LCSW Law & Ethic Practice Test 2

*3. Which situation is less likely to be an inappropriate dual relationship? Content Area: Law: Confidentiality, Privilege, and Consent You must identify which choice would be the least likely to constitute an INAPPROPRIATE dual relationship. A. A small town where social worker and cashier (client) see each other at the local store. B. A small town where social worker and next-door neighbor (client) see each other in the neighborhood watch meetings. C. A small town where a social worker's brother-in-law's sibling comes to therapy for couple's counseling. D. A small town where a social worker's CPA seeks couple's counseling with the social worker.

A. A small town where social worker and cashier (client) see each other at the local store. The cashier/client would not present an inappropriate dual relationship. This would be an instance, especially in a small town where the number of stores may be limited, where the contact in the community may be unavoidable.

*76. A social worker who is running a therapy group receives an email from one member of the group, describing some personal issues that she does not feel comfortable discussing in the group setting. The social worker has all group members on a contact list and in his reply to this individual he accidentally does a "reply all" to the members of the group: "Please bring that up in the group if you feel comfortable doing so; if not, I can give you some referrals." What should the social worker do to fulfill ethical obligations? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to respond in an ethical and competent way when confidentiality has been compromised. A. Address the mistake in the next group. B. Refer to any "no secrets" policies that allow the social worker to bring up an individual's issues. C. Nothing needs to be done; no one's confidentiality was breached.. D. Send a private email to the client who sent the first email with an apology for the breach of confidentiality.

A. Address the mistake in the next group. From an ethical point of view, clients' experiences need to be validated, and they all saw this email. It would be important to address the confidentiality breach and assess the participants' reactions.

*50. The parent of a child on your child's baseball team is a doctor and wants to send a client to you. On the sidelines, you and this parent often talk about the relationship between illness and how family dsyfunctions develop around those illnesses. The doctor is impressed by your insight and asks for your card. You would: Content Area: Ethics: Business Practices and Policies This question asks how you would manage your ethical responsibilities when you receive a referral from someone you know. A. Agree to see his referral. B. Not see his referral because this constitutes a dual relationship. C. Assess whether it would affect your child and the doctor's child. D. Not see the potential client but refer to a colleague.

A. Agree to see his referral. Ethically, you could agree to see this referral. An acquaintance who refers business to you would not constitute a dual relationship.

11. Miriam, a 52-year-old car saleswoman, is referred for therapy by her doctor after Miriam told him that her boyfriend broke up with her and told her that she has trouble respecting other people's boundaries and is too interpersonally aggressive. From the beginning of treatment, Miriam asks the social worker many questions about the social worker's relationships, family, hobbies and interests, and taste in music and movies. At the fifth session, Miriam asks the social worker where she went to graduate school, how long she has been licensed, and if she has any areas of expertise and training. How should the social worker respond to the questions Miriam is now asking? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the elements of informed consent and a social worker's ethical responsibility to obtain informed consent from clients. A. Answer Miriam's questions. B. Do not answer Miriam's questions and explore her reaction to the social worker's boundary setting. C. Ask Miriam if she has concerns about the social worker's competence and experience. D. Remain silent and allow Miriam to do her own processing as part of learning to respect others' boundaries.

A. Answer Miriam's questions. Social workers must make a distinction between clinical interventions and ethical responsibilities. Clients have the right to such information as where the social worker went to graduate school, how long the social worker has been licensed, and if there are any areas of expertise and training. Such questions should not be treated as inappropriate or boundary violating and are part of the process of a client determining whether or not the social worker offers the kind of services the client wants or needs.

28. LeDoux is an African-American client who tells you he doesn't like the idea of therapy and doesn't trust you. He says he is only coming because his social worker said if he didn't get therapy to work on his anger issues, he would have a harder time getting his kids back. In establishing an alliance with LeDoux, you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of human diversity issues. A. Ask him to tell you more about his ideas of therapy and his mistrust of you. B. Refer LeDoux to another therapist since he indicates that he does not trust you. C. Establish a highly structured therapy focusing on problem-solving. D. Take a thorough family history looking for patterns of mistrust and anger.

A. Ask him to tell you more about his ideas of therapy and his mistrust of you. When working with clients who have culturally-based expectations of therapy or who may view the social worker with mistrust, it is important to first form an alliance with the client. Expressing interest in the client's experience and feelings is one way to form an alliance.

*19. Your client, a 19-year-old mechanic, confides to you that he recently participated in a robbery. Two weeks later, you are served with a subpoena for information about this client's treatment. You attempt to reach your client but are unable to do so. Legally, you must: Content Area: Law: Confidentiality, Privilege, and Consent This question tests your legal requirement regarding a subpoena. A. Assert client privilege. B. Notify your client of this subpoena. C. Turn over all records as per the subpoena. D. Notify the client's attorney that you cannot reach the client.

A. Assert client privilege. By the process of elimination, "A" is the only correct answer. None of the other choices are legal requirements.

72. You witness a mother abusing her child in a shopping mall. Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse reporting laws. A. Ethically, you should report the child abuse. B. Legally, you do not have to report the abuse. C. You will be in violation of ethical standards if you do not report to the police or child protective service agency. D. Legally, you must report the abuse by phone and follow up with a written report within 36 hours.

B. Legally, you do not have to report the abuse. This answer is the most accurate. You do not have to report child abuse if you learned of it outside your professional capacity.

83. A client comes to his session with his 72-year-old father, who uses a walker from a fall which he reports was caused by a fight with his wife. The father tells you that his wife has been stealing his social security checks each month and gives him only $5.00 a week. At this point you should: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question continues to test your knowledge of reporting elder abuse. A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse. B. Call Adult Protective Services and report the financial abuse and "undue influence." C. Explore possibilities for alternative living arrangements with the father and address the feelings both he and your client may be feeling due to this trauma. D. Report the financial abuse, even though it is optional, since the victim and your client have requested your assistance in this matter.

A. Call Adult Protective Services with the clients in your office and report physical abuse and financial abuse. Legally you are mandated to report the physical abuse and financial abuse.

65. Lisa, age 43, is going through a bitter divorce. She brings her only child, Jamal, age 8, for therapy at the request of his school counselor. He was caught cheating on a test and lied about it to the teacher, the principal, and his mother. As you gather history, Lisa keeps revisiting the injustices of her having to "pay for HIS bad parenting." When you question her further, she rails about how her ex-husband spoiled Jamal by giving him everything, never backing her up with discipline, etc. She says, "He's such a jerk. And now he lives in a nice condo and I'm stuck in this dingy little apartment with this dishonest, ungrateful kid. I just can't believe I have to do this. I can't afford therapy and, I don't want to be schlepping him over here every week." What is the best way to proceed regarding her concern about paying your fee? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your sensitivity to client needs and ethical fee setting. A. Consider offering to see Jamal on a sliding scale or pro bono basis. B. Ask Lisa if she'd like you to call her ex-husband to get some of the payment from him. C. Tell Lisa that she doesn't have to pay for therapy because you'll see her on a pro bono basis. D. Have Lisa sign a release for you to confer with her ex-husband regarding the fee.

A. Consider offering to see Jamal on a sliding scale or pro bono basis. This is the most ethical choice. Considering whether to see Jamal on a sliding scale or pro bono basis would address Lisa's apparent financial stresses and allow Jamal to get needed treatment.

30. You are seeing Roger and his wife, Rose, in conjoint therapy. You have been working on helping Rose and Roger communicate better during arguments. In today's session, you learn that over the past few years Roger has physically abused Rose when he loses his temper. You are: Content Area: Ethics: Therapeutic Relationship/Services This question reviews the ethics surrounding spousal abuse. A. Ethically responsible to provide her with referrals. B. Legally bound to report spousal abuse. C. Appalled at his behavior and tell him so. D. Ethically bound to call the police.

A. Ethically responsible to provide her with referrals. There is no legal obligation to report spousal abuse, but there is an ethical responsibility to ensure client safety. Therapeutically, this may consist of a referral to a shelter, an attorney for a restraining order, and/or the establishment of separate living quarters. This can be followed by long-term interventions such as the implementation of anger management and improved communication skills.

*22. Maria, age 27, comes to treatment with her husband Juan. Maria had a miscarriage 3 months ago and she tells you that she just can't get over it and doesn't know if she can go on. Juan says that he has tried everything to cheer her up, but that he's getting sick of her moping around. What action would the therapist take to fulfill ethical obligations? Content Area: Ethics: Therapeutic Relationship/Services Social workers are ethically obligated to determine the client's best interests which includes assessing whether they will benefit from therapy. A. Evaluate whether Maria can benefit from therapy if they continue in conjoint therapy. B. Tell them your experience and expertise in working with families who have trouble having children. C. Suggest a few individual sessions to get full informed consent from each client. D. Answer any question that they have about couple's therapy.

A. Evaluate whether Maria can benefit from therapy if they continue in conjoint therapy. You are ethically obligated to assess if a client can benefit from treatment. A conjoint unit may not be in this client's best interests.

15. A 40-year-old woman comes for individual therapy to work on panic attacks that are affecting her job performance and attendance. She and her husband see their pastor for marriage counseling. She says that her pastor has encouraged her to do this, so that they can focus on the marital issues. How would you proceed in addressing the referral from the pastor? Content Area: Ethics: Business Practices and Policies This question addresses managing a client's concurrent relationship with other providers of care to the client. A. Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together. B. Get a release to speak with the pastor and help him to see that the panic attacks and her marriage are directly related. C. Maintain your client's confidentiality and proceed with treatment. D. Do not begin treatment with the woman until it is clear that you and the pastor are not working on the same issues, which would be unethical.

A. Get a release to speak with the pastor and discuss his reason for the referral and how the two of you might work together. This would be the most ethical and clinically efficacious way to proceed. The pastor may have relevant information impacting your treatment of the wife, and it would be important to establish a working relationship with your client's other counselor.

39. You have been treating Roberto in individual therapy for 6 months. In session, he gets angry with you for not telling him his insurance only authorized 20 sessions. He thinks you should simply accept his co-payment of $30.00 in the future because it is "your fault." What would you do in this case? Content Area: Ethics: Therapeutic Relationship/Services This question concerns your ethical management of a client's changing financial circumstances. A. Apologize and accept his $30 co-payment. B. Discuss the situation and attempt to negotiate a fee acceptable to both of you. C. Inform Roberto that he is now responsible for your full fee or he will have to be terminated. D. Tell Roberto your personal finances prevent you from accepting such a low fee.

B. Discuss the situation and attempt to negotiate a fee acceptable to both of you. This is the best answer of the choices given. Although Roberto thinks you should accept his co-payment as the fee, you still have not attempted to negotiate a mutually acceptable fee. This discussion would be your next step. If you could not agree on a fee, he should be given a lower-cost referral to provide for continuity of treatment.

44. You get a telephone call from a highly agitated woman who states that her live-in boyfriend has been battering her whenever he drinks, which is at least once a week. She says she is considering leaving but that it is difficult because she has severe cerebral palsy and uses a wheelchair. You: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question addresses dependent adult abuse. A. Must gather as much information as possible and make a report of physical abuse to Adult Protective Services since this woman is a dependent adult. B. Are not yet this woman's social worker, so you give her the number to Adult Protective Services and encourage her to call them and/or the police to make a report. C. Set up an appointment for as soon as possible and assist her by giving her numbers for battered women's shelters that are wheelchair accessible. D. May choose to make a report because you have not witnessed the injuries or the abuse yourself.

A. Must gather as much information as possible and make a report of physical abuse to Adult Protective Services since this woman is a dependent adult. Given her severe cerebral palsy and wheelchair use and probable dependence on her boyfriend or others for some assistance, this is the best answer. The report must be made immediately by telephone and a follow-up written report must be made within 2 working days. Note that just being a wheelchair user does not necessarily mean that one is "dependent."

*90. Your client works as a pilot and often misses appointments because she is called out-of-town at the last minute. When billing her insurance, you: Content Area: Law: Legal Standards for Professional Practice. This question evaluates your knowledge of appropriate ethical guidelines for insurance billing and insurance fraud. A. Note carefully which sessions the client actually attended. B. Must not include missed sessions on the bill since insurance will not pay for these. C. May not commit insurance fraud by noting which of the sessions were canceled within your 24 hour limit and which were canceled at the last minute. D. May remind her she will have to pay for missed sessions herself.

A. Note carefully which sessions the client actually attended. It is vital to clearly note which sessions were missed on the bill (which will be sent to the insurance company), or this is insurance fraud.

*94. A female social worker who is having problems in her own marriage finds that she is consistently siding with the wife in couples therapy. Ethically, the social worker's primary obligation is to: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to meet client needs when negative counter-transference could impact objectivity and client welfare. A. Obtain supervision to address counter-transference. B. Discontinue conducting therapy until her own marital problems are resolved. C. Attempt to balance treatment by siding with the husband. D. Call in a co-therapist to monitor the therapist's behavior.

A. Obtain supervision to address counter-transference. The ethical obligation, when a therapist is unable to maintain objectivity, is to seek supervision or consultation.

*24. George has been referred to you by his doctor for anxiety-related issues. He tells you that while he really wants to be in therapy, he can't afford it right now and asks if it would be okay if, instead of your fee, George will give you credit in the amount of your fee at the grocery store he owns in the small rural community where you both live. Ethically this would be: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of dual relationships. A. Permissible under some circumstances. B. Inadvisable under all circumstances. C. A prohibited dual relationship. D. Bartering, which is prohibited by ethical standards.

A. Permissible under some circumstances. Ethical standards say that social workers do not usually barter or are discouraged from doing this but the standards make allowances for doing business in communities where bartering is standard practice.

*13. You are seeing a 45-year-old woman in treatment. She lives with her mother, age 71, who has Alzheimer's Disease and lives in a residential facility for ongoing medical care. She tells you in session that at one point, the nursing staff kept her mother in bed for three weeks. You would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. Your knowledge of reporting mandates for elder abuse is being checked. A. Report by telephone within 24 hours to law enforcement. B. Report immediately to Adult Protective Services by phone and follow-up with a written report within 36 hours. C. Report by telephone immediately to law enforcement. D. Refer her to a support group for caretakers, arrange for respite care, and work with her on issues of grief and loss.

A. Report by telephone within 24 hours to law enforcement. If physical abuse occurs in a long-term facility and does NOT result in serious bodily harm, a telephone report must be made to local law enforcement within 24 hours and a written report within 24 hours to law enforcement, the facility's licensing agency, and the ombudsman.

80. Your 17-year-old client tells you that she was molested on many occasions as a younger child. She tells you that she was taken from the home in which it occurred and has never returned. She tells you that she found the perpetrator on a social networking site that makes her think he is still looking for under-age victims. She shows you his posts and you concur. What would be the most important legal requirement that you would have in such a case? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of child abuse reporting requirements. A. Report the abuse to CPS immediately by phone and with a written report within 36 hours. B. Inform her of her rights about reporting him now that she is an adult. C. Advise her to make a police report about a sexual predator. D. Develop a safety plan if he responds to her posts.

A. Report the abuse to CPS immediately by phone and with a written report within 36 hours. You have reasonable suspicion that the perpetrator could be soliciting minors given your client's history and her report of his activity on the internet.

23. A social worker has decided to offer telehealth as part of her practice. Ethically, the therapist should: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of how to ethically manage the limits and risks of telehealth. A. Specify any particular limits of confidentiality as they pertain to internet security and privacy. B. Avoid a dual relationship by making clear when she is available on the internet and when she is not. C. Charge and disclose an equivalent fee for telehealth as for in-person sessions. D. Anticipate an unavoidable dual relationship that could arise if in-person clients also receive telehealth services.

A. Specify any particular limits of confidentiality as they pertain to internet security and privacy. There are no special mandated "limits of confidentiality" that pertain to telehealth, but privacy and confidentiality could be compromised in telehealth sessions, and therapists would have the ethical obligation to clarify those risks.

*2. Your lawyer calls you to warn you that you may receive a subpoena for the complete treatment record of Mr. Milsap, who you have been treating for five years. Two months ago, Mr. Milsap received minor injuries in an accident at work in which three people were killed when a fully loaded forklift overturned. Mr. Milsap is suing for negligence and claiming severe emotional damage, including PTSD. When you tell Mr. Milsap about the subpoena, he is frantic since he doesn't want anyone to know about the brief affair he had with his secretary four years ago, which is documented in your treatment records. He asks that you submit a summary of information relevant to the accident and his PTSD or to omit from the records information about the long-ago affair. How should you respond? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of how to legally retain records. A. Tell Mr. Milsap that you cannot honor his request. B. Submit a summary of the records related to the accident and the PTSD. C. Supply the treatment records as requested, but omit information of the long-ago affair, in accordance with the laws of privilege. D. Contact the court and seek a waiver to narrow the scope of the subpoena in order to protect your client's confidentiality.

A. Tell Mr. Milsap that you cannot honor his request. Without the permission of the court or the party issuing the subpoena, a social worker may not produce a summary or alter (by omission or any other way) the treatment record subpoenaed.

56. A social worker is becoming increasingly concerned that one client, who is acutely suicidal, is not improving. The social worker has suggested that the client speak with people in his life who might be supportive and be able to help, but the client only wants to speak with the social worker. The social worker is concerned about boundaries if she speaks with the client as often as he needs, which is at least once day. The client has threatened to leave therapy entirely if the social worker keeps suggesting outside support. Ethically, the social worker should: Content Area: Ethics: Therapeutic Relationship/Services This question pertains to ethical aspects of termination. A. Tell the client directly the social worker's concerns if the client does not return to therapy. B. See the client at least once a day to prevent harm and imminent risk. C. Terminate with the client and have him involuntarily hospitalized. D. Allow the client to terminate if the social worker is unable to provide adequate support.

A. Tell the client directly the social worker's concerns if the client does not return to therapy. Ethically, the social worker is obligated to have a direct informed consent conversation with a client, even clients who are acutely symptomatic.

73. When working with a female client who is being abused by her partner, what is your ethical responsibility? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of your ethical responsibilities when you become aware that a client is being abused by her partner. A. To establish a plan of safety, including shelters and established support systems. B. To make an optional dependent adult abuse report to protect the client if she is pregnant. C. To report child abuse if children were witnesses to the abuse which negatively impacted them. D. To refer the client to a divorce lawyer.

A. To establish a plan of safety, including shelters and established support systems. The ethical responsibility is to establish a plan of safety, including shelters and established support systems. Legally, mental health professionals cannot usually break confidentiality due to domestic violence unless the recipient of the abuse falls within a protected class of individuals.

55. You are seeing a client, Tom, for six months. Tom occasionally mentions his cousin, who specializes in installation of landscaped ponds. You've always wanted a landscaped pond with koi. Which of the following represents an ethical course of action? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of dual relationships. A. You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction. B. You call your client's cousin, along with several other landscapers, to gather price quotes. C. You call your client's cousin and mention that you are an acquaintance of Tom's hoping that he'll give you a break on the price. D. You ask Tom how he would feel if you hired his cousin to install a pond.

A. You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction. Ethical standards prohibit business ventures or social interactions with a patient, spouse, partner, or family member. Hiring Tom's cousin would be considered an unethical dual relationship.

*26. Which of the following is a legally allowable scenario in which a social worker may treat a minor without parental consent? Content Area: Law: Confidentiality, Privilege, and Consent This question focuses on knowing when you may legally treat a minor without parental consent. A. A 10-year-old suicidal female whose twin brother recently died in a boating accident. B. A 12-year-old depressed male whose cultural background strongly discourages therapy. C. A 15-year old having consensual sexual intercourse with a 20-year-old. D. A 16-year-old having consensual sexual intercourse with a 25-year old.

B. A 12-year-old depressed male whose cultural background strongly discourages therapy. If a minor is at least 12 years old and is mature enough to participate in outpatient treatment, you may provide treatment without parental consent for various clinical issues if, in your professional opinion, parental involvement would be ill-advised.

38. 38. Which of the following represents a Tarasoff situation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions that would impose a Tarasoff duty to protect situation. A. In a conjoint session, the wife tells her husband that before the week is over that she is "going to gun him down." B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night. C. A client tells you that her husband is "totally fed up with his supervisor" and is going to disfigure the man's face with a chemical solution. D. A man, who just bought a semi-automatic rifle, tells you that he is going to go on a freeway overpass and randomly shoot at passing cars.

B. A client texts you that she is angry, that she has AIDS, and that she's going to put her "tainted blood in a syringe" and inject her partner tomorrow night. The threat was conveyed to you by your client, and it represents a serious and imminent threat to commit physical violence against a reasonably identified other. Although the laws of confidentiality require that we not report an HIV-positive client whose intentional behavior is to infect others through sex, injecting another person with a syringe without their permission constitutes an act of violence.

*95. Which of the following scenarios describes a social worker's legal duties regarding the use of telemedicine? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of the difference between legal and ethical responsibilities. A. A social worker bills an internet client the fee before starting therapy. B. A social works breaks confidentiality because an internet client is engaging in child abuse. C. A social worker provides a client a copy of the informed consent document to download and return with a signature. D. Referring a client to a CPS website if the client reports child abuse.

B. A social works breaks confidentiality because an internet client is engaging in child abuse. Breaking confidentiality when making a mandated child abuse report is a legally required obligation, not an ethical decision or responsibility.

100. You have been seeing a client for 3 months. You learn she has a daughter who attends the same pre-school as your son. How do you ethically handle this dual relationship? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your knowledge of ethical management of dual relationships. A. Refer your client out since the therapy relationship is still fairly new. B. Acknowledge the coincidence, explore your client's reactions and discuss how you will both act should you see each other at school functions. C. Transfer your son to another pre-school to avoid a dual relationship. D. Do not acknowledge the coincidence in session since it is a large pre-school and unlikely you will encounter one another.

B. Acknowledge the coincidence, explore your client's reactions and discuss how you will both act should you see each other at school functions. This demonstrates proper clinical management for several reasons: this is an unavoidable dual relationship, you are addressing the coincidence, you are being sensitive to your client's reactions and planning how you will handle seeing one another in a public setting.

64. Social workers are required by law to comply with certain legal standards in the state in which they are licensed. All of the following are legal issues EXCEPT: Content Area: Ethics: Therapeutic Relationship/Services This question requires that you discriminate between legal and ethical issues. A. Suicide. B. Asking your client, who is a contractor, for information about drywall. C. Setting a fee. D. A dependent adult who states that his prescribed seizure medication has not been dispensed by his care custodian.

B. Asking your client, who is a contractor, for information about drywall. Engaging in a separate and distinct relationship either spontaneously, within a therapeutic relationship or after a reasonable period of time following the termination of the therapeutic relationship, constitutes a dual relationship. This is an ethical issue.

40. Andy, a 42-year-old actor, missed his last session. The Motion Picture Industry Pension and Health Plan pays for a portion of his sessions. How should you go about collecting his missed session fee? Content Area: Law: Legal Standards for Professional Practice. This test item focuses on legal insurance billing procedures. A. Bill Andy for the co-payment and indicate the cancelled session code with his insurance. B. Charge Andy and have him contact the insurance company. C. Bill the insurance company with the 50-minute code as usual. D. Bill Andy for the co-payment and indicate the 50-minute code.

B. Charge Andy and have him contact the insurance company. Billing the client, and letting him seek reimbursement from the insurance company is correct. This choice puts the responsibility on the client, where it belongs.

97. Deanne is a 13-year-old who is in therapy with you without her parents' consent. In this case, who is the holder of the privilege? Content Area: Law: Confidentiality, Privilege, and Consent The issue presented in this vignette is whether a minor can be the holder of privilege. A. You, due to client privilege. B. Deanne. C. The state because Deanne is a minor. D. Deanne's parents because parents hold privilege for minors.

B. Deanne. Privilege resides with all clients unless the ability to exercise (i.e., assert or waive) privilege has been adjudicated away from them.

4. Three months after the death of Danielle, whom you treated for several years, you receive a written request from Arthur, her husband of 32-years, asking for access to his late wife's files. You saw them conjointly for a few sessions when Danielle requested he be there. How would you proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge regarding who has access to a client's records after their death. A. Assert privilege. B. Deny his request. C. Allow him to inspect the records. D. Provide a summary or a copy of the records.

B. Deny his request. Given the limited information we have in this scenario, denying the request would be the best course of action until proper authorization could be obtained by the dead woman's legal representative.

*57. You are working in a group practice and learn that one of your colleagues tends to have "a drink" in his office between clients. How do you handle the situation? Content Area: Ethics: Business Practices and Policies You must choose the best way to address your colleague's apparent drinking problem. A. Tell your other colleagues in the group and perform a group intervention. B. Discreetly confront your colleague about his drinking. C. Contact the BBS. D. Encourage your colleague to contact an ethics board for advice.

B. Discreetly confront your colleague about his drinking. Ethics standards strongly encourage social workers to intervene when colleagues are risking client care.

33. You recently began treating a 16-year-old female without parental consent. The client has been feeling suicidal and feels unable to discuss her problems with her parents. You receive a voicemail message from her father, angrily wanting to know why you're treating his daughter. What would be your responsibility? Content Area: Law: Confidentiality, Privilege, and Consent This question deals with the legalities pertaining to the confidentiality of a minor client whom you are seeing without parental consent. A. Obtain consent from the father in order to continue therapy with appropriate consent. B. Do not contact the father and maintain the client's confidentiality. C. Process the message with the client and invite the client's father to join in a future session. D. Obtain consent from both her parents to continue seeing the client.

B. Do not contact the father and maintain the client's confidentiality. You would maintain the client's confidentiality because she has the legal right to it, and suicide is not a mandated breach of confidentiality. You might consider breaking her confidentiality if her suicidal ideation includes an imminent plan and time frame, but the vignette does not indicate crisis-level suicide that would warrant a breach of confidentiality.

48. When discussing exceptions to confidentiality with a client, which of the following would not be considered such an exception? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of limits of confidentiality. A. Suicidal thoughts. B. Domestic violence. C. Grave disability. D. Threats to destroy another's property.

B. Domestic violence. Domestic violence does not usually fall under the exceptions to confidentiality unless a child abuse report needs to be filed as a result of the domestic violence or if the abused party is under the protected class of individuals.

6. You have been participating in the town's bowling league for six months when one of the clients you have been treating joins the league. While speaking to your client about it in the next session, you find out she loves it and plans to stay in the league. First you would: Content Area: Ethics: Professional Competence and Preventing Harm. This question of ethics asks you what your FIRST step would be in this dual relationship scenario. A. Switch leagues. B. Explain the nature of dual relationships to her. C. Ask her to switch leagues. D. Give her bowling tips to build rapport.

B. Explain the nature of dual relationships to her. Explaining dual relationships to her would be the best way to start, and the question is asking what you would do FIRST. What you decide from this point depends on the size of your town and whether you believe this is an avoidable dual relationship.

*36. At an initial intake, a client discloses that she recently left her husband and does not have the means to pay your standard fee. The client notices that your waiting room is shabby and offers to paint it in exchange for your therapy. You agree to four sessions in exchange for the work. You proceed with therapy, but when she is finished, you realize she has ruined the carpet, spilled paint on a lamp and the woodwork, and didn't use the color you had asked. You realize that you feel foolish and ripped off. How would you address the situation? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of dual relationships. A. Discuss your concerns about the paint with the client and ask her to either repaint the office or work out a plan for her to pay for the four sessions so that your judgment of her will not impair your ability to work with her. B. Honor the original agreement, and if your ability to work with this client feels compromised, discuss your concerns with the client and offer to help her transition to another therapist because of the ethical conflict. C. Honor the original agreement, consult to manage your counter-transference, and continue with therapy. D. Without disclosing your personal reactions, explain that you'd like her to pay you for the therapy because you weren't satisfied with her work, tell her you'll be unable to work with her further, and help her to transition to another therapist.

B. Honor the original agreement, and if your ability to work with this client feels compromised, discuss your concerns with the client and offer to help her transition to another therapist because of the ethical conflict. Ethically, a therapist would be obliged to honor the original agreement. If the therapist's feelings were interfering with the ability to do good therapy, then it would be ethically correct to find the client another therapist and to explain to the client the reasons to do so. Ethical standards say that therapists have the right to terminate treatment for reasons including ethical conflicts.

*18. A self-referred client comes to you wanting therapy for work problems. During the intake, the client reveals he has been going to another therapist for the last four months but states, "I'm planning to leave her anyway." The client admits he has not discussed this with his current therapist and says, "I'm seeing her for a different issue anyway." What is your ethical responsibility in this situation? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of how to handle concurrent therapies. A. Accept the new client, as he intends to terminate with his current therapist. B. Inform the client that you will be unable to see him until he has terminated with his current therapist. C. Contact the other therapist to discuss the treatment goals before deciding whether to take on the client. D. Accept the new client, as he reports his goals with the other therapist differ from the goals he wants to explore with you.

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

82. Jeannie and Chuck Jones and their two children Brooke and Josh, have been seeing you for family counseling for 6 weeks when they come to see you right after a "big family fight." You notice a rip in Josh's clothes and Brooke's red eyes leads you to believe she has been crying. You separate the family and gather a lot of information about the fight. Which statement would NOT lead to a child abuse report? Content Area: Law: Limits to Confidentiality/Mandated Reporting. The focus of this question is child abuse reporting mandates. A. Josh tells you his father tried to push him into a cold shower, and his clothes ripped pulling away. B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach. C. Josh tells you his Dad was also trying to lock him in the closet. D. Brooke tells you her Dad repeatedly said she was stupid.

B. Jeannie says that after the fight with the children, she and her husband got into another fight alone in the bedroom, and he punched her in the stomach. Jeannie telling you that after the fight with the children, her husband and her got into another fight alone in the bedroom, and he punched her in the stomach, would not be reportable. It is not clear that the children witnessed the spousal abuse since it occurred alone in the bedroom, and/or that they had any emotional distress specific to it.

*52. Mollie, age 62, reports that she has been the victim of spousal abuse over the last year by her husband of 40 years, Roland, age 67. You have told her that you will assess for elder abuse. Legally, how should you proceed? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question reviews your knowledge of reporting responsibilities. A. Make an elder abuse report to Adult Protective Services. B. Maintain confidentiality and assess for possible elder abuse. C. Make a report to law enforcement within 2 working days. D. Make a physical abuse report to Adult Protective Services.

B. Maintain confidentiality and assess for possible elder abuse. There are no reporting mandates here since Mollie is not an elder or dependent adult. Assessing further for elder abuse is something you certainly could do, because there is violence in the relationship, and Roland is an elder.

7. Mimi tells you that her brother is HIV+ and has recently sero-converted to full-blown AIDS. She is terrified because she overheard her brother talking about passing on "The Gift." She informs you that he wants to have sex with his new partner with the purpose of giving him the HIV virus. She thinks it's terrible that her brother plans to knowingly give someone HIV. In this case you would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to proceed legally in a case where the transmission of HIV is probable. A. Call the person he plans to have sex with in accordance with the Tarasoff decision. B. Maintain confidentiality and process her feelings. C. Ask Mimi to have her brother set up an appointment. D. Call the public health service in the area and report what you have heard in an unofficial capacity.

B. Maintain confidentiality and process her feelings. The law is clear that you need to maintain confidentiality when the transmission of HIV is by sexual means.

35. The O'Rourkes have been married for 4 years. Tina says that she and her husband are worried that Megan may be anorexic since they found her internet searches on anorexic websites. Megan's biological mother died 2 years ago. If they want to pay with insurance, you would: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of fee negotiations that must occur before therapy starts A. Tell them the name of the billing service you use if you have one. B. Obtain confirmation about their benefits before the first session. C. Explain the risks to their confidentiality if they want to use third-party payors. D. Establish a co-pay that is equivalent to cash payments before the first session.

B. Obtain confirmation about their benefits before the first session. You would need to confirm the client's benefits (payment policy set by the insurance company) before starting therapy. This is equivalent to setting the fee before therapy.

*63. You are working with a client who has expressed suicidal thoughts. You see the client once every two weeks because he does not have insurance. He uses your sliding scale and sometimes texts you between sessions. Which of the following steps would be considered reasonable in fulfilling the duty to ensure the safety of a suicidal client? Content Area: Ethics: Business Practices and Policies This question addresses your knowledge of a social worker's responsibilities to ensure the safety of a suicidal client. A. Schedule extra sessions with your client. B. Obtain the client's promise not to harm him/herself until you meet again and use a "self care" contract to reinforce the promise. C. Give the client the number of the suicide prevention hotline. D. Explore your client's support network.

B. Obtain the client's promise not to harm him/herself until you meet again and use a "self care" contract to reinforce the promise. If a client promises, in writing, not to harm him/herself until your next meeting, and the social worker reasonably believes that the client agreed in good faith, this would be a reasonable step to ensure the client's safety.

5. Your client Maurice tells you that he was involved in a bank robbery and "got away with it." He says the money is stashed in a safety deposit box at a local bank. You are: Content Area: Law: Confidentiality, Privilege, and Consent This question deals with a social worker's legal responsibilities related to past crimes. A. Required to report this to the bank and to the police. B. Required to maintain confidentiality. C. Obligated to advise your client of the legal requirement to break confidentiality. D. Permitted to break confidentiality to protect the public at large.

B. Required to maintain confidentiality. A social worker is legally obligated to maintain confidentiality in this instance.

*34. Albert and Frank are referred to a social worker for conjoint counseling. Albert does not like it that Frank is so controlling, and Frank's problem is that he considers Albert to be lazy. In one session, their arguing becomes so aggressive that you consider seeing them separately. Albert says it would be a good idea, and Frank says that he will do whatever is best. Ethically, how should the social worker proceed if individual therapy is agreed upon? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to provide informed consent as you learn you client's expectations of therapy. A. Close the conjoint file and tell them that you will not be able to see them together once individual therapy starts. B. Tell them how individual therapy will be different from conjoint therapy. C. Tell them how you plan to utilize "no secrets" policies. D. Ask them for revised treatment goals.

B. Tell them how individual therapy will be different from conjoint therapy. In order to help them make the decision about starting individual therapy, you would provide some parameters so you have informed consent.

*49. Guidelines regarding advertising state that social workers must advertise in a way that is honest and not misleading. Which of the following is a true statement regarding advertising policies? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of advertising principles associated with LCSW practice. A. A prelicensed social worker may not use the term "psychotherapist" on a business card. B. The advertisement must indicate the full name of the licensee and the complete license number. C. It is not permissible for an LCSW to use "Ph.D." if s/he is not a psychologist. D. A social worker cannot use the term "Psychotherapy" on a business card.

B. The advertisement must indicate the full name of the licensee and the complete license number. It is a legal requirement that the LCSW's full name and license number or associate's registration number be on the advertisement.

*12. You have been treating Jennifer who has had difficulties establishing and maintaining intimate relationships with men. Several months into treatment, she was arrested for an attempted murder of a male celebrity. In her trial, Jennifer is pleading not guilty by reason of insanity. Who holds the privilege for Jennifer's therapeutic records? Content Area: Law: Confidentiality, Privilege, and Consent This question checks your comprehension of privilege. A. The social worker. B. The client. C. There is no privilege. D. The judge.

B. The client. In this situation, since Jennifer has introduced her emotional condition into the trial, her right to privilege MAY be waived. Since there is no indication that she or the court has waived her privilege, it continues to be held by her.

68. You have been seeing Marsha, 11, with the consent of her mother, Jan. Jan is requesting a copy of Marsha's therapy notes because she wants to provide them to the school counselor. Under which of the following conditions can you refuse Jan's request? Content Area: Law: Confidentiality, Privilege, and Consent This question assesses your knowledge of the laws pertaining to parental request of a minor's records. A. Marsha will not sign an authorization to release the information to her mother. B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being. C. Jan wants you to produce a copy of the records within 3 weeks time. D. You don't feel comfortable breaching Marsha's confidentiality.

B. The content of the therapy notes may have a harmful effect on Marsha's psychological well-being. If releasing the content of therapy notes will result in a negative impact on the minor's physical safety and/or psychological well-being, then the social worker has a right to refuse a parent's inspection of the records.

21. A therapist offers telehealth services for a slightly reduced fee for clients who cannot afford transportation or do not have a car. At what point during the provision of telehealth with a client would it be legally required to refer the client for crisis care? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of the legal standard of care when providing telehealth. A. When the client tells you that she is actually 12, not 18. B. When the therapist recognizes that the client is suicidal. C. If the client tells that therapist that this will be "our last session." D. The client tells you that she does not have health insurance and has not been to a doctor in five years.

B. When the therapist recognizes that the client is suicidal. Although being suicidal all by itself may not yet be a crisis, clients who are in potential danger must be referred to services they can access close to where they live.

*41. A social worker becomes attracted to a client. The social worker deals with his/her feelings appropriately and the client feels s/he is ready to terminate. Upon termination, the social worker realizes s/he still has sexual feelings for the client and would like to pursue a relationship. Ethically, how long should the social worker wait before pursuing such a relationship with this client? Content Area: Ethics: Professional Competence and Preventing Harm. This question asks for the NASW information about sex with a client. A. 6 months. B. 12 months. C. 24 months. D. An indefinite time, because post-therapy relationships are prohibited by law.

C. 24 months. According to the NASW code of Ethics, if a social worker waits a minimum of two years to begin a romantic relationship with a client, that social worker is adhering to the standards. Ideally, social workers do not pursue romantic relationships with clients at all, however.

*75. During your intake interview, you learn that your client is a lawyer. As you discuss the limits of confidentiality, the client asks, "can you plead the Fifth like I can in court?" As you consider your answer, you consider some hypotheticals. Privilege might be waived in which instance? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking you to choose when privilege could be waived. A. A client is a 13-year-old girl, who you are seeing without parental consent, and has been selling drugs. B. A client has told you he has been involved in hacking a corporate database under an assumed name. C. A client accused of assault and battery uses insanity as a defense in court. D. A 64-year-old woman complains to you that her bank is making automatic withdrawals without permission.

C. A client accused of assault and battery uses insanity as a defense in court. If insanity is used as a defense for a crime, then the client may have waived his or her right to privilege.

*92. A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would: Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist's boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship. A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations. B. Contact the therapist to discuss the legal/ethical consequence of his actions. C. Assess for further boundary violations. D. Contact the BBS to report the therapist's inappropriate actions.

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.

81. Your client, Barbara, has been unemployed for three months. In her last session she stated that she plans to kill her ex-boss tomorrow because he's the cause of all her unhappiness. You call the police to alert them to Barbara's plan, but they don't seem to take you seriously because there isn't a weapon involved. The officer on the phone tells you not to worry about it. Given your responsibilities under the Tarasoff ruling, you would: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question involves a Tarasoff situation. A. Document your phone call outlining your concerns and justifying your actions in order to cover your liability. B. Have Barbara come in immediately for crisis counseling. C. Call Barbara's ex-boss and warn him of her plan. D. Call Barbara and find out if she has a gun so you can tell the police.

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.

85. Which of the following conditions would meet the definition for being gravely disabled under 5150 criteria? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of conditions which define a person as being gravely disabled. A. Command auditory hallucinations telling the client to kill other people. B. Command auditory hallucinations telling the client to kill him or herself. C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home. D. Choosing to be homeless.

C. Command auditory hallucinations telling the client his/her food is poisoned and s/he cannot go home. A client who cannot access food and housing due to mental illness, such as psychosis (auditory hallucinations), would be considered gravely disabled.

25. Ajax, a 51-year-old former convict, comes to therapy because he tells you he has been depressed ever since he left prison. He just doesn't feel like he fits in anywhere and still feels terribly guilty for the murders he committed that have gone unpunished. He says he is tired of spending every day looking over his shoulder and would be better off dead. What is your legal responsibility in this case? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of confidentiality laws. A. Call the police because you have knowledge of a murder. B. Initiate an involuntary hospitalization because he is suicidal. C. Consider breaking confidentiality to ensure his safety. D. Notify his next of kin.

C. Consider breaking confidentiality to ensure his safety. Evidence Code 1024 gives social workers the right to break confidentiality to ensure the safety of their client. This is the best answer of the choices.

27. A social worker chooses a preschool for his daughter and enrolls her. One month after she started school, the social worker discovers that a client's child is in the same class. What would be the social worker's least appropriate action? Content Area: Ethics: Professional Competence and Preventing Harm. This question is assessing your knowledge of how to manage possible dual relationships. Pay careful attention to the way this question is worded. A. Begin looking for another preschool for his daughter. B. Discuss with the client how she feels about the situation. C. Discuss the possibility of trading carpooling in exchange for some of the cost of therapy. D. Immediately take his daughter out of the school.

C. Discuss the possibility of trading carpooling in exchange for some of the cost of therapy. Carpooling in exchange for the cost of therapy is the least appropriate option of the choices given.

29. You were working with Arlen for six months when he lost his job working with an internet start-up company. At that time you agreed to use your sliding scale to reduce your fee to accommodate Arlen since after six months a solid therapeutic bond was in place. From the perspective of professional conduct, which is most important to do at this time? Content Area: Law: Legal Standards for Professional Practice. This question pertains to professional conduct as it pertains to fees. A. Establish a target date with Arlen for when he will have a new job. B. Examine Arlen's feelings about you reducing your fee for him. C. Discuss with Arlen under what circumstances, such as obtaining a new job, you will re-establish his original fee structure. D. Make sure Arlen is aware of community resources for job seekers.

C. Discuss with Arlen under what circumstances, such as obtaining a new job, you will re-establish his original fee structure. When making a temporary fee reduction, in order to maintain clear ethical boundaries about fees and payments, you should make certain Arlen knows the expectations about when you will resume charging him his original customary fee.

77. A second generation Chinese-American man comes into therapy and asks you to help him find a wife because his father is pressuring him to get married. Your FIRST intervention would be to: Content Area: Ethics: Therapeutic Relationship/Services The question asks for "your first intervention." A. Indicate that his needs would best be served by an Asian mental health professional. B. Inform him that this is an inappropriate goal for treatment. C. Engage him in a discussion of his motivation and past efforts. D. Address his presenting problem and assist him in finding a wife.

C. Engage him in a discussion of his motivation and past efforts. In the initial stages of therapy, the establishment of trust and rapport is a crucial component to successful work, which "C" embodies as it deals with the presenting problem and the underlying emotions associated with it.

31. Rachel comes to you after finding out she had been laid off from her job. Rachel reports she doesn't understand why, except for the possibility that "the boss always had it in for me after I refused to go out with him." Rachel then states, "He needs to watch out, if he knows what's good for him." Upon assessing further, Rachel tells you she has "a way" to keep his car from running, "That'll show him." What is your response in this situation? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of your ethical responsibilities under Evidence Code 1024. A. Legally, you must contact the police and warn the boss under the Tarasoff ruling. B. Ethically, you should warn the boss under the Tarasoff ruling. C. Ethically, you could contact the boss under the auspices of Evidence Code 1024. D. You have no legal or ethical obligations.

C. Ethically, you could contact the boss under the auspices of Evidence Code 1024. You may ethically break confidentiality under Evidence Code 1024 to warn the boss of the client's plan/intent to damage his car.

*51. You have been working for seven months with a young adult who has recently become very involved with a Nazi skinhead group. You have strong feelings about the detrimental effects such an affiliation can have and will need to: Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how to handle counter-transference issues with a client. A. Address your concerns with the client without contaminating the therapy. B. Discuss the case with your colleagues and get consultation in order to manage your personal bias. C. Evaluate whether or not you can continue to work effectively with this client. D. Refer this client out since your bias will get in the way of her progress.

C. Evaluate whether or not you can continue to work effectively with this client. The first priority is to determine if you can work effectively with the client.

9. You have seen Abby, age 24, four times. In her fifth session, she discloses to you that her previous mental health provider fondled her while he was conducting hypnosis with her. Your legal obligation is to: Content Area: Law: Legal Standards for Professional Practice. This question assesses your knowledge of your legal obligation regarding clients who have had sexual contact with a previous mental health provider. A. Inform Abby of the reporting options that are available to her. B. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex." C. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex" and discuss the contents with her. D. Refer Abby to the BBS which will send her a copy of the booklet "Professional Therapy Never Includes Sex" and file the report with their Ethics Committee.

C. Give Abby a copy of the booklet "Professional Therapy Never Includes Sex" and discuss the contents with her. You are legally obligated to give a client, who reports having had sexual contact with a previous mental health provider, the booklet "Professional Therapy Never Includes Sex" as well as discuss the contents of the booklet with her.

*37. Your new client, Suzanne, age 38, says her life feels out of control, and that she is considering getting a divorce. She is not sure she wants to keep coming to therapy. After a session, her husband Bud leaves a telephone message in which he says if Suzanne leaves him, he will kill himself. He asks that you call him back. How would you clinically manage your ethical responsibilities? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of the ethical obligations as they pertain to termination and referrals. A. Explain to Bud your "no secrets" policy and that you will have to disclose to Suzanne that he called you. B. Offer to Suzanne that she include Bud in a session but inform her of the risks and benefits first C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy. D. Assess Bud for suicide because you are in your professional capacity.

C. If Suzanne falls behind in her payments, give advance notice if you plan to terminate therapy. Reasonable notice of termination is required if you plan to terminate because a client has not paid.

14. Mary is a married 17-year-old who was recently raped by her husband's best friend. She doesn't want to tell her husband because she feels that she may have inadvertently encouraged him and is feeling ashamed. Tearfully, she tells you that she is pregnant and doesn't know what to do. Her best girlfriend has told her to get an abortion. She is conflicted about this because of strong religious beliefs. She says she's very confused and asks you what you would do if you were in her position. How would you ethically respond to this situation? Content Area: Ethics: Therapeutic Relationship/Services This question assesses your knowledge of the ethical boundaries that are necessary for effective therapy. A. Advise her to discuss this situation with her husband. B. Indicate that you have a "no secrets" policy and invite her husband into the session. C. Indicate that you cannot make life decisions for a client. D. Refer her to Planned Parenthood.

C. Indicate that you cannot make life decisions for a client. Social workers respect the right of patients to make decisions and inform them that their decisions are their own responsibility.

59. A newly licensed social worker wants to establish her practice. She goes to several neighborhood psychiatrists and doctors advertising her practice and offering small tokens of appreciation in return. What is the problem here? Content Area: Law: Legal Standards for Professional Practice. This question concerns the practice of purchasing referrals. A. A social worker must be licensed for a period of two years before s/he can advertise door to door. B. It is not ethical for her to go door-to-door to advertise her practice. C. It is not legal for her to offer compensation for referrals. D. Advertising is restricted to business cards and association literature.

C. It is not legal for her to offer compensation for referrals. It is illegal for mental health professionals to offer compensation or rewards for referrals.

84. You have assessed a chronically depressed client for suicidal tendencies and determined the person to be at high-risk. You are: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the law pertaining to suicidal clients. A. Legally bound to report. B. Ethically responsible to notify family or "others responsible for the client's well-being." C. Legally responsible to intervene. D. Not responsible in any way as the client has a right to make his/her own decision.

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.

*53. Maxwell, age 46, is referred to you by his EAP because he is depressed and drinking daily on the job. He witnessed a train wreck 3 weeks ago in which several people were killed. Now he says he is terrified to leave the house without a couple of drinks to calm him down. He says that every time he hears a loud noise he feels faint, and he wakes up sweating and shaking. What action would the social worker take? Content Area: Ethics: Therapeutic Relationship/Services This question tests your ability to respond to client's needs in an ethical way. A. Determine the client's ability to respond to anxiety treatment interventions. B. Evaluate the client's need for a crisis intervention, C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions. D. Tell him that his treatment will be confidential as it pertains to his EAP.

C. Limit the informed consent conversation to the legal requirements (fees, your business name and license) and proceed with crisis interventions. Ethically, you cannot avoid informed consent even in a crisis. So it would be ethical to give the client the legally required information and meet any crisis needs immediately.

*8. You've been seeing a couple for marital therapy. The husband arrives for their weekly session alone and reports that his wife is staying in the car. He says that she refuses to come to your office because you are always taking his side. He wants to go ahead with the session without her. You decide to: Content Area: Ethics: Therapeutic Relationship/Services This question asks you how to proceed in a marital therapy scenario. A. Proceed with the session, seeing him alone. B. Terminate the therapy and give him a referral to another mental health professional. C. Make another appointment for both of them since the couple is your client. D. Go down to the car and ask the wife to come in so that you can explore this issue.

C. Make another appointment for both of them since the couple is your client. In conducting marital therapy, your client is the couple. By asking that both partners be present, you are demonstrating that you do not take sides. This might encourage the wife to attend the next session in order to explore her feelings of being treated unfairly.

96. A couple, whose children have all graduated from high school, is considering adopting an elementary school-age child. They believe that a child who has not yet been adopted would do well in their household, and they want to give back to society. How should the social worker approach this couple's decision? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to respond to clients' treatment needs. A. Advise them on the cultural implications of adoption. B. Assess for a phase of life problem. C. Obtain consultation about adoption. D. Refer if the couple has reached the original treatment goals.

C. Obtain consultation about adoption. Getting consultation is a potentially useful thing to do when client presents a new issue.

*91. Rob, a 27- year-old African American male, and Cynthia, his 24-year-old Mexican American girlfriend, have decided to live together after six months of dating. Cynthia asked Rob to participate in therapy, and Rob agrees to attend one month of therapy in order to "try it out." During the first session, Cynthia softly reports that Rob cannot control his anger. Rob quickly turns to Cynthia and shouts, "You're the one that's too sensitive!" When creating a safety plan with Cynthia, you would do all of the following EXCEPT: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of the legal obligations to assess a client's safety and treat the client within your scope of practice. A. Make yourself available by phone and increase the frequency of sessions. B. Provide a list of addresses and phone numbers to local shelters, emergency housing agencies, and crisis centers. C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them. D. Advise Cynthia to gather important items in one place (i.e. extra set of car keys, debit and credit cards, medical records and prescription refills, etc.).

C. Provide a safety plan session for Cynthia and Rob in order to help decrease verbal and physical abuse between them. Including Rob in the creation of the safety plan and possible emergency escape plan would only put Cynthia at risk. Rob's knowledge of these plans may lead to a violent reaction from Rob.

*71. Matthew, age 40, and Delilah, age 27, have been married for 8 months and have been referred to you by the pastor of their church. Delilah says, "It's like I keep marrying the same man. Just like my 2 ex's, he flies off the handle at the drop of a pin, and I don't like the way he disciplines the kids." Matthew says, "She needs to listen to me about how to raise children and seriously adhere to Biblical teachings." How would you manage your scope of practice obligations in light of the domestic violence? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of working within the scope of practice to assess the safety of clients. A. Establish your right to break confidentiality to prevent domestic violence. B. Explain that there are exceptions to confidentiality, including the reporting of child abuse. C. Question Matthew and Delilah separately about possible domestic violence. D. Do not confirm nor deny to the pastor that Matthew is or is not your client.

C. Question Matthew and Delilah separately about possible domestic violence. Scope of practice obligations require that you conduct therapy and safety assessments in a way that meets the standard of care.

74. An HMO refers a client dealing with depression. When the client arrives at her first session she explains that she's not depressed but is seeking vocational counseling, intellectual testing, and information regarding her desire to change careers. She states that she didn't believe the insurance company would authorize treatment for such a "lame reason." What would you do? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of how to work within your scope of practice. A. Inform her that she will have to pay out of pocket. B. Proceed with treatment. C. Refer the client to a career counselor. D. Call the insurance company and inform them that you will be seeing her for reasons other than depression.

C. Refer the client to a career counselor. Based on the information given, referring the client to a career counselor is the appropriate option.

*17. Eugenia, a 36-year-old massage therapist from Brazil, is referred by a former client. She presents in a highly agitated manner and occasionally slurs her words as she tells you that her ex-husband is stalking her and her 16-year-old daughter. She is considering obtaining a temporary restraining order against him. Eugenia has no health insurance and wants to know if you can extend credit to her or receive massages in exchange for therapy. What is your legal course of action? Content Area: Law: Legal Standards for Professional Practice. This question tests your ability to differentiate legal from ethical issues. A. Inform Eugenia that if she enters her emotional state into the proceeding to obtain the restraining order, her right to privilege will be waived. B. Refrain from giving legal advice regarding the restraining order due to scope of competence. C. Refer to legal aid for restraining order help or to assist with assault charges. D. Avoid dual relationships regarding becoming a massage client.

C. Refer to legal aid for restraining order help or to assist with assault charges. Eugenia is thinking about a temporary restraining order, and the help a social worker would give would be in directing her to the appropriate resources. It would be out of your scope of practice to give her legal advice yourself.

54. All of the following would represent a permitted breach of confidentiality without the need for a client release EXCEPT: Content Area: Ethics: Business Practices and Policies This question tests your knowledge of instances in which we are permitted OR mandated to break client confidentiality. A. Filing a child abuse report. B. Ensuring safety for a suicidal client. C. Responding to a CPS caseworker's request for family history following a child abuse report. D. Calling the police to notify authorities that your client is leaving your office intoxicated and driving a motor vehicle.

C. Responding to a CPS caseworker's request for family history following a child abuse report. A social worker is not permitted to respond to a CPS caseworker's follow-up inquiries without a written request if the request does not specifically pertain to the child abuse report.

93. A man calls you to ask about his wife's therapy bill since she has been using his insurance. He asks if you can provide copies of the previous three months' bills because the insurance company has lost them. Upon hearing his request, you: Content Area: Law: Confidentiality, Privilege, and Consent This question asks for the confidentiality rules in regard to third party callers. The issue of the insurance statements is secondary to the confidentiality issue. A. Send a copy of the bill since it is his insurance. B. Call his wife and ask if she would like you to send him a copy or if she would prefer you send it addressed to her. C. Tell him you cannot confirm or deny that his wife is your client. D. Give his wife the bill copies at her next session.

C. Tell him you cannot confirm or deny that his wife is your client. Whenever anyone calls asking about anyone other than themselves, it is vital to not reveal any confidential client information.

47. You are obtaining a release of information from a client to confer with the client's psychiatrist. The client tells you that she is thinking of finding a new psychiatrist because this one never listens to her. She is concerned that if you talk to the psychiatrist, you will develop a negative opinion of her. Which of the following would you find on a release of information form? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your understanding of what information is included on a release of information form. A. The client's name and diagnosis. B. The client's social security number and diagnosis. C. The purpose of the release and the social worker's license number. D. The length of time the client has been in treatment and the social worker's license number.

C. The purpose of the release and the social worker's license number. The purpose of the release and the social worker's license number would both be on a release of information form.

60. You are meeting with a client in your private practice for the first time. She tells you that she found you with an internet search with the search term "expert in eating disorders." Which of the following must, by law, be disclosed prior to beginning the session? Content Area: Law: Confidentiality, Privilege, and Consent This question is testing your knowledge of ethical and legal requirements of an informed consent. A. Explaining the limits of confidentiality. B. Explain your scope of competence since you claim to be an "expert." C. Your fee. D. Your full name and license designation.

C. Your fee. Disclosing your fee is legally required prior to the commencement of therapy.

88. A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have: Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal and ethical standards in dealing with referrals. A. Expressed your gratitude in an appropriate and professional manner. B. Not acted unethically or illegally since you did not solicit the referral. C. Not acted unethically or illegally since you did not directly pay the colleague for the referral. D. Acted unethically and illegally.

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.

*89. Your client has two children and is divorced. She tells you that when she arrived at her ex-husband's house last night to pick up the children, he had locked the doors and texted her that, "Me and my children are moving across the country." He has no criminal history, but she is afraid she will never see her children again. Which of the following is the clinician's first intervention? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of when to make referrals for expertise outside of your scope of practice. A. Advise her to call Child Protective Services for abduction. B. Explore the events immediately preceding this one. C. Call the police. D. Advise her to call her lawyer.

D. Advise her to call her lawyer. Your only obligation in this situation is to maintain confidentiality and assess for a possibility of a crisis interventions. If the client is not afraid that the father will harm the children, she needs to call her lawyer to pursue legal options.

*45. The Baker family comes to counseling referred by their pastor. Derek, their 14-year-old son, has been hanging out with a "bad crowd." He isn't doing his homework, is sloppy doing chores, and has failed to show up for choir practice at the church. Their other child, Sarah, who is 12 years old, not only doesn't want to go to choir practice, she doesn't want to go to church at all. Sarah says, "I don't care if I go to hell; at least I'll be able to sleep in on Sundays!" Mr. and Mrs. Baker say they don't want to "do anything rash." "Please help," says Mrs. Baker. How would you proceed with managing your ethical responsibilities? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage family treatment from an ethical perspective. A. Have the couple tell you what they have attempted to do to manage this conflict thus far. B. Tell the family that you work from a systems perspective, and that you will be "reframing" the children. C. Clarify for the family your role with the pastor. D. Ask Mrs. Baker what she means by "help."

D. Ask Mrs. Baker what she means by "help." This is a way of providing informed consent about client's expectations.

*43. Mrs. Bailey sees the photograph of your dogs in your office and brings you a basket of dog treats. How would you respond to her gift? Content Area: Ethics: Business Practices and Policies This ethical question regarding gifts tests your sensitivity to the issue of professional boundaries and dual relationships. A. Accept the gift in the spirit in which it was given. B. Take one of the treats as a gesture and return the rest. C. Thank her for her thoughtfulness and decline the gift. D. Assess the motivation behind the gift.

D. Assess the motivation behind the gift. Assessing the motivation and the value of a gift is very important in determining whether you should accept it or not. What needs to be determined is whether the act of giving the gift supports Mrs. Bailey's therapeutic process and needs.

61. Ponciano and Berta are a Guatemalan couple who have been in treatment with you. They are moving back to Guatemala this week. They come to session and present you with some freshly baked sweetbread that Berta says she made especially for you because of all you have done for them. She tells you that it is a custom in her country to make a parting gift when friends are separating. How would you respond? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of the ethics that pertain to gifts from clients. A. Accept the gift but explain that gift giving is not usually a part of a therapeutic relationship. B. Refuse the sweetbread because, ethically, social workers should not accept gifts from clients. C. Further explore their customs but do not accept the sweetbread because it is unethical. D. Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session.

D. Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session. This would be the most appropriate response. Ethical standards are guidelines and there are circumstances in which other considerations, such as cultural issues, would allow for accepting a gift of this nature.

99. Angelina, a 20-year-old college student, comes to see you complaining that she's having difficulty breathing and concentrating, and that she thinks it's "all in her head." Angelina says she was date raped three weeks ago and says you are the only person who knows. She hasn't told her parents and doesn't want them to know about it. Angelina says, "Please help me. I can't take this anymore." She tells you that her parents have told her that they will pay for her therapy. How would you manage the legal issue of payment? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of the legal issues that pertain to fees. A. Explain the limits of confidentiality if a third party is paying for therapy. B. Consider offering Angelina a lower fee so that she can pay for her own therapy. C. Talk to Angelina about whether she wants her parents to pay for therapy. D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement.

D. Bill Angelina for therapy and let her decide whether to give the statement to her parents for reimbursement. Angelina is an adult in therapy. Your legal obligation is to collect your fee and allow the client to determine how she will get paid.

*20. Kevin is 17-years-old and tells you that he was upset when, as a small child, his father would hit his mother. He tells you that the abuse stopped a few years ago. Kevin says that his father is 70-years-old and is "running out of steam." Now when his father "gets out of line," he and his mother simply lock the father in his room until he settles down. He is glad his father has become more manageable. What would you do next? Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question reviews your mandated reporting responsibilities. A. Assess the whole family further in the next session. B. Call Adult Protective Services immediately because the father is being unlawfully detained. C. Call an agency designated to take a child abuse report because Kevin lives in a household in which there has been spousal abuse. D. Call Adult Protective Services and an agency designated to take a child abuse report immediately.

D. Call Adult Protective Services and an agency designated to take a child abuse report immediately. Call Adult Protective Services immediately because there is reasonable suspicion of an elder being isolated. Call an agency designated to take a child abuse report because Kevin is still a minor, and he is reporting having witnessed spousal abuse that caused him distress.

16. Recently your mother died and a client comes in grieving the loss of his mother. What would you do FIRST? Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your ability to recognize the influence of counter-transference and when your functioning is impaired. A. Talk about this situation in your own therapy. B. Seek consultation. C. Refer the client to another therapist. D. Determine if you can deal with this client at this time.

D. Determine if you can deal with this client at this time. First you would have to assess the client's best interests; only if you can continue to work with the client would you need to manage your counter-transference.

79. Christine is a 14-year-old ward of the court. During the first session she says that her group home counselor is not helping her. Christine says that another child in the group home has sexually molested her, but no one believes her. She says that an abuse report was filed, but nothing came of it. She wants therapy to help her manage her feelings. Legally the next step would be to: Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of how to report child abuse when the abuse happens out of the child's home. A. Get consent from her court-appointed attorney. B. Get consent from her group home counselor. C. Have her terminate with her group home counselor. D. File a child abuse report.

D. File a child abuse report. Christine has told you that she was sexually abused and, although, she said a report was already filed, you need to fulfill your mandate to report child abuse.

*1. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of Section 1024 of the Evidence Code. A. Maintain Roger's confidentiality. B. Warn the manager of the factory because this is analogous to a Tarasoff situation. C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision. D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.

D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened.

78. Roger Kelly has been coming into work late, borrowing money from other employees, and creditors had begun calling him at work regarding overdue bills. He was recently fired from his job because of inadequate performance after a physical altercation with another employee. His boss terminated him and indicated that his recent change in attitude, unpredictable behavior, and job performance would have caused him to be terminated in any case. Roger is so angry about the termination that he threatens to sabotage several machines at the record-pressing factory. How should the social worker proceed? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of Section 1024 of the Evidence Code. A. Maintain Roger's confidentiality. B. Warn the manager of the factory because this is analogous to a Tarasoff situation. C. Ethically, the social worker may choose to break confidentiality according to the Landeros vs. Flood decision. D. Follow the guidelines as set forth in Section 1024 of the Evidence Code.

D. Follow the guidelines as set forth in Section 1024 of the Evidence Code. The Tarasoff Decision does not pertain to the protection of physical property. However, Evidence Code 1024 states that the social worker has a "right" to warn when property is threatened.

*98. A person calls telling you that she is your client's conservator. Your client is physically disabled and has told you about the challenges associated with being under conservatorship. The client tells you that she hates not being able to make her own decisions. How do you manage your ethical obligations related to informed consent? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge about the ethical requirements for informed consent. A. If you have any concerns for the client's safety, tell the conservator about the limits of confidentiality related to dependent adults. B. Determine the type of conservatorship. LPS conservatorships allow the conservator to consent to treatment. C. Tell the conservator about your mandate to report dependent adult abuse. D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults.

D. If you have any concerns for the client's safety, tell the client about the limits of confidentiality related to dependent adults. If you have concerns about a dependent adult's safety, you are legally and ethically obligated to inform the CLIENT about the limits of confidentiality. Although "Consent To Treat" came from the conservatorship, the client's rights to confidentiality are still relevant.

69. Mrs. Moran is referred to you by a former client. On the phone she refers to you as "Dr.," although you do not possess this degree or license. It is apparent to you that Mrs. Moran is quite depressed. How would you handle this situation? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of ethical standards regarding the obligation to accurately represent licensing status. A. Inform Mrs. Moran of your license status once her mood has stabilized and she is in a better mental state to understand and evaluate this information. B. Refer Mrs. Moran to a doctor since her statement indicates that she is seeking the services of a psychologist, psychiatrist, or M.D. C. Give Mrs. Moran your business card which will provide her with your accurate qualifications. D. Inform Mrs. Moran of your license and qualifications.

D. Inform Mrs. Moran of your license and qualifications. Ethical standards require social workers to correct inaccurate representations of their licensing status and professional qualifications. There is no reason not to inform Mrs. Moran of your licensing status simply because she is "quite depressed."

67. The Humburgs come to counseling with their 16-year-old son, Cameron, because they found drugs in his room. They don't want the other two children, ages 9 and 11, to know. They want you to suggest some strategies to help Cameron overcome this problem. Ethically, you would: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to explain the parameters of therapy with clients. A. Give them time to adjust to therapy since this is their first session and see just the three of them. B. Tell them that you are a Family Systems therapist and the other children should be included. C. Tell them that it would be outside of your scope of practice as a systems therapist to exclude the other two children. D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them.

D. Inform them of the risks and benefits of Family Systems therapy and see just the three of them. Ethically, you have to explain the parameters of therapy.

32. In your private practice you see mostly adults. The one child that you treat was removed from his parents by Social Services after they were reported for child neglect. During your sessions with Mark, you find yourself becoming more and more attached and wanting to take care of Mark yourself. What is the appropriate way to deal with your feelings? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to deal with your counter-transference. A. Recognize that your attachment is normal, as you feel sympathy for Mark's situation. B. Discuss your counter-transference in supervision. C. Let Mark know about your feelings to show him he still is a lovable little boy, and any issues about having him removed from the home is about his parents and not about Mark. D. Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on.

D. Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on. The most ethical way to deal with counter-transference is through journaling, peer consultation and personal therapy, in an attempt to regain perspective.

66. Your client, Jordan, has just tested positive for HIV. He is in a relationship and is convinced that if he tells his partner, Julian, he will leave him. What are your ethical responsibilities in this situation? Content Area: Ethics: Business Practices and Policies This question tests your knowledge of ethical considerations regarding confidentiality and clients' HIV status. A. Refuse to treat Jordan further unless he tells Julian of his HIV-positive status. B. Tell Jordan that he should tell Julian. C. Call Julian. D. Maintain confidentiality.

D. Maintain confidentiality. As a social worker you are legally and ethically required to maintain confidentiality when you are aware that your client is HIV positive.

46. A psychiatrist refers you a client with severe anxiety. The day before an intake session, the client calls you to ask if he can see you right away because he is afraid he will take all of the anti-anxiety medication he owns. He tells you that he is actually seeing three different doctors to get as much medication as he can. In collaborating with his doctors, which of the following would be the most ethical approach? Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to collaborate and consult according to ethical (rather than legal) standards. A. File three separate releases in the client's file. B. Tell him that you plan to speak to all of his doctors with or without a release. C. Ask him which doctor he would prefer that you talk to. D. Obtain consultation from each doctor about his case.

D. Obtain consultation from each doctor about his case. The best answer choice from an ethical point of view would be to speak with each doctor. This is a scope of competence question that tests your knowledge of how to utilize consultation.

42. To prepare clients for termination, a social worker schedules sessions every other week and then once a month. Over time, he finds that clients cancel their monthly sessions. Some clients just stop calling entirely without making a monthly appointment. Which of the following would NOT be an ethical concern related to the termination process? Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to handle termination in a competent way. A. Formally terminate with no-show clients. B. Provide informed consent before changing the session frequency. C. Assess whether the infrequent sessions are in the client's best interests. D. Offer a sliding fee for the intermittent sessions.

D. Offer a sliding fee for the intermittent sessions. There is no legal or ethical requirement to slide fees as part of termination.

*62. A male client comes to see you for the first time. As he talks, you begin to realize that he is definitely going to harm someone. He has a plan and is going to act, but he has not identified his intended victim to you yet. Just as he is about to tell you the identity of the name of the intended victim, you realize that you have not explained to him the limits of confidentiality: Content Area: Ethics: Therapeutic Relationship/Services This question tests your knowledge of how to manage your ethical and legal obligations when a client might be dangerous. A. Tell him to stop and refer him to someone else. B. Wait until he identifies the intended victim and then explain the limits of confidentiality, as you must do as part of obtaining informed consent. C. Ask him to stop and explain to him the limits of confidentiality as part of informed consent. D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim.

D. Proceed with the session and carry out your duty to protect, per Tarasoff, if he identifies the potential victim. This is what you would have to do. At this point, the well-being of the intended victim outweighs the ethical concerns about informed consent.

70. A 56-year-old woman that you have been treating has just experienced the death of her husband. His was the primary income, and she was not aware of all of the financial responsibilities. She tells you that she has been getting calls from bankers, real estate planners, and lawyers offering to provide assistance. If you become concerned for her welfare, you should: Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how and for whom to make appropriate referrals. A. Refer her to a lawyer. B. File an elder abuse report: financial abuse. C. File an elder abuse report: undue influence. D. Refer her to a financial planner.

D. Refer her to a financial planner. She needs assistance and education about how to manage her and her husband's finances.

58. Maya, a 15-year-old emancipated minor, comes in to see you without parental consent. She tells you that last week her 20-year-old husband, Oliver, raped her when she refused to have sex with him. She's been feeling depressed and disoriented ever since this happened. Which of the following would represent the correct legal analysis of this situation? Content Area: Law: Confidentiality, Privilege, and Consent This question tests your knowledge of child abuse reporting laws. A. Since Maya is depressed and disoriented, you can treat her without parental consent. B. Since Maya is married the rape would represent spousal abuse and you would have an ethical responsibility to ensure her safety. C. Since Oliver is only 5 years older than Maya, Oliver's actions would not constitute lewd and lascivious behavior. D. Since Maya is 15 years old, the rape would constitute child abuse.

D. Since Maya is 15 years old, the rape would constitute child abuse. Although Maya is an emancipated minor, she is only considered an adult in certain legal circumstances. As a minor, a social worker is required to report abuse, which rape clearly is.

*87. After completing a three-month course on hypnotherapy, you decide to advertise your new specialty. You receive a call from Christopher, who says he would like to come in for a session, so that you could hypnotize him to stop smoking. He says he's tried the patch and nicotine gum, but he needs your help to quit once and for all. How would you respond to Christopher's request for treatment? Content Area: Law: Legal Standards for Professional Practice. This question deals with scope of practice for mental health professionals. A. Make an appointment because hypnotherapy is now part of your scope of competence. B. Inform him of your fee before the commencement of treatment. C. Refer him to a medical doctor. D. Tell him that you will not be able to help him quit smoking.

D. Tell him that you will not be able to help him quit smoking. Using hypnotherapy to help Christopher stop smoking would have to be within the context of therapy, and not as a stand-alone treatment. Otherwise, it is outside the scope of practice.

*10. You have been working with a client for six months. The client sometimes forgets her checkbook and tells you that she will bring it at the next session. She has accumulated a debt of $500. What would be your least important consideration when attempting to collect an unpaid bill from the client? Content Area: Ethics: Business Practices and Policies This question reviews proper management of collections, knowing what constitutes a breach of duty and asks you to identify the strategy you would not use. A. Having the client pay at the beginning of each new session. B. Providing a collection agency with only the client's name, address and amount owed. C. Establishing with the client a satisfactory payment plan to pay off the bill. D. Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty.

D. Telling the client that her not paying you establishes an exception to confidentiality because it is a breach of duty. A client's failure to pay does represent a legal "breach of duty" but that is not related to how you would proceed with collections.

86. Your 15-year-old client comes to session extremely agitated because she just found out that a photo she sent to her boyfriend is now circulating all over the school. She is getting harassing comments about her appearance and sexual promiscuity. She is afraid that the school will contact her parents if she reports the harassment to school authorities. How do the laws pertaining to bullying direct your actions as a social worker? Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate interventions with a minor. A. You may speak with the school, or they may speak to you without a release. B. You must report to the school authorities, but you are not required to report to the police. C. You may advise your client about her reporting requirements. D. You may tell your client about the laws pertaining to cyberbullying.

D. You may tell your client about the laws pertaining to cyberbullying. You may tell your client about the laws regarding cyber-bullying. The laws about bullying define bullying (e.g., face-to-face or digital harassment, threats, persecution, etc.) and what the school district is permitted to do. You may not give legal advice because that would be out of your scope of practice.