LCSW Law & Ethics Practice Test

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.

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.

*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.

A. Determine the family's understanding of the purpose of the therapy. Ethically, you would want to clarify the client's purpose.

*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.

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.

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.

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.

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.

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.

*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.

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.

*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.

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.

*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.

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.

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.

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.

*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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

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.

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.

*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.

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.

*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.

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.

*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."

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.

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.

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."

*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.

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.

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.

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.

*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.

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.

*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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

*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.

A. Disclose any fees which are different from in-person sessions. Fee disclosures are legally required before changes to treatment occur.

*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.

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.

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.

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.

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.

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.

*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.

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.

*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.

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.

*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.

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.

*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.

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.

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

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.

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.

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.

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.

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.

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.

A. Make appropriate referrals. Making appropriate referrals is the ethical course of action when a social worker is unable to provide services.

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

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

*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.

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.

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.

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.

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.

A. She must submit to you a request in writing. Clients must submit in writing any request to see their records.

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.

A. Tell her if you have raised your fees. You must disclose your fee before beginning therapy with a new or returning client.

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.

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.

*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.

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.

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

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.

*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.

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.

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.

A. Without providing adequate notice. Ethical standard standards require that clients be given notice of fee increases before they occur.

*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.

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.

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.

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.

*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.

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.

*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.

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.

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.

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.

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.

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.

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

B. Hypnotherapy. Hypnotherapy needs specific additional training beyond the education required to obtain a mental health professional license.

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.

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.

*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.

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."

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.

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.

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.

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.

*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.

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.

*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.

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.

*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.

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.

*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.

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.

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.

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.

*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.

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.

*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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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."

*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.

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.

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.

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.

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.

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.

*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.

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.

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.

C. Counsel both of them. As social workers, it is important for us not to impose our values and beliefs on our clients.

*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.

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.

*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.

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.

*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.

C. Engage Bobby in a therapeutic conversation. The ethical standard is to speak with the colleague to try to rectify the issue first.

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.

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.

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.

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.

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.

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.

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.

C. Informed consent. This type of statement that refers to boundaries and social worker availability represents informed consent.

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.

C. Informing the couple of your "no secrets" policy Informing the couple of your "no secrets" policy is solely an ethical responsibility.

*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.

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.

*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.

C. It is unethical. LCSW's do not use their professional relationships with patients to further their own interests.

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.

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.

*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.

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.

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.

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.

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.

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.

*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.

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.

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.

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

*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.

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.

*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.

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.

*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.

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.

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.

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.

*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.

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.

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.

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.

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.

D. A 17-year-old client. A person who is under age 18 cannot initiate a 5150.

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.

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.

*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.

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.

*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.

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.

*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.

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.

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."

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.

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.

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.

*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.

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."

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.

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.

*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.

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.

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.

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.

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.

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).

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.

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.

*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.

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.

*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.

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.

*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.

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.

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.

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.

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.

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.

*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.

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.

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.

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.

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.

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.

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.

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.

*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.

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."

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.

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.