Prepare for your Marriage and Family Therapist (MFT) Law and Ethics exam with these practice questions and answers. This guide covers confidentiality, dual relationships, mandated reporting, and licensing requirements.
Q: MFT Scope of Practice
Answer: A legal term. An LMFT may:Practice psychotherapyDiagnose and treat mental disorders (in order to improve client’s relationships)Administer and interpret psychological tests (as long as doing so is within the MFT’s scope of competence as determined by education, training, or experience, and as long as it is directed toward improving client’s relationships
Q: Privilege
Answer: A legal term. The legal right not to have confidential information revealed during legal proceedings or in court. The client or client representative holds the privilege.
Q: Subpoenas and privilege
Answer: A therapist’s first response upon receiving a subpoena is to assert privilege. The therapist can release records if the client gives him written permission to do so, or if the court orders him to do so.
Q: Who holds privilege?
Answer: The client, if he is an adult, or if he is a minor who is receiving treatment without parental consent.The court can waive the privilegeIf a minor is a ward of the state, the minor holds privilege, which can be waived by the court or by the client’s attorneyIf there is a legal guardian, he/she can waive privilege on behalf of client
Q: Exceptions to privilege
Answer: A judge decides if the facts of the case fall under one of the following exceptions to privilege:The client has introduced his emotional condition in a legal proceedingThe client has treated information as if it were not confidentialThe thx has been appointed by the court to examine the clientThe thx has been ordered by the court to divulge informationThe client has sought therapy to commit and/or escape punishment for a crimeProceedings to determine sanityProceedings to establish client competence
Q: Confidentiality
Answer: Both legal & ethical termThx cannot divulge HIV even if client is endangering a partnerMandated reporters are allowed to respond to follow-up inquiries from investigators
Q: Mandated Exceptions to Confidentiality
Answer: Suspected abuseTarasoffThe Patriot Act of 2002
Q: Permissive Exceptions to Confidentiality
Answer: Client is a danger to self, or to the person or property of others (California evidence code 1024)Disclosures to licensed professionals (such as supervisor or colleague) to get help in treating clientWhen there is an authorization to release PHIWhen client has signed a health insurance claim formBreach of duty (thx sues client for non-payment, or client sues thx for malpractice)
Q: Child Abuse Reporting
Answer: Immediately by phoneWithin 36 hours by written report
Q: Optional reporting of child abuse
Answer: Emotional abuse and fetal abuse
Q: Out of state reporting of child abuse
Answer: Must be reported no matter where it occurs, and no matter the location of the victim/abuserAll reports must always be made to CPS or law enforcement within California
Q: Historical reporting of child abuse
Answer: When victim is now over 18, no reportWhen victim is now over 18, but thx has a reasonable suspicion that the perpetrator has or is abusing others who are currently under the age of 18″Having access” is a myth; emphasis is on “reasonable suspicion”
Q: Non-reportable “Lewd & Lascivious Conduct”
Answer: • A minor is under 14 years old and his or her partner is under 14 years old, assuming they are of “similar age, maturity, & sophistication.”• A minor is 14 years old and his or her partner is under 24 years old.• A minor is 15 years old and his or her partner is under 25 years old.
Q: Reportable “Lewd & Lascivious conduct”
Answer: If child is under 14 and is the recipient of “lewd & lascivious conduct” (touching in order to sexually arouse) by someone 14 or older, this is reportableIf child is 14 or 15 and is the recipient of “lewd & lascivious conduct” (touching in order to sexually arouse) by someone at least 10 years older (24 or 25), this is reportable
Q: Reportable Sexual Intercourse
Answer: If child is under 14 and having sex with someone 14 or older, this is reportableUnder 16 & having sex with someone 21 or older, this is reportable
Q: Non-reportable Sexual Intercourse
Answer: A minor is under 14 years old and his or her partner is under 14 years old, assuming they are of “similar age, maturity, & sophistication.”A minor is 14 or 15 years old and his or her partner is over 14 years old but under 21 years oldA minor is 16 years old or older and his or her partner is 14 or older
Q: Forms of Elder Abuse
Answer: Physical abuseAbandonmentIsolation (such as to keep them from reporting)NeglectAbductionFinancial
Q: Tarasoff
Answer: Thx must protect an intended victim when client, close family member of client, or a credible 3rd party has told thx of client’s “serious threat” (which mist be imminent) of “physical violence” to a “reasonably identifiable victim”
Q: Tarasoff duty to protect
Answer: A thx has fulfilled his responsibility and saved himself from a lawsuit if he warns the police and the intended victimOr, he can have the client hospitalized through a 5150 (but this does not provide immunity)Thx should:Tell police within 24 hoursWarn intended victimWarn someone who can tell the intended victimHave client dispose of the meansInstitute a “no violence” planHave the client hospitalizedWhatever else can be done to protect the intended victim
Q: Tarasoff related court decisions
Answer: Bellah vs Greenson: Tarasoff does not apply to threats of suicide or threats to propertyThompson vs Alameda: for Tarasoff to apply, the victim must be identifiable and the peril must be foreseeableHeadlined vs Superior Court of Orange County: Tarasoff damages can include bystanders (only adds to liability)Melendez vs superior court: thx can use statements made by client in order to convince the victim of dangerEwing vs Goldstein: the information need not come from client, but can come from family member or credible 3rd party
Q: The Patriot Act of 2002
Answer: Allows the FBI or other government agents to get special subpoenas to compel therapists to turn over whatever PHI is wantedAND, thx cannot disclose to client or anyone else that the records were sought or obtained
Q: Suicidal Clients
Answer: Therapists must take “reasonable steps” to prevent suicideThese include:A self-care planIncreased contact (more sessions, more often)Disposal of meansReferrals for medicationTelling friends/family so as to create a 24-hour no-suicide watch teamVoluntary hospitalizationInvoluntary hospitalizationA thx may break confidentiality (Evidence code 1024), but should be able to demonstrate that it was necessary to do so
Q: 5150
Answer: Involves any client who is gravely disabled or a danger to self or othersAnyone can initiate a 5150, but only certain people can invoke a 5150
Q: Who can invoke a 5150?
Answer: Police officersMembers of the attending staff of a county certified facilityOther professionals designated by the county
Q: Partner Abuse Reporting
Answer: We never reportOnly doctors who treat wounds from the abuse can report
Q: Who can give consent to treat a minor?
Answer: Either parent in an intact marriageEither parent in a divorce in which there is joint legal custody (unless otherwise stipulated in divorce decree)Only the parent named as sole legal custodian (if there is one)A legal guardianCaregiver raising the child in the absence or unavailability of the parents, and who sign a “Caregiver’s Authorization Affidavit.” Parents/legal guardians can always override the caregiverA minor parent can consent, as long as the parent is mature enough to understand the nature of the therapeutic processAdoptive parentsEither unmarried biological parentStepparents cannot without a Caregiver’s Auth AffidavitFoster parents cannot; client’s attorney does this
Q: Emancipated Minors
Answer: This is a minor with the legal right to consent to treatmentA thx can treat an emancipated minor without parental consent
Q: How to become an emancipated minor
Answer: Be at least 14 andBe or have been legally married orBe currently enlisted in the military orBe emancipated by a courtThx should ask to see marriage certificate, enlistment papers, or court orderSuspected child abuse reporting still applies as long as client is below 18
Q: When we can treat a minor
Answer: The minor is 12 or olderThe therapy is out-patientThe minor must be mature enough to participate intelligently in treatmentThe minor is responsible for the therapist’s fee (the parent is not responsible)There is a good reason why involvement of parents would not be appropriateThx must enter into his case notes of his attempts to contact parents, or the reason for not doing soThere is no longer a requirement that the child be a danger to self or others, or a victim of incestHowever, the minor cannot on his own consent to meds, psychosurgery, or electric shock therapy
Q: When dealing with CSW’s or probation officers
Answer: It’s up to the thx to determine whether the information requested is “reasonably necessary” — not the CSW or probation officer
Q: Record Keeping
Answer: Must do so “consistent with sound clinical judgment, the standards of the profession, and the nature of the services being rendered”Records must be stored, transmitted, transported, and disposed of in ways that protect client confidentialityLMFT’s urged to keep records for 10 years (psychologists required to keep them for 7)In the case of a minor, keep records for 10 years or until minor is 21
Q: Access to Records
Answer: Clients and parents can see recordsRequests to see records must be in writingThx can then:Let client see the actual recordsGive client a copy of recordsGive client a summary of recordsRefuse access if substantial risk of detrimental consequences to client upon seeing the recordsIf thx refuses access, thx must determine that allowing access would harm therapeutic alliance or risk harm to client’s physical or emotional well-being
Q: Sexual misconduct with a client
Answer: Thx must give client the brochure entitled, “Professional Therapy Never Includes Sex”If the reporting client is an adult, no reportIf the client is a minor, report to CPSIf thx has reasonable suspicion that former thx may be abusing minors, must reportBBS will not receive a report of sexual misconduct from another thx
Q: Sexual misconduct with a client-2
Answer: Prohibited by law and ethical standardsIs a felonyThx is both civilly liable and criminally liable, even if client initiated or consented to itMandatory revocation of licenseNo sex with a client for 2 years
Q: Grounds for divorce
Answer: “Blame” has been abolishedIrreconcilable differences on the part of at least 1 spouseIncurable insanityMust reside in California for at least 6 monthsMust reside in the county for at least 3 months
Q: Custody & Consent to treat a minor
Answer: Physical custody has no impactOnly legal custody mattersIf there is “joint legal custody” or just “joint custody” then either parentIf there is sole legal custody, then it is whoever has that
Q: Disability Insurance must cover
Answer: Schizophrenia, schizoaffective D/O, Bipolar D/O, Major Depressive D/O, Panic Disorder, Obsessive-Compulsive D/O, Autism Spectrum Disorder, Anorexia Nervosa, and Bulimia Nervosa
Q: Telehealth
Answer: Written informed consent is not necessary, as long as thx documents consent in client’s file
Q: Supervision requirements-1
Answer: A licensed professional in private practice can supervise no more than 3 individuals registered MFT interns
Q: Supervision requirements-2
Answer: A supervisor must have been licensed for at least 2 yearsMust complete 6 hours of continuing education in supervision within 60 days of commencing supervisionMust complete 6 hours of supervision coursework in every licensing renewal period
Q: Hypnotherapy & MFTs
Answer: No certification requiredMFT must be competent through education, training, or experience
Q: Psychological Tests & MFTs
Answer: We can administer and interpret such tests if we are competent (through education, training, or experience) and if they are given to improve client’s relationships
Q: Retired licenses
Answer: Cost is $40 for the rest of one’s lifeCannot do anything that requires a licenseCan restore license to active status by paying required fees and completing mandatory continuing education
Q: Sexual Orientation
Answer: It is illegal for any mental health professional to engage in “sexual orientation change efforts” with anyone under the age of 18
Q: Victims of violent crime
Answer: Minors who suffer emotional injuries as a result of witnessing a violent crime may be eligible for up to $5,000 for mental health counseling through the California Victim Compensation Program
Q: Victims of Sexual Assault
Answer: May request a forensic medical exam without any obligation to participate in the criminal justice system. And the cost of the exam cannot be charged to the victim.
Q: CAMFT Ethical Standards
Answer: MFTs should be familiar with these and use them as a guide for ethical behavior
Q: CAMFT Ethical Behavior
Answer: Must satisfy the judgment of:The individual therapistHis/her peers, based upon a set of recognized norms
Q: Responsibility to patients-1
Answer: Must not condone or engage in discrimination on the basis of race, gender, gender identity, gender expression, religion, national origin, age, sexual orientation, disability, SES, or marital status. Must make reasonable efforts to accommodate clients with physical disabilities
Q: Responsibility to patients-2
Answer: Must be aware of and not perpetuate historical and social prejudices when diagnosing and treating patients because such conduct may lead to misdiagnosing and pathologizing patients
Q: Responsibility to patients-3
Answer: Must avoid dual relationships that are likely to impair professional judgment or exploit a client. Not all dual relationships are unethical. When one occurs, MFTs must take steps to ensure that judgment is not impaired and that no exploitation occurs.
Q: Responsibility to patients-4
Answer: No borrowing money, hiring, engaging in a business venture or close personal relationship with a client or client family member
Q: Responsibility to patients-5
Answer: No sex with clients or client family membersNo therapy with someone with whom thx has had a prior sexual relationship withNo therapy with the partner/spouse of person with whom thx has had a prior sexual relationship with
Q: Responsibility to patients-6
Answer: Must provide contact information and specified procedures in case of emergency or therapist absence
Q: Responsibility to patients-7
Answer: Use sound clinical judgment when terminating and do so in an appropriate manner
Q: Reasons for termination
Answer: Client not benefiting from therapyContinuing treatment is not appropriateThx is unable to provide treatment due to the therapist’s incapacity or extended absenceTo avoid an ethical conflict or problem
Q: Responsibility to patients-8
Answer: MFTs do not abandon or neglect clients in treatment. If I can’t continue treatment, I must make arrangements for continuation of treatment
Q: Responsibility to patients-9
Answer: MFTs do not maintain the therapeutic relationship solely for financial gain. We cannot terminate for non-payment of fees except when termination is handled in a clinically appropriate manner
Q: Responsibility to patients-10
Answer: MFTs are client-centered, so we respect their choices, including those we may not morally agree with. In addition, we put together treatment plans in harmony with client choices and goals, and the offer a reasonable likelihood of client benefit.
Q: Responsibility to patients-11
Answer: If we do therapy via Skype or telephone, we are careful to go over the potential pitfalls of this, such as any risks involved, issues of confidentiality, clinical limitations, transmission difficulties, and ability to respond to emergencies.
Q: Responsibility to patients-12
Answer: Whenever the MFT’s personal values, attitudes, and/or beliefs are a determinative factor in diagnosing or limiting treatment provided to a client, we must disclose such information to the client.
Q: Responsibility to patients-13
Answer: We must inform clients of potential risks/benefits when utilizing novel or experimental techniques, or when there is a risk of physical harm from the utilization of any technique
Q: Responsibility to patients-14
Answer: We must inform clients of the extent of our availability for emergencies and other contacts between sessions. If we are out of town, we must provide resources locally for client to contact in an emergency.
Q: Responsibility to patients-15
Answer: MFTs do not withhold patient records or information solely because the therapist has not been paid for prior services
Q: Responsibility to patients-16
Answer: MFTs do not limit their discussions of treatment options to what is covered by 3rd-party payers
Q: Financial Arrangements
Answer: MFTs do not offer or accept payment for referralsDisclose their fees and fee arrangements in advance
Q: Advertising
Answer: MFTs do not solicit testimonials from clientsMFTs can represent themselves as specializing, as long as they have the education, training, or experience to back it up
Q: At the first session:
Answer: MFT interns must provide name of employer, supervisor & type of license, intern registration number
Q: When interns advertise:
Answer: Must include name of employer, the fact that the intern is under supervision, the intern registration number, and the title “marriage and family therapist registered intern” if the abbreviation MFTI is used in the advertisement