paying for referrals.

A. Illegal; don't do it.

B. A bit unusual perhaps, but not unethical since the "prize" is not expensive and no one is really paying for referrals.

C. Likely to have you lose your license if you are reported to an ethics board.

D. Questionable at best and unethical since it is close to paying for referrals.
Answer: 1. Protection of life
2. Equality and inequality
3. autonomy and freedom
4. least harm
5. quality of life
6. privacy and confidentiality
7. truthfulness and full disclosure
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Question: 144. Greg, age 29, comes in to see you about relationship problems. He has been in a wheelchair for 10 years as a result of a diving accident. After you have been seeing him for several months, he reports that the female nurse that he needs to care for him has made unwanted sexual advances towards him. Legally you:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question addresses your knowledge of dependent adult abuse.

A. Do not need to report the incident because the law does not perceive women to be sexually abusive to adult males.

B. Would report the incident to Adult Protective Services immediately.

C. Would not report because both individuals are adults.

D. Would report by phone to Adult Protective Services within 2 working days.
Answer: Report by phone immediately or as soon as possible
Written report within 2 working days of receiving information
Usually reported to adult protective services or to local law enforcement agency
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Question: 145. You have been seeing a couple for several months. The therapeutic issues have focused on communication and trust. You receive a call from the husband who tells you that he has bought a gun "to protect my family from all of the violence out there." Since his wife is firmly against possessing guns, he has decided not tell her. You would:

Content Area: Ethics: Therapeutic Relationship/Services
This question involves ethics in application to secrecy in couples therapy.

A. Remind him of your no secrets policy and encourage the husband to tell his wife about the phone call and the gun.

B. Not bring up the content of the phone call since you've established that he is not intending to hurt his wife or children. This does not constitute a Tarasoff situation.

C. Focus on the issue of trust in their marriage which will encourage the husband to tell his wife.

D. Inform him that you do not keep secrets. You assume that he wants his wife to know or he would not have told you. Therefore, if he does not tell his wife in the next session, you will inform her of the conversation.
Answer: CPS phone call within 24 hours and fax written within 36 hours
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Question: 146. You receive a text from a potential client. She tells you that she got your name from a friend of hers and would like to know "what's involved in getting started with therapy." In response to her, you take a picture of your consent form and fee and send it to her. She responds "K" and asks when she can come for a first session. What is your next legal step?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal fee arrangements.

A. Obtain a written agreement about the fees for therapy.

B. Obtain written informed consent because "K" is not sufficient.

C. Discuss your consent form before she arrives for her first session.

D. Tell her that texts are part of her treatment file.
Answer: The duty to warn and to protect. If a client reports a threat to others and it is a serious imminent danger the clinician responsibility is to report the threat to victim, law enforcement and do what is in their power to stop client within reason.
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Question: 147. During a session with a couple in their 70's, you notice the man has a bruise on his head, and the woman tearfully admits that she loses her temper and hits him with pots and pans. In clinically managing the legal issue of elder abuse, how would you proceed?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your ability to balance your reporting responsibilities with your clinical need to maintain a safe therapeutic environment.



B. When the two are not in the room, call up an agency designated to take such a report, follow it up with a written report within 2 working days, create a "no violence plan," and refer to a support group.

C. Create a "no violence plan," teach time-outs, arrange for a support group, and if those interventions don't work, call an agency designated to take such a report.


Answer: Ewing vs Goldstein and Ewing vs. Northridge medical center
--court cases that extended the duty to protect identifiable victims from potential harm to include communication from a third parties (family members) that indicate a possible threat.
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Question: 148. Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem; the fee is covered under the overall adoption agreement." What are your ethical obligations?

Content Area: Ethics: Business Practices and Policies
This question tests your knowledge of ethical obligations.

A. Determine the family's understanding of the purpose of the therapy and refer for an academic assessment.

B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session.

C. Determine the identified patient and refer to a pediatrician.

D. Tell Chong-Wook and Dae-Sup the fee at the first session and explain that you may need to consult with the school counselor and adoption agency.
Answer: 1. Client confidentiality
2. informed consent
3. mandate to do no harm as a result of intervention and evaluation activities
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Question: 149. Rhonda, a 22-year-old college student, comes to therapy looking for advice. She says her boyfriend hit her last week and now she knows she should leave him, but it's very hard to do. In the past she has told him she didn't want to see him anymore, but she always gives in when he calls to get together again. She finds herself saying, "just one more time." She hates being alone and ends up seeing him for companionship. At the end of the session, she asks you if therapy is going to be able to help her. What is your next step?

Content Area: Ethics: Therapeutic Relationship/Services
This question requires that you stay focused on what a client is asking of you.

A. Provide a safe holding environment.

B. Explain the pros and cons of therapy.

C. Join with her concerning her fears.

D. Have her join a singles support group.
Answer: 1. Research participants must be volunteers
2. Potential participants should be given sufficient information about the study to determine any possible risks or discomforts as well as benefits
3. No harm shall result as a consequence of participation
4. Protection of sensitive information privacy of research is protected
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Question: 150. Your 18-year-old female client Martha tells you that she was molested on many occasions as a child. She tells you that she is now living with her boyfriend so that she doesn't have to stay in the same house where it all happened. She is hoping that a change of scenery is a first step in getting away from her childhood. What would be the most important legal requirement that you would have in such a case?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed in a case of historical child abuse.

A. Report the abuse to CPS immediately by phone and follow up with a written report within 36 hours.

B. Find out if the abuse has already been reported.

C. Explore if the perpetrator still lives in the area.

D. Maintain confidentiality.
Answer: Service
Social Justice
Dignity and worth of the person
Importance of Human Relationships
Integrity
Competence
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Answer: Therapeutic, legal & ethical issues ================================================== Question: What is a leading cause of ethical complaints? Litigation for malpractice? Answer: Confidentiality 4th most frequent basis of disciplinary action ================================================== Question: According to the NASW Code of Ethics, social workers should protect confidentiality of all info except for when? Answer: Compelling professional reasons As necessary to prevent "serious, foreseeable, and imminent harm" to a client or other identifiable person. ================================================== Question: To what level of detail should confidentiality be broken when necessary? Answer: In the”Question: Confidentiality falls into what three types of issues? Answer: Therapeutic, legal & ethical issues ================================================== Question: What is a leading cause of ethical complaints? Litigation for malpractice? Answer: Confidentiality 4th most frequent basis of disciplinary action ================================================== Question: According to the NASW Code of Ethics, social workers should protect confidentiality of all info except for when? Answer: Compelling professional reasons As necessary to prevent "serious, foreseeable, and imminent harm" to a client or other identifiable person. ================================================== Question: To what level of detail should confidentiality be broken when necessary? Answer: In these instances, professionals should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed. ================================================== Question: What type of consent is required in order for mental health professionals to disclose to third parties? Answer: Written Verbal - in emergency situations only ================================================== Question: What are the exceptions to confidentiality? Answer: Under California law, there are several exceptions to the confidentiality of psychotherapy. The primary exceptions to confidentiality concern harm to self or others: Where there is a reasonable suspicion that a client is likely to harm him or herself unless protective measures are taken. Where there is a reasonable suspicion of child abuse or elder adult physical abuse (see Mandated Reporting section); Where there is a reasonable suspicion of the potential for danger of violence to others (see Duty to Warn section); ================================================== Question: What is reasonable suspicion according to Lowenthal Child Abuse Reporting guidelines? Answer: 1. Reasonable suspicion does not require certainty that child abuse or neglect has occurred; 2. Reasonable suspicion does not require a specific medical indication of child abuse or neglect; any reasonable suspicion is sufficient; and 3. Reasonable suspicion may be based on any information considered credible by the reporter, including statements from other individuals. ================================================== Question: How should a therapist approach treatment confidentiality with families or couples? Answer: It is important for the provider to be specific with regard to confidentiality issues and to seek agreement among the parties involved concerning each individual's right to confidentiality and obligation to preserve the confidentiality of information shared by others. ================================================== Question: How should a therapist approach treatment confidentiality with groups? Answer: The mental health provider cannot guarantee that group members will keep information confidential and this information is important to share with all group members in advance of group psychotherapy. ================================================== Question: Can clients access their therapeutic medical record? Answer: Yes - clinicians are ethically mandated to support clients in record review. Per the NASW ethical code: "Social workers should provide clients with reasonable access to records concerning the clients. Social workers who are concerned that clients' access to their records could cause serious misunderstanding or harm to the client should provide assistance in interpreting the records and consultation with the client regarding the records. Social workers should limit clients' access to their records, or portions of their records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to the client. Both clients' requests and the rationale for withholding some or all of the record should be documented in clients' files." ================================================== Question: What is privileged communication? Answer: Privileged communication refers to a private statement that must be kept in confidence by the recipient for the benefit of the communicator." ================================================== Question: How many privileges are there in CA? Answer: 13 recognized ================================================== Question: Who holds the privilege? Answer: Client if no guardian or conservator If so, guardian/conservator holds it ================================================== Question: Who holds privilege if client is dead? Answer: Personal representative ================================================== Question: If you want to release information from a group, family or couple, what must you do? Answer: • If your identified patient is a group, family, or couple you must receive a waiver from each and every member of the group before you can release any information. ================================================== Question: Do minor children hold privilege? Answer: Yes - If your patient is a minor child, he or she holds the privilege. A minor's parents do not hold the privilege for the minor. The only time a parent could hold the privilege for the minor is if the court has specifically appointed the parent as a guardian ad litem ================================================== Question: How is privilege asserted for minors with regard to attorneys? Answer: • If your patient is a minor, you must assert the privilege on his or her behalf. If the minor has an attorney, the attorney can make the decision to waive or assert the privilege. ================================================== Question: What does the NASW Code of Ethics say about when the law orders social workers to break confidentiality without client permission? Answer: Social workers should protect the confidentiality of clients during legal proceedings to the extent permitted by law. When a court of law or other legally authorized body orders social workers to disclose confidential or privileged information without a client's consent and such disclosure could cause harm to the client, social workers should request that the court withdraw the order or limit the order as narrowly as possible or maintain the records under seal, unavailable for public inspection." Although it is ethically preferable, then, not to reveal treatment information, this may still be required by the court. ================================================== Question: What could happen if a provider receives a subpoena from an attorney to provide copies of clinical records? Answer: waive privilege and allow the provider to provide the subpoenaed information; or invoke privilege and refuse to allow the release of information. In the latter case, the judge will determine whether the treating professional must release information and the judge can issue a court order. ================================================== Question: What is required in order for a social worker to be forced to provide information even though privilege is invoked? Answer: Court order by the judge ================================================== Question: In CA, how old must minors be to consent to mental health treatment or counseling if 2 requirements are met? What are the requirements? Answer: 12 a) 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 1) The minor would present a danger of serious physical or mental harm to self or others without the mental health treatment or counseling or residential shelter services or 2) is an alleged victim of incest or child abuse." ================================================== Question: If requirements are met, can minors 12+ consent to medical care and counseling related to dx and tx of a drug or alcohol problem? What about psych meds or inpt hospitalization? Answer: Yes to subst abuse tx No to psych meds or inpt hospitalization - both require parental consent ================================================== Question: What is required to share a minor's (12+) information/medical record with others, including parents? Answer: Minor's written consent ================================================== Question: Should a provider attempt to involve a parent/guardian in a minor's tx? Answer: Yes - unless inappropriate ================================================== Question: At what age does a person become an "elder" under California Welfare and Institution Code? Answer: 65 ================================================== Question: When should a therapist file a report? How about for APS? Answer: Immediately by phone and a written report within 36 hours Immediately by phone and written report within 2 working days ================================================== Question: What do mandated reporters have immunity to? Answer: Civil & criminal liability ================================================== Question: What is a mandated reporter subject to if they fail to file a report? Answer: Misdemeanor criminal prosecution & fines If harm comes to a child through the result of a professional's failure to report abuse, even stiffer penalties may exist. ================================================== Question: What does CA require of social workers applying for a license with regard to child abuse reporting? Answer: Due to the importance of accurate knowledge of child abuse, all persons applying for a license as a marriage and family therapist or clinical social worker needs to complete at least 7 hours of training in child abuse assessment and reporting. Additionally the BBS will not issue a license to a person who has been convicted of a crime in this or any other state or in a territory of the United States that involves sexual abuse of children or who is required to register pursuant to Section 290 of the Penal Code or the equivalent in another state or territory. ================================================== Question: What is Laura's Law? Answer: "Laura's Law," was written in response to these concerns. Laura's Law allows California counties to decide whether to opt to implement a community-based, court-monitored outpatient treatment program. These programs require outpatient treatment for a seriously mentally ill person who is unlikely to survive safely in the community without supervision, has a history treatment noncompliance, and presents a serious risk of harm to self or others. At the present time some, but not all, California counties have adopted Laura's Law. ================================================== Question: When can a person be placed in assisted outpatient treatment? Answer: The person must: 1) Be eighteen years of age or older; 2) Be suffering from a mental illness; 3) Be unlikely to survive safely in the community without supervision 4) Have a history of non-compliance with treatment that has either: 5) Have been offered an opportunity to voluntarily participate in a treatment plan by the local mental health department but continue to fail to engage in treatment; 6) Be substantially deteriorating; 7) Be, in view of his or her treatment history and current behavior, in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would likely result in the person meeting California's inpatient commitment standard, which is being: A.) A serious risk of harm to himself or herself or others; or B.) Gravely disabled (in immediate physical danger because unable to meet basic needs for food, clothing, or shelter); 8) Be likely to benefit from assisted outpatient treatment; and 9) Participation in the assisted outpatient program is the least restrictive placement necessary to ensure the person's recovery and stability. ================================================== Question: Who can file a petition for AOT? Answer: Only the county mental health director may file a petition for AOT, but treatment providers or family members may request that such a petition be filed. ================================================== Question: How may a therapist carry out the "duty to protect?" (Tarasoff) What is the consequence of not acting? Answer: - Notify the police - Warn the intended victim - And/or take other reasonable steps to protect the individual - the psychotherapist's duty is to make a "reasonable effort to communicate the threat to the victim or victims and to a law enforcement agency" Failure to act may also result in potential civil liabilities ================================================== Question: When is Tarasoff required? Answer: "where the patient has communicated to the psychotherapist a serious threat of physical violence against a reasonably identifiable victim or victims" ================================================== Question: Is there a difference in duty to protect if a pt communicates directly to therapist vs. info relayed by an immediate family member? Answer: No - duty is the same *Only if a family member communicates this. Not beyond ================================================== Question: What are some symptoms of compassion fatigue? Answer: Relational/Work-Related Symptoms (Lombardo & Eyre, 2011) • Avoidance or dread of working with certain patients • Boundary issues, such as over-involvement with patients • Reduced ability to feel empathy towards patients or families • Frequent use of sick days Physical/Emotional Symptoms • Lack of joyfulness/Irritability • Poor concentration, focus, and judgment • Sleep disturbances • Excessive use of substances Anxiety ================================================== Question: What assessment can be used free of charge to self-monitor compassion fatigue? Answer: Proquol ================================================== Question: Can social workers consult with colleagues for advice on areas outside their scope of practice? Answer: Yes - do so with the least amount of information necessary ================================================== Question: What is informed consent? Answer: "agreement to a proposed course of treatment based on receiving clear, understandable information about the treatment's potential benefits and risks." Includes: 1) a description of the diagnosis, treatment, risk and benefits 2) discussion of other options, 3) clinician's qualifications to perform treatment. ================================================== Question: What should be included in informed consent and how should it be conducted? Answer: Informed consent may take various forms, such as a client information brochure or a discussion between client and therapist. Whatever format it takes, informed consent should include the following factors: -Goals of therapy/psychotherapy services -Risks and benefits of therapy -Approximate length of the process -Alternatives to therapy -Fees and services, including processes if bills are not paid -Qualifications and background of the counselor -Treatment procedures, including emergency procedures -Third party disclosures -Choices between paying with and without insurance -Limits of confidentiality ================================================== Question: Is informed consent required for school-based psych services b/w teacher & therapist? What about a psych crisis? Answer: No - as long as interventions are under the authority of the teacher & w/i scope of typical classroom intervention Parent consent is required if consultation is extensive or intrudes on student/family privacy; and for mental health screenings No ================================================== Question: Written informed consent is required when? Answer: Psychosurgery, ECT, research studies ================================================== Question: LEGAL: Privilege does not apply in the following circumstances Answer: The client authorizes a release of information A therapist is legally mandated to breach confidentiality The client has disclosed a significant part of the information to a third person The situation represents one of the legally defined exceptions to privilege. ================================================== Question: LEGAL: Privilege and Patient-Litigant Exception Answer: Legally Defined Exception to privilege If a patients emotional condition has been raised as an issue by the patient or representative ex: employee suing boss for sexual harassment claiming it caused emotional distress that led to diagnosis of panic disorder. Information obtained by woman's therapist relevant to her diagnosis is not privileged ================================================== Question: LEGAL: Privilege exceptions in Court-Appointed Psychotherapy Answer: Legally Defined Exception to privilege Therapist has been appointed by court to examine defendant as long as it wasn't defendants attorney wasn't the one to request. Example: Judge orders man on trial for murder to undergo psychological testing to decide if he is competent to stand trial. Information obtained in eval. relevant to competence is not privileged. ================================================== Question: LEGAL: Proceeding to Establish Competence Answer: Legally Defined Exception to privilege Example: daughter of man with suspected cognitive disabilities request conservatorship. Therapist who evaluated man may testify about results of cognitive evaluation. ================================================== Question: LEGAL: Patient under 16 is a Victim of a Crime Answer: Legally Defined Exception to privilege Example: Therapist testifies in court on behalf of 14 yr old boy who told her older teenagers were extorting money from him. Exception to privilege to protect boy from harm. ================================================== Question: ETHICAL: NASW Core Values Answer: Service Social Justice Dignity and Worth of the Person Importance of Human Relationships Integrety Competence ================================================== Question: A therapist is treating a mother, step-father, 12-year-old son and 4-year old daughter for family therapy. The mother requests that the therapist speak to the son's teacher because he has been complaining of problems in the classroom. When obtaining a release to speak to the teacher, the therapist must get written consent from the entire family. Answer: False ================================================== Question: According to HIPAA, psychotherapy notes are released to third-party payers for billing. Answer: False ================================================== Question: A therapist who was a victim of sexual abuse as a child meets with an 18-year-old client who also experienced childhood sexual abuse from a teacher. The therapist is concerned about working effectively with this client due to her lack of experience in treating sexual abuse. It is appropriate for the therapist to refer the client to someone who specializes in sexual abuse because it is out of the therapists scope of competence. Answer: True ================================================== Question: A therapist should always support a client's right to self-determination first. Answer: True ================================================== Question: A safety plan does not include giving the client Domestic Violence resources. Answer: False ================================================== Question: A client, who is a single mother, informs the therapist that she was offered a better job in another state where she does not know anyone. She requests assistance finding childcare for her 5-year old. She adds that she thinks that it would be easier for her to remain in her present living arrangement with her parents until the child is older. The therapist thinks the client should stay. The therapist should explore the pros and cons of her options. Answer: True ================================================== Question: During informed consent, the client should always have a good understanding of what services they are receiving. Answer: True ================================================== Question: A therapist accepts insurance in private practice. The insurance company sends notice to the therapist requesting copies of five client files for an audit. This is a typical practice of the insurance company. The therapist should make sure each file has an authorization and then submit the files. Answer: True ================================================== Question: A mother of an 11-year-old boy was arrested and subsequently ordered to enter a 90-day detox facility for drug and alcohol abuse. The son was sent to live with a foster family temporarily when the mother went into a detox facility. The child has been court-ordered to attend therapy. The therapist should obtain consent for his treatment from first the lawyer and second the social worker. Answer: True ================================================== Question: A therapist has been seeing a gay couple for several months for relationship issues. Between sessions, one of the men calls distraught because he learned he has HIV. "I don't know what to do! Please don't tell my partner." The therapist should assure him that you will maintain his confidentiality and explore his reasons for not wanting his partner to know. Answer: True ================================================== Question: Fees are not a legally required aspect of informed consent. Answer: False ================================================== Question: A therapist is part of an interdisciplinary team at a residential center for teens. The therapist should make it clear to the residents that confidential disclosures are shared with the treatment team. Answer: True ================================================== Question: A therapist does not have to accept a subpoena. Answer: False ================================================== Question: A client seeks therapy for anxiety after a car accident. She also decides to sue the driver of the other car who was at fault claiming that the accident has left her too anxious to drive. The therapist receives a subpoena for the client's records and should accept the subpoena, maintain confidentiality, and assert privilege if the client so directs. Answer: True ================================================== Question: A therapist treating an EAP client or court ordered client can only provide attendance history when their employer or probation officer contacts the therapist for updates. Answer: True ================================================== Question: A therapist should never respect a client's beliefs, especially if the therapist has different beliefs. Answer: False ================================================== Question: A therapist should always respect a client's beliefs unless it is affecting the therapist and not allowing them to do their job appropriately. Answer: True ================================================== Question: 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. The case manager should report the situation to the police immediately. Answer: True ================================================== Question: A therapist is allowed to confirm or acknowledge a client at the request of a lawyer. Answer: False ================================================== Question: If a therapist denies client access to their records and the client becomes angry, the therapist should consult a lawyer. Answer: False ================================================== Question: A therapist can bill the insurance for a missed client appointment, but they may not pay. Answer: True ================================================== Question: A recently licensed therapist took one course on emotionally focused therapy during his internship. Now that he is licensed it is appropriate for him to advertise himself as having an "expertise in emotionally focused couples therapy." Answer: False ================================================== Question: 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. It is appropriate for the clinician to accept produce from client's farm as payment if that is client's only source of payment. Answer: True ================================================== Question: A client 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. The clinician should terminate services if it is clear that the client is not a danger to self or others. Answer: True ================================================== Question: 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. It is acceptable for the client to provide house repair services for the therapist in exchange for continuing therapy. Answer: False ================================================== Question: A therapist, who was formerly employed as a financial planner, now treats couples with relationship issues. It is acceptable for the therapist to assist couples he is treating with financial planning when that is one of the sources of their conflict. Answer: False ================================================== Question: A therapist has been treating a woman for depression in private practice for four months. During an emotional session the client discloses that she was sexually molested when she was eight by her neighbor. Since the therapist has minimal training in treating childhood sexual abuse it is acceptable for the therapist to refer the client to a trained child sexual abuse therapist. Answer: False ================================================== Question: A therapist has been treating a client with Generalized Anxiety Disorder for five months. The client's symptoms have disappeared and the client is functioning well. The therapist enjoys the sessions with the client so she has been reluctant to bring up termination. Also, the client pays full fee and the therapist is worried about losing the income. It is unethical for the therapist to continue therapy with this client. Answer: True ================================================== Question: A 13-year-old girl is referred by her teacher for therapy for depression. The therapist determines she is mature enough to consent for her treatment. LEGALLY the therapist should first determine whether her parents should give consent. Answer: True ================================================== Question: A new client comes to the initial therapy session in crisis. The therapist does not inform the client of the fee prior to the initial session. When the client receives the bill, she refuses to pay. In this situation, the therapist should accept the client's refusal to pay. Answer: True ================================================== Question: A therapist in a small rural community has decided to consult with a colleague about a client who does not seem to be progressing in therapy. As part of the consultation the therapist should obtain a release from the client since the colleague might know him/her. Answer: True ================================================== Question: A client wants to see his records. The therapist determines that there is high risk of detrimental consequences to the client if the client were to see the records. The therapist should deny the request to access the records and document why it was denied. Answer: True ================================================== Question: A therapist is working in a small rural town and is the only provider within the area. A neighbor from a nearby farm requests that her son receive counseling services. The therapist has seen the boy on several occasions in the local store, but has minimal interaction with him or his mother. The therapist should decline to provide therapy to the client. Answer: False ================================================== Question: A therapist receives an order from the court for a former client's records. The therapist is concerned that the release of the records will cause harm to the client. The therapist advocates to the court to limit the scope of the release. The court declines the request so the therapist must provide a copy of the records immediately. Answer: True ================================================== Question: During a session, a client makes a vague threat toward his former boss. When the therapist asks what the client means by the statement, the client ignores the question. The therapist should remind client you are a mandated reporter. Answer: False ================================================== Question: A court-ordered client with a history of violence shares that he is really pissed off at his former boss and is "going to wait for him after work one of these days to make him pay." When the therapist asks the client what he means by the statement, the client tells him angrily to "forget it". Due to client's violent history and the fact that he does not want to discuss it, the therapist should inform the police. Answer: True ================================================== Question: The informed consent for treatment is not part of the summary of records. Answer: True ================================================== Question: The purpose of laws and regulations pertaining to psychotherapy advertising is to ensure the public is well-informed and not misled. Answer: True ================================================== Question: It is unethical for a therapist starting a new practice to advertise in her community. Answer: False ================================================== Question: A gay couple comes in to see you for the first session. They state that they have been referred by one of the partner's individual therapist. The referring therapist told them that you have extensive experience in working with gay couples. In actuality, you have treated a good number of heterosexual couples, but have seen only a few gay couples. As their therapist you should correct the inaccurate information with both the couple and the referring therapist without divulging your client's identity. Answer: True ================================================== Question: To what services can minors consent to at any age? Answer: Pregnancy, contraception, abortion (no parental contact without written consent) Sexual assault/rape services under 12: med dx, tx & evidence collection (provider must attempt to contact parents & report to CPS) ================================================== Question: Is ECT allowed for minors? Answer: ♣ 12-15 only if considered life-saving - both child and parent consent required ♣ 16-17 - voluntary consent by minor; share with parents with written consent ================================================== Question: To what services can 12+ consent to? Answer: Parent comm not permitted without written consent: - ID/STI prevention, dx, tx - AIDS/HIV testing & tx - Rape services - Outpt mental health services (have to attempt to involve parents; can discuss verbally, but medical records require written consent) ---> minor has to be mature enough & present danger/harm to self or others w/o tx OR is alleged victim of child abuse or incest ================================================== Question: To what services can minors not consent to, even if 12+? Answer: Psych meds Inpt psych hospitalization (parents cannot force tho unless 5150) ================================================== Question: If a child is under 14, who are they legally permitted to have sex with? 14/15? 16+? Answer: Under 14 14 - 21 Any age ================================================== Question: Is emotional abuse required to be reported to CPS? Answer: No ================================================== Question: How old is an elder? Answer: 65+ ================================================== Question: How soon must verbal and written reports be made for child abuse? Answer: Immediately w/i 36 hours for written ================================================== Question: How soon must verbal and written reports be made for elder abuse? Answer: Immediately (by phone or confidential internet reporting tool) w/i 2 working days for written ================================================== Question: What form is used for written abuse reports? Answer: DOJ form ================================================== Question: How many hours of training in child abuse assessment is required of LCSWs? Answer: 7 hours ================================================== Question: Can a person/agency be at risk for litigation upon a negligent/intentional confidentiality breach even if the person drops charges? Answer: Yes A licensing or certifying board may assess an admin fine or civil penalty whether or not the patient suffers any damages (CA confidentiality of medical information act - CMIA) Lanterman-Petris-Short Act (LPS): civil damages for negligent disclosure ================================================== Question: When is drug use by parents reportable to CPS? Answer: When parent is manufacturing a controlled substance in the presence under a child of age 16 Other drug use would only be reportable if the father could not care for his child safely as a result of use ================================================== Question: What is required when a baby is born with positive drug tox/withdrawal sxs? Answer: An assessment of needs for the infant and infant's family and to make a referral for appropriate services ================================================== Question: How should social workers act when they disagree with agency policy or procedure? Answer: - Advocate & discuss with colleagues & admin first informally - If necessary, do the above but more formally - If necessary, involve appropriate outside agencies (governors office, media, advocacy organization) - Avoid conflicts of interest by informing clients of real or potential conflicts of interests ================================================== Question: How long must medical records be retained after client discharge? Answer: 7 years (but 10 is recommended) For minors, at least 7 years after they turn 18 ================================================== Question: What is the NASW's position regarding sliding-scale fees? Answer: Consideration should be given to the client's ability to pay ================================================== Question: What should clients of military therapists be informed of? Answer: Military therapists have neither control over whom they consult or evaluate nor ways to prevent dual relationships and conflicts of interest. Clients in these settings must be fully informed of the disclosures that may result from the unavoidable dual relationship. Comparable conflicts may arise when non-military therapists are involved in court cases. - They are legally mandated to the dual roles - National defense, unit integrity, combat readiness etc are higher than individual welfare in the military - Sometimes people serve alongside clients in military as officers & also as guards in prisons ================================================== Question: What information are military commanding officers allowed to know about information obtained by a social worker? What about what information is required to be reported to prison authority? Answer: - Relevant to national security or combat readiness - Relevant to security & safety ================================================== Question: What disclosures can be made of people in correctional institutions? Answer: 1) Provision of health care 2) Health and safety of inmate and other inmates; also of correctional institution personnel; personnel responsible for transporting/transferring inmates 3) Law enforcement on the correctional institutions premises 4) the 'administration and maintenance of the safety, security, and good order' of the institution Fugitive - no restrictions - as it is useful for apprehension of the inmate ================================================== Question: Can prisoners obtain med records copies, billing or other records? Answer: No - not allowed to obtain a copy. Can inspect records unless they are psychotherapy notes or contain info for criminal/admin proceedings Can deny if access would put at risk the health, safety, security, custody, or rehabilitation of the inmate or other inmates, or the safety of any officer, employee, or other person at the correctional institution as well as the safety of any person responsible for transporting the inmate ================================================== Question: Under HIPPA do client's have the right to see their psychotherapy notes? Answer: No - therapists have the right to keep them private (as long as they are kept separate from the medical record) They can be made available to other providers given client's consent ================================================== Question: What is the CA statute of limitations on civil action? Answer: Between 1 - 4 years ================================================== Question: What is required for breach of confidentiality with regard to SI? Answer: Plans, means & intent ================================================== Question: What is the 4th most common disciplinary action? Answer: lack of keeping client confidentiality ================================================== Question: What is a leading cause of litigation? Answer: breech of confidentiality ================================================== Question: According to the Code of Ethics, when is the only exception for breeching confidentiality? Answer: compelling professional reasons ================================================== Question: When is the only time, beside a court subpoena, that a counselor can release protected client information? Answer: Written consent from client or legal guardian ================================================== Question: T or F? Keeping client information confidential does not include when disclosure is necessary to prevent serious forseeable imminent harm to client or others. Answer: T ================================================== Question: T or F? Counselors should provide the most amount of information when disclosing confidential information. Answer: F ================================================== Question: T or F? Verbal consent to disclose client information is never permitted. Answer: F, verbal consent is ok in emergency situations ================================================== Question: What is informed consent? Answer: A client is informed in advance, circumstances under which the counselor is allowed to disclose client information ================================================== Question: What are the stipulations of breaking confidentiality? Answer: 1. when a client is at harm of hurting oneself if protective measures were not taken 2. Reasonable suspicion of child or elder abuse/neglect 3. reasonable suspicion of potential for danger/violence to others ================================================== Question: How does confidentiality work when you are doing psychotherapy with a group/family? Answer: counselor must be clear and specific as to confidentiality issues and to review each member's right to confidentiality & obligation to preserve the confidentiality of information by others ================================================== Question: T or F? A provider cannot ensure that confidentiality will be kept by other group members. Answer: T ================================================== Question: What is privilege? Answer: legal right of keeping clinical records confidential ================================================== Question: How does NASW stand on court order of client records? Answer: Social workers should protect the confidentiality of clients during legal proceedings to the extent permitted by law. When a court of law or other legally authorized body orders social workers to disclose confidential or privileged information without a client's consent and such disclosure could cause harm to the client, social workers should request that the court withdraw the order or limit the order as narrowly as possible or maintain the records under seal, unavailable for public inspection ================================================== Question: What is the term, "age of consent"? Answer: laws related to the legal and medical rights of minors and is the age at which a minor can consent to tx without parental authorization ================================================== Question: T or F? Mandated reporters have immunity from civil and criminal liability Answer: T ================================================== Question: What happens if you know or have suspicion of abuse/neglect and you do not report it? Answer: punishment of misdemeanor criminal prosecution and fines ================================================== Question: T or F? No client has 100% guarantee of complete confidentiality Answer: T ================================================== Question: What is the primary goal of social work? Answer: enhance human well-being and help meet the needs of all people who are vulnerable or oppressed ================================================== Question: T or F? Child abuse is usually found in a combination of types rather than alone. Answer: T ================================================== Question: What are the five things to take into consideration when looking at child abuse? Answer: 1. age of child 2. Developmental levels of child 3. severity of action 4. frequency of action 5. contextual=historical/cultural perspectives of family ================================================== Question: What is MBP? Answer: intentional simulation of physical illness by a parent in his or her child, usually for the purpose of attention. This may include fabricating symptoms or actually inducing symptoms (such as causing a child to have a fever, feeding the child things he or she should not ingest, etc.) ================================================== Question: What constructs child neglect? Answer: emotional, physical and educational ================================================== Question: What does physical neglect entail? Answer: Physical neglect includes refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision. ================================================== Question: What does educational neglect entail? Answer: Educational neglect includes the allowance of chronic truancy, failure to enroll a child of mandatory school age in school, and failure to attend to a special educational need. ================================================== Question: What does emotional neglect entail? Answer: Educational neglect includes the allowance of chronic truancy, failure to enroll a child of mandatory school age in school, and failure to attend to a special educational need. ================================================== Question: What is the most difficult subset of abuse to prove? Answer: emotional abuse= emotional injury AND Change in emotional stability of child ================================================== Question: What are signs of physical abuse? Answer: • Has unexplained burns, bites, bruises, broken bones, or black eyes • Has fading bruises or other marks noticeable after an absence from school • Seems frightened of the parents and cries when it is time to go home • Shrinks at the approach of adults • Reports abuse to you or another adult caregiver ================================================== Question: What are signs of child neglect? Answer: • Is frequently absent from school • Begs or steals food or money • Lacks needed medical or dental care, immunizations, or glasses • Is consistently dirty and has severe body odor • Lacks sufficient clothing for the weather • Abuses alcohol or other drugs • States that there is no one at home to provide care ================================================== Question: What are signs of child sexual abuse? Answer: • Suddenly refuses to change for gym or to participate in physical activities • Reports nightmares or bedwetting • Experiences a sudden change in appetite • Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior • Becomes pregnant or contracts a venereal disease, particularly if under age 14 • Runs away • Reports sexual abuse by a parent or another adult caregiver ================================================== Question: What are the 3 components of HIPAA? Answer: 1. Portability standards that ensure the continuity of healthcare 2. Privacy standards that govern the disclosure of protected health information 3. Security standards that protect the development and maintenance of health information ================================================== Question: Why was HIPAA established? Answer: to protect PHI- protected health information ================================================== Question: T or F? psychotherapy notes are treated differently than health records. Answer: T, more discretion, clients do not have right to obtain copy under HIPAA ================================================== Question: What is HIPAA's definition of psychotherapy notes? Answer: That the notes are kept separate from the rest of the client chart ================================================== Question: What would the Notice of Privacy Practices include? Answer: • Information about treatment issues (e.g., the coordination or management of PHI with a third party • Submission of PHI for Payment • Exceptions to Confidentiality • How Sensitive Health Information is handled • Right of Access to medical records. ================================================== Question: What is a central issue around advertising? Answer: potential vulnerability of the client relative to the therapist. Vulnerability may include client insecurities, emotional problems, or lack of information about professional psychology services. ================================================== Question: What does Tarasoff law entail? Answer: therapist must warn the person whom the threat is advanced toward "duty to protect" -notify police -warn victim ================================================== Question: What does Ewing law entail? Answer: The court did not differentiate between threats conveyed directly by the patient and those related by an immediate family member of the patient. -hear from patient or family member ================================================== Question: What is true of the Standard of Care? Answer: 1. it is a legal concept 2. it is continually changing 3. it is derived from legal professional-communal principles ================================================== Question: a therapist is seeing a woman for depression and her goal is to pay taxes back. The therapist is also a public accountant. The client asks to bring in her documents to the next session. What should the therapist do? Answer: Refuse because it is outside her scope of practice ================================================== Question: A new client seeks tx for 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 tx. The bx of the therapist is: Answer: Unethical because the therapist is working outside her scope of competence ================================================== Question: A therapist should honor a client's self-determination in all of the following scenarios except: Answer: When the client is in danger of harming himself ================================================== Question: In what situation would a therapist not be required to obtain informed consent? Answer: the therapist is contacted by an adult patient who has SI and a plan ================================================== Question: A therapist arrives at the office and sees a client has broken in and is looking through files. The therapist should: Answer: call the police and inform them of the name of the client ================================================== Question: In what situation does a client not have privilege? Answer: When a client files a malpractice suit against the therapist ================================================== Question: A client seeks tx from a therapist for anger after finding out about his partner's extramarital affair. In the first session he states he will do "whatever it takes" to get even. What should the therapist do? Answer: Seek further clarification of the statement ================================================== Question: A family comes to therapy and the 14 year old son has been found drunk twice. The son says in session, "I hate school. I get bullied everyday. You guys don't care. You just pray". What should the therapist assess next? Answer: Son's risk of self harm. ================================================== Question: A woman comes to therapy and discloses that she has been abused by her husband and that her children have been witness to the abuse for last 2 months. How should the therapist respond? Answer: Develop safety plan with client ================================================== Question: A therapist is contacted by a new client's conservator, which is the brother of the client who is dx with schizophrenia. The brother wants to be present in sessions to make sure the client is not lying and telling accurate information. What should the therapist do? Answer: explore pros and cons of including the brother and set appropriate boundaries ================================================== Question: A client submits a written request to access their records. There is not a clinical reason to withhold the records. What should the therapist do? Answer: The client may inspect the records within 5 days, receive a tx summary within 10 days, or receive a copy within 15 days ================================================== Question: in order to meet the standard of care in the event of the death of a therapist, the therapist should: Answer: create an up-to-date professional will ================================================== Question: A therapist must comply with HIPAA regulations if: Answer: The therapist communicates electronically with patients ================================================== Question: A couple seeks therapy for relationship issues. They want to use the wife's insurance and request the therapist bills insurance for individual tx of anxiety. The therapist agrees. The therapist's decision is: Answer: unacceptable because it is illegal ================================================== Question: A therapist attends a 2-day workshop on tx sexual disorders. Besides the workshop the therapist has no other training. After the workshop, he lists the Treating SexualDisorders as expertise. The action is: Answer: illegal and unethical ================================================== Question: A therapist has been seeing a client for 6 months but the client moves to WA. The client sees other therapists in WA but does not feel its a good fit and wants to continue services with therapist over the phone. The therapist agrees and reviews the tele therapy consent for tx. The action is: Answer: illegal ================================================== Question: A therapist receives a phone call from a prospective client. When is the therapist legally obligated to discuss fees? Answer: prior to the onset of therapy. ================================================== Question: a client dx with schizophrenia has been given a prescription for med by psych. the client stopped taking the med because of side effects. What should the therapist do? Answer: refer the client back to the psychiatrist ================================================== Question: A therapist discovers she attends the same church as a client. The client asks the therapist to accompany her on weekly church services. The client says it is hard for her to get around and does not have support nearby. There therapist should: Answer: clarify professional boundaries ================================================== Question: If a therapist is in a first session/intake with a client where they feel uncomfortable in working with the client due to sexual orientation. What should the therapist do? Answer: Seek consultation with colleagues to discuss discomfort. ================================================== Question: What should a therapist do when a client tells them they had a sexual relationship with a previous therapist? Answer: provide the client with the brochure "Professional Therapy Never Includes Sex" ================================================== Question: A therapist in private practice has been seeing a client for three months and has not noticed a change in the client's sx or affect. The therapist should: Answer: seek consultation from a an experienced colleague about the case ================================================== Question: A therapist wants to submit a research article in a professional journal. The therapist submits an abstract proposing a study of panic disorders. What should the therapist do first? Answer: Obtain informed consent from subjects ================================================== Question: During supervision, the supervisee invites the supervisor to birthday party. The supervisor likes the supervised and would like to attend. The supervisor should: Answer: acknowledge the invitation and desire to attend, but explain importance of professional boundaries ================================================== Question: A woman has been in therapy for two years for depression. She would like to continue therapy in fear her life will go back to the way it was. What should the course of tx be? Answer: discuss termination issues and gradually decrease the frequency of contact ================================================== Question: Type abuse that is optional to report, a permitted report Answer: Emotional abuse ================================================== Question: Time in which written must be made in the case of suspected child abuse Answer: 36 hours on Department of Justice forms ================================================== Question: Time in which report of elder abuse, not in a care facility, required, both verbal and written reports Answer: report must be made by phone ASAP and written report made in 2 working days ================================================== Question: Time in which report of elder physical abuse is required, w/ serious bodily injury, when abuse is occurring in a long term living facility Answer: 24 hours by phone to law enforcement, written report 24 hours to law enforcement AND local Ombudsman AND Long Term Care facility licensing board ================================================== Question: Time in which report of elder physical abuse is required, with out serious bodily injury, when abuse is occurring in a long term living facility Answer: ASAP by phone to local law enforcement OR local Ombudsman, written report within 2 business days to law enforcement OR Ombudsman ================================================== Question: Headland vs Orange County Answer: mental health worker is liable to foreseeable bystanders if worker does not for fill Tarasoff responsibility ================================================== Question: Evidence Code 1024 Answer: gives mental health professionals permission to break confidentiality to prevent Cx harm to self, others or property ================================================== Question: Release of Authorization can be revoked only when Answer: Clinician receives written notification from the Cx requisition revocation ================================================== Question: Length of time 2015 ruling determines clinicians must retain records after service termination date Answer: 7 years after termination of service date ================================================== Question: Length of time records of a minor are to be retained after service termination Answer: Minimum of 7 years after Cx turns 18 ================================================== Question: Progress notes are Answer: legal and held to standard of care ================================================== Question: Process notes are Answer: subjective and only for the professional to use and should be destroyed when no longer relevant and necessary to cx's Tx ================================================== Question: Authorization to mental health services when parents are in an intact marriage Answer: each parent can authorize Tx, however it is recommended that both be included ================================================== Question: Authorization to mental health services when parents are divorced and have joint legal custody Answer: both parents can consent to Tx ================================================== Question: Authorization to mental health services when parents are divorced and one parent has soul legal custody Answer: only parent with soul legal custody can consent to Tx ================================================== Question: uthorization to mental health services when child is in Foster Care Answer: the child's attorney can authorize consent to Tx ================================================== Question: Length of time Care Givers Authorization Affidavit is valid Answer: 1 year after the sign in date and can be revoked if the legal parent decides to consent or revoke Tx ================================================== Question: As of the 2011 court ruling pertaining to minors ability to consent to own Tx minors can... Answer: consent to their own Tx if the minor is 12+ years of age and mature enough to participate in therapy ================================================== Question: Clinicians responsibility if Cx states that another therapist engaged in sexual activity with Cx Answer: present the Cx with the brochure about sexual misconduct and therapy ================================================== Question: Amount of continuing education hours a clinician must acquire within the initial license renewal period Answer: at least 18 hours ================================================== Question: Amount of continuing education hours a clinician must acquire within the 2 year license period Answer: at least 36 hours, 6 of which obtain to Law and Ethics ================================================== Question: Scope of Practice Answer: all services defined by education and licensure a mental health professional is allowed to preform ================================================== Question: Special Relationship Answer: when one person is vulnerable and dependent upon another person ex: Cx/Clinician relationship ================================================== Question: Standard of Care Answer: average degree of skill, care and diligence practiced by members of the same profession, practicing in the same or similar locality ================================================== Question: Definition of Law Answer: formal code or decision established by a legislative body and interpreted by the courts, indicating what to do and not to do under a given circumstance ================================================== Question: Three sources of legal obligation Answer: statues and regulations, boards authorized by legislature, court cases ================================================== Question: Examples of Gross negligence and incompetence Answer: misrepresentation of a degree, reckless physical or mental harm, wrongful insurance billing, engaging in sexual relationships sooner then two years following termination of services ================================================== Question: Definition of Ethics Answer: ways considered "best" or "right" by standards established by professional organization ================================================== Question: Patient Bill of Rights allows Cx to Answer: request and receive information about clinicians background, fees and payment, length of therapy and subsequent care, limits of confidentiality seek 2nd opinion etc. ================================================== Question: Definition of Privilege Answer: Cx's right not to have confidential information revealed during legal proceedings ================================================== Question: Supine Answer: request for information ================================================== Question: Court Order Answer: requiring clinician present information requested ================================================== Question: Quashed Supena Answer: supena is null and void and no information is required to be turned over by the clinician. Cx asserts privilege and it is granted. ================================================== Question: Waiving Privilege Answer: Cx signs waiver and information is turned over to courts ================================================== Question: Definition of Confidentiality Answer: the legal and ethical requirement restricting the provider from giving information about things disclosed in Tx ================================================== Question: Definition of physical abuse Answer: physical injury or death inflicted by other than accidental means ================================================== Question: Definition of sexual abuse Answer: sexual assault, exploitation, rape, dude and lascivious acts, oral copulation, sexual penetration and molestation. ================================================== Question: AB1775, law Answer: law which make digital transmission of minors engaging in sexual activities illegal ================================================== Question: Definition of neglect Answer: maltreatment of Cx including malnutrition, willful endangerment, failing to protect from dangerous situations, failure to provide supervision ================================================== Question: Definition of willful cruelty Answer: permitting unjustifiable mental/ physical pain upon a child ================================================== Question: Definition of elder Answer: any adult 65 or older residing or who intends to reside in the state of California ================================================== Question: Definition of a dependent adult Answer: any person 18-64 residing in or intending to reside in California with physical, mental or financial limitations which restrict their ability to carry out normal activities of daily life, protect own rights and live independently ================================================== Question: Definition of Tarasoff Answer: duty to protect ================================================== Question: End of life option Act Answer: allows people 18 years and older to self administer a lethal dose of an aid in dying drug prescribed by Cx attending physician when a Cx has a terminal illness and will die within 6 months of diagnosis ================================================== Question: Definition of Telehealth Answer: practice of delivering healthcare, diagnosing, providing Tx and transfer of medical data using audio, video etc. ================================================== Question: Ethical Standards Answer: encourage behavior and practices that are "right and good" ================================================== Question: Scope of Competence Answer: areas of skill or expertise a mental heath practitioner possess ================================================== Question: Counter-transference Answer: when the strong reactions f a therapist prevent practitioner from being able to adequately attending to the Cx needs/Tx ================================================== Question: K1. Knowledge of laws regarding confidential communications within the therapeutic relationship. Answer: B. Clarify for the family how your therapeutic work differs from religious counseling. This response addresses your client's expectations about therapy and promotes a better understanding of the process. ================================================== Question: K2. Knowledge of laws regarding the disclosure of confidential information to other individuals, professionals, agencies, or authorities. Answer: B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case. It would be important to have peer supervision or a paid supervisor in cases like this where counter-transference issues are bound to arise. An eventual referral for one or both clients might be necessary also. ================================================== Question: K3. Knowledge of laws regarding holder of privilege. Answer: D. Document your crisis interventions in the first session. The laws about record-keeping require you to document any and all interventions. ================================================== Question: K4. Knowledge of laws regarding privileged communication. Answer: C. Maintain confidentiality. Based on the information given in this question you would maintain confidentiality. Juan's threat is dependant upon the death of another person which eliminates the "imminence" that breaking confidentiality under Tarasoff requires. ================================================== Question: K5. Knowledge of laws regarding the release of privileged information. Answer: B. Decline to make an appointment and refer her to another therapist. The woman who wants to become your client has a prior relationship with you as your child's piano teacher. This is an easily avoidable dual relationship since there are many other therapists that could help this woman. ================================================== Question: K6. Knowledge of legal requirements for responding to subpoenas and court orders. Answer: A. Help Hermoine with her crisis until her therapist returns. Helping Hermoine with her crisis would be the only ethical way to proceed in this instance since her new therapist cannot be reached, and she has called you for help. Even though you had terminated and were no longer her therapist, when someone calls a social worker in crisis, the law presumes at that point the existence of a special relationship in which the therapist must act in the best interests and welfare of that person. ================================================== Question: K7. Knowledge of legal criteria and requirements for providing therapeutic services to minors. Answer: C. By telephone as soon as possible and in writing within two working days. Mandated reporters must report dependent adult abuse "immediately or as soon as possible by telephone, and shall prepare and send a written report within two working days." ================================================== Question: K8. Knowledge of laws regarding documentation of therapeutic services. Answer: B. Tell minor clients how you will contact parents if you think there is an emergency. Discussing the limits of confidentiality is an element of informed consent. ================================================== Question: K9. Knowledge of laws pertaining to the maintenance/disposal of client records. Answer: D. The client has the right to withdraw from the study at any time. The client has the right to withdraw from the study at any time, and we as therapists, are to respect the client's wishes. ================================================== Question: K10.Knowledge of laws pertaining to client's access to treatment records. Answer: B. The client signed a waiver of privilege for the records. No records would be disclosed until the client or the client's representative waived privilege. ================================================== Question: K11.Knowledge of laws pertaining to the release of client records to other individuals, professionals, or third parties. Answer: C. It is a legal principle that protects client conversations unless there is a court order. Privilege is the legal right of the client not to have confidential information revealed during a legal proceeding. Only a client, judge or court order would challenge privilege. ================================================== Question: K12.Knowledge of laws regarding the consent to and delivery of services via information and communication technologies. Answer: D. Determine if you can deal with this client at this time. "A", "B", and "C" are all possibilities once you "Determine if you can deal with this client at this time." ================================================== Question: K13.Knowledge of legal requirements of the Health Information Portability and Accountability Act (HIPAA). Answer: D. Assessing whether a medication evaluation would be necessary. From an ethical point (safety-minded) of view, a therapist would first need to consider all treatment modalities to help a client. In this case, that would include considering whether his anxiety is so severe that medication would help him benefit from therapeutic interventions. ================================================== Question: K14. Knowledge of indicators of abuse, neglect, or exploitation of dependent adults. Answer: C. Being arrested for shoplifting. The law (Business and Professions Code 4982(a) says unprofessional conduct addresses licensees or registrants who have been "convicted" of an offense, not just arrested. ================================================== Question: K15. Knowledge of laws pertaining to the reporting of known or suspected incidents of abuse, neglect, or exploitation of dependent adults. Answer: C. Informing the couple of your "no secrets" policy Informing the couple of your "no secrets" policy is solely an ethical responsibility. ================================================== Question: K16. Knowledge of indicators of abuse, neglect, or exploitation of elderly clients. Answer: A. Assist them with information you deem pertinent to the situation at hand. In the event of a medical emergency it is permissible to give information to medical professionals that may be treating the client. Social workers are permitted to speak with other health professionals for purposes of treatment and diagnosis in recognition of situations such as these. ================================================== Question: K17. Knowledge of laws pertaining to the reporting of known or suspected incidents of abuse, neglect, or exploitation of elderly clients. Answer: B. Accommodate your fee since you've established a bond. Because you've established a bond, accommodating your fee would be in the best interests of the client. If an accommodated fee cannot be agreed upon, then providing three low-cost therapy referrals would be appropriate. ================================================== Question: K18. Knowledge of indicators of abuse/neglect of children and adolescents. Answer: C. Engage Bobby in a therapeutic conversation. The ethical standard is to speak with the colleague to try to rectify the issue first. ================================================== Question: K19. Knowledge of laws pertaining to the reporting of known or suspected incidents of abuse/neglect of children and adolescents. Answer: B. Make three referrals out of town. Ethically, you need to provide Liz with the containment she needs to work through her early childhood issues. This can best be accomplished by referring her to social workers in her new area rather than concretizing her transference to you, i.e., "you're the only person who can understand and help me." ================================================== Question: K20. Knowledge of symptoms of mental impairment that may indicate the need for involuntary hospitalization. Answer: A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee. It is legal and ethical to bill insurers for missed sessions as long as this is clearly indicated in the billing codes. ================================================== Question: K21. Knowledge of protocols for initiating involuntary hospitalization. Answer: C. Document your decision to meet individually with José. An important legal obligation, since you are changing the unit of treatment from a dyad to individual treatment of a minor, is to obtain consent to treat a minor and document it. ================================================== Question: K22. Knowledge of laws regarding confidentiality in situations of client danger to self or others. Answer: C. It is unethical. LCSW's do not use their professional relationships with patients to further their own interests. ================================================== Question: K23. Knowledge of methods/criteria for identifying situations where client poses a danger to others. Answer: C. The fee and the true name and license of the designated owner of the practice. The fee and the name of the owner of the practice, if using a fictitious business name, are legally required disclosures at the onset of therapy. ================================================== Question: K24. Knowledge of laws pertaining to duty to protect when client indicates intent to cause harm. Answer: A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable. Information about availability between sessions or in emergencies is an element of safety planning which is both a legal and ethical requirement. ================================================== Question: K25. Knowledge of situations/conditions that constitute reasonable indicators of client's intent to cause harm. Answer: A. Decline to supervise the intern. Declining to supervise the intern is the best ethical choice given here (it is possible that with the proper ongoing consultation and responsible care, this particular dual relationship could be ethically acceptable). Although some dual relationships are considered unavoidable, particularly when there are limited choices, the ethics are less ambiguous in stating that supervisors do not take on current or former therapy clients. ================================================== Question: K26. Knowledge of laws regarding privilege exceptions in litigation involving client's mental or emotional condition as raised by the client or client's representative. Answer: B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy. If he is in family therapy now, but changed to individual therapy, you would need legal consent-to-treat with a minor. ================================================== Question: K27. Knowledge of laws regarding privilege exceptions where client alleges breach of duty. Answer: B. You would need to assess for child abuse. Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse. ================================================== Question: K28. Knowledge of laws regarding privilege exceptions in court-appointed evaluation or therapy. Answer: A. Review the fee policies outlined in your informed consent document. Going over relevant fee policies such as the basis on which it is computed, sliding scale polices or fees for late cancellations constitutes sound ethical management. ================================================== Question: K29. Knowledge of laws pertaining to privilege exceptions in defendant-requested evaluation or therapy. Answer: A. That you will need them to sign an agreement to change the treatment plan. Ethics do not require a signature on a treatment plan. ================================================== Question: K30. Knowledge of laws pertaining to the reporting of crimes perpetrated against a minor. Answer: A. Scope of competence. Anything that interferes with a clinician's ability to perform to the standard of care would be a scope of competence issue. ================================================== Question: K31. Knowledge of laws regarding privilege exceptions in crime or tort involving minors. Answer: A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you. Before you take on a new case, you want to consider your level of education, training and experience to determine if you are capable of treating this client or if consultation is needed. Also, you need to consider this client's goals. If the client wants help with relationship issues, this is within your scope of practice, but if the client's needs are not relationship-oriented, then this case would be out of your scope of practice. ================================================== Question: K32.Knowledge of laws regarding sexual conduct between therapist and client. Answer: C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent. Joint custody may require one or both parents to consent. You must look over the custody papers to review what the court mandates. ================================================== Question: K33. Knowledge of legal requirements for providing client with the brochure Professional Therapy Never Includes Sex. Answer: A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so. In custody or visitation proceedings, if a child is represented by an attorney, that person has the right to obtain a child's clinical records or to interview the assessing or treating social worker. Ethically, you would also discuss this confidentiality issue with your client. ================================================== Question: K34.Knowledge of laws that define the scope of clinical practice. Answer: A. Determine the family's understanding of the purpose of the therapy. Ethically, you would want to clarify the client's purpose. ================================================== Question: K35.Knowledge of laws that define professional conduct for licensed practitioners. Answer: B. Refer the client back to the insurance company. Clients who are referred by insurance companies should be referred back to the payor to get another referral. This way, they can be more sure that their sessions will be financially covered. ================================================== Question: K36.Knowledge of laws regarding disclosures required prior to initiating therapeutic services. Answer: A. You indicate to your client that she can give your number to the program coordinator. This response is the best choice. By letting the program coordinator contact you, you can avoid exploiting the client in order to advance a relationship with the program coordinator. ================================================== Question: K37.Knowledge of laws and regulations regarding third-party reimbursement. Answer: B. Self-harm behavior. Self-harm behavior is not a type of dependent adult and elder abuse. Welfare and Institutions Code defines dependent adult and elder abuse as knowledge or reasonable suspicion of the following: physical abuse, abandonment, isolation, neglect, financial abuse, and abduction. ================================================== Question: K38.Knowledge of parity laws regarding the provision of mental health services. Answer: B. Consult with professional peers regarding your discomfort. You want to be aware of how your discomfort may impact the therapy and, as an initial step, deal with it through research and consultation with colleagues. ================================================== Question: K39.Knowledge of laws regarding advertisement and dissemination of information of professional qualifications, education, and professional affiliations. Answer: C. Change the diagnosis when you have confirmed it on any insurance forms. To avoid fraud you would have to code the diagnosis you currently are considering and change it when necessary. ================================================== Question: K40.Knowledge of legal requirements regarding payment or acceptance of money or other considerations for referral of services. Answer: B. Notification to the person signing the agreement that they have a right to receive a copy of it. An Authorization to Release Confidential Information form must contain a statement that the person signing the agreement is entitled to a copy of the agreement. ================================================== Question: 3. A 17-year-old girl, Janet, is referred to you by her school counselor. Janet's nose, eyebrow, and tongue are pierced, and her hair is dyed green and yellow. Janet says that recently her twin brother Michael comes into her room at night and tries to "play sleep-over" with her. Janet tells you that a cute boy she met at a rave last week wants her to move in with him. She asks you not to tell her parents that she's seeing you because they're "extremely religious." How would you manage your ethical responsibilities if you were working with the entire family? Content Area: Ethics: Therapeutic Relationship/Services This question test your knowledge of the ethical issues that arise when treating a family unit. A. Clarify for Janet that, as a victim of abuse, she can consent to her own treatment without her parents' permission. B. Clarify for the family how your therapeutic work differs from religious counseling. C. Review your fee policy, especially as this case involves various family members and religious issues. D. Explain the limits of confidentiality to Janet with regard to sexual abuse. Answer: A. Maintain confidentiality. Claire is 18 and considered an adult. Thus, making a report would be breaching confidentiality. Social workers do not report historical abuse. Your legal obligation is to maintain Claire's confidentiality. ================================================== Question: 8. Cherilyn, your client of six months, tells you that she's recently begun having an affair with Tony. As she discusses their affair, you realize that Tony is another one of your clients whom you've been seeing for the past year with his wife and two teenage children. In order not to contaminate the therapeutic relationship with Cherilyn or Tony, what would you do? Content Area: Ethics: Professional Competence and Preventing Harm. This question checks your ability to make distinctions between difficult ethical choices and tests your understanding of dual relationships. A. Gently terminate with Cherilyn without telling her why. This preserves confidentiality, and since you've been seeing Tony and his family longer, you owe them more professional allegiance. B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case. C. Call an attorney and discuss legal issues around dual relationships so you can determine the best action to take. D. Continue seeing Cherilyn as usual. Ask Tony in for a private conference so you can ask about his commitment to his marriage and family, being careful not to break any confidences. Answer: D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey. If any fees are associated with clinical practice, social workers are legally obligated to disclose them before providing a service. ================================================== Question: 10. Your client comes to a first session in a crisis. You do not have time for a full informed consent conversation, but you tell the client the fee and your license number. What is your legal obligation now? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of informed consent and record-keeping. A. Document your informed consent conversation within 5 days. B. Document your informed consent conversation within 10 days. C. Document your treatment plan now that the crisis has passed. D. Document your crisis interventions in the first session. Answer: D. Call up an agency designated to take such a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a "no violence plan." This answer contains the basic steps you must take when you know of or have reasonable suspicion of elder abuse, and it shows good clinical management in processing any feelings your clients might have about their social worker filing a report. ================================================== Question: 12. Your client Juan tells you that his brother, Jose, was stabbed to death a year ago by his cousin in a drug deal gone bad. Juan further states that he told his cousin that he intends to murder him for stabbing Jose, but he is going to wait until his aunt dies because she would be too upset by the death of her only son. He tells you that the cousin lives in another state, but he will find him when the time comes. In this situation, what is your legal responsibility? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a possible Tarasoff situation. A. Under the Ewing v. Goldstein decision you must contact the aunt and warn her about the threat to kill her son. B. Under the Tarasoff decision you must call the police and warn the victim. C. Maintain confidentiality. D. This is privileged information and may not be disclosed without a subpoena. Answer: D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened. ================================================== Question: 17. Your child's piano teacher sees you at a P.T.A. meeting and says she's heard that you are a good psychotherapist and asks if she can make an appointment to see you. She says her mother recently passed away and that she is now her elderly father's caretaker. She says "the situation is bringing up a lot of anger" for her because her father sexually abused her when she was a child. In this situation, you should: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical behavior regarding potential dual relationships. A. Report the abuse to Children's Protective Services. B. Decline to make an appointment and refer her to another therapist. C. Report the abuse to Adult Protective Services. D. Make an appointment and try to help her work through the grief and anger issues. Answer: A. Tell Mr. Milsap that you cannot honor his request. Without the permission of the court or the party issuing the subpoena, a social worker may not produce a summary or alter (by omission or any other way) the treatment record subpoenaed. ================================================== Question: 20. After 6 months of treatment with Hermoine, she says that she wants to see a therapist whose sexual orientation is different than yours. After processing this over the next two sessions, you have two additional termination sessions, give her three referrals and terminate the therapeutic relationship. Several weeks later, Hermoine calls you in crisis and says her new therapist is out of town and isn't returning her phone calls. She asks you to help her. What would you do? Content Area: Ethics: Therapeutic Relationship/Services This question tests your decision-making process. A. Help Hermoine with her crisis until her therapist returns. B. It is unethical for you to work with Hermoine once you have terminated treatment with her and she has begun treatment with a new therapist. C. Tell Hermoine that you will not be able to help her since she has terminated treatment with you. D. Tell Hermoine that she should find out who is taking calls for her new therapist and speak with that person. Answer: B. Deny his request. Given the limited information we have in this scenario, denying the request would be the best course of action until proper authorization could be obtained by the dead woman's legal representative. ================================================== Question: 9. How should physical abuse of a dependent adult be reported by a mental health professional? Content Area: Law: Limits to Confidentiality/Mandated Reporting This question tests your understanding of the legal issue of reporting dependent adult abuse. A. If there is serious bodily harm, within 24 hours. B. By telephone within two working days and in writing as soon as possible. C. By telephone as soon as possible and in writing within two working days. D. By telephone as soon as possible and in writing within 36 hours. Answer: A. Answer Miriam's questions. Social workers must make a distinction between clinical interventions and ethical responsibilities. Clients have the right to such information as where the social worker went to graduate school, how long the social worker has been licensed, and if there are any areas of expertise and training. Such questions should not be treated as inappropriate or boundary violating and are part of the process of a client determining whether or not the social worker offers the kind of services the client wants or needs. ================================================== Question: *18. When unable to reach a client by phone, a social worker texts the client's mother to tell her that her son is talking seriously about running away from home because of the step-father's abuse. She texts back to tell you that he is home safely but "thanks for the heads-up." What are the social worker's ethical obligations regarding the confidentiality of minors? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to handle informed consent about the limits of confidentiality in the treatment of minors. A. Obtain written informed consent from the minor that allows texts to parents in an emergency. B. Tell minor clients how you will contact parents if you think there is an emergency. C. Tell minor clients that you will show them any texts from parents. D. Obtain informed consent from parents about your mandates to break confidentiality. Answer: B. The client. In this situation, since Jennifer has introduced her emotional condition into the trial, her right to privilege MAY be waived. Since there is no indication that she or the court has waived her privilege, it continues to be held by her. ================================================== Question: 20. You are conducting a research study on divorce. In the informed consent process, what information do you need to provide your clients? Content Area: Ethics: Business Practices and Policies This question assesses your knowledge of procedures when conducting research using human participants. A. The importance of the client remaining in the study until the very end to maintain the validity of the study. B. That dual relationships may be inevitable due to the nature of the study. C. That any information obtained may be used in the study. D. The client has the right to withdraw from the study at any time. Answer: A. Report by telephone within 24 hours to law enforcement. If physical abuse occurs in a long-term facility and does NOT result in serious bodily harm, a telephone report must be made to local law enforcement within 24 hours and a written report within 24 hours to law enforcement, the facility's licensing agency, and the ombudsman. ================================================== Question: *21. If a social worker digitally recorded a session with a client and then receives a subpoena for records because the client is claiming emotional distress, the recorded session would be provided to the court if: Content Area: Law: Limits to Confidentiality/Mandated Reporting This question tests your knowledge of how to respond to a subpoena. A. The client signed a release to record a session. B. The client signed a waiver of privilege for the records. C. The client signed a consent form allowing the session to be videotaped. D. Digital recording must be disclosed with any records in a subpoena. Answer: A. Assert client privilege. By the process of elimination, "A" is the only correct answer. None of the other choices are legal requirements. ================================================== Question: *22. A client is referred to you by his attorney. The client tells you that he is reluctant to talk to you because he doesn't want what he says in therapy coming out in court. Choose the statement that could BEST explain privilege to this client: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of privilege. You must be able to distinguish between confidentiality and privilege as well as between law and ethics. A. It is an ethical concept involving the right of a social worker to withhold information in a legal proceeding. B. It is a legal and ethical principle which involves a restriction on the volunteering of information about a client. C. It is a legal principle that protects client conversations unless there is a court order. D. Attorney/client privilege extends to the client of a social worker that the attorney uses for referrals. Answer: A. Specify any particular limits of confidentiality as they pertain to internet security and privacy. There are no special mandated "limits of confidentiality" that pertain to telehealth, but privacy and confidentiality could be compromised in telehealth sessions, and therapists would have the ethical obligation to clarify those risks. ================================================== Question: *23. A client who was referred by his rabbi comes in to see you for issues of grief related to the loss of his mother two weeks ago. Recently your mother died too. What would you do FIRST? Content Area: Ethics: Professional Competence and Preventing Harm This question tests your knowledge of how to manage counter-transference. A. Talk about this situation in your own therapy. B. Seek professional consultation. C. Refer the client to another mental health professional who specializes in grief and loss issues. D. Determine if you can deal with this client at this time. Answer: A. Permissible under some circumstances. Ethical standards say that social workers do not usually barter or are discouraged from doing this but the standards make allowances for doing business in communities where bartering is standard practice. ================================================== Question: *24. Steven comes to you for help with debilitating anxiety. He says that his anxiety is beginning to interfere with his relationships and his job. He is afraid to drive his car because he thinks that he is going to hit someone. He doesn't know how he will ever take a girl out on a date or get to work if he doesn't get control over this. He thinks he should be able to get over this by himself. The therapist should begin by: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical obligations when selecting treatment interventions. A. Teaching him relaxation techniques and pairing those with thoughts and images of driving his car. B. Explaining the benefits of a behaviorist approach for severe anxiety. C. Documenting in an initial treatment plan the client's goals for treatment of anxiety. D. Assessing whether a medication evaluation would be necessary. Answer: C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy. Reasonable notice of termination is required if you plan to terminate because a client has not paid. ================================================== Question: *25. Which of the following is not considered by law to be unprofessional conduct by a social worker? Content Area: Law: Legal Standards for Professional Practice This question asks you to identify unlawful unprofessional conduct. A. A conviction after pleading no contest to a DUI. B. Thanking a friend for a referral by taking her out to dinner. C. Being arrested for shoplifting. D. Poor record keeping. Answer: B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night. The threat was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. Although the laws of confidentiality require that we not report an HIV-positive client whose intentional behavior is to infect others through sex, injecting another person with a syringe without their permission constitutes an act of violence. ================================================== Question: 33. A couple comes in to see you for therapy. They are referred by the wife's individual therapist. The husband has recently discovered his wife has been cheating on him and he is unsure if he wants to continue the relationship. What is solely an ethical responsibility in treating this couple? Content Area: Ethics: Therapeutic Relationship/Services This question addresses your ethical responsibility in treating a couple. A. Getting a signed release from both the husband and the wife to speak with the wife's therapist. B. Designating a fee prior to the commencement of therapy. C. Informing the couple of your "no secrets" policy. D. Having the wife sign a release to speak with her therapist. Answer: B. Charge Andy and have him contact the insurance company. Billing the client, and letting him seek reimbursement from the insurance company is correct. This choice puts the responsibility on the client, where it belongs. ================================================== Question: *36. You get a call from the emergency room regarding one of your clients who was brought in by the PET team and is incoherent, delusional, and unstable. While they were going through his belongings they found his driver's license and your card. The psychiatrist on call wants to know if you can give them any information about this person that might be helpful. You would: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to protect client safety and confidentiality at the same time. A. Assist them with information you deem pertinent to the situation at hand. B. Inform them that you cannot confirm or deny if this person is your client. C. Tell them that they will have to obtain a release signed by the client and fax it to you before you can disclose any information. D. Ask to speak with your client before disclosing any information. Answer: D. Assess the motivation behind the gift. Assessing the motivation and the value of a gift is very important in determining whether you should accept it or not. What needs to be determined is whether the act of giving the gift supports Mrs. Bailey's therapeutic process and needs. ================================================== Question: *38. You contract with a family for ten sessions, as that is all their insurance would cover. After the ten sessions they want to continue therapy but can't afford your full fee. What would you do next? Content Area: Ethics: Therapeutic Relationship/Services This question addresses your management of insurance clients with limited coverage, your sensitivity to the ethical concerns of client abandonment and ethical standards. A. Refer them to a low-fee clinic. B. Accommodate your fee since you've established a bond. C. Terminate with the family since you have met the terms of the contract. D. Assess their motivation for continuing therapy. Answer: D. Obtain consultation from each doctor about his case. The best answer choice from an ethical point of view would be to speak with each doctor. This is a scope of competence question that tests your knowledge of how to utilize consultation. ================================================== Question: *39. Cheryl and Bobby are in joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. It would be appropriate for Cheryl to: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to assess and address other professionals' competence if it endangers clients. A. Avoid making any referrals to Bobby. B. Offer to take some of his caseload. C. Engage Bobby in a therapeutic conversation. D. Report Bobby to a regulatory body. Answer: B. The advertisement must indicate the full name of the licensee and the complete license number. It is a legal requirement that the LCSW's full name and license number or associate's registration number be on the advertisement. ================================================== Question: *44. Your client, Liz, is a 17-year-old female who is leaving for college out of town at the end of the month. She was molested by her uncle as a young child and is working through these issues with you. She has developed a close working relationship with you and wants to continue to work only with you. You would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the legal issues that pertain to treating clients who are moving. A. Consult with a colleague about transference/counter-transference issues. B. Make three referrals out of town. C. Plan for weekly, hourly phone sessions with you. D. See her on school breaks. Answer: C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions. Ethically, you cannot avoid informed consent even in a crisis. So it would be ethical to give the client the legally required information and meet any crisis needs immediately. 54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality. A. Filing a child abuse report. B. Ensuring safety for a suicidal client. C. Responding to a CPS caseworker's request for family history following a child abuse report. D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle. ================================================== Question: *45. Your client missed a regularly scheduled appointment. Your policy, made clear to the client in your informed consent document, is that clients will be billed for missed appointments. The client asks you to bill the insurance company. What would you do? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate billing procedures. A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee. B. Explain that billing insurance for missed sessions is insurance fraud. C. Let it go, since by law, insurers cannot be billed for missed sessions and clients with insurance are not required to pay out of pocket. D. Bill the insurance company for the session. Answer: C. Responding to a CPS caseworker's request for family history following a child abuse report. A social worker is not permitted to respond to a CPS caseworker's follow-up inquiries without a written request if the request does not specifically pertain to the child abuse report. ================================================== Question: *50. José, a 14-year-old Mexican-American boy, comes to therapy with his mother. He presents with a flat affect and avoids eye contact during the initial assessment session. During the assessment process, José remains quiet as his mother provides a list of José's symptoms and behaviors that she would like you, as the social worker, to address. Before the initial assessment session comes to an end, José requests that you meet with him individually from now on. After deciding that it would be appropriate to schedule individual sessions, what is your legal obligation? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal obligations that pertain to documentation. A. Assess whether the absence of Jose's father is having an impact on his behavior or this session. B. Refer his mother for individual therapy to avoid abandoning her as part of the treatment unit. C. Document your decision to meet individually with José. D. Ask his mother to sign a new consent form for him to be treated individually. Answer: D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim. This is what you would have to do. At this point, the well-being of the intended victim outweighs the ethical concerns about informed consent. ================================================== Question: *52. After your session with Scott, you decide to buy $10,000 worth of the stock that he was talking about. In a short time the stock tailspins to 10% of its initial price offering. How would you characterize the social worker's action? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your sensitivity to the issues of professional boundaries and dual relationships. A. It is illegal and unethical. B. As the social worker did not solicit the information, the social worker was free to purchase the stock. C. It is unethical. D. It is unethical if it interferes with the nature of the therapeutic relationship. Answer: B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being. If releasing the content of therapy notes will result in a negative impact on the minor's physical safety and/or psychological well-being, then the social worker has a right to refuse a parent's inspection of the records. ================================================== Question: *53. What is a social worker legally required to disclose to a client at the beginning of treatment as part of the ethical obligation for informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question reviews your knowledge of the legal and ethical aspects of informed consent. A. The fee, the true name and license of the designated owner of the practice, and the limits of confidentiality. B. The fee and the type of license held by the social worker and the expiration date of a release authorization. C. The fee and the true name and license of the designated owner of the practice. D. The fee, the type of license held by the social worker, and limits of confidentiality. Answer: C. A client accused of assault and battery uses insanity as a defense in court. If insanity is used as a defense for a crime, then the client may have waived his or her right to privilege. ================================================== Question: 56. A therapist who performs telehealth advertises that the main advantage of internet therapy is that the client can reach a therapist in real-time. "If crises come up or just a quick question, online therapy can meet your needs right away." This advertising is: Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of the legal parameters for advertising on the internet. A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable. B. Legal if telehealth is within the therapist's scope of practice. C. Unethical because online therapy cannot be used in a crisis. D. Unethical because clients will expect a social worker to be available 24/7. Answer: C. Engage him in a discussion of his motivation and past efforts. In the initial stages of therapy, the establishment of trust and rapport is a crucial component to successful work, which "C" embodies as it deals with the presenting problem and the underlying emotions associated with it. ================================================== Question: *63. Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town's only community counseling clinic. In his second week at the clinic Eli is given a list of new interns he will be supervising and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do? Content Area: Ethics: Business Practices and Policies This question tests your knowledge regarding supervision and dual relationships. A. Decline to supervise the intern. B. Ask the client to choose between having Eli as a social worker or a supervisor. C. Terminate the therapy since it conflicts with Eli's role as a supervisor as well as the client's desire for training and career advancement. D. Proceed as a supervisor since this is a case of an unavoidable dual relationship. Answer: C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home. A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled. ================================================== Question: *65. You are treating a family of four in therapy. The oldest child, age 17, suggested that you do telehealth sessions with him. Legally, in order to do this you must: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal parameters for the use of telemedicine/telehealth. A. Obtain written consent-to-treat from him because he is age 12 and older, to change the treatment plan. B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy. C. Legally obtain informed consent with the whole family to change the treatment plan. D. Determine your fee schedule for a different medium. Answer: D. Tell him that you will not be able to help him quit smoking. Using hypnotherapy to help Christopher stop smoking would have to be within the context of therapy, and not as a stand-alone treatment. Otherwise, it is outside the scope of practice. ================================================== Question: *69. Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women's make-up and shoes. Legally, what would be your first concern? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of legal requirements when treating minors. A. You would need to get consent from his parents because he is being abused at school. B. You would need to assess for child abuse. C. You would need him to sign a release to speak with his school. D. You would need to assess for possible suicidal ideation. Answer: D. Advise her to call her lawyer. Your only obligation in this situation is to maintain confidentiality and assess for a possibility of a crisis interventions. If the client is not afraid that the father will harm the children, she needs to call her lawyer to pursue legal options. ================================================== Question: *73. Audrey, age 32, comes into your office while her father, Carl, and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father, Carl, and she asks, "Can I pay you when my 'ex' pays his overdue child support?" How would you manage the ethical issue of fees? Content Area: Ethics: Business Practices and Policies This questions test your knowledge of the ethics that pertain to fees, fee disclosure and fee management. A. Review the fee policies outlined in your informed consent document. B. Disclose your fee prior to providing therapy or as soon as practically possible. C. If you see Audrey alone and her father is paying, explain that she must collect the fee from him and then pay you. D. Discuss Audrey's request that you wait to be paid until the 'ex' pays his overdue child support. Answer: D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults. If you have concerns about a dependent adult's safety, you are legally and ethically obligated to inform the CLIENT about the limits of confidentiality. Although "Consent To Treat" came from the conservatorship, the client's rights to confidentiality are still relevant. ================================================== Question: *82. A lesbian couple that you have been seeing asks you about Emotionally Focused Therapy. One of the partners tells you that she saw it on a daytime talk show and would like to see if it can help them. What should you NOT tell them if you feel competent to do this kind of therapy? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to ethically change the treatment plan, which requires informed consent from clients. A. That you will need them to sign an agreement to change the treatment plan. B. The risks and benefits of this type of therapy. C. How you will help them determine new treatment goals that fit with EFT. D. Your skills and experience in working with EFT. Answer: C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary. Giving clients information about payment is a legal and scope of practice issue. ================================================== Question: 92. Cheryl and Bobby are in a joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. Cheryl tells Bobby that she won't make any more referrals to Bobby. If Bobby decides to get some outside support, he is ethically managing his: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of different ethical principles. A. Scope of competence. B. Counter-transference. C. Dual relationship. D. Scope of practice. Answer: D. Maintain confidentiality. YOUR only legal obligation here is to protect your client's confidentiality. ================================================== Question: 98. You just received a referral from a local psychiatrist. The client suffers from a severe psychotic disorder and must take psychotropic medications. You have never treated anyone with a chronic mental illness in your private practice before so you must: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of standards for ethical client treatment. A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you. B. Let the doctor know you appreciate the referral, but you are out of your scope of practice in taking on this particular client. C. Find a supervisor to assist and guide you in working with this client so that you are covered legally. D. Tell the doctor that you would like to take this case and are prepared to research this diagnosis and work closely with him so that you might effectively treat the client and expand your capabilities as a clinician. Answer: C. You are mandated to report this situation to a children's protective agency. This is a mandated report because the social worker has reasonable suspicion of neglect based on the doctor's medical diagnosis. Although the parents have consulted with a doctor, their decision to not seek care based on the doctor's findings constitutes reasonable suspicion of medical neglect. ================================================== Question: 104. A 6-year-old child has been brought in by his mother for counseling. She wants you to explain to him why he is in therapy because she feels like she doesn't have the right words, and it could scare him. How do you handle obtaining consent for the child? Content Area: Law: Confidentiality, Privilege, and Consent This question concerns consent to treat a minor and custody. A. If the parents are divorced, review the custody papers. Joint custody means both parents must consent. B. Determine the marital status of the family. If the parents are still married, then both must consent. C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent. D. If the parents are divorced, review the custody papers. Either parent may consent if they are the biological parent. Answer: D. Ask her to get you quickly up to date on her general treatment so far. Ethics require an action directed toward the client's immediate safety. You would need to know how "serious" her situation is before determining the next step ================================================== Question: *105. A social worker has been treating Mikey, age 12, for the last 8 months. He has been dealing with feelings of depression and tells you that he is not doing well in school. He tells you that his parents recently filed for divorce, and he does not know with which parent he wants to live. A few weeks later, you receive a call from an attorney who tells you that she was appointed to represent Mikey in the divorce proceedings. She is requesting a copy of your records. How do you respond in this situation? Content Area: Ethics: Therapeutic Relationship/Services This question involves legal and ethical issues related to the release of clinical records. A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so. B. Ask Mikey if he would sign a release to allow you to release the records to the attorney because ethically, you must act in his best interests. C. Release records with both parents' authorization if it is in Mikey's best interests to do so. D. Do not speak with the attorney because your client's confidentiality is the more important ethical obligation in this instance. Answer: C. Discuss any suspicions that would validate terminating the client. A client's potential violence would not be a reason for terminating the client. It might be a reason, however, for breaking confidentiality. ================================================== Question: *107. Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night, so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem, the fee is covered under the overall adoption agreement." What are your ethical obligations? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical obligations. A. Determine the family's understanding of the purpose of the therapy. B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session. C. Determine the identified patient and refer to a pediatrician. D. Tell Chong-Wook and Dae-Sup the fee at the first session, and explain that you may need to consult with the school counselor and adoption agency. Answer: A. Maintain confidentiality. Mental health professionals licensed in California are only mandated reporters of Elder and Dependent Adult abuse if the victim is a resident of the state of California. Maintaining confidentiality is your legal obligation. ================================================== Question: 110. A social worker works for a managed care panel and receives most of her clients by referrals from the managed care company. A client comes for a first session, and the social worker realizes that the client has treatment expectations that are out of her scope of competence. What should the social worker do? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage your ethical and legal obligations when a client is out of your scope of competence. A. Speak with the insurance company about her scope of competence. B. Refer the client back to the insurance company. C. Refer the client to a colleague who can meet his needs. D. Collect the co-pay but do not bill for the session. Answer: B. Refer him to an MD. Overuse of pain medications and back pain would require a medical referral. ================================================== Question: 112. A client you have been treating, who is also a social worker, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships. A. You indicate to your client that she can give your number to the program coordinator. B. You thank her for thinking of you, but you refuse the offer to avoid a dual relationship. C. You tell her that you are interested and ask her to set up a meeting between you and the program coordinator. D. You wait until you terminate therapy and then remind your former client of her previous offer. Answer: D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due. Although this may not be a perfect solution to the problem, it does reinforce boundaries, stop the balance from getting higher, and suspend treatment in a situation in which professional judgment may be impaired and in which the client may feel exploited (as a debtor, Ronald may not feel capable of participating openly and honestly in therapy). ================================================== Question: 115. Which of the following is NOT a type of dependent adult and elder abuse? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the parameters of elder and dependent adult abuse. A. Abandonment. B. Self-harm behavior. C. Isolation. D. Abduction. Answer: A. Assert privilege. If you are unable to contact your client, you must continue to assert privilege. You do not know what is in the client's best legal interests so all you can do is continue to assert privilege. ================================================== Question: *117. You recently get a new, male client who is visually impaired. You've never worked with a client with a physical disability and are feeling a little uncomfortable with the client when he is sitting in the room. What is the best way to handle your discomfort? Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how to handle a client who makes you "a little uncomfortable." A. Let the client know of your discomfort and ask if he would prefer a different therapist. B. Consult with professional peers regarding your discomfort. C. Deal with your counter-transference in your own therapy. D. Do research on blindness to help you with an understanding of your client's needs. Answer: B. Open a separate file if the client was in family therapy before. Maintaining treatment files for different units of treatment is a legal obligation. ================================================== Question: *120. You have been treating Anita for three sessions for depression and relationship issues. You are considering a diagnosis of Major Depression and other DSM-5 diagnoses. You are not sure which is appropriate yet. Legally: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice. A. Do not treat the client unless your advertising indicates that you have expertise with depression or mood disorders. B. Consider whether it is in your scope of competence to work with depressive disorders. C. Change the diagnosis when you have confirmed it on any insurance forms. D. Do not submit insurance billing until you have confirmed a diagnosis. Answer: False, limits to confidentiality include suicide, homicide, and child abuse ================================================== Question: *125. Some clients are referred to social workers by other helping agencies and collaboration advances client welfare. Your new client tells you that she signed a release with the agency that referred her to you. You ask her to sign your release as well. Which of the following must appear on the release? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legally required elements of release authorization. A. A "Notice of Privacy Practices" if the client is a "covered entity" under HIPAA. B. Notification to the person signing the agreement that they have a right to receive a copy of it. C. It must include an expiration date established by the client. D. It must state the client's diagnosis and reason for approving the release authorization. Answer: True ================================================== Question: *130. An 18-year-old woman named Claire, states in her first session that she's thrilled to be out of her home and to be away from "that monster of a father," whom she says sexually abused her since she was 15. She tells you she has a two younger siblings who still live at home. What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations surrounding confidentiality. A. Maintain confidentiality. B. File a child abuse report for the abuse that Claire suffered since 15. C. File a report with CPS for reasonable suspicion of abuse for Claire's younger siblings. D. Ask Claire to sign an authorization to speak with her siblings to determine if they are safe. Answer: True ================================================== Question: 131. As part of his telehealth practice, a social worker offers quick assessment surveys online to help potential clients decide if they want therapy. The surveys do not ask for any identifying information. The social worker has access to the results of the surveys but does not ask for the name of the consumer, to avoid the appearance of solicitation. This is legal if: Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of legal types of advertising and fee arrangements. A. He provides referrals for any online survey respondents who are in a crisis. B. He also offers the survey to current clients at no cost. C. He advertises that the online assessments are consistent with DSM standards. D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey. Answer: False, this would be out of scope of practice ================================================== Question: 147. During a session with a couple in their 70's, you notice the man has a bruise on his head, and the woman tearfully admits that she loses her temper and hits him with pots and pans. In clinically managing the legal issue of elder abuse, how would you proceed? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your ability to balance your reporting responsibilities with your clinical need to maintain a safe therapeutic environment. A. Call up an agency designated to take such a report, with the two in the room, arrange for respite care, teach anger management, and create a "no violence plan." B. When the two are not in the room, call up an agency designated to take such a report, follow it up with a written report within 2 working days, create a "no violence plan," and refer to a support group. C. Create a "no violence plan," teach time-outs, arrange for a support group, and if those interventions don't work, call an agency designated to take such a report. D. Call up an agency designated to take such a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a "no violence plan." Answer: false ================================================== Question: 1. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of Section 1024 of the Evidence Code. A. Maintain Roger's confidentiality. B. Warn the manager of the factory because this is analogous to a Tarasoff situation. C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision. D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. Answer: The services that a social worker can legally preform under a specific license ================================================== Question: 2. Your lawyer calls you to warn you that you may receive a subpoena for the complete treatment record of Mr. Milsap, who you have been treating for five years. Two months ago, Mr. Milsap received minor injuries in an accident at work in which three people were killed when a fully loaded forklift overturned. Mr. Milsap is suing for negligence and claiming severe emotional damage, including PTSD. When you tell Mr. Milsap about the subpoena, he is frantic since he doesn't want anyone to know about the brief affair he had with his secretary four years ago, which is documented in your treatment records. He asks that you submit a summary of information relevant to the accident and his PTSD or to omit from the records information about the long-ago affair. How should you respond? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to legally retain records. A. Tell Mr. Milsap that you cannot honor his request. B. Submit a summary of the records related to the accident and the PTSD. C. Supply the treatment records as requested, but omit information of the long-ago affair, in accordance with the laws of privilege. D. Contact the court and seek a waiver to narrow the scope of the subpoena in order to protect your client's confidentiality. Answer: Their expertise, education, and training. ================================================== Question: 4. Three months after the death of Danielle, whom you treated for several years, you receive a written request from Arthur, her husband of 32-years, asking for access to his late wife's files. You saw them conjointly for a few sessions when Danielle requested he be there. How would you proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge regarding who has access to a client's records after their death. A. Assert privilege. B. Deny his request. C. Allow him to inspect the records. D. Provide a summary or a copy of the records. Answer: Competency means you have acquired expertise in an area within LCSW scope of practice. Generally competency is gained through education, training, and experience. ================================================== Question: 11. Miriam, a 52-year-old car saleswoman, is referred for therapy by her doctor after Miriam told him that her boyfriend broke up with her and told her that she has trouble respecting other people's boundaries and is too interpersonally aggressive. From the beginning of treatment, Miriam asks the social worker many questions about the social worker's relationships, family, hobbies and interests, and taste in music and movies. At the fifth session, Miriam asks the social worker where she went to graduate school, how long she has been licensed, and if she has any areas of expertise and training. How should the social worker respond to the questions Miriam is now asking? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent and a social worker's ethical responsibility to obtain informed consent from clients. A. Answer Miriam's questions. B. Do not answer Miriam's questions and explore her reaction to the social worker's boundary setting. C. Ask Miriam if she has concerns about the social worker's competence and experience. D. Remain silent and allow Miriam to do her own processing as part of learning to respect others' boundaries. Answer: You should refer the client to another professional. This way you are only providing one type of service to a client (thereby avoiding a dual relationship) ================================================== Question: 12. You have been treating Jennifer who has had difficulties establishing and maintaining intimate relationships with men. Several months into treatment, she was arrested for an attempted murder of a male celebrity. In her trial, Jennifer is pleading not guilty by reason of insanity. Who holds the privilege for Jennifer's therapeutic records? Content Area: Law: Confidentiality, Privilege, and Consent This question checks your comprehension of privilege. A. The social worker. B. The client. C. There is no privilege. D. The judge. Answer: Whenever it's in the best interest of the client. ================================================== Question: 13. You are seeing a 45-year-old woman in treatment. She lives with her mother, age 71, who has Alzheimer's Disease and lives in a residential facility for ongoing medical care. She tells you in session that at one point, the nursing staff kept her mother in bed for three weeks. You would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. Your knowledge of reporting mandates for elder abuse is being checked. A. Report by telephone within 24 hours to law enforcement. B. Report immediately to Adult Protective Services by phone and follow-up with a written report within 36 hours. C. Report by telephone immediately to law enforcement. D. Refer her to a support group for caretakers, arrange for respite care, and work with her on issues of grief and loss. Answer: Refer the client to a doctor to discuss sleep medicine. scope of practice. LCSW cannot make medicine recommendations. ================================================== Question: 19. Your client, a 19-year-old mechanic, confides to you that he recently participated in a robbery. Two weeks later, you are served with a subpoena for information about this client's treatment. You attempt to reach your client but are unable to do so. Legally, you must: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your legal requirement regarding a subpoena. A. Assert client privilege. B. Notify your client of this subpoena. C. Turn over all records as per the subpoena. D. Notify the client's attorney that you cannot reach the client. Answer: Refer to doctor to rule out medical concerns, reframe as communication issue, or refer to sex therapist. Scope of competency. Therapist does not have expertise is sex therapy ================================================== Question: 23. A social worker has decided to offer telehealth as part of her practice. Ethically, the therapist should: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to ethically manage the limits and risks of telehealth. A. Specify any particular limits of confidentiality as they pertain to internet security and privacy. B. Avoid a dual relationship by making clear when she is available on the internet and when she is not. C. Charge and disclose an equivalent fee for telehealth as for in-person sessions. D. Anticipate an unavoidable dual relationship that could arise if in-person clients also receive telehealth services. Answer: False, hypnotherapy is in scope of practice but may not be in scope of competence. ================================================== Question: 24. George has been referred to you by his doctor for anxiety-related issues. He tells you that while he really wants to be in therapy, he can't afford it right now and asks if it would be okay if, instead of your fee, George will give you credit in the amount of your fee at the grocery store he owns in the small rural community where you both live. Ethically this would be: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of dual relationships. A. Permissible under some circumstances. B. Inadvisable under all circumstances. C. A prohibited dual relationship. D. Bartering, which is prohibited by ethical standards. Answer: False, that would define scope of competency not scope of practice ================================================== Question: 37. Your new client, Suzanne, age 38, says her life feels out of control, and that she is considering getting a divorce. She is not sure she wants to keep coming to therapy. After a session, her husband Bud leaves a telephone message in which he says if Suzanne leaves him, he will kill himself. He asks that you call him back. How would you clinically manage your ethical responsibilities? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical obligations as they pertain to termination and referrals. A. Explain to Bud your "no secrets" policy and that you will have to disclose to Suzanne that he called you. B. Offer to Suzanne that she include Bud in a session but inform her of the risks and benefits first C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy. D. Assess Bud for suicide because you are in your professional capacity. Answer: True, get consultations based on client need. ================================================== Question: 38. Which of the following represents a Tarasoff situation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions that would impose a Tarasoff duty to protect situation. A. In a conjoint session, the wife tells her husband that before the week is over that she is "going to gun him down." B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night. C. A client tells you that her husband is "totally fed up with his supervisor" and is going to disfigure the man's face with a chemical solution. D. A man, who just bought a semi-automatic rifle, tells you that he is going to go on a freeway overpass and randomly shoot at passing cars. Answer: Department of Consumer Affairs (DCA) Board of Behavioral Sciences (BBS) ================================================== Question: 40. Andy, a 42-year-old actor, missed his last session. The Motion Picture Industry Pension and Health Plan pays for a portion of his sessions. How should you go about collecting his missed session fee? Content Area: Law: Legal Standards for Professional Practice. This test item focuses on legal insurance billing procedures. A. Bill Andy for the co-payment and indicate the cancelled session code with his insurance. B. Charge Andy and have him contact the insurance company. C. Bill the insurance company with the 50-minute code as usual. D. Bill Andy for the co-payment and indicate the 50-minute code. Answer: NASW, BBS, and the legal system (either civil or criminal). ================================================== Question: 43. Mrs. Bailey sees the photograph of your dogs in your office and brings you a basket of dog treats. How would you respond to her gift? Content Area: Ethics: Business Practices and Policies This ethical question regarding gifts tests your sensitivity to the issue of professional boundaries and dual relationships. A. Accept the gift in the spirit in which it was given. B. Take one of the treats as a gesture and return the rest. C. Thank her for her thoughtfulness and decline the gift. D. Assess the motivation behind the gift. Answer: True. BBS has many resources to help you do so. ================================================== Question: 46. A psychiatrist refers you a client with severe anxiety. The day before an intake session, the client calls you to ask if he can see you right away because he is afraid he will take all of the anti-anxiety medication he owns. He tells you that he is actually seeing three different doctors to get as much medication as he can. In collaborating with his doctors, which of the following would be the most ethical approach? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to collaborate and consult according to ethical (rather than legal) standards. A. File three separate releases in the client's file. B. Tell him that you plan to speak to all of his doctors with or without a release. C. Ask him which doctor he would prefer that you talk to. D. Obtain consultation from each doctor about his case. Answer: A therapist's responsibility to breach confidentiality if a client threatens an identifiable person. ================================================== Question: 49. Guidelines regarding advertising state that social workers must advertise in a way that is honest and not misleading. Which of the following is a true statement regarding advertising policies? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of advertising principles associated with LCSW practice. A. A prelicensed social worker may not use the term "psychotherapist" on a business card. B. The advertisement must indicate the full name of the licensee and the complete license number. C. It is not permissible for an LCSW to use "Ph.D." if s/he is not a psychologist. D. A social worker cannot use the term "Psychotherapy" on a business card. Answer: Tarasoff v. Regents of the University of California ================================================== Question: 53. Maxwell, age 46, is referred to you by his EAP because he is depressed and drinking daily on the job. He witnessed a train wreck 3 weeks ago in which several people were killed. Now he says he is terrified to leave the house without a couple of drinks to calm him down. He says that every time he hears a loud noise he feels faint, and he wakes up sweating and shaking. What action would the social worker take? Content Area: Ethics: Therapeutic Relationship/Services This question tests your ability to respond to client's needs in an ethical way. A. Determine the client's ability to respond to anxiety treatment interventions. B. Evaluate the client's need for a crisis intervention, C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions. D. Tell him that his treatment will be confidential as it pertains to his EAP. Answer: A client told a therapist they were going to kill a woman. The therapist did not warn the woman or her parents and she was killed by the client. ================================================== Question: 54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality. A. Filing a child abuse report. B. Ensuring safety for a suicidal client. C. Responding to a CPS caseworker's request for family history following a child abuse report. D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle. Answer: That if a client's family member tells a therapist something that makes the therapist concerned about the client's homocidality; they must warn the person. Information not source triggers duty to warn. ================================================== Question: 62. A male client comes to see you for the first time. As he talks, you begin to realize that he is definitely going to harm someone. He has a plan and is going to act, but he has not identified his intended victim to you yet. Just as he is about to tell you the identity of the name of the intended victim, you realize that you have not explained to him the limits of confidentiality: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage your ethical and legal obligations when a client might be dangerous. A. Tell him to stop and refer him to someone else. B. Wait until he identifies the intended victim and then explain the limits of confidentiality, as you must do as part of obtaining informed consent. C. Ask him to stop and explain to him the limits of confidentiality as part of informed consent. D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim. Answer: You should ask about history of violence, other violent thoughts or fantasies, if client has a plan and if they have means/opportunity to carry out plan. ================================================== Question: 68. You have been seeing Marsha, 11, with the consent of her mother, Jan. Jan is requesting a copy of Marsha's therapy notes because she wants to provide them to the school counselor. Under which of the following conditions can you refuse Jan's request? Content Area: Law: Confidentiality, Privilege, and Consent This question assesses your knowledge of the laws pertaining to parental request of a minor's records. A. Marsha will not sign an authorization to release the information to her mother. B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being. C. Jan wants you to produce a copy of the records within 3 weeks time. D. You don't feel comfortable breaching Marsha's confidentiality. Answer: True ================================================== Question: 75. During your intake interview, you learn that your client is a lawyer. As you discuss the limits of confidentiality, the client asks, "can you plead the Fifth like I can in court?" As you consider your answer, you consider some hypotheticals. Privilege might be waived in which instance? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking you to choose when privilege could be waived. A. A client is a 13-year-old girl, who you are seeing without parental consent, and has been selling drugs. B. A client has told you he has been involved in hacking a corporate database under an assumed name. C. A client accused of assault and battery uses insanity as a defense in court. D. A 64-year-old woman complains to you that her bank is making automatic withdrawals without permission. Answer: False ================================================== Question: 77. A second generation Chinese-American man comes into therapy and asks you to help him find a wife because his father is pressuring him to get married. Your FIRST intervention would be to: Content Area: Ethics: Therapeutic Relationship/Services The question asks for "your first intervention." A. Indicate that his needs would best be served by an Asian mental health professional. B. Inform him that this is an inappropriate goal for treatment. C. Engage him in a discussion of his motivation and past efforts. D. Address his presenting problem and assist him in finding a wife. Answer: true ================================================== Question: 85. Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions which define a person as being gravely disabled. A. Command auditory hallucinations telling the client to kill other people. B. Command auditory hallucinations telling the client to kill him or herself. C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home. D. Choosing to be homeless. Answer: False. ================================================== Question: 87. After completing a three-month course on hypnotherapy, you decide to advertise your new specialty. You receive a call from Christopher, who says he would like to come in for a session, so that you could hypnotize him to stop smoking. He says he's tried the patch and nicotine gum, but he needs your help to quit once and for all. How would you respond to Christopher's request for treatment? Content Area: Law: Legal Standards for Professional Practice. This question deals with scope of practice for mental health professionals. A. Make an appointment because hypnotherapy is now part of your scope of competence. B. Inform him of your fee before the commencement of treatment. C. Refer him to a medical doctor. D. Tell him that you will not be able to help him quit smoking. Answer: 1. Identify risk factors 2. identify protective factors 3. conduct suicide inquiry 4. determine risk level/appropriate intervention 5. document what you did and why ================================================== Question: 89. Your client has two children and is divorced. She tells you that when she arrived at her ex-husband's house last night to pick up the children, he had locked the doors and texted her that, "Me and my children are moving across the country." He has no criminal history, but she is afraid she will never see her children again. Which of the following is the clinician's first intervention? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of when to make referrals for expertise outside of your scope of practice. A. Advise her to call Child Protective Services for abduction. B. Explore the events immediately preceding this one. C. Call the police. D. Advise her to call her lawyer. Answer: Identify risk factors (PTSD diagnosis, job loss, intoxication/possible substance abuse, talking about death, past suicidal threats and gestures.) Ask directly about suicidal ideation, plan, intent and past behaviors). Decide if client is harm to self or not. if yes, 5150 and document if no, go over protective factors, support system, hotline #s, and document. ================================================== Question: 98. A person calls telling you that she is your client's conservator. Your client is physically disabled and has told you about the challenges associated with being under conservatorship. The client tells you that she hates not being able to make her own decisions. How do you manage your ethical obligations related to informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge about the ethical requirements for informed consent. A. If you have any concerns for the client's safety, tell the conservator about the limits of confidentiality related to dependent adults. B. Determine the type of conservatorship. LPS conservatorships allow the conservator to consent to treatment. C. Tell the conservator about your mandate to report dependent adult abuse. D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults. Answer: An 72 hour involuntary psychiatric hold. ================================================== Question: 108. George takes care of his wife, Gracie because she is unable to work. George asks you to help him manage his finances so that he is able to pay Gracie's medical bills, the family bills, and afford therapy. How should you respond to George's request and still maintain proper therapeutic boundaries? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to act within your scope of practice. A. Call a financial planner that you know sometimes works on a sliding scale to explain George's situation and see if she is willing to help. B. Explain to George that you cannot use therapy time to help him with his finances because it is out of your scope of competence. C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary. D. Introduce George to a budget minder book, show him how to create a budget, and provide referrals to websites to find less expensive medication. Answer: False ================================================== Question: 116. Your client Silvia comes to therapy upset because she overheard her neighbor stating that he plans to shoot the mayor tomorrow evening and owns a gun. She tells you she has tried to calm him down, but he just "keeps blaming the system for his unemployment." What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations related to the Tarasoff ruling. A. Call the police and notify the mayor. B. Discuss options that Silvia has to prevent harm to the mayor. C. Call the police and inform them of the imminent danger. D. Maintain confidentiality. Answer: False, one component of 5150 is danger due to mental disorder. ================================================== Question: 117. Mr. and Mrs. Chavez come to see you because they are referred to you by their physician. Their doctor has told them that their youngest son has a kidney disorder that will require surgery in the near future. The couple believes that God will intervene in this situation and refuse surgery based on their religious beliefs. Which of the following statements is the BEST response to this situation? Content Area: Ethics: Therapeutic Relationship/Services This is a question concerning medical neglect. A. The parents have the final right to make critical decisions for their son's medical care. B. "Cultural competence" is an ethical obligation that requires social workers to avoid imposing their own values on the client. C. You are mandated to report this situation to a children's protective agency. D. You are legally required to inform the doctor about the parent's decision Answer: false, even if child abuse is suspected it must be reported. ================================================== Question: 120. A therapist is leaving for vacation and has referred all of her clients to you. On the day before your colleague is set to leave town, one of her clients calls you and says that she is in crisis and needs to be seen tomorrow. She adds, "my therapist told me that I could call you if I thought seriously about killing myself. Well, it feels pretty serious." Your ethical priority is to: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to intervene ethically in a potential crisis. A. Notify the referring therapist of the client's treatment needs. B. Tell the client to call her therapist who is still available in town. C. Provide the client with a crisis number hotline until you are "on duty" for these clients. D. Ask her to get you quickly up to date on her general treatment so far. Answer: False, therapists should explain both verbally and in writing. ================================================== Question: 123. A client, who is in court-mandated therapy, tells the social worker that he is going to leave the state because he doesn't want to be in therapy or go to jail for violating probation. The social worker tries to encourage the client to see the benefits of staying in therapy, but the client becomes visibly angry and agitated. If the social worker is concerned about the client's potential for violence, the reason for seeking consultation is NOT to: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when consultation is required to maintain scope of competence. A. Meet the legal standard of care. B. Assess the social worker's own blind spots to risk. C. Discuss any suspicions that would validate terminating the client. D. Reassess the social worker's scope of competence. Answer: false, only give information relevant to report. ================================================== Question: 127. Your 52-year-old client returns from visiting his brother in Florida. He explains that his brother, who cares for their 84-year-old father, doesn't take him to his doctor or physical therapy appointments and she occasionally forgets to fill his prescription medication. What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of the parameters of elder abuse reporting and when to maintain confidentiality. A. Maintain confidentiality. B. Call Adult Protective Services (APS) in Florida and file a written report within two working days. C. Encourage your client to file an Elder Abuse Report. D. Call Adult Protective Services (APS) in California and file a written report within 36 hours. Answer: true. your license may also be taken away. ================================================== Question: 133. Richard, 38, tells you that he is missing more and more work due to back pain. He tells you that he has been to several doctors who prescribe pain medication because he cannot afford to take time off of work. He tells you that he skips work or leaves early because sometimes the "meds make me so tired and fuzzy in my thinking,that I would be fired if I showed up like that." As a social worker who is not experienced with substance abuse, what is your next course of action? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when to make competent referrals. A. Refer him to AA. B. Refer him to an MD. C. Encourage him to take time off of work to get physical therapy for his back. D. Obtain consultation to determine the extent of his problem. Answer: You should inform the client that you need to report this relationship to CPS and then make the CPS report. ================================================== Question: 143. Ronald is a 37-year-old moderately successful artist you have been treating for three years for depression and relationship issues. His income is sporadic, and you bill him monthly, but he had never let his balance get too high. Now he owes you $2,100. He offers to give you a painting whose value is roughly equal to the amount he owes you. How would you proceed? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical issues regarding client debt, dual relationships, and bartering and techniques to manage those issues. A. Decline the painting and tell him that based on his history with you, you trust that he will pay you in full when he gets the money. B. Accept the painting so that you can eliminate the debtor/creditor dual relationship. C. Accept the painting but process with Ronald the meaning of exchanging his art for your services and have him sign a statement of mutual agreement. D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due. Answer: false ================================================== Question: 147. Terran came to five couples' sessions with his wife complaining about how she belittles him and expects him to act more American. Terran had a difficult time listening and compromising because he believed his wife was disrespecting him, and they terminated treatment. You receive a subpoena for his records from an attorney representing his employer and learn that he is suing his employer for discrimination and emotional suffering. When you try to contact Terran about the subpoena, he does not return your calls. You would: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to proceed when you receive a subpoena. A. Assert privilege. B. Call his attorney and ask the attorney to ask Teran to call you back. C. Contact Terran's wife since she was in session and has a right to confidentiality too. D. Release the records since he has entered his emotional state into a legal proceeding and this represents an exception to privilege. Answer: true ================================================== Question: 148. A client that you treated 10 years ago terminated when her therapy goals had been reached, and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to maintain the standards of practice for documentation of client files. A. Have the client sign a new release authorization. B. Open a separate file if the client was in family therapy before. C. Sign a new informed consent form. D. Refer to another therapist if the client was a minor in therapy before. Answer: True ================================================== Question: T or F? California psychotherapists must maintain client confidentiality at all times. Answer: 65 and up or a dependent adult between ages 18 and 64 with physical and mental limitations. ================================================== Question: T or F? Based on California law, California therapists (LCSWs, LMFTs, and LPCCs) are not mandated reporters of domestic violence or intimate partner violence (IPV). Answer: true ================================================== Question: T or F? If a 13-year old has consensual sex with another who is 14 or older, it is a mandated child abuse reporting situation. Answer: false ================================================== Question: T or F? There is generally no problem with therapists providing advice to their clients regarding medication if the therapist is knowledgeable about the medication and it is deemed to be in the client's best interest. Answer: ASAP after you suspect it ================================================== Question: T or F? Research indicates that men are slightly more likely to commit elder abuse than women. Answer: within two working days. (children is 36 hours or 1.5 days) ================================================== Question: Define: Scope of Practice Answer: true ================================================== Question: What defines someone's scope of competency? Answer: false ================================================== Question: What is the difference between scope of practice and scope of competency? Answer: false ================================================== Question: If you are a LCSW and another type of license (attorney, CPA, medicine, real estate, etc.), what should you do with a client who needs both types of services? Answer: false ================================================== Question: According to the NASW code of ethics when should a LCSW seek advice or consultation on a client/case? Answer: true ================================================== Question: What should you doand which legal/ethical issue is represented? A male adult client presents personal and medical problems. The client complains about frequent and continual failures at resolving these problems. He reports trouble sleeping and repeatedly asks the therapist for specific recommendations regarding the best medication to treat insomnia. Answer: false ================================================== Question: What should you do and which legal/ethical issue is represented? The clients, a married couple, initiate therapy regarding communication problems. After three months, the husband reveals that he has had difficulty becoming sexually aroused and that sexual intercourse and intimacy have become a problem. The wife reveals that she has always had low sexual arousal. The couple now requests the therapist work with them regarding the problems in their sex life. The therapist begins to provide sex therapy to the clients, even though she has no specialized training, education, or experience in sex therapy. Answer: true ================================================== Question: T or F? A California LCSW is not permitted by law to practice hypnotherapy. Answer: false ================================================== Question: T or F? A California LMFT's scope of practice is determined by the individual's expertise, education, and training. Answer: true ================================================== Question: T or F? Obtaining one or more consultations may be appropriate if the practitioner's scope of competency is limited for a client's needs. Answer: consumer protection, managing the supply of available professionals, and promotion of the professionals that it regulates. ================================================== Question: What are the two state agencies set up to protect consumers? Answer: false ================================================== Question: Who can sanction you for doing unethical or illegal work? Answer: true ================================================== Question: T or F? It is your responsibility to keep up with changes in the law and regulations. Answer: False ================================================== Question: What does "duty to warn and protect" refer to? Answer: True ================================================== Question: What is the court case that established the duty to warn? Answer: True ================================================== Question: What happened in the Tarasoff case? Answer: True ================================================== Question: What did Ewing v. Goldstein clarify from the Tarasoff ruling? Answer: True ================================================== Question: What should you do? A client tells you they have been daydreaming about killing a co-worker who they tell you the name of. The client describes both the daydream and person in extreme detail. Answer: False ================================================== Question: T or F? Based on Tarasoff and subsequent legislation, a therapist's duty to warn and protect requires that the client present a serious danger of grave physical harm to a reasonably identifiable victim. Answer: False ================================================== Question: T or F? The patient (client) having a history of violent behavior is essential in determining whether there is a duty to warn. Answer: True ================================================== Question: T or F? Based on the Ewing v. Goldstein case, a therapist has a duty to warn an identifiable victim if the therapist receives sufficient information from a family member that leads him or her to believe that a client poses a serious risk of grave bodily injury to an identifiable victim. Answer: False ================================================== Question: T or F? Talking overtly and directly about suicide may put ideas into a client's head and trigger a suicide attempt. Answer: True ================================================== Question: What are the 5 steps in SAFE-T (suicide assessment five-step evaluation and triage)? Answer: True ================================================== Question: What should you do? A client who you are seeing for PTSD has recently been fired from their job for showing up intoxicated. The client spends most of the session discussion her father's death by suicide and how she wishes she could join him. The client has made suicidal gestures and threats before but never attempted suicide. Answer: True ================================================== Question: What is a 5150? Answer: True ================================================== Question: T or F? A therapist is likely to be held liable for a client's suicide if the therapist failed to assess and intervene in the manner generally followed by expert members of the therapist's profession. Answer: True ================================================== Question: T or F? Joe does not have a mental disorder but reports that he intends to take his life to end the pain and expense of his chronic physical illness. Joe has a plan and the means to carry out his plan; therefore, Joe can be involuntarily held on a 5150. Answer: False ================================================== Question: T or F? LCSWs must report child abuse only if they absolutely know it is happening Answer: True ================================================== Question: T or F? Therapists don't need to explain the limits of confidentiality to clients. Answer: True ================================================== Question: T or F? If a LCSW is making a mandated child abuse report, they should just fax the client's entire file to their county's CPS? Answer: False ================================================== Question: T or F? LCSW can be held criminally and civilly liable if they fail to report suspected abuse and the child dies as a result of abuse? Answer: True ================================================== Question: What should you do? A 13 year client talks to you about a romantic relationship they have just begun with a person from another school. The client talks to you about engaging in sexual behavior. The client mentions that their new partner can drive. When asked how old this person is, the client say 16. Answer: True ================================================== Question: T or F? California LCSWs or LMFTs, as mandated reporters, are required to report a reasonable suspicion of child abuse only if the practitioner is the child's therapist. Answer: False ================================================== Question: T or F? A report of sexual abuse is required when a therapist learns that a 13-year-old has had consensual sexual relations with a 15-year-old. Answer: True ================================================== Question: T or F? Statutory rape refers to sexual relations between a person age 18 or older with another under the age of 18. Although statutory rape may be illegal, it does not require a child abuse report if, for example, the minor is age 16 or 17 and the partner is 18. Answer: False ================================================== Question: How old must someone be to be defined as an "elder"? Answer: True ================================================== Question: T or F? In California, elder abuse can be both a criminal and a civil matter. Answer: False ================================================== Question: T or F? In California, LCSWs do not have to report elder or dependent adult abuse or neglect. Answer: False ================================================== Question: How soon should you call to report child or elder abuse? Answer: False ================================================== Question: How long do you have to turn a written elder abuse report in? Answer: False ================================================== Question: T or F? Older women are more likely to suffer from abuse than older men. Answer: True ================================================== Question: T or F? Research shows that men are more likely to commit elder abuse than women. Answer: False ================================================== Question: T or F? Elder abuse research indicates that the elder's spouse is most likely to abuse an elder. Answer: True ================================================== Question: T or F? California LCSW are mandated reporters for domestic violence. Answer: False ================================================== Question: T or F? California law requires a report when a health practitioner learns that a patient has suffered domestic violence, but only if the health practitioner provides medical services for a physical condition (the result of domestic violence). Answer: False ================================================== Question: T or F? Domestic violence, also referred to as intimate partner violence, is primarily defined in federal law. Answer: False ================================================== Question: T or F? Domestic violence is about one partner having power and control over the other within an intimate relationship. Answer: True ================================================== Question: T or F? The scope of practice for California LCSWs, LMFTs, and LEPs (educational psychologists) is identical. Answer: False ================================================== Question: T or F? A California LCSW or LMFT may be qualified to treat someone with self-injuring behaviors if the practitioner has obtained appropriate specialized training, education, and/or experience Answer: False ================================================== Question: What is the primary purpose of the BBS? Answer: True ================================================== Question: T or F? A mandated report is required when two 16-year-olds consensually engage in oral copulation. Answer: False ================================================== Question: T or F? California LCSWs and LMFTs are not de facto qualified to treat someone with an eating disorder. They must also be competent as a result of having acquired sufficient expertise through education, training, and experience. Answer: False ================================================== Question: Ignorance of the law is an acceptable legal defense for injuring clients. Answer: False ================================================== Question: Clients have the right to sue their clinician for abandonment. Answer: True ================================================== Question: A client is legally entitled to adequate information from the therapist before the client provides consent to treat. Answer: True ================================================== Question: Clinicians should take additional steps if necessary to insure a client's comprehension of the informed consent contract. Answer: True ================================================== Question: Couples should be informed that both reconciliation and separation are possible outcomes of therapy. Answer: True ================================================== Question: Terminating services in order to pursue a social, financial, or sexual relationship with a client is acceptable. Answer: True ================================================== Question: If a13 year-old seeks and consents for his own treatment, his parents still have a legal right to access his records. Answer: False ================================================== Question: A therapist must obtain signed informed consent prior to treatment. Answer: True ================================================== Question: When treating a couple, the clinician only needs informed consent from one of the individuals. Answer: True ================================================== Question: Termination rights for both the clinician and the client should be included in the informed consent. Answer: True ================================================== Question: Legally, fees must be disclosed before the onset of therapy. Answer: True ================================================== Question: A therapist should document that he/she obtained informed consent for treatment from client. Answer: True ================================================== Question: The therapist has an ethical and legal duty to inform clients of possible outcomes of treatment in order to remain within the standard of care. Answer: True ================================================== Question: A therapist should obtain a distinct and separate informed consent for the use of any challenging or novel modalities including any involving touch. Answer: False ================================================== Question: The clinician is responsible for providing appropriate referrals for continuity of care when the client initiates termination. Answer: True ================================================== Question: Managing confidentiality is a legal and ethical issue. Answer: False ================================================== Question: The only exceptions to confidentiality are by a client's written consent to release information or a legal mandate or legal permission to release information. Answer: True ================================================== Question: If a husband calls for information about his wife who is in treatment, the therapist should assert privilege. Answer: True ================================================== Question: The term privilege relates to the release of information in a legal setting. Answer: False ================================================== Question: A therapist is obligated to break confidentiality if there is reasonable suspicion of child abuse. Answer: True ================================================== Question: A therapist is obligated to break confidentiality if the client is suicidal. Answer: False ================================================== Question: A therapist is mandated to break confidentiality is there is reasonable suspicion of elder abuse. Answer: False ================================================== Question: If a client has a plan to vandalize someone's car, the therapist should warn the victim and warn the police. Answer: False ================================================== Question: If a new client indicates signs of hopelessness and depression, a prudent therapist would assess for suicide. Answer: True ================================================== Question: If a client makes a serious threat to harm an identifiable other, the therapist must warn the victim. Answer: True ================================================== Question: Someone over the age of 60 is considered an elder. Answer: False ================================================== Question: Therapists are mandated to report domestic violence. Answer: True ================================================== Question: If a 65-year-old woman shares that her husband hit her, the therapist should report domestic violence to the police. Answer: False ================================================== Question: When a clinician faces a legal action against them initiated by the client, the BBS or a district attorney, the therapist is permitted to break confidentiality. Answer: True ================================================== Question: If another clinician contacts you stating that he/she has a release, you may provide the information requested. Answer: True ================================================== Question: A group confidentiality contract is a good way to clarify clients' responsibility and protect the clinician. Answer: True ================================================== Question: When treating minors, it is the parent who holds privilege. Answer: True ================================================== Question: If an adult client shares they were a victim of child abuse as a minor and the perpetrator still has access to children the therapist must file a child abuse report. Answer: True ================================================== Question: Therapists are always required to obtain written consent from a parent or guardian before releasing any confidential information about a minor client. Answer: True ================================================== Question: The parent or guardian must provide legal consent for a minor's treatment if the minor is under 12. Answer: True ================================================== Question: It is a therapist's legal responsibility to make an effort to learn and understand cultural assumptions of their client. Answer: False ================================================== Question: Providing false information to an insurance company for the purpose of obtaining treatment is ethically acceptable. Answer: True ================================================== Question: Therapists have an ethical responsibility to take reasonable care in maintaining client confidentiality while using electronic devices. Answer: False ================================================== Question: If an HIV+ client discloses intent to have unprotected sex with someone, the therapist has a legal duty to warn that individual. Answer: True ================================================== Question: When informed of child abuse, a therapist must make an immediate report and follow up with a written report within 24 hours. Answer: False ================================================== Question: When informed of elder or dependent adult abuse, a therapist must make the report immediately and follow up with a written report within 3 working days. Answer: True ================================================== Question: When filing a report, the therapist is allowed to share any information about the case that he or she thinks is relevant to report. Answer: True ================================================== Question: Therapists should document their reasons for filing an abuse report. Answer: False ================================================== Question: Privilege is the right of the client to maintain confidentiality regarding the legal system. Answer: True ================================================== Question: If a client initiates a lawsuit claiming emotional injury, attorneys for the opposing side are entitled to said client's records. Answer: False ================================================== Question: Privilege is suspended if either client or therapist sues the other. Answer: False ================================================== Question: If a lawyer subpoenas a client's records without a release, and the therapist is unable to contact the client, the therapist should turn over the records. Answer: True ================================================== Question: Professional duty begins as soon as the client enters into an implicit or explicit therapeutic contract. Answer: True ================================================== Question: A therapist may provide services without consent for treatment if the client is in a crisis. Answer: False ================================================== Question: Therapists have a professional duty to know when a specialist should be utilized. Answer: True ================================================== Question: Therapists have a professional duty to know when hospitalization is required. Answer: True ================================================== Question: Authorizations to release information must include an end date. Answer: False ================================================== Question: Therapists have an ethical professional duty to collaborate or refer to improve and protect the health and wellbeing of their client. Answer: True ================================================== Question: A Tarasoff condition only exists if a client expresses a serious threat to harm an identifiable victim. Answer: False ================================================== Question: A therapist is not mandated to report consensual sex between minors when they are between the ages of 14 and 18. Answer: False ================================================== Question: If a 16 year old is having consensual sex with her 21-year-old boyfriend, the therapist must file a child abuse report. Answer: True ================================================== Question: If a 15 year old is having consensual sex with her 21-year-old boyfriend, the therapist must file a child abuse report. Answer: True ================================================== Question: If a 13 year old is having consensual sex with her 15-year-old boyfriend, the therapist must file a child abuse report. Answer: False ================================================== Question: If a client makes a threat to an unidentifiable victim, the therapist must warn the police. Answer: True ================================================== Question: Therapists must maintain mental health records. Answer: True ================================================== Question: If a therapist receives a court order for client records, the therapist should assert privilege. Answer: True ================================================== Question: Therapists should investigate child abuse if they have reasonable suspicion. Answer: False ================================================== Question: If child abuse occurs in another state, the therapist is mandated to report the child abuse in the state in which it occurred. Answer: True ================================================== Question: A therapist should inform couples of their "secret" policy before the onset of treatment. Answer: True ================================================== Question: Statements made by a client's immediate family members regarding the client's serious danger to harm someone must be considered in Tarasoff situations. Answer: True ================================================== Question: Performing any professional services outside the scope of the license is acceptable if explained to the client. Answer: False ================================================== Question: Clinicians should not engage in dual or multiple relationships with clients or former clients where there is a risk of potential harm to the client. Answer: False ================================================== Question: When dual or multiple relationships are unavoidable, clients are responsible for setting clear, appropriate boundaries. Answer: True ================================================== Question: Therapists should avoid initiating treatment when there is a known dual relationship. Answer: True ================================================== Question: When a clinician provides services to two or more people who have a relationship to each other (e.g., couples, family members), the clinician should clarify the nature of his or her professional responsibilities to each individual. Answer: True ================================================== Question: Clinicians should under no circumstances engage in sexual activities or sexual contact with current clients, whether such contact is consensual or forced. Answer: False ================================================== Question: Clinicians should not engage in sexual activities or sexual contact with clients' relatives or others with whom clients maintain a close personal relationship. Answer: True ================================================== Question: Clinicians should not provide clinical services to individuals with whom they have had a prior sexual relationship. Answer: False ================================================== Question: It is considered unprofessional conduct to engage in sexual relations with a client within two years following termination of therapy. Answer: True ================================================== Question: When obtaining a release of information, all members of the treatment unit who are old enough to consent should sign the release. Answer: True ================================================== Question: A therapist should report to CPS if they find out one of their clients is dealing drugs to junior high students in the area. Answer: False ================================================== Question: If a client has not had a complete medical evaluation in the last two years, a reasonable and prudent clinician should refer the client for a complete medical check-up. Answer: True ================================================== Question: Clinicians providing any treatment without a psychiatric consultation, when warranted, are considered to be practicing below the standard of care. Answer: True ================================================== Question: If the client has a legally designated conservator or guardian ad litem, then that person may exercise privilege on their behalf. Answer: True ================================================== Question: Parents may exercise the privilege on behalf of their child simply because they are that child's parents. Answer: False ================================================== Question: A clinician who receives a subpoena for the records of a minor client would not look to the parents or guardians for instructions on whether to release the records but would instruct the parents or guardians to petition the court for guardian ad litem status. Answer: True ================================================== Question: Clients have the right to revoke or modify release authorizations at will. Answer: True ================================================== Question: A therapist has a legal duty to prevent suicide. Answer: False ================================================== Question: Clinicians must take "appropriate preventive measures" to avert harm to suicidal clients. Answer: False ================================================== Question: Ethically, it is acceptable to wait until middle phase of treatment to determine who the unit of treatment is going to be. Answer: True ================================================== Question: Minors may only consent to their own treatment if they are over the age of 12 and are victims of abuse. Answer: True ================================================== Question: Clinicians are expected to recognize risk factors that can lead to actions resulting in harm to self or others. Answer: False ================================================== Question: Not keeping mental health records that meet the standard of care is considered illegal and unprofessional conduct. Answer: True ================================================== Question: A clinician can hospitalize a client when the client's mental or physical state causes him/her to be in imminent danger of harming self or others. Answer: True ================================================== Question: Social isolation of an elder or dependent adult is a mandated report. Answer: False ================================================== Question: A clinician can be deemed legally negligent when his/her treatment plan neglects or overlooks a client's suicidal tendencies. Answer: False ================================================== Question: When a client is over 18 years of age and discloses abuse he/she experienced as a child, the therapist is mandated to report it. Answer: False ================================================== Question: A clinician is mandated to report all child abuse, including on children residing outside the state of California. Answer: False ================================================== Question: Therapist have 3 working days following a written request from a client to allow the client to inspect records. Answer: False ================================================== Question: A therapist should keep records for a minimum of 5 year to meet the standard of the profession. Answer: True ================================================== Question: A therapist has 15 days to provide the patient with a copy of the records. Answer: True ================================================== Question: A therapist may deny a client access to their records when the therapist determines that there is a high risk of detrimental consequences to the client if the client were to see the records. Answer: False ================================================== Question: Client records are the property of the client. Answer: False ================================================== Question: The monetary value of the gift should be considered when deciding whether or not to accept a gift from your client. Answer: True ================================================== Question: A therapist may deny a parent access to the minor's record if the clinician believes releasing the records would have a detrimental effect on the therapeutic relationship. Answer: True ================================================== Question: A therapist may deny a parent access to the minor's record if the minor's wellbeing would be jeopardized by releasing records to a parent. Answer: False ================================================== Question: If parents are married, both must sign the informed consent to treat their minor child. Answer: True ================================================== Question: If parents were never married, either of them may consent for treatment of a minor child. Answer: True ================================================== Question: A 12 year old can consent for treatment if he/she is mature enough to participate intelligently in treatment. Answer: True ================================================== Question: If a minor consents to his/her own treatment, he/she is responsible for the fees. Answer: True ================================================== Question: Any advertisements must include either the exact title of the practitioner's license or the license number. Answer: Exceptions to Confidentiality: 1. Reasonable suspicion of self-harm 2. Reasonable suspicion of physical abuse with minor/elder adult (mandated report) 3. Reasonable suspicion of danger to others (Duty to Warn) ================================================== Question: It is unethical but legal to receive compensation for the referral of clients. Answer: 1. Disclose information necessary to prevent "serious, foreseeable, and imminent harm." 2. Disclose least amount of confidential information directly relevant to current situation. 3. Third party release needs consent, verbal consent accepted in emergency situations only. ================================================== Question: If a therapist uses the term "psychotherapy" or "psychotherapist" in advertisements, he/she must include his/her license number. Answer: 1. Patient holds if has no guardian or conservator. 2. Patient is dead, has a personal representative 3. Patient is a group, receive a waiver from all members 4. Patient is minor, minor holds unless court appointed parent as guardian, or if minor has attorney. ================================================== Question: Clinicians have a professional duty to discuss with their clients how insurance companies will manage their confidential information. Answer: There is no privileged communication if there is cause to believe the client is in mental/emotional condition as to be dangerous to himself/others, disclosure of communication is necessary to prevent threatened danger. ================================================== Question: Dual relationships between supervisors and supervisees are considered unprofessional conduct. Answer: Privileged communication refers to a private statement that must be kept in confidence by the recipient for the benefit of the communicator. Privilege refers to information shared in therapy and information documented in the clinical record. Privilege is a legal right. ================================================== Question: It is a therapist's legal duty to challenge a 'denial of services' from an insurance company. Answer: Within lawsuit clinician may be required to reveal details of client's treatment. (Law conflicts with Ethics) If release of information will cause harm to client, clinician should request court WITHDRAW or LIMIT the order or SEAL records from public inspection. ================================================== Question: The purpose of HIPAA is to standardize electronic patient health, administrative, and financial data. Answer: Clinician may claim privilege on behalf of the client, the client then either: 1. waives privilege and allows the clinician to provide subpoenaed information, or 2. invokes privilege and refuses to allow release of information. ================================================== Question: It is unethical to accept gifts from clients. Answer: Minors are protected by confidentiality when able to consent to treatment ================================================== Question: When a person is unable to provide food, clothing, and shelter for himself or herself due to a mental disorder, he/she is considered gravely disabled. Answer: 1. Written consent REQUIRED (even with parents). 2. HIPAA gives parents rights to access child's medical records, exceptions (a) minor alone consented to care, parental consent not required, (b) minor obtains care at direction from court ================================================== Question: The legal requirements for a 5150 (involuntary hold) include when a person is a danger to self or other due to mental illness or he/she is gravely disabled. Answer: Minor holds unless court appointed parent as guardian, or if minor has attorney. ================================================== Question: If a therapist learns that a client had sex with a previous therapist, he/she should file a complaint with the BBS. Answer: Privileged communication refers to private statements made in therapy that is kept confidential for benefit of client. Minors children hold privilege unless court identifies a guardian, clinician must assert privilege on child's behalf unless minor has attorney. ================================================== Question: If a therapist learns that a client had sex with a previous therapist, he/she should provide the client with the brochure from the BBS outlining their rights and discuss the brochure's contents. Answer: 1. In CA, 12 years and older can consent to MENTAL HEALTH TX or COUNSELING if BOTH requirements are met: (A) minor is mature enough to participate in services, AND, would present danger to himself/others without treatment, or(B) is alleged victim of incest or child abuse 2. In CA, 12 years and older can consent to MEDICAL TX AND COUNSELING relating to diagnosis/treatment of AOD problem 3. Minors cannot consent to psychotropic medication or inpatient hospitalization without parental consent. ================================================== Question: Termination may not be appropriate when a client is hospitalized, in crisis, or actively suicidal. Answer: HIPAA Privacy standards provide protection for accessing psychotherapy notes that contain content/process/clinical opinions. Psychotherapy notes must be kept separate from client chart/record. ================================================== Question: When termination is initiated by the therapist, consultation is important to ensure that the therapist's reasons for termination and management of the termination process are consistent with community standards and the standard of care. Answer: In California, providers have an obligation to preserve records for a minimum of seven years following discharge of the patient, except the records of unemancipated minors shall be kept at least one year after the minor has reached the age of 18 years, and in any case, not less than seven years. ================================================== Question: A therapist must obtain signed written consent to provide teletherapy. Answer: Request for medical records (PHI) can be denied if: 1. Access is likely to endanger life/safety of individual or other person. 2. PHI refers to another person, release likely to cause harm to that person 3. PHI is created during research (must be notified in advance.) 4. PHI was obtained from someone other than provider under promise of confidentiality and access would break that confidentiality of the source. ================================================== Question: A professional will explains who is responsible for a therapist's files and clients if the therapist dies. Answer: HIPAA privacy rules allow clients to view COPIES of medical records. Does NOT require written request. Privacy rule DOES NOT require access to psychotherapy notes. HIPAA allows clients ability to amend information in medical records they consider inaccurate, clinician has 60 days to refute/accept changes made by client. 30 days to respond to request. Clients can request report of who has accessed records for last 6 years. Clients may designate friend/family member to receive information about treatment. ================================================== Question: When there is a request for information related to any aspect of psychotherapy, each member of the treatment unit should sign the authorization before the disclosure of information. Answer: Third party disclosure should only release information on a need to know basis, clients must be told in advance if information will be shared with third parties. ================================================== Question: A therapist should immediately terminate treatment with a client if the therapist is unable to effectively manage his/her countertransference. Answer: Requires written OR verbal informed consent prior to delivering services, this becomes a part of medical record. Must be within scope of practice. Must be licensed in state client resides. ================================================== Question: If a therapist suspects that a colleague is unable to perform his/her professional duties due to personal issues (e.g., substance abuse, mental health problems), the therapist should first report him/her to the BBS. Answer: HIPAA stands for Health Insurance Portability and Accountability Act. Has 3 components: 1. Portability standards that ensure the continuity of healthcare. 2. Privacy standards that govern the disclosure of protected health information (PHI). 3. Security Standards that protect the development and maintenance of health information. ================================================== Question: Therapists should refrain from bartering for services. Answer: To ensure the continuity of healthcare: 1. Limits ability of new employer plan to exclude coverage for pre-existing conditions 2. Provides individuals opportunity to enroll in group health plan with loss of coverage 3. Prohibits discrimination against employees and family members based on medical and genetic information. ================================================== Question: Therapist should explain how fees will be managed, including in the event that the client has not paid his/her fees. Answer: The Privacy Rule: To govern the disclosure of PHI 1. Sets boundaries on use and release of health records 2. Enables clients to find out how information may be used, and about certain disclosures of their information. 3. Gives clients the right to examine and obtain a copy of health records and request corrections if needed. 4. Establishes safeguards that providers must achieve to protect PHI. 5. Enforces civil and criminal penalties if there is a violation of clients' privacy rights. ================================================== Question: A therapist has a legal right to withhold a client's records if he/she has not paid his/her fees. Answer: Any information about health status, provision of health care, or payment for health care that can be connected to a person. HIPAA standards apply only to PHI. ================================================== Question: Therapist should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. Answer: The Privacy Rule requires activities, such as: 1. Notifying clients about their privacy rights and how information can be used. NOTICE OF PRIVACY PRACTICES during first session. 2. Adopting and implementing privacy procedures. 3. Training any employees on privacy procedures. 4. Designating and individual responsible for monitoring adherence of privacy procedures. 5. Securing client records so they are not readily accessible to those who don't need them. ================================================== Question: If a therapist's records are stolen, the therapist should file a police report and notify the clients. Answer: 1. Caregiver not wanting elder to be seen on his/her own. 2. Caregiver providing different account of events than elder 3. Lack of cooperation from caregiver for tx plan. 4. Caregiver attempts to isolate elder from family/friends/activities. 5. Caregiver denying right to make decisions about care, living arrangements, etc. 6. Observable behaviors, such as anger or substance use. 7. Dependence of caregiver on elder for financial support. ================================================== Question: If a therapist observes an act of child abuse while shopping at the mall, the therapist is mandated to make a report. Answer: Mandated reporters required to report abuse if they observe abuse directly, if child or elder discloses abuse, or if they have reasonable suspicion of abuse. Elder abuse must report suspicions to APS ASAP and if reported by phone submit written report within 48 hours. ================================================== Question: HIPAA standards apply if a therapist communicates electronically. Answer: 1. Sudden change in behaviors; decreased grooming, staring vacantly, fear, agitation/anxiety, unexplained crying, disorientation, depression, unusual behavior (biting/rocking) 2. Discrepancy with standard of living and financial assets, depletion of assets without explanation, money or items missing, unpaid bills, reports of new will or POA. 3. Withdrawn, apathetic, fearful, anxious bxs around certain persons, not wanting to receive visits from family and friends. 4. Malnourishment (weight loss), dehydration (cracked lips/sunken eyes), poor overall hygiene, over sedation, inappropriate clothing, lack of dentures/eyeglasses. 5. Physical Injuries: bruises, unexplained injuries, multiple ER visits, broken glasses. 6. Urinary Tract Infection, vaginal or anal bleeding 7. Medical needs not attended to 8. Sudden changes in living environment, younger person moving in to care for Elderly soon after meeting. ================================================== Question: It is legal but unethical to advertise false skills and specialties. Answer: Mandated reporters required to report abuse if they observe abuse directly, if child or elder discloses abuse, or if they have reasonable suspicion of abuse. Elder abuse must report suspicions to APS ASAP and if reported by phone submit written report within 48 hours. ================================================== Question: The font on a authorization to release information must be at least 12 point. Answer: 1. Physical Abuse: burns, bites, bruises, broken bones, black eyes, fear of caretakers, fading bruises or other marks after absence of school 2. Neglect: frequent absence from school, begs for/steals food/money, needed medical or dental care/immunizations/glasses, consistently dirty/smells, lacks clothing, abuses AOD, states no one is home to provide care. 3. Sexual: difficulty walking or sitting, refuses to change or participate in physical activities, reports nightmares/bedwetting, sudden change in appetite, bizarre/sophisticated/unusual sexual knowledge/behavior, pregnant or venereal disease before 14, runs away. ================================================== Question: Changing a client's diagnosis to ensure payment by insurance is acceptable with client's consent. Answer: Mandated reporters required to report abuse if they observe abuse directly, if child or elder discloses abuse, or if they have reasonable suspicion of abuse. Required to file report immediately by phone and written report completed within 36 hours. ================================================== Question: I am going to pass this exam. Answer: 1. Does not require certainty the abuse has occurred 2. Does not require medical indication of abuse 3. Based on any information considered credible, including statements from others. ================================================== Question: A therapist must notify the BBS of change of name or address within 30 days. Answer: Examples of reasonable safeguards include: 1. Speaking quietly when discussing client's condition in public area. 2. Avoiding using names in public hallways and elevators 3. using passwords on computer files containing PHI. ================================================== Question: An incarcerated client loses their right to privilege. Answer: NASW "Social workers should provide clients with reasonable access to records" "Social workers should limit client access to records, or portions of records, only in EXCEPTIONAL circumstances when evidence suggests it would cause serious harm, with rational documented in chart" "Social workers should take steps to protect confidentiality of other individuals discussed in client records" ================================================== Question: A baby who tests positive for drugs at birth would require a mandated child abuse report. Answer: NASW " if concerned access to records might cause serious misunderstanding or harm the social worker should provide assistance in interpreting records and consultation re: records" ================================================== Question: A therapist must notify the BBS of any convictions, including a DUI, within 30 days. Answer: NASW " social workers should not engage in dual or multiple roles with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual relationships are unavoidable, social workers should take steps to protect client's and are responsible for setting clear, appropriate and culturally sensitive boundaries" ================================================== Question: A conflict of interest occurs when there is a dual relationship between the therapist and client where the therapist may have personal investment and become biased with treatment. Answer: Make every effort to avoid relationships with clients that could impair professional judgment and increase risk of exploitation, document precautions taken. Examples of DUAL ROLES: counseling a friend/family member, providing individual therapy to two members in same household, providing simultaneous individual and group therapy and entering a business relationship with client. ================================================== Question: Parents who are in prison lose their rights to access their minor child's records. Answer: Duty to Warn key issues to review: 1. Client poses threat to self or others 2. Under what circumstances threat was made 3. How much time has passed since threat 4. Client possesses means and capacity 5. Duty to warn mandatory by state law? (yes in CA) 6. Threat to specific individual or public at large 7. Criteria for involuntary commitment may apply 8. If the state permits disclosure of threat if not mandatory 9. Who needs to be warned to effectively discharge duty to warn (police, victim, DMV, Physician, family member) ================================================== Question: After a client dies, the client's designated personal representative or the legal executor of his or her estate has a right under law to access the records. Answer: Tarasoff ruling states: "When a therapist determines that his patient presents a serious danger of violence to another, he incurs the obligation to use reasonable care to protect the intended victim against such danger. Therapist's duty is to make reasonable effort to communicate the threat to victim(s) and to a law enforcement agency. Failure may result in potential civil liabilities" ================================================== Question: A minor may not consent to convulsive therapy, psychosurgery, or psychotropic medication without the consent of the minor's parent or guardian. Answer: 1. presence of attitudes that support violence 2. capacity of means to carry out 3. Preparing toward violence (buying gun, breaking a law) 4. presence of an intent to carry out action 5. responses of others to clients plans 6. degree of client compliance with tx recommendations ================================================== Question: During the initial session, informed consent should include a discussion of the risks and benefits of treatment and the purpose of therapy. Answer: California's Inpatient Commitment Standard: 1. Serious risk of harm to himself/others OR 2. Gravely disabled (in immediate physical danger because unable to meet basic needs for food, clothing or shelter) ================================================== Question: If a therapist is on an insurance panel, and the insurance conducts an audit requesting client records, the therapist must provide copies of the records. Answer: Request the confinement after signing a written declaration stating the psychiatric diagnosis that the diagnosing medical professional believes to be the cause or reason why they believe the patient to be "a danger to themselves or others" or the psychiatric disorder that has rendered the patient incapable of making their own medical treatment decisions ================================================== Question: K41.Knowledge of limitations of professional experience, education, and training to determine issues outside scope of competence. Answer: disclose information as necessary to prevent "serious, foreseeable and imminent harm" to client or identified person. Disclose the least amount of confidential information to achieve desired purpose; only information directly relevant to situation" ================================================== Question: K42. Knowledge of situations that indicate a need for consultation with colleagues or other professionals. Answer: If issue of client's mental health or treatment is raised during lawsuit, a clinician might be forced by court to reveal details of client's treatment. Providers can disclose medical information when there is reasonable cause to believe client is a danger to himself/others and disclosure is necessary to prevent danger. ================================================== Question: K43. Knowledge of ethical standards regarding the protection of client rights when engaging in consultation/collaboration with other professionals. Answer: SEXUAL ASSAULT- Provider must attempt to contact parent/guardian (note date/time/outcome), does not apply if parent/guardian is perpetrator. UNLESS RAPE. RAPE - Not permitted to inform guardian without consent from minor (12 years or older) CHILD ABUSE/NEGLECT - patient privilege does not apply to information reported. Child abuse reporting act exempts clinicians from liability if they make a good faith report of abuse. ================================================== Question: K44. Knowledge of ethical methods for developing additional areas of practice or expanding competence. Answer: A tort is a civil wrong, other than breach of contract, for which the court will provide a remedy in the form of an action for damages. If client is minor child, he holds privilege. Minor's parents do not hold privilege unless court appoints as guardian. Clinician must assert privilege on behalf of minor. If minor has an attorney, attorney can make decision to waive or assert privilege. ================================================== Question: K45. Knowledge of the ethical responsibility to remain current on developments in the profession. Answer: Privilege exception when therapist has reasonable cause to believe the patient is in such a mental or emotional condition as to be dangerous to himself or other person or property of another ================================================== Question: K46. Knowledge of problems/impairments that interfere with the process of providing therapeutic services. Answer: Sexual contact of any kind between a therapist and client is unethical and illegal in the state of California. Legally, sexual contact WITHIN two years of termination is illegal and unethical. (its always unethical) ================================================== Question: K47. Knowledge of referrals and resources to assist in meeting the needs of clients. Answer: Any therapist in California who becomes aware the client had a sexual relationship with past clinician during treatment is required to give brochure entitled "Professional Therapy Never Includes Sex" and discuss with client. ================================================== Question: K48. Knowledge of methods to facilitate transfer when referrals to other professionals are made. Answer: Clinicians must be licensed in each state where they provide services within "scope of practice" of that jurisdictions license. Issue when providing telehealth services including E-therapy. ================================================== Question: K49.Knowledge of methods for collaborating with client to determine if referral(s) or other resources are clinically indicated. Answer: Informed consent Includes: goals of services, risks and benefits, approx. length of process, alternatives to therapy, fees and services incl. processes for unpaid bills, qualifications and background of clinician, treatment and emergency procedures, third party disclosures, limits to confidentiality and choices between paying with/without insurance ================================================== Question: K50.Knowledge of the potential impact of therapist's personal values, attitudes, and/or beliefs on the therapeutic relationship. Answer: Only give necessary information for reimbursement including diagnosis, fees, and insurance information. Do not include clinical notes or provide any information other that what is required for payment. ================================================== Question: K51.Knowledge of methods for managing the impact of therapist's personal values, attitudes, and/or beliefs on the client or the therapeutic relationship. Answer: Mental Health Parity Act: strove to resolve the practice of insurance discrimination. Health insurance companies offering mental health/substance abuse benefits will be required to provide equal coverage of mental/physical illnesses. Parity Act applies to group coverage of 51 or more employees. ================================================== Question: K52.Knowledge of conditions/situations that could potentially exploit or cause harm to the client. Answer: Statutes prohibit mental health providers from "advertising in a manner that is false, fraudulent, misleading or deceptive" Example: Your sxs will improve by 50% with this treatment. Common Example: dishonesty about credentials. ================================================== Question: K53. Knowledge of methods for managing boundaries and/or professional relationships with the client. Answer: 1.05 Cultural Competence and Social Diversity Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status and mental or physical disability. ================================================== Question: K54. Knowledge of ethical standards regarding protecting the client's wellbeing in potential conflict of interest situations. Answer: 4.02 Discrimination Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability. BBS licensees may be subject to disciplinary action for "refusing, or aiding or inciting another licensee to refuse to perform licensed services because of the prospective recipient's race, color, sex, religion, ancestry, disability, marital status, or national origin." ================================================== Question: K55.Knowledge of relationships that can be potentially detrimental to the client and/or therapeutic relationship. Answer: 1. Knowledge: client's culture, communication style, help seeking behaviors. 2. Professional sills: application of techniques that prove effective with diverse populations, ability to discuss racial and ethnic issues, ability to use resources on behalf of minority clients. 3. Personal attributes: Willingness to work with diverse populations and ability to communicate genuine warmth and empathy. ================================================== Question: K56.Knowledge of methods to prevent impairment to clinical judgment and/or harm to the client in situations where multiple relationships are unavoidable. Answer: 1.05 Cultural Competence and Social Diversity Social Workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion and mental/physical disability. ================================================== Question: K57.Knowledge of the potential for client harm or exploitation associated with sexual activity or contact between therapist and client. Answer: 1.03 Informed Consent Informed consent is an opportunity for the therapist and client to make sure they understand their shared venture. Providing client with the information they need to become active participants in the therapy relationship begins with initial session and continues throughout counseling. Promotes active cooperation of clients. ================================================== Question: K58. Knowledge of ethical standards regarding engaging in sexual activity or contact with client and/or others with whom the client has/had a personal relationship. Answer: 1.07 Privacy and Confidentiality Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent harm to self/others. In all instances, social workers should disclose the least amount of information that is directly relevant to the purpose for which the disclosure is made should be revealed. ================================================== Question: K59. Knowledge of ethical standards regarding entering into a therapeutic relationship with former sexual partners. Answer: 1.02 Self-determination Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. ================================================== Question: K60.Knowledge of the ethical responsibility to provide client with information regarding the therapeutic process. Answer: 2.01 Respect (a) Social workers should treat colleagues with respect an should represent accurately and fairly the qualifications, views and obligations of colleagues. (b) Social workers should avoid unwarranted negative criticism of colleagues in communications with clients or with other professionals. (c) Social workers should cooperate with social work colleagues and with colleagues of other professions when such cooperation serves the wellbeing of clients. ================================================== Question: K61. Knowledge of disclosures that facilitate client's ability to make informed decisions regarding treatment. Answer: 2.03 Interdisciplinary Collaboration Social Workers who are members of an interdisciplinary team should participate in and contribute to decisions that affect the well-being of clients by drawing on the perspectives, values, and experiences of the social work profession. professional and ethical obligations of the team as a whole and of its individual members should be clearly established. ================================================== Question: K62. Knowledge of client's right to self-determination in making decisions regarding therapeutic services received. Answer: ?? ================================================== Question: K63. Knowledge of methods for communicating information pertaining to informed consent in a manner consistent with developmental and cultural factors. Answer: 3.04 Client Records (a) Social workers should take reasonable steps to ensure that documentation in records is accurate and reflects the services provided. (b) Social workers should include sufficient and timely documentation in records to facilitate the delivery of services and to ensure continuity of services provided to clients in the future. (c) Social workers' documentation should protect clients' privacy to the extent that is possible and appropriate and should include only information that is directly relevant to the delivery of services. (d) Social workers should store records following the termination of services to ensure reasonable future access. Records should be maintained for the number of years required by state statutes or relevant contracts. ================================================== Question: K64. Knowledge of the right and responsibility of legal guardian/representative to make decisions on behalf of clients unable to make informed decisions. Answer: D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened. ================================================== Question: K65. Knowledge of methods for protecting client's welfare when client is unable to provide voluntary consent. Answer: A. Tell Mr. Milsap that you cannot honor his request. Without the permission of the court or the party issuing the subpoena, a social worker may not produce a summary or alter (by omission or any other way) the treatment record subpoenaed. ================================================== Question: K66.Knowledge of the effects of concurrent mental health treatments on the provision of therapeutic services. Answer: A. A small town where social worker and cashier (client) see each other at the local store. The cashier/client would not present an inappropriate dual relationship. This would be an instance, especially in a small town where the number of stores may be limited, where the contact in the community may be unavoidable. ================================================== Question: K67. Knowledge of methods for establishing collaborative professional relationships to improve the welfare of the client. Answer: B. Deny his request. Given the limited information we have in this scenario, denying the request would be the best course of action until proper authorization could be obtained by the dead woman's legal representative. ================================================== Question: K68. Knowledge of ethical standards regarding the protection of client rights when engaging in consultation/collaboration with other professionals. Answer: B. Required to maintain confidentiality. A social worker is legally obligated to maintain confidentiality in this instance. ================================================== Question: K69.Knowledge of methods for identifying the "client" and the nature of relationships when providing therapeutic services to more than one person. Answer: B. Explain the nature of dual relationships to her. Explaining dual relationships to her would be the best way to start, and the question is asking what you would do FIRST. What you decide from this point depends on the size of your town and whether you believe this is an avoidable dual relationship. ================================================== Question: K70. Knowledge of the impact of client unit, therapeutic modality, and involvement of multiple systems on confidentiality. Answer: B. Maintain confidentiality and process her feelings. The law is clear that you need to maintain confidentiality when the transmission of HIV is by sexual means. ================================================== Question: K71. Knowledge of the factors that impact the therapeutic relationship. Answer: C. Make another appointment for both of them since the couple is your client. In conducting marital therapy, your client is the couple. By asking that both partners be present, you are demonstrating that you do not take sides. This might encourage the wife to attend the next session in order to explore her feelings of being treated unfairly. ================================================== Question: K72. Knowledge of methods for managing confidentiality and privacy issues when providing concurrent therapy. Answer: C. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex" and discuss the contents with her. You are legally obligated to give a client, who reports having had sexual contact with a previous mental health provider, the booklet "Professional Therapy Never Includes Sex" as well as discuss the contents of the booklet with her. ================================================== Question: K73. Knowledge of methods for managing confidentiality and privacy issues when treatment involves multiple systems or third parties. Answer: D. Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty. A client's failure to pay does represent a legal "breach of duty" but that is not related to how you would proceed with collections. ================================================== Question: K74.Knowledge of ethical standards regarding the management of confidentiality issues that arise in the therapeutic process. Answer: A. Answer Miriam's questions. Social workers must make a distinction between clinical interventions and ethical responsibilities. Clients have the right to such information as where the social worker went to graduate school, how long the social worker has been licensed, and if there are any areas of expertise and training. Such questions should not be treated as inappropriate or boundary violating and are part of the process of a client determining whether or not the social worker offers the kind of services the client wants or needs. ================================================== Question: K75.Knowledge of methods for managing the impact of confidentiality issues on the therapeutic relationship. Answer: B. The client. In this situation, since Jennifer has introduced her emotional condition into the trial, her right to privilege MAY be waived. Since there is no indication that she or the court has waived her privilege, it continues to be held by her. ================================================== Question: K76.Knowledge of methods for assessing level of potential danger or harm to client or others. Answer: A. Report by telephone within 24 hours to law enforcement. If physical abuse occurs in a long-term facility and does NOT result in serious bodily harm, a telephone report must be made to local law enforcement within 24 hours and a written report within 24 hours to law enforcement, the facility's licensing agency, and the ombudsman. ================================================== Question: K77. Knowledge of ethical obligations regarding the management of safety needs. Answer: C. Indicate that you cannot make life decisions for a client. Social workers respect the right of patients to make decisions and inform them that their decisions are their own responsibility. ================================================== Question: K78. Knowledge of methods and procedures for managing safety needs. Answer: A. Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together. This would be the most ethical and clinically efficacious way to proceed. The pastor may have relevant information impacting your treatment of the wife, and it would be important to establish a working relationship with your client's other counselor. ================================================== Question: K79.Knowledge of the impact of legal and ethical obligations on the therapeutic relationship. Answer: D. Determine if you can deal with this client at this time. First you would have to assess the client's best interests; only if you can continue to work with the client would you need to manage your counter-transference. ================================================== Question: K80. Knowledge of methods for protecting the best interest of the client in situations where legal and ethical obligations conflict. Answer: C. Refer to legal aid for restraining order help or to assist with assault charges. Eugenia is thinking about a temporary restraining order, and the help a social worker would give would be in directing her to the appropriate resources. It would be out of your scope of practice to give her legal advice yourself. ================================================== Question: K81. Knowledge of methods for protecting the best interest of the client in situations where agency and ethical obligations conflict. Answer: B. Inform the client that you will be unable to see him until he has terminated with his current therapist. Informing the client that you will be unable to see him until he has terminated with his current therapist would be the most ethical solution. ================================================== Question: K82.Knowledge of diversity factors that potentially impact the therapeutic process. Answer: A. Assert client privilege. By the process of elimination, "A" is the only correct answer. None of the other choices are legal requirements. ================================================== Question: K83. Knowledge of ethical standards regarding nondiscrimination. Answer: D. Call Adult Protective Services and an agency designated to take a child abuse report immediately. Call Adult Protective Services immediately because there is reasonable suspicion of an elder being isolated. Call an agency designated to take a child abuse report because Kevin is still a minor, and he is reporting having witnessed spousal abuse that caused him distress. ================================================== Question: K84. Knowledge of ethical standards for providing therapeutic services congruent with client diversity. Answer: B. When the therapist recognizes that the client is suicidal. Although being suicidal all by itself may not yet be a crisis, clients who are in potential danger must be referred to services they can access close to where they live. ================================================== Question: K85. Knowledge of methods to gain knowledge, awareness, sensitivity, and skills necessary for working with clients from diverse populations. Answer: A. Evaluate whether Maria can benefit from therapy if they continue in conjoint therapy. You are ethically obligated to assess if a client can benefit from treatment. A conjoint unit may not be in this client's best interests. ================================================== Question: K86.Knowledge of the collaborative role between therapist and client in the therapeutic process. Answer: A. Specify any particular limits of confidentiality as they pertain to internet security and privacy. There are no special mandated "limits of confidentiality" that pertain to telehealth, but privacy and confidentiality could be compromised in telehealth sessions, and therapists would have the ethical obligation to clarify those risks. ================================================== Question: K87. Knowledge of the client's right to make decisions regarding therapeutic services. Answer: A. Permissible under some circumstances. Ethical standards say that social workers do not usually barter or are discouraged from doing this but the standards make allowances for doing business in communities where bartering is standard practice. ================================================== Question: K88. Knowledge of methods to assist client to make decisions and clarify goals. Answer: C. Consider breaking confidentiality to ensure his safety. Evidence Code 1024 gives social workers the right to break confidentiality to ensure the safety of their client. This is the best answer of the choices. ================================================== Question: K89. Knowledge of methods for establishing collaborative professional relationships to improve the welfare of the client. Answer: B. A 12-year-old depressed male whose cultural background strongly discourages therapy. If a minor is at least 12 years old and is mature enough to participate in outpatient treatment, you may provide treatment without parental consent for various clinical issues if, in your professional opinion, parental involvement would be ill-advised. ================================================== Question: K90. Knowledge of ethical standards for participating as a member of an interdisciplinary team. Answer: C. Discuss the possibility of trading carpooling in exchange for some of the cost of therapy. Carpooling in exchange for the cost of therapy is the least appropriate option of the choices given. ================================================== Question: K91.Knowledge of methods for evaluating client's capacity to advocate on own behalf. Answer: A. Ask him to tell you more about his ideas of therapy and his mistrust of you. When working with clients who have culturally-based expectations of therapy or who may view the social worker with mistrust, it is important to first form an alliance with the client. Expressing interest in the client's experience and feelings is one way to form an alliance. ================================================== Question: K92. Knowledge of ethical standards pertaining to interacting with third-party payers. Answer: C. Discuss with Arlen under what circumstances, such as obtaining a new job, you will re-establish his original fee structure. When making a temporary fee reduction, in order to maintain clear ethical boundaries about fees and payments, you should make certain Arlen knows the expectations about when you will resume charging him his original customary fee. ================================================== Question: K93. Knowledge of ethical standards pertaining to interacting with other service delivery systems. Answer: A. Ethically responsible to provide her with referrals. There is no legal obligation to report spousal abuse, but there is an ethical responsibility to ensure client safety. Therapeutically, this may consist of a referral to a shelter, an attorney for a restraining order, and/or the establishment of separate living quarters. This can be followed by long-term interventions such as the implementation of anger management and improved communication skills. ================================================== Question: K94. Knowledge of methods for enhancing client's ability to meet own needs. Answer: C. Ethically, you could contact the boss under the auspices of Evidence Code 1024. You may ethically break confidentiality under Evidence Code 1024 to warn the boss of the client's plan/intent to damage his car. ================================================== Question: K95.Knowledge of ethical considerations and conditions for interrupting or terminating therapeutic services. Answer: D. Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on. The most ethical way to deal with counter-transference is through journaling, peer consultation and personal therapy, in an attempt to regain perspective. ================================================== Question: K96. Knowledge of referrals/resources to provide consistent care in the event therapeutic services must be interrupted or discontinued. Answer: B. Do not contact the father and maintain the client's confidentiality. You would maintain the client's confidentiality because she has the legal right to it, and suicide is not a mandated breach of confidentiality. You might consider breaking her confidentiality if her suicidal ideation includes an imminent plan and time frame, but the vignette does not indicate crisis-level suicide that would warrant a breach of confidentiality. ================================================== Question: K97. Knowledge of methods to facilitate transfer when referrals to other professionals are made. Answer: B. Tell them how individual therapy will be different from conjoint therapy. In order to help them make the decision about starting individual therapy, you would provide some parameters so you have informed consent. ================================================== Question: K98.Knowledge of factors and/or conditions that indicate client is ready for termination of therapeutic services. Answer: B. Obtain confirmation about their benefits before the first session. You would need to confirm the client's benefits (payment policy set by the insurance company) before starting therapy. This is equivalent to setting the fee before therapy. ================================================== Question: K99. Knowledge of factors and/or conditions that indicate client is not benefiting from treatment. Answer: B. Honor the original agreement, and if your ability to work with this client feels compromised, discuss your concerns with the client and offer to help her transition to another therapist because of the ethical conflict. Ethically, a therapist would be obliged to honor the original agreement. If the therapist's feelings were interfering with the ability to do good therapy, then it would be ethically correct to find the client another therapist and to explain to the client the reasons to do so. Ethical standards say that therapists have the right to terminate treatment for reasons including ethical conflicts. ================================================== Question: K100. Knowledge of methods for managing the termination process. Answer: C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy. Reasonable notice of termination is required if you plan to terminate because a client has not paid. ================================================== Question: K101. Knowledge of methods to prevent client abandonment and/or client neglect. Answer: B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night. The threat was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. Although the laws of confidentiality require that we not report an HIV-positive client whose intentional behavior is to infect others through sex, injecting another person with a syringe without their permission constitutes an act of violence. ================================================== Question: LEGAL: Confidential Communications Therapeutic Relationship Answer: B. Discuss the situation and attempt to negotiate a fee acceptable to both of you. This is the best answer of the choices given. Although Roberto thinks you should accept his co-payment as the fee, you still have not attempted to negotiate a mutually acceptable fee. This discussion would be your next step. If you could not agree on a fee, he should be given a lower-cost referral to provide for continuity of treatment. ================================================== Question: LEGAL: Disclosure of Confidential Information to individuals, professionals, agencies and authorities Answer: B. Charge Andy and have him contact the insurance company. Billing the client, and letting him seek reimbursement from the insurance company is correct. This choice puts the responsibility on the client, where it belongs. ================================================== Question: LEGAL: Identify Holder of Privilege (age, legal status, content of therapy) Answer: C. 24 months. According to the NASW code of Ethics, if a social worker waits a minimum of two years to begin a romantic relationship with a client, that social worker is adhering to the standards. Ideally, social workers do not pursue romantic relationships with clients at all, however. ================================================== Question: LEGAL: Laws regarding Privileged Communication Answer: D. Offer a sliding fee for the intermittent sessions. There is no legal or ethical requirement to slide fees as part of termination. ================================================== Question: LEGAL: Privileged COMMUNICATION in Legal/Judicial Matters Answer: D. Assess the motivation behind the gift. Assessing the motivation and the value of a gift is very important in determining whether you should accept it or not. What needs to be determined is whether the act of giving the gift supports Mrs. Bailey's therapeutic process and needs. ================================================== Question: LEGAL: Laws regarding RELEASE of privileged information in judicial/legal matters Answer: A. Must gather as much information as possible and make a report of physical abuse to Adult Protective Services since this woman is a dependent adult. Given her severe cerebral palsy and wheelchair use and probable dependence on her boyfriend or others for some assistance, this is the best answer. The report must be made immediately by telephone and a follow-up written report must be made within 2 working days. Note that just being a wheelchair user does not necessarily mean that one is "dependent." ================================================== Question: LEGAL: Laws regarding privileged information in RESPONDING to subpoenas and court orders. Answer: D. Ask Mrs. Baker what she means by "help." This is a way of providing informed consent about client's expectations. ================================================== Question: LEGAL: Confidentiality with MINORS Answer: D. Obtain consultation from each doctor about his case. The best answer choice from an ethical point of view would be to speak with each doctor. This is a scope of competence question that tests your knowledge of how to utilize consultation. ================================================== Question: LEGAL: Disclosure of Confidential information to other individuals, professionals, agencies or authorities when working with MINORS. Answer: C. The purpose of the release and the social worker's license number. The purpose of the release and the social worker's license number would both be on a release of information form. ================================================== Question: LEGAL: Holder of privilege with MINORS Answer: B. Domestic violence. Domestic violence does not usually fall under the exceptions to confidentiality unless a child abuse report needs to be filed as a result of the domestic violence or if the abused party is under the protected class of individuals. ================================================== Question: LEGAL: Laws regarding privileged communication with MINORS Answer: B. The advertisement must indicate the full name of the licensee and the complete license number. It is a legal requirement that the LCSW's full name and license number or associate's registration number be on the advertisement. ================================================== Question: LEGAL: Legal criteria/requirements for providing services to MINORS Answer: A. Agree to see his referral. Ethically, you could agree to see this referral. An acquaintance who refers business to you would not constitute a dual relationship. ================================================== Question: LEGAL: Laws regarding documentation of therapeutic services. Answer: C. Evaluate whether or not you can continue to work effectively with this client. The first priority is to determine if you can work effectively with the client. ================================================== Question: LEGAL: Laws regarding maintenance/disposal of records Answer: B. Maintain confidentiality and assess for possible elder abuse. There are no reporting mandates here since Mollie is not an elder or dependent adult. Assessing further for elder abuse is something you certainly could do, because there is violence in the relationship, and Roland is an elder. ================================================== Question: LEGAL: Laws pertaining to client's access to tx records, REQUEST CAN BE DENIED IF: Answer: C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions. Ethically, you cannot avoid informed consent even in a crisis. So it would be ethical to give the client the legally required information and meet any crisis needs immediately. ================================================== Question: LEGAL: Laws pertaining to client's access to tx records Answer: C. Responding to a CPS caseworker's request for family history following a child abuse report. A social worker is not permitted to respond to a CPS caseworker's follow-up inquiries without a written request if the request does not specifically pertain to the child abuse report. ================================================== Question: LEGAL: Laws pertaining to release of records to other individuals, professionals, or third parties. Answer: A. You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction. Ethical standards prohibit business ventures or social interactions with a patient, spouse, partner, or family member. Hiring Tom's cousin would be considered an unethical dual relationship. ================================================== Question: LEGAL: Telehealth regulations regarding consent and delivery of services via information and communication technologies Answer: A. Tell the client directly the social worker's concerns if the client does not return to therapy. Ethically, the social worker is obligated to have a direct informed consent conversation with a client, even clients who are acutely symptomatic. ================================================== Question: LEGAL: HIPAA legal requirements Answer: B. Discreetly confront your colleague about his drinking. Ethics standards strongly encourage social workers to intervene when colleagues are risking client care. ================================================== Question: LEGAL: HIPAA and PORTABILITY standards Answer: D. Since Maya is 15 years old, the rape would constitute child abuse. Although Maya is an emancipated minor, she is only considered an adult in certain legal circumstances. As a minor, a social worker is required to report abuse, which rape clearly is. ================================================== Question: LEGAL: HIPAA and PRIVACY standards Answer: C. It is not legal for her to offer compensation for referrals. It is illegal for mental health professionals to offer compensation or rewards for referrals. ================================================== Question: LEGAL: Protected Health Information (PHI) Answer: C. Your fee. Disclosing your fee is legally required prior to the commencement of therapy. ================================================== Question: LEGAL: The Privacy Rule (implications in practice) Answer: D. Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session. This would be the most appropriate response. Ethical standards are guidelines and there are circumstances in which other considerations, such as cultural issues, would allow for accepting a gift of this nature. ================================================== Question: LEGAL: Indicators of abuse, neglect or exploitation of DEPENDENT ADULTS Answer: D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim. This is what you would have to do. At this point, the well-being of the intended victim outweighs the ethical concerns about informed consent. ================================================== Question: LEGAL: Laws pertaining to reporting known or suspected abuse of DEPENDENT ADULTS Answer: B. Obtain the client's promise not to harm him/herself until you meet again and use a "self care" contract to reinforce the promise. If a client promises, in writing, not to harm him/herself until your next meeting, and the social worker reasonably believes that the client agreed in good faith, this would be a reasonable step to ensure the client's safety. ================================================== Question: LEGAL: Indicators of abuse, neglect or exploitation of ELDERLY clients Answer: B. Asking your client, who is a contractor, for information about drywall. Engaging in a separate and distinct relationship either spontaneously, within a therapeutic relationship or after a reasonable period of time following the termination of the therapeutic relationship, constitutes a dual relationship. This is an ethical issue. ================================================== Question: LEGAL: Laws pertaining to reporting known or suspected abuse of ELDERLY Clients Answer: A. Consider offering to see Jamal on a sliding scale or pro bono basis. This is the most ethical choice. Considering whether to see Jamal on a sliding scale or pro bono basis would address Lisa's apparent financial stresses and allow Jamal to get needed treatment. ================================================== Question: LEGAL: Indicators of abuse, neglect or exploitation of MINOR clients Answer: D. Maintain confidentiality. As a social worker you are legally and ethically required to maintain confidentiality when you are aware that your client is HIV positive. ================================================== Question: LEGAL: Laws pertaining to reporting known or suspected abuse of MINOR clients Answer: D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them. Ethically, you have to explain the parameters of therapy. ================================================== Question: LEGAL: Reporting "Reasonable Suspicion" with MINORS Answer: B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being. If releasing the content of therapy notes will result in a negative impact on the minor's physical safety and/or psychological well-being, then the social worker has a right to refuse a parent's inspection of the records. ================================================== Question: ETHICAL: Confidentiality and "reasonable protection" of client records. Answer: D. Inform Mrs. Moran of your license and qualifications. Ethical standards require social workers to correct inaccurate representations of their licensing status and professional qualifications. There is no reason not to inform Mrs. Moran of your licensing status simply because she is "quite depressed." ================================================== Question: ETHICAL: Releasing client records upon request Answer: D. Refer her to a financial planner. She needs assistance and education about how to manage her and her husband's finances. ================================================== Question: ETHICAL: Assisting clients with interpreting therapeutic records. Answer: C. Question Matthew and Delilah separately about possible domestic violence. Scope of practice obligations require that you conduct therapy and safety assessments in a way that meets the standard of care. ================================================== Question: ETHICAL: Clarifying roles when not acting as LCSW Answer: B. Legally, you do not have to report the abuse. This answer is the most accurate. You do not have to report child abuse if you learned of it outside your professional capacity. ================================================== Question: ETHICAL: Guidelines when engaging in conflicting or dual roles. Answer: A. To establish a plan of safety, including shelters and established support systems. The ethical responsibility is to establish a plan of safety, including shelters and established support systems. Legally, mental health professionals cannot usually break confidentiality due to domestic violence unless the recipient of the abuse falls within a protected class of individuals. ================================================== Question: LEGAL: Identifying situations where client poses danger to others Answer: C. Refer the client to a career counselor. Based on the information given, referring the client to a career counselor is the appropriate option. ================================================== Question: LEGAL: Duty to protect when client indicates INTENT to cause harm Answer: C. A client accused of assault and battery uses insanity as a defense in court. If insanity is used as a defense for a crime, then the client may have waived his or her right to privilege. ================================================== Question: LEGAL: Situations/conditions that constitute reasonable indicators of client's intent to cause harm Answer: A. Address the mistake in the next group. From an ethical point of view, clients' experiences need to be validated, and they all saw this email. It would be important to address the confidentiality breach and assess the participants' reactions. ================================================== Question: LEGAL: Symptoms of impairment that indicate need for involuntary hospitalization Answer: C. Engage him in a discussion of his motivation and past efforts. In the initial stages of therapy, the establishment of trust and rapport is a crucial component to successful work, which "C" embodies as it deals with the presenting problem and the underlying emotions associated with it. ================================================== Question: LEGAL: Protocols for initiating involuntary hospitalization Answer: D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened. ================================================== Question: LEGAL: laws regarding confidentiality in situations of client danger to self or others Answer: D. File a child abuse report. Christine has told you that she was sexually abused and, although, she said a report was already filed, you need to fulfill your mandate to report child abuse. ================================================== Question: LEGAL: Laws regarding privilege exceptions in litigation involving mental condition by client or representative Answer: A. Report the abuse to CPS immediately by phone and with a written report within 36 hours. You have reasonable suspicion that the perpetrator could be soliciting minors given your client's history and her report of his activity on the internet. ================================================== Question: LEGAL: Laws pertaining to reporting crimes against a MINOR Answer: C. Call Barbara's ex-boss and warn him of her plan. Warning the victim may be done in the interests of protecting the public and protecting the social worker from liability related to breaking the confidentiality of the potentially dangerous client. As of 2014, there is only a legal responsibility to contact law enforcement within 24 hours. After doing that, warning the potential victim is next. ================================================== Question: LEGAL: Laws regarding privilege exceptions in crime or tort involving MINORS Answer: B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach. Jeannie telling you that after the fight with the children, her husband and her got into another fight alone in the bedroom, and he punched her in the stomach, would not be reportable. It is not clear that the children witnessed the spousal abuse since it occurred alone in the bedroom, and/or that they had any emotional distress specific to it. ================================================== Question: LEGAL: Laws regarding privilege exceptions in court-appointed evaluation or therapy Answer: A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse. Legally you are mandated to report the physical abuse and financial abuse. ================================================== Question: LEGAL: Laws re: sexual conduct between therapist and client Answer: C. Legally responsible to intervene. A clinician is not legally responsible to report a suicidal client, but is legally responsible to take reasonable steps to ensure the safety of a suicidal client which can be managed in a number of ways. Evidence Code 1024 allows clinicians to break confidentiality when a client, due to a mental disorder, is a danger to self or the property of another and breaking confidentiality would prevent the threatened harm. ================================================== Question: LEGAL: Legal requirements for providing client with "Professional Therapy Never Includes Sex" Answer: C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home. A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled. ================================================== Question: LEGAL: Laws that define SCOPE of clinical practice Answer: D. You may tell your client about the laws pertaining to cyberbullying. You may tell your client about the laws regarding cyber-bullying. The laws about bullying define bullying (e.g., face-to-face or digital harassment, threats, persecution, etc.) and what the school district is permitted to do. You may not give legal advice because that would be out of your scope of practice. ================================================== Question: LEGAL: Laws re: disclosures required prior to therapeutic services. Answer: D. Tell him that you will not be able to help him quit smoking. Using hypnotherapy to help Christopher stop smoking would have to be within the context of therapy, and not as a stand-alone treatment. Otherwise, it is outside the scope of practice. ================================================== Question: LEGAL: Laws re: third party reimbursement Answer: D. Acted unethically and illegally. Although the gift is not substantial in value, social workers are prohibited by law and ethical standards from accepting or providing any kind of remuneration for referrals. ================================================== Question: LEGAL: Parity laws re: provision of mental health services Answer: D. Advise her to call her lawyer. Your only obligation in this situation is to maintain confidentiality and assess for a possibility of a crisis interventions. If the client is not afraid that the father will harm the children, she needs to call her lawyer to pursue legal options. ================================================== Question: LEGAL: Laws re: ADVERTISEMENT and DISEMINATION of qualifications Answer: A. Note carefully which sessions the client actually attended. It is vital to clearly note which sessions were missed on the bill (which will be sent to the insurance company), or this is insurance fraud. ================================================== Question: ETHICAL: Diversity Factors that affect therapeutic process Answer: C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them. Including Rob in the creation of the safety plan and possible emergency escape plan would only put Cynthia at risk. Rob's knowledge of these plans may lead to a violent reaction from Rob. ================================================== Question: ETHICAL: Standards regarding nondiscrimination with re: to diversity Answer: C. Assess for further boundary violations. Assessing for further boundary violations would be important in order to determine the extent of boundary violations and if there had been any sexual contact between the therapist and your client. ================================================== Question: ETHICAL: Standards for providing therapeutic services with re: to diversity Answer: C. Tell him you cannot confirm or deny that his wife is your client. Whenever anyone calls asking about anyone other than themselves, it is vital to not reveal any confidential client information. ================================================== Question: ETHICAL: Methods to gain knowledge, awareness, sensitivity and skills necessary for working with diverse populations Answer: A. Obtain supervision to address counter-transference. The ethical obligation, when a therapist is unable to maintain objectivity, is to seek supervision or consultation. ================================================== Question: ETHICAL: Clients right to make decisions re: therapeutic services Answer: B. A social works breaks confidentiality because an internet client is engaging in child abuse. Breaking confidentiality when making a mandated child abuse report is a legally required obligation, not an ethical decision or responsibility. ================================================== Question: ETHICAL: Ethical standards re: protection of client rights when engaging with other professionals. Answer: C. Obtain consultation about adoption. Getting consultation is a potentially useful thing to do when client presents a new issue. ================================================== Question: ETHICAL: Methods to assist client to make decisions and clarify goals Answer: B. Deanne. Privilege resides with all clients unless the ability to exercise (i.e., assert or waive) privilege has been adjudicated away from them. ================================================== Question: ETHICAL: methods for establishing collaborative professional relationships to improve welfare of client Answer: D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults. If you have concerns about a dependent adult's safety, you are legally and ethically obligated to inform the CLIENT about the limits of confidentiality. Although "Consent To Treat" came from the conservatorship, the client's rights to confidentiality are still relevant. ================================================== Question: ETHICAL: ethical standards for participating as a member of an interdisciplinary team. Answer: D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement. Angelina is an adult in therapy. Your legal obligation is to collect your fee and allow the client to determine how she will get paid. ================================================== Question: LEGAL: Legal requirements re: payment/barter for referrals Answer: B. Acknowledge the coincidence, explore your client's reactions and discuss how you will both act should you see each other at school functions. This demonstrates proper clinical management for several reasons: this is an unavoidable dual relationship, you are addressing the coincidence, you are being sensitive to your client's reactions and planning how you will handle seeing one another in a public setting. ================================================== Question: ETHICAL: Documentation of therapeutic services Answer: B. Provide informed consent. Before changing the unit of treatment, which is including the children in this vignette, the social worker would need to provide informed consent with the primary client. ================================================== Question: *1. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of Section 1024 of the Evidence Code. A. Maintain Roger's confidentiality. B. Warn the manager of the factory because this is analogous to a Tarasoff situation. C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision. D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. Answer: D. Keep the records confidential and alert Cathy of the subpoena. Since Cathy and the children were seen conjointly, the records include confidential information regarding Cathy. Therefore, the best option would be to keep the records confidential and let Cathy and her attorney decide how to proceed. ================================================== Question: *2. Your lawyer calls you to warn you that you may receive a subpoena for the complete treatment record of Mr. Milsap, who you have been treating for five years. Two months ago, Mr. Milsap received minor injuries in an accident at work in which three people were killed when a fully loaded forklift overturned. Mr. Milsap is suing for negligence and claiming severe emotional damage, including PTSD. When you tell Mr. Milsap about the subpoena, he is frantic since he doesn't want anyone to know about the brief affair he had with his secretary four years ago, which is documented in your treatment records. He asks that you submit a summary of information relevant to the accident and his PTSD or to omit from the records information about the long-ago affair. How should you respond? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to legally retain records. A. Tell Mr. Milsap that you cannot honor his request. B. Submit a summary of the records related to the accident and the PTSD. C. Supply the treatment records as requested, but omit information of the long-ago affair, in accordance with the laws of privilege. D. Contact the court and seek a waiver to narrow the scope of the subpoena in order to protect your client's confidentiality. Answer: C. Maintain Aaron's confidentiality. Maintaining confidentiality is the only legally correct action of the answers provided here. ================================================== Question: *3. Which situation is less likely to be an inappropriate dual relationship? Content Area: Law: Confidentiality, Privilege, and Consent You must identify which choice would be the least likely to constitute an INAPPROPRIATE dual relationship. A. A small town where social worker and cashier (client) see each other at the local store. B. A small town where social worker and next-door neighbor (client) see each other in the neighborhood watch meetings. C. A small town where a social worker's brother-in-law's sibling comes to therapy for couple's counseling. D. A small town where a social worker's CPA seeks couple's counseling with the social worker. Answer: B. Turn down the referral and suggest other clinicians. Because a relationship has already been established with the husband, it is best to refer his wife to another therapist. ================================================== Question: 4. Three months after the death of Danielle, whom you treated for several years, you receive a written request from Arthur, her husband of 32-years, asking for access to his late wife's files. You saw them conjointly for a few sessions when Danielle requested he be there. How would you proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge regarding who has access to a client's records after their death. A. Assert privilege. B. Deny his request. C. Allow him to inspect the records. D. Provide a summary or a copy of the records. Answer: A. Ascertain their level of acculturation. A family's acculturation status is an important factor in assessing for treatment, helping the social worker determine the family's level of adjustment to this culture, their current worldview, family values, and level of comfort with U.S. norms and values. ================================================== Question: 5. Your client Maurice tells you that he was involved in a bank robbery and "got away with it." He says the money is stashed in a safety deposit box at a local bank. You are: Content Area: Law: Confidentiality, Privilege, and Consent This question deals with a social worker's legal responsibilities related to past crimes. A. Required to report this to the bank and to the police. B. Required to maintain confidentiality. C. Obligated to advise your client of the legal requirement to break confidentiality. D. Permitted to break confidentiality to protect the public at large. Answer: C. Help them problem solve but not give them any personal opinions. Ethical standards regarding boundaries require that therapists avoid giving opinions and remind the client that they are responsible for their own choices. ================================================== Question: 6. You have been participating in the town's bowling league for six months when one of the clients you have been treating joins the league. While speaking to your client about it in the next session, you find out she loves it and plans to stay in the league. First you would: Content Area: Ethics: Professional Competence and Preventing Harm. This question of ethics asks you what your FIRST step would be in this dual relationship scenario. A. Switch leagues. B. Explain the nature of dual relationships to her. C. Ask her to switch leagues. D. Give her bowling tips to build rapport. Answer: D. Including a child abuse report in the file if one is made. Whatever the agency policy is, a mandated breach of confidentiality must be included in the client's file. A child abuse report may be kept separate from the treatment file to preserve the child's confidentiality, but it cannot be omitted entirely. ================================================== Question: 7. Mimi tells you that her brother is HIV+ and has recently sero-converted to full-blown AIDS. She is terrified because she overheard her brother talking about passing on "The Gift." She informs you that he wants to have sex with his new partner with the purpose of giving him the HIV virus. She thinks it's terrible that her brother plans to knowingly give someone HIV. In this case you would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a case where the transmission of HIV is probable. A. Call the person he plans to have sex with in accordance with the Tarasoff decision. B. Maintain confidentiality and process her feelings. C. Ask Mimi to have her brother set up an appointment. D. Call the public health service in the area and report what you have heard in an unofficial capacity. Answer: C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary. Giving clients information about payment is a legal and scope of practice issue. ================================================== Question: *8. You've been seeing a couple for marital therapy. The husband arrives for their weekly session alone and reports that his wife is staying in the car. He says that she refuses to come to your office because you are always taking his side. He wants to go ahead with the session without her. You decide to: Content Area: Ethics: Therapeutic Relationship/Services This question asks you how to proceed in a marital therapy scenario. A. Proceed with the session, seeing him alone. B. Terminate the therapy and give him a referral to another mental health professional. C. Make another appointment for both of them since the couple is your client. D. Go down to the car and ask the wife to come in so that you can explore this issue. Answer: A. Yes, because she is seeing another therapist and you must avoid exploitation. In general, social workers are ethically allowed to terminate if a client who needs care is getting it, and duplication of care would exploit the client. ================================================== Question: 9. You have seen Abby, age 24, four times. In her fifth session, she discloses to you that her previous mental health provider fondled her while he was conducting hypnosis with her. Your legal obligation is to: Content Area: Law: Legal Standards for Professional Practice. This question assesses your knowledge of your legal obligation regarding clients who have had sexual contact with a previous mental health provider. A. Inform Abby of the reporting options that are available to her. B. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex." C. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex" and discuss the contents with her. D. Refer Abby to the BBS which will send her a copy of the booklet "Professional Therapy Never Includes Sex" and file the report with their Ethics Committee. Answer: C. Not buy the stock because of ethical considerations. Ethically, you would not buy the stock because this information was revealed to you in your professional capacity. Clinically, the potential for powerful counter-transference threatens your therapeutic relationship. ================================================== Question: *10. You have been working with a client for six months. The client sometimes forgets her checkbook and tells you that she will bring it at the next session. She has accumulated a debt of $500. What would be your least important consideration when attempting to collect an unpaid bill from the client? Content Area: Ethics: Business Practices and Policies This question reviews proper management of collections, knowing what constitutes a breach of duty and asks you to identify the strategy you would not use. A. Having the client pay at the beginning of each new session. B. Providing a collection agency with only the client's name, address and amount owed. C. Establishing with the client a satisfactory payment plan to pay off the bill. D. Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty. Answer: A. Colleen has a history self-harm. Although a history of self-harm may be a valid clinical reason to treat a minor without parental consent, this is not a legal requirement. Social workers may treat a minor 12 or older without parental consent if the minor is mature enough to participate intelligently in therapy. There is no longer a requirement for the minor to be a victim of child abuse or a danger to self or others in order to receive treatment without parental consent. ================================================== Question: 11. Miriam, a 52-year-old car saleswoman, is referred for therapy by her doctor after Miriam told him that her boyfriend broke up with her and told her that she has trouble respecting other people's boundaries and is too interpersonally aggressive. From the beginning of treatment, Miriam asks the social worker many questions about the social worker's relationships, family, hobbies and interests, and taste in music and movies. At the fifth session, Miriam asks the social worker where she went to graduate school, how long she has been licensed, and if she has any areas of expertise and training. How should the social worker respond to the questions Miriam is now asking? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent and a social worker's ethical responsibility to obtain informed consent from clients. A. Answer Miriam's questions. B. Do not answer Miriam's questions and explore her reaction to the social worker's boundary setting. C. Ask Miriam if she has concerns about the social worker's competence and experience. D. Remain silent and allow Miriam to do her own processing as part of learning to respect others' boundaries. Answer: D. Explore whether the client wants you to assess her child for AD/HD. The client found you due to your online assessment; clarifying its relationship to in-person treatment would be an ethical way to proceed. ================================================== Question: *12. You have been treating Jennifer who has had difficulties establishing and maintaining intimate relationships with men. Several months into treatment, she was arrested for an attempted murder of a male celebrity. In her trial, Jennifer is pleading not guilty by reason of insanity. Who holds the privilege for Jennifer's therapeutic records? Content Area: Law: Confidentiality, Privilege, and Consent This question checks your comprehension of privilege. A. The social worker. B. The client. C. There is no privilege. D. The judge. Answer: B. Reach an agreed-upon fee arrangement prior to the commencement of therapy. This would be a legal obligation. ================================================== Question: *13. You are seeing a 45-year-old woman in treatment. She lives with her mother, age 71, who has Alzheimer's Disease and lives in a residential facility for ongoing medical care. She tells you in session that at one point, the nursing staff kept her mother in bed for three weeks. You would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. Your knowledge of reporting mandates for elder abuse is being checked. A. Report by telephone within 24 hours to law enforcement. B. Report immediately to Adult Protective Services by phone and follow-up with a written report within 36 hours. C. Report by telephone immediately to law enforcement. D. Refer her to a support group for caretakers, arrange for respite care, and work with her on issues of grief and loss. Answer: B. Yes, but only with informed consent. With adequate training and informed consent, social workers are permitted to introduce new modalities to new and existing clients. ================================================== Question: 14. Mary is a married 17-year-old who was recently raped by her husband's best friend. She doesn't want to tell her husband because she feels that she may have inadvertently encouraged him and is feeling ashamed. Tearfully, she tells you that she is pregnant and doesn't know what to do. Her best girlfriend has told her to get an abortion. She is conflicted about this because of strong religious beliefs. She says she's very confused and asks you what you would do if you were in her position. How would you ethically respond to this situation? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of the ethical boundaries that are necessary for effective therapy. A. Advise her to discuss this situation with her husband. B. Indicate that you have a "no secrets" policy and invite her husband into the session. C. Indicate that you cannot make life decisions for a client. D. Refer her to Planned Parenthood. Answer: D. Consider the client's cultural values and his expectations of therapy. The client comes from a culture where therapy may be foreign to him. It is important to establish with the client the objectives of therapy and to understand his emotional style that may have been derived from his cultural background. ================================================== Question: 15. A 40-year-old woman comes for individual therapy to work on panic attacks that are affecting her job performance and attendance. She and her husband see their pastor for marriage counseling. She says that her pastor has encouraged her to do this, so that they can focus on the marital issues. How would you proceed in addressing the referral from the pastor? Content Area: Ethics: Business Practices and Policies This question addresses managing a client's concurrent relationship with other providers of care to the client. A. Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together. B. Get a release to speak with the pastor and help him to see that the panic attacks and her marriage are directly related. C. Maintain your client's confidentiality and proceed with treatment. D. Do not begin treatment with the woman until it is clear that you and the pastor are not working on the same issues, which would be unethical. Answer: D. Maintain confidentiality. YOUR only legal obligation here is to protect your client's confidentiality. ================================================== Question: 16. Recently your mother died and a client comes in grieving the loss of his mother. What would you do FIRST? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your ability to recognize the influence of counter-transference and when your functioning is impaired. A. Talk about this situation in your own therapy. B. Seek consultation. C. Refer the client to another therapist. D. Determine if you can deal with this client at this time. Answer: C. You are mandated to report this situation to a children's protective agency. This is a mandated report because the social worker has reasonable suspicion of neglect based on the doctor's medical diagnosis. Although the parents have consulted with a doctor, their decision to not seek care based on the doctor's findings constitutes reasonable suspicion of medical neglect. ================================================== Question: *17. Eugenia, a 36-year-old massage therapist from Brazil, is referred by a former client. She presents in a highly agitated manner and occasionally slurs her words as she tells you that her ex-husband is stalking her and her 16-year-old daughter. She is considering obtaining a temporary restraining order against him. Eugenia has no health insurance and wants to know if you can extend credit to her or receive massages in exchange for therapy. What is your legal course of action? Content Area: Law: Legal Standards for Professional Practice. This question tests your ability to differentiate legal from ethical issues. A. Inform Eugenia that if she enters her emotional state into the proceeding to obtain the restraining order, her right to privilege will be waived. B. Refrain from giving legal advice regarding the restraining order due to scope of competence. C. Refer to legal aid for restraining order help or to assist with assault charges. D. Avoid dual relationships regarding becoming a massage client. Answer: C. Obtain consent from Molly since she is the legal guardian. You would obtain consent from Molly since she is the legal guardian. ================================================== Question: *18. A self-referred client comes to you wanting therapy for work problems. During the intake, the client reveals he has been going to another therapist for the last four months but states, "I'm planning to leave her anyway." The client admits he has not discussed this with his current therapist and says, "I'm seeing her for a different issue anyway." What is your ethical responsibility in this situation? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of how to handle concurrent therapies. A. Accept the new client, as he intends to terminate with his current therapist. B. Inform the client that you will be unable to see him until he has terminated with his current therapist. C. Contact the other therapist to discuss the treatment goals before deciding whether to take on the client. D. Accept the new client, as he reports his goals with the other therapist differ from the goals he wants to explore with you. Answer: D. Talk about this issue with a colleague in consultation or with your own therapist. Journaling, consulting, psychotherapy, or other processes that help a social worker to resolve strong emotional reactions to a client constitute appropriate ethical conduct in such situations. ================================================== Question: *19. Your client, a 19-year-old mechanic, confides to you that he recently participated in a robbery. Two weeks later, you are served with a subpoena for information about this client's treatment. You attempt to reach your client but are unable to do so. Legally, you must: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your legal requirement regarding a subpoena. A. Assert client privilege. B. Notify your client of this subpoena. C. Turn over all records as per the subpoena. D. Notify the client's attorney that you cannot reach the client. Answer: D. Ask her to get you quickly up to date on her general treatment so far. Ethics require an action directed toward the client's immediate safety. You would need to know how "serious" her situation is before determining the next step. ================================================== Question: *20. Kevin is 17-years-old and tells you that he was upset when, as a small child, his father would hit his mother. He tells you that the abuse stopped a few years ago. Kevin says that his father is 70-years-old and is "running out of steam." Now when his father "gets out of line," he and his mother simply lock the father in his room until he settles down. He is glad his father has become more manageable. What would you do next? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question reviews your mandated reporting responsibilities. A. Assess the whole family further in the next session. B. Call Adult Protective Services immediately because the father is being unlawfully detained. C. Call an agency designated to take a child abuse report because Kevin lives in a household in which there has been spousal abuse. D. Call Adult Protective Services and an agency designated to take a child abuse report immediately. Answer: D. Report child abuse to the police. Mandated reporters must report knowledge or reasonable suspicion of the abuse of any child if they hear of it in their professional capacity. The description of an adult who has authority over children regularly hitting them would constitute, at the very least, a reasonable suspicion of child abuse and would therefore, mandate a report to the police. ================================================== Question: 21. A therapist offers telehealth services for a slightly reduced fee for clients who cannot afford transportation or do not have a car. At what point during the provision of telehealth with a client would it be legally required to refer the client for crisis care? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal standard of care when providing telehealth. A. When the client tells you that she is actually 12, not 18. B. When the therapist recognizes that the client is suicidal. C. If the client tells that therapist that this will be "our last session." D. The client tells you that she does not have health insurance and has not been to a doctor in five years. Answer: B. The social worker wants to change the focus of his or her practice and only treat "high functioning" clients. Deciding to change the focus of practice would not be sound ethical or clinical reasons for deciding to terminate treatment with an ongoing client. ================================================== Question: *22. Maria, age 27, comes to treatment with her husband Juan. Maria had a miscarriage 3 months ago and she tells you that she just can't get over it and doesn't know if she can go on. Juan says that he has tried everything to cheer her up, but that he's getting sick of her moping around. What action would the therapist take to fulfill ethical obligations? Content Area: Ethics: Therapeutic Relationship/Services Social workers are ethically obligated to determine the client's best interests which includes assessing whether they will benefit from therapy. A. Evaluate whether Maria can benefit from therapy if they continue in conjoint therapy. B. Tell them your experience and expertise in working with families who have trouble having children. C. Suggest a few individual sessions to get full informed consent from each client. D. Answer any question that they have about couple's therapy. Answer: C. Discuss any suspicions that would validate terminating the client. A client's potential violence would not be a reason for terminating the client. It might be a reason, however, for breaking confidentiality. ================================================== Question: 23. A social worker has decided to offer telehealth as part of her practice. Ethically, the therapist should: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to ethically manage the limits and risks of telehealth. A. Specify any particular limits of confidentiality as they pertain to internet security and privacy. B. Avoid a dual relationship by making clear when she is available on the internet and when she is not. C. Charge and disclose an equivalent fee for telehealth as for in-person sessions. D. Anticipate an unavoidable dual relationship that could arise if in-person clients also receive telehealth services. Answer: B. Forego payment because you did not adequately explain the process of fee collection and insurance billing to Chetwyn. You would forego payment because you did not adequately explain the process of fee collection and insurance billing to your client. ================================================== Question: *24. George has been referred to you by his doctor for anxiety-related issues. He tells you that while he really wants to be in therapy, he can't afford it right now and asks if it would be okay if, instead of your fee, George will give you credit in the amount of your fee at the grocery store he owns in the small rural community where you both live. Ethically this would be: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of dual relationships. A. Permissible under some circumstances. B. Inadvisable under all circumstances. C. A prohibited dual relationship. D. Bartering, which is prohibited by ethical standards. Answer: A. Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards. Social workers have a legal and ethical responsibility to correct false, misleading, or inaccurate information and representations of themselves, made by themselves or others concerning their qualifications, education, license, license status, services, products, etc. ================================================== Question: 25. Ajax, a 51-year-old former convict, comes to therapy because he tells you he has been depressed ever since he left prison. He just doesn't feel like he fits in anywhere and still feels terribly guilty for the murders he committed that have gone unpunished. He says he is tired of spending every day looking over his shoulder and would be better off dead. What is your legal responsibility in this case? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of confidentiality laws. A. Call the police because you have knowledge of a murder. B. Initiate an involuntary hospitalization because he is suicidal. C. Consider breaking confidentiality to ensure his safety. D. Notify his next of kin. Answer: A. You would need to determine if your scope of competence was adequate. Homosexuality does not capture the range of gender identity issues, so just because your client appreciates your approach with her, your ability to treat other types of issues would be your first concern. ================================================== Question: *26. Which of the following is a legally allowable scenario in which a social worker may treat a minor without parental consent? Content Area: Law: Confidentiality, Privilege, and Consent This question focuses on knowing when you may legally treat a minor without parental consent. A. A 10-year-old suicidal female whose twin brother recently died in a boating accident. B. A 12-year-old depressed male whose cultural background strongly discourages therapy. C. A 15-year old having consensual sexual intercourse with a 20-year-old. D. A 16-year-old having consensual sexual intercourse with a 25-year old. Answer: A. Maintain confidentiality. Mental health professionals licensed in California are only mandated reporters of Elder and Dependent Adult abuse if the victim is a resident of the state of California. Maintaining confidentiality is your legal obligation. ================================================== Question: 27. A social worker chooses a preschool for his daughter and enrolls her. One month after she started school, the social worker discovers that a client's child is in the same class. What would be the social worker's least appropriate action? Content Area: Ethics: Professional Competence and Preventing Harm. This question is assessing your knowledge of how to manage possible dual relationships. Pay careful attention to the way this question is worded. A. Begin looking for another preschool for his daughter. B. Discuss with the client how she feels about the situation. C. Discuss the possibility of trading carpooling in exchange for some of the cost of therapy. D. Immediately take his daughter out of the school. Answer: A. Tell him that you can't treat him without the the agreement of the other therapist. Social workers generally do not provide services to a person receiving treatment or therapy from another therapist unless by explicit agreement by or with full termination of the other therapist. ================================================== Question: 28. LeDoux is an African-American client who tells you he doesn't like the idea of therapy and doesn't trust you. He says he is only coming because his social worker said if he didn't get therapy to work on his anger issues, he would have a harder time getting his kids back. In establishing an alliance with LeDoux, you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of human diversity issues. A. Ask him to tell you more about his ideas of therapy and his mistrust of you. B. Refer LeDoux to another therapist since he indicates that he does not trust you. C. Establish a highly structured therapy focusing on problem-solving. D. Take a thorough family history looking for patterns of mistrust and anger. Answer: D. Records must be retained for a minimum of 7 years after the date that the client terminates treatment. Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015). For minors who terminate treatment, records must be retained for a minimum of 7 years after the minor would have been 18 or at least until the minor client would have been 25. ================================================== Question: 29. You were working with Arlen for six months when he lost his job working with an internet start-up company. At that time you agreed to use your sliding scale to reduce your fee to accommodate Arlen since after six months a solid therapeutic bond was in place. From the perspective of professional conduct, which is most important to do at this time? Content Area: Law: Legal Standards for Professional Practice. This question pertains to professional conduct as it pertains to fees. A. Establish a target date with Arlen for when he will have a new job. B. Examine Arlen's feelings about you reducing your fee for him. C. Discuss with Arlen under what circumstances, such as obtaining a new job, you will re-establish his original fee structure. D. Make sure Arlen is aware of community resources for job seekers. Answer: C. Clarify what she means by "helping her." Ethically, you would need to determine the client's expectations to then determine if you can meet them. ================================================== Question: 30. You are seeing Roger and his wife, Rose, in conjoint therapy. You have been working on helping Rose and Roger communicate better during arguments. In today's session, you learn that over the past few years Roger has physically abused Rose when he loses his temper. You are: Content Area: Ethics: Therapeutic Relationship/Services This question reviews the ethics surrounding spousal abuse. A. Ethically responsible to provide her with referrals. B. Legally bound to report spousal abuse. C. Appalled at his behavior and tell him so. D. Ethically bound to call the police. Answer: C. Refuse the champagne and explore the meaning behind the gift. Refusing the gift but processing its meaning is the best ethical course of action. If this client were later to become unhappy with your service and file a complaint with the BBS, investigators would construe your acceptance of an expensive gift as a lack of appropriate boundaries. Exploring the meaning and the impact of your refusal would be appropriate and could be therapeutically beneficial as well. ================================================== Question: 31. Rachel comes to you after finding out she had been laid off from her job. Rachel reports she doesn't understand why, except for the possibility that "the boss always had it in for me after I refused to go out with him." Rachel then states, "He needs to watch out, if he knows what's good for him." Upon assessing further, Rachel tells you she has "a way" to keep his car from running, "That'll show him." What is your response in this situation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of your ethical responsibilities under Evidence Code 1024. A. Legally, you must contact the police and warn the boss under the Tarasoff ruling. B. Ethically, you should warn the boss under the Tarasoff ruling. C. Ethically, you could contact the boss under the auspices of Evidence Code 1024. D. You have no legal or ethical obligations. Answer: D. Discuss the situation with your client. A social worker's legal responsibility in this situation is to maintain confidentiality, so discussing it and working with the client on options to best protect herself would be a reasonable thing to do. ================================================== Question: 32. In your private practice you see mostly adults. The one child that you treat was removed from his parents by Social Services after they were reported for child neglect. During your sessions with Mark, you find yourself becoming more and more attached and wanting to take care of Mark yourself. What is the appropriate way to deal with your feelings? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to deal with your counter-transference. A. Recognize that your attachment is normal, as you feel sympathy for Mark's situation. B. Discuss your counter-transference in supervision. C. Let Mark know about your feelings to show him he still is a lovable little boy, and any issues about having him removed from the home is about his parents and not about Mark. D. Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on. Answer: B. Refer him to an MD. Overuse of pain medications and back pain would require a medical referral. ================================================== Question: 33. You recently began treating a 16-year-old female without parental consent. The client has been feeling suicidal and feels unable to discuss her problems with her parents. You receive a voicemail message from her father, angrily wanting to know why you're treating his daughter. What would be your responsibility? Content Area: Law: Confidentiality, Privilege, and Consent This question deals with the legalities pertaining to the confidentiality of a minor client whom you are seeing without parental consent. A. Obtain consent from the father in order to continue therapy with appropriate consent. B. Do not contact the father and maintain the client's confidentiality. C. Process the message with the client and invite the client's father to join in a future session. D. Obtain consent from both her parents to continue seeing the client. Answer: B. Advise the clients about the risks of this dual relationship. Before entering into a dual role, a social worker is ethically obligated to advise the client of the risks. ================================================== Question: *34. Albert and Frank are referred to a social worker for conjoint counseling. Albert does not like it that Frank is so controlling, and Frank's problem is that he considers Albert to be lazy. In one session, their arguing becomes so aggressive that you consider seeing them separately. Albert says it would be a good idea, and Frank says that he will do whatever is best. Ethically, how should the social worker proceed if individual therapy is agreed upon? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to provide informed consent as you learn you client's expectations of therapy. A. Close the conjoint file and tell them that you will not be able to see them together once individual therapy starts. B. Tell them how individual therapy will be different from conjoint therapy. C. Tell them how you plan to utilize "no secrets" policies. D. Ask them for revised treatment goals. Answer: C. Not agree to trade services and attempt to slide her fee to a rate agreeable to both of you. Of the choices provided this is the most ethical, avoiding a dual relationship and attempting to come to an agreeable fee. ================================================== Question: 35. The O'Rourkes have been married for 4 years. Tina says that she and her husband are worried that Megan may be anorexic since they found her internet searches on anorexic websites. Megan's biological mother died 2 years ago. If they want to pay with insurance, you would: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of fee negotiations that must occur before therapy starts A. Tell them the name of the billing service you use if you have one. B. Obtain confirmation about their benefits before the first session. C. Explain the risks to their confidentiality if they want to use third-party payors. D. Establish a co-pay that is equivalent to cash payments before the first session. Answer: A. You have every right to place an ad in this newspaper. A social worker, like anyone else, has a right to advertise in the local paper. You did not directly interact with the client nor did you intend for your client to work on your ad. This would be an example of an unavoidable dual relationship. ================================================== Question: *36. At an initial intake, a client discloses that she recently left her husband and does not have the means to pay your standard fee. The client notices that your waiting room is shabby and offers to paint it in exchange for your therapy. You agree to four sessions in exchange for the work. You proceed with therapy, but when she is finished, you realize she has ruined the carpet, spilled paint on a lamp and the woodwork, and didn't use the color you had asked. You realize that you feel foolish and ripped off. How would you address the situation? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships. A. Discuss your concerns about the paint with the client and ask her to either repaint the office or work out a plan for her to pay for the four sessions so that your judgment of her will not impair your ability to work with her. B. Honor the original agreement, and if your ability to work with this client feels compromised, discuss your concerns with the client and offer to help her transition to another therapist because of the ethical conflict. C. Honor the original agreement, consult to manage your counter-transference, and continue with therapy. D. Without disclosing your personal reactions, explain that you'd like her to pay you for the therapy because you weren't satisfied with her work, tell her you'll be unable to work with her further, and help her to transition to another therapist. Answer: D. Address the wife's concerns about her husband's "monopolizing" the session. Ethics require that you meet the "client where they are", and addressing her question is one way of clarifying expectations and providing informed consent about a change in the treatment. ================================================== Question: *37. Your new client, Suzanne, age 38, says her life feels out of control, and that she is considering getting a divorce. She is not sure she wants to keep coming to therapy. After a session, her husband Bud leaves a telephone message in which he says if Suzanne leaves him, he will kill himself. He asks that you call him back. How would you clinically manage your ethical responsibilities? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical obligations as they pertain to termination and referrals. A. Explain to Bud your "no secrets" policy and that you will have to disclose to Suzanne that he called you. B. Offer to Suzanne that she include Bud in a session but inform her of the risks and benefits first C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy. D. Assess Bud for suicide because you are in your professional capacity. Answer: B. Explain that terminating therapy to pursue another relationship is unethical. The first thing to do is inform the client of the guiding ethical standard which will guide your behavior. ================================================== Question: 38. 38. Which of the following represents a Tarasoff situation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions that would impose a Tarasoff duty to protect situation. A. In a conjoint session, the wife tells her husband that before the week is over that she is "going to gun him down." B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night. C. A client tells you that her husband is "totally fed up with his supervisor" and is going to disfigure the man's face with a chemical solution. D. A man, who just bought a semi-automatic rifle, tells you that he is going to go on a freeway overpass and randomly shoot at passing cars. Answer: D. Take the client's lead in the treatment plan to minimize the effects of negative counter-transference. Taking the client's lead may not be in the client's best interests from a legal, ethical or clinical point of view. ================================================== Question: 39. You have been treating Roberto in individual therapy for 6 months. In session, he gets angry with you for not telling him his insurance only authorized 20 sessions. He thinks you should simply accept his co-payment of $30.00 in the future because it is "your fault." What would you do in this case? Content Area: Ethics: Therapeutic Relationship/Services This question concerns your ethical management of a client's changing financial circumstances. A. Apologize and accept his $30 co-payment. B. Discuss the situation and attempt to negotiate a fee acceptable to both of you. C. Inform Roberto that he is now responsible for your full fee or he will have to be terminated. D. Tell Roberto your personal finances prevent you from accepting such a low fee. Answer: A. Decline to see Pat because professional ethics forbid social workers from treating former sex partners. Professional ethics forbid social workers from treating former sex partners. ================================================== Question: 40. Andy, a 42-year-old actor, missed his last session. The Motion Picture Industry Pension and Health Plan pays for a portion of his sessions. How should you go about collecting his missed session fee? Content Area: Law: Legal Standards for Professional Practice. This test item focuses on legal insurance billing procedures. A. Bill Andy for the co-payment and indicate the cancelled session code with his insurance. B. Charge Andy and have him contact the insurance company. C. Bill the insurance company with the 50-minute code as usual. D. Bill Andy for the co-payment and indicate the 50-minute code. Answer: B. Tell clients that she will not take calls during that time. The ethical obligation related to informed consent is that social workers provide clear information about their availability. ================================================== Question: *41. A social worker becomes attracted to a client. The social worker deals with his/her feelings appropriately and the client feels s/he is ready to terminate. Upon termination, the social worker realizes s/he still has sexual feelings for the client and would like to pursue a relationship. Ethically, how long should the social worker wait before pursuing such a relationship with this client? Content Area: Ethics: Professional Competence and Preventing Harm. This question asks for the NASW information about sex with a client. A. 6 months. B. 12 months. C. 24 months. D. An indefinite time, because post-therapy relationships are prohibited by law. Answer: B. Clarify your scope of competence before agreeing to treat her. Depending upon your license, you may or may not be skilled with "inner conflicts." As part of your ethical scope of competence obligations, you are ethically obligated to determine if you are competent to treat this client. ================================================== Question: 42. To prepare clients for termination, a social worker schedules sessions every other week and then once a month. Over time, he finds that clients cancel their monthly sessions. Some clients just stop calling entirely without making a monthly appointment. Which of the following would NOT be an ethical concern related to the termination process? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to handle termination in a competent way. A. Formally terminate with no-show clients. B. Provide informed consent before changing the session frequency. C. Assess whether the infrequent sessions are in the client's best interests. D. Offer a sliding fee for the intermittent sessions. Answer: D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due. Although this may not be a perfect solution to the problem, it does reinforce boundaries, stop the balance from getting higher, and suspend treatment in a situation in which professional judgment may be impaired and in which the client may feel exploited (as a debtor, Ronald may not feel capable of participating openly and honestly in therapy). ================================================== Question: *43. Mrs. Bailey sees the photograph of your dogs in your office and brings you a basket of dog treats. How would you respond to her gift? Content Area: Ethics: Business Practices and Policies This ethical question regarding gifts tests your sensitivity to the issue of professional boundaries and dual relationships. A. Accept the gift in the spirit in which it was given. B. Take one of the treats as a gesture and return the rest. C. Thank her for her thoughtfulness and decline the gift. D. Assess the motivation behind the gift. Answer: D. Give Burt the brochure, "Professional Therapy Never Includes Sex" regarding sex and therapy and discuss it with him. "Professional Therapy Never Includes Sex" should be provided for this client as well as a discussion of its contents. ================================================== Question: 44. You get a telephone call from a highly agitated woman who states that her live-in boyfriend has been battering her whenever he drinks, which is at least once a week. She says she is considering leaving but that it is difficult because she has severe cerebral palsy and uses a wheelchair. You: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question addresses dependent adult abuse. A. Must gather as much information as possible and make a report of physical abuse to Adult Protective Services since this woman is a dependent adult. B. Are not yet this woman's social worker, so you give her the number to Adult Protective Services and encourage her to call them and/or the police to make a report. C. Set up an appointment for as soon as possible and assist her by giving her numbers for battered women's shelters that are wheelchair accessible. D. May choose to make a report because you have not witnessed the injuries or the abuse yourself. Answer: B. Review the nature of your license as it is explained in your informed consent. Explaining the nature of your license by using your general office policy reinforces the therapeutic frame that you would have initiated in an informed consent discussion at the beginning of therapy. ================================================== Question: *45. The Baker family comes to counseling referred by their pastor. Derek, their 14-year-old son, has been hanging out with a "bad crowd." He isn't doing his homework, is sloppy doing chores, and has failed to show up for choir practice at the church. Their other child, Sarah, who is 12 years old, not only doesn't want to go to choir practice, she doesn't want to go to church at all. Sarah says, "I don't care if I go to hell; at least I'll be able to sleep in on Sundays!" Mr. and Mrs. Baker say they don't want to "do anything rash." "Please help," says Mrs. Baker. How would you proceed with managing your ethical responsibilities? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage family treatment from an ethical perspective. A. Have the couple tell you what they have attempted to do to manage this conflict thus far. B. Tell the family that you work from a systems perspective, and that you will be "reframing" the children. C. Clarify for the family your role with the pastor. D. Ask Mrs. Baker what she means by "help." Answer: C. The court has not appointed guardians ad litem. Until the court appoints guardians ad litem, you cannot release the records for the unit of treatment. A guardian ad litem is appointed by the court to make legal decisions in the best interests of a child. Without guardian ad litem status, parents cannot waive privilege for their children. ================================================== Question: 46. A psychiatrist refers you a client with severe anxiety. The day before an intake session, the client calls you to ask if he can see you right away because he is afraid he will take all of the anti-anxiety medication he owns. He tells you that he is actually seeing three different doctors to get as much medication as he can. In collaborating with his doctors, which of the following would be the most ethical approach? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to collaborate and consult according to ethical (rather than legal) standards. A. File three separate releases in the client's file. B. Tell him that you plan to speak to all of his doctors with or without a release. C. Ask him which doctor he would prefer that you talk to. D. Obtain consultation from each doctor about his case. Answer: A. Assert privilege. If you are unable to contact your client, you must continue to assert privilege. You do not know what is in the client's best legal interests so all you can do is continue to assert privilege. ================================================== Question: 47. You are obtaining a release of information from a client to confer with the client's psychiatrist. The client tells you that she is thinking of finding a new psychiatrist because this one never listens to her. She is concerned that if you talk to the psychiatrist, you will develop a negative opinion of her. Which of the following would you find on a release of information form? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your understanding of what information is included on a release of information form. A. The client's name and diagnosis. B. The client's social security number and diagnosis. C. The purpose of the release and the social worker's license number. D. The length of time the client has been in treatment and the social worker's license number. Answer: B. Open a separate file if the client was in family therapy before. Maintaining treatment files for different units of treatment is a legal obligation. ================================================== Question: 48. When discussing exceptions to confidentiality with a client, which of the following would not be considered such an exception? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of limits of confidentiality. A. Suicidal thoughts. B. Domestic violence. C. Grave disability. D. Threats to destroy another's property. Answer: A. Not see the client. This is a situation in which you are confronted with a possible avoidable dual relationship; avoid it by not seeing the client. ================================================== Question: *49. Guidelines regarding advertising state that social workers must advertise in a way that is honest and not misleading. Which of the following is a true statement regarding advertising policies? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of advertising principles associated with LCSW practice. A. A prelicensed social worker may not use the term "psychotherapist" on a business card. B. The advertisement must indicate the full name of the licensee and the complete license number. C. It is not permissible for an LCSW to use "Ph.D." if s/he is not a psychologist. D. A social worker cannot use the term "Psychotherapy" on a business card. Answer: ETHICAL ISSUE: Privacy + Confidential ================================================== Question: *50. The parent of a child on your child's baseball team is a doctor and wants to send a client to you. On the sidelines, you and this parent often talk about the relationship between illness and how family dsyfunctions develop around those illnesses. The doctor is impressed by your insight and asks for your card. You would: Content Area: Ethics: Business Practices and Policies This question asks how you would manage your ethical responsibilities when you receive a referral from someone you know. A. Agree to see his referral. B. Not see his referral because this constitutes a dual relationship. C. Assess whether it would affect your child and the doctor's child. D. Not see the potential client but refer to a colleague. Answer: LEGAL and ETHICAL ================================================== Question: *51. You have been working for seven months with a young adult who has recently become very involved with a Nazi skinhead group. You have strong feelings about the detrimental effects such an affiliation can have and will need to: Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how to handle counter-transference issues with a client. A. Address your concerns with the client without contaminating the therapy. B. Discuss the case with your colleagues and get consultation in order to manage your personal bias. C. Evaluate whether or not you can continue to work effectively with this client. D. Refer this client out since your bias will get in the way of her progress. Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: *52. Mollie, age 62, reports that she has been the victim of spousal abuse over the last year by her husband of 40 years, Roland, age 67. You have told her that you will assess for elder abuse. Legally, how should you proceed? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question reviews your knowledge of reporting responsibilities. A. Make an elder abuse report to Adult Protective Services. B. Maintain confidentiality and assess for possible elder abuse. C. Make a report to law enforcement within 2 working days. D. Make a physical abuse report to Adult Protective Services. Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: *53. Maxwell, age 46, is referred to you by his EAP because he is depressed and drinking daily on the job. He witnessed a train wreck 3 weeks ago in which several people were killed. Now he says he is terrified to leave the house without a couple of drinks to calm him down. He says that every time he hears a loud noise he feels faint, and he wakes up sweating and shaking. What action would the social worker take? Content Area: Ethics: Therapeutic Relationship/Services This question tests your ability to respond to client's needs in an ethical way. A. Determine the client's ability to respond to anxiety treatment interventions. B. Evaluate the client's need for a crisis intervention, C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions. D. Tell him that his treatment will be confidential as it pertains to his EAP. Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: 54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality. A. Filing a child abuse report. B. Ensuring safety for a suicidal client. C. Responding to a CPS caseworker's request for family history following a child abuse report. D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle. Answer: LEGAL and ETHICAL ================================================== Question: 55. You are seeing a client, Tom, for six months. Tom occasionally mentions his cousin, who specializes in installation of landscaped ponds. You've always wanted a landscaped pond with koi. Which of the following represents an ethical course of action? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of dual relationships. A. You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction. B. You call your client's cousin, along with several other landscapers, to gather price quotes. C. You call your client's cousin and mention that you are an acquaintance of Tom's hoping that he'll give you a break on the price. D. You ask Tom how he would feel if you hired his cousin to install a pond. Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: 56. A social worker is becoming increasingly concerned that one client, who is acutely suicidal, is not improving. The social worker has suggested that the client speak with people in his life who might be supportive and be able to help, but the client only wants to speak with the social worker. The social worker is concerned about boundaries if she speaks with the client as often as he needs, which is at least once day. The client has threatened to leave therapy entirely if the social worker keeps suggesting outside support. Ethically, the social worker should: Content Area: Ethics: Therapeutic Relationship/Services This question pertains to ethical aspects of termination. A. Tell the client directly the social worker's concerns if the client does not return to therapy. B. See the client at least once a day to prevent harm and imminent risk. C. Terminate with the client and have him involuntarily hospitalized. D. Allow the client to terminate if the social worker is unable to provide adequate support. Answer: LEGAL: Unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: *57. You are working in a group practice and learn that one of your colleagues tends to have "a drink" in his office between clients. How do you handle the situation? Content Area: Ethics: Business Practices and Policies You must choose the best way to address your colleague's apparent drinking problem. A. Tell your other colleagues in the group and perform a group intervention. B. Discreetly confront your colleague about his drinking. C. Contact the BBS. D. Encourage your colleague to contact an ethics board for advice. Answer: LEGAL and ETHICAL ================================================== Question: 58. Maya, a 15-year-old emancipated minor, comes in to see you without parental consent. She tells you that last week her 20-year-old husband, Oliver, raped her when she refused to have sex with him. She's been feeling depressed and disoriented ever since this happened. Which of the following would represent the correct legal analysis of this situation? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of child abuse reporting laws. A. Since Maya is depressed and disoriented, you can treat her without parental consent. B. Since Maya is married the rape would represent spousal abuse and you would have an ethical responsibility to ensure her safety. C. Since Oliver is only 5 years older than Maya, Oliver's actions would not constitute lewd and lascivious behavior. D. Since Maya is 15 years old, the rape would constitute child abuse. Answer: LEGAL and ETHICAL ================================================== Question: 59. A newly licensed social worker wants to establish her practice. She goes to several neighborhood psychiatrists and doctors advertising her practice and offering small tokens of appreciation in return. What is the problem here? Content Area: Law: Legal Standards for Professional Practice. This question concerns the practice of purchasing referrals. A. A social worker must be licensed for a period of two years before s/he can advertise door to door. B. It is not ethical for her to go door-to-door to advertise her practice. C. It is not legal for her to offer compensation for referrals. D. Advertising is restricted to business cards and association literature. Answer: Failure to keep records consistent with clinical judgment, standards, nature of services = unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: 60. You are meeting with a client in your private practice for the first time. She tells you that she found you with an internet search with the search term "expert in eating disorders." Which of the following must, by law, be disclosed prior to beginning the session? Content Area: Law: Confidentiality, Privilege, and Consent This question is testing your knowledge of ethical and legal requirements of an informed consent. A. Explaining the limits of confidentiality. B. Explain your scope of competence since you claim to be an "expert." C. Your fee. D. Your full name and license designation. Answer: 1-Termination or interruption of services w/o notifying ct promptly + arranging transfer/ referral as needed . 2- Failure to take reasonable steps to avoid abandoning cts who are still in need of services 3-Failure to terminate when services no longer serve ct's needs 3- = ETHICAL VIOLATIONS ================================================== Question: 61. Ponciano and Berta are a Guatemalan couple who have been in treatment with you. They are moving back to Guatemala this week. They come to session and present you with some freshly baked sweetbread that Berta says she made especially for you because of all you have done for them. She tells you that it is a custom in her country to make a parting gift when friends are separating. How would you respond? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the ethics that pertain to gifts from clients. A. Accept the gift but explain that gift giving is not usually a part of a therapeutic relationship. B. Refuse the sweetbread because, ethically, social workers should not accept gifts from clients. C. Further explore their customs but do not accept the sweetbread because it is unethical. D. Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session. Answer: Prior to the commencement of treatment, failing to disclose to ct or prospective ct the fee to be charged for the profess.services, or the basis upon which fee to be computed = ILLEGAL ================================================== Question: *62. A male client comes to see you for the first time. As he talks, you begin to realize that he is definitely going to harm someone. He has a plan and is going to act, but he has not identified his intended victim to you yet. Just as he is about to tell you the identity of the name of the intended victim, you realize that you have not explained to him the limits of confidentiality: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage your ethical and legal obligations when a client might be dangerous. A. Tell him to stop and refer him to someone else. B. Wait until he identifies the intended victim and then explain the limits of confidentiality, as you must do as part of obtaining informed consent. C. Ask him to stop and explain to him the limits of confidentiality as part of informed consent. D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim. Answer: Misrepresentation re type or status of a license/reg., or other misrepresentation or permitting misrepresentation of his or her education, qualifications, profess affiliations= ILLEGAL ================================================== Question: *63. You are working with a client who has expressed suicidal thoughts. You see the client once every two weeks because he does not have insurance. He uses your sliding scale and sometimes texts you between sessions. Which of the following steps would be considered reasonable in fulfilling the duty to ensure the safety of a suicidal client? Content Area: Ethics: Business Practices and Policies This question addresses your knowledge of a social worker's responsibilities to ensure the safety of a suicidal client. A. Schedule extra sessions with your client. B. Obtain the client's promise not to harm him/herself until you meet again and use a "self care" contract to reinforce the promise. C. Give the client the number of the suicide prevention hotline. D. Explore your client's support network. Answer: Termination based on failure to pay overdue balance w/o following: payment policies were made clear, ct not in imminent risk, consequences of nonpayment addressed = ETHICAL VIOLATION ================================================== Question: 64. Social workers are required by law to comply with certain legal standards in the state in which they are licensed. All of the following are legal issues EXCEPT: Content Area: Ethics: Therapeutic Relationship/Services This question requires that you discriminate between legal and ethical issues. A. Suicide. B. Asking your client, who is a contractor, for information about drywall. C. Setting a fee. D. A dependent adult who states that his prescribed seizure medication has not been dispensed by his care custodian. Answer: Failure to ensure fees are fair, reasonable. + commensurate w services. Failure to consider ct's ability to pay= ETHICAL VIOLATION: ================================================== Question: 65. Lisa, age 43, is going through a bitter divorce. She brings her only child, Jamal, age 8, for therapy at the request of his school counselor. He was caught cheating on a test and lied about it to the teacher, the principal, and his mother. As you gather history, Lisa keeps revisiting the injustices of her having to "pay for HIS bad parenting." When you question her further, she rails about how her ex-husband spoiled Jamal by giving him everything, never backing her up with discipline, etc. She says, "He's such a jerk. And now he lives in a nice condo and I'm stuck in this dingy little apartment with this dishonest, ungrateful kid. I just can't believe I have to do this. I can't afford therapy and, I don't want to be schlepping him over here every week." What is the best way to proceed regarding her concern about paying your fee? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your sensitivity to client needs and ethical fee setting. A. Consider offering to see Jamal on a sliding scale or pro bono basis. B. Ask Lisa if she'd like you to call her ex-husband to get some of the payment from him. C. Tell Lisa that she doesn't have to pay for therapy because you'll see her on a pro bono basis. D. Have Lisa sign a release for you to confer with her ex-husband regarding the fee. Answer: Accepting barter w/o all of the following:it's an accepted practice among profs locally, essential for provision of services, +initiated by ct + w ct's consent = ETHICAL VIOLATION ================================================== Question: 66. Your client, Jordan, has just tested positive for HIV. He is in a relationship and is convinced that if he tells his partner, Julian, he will leave him. What are your ethical responsibilities in this situation? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical considerations regarding confidentiality and clients' HIV status. A. Refuse to treat Jordan further unless he tells Julian of his HIV-positive status. B. Tell Jordan that he should tell Julian. C. Call Julian. D. Maintain confidentiality. Answer: Soliciting private fee/ remuneration for services to cts who are entitled to them thru your employer or agency= ETHICAL VIOLATION: NASW 1.13 Payment for Services ================================================== Question: 67. The Humburgs come to counseling with their 16-year-old son, Cameron, because they found drugs in his room. They don't want the other two children, ages 9 and 11, to know. They want you to suggest some strategies to help Cameron overcome this problem. Ethically, you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to explain the parameters of therapy with clients. A. Give them time to adjust to therapy since this is their first session and see just the three of them. B. Tell them that you are a Family Systems therapist and the other children should be included. C. Tell them that it would be outside of your scope of practice as a systems therapist to exclude the other two children. D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them. Answer: 1-Not providing cts w/ reasonable access to records.2- Not assisting ct to interpret them if access to records might lead to serious misunderstanding or harm3- not limiting access + documenting rationale when there is compelling evidence that serious harm would result = ETHICAL VIOLATIONS ================================================== Question: 68. You have been seeing Marsha, 11, with the consent of her mother, Jan. Jan is requesting a copy of Marsha's therapy notes because she wants to provide them to the school counselor. Under which of the following conditions can you refuse Jan's request? Content Area: Law: Confidentiality, Privilege, and Consent This question assesses your knowledge of the laws pertaining to parental request of a minor's records. A. Marsha will not sign an authorization to release the information to her mother. B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being. C. Jan wants you to produce a copy of the records within 3 weeks time. D. You don't feel comfortable breaching Marsha's confidentiality. Answer: 1-Failure to provide the brochure re the rights of, and remedies for, patients who have been involved sexually with their psychotherapist. 2- Failure todiscuss with the patient the brochure prepared by the department= ILLEGAL. ================================================== Question: 69. Mrs. Moran is referred to you by a former client. On the phone she refers to you as "Dr.," although you do not possess this degree or license. It is apparent to you that Mrs. Moran is quite depressed. How would you handle this situation? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical standards regarding the obligation to accurately represent licensing status. A. Inform Mrs. Moran of your license status once her mood has stabilized and she is in a better mental state to understand and evaluate this information. B. Refer Mrs. Moran to a doctor since her statement indicates that she is seeking the services of a psychologist, psychiatrist, or M.D. C. Give Mrs. Moran your business card which will provide her with your accurate qualifications. D. Inform Mrs. Moran of your license and qualifications. Answer: Sex with a ct or a former ct w/in 2yrs from termination, soliciting sex from a ct, or committing sexual abuse or sex.misconduct w/ct or committing act punishable as sex crime, if it's subst.related to qualifications, functions, duties of a clinical social worker.= ILLEGAL ================================================== Question: 70. A 56-year-old woman that you have been treating has just experienced the death of her husband. His was the primary income, and she was not aware of all of the financial responsibilities. She tells you that she has been getting calls from bankers, real estate planners, and lawyers offering to provide assistance. If you become concerned for her welfare, you should: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how and for whom to make appropriate referrals. A. Refer her to a lawyer. B. File an elder abuse report: financial abuse. C. File an elder abuse report: undue influence. D. Refer her to a financial planner. Answer: Clarify who is considered ct and the nature of professional obligations to various individuals ETHICS ================================================== Question: *71. Matthew, age 40, and Delilah, age 27, have been married for 8 months and have been referred to you by the pastor of their church. Delilah says, "It's like I keep marrying the same man. Just like my 2 ex's, he flies off the handle at the drop of a pin, and I don't like the way he disciplines the kids." Matthew says, "She needs to listen to me about how to raise children and seriously adhere to Biblical teachings." How would you manage your scope of practice obligations in light of the domestic violence? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of working within the scope of practice to assess the safety of clients. A. Establish your right to break confidentiality to prevent domestic violence. B. Explain that there are exceptions to confidentiality, including the reporting of child abuse. C. Question Matthew and Delilah separately about possible domestic violence. D. Do not confirm nor deny to the pastor that Matthew is or is not your client. Answer: Failure to comply with child abuse reporting requirements (call asap, f/u in writing w/in 36 hours)= Unprofessional conduct (conditions for Suspension, Revocation of license) ================================================== Question: 72. You witness a mother abusing her child in a shopping mall. Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse reporting laws. A. Ethically, you should report the child abuse. B. Legally, you do not have to report the abuse. C. You will be in violation of ethical standards if you do not report to the police or child protective service agency. D. Legally, you must report the abuse by phone and follow up with a written report within 36 hours. Answer: ETHICS/ NASW ================================================== Question: 73. When working with a female client who is being abused by her partner, what is your ethical responsibility? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of your ethical responsibilities when you become aware that a client is being abused by her partner. A. To establish a plan of safety, including shelters and established support systems. B. To make an optional dependent adult abuse report to protect the client if she is pregnant. C. To report child abuse if children were witnesses to the abuse which negatively impacted them. D. To refer the client to a divorce lawyer. Answer: LEGAL + ETHICAL ================================================== Question: 74. An HMO refers a client dealing with depression. When the client arrives at her first session she explains that she's not depressed but is seeking vocational counseling, intellectual testing, and information regarding her desire to change careers. She states that she didn't believe the insurance company would authorize treatment for such a "lame reason." What would you do? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice. A. Inform her that she will have to pay out of pocket. B. Proceed with treatment. C. Refer the client to a career counselor. D. Call the insurance company and inform them that you will be seeing her for reasons other than depression. Answer: ETHICS ================================================== Question: *75. During your intake interview, you learn that your client is a lawyer. As you discuss the limits of confidentiality, the client asks, "can you plead the Fifth like I can in court?" As you consider your answer, you consider some hypotheticals. Privilege might be waived in which instance? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking you to choose when privilege could be waived. A. A client is a 13-year-old girl, who you are seeing without parental consent, and has been selling drugs. B. A client has told you he has been involved in hacking a corporate database under an assumed name. C. A client accused of assault and battery uses insanity as a defense in court. D. A 64-year-old woman complains to you that her bank is making automatic withdrawals without permission. Answer: LEGAL + ETHICAL ================================================== Question: *76. A social worker who is running a therapy group receives an email from one member of the group, describing some personal issues that she does not feel comfortable discussing in the group setting. The social worker has all group members on a contact list and in his reply to this individual he accidentally does a "reply all" to the members of the group: "Please bring that up in the group if you feel comfortable doing so; if not, I can give you some referrals." What should the social worker do to fulfill ethical obligations? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to respond in an ethical and competent way when confidentiality has been compromised. A. Address the mistake in the next group. B. Refer to any "no secrets" policies that allow the social worker to bring up an individual's issues. C. Nothing needs to be done; no one's confidentiality was breached.. D. Send a private email to the client who sent the first email with an apology for the breach of confidentiality. Answer: LEGAL (Tarasoff decision) ================================================== Question: 77. A second generation Chinese-American man comes into therapy and asks you to help him find a wife because his father is pressuring him to get married. Your FIRST intervention would be to: Content Area: Ethics: Therapeutic Relationship/Services The question asks for "your first intervention." A. Indicate that his needs would best be served by an Asian mental health professional. B. Inform him that this is an inappropriate goal for treatment. C. Engage him in a discussion of his motivation and past efforts. D. Address his presenting problem and assist him in finding a wife. Answer: LEGAL ================================================== Question: 78. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of Section 1024 of the Evidence Code. A. Maintain Roger's confidentiality. B. Warn the manager of the factory because this is analogous to a Tarasoff situation. C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision. D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. Answer: LEGAL + ETHICAL ================================================== Question: 79. Christine is a 14-year-old ward of the court. During the first session she says that her group home counselor is not helping her. Christine says that another child in the group home has sexually molested her, but no one believes her. She says that an abuse report was filed, but nothing came of it. She wants therapy to help her manage her feelings. Legally the next step would be to: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to report child abuse when the abuse happens out of the child's home. A. Get consent from her court-appointed attorney. B. Get consent from her group home counselor. C. Have her terminate with her group home counselor. D. File a child abuse report. Answer: LEGAL ================================================== Question: 80. Your 17-year-old client tells you that she was molested on many occasions as a younger child. She tells you that she was taken from the home in which it occurred and has never returned. She tells you that she found the perpetrator on a social networking site that makes her think he is still looking for under-age victims. She shows you his posts and you concur. What would be the most important legal requirement that you would have in such a case? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse reporting requirements. A. Report the abuse to CPS immediately by phone and with a written report within 36 hours. B. Inform her of her rights about reporting him now that she is an adult. C. Advise her to make a police report about a sexual predator. D. Develop a safety plan if he responds to her posts. Answer: LEGAL ================================================== Question: 81. Your client, Barbara, has been unemployed for three months. In her last session she stated that she plans to kill her ex-boss tomorrow because he's the cause of all her unhappiness. You call the police to alert them to Barbara's plan, but they don't seem to take you seriously because there isn't a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question involves a Tarasoff situation. A. Document your phone call outlining your concerns and justifying your actions in order to cover your liability. B. Have Barbara come in immediately for crisis counseling. C. Call Barbara's ex-boss and warn him of her plan. D. Call Barbara and find out if she has a gun so you can tell the police. Answer: LEGAL and ETHICAL ================================================== Question: 82. Jeannie and Chuck Jones and their two children Brooke and Josh, have been seeing you for family counseling for 6 weeks when they come to see you right after a "big family fight." You notice a rip in Josh's clothes and Brooke's red eyes leads you to believe she has been crying. You separate the family and gather a lot of information about the fight. Which statement would NOT lead to a child abuse report? Content Area: Law: Limits to Confidentiality/Mandated Reporting. The focus of this question is child abuse reporting mandates. A. Josh tells you his father tried to push him into a cold shower, and his clothes ripped pulling away. B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach. C. Josh tells you his Dad was also trying to lock him in the closet. D. Brooke tells you her Dad repeatedly said she was stupid. Answer: LEGAL and ETHICAL ================================================== Question: 83. A client comes to his session with his 72-year-old father, who uses a walker from a fall which he reports was caused by a fight with his wife. The father tells you that his wife has been stealing his social security checks each month and gives him only $5.00 a week. At this point you should: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question continues to test your knowledge of reporting elder abuse. A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse. B. Call Adult Protective Services and report the financial abuse and "undue influence." C. Explore possibilities for alternative living arrangements with the father and address the feelings both he and your client may be feeling due to this trauma. D. Report the financial abuse, even though it is optional, since the victim and your client have requested your assistance in this matter. Answer: LEGAL ================================================== Question: 84. You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the law pertaining to suicidal clients. A. Legally bound to report. B. Ethically responsible to notify family or "others responsible for the client's well-being." C. Legally responsible to intervene. D. Not responsible in any way as the client has a right to make his/her own decision. Answer: Failure to provide services only w/ valid inf. consent incl. purpose, risks + limits of services costs, alternatives,right to refuse/withdraw consent, time frame covered by consent = ETHICAL VIOLATION ================================================== Question: 85. Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions which define a person as being gravely disabled. A. Command auditory hallucinations telling the client to kill other people. B. Command auditory hallucinations telling the client to kill him or herself. C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home. D. Choosing to be homeless. Answer: Failure to provide information about the nature and extent of services and about the extent of clients' right to refuse service= ETHICAL VIOLATION ================================================== Question: 86. Your 15-year-old client comes to session extremely agitated because she just found out that a photo she sent to her boyfriend is now circulating all over the school. She is getting harassing comments about her appearance and sexual promiscuity. She is afraid that the school will contact her parents if she reports the harassment to school authorities. How do the laws pertaining to bullying direct your actions as a social worker? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate interventions with a minor. A. You may speak with the school, or they may speak to you without a release. B. You must report to the school authorities, but you are not required to report to the police. C. You may advise your client about her reporting requirements. D. You may tell your client about the laws pertaining to cyberbullying. Answer: Failure to inform recipients of the limitations and risks associated with such services = ETHICAL VIOLATION ================================================== Question: *87. After completing a three-month course on hypnotherapy, you decide to advertise your new specialty. You receive a call from Christopher, who says he would like to come in for a session, so that you could hypnotize him to stop smoking. He says he's tried the patch and nicotine gum, but he needs your help to quit once and for all. How would you respond to Christopher's request for treatment? Content Area: Law: Legal Standards for Professional Practice. This question deals with scope of practice for mental health professionals. A. Make an appointment because hypnotherapy is now part of your scope of competence. B. Inform him of your fee before the commencement of treatment. C. Refer him to a medical doctor. D. Tell him that you will not be able to help him quit smoking. Answer: Engaging in dual or multiple relationships w/clients or former clients in which there is a risk of exploitation or potential harm to the client = ETHICAL VIOLATION ================================================== Question: 88. A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal and ethical standards in dealing with referrals. A. Expressed your gratitude in an appropriate and professional manner. B. Not acted unethically or illegally since you did not solicit the referral. C. Not acted unethically or illegally since you did not directly pay the colleague for the referral. D. Acted unethically and illegally. Answer: Soliciting private infor from cts unless it is essential to provide services or conduct evaluation/ research. Once private information is shared, not complying w/ standards of confidentiality = ETHICAL VIOLATION ================================================== Question: *89. Your client has two children and is divorced. She tells you that when she arrived at her ex-husband's house last night to pick up the children, he had locked the doors and texted her that, "Me and my children are moving across the country." He has no criminal history, but she is afraid she will never see her children again. Which of the following is the clinician's first intervention? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of when to make referrals for expertise outside of your scope of practice. A. Advise her to call Child Protective Services for abduction. B. Explore the events immediately preceding this one. C. Call the police. D. Advise her to call her lawyer. Answer: sex w/ a client or former ct w/in 2years from termination, soliciting sex, or committing act of sexual abuse or misconduct w/ a ct, or committing an act punishable as a sex crime, if its subst. related to qualifications, functions, duties of clinical SW = ILLEGAL ================================================== Question: *90. Your client works as a pilot and often misses appointments because she is called out-of-town at the last minute. When billing her insurance, you: Content Area: Law: Legal Standards for Professional Practice. This question evaluates your knowledge of appropriate ethical guidelines for insurance billing and insurance fraud. A. Note carefully which sessions the client actually attended. B. Must not include missed sessions on the bill since insurance will not pay for these. C. May not commit insurance fraud by noting which of the sessions were canceled within your 24 hour limit and which were canceled at the last minute. D. May remind her she will have to pay for missed sessions herself. Answer: Failure to discuss nature of confidentiality + limitations of clients' right to confidentiality as soon as possible in SW-client relationship= ETHICAL VIOLATION ================================================== Question: *91. Rob, a 27- year-old African American male, and Cynthia, his 24-year-old Mexican American girlfriend, have decided to live together after six months of dating. Cynthia asked Rob to participate in therapy, and Rob agrees to attend one month of therapy in order to "try it out." During the first session, Cynthia softly reports that Rob cannot control his anger. Rob quickly turns to Cynthia and shouts, "You're the one that's too sensitive!" When creating a safety plan with Cynthia, you would do all of the following EXCEPT: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal obligations to assess a client's safety and treat the client within your scope of practice. A. Make yourself available by phone and increase the frequency of sessions. B. Provide a list of addresses and phone numbers to local shelters, emergency housing agencies, and crisis centers. C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them. D. Advise Cynthia to gather important items in one place (i.e. extra set of car keys, debit and credit cards, medical records and prescription refills, etc.). Answer: 1-Failure to seek agreement re each person's right to confid. +obligation to preserve the confidentiality of others.2- Failure to inform you cant guarantee all participants will honor such agreements= ETHICAL VIOLATION ================================================== Question: *92. A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would: Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist's boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship. A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations. B. Contact the therapist to discuss the legal/ethical consequence of his actions. C. Assess for further boundary violations. D. Contact the BBS to report the therapist's inappropriate actions. Answer: Failure to keep all info confid. except for compelling prof.reasons- e.g. when disclosure needed to prevent serious, foreseeable,+imminent harm to a client or other identifiable person=ETHIC. VIOLATION ================================================== Question: 93. A man calls you to ask about his wife's therapy bill since she has been using his insurance. He asks if you can provide copies of the previous three months' bills because the insurance company has lost them. Upon hearing his request, you: Content Area: Law: Confidentiality, Privilege, and Consent This question asks for the confidentiality rules in regard to third party callers. The issue of the insurance statements is secondary to the confidentiality issue. A. Send a copy of the bill since it is his insurance. B. Call his wife and ask if she would like you to send him a copy or if she would prefer you send it addressed to her. C. Tell him you cannot confirm or deny that his wife is your client. D. Give his wife the bill copies at her next session. Answer: Failure to inform clients, to extent possible, re disclosing confid. info +potential consequences, when feasible beforehand (whether SW disclosing on basis of a legal requirement or ct consent)=ETHIC. VIOL. ================================================== Question: *94. A female social worker who is having problems in her own marriage finds that she is consistently siding with the wife in couples therapy. Ethically, the social worker's primary obligation is to: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to meet client needs when negative counter-transference could impact objectivity and client welfare. A. Obtain supervision to address counter-transference. B. Discontinue conducting therapy until her own marital problems are resolved. C. Attempt to balance treatment by siding with the husband. D. Call in a co-therapist to monitor the therapist's behavior. Answer: Failure to limit cts' right to self-determin. when, in your professional judgment, cts' actions or potential actions pose a serious, foreseeable,+imminent risk to themselves or others. =ETHIC. VIOLATION ================================================== Question: *95. Which of the following scenarios describes a social worker's legal duties regarding the use of telemedicine? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of the difference between legal and ethical responsibilities. A. A social worker bills an internet client the fee before starting therapy. B. A social works breaks confidentiality because an internet client is engaging in child abuse. C. A social worker provides a client a copy of the informed consent document to download and return with a signature. D. Referring a client to a CPS website if the client reports child abuse. Answer: 1-Not consulting w/ colleagues when it's in ct's best interests. 2-When consulting, disclosing more ct info than necessary =ETHIC. VIOLATION ================================================== Question: 96. A couple, whose children have all graduated from high school, is considering adopting an elementary school-age child. They believe that a child who has not yet been adopted would do well in their household, and they want to give back to society. How should the social worker approach this couple's decision? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to respond to clients' treatment needs. A. Advise them on the cultural implications of adoption. B. Assess for a phase of life problem. C. Obtain consultation about adoption. D. Refer if the couple has reached the original treatment goals. Answer: Giving or receiving payment for a referral (when no professional service is provided by the referring party)=ETHIC. VIOLATION ================================================== Question: 97. Deanne is a 13-year-old who is in therapy with you without her parents' consent. In this case, who is the holder of the privilege? Content Area: Law: Confidentiality, Privilege, and Consent The issue presented in this vignette is whether a minor can be the holder of privilege. A. You, due to client privilege. B. Deanne. C. The state because Deanne is a minor. D. Deanne's parents because parents hold privilege for minors. Answer: 1-sex w/supervisees/ students. 2- Failure to avoid sex w/ colleagues; failure to transfer professional responsibilities, when necessary, to avoid a conflict of interest, if having or anticipating sexual relationship w/ colleague. =ETHIC. VIOLATIONS ================================================== Question: *98. A person calls telling you that she is your client's conservator. Your client is physically disabled and has told you about the challenges associated with being under conservatorship. The client tells you that she hates not being able to make her own decisions. How do you manage your ethical obligations related to informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge about the ethical requirements for informed consent. A. If you have any concerns for the client's safety, tell the conservator about the limits of confidentiality related to dependent adults. B. Determine the type of conservatorship. LPS conservatorships allow the conservator to consent to treatment. C. Tell the conservator about your mandate to report dependent adult abuse. D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults. Answer: 1-Failure to discuss concerns directly w/ colleague when feasible +when such discussion is likely to be productive. 2- Failure to proceed, when necessary, to take actions through formal channels = =ETHIC. VIOLATIONS ================================================== Question: 99. Angelina, a 20-year-old college student, comes to see you complaining that she's having difficulty breathing and concentrating, and that she thinks it's "all in her head." Angelina says she was date raped three weeks ago and says you are the only person who knows. She hasn't told her parents and doesn't want them to know about it. Angelina says, "Please help me. I can't take this anymore." She tells you that her parents have told her that they will pay for her therapy. How would you manage the legal issue of payment? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of the legal issues that pertain to fees. A. Explain the limits of confidentiality if a third party is paying for therapy. B. Consider offering Angelina a lower fee so that she can pay for her own therapy. C. Talk to Angelina about whether she wants her parents to pay for therapy. D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement. Answer: 1-Failure to consult w/ the colleague when feasible+ assist in taking remedial action. 2- Failure, If problem persists +colleague hasnt taken steps to address it, to take action thru appropriate channels established by employers, agencies, NASW, licensing + regulatory bodies =ETHIC. VIOLATIONS ================================================== Question: 100. You have been seeing a client for 3 months. You learn she has a daughter who attends the same pre-school as your son. How do you ethically handle this dual relationship? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of ethical management of dual relationships. A. Refer your client out since the therapy relationship is still fairly new. B. Acknowledge the coincidence, explore your client's reactions and discuss how you will both act should you see each other at school functions. C. Transfer your son to another pre-school to avoid a dual relationship. D. Do not acknowledge the coincidence in session since it is a large pre-school and unlikely you will encounter one another. Answer: Establish + maintain billing practices that accurately reflect nature + extent of services provided and that identify who provided the service in the practice setting. ETHICS ================================================== Question: 101. A client who has been in individual therapy wants to bring her children for therapy. The first thing a social worker must do if the social worker agrees to see the children with their mother is: Content Area: Ethics: Therapeutic Relationship/Services This questions tests your knowledge of the ethical steps required for changing a treatment unit or plan. A. Change the unit of treatment. B. Provide informed consent. C. Talk about the risks and benefits of family therapy. D. Refer the daughter to an individual therapist. Answer: Failure to be a diligent steward of the resources of employing organization =ETHIC. VIOLATIONS ================================================== Question: *102. Cathy is a 28-year-old clerk who works in a department store. A social worker has been seeing Cathy, her 7-year-old son, and her 5-year-old daughter in therapy for a month. She never married her children's father, Bob, who calls "once in a blue moon" requesting to spend time with the kids or will arrive at the door with presents. She receives no support from him and doesn't want to ask him for money because she feels that he will want to visit them more if she does. If Bob subpoenas the children's therapy records, what would be the most appropriate move for the social worker to take? Content Area: Law: Confidentiality, Privilege, and Consent This question checks your knowledge on confidentiality and privilege. A. Keep the records confidential and make an appointment with Bob to discuss his concerns. B. Indicate to Bob that you can only release the records if Cathy signs a release form. C. Determine whether the subpoena came from an attorney or the court. D. Keep the records confidential and alert Cathy of the subpoena. Answer: 1-Failure to discuss w/ client benefits/risks of transferring care. 2- Failure to discuss w/ ct whether consultation w/ previous service provider would be in ct's best interests. =ETHIC. VIOLATIONS ================================================== Question: 103. During the week you get a call from a concerned mother. She tells you that her 15-year-old son, Aaron, who is in therapy with you, sometimes talks with a gang member on the phone. Today she accidentally picked up the phone and overheard the gang member saying that he is going to kill Aaron. Legally, how would you proceed? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of Tarasoff laws. A. Treat the situation as a Tarasoff case. B. Report the information to the police. C. Maintain Aaron's confidentiality. D. Let Aaron know his mother called. Answer: To practice, condone, facilitate, or collaborate w/ any form of discrimination =ETHIC. VIOLATIONS ================================================== Question: *104. A man is in therapy, and he is pleased with the way it is going. He refers his wife to his therapist. What should the therapist do in this situation? Content Area: Ethics: Professional Competence and Preventing Harm. This question explores the ethics of initiating therapy with the spouse of an established client. A. Encourage his wife to come in for conjoint therapy. B. Turn down the referral and suggest other clinicians. C. Wait until his therapy is done before accepting his wife as a client. D. See the wife individually until you have established a therapeutic alliance, then if the couple desires, see them conjointly. Answer: Soliciting testimonial endorsements (incl. consent to use ct's prior statement as a testimonial endorsement) from current clients or others vulnerable to undue influence=ETHIC. VIOLATIONS ================================================== Question: 105. How would you assess an immigrant family at a first session? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of assessment techniques when working with immigrant families. A. Ascertain their level of acculturation. B. Determine that the father is in accord with therapy. C. Reassure the family that seeking treatment is not a sign of weakness. D. Refer the family to an immigrant support group. Answer: 1-To allow own personal problems, psych.soc.distress, legal probs, SA, or MH difficulties to interfere w/ prof. judgment +performance. 2- If it occurs, failure to seek immediate consultation +take immed. remedial action. =ETHIC. VIOLATION ================================================== Question: *106. You have been seeing Terrie and Jennifer, a gay couple. Terrie and Jennifer want at least one child, but they strongly disagree about whether they should adopt a child or have one by artificial insemination. In their next session, they say they need your help to solve this quandary. You should: Content Area: Ethics: Professional Competence and Preventing Harm. This question evaluates your understanding of appropriate therapeutic boundaries regarding important client decisions. A. Ethically, not give your opinion on this subject. B. Use applied therapeutic techniques to help them evaluate both options before you decide if it would be therapeutically useful to state your opinion. C. Help them problem solve but not give them any personal opinions. D. Refer them to specialists in adoption and artificial insemination so that they can get more information which would allow them to better decide. Answer: Allowing one's private conduct to interfere w/ ability to fulfill profess.responsibilities. =ETHIC. VIOLATION ================================================== Question: 107. A social worker was recently hired at an agency that specializes in work with victims of domestic violence. The agency policy states that the social worker must not include any mandated information in the client's file because it puts the children at risk of stigma if their files are ever subpoenaed. The social worker is responsible for: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to proceed legally when an agency policy conflicts with the law. A. Speaking with an outside consultant to determine the best course of action. B. Reporting the agency to the BBS because other colleagues may act unethically or illegally as a result of this policy. C. Developing a safety plan with the mother. D. Including a child abuse report in the file if one is made. Answer: Faiure to act to prevent the unauthorized and unqualified practice of social work =ETHIC. VIOLATION ================================================== Question: *108. George takes care of his wife, Gracie because she is unable to work. George asks you to help him manage his finances so that he is able to pay Gracie's medical bills, the family bills, and afford therapy. How should you respond to George's request and still maintain proper therapeutic boundaries? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to act within your scope of practice. A. Call a financial planner that you know sometimes works on a sliding scale to explain George's situation and see if she is willing to help. B. Explain to George that you cannot use therapy time to help him with his finances because it is out of your scope of competence. C. Inform George that he will still need to pay you for therapy, but that you are willing to adjust your fee if necessary. D. Introduce George to a budget minder book, show him how to create a budget, and provide referrals to websites to find less expensive medication. Answer: Legal ================================================== Question: 109. A client you have been treating for 3 months is suing you because her online therapist told her that she has undiagnosed Bipolar I Disorder. You did not know that she was also pursuing online treatment from a different therapist. She is claiming emotional distress as a result of your negligence in diagnosing and treating her. Would ethics standards allow you to terminate this client? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethics that regulate termination. A. Yes, because she is seeing another therapist and you must avoid exploitation. B. No, because you continued to treat her without asking about another therapist. C. Yes, because she is seeing another therapist who has a better scope of competence. D. No, because she is suing you and you must avoid negative counter-transference. Answer: Ethical ================================================== Question: 110. A reality-oriented, high-functioning client tells you she has been following a company's stock for a number of years and the company's stock price is several points below the company's book value. She tells you the company's profits should double in the next two quarters due to a return on recent expansion. You would: Content Area: Ethics: Professional Competence and Preventing Harm. This question reviews the ethics of acting on financial investment information obtained in a therapeutic setting. A. Legally not be able to purchase the stock because you received the information in confidence. B. Legally not buy the stock, but you could advise your friends to do so. C. Not buy the stock because of ethical considerations. D. Buy the stock, but only without the client's knowledge. Answer: EThical ================================================== Question: 111. A 13-year old named Colleen leaves you a voicemail asking if you'll be her social worker. Before treating Colleen without parental consent, you need to determine that all of the following factors are present EXCEPT: Content Area: Law: Confidentiality, Privilege, and Consent This question reviews the situations where a minor can receive therapy without parental consent. A. Colleen has a history self-harm. B. Colleen is at least 12 years old. C. There is a good reason not to include Colleen's parents. D. Colleen is mature enough to participate in therapy. Answer: Legal and Ethical ================================================== Question: *112. As part of her telehealth practice, a social worker offers quick online surveys to help clients decide if they want therapy. The surveys ask standard questions for typical diagnoses. One day a client asks for an in-person session because the test suggested that her child has AD/HD. How should the social worker proceed with informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question tests how you would provide informed consent from an internet referral. A. Discuss the fee for a complete AD/HD assessment. B. Discuss the limits of confidentiality related to an online assessment. C. Have the client sign a release authorization to discuss the online survey. D. Explore whether the client wants you to assess her child for AD/HD. Answer: Legal ================================================== Question: 113. 14-year-old Athena and her mother, Voula, moved here from Greece one year ago and were referred by Athena's school counselor. Athena has been cutting school and her grades have been dropping. Tearfully, Voula says, "I don't know what I've done wrong. I just want to sleep all the time." Voula asks, "Can I pay for therapy when I get a job?" How would you clinically manage the legal issue of fees? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal issues that pertain to fees. A. Manage any counter-transference reactions about the suggested fee arrangement. B. Reach an agreed-upon fee arrangement prior to the commencement of therapy. C. Offer Voula a sliding scale fee before beginning therapy and document your agreement. D. Tell Voula you cannot let her run up a debt because it could create a dual relationship. Answer: provide access except when there is compelling evidence that serious physical injury or death would result. ================================================== Question: 114. After completing a series in "mindfulness," a social worker wants to use new interventions with ongoing clients. From an ethical point of view, can the social worker use this new modality? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to proceed ethically with a change in treatment plan which requires informed consent. A. Yes, but only with new clients. B. Yes, but only with informed consent. C. No, because it represents a change to the treatment plan. D. No, because it represents a change to treatment goals. Answer: provide access except when there is "compelling evidence" that "serious harm" would result ================================================== Question: 115. You have been treating a client who has just immigrated from China. The client does not want to discuss his emotions and wants you to give him advice regarding how to have a successful business in America. You would: Content Area: Ethics: Therapeutic Relationship/Services This question pulls for your treatment strategies when managing diverse populations. A. Share your ideas about viable business opportunities. B. Confront the client regarding his resistance to talking about his emotions. C. Empathize with him regarding the stress that accompanies acculturation. D. Consider the client's cultural values and his expectations of therapy. Answer: you must keep adequate clinical records consistent with the standards of your profession ================================================== Question: 116. Your client Silvia comes to therapy upset because she overheard her neighbor stating that he plans to shoot the mayor tomorrow evening and owns a gun. She tells you she has tried to calm him down, but he just "keeps blaming the system for his unemployment." What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations related to the Tarasoff ruling. A. Call the police and notify the mayor. B. Discuss options that Silvia has to prevent harm to the mayor. C. Call the police and inform them of the imminent danger. D. Maintain confidentiality. Answer: consent by just one member of couple ================================================== Question: 117. Mr. and Mrs. Chavez come to see you because they are referred to you by their physician. Their doctor has told them that their youngest son has a kidney disorder that will require surgery in the near future. The couple believes that God will intervene in this situation and refuse surgery based on their religious beliefs. Which of the following statements is the BEST response to this situation? Content Area: Ethics: Therapeutic Relationship/Services This is a question concerning medical neglect. A. The parents have the final right to make critical decisions for their son's medical care. B. "Cultural competence" is an ethical obligation that requires social workers to avoid imposing their own values on the client. C. You are mandated to report this situation to a children's protective agency. D. You are legally required to inform the doctor about the parent's decision. Answer: need consent from each individual prior to releasing ================================================== Question: *118. Molly brings 13-year-old Marvin to your office and indicates that she believes the boy is depressed and needs therapy. She indicates that she is Marvin's legal guardian, and that she has consulted with the father, who also wants therapy for Marvin, and says he is willing to cooperate in any way necessary to see that Marvin gets treatment. How would you proceed in obtaining consent to treat Marvin? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge about consent to treat a minor. A. Consent is not necessary since Marvin is over the age of 12 and is depressed. B. Obtain consent from Marvin's father since he wants therapy for Marvin and has indicated a willingness to cooperate with his treatment. C. Obtain consent from Molly since she is the legal guardian. D. Ask to see the custody papers to determine who should sign for consent to treat Marvin. Answer: can keep joint or separate records. The law requires you to keep adequate clinical records consistent with the standards of your profession, but the law allows you to keep records for a couple either separately or conjointly. ================================================== Question: *119. There's something about your client, Zohar, that reminds you of your brother, and you often find yourself thinking about your brother during sessions and having strong reactions to Zohar because of associations with your brother. Once you accidentally called him by your brother's name. In such a situation, a social worker should: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical behavior when dealing with counter-transference. A. Make the situation transparent by explaining to Zohar that he reminds you of your brother and process the meaning of this with him. B. Explain the situation to Zohar and tell him that in order to ensure treatment unclouded by personal reactions, you need to refer him to another mental health professional. C. Explain the situation to Zohar and ask how he wants to deal with it. D. Talk about this issue with a colleague in consultation or with your own therapist. Answer: Do not use derogatory language in written or verbal communications to or about cts. Use accurate + respectful language. ================================================== Question: *120. A therapist is leaving for vacation and has referred all of her clients to you. On the day before your colleague is set to leave town, one of her clients calls you and says that she is in crisis and needs to be seen tomorrow. She adds, "my therapist told me that I could call you if I thought seriously about killing myself. Well, it feels pretty serious." Your ethical priority is to: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to intervene ethically in a potential crisis. A. Notify the referring therapist of the client's treatment needs. B. Tell the client to call her therapist who is still available in town. C. Provide the client with a crisis number hotline until you are "on duty" for these clients. D. Ask her to get you quickly up to date on her general treatment so far. Answer: Legal ================================================== Question: *121. Zach comes to his session angry and upset after witnessing a scene at his tennis club where he observed Ludwig Babcock, a tennis trainer, slap a child several times. Zach says that his son told him Ludwig often hits students, but that this is Ludwig's way of preparing the students for competition. After you hear Zach's story, you would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse and reporting requirements. A. Support Zach in expressing his feelings of anger and sadness since neither the alleged perpetrator nor the alleged victim is your client. B. Urge Zach to call Child Protective Services and report child abuse. C. Maintain confidentiality since there is no evidence that the students are injured by the slaps and hits. D. Report child abuse to the police. Answer: legal principle requiring professionals to engage in the standard of care that is practiced by reasonable and prudent members of their own profession in their own locality ================================================== Question: 122. A social worker terminates treatment with a client after six months of therapy. The client files a complaint about this. In order to demonstrate that the social worker had sound reasons for deciding to terminate the treatment, all of the following could be acceptable reasons for terminating EXCEPT: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical parameters on treatment termination. A. The client has failed to pay a debt of $700 in unpaid fees despite warnings from the social worker that termination could result. B. The social worker wants to change the focus of his or her practice and only treat "high functioning" clients. C. The social worker realizes that the client is involved in a sexual relationship with the social worker's ex-partner. D. The social worker has been unable to resolve strong emotional reactions to the client who reminds the social worker of his/her mother. Answer: Ethical ================================================== Question: 123. A client, who is in court-mandated therapy, tells the social worker that he is going to leave the state because he doesn't want to be in therapy or go to jail for violating probation. The social worker tries to encourage the client to see the benefits of staying in therapy, but the client becomes visibly angry and agitated. If the social worker is concerned about the client's potential for violence, the reason for seeking consultation is NOT to: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when consultation is required to maintain scope of competence. A. Meet the legal standard of care. B. Assess the social worker's own blind spots to risk. C. Discuss any suspicions that would validate terminating the client. D. Reassess the social worker's scope of competence. Answer: needs and best interests ================================================== Question: *124. You negotiate a fee with your new client Chetwyn, who asks if his insurance company will pay for the sessions. You tell him that having worked with this company in the past, you're certain that they will pay for your work together. When you receive a check from the insurance company, only half the sessions are reimbursed because you have been meeting with Chetwyn twice a week. You would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical standards pertaining to fees and insurance billing. A. Bill Chetwyn for services provided that the insurance company did not cover. B. Forego payment because you did not adequately explain the process of fee collection and insurance billing to Chetwyn. C. Advocate for full coverage of Chetwyn's mental health treatment with the insurance company. D. Explain to Chetwyn what happened and inform him that he is responsible for any fees not paid by his insurance company. Answer: act to prevent the actions, do not maint ================================================== Question: *125. Don LaMond is the guest speaker at a conference about domestic violence. He is a licensed social worker but also has a Ph.D. in economics. When the announcer introduces him to the audience, he refers to him as Doctor Don LaMond. Don should: Content Area: Ethics: Business Practices and Policies This question addresses the ethical and legal necessity to clarify one's qualifications in the mental health field. A. Clarify immediately to the audience that he is not a doctor of psychology, as required by ethical standards and legal standards. B. Correct the announcer privately after the presentation. C. Proceed with his presentation. This sort of thing happens all the time. There is no legal or ethical responsibility to do anything. D. Clarify immediately any misleading information as to his qualifications, professional status, or education, as required by law. Answer: no more than 4 years from date ================================================== Question: *126. Several of your clients are homosexual, and one client in particular is the leader of a group for a range of gender identity support groups. She refers several clients to you because she is impressed with your ability to stay "open minded about whoever people want to be." Ethically, what would you want to address first? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to maintain ethical standards with diverse populations. A. You would need to determine if your scope of competence was adequate. B. Avoid a dual relationship with your client by soliciting referrals. C. Since these clients might know each other, explain the limits of confidentiality. D. Explain that if they are in the group for gender identity issues, you cannot treat them for the same issue. Answer: when a SW or client acts in a way outside of their agreed upon duties/role ================================================== Question: 127. Your 52-year-old client returns from visiting his brother in Florida. He explains that his brother, who cares for their 84-year-old father, doesn't take him to his doctor or physical therapy appointments and she occasionally forgets to fill his prescription medication. What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of the parameters of elder abuse reporting and when to maintain confidentiality. A. Maintain confidentiality. B. Call Adult Protective Services (APS) in Florida and file a written report within two working days. C. Encourage your client to file an Elder Abuse Report. D. Call Adult Protective Services (APS) in California and file a written report within 36 hours. Answer: 1. at least 12 years old 2. clinical judgment that they are mature enough to participate in and benefit from the therapy AND 3. clinical judgment that without the therapy they would be at serious risk of harm to self or others OR 4. They are an alleged victim of abuse or incest ================================================== Question: *128. A man identifying himself as Lefty calls to set up an appointment for therapy. He tells you that he has a hard time with confrontation and that as a result, he often ends up having to do things he doesn't want to do, and that other people treat him "like a doormat." Lefty tells you that specifically, he wants your help in terminating with his current therapist and doesn't know how to do it. You would: Content Area: Ethics: Therapeutic Relationship/Services This item tests your knowledge of ethical standards related to a therapist's professional competence and integrity. A. Tell him that you can't treat him without the the agreement of the other therapist. B. Tell him that you can't treat him while he is seeing another therapist, and support Lefty in his efforts to terminate with the other therapist before beginning treatment. C. Agree to see Lefty, obtain a release to speak to the other therapist and consult about how to best help Lefty. D. Agree to see Lefty and help him to be assertive and to stand up for himself as he requested. Answer: When working with a family or couple as a unit, the unit is considered the 'client' rather than each individual. Therefore therapists may assert that they may need to share information learned in individual sessions with the other members of the unit. ================================================== Question: *129. What is the expected length of time to keep client records after the client has been terminated? Content Area: Ethics: Business Practices and Policies This question assesses your knowledge of the length of time you are required to keep a client's records after therapy has been terminated. A. Records must be retained for a minimum of 7 years after the date that the client begins treatment. B. At least 7 years after the termination of an adult client and 10 years after the termination of a minor client. C. At least 7 years after the termination of an adult client or until a minor client turns 21. D. Records must be retained for a minimum of 7 years after the date that the client terminates treatment. Answer: Maintain confidentiality and do not report ================================================== Question: 130. You schedule a couples' counseling session, but when a 29-year-old female comes to the initial session she apologizes for her husband and explains that he refuses to attend couples' counseling. She is concerned about his drinking and drug use and thought counseling might get him the help he needs. She states that her husband will never admit he has a substance abuse problem, and that she is fed up. She asks you to help her. Ethically, you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical obligations that pertain to clients' expectations of treatment. A. Inform her of your "no secrets" policy now, in case couples therapy does occur later. B. Since she apologized for him and wants couples counseling to help him, assess for co-dependency and whether individual therapy might be more effective. C. Clarify what she means by "helping her." D. Inform her that it would be a dual relationship if you began therapy with her individually and then saw both of them concurrently. Answer: must assess the ct's motivation for giving the gift. IF giving the gift supports the ct's therapeutic process and needs, it may be ok to accept ================================================== Question: *131. Your client returns from a vacation in France with an expensive bottle of champagne and gives it to you to thank you "for all the wonderful help you've given her." You: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical conduct in the area of client gift-giving. A. Accept the champagne in the spirit in which it was offered. B. Accept the champagne and explore the meaning behind the gift. C. Refuse the champagne and explore the meaning behind the gift. D. Accept the champagne but tell her you're going to give it to a colleague so as not to create a dual relationship with her. Answer: provide info directly pertaining to child abuse allegations, otherwise request must be in writing for anything else ================================================== Question: *132. A recently divorced 40-year-old client tells you that her ex-husband is leaving threatening remarks on her social network pages. She has tried to block him, but he finds ways to get on anyway. He lives out of state so she tells you that she doesn't really think he is a threat; "he's just trying to get under my skin, and it is working!" As a mental health professional, what would be your best legal course of action? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of a social worker's legal responsibilities concerning confidentiality when a client is threatened. A. Report to the police because of the serious threat of violence to an identifiable victim. B. Provide your client with the numbers of shelters or see if she is willing to stay with friends or family members if the threat is imminent and serious. C. Ask your client to invite her ex-husband to a session and teach harm reduction techniques. D. Discuss the situation with your client. Answer: youth under 14 with consensual partner 14 yo+ ================================================== Question: 133. Richard, 38, tells you that he is missing more and more work due to back pain. He tells you that he has been to several doctors who prescribe pain medication because he cannot afford to take time off of work. He tells you that he skips work or leaves early because sometimes the "meds make me so tired and fuzzy in my thinking,that I would be fired if I showed up like that." As a social worker who is not experienced with substance abuse, what is your next course of action? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of when to make competent referrals. A. Refer him to AA. B. Refer him to an MD. C. Encourage him to take time off of work to get physical therapy for his back. D. Obtain consultation to determine the extent of his problem. Answer: sexual activity with youth 14-15, consensual partner 10+ yrs older (24/25+) ================================================== Question: 134. A mediator contacts a social worker requesting that she contribute to an ongoing child-custody decision. If the social worker agrees to provide information, the social worker should: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge about how to provide informed consent regarding dual relationships. A. Tell the mediator the fee for conducting custody evaluations before doing so. B. Advise the clients about the risks of this dual relationship. C. Determine if custody evaluation is within her scope of practice. D. Limit information disclosed to the mediator that is related to custody. Answer: consenual intercourse with minor under 16 and adult 21+, 16+ no report ================================================== Question: 135. After seeing Mary in therapy for six months, she reports she can't afford your fee anymore, and wishes to trade services. She wants to provide all your marketing and printing needs to promote your practice. Since she is already your client you would: Content Area: Ethics: Business Practices and Policies Your knowledge of dual relationships and the ethics of bartering for therapeutic services is tested here. A. Agree to trade services because it would be unethical to terminate at this point in treatment. B. Not agree to trade services and refer her to a low-fee counseling center immediately. C. Not agree to trade services and attempt to slide her fee to a rate agreeable to both of you. D. Agree to trade services if a sliding scale fee could not be agreed upon, but reassess the arrangement in a few months. Answer: any forced or coerced sexual activity w/ youth under 18, perpetrator any age ================================================== Question: *136. Your client works for a local newspaper arranging advertising space. You place an ad in the same newspaper for an upcoming therapy group. The client turns out to be the person who does the ad layout. Ethically: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your ability to recognize your role in a dual relationship. A. You have every right to place an ad in this newspaper. B. This is an avoidable dual relationship and you should have advertised in a different newspaper. C. You are required to withdraw the ad. D. You should request that the client decline the job if it happens again. Answer: NO ================================================== Question: *137. A social worker working with an individual is becoming convinced that marital therapy would be better for a client. The social worker suggests that the client bring her husband for a session, but the client is afraid her husband will monopolize the session. Scope of competence obligations require the social worker to: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to proceed ethically when conjoint therapy may be in the best interests of the client. A. Refer the client to a couples therapist. B. Sign a "no secrets" policy at the first session if the husband does come for a session. C. Explore her reasons for recommending conjoint therapy. D. Address the wife's concerns about her husband's "monopolizing" the session. Answer: Use is impairing their ability to care for their child ================================================== Question: 138. After seven sessions, your client tells you that she just started seeing another therapist. She explains that she knows that therapists cannot be friends with their clients so she figured she would take the first step and find another therapist. She tells you she would like this to be your last session, and she will text you in a couple of months. You: Content Area: Ethics: Therapeutic Relationship/Services This question addresses the ethics of the therapist/client relationship, including client abandonment. A. Since the client initiated the termination, you should terminate. B. Explain that terminating therapy to pursue another relationship is unethical. C. Do not return her texts when it appears. D. Should seek consultation to avoid the appearance of client abandonment. Answer: Parent drug use will impair ability to care for the child ================================================== Question: *139. José, a 49-year-old single Mexican-American surgeon, is abusing prescription medication. He was referred to therapy by his lawyer and is thirty minutes late for his first session. José says he doesn't want you to take notes, "Because my patient is suing me and I don't want more evidence against me in court." José declines a referral to a 12-step group because he fears he might be recognized. He asks you to teach him to stop using drugs. Which of the following is NOT an ethical obligation that would affect your ongoing treatment of Jose? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to assess whether the client will benefit from therapy. A. Assess whether your treatment plan will require 12-step participation now or at some time in the future. B. Because 12-step programs do not duplicate individual therapy, tell the client that concurrent treatment is advisable. C. Explain the risks and benefits of 12-step programs. D. Take the client's lead in the treatment plan to minimize the effects of negative counter-transference. Answer: You can be subject to civil penalties ================================================== Question: 140. You receive a phone call from Pat, a former high school sweetheart and first sex partner. You and Pat have not spoken in 20 years, and now Pat asks if you will provide treatment for some life adjustment issues. Pat says you would be perfect because there is already trust between you from the old days. How would you proceed? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your ethical information regarding therapy with former sexual partners. A. Decline to see Pat because professional ethics forbid social workers from treating former sex partners. B. Make an appointment with Pat since there are no laws or ethics about treating someone with whom a social worker has previously had sex. C. Agree to treat Pat since it has been more than two years since there was a sexual relationship. D. Decline to see Pat because social workers cannot have sex with former clients. Answer: Release all records with the exception of psychotherapy notes (private notes kept separate from medical record) ================================================== Question: 141. After a crisis in her own life, a social worker cancels her appointments with clients for two weeks. What must she do next to meet ethical obligations related to informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question pertains to providing clients with information about your availability which is part of informed consent. A. Tell clients that she will reassess her ability before returning to work. B. Tell clients that she will not take calls during that time. C. Reconsider treatment plans when she returns. D. Obtain consultation to assess if she is ready to return. Answer: assert privilege b/c making that decision is outside a SW's scope of practice, only the court can decide that ================================================== Question: *142. A potential client says she wants to work on "inner conflicts." You would: Content Area: Ethics: Professional Competence and Preventing Harm. This is an informed consent and scope of competence question. A. Refer her to a psychologist or psychiatrist. B. Clarify your scope of competence before agreeing to treat her. C. Suggest that working on her relationship issues could work out her inner conflicts. D. Initially explore her inner conflicts to determine your treatment plan. Answer: -client has introduced his or her emotional condition in a legal proceeding -client has treated privileged information as though it were not confidential • breach of duty • The therapist sues the client for non-payment (content of therapy remains confidential). • The client sues the therapist for malpractice. • therapist appointed by court to examine client • If the client has sought psychotherapy to commit a crime and/or escape punishment for a crime. • client is under 16 and victim of a crime (e.g. extortion, statutory rape) • In a proceeding requested by a defendant to determine sanity. • client brings proceeding to establish competence. ================================================== Question: *143. Ronald is a 37-year-old moderately successful artist you have been treating for three years for depression and relationship issues. His income is sporadic, and you bill him monthly, but he had never let his balance get too high. Now he owes you $2,100. He offers to give you a painting whose value is roughly equal to the amount he owes you. How would you proceed? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical issues regarding client debt, dual relationships, and bartering and techniques to manage those issues. A. Decline the painting and tell him that based on his history with you, you trust that he will pay you in full when he gets the money. B. Accept the painting so that you can eliminate the debtor/creditor dual relationship. C. Accept the painting but process with Ronald the meaning of exchanging his art for your services and have him sign a statement of mutual agreement. D. Decline the painting and suspend treatment until Ronald pays you a significant amount towards reducing the balance due. Answer: 1. document attempts to connect with parents and involve them in the treatment unless clinical judgment that this would be inappropriate/detrimental to minor 2. remember that parents are NOT responsible for payment if minor receives tx w/o their permission ================================================== Question: *144. Burt, a withdrawn young adult, has been seeing you to help him with debilitating anxiety in social situations. You learn that Burt's previous therapist used highly questionable methods, including having Burt take her on "dates." He hints that this social worker encouraged him to have sex with her. What should you do? Content Area: Law: Legal Standards for Professional Practice. This addresses therapist/client sexual contact and unethical social worker behavior. A. Call the appropriate licensing board and see if any reports have been made on this other therapist in the past. B. Continue to see Burt and monitor closely anything he says regarding this social worker, so you can take appropriate action when necessary. C. Question Burt directly on whether he had sex with the previous social worker and give him the brochure if he says yes. D. Give Burt the brochure, "Professional Therapy Never Includes Sex" regarding sex and therapy and discuss it with him. Answer: 1. SW should maintain minor's confidentiality in tx and clearly outline policies about this in writing during initial consents 2. SW can deny parent access to minor's records if you think it will have a detrimental effect on your therapeutic rx with minor, their physical or psychological safety/wellbeing 3. Parents legally have right to see minor's tx info and assert privilege on their behalf if they are deemed a guardian ad litem ================================================== Question: 145. Bridget comes to therapy describing how sad and hopeless she feels. You give her a Beck's Depression Inventory that reveals that she has a moderately high level of depression. At the end of the session, she asks you for a prescription for Zoloft. What is your initial response to her request? Content Area: Ethics: Business Practices and Policies This question probes your understanding of techniques for addressing a client's expectations of therapy. A. Suggest to Bridget that she increase her level of physical exercise. B. Review the nature of your license as it is explained in your informed consent. C. Refer Bridget to a psychiatrist for a medication evaluation. D. Discuss with Bridget the pros and cons of taking an antidepressant medication. Answer: Person's mental/psychiatric condition prevents him/her from being able to provide for: -food -clothing -and/or shelter AND -there is no indication that anyone is willing or able to assist him/her in procuring these needs ================================================== Question: *146. Twelve years ago, the Drake family came to see you for family therapy. At that time Mr. and Mrs. Drake were having problems with their two children, ages 2 and 5. The Drakes are now divorcing and are in court to determine custody of their two children. You receive a subpoena from Mr. Drake's attorney for therapy records for these sessions. You call both Mr. and Mrs. Drake and they each ask you to release the records and send you waivers to that effect. You still would not release the records because: Content Area: Law: Confidentiality, Privilege, and Consent This question explores your knowledge of privilege and how to handle subpoenas in a custody case. A. The children must sign releases since they are old enough to participate in custody issues. B. You no longer have the records after 10 years. C. The court has not appointed guardians ad litem. D. The judge has not ordered the release of the records. Answer: Minor's mental/psychiatric condition prevents him/her from being able to provide for: -food -clothing -and/or shelter EVEN IF they are supplied for them directly (i.e. paranoia/depression) ================================================== Question: 147. Terran came to five couples' sessions with his wife complaining about how she belittles him and expects him to act more American. Terran had a difficult time listening and compromising because he believed his wife was disrespecting him, and they terminated treatment. You receive a subpoena for his records from an attorney representing his employer and learn that he is suing his employer for discrimination and emotional suffering. When you try to contact Terran about the subpoena, he does not return your calls. You would: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to proceed when you receive a subpoena. A. Assert privilege. B. Call his attorney and ask the attorney to ask Teran to call you back. C. Contact Terran's wife since she was in session and has a right to confidentiality too. D. Release the records since he has entered his emotional state into a legal proceeding and this represents an exception to privilege. Answer: •social workers can provide via phone, video, fax, email •only SWs licensed in CA can provide telecare to clients in CA •Medi-Cal only reimburses for video conferencing •Verbal consent is sufficient ================================================== Question: *148. A client that you treated 10 years ago terminated when her therapy goals had been reached, and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to maintain the standards of practice for documentation of client files. A. Have the client sign a new release authorization. B. Open a separate file if the client was in family therapy before. C. Sign a new informed consent form. D. Refer to another therapist if the client was a minor in therapy before. Answer: 1) information about the nature, extent, and duration of the participation requested 2) disclosure of the risks and benefits of participation in the research 3) must be written ================================================== Question: 149. You discover that you are dating a potential client's ex-husband. You would: Content Area: Ethics: Business Practices and Policies This question checks your knowledge of ethical, transference, and counter-transference issues. A. Not see the client. B. Discuss with the client how she feels about your relationship with her ex-husband. C. Begin to see the new client and seek consultation. D. Break off the relationship with the man and begin the therapeutic relationship with the client. Answer: C. Obtain written authorization from the entire family to contact their lawyers and waive/assert privilege as the family sees fit. You would be required to obtain written authorizations from the family in order to contact their lawyers who would determine whether to waive or assert privilege. ================================================== Question: 150. Answer: A. Call Adult Protective Services and report physical abuse. Social workers are mandated to report physical injury to an elder, inflicted by another person, that occurs by other than accidental means. ================================================== Question: Soliciting private info beyond what is essential for providing services: ethical or legal? Answer: B. Clarify for the family how your therapeutic work differs from religious counseling. This response addresses your client's expectations about therapy and promotes a better understanding of the process. ================================================== Question: Maintaining clinical records: ethical or legal? Answer: C. Do not accept the gift, explain to Melissa how the gift giving could negatively impact the therapeutic relationship, and process Melissa's reaction. Not accepting this expensive gift is the ethical course of action. Additionally, explaining your reasoning to Melissa and processing her reaction demonstrates good ethical management. ================================================== Question: Securing a license/registration by fraud: ethical or legal? Answer: C. Only to those qualified to interpret them. Psychological evaluation test scores should only be released to people who are able to interpret them appropriately. However, if a client insists on seeing his/her test scores, the therapist must release them but must also provide interpretation of the scores in a way that the client can understand. ================================================== Question: Incompetence in performance of clin SW: ethical or legal? Answer: A. Fetal abuse. Fetal abuse is optional under the mandated reporting laws. ================================================== Question: Act or omission that falls sufficiently below standard of conduct as to constitute gross negligence: ethical or legal? Answer: B. Determine who has been assigned by the court as the guardian ad litem for the minor and inform him/her of the subpoena. It would be important to determine who is your client's guardian ad litem and inform him/her of the subpoena so a decision about privilege can be made in the best interest of the child. ================================================== Question: Sexual relationships: ethical or legal? Answer: B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case. It would be important to have peer supervision or a paid supervisor in cases like this where counter-transference issues are bound to arise. An eventual referral for one or both clients might be necessary also. ================================================== Question: Performing, acting as if able to perform, offering to perform any professional services beyond scope of license: ethical or legal? Answer: B. Acknowledge the effects of racism and listen to his perspective. Acknowledging that racism exists is a supportive and immediately genuine response. Allowing this client to share his experiences will build trust and rapport. ================================================== Question: Failure to maintain confidentiality: ethical or legal? Answer: D. Document your crisis interventions in the first session. The laws about record-keeping require you to document any and all interventions. ================================================== Question: Fee disclosure: ethical or legal? Answer: A. Respect her wishes to terminate and explain that you will not respond to emails or social network posts that invite your friendship. You may terminate a client if they want to end therapy, but if they want to terminate in order to pursue a friendship, you would need to process how this will occur before the therapy ends. ================================================== Question: Paying, accepting payment/ remuneration for referrals: ethical or legal? Answer: C. Maintain confidentiality. Based on the information given in this question you would maintain confidentiality. Juan's threat is dependant upon the death of another person which eliminates the "imminence" that breaking confidentiality under Tarasoff requires. ================================================== Question: Keeping records (LEGAL) Answer: B. Thank you for your acknowledgement of our work together. Let's discuss the implications. Having a discussion about therapeutic boundaries and dual relationships minimizes the chances for misunderstandings and clarifies your role at this ceremony. ================================================== Question: Termination of services -arranging transfer (ETHICAL) Answer: C. Megan is a danger to herself or others without treatment. As of January 1, 2011 (SB543; Leno), mental health professionals, including LCSW's and ASW's, may treat a minor 12 or older without parental consent if the minor is mature enough to participate intelligently in therapy, and there is no longer a requirement for the child to be a victim of child abuse or a danger to self or others. ================================================== Question: Fees (LEGAL) Answer: D. Invite them to explain how their different cultural backgrounds impact their relationship. Having clients educate you about the impact of human diversity issues on their own experience conveys respect, builds rapport, and helps them to clarify and gain insight into the impact it has on their lives. ================================================== Question: Misrepresenting education/license/registration/ qualifications Answer: D. Tell her about the husband's phone call and any fee changes that might result from a change in her insurance coverage. Any changes to fee policies must be discussed before they occur, as directed by legal and ethical standards. ================================================== Question: Termination based on failure to pay (ETHICAL) Answer: B. Decline to make an appointment and refer her to another therapist. The woman who wants to become your client has a prior relationship with you as your child's piano teacher. This is an easily avoidable dual relationship since there are many other therapists that could help this woman. ================================================== Question: Payment for Services: Fees (ETHICAL) Answer: D. Clarify Darren and Samantha's expectations about therapy. Clarifying a client's expectations would begin to answer a client's inquiries about the therapeutic process. ================================================== Question: Payment for Services: Accepting barter (ETHICAL) Answer: A. Call Adult Protective Services immediately to file a neglect report. Reasonable suspicion of neglect exists and it would be up to Adult Protective Services to investigate further. ================================================== Question: Payment for Services: private practice by agency employee (ETHICAL) Answer: A. Help Hermoine with her crisis until her therapist returns. Helping Hermoine with her crisis would be the only ethical way to proceed in this instance since her new therapist cannot be reached, and she has called you for help. Even though you had terminated and were no longer her therapist, when someone calls a social worker in crisis, the law presumes at that point the existence of a special relationship in which the therapist must act in the best interests and welfare of that person. ================================================== Question: Access to Records (ETHICAL) Answer: C. Stop the discussion and do not talk about these clients again. The rules of confidentiality would require the social workers to stop the discussion and not talk about these clients. ================================================== Question: Alleged sexual misconduct of ct's former therapist (LEGAL) Answer: B. The BBS found that the therapist terminated therapy in order to pursue a sexual relationship. Terminating therapy in order to pursue a sexual relationship with a client is prohibited. ================================================== Question: Sexual conduct (LEGAL) Answer: C. Maintain confidentiality because you do not know the age of the mother. You would maintain confidentiality because you do not know his mother's age and you do not have "reasonable suspicion" of elder abuse. ================================================== Question: When providing services to couples/ family members (ETHICAL) Answer: C. Inform Ki that the risks and benefits of therapy may be that he "finds himself" but may change some of his family values. Informing a client about the risks and benefits of therapy which includes altering their sense of self and their family, is an ethical obligation. ================================================== Question: Child abuse reporting (LEGAL) Answer: B. Give her the brochure "Professional Therapy Never Includes Sex" and discuss her options. Therapist sex with a client is prohibited. When a client reveals that s/he has had sex with a former therapist, the treating mental health professional is required to give her/him the brochure "Professional Therapy Never Includes Sex," as well as discuss it with them. ================================================== Question: Seeking consult when needed: ethical or legal? Answer: A. Without providing adequate notice. Ethical standard standards require that clients be given notice of fee increases before they occur. ================================================== Question: Informed consent to tx: ethical or legal? Answer: C. Recommend individual therapy if there are any regressive symptoms in any individual. If the family wants to terminate but one person might still be in need of individual treatment, it would be ethical to recommend this. ================================================== Question: Client self determination: ethical or legal? Answer: B. The court may appoint an attorney to represent the best interests of the child. The courts can assign a guardian ad litem, if needed, to represent the best interests of the child. ================================================== Question: COnflict of interest: ethical or legal? Answer: C. By telephone as soon as possible and in writing within two working days. Mandated reporters must report dependent adult abuse "immediately or as soon as possible by telephone, and shall prepare and send a written report within two working days." ================================================== Question: Duty to Warn: ethical or legal? Answer: D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually. You would need to determine the unit of treatment before doing any of the other actions. ================================================== Question: Scope of Practice: ethical or legal? Answer: C. Inform the supervisor that it is unethical to split fees. It is not ethical for LCSW's to split fees. NASW's ethical standards state that Licensed Clinical Social Workers do not offer or accept payment for referrals. ================================================== Question: Scope of Competence: ethical or legal? Answer: B. Evaluate what would be in the client's best interests and how accepting or rejecting the gift might affect treatment. Depending on the clinical issues, cost of the gift, length of time you've been seeing the client etc. this answer would allow you to act according to the client's needs. ================================================== Question: Standard of care: ethical or legal? Answer: B. Hypnotherapy. Hypnotherapy needs specific additional training beyond the education required to obtain a mental health professional license. ================================================== Question: Privileged Communication: ethical or legal? Answer: B. Indicate that you assessed her risk as "low" and suggested that she call her therapist Although the client has terminated, you still have an ethical obligation that pertains to crisis management. If her crisis were acute, you would have to do more than simply refer her back to her therapist. ================================================== Question: Misrepresentation: ethical or legal? Answer: A. Contact your client to determine if she wants you to waive or assert privilege. Clients hold their own privilege and a social worker must consult with the client to determine whether privilege is to be waived or asserted. ================================================== Question: Fee disclosure: ethical or legal? Answer: C. Call the police immediately and his ex-girlfriend's family. In the vignette described there is imminent peril and there is a reasonably identified victim(s). The Duty to Protect includes the mandate to notify the police first and a warning to the identified victim is permitted. ================================================== Question: Elder/ Dep Adult Abuse Reports: ethical or legal? Answer: B. No, if the social worker does not reveal identifying information about the client to the other professional. According to the National Association of Social Worker's (NASW) Code of Ethics, section (1.07) (q) Privacy and Confidentiality, "Social workers should not disclose identifying information when discussing clients with consultants unless the client has consented to disclosure of confidential information or there is a compelling need for such disclosure." This section implies that the client's direct consent to consult with another professional is required only if identifying information about the client is revealed. Thus, if general aspects of the case are discussed with another professional, permission from the client is not needed. ================================================== Question: Informed consent (ETHICAL) Answer: B. Tell minor clients how you will contact parents if you think there is an emergency. Discussing the limits of confidentiality is an element of informed consent. ================================================== Question: Involuntary clients (ETHICAL) Answer: A. Accept the cookies and explore their meaning with Maria and Juan. Accepting the cookies and exploring their meaning with Maria and Juan would be the best choice available. The cookies are a small gift which may have a cultural component. It is important, once the decision to accept the gift is made, that the personal meanings behind it are explored. ================================================== Question: Providing services via electronic media ETHICAL Answer: D. The client has the right to withdraw from the study at any time. The client has the right to withdraw from the study at any time, and we as therapists, are to respect the client's wishes. ================================================== Question: Dual / Multiple relationships ETHICAL Answer: B. The client signed a waiver of privilege for the records. No records would be disclosed until the client or the client's representative waived privilege. ================================================== Question: Right to privacy (ETHICAL) Answer: C. It is a legal principle that protects client conversations unless there is a court order. Privilege is the legal right of the client not to have confidential information revealed during a legal proceeding. Only a client, judge or court order would challenge privilege. ================================================== Question: Sexual misconduct/ abuse Answer: D. Determine if you can deal with this client at this time. "A", "B", and "C" are all possibilities once you "Determine if you can deal with this client at this time." ================================================== Question: Explaining limits of confidentiality (ETHICAL) Answer: D. Assessing whether a medication evaluation would be necessary. From an ethical point (safety-minded) of view, a therapist would first need to consider all treatment modalities to help a client. In this case, that would include considering whether his anxiety is so severe that medication would help him benefit from therapeutic interventions. ================================================== Question: Confidentiality w/ couples, families, groups (ETHICAL) Answer: C. Being arrested for shoplifting. The law (Business and Professions Code 4982(a) says unprofessional conduct addresses licensees or registrants who have been "convicted" of an offense, not just arrested. ================================================== Question: Right to confidentiality (ETHICAL) Answer: A. Ask if the client would like to be referred to as "he" or "she". From a diversity perspective, the social worker should directly and respectfully ask the client if s/he would like to be referred to as "he" or "she." ================================================== Question: Disclosure of confidential info (ETHICAL) Answer: A. To contact an agency designated to take a report and follow up with a written report within 36 hours. Your responsibility is to contact a designated agency and follow up with a written report within 36 hours. ================================================== Question: Self-determination (ETHICAL) Answer: C. The social worker should not make this type of referral yet as the client is still in a vulnerable condition. EMDR can be especially effective when a person is suffering from a recent trauma. In addition, you have already determined the client's need for this referral. ================================================== Question: Consulting with colleagues (ETHICAL) Answer: A. Assert privilege until a guardian ad litem has been appointed for the client. When subpoenas are received for testimony or records involving clients who are minors therapists should assert privilege until the parent(s) or guardians of the child obtain "guardian ad litem" status. ================================================== Question: Referrals (ETHICAL) Answer: B. Outline the process of treatment. Engaging in the process of informed consent, for example, explaining the therapeutic process at the beginning of therapy is an ethical obligation. ================================================== Question: Sex with colleagues (ETHICAL) Answer: A. Disclose any fees which are different from in-person sessions. Fee disclosures are legally required before changes to treatment occur. ================================================== Question: Unethical actions by colleagues (ETHICAL) Answer: C. Counsel both of them. As social workers, it is important for us not to impose our values and beliefs on our clients. ================================================== Question: Incompetent or Impaired colleague (ETHICAL) Answer: C. Informing the couple of your "no secrets" policy Informing the couple of your "no secrets" policy is solely an ethical responsibility. ================================================== Question: Billing (ETHICAL) Answer: A. Report immediately to Adult Protective Services and make a written report within 2 working days. There is a mandated responsibility here since you have knowledge or reasonable suspicion of elder abuse. You would report immediately by phone and follow up with a written report within 2 working days. ================================================== Question: Responsibilities towards employer (ETHICAL) Answer: A. Provided ethical informed consent. The social worker's explanation to the client about the clinical effectiveness of texts and emails is a form of informed consent. ================================================== Question: Client transfer (ETHICAL) Answer: A. Assist them with information you deem pertinent to the situation at hand. In the event of a medical emergency it is permissible to give information to medical professionals that may be treating the client. Social workers are permitted to speak with other health professionals for purposes of treatment and diagnosis in recognition of situations such as these. ================================================== Question: Discrimination (ETHICAL) Answer: A. Complete class as usual without acknowledging the client unless he/she acknowledges you and explore his/her reactions in your next session. Maintaining confidentiality means not acknowledging clients without their permission when you see them outside of therapy. It would be important to discuss the client's feelings about seeing you outside the therapeutic setting. ================================================== Question: Solicitations (ETHICAL) Answer: B. Accommodate your fee since you've established a bond. Because you've established a bond, accommodating your fee would be in the best interests of the client. If an accommodated fee cannot be agreed upon, then providing three low-cost therapy referrals would be appropriate. ================================================== Question: Impairment (ETHICAL) Answer: C. Engage Bobby in a therapeutic conversation. The ethical standard is to speak with the colleague to try to rectify the issue first. ================================================== Question: Private conduct (ETHICAL) Answer: B. A peace officer, staff member of an evaluation facility, or other professional person designated by the county. A peace officer, a staff member of an evaluation facility or other professionals designated by the county, may invoke a 5150. ================================================== Question: Integrity of profession (ETHICAL) Answer: D. Review dual relationships with your client and healthy boundaries. Of the answers provided, reviewing dual relationships with your client and healthy boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be uncomfortable for your client, or create any therapeutic problems. It is the most reasonable of the options provided. ================================================== Question: Minor consent: ethical or legal? Answer: A. Journaling, peer consultation and individual therapy. Journaling, peer consultation and individual therapy are the appropriate steps in which you would ethically deal with counter-transference. ================================================== Question: "No secrecy" rule: ethical or legal? Answer: C. You have sufficient reason to treat Brianna without parental consent. This scenario indicates that Brianna meets all the legal requirements for being treated without parental consent: she is mature enough to participate intelligently in therapy, she meets the minimum age requirement of 12-years-old, treatment will occur in an outpatient setting and she is responsible for the fee. The only criterion that remains is to determine if there is a clinical reason to exclude her parents. ================================================== Question: Professional boundaries: ethical or legal? Answer: B. Make three referrals out of town. Ethically, you need to provide Liz with the containment she needs to work through her early childhood issues. This can best be accomplished by referring her to social workers in her new area rather than concretizing her transference to you, i.e., "you're the only person who can understand and help me." ================================================== Question: Explain your privacy practices (incl. privileged communication) Answer: A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee. It is legal and ethical to bill insurers for missed sessions as long as this is clearly indicated in the billing codes. ================================================== Question: Protecting privileged communcation Answer: C. Legally fulfilled your responsibility to provide accurate information about your qualifications. You are legally required to provide accurate information about the range of services you can provide, given your license. ================================================== Question: Access to records (legal) Answer: B. Seek consultation. Of the choices given, seeking consultation is the first step you would take if you are having angry feelings towards this client. It would be important to understand your reaction and to carefully assess how you would proceed. ================================================== Question: Access to records (ethical) Answer: C. Direct questions about his revenge plans. The social worker would need to determine if the client has a specific and imminent plan to warrant breaking confidentiality. ================================================== Question: Keeping records (legal) Answer: B. The social worker and client both agree that it seems as if no further progress can be made. This is the best answer since it takes into account both social worker and client and the very important concern of client progress. ================================================== Question: Access to couple therapy records by 3rd party (legal) Answer: C. Document your decision to meet individually with José. An important legal obligation, since you are changing the unit of treatment from a dyad to individual treatment of a minor, is to obtain consent to treat a minor and document it. ================================================== Question: Access to couple therapy records by 3rd party (ethical) Answer: B. Notes on any peer consultations regarding counter-transference issues around the case. Notes dealing with the social worker's personal issues should not be placed into a client's chart. ================================================== Question: Keeping records of couple (legal) Answer: C. It is unethical. LCSW's do not use their professional relationships with patients to further their own interests. ================================================== Question: Derogatory language (ethics) Answer: C. The fee and the true name and license of the designated owner of the practice. The fee and the name of the owner of the practice, if using a fictitious business name, are legally required disclosures at the onset of therapy. ================================================== Question: Involuntary hold (ethical or legal?) Answer: D. Decline his request to tell her for him. Declining his request is the only ethical answer. You might also say that you will support him while he tells her, if he wishes. ================================================== Question: standard of care (meaning) Answer: B. You are legally mandated to contact Adult Protective Services for dependent adult abuse. This disabled client says she's on SSI (Supplemental Security Income) which indicates she has a severe disability preventing her from gaining income through employment. Chances are she would be considered a dependent adult and it is important to report financial abuse of dependent adults to APS. ================================================== Question: Seeking consultation when needed (ethical or legal) Answer: A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable. Information about availability between sessions or in emergencies is an element of safety planning which is both a legal and ethical requirement. ================================================== Question: In making decisions about ethics, always put the clients' ___________ first Answer: A. She must submit to you a request in writing. Clients must submit in writing any request to see their records. ================================================== Question: Evidence Code 1024: client threatens danger to self, others, or property. What should a SW do? Answer: B. You may practice EMDR if you are properly trained. A therapist may utilize EMDR as long as s/he has the appropriate education, training and experience. ================================================== Question: Civil court statue of limitation for how long a SW can be sued for liability for a client's suicide Answer: A. At the commencement of treatment. At the beginning of the first session is the best answer. You would want to have an ongoing review of policies, as needed, throughout the course of treatment. ================================================== Question: 'Breach of Duty' is Answer: C. Informed consent. This type of statement that refers to boundaries and social worker availability represents informed consent. ================================================== Question: Requirements to treat a minor without parental consent Answer: D. Explore with the client what he means by "psychoanalysis." Educate him on your theoretical approach and inform him of your limitations regarding psychoanalysis. Let him decide if he would like to continue therapy with you or receive referrals. It would be important to explore with the client what he means by "psychoanalysis," as he may be referring to psychotherapy in a more general way. As part of informed consent, it is also important to explain to him about your theoretical approach so that he is informed about the service you do offer. This puts him in a position to make an educated decision about continuing therapy with you or receiving referrals for other mental health professionals. ================================================== Question: 'No Secrets' policy Answer: D. Speak to her supervisor about making adjustments in her workload. NASW ethical standards say that social workers whose personal problems interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action, including making adjustments in workload. ================================================== Question: Legal requirement if HIV+client reports intentions to infect other via sex Answer: A. Decline to supervise the intern. Declining to supervise the intern is the best ethical choice given here (it is possible that with the proper ongoing consultation and responsible care, this particular dual relationship could be ethically acceptable). Although some dual relationships are considered unavoidable, particularly when there are limited choices, the ethics are less ambiguous in stating that supervisors do not take on current or former therapy clients. ================================================== Question: Rules for deciding wherther to accept a gift from a client Answer: A. Provide Joyce with safety information. As Joyce appears to be the victim of abuse by John's son, it is important that you provide her with safety information. ================================================== Question: CPS worker requests information about a client following a child abuse report, what do you do? Answer: B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy. If he is in family therapy now, but changed to individual therapy, you would need legal consent-to-treat with a minor. ================================================== Question: When mandated report is required for consensual sexual touching/intercourse Answer: D. Ask each family member to explain to you from their point of view the meaning this religious ceremony has to them and their family. The most inclusive and culturally considerate answer would be to have each family member represent their own views on religion and expand their perspectives by discussing the impact of religion on the family as a whole. ================================================== Question: Mandated report required for Lewd/lascivious acts with ages: Answer: A. Mental suffering. Optional Category. Mental suffering (fear, agitation, confusion, severe depression, serious emotional stress brought on by threats, harassment, or intimidating behavior) are not mandated. ================================================== Question: Mandated report required for sexual abuse when: Answer: D. Acted unethically and illegally. Although the gift is not substantial in value, social workers are prohibited by law and ethical standards from accepting or providing any kind of remuneration for referrals. ================================================== Question: Mandated report required for sexual assault when: Answer: B. You would need to assess for child abuse. Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse. ================================================== Question: Is there a mandated reporting requirement for emotional abuse? Answer: A. Tell the client it would be a dual relationship to act as a social worker and sponsor. Social workers are obligated to tell clients that if a dual relationship is avoidable, that it must be avoided. ================================================== Question: Mandated report required for parent alcohol/marijuana use only required when: Answer: C. Assess for further boundary violations. Assessing for further boundary violations would be important in order to determine the extent of boundary violations and if there had been any sexual contact between the therapist and your client. ================================================== Question: Mandated report required for newborn testing positive or illicit drugs only when: Answer: A. Call Child Protective Services. It is possible that the consensual sexual activity between the older sister and her boyfriend may be reportable but the exposure of Patricia to it definitely triggers a mandated report. ================================================== Question: What can happen if you don't comply with a subpoena? Answer: A. Review the fee policies outlined in your informed consent document. Going over relevant fee policies such as the basis on which it is computed, sliding scale polices or fees for late cancellations constitutes sound ethical management. ================================================== Question: When client gives consent to release their records to court, social workers are legally obligated to: Answer: C. The social worker will speak only with the person on the release. This answer provides the client with information to the client so that she can consent or refuse to consent to this part of the treatment. ================================================== Question: If a SW receives a subpoena that they believe is an 'exception to privilege' circumstance, they should FIRST: Answer: D. This would be considered outside of your scope of competence. EMDR in this vignette is outside of your scope of competence. Being in your scope of competence entails that you perform professional services warranted by your "education, training, and experience." ================================================== Question: primary circumstance where privilege of a client's information can be waived in court: Answer: C. Not disclose to John's mother that John is your client. Given the choices available, not disclosing to the mother John is your client is the legal course of action because we don't know if the woman on the telephone is actually John's mother. In order to speak to her, a release would be required.; therefore, the social worker's initial obligation is to maintain John's confidentiality. ================================================== Question: What is a therapist required to do regarding parents when treating a minor without consent? (2 things) Answer: D. Rowene violated ethical standards, but not the law. Both the law and ethical standards clearly state that sexual relationships between social worker and client are prohibited during therapy and in the two year period following termination. The sexual relationship started more than two years following termination, so the relationship is not illegal. However it violates NASW Ethical code 1.09 (c) which states that social workers do not have sexual relationships with former clients. ================================================== Question: Important rules of confidentiality when treating minors: (3 things) Answer: B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son. You must report both known and suspected child abuse to a child protective agency. Since your client tells you that the elementary school swim instructor is molesting her 9-year-old son, you are mandated to report this abuse. ================================================== Question: "Gravely disabled" criteria for 5150 forcible hospitalization of an adult: Answer: A. Under no circumstances, since a client is always a client and this could constitute a dual relationship. Non-sexual, post-therapy relationships may be ethical depending upon the reasonableness of the post-therapeutic relationship and the reasonableness of the time since therapy. However, the highest ethical standard is to avoid relationships with former clients because they may want to return to therapy. ================================================== Question: "Gravely disabled" criteria for 5150 forcible hospitalization of a minor: Answer: B. Provide her with a copy of "Professional Therapy Never Includes Sex" and answer her questions about it. Your legal responsibility is to provide the pamphlet "Professional Therapy Never Includes Sex" and discuss it with the client if he or she informs you of sexual misconduct between him/herself and a therapist. ================================================== Question: Rules for providing telemedicine Answer: D. Set the fee before the first session. Setting the fee before the first session is both a legal and ethical responsibility. It is one of many things to do when setting boundaries. ================================================== Question: SW research informed consent must include what? Answer: A. That you will need them to sign an agreement to change the treatment plan. Ethics do not require a signature on a treatment plan. ================================================== Question: 1. You are treating a family consisting of Sharon, 33, Mike, 36, Carol, 15, and Billy, 12. You receive a subpoena from a lawyer, regarding a lawsuit over an inheritance, for which another family member is suing your clients. The subpoena requests all records for the purpose of showing that this family is not mentally competent to receive the inheritance. How would you manage this situation? Content Area: Law: Confidentiality, Privilege, and Consent This question looks at your legal responsibility when receiving a subpoena for an entire family, not just an individual client. A. Get a release from the parents since the parents hold the children's privilege. B. Contact the lawyer to assert privilege on behalf of the family. C. Obtain written authorization from the entire family to contact their lawyers and waive/assert privilege as the family sees fit. D. Comply with the subpoena since their mental condition has been entered into a legal proceeding and send a copy of the records. Answer: C. The 14-year-old client. The client is always the holder of his or her own privilege, unless the court assigns a guardian ad litem or conservator. ================================================== Question: 2. Sidney comes to his session with his 80-year-old mother, who uses a walker following a bad fall, that she reports was caused by a fight with her husband. The mother tells you that the fight was her fault, and she knew that if she kept goading her husband, he would explode. A social worker in this situation must: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of laws regarding elder abuse. A. Call Adult Protective Services and report physical abuse. B. Call law enforcement within 24 hours and follow-up with a written report to local law enforcement, licensing agency, and ombudsman. C. Explore possibilities for alternative living arrangements and address the feelings both she and Sidney are experiencing. D. Report domestic violence since the victim was an elder. Answer: B. Report the incidents to a children's protective agency. This vignette describes sibling abuse that has been occurring for a while. The parents are not in control of the situation, and you are mandated to report. ================================================== Question: *3. A 17-year-old girl, Janet, is referred to you by her school counselor. Janet's nose, eyebrow, and tongue are pierced, and her hair is dyed green and yellow. Janet says that recently her twin brother Michael comes into her room at night and tries to "play sleep-over" with her. Janet tells you that a cute boy she met at a rave last week wants her to move in with him. She asks you not to tell her parents that she's seeing you because they're "extremely religious." How would you manage your ethical responsibilities if you were working with the entire family? Content Area: Ethics: Therapeutic Relationship/Services This question test your knowledge of the ethical issues that arise when treating a family unit. A. Clarify for Janet that, as a victim of abuse, she can consent to her own treatment without her parents' permission. B. Clarify for the family how your therapeutic work differs from religious counseling. C. Review your fee policy, especially as this case involves various family members and religious issues. D. Explain the limits of confidentiality to Janet with regard to sexual abuse. Answer: A. Would explain that you need a release from the parents to communicate to the court. Even though the court referred this family, the family is your client, and you cannot break confidentiality without a written release. ================================================== Question: 4. Your client Melissa comes in at Christmas time, gives you an expensive watch, and expresses how thankful she is for the help you have given her. How would you best ethically proceed? Content Area: Ethics: Business Practices and Policies This question assesses your knowledge of the ethical management of gift-giving by clients. A. Review your informed consent document with Melissa specifically discussing boundaries. B. Accept the watch since Melissa very rarely gives you gifts, and you suspect there may be an element of cultural diversity to heed. C. Do not accept the gift, explain to Melissa how the gift giving could negatively impact the therapeutic relationship, and process Melissa's reaction. D. Do not accept the gift since ethical standards prohibit accepting gifts from clients. Answer: A. Educate yourself on the psychosocial impact of being in a wheelchair. A better understanding of the issues Dale and Natasha face as a result of Dale's disability would certainly be an important aspect of their treatment and would meet your ETHICAL obligations. ================================================== Question: 5. Psychological evaluation test scores should be released to: Content Area: Ethics: Business Practices and Policies This question deals with the ethics involved in the release of test scores. A. Clients always. B. Only the parents of children. C. Only to those qualified to interpret them. D. Only to other therapists who have the proper training to interpret them. Answer: A. Only accept referrals within his scope of competence. Robert should only accept referrals within his scope of competence as determined by education, training and experience. While developing new areas of practice, mental health workers take steps to ensure competence through appropriate education, training, consultation, supervision, etc. ================================================== Question: 6. Which of the following constitutes an optional reporting (rather than a mandated) situation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question asks you to identify the situation in which reporting would be an option rather than a requirement. A. Fetal abuse. B. Neglect. C. Undue influence of an elder. D. Willful cruelty. Answer: C. Refer John back to the prescribing psychiatrist. Referring John back to the psychiatrist would be the most appropriate action, as the psychiatrist could explain the benefits of taking the medication and the repercussions of abruptly terminating it. ================================================== Question: 7. A 6-year-old girl who,se parents are involved in a longstanding custody trial, is in treatment with you. She is in therapy with the consent of both parents. You receive a subpoena from the father's attorney for your session notes to bolster the father's claim that he should have sole custody. What is your legal responsibility? Content Area: Law: Confidentiality, Privilege, and Consent This question addresses your knowledge of what to do when you receive a subpoena. A. Inform your client's mother of the subpoena to determine whether to assert or waive privilege. B. Determine who has been assigned by the court as the guardian ad litem for the minor and inform him/her of the subpoena. C. Do not respond to the subpoena in order to protect the confidentiality and privilege of your client. D. Ask the client whether she wants to assert or waive privilege. Answer: D. Ask her what her goals have been with the other therapist and request a release to speak with that therapist. Asking her what her goals have been with the other therapist and requesting a release to speak with that therapist is the best course of action at this time. It is only unethical to have two therapists, if the therapists are working on the same material. It must be clarified what this client is working on in therapy with this other therapist before proceeding. ================================================== Question: 8. Cherilyn, your client of six months, tells you that she's recently begun having an affair with Tony. As she discusses their affair, you realize that Tony is another one of your clients whom you've been seeing for the past year with his wife and two teenage children. In order not to contaminate the therapeutic relationship with Cherilyn or Tony, what would you do? Content Area: Ethics: Professional Competence and Preventing Harm. This question checks your ability to make distinctions between difficult ethical choices and tests your understanding of dual relationships. A. Gently terminate with Cherilyn without telling her why. This preserves confidentiality, and since you've been seeing Tony and his family longer, you owe them more professional allegiance. B. Say nothing and continue seeing both clients while you monitor your counter-transference and ask colleagues for assistance with the case. C. Call an attorney and discuss legal issues around dual relationships so you can determine the best action to take. D. Continue seeing Cherilyn as usual. Ask Tony in for a private conference so you can ask about his commitment to his marriage and family, being careful not to break any confidences. Answer: D. Call your client. You must call Cynthia to proceed. You cannot confirm or deny that Cynthia is your client until she signs a statement allowing you to assert or waive privilege on her behalf. ================================================== Question: 9. A 25-year-old African-American male client tells you that he can't find a job, and he blames it on racism. He believes that he is qualified for the jobs he applies to but does not have a college diploma. He tells you that he was told that a high school education would open doors. How would you respond to this? Content Area: Ethics: Therapeutic Relationship/Services This tests your knowledge of human diversity issues. A. Encourage him to consider actual shortcomings he may have. B. Acknowledge the effects of racism and listen to his perspective. C. Challenge his irrational thinking and refer him to a vocational counselor. D. Validate his perspective until he is ready to take responsibility for his failures. Answer: C. Suggest Janet take anti-depressants. As an LCSW, you would refer the client to a psychiatrist but you would not suggest a client take medication. ================================================== Question: 10. Your client comes to a first session in a crisis. You do not have time for a full informed consent conversation, but you tell the client the fee and your license number. What is your legal obligation now? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of informed consent and record-keeping. A. Document your informed consent conversation within 5 days. B. Document your informed consent conversation within 10 days. C. Document your treatment plan now that the crisis has passed. D. Document your crisis interventions in the first session. Answer: A. Scope of competence. Anything that interferes with a clinician's ability to perform to the standard of care would be a scope of competence issue. ================================================== Question: 11. A client announces a desire to terminate therapy at the beginning of your fifth session. The client would like to become friends and tells you that the two of you could have the same kind of conversations but they could go on longer. She tells you that she is already interviewing other therapists which is "better for me because they take insurance." You would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical standards as they pertain to dual relationships and termination. A. Respect her wishes to terminate and explain that you will not respond to emails or social network posts that invite your friendship. B. Attempt to process her desire to terminate as clinical material. C. Seek consultation in case your counter-transference conveyed to your client that you wanted to be friends. D. Tell her you cannot terminate therapy under these circumstances. Answer: D. Waive your "no secrets" policy and call the wife to assess whether she is currently in danger. Ethically, the clinician would be best advised to assess as soon as possible whether the wife is in imminent danger and to plan accordingly. Perhaps the wife needs an immediate referral to a domestic violence shelter and assistance in making a safety plan. Waiting until the next appointment may place the wife in danger. ================================================== Question: 12. Your client Juan tells you that his brother, Jose, was stabbed to death a year ago by his cousin in a drug deal gone bad. Juan further states that he told his cousin that he intends to murder him for stabbing Jose, but he is going to wait until his aunt dies because she would be too upset by the death of her only son. He tells you that the cousin lives in another state, but he will find him when the time comes. In this situation, what is your legal responsibility? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a possible Tarasoff situation. A. Under the Ewing v. Goldstein decision you must contact the aunt and warn her about the threat to kill her son. B. Under the Tarasoff decision you must call the police and warn the victim. C. Maintain confidentiality. D. This is privileged information and may not be disclosed without a subpoena. Answer: D. Review dual relationships with your client, and healthy client-social worker boundaries. Of the answers provided, reviewing dual relationships with your client, and healthy client-social worker boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be too uncomfortable for your client, or create any therapeutic problems. Of the options provided, it is the most reasonable. ================================================== Question: 13.You have been seeing Amber and John as a couple when they announce their upcoming wedding plans and invite you to attend. They warmly thank you for your help and say they want you to be included in their special day. Your best response would be: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to manage dual relationships. A. Thank you, but social workers are not allowed to have interaction with clients outside of therapy. B. Thank you for your acknowledgement of our work together. Let's discuss the implications. C. My policy is that I will attend the wedding, but not the reception. D. I will attend, but because of confidentiality, I must be introduced as a friend or teacher rather than your social worker. Answer: A. Maintain computer security, i.e. firewalls, passwords, etc. The client is worried about a security breach. Even though you are not responsible, you are ethically obligated to make sure that your practice adheres to privacy measures in the age of digital information transfer. ================================================== Question: 14. While checking messages at the end of the day, you listen to a voicemail from a girl named Megan. She states that she got your number from her friend Claire whom you "helped a lot a couple of years ago." Megan says she's having a hard time getting used to high school and feels like she "doesn't fit in anywhere." Megan asks if she can see you tomorrow and says she doesn't want her parents to know. Before treating Megan without parental consent, you need to determine that all of the following factors are present EXCEPT: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to proceed with consent to treat a minor. A. Megan is at least 12 years old. B. Megan is mature enough to participate in therapy. C. Megan is a danger to herself or others without treatment. D. There is a good reason not to include Megan's parents. Answer: D. A 17-year-old client. A person who is under age 18 cannot initiate a 5150. ================================================== Question: 15. Felix, a 30-year-old Caucasian, has been placed on administrative leave for excessive absences and is referred to you by his EAP. His partner Pablo, a 32-year-old Peruvian-American, joins him in the session. Lately they have been "fighting all the time," and at work nobody knows that they are a couple because Felix fears they'll be fired. Felix begins to cry and says, "I saw Pablo staring at another man, and I'm worried because I've been hurt in past relationships, and I'm sad because it's happening again." How would you incorporate the cultural diversity issue of a gay, bi-cultural relationship into your treatment plan? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to assess the impact of cultural diversity on the counseling relationship. A. Create gay-friendly goals that consider each of their cultural backgrounds. B. Refer Pablo to a 12-step group for gay men. C. Manage your counter-transference if you have a negative reaction to any of the presenting issues (e.g., gay relationship, substance abuse, staying in the closet, etc.) that are impacting your objectivity. D. Invite them to explain how their different cultural backgrounds impact their relationship. Answer: C. Need a written release signed by both Sue and Jerry before you can communicate with the court. Since Sue and Jerry are your clients, you must get a written release from both before divulging any information about them. ================================================== Question: *16. You are treating a woman in therapy for mid-life issues. A month into treatment her husband calls to discuss her progress and the expected length of treatment because his insurance only covers 18 sessions of mental health. She told you that he might call and gave you his name so you are not surprised. Legally: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal issues that pertain to treatment. A. You could speak with him because she told you his name and you expect the phone call. B. Before the insurance runs out, negotiate a cash fee with the client. C. Provide informed consent if you plan to adjust her treatment to end within 18 sessions. D. Tell her about the husband's phone call and any fee changes that might result from a change in her insurance coverage. Answer: A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you. Before you take on a new case, you want to consider your level of education, training and experience to determine if you are capable of treating this client or if consultation is needed. Also, you need to consider this client's goals. If the client wants help with relationship issues, this is within your scope of practice, but if the client's needs are not relationship-oriented, then this case would be out of your scope of practice. ================================================== Question: 17. Your child's piano teacher sees you at a P.T.A. meeting and says she's heard that you are a good psychotherapist and asks if she can make an appointment to see you. She says her mother recently passed away and that she is now her elderly father's caretaker. She says "the situation is bringing up a lot of anger" for her because her father sexually abused her when she was a child. In this situation, you should: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical behavior regarding potential dual relationships. A. Report the abuse to Children's Protective Services. B. Decline to make an appointment and refer her to another therapist. C. Report the abuse to Adult Protective Services. D. Make an appointment and try to help her work through the grief and anger issues. Answer: D. Evaluate the seriousness of her depression to determine if you can treat her. The social worker's ethical obligation is to determine if the client will benefit from treatment, which requires an assessment of the presenting problem. ================================================== Question: 18. Darren and Samantha are referred to you by Samantha's psychiatrist. Samantha's psychiatrist has diagnosed Samantha with Schizophrenia. Darren says that he hasn't been sleeping and can't concentrate at work, and that he's afraid to do the shopping himself because when he goes out his heart pounds, he thinks he's going crazy, and it would be embarrassing to him. Darren says he's at the end of his rope and isn't sure he can take Samantha's behavior much longer. When he asks how therapy will help, you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to provide clients with information about the social worker's training and experience. A. Have Darren authorize the consent form for Samantha as her dependent adult care custodian. B. Refer to a support group for families dealing with mental illness. C. Ensure that Samantha and Darren understand and sign your informed consent document. D. Clarify Darren and Samantha's expectations about therapy. Answer: A. Tell her if you have raised your fees. You must disclose your fee before beginning therapy with a new or returning client. ================================================== Question: *19. You have been seeing Nathan, age 70, for 5 months. He has been managing on his own with some help from his daughter, Pat, who visits frequently. For the past month you have been working with Nathan on his relationship with Pat. She has been frustrated with him because he has complained of being bored, but he won't do anything about it. In your next session he comes in with bruises on his forearms. He states that he fell while walking up the rickety front steps to his house. You would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your ability to differentiate elder abuse from other safety concerns for the elderly and to make the appropriate referrals. A. Call Adult Protective Services immediately to file a neglect report. B. Suggest a home improvement company specializing in safety for the elderly. C. Suggest respite care. D. Suggest a Senior Citizens' Center. Answer: A. Refer them to a social worker who has experience with domestic violence issues. The couple needs help with domestic violence issues. It should not be presumed that lesbian clients need lesbian social workers, or that social workers are uncomfortable working with gay and lesbian clients unless proven otherwise. ================================================== Question: 20. After 6 months of treatment with Hermoine, she says that she wants to see a therapist whose sexual orientation is different than yours. After processing this over the next two sessions, you have two additional termination sessions, give her three referrals and terminate the therapeutic relationship. Several weeks later, Hermoine calls you in crisis and says her new therapist is out of town and isn't returning her phone calls. She asks you to help her. What would you do? Content Area: Ethics: Therapeutic Relationship/Services This question tests your decision-making process. A. Help Hermoine with her crisis until her therapist returns. B. It is unethical for you to work with Hermoine once you have terminated treatment with her and she has begun treatment with a new therapist. C. Tell Hermoine that you will not be able to help her since she has terminated treatment with you. D. Tell Hermoine that she should find out who is taking calls for her new therapist and speak with that person. Answer: C. Legally responsible to intervene. A clinician is not legally responsible to report a suicidal client, but is legally responsible to take reasonable steps to ensure the safety of a suicidal client which can be managed in a number of ways. Evidence Code 1024 allows clinicians to break confidentiality when a client, due to a mental disorder, is a danger to self or the property of another and breaking confidentiality would prevent the threatened harm. ================================================== Question: 21. Answer: A. Discuss with Shelly the nature of the therapeutic relationship and explore her feelings and assumptions. Shelly is beginning to view the therapeutic relationship differently than the social worker views it. It would be your ethical obligation to explore with Shelly her assumptions, so that corrective work can be accomplished, and at the same time, the relationship can be strengthened. ================================================== Question: 22. Answer: C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent. Joint custody may require one or both parents to consent. You must look over the custody papers to review what the court mandates. ================================================== Question: 1. Two social workers are dating. They are at dinner and they are talking about their clients. They discover that each of them is seeing a different member of the same couple for individual therapy. What should these social workers do? Content Area: Law: Confidentiality, Privilege, and Consent This question is about the legal responsibility of social workers outside of the therapeutic setting discussing a client. A. No action is necessary since licensed health professionals may consult for purposes of diagnosis and treatment without a release. B. Stop the discussion and obtain releases so that such discussions in the future do not breach confidentiality. C. Stop the discussion and do not talk about these clients again. D. There are no legal or ethical guidelines requiring social workers in such situations to do anything. Answer: A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so. In custody or visitation proceedings, if a child is represented by an attorney, that person has the right to obtain a child's clinical records or to interview the assessing or treating social worker. Ethically, you would also discuss this confidentiality issue with your client. ================================================== Question: 2. Revocation of a LCSW's license after having been found to have engaged in sexual misconduct with a client would occur after: Content Area: Ethics: Professional Competence and Preventing Harm This question tests your knowledge of the penalties for social workers having sex with a client. A. A social worker filed a complaint with the BBS on behalf of a client. B. The BBS found that the therapist terminated therapy in order to pursue a sexual relationship. C. The social worker gives the client the pamphlet "Professional Therapy Never Includes Sex" and discusses it with the client. D. The BBS cites the offending social worker within 10 years of the statute of limitations. Answer: A. Discuss a new fee arrangement before changing the fee. Legally, you must discuss and agree to any fees or changes in fees before treatment at that fee begins. ================================================== Question: 3. Your client, George, tells you that his mother just got remarried. He tells you that he is worried that the new husband's children are going to go after his inheritance. He tells you that he has very little contact with the new family and wants to keep it that way. What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting This question tests your knowledge of how to proceed when you may need to assess for or report elder abuse. A. You must asses for elder abuse, considering "undue influence" regarding the mother's estate. B. You should refer the client to an attorney to determine if he has a case. C. Maintain confidentiality because you do not know the age of the mother. D. Report elder abuse, considering "abandonment" because he has "very little contact" with his mother. Answer: A. Determine the family's understanding of the purpose of the therapy. Ethically, you would want to clarify the client's purpose. ================================================== Question: 4. Ki is a 26-year-old Korean who immigrated to the U.S. with his father 10 years ago. Ki wants to be an artist but his father has saved his money and demands that Ki goes to medical school like his grandfather. Ki says he's depressed and he would rather die than become a doctor. He says he's too stupid to pass the classes in medical school anyway. He doesn't know how to tell his father. The social worker determines that Ki is not suicidal. The most appropriate ethical intervention is to: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical obligations that pertain to cultural competence. A. Recognize the importance of cultural considerations and acknowledge that Ki may have to follow his father's wishes. B. Ask Ki to bring his father in for a family session because of cultural values that encourage respect for elders. C. Inform Ki that the risks and benefits of therapy may be that he "finds himself" but may change some of his family values. D. Ask to see Ki's artwork to reframe him as an individual and your alliance as a place where he can be an individual. Answer: C. Take reasonable steps to ensure her safety. This legal precedent demands that we take reasonable steps to ensure the safety of a suicidal client. It doesn't say how it must be done. ================================================== Question: 5. June discloses that she had been molested by a step-brother when she was 15. She is now 28 and was divorced from her husband three years ago. Before seeing you, she saw another therapist and she has just told you that she had sex with him. She wants therapy to focus on the stormy relationship issues that led to her divorce, not on past sexual molestation or exploitation. You would: Content Area: Law: Legal Standards for Professional Practice, tests your understanding of the legal responsibilities of therapists who learn that a client has had sex with a previous therapist. A. Respect her wishes and continue to focus on resolving the issues on which she wants to work. B. Give her the brochure "Professional Therapy Never Includes Sex" and discuss her options. C. Report the therapist to the BBS to protect the other therapist's present and future clients. D. Work on the sexual exploitation in therapy. Answer: C. Call Barbara's ex-boss and warn him of her plan. Warning the victim may be done in the interests of protecting the public and protecting the social worker from liability related to breaking the confidentiality of the potentially dangerous client. As of 2014, there is only a legal responsibility to contact law enforcement within 24 hours. After doing that, warning the potential victim is next. ================================================== Question: 6. Dr. Sveda has been treating Carliss for seven years during which time the fee has been $50. Carliss finally earns his Ph.D. and gets a job for substantially more money than he had been making. Dr. Sveda tells Carliss he'd like to revisit the fee that Carliss has been paying. Carliss becomes quite upset and tells Dr. Sveda that it would be unethical for him to raise the fee. Dr. Sveda calls for consultation and is given the proper answer which is that social workers are discouraged from increasing a client's fees: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical considerations in raising client fees. A. Without providing adequate notice. B. To avoid exploitation of the client. C. Unless all client fees are increased. D. According to strict ethical standards for the mental health profession. Answer: B. Refer the client back to the insurance company. Clients who are referred by insurance companies should be referred back to the payor to get another referral. This way, they can be more sure that their sessions will be financially covered. ================================================== Question: 7. Joe and Marcie Green and their three children ages 12, 15 and 17, have been in family therapy with you for about 9 months on a regular basis. Joe says that they are getting along much better. Marcie says that the children seem to be willing to spend more time at home and are arguing less with each other. They think that things are so much better that they are ready to end treatment. What is your ethical obligation after deciding to terminate family therapy? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical obligations that pertain to provide clients with information about the therapeutic process, which includes termination. A. Recommend staying in therapy if there are any regressive symptoms in any individual. B. Document your agreement with them that they are ready to terminate. C. Recommend individual therapy if there are any regressive symptoms in any individual. D. Terminate because ethically you are not permitted to extend treatment beyond a client's ability to benefit. Answer: D. Maintain confidentiality and retain the client's files for 7 years. It is your legal responsibility to maintain confidentiality even after the death of a client. Records must be retained for a minimum of 7 years after the date that the client terminates treatment (SB 578, effective January 1, 2015). ================================================== Question: 8. Which of the following is true in a court custody case? Content Area: Law: Confidentiality, Privilege, and Consent This question examines the parameters of privilege. A. A minor does not hold his/her own privilege. B. The court may appoint an attorney to represent the best interests of the child. C. The parents can waive their child's privilege. D. The parents' attorney can waive privilege on behalf of the child. Answer: A. You indicate to your client that she can give your number to the program coordinator. This response is the best choice. By letting the program coordinator contact you, you can avoid exploiting the client in order to advance a relationship with the program coordinator. ================================================== Question: 9. How should physical abuse of a dependent adult be reported by a mental health professional? Content Area: Law: Limits to Confidentiality/Mandated Reporting This question tests your understanding of the legal issue of reporting dependent adult abuse. A. If there is serious bodily harm, within 24 hours. B. By telephone within two working days and in writing as soon as possible. C. By telephone as soon as possible and in writing within two working days. D. By telephone as soon as possible and in writing within 36 hours. Answer: A. Contrary to the spirit and intent of ethical standards. Ethical standards encourage social workers to disclose, at the appropriate time and in the context of treatment (such as when clients request the information), information about their education, experience, training, theoretical information, etc. ================================================== Question: 10. Jessica, age 14, comes to see you with her mother. She appears withdrawn and fatigued and refuses to speak with you. Her mother explains that in the last few months Jessica's behavior has changed drastically. How would you manage this family's treatment needs from an ethical perspective? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the steps to take in starting treatment with a new family unit. A. Explain the family systems model. B. If you are unable to make progress with the family, give them three referrals. C. Evaluate how willing the mother is to reframe the problem as the "family problem" rather than Jessica as the problem. D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually. Answer: A. Inform them that it would be unethical and help them find a way to pay for continued therapy. It is unethical to enter into bartering dual relationships with clients. It is also important not to abandon clients. This answer provides many opportunities to help the clients, including adjusting your fee. ================================================== Question: 11. Your former supervisor refers a client to you and suggests that you split the client fee as you did while under her supervision. You would: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to manage referrals that meets ethical obligations. A. Report this unethical behavior to the BBS. B. Negotiate a new split fee arrangement. C. Inform the supervisor that it is unethical to split fees. D. Inform the supervisor that since you are now a licensed social worker she can only get 25% of the client's total fee. Answer: B. Self-harm behavior. Self-harm behavior is not a type of dependent adult and elder abuse. Welfare and Institutions Code defines dependent adult and elder abuse as knowledge or reasonable suspicion of the following: physical abuse, abandonment, isolation, neglect, financial abuse, and abduction. ================================================== Question: *12. You are given an unwrapped book of inspirational religious poetry by one of your clients as a holiday gift. This book strongly contradicts your personal religious beliefs. You decide to: Content Area: Ethics: Professional Competence and Preventing Harm This question tests your ability to deal with the therapeutic alliance and potential counter-transference in light of gift-giving. A. Accept the gift in the spirit in which it was given and say nothing about your spiritual beliefs. B. Evaluate what would be in the client's best interests and how accepting or rejecting the gift might affect treatment. C. Gently explain to your client that you cannot accept such a personal gift. D. Thank the client for her thoughtfulness but let her know that your policy is that you don't accept gifts from clients. Answer: B. Providing informed consent. From an ethical standpoint, the therapist is providing the client with information to help the client assess his/her desire to be in therapy, which is the intent of informed consent. ================================================== Question: 13. Which of the following techniques would be considered out of a mental health professional's scope of competence if they did not receive the needed specialized training? Content Area: Law: Legal Standards for Professional Practice This question focuses on your knowledge of a mental health professional's scope of competence. A. Couples therapy B. Hypnotherapy C. Psychotherapy D. Adolescent therapy Answer: B. Consult with professional peers regarding your discomfort. You want to be aware of how your discomfort may impact the therapy and, as an initial step, deal with it through research and consultation with colleagues. ================================================== Question: 14. You terminated therapy with Margaret after 3 years because she wanted to work with a therapist with her same sexual orientation. You gave her a referral to a new therapist who she has seen a few times. Several weeks later Margaret leaves you a message saying that she is having a conflict at work and wants to speak with you because only you can help her. When documenting this call you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to document your care for a client, even a former client. A. Note that you told her that you cannot ethically treat her because she is already in treatment with another therapist. B. Indicate that you assessed her risk as "low" and suggested that she call her therapist C. Confirm that you had a signed termination agreement. D. Get a release to speak with her other therapist to coordinate care. Answer: B. Give the doctor the information he needs. Give the doctor the information he needs. Civil Code 56.10 (The California Medical Information Act) gives licensed health professionals the ability to consult for purposes of diagnosis and treatment without a release authorization. ================================================== Question: *15. You've been treating a woman who is in the midst of a divorce. You receive a subpoena in the mail from her husband's lawyer asking for your client's records. You: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to respond to a subpoena. A. Contact your client to determine if she wants you to waive or assert privilege. B. Would contact the husband's lawyer and assert privilege. C. Ignore the subpoena since there is no one to whom you can assert privilege. D. Must comply with the subpoena since it is an official court document and you would otherwise be in contempt of court. Answer: C. Tell the client what you plan to tell the school. The best ethical approach before speaking with the school, even if your disclosure is narrow, is to discuss it with the client first. ================================================== Question: 16. Mike, your 17-year-old client, has a history of fire-setting. He is in therapy as a result of a court order and his parents know he is in treatment. He tells you that he is angry with his ex-girlfriend and says that he plans to set fire to her house tonight. What should you do? Content Area: Law: Limits to Confidentiality/Mandated Reporting This question is assessing your ability to determine a Tarasoff situation. A. Call his parents so they can be sure that he doesn't go unsupervised. B. Maintain confidentiality. C. Call the police immediately and his ex-girlfriend's family. D. Call the police immediately. Answer: C. Change the diagnosis when you have confirmed it on any insurance forms. To avoid fraud you would have to code the diagnosis you currently are considering and change it when necessary. ================================================== Question: 17. A social worker consults with another professional about a particularly challenging case. Has an ethical violation occurred? Content Area: Ethics: Professional Competence and Preventing Harm This question assesses your ability to collaborate with other professionals when issues arise outside the social worker's expertise. A. Yes, if the social worker does not reveal confidential client information to the other professional. B. No, if the social worker does not reveal identifying information about the client to the other professional. C. Yes, if the social worker has a signed consent by the client to consult. D. No, if the other professional agrees to keep the client information confidential. Answer: C. Accept the gift and explore what it means for her to give you the muffins. Appropriate gifts (inexpensive, non-romantic, etc.) may be accepted by social workers without impairing their judgment or exploiting the client and should be processed to be most ethical. ================================================== Question: *18. When unable to reach a client by phone, a social worker texts the client's mother to tell her that her son is talking seriously about running away from home because of the step-father's abuse. She texts back to tell you that he is home safely but "thanks for the heads-up." What are the social worker's ethical obligations regarding the confidentiality of minors? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to handle informed consent about the limits of confidentiality in the treatment of minors. A. Obtain written informed consent from the minor that allows texts to parents in an emergency. B. Tell minor clients how you will contact parents if you think there is an emergency. C. Tell minor clients that you will show them any texts from parents. D. Obtain informed consent from parents about your mandates to break confidentiality. Answer: A. Refer the client to another therapist and disclose the reasons. Treating a client who was dating a member of the social worker's family would constitute a dual relationship, and the most ethical way to proceed would be to give the client some referrals. ================================================== Question: *19. Maria and Juan have been seeing you for couples' counseling for six weeks. In the 7th session, Maria brings you a batch of fresh, hot, home-baked oatmeal raisin cookies. You would: Content Area: Ethics: Business Practices and Policies This ethical question, with a flair of human diversity, reviews ethical policy as it relates to gift giving. A. Accept the cookies and explore their meaning with Maria and Juan. B. Refuse the cookies and explore their meaning with Maria and Juan. C. Accept the cookies and eat one immediately. D. Refuse the cookies and tell Maria about your "no gift policy." Answer: C. Tell them that using their son's "mental anguish" in a lawsuit could compromise their confidentiality in therapy. Although you must avoid giving legal advice, you could tell the parents of the potential risks of introducing their son's mental state in a legal proceeding, i.e., that it nullifies the privilege of therapy sessions with them and their son. ================================================== Question: 20. You are conducting a research study on divorce. In the informed consent process, what information do you need to provide your clients? Content Area: Ethics: Business Practices and Policies This question assesses your knowledge of procedures when conducting research using human participants. A. The importance of the client remaining in the study until the very end to maintain the validity of the study. B. That dual relationships may be inevitable due to the nature of the study. C. That any information obtained may be used in the study. D. The client has the right to withdraw from the study at any time. Answer: C. Return the sweater and encourage the man to bring it up in session. Returning the sweater and encouraging him to bring up the topic in session allows for the agreed-upon payment arrangement to be maintained and avoids collusion with the husband. ================================================== Question: *21. If a social worker digitally recorded a session with a client and then receives a subpoena for records because the client is claiming emotional distress, the recorded session would be provided to the court if: Content Area: Law: Limits to Confidentiality/Mandated Reporting This question tests your knowledge of how to respond to a subpoena. A. The client signed a release to record a session. B. The client signed a waiver of privilege for the records. C. The client signed a consent form allowing the session to be videotaped. D. Digital recording must be disclosed with any records in a subpoena. Answer: B. Notification to the person signing the agreement that they have a right to receive a copy of it. An Authorization to Release Confidential Information form must contain a statement that the person signing the agreement is entitled to a copy of the agreement. ================================================== Question: *22. A client is referred to you by his attorney. The client tells you that he is reluctant to talk to you because he doesn't want what he says in therapy coming out in court. Choose the statement that could BEST explain privilege to this client: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of privilege. You must be able to distinguish between confidentiality and privilege as well as between law and ethics. A. It is an ethical concept involving the right of a social worker to withhold information in a legal proceeding. B. It is a legal and ethical principle which involves a restriction on the volunteering of information about a client. C. It is a legal principle that protects client conversations unless there is a court order. D. Attorney/client privilege extends to the client of a social worker that the attorney uses for referrals. Answer: A. Inform her of the results in language she can understand. Ethics require that therapists explain all of therapy, including assessments, in terms a client can understand. ================================================== Question: *23. A client who was referred by his rabbi comes in to see you for issues of grief related to the loss of his mother two weeks ago. Recently your mother died too. What would you do FIRST? Content Area: Ethics: Professional Competence and Preventing Harm This question tests your knowledge of how to manage counter-transference. A. Talk about this situation in your own therapy. B. Seek professional consultation. C. Refer the client to another mental health professional who specializes in grief and loss issues. D. Determine if you can deal with this client at this time. Answer: C. Talk with the client about the risks of dual relationships. No matter how a dual relationship emerges, on the internet or in a session, the social worker's ethical obligation is to discuss the risks and avoid it if possible. ================================================== Question: *24. Steven comes to you for help with debilitating anxiety. He says that his anxiety is beginning to interfere with his relationships and his job. He is afraid to drive his car because he thinks that he is going to hit someone. He doesn't know how he will ever take a girl out on a date or get to work if he doesn't get control over this. He thinks he should be able to get over this by himself. The therapist should begin by: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical obligations when selecting treatment interventions. A. Teaching him relaxation techniques and pairing those with thoughts and images of driving his car. B. Explaining the benefits of a behaviorist approach for severe anxiety. C. Documenting in an initial treatment plan the client's goals for treatment of anxiety. D. Assessing whether a medication evaluation would be necessary. Answer: A. Ask them to educate you about important differences and to tell you how these relate to their presenting problem. A policy where you model appropriate communication skills will allow your clients to feel more comfortable and facilitate discussion of diversity issues. ================================================== Question: *25. Which of the following is not considered by law to be unprofessional conduct by a social worker? Content Area: Law: Legal Standards for Professional Practice This question asks you to identify unlawful unprofessional conduct. A. A conviction after pleading no contest to a DUI. B. Thanking a friend for a referral by taking her out to dinner. C. Being arrested for shoplifting. D. Poor record keeping. Answer: C. Tell the colleague that her actions violate ethical standards. Social workers do not operate as "snitches" on other social workers. However, it is ethically appropriate for us to confront a social worker who is engaging in unethical practices. ================================================== Question: 26. A social worker has been working with a client who informs the social worker that he has been living as a woman since he was 35. He is now 45 and wants to begin transitioning into an anatomical woman. The client tells the social worker that he already has confirmed that his insurance will pay for it but he is self-employed so it is going to be very expensive. How should the social worker proceed? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage diversity from an ethical point of view. A. Ask if the client would like to be referred to as "he" or "she." B. Use a the client's signed consent form to determine if he signs it as a woman or as a man. C. Include a diagnosis of "Gender Dysphoria" on any insurance forms if he signs a release to allow this. D. If the social worker feels that any counter-transference will impact the therapy, refer the client to a specialist. Answer: A. Maintain confidentiality. Claire is 18 and considered an adult. Thus, making a report would be breaching confidentiality. Social workers do not report historical abuse. Your legal obligation is to maintain Claire's confidentiality. ================================================== Question: 27. You find out that your 14-year-old client's mother is beating her for not making her bed in the mornings. You have determined you need to make a child abuse report. What is your legal responsibility as a mandated reporter? Content Area: Law: Limits to Confidentiality/Mandated Reporting This test item addresses your responsibility as a mandated reporter. A. To contact an agency designated to take a report and follow up with a written report within 36 hours. B. To contact an agency designated to take a report and follow up with a written report within forty-eight hours. C. To contact an agency designated to take a report and follow up with a written report within two working days. D. To contact an agency designated to take a report and follow up with a written report within seventy-two hours Answer: D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey. If any fees are associated with clinical practice, social workers are legally obligated to disclose them before providing a service. ================================================== Question: 28. After working with a rape survivor for 3 weeks, the social worker determines that the client would benefit from an adjunctive referral to a therapist who specializes in EMDR. All of the following would be clinical considerations in making such a referral except? Content Area: Ethics: Professional Competence and Preventing Harm This question addresses issues related to using concurrent social workers. A. It would be necessary to obtain a release in order to work collaboratively with the EMDR therapist. B. The treatment plan may need to be modified, as the trauma-related symptoms may begin to shift and lead to other issues that need processing. C. The social worker should not make this type of referral yet as the client is still in a vulnerable condition. D. There may be an impact on your therapeutic relationship with this client who may compare or feel torn between two therapists. Answer: A. Allow the client to inspect the records, receive a copy, or receive a summary. Allowing the client to inspect the records, receive a copy, or receive a summary is what the law requires social workers to do. Social workers may also, under limited circumstances, refuse the client any access to the records at all if they feel that the release of the records will be harmful to the client. ================================================== Question: 29. You are working with a 13-year-old client whose parents are going through a divorce. She texts you one day to tell you that even though she lives full-time with her mother, her dad is now hiring a lawyer for her to come live with him. You receive a subpoena for your records for the purpose of a custody hearing. You would: Content Area: Law: Confidentiality, Privilege, and Consent This question evaluates your understanding of how to respond to a subpoena. A. Assert privilege until a guardian ad litem has been appointed for the client. B. Contact the parent under whose authorization you are treating the 13-year-old and assert or waive privilege, depending on that person's wishes. C. Speak to both parents and assert or waive privilege depending on their wishes. D. Release the records in order to comply with the subpoena and avoid being in contempt of court. Answer: C. You've taken a practical course on EMDR and have obtained certification. Taking courses and obtaining certification demonstrates a minimum level of competence to be able to use EMDR in your own practice. Continual education will keep you current on EMDR practices. ================================================== Question: *30. In her first session, Shannon, who is highly anxious, asks you how long therapy will last. You would: Content Area: Ethics: Therapeutic Relationship/Services This question is checking your understanding of developing a therapeutic alliance and the importance of explaining the process of therapy at the outset of treatment (informed consent). A. Interpret her question as an anxiety reaction. B. Outline the process of treatment. C. Encourage her to explore the concerns that brought her to therapy. D. Explore past therapy experiences. Answer: A. If you have a sobriety contract in place, terminate any session at which Pablo comes in intoxicated. If a client is unable to benefit from therapy, it is ethical to end the session. ================================================== Question: *31. After being in weekly therapy for 9 months, the client asks if she and the social worker can use telehealth to have sessions on an as-needed basis. If the social worker determines that this is clinically appropriate, what does the social worker need to do to make sure that online sessions are legal? Content Area: Law: Legal Standards for Professional Practice This question tests your knowledge about the legalities associated with fee negotiations. A. Disclose any fees which are different from in-person sessions. B. Tell the client about confidentiality protections she must have on her computer. C. Maintain separate files for the different modalities. D. Get her consent for video recording in writing. Answer: C. Ethically working within your scope of competence. Ethically and legally, you may tell your clients about laws which affect their treatment as long as you don't give legal advice. ================================================== Question: 32. In your first session with Peter and Veronica, they disclose to you that although they have a five year relationship, Veronica is married to someone else. You should: Content Area: Ethics: Professional Competence and Preventing Harm This question pertains to issues impacting conjoint therapy. A. Refuse to see Veronica but counsel Peter. B. Refuse to counsel either of them until Veronica tells her husband about this affair. C. Counsel both of them. D. Counsel Veronica and her husband. Answer: C. Only share information with those providers that advance the welfare of the client. Ethics codes are primarily designed to assure that therapists balance the best interests of the client in their sociocultural context with clinical competence. Sharing information with other providers, if it is confidential and clinically appropriate, fulfills this ethical obligation. ================================================== Question: 33. A couple comes in to see you for therapy. They are referred by the wife's individual therapist. The husband has recently discovered his wife has been cheating on him and he is unsure if he wants to continue the relationship. What is solely an ethical responsibility in treating this couple? Content Area: Ethics: Therapeutic Relationship/Services This question addresses your ethical responsibility in treating a couple. A. Getting a signed release from both the husband and the wife to speak with the wife's therapist. B. Designating a fee prior to the commencement of therapy. C. Informing the couple of your "no secrets" policy. D. Having the wife sign a release to speak with her therapist. Answer: B. A provisional diagnosis. Informed consent would NOT include a provisional diagnosis. The main purpose of informed consent is to give your client information about your services and the process of psychotherapy so that they may make an informed decision about treatment. ================================================== Question: *34. Gladys, age 65, reports she has kicked her 67-year-old husband when it looked like he wasn't listening to her. He tells you that his hearing is poor and most of the time he heard her the first time anyway. What would you do? Content Area: Law: Limits to Confidentiality/Mandated Reporting This question addresses the parameters involved in reporting elder abuse. A. Report immediately to Adult Protective Services and make a written report within 2 working days. B. Refer him to an MD for possible improvements in his hearing. C. Since they are spouses, do conjoint work pertaining to anger management. D. Maintain confidentiality since you are not mandated to report since both spouses are 65 and older. Answer: D. Send his records as requested. Sending his records is the correct answer. Mental health professionals do not withhold patient records or information solely because the practitioner has not been paid for therapy services. ================================================== Question: *35. Toward the end stages of therapy a client asks his social worker if they can use text or email between sessions to communicate as the final sessions get more spread apart. The social worker suggests that texts and emails won't really get the client used to less contact; they will only be substitutes. The social worker has: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to respond ethically to clients' requests about changing treatment. A. Provided ethical informed consent. B. Legally maintained confidentiality. C. Legally avoided client abandonment. D. Avoided a dual relationship. Answer: A. Make appropriate referrals. Making appropriate referrals is the ethical course of action when a social worker is unable to provide services. ================================================== Question: *36. You get a call from the emergency room regarding one of your clients who was brought in by the PET team and is incoherent, delusional, and unstable. While they were going through his belongings they found his driver's license and your card. The psychiatrist on call wants to know if you can give them any information about this person that might be helpful. You would: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to protect client safety and confidentiality at the same time. A. Assist them with information you deem pertinent to the situation at hand. B. Inform them that you cannot confirm or deny if this person is your client. C. Tell them that they will have to obtain a release signed by the client and fax it to you before you can disclose any information. D. Ask to speak with your client before disclosing any information. Answer: B. Determine if the client is a resident of California. The social worker must conform with the law, which requires that the client reside in the state of California. ================================================== Question: *37. You have attended a yoga class every Saturday morning for the last 5 years. Today when you arrive you notice your client signing in at the counter for the class you attend. What are your ethical responsibilities? Content Area: Ethics: Professional Competence and Preventing Harm This question tests your knowledge of ethical responsibilities regarding dual relationships and techniques to manage this responsibility. A. Complete class as usual without acknowledging the client unless he/she acknowledges you and explore his/her reactions in your next session. B. Leave immediately before the client sees you. C. Say to your client, "Don't worry, everything we talk about in therapy is confidential." D. Say hello to your client, complete the class as usual, and incorporate yoga and body movement in your treatment plan. Answer: B. No, because this is financial exploitation and does not demonstrate a clinically sound reason to terminate therapy. This is not ethically sound because ethical standards state that mental health professionals do not financially exploit their clients or refer (i.e., abandon) for financial reasons. She is already paying by insurance, and you cannot change your payment policies without advance notice and a chance for the client to renegotiate. ================================================== Question: *38. You contract with a family for ten sessions, as that is all their insurance would cover. After the ten sessions they want to continue therapy but can't afford your full fee. What would you do next? Content Area: Ethics: Therapeutic Relationship/Services This question addresses your management of insurance clients with limited coverage, your sensitivity to the ethical concerns of client abandonment and ethical standards. A. Refer them to a low-fee clinic. B. Accommodate your fee since you've established a bond. C. Terminate with the family since you have met the terms of the contract. D. Assess their motivation for continuing therapy. Answer: B. Keep your opinions to yourself. Deciding what to do with a pregnancy is a decision the couple must live with, not the social worker. ================================================== Question: *39. Cheryl and Bobby are in joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. It would be appropriate for Cheryl to: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to assess and address other professionals' competence if it endangers clients. A. Avoid making any referrals to Bobby. B. Offer to take some of his caseload. C. Engage Bobby in a therapeutic conversation. D. Report Bobby to a regulatory body. Answer: D. Questionable at best and unethical since it is close to paying for referrals. Setting up this type of incentive for making referrals is close to paying for them and is unethical and illegal. ================================================== Question: 40. A "5150" or involuntary confinement may be invoked by: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question pertains to your knowledge of who can invoke a 5150. A. Any licensed mental health professional. B. A peace officer, staff member of an evaluation facility, or other professional person designated by the county. C. Family members of persons to be confined. D. All of the above. Answer: B. Would report the incident to Adult Protective Services immediately. A dependent adult is legally defined as someone between the ages of 18 and 64 who is emotionally, financially, or physically unable to care for him/herself. Since Greg is in a wheelchair and has a nurse attending to him, he would be considered a dependent adult. Therefore, this would be reportable to Adult Protective Services immediately by phone, followed by a written report within 2 working days. ================================================== Question: *41. A client joins a social worker's church congregation. The social worker should: Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how you would handle a situation involving a potential dual relationship and boundaries. A. Leave the congregation. B. Tell the client s/he needs to join a different congregation. C. Stay in the congregation but avoid direct social interactions. D. Review dual relationships with your client and healthy boundaries. Answer: A. Remind him of your no secrets policy and encourage the husband to tell his wife about the phone call and the gun. Reminding him of your no secrets policy is the only answer that implies that you have informed your clients of a no secrets policy and it focuses clearly and correctly on how to resolve this therapeutic issue. ================================================== Question: 42. You are working with a family and learn that the father is neglecting the child. After making a report to CPS, you feel anger towards the father. What is/are the best way(s) to deal with your counter-transference? Content Area: Ethics: Professional Competence and Preventing Harm This question looks at your knowledge of appropriately handling counter-transference issues. A. Journaling, peer consultation and individual therapy. B. Journaling, progressive muscle relaxation, and diaphragmatic breathing. C. Individual therapy, as you already know your anger won't be resolved through independent measures. D. Refer the family to another therapist who specializes in victimized children and has her counter-transference issues resolved around these issues Answer: A. Obtain a written agreement about the fees for therapy. Although her text response could imply her agreement, it would be more legally sound to obtain her agreement to the fees in writing. The "K" does not necessarily prove that she read anything you sent. ================================================== Question: 43. 13-year-old Brianna comes to the clinic where you are doing intakes and asks if she can get a social worker. You assess that Brianna is mature enough to participate intelligently in therapy and Brianna says she can pay for therapy if there is a low fee. In order for Brianna to be seen without parental consent, what other information would you need to know? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal requirements for treating a minor without parental consent. A. That Brianna's uncle began to molest her a month ago. B. That Brianna has daydreams of harming herself and no one in whom to confide. C. You have sufficient reason to treat Brianna without parental consent. D. That Brianna is in the process of petitioning the court for emancipation. Answer: D. Call up an agency designated to take such a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a "no violence plan." This answer contains the basic steps you must take when you know of or have reasonable suspicion of elder abuse, and it shows good clinical management in processing any feelings your clients might have about their social worker filing a report. ================================================== Question: *44. Your client, Liz, is a 17-year-old female who is leaving for college out of town at the end of the month. She was molested by her uncle as a young child and is working through these issues with you. She has developed a close working relationship with you and wants to continue to work only with you. You would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the legal issues that pertain to treating clients who are moving. A. Consult with a colleague about transference/counter-transference issues. B. Make three referrals out of town. C. Plan for weekly, hourly phone sessions with you. D. See her on school breaks. Answer: A. Determine the family's understanding of the purpose of the therapy and refer for an academic assessment. Ethically, you would want to clarify the client's purpose. Since the referral was from the school, it could be in the client's best interests to assess the needs there. ================================================== Question: *45. Your client missed a regularly scheduled appointment. Your policy, made clear to the client in your informed consent document, is that clients will be billed for missed appointments. The client asks you to bill the insurance company. What would you do? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate billing procedures. A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee. B. Explain that billing insurance for missed sessions is insurance fraud. C. Let it go, since by law, insurers cannot be billed for missed sessions and clients with insurance are not required to pay out of pocket. D. Bill the insurance company for the session. Answer: B. Explain the pros and cons of therapy. This question is asking you to respond to a client's inquiry about whether therapy will be helpful. Explaining the costs and benefits of therapy addresses this concern. ================================================== Question: *46. At your 12-step meeting you mention that you are a social worker. Some other participants ask if being a social worker makes you a good sponsor. If you tell them that sponsorship is not within your scope of practice you have: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to respond when clients want a service that is beyond your licensure to provide. A. Failed to provide informed consent. B. Fulfilled your ethical obligation to restore boundaries. C. Legally fulfilled your responsibility to provide accurate information about your qualifications. D. Legally failed to fulfill your responsibility to provide referrals. Answer: D. Maintain confidentiality. In this case, maintaining confidentiality is the best of the answer choices. If you subsequently had reason to suspect that the perpetrator had abused a person who is a minor, you would then be mandated to report to CPS. ================================================== Question: *47. You are seeing a 52-year-old man who is unable to keep a job. He states that he always ends up fighting with his bosses who then fire him. During a session he makes a derogatory comment about his last boss' homosexuality. You find yourself becoming angry towards this client. What would you do? Content Area: Ethics: Professional Competence and Preventing Harm. You must choose which course to pursue in response to your becoming angry at the client. A. Disclose how you feel. B. Seek consultation. C. Refer him out. D. Put your own feelings on the shelf and deal with the client's issues. Answer: Codes devloped by mental health practioners for the purpose of setting professional standards for approproate behaviors, defining professional expectations and preventing harm to clients ================================================== Question: *48. For several sessions, you have been working with a client who insists that he "will not rest" until he makes his son's teacher pay for the false child abuse report that the teacher made. He feels that his family has been shamed and anyone who does an internet search on him will think he is a child abuser. He tells you he would never "put hands on a woman, but I will think of something." The social worker's early intervention plan should include: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This questions tests your knowledge of how to assess for danger and the need to break confidentiality in a potential crisis situation. A. Notifying the police and the teacher. B. Creating a therapeutic environment where the client can speak openly. C. Direct questions about his revenge plans. D. Educating the client about the law regarding your mandate to over report child abuse. Answer: Enhance human well being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed and living in poverty ================================================== Question: 49. A social worker has been working with a difficult and resistant client for several months. The social worker might make some referrals to other social workers because: Content Area: Ethics: Therapeutic Relationship/Services This question checks your understanding of reasons to refer a client to a different social worker. A. The social worker is having a counter-transference reaction. B. The social worker and client both agree that it seems as if no further progress can be made. C. The client probably needs a more directive and confrontational approach. D. The client begins to miss sessions. Answer: Social workers should protect the confidentiality of all information obtained in the course of professional service, except compelling professional reasons ================================================== Question: *50. José, a 14-year-old Mexican-American boy, comes to therapy with his mother. He presents with a flat affect and avoids eye contact during the initial assessment session. During the assessment process, José remains quiet as his mother provides a list of José's symptoms and behaviors that she would like you, as the social worker, to address. Before the initial assessment session comes to an end, José requests that you meet with him individually from now on. After deciding that it would be appropriate to schedule individual sessions, what is your legal obligation? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal obligations that pertain to documentation. A. Assess whether the absence of Jose's father is having an impact on his behavior or this session. B. Refer his mother for individual therapy to avoid abandoning her as part of the treatment unit. C. Document your decision to meet individually with José. D. Ask his mother to sign a new consent form for him to be treated individually. Answer: 1. Suspension of hurting one self 2. Suspensions of child abuse 3. Suspension of hurting others ================================================== Question: 51. When writing notes about your client's therapy, which of the following information would not be kept in a client's chart? Content Area: Ethics: Business Practices and Policies This question addresses the parameters of record keeping. A. The client's diagnosis. B. Notes on any peer consultations regarding counter-transference issues around the case. C. The informed consent signed by the client. D. The treatment plan. Answer: 1. Reasonable suspicion does not require certainity the child abuse or neglect has occured 2. Reasonable suspicion does not require a specific medical indication of child abuse or neglect; any reasonable suspesion is suffeciant 3. Reasonable suspicion may be based on any information considered credible by reporter, including statements by others ================================================== Question: *52. After your session with Scott, you decide to buy $10,000 worth of the stock that he was talking about. In a short time the stock tailspins to 10% of its initial price offering. How would you characterize the social worker's action? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your sensitivity to the issues of professional boundaries and dual relationships. A. It is illegal and unethical. B. As the social worker did not solicit the information, the social worker was free to purchase the stock. C. It is unethical. D. It is unethical if it interferes with the nature of the therapeutic relationship. Answer: An entity with a legitimate need to know. I.e teachers, school counselors, primary care physcians, members of hospital treatment team, agency personal, insurance companies, gatekeepers to services ================================================== Question: *53. What is a social worker legally required to disclose to a client at the beginning of treatment as part of the ethical obligation for informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question reviews your knowledge of the legal and ethical aspects of informed consent. A. The fee, the true name and license of the designated owner of the practice, and the limits of confidentiality. B. The fee and the type of license held by the social worker and the expiration date of a release authorization. C. The fee and the true name and license of the designated owner of the practice. D. The fee, the type of license held by the social worker, and limits of confidentiality. Answer: Refers to a private statement that must be kept in confidence by the recepient for thr benefit of the communicator ================================================== Question: 54. Hank, a 27-year-old stockbroker, is referred by his EAP for 6 sessions. In the 5th session Hank tells you that he has recently acknowledged to himself that he is gay and doesn't know how to tell his fiancee. He wants to bring her to the next session and have you tell her for him. The best course of action would be to: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to manage client expectations and boundaries. A. Remind him that he only has one more session and that may not be how he wants to use it. B. Suggest more sessions to clarify his sexual orientation. C. Ask him how he knows he is gay. D. Decline his request to tell her for him. Answer: Privilege refers to information shared verbally by the client in psychotherapy sessions and information documented in the clincsl records ================================================== Question: 55. A disabled client reports difficulty getting her medications because her son spends her SSI checks on gambling debts. What is your legal responsibility? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of your responsibilities as a mandated reporter. A. You have no reporting mandate for domestic violence. B. You are legally mandated to contact Adult Protective Services for dependent adult abuse. C. You are legally mandated to contact Adult Protective Services for elder abuse. D. You are ethically responsible to put the client's son on a 5150 for danger to others, as his mother could die without the medications. Answer: Is established by ca evidence code 1014 ================================================== Question: 56. A therapist who performs telehealth advertises that the main advantage of internet therapy is that the client can reach a therapist in real-time. "If crises come up or just a quick question, online therapy can meet your needs right away." This advertising is: Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of the legal parameters for advertising on the internet. A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable. B. Legal if telehealth is within the therapist's scope of practice. C. Unethical because online therapy cannot be used in a crisis. D. Unethical because clients will expect a social worker to be available 24/7. Answer: 1: The patient is the holder of the privilege when he or she has no guardian or conservator. If the patient has a guardian or conservator, then the guardian or conservator holds the privilege. 2 If the patient is dead, the personal representative of the decedent holds the privilege. 3 If your identified patient is a group, family, or couple you must receive a waiver from each and every member of the group before you can release any information. 4 If your patient is a minor child, he or she holds the privilege. A minor's parents do not hold the privilege for the minor. The only time a parent could hold the privilege for the minor is if the court has specifically appointed the parent as a guardian ad litem. 5 If your patient is a minor, you must assert the privilege on his or her behalf. If the minor has an attorney, the attorney can make the decision to waive or assert the privilege. ================================================== Question: 57. As you arrive to work in the morning you notice your office has been broken into and your client, Matilda, who has been diagnosed with Borderline Personality Disorder, has pried open your locked file cabinet, has her file under her arm, and is about to leave the premises. She tells you she knows that she has a legal right to her own records. You tell her that this is true but that legally, in order for her to see the records: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal protocols for a client requesting to see her records. A. She must submit to you a request in writing. B. She must sign a release authorization because after she leaves the office with her records it is possible that unknown third parties will see the records. C. You must first inspect the records to make sure that there is nothing in them that would be detrimental to her mental condition or to the therapeutic process. D. Fill out the appropriate HIPAA forms to insure the privacy of her protected health information. Answer: 1. Service 2. Social justice 3. Dignity and worth of the person 4. Importance of human relationships 5. Integrity 6. Competence ================================================== Question: 58. You are a newly licensed social worker. You would like to incorporate EMDR into your practice. Which of the following statements is CORRECT? Content Area: Ethics: Professional Competence and Preventing Harm. Awareness of when EMDR can be incorporated into your practice is being tested here. A. EMDR is not within the scope of practice for a mental health professional. B. You may practice EMDR if you are properly trained. C. You are legally required to inform a client in the first session that you use EMDR. D. You may practice EMDR only if you are certified by your state licensing board. Answer: Privilege is not absolute, if there is a issue of a clients mental health or psychological treatment is raised during the course of a lawsuit, a ,metal health provider might be forced by the court to reveal the details of the clients treatment ================================================== Question: *59. The best time to establish your office policies with a client is: Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of the ethical standards in establishing office policies. A. At the commencement of treatment. B. Within the first couple of sessions. C. On an ongoing need-to-know basis. D. When your client asks. Answer: may claim privilege on behalf of the client (per CA Evidence Code 1015). The client may then: 1.waive privilege and allow the provider to provide the subpoenaed information; or 2 invoke privilege and refuse to allow the release ================================================== Question: 60. In order to tell her clients about how she works with social media, a social worker says that she will only send texts to confirm a cancellation. This agreement between the client and the social worker represents: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of the contents of informed consent. A. A Treatment plan. B. A waiver of privilege. C. Informed consent. D. Limits of confidentiality. Answer: California, minors who are 12 years of age or older may consent to mental health treatment or counseling if both of the following requirements are met: a) 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 1) The minor would present a danger of serious physical or mental harm to self or others without the mental health treatment or counseling or residential shelter services or 2) is an alleged victim of incest or child abuse ================================================== Question: 61. A potential client was referred to you by a former client. He is specifically requesting "psychoanalysis," is willing to pay cash and wants to see you 2-3 times a week. You work from an Existential theoretical orientation. You know a supervisor who works psychoanalytically and you believe you would receive good supervision from him if you were to see this client. What will you do? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical responsibility to clarify expectations of therapy and work within your scope of competence. A. Inform the client of your theoretical orientation and let him decide what he would like to do. B. Tell the client you would be willing to see him but only one time a week and start educating yourself regarding psychoanalysis. C. Tell the client you cannot see him because you're not a psychoanalyst and offer three referrals. D. Explore with the client what he means by "psychoanalysis." Educate him on your theoretical approach and inform him of your limitations regarding psychoanalysis. Let him decide if he would like to continue therapy with you or receive referrals. Answer: minor who is 12 years of age or older may consent to medical care and counseling relating to the diagnosis and treatment or a drug or alcohol problem. Minors cannot consent to psychotropic medication or inpatient hospitalization without parental ================================================== Question: 62. Miranda, a medical social worker is going through a painful and conflict-ridden custody battle with her ex-husband. She notices that she has a hard time paying attention in rounds and last week became irritated with a patient and another member of her interdisciplinary team. According to professional ethical standards, how should Miranda proceed? Content Area: Ethics: Professional Competence and Preventing Harm. This question reviews your knowledge of managing social worker's issues and conflicts that interfere with the ability to deliver professional services. A. Apologize to the patient and colleague. B. Take a personal day. C. Take a leave of absence until the custody situation has been resolved. D. Speak to her supervisor about making adjustments in her workload. Answer: , which pertains to child abuse, requires that mandated reporters, make a report of child abuse whenever a "reasonable suspicion" of abuse exists. An abuse report is required whenever a mental health provider learns about the abuse in his or her professional capacity. ================================================== Question: *63. Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town's only community counseling clinic. In his second week at the clinic Eli is given a list of new interns he will be supervising and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do? Content Area: Ethics: Business Practices and Policies This question tests your knowledge regarding supervision and dual relationships. A. Decline to supervise the intern. B. Ask the client to choose between having Eli as a social worker or a supervisor. C. Terminate the therapy since it conflicts with Eli's role as a supervisor as well as the client's desire for training and career advancement. D. Proceed as a supervisor since this is a case of an unavoidable dual relationship. Answer: Elder is over 65 years age ================================================== Question: 64. You find out that your client Joyce has been living with John for one year. John has a son who has become violent with Joyce on several occasions. She states that she really cares for John but doesn't know what to do about his son. How would you handle this situation? Content Area: Ethics: Therapeutic Relationship/Services This question pertains to a social worker's ethical responsibility to provide for a client's safety. A. Provide Joyce with safety information. B. Obtain Joyce's informed consent. C. Refer Joyce to a woman's support group. D. Refer the son to a high-risk teen group. Answer: Is one whose physical or mental health that puts them at increased risk of abuse ================================================== Question: *65. You are treating a family of four in therapy. The oldest child, age 17, suggested that you do telehealth sessions with him. Legally, in order to do this you must: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal parameters for the use of telemedicine/telehealth. A. Obtain written consent-to-treat from him because he is age 12 and older, to change the treatment plan. B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy. C. Legally obtain informed consent with the whole family to change the treatment plan. D. Determine your fee schedule for a different medium. Answer: Financial abuse Abandonment Neglect ================================================== Question: *66. Isaac and Fanny want their son Adam to have his Bar Mitzvah ceremony at the Orthodox synagogue that they belong to. Adam will only agree to study for his Bar Mitzvah at the local youth-oriented Hillel Temple that is less traditional. As a social worker, the most helpful initial step would be to: Content Area: Ethics: Therapeutic Relationship/Services This question asks you to clinically evaluate diversity of religious beliefs within a family. A. Suggest a compromise and see how they respond. B. Ask permission to speak with both Rabbis for their input. C. Ask the family members individually to share with you their thoughts about religion. D. Ask each family member to explain to you from their point of view the meaning this religious ceremony has to them and their family. Answer: Refers to the assumption that the reporter to the best of their knowledge had reason to believe the child in question was being subjected to abuse or neglect. Even if the allegations are false the reporter is provided with immunity ================================================== Question: 67. According to the Elder/Dependent Adult Abuse Reporting Law, you are mandated to report all of the following EXCEPT: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the Elder/Dependent Adult Abuse Reporting Law. A. Mental suffering B. Self-neglect C. Financial abuse D. Physical abuse Answer: Laura's Law allows California counties to decide whether to opt to implement a community-based, court- monitored outpatient treatment program. These programs require outpatient treatment for a seriously mentally ill person who is unlikely to survive safely in the community without supervision, has a history treatment noncompliance, and presents a serious risk of harm to self or others. At the present time some, but not all, California counties have adopted Laura's Law. ================================================== Question: 68. A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal and ethical standards in dealing with referrals. A. Expressed your gratitude in an appropriate and professional manner. B. Not acted unethically or illegally since you did not solicit the referral. C. Not acted unethically or illegally since you did not directly pay the colleague for the referral. D. Acted unethically and illegally. Answer: (1) the presence of attitudes that support violence, (2) the client's capacity of means to carry out violence, (3) the crossing of a threshold toward violence such as purchasing a gun or breaking a law, (4) the presence of an intent to carry out an action, (5) the responses of others to the client's plans, and (6) the degree of client compliance with professional recommendations to reduce risk. ================================================== Question: *69. Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women's make-up and shoes. Legally, what would be your first concern? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of legal requirements when treating minors. A. You would need to get consent from his parents because he is being abused at school. B. You would need to assess for child abuse. C. You would need him to sign a release to speak with his school. D. You would need to assess for possible suicidal ideation. Answer: Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience. b) Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques. c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm. ================================================== Question: 70. A social worker who works from a Humanistic model tells a few of her clients that she has been sober for 10 years. She finds that clients feel safer with a social worker who is in recovery like themselves. What is a LCSW's ethical obligation to a client if a client wants the social worker to be his sponsor after one year of sobriety and participation in AA? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to ethically manage a client's request that you participate in a dual relationship. A. Tell the client it would be a dual relationship to act as a social worker and sponsor. B. Wait at least two years to begin any type of relationship concurrent with therapy. C. Agree to be the sponsor only after the client terminates therapy and if the client initiates the termination. D. Assess for any counter-transference that would encourage the social worker to become the sponsor. Answer: Informed consent involves providing clients with information necessary to make educated decisions about treatment. Can be in writing or by conversation ================================================== Question: *71. A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would: Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist's boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship. A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations. B. Contact the therapist to discuss the legal/ethical consequence of his actions. C. Assess for further boundary violations. D. Contact the BBS to report the therapist's inappropriate actions. Answer: Goals of therapy/psychotherapy services - Risks and benefits of therapy - Approximate length of the process - Alternatives to therapy - Fees and services, including processes if bills are not paid - Qualifications and background of the counselor - Treatment procedures, including emergency procedures - Third party disclosures - Choices between paying with and without insurance -limits of confidentiality ================================================== Question: 72. Patricia, a 12-year-old client, tells you that she hates it when her older sister lets her boyfriend sneak into her room at night. The older sister is 15 and the boyfriend is 18. Patricia says they continue to do "nasty stuff" even though she tells them to stop. What would be your next step? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of laws that differentiate between reportable sexual abuse and non-reportable consensual sex involving minors. A. Call Child Protective Services. B. Tell the parents. C. Have a session with the sisters. D. Find out if they are having intercourse. Answer: Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. ================================================== Question: *73. Audrey, age 32, comes into your office while her father, Carl, and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father, Carl, and she asks, "Can I pay you when my 'ex' pays his overdue child support?" How would you manage the ethical issue of fees? Content Area: Ethics: Business Practices and Policies This questions test your knowledge of the ethics that pertain to fees, fee disclosure and fee management. A. Review the fee policies outlined in your informed consent document. B. Disclose your fee prior to providing therapy or as soon as practically possible. C. If you see Audrey alone and her father is paying, explain that she must collect the fee from him and then pay you. D. Discuss Audrey's request that you wait to be paid until the 'ex' pays his overdue child support. Answer: -Counseling a friend, family member or someone known to the therapist - Providing individual therapy to two members of the same household - Providing simultaneous individual and group therapy - Entering a business relationship with a client Entering a social relationship with a client - Hiring a patient to do work for the therapist - Bartering goods or services to pay for therapy - Supporting the patient's isolation from social support systems - Increasing dependency on the therapist. ================================================== Question: *74. A social worker wants to speak with a client's nurse practitioner and brings up the subject of signing a release in order to do so. As part of informed consent, a client begins asking the social worker what she will do with the release. The social worker should explain that: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to talk with clients about the impact of their signing a release authorization. A. The release will expire in one year. B. The client is entitled to receive a copy of the release. C. The social worker will speak only with the person on the release. D. The social worker will tell the client before speaking with the third party. Answer: The California Business and Professional Code and the Civil Code (Section 43.93) discuss sexual relationships between of clients by therapists. In California, it is illegal for a psychotherapist to engage in sexual contact with a patient or former patient under any of the following circumstances: a. during therapy; b. within two years of termination of therapy; and c. by means of therapeutic deceptio ================================================== Question: *75. You have been working at your agency for 8 months and you have observed a colleague using EMDR. You are very impressed with the results she is having. You read an article about EMDR in a professional magazine. You also register with an EMDR council on the Internet. You begin using this technique with your clients. In this instance: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to assess your ability to treat a client within your scope of competence. A. You may use this technique with your clients because you are registered on the Internet with the EMDR site. B. This would be considered outside of your scope of practice. C. Since you have studied the technique, it is ethical to practice with your clients. D. This would be considered outside of your scope of competence. Answer: -When a client accrues a large bill and cannot pay for services -When a client who has previously paid in full for services now requires a sliding scale -When there is a role change (e.g., an agency therapist is promoted to a non-clinical role) -When the therapist does not see continued need for treatment When there is a lack of treatment progress -When there is a threat to the clinician -When a client's issues exceed the clinician's scope of competence ================================================== Question: 76. John, 15, has lived with his father since his parents divorced. When expelled from school, his father brought him to you for counseling. The following week you get a call from Clara who identifies herself as John's mother. She says that her son needs to live with her if he is ever going to "be a better man than his father." Your initial step would be to: Content Area: Law: Confidentiality, Privilege, and Consent This test item addresses procedures to protect client confidentiality. A. Get a release from John's father to talk to his mother. B. Get a release signed by both John and his father. C. Not disclose to John's mother that John is your client. D. Invite John's mother to the next session. Answer: Health insurance companies offering mental health benefits will be required to provide equal coverage of mental and physical illnesses. requires health insurers to guarantee that the mental health and substance use benefits they offer are consistent with coverage offered for physical disorders or diseases. ================================================== Question: 77. During the course of therapy, a very strong emotional bond develops between Rowene and her client, Artie. Three years after the therapy terminates, Rowene and Artie run into each other at a delicatessen and decide to share a pastrami sandwich. One thing leads to another and several dill pickles later, Rowene and Artie begin a sexual relationship. One year later they break up. Artie, hurt and vengeful, files a complaint with the BBS claiming Rowene engaged in an unethical dual relationship with Artie by virtue of the relationship they entered into after therapy. Regarding this claim, which of the following responses is true? Revocation of a LCSW's license after having been found to have engaged in sexual misconduct with a client would occur after: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of legal and ethical standards involving post therapy sexual relationships. A. Rowene violated neither legal nor ethical standards. B. Rowene violated both legal and ethical standards. C. Rowene violated the law, but not ethical standards. D. Rowene violated ethical standards, but not the law. Answer: California's statute mandates that health insurance plans offered in the state provide coverage for a list of nine mental health conditions: schizophrenia, schizoaffective disorder, bipolar disorder, major depression, panic disorder, obsessive- compulsive disorder, pervasive developmental disorder or autism, anorexia nervosa, and bulimia nervosa. The state law also has broader scope than the federal parity statutes, covering all group insurance plans as well as individual insurance plans. ================================================== Question: 78. As a mental health professional, which of the following situations are you mandated to report? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking for the situation that you are mandated to report. A. Your 30-year-old female client is beating her husband and there are two young children in the home. B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son. C. You have suspicions that your 63-year-old client is being beaten by her son-in-law. D. Your severely depressed client tells you that she wants to die. Answer: Request for domestic violence restraining order (DV-100) And the California telecommunications systems (CLETS) information form ================================================== Question: *79. Two years and one day after terminating with your client, Bob, he calls you and says that he has extra tickets to the NBA playoff game tonight and would like to invite you to the game with him and his wife. Under what circumstances might it be ethically appropriate for you to accept? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge regarding dual relationships. A. Under no circumstances, since a client is always a client and this could constitute a dual relationship. B. Under all circumstances, since this post-therapeutic relationship would occur more than two years following termination of treatment. C. If both you and the former client felt comfortable with meeting in this way. D. If you were to obtain professional consultation to determine the reasonableness of this post-therapeutic relationship. Answer: makes protection orders enforceable against state lines. If a victim believes that an order of protection has been violated, he or she should call police immediately. In many states, violators of protective orders are immediately arrested and jailed. ================================================== Question: *80. You are treating a client who discloses that she has had sexual relations with all her prior therapists. You: Content Area: Law: Legal Standards for Professional Practice. This question involves your legal responsibility in treating a client who has had sexual relations with prior therapists. A. Consider a diagnosis of Borderline Personality Disorder. B. Provide her with a copy of "Professional Therapy Never Includes Sex" and answer her questions about it. C. Provide her with a copy of "Professional Therapy Never Includes Sex" and describe the laws prohibiting therapist sex with clients. D. Contact the BBS and inform them of the client's reports. Answer: Are community based services that assist and support parents in their role as caregivers ================================================== Question: *81. Laurel, age 28, a corporate fund-raiser, and Marty, age 30, an electrician, are referred to you by Marty's E.A.P. Three weeks ago Marty witnessed the death by electrocution of a co-worker while they were working on a high-power utility line. Since then, Marty says he can't concentrate, is having nightmares, can't sleep, and finds himself reliving the incident over and over again. Laurel says Marty's problems are due to his drinking, not his co-worker's death. How would you handle the ethical responsibilities pertaining to boundaries? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to manage boundaries. A. Avoid membership in gyms or country clubs to which either Marty or Laurel belong. B. Inform Marty how privilege works in case he is subpoenaed regarding the co-worker's death. C. Have Marty sign a release so that you can speak to his E.A.P. D. Set the fee before the first session. Answer: Are short term, family focused and community based services designed to help families cope with significant stresses or problems that interfere with their ability to nurture their children ================================================== Question: *82. A lesbian couple that you have been seeing asks you about Emotionally Focused Therapy. One of the partners tells you that she saw it on a daytime talk show and would like to see if it can help them. What should you NOT tell them if you feel competent to do this kind of therapy? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to ethically change the treatment plan, which requires informed consent from clients. A. That you will need them to sign an agreement to change the treatment plan. B. The risks and benefits of this type of therapy. C. How you will help them determine new treatment goals that fit with EFT. D. Your skills and experience in working with EFT. Answer: Health insurance portability and accountability act 1996 ================================================== Question: *83. Who holds the privilege for a 14-year-old client in a custody case? Content Area: Law: Confidentiality, Privilege, and Consent This question reviews your knowledge of privilege. A. The parents of the minor. B. The lawyer overseeing the client's case. C. The 14-year-old client. D. The social worker. Answer: Known as the administrative simplification (AS) provisions requires the establishment of national standards for electronic health care transactions and addresses the security and privacy of health data ================================================== Question: *84. A family with a 16-year-old daughter and a 15-year-old son comes in to see you. The siblings are of equal height and build. The parents report that they have been referred to you by the school counselor because of the children's frequent squabbles. You discover they both have hit the other hard enough to give each other black eyes. You would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. The question relates to reporting requirements for sibling abuse. A. Set up a strict policy of no hitting; teach anger management skills to both siblings; and instruct the parents on recognizing the warning signs that lead to the children's violence. B. Report the incidents to a children's protective agency. C. Inform the parents that if they don't contain the violence, you will report the incident to a children's protective agency. D. Take steps to contain the violence. Since the violence is between siblings that are close in age and evenly matched, it is not reportable since it is a mutual affray between minors. Answer: Portability standards that ensure the continuity of healthcare 1.Privacy standards that govern the disclosure of protected health information 2. Security standards that protect the development and maintenance of health information ================================================== Question: *85. The juvenile court refers a family to you. The 14-year-old son has been found guilty of vandalism and recently tested positive for using marijuana. The parents say the boy's friends are to blame, and they want your help to convince the court that their son was a victim of these older boys pressuring and threatening him. Ethically you: Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of how to act in an ethical manner with a client who has been referred by the juvenile court. A. Would explain that you need a release from the parents to communicate to the court. B. Could tell the court what the parents have told you. C. Must consult with the boy's attorney so that you remain in your scope of competence. D. Make a child abuse report concerning the older boys' threats. Answer: 1. Limits the ability of a new employer plan to exclude coverage for preexisting conditions 2. Provides individuals with the opportunity to enroll in a group health plan if they lose other coverage or experience certain life events 3. Prohibits discrimination against employees and their dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information ================================================== Question: 86. Your client of six months, Dale, who was referred to you by her wheelchair aerobics instructor, comes to session with her 16-year old daughter Natasha. Dale is worried about abrupt changes in Natasha who has suddenly become argumentative and secretive. Natasha continues, "I'm sick and tired of helping her get to the bathroom. I want to be out with my friends." How would you manage your ethical obligations as they pertain to diversity? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to incorporate diversity issues into the therapy from an ethical perspective. A. Educate yourself on the psychosocial impact of being in a wheelchair. B. Refer Dale to a support group for mothers in wheelchairs. C. Join with the family by acknowledging similarities between Dale and Natasha. D. Construct equipment, redesign entrances, or otherwise provide adequate wheelchair accessibility to your office. Answer: Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. The law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to that individual's enrollment date in the plan. ================================================== Question: 87. Due to economic constraints, Robert has decided to broaden his practice and is willing to accept types of clients with whom he has not previously worked. Which ethical principle best characterizes what he should do? Robert should: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of scope of competence. A. Only accept referrals within his scope of competence. B. Accept all referrals and get proper consultation and training as necessary. C. Not accept any referrals outside of his experience. D. Not accept any referrals for which he has had no formal training. Answer: Protected health information is any information about health status, provision of health care, or payment for health care that can be connected to a person ================================================== Question: *88. John is a client whom you referred to a psychiatrist for an evaluation. He was reluctant to go because he has a history of steroid abuse that he does not like to talk about. He was given a prescription for SSRIs to alleviate his depression that he has been taking for six months. John comes to session this week and tells you that he has stopped taking the medication. You would: Content Area: Law: Legal Standards for Professional Practice. This question focuses on the issue of scope of practice. A. Ensure that John takes the medication. B. Educate John about the impact of terminating the antidepressant medication. C. Refer John back to the prescribing psychiatrist. D. Explore the reasons for John's refusal and suggest that another antidepressant might be more appropriate. Answer: Any information about a person's past, present or future mental health status Names All client address information other than their state of residence Dates (except year) related to an individual, including birth date, admission date, discharge date Client phone or fax numbers E-mail address Social Security numbers Client photographs ================================================== Question: *89. Michelle, a 52-year-old car saleswoman, has been seeing you for individual counseling. She has a history of stormy relationships and affairs with married men. In one session, after discussing her tendency to avoid intimacy with any one man by juggling too many men at once, she tells you she's been seeing another therapist on the side. Ethically you: Content Area: Ethics: Therapeutic Relationship/Services This item reviews the ethics of a client having two separate therapists. A. Tell her it is unethical to have two therapists and encourage her to pick between you and the other therapist. B. Tell her it is unethical, and you can't see her again until she terminates with the other therapist. C. Explore the similarity between what she is doing in her relationships and with her therapy. D. Ask her what her goals have been with the other therapist and request a release to speak with that therapist. Answer: A key component of HIPAA is the Privacy Rule. The HIPAA Privacy Rule creates national standards to protect individuals' medical records and other personal health information. 1. It sets boundaries on the use and release of health records. 2. It enables clients to find out how information may be used, and about certain disclosures of their information that have been made. 3. It gives patients the right to examine and obtain a copy of their health records and to request corrections if data is incorrect. 4. It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information. 5. It enforces civil and criminal penalties if there is a violation of clients' privacy rights ================================================== Question: *90. Cynthia, a 42-year-old, divorced mother of two children, is your client. She has been seeing you to work on overwhelming feelings of anxiety. Her children are being seen in therapy by a well-respected child psychologist to deal with the upset of the divorce. Her husband is suing her for custody of the children. You have been contacted by his lawyer who has subpoenaed your records. You would: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of your legal obligations as they pertain to privilege. A. Release your records. B. Tell the lawyer you refuse to release Cynthia's records. C. Release only a summary of your records. D. Call your client. Answer: If you are an individual mental health provider or work for a hospital, health plan or health care clearinghouse that transmits information electronically you are affected by HIPAA. ================================================== Question: *91. Your client, Janet, 25 years old, reports being tired all the time, spending less time doing activities that she used to enjoy and crying often for no apparent reason. Janet reports losing weight and spending less time with family and friends. You assess for suicide and judge the risk to be low. You may use all of the following interventions, EXCEPT: Content Area: Law: Confidentiality, Privilege, and Consent This question assesses your understanding of interventions used with suicidal clients. A. Talk with Janet about the problems in her life and her lack of interest. B. Mobilize external and internal resources. C. Suggest Janet take anti-depressants. D. Offer empathy and emotional support and contracting for ongoing contact with you as necessary. Answer: The term "covered entity," includes any mental health provider who submits billing information to managed care companies or other third parties. Please note that if there is even a single electronic transmission to an insurance carrier or other third party, the HIPAA requirement states that you must immediately become compliant with all guidelines ================================================== Question: 92. Cheryl and Bobby are in a joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. Cheryl tells Bobby that she won't make any more referrals to Bobby. If Bobby decides to get some outside support, he is ethically managing his: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of different ethical principles. A. Scope of competence. B. Counter-transference. C. Dual relationship. D. Scope of practice. Answer: --If access is reasonably likely to endanger the life or physical safety of the individual or another person --The PHI refers to another person (except for a health care provider) and access is reasonably likely to cause substantial harm to that person; or --If PHI is created during research, the access to PHI may be temporarily suspended if the individual is notified in advance --If the PHI was obtained from someone other than a health care provider under a promise of confidentiality and the access requested would reveal the source of the information ================================================== Question: 93. You are a social worker at a private agency funded by a religious charitable organization. You are assigned to work with a couple that initially reported communication problems. You explain the limits of confidentiality and your "no secrets" policy at the first session. After the first session, you receive a message on your voicemail from the wife that says her husband has been physically abusing her. What is the most ethical course of action? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical management of your "no secrets" policy. A. Call the wife and remind her of your "no secrets" policy, and that you will disclose her message to the husband at their next session. B. Call the wife and remind her of your "no secrets" policy, and that you expect her to disclose her message to the husband at their next session. C. Waive your "no secrets" policy and assess for physical abuse at the next session by interviewing the couple separately. D. Waive your "no secrets" policy and call the wife to assess whether she is currently in danger. Answer: ---When the minor is the one who consents to care and the consent of the parent is not required under State or other applicable law. --When the minor obtains care at the direction of a court or a person appointed by the court. ---When, and to the extent that, the parent agrees that the minor and the health care provider may have a confidential relationship. ================================================== Question: *94. Karen has been a client of yours for almost six months. One day when you are in church you notice that Karen's name is in the church bulletin welcoming her as a new member of the congregation. You doubt that she knew you went to this church. You should: Content Area: Ethics: Business Practices and Policies This question reviews your knowledge of dual relationship protocol. A. Leave the congregation. B. Tell the client she needs to join a different congregation. C. Stay in the congregation but avoid direct social interactions. D. Review dual relationships with your client, and healthy client-social worker boundaries. Answer: Notes recorded in any medium by a mental Heath professional documenting or analyzing the contents of conversation during a private counseling session ================================================== Question: 95. Your client just found out that her identity has been stolen on the internet and she is worried that whoever stole her identity will also know that she was in therapy from the online bills and emails she paid to you, her social worker. What should you do to fulfill your scope of competence obligations? Content Area: Ethics: Business Practices and Policies This question relates to general scope of competence issues-any issue related to your ability to provide treatment in a competent manner. A. Maintain computer security, i.e. firewalls, passwords, etc. B. Refer the client to a new mental health professional. C. Destroy records in a confidential manner. D. Assure that you are competent to provide internet therapy. Answer: Requires mental health providers to anticipate threats to, or inappropriate uses of confidential information. It only applies to electronic protected health information or ephi ================================================== Question: 96. Which of the following people CANNOT initiate a 5150? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge about initiating a 5150 (an involuntary 72-hour-hold). Initiating a 5150 is making the request for a formal 5150 evaluation to take place. A. A parent. B. A social worker. C. A paramedic. D. A 17-year-old client. Answer: Health care claims Health care payment and remittance advice Electronic requests for coordination of benefits Electronic treatment request forms ================================================== Question: *97. The court sends Sue and Jerry to you for marital counseling after a domestic violence incident. A month after the referral, the court requests a report on the couple's attendance and progress. You: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to respond to a court request. A. Can inform the court of the couple's attendance, but not progress without a written release signed by Sue or Jerry. B. Should assert privilege on behalf of the couple. C. Need a written release signed by both Sue and Jerry before you can communicate with the court. D. Cannot assert privilege on behalf of the couple. Answer: 1.HIPAA standards apply to protected health information: "information about health status, provision of health care, or payment for health care that can be connected to a person." This broadly includes any part of a client's medical record or payment history. 2. HIPAA sets boundaries on the use and release of health records. 3. HIPAA patients the right to examine and obtain a copy of their own health records and request corrections. 4. It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information. 5. Providers must notify clients about their privacy rights and how their information can be used. 6. Mental health practitioners must adopt and implement privacy procedures ================================================== Question: 98. You just received a referral from a local psychiatrist. The client suffers from a severe psychotic disorder and must take psychotropic medications. You have never treated anyone with a chronic mental illness in your private practice before so you must: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of standards for ethical client treatment. A. Consider whether you have the appropriate education, training and experience to accept this case. Also, look at the client's goals for coming to see you. B. Let the doctor know you appreciate the referral, but you are out of your scope of practice in taking on this particular client. C. Find a supervisor to assist and guide you in working with this client so that you are covered legally. D. Tell the doctor that you would like to take this case and are prepared to research this diagnosis and work closely with him so that you might effectively treat the client and expand your capabilities as a clinician. Answer: Text based forms of communication include email chat rooms text messages and listservs. Forms of communication that aren't text based include telephone and videoconferencing ================================================== Question: *99. A social worker receives a phone call from a young woman who asks if they can talk before she makes an appointment. In an initial phone call, the woman introduces herself and asks how long you have been a social worker. Missie tells you that she is depressed and that there is no pleasure or joy in anything she does. She doesn't have a lot of time or a lot of money but wants to know if you can help her to feel better. What is the social worker's obligation? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical obligations. A. Tell her how long you have been licensed and how many clients you have. B. Ask her how many sessions she can afford and use a therapy model that suits her needs. C. Before making her a client, perform informed consent about what to expect from therapy. D. Evaluate the seriousness of her depression to determine if you can treat her. Answer: Synchronous communication is most easily facilitated through instant messaging, chat rooms, telephone, and videoconference. Synchronous communication provides immediate feedback, since both the practitioner and client are engaged in conversation during the same time frame ================================================== Question: 100. A client that you treated 3 years ago terminated when her therapy goals had been reached and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal requirements when starting therapy. A. Tell her if you have raised your fees. B. Tell her that you must make referrals if her needs are out of your scope of competence. C. You must open a separate file. D. She must sign a new release authorization since they expire after one year. Answer: Asynchronous communication allows for correspondence without simultaneous connection (Maheu, et al., 2005). Examples include postal mail, e-mail, facsimile, and voicemail. These forms of contact generally do not allow for immediate feedback or a consistent flow of conversatio ================================================== Question: *101. In making a referral for a lesbian couple dealing with domestic violence issues, the social worker should: Content Area: Ethics: Therapeutic Relationship/Services This question tests your sensitivity to human diversity issues. A. Refer them to a social worker who has experience with domestic violence issues. B. Not consider their sexual orientation since this is irrelevant to the domestic violence issues. C. Refer them to a lesbian social worker. D. Refer them to a gay and lesbian community center. Answer: --The treatment process or procedure --Benefits associated with the treatment or procedure; --- Risks associated with the treatment procedure; --Actions taken to prevent client risk -- Procedures for emergencies. ================================================== Question: 102. You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the law pertaining to suicidal clients. A. Legally bound to report. B. Ethically responsible to notify family or "others responsible for the client's well-being." C. Legally responsible to intervene. D. Not responsible in any way as the client has a right to make his/her own decision. Answer: to prevent hackers from accessing patient records and to prevent computer viruses from corrupting electronic data (Zack, 2004). Several different security options are available to practitioners and clients for maintaining a secure computer network. For a licensed therapist practicing E-therapy, experts recommend securing clients' electronic records by utilizing password protection programs, computer network firewalls, wiping software, and document encryption. ================================================== Question: 103. You have been seeing Shelly, 54, for two years. During one session, Shelly expresses the wish that the two of you could get together for coffee, since she likes you as a person, and she has been feeling very lonely lately. You would: Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of the impact of the therapeutic relationship on a client and the necessity to review the relationship with a client on occasion. A. Discuss with Shelly the nature of the therapeutic relationship and explore her feelings and assumptions. B. Agree to conduct therapy while the two of you walk in the neighborhood around your office. C. Give Shelly homework to ask a friend to go out for coffee. D. Inform Shelly that going out for coffee is a boundary violation, and that you would not think of violating this boundary. Answer: Medicare deemed online videoconference billable in October 2001 ================================================== Question: 104. A 6-year-old child has been brought in by his mother for counseling. She wants you to explain to him why he is in therapy because she feels like she doesn't have the right words, and it could scare him. How do you handle obtaining consent for the child? Content Area: Law: Confidentiality, Privilege, and Consent This question concerns consent to treat a minor and custody. A. If the parents are divorced, review the custody papers. Joint custody means both parents must consent. B. Determine the marital status of the family. If the parents are still married, then both must consent. C. If the parents are divorced, review the custody papers. Determine whether one or both parents must consent. D. If the parents are divorced, review the custody papers. Either parent may consent if they are the biological parent. Answer: provides several means for reducing medical errors, such as: 1) Establishing a national focus to create leadership, research, tools, and protocols to enhance the knowledge base about safety; 2) Identifying and learning from errors by developing a nationwide public mandatory reporting system and by encouraging health care organizations and practitioners to develop and participate in voluntary reporting systems; 3) Raising performance standards and expectations for improvements in safety through the actions of oversight organizations, professional groups, and group purchasers of health care, and 4) Implementing safety systems in health care organizations to en-sure safe practices at the delivery level. ================================================== Question: *105. A social worker has been treating Mikey, age 12, for the last 8 months. He has been dealing with feelings of depression and tells you that he is not doing well in school. He tells you that his parents recently filed for divorce, and he does not know with which parent he wants to live. A few weeks later, you receive a call from an attorney who tells you that she was appointed to represent Mikey in the divorce proceedings. She is requesting a copy of your records. How do you respond in this situation? Content Area: Ethics: Therapeutic Relationship/Services This question involves legal and ethical issues related to the release of clinical records. A. Having determined that the lawyer is the child's counsel, you would release your clinical records to her, and tell your client that you are doing so. B. Ask Mikey if he would sign a release to allow you to release the records to the attorney because ethically, you must act in his best interests. C. Release records with both parents' authorization if it is in Mikey's best interests to do so. D. Do not speak with the attorney because your client's confidentiality is the more important ethical obligation in this instance. Answer: Professionals make mistakes such as incorrectly diagnosis someone ================================================== Question: *106. A couple is in sex therapy. The sex therapy has focused on differences in their sexual desires. As they begin to make progress, one of the partners asks if they can come every other week, and if they do, if they can they pay a lower fee. What is your legal obligation? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to legally negotiate fees. A. Discuss a new fee arrangement before changing the fee. B. Document a new fee arrangement in your files. C. Refer the client to a lower-fee therapist. D. Self-assess any counter-transference that causes you to feel manipulated. Answer: When the clinician fails to act in someway ================================================== Question: *107. Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night, so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem, the fee is covered under the overall adoption agreement." What are your ethical obligations? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of ethical obligations. A. Determine the family's understanding of the purpose of the therapy. B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session. C. Determine the identified patient and refer to a pediatrician. D. Tell Chong-Wook and Dae-Sup the fee at the first session, and explain that you may need to consult with the school counselor and adoption agency. Answer: Unexpected occurrences involving death or serious physical or psychological injury or the risk thereof ================================================== Question: 108. Veronica, a 29-year-old coffee store manager, is in counseling because she is very depressed. She reports that she only works and sleeps and has no hope of things improving. She frequently says, "Dying is the only way out." The case of Bellah v. Greenson would compel you to: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the legal parameters when a client is suicidal. A. Initiate a 5150. B. Obtain a "self-care plan." C. Take reasonable steps to ensure her safety. D. Contact friends for a 24-hour watch. Answer: Suggests that should event recur it would carry a significant chance of an adverse outcome ================================================== Question: 109. Your client, Barbara, has been unemployed for three months. In her last session she stated that she plans to kill her ex-boss tomorrow because he's the cause of all her unhappiness. You call the police to alert them to Barbara's plan, but they don't seem to take you seriously because there isn't a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question involves a Tarasoff situation. A. Document your phone call outlining your concerns and justifying your actions in order to cover your liability. B. Have Barbara come in immediately for crisis counseling. C. Call Barbara's ex-boss and warn him of her plan. D. Call Barbara and find out if she has a gun so you can tell the police. Answer: What happened Why did it happen What to do to prevent it happening again ================================================== Question: 110. A social worker works for a managed care panel and receives most of her clients by referrals from the managed care company. A client comes for a first session, and the social worker realizes that the client has treatment expectations that are out of her scope of competence. What should the social worker do? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage your ethical and legal obligations when a client is out of your scope of competence. A. Speak with the insurance company about her scope of competence. B. Refer the client back to the insurance company. C. Refer the client to a colleague who can meet his needs. D. Collect the co-pay but do not bill for the session. Answer: Physical cause Human cause Organizational cause ================================================== Question: 111. You have been seeing a 22-year-old gay client for two years and treating him for depression. You get a call from his partner informing you that your client has committed suicide. Your best course of action would be to: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of confidentiality issues after the death of a client. A. Inquire as to whether the partner has legal authority regarding the disposal of your client's records. B. Offer to take the partner as a client to help him process his feelings of grief and loss. C. Hire an attorney regarding the suicide and make sure your notes on treating your client's depression are up to date. D. Maintain confidentiality and retain the client's files for 7 years. Answer: Tangible causes such as material items failing in some way. An example of this would be if a psychiatric medication caused an adverse reaction ================================================== Question: *112. A client you have been treating, who is also a social worker, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships. A. You indicate to your client that she can give your number to the program coordinator. B. You thank her for thinking of you, but you refuse the offer to avoid a dual relationship. C. You tell her that you are interested and ask her to set up a meeting between you and the program coordinator. D. You wait until you terminate therapy and then remind your former client of her previous offer. Answer: People did something wrong or did not do something that was needed. An example of this would be a therapist failing to take precautions to ensure the safety of a suicidal patient ================================================== Question: 113. Darius is a psychoanalytically-oriented social worker who prefers to be a "blank screen" and who, as a matter of theoretical orientation, prefers not to disclose personal information. When his clients ask him about his experience, education, training, or his ideas about the therapeutic process, Darius finds ways to avoid answering their questions. This way of handling client questions is: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical standards related to informed consent. A. Contrary to the spirit and intent of ethical standards. B. Ethically appropriate but legally questionable. C. More in tune with postmodern approaches to therapy. D. A questionable application of psychoanalytic theory. Answer: A system, process, or policy that people use to make decisions or do their work is defective. An example of this would be an organization policy that delays the reporting of child or elder abuse ================================================== Question: *114. You have been seeing Jill and Dan, a couple in their mid-30s, for 2 months. Dan's insurance has been paying a portion of their therapy. Dan informs you that he has been laid off from his job and is looking for work. The two complain of their finances. Jill works from home, running her own catering business. The couple would like to continue seeing you and ask if Jill could trade some services for their therapy. How would you handle this request? Content Area: Ethics: Business Practices and Policies This question asks you to choose the best way to proceed in a situation in which your client wants to barter for therapeutic services. A potential dual relationship is involved. A. Inform them that it would be unethical and help them find a way to pay for continued therapy. B. Acknowledge their struggle and accept the arrangement. C. Refer them to a financial counselor and discontinue therapy. D. Refer them to a couples' support group. Answer: 4.01 Competence (a) Social workers should accept responsibility or employment only on the basis of existing competence or the intention to acquire the necessary competence. (b) Social workers should strive to become and remain proficient in professional practice and the performance of professional functions. Social workers should critically examine and keep current with emerging knowledge relevant to social work. Social workers should routinely review the professional literature and participate in continuing education relevant to social work practice and social work ethics. (c) Social workers should base practice on recognized knowledge, including empirically based knowledge, relevant to social work and social work ethics. ================================================== Question: 115. Which of the following is NOT a type of dependent adult and elder abuse? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the parameters of elder and dependent adult abuse. A. Abandonment. B. Self-harm behavior. C. Isolation. D. Abduction. Answer: 4.05 Impairment (a) Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. (b) Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others. ================================================== Question: 116. A therapist who takes a Narrative approach begins to explain the risks and benefits of therapy. The client asks if this is part of the therapy, and the therapist agrees that it is. The therapist then asks the client, "what do you understand about how therapy is 'supposed' to be?" From an ethical standpoint, the therapist is: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical conceptualizations of interventions. A. Deconstructing the client's dominant discourse. B. Providing informed consent. C. Avoiding cultural bias. D. Externalizing the client's ideas about therapy. Answer: 1.05 cultural competence and social diversity A)Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures. (b) Social workers should have a knowledge base of their clients' cultures and be able to demonstrate competence in the provision of services that are sensitive to clients' cultures and to differences among people and cultural groups. (c) Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability. ================================================== Question: *117. You recently get a new, male client who is visually impaired. You've never worked with a client with a physical disability and are feeling a little uncomfortable with the client when he is sitting in the room. What is the best way to handle your discomfort? Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how to handle a client who makes you "a little uncomfortable." A. Let the client know of your discomfort and ask if he would prefer a different therapist. B. Consult with professional peers regarding your discomfort. C. Deal with your counter-transference in your own therapy. D. Do research on blindness to help you with an understanding of your client's needs. Answer: Social workers should avoid unwarranted negative criticism of colleagues in communications with clients or with other professionals. Unwarranted negative criticism may include demeaning comments that refer to colleagues' level of competence or to individuals' attributes such as race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability ================================================== Question: 118. When you check your messages you find a message from an emergency room doctor who says that he is treating a man who overdosed, and that this man had your business card in his pocket. You recognize the name as a client you have been treating, and whom you know has a history of substance abuse. The doctor wants information from you. How would you proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge about when a mental health worker may speak to a medical professional regarding a client. A. Tell the doctor you will need him to fax a release authorization signed by the client in order to speak to him. B. Give the doctor the information he needs. C. Do not acknowledge that you know the man. D. Do not return the phone call. Answer: Social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability. ================================================== Question: *119. Your 15-year-old client is using a false email and social network page to bully other students at school. He tells you he does it so that the school won't catch him. He is in therapy with the consent of his parents, and you have a release to speak with the school. If the school calls, and you decide to speak with the school, how do you fulfill your ethical obligations for informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage a breach of confidentiality in an ethical way. A. Only disclose information pertinent to the school's questions. B. Tell his parents that you plan to speak with the school before doing so. C. Tell the client what you plan to tell the school. D. Speak to his parents before you talk to the school. Answer: Social workers should act to prevent and eliminate domination of, exploitation of, and discrimination against any person, group, or class on the basis that of race, ethnicity, national origin, color, sex,sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability. ================================================== Question: *120. You have been treating Anita for three sessions for depression and relationship issues. You are considering a diagnosis of Major Depression and other DSM-5 diagnoses. You are not sure which is appropriate yet. Legally: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice. A. Do not treat the client unless your advertising indicates that you have expertise with depression or mood disorders. B. Consider whether it is in your scope of competence to work with depressive disorders. C. Change the diagnosis when you have confirmed it on any insurance forms. D. Do not submit insurance billing until you have confirmed a diagnosis. Answer: Social workers should provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Social workers should use clear and understandable language to inform clients of the purpose of the services, risks related to the services, limits to services because of the requirements of a third-party payer, relevant costs, reasonable alternatives, clients' right to refuse or withdraw consent, and the time frame covered by the consent. Social workers should provide clients with an opportunity to ask questions. (b) In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients' comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible. (c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients' interests by seeking permission from an appropriate third party, informing clients consistent with the clients' level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients' wishes and interests. Social workers should take reasonable steps to enhance such clients' ability to give informed consent. (d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients' right to refuse service. (e) Social workers who provide services via electronic media (such as computer, telephone, radio, and television) should inform recipients of the limitations and risks associated with such services. ================================================== Question: 121. A client gives you a small basket of homemade muffins as a gesture of appreciation. You: Content Area: Ethics: Business Practices and Policies This item assesses the ethical protocol in accepting/declining gifts from clients. A. Decline the muffins and explain that ethical social workers don't accept gifts from clients. B. Refuse or accept the gift based on cultural considerations and the meaning of gift giving in the client's culture-of-origin. C. Accept the gift and explore what it means for her to give you the muffins. D. Accept the gift in the spirit in which it was intended and move on. Answer: If you are an individual mental health provider or work for a hospital, health plan or health care clearinghouse that transmits information electronically you are affected by HIPAA. HIPAA provisions call these individuals or institutions "covered entities." ================================================== Question: *122. During a 5th session with a client, Keesterman realizes the client is dating his daughter. How should Keesterman proceed? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge about how to proceed when an ethical conflict develops during the process of therapy. A. Refer the client to another therapist and disclose the reasons. B. Disclose to the client the ethical conflict and discuss whether to continue treatment or refer to another therapist. C. Continue treatment to avoid abandoning the client. D. Terminate treatment and do not disclose the reasons. Answer: ---Portability standards that ensure the continuity of healthcare --Privacy standards that govern the disclosure of protected health information --Security standards that protect the development and maintenance of health information ================================================== Question: *123. Parents of 7-year-old Todd bring him in because he told them an older kid at school pulled his pants down in the boy's bathroom and laughed at him. They tell you that they also found harassing texts on their son's cell phone from the same kid and some others. The parents demand that you evaluate Todd for mental anguish because they want to sue the school for allowing bullying on its premises. Legally, the social worker should: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question probes your knowledge of the clinical and legal consequences of bringing one's mental status into a legal proceeding. A. Identify this as a form of sexual harassment but process it as child abuse. B. Advise the parents to try talking with the school's representatives before proceeding with any legal action. C. Tell them that using their son's "mental anguish" in a lawsuit could compromise their confidentiality in therapy. D. Consider making a report to an agency designated to receive a child abuse report within 24 hours by phone and within 48 hours in writing. Answer: The HIPAA Privacy Rule creates national standards to protect individuals' medical records and other personal health information. It sets boundaries on the use and release of health records. It gives patients the right to examine and obtain a copy of their health records and to request corrections if data is incorrect. Clients needed to be notified about privacy practices during first session ================================================== Question: 124. A social worker is seeing a couple on a sliding fee basis. They are having difficulty paying at this rate. When the social worker goes out to the waiting room, she discovers a cashmere sweater with a note pinned to it. The note says, "Don't tell my wife about this." What should the social worker do about this? Content Area: Ethics: Therapeutic Relationship/Services This question pertains to the issues of secrets, dual relationships, and appropriate means of payment for therapy. A. Thank him for the sweater and tell his wife. B. Thank him for the sweater and not tell his wife. C. Return the sweater and encourage the man to bring it up in session. D. Return the sweater and maintain the man's confidentiality. Answer: B. Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client. (c) Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed. information germane to the purpose for which the communication is made. (d) Social workers should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. This applies whether social workers disclose confidential information on the basis of a legal requirement or client consent. I. Social workers should protect the confidentiality of clients' written and electronic records and other sensitive information. Social workers should take reasonable steps to ensure that clients' records are stored in a secure location and that clients' records are not available to others who are not authorized to have access. ================================================== Question: *125. Some clients are referred to social workers by other helping agencies and collaboration advances client welfare. Your new client tells you that she signed a release with the agency that referred her to you. You ask her to sign your release as well. Which of the following must appear on the release? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legally required elements of release authorization. A. A "Notice of Privacy Practices" if the client is a "covered entity" under HIPAA. B. Notification to the person signing the agreement that they have a right to receive a copy of it. C. It must include an expiration date established by the client. D. It must state the client's diagnosis and reason for approving the release authorization. Answer: 1.04 Competence (c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm. ================================================== Question: *126. You are working as an associate therapist at a non-profit agency. As part of your treatment, you collaborated with a psychologist and conducted some assessment inventories to evaluate your client's progress. Your client asks you how she scored on her depression test after being in therapy for six months. Your ethical responsibility in this case would be to: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to clinically and ethically discuss assessment tests with clients. A. Inform her of the results in language she can understand. B. Give her a copy of every test she completed with a summary of scores. C. Evaluate if telling her the test scores will disrupt the therapy. D. Explain to her that she has the right to decline an assessment. Answer: a) When setting fees, social workers should ensure that the fees are fair, reasonable, and commensurate with the services performed. Consideration should be given to clients' ability to pay. B. Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary. (c) Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client. ================================================== Question: 127. A social worker is surprised to learn in session that a client did a "google" search and found out that the social worker has another job in another field. The social worker is also a personal trainer and yoga teacher. The client asks which career the social worker likes better and says that she always wanted to try yoga. The social worker feels like the client is interrogating her and is concerned that the client may show up in a yoga class. How should the social worker proceed? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to manage possible dual relationships and the ethics of having a digital and social media presence. A. Address any counter-transference about the potential dual relationship. B. Block the client from the website that allows people to enroll in the yoga class. C. Talk with the client about the risks of dual relationships. D. Tell the client that you would prefer to know in advance if a client is doing a search, and that you will also tell the client in advance if you search them on the internet. Answer: Self- determination Informed consent Preserving professional boundaries Safeguarding confidentiality ================================================== Question: *128. A professional couple, who moved here from India two years ago, begins therapy with you. You know little about their culture. In your work together you: Content Area: Ethics: Therapeutic Relationship/Services This question ascertains your knowledge of cross-cultural issues. A. Ask them to educate you about important differences and to tell you how these relate to their presenting problem. B. Do your own research on upper-class Indians to have a better understanding of your clients. C. Ask them if they feel comfortable working with you since you are unfamiliar with their native culture. D. Recommend an Indian therapist who will better understand their concerns. Answer: What an ordinary reasonable and prudent professional with the same or similar training would have done under the same or similar circumstances ================================================== Question: 129. A social worker told a colleague how she had bartered with a client, exchanging therapy for having her office painted. How should the social worker who received this information respond? Content Area: Ethics: Business Practices and Policies This question looks at your familiarity with dual relationships and the appropriate response to a colleague exhibiting poor boundaries. A. Report to the BBS. B. Report to an ethics committee. C. Tell the colleague that her actions violate ethical standards. D. Do nothing because there is no reporting requirement for this type of situation. Answer: If parents are the one who consented to therapy they have the right to clinical records ================================================== Question: *130. An 18-year-old woman named Claire, states in her first session that she's thrilled to be out of her home and to be away from "that monster of a father," whom she says sexually abused her since she was 15. She tells you she has a two younger siblings who still live at home. What is your legal obligation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question assesses your knowledge of legal obligations surrounding confidentiality. A. Maintain confidentiality. B. File a child abuse report for the abuse that Claire suffered since 15. C. File a report with CPS for reasonable suspicion of abuse for Claire's younger siblings. D. Ask Claire to sign an authorization to speak with her siblings to determine if they are safe. Answer: Refers to the right to withhold information from court. Privilege exists to benefit of the client and belongs to the client ================================================== Question: 131. As part of his telehealth practice, a social worker offers quick assessment surveys online to help potential clients decide if they want therapy. The surveys do not ask for any identifying information. The social worker has access to the results of the surveys but does not ask for the name of the consumer, to avoid the appearance of solicitation. This is legal if: Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of legal types of advertising and fee arrangements. A. He provides referrals for any online survey respondents who are in a crisis. B. He also offers the survey to current clients at no cost. C. He advertises that the online assessments are consistent with DSM standards. D. The surveys are offered at no cost, or fees for completing the surveys are disclosed before the client begins the survey. Answer: ---Portability standards that ensure the continuity of healthcare --Privacy standards that govern the disclosure of protected health information --Security standards that protect the development and maintenance of health information ================================================== Question: 132. Your client of five years asks to see a copy of his treatment records and submits the request to you in writing. How should a social worker respond? Content Area: Law: Confidentiality, Privilege, and Consent This question probes your knowledge of how to respond to client requests of access to their treatment records. A. Allow the client to inspect the records, receive a copy, or receive a summary. B. Inform the client that the records belong to the social worker, and that there is no right to client access to treatment records. C. Explain that clients are only entitled to summaries of the treatment record. D. Assert the privilege unless the request is accompanied by a court order. Answer: The HIPAA Privacy Rule creates national standards to protect individuals' medical records and other personal health information. It sets boundaries on the use and release of health records. It gives patients the right to examine and obtain a copy of their health records and to request corrections if data is incorrect. Clients needed to be notified about privacy practices during first session ================================================== Question: 133. A new client, Susan, comes into your office reporting difficulties making presentations during staff meetings and has another big presentation in three weeks. Susan says, "I've heard of some technique called EMDR which is supposed to help with things like this. Can you help me?" Under what circumstances would you be allowed to perform EMDR with a client? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of scope of practice and competence. A. You've read a book on the subject which includes step-by-step instructions. B. You consulted with a colleague who shows you how to do EMDR. C. You've taken a practical course on EMDR and have obtained certification. D. Your personal therapist used EMDR with you so you know how it works. Answer: B. Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally authorized to consent on behalf of a client. (c) Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person. In all instances, social workers should disclose the least amount of confidential information necessary to achieve the desired purpose; only information that is directly relevant to the purpose for which the disclosure is made should be revealed. information germane to the purpose for which the communication is made. (d) Social workers should inform clients, to the extent possible, about the disclosure of confidential information and the potential consequences, when feasible before the disclosure is made. This applies whether social workers disclose confidential information on the basis of a legal requirement or client consent. I. Social workers should protect the confidentiality of clients' written and electronic records and other sensitive information. Social workers should take reasonable steps to ensure that clients' records are stored in a secure location and that clients' records are not available to others who are not authorized to have access. ================================================== Question: *134. Felix, a 30-year-old Caucasian, has been placed on administrative leave for excessive absences and is referred to you by his EAP. His partner, Pablo, a 32-year-old Peruvian-American, joins him in the session. Lately they have been "fighting all the time," and at work nobody knows that they are a couple because Felix fears they'll be fired. Pablo shoots an angry glance at Felix and says, "You worry too much. I can't take you moping around all the time, and the reason I drink so much is because you stopped having sex with me." What is your ethical obligation pursuant to Pablo's drinking? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical assessments and actions you can take to determine a client's ability to benefit from treatment. A. If you have a sobriety contract in place, terminate any session at which Pablo comes in intoxicated. B. Establish long-term sobriety as a treatment goal for Pablo. C. If you have a no secrets policy in place, ask Felix to come for an individual session if Pablo is intoxicated. D. Sign a self-care contract with Pablo that includes the provision that he will attend AA concurrent with couples' counseling. Answer: 1.04 Competence (c) When generally recognized standards do not exist with respect to an emerging area of practice, social workers should exercise careful judgment and take responsible steps (including appropriate education, research, training, consultation, and supervision) to ensure the competence of their work and to protect clients from harm. ================================================== Question: *135. Your 17-year-old client is the head of Parents, Families, and Friends of Lesbians and Gays (PFLAG) group at school. She tells you that some of the students blog about "conversion therapy" and she wants your "expert opinion" so she can share it with her group. If you explain the law prohibiting sexual orientation change therapy, you are: Content Area: Ethics: Business Practices and Policies This question tests your knowledge about informed consent and what you are required to discuss. A. Illegally acting outside of your scope of practice. B. Ethically fulfilling informed consent. C. Ethically working within your scope of competence. D. Ethically managing your counter-transference. Answer: a) When setting fees, social workers should ensure that the fees are fair, reasonable, and commensurate with the services performed. Consideration should be given to clients' ability to pay. B. Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary. (c) Social workers in fee-for-service settings may terminate services to clients who are not paying an overdue balance if the financial contractual arrangements have been made clear to the client, if the client does not pose an imminent danger to self or others, and if the clinical and other consequences of the current nonpayment have been addressed and discussed with the client. ================================================== Question: *136. In working with a treatment team that consists of a therapist, medical doctor, and a nurse practitioner, the therapist has a release to speak with all of the client's health providers. The therapist should do which of the following to adhere to ethical standards? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to ethically retain confidentiality when working with a team of providers. A. Provide the client with a copy of the release. B. Avoid a dual relationship with any of the health care providers. C. Only share information with those providers that advance the welfare of the client. D. Only share information with those providers if the client is a danger to self or others. Answer: Self- determination Informed consent Preserving professional boundaries Safeguarding confidentiality ================================================== Question: 137. You are seeing a client who has been in therapy before. As you begin your informed consent discussion, she asks you to "skip this part, I have heard it all before. I want to just start telling you what is going on. We are on the 50-minute clock." You tell her that you are required to provide at least the basics of informed consent. Informed consent should include all of the following EXCEPT: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent. A. Excerpts of general therapy ethical standards. B. A provisional diagnosis. C. Information regarding the benefits and drawbacks of therapy. D. The expected length of sessions and treatment. Answer: What an ordinary reasonable and prudent professional with the same or similar training would have done under the same or similar circumstances ================================================== Question: 138. Mr. Meltzer saw you for ongoing therapy for eleven months and still has an outstanding balance. You referred him to another therapist for clinical reasons, not related to his debt. He signed a release so that you can forward his record to his new therapist in another city. You proceed to: Content Area: Ethics: Business Practices and Policies This question reviews ethical guidelines and how they relate to patients who leave treatment with an outstanding balance. A. Explain that you will forward his records when he pays the balance. B. Ask his new therapist to collect the balance for you. C. Release the records to a collection agency in order to obtain the balance. D. Send his records as requested. Answer: If parents are the one who consented to therapy they have the right to clinical records ================================================== Question: 139. You are working as an intern at a non-profit agency. Your client of the past year has made substantial progress and the two of you enjoy a close relationship. You are now ready to leave the agency and will not be available to continue treatment with this client. Your ethical responsibility in this case would be to: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to proceed when an interruption or termination of your services will occur. A. Make appropriate referrals. B. Since she knew that you were a registered associate when she started therapy, tell her that this type of termination is part of the licensing process. C. Explain to your client why you cannot continue treatment with her. D. Tell her that you will be able to meet her for coffee now that she is no longer officially your client. Answer: Refers to the right to withhold information from court. Privilege exists to benefit of the client and belongs to the client ================================================== Question: *140. Before accepting a client for telehealth services, what action should the social worker take? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the laws that pertain to telehealth. A. Determine the appropriateness of treating a client remotely. B. Determine if the client is a resident of California. C. Describe the risks, such as confidentiality risks, of internet therapy. D. Provide detailed informed consent about the social worker's experience or limits of experience with telehealth. Answer: -Supervision, consultation, TX team meetings, staff meetings --Client waivers --privileged communication --danger to self or others --suspicion of child/elder abuse ---subpoena ================================================== Question: 141. You have been seeing your client, Anne, for seven months, who pays through her insurance company. She goes on vacation for three weeks and calls to schedule her next appointment. You explain to Anne that her insurance takes a long time to reimburse you. You give Anne the option to pay your full fee or to be given several referrals to other therapists. Is this ethically sound? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to proceed with collecting payment. A. Yes, because you are offering her either continued treatment at your usual and customary fee or referrals to other therapists. B. No, because this is financial exploitation and does not demonstrate a clinically sound reason to terminate therapy. C. Yes, because Anne went on an extended vacation thus causing a disruption in treatment. D. No, because you are obligated to take insurance. Answer: therapist obligation to keep information given in the therapeutic relationship free from unauthorized disclosures ================================================== Question: *142. You have been seeing Juan and Lucita, a young unmarried couple, for a few months when they announce that they are expecting a baby for which they do not feel prepared. They want to use the therapy time to discuss their options of having the baby and keeping it, giving it up for adoption, or having an abortion. You have very strong feelings about abortion. You would: Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of handling situations that can potentially conflict with the social worker's values. A. Tell them of your bias. B. Keep your opinions to yourself. C. Tell them you can't help them deal with this crisis because of your strong feelings and refer to another mental health professional. D. Tell them it would be best if they talked to their priest about this matter. Answer: Evidence Code 1010-1027: The legal right not to have confidential communication revealed in a legal setting. Is a rule of evidence that allows one party in a legal proceeding (the client) to limit the admissibility of statements originally communicated in confidence, thus rendering the witness (therapist) incompetent to testify regarding a particular matter ================================================== Question: *143. You, a social worker, and the attorney in your office building agree to work together and make referrals back and forth. You each commit to making three referrals monthly and that the person making the most referrals that actually turn into paying clients over the next three months will "win" a weekend for two in Las Vegas. This arrangement is: Content Area: Law: Legal Standards for Professional Practice. This checks your understanding of business practices regarding paying for referrals. A. Illegal; don't do it. B. A bit unusual perhaps, but not unethical since the "prize" is not expensive and no one is really paying for referrals. C. Likely to have you lose your license if you are reported to an ethics board. D. Questionable at best and unethical since it is close to paying for referrals. Answer: 1. Protection of life 2. Equality and inequality 3. autonomy and freedom 4. least harm 5. quality of life 6. privacy and confidentiality 7. truthfulness and full disclosure ================================================== Question: 144. Greg, age 29, comes in to see you about relationship problems. He has been in a wheelchair for 10 years as a result of a diving accident. After you have been seeing him for several months, he reports that the female nurse that he needs to care for him has made unwanted sexual advances towards him. Legally you: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question addresses your knowledge of dependent adult abuse. A. Do not need to report the incident because the law does not perceive women to be sexually abusive to adult males. B. Would report the incident to Adult Protective Services immediately. C. Would not report because both individuals are adults. D. Would report by phone to Adult Protective Services within 2 working days. Answer: Report by phone immediately or as soon as possible Written report within 2 working days of receiving information Usually reported to adult protective services or to local law enforcement agency ================================================== Question: 145. You have been seeing a couple for several months. The therapeutic issues have focused on communication and trust. You receive a call from the husband who tells you that he has bought a gun "to protect my family from all of the violence out there." Since his wife is firmly against possessing guns, he has decided not tell her. You would: Content Area: Ethics: Therapeutic Relationship/Services This question involves ethics in application to secrecy in couples therapy. A. Remind him of your no secrets policy and encourage the husband to tell his wife about the phone call and the gun. B. Not bring up the content of the phone call since you've established that he is not intending to hurt his wife or children. This does not constitute a Tarasoff situation. C. Focus on the issue of trust in their marriage which will encourage the husband to tell his wife. D. Inform him that you do not keep secrets. You assume that he wants his wife to know or he would not have told you. Therefore, if he does not tell his wife in the next session, you will inform her of the conversation. Answer: CPS phone call within 24 hours and fax written within 36 hours ================================================== Question: 146. You receive a text from a potential client. She tells you that she got your name from a friend of hers and would like to know "what's involved in getting started with therapy." In response to her, you take a picture of your consent form and fee and send it to her. She responds "K" and asks when she can come for a first session. What is your next legal step? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal fee arrangements. A. Obtain a written agreement about the fees for therapy. B. Obtain written informed consent because "K" is not sufficient. C. Discuss your consent form before she arrives for her first session. D. Tell her that texts are part of her treatment file. Answer: The duty to warn and to protect. If a client reports a threat to others and it is a serious imminent danger the clinician responsibility is to report the threat to victim, law enforcement and do what is in their power to stop client within reason. ================================================== Question: 147. During a session with a couple in their 70's, you notice the man has a bruise on his head, and the woman tearfully admits that she loses her temper and hits him with pots and pans. In clinically managing the legal issue of elder abuse, how would you proceed? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your ability to balance your reporting responsibilities with your clinical need to maintain a safe therapeutic environment. A. Call up an agency designated to take such a report, with the two in the room, arrange for respite care, teach anger management, and create a "no violence plan." B. When the two are not in the room, call up an agency designated to take such a report, follow it up with a written report within 2 working days, create a "no violence plan," and refer to a support group. C. Create a "no violence plan," teach time-outs, arrange for a support group, and if those interventions don't work, call an agency designated to take such a report. D. Call up an agency designated to take such a report, follow it up within two working days with a written report, process feelings of betrayal that may result from breaking the confidence, and create a "no violence plan." Answer: Ewing vs Goldstein and Ewing vs. Northridge medical center --court cases that extended the duty to protect identifiable victims from potential harm to include communication from a third parties (family members) that indicate a possible threat. ================================================== Question: 148. Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem; the fee is covered under the overall adoption agreement." What are your ethical obligations? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical obligations. A. Determine the family's understanding of the purpose of the therapy and refer for an academic assessment. B. Determine the identified patient and tell Chong-Wook and Dae-Sup the fee before the first session. C. Determine the identified patient and refer to a pediatrician. D. Tell Chong-Wook and Dae-Sup the fee at the first session and explain that you may need to consult with the school counselor and adoption agency. Answer: 1. Client confidentiality 2. informed consent 3. mandate to do no harm as a result of intervention and evaluation activities ================================================== Question: 149. Rhonda, a 22-year-old college student, comes to therapy looking for advice. She says her boyfriend hit her last week and now she knows she should leave him, but it's very hard to do. In the past she has told him she didn't want to see him anymore, but she always gives in when he calls to get together again. She finds herself saying, "just one more time." She hates being alone and ends up seeing him for companionship. At the end of the session, she asks you if therapy is going to be able to help her. What is your next step? Content Area: Ethics: Therapeutic Relationship/Services This question requires that you stay focused on what a client is asking of you. A. Provide a safe holding environment. B. Explain the pros and cons of therapy. C. Join with her concerning her fears. D. Have her join a singles support group. Answer: 1. Research participants must be volunteers 2. Potential participants should be given sufficient information about the study to determine any possible risks or discomforts as well as benefits 3. No harm shall result as a consequence of participation 4. Protection of sensitive information privacy of research is protected ================================================== Question: 150. Your 18-year-old female client Martha tells you that she was molested on many occasions as a child. She tells you that she is now living with her boyfriend so that she doesn't have to stay in the same house where it all happened. She is hoping that a change of scenery is a first step in getting away from her childhood. What would be the most important legal requirement that you would have in such a case? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed in a case of historical child abuse. A. Report the abuse to CPS immediately by phone and follow up with a written report within 36 hours. B. Find out if the abuse has already been reported. C. Explore if the perpetrator still lives in the area. D. Maintain confidentiality. Answer: Service Social Justice Dignity and worth of the person Importance of Human Relationships Integrity Competence ==================================================