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CA Law and Ethics Exam Questions with Rationale Solutions Latest Guide
T/F: In advertising, failure to disclose material facts is NOT PROHIBITED. - CORRECT ANSWER> FALSE (it's prohibited if it's likely to mislead or deceive as a result of lack of disclosure) T/F: It is PROHIBITED to advertise about fees without fully disclosing all variables and other material factors. - CORRECT ANSWER> TRUE (other than standard consultation or other specific services) When are you ALLOWED to advertise about your superiority or su perior services? - CORRECT ANSWER> When it's RELEVANT to the service being provided and can be substantiated with SCIENTIFIC EVIDENCE. T/F: You are ALLOWED to solicit testimonials from clients. - CORRECT ANSWER> FALSE (this is ETHICALLY prohibited) In child abuse reporting, what are the three categories of mandated reports? - CORRECT ANSWER> physical abuse, sexual abuse, and neglect Which of these require a child abuse report? a) exposure to DV b) neglect c) emotional abuse d) physical abuse e) sexual abuse - CORRECT ANSWER> b) neglect d) physical abuse e) sexual abuse T/F: In child abuse reporting, if the action occurred outside of California, it IS NOT REPORTED to California authorities. - CORRECT ANSWER> FALSE (it's reported to CA authorities regardless of where it occurred)
T/F: If an adult client reports abuse that occurred when they were a minor, the therapist would maintain confidentiality. - CORRECT ANSWER> TRUE (unless there's reasonable suspicion that the perpetrator was abusing other minors) If an adult client reports abuse that occurred when they were a minor, when should confidentiality be broken (by making a report)? - CORRECT ANSWER> If there's reasonable suspicion that the perpetrator was abusing other minors. T/F: If a child is taken out of state without permission, a report SHOULD NOT be made. - CORRECT ANSWER> TRUE (this is kidnapping not abuse/neglect, so client should be encouraged to contact law enforcement) T/F: A report should be made if a client reports their child has been kidnapped (e.g. taken out of state without permission). - CORRECT ANSWER> FALSE (this is not abuse/neglect, client should be encouraged to contact law enforcement) What are the circumstances in which CONSENSUAL sex involving minor(s) requires a report? - CORRECT ANSWER> 1) one is 13 or younger, the other is 14+
- one is 15 or younger, the other is 21+ What are the circumstances in which NON-CONSENSUAL sex involving minor(s) requires a report? - CORRECT ANSWER> always T/F: Downloading, possessing, or transmitting child pornography constitutes sexual exploitation of a minor and requires a mandated report. - CORRECT ANSWER> TRUE (if it's a minor who has the pornography, it follows the same age rules as consensual sex involving minors) T/F: Therapists must always assess for child abuse/neglect when any risk factors are present. - CORRECT ANSWER> TRUE T/F: If child abuse is discovered when you're not working professionally, filing a child abuse report is still required. - CORRECT ANSWER> FALSE (it's optional) T/F: You are legally required to inform the client of the need to file a child abuse report. - CORRECT ANSWER> FALSE (but it's considered best practice unless it'd put client, victim, or therapist in danger)
What are the THREE MANDATED EXCEPTIONS to confidentiality? - CORRECT ANSWER>
- Child abuse
- elder/dependent adult abuse
- threat of physical violence to others One mandated exception to confidentiality is CHILD ABUSE, in which there is knowledge or reasonable suspicion of what? (5 answers) - CORRECT ANSWER> 1) physical abuse
- sexual abuse
- neglect
- willful cruelty or unjustified punishment
- unlawful corporal punishment or injury One mandated exception to confidentiality is ELDER/DEPENDENT ADULT ABUSE, in which there is knowledge or reasonable suspicion of what (if the adult resides in California)? (6 answers) - CORRECT ANSWER> 1) physical abuse
- neglect
- financial abuse
- abandonment
- isolation
- abduction One mandated exception to confidentiality is when a therapist must report to law enforcement if the client communicates: - CORRECT ANSWER> serious threat of physical violence against reasonably identifiable victim(s) Apart from the big three, what are some other specific instances in which there is NO CLIENT RIGHT to confidentiality? (4 answers) - CORRECT ANSWER> 1) court order
- order from state board/commission/agency (e.g. BBS)
- search warrant for the therapist
- coroner's request in specific instances (either identifying next of kin or for public health concerns) Apart from the big three, what are some other generally permitted exceptions to confidentiality? (7 answers) - CORRECT ANSWER> 1) client is at high risk of suicide
- client is gravely disabled
- signed an authorization
- billing insurance
- disclosures to parents of minor clients
- disclosures to other MH providers to prevent harm to client
- probation office is entitled to know about therapy attendance If there are signs a client might be a DANGER TO OTHERS, what is your legal/ethical duty? - CORRECT ANSWER> You have the LEGAL duty to manage the situation. What are three signs that the client is a DANGER TO OTHERS? - CORRECT ANSWER> 1) client expressing a clear plan
- client alluding to a plan
- someone who knows the client sharing knowledge or concerns of a plan In the case of a DANGER TO OTHERS, if there is not a clear threat to an identifiable other, what should you do? - CORRECT ANSWER> Complete a full assessment of the situation. What 2 duties are involved when there is a serious threat of physical violence against reasonably identifiable victim(s) (i.e. DANGER TO OTHERS)? - CORRECT ANSWER> 1) duty to report
- duty to protect What is involved with the DUTY TO REPORT in the case of DANGER TO OTHERS? - CORRECT ANSWER> You must report to local law enforcement agency within 24 hours (this is for keeping weapons out of the client's possession).
Written report to law enforcement, local ombudsman, and licensing agency WITHIN 24 HOURS. For ELDER ABUSE within long-term care facility, what are the reporting rules for PHYSICAL ABUSE that resulted in SERIOUS bodily injury? - CORRECT ANSWER> Report to law enforcement IMMEDIATELY (no more than 2 hours). Written report to law enforcement, local ombudsman, and licensing agency WITHIN 2 HOURS. For ELDER ABUSE within long-term care facility, what are the reporting rules for PHYSICAL ABUSE by another RESIDENT WITH DEMENTIA? - CORRECT ANSWER> Report to law enforcement or local ombudsman (phone or internet). If by phone, written report within 24 HOURS. For ELDER ABUSE within long-term care facility, what are the 4 different abuse situations that have specific different reporting rules? - CORRECT ANSWER> 1) non-physical abuse
- physical abuse resulting in non-serious injury
- physical abuse resulting in serious injury
- physical abuse perpetrated by another resident with dementia T/F: HIPAA only applies to electronic records. - CORRECT ANSWER> TRUE T/F: According to HIPAA, psychotherapy notes can be stored within the same file in a folder. - CORRECT ANSWER> TRUE (they just can't be on the same sheet of paper) What does HIPAA say about psychotherapy notes and a client's medical record. - CORRECT ANSWER> They must be SEPARATED from the rest of the client's medical records, means at lease on separate sheets of paper. T/F: If a client signs HIPAA documents at the beginning of treatment, psychotherapy notes can be released to HIPAA covered providers. - CORRECT ANSWER> FALSE (psychotherapy notes require client's authorization for release, in contrast to other records) What are the general HIPAA rules for PSYCHOTHERAPY NOTES, in contrast to "treatment notes," "medical record," or "psychotherapy record?" (3 answers) - CORRECT ANSWER> 1) they require specific authorization, while the others are covered by the initial HIPAA documents
- they are not generally provided to the client if they make a written request for access to records
- they are not disclosed with a subpoena What are the 5 RIGHTS given to clients via HIPAA privacy rules? - CORRECT ANSWER> 1) to request restrictions on certain uses/disclosures of PHI
- to receive confidential communications from health care providers
- to inspect/get a copy of PHI
- to amend their PHI
- to receive a paper copy of therapist's NPP (Notice of Privacy Practices) Per HIPAA, what are the requirements regarding a therapist's NPP (Notice of Privacy Practices)?
- CORRECT ANSWER> 1) must be given to clients before receiving treatment
- copy of NPP must be posted on therapist's premises and/or website
- therapist must get written acknowledgement that client has received copy of NPP T/F: Per HIPAA, all covered entities must be assigned an NPI (National Provider Identifier). - CORRECT ANSWER> TRUE DEFINITION: agreement by a patient to a procedure after achieving an understanding of the relevant facts and the risks involved - CORRECT ANSWER> informed consent DEFINITION: notes documenting or analyzing the contents of a conversation that occurs during a counseling session; includes client's secrets, disclosures, and verbatim comments - CORRECT ANSWER> psychotherapy notes T/F: A client's initial INFORMED CONSENT covers all future treatment, even if there are changes to treatment. - CORRECT ANSWER> FALSE (consent should be reviewed if there is a change in treatment) Failure to obtain INFORMED CONSENT constitutes a failure to maintain ______ and exposes a therapist to ______ liability. - CORRECT ANSWER> Failure to obtain informed consent constitutes a failure to maintain A STANDARD OF CARE and exposes a therapist to CIVIL liability. What are the LEGAL requirements to be disclosed in an INFORMED CONSENT?
What's the INFORMED CONSENT law for treating MINORS if parents never married? - CORRECT ANSWER> either parent may consent What's the INFORMED CONSENT law for treating MINORS if parents are divorced? - CORRECT ANSWER> custody agreement determines who can consent What's the INFORMED CONSENT law for treating MINORS if the child is in foster care? - CORRECT ANSWER> child's lawyer must consent unless the court has issued a Minute Order for social worker or foster parent to consent What are 2 reasons to treat without INFORMED CONSENT? - CORRECT ANSWER> 1) crisis situation
- when a client refuses informed consent DEFINITION: the client's legal right not to have confidential information revealed during a legal proceeding - CORRECT ANSWER> privilege Who holds PRIVILEGE (i.e. the legal right not to have confidential info revealed during legal proceeding)? (4 answers) - CORRECT ANSWER> 1) client (regardless of age)
- all members of the treatment unit
- a guardian ad litem or conservator
- if client is deceased, their personal representative DEFINITION: a person who is appointed by the court to represent someone who is not of legal age to make decisions for themselves - CORRECT ANSWER> guardian ad litem DEFINITION: a person/organization who is appointed by the court to care for another adult who cannot care for themself or manage their own finances - CORRECT ANSWER> conservator T/F: Clients who are younger than 12 years do not hold PRIVILEGE. - CORRECT ANSWER> FALSE (all clients hold privilege) One exception to PRIVILEGE is in the case of a BREACH OF DUTY. What are 2 examples of this? - CORRECT ANSWER> 1) client sues therapist for malpractice
- therapist sues client for non-payment (therapy content remains confidential)
What are the 10 exceptions to privilege? - CORRECT ANSWER> 1) client has introduced their emotional condition in legal proceeding
- client sought therapy to commit a crime and/or escape punishment for a crime
- client is 15 or younger and has been the victim of a crime
- therapist appointed by court to examine client
- in a proceeding to determine client's sanity
- in a proceeding to establish client's competence
- if client is dangerous to self or others or other's property and disclosure is necessary to prevent danger
- breach of duty
- client treats confidential info as if it weren't confidential (e.g. disclosing it on TV or media)
- (if client is deceased) coroner requests info during public health investigation or when authorized by client's representative Regarding client's PRIVILEGE, who can issue subpoenas to the therapist? - CORRECT ANSWER> a judge or a lawyer What steps should be taken when you are responding to a SUBPOENA with regard to client's PRIVILEGE? - CORRECT ANSWER> 1) contact the client
- if unreachable, assert privilege on behalf of client
- if client wants to waive privilege, get a signed waiver
- if client wants to waive but you think it'd be harmful, inform the client and proceed as the client wishes
- if you believe it's an exception to privilege, still assert privilege and let court decide T/F: If a client is unreachable when you receive a subpoena, you should assert privilege on their behalf. - CORRECT ANSWER> TRUE
T/F: You can have your license suspended/revoked if you publicly share an IQ test. - CORRECT ANSWER> TRUE (because it depends "in part on the naivete of the subject, in ways that might invalidate the test or device") If you're working with a population with whom you have no prior experience (e.g. OCD) and your competence is in question, how should you protect yourself from having your license revoked? - CORRECT ANSWER> Disclose to clients, get support to assure your competence. T/F: It is okay for a supervisor to sign off on hours that were performed by an associate while that associate was being supervised by someone else. - CORRECT ANSWER> FALSE (and this can lead to the supervisor's license being revoked. If you are convicted of a felony or misdemeanor, how should you protect yourself from having your license revoked? - CORRECT ANSWER> You must notify BBS within 30 days and supply details of the conviction. T/F: You can never charge for collaboration or consultation with another licensee. - CORRECT ANSWER> FALSE (but it must be disclosed to the client first) List of rules regarding UNPROFESSIONAL CONDUCT that could lead to license revocation, specifically those to THERAPIST'S CRIMES. (3 answers) - CORRECT ANSWER> 1) conviction of a crime substantially related to duties (including sex crimes)
- using drugs/alcohol in the course of therapy or that may harm the public
- failure to report misdemeanor/felony to BBS within 30 days of conviction List of rules regarding UNPROFESSIONAL CONDUCT that could lead to license revocation, specifically relating to TREATMENT OF CLIENTS. (3 answers) - CORRECT ANSWER> 1) having sex with client within 2 years following termination
- committing any sexual misconduct with a client (including soliciting sex)
- intentionally or recklessly causing physical or emotional harm to client
List of rules regarding UNPROFESSIONAL CONDUCT that could lead to license revocation, specifically relating to one's DUTIES IN TREATING CLIENTS. (8 answers) - CORRECT ANSWER> 1) failure to maintain confidentiality
- failure to disclose fees to client prior to start of services
- performing beyond the scope of your experience/training
- allowing a trainee under your supervision to perform beyond their scope
- failure to keep records adequately
- failure to comply with child and elder abuse and danger to others requirements
- corruption relating to referrals (e.g. charging for referrals)
- charging for consultation (without disclosing this to the client) List of rules regarding UNPROFESSIONAL CONDUCT that could lead to license revocation, specifically relating FRAUD/DECEPTION/DISHONESTY. (9 answers) - CORRECT ANSWER> 1) securing license through fraud
- misrepresenting license status
- misrepresenting professional qualifications
- impersonating someone else's license
- allowing another person to use your license
- violating statutes relating to gaining of experience/supervision
- committing any dishonest/corrupt/fraudulent acts substantially related to duties
- false/deceptive advertising
- publication of tests that rely in part on the naivete of the subject, in ways that might invalidate the test (e.g. IQ test) Here's a list of 8 examples of UNPROFESSIONAL CONDUCT that could lead to license revocation - CORRECT ANSWER> 1) getting a DUI
ETHICAL:
- all members of treatment unit who are 12+ should sign Delineate the LEGAL and ETHICAL issues regarding BUSINESS PRACTICES. - CORRECT ANSWER> LEGAL:
- post license
- disclose owner's name and license of business ETHICAL: n/a Delineate the LEGAL and ETHICAL issues regarding CHILD ABUSE. - CORRECT ANSWER> LEGAL:
- mandated report if reasonable suspicion ETHICAL:
- none - but BBS likes you to process need to report with client Delineate the LEGAL and ETHICAL issues regarding CONFIDENTIALITY. - CORRECT ANSWER> LEGAL:
- provide NPP
- maintain confidentiality except when mandated or permitted to break it ETHICAL:
- inform of limits
- maintain confidentiality except when mandated or permitted to break it Delineate the LEGAL and ETHICAL issues regarding CONSULTATION. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- should be done when clinically indicated
- protect identity of client
Delineate the LEGAL and ETHICAL issues regarding COUNTERTRANSFERENCE. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- manage it
- seek consultation when problematic Delineate the LEGAL and ETHICAL issues regarding DUAL RELATIONSHIPS/CONFLICT OF INTERESTS. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- avoid dual relationships because of potential conflict of interest
- manage unavoidable dual relationships Delineate the LEGAL and ETHICAL issues regarding DIVERSITY. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- understand cultural factors affecting clinical issues Delineate the LEGAL and ETHICAL issues regarding ELDER/DEPENDENT ABUSE. - CORRECT ANSWER> LEGAL:
- mandated report if reasonable suspicion
- report to appropriate agency ETHICAL:
- none - but BBS likes you to process need to report with client Delineate the LEGAL and ETHICAL issues regarding FEES. - CORRECT ANSWER> LEGAL:
- disclose fees ETHICAL:
- manage fees
- disclose fee policies
- limits of confidentiality
- therapist background Delineate the LEGAL and ETHICAL issues regarding INSURANCE. - CORRECT ANSWER> LEGAL:
- illegal to submit false claims ETHICAL:
- advocate if needed services are denied
- advise client that information would be shared with insurance
- avoid false claims Delineate the LEGAL and ETHICAL issues regarding ISSUES WITH OTHER THERAPISTS. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- support when compromised
- do not see a client who is being treated by another therapist
- do not solicit clients from other therapists Delineate the LEGAL and ETHICAL issues regarding PERSONAL PROBLEMS. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- Seek professional help for mental health/substance abuse issues (DUI can result in suspension of license) Delineate the LEGAL and ETHICAL issues regarding PRIVILEGE. - CORRECT ANSWER> LEGAL:
- only applies to legal situations
- notify client of subpoena
- assert privilege
ETHICAL
- should inform client of potential risks of waiving privilege Delineate the LEGAL and ETHICAL issues regarding RECORDS. - CORRECT ANSWER> LEGAL:
- maintain sound records for 7 years or until minor is 25
- keep records locked and secure
- comply with record requests appropriately
- never alter records ETHICAL:
- maintain sound records
- do not withhold for lack of payment
- protect client records Delineate the LEGAL and ETHICAL issues regarding REFERRALS. - CORRECT ANSWER> LEGAL:
- illegal to pay or receive payments for referrals ETHICAL:
- unethical to pay or receive payments for referrals
- provide clinically appropriate referrals Delineate the LEGAL and ETHICAL issues regarding SCOPE OF COMPETENCE. - CORRECT ANSWER> LEGAL: n/a ETHICAL:
- should only work within bounds of education, skills, and training
- stay current with skills Delineate the LEGAL and ETHICAL issues regarding SCOPE OF PRACTICE. - CORRECT ANSWER> LEGAL: