3Law & ethic exam 3

Which of the following is required for a valid claim of malpractice? Select one: a. The therapist must have had malevolent intentions and there must be a causal connection between the therapist's actions and the harm suffered by the client. b. The therapist must have had malevolent intentions and or or there must be some harm to the client as a result of the therapist's actions. c. The therapist may or may not have had malevolent intentions, but there must be a causal connection between the therapist's actions and the harm suffered by the client. d. The therapist must have violated normal "standards of practice" or must have had malevolent intentions.

C is correct: Malpractice cases are civil suits that require a plaintiff (e.g., the client) to prove his or her claim by a "preponderance of the evidence." In other words, the plaintiff must establish a standard of care and show that the therapist did not meet it. For a client or other person to bring a claim of malpractice against a therapist, three conditions must be met: (1) The therapist had a professional relationship with the person, which established a legal duty of care; (2) the therapist has breached that duty by acting in a way not consistent with the expected standard of care (e.g., by acting negligently); and (3) as a direct result of the breach of duty, the person has suffered harm. The therapist's actions do not have to have been malevolent but there must be evidence that the therapist's actions are the cause of the harm suffered by the client.

A counselor who has recently died had made arrangements to pass along her records to another therapist. What should this therapist do with the records? Select one: a. The therapist should return them to the clients. b. The therapist should destroy the records. c. The therapist should maintain the records. d. The therapist has no obligation.

C is correct: The therapist should maintain the records within the same ethical guidelines that any other records are kept.

A 14-year-old girl discloses to you that she is being harassed and physically threatened by a gang. Recently, a member of the gang pulled a knife on her. She doesn't want her parents to know. What should you do? Select one: a. Call her parents. b. Determine the danger, then report if indicated. c. Call the police and her parents. d. Assess the girl's needs.

C is correct: This is a dangerous situation and it also represents an exception to privilege (Evidence Code 1027, child under 16 victim of crime). Therapeutically, you may need to work with the client on telling her parents but "C" is the only answer that describes an appropriate way of obtaining the kind of protection that the girl seems to need. Answer A: Given the level of danger, this is probably not enough to protect the girl. Answer B: You already know that the girl is in danger. Answer D: You will certainly attempt to find out what other needs the girl may have. It's already clear, however, that she needs protection immediately. And her safety needs override her concerns about telling her parents.

Licensed professional clinical counselors are required to complete not less than _____ of approved continuing education every two years. Select one: a. 12 b. 24 c. 36 d. 48

C is correct: This is stated in Business and Professions Code 4999.76.

When a therapist dies, what is most likely to happen to her records? Select one: a. The records will be given to her clients. b. The records will be handled by her spouse (executor). c. The records will be disbursed as specified in the therapist's will. d. The records will be destroyed.

C is correct: This is the best of the four answers. Although there are no standard guidelines for the handling of records after a therapist dies, records are the property of the therapist. As such, arrangements should be made by a therapist for the proper handling of records after her death. It would seem that the most competent person to handle the records would be a colleague, but if the therapist's will doesn't specify such an arrangement, then the person assigned as the executor of the estate would need to handle this. Answer A: The physical records are the property of the therapist, not her clients. Answer B: This may be the outcome but isn't always the case. Also, the therapist may not have a spouse. Answer D: This is not a good answer. Attorney Richard Leslie (1994) recommends that therapists retain client records for no less than seven years following termination of the therapist-patient relationship and, in the cases of nonemancipated minors, for no less than seven years and at least for one year after the minor turns 18. This answer doesn't take this practice into consideration.

Under which of the following conditions would you be mandated to file a child abuse report? Select one: a. consensual sexual intercourse between a 16 year old and a 21 year old b. a 15 year old who is engaging in lewd and lascivious conduct voluntarily with a 23 year old c. a 17 year old who is the victim of rape d. all of the above

C is correct: This question addresses various conditions that may require you to file a child abuse report. You must report an incident of rape that involves a minor. Answer D: See explanation above.

A 31-year-old woman, Inga, comes to therapy because her family and friends are concerned about her recent behavior. Inga has remarried and has three stepchildren whom she complains are causing her problems. Some days she gets so frustrated that she will not get out of bed and she has lost her appetite. She says, "I feel like they are always against me." She has given you no indication that she is suicidal or is a danger to her family. You should: Select one: a. contact her husband. b. call the police. c. refer her to a psychiatrist. d. initiate a 5150.

C is correct: Through the process of elimination, this would be the best option. This patient is clearly distressed and possibly paranoid; it's not clear, however, what level of intervention is required. Answer D: Involuntary hospitalization should be a last resort option, and there is insufficient information in this question to indicate the need for a 5150.

Section 5150 of the Welfare and Institutions Code allows an individual to be involuntarily hospitalized for up to _____ without notifying him or her of his right to a certification review hearing. Select one: a. 12 days b. 7 days c. 72 hours d. 24 hours

C is correct: WIC Section 5150 states that, "when any person, as a result of a mental disorder, is a danger to others, or to himself or herself, or gravely disabled, a peace officer, a member of the attending staff of an evaluation facility designated by the county, designated members of a mobile crisis team, or other professional person designated by a county, may upon probable cause, take, or cause to be taken, the person into custody and place him or her in a facility designated by the county and approved by the State Department of Mental Health as a facility for 72-hour treatment and evaluation." Note that a certification review hearing is not required until the individual has been certified for an additional 14-day hold after the initial 72-hour hold.

Sexual harassment of clients by counselors: Select one: a. is permissible two years after counseling has terminated b. is not mentioned by ethics codes and thus has no relevance to counseling ethics c. is not mentioned by ethics codes but is clearly unethical d. is explicitly mentioned by ethics codes and is clearly unethical

D This is an example of where you don't want to over-think. Obviously, sexual harassment is unethical. The main issue, then, is whether it's mentioned in the ethics code, leaving you with C or D as the correct answer. Sexual harassment is specifically mentioned by both the NBCC Code of Ethics ("shall not engage in sexual harassment") and by the ACA Code of Ethics ("do not engage in or condone sexual harassment"), so D is correct.

Melissa, age 12, tells the counselor that she really needs to talk to someone about how her "friends" are gossiping about her on Facebook. She says she doesn't want her parents involved because they don't understand how Facebook works, and probably would force her to stop using it. They also don't believe in therapy, she says. How should the counselor proceed? Select one: a. Contact her parents immediately because she may be in danger. Some teens have become suicidal when harassed on Facebook. Hopefully you can persuade the parents that the girl needs therapy. b. See her because she is old enough to consent to her own treatment, but also notify Facebook because their rules say the minimum age for an account is 13. c. See her for this one session, but then notify her parents, as there is no clear reason why it might be inappropriate to do so. d. See her because she is old enough to consent to her own treatment, and may not participate if you insist on parental involvement. California law no longer requires the minor to be in danger if treatment is not provided.

D is correct. However, a good case could be made for choice "C" as well. Legal requirements regarding the consent of unemancipated minors who are 12 years of age or older are provided in and C Section 124260, which became effective on January 1, 2011. Section 124260(b) permits a minor who is at least 12 years of age to consent to outpatient "mental health treatment or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services."

Your client is a 72-year old female who is suffering from dementia. She claims that her husband is abusing her. You have interviewed all of her family members and they claim that there is no abuse occurring. A medical doctor has evaluated her and has found no evidence of abuse. Consequently you do not believe that your client has been abused. Select one: a. You must file a report. b. You should encourage your client to file a report. c. You should encourage a member of the family to file a report. d. You are not required to file a report.

D is correct: "A mandated reporter . . . shall not be required to report . . . an incident where all of the following conditions exist: (i) The mandated reporter has been told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse, abandonment, abduction (effective January 1, 2003), isolation, financial abuse, or neglect. (ii) The mandated reporter is not aware of any independent evidence that corroborates the statement that the abuse has occurred. (iii) The elder or dependent adult has been diagnosed with a mental illness or dementia, or is the subject of a court-ordered conservatorship because of a mental illness or dementia. (iv) In the exercise of clinical judgment . . . the psychotherapist . . . reasonably believes that the abuse did not occur" (W.I.C. 15630, section b(2)(A)).

Your client, Nancy, single and age 37, has informed you that she just terminated a sexual relationship with her former psychologist, who is also single. The relationship occurred while she was his patient. She indicates that she voluntarily participated in the relationship and she did not feel the least bit exploited. Furthermore, she continues to remain "good friends" with this psychologist. What should you do first, and then what would you do next? Select one: a. You should file a complaint with the Board of Psychology and then you should inform the other psychologist that you have filed the complaint. b. You should contact a lawyer and then notify a law enforcement agency. c. You should address this issue therapeutically with Nancy and encourage Nancy to confront her former psychologist. d. You should provide Nancy with the brochure, Professional Therapy Never Includes Sex, and then you should discuss it with her.

D is correct: "Any psychotherapist or employer of a psychotherapist who becomes aware through a patient that the patient had alleged sexual intercourse or alleged sexual contact with a previous psychotherapist during the course of a prior treatment, shall provide to the patient a brochure promulgated by the department that delineates the rights of, and remedies for, patients who have been involved sexually with their psychotherapist. Further, the psychotherapist or employer shall discuss with the patient the brochure prepared by the department" (Business and Professions Code 728, section a).

A counselor is scheduled to perform an assessment of a 50-year-old Chinese married woman with two children. The client speaks only limited English, so one of the children has volunteered to translate for the counselor. Which of the following is true? Select one: a. The counselor should allow the child to translate for the counselor if the child is an adult. b. The counselor should allow the child to translate for the counselor if the child is proficient in English and Chinese. c. The counselor should allow the child to translate for the counselor if the mother willingly consents to this arrangement. d. The counselor should not allow the child to translate for the mother.

D is correct: "Counselors communicate information in ways that are both developmentally and culturally appropriate. Counselors use clear and understandable language when discussing issues related to informed consent. When clients have difficulty understanding the language that counselors use, counselors provide necessary services (e.g., arranging for a qualified interpreter or translator) to ensure comprehension by clients. In collaboration with clients, counselors consider cultural implications of informed consent procedures and, where possible, counselors adjust their practices accordingly" (ACA Ethical Standard A.2.c, 2014). In this situation, there are many potential biases that may influence the child's translations for his or her mother so the child would not be considered a "qualified" interpreter. Moreover, it would be difficult for the child to try to avoid "helping" his or her mother during the assessment.

Each of the following is permitted for clinical counselor trainees, interns, and applicants, except: Select one: a. perform services as an employee b. perform services as a volunteer c. shall be paid by their employers d. shall be paid by patients or clients

D is correct: As stated in Business and Professions Code 4999.47, "[c]linical counselor trainees, interns, and applicants shall perform services as an employee or as a volunteer, not as an independent contractor ... shall not receive any remuneration from patients or clients, and shall only be paid by their employers."

As defined in California Evidence Code Section 1013, the "holder of the privilege" refers to all of the following except: Select one: a. a client who has no guardian or conservator. b. the guardian or conservator of a client who has a guardian or conservator. c. the personal representative of a client when the client is deceased. d. a health care provider who has obtained a signed release from the client.

D is correct: Evidence Code Section 1013 identifies the individuals listed in answers "A", "B", and "C" as holders of the privilege. Therefore, answer "D" is the correct response. Note that a waiver signed by the client allows a health care provider to release privileged information but does not make the health care provider the holder of the privilege. A health care provider is never the holder of the privilege.

You receive a written request from a former client for a copy of his therapy records. His request does not include your psychotherapy notes. Unless you have a lawful reason for withholding the records, you must respond to the request by sending: Select one: a. a copy or summary of the records within 5 days. b. a copy or summary of the records within 15 days. c. a copy of the records within 7 days. d. a copy of the records within 15 days.

D is correct: HIPAA requires health providers to provide patients with copies of their records (PHI) when the provider receives a written request for the records and there is no lawful reason for withholding the records; and the 15 day requirement for providing the records is established by Health and Safety Code Section 123110(b). Note, that HIPAA's requirements with regard to the release of a copy (rather than a summary) of records takes precedence over state law ( and C 123110) since HIPAA is more stringent in terms of providing patients with access to their records. Also note that the requirement to provide a copy of the records (versus a summary) does not apply to psychotherapy notes since HIPAA does not require release of psychotherapy notes to patients. Therefore, and C 123110 applies to psychotherapy notes, and it permits providing a copy or a summary of the records.

You have been seeing Alfredo A. in therapy for over six months and believe he is no longer benefiting from therapy. However, when you discuss the possibility of terminating therapy, he says he's happy with his progress and wants to continue. As an ethical counselor, you: Select one: a. agree to continue seeing Alfredo since he is satisfied with the progress of therapy. b. agree to continue seeing Alfredo for an additional period of time but, at the end of that period, insist on terminating therapy. c. explain to Alfredo that these are normal reactions to the end of therapy and set a date for termination. d. see if additional goals for treatment can be identified but, if not, set a date for termination and, if appropriate, provide him with referrals to other therapists.

D is correct: Termination of therapy is addressed in ACA Ethical Standard A.11.c (2014), which states: "Counselors terminate a counseling relationship when it becomes reasonably apparent that the client no longer needs assistance, is not likely to benefit, or is being harmed by continued counseling. Counselors may terminate counseling when in jeopardy of harm by the client or by another person with whom the client has a relationship, or when clients do not pay fees as agreed upon. Counselors provide pretermination counseling and recommend other service providers when necessary." Answers A and B clearly violate this requirement. Although discussing Alfredo's feelings about termination (answer C) is not necessarily unacceptable, answer D is not only consistent with your ethical obligations but also better addresses Alfredo's best interests.

Luz is a 9 year old who is having conduct problems at school. She has begun to dabble in drugs and occasionally displays sexualized behavior. A counselor is permitted to provide Luz therapy if: Select one: a. she presents a danger to herself. b. she can understand the consequences of her behavior. c. she has been the victim of incest. d. her parents have consented.

D is correct: The relevant issue is that Luz is only 9 years old. If a minor is under the age of 12, a parent's consent must be obtained.

Your client is a 75-year-old female who is suffering from dementia. She claims that her husband is abusing her. You have interviewed all of her family members and they claim that there is no abuse occurring. A medical doctor has evaluated her and has found no evidence of abuse. Consequently you do not believe that your client has been abused. Which of the following is true? Select one: a. You must still file a report. b. You should encourage your client to file a report. c. You should encourage a member of the family, other than the husband, to file a report. d. You are not required to file a report.

D is correct: There is a limitation on the duty to report elder or dependent adult abuse in circumstances where all four of the following conditions exist: (1) the mandated reporter has been told by an elder or dependent adult that she has experienced behavior constituting physical abuse, abandonment, abduction, isolation, financial abuse, or neglect; (2) the mandated reporter is not aware of any independent evidence that corroborates the statement that the abuse has occurred; (3) the elder or dependent adult has been diagnosed with a mental illness, defect, dementia, or incapacity, or is the subject of a court-ordered conservatorship because of a mental illness, defect, dementia, or incapacity; and (4) the mandated reporter reasonably believes that the abuse did not occur. The above information does not impose on mandated reporters a duty to investigate a known or suspected incident of abuse, however. The law also provides that the above information shall not be construed to lessen or restrict any existing duty of mandated reporters.

A counselor is a professor at a local college. He is sexually involved with a masters-level student from one of his classes. Select one: a. This is unethical. b. This is unethical unless he can demonstrate that there is no exploitation. c. This is not unethical because the Ethics Code only prohibits sexual relationships with clients. d. This is not unethical because this is occurring in an academic setting.

A is correct: "Counselor educators are prohibited from sexual or romantic interactions or relationships with students currently enrolled in a counseling or related program and over whom they have power and authority. This prohibition applies to both in-person and electronic interactions or relationships." (ACA Ethical Standard F.10.a, 2014).

If a client has assaulted his counselor, the counselor: Select one: a. may disclose the facts about the incident. b. may disclose any confidential information about the client, including the nature of the clien and 's therapy, once the counselor became a victim of a crime. c. may not disclose any information if the incident occurred within a therapeutic context. d. may not disclose information under any circumstances unless this is a Tarasoff situation.

A is correct: "The commission of a crime is outside the confidential relationship. A treater may report the patient's name and facts about what occurred to the police. A treater may not reveal anything about the nature, course, or content of the therapy, all of which remain confidential. The facts of the crime, and the circumstances surrounding the crime, however, are not confidential, and you do not need the client's permission to share them with the authorities" [in Behnke, S. H., Preis, J., and Bates. R. T. (1998). The Essentials of California Mental Health Law. New York: W.W. Norton and Company, p. 143].

The mother of a 15-year-old girl refuses to seek medical treatment for her daughter, although the girl is seriously underweight. The mother tells the counselor that it is against her cultural beliefs. The counselor should: Select one: a. file a child abuse report. b. consult with a child psychologist who specializes in eating disorders. c. ask the daughter if she feels her health is in danger. d. respect the mothe and 's beliefs

A is correct: According to Penal Code 11166, a counselor is mandated to file a report when a minor is a victim of "child abuse or neglect." In this question, the mother's actions appear to constitute severe neglect - "the negligent failure of a person having the care or custody of a child to protect the child from severe malnutrition or medically diagnosed nonorganic failure to thrive" (Penal Code 11165.2).

Under which of the following conditions would a counselor be able to discuss confidential information about a client? Select one: a. The counselor is seeking consultation about a client while disguising the clien and 's identity. b. The counselor receives an inquiry from the personal physician of the client. c. The client is a minor. d. The client is HIV positive and engaging in reckless behavior.

A is correct: Counselors are permitted to discuss confidential information about their clients when consulting with colleagues if they protect the identity of the clients.

A counselor is treating a 16-year old emancipated minor who recounts an incident in which she was sexually abused at the age of 14 by a neighbor. How should the counselor respond? Select one: a. report this incident of child abuse b. report this incident of child abuse if the perpetrator continues to pose a danger to minors c. report this incident of child abuse if the perpetrator was an adult at the time of the incident d. maintain the client's confidentiality

A is correct: In the child abuse and neglect reporting act, a child is defined as "a person under the age of 18 years" (Penal Code 11165). The law does not, however, make a distinction for a minor who is emancipated, since the intent of the law is to protect children from abuse and neglect. Consequently, the counselor has an obligation to file a report.

False advertising of psychotherapy services is: Select one: a. illegal and unethical. b. illegal only. c. unethical only. d. not illegal nor unethical.

A is correct: The misrepresentation of psychotherapy services in advertisements is a violation of the Business and Professional Codes and ACA Code of Ethics (2014).

You are working in individual counseling with a 9-year-old girl who tells you that a neighbor, a 17-year-old boy, often asks her to lift up her dress. When she complies, he stares at her and laughs but, she says, he has never touched her. The girl seems very embarrassed when she discloses this activity but then quickly says she doesn't see anything wrong with it. She also says she doesn't know how to make the boy stop because "he's big and strong." What should you do with this information? Select one: a. Report child abuse to a designated agency. b. Maintain confidentiality because no child abuse has occurred. c. Tell the girl's parents about this. d. Take a "wait and see" attitude because the boy hasn't touched her.

A is correct: This question is difficult because the boy's behavior doesn't fit neatly into what you might think of as "child abuse." However, you wouldn't simply accept what this child has said, in terms of whether she's been harmed by the boy's behavior. In fact, P.C. 11165.3 addresses a form of child abuse called "willful cruelty," and what's described in this question could be interpreted as the boy willfully causing mental suffering to a child. So, willful cruelty, not sexual abuse, is probably what you'd report in this case. (You might have thought of this boy's behavior as sexually exploitive but, according to California's law on child abuse, sexual exploitation occurs when the exploiter profits in some way, for example, through the distribution of pornographic pictures of children.) Answer B: As noted, this activity sounds as though it's a form of willful cruelty (infliction of unjustifiable mental suffering on a child). Answer C: You may well inform the parents. This is not the best choice, however, because you have a mandate to file a child abuse report. Answer D: You may have been tempted to choose "D," thinking that "wait and see" means continue to assess. However, as indicated above, you should make a report based on the information you already have.

A new patient has a diagnosis of anxiety, and is taking medication provided by a physician at a community clinic. After the first session, the counselor wants more information about the patient's medication and how it may affect counseling. HIPAA laws provide that Select one: a. The counselor may call the community clinic if the new patient has signed a Notice of Privacy Policies, because health care providers do not need authorizations to consult about a patien and 's treatment. b. The counselor may not call the community clinic unless the new client has given signed consent to talk specifically to the physician who prescribed medication. c. The counselor may talk to the community clinic only if s or he is a covered entity. d. The counselor may communicate with the community clinic, but only electronically.

A is selected as correct, although a very good case could be made for choice "B". Choice "B" describes what most counselors would do in practice. Ethically, and as a matter of respect and courtesy, we would get written permission before communicating with another professional involved in the treatment of the patient. However, the law has never absolutely required it. Even before HIPAA, health care providers, including psychotherapists, did not have to keep confidentiality among those who are there "to further the interests of the patient in treatment." Choice "C" and "D" use HIPAA terminology such as "covered entity" and "communicate electronically," but they are clearly wrong.

With regard to releasing confidential information about a client: Select one: a. a counselor must always first obtain a release from the client b. a counselor must always first obtain a release unless the client's identity will not be revealed c. a counselor must obtain a release from the client in certain situations d. it is essentially up to the counselor to decide whether or not to obtain a release from the client

Although the general rule is to maintain client confidentiality, just as with most rules, there are exceptions. There are certain situations (e.g., when the client is believed to be a danger to him or herself or to another person), when a counselor is both legally and ethically required to violate client confidentiality. Consequently, of the responses given, C is the best one.

A counselor would be violating test integrity and security when he or she: Select one: a. shows a client several questions from a standardized test before administering the test to the client. b. discusses a client's responses to several test items to help the client understand why she received a low score. c. provides a client with the exact scores she obtained on a standardized test. d. engages in any of the activities described in the above answers.

Answer A is correct. Counselors are ethically and legally required to maintain test integrity and security, and showing a client several test items before administering the test to the client would violate this requirement.

Which of the following would you be best advised NOT to include in a client's clinical record? Select one: a. information relevant to the client's diagnosis or treatment that is unverified b. informed consents and authorizations c. information about decisions related to sensitive and dangerous issues d. information about the client's prognosis

Answer A is correct. Of the information listed in the answers, unverified information (e.g., information that is judgmental without documentation for those judgments, information from third parties who do not have direct information about the client) would be the type of information you would NOT want to include in a client's record.

Which of the following describes the August 14, 2002 modification to the Federal Health Privacy Rule with regard to obtaining consent from a patient before disclosing protected health information (PHI)? Select one: a. The modification eliminated the requirement for direct treatment providers to obtain a written consent prior to disclosing PHI for treatment, payment, or health care operations. b. The modification added the requirement for direct treatment providers to obtain a written consent prior to disclosing PHI for treatment, payment, or health care operations. c. The modification added the requirement for direct treatment providers to obtain either a written or oral consent prior to disclosing PHI for treatment, payment, or health care operations. d. The modification eliminated the requirement to obtain a written consent in emergency situations only.

Answer A is correct. The U. S. Department of Health and Human Services issued several important modifications to the HIPAA Privacy Rule in August 14, 2002. One of the most significant modifications was the change related to obtaining a patient's consent prior to disclosing PHI. This modification makes obtaining patient consent for using or disclosing PHI for treatment, payment, and health care operations a voluntary (rather than required) procedure. Note, however, to be consistent with California law and ethical requirements, therapists should continue to obtain a written or verbal consent from a patient prior to disclosing information for treatment, payment, or health care operations.

A health provider may release a patient's protected health information (PHI) for the purpose of clinical research: Select one: a. only with authorization from the patient. b. with authorization from the patient or the approval of an Institutional Review Board or Privacy Board. c. when the potential value of the research results warrants release of the information. d. whenever the research is being conducted by an approved research facility or organization.

Answer B is correct. The requirements of HIPAA's Privacy Rule and California Civil Code Section 56.10(c)(7) are inconsistent with regard to the release of information for research purposes. However, the requirements of HIPAA pre-empt California law because they are more stringent (i.e., they provide the client with greater privacy protection). According to the Privacy Rule (45 C.F.R. 164.512), a patient's PHI can be released without authorization from the patient for research purposes when (a) approval to do so has been granted by an Institutional Review Board or Privacy Board; (b) the patient is deceased; or (c) a limited data set that excludes direct identifiers is provided under a data use agreement between the health provider and researcher.

When a client asks for a summary of his or her record (rather than a copy of the entire record), a psychotherapist must provide the summary within _____ working days after receipt of the client's written request unless the record is of "extraordinary length" or treatment of the client was terminated within the last ten days. Select one: a. 6 b. 10 c. 15 d. 20

Answer B is correct. This issue is addressed in Section 123130 of the California Health and Safety Code. It states that a "health care provider may prepare a summary of the record ... for inspection and copying by a patient. If the health care provider chooses to prepare a summary of the record rather than allowing access to the entire record, he or she shall make the summary of the record available to the patient within 10 working days from the date of the patient's request. However, if more time is needed because the record is of extraordinary length or because the patient was discharged from a licensed health facility within the last 10 days, the health care provider shall notify the patient of this fact and the date that the summary will be completed, but in no case shall more than 30 days elapse between the request by the patient and the delivery of the summary." (Note that, while California law allows health care providers to provide summaries to clients rather than complete records, HIPAA allows this only when the client agrees to this alternative.)

You have been treating Sam, age 7, for three months. He has been brought to counseling by his father, Alex, who is his legal guardian. Sam is being treated for difficulties he has been having at school. Melissa, the non-custodial mother of Sam, sends you a letter requesting a summary of Sam's records. You would: Select one: a. have to get a written request from Sam's custodial parent before you could release a summary of Sam's therapy records. b. give the summary of Sam's records to his mother. c. have to get a signed release from both the mother and father before you can give a summary of the records to the mother. d. refuse to send a summary of the records to Sam's mother.

Answer B is correct. When records do not pertain to health care for which the minor has legally consented or could have consented, the parents or legal guardians of a minor ordinarily have the right to have access to the minor's records which makes answer D incorrect. It is helpful to remember that biological parents have the right to records. While you may have to have the legal guardian sign your consent for treatment for the minor, the same is not true for the minor's records, which makes answers A and C incorrect.

Administering which of the following types of tests is considered to be within an LPCC's scope of practice? Select one: a. neuropsychological tests and measures of personality b. achievement tests and individually administered intelligence tests c. aptitude tests and achievement tests d. objective and projective m

Answer C is correct. Business and Professions Code Section 4999.20(c) states that, in terms of the types of assessment that may be administered, scored, and interpreted by professional clinical counselors, "assessment" does not include "the use of projective techniques in the assessment of personality, individually administered intelligence tests, neuropsychological testing, or utilization of a battery of three or more tests to determine the presence of psychosis, dementia, amnesia, cognitive impairment, or criminal behavior."

HIPAA's Security Rule lists several technical safeguards for protecting electronic PHI (ePHI) from unauthorized release. Encryption is one of these safeguards and is listed as an "addressable" safeguard, which means that a covered entity: Select one: a. is not required to encrypt electronically stored or transmitted PHI when the client has signed a waiver of confidentiality. b. is required to encrypt electronically stored or transmitted PHI only when a breach of client confidentiality has occurred in the past. c. may choose not to encrypt electronically stored or transmitted PHI when it is not reasonable or appropriate to do so. d. must encrypt all electronically stored or transmitted PHI.

Answer C is correct. HIPAA's Security Rule provides regulations related to the creation, storage, and transmission of PHI in any electronic form (e.g., Internet, e-mail, CDs, computer drives) and lists several administrative, physical, and technical safeguards for protecting electronic PHI from unauthorized release. These safeguards are categorized as either "required implementation specifications" or "addressable implementation specifications." Required specifications are mandatory, but addressable specifications allow a covered entity flexibility when (a) it is determined that the specification is not reasonable or appropriate for the covered entity's environment and (b) the covered entity documents why the specification is not reasonable or appropriate and implements an equivalent alternative measure as appropriate. Implementing "security measures to reduce risks and vulnerabilities to a reasonable and appropriate level" is a required specification [45 CFR Section 164.308(a)(1)(ii)(B)], while encryption of electronic PHI is an addressable specification [45 CFR Sections 164.312(a)(2)(iv) and 164.312(e)(2)(ii)].

During the initial 72-hour involuntary commitment, it is determined that Luis L. is still at high risk for suicide. According to the California Welfare and Institutions Code, Luis may be detained for an additional 14 days for treatment under certain conditions. One of these conditions is that Luis be informed that he is entitled to a certification review hearing within the first ________ of the 14-day hold. Select one: a. 24 hours b. 48 hours c. four days d. six days

Answer C is correct. Legal requirements for detaining an individual beyond the initial 72-hour hold are described in Sections 5250 to 5259.3 of the Welfare and Institutions Code. Section 5250 states that, after a 72-hour hold, an individual may be held for an additional 14 days if it is determined that he or she is still a danger to self or others or is gravely disabled. However, Section 5254 also requires that the individual be notified that he or she "is entitled to a certification review hearing, to be held within four days of the date on which the person is certified for a period of intensive treatment."

Which of the following statements is true regarding counselors and the use of social media? Select one: a. the ACA Code of Ethics does not address the use of social media by counselors b. the ACA Code of Ethics prohibits counselors from using social media as part of their counseling practice c. in cases where counselors wish to maintain a professional and personal presence for social media use, separate professional and personal web pages and profiles should be created to clearly distinguish between the two kinds of virtual presence. d. in cases where counselors wish to maintain a professional and personal presence for social media use, counselors may integrate web pages and profiles as long as clients are informed

Answer C is correct. The correct answer is taken from the ACA Code of Ethics (2014).

A primary goal of the Promoting Safe and Stable Families Act is to: Select one: a. reduce the number of homeless families. b. reduce the incidence of spousal or partner abuse in high-risk families. c. keep children safe from abuse and neglect. d. assist divorced parents with developing and adhering to a parenting plan.

Answer C is correct. The primary goals of the Promoting Safe and Stable Families Act (PSSF) are to keep children safe from maltreatment in their homes, support families who are preparing to reunify or adopt, and promote safe and permanent placements for children in foster care.

When writing case notes for members of a therapy group, a counselor: Select one: a. may use the same notes for each member. b. may use the same notes for each member but should prepare a separate copy for each member's file. c. must omit or delete the names and any other identifying information from the notes for each member. d. may use the same notes for each member if the counselor gets a signed authorization to do so from all members.

Answer C is correct. To ensure the confidentiality of each group member, it is important to omit or delete the names and other identifying information about other group members in the case notes for each member.

A counselor is hired by a company to provide services to employees as part of the company's employee assistance program. The company has traditionally photocopied standardized psychometric tests to save money, and the program director, who is a licensed psychologist, instructs the counselor to continue using the photocopied tests. The counselor believes that photocopying the tests violates copyright laws and, consequently, should: Select one: a. use only tests that have not been photocopied to assess employees. b. report the program director to the state licensing board immediately. c. talk with the program director to attempt to resolve the company's misuse of the tests. d. administer the tests as instructed since use of the tests is the program director's responsibility.

Answer C is correct: Photocopying standardized tests is unethical and illegal. Using only tests that have not been photocopied (answer A) would not resolve the company's misuse of the tests. Reporting the director might be an option (answer B), but the best initial action would be to attempt to resolve the matter informally by talking to the program director. (The counselor would also want to obtain more information about which tests are being photocopied and whether or not permission from the publisher to do so has been obtained.) Administering the tests (answer D) is not an acceptable course of action since doing so would be unethical and illegal.

The "family preservation services" component of the Promoting Safe and Stable Families Act consists of: Select one: a. services designed to encourage more adoptions out of the foster care system. b. time-limited services designed to facilitate the reunification of a child who has been placed in foster care with his or her parents. c. community-based services designed to promote the safety and well-being of children and their families. d. services designed to alleviate crises that may lead to the placement of children in foster care and provide support to families that reunify or adopt.

Answer D is correct. A primary goal of the Promoting Safe and Stable Families Act (WIC Section 16601) is to provide services that help ensure permanency placement for children by reuniting them with their parents, adoption, or another permanent living arrangement. It includes four service components. Answer D accurately describes family preservation services, which are designed to help families that are at risk or in crisis and include programs to help children return to their families (if appropriate), preplacement preventive services, follow-up services, and temporary respite care for children. Answer A describes adoption promotion and support services; answer B describes time-limited family reunification services; and answer C describes family support services.

You have been working with Ralph R. in counseling for eight months to help him cope with chronic anxiety. During a recent session, Ralph revealed to you that he is gay. You do not have experience working with gay clients. You should: Select one: a. tell Ralph that your experience treating gay clients is limited and refer him to another therapist. b. continue to see Ralph only if you believe that his anxiety is unrelated to concerns about his sexual orientation. c. continue seeing the Ralph in therapy but seek consultation if he does not respond positively to treatment. d. seek consultation to determine the best course of action and, if you decide to continue seeing Ralph, obtain additional guidance while working with him if needed.

Answer D is correct. ACA Ethical Standard C.2.a (2014) states: "Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population." Ralph's sexual orientation may be a contributor to his chronic anxiety. However, since you have been seeing Ralph for eight months, you would not want to abandon him by referring him to another therapist, but you would want to consider the impact of your lack of experience working with gay clients on your ability to provide effective therapeutic services to him. Therefore, of the answers given, answer D is most consistent with your ethical obligations.

To serve as a therapeutic provider of supervised visitation, an LPCC must: Select one: a. have been licensed for at least two years. b. have been licensed for at least one year and completed supervised work experience. c. have completed supervised work experience. d. have completed appropriate training.

Answer D is correct. SB 146 added LPCCs as individuals qualified to act as therapeutic providers of supervised visitation. To be a provider, an LPCC must receive training that covers the topics specified in the California Rules of Court, Standard 5.20. Topics include child abuse reporting laws, developmental needs of children, confidentiality, conflicts of interest, and record-keeping procedures.

The Distance Credentialed Counselor (DCC) and Distance Credentialed Facilitator (DCF) credentials are offered by which of the following organizations? Select one: a. American Counseling Association b. California Association for Licensed Professional Counselors c. American Mental Health Counselor's Association d. Center for Credentialing and Education, Inc.

Answer D is correct. The DCC and DCF credentials are offered by the Center for Credentialing and Education, Inc. in collaboration with ReadyMinds (www.readyminds.com). Note that DCC is an affiliate of the National Board for Certified Counselors and Affiliates (NBCC).

As defined in California Evidence Code Section 1013, after a therapy client has died, the "holder of the privilege" for confidential information obtained during the course of therapy is: Select one: a. the court. b. the client's closest family member. c. the counselor. d. the client's representative.

Answer D is correct. This is a straightforward question that simply requires you to be familiar with the provisions of California Evidence Code Section 1013, which defines the "holder of the privilege" as (a) the patient when he has no guardian or conservator, (b) the patient's guardian or conservator, or (c) the personal representative of a patient who is deceased.

A minister who runs a local youth organization comes to see you. He tells you that his alcohol use has gotten out of control. He says that he has been drunk a number of times during his youth group meetings. As a licensed counselor you should: Select one: a. Report to Child Protective Services b. Call his employer and report his alcohol use c. Maintain his confidentiality and refer him to an alcohol treatment program d. Maintain his confidentiality

Answer c is correct. The best answer would be to assess to see if the minister is harming minors and report to CPS if there is abuse, but this is not offered. Therefore, we have to look at the next best choice, which is often the case.

You have been seeing a family for about six months. They bring you an inexpensive seasonal gift. You should: Select one: a. accept the gift, since it is not unethical and it would damage the therapeutic relationship to refuse. b. accept the gift and interpret its meaning to the family. c. decline the gift and explain why. d. decline the gift but do not explain why.

B is correct, although A is also a true statement. Neither laws nor ethics forbid the counselor to take a small gift of negligible monetary value. However, interpreting the feelings or intentions behind the gift adds something of value to the therapy, so "B" is a better choice than "A". "C" is better than "D" because mystifying the client unnecessarily is always a bad idea. However, there is no good reason to decline this type of gift.

According to the ethics code, counselors are prohibited from soliciting testimonials: Select one: a. in all circumstances. b. from current psychotherapy clients. c. from former supervisors d. from professional colleagues.

B is correct: "Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue influence. Counselors discuss with clients the implications of and obtain permission for the use of any testimonial" (ACA Ethical Standard C.3.b, 2014).

According to the Business and Professions Code, which of the following must be posted in a conspicuous location in your principal office? Select one: a. your diploma b. your license c. your policy regarding the collection of unpaid fees d. all of the above

B is correct: According to Business and Professions Code, "A licensee shall display his or her license in a conspicuous place in the licensee's primary place of practice." Note, too, that under HIPAA, you must also post the Notice of Privacy Practices in a prominent place in your office where clients can read it.

You have been seeing an elderly woman for one month. Her husband is 70 years old and retired, and she is 66 years old. Her husband has recently had a stroke. During an individual session, she tells you that he is moody and difficult, and sometimes hits her. She rolls up her sleeves and shows you two large bruises. You should: Select one: a. consider that the stroke may be the cause of his moodiness and violence b. report elder abuse c. refer the couple to a physician before reporting abuse d. call adult protective services and ask if you should file a report

B is correct: According to the Elder and Dependent Adult Abuse Reporting Law in California, you must report cases of known or reasonably suspected physical abuse of elderly adults (age 65 or older). >b. CORRECT This is correct; see explanation above.

Bernice, age 9-1 or 2, is brought to therapy by her mother, who reports that Bernice's behavior has recently changed both at home and at school. On questioning Bernice, you learn that she has been sexually abused by the brother of her best friend. What is your most appropriate course of action in this situation? Select one: a. Obtain the mother's consent to make a report, make a report to the authorities, and refer the girl for a medical evaluation. b. Inform the mother of your duty to report, make a report to the authorities, and refer the girl for a medical evaluation. c. Inform the mother of your duty to report the abuse, make a report to the authorities, and contact the friend's parents. d. Urge the mother to file a report, make a report to the authorities if she is unwilling to do so, and notify the friend's parents.

B is correct: In this situation, you are legally required to make a child abuse report to the authorities. Informing the mother of your legal duty to do so and referring the girl for a medical evaluation would also be appropriate actions. Answer C: Contacting the friend's parents would not be appropriate.

A minor who is ____ years of age or older may consent to medical care and counseling relating to the diagnosis and treatment of a drug- or alcohol-related problem. Select one: a. 10 b. 12 c. 15 d. 16

B is correct: This is stated in Family Code 6929.

Which of the following is the legal definition of reasonable suspicion? Select one: a. There is credible suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect. b. It is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect. c. It is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause any person, drawing, when appropriate, on his or her life experiences, to suspect child abuse or neglect. d. There is credible suspicion, based upon facts that could cause any person, drawing, when appropriate, on his or her life experiences, to suspect child abuse or neglect.

B is correct: This is the exact wording in Penal Code 11166 regarding reasonable suspicion.

The informed consent procedure in telemedicine must include: Select one: a. the qualifications of the health care provider b. the potential benefits and risks of treatment c. the address and telephone number of the board d. the email address of the health care provider

B is correct: Under Business and Professions Code 2290.5, the informed consent procedure shall provide patients with a "description of the potential risks, consequences, and benefits of telemedicine."

As defined by the Business and Professions Code, professional clinical counseling encompasses all of the following, except: Select one: a. conducting assessments for the purpose of establishing counseling goals b. nonclinical forms of counseling c. counseling interventions and psychotherapeutic techniques d. assessment or treatment of couples or families unless appropriate training and education has been completed

B is the correct: Choice B is correct because it is not included in the definition of professional clinical counseling. Business and Professions Code 4999.20 states that professional clinical counseling "means the application of counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems ... includes conducting assessments for the purpose of establishing counseling goals and objectives to empower individuals to deal adequately with life situations, reduce stress, experience growth, change behavior, and make well-informed, rational decisions.

Michael, age 12, is brought to counseling by his mother Deborah, to deal with behavior problems that have developed since the parents divorced a year ago. Michael's father has moved out of state, and Deborah shows the counselor documentation that she has joint legal custody. After a few sessions, the father calls the counselor, saying he is back in California, and wants to see the records of his son's treatment. He tells the counselor that he is trying to gain sole custody because Deborah is a bad mother. The counselor should: Select one: a. Show the father the records because he shares privilege with Deborah because they have joint legal custody. b. Show the father the records because he is just as much entitled to see them as Deborah would be. c. Do and 't show the father the records because it is likely to be damaging to the therapeutic relationship. d. Don't show the father the records because Michael holds his own privilege, and has not waived it.

C is correct, although B is also true. The laws regarding access to records and privilege with minors are confusing and contradictory. Children DO in fact hold their own privilege, but access to records is described in a different place in the statutes. There, the parent is described as the "patient's legal representative," entitled to access to records unless the counselor believes it would be damaging to the minor client for the parent to see those records. B is true because regardless of divorce or custody arrangements, neither parent "shall be denied access to information because they are not the custodial parent." However, C is a better answer because it fits both the law and the clinical situation - having his counselor provide ammunition in a custody battle is clearly going to damage Michael's trust in the therapy process. D is also a true answer, but implies that Michael should be invited to decide whether his father sees the records or not, which is clinically inappropriate.

Question ID:30739 Who may release a person who has been admitted for 72-hour treatment under W.I.C. 5150? Select one: a. the patient himself or herself b. a patient advocate c. a psychiatrist directly responsible for the patient's treatment d. no one; the patient must not be released during the initial 72 hours of the hold

C is correct: "Each person admitted to a facility for 72-hour treatment and evaluation under the provisions of this article shall receive an evaluation as soon after he or she is admitted as possible and shall receive whatever treatment and care his or her condition requires for the full period that he or she is held. The person shall be released before 72 hours have elapsed only if the psychiatrist directly responsible for the person's treatment believes, as a result of his or her personal observations, that the person no longer requires evaluation or treatment. If any other professional person who is authorized to release the person, believes the person should be released before 72 hours have elapsed, and the psychiatrist directly responsible for the person's treatment objects, the matter shall be referred to the medical director of the facility for the final decision" (Welfare and Institutions Code 5152(a)).

You are treating Shannon who is a 25-year-old, recently widowed mother of three young children, ages 2, 4, and 5. She tells you that months ago she killed her newborn infant because she could not handle the responsibility of caring for a fourth child. She now has nightmares nearly every night about what she had done. Select one: a. Because this is a Tarasoff situation, you must follow the mandates under Tarasoff. b. You are mandated to file a report when the crime involves a homicide. c. You are mandated to file a child abuse report. d. You should maintain your clien and 's confidentiality.

C is correct: "The agency shall be notified and a report shall be prepared and sent even if the child has expired, regardless of whether or not the possible abuse was a factor contributing to the death, and even if suspected child abuse was discovered during an autopsy" (Penal Code 11166, section a(2)). >c. CORRECT As noted in Penal Code 11166, you shall file a report even if the child is deceased.

James, age 16, is brought to therapy by his mother who believes he may be depressed. In individual sessions, James reveals that he is unsure about his sexual orientation and is exploring sexually with a male friend. He begs the counselor not to disclose anything to his mother, because she won't understand. What should the counselor do? Select one: a. Reassure the client that all information conveyed in individual therapy is considered confidential, and remind him that this policy was explained to the mother before therapy began. b. Remind the client that certain kinds of information or suspicions must be disclosed to authorities, but not necessarily to his mother, and encourage him to be cautious about describing activities that might be reportable. c. Reassure the client that in general, information conveyed in individual therapy is considered confidential, but that certain kinds of information or suspicions must be disclosed to authorities. d. Remind the client that because he is a minor and his mother initiated the therapy, she may have a right to regular progress reports, where significant information may not be omitted.

C is correct: A is incorrect because there are important exceptions to the general principle of confidentiality. B is incorrect because it encourages the client to avoid discussing clinically relevant issues where there might in fact be dangerous behavior that needs to be reported. D is incorrect because minors are entitled to a confidential relationship regardless of who initiated the therapy. Progress reports to parents are often a good idea clinically, but there are no legal or ethical requirements for these.

A client asks Dr. Ken Kendall for a copy of her therapy record. Dr. Kendall may provide the client with a summary of the record (rather than the complete record) if: Select one: a. he explains his reasons for doing so to the client. b. the client's request was verbal rather than in writing. c. the client requested a summary and the request from the client was in writing. d. he believes it's in the client's best interest

C is correct: Although California law permits a health care provider to determine whether to provide a client with a record summary or an entire record, HIPAA's privacy rule allows this only if the client agrees in advance to receiving a summary. Because HIPAA grants clients greater access to their records, it preempts California law. In addition, HIPAA and California law both require that a client's request for access to his or her records be in writing.

Candidates for licensure as a professional clinical counselor must complete a minimum of __________ postdegree hours of supervised clinical mental health experience related to the practice. Select one: a. 2,000 b. 2,500 c. 3,000 d. 3,200

C is correct: As stated in Business and Professions Code 4999.46, "[t]he experience shall include a minimum of 3,000 postdegree hours of supervised clinical mental health experience related to the practice of professional clinical counseling.

You receive a call from an emergency room physician who is treating your client. The client has given her consent for the physician to access her records. However, the client owes you money for two months of therapy. Which of the following is true? Select one: a. You may withhold the records if you have given the client an opportunity to make a payment. b. You may withhold the records at your discretion under these circumstances. c. You may not withhold the records. d. You have no obligation to make the records available.

C is correct: California law prohibits health care providers from withholding patient records or summaries of patient records because of an unpaid bill for health care services.

According to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which of the following statements is most consistent with the Privacy Rule's "minimum necessary" requirement? Select one: a. Psychotherapists should disclose protected health information to the minimum necessary number of people. b. The minimum necessary requirement establishes the number of years that psychotherapists should maintain their records. c. Psychotherapists should limit the access, disclosure of, and requests for protected health information to the minimum necessary to accomplish the intended purpose. d. The minimum necessary requirement establishes clear standards for the format and content of psychotherapy notes and records.

C is correct: HIPAA's minimum-necessary requirement addresses the amount of protected health information (PHI) that can be disclosed to outside entities. HIPAA's privacy rule requires a covered entity to make reasonable efforts to limit use, disclosure of, and requests for PHI to the minimum necessary to accomplish the intended purpose. "To allow covered entities the flexibility to address their unique circumstances, the rule requires covered entities to make their own assessment of what protected health information is reasonably necessary for a particular purpose, given the characteristics of their business and workforce, and to implement policies and procedures accordingly" [See California Office of HIPAA Implementation's Frequently Asked Questions at www.calohi.ca.gov or state or calohi or ohiHome.jsp]. The minimum-necessary requirement is similar to ethical requirements governing confidentiality. ACA Ethical Standard B.2.e (2014) states, "To the extent possible, clients are informed before confidential information is disclosed and are involved in the disclosure decision-making process. When circumstances require the disclosure of confidential information, only essential information is revealed."

A teacher calls to tell you that a 10-year-old student in her class claims to have been sexually abused. She says that the child wants to remain anonymous but is requesting help from a counselor without her parents' knowledge. The teacher says that the child stated that her parents have "threatened to hurt her" if she should ever tell anyone about the abuse. The teacher has not filed a child abuse report because of the child's fears. What should you do? Select one: a. Tell the teacher that you can't see the child without her parents' permission. b. Make arrangements to see the child for an evaluation as soon as possible since this is an emergency. c. Call the parents to arrange a family session so that you can clarify the situation. d. Encourage the teacher to file a child abuse report.

D is correct: This is the best answer. The teacher, in her professional capacity, has apparently acquired a reasonable suspicion that this child has been abused and, therefore, the teacher is required to file a child abuse report. Answer A: While this is true, "D" is a better answer because the best interests of the child would be much better served by action than inaction. In other words, while you will convey this information to the teacher, it's even more important, in terms of the child's welfare, to encourage the teacher to meet her reporting obligation. Answer B: You can't see this child (a 10 year old) without consent from at least one of her parents. And while the "arrangements" you make could include contacting her parents to set up the appointment, it's not clear that you should involve the parents at this time, given what the girl has said. The priority is to provide protection for the child by urging the teacher to file a report. Answer C: The only person who has contacted you about this case is the child's teacher; no matter how concerned you might be about this child, you can't call these parents "out of the blue" and ask them to come in. In addition, as noted above, involving the parents in this way might endanger the child. The priority is to provide protection for the child by telling the teacher to file a child abuse report.

The legal requirements for involuntary hospitalization and treatment in California are based on a person's mental disorder. The courts in California have usually interpreted "mental disorder" to mean which of the following? Select one: a. a GAF score of 10 or below b. all the mental disorders in the current edition of the DSM c. any significant mental disorder in the current edition of the DSM, though grave disability cannot be based on dementia or intellectual disability alone d. any significant mental disorder in the current edition of the DSM, though grave disability cannot be based on intellectual disability alone.

D is correct: Though the legal requirements for involuntary hospitalization and treatment in California are based on a person's mental disorder, the law does not specifically define "mental disorder" for purposes of involuntary hospitalization or treatment. In California, the courts have usually interpreted "mental disorder" to include any significant mental disorder identified in the current edition of the DSM. Grave disability cannot, however, be based on intellectual disability alone.

A good friend of yours asks if you would provide him counseling. Select one: a. You can provide counseling if you explain the potential risks. b. It would be appropriate if you were no longer friends. c. You can begin counseling sessions and then you would continue to assess for potential problems. d. You should not accept your friend as a client and refer him to another professional.

D is correct: You should not provide counseling when there is a pre-existing relationship that may impair the counselor's objectivity and effectiveness in performing his or her functions as a counselor, which can be potentially harmful to the individual. "Counselors act to avoid harming their clients, trainees, and research participants and to minimize or to remedy unavoidable or unanticipated harm" (ACA Ethical Standard A.4.a, 2014).

A woman who attends the same church that you attend wants you to be her counselor. You've never had any direct contact with her previously to the best of your knowledge. Select one: a. You should not see her because it would be a dual relationship. b. You should decline, and refer her to three other possible mental health professionals. c. Go ahead and arrange to see her as you would any other new client. d. See her, but make sure you are and 't in the same small groups or activities in church.

D is the best answer of those given. Yes, it would be in some ways a dual relationship, but not all dual relationships are unethical, and some cannot be avoided. As long as appropriate precautions are taken to protect the client from exploitation, this type of overlapping relationship is not unethical. Avoiding close contact with the client in church related activities would be appropriate. Answer B is incorrect because there is no ethical need to decline, and there is no ethical or legal mandate to refer to three mental health professionals.

The Family Educational Rights and Privacy Act (also known as the Buckley Amendment) gives students the right to access their own educational records: Select one: a. at all times b. at no time c. if students have graduated from high school d. if students are 18 or older

D. The Family Educational Rights and Privacy Act, or Buckley Amendment, gives students 18 or older the right to access their own educational records. Prior to the child turning 18, parents have the right to access their child's records but the child does not.

Dorothy comes to you for help dealing with self-esteem issues. She tells you that she is unemployed and cannot afford counseling, but offers to do some office work in lieu of payment. You should: Select one: a. accept the offer only you are comfortable with it b. refer Dorothy to a low fee agency c. either reduce the fee or refer Dorothy to another agency that can accommodate her, but not accept the offer. d. tell Dorothy that this arrangement is illegal

The correct answer is C. This is a "close call" question addressing the ethical issues of dual relationships and bartering for services. Answer C is the best answer - it is more inclusive than B in terms of the options available for Dorothy in this situation and it states that the counselor cannot accept the arrangement. Counselors may barter "only if the bartering does not result in exploitation or harm, if the client requests it, and if such arrangements are an accepted practice among professionals in the community. Counselors consider the cultural implications of bartering and discuss relevant concerns with clients and document such agreements in a clear written contract" (ACA Code of Ethics, A.10.e, 2014). The decision should not be based on whether the counselor is comfortable with Dorothy's suggestion (answer A). Answer B is a possibility but is less inclusive than C. Also, to serve Dorothy's best interests, before simply referring her, you would probably try to find a workable fee arrangement with her. Bartering services for counseling has the potential to be unethical, but it is not illegal (this eliminates answer D). The problem with bartering is being able to measure on a "like for like" financial basis. What is described in this question could also lead to a dual relationship - counselor and employer.

To ensure that a consent to treatment form is truly an "informed" consent, a counselor should: Select one: a. make sure that the client reads the entire form before signing it b. warn the client of the potential risks involved in signing the form c. make sure the client understands the information contained in the form before he or she signs it. d. warn the client of the potential limits of confidentiality

This is a difficult question since all of the answers describe conditions that should be met. You have to pick the best answer of those given. Legally, three elements are necessary for informed consent: capacity, comprehension, and voluntariness. Response C is the only one that directly addresses at least one of these conditions (comprehension) and, therefore, is the best answer.

our client tells you that one of his co-workers is angry and planning to blow up their boss's house. The co-worker was passed over for a promotion, "probably because he has a hot temper." The client appears worried about this situation, and doesn't seem to know what to do. What do you do: Select one: a. explain to your client your mandate to warn the boss and call the police b. call the police immediately c. call the boss immediately d. discuss options with the client.

This question is testing your knowledge of a counselor's legal mandate in regards to potential violence. The "duty to protect" applies only when the person who has made a threat of harm against another person is your client. In other words, there is no legal obligation to warn the victim or notify the police in a hearsay situation like this one.a. Incorrect This answer would be correct if this were a Tarasoff-related situation, but it is not since the "threat" is not coming from your client.b. Incorrect You cannot tell anyone about this threat without your client's permission; otherwise, you would violate his confidentiality. See explanation for "a."c. Incorrect See explanations for "a" and "b."d. CORRECT This vague answer is the best one offered: you should discuss the client's responsibility, as a citizen, to notify his boss of the threat.

A 20-year-old client tells you of abuse that was done to him when he was a child in a foster home. He says he knows that his foster father still has foster children who live with him. What is your legal requirement: Select one: a. to report the molestation of this client b. to work with the issue therapeutically c. to maintain your client's confidentiality d. to assess whether the foster father may be currently abusing other children and report suspected abuse if you believe he is.

This question tests your understanding of the child abuse reporting law, specifically what may be required of you when a client over the age of 18 informs you about abuse he suffered before he was age 18. Answer "d" correctly states your obligation in this type of situation.a. Incorrect Rulings by the Attorney General indicate that, unless the client is still under age 18, the counselor need not report abuse the client suffered as a child.b. Incorrect Although you would want to do this, the question asks about your "legal requirement."c. Incorrect This is true: you cannot break an adult client's confidentiality to report abuse that occurred when he was a minor; "d," however, is a more complete response.d. CORRECT A counselor should be alert to the possibility that the client's abuser may be currently victimizing other minors. He or she should enlist the adult victim's aid in gathering information. If the counselor comes to reasonably suspect or know that the adult client's perpetrator is now abusing other minors, he or she must file a report. (Note that, in this case, a better answer would be to report the foster father for suspected child abuse, since there is enough information given in the question to constitute a reasonable suspicion of current abuse. However, since that is not a choice given to you, this is the best of the four answers.)

Your client is age 14 and pregnant. She is using cocaine almost daily, and her mother doesn't know this. She plans to keep the baby and continue living with her mother after the birth. Which of the following is true about your legal obligations in this situation? a. You should maintain the client's confidentiality but counsel her about the effects of drug use. b. You should notify the client's mother about this situation. c. You should file a child abuse report concerning the mother. d. You should report fetal abuse.

a. You should maintain the client's confidentiality but counsel her about the effects of drug use. A is correct: This situation might stir up a moral dilemma for you but, for the purpose of choosing your answer, you must focus on your legal mandates only. Answer "A" is most in line with your legal requirements: Although you are not legally required to counsel the client about the effects of her drug use, because this situation doesn't constitute an exception to privilege you must maintain her confidentiality. "A" is the only answer that indicates this. And because the client is engaged in destructive behavior, you would have an ethical obligation to educate her about the effects of this behavior on herself and her baby and should arrange for her to receive appropriate help. Finally, because the client is pregnant at age 14, you'd also want to explore whether there has been sexual abuse of a minor, but the answers don't address that issue. Answer B: You are not legally mandated to inform the client's mother; and, from an ethical standpoint, the client is entitled to a confidential relationship with you. This rationale doesn't mean that you won't ever inform the mother about this situation; it just means that you aren't legally required to do so. Answer C: Further exploration might reveal that the client is neglected by her mother but the information in the question doesn't rise to the level of a "reasonable suspicion" of child abuse or neglect - i.e., it may turn out that the mother is trying hard to parent her daughter but the girl is difficult to manage. Answer D: Counselors are not required to report fetal abuse. However, county agencies may investigate fetal abuse reports and, therefore, counselors may (not "should") report such incidents when they become aware of them.

Your client, age 24, has been diagnosed with dissociative identity disorder, which apparently stems from years of child abuse. You have no training in treating clients with this disorder. You should: Select one: a. inform your client about your lack of experience in treating dissociative identity disorder, and let her decide whether she would like you to treat her for this disorder. b. learn more about this disorder before you make any decisions. c. begin to treat your client for this disorder as long as you are consulting with another therapist who is experienced with this disorder. d. refer her to another therapist who is qualified to treat your client for this disorder.

d. refer her to another therapist who is qualified to treat your client for this disorder. D is correct: "Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population" (ACA Ethical Standard C.2.a, 2014). Because you have no training in treating clients with DID, a referral is indicated.