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CA Law and Ethics Exam 1 Assessment Questions with Rationale Solutions
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Applicable California law and a practitioner's professional code of ethics (such as the NASW or CAMFT Code of Ethics) ... - CORRECT ANSWER> ... do NOT hold equal weight in court cases. Only some of the ethical standards outlined in the professional ethical standards are enforceable guidelines for professional conduct. The extent to which ethical standards are legally enforceable is a matter of professional judgment on the part of those responsible for reviewing alleged violations. As opposed to boundary crossings, boundary violations occur when practitioners do which of the following? - CORRECT ANSWER> Exploit clients or engage in unacceptable dual relationships with clients. As opposed to boundary violations, boundary crossings occur when practitioners do which of the following? - CORRECT ANSWER> Develop acceptable and, perhaps, unavoidable dual relationships with clients. Dual relationships between social work practitioners and clients ... - CORRECT ANSWER> Are sometimes unavoidable; when dual relationships occur, they require careful and skillful management. Dual relationships occur consecutively and simultaneously. - CORRECT ANSWER> TRUE. Dual relationships can occur consecutively and simultaneously. Examples of a consecutive dual relationship include hiring a former client and becoming friends with a former client. Examples of a simultaneous dual relationship include having unanticipated social contact with a current client and accepting a gift from a current client. The NASW Code of Ethics prohibits sexual relationships between social workers and former clients ... - CORRECT ANSWER> Under all circumstances, with the proviso that if social workers engage in conduct contrary to this prohibition or claim that an exception to this prohibition is warranted because of extraordinary circumstances, it is social workers—not their clients—who assume the full burden of demonstrating that the former client has not been exploited, coerced, or manipulated, intentionally or unintentionally.
The NASW Code of Ethics prohibits all physical contact between social workers and clients. - CORRECT ANSWER> FALSE. The Code recognizes that physical contact between practitioners and clients may be permissible in narrow circumstances. Examples include handshakes or a brief hug at the conclusion of the professional-client relationship. However, practitioners should recognize that any physical contact can introduce complex boundary issues. In some instances, clients' religious or cultural beliefs may prohibit physical contact. Practitioners who consider any form of physical contact with clients should consider the potential for psychological harm. The first Institutional Ethics Committee (IEC) in the United States was established in conjunction with which of the following? - CORRECT ANSWER> Karen Ann Quinlan case. The first formal institutional ethics committee in the United States was established in the mid-1970s in the context of the famous case involving Karen Ann Quinlan. Ms. Quinlan was hospitalized and in a persistent vegetative state following a drug overdose. Quinlan's parents and hospital staffers disagreed about termination of life support technology. The case went to court, which led to the creation of an ethics committee to provide consultation; as a result, such committees are now widespread. Dual relationships between a practitioner and a client can occur in which of the following contexts?
- CORRECT ANSWER> Dual relationships can arise in the form of social, business, or professional relationships between practitioners and current and former clients. Social relationships can arise when practitioners and clients live and work in the same community. Business relationships can arise when practitioners and former clients join forces in real estate investments. Professional relationships can arise when practitioners and their agencies hire former clients as peer-support specialists. Which of the following is not one of the primary purposes of Institutional Ethics Committees (IECs)? - CORRECT ANSWER> Binding decisions when IECs are consulted about ethical dilemmas. Typically, ethics committees include interdisciplinary membership and provide nonbinding consultation on complex ethics cases. Professionals, clients, and interested third parties may request consultation. Many ethics committees also sponsor ethics education and training, and some ethics committees become involved in the development of ethics-related policies. According to the NASW Code of Ethics, social workers should explore and participate in bartering only in very limited circumstances, including which of the following? - CORRECT ANSWER> The Code discourages bartering arrangements between social workers and clients but does not
(especially when clients struggle to maintain clear boundaries in their personal lives), and the conditions surrounding termination of the clinical relationship (for example, whether the professional-client relationship ended because the clinical work concluded on its own, as opposed to having terminated to move to an intimate relationship). An act of omission (as opposed to commission) related to boundaries occurs when a practitioner ... - CORRECT ANSWER> Fails to properly discuss emerging boundary issues in the professional-client relationship. An act of commission related to boundaries occurs when a practitioner ... - CORRECT ANSWER> Maintains an inappropriate relationship with a current or former client. In negligence theory, the concept of standard of care refers to - CORRECT ANSWER> the way an ordinary, reasonable, and prudent professional would act under the same or similar circumstances. an element of professional malpractice? - CORRECT ANSWER> In cases that allege professional negligence, lawyers and courts of law use several criteria to determine whether a practitioner engaged in professional malpractice. Standard negligence theory requires evidence that the practitioner owed a duty to the client; the practitioner breached (violated) that duty; the client suffered some kind of harm or injury (i.e., emotional, physical, financial); and there is evidence that the practitioner's conduct caused the injury (known as proximate cause). State law, case law, and professional ethical standards provide California licensed psychotherapists with... - CORRECT ANSWER> ... the responsibility "to do no harm." It is in meeting this responsibility that therapists create clinical safety. The term "internal reality" is used to describe... - CORRECT ANSWER> ... factors that include (but are not limited to) an individual's life experiences, beliefs, biases, fears, personal history, emotional injuries, religious values, financial values, socioeconomic values, relational power differentials, cultural values, morals, and life expectations. statements about clinical safety - CORRECT ANSWER> To create clinical safety, therapists must gain extensive knowledge, training, and clinical skills that assist them to appropriately assess, diagnose, and treat clients.
Clinical safety is frequently challenged when a therapist faces clinical, ethical, and legal issues involving suspected child abuse, elder or dependent adult abuse, or a risk of suicide. "internal reality" - CORRECT ANSWER> used throughout the course content to describe a compilation of factors that include, but are not limited to, an individual's life experiences, beliefs, biases, fears, emotional injuries, religious values, financial values, socioeconomic values, cultural values, relational power differentials, and morality. These factors can be useful in therapy, but they can also cloud clinical judgment if not tempered by objectivity gained through self-awareness, knowledge, training, and clinical skills. In California, unprofessional conduct for LCSW and LMFT licensees is defined by... - CORRECT ANSWER> ... the Business and Professions Code and can also be found listed in the BBS document "Laws and Regulations Relating to the Practice of LPCCs, MFTs, LEPs, and LCSWs." In which of the following situations does California law mandate (require) therapists to breach confidentiality? - CORRECT ANSWER> A client in a psychotic episode states that she will shoot a gun through her neighbor's window but does not intend to harm anyone. Tarasoff duty arises when a therapist's patient presents a danger of serious violence against an identifiable other person, regardless of the patient's intention. As mandated reporters of child abuse, California LCSWs and LMFTs are required to report suspected abuse... - CORRECT ANSWER> ... immediately by telephone and then submit a written or faxed report within 36 hours In California, which of the following is an exception to psychotherapist-patient privilege? - CORRECT ANSWER> If a client's mental or emotional condition is such that she is a danger to self, others, or the property of others. Statements regarding written release of information required by the California Confidentiality of Medical Information Act (COMIA)? - CORRECT ANSWER> The document must be handwritten or in a typeface of 14 points or larger. The document must state the name or function of the person authorized to release information. The document must advise the person who signed the authorization of his right to receive a copy of the authorization.
To be a proper document, the written release of information must contain all nine legally mandated components per California Civil Code 56-56.37. - CORRECT ANSWER> If information is released based on a written form that is missing one of the legally mandated components, the client's confidentiality is considered to be breached. Unprofessional conduct refers to - CORRECT ANSWER> behavior defined by the California Business and Professions Code, whereas unethical conduct is defined by standards listed in the profession's codes of ethics, such as the NASW, CAMFT, or AAMFT Code of Ethics. Ethical decision making is a process that is often complex - CORRECT ANSWER> Consider professional values, principles, and standards detailed in psychotherapists' professional code of ethics. Consider how the issues would be judged if reviewed by peers and forensic experts. Consider state laws and regulations, case law, and employer policies and procedures. LCSWs and LMFTs have a therapeutic duty to diagnose accurately and appropriately when practicing psychotherapy. The duty to diagnose does not apply to the provision of social services, which are something other than psychotherapy. In malpractice suits against psychotherapists, plaintiffs claim that the therapist has violated which of the following? - CORRECT ANSWER> Standard of care (expert witness opinions). Case law (common law; precedents). Statutory law (codified law). standard of care - CORRECT ANSWER> Any discussion of the standard of care is fraught with the danger of controversy and some ambiguity. The standard of care is common law to be pointed to and expounded upon. The standard of care is a concept that is argued in courtrooms. This argument is based on expert opinion from clinicians retained by both the plaintiff and defendant. Fax machines communicate with each other across hard-wired lines and are considered to - CORRECT ANSWER> be secure when properly used.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) - CORRECT ANSWER> a federal law, and any legal action taken due to inappropriate management of clients' personal information will take place in a federal court. To ensure that the scope of competence for treating presenting issues is met, therapists are encouraged to adopt which of the following strategies? - CORRECT ANSWER> Continually assess and ensure that all clinical issues for which the practitioner offers treatment meet or exceed the scope of competence. Consult with objective and experienced colleagues regarding one's level of training, knowledge, and experience in a specific clinical area; for example, studying the current standards for working with suicidal or substance-abusing clients. Attend lectures, classes, presentations, or other postgraduate training; read books and journals; and join study groups. therapeutic duty - CORRECT ANSWER> Avoid breaches of confidentiality when keeping, storing, and transferring mental health records.Avoid abandoning a client. Give proper advice, instructions, and warnings. Know when hospitalization is required. California Business and Professions Code prohibits sexual relations with a former client for two years following termination of services, the NASW Code of Ethics prohibits sexual relations with former clients at... - CORRECT ANSWER> ... any time access to records - CORRECT ANSWER> The NASW Code of Ethics states: "Social workers should limit clients' access to their records, or portions of their records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to the client." It is the federal HIPAA law that uses the stricter standard for barring access to records based on the risk of serious physical injury or death to the client or another person. The NASW Code of Ethics has no ethical standard that requires a social worker to comply with all state and federal laws. - CORRECT ANSWER> Although the Code of Ethics requires compliance with the law in a few specifically defined situations (e.g., complying with a court order, complying with laws governing technology and social work practice), there is no ethical standard requiring compliance with laws in general.
violence to another person must be disclosed. There is no law requiring or permitting disclosure of information about a past murder of an adult (ages 18-64). When must California LCSWs disclose their fees? - CORRECT ANSWER> Prior to the commencement of treatment. According to California law, an LCSW may not have sexual relations with a former client... - CORRECT ANSWER> For a period of two years following termination from therapy. HIPAA law states that a social worker must provide a client with access to his or her clinical records upon request, unless the social worker believes that viewing the record would do which of the following? - CORRECT ANSWER> Cause serious physical injury or death. Dual relationships are explicitly prohibited by which of the following? - CORRECT ANSWER> The Code of Ethics Standard 1.06 (c) states: "Do not engage in dual or multiple relationships with clients or former clients in which there is risk of exploitation or potential harm to the client. When dual or multiple relationships are unavoidable, take steps to protect clients and set clear, appropriate, and culturally sensitive boundaries." According to the NASW Code of Ethics, a social worker's primary responsibility is to do which of the following? - CORRECT ANSWER> promote the well-being of clients. According to the NASW Code of Ethics, a client's right to self-determination may be limited only when the client's actions or potential actions do which of the following? - CORRECT ANSWER> Pose a serious, foreseeable, and imminent risk to self or others. Legally, the essential feature of informed consent is that the client ... - CORRECT ANSWER> Has been provided with a full disclosure of facts needed to make an informed and intelligent decision. When a social worker solicits personal information about a client that is not necessary for the provision of services to that client, the social worker has violated the client's right to which of the following? - CORRECT ANSWER> Privacy. "Respect your client's right to privacy. Do not solicit private information unless it is essential to providing services or conducting research. Once private information is shared, standards of confidentiality apply." When counseling families, couples, or groups, a therapist has an ethical responsibility to... - CORRECT ANSWER> ... seek agreement among the parties involved concerning their obligation
to preserve each individual's right to confidentiality and to acknowledge the therapist's inability to guarantee that all participants will honor such agreements. According to the NASW Code of Ethics, in fee for service settings, services may be terminated when clients fail to pay an overdue balance only if... - CORRECT ANSWER> ... the financial contractual arrangements have been made clear to the client, the client does not pose an imminent danger, and the consequences of the current nonpayment have been addressed with the client. According to the California Business and Professions Code (BPC), Chapter 14: Social Worker, the term "gross negligence" refers to which of the following? - CORRECT ANSWER> Acts or omissions falling below the profession's standard of conduct. Under HIPAA regulations, when a therapist withholds a client's access to his or her own record, the therapist must inform the client of... - CORRECT ANSWER> ...the right to a second opinion. If the second opinion does not hold that seeing the record would likely cause serious physical injury or death, the client then has a right to see the record. According to the NASW Code of Ethics, a client's consent to receive social work services can be considered "informed consent" only if... - CORRECT ANSWER> ... the client was first informed of the potential risks related to the service. It is the responsibility of every California licensed psychotherapist to... - CORRECT ANSWER> ... be familiar with and to give a copy of the brochure "Professional Therapy Never Includes Sex" to clients who report sexual activity with a prior therapist According to California Business and Professions Code (BPC) Chapter 14, Section 4992.3, which of the following is defined as unprofessional conduct? - CORRECT ANSWER> Failure to keep records consistent with sound clinical judgment, the standards of the profession, and the nature of the services being rendered. Advertising in a manner that is false, fraudulent, misleading, or deceptive, as defined by Section
Intentionally or recklessly causing physical or emotional harm to any client. Applicable California law and a practitioner's professional code of ethics (such as the NASW or CAMFT Code of Ethics)... - CORRECT ANSWER> ... do NOT hold equal weight in court. Only some of the ethical standards outlined in the professional ethical standards are enforceable
To manage termination of treatment safely... - CORRECT ANSWER> ...Develop a systematic plan for terminating a client and document this plan. Assess the client's mental status and sense of self to determine whether termination is likely to enhance the client's process or to cause harm. Discuss with the client the process of termination, its possible impact on the client's process, and the feelings that may be experienced as a result of termination. Therapists are not legally or ethically prohibited from entering into a nonsexual friendship with a client after therapy has been completed... - CORRECT ANSWER> ...However, legal and ethical standards that address friendships, and other possible dual relationships, with former clients highlight potential difficulties for therapists and clients who enter such relationships. California courts protect clients who have suffered sexual violation by a therapist and help them to seek a monetary remedy. Civil Code Section 43.93 allows for... - CORRECT ANSWER> ...civil action (a malpractice action seeking to recover money) against a psychotherapist who has had sex with a client during the course of therapy, or within two years following termination of therapy, or by means of deception. handling a crisis issue - CORRECT ANSWER> The therapist must have sufficient scope of competence to accurately recognize and safely address crisis issues.The therapist's duty is to create safety, structure, and stability when crisis issues are present. The therapist must document the decision-making process utilized to assess and manage any crisis issue. Evidence Code 1024 states that... - CORRECT ANSWER> ...LCSWs (who are practicing psychotherapy) and LMFTs are permitted to breach confidentiality when a client's mental or emotional state presents a danger to self or others. After a thorough assessment, it becomes clear that a client is severely depressed and considering suicide. One of the first things a therapist should do is... - CORRECT ANSWER> ...refer the client to a physician to rule out physical problems causing depression. If it is found that a physical problem or problems are causing the depression, then the treatment of medical issues will be critical to reducing the suicide risk.
To safely manage the termination of therapy... - CORRECT ANSWER> ... therapists are wise to develop a systematic plan for doing so. It is important to document factors that will be used in the decision to terminate therapy, not only verbally with the client, but in writing as well. When a malpractice suit is filed against a therapist, the opposing attorney (the client's attorney) will attempt to establish which of the following? - CORRECT ANSWER> Whether the therapist managed crisis and high-risk issues in a safe and appropriate manner. Whether the therapist caused injury to the client through acts of commission or omission. Whether the therapist applied legal and ethical standards to create and maintain clinical safety throughout treatment. When a parent fails to follow through on a pediatrician's recommendations for her child, a child abuse report is not required if... - CORRECT ANSWER> ...the parent's decision was informed and appropriate. The Child Abuse and Neglect Reporting Act states: "An informed and appropriate medical decision made by parent or guardian after consultation with a physician or physicians who have examined the minor does not constitute neglect." Intentional and endangers the child's health. A parent's failure to provide adequate food, clothing, shelter, or medical care constitutes severe neglect if the parent's behavior is which of the following?
- CORRECT ANSWER> Intentional and endangers the child's health Whenever a mandated reporter develops a reasonable suspicion that child abuse has occurred, he must make a report by phone immediately, which must be followed up by a written report within which of the following time frames? - CORRECT ANSWER> Thirty-six hours. A child abuse report may be filed by fax or electronic transmission in which of the following situations? - CORRECT ANSWER> Only if a telephone report was attempted, but not possible. The law states that a mandated reporter who is unable to submit an initial report by telephone shall immediately, or as soon as is practicably possible, submit the initial report by fax or electronic transmission. When a child abuse report is filed by fax or electronic transmission, the report must be... - CORRECT ANSWER> ... made on a form issued by the California Department of Justice. When two or more mandated reporters jointly have knowledge of a suspected instance of child abuse, and when there is agreement among them... - CORRECT ANSWER> ...the telephone report
When a dependent adult has been abused in a California state hospital, the report must be made to which of the following? - CORRECT ANSWER> The designated investigator of the state department of state hospitals. Civil law defines elder abuse as... - CORRECT ANSWER> ...physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment resulting in physical harm or pain or mental suffering. This definition also means the deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering. Tarasoff duty - CORRECT ANSWER> The patient presents a danger of serious violence to an identifiable person. In the original Tarasoff case, the therapist failed to do which of the following? - CORRECT ANSWER> Notify the potential victim. The California Evidence Code defines "patient" as which of the following? - CORRECT ANSWER> Anyone who consults a psychotherapist to secure a diagnosis or treatment for her own mental or emotional condition. As a psychotherapy patient, prior to giving informed consent for treatment, the individual should first be ... - CORRECT ANSWER> Informed of the implications of being a patient. Unlike clients, collaterals are not entitled to which of the following? - CORRECT ANSWER> Privileged communication protections. Privileged communication applies to psychotherapy clients, or patients, not to their significant others. As discussed in the course content, a family system can be treated as "the client" in theory and based on legal and ethical standards. - CORRECT ANSWER> Although the view that "the family system is the client" may be clinically meaningful, neither the law nor professional codes of ethics recognize multiple persons as a "client." Legally a client is an individual, and whoever is designated as the client would have a client's legal rights, while anyone designated as the client's collateral does not have a client's legal rights. In Thompson v. County of Alameda, the court ruled that when a therapist has a patient who threatens to "take the life of a young child residing in the neighborhood," the therapist does not have a duty to warn (Tarasoff duty). Why? - CORRECT ANSWER> The potential victim was not readily identifiable.
A therapist has a duty to warn the potential victim of a patient's likelihood of serious violence if the information about the danger comes from which of the following? - CORRECT ANSWER> Anyone considered credible by the therapist. Psychotherapists, as defined in California Evidence Code Section 1010... - CORRECT ANSWER> ...have immunity from monetary liability when the therapist breaches confidentiality in order to carry out a duty to warn a potential victim of an act of serious violence by one of the therapist's patients. To reduce liability and enhance clinical effectiveness, it is essential to document a high standard of clinical practice. Which of the following strategies should be incorporated into practice? - CORRECT ANSWER> Documentation of thorough assessments, validation of diagnoses, and clear and specific treatment goals and objectives. Documentation of clear descriptions of interventions used and client responses to the interventions. Documentation that distinguishes clients from applicants, collaterals, and customers.
