Prepare for Law and Ethics licensing exams with this study guide and practice questions. This covers professional ethics, legal requirements, and regulatory compliance.
Q: What is informed consent?
Answer: Risks and benefits, what tx will be like, fees, license status, technology use, fictitious business, and HIPPA, limits of confidentiality, cancellation policy, crisis contact
Q: Consent with a minor?
Answer: 12+ older can consent if mature and if reason not to include parent
Q: Consent for divorced parents?
Answer: Look @ custody agreement to see who signs off on consent, if no indication best practice to get them both to sign
Q: Court order for MHS who signs?
Answer: First lawyer can consent, then SW, then foster parent b/c judge issued a court order or if have caregiver’s affadivit
Q: 10 MANDATED limits to confidentiality?
Answer: Child abuse and neglect, elder dependent abuse and neglect, danger to others, PHI signed, court order by judge, BBS investigation, search warrant for office, coroner investigation, formal request for records if client dies, patriot act
Q: 6 Permmitable limits of confidentiality?
Answer: danger to self, thp can notify parents if thp works at college, crisis situation, insurance communication, audit, crime against thp
Q: Who holds privilege
Answer: Clt always has privilege regardless of age, guardian ad litem and conservator also can too but client still holds privilege
Q: 10 exceptions to privilege?
Answer: introducing emotional condition into proceeding, treated confidential info as if it weren’t, breach of duty (clt did not pay or clt suing thp), thp examining clt, clt seeking therapy to avoid crime or punishment, clt under 16 and is victim of crime, clt is in a mental/emotional condition danger to self or another person, coroner, insanity, or competency
Q: Reasons to report child abuse and neglect?
Answer: call it in and complete written report within 36 hours, reasonable suspicion on such as physical abuse bruises, broken bones, burn, medical neglect such as when child ill, malnourishment, lack of supervision, using objects, sexual abuse, nude selfies,
Q: Reporting abuse about others and if it happened outside of California?
Answer: Still report it if within official capacity, if abuse happens out of CA you file it in CA because license is here
Q: Consensual sex between minors?
Answer: 13 and younger can have sex with 13 and younger, anyone older is a report
Q: Consensual sex with 21 year old?
Answer: If person is 21 or older, the other person needs to be 16/old enough to drive
Q: Who is a dependent adult?
Answer: A dependent adult is someone between 18-64 years old that has physical, mental or financial situation that prevents them from taking care of themselves
Q: 6 types of abuse for dependent adult or elder?
Answer: Physical abuse such as restraints or over medicating, deprivation of food water, sexual abuse, abandonment, isolation, neglect such as basic hygiene, self neglect, medical neglect such as not being taken to the doctor or given medication, financial abuse such as fraud or getting checks taken away, abduction
Q: Who and how to report elder and dependent abuse?
Answer: if living at home or in a private residence or with another person call Adult Protective Services and submit written report within 2 days, if in a care facility call law enforement and local ombdusman and report goes to LAPD an dombudsman
Q: Tarasoff?
Answer: Duty to protect victims, mandated to notify law enforcement and share specific of threat and any relevant info (hx of violence), may also notify victim this is when client communicates plan and identifies person
Q: What if its a vague threat?
Answer: Assess further to identify what threat means
Q: Managing suicidal ideation?
Answer: Assess plans, means and intent, first step remove means, voluntary hospitalization, most extreme 5150
Q: preventive measures for suicidality not hospitilazation?
Answer: increasing client contact, no harm contract, activate support system, referral for psychotropic medication
Q: DV between elders how to proceed?
Answer: Proceed as elder abuse if victim is 65
Q: DV exposed to child how to proceed?
Answer: if child continuously exposed to DV its failure to protect and report child abuse NOT DV, if child harmed straight up DV report
Q: Conservatorship details?
Answer: both conservator and patient can authorize med tx and both have right to sign informed consent, HOWEVER conservator can’t force patient to get a certain tx and patient has right to confidentiality
Q: maintaining records
Answer: must keep records for a minimum of 7 years if adult , and if minor a minimum of 7 years after they turn 18 at least until client 25, clock restarts if you saw and client and then saw client again 2 years later
Q: Who owns records?
Answer: Clients do not own records, therapist if PP or agency owns records
Q: how to request records?
Answer: client must make a written request
Q: how therapist responds to request for records?
Answer: a therapist has 5 business days to allow client to inspect records, can provide also a tx summary 10 days to provide, an actual copy of record can charge 25 cents per page 15 business days to provide copy, , thp may also decline request and document potential consequences
Q: Minors authorization of records?
Answer: if sharing records would cause harm that’s enough of a reason, if the client is a minor and whether they consented or not, the client has to sign a release, it’s up to the client if they want to release records
Q: PHI details?
Answer: font must be 14 pt, if copy machine not working you would ask them to write it out in their writing, specific purpose of PHI, name of other provider, end date, notification of clt’s right to authorization
Q: What is a professional will?
Answer: A professional will is an outline that protects confidentiality and says storage and transfer of records, bridge therapists for client transitions, designated license therapist,
Q: HIPPA providers?
Answer: submitting electronically and to insurances, must always provide notice of privacy practices
Q: hippa records?
Answer: Psychotherapy notes and psychotherapy.medical records, 5 days to inspect, 10 to do summary, 15 to provide copy
Q: medical psychotherapy note?
Answer: Bare minimum info about dx, tx plan, start end times of sessions, interventions, progress on sxs change
Q: psychotherapy notes?
Answer: include contexts of convo, reflections, case conceptualization, countertransference
Q: What’s fraud?
Answer: Creating a dx just to get the client services, faking medical necessity
Q: Important to discuss who pays if insurance doesn’t go through?
Answer: Pay out of pocket, client still responsible
Q: increasing severity of dx from NOS to MDD, bill for missed appointment, bill couple individually, submitting claims without license if person unlicensed?
Answer: FRAUD
Q: Charging a higher fee b/c client is insured?
Answer: Unethical
Q: advocate for payment?
Answer: Yes ethical standard if insurance denies it and clt meets medical necessity and needs services
Q: elements needed when advertisting?
Answer: license number, appropriate title (LCSW ACSW etc), careful with saying expert need to back it up, can specify treating certain conditions, if have another degree such as a PHD can specify in what the PHD is, NO TESTIMONIALS
Q: telehealth informed consent differences to regular consent?
Answer: Determine if telehealth is appropriate, its okay to have just verbal consent, added piece about crisis and what happens if client needs in person support, talking about what happens if computer goes down and have procedures for clt to access resources and support necessary, potential risks relating to appropriately assessing
Q: what state can you treat with telehealth?
Answer: only tx cts within your jurisdication, not other states
Q: discussing fees with client?
Answer: discuss fee and clt’s capability to pay, duration of thpy
Q: raising fees?
Answer: must notify clt before raising fee
Q: sliding scale?
Answer: can lower fee but committing to that fee for the reminder of therapy
Q: review payment with clt?
Answer: frequency of billing, methods of payment in informed consent
Q: if you are increasing your fees where should it go and how?
Answer: state in informed consent and say when eg. on the 1st
Q: how many months of notice before fees increase?
Answer: at least 3 months written notice
Q: if clt loses job and has been working for you what to do?
Answer: adjust fees for crisis
Q: if clt earns more and has been working with you and you want to increase?
Answer: can increase and say im hoping you can pay the full fee starting xyz date
Q: if clt doesnt pay bill for a while what to do?
Answer: submit to collection agency with just name and amount
Q: if a clt fails to pay bill can you withhold their records?
Answer: NO you can’t with hold their records
Q: is bartering acceptable?
Answer: only acceptable if its a practice within the professionals in the community
Q: What if a client wants to keep paying for services and what about their debt?
Answer: it would be unethical to keep allowing them to accumulate debt, it would be acceptable reason to terminate clt, but take into consideration if clt is in crisis and if it would be ethical to terminate services
Q: Should collection be in an informed consent?
Answer: Collection should be in an informed consent it’s the only way that collections can be used.
Q: When referrals needed?
Answer: whenever they need anything outside scope of practice, anything outside scope of competence, if someone cant afford your fee, anytime terminate with clients especially when ending practice and moving to another state
Q: what happens if terminating prematurely?
Answer: if terminating prematurely, job to ensure continuity of care and access to tx
Q: if a client not making progress after months such as seeking consultation, restructuring goals, what to do?
Answer: want to discuss with clt change in therapist and want to document that thp sought consultation and made every effort to help clt
Q: What to do in DV for standard of care?
Answer: For DV standard of care, give clt access to referrals in case of a crisis
Q: Whenever give referrals do you document it?
Answer: Yes document it in tx notes
Q: Can you accept payments for referrals?
Answer: You cannot accept payments for referrals and you cannot pay for referrals. it becomes a conflict of interest
Q: Can you change tx unit from individual to couple?
Answer: Yes you can but acknoweldged that you have a relationship with one person already include that in informed consent
Q: What is boundary crossing?
Answer: Examples taking an anorexic clt out to eat, running into clt in an unavoidable situation
Q: What is boundary violation?
Answer: Crossing a boundary when it’s clinically inappropriate eg going out to dinner with clt, accepting concert tickets, clts calling on the phone for hours multiple times
Q: What to take into consideration about a gift?
Answer: The monetary value and the emotional significance
Q: Whether you accept or refuse the gift what’s the best thing to do?
Answer: discuss the gift with the client
Q: Sexual relationships with clt allowed?
Answer: NASW code of ethics says no
Q: dual relationships that should be avoided?
Answer: sexual relationships, any kind of business venture, becoming friend with client
Q: is it an unethical relationship when a friend asks you to treat their niece?
Answer: Yes it is
Q: what if the client is your sister’s neighbor down the line what do you do?
Answer: discuss dual relationship impact on clt, and you would not terminate right away
Q: how to manage countertransference?
Answer: seek consultation, journaling, peer consultation
Q: personal issues how to manage?
Answer: therapist’s responsibility to not engage in therapy when dealing with those issues
Q: What to do if you find out a therapist had sex with a client?
Answer: give brochure therapy never includes sex and discuss brochure and their options
Q: what to do when a colleague is acting unethically or illegally?
Answer: confront colleague and talk to them, bring it to their attention, if the situation doesnt resolve then do bbs report, but BBS says talk to them first before any accusation
Q: for consultation do you need release?
Answer: No as long as not providing identifying information
Q: Supervisees need to sign what important document?
Answer: that their aware of mandated reporter role and provide informed consent that they receive supervision
Q: what to do when a client calls you out on not knowing about their culture?
Answer: best thing is therapist try to advance their knowledge by talking to clt and seeking outside supervision
Q: In a scenario of crisis vs cultural exploration which is more important?
Answer: CRISIS
Q: When to include termination?
Answer: in informed consent, let them know, inappropriate to terminate when clt is in crisis