1. Steven
is a client you have been seeing in individual counseling for 6 weeks
concerning issues of domestic violence. In today’s session, he asks you if you
would help him stop smoking. He desperately wants to work on this issue, and
states he is not willing to continue to discuss his issues of explosive anger
(which brought him into counseling) until he is successful in his attempt to
stop smoking. You do not have any background or training in smoking cessation
treatment. Your best response under the circumstances is:
a. Given Steven’s unwillingness to address
what you consider his primary issues, you agree to help
him stop smoking, but only for a limited number of sessions.
b. Offer to refer him to another
therapist or program that specializes in smoking cessation while he continues
his anger management work with you.
c. Tell him you consider his desire to exclusively address his
smoking as an attempt to avoid addressing his real issues of his anger and
violence
d. Tell him you would consider addressing his smoking only
after he has shown his willingness to address his anger and violence issues.
2. Mark is a
20-year-old college student who you have been treating for specific phobia.
Over the last four months, he has made great strides and is feeling much more
confident. In your last session, Mark explains that, while it has not had a
major impact on his life, he has always been bothered by the fact that he will
often pass out at the sight of blood. While you have treated specific phobias
before successfully with systematic desensitization, you have never treated a
blood-injection type phobia. You are unsure if the normal way you go about
treating phobias will work because “passing out” is different from the expected
phobic response of fear. When you tell Mark that you have no experience
treating his condition, he says that you are the only therapist he has had that
he trusts, and would not feel comfortable seeing anyone else. What is the most
appropriate intervention for Mark?
a. Get enrolled in a course teaching
you how to treat blood-injection type phobia and learn it as fast as you can.
b. Immediately refer Mark to a
colleague who has the particular skill. You cannot provide services if you have
not had graduate school training in this area.
c. Treat Mark anyway because you do
have experience treating other phobias, and if you fail to treat Brian, you
would be abandoning your client.
3. What do you
think the number one cause of malpractice claims and disciplinary actions
against therapists is?
a.Sexual and/or other dual relationships
c.Improper financial arrangements
4. You have seen a
young woman, Margaret, in your private practice office three times for
individual treatment of her depression. She indicated that her depression is a
very long- standing problem. In addition to depression she had many pressing
concerns, such as financial problems and having an affair with her married
boss, Mr. Brown. You receive a call from Mr. Brown’s wife stating that your
client gave her your number and further that Margaret was threatening suicide.
Mrs.Brown asks you if you know whereMargaret is, and if you know of anything
going on “between Margaret and my husband.” Think through the legal and ethical
issues. What is the most ethical intervention that you should take?
a. Immediately call your attorney.
b. Say nothing to Mrs. Brown, and
immediately try to reach Margaret to see if she is indeed suicidal.
c. Say nothing and completely ignore
the call. She is not your client and you cannot say anything legally to her
about Margaret.
d. Offer to see Mrs. Brown in
counseling since she obviously has issues to discuss. Immediately call the
police.
5. A single woman with two toddlers comes in for a first
appointment. When you made the appointment, her stated reason for wanting
counseling was to deal with her anger. You do not usually inform clients during
the initial phone call about limits to confidentiality, preferring to cover
that in person the first session. At the beginning of the appointment, the
woman states she needs help with her anger. She tells you she has recently
become so angry at her 3 year old that she “spanked him with a hairbrush” much
harder than she had intended, leaving bruises. What is your legal and ethical
obligation?
a. Ask her to bring the child in so you can verify if there
are any bruises. Explain you may have to file a child abuse report if there
are.
b. You have the option to report, but
it would probably be best to not report as the client may leave therapy.
c. You have no option in this case as
it clearly describes physical abuse. You are required to report. Your best bet
is to involve the client in this process and hope you can keep her engaged in
treatment.
d. Given you did not have a chance to
inform her about the legal limits of confidentially, you would work with
her on her anger and parenting skills. You would not have to
report.
6. Your client has been denied access to
an activity because he started a fight with another client. Your client states
he did not start the fight and wants to “set the record straight” by adding his
view point to the chart. What should you do?
a.Tell him, no way, the chart is a legal
record for the staff to document
b.
Give him the chart and let him write in his side of the story.
c.Tell him he can write down his view of
the fight and you’ll put it in the chart or help him fill out a grievance
report.
d.Refuse
to add his views in the charts since it is a clinical record.
7. The general purpose
of HIPAA compliance is to:
a. give client
more control over their health information
b. give therapist less control
over client health information
c. hold health care providers
accountable with civil and criminal penalties if they violate patients' privacy
rights
d. protect client’s privacy
8. Your client has been admitted into a medical hospital having
broken her foot. The nurse from the hospital calls and asks you to fax over a
list of the client’s current medications and documentation identifying her
psychiatric diagnosis. What should you do to respond to the nurse's request?
a. Copy the information from the chart and FAX it to the
hospital and give her a description of the client’s
current behaviors.
b.FAX the information on the medication and the diagnosis
following appropriate confidentiality protocol.
c.Clarify with the requesting nurse and
our medical personnel whether or not to send the requested information
and fax following appropriate confidentiality protocol.
d. Refuse to FAX the client’s records to protect the
client’s privacy.
9. You receive a
letter from the Board of Examiners for LCSW's saying that one of your clients
in your private practice has filed a complaint. The complaint alleges that you
violated the profession’s Code of Ethics. Because a Code of Ethics is not the
same as law, you should be:
Just as concerned than if you violated the law.
a. Less concerned than if you violated the law. The worse
that can happen is the licensing board sanctions you.
c. Just as concerned than if you violated the law.
c. Prepared to testify in court but not seriously concerned.
10.
A
couple you have been seeing in marital counseling for six months decide to
divorce. The husband calls you and asks that you provide testimony in their
divorce proceedings on his behalf. What should you tell him?
a. You are not allowed to testify as you have never been
approved by the court as an expert witness.
b. You can testify, but can say nothing
as it relates to his wife unless she agrees to waive her privilege as well.
d. You cannot testify legally and
ethically. His waiver of privilege does not affect the wife’s right to claim
privilege, even if it concerns the same information. Your client in this case
was the couple, not either individual.
11. Victor has been
seeing you for several months for substance abuse problems. He comes into his
session with you in a rage. His wife has just left him with their two children.
He strongly suspects that she is having an affair with a mutual friend. He
states that he intends to get drunk, go find his wife, and “let her have it.” What is your legal and ethical obligation?
c. Since the wife is in danger, and a clearly
identifiable victim, you must warn her and tell the police of the danger.
d.
Offer Victor extra time in the session to help him deal with
his anger. Find out as best you can what he means “let her have it,” and assess
the risk. He contracts with you to not do anything to harm his wife or himself.
12. Your client, a
30-year-old single woman, tells you that she is “feed up with it all and it’s
not worth it anymore.” She says she does not want to continue living anymore.
What should you do NEXT?
a.
Get consultation
b. Do a thorough suicide assessment and document it. If you
determine she is indeed a serious suicide risk, take action to prevent this,
such as calling the police, getting her to a hospital, calling a family member.
c.
Immediately call the police and a family member as well since she is clearly in
danger of killing herself.
d.
You have no duty to protect in this situation as she is not threatening to harm
another person.
13. You have started to complete paperwork about a client.
You’ve completed the portion with the client’s name, case number, birth date
and how they came to be in your program. You spill coffee on the document, so
you have to start a new form. What should you do with the ruined form?
a. Throw it in the recycle bin.
b. Tear it up and put it in the trash.
c. Keep it in the record and add the new form.
d. Have the form shredded
14. You are a social worker accessing client information in the
computer. It’s just about lunch time and a friend, who does not work for us,
sits down next to you to wait for you to finish so that you can leave for
lunch. What should the social worker do NEXT?
a.
Complete your work and turn off your computer when you are
done.
b.
Ask your friend to wait for you in an area of the building
that is not used for client business
c.
. Ask your friend to sit at your coworker’s desk and wait
for you.
d.
Attempt to speak to your supervisor regarding
this issue.
15. A client is having a visit at home with her mother who is
the client’s conservator. The client’s husband, who she has asked that we not
contact, calls you and wants to talk to the client. What should you NEXT?
b. Tell the husband the client’s not at
the program and she is at her mother’s.
c. Tell the husband the client’s not at
the program and you don’t know where she is.
d.
Tell the husband you can not tell anyone who is or is not
part of the program.
16. Which of the
following statements are true?
b.
Passwords should be the same for all computers
c.
Do not use personal information as a password, (names, DOB, etc…).
c.
It is okay to share your password with anyone
17.
You are a practicing psychotherapist, with known
expertise in the use of hypnosis. Your neighbor, who you have met twice, asks
you to hypnotize her so she can lose weight. You tell her you cannot do that,
but would gladly refer her to other competent therapist who could help her.
Three weeks and 20 more pounds later, she files a malpractice suit against you
alleging breach of duty. Which of the following is true:
a. . You
are guilty of malpractice since you should have agreed to help your neighbor
b. You are
guilty of malpractice since hypnosis is not a generally accepted standard of
practice for weight loss
c. You are
not guilty of malpractice as you do not have a professional relationship with
this neighbor
d. You are
not guilty of malpractice, since you did not provide the treatment she wanted
18. You receive a call
from the Social Security department inquiring whether or not you are the
treating therapist for Joe Normal. The worker states that if you are the
treating therapist of Joe, he has certification paperwork he needs to send you,
and if not he needs to know that so he can continue to locate Joe's therapist.
You inform the worker you are not treating Joe Normal. You have:
a. A. just
violated confidentiality. Even the fact that you are not treating the person
must be kept confidential.
b. not violated confidentiality
since Joe is not your client and you don't know him.
c. done a good thing so that
Joe's worker could find his therapist
d. not violated
confidentiality, as you can legally give such information to Social Security.
19.Choose
the best ending to this statement: To successfully bring a malpractice suit
against you, a client must
a. find the right
attorney.
b.establish that you were
derelict in your duty that directly caused damages to them.
c. show that you practiced
outside the scope of your competence
d. prove that you did something
illegal or unethical in your work with them.
20. Without a signed authorization from the client, Protected Health
Information (PHI) can be disclosed to:
a.
A. Law enforcement agencies when needed for legal purposes
B. Co-workers who require the
information for treatment, payment, or healthcare operation
c. Public health officials
d. All of the above are correct
ANSWERS
1.
Choice B is the correct response, The best
approach is to refer Steven to another therapist or program that specializes in
smoking cessation while he continues his anger management work with you.
2.
The correct response
is choice D, Which one of these you would
do depends on the situation. You’ve now learned some ways to avoid engaging in
malpractice.. Choice a is incorrect, refer and consult when in doubt of your
competence. Maintain your competency by keeping abreast of developments in
diagnosis and treatment. Choice b is incorrect, terminate treatment carefully
and for the right reasons. Find an appropriate referral. "Under managed
care plans, therapists may be accused of abandonment if they terminate when
doing so could result in harm to the client." Choice c is incorrect,
practice well within the scope of your competency and expertise. Know the
limits of your training and experience.
3.
The correct response
is A"Sexual and/or other dual
relationships. 43% of cases opened for investigation by the APA’s Ethics
Committee, and 21.1% of all malpractice claims. Sadly, all four are the
top reasons for malpractice claims and disciplinary actions by licensing
boards.
4.
The best response is
choice B, hopefully, you have
already discussed options and your response with Margaret should you be in a
similar situation. Choice A is incorrect. Choice C is partially correct. You
cannot legally even acknowledge that you know Margaret to Mrs. Brown, much less
give her any information. Choice D is incorrect
5.
The correct response
is choice C, you are required to
report
6.
The correct response
is choice C, clients have a right to
request to amend their records with supervision.
7.
The correct response
is choice C. This choice is more
complete than D. A and B are incorrect.
8. The correct response
is choice C, we should ask to
determine the Need to Know; medication is OK, but the diagnosis may not be.
This would be in the best interest of the client since the client’s health is
at risk.
9
The Correct response is choice C, Depending on the nature of the
violation, you cannot only lose your license, but there can be grounds for
legal/criminal action as well. Choice A is not the best response,
Sanctions may include the suspension or revocation of your license to practice.
Choice B and D are incorrect.
10. The correct response
is choice D, you cannot testify
legally and ethically and it is a more complete answer. Choice A is incorrect.
Choice B is Technically correct, but not as good as choice D. Choice C is
incorrect.
11. The best response is
choice D. You do not have a specific
enough threat from the example to warrant breaching his confidentiality. If,
however, you determine from your assessment that he is at serious risk of
harming his wife, you must take action to protect; notify the police and warn
the wife. Choice A is a good idea but, not as good as choice D. Choice B is
incorrect, If you determine from your assessment that he is at serious risk of
harming his wife, you must take action to protect; notify the police and warn
the wife. Choice C is incorrect, you do not have a specific enough threat from
the example to warrant breaching his confidentiality.
12. The
correct response is choice B. Choice
A is a good idea, but not the best answer. Choice C is incorrect. You may want
to do a thorough suicide assessment and document it, then take action. Choice D
is incorrect. Therapists have a legal duty to protect suicidal clients once it
is determined that a client is at risk.
13.
The correct response is choice D as it protects the client’s privacy.
14. The correct response
is choice B. This prevents any
accidental access to PHI. Choice A is incorrect. Your friend could be reading
the screen while you are working. Choice C is incorrect, your coworker might
have confidential info at his/her work station.
D is incorrect as it doesn’t address the issue and this issue can be
resolved without a supervisor.
15. The
correct response is choice D. This
is the only choice that protects the client’s privacy.
16. The Correct response
is choice C
17.
The Correct response is choice D. You are
not guilty of malpractice, since you did not provide the treatment she wanted
18. The
Correct response is choice A. just violated confidentiality. Even the fact that you are not
treating the person must be kept confidential.
19. The Correct response
is choice B. establish that you were
derelict in your duty that directly caused damages to them.
|
20. The
Correct response is choice D. All of the
above are correct
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