Term
| You have been treating the Carrington family which includes 17-year-old Karen who is suffering from Anorexia Nervosa. You request and receive a copy of Karen's medical file. In the report, it states that Karen has genital warts. After you read this file, you: |
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Definition
Put it in your file.
Since your records are confidential and kept in a safe place, the medical records should be filed. |
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Term
| A female therapist who is having problems in her own marriage finds that she is consistently siding with the wife in couples therapy. Ethically, the therapist's primary obligation is to: |
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Definition
Obtain supervision to address countertransference.
The ethical obligation when a therapist is unable to maintain objectivity is to seek supervision or consultation. |
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Term
| At an initial intake, a client discloses that she recently left her husband and does not have the means to pay your standard fee. The client notices that your waiting room is shabby, and offers to paint it in exchange for your therapy. You agree to four sessions in exchange for the work. You proceed with therapy, but when she is finished, you realize she has ruined the carpet, spilled paint on a lamp and the woodwork, and didn't use the color you had requested. You realize that you feel foolish and ripped off. How would you address the situation? |
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Definition
Honor the original agreement, consult to manage your countertransference, and continue with therapy.
Ethically a therapist would be obliged to honor the original agreement. |
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Term
| Several of your clients are homosexual and one client in particular is the leader of a group for a range of gender identity support groups. She refers several clients to you because she is impressed with your ability to stay "open minded about whoever people want to be." Ethically, what would you want to address first? |
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Definition
You would need to determine if your scope of competence was adequate.
Homosexuality does not capture the range of gender identity issues, so just because your client appreciates your approach with her, your ability to treat other types of issues would be your first concern |
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Term
| A lesbian couple that you have been seeing asks you about Emotionally Focused Therapy. One of the partners tells you that she saw it on a daytime talk show and would like to see if it can help them. What should you tell them if you do not feel competent to do this kind of therapy? |
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Definition
That you will not be able to integrate EFT goals into their treatment.
Therapists are ethically required to avoid treating clients who have needs that are outside of the therapist's scope of competence. You would have to tell the clients about your limitations. |
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Term
| A man is in therapy and he is pleased with the way it is going. He refers his wife to his therapist. What should the therapist do in this situation? |
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Definition
Turn down the referral and suggest other clinicians.
Because a relationship has already been established with the husband, it is best to refer his wife to another therapist. |
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Term
| A client you have been treating, who is also a therapist, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation? |
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Definition
You indicate to your client that she can give your number to the program coordinator.
By letting the program coordinator contact you, you can avoid exploiting the client in order to advance your relationship with the program coordinator. |
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Term
| In your first session with Peter and Veronica, they disclose to you that although they have a five year relationship, Veronica is married to someone else. You should: |
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Definition
Counsel both of them.
As therapists, it is important for us not to impose our values and beliefs on our clients. Both people came to you for counseling which means they are the unit of treatment |
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Term
| You recently get a new male client who is visually impaired. You've never worked with a client with a physical disability and are feeling a little uncomfortable with the client when he is sitting in the room. What is the best way to handle your discomfort? |
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Definition
Consult with professional peers regarding your discomfort.
You want to be aware of how your discomfort may impact the therapy and, as an initial step, deal with it through research and consultation with colleagues. |
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Term
| You are a newly licensed therapist. You would like to incorporate EMDR into your practice. Which of the following statements is CORRECT? |
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Definition
You may practice EMDR if you are properly trained.
A therapist may utilize EMDR as long as s/he has the appropriate education, training and experience. |
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Term
| Revocation of a LMFT's license after having been found to have engaged in sexual misconduct with a client would occur after: |
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Definition
The BBS found that the prior therapist terminated therapy in order to pursue a sexual relationship.
Terminating therapy in order to pursue a sexual relationship with a client is prohibited and could result in the revocation of a therapist's license |
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Term
| After completing a series in "mindfulness" a therapist wants to use new interventions with ongoing clients. From an ethical point of view, When can the therapist use this new modality? |
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Definition
Right away, but only with the client's informed consent.
With adequate training and informed consent, therapists are permitted to introduce new modalities to new and existing clients. |
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Term
| You have been seeing Cindy, a 29-year-old dental assistant, for five months when she comes to therapy reporting she was date-raped the night before. You have never worked with someone who has experienced a recent rape. In considering Cindy's current needs, you should: |
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Definition
Seek consultation and continue to see Cindy.
Seeking consultation and continuing to see Cindy is the most ethical answer available. |
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Term
| You have been seeing Juan and Lucita, a young unmarried couple, for a few months when they announce that they are expecting a baby for which they do not feel prepared. They want to use the therapy time to discuss their options of having the baby and keeping it, giving it up for adoption or having an abortion. You have very strong feelings about abortion. You would: |
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Definition
Keep your opinions to yourself.
You would keep your opinions private. It is ethically important that the therapist not attempt to sway the couple's decision by stating an opinion. |
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Term
| When referring a suicidal client, according to Gross V.Allen, a therapist is required to: |
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Definition
A therapist is required to disclose the client's history of suicide attempts to a referral.
Gross v. Allen requires that a therapist who is making a referral of a suicidal client to another health care provider, disclose pertinent information to enable competent treatment by the other provider. |
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Term
| Due to economic constraints, Robert has decided to broaden his practice and is willing to accept types of clients with whom he has not previously worked. Which ethical principle best characterizes what he should do? Robert should: |
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Definition
Only accept referrals within his scope of competence.
Robert should only accept referrals within his scope of competence as determined by education, training and experience. While developing new areas of practice, therapists take steps to ensure competence through appropriate education, training, consultation, supervision, etc. |
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Term
| A 56-year-old woman that you have been treating has just experienced the death of her husband. His was the primary income and she was not aware of all of the financial responsibilities. She tells you that she has been getting calls from bankers, real estate planners and lawyers offering to provide assistance. If you become concerned for her welfare, you should: |
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Definition
Refer her to a financial planner.
She needs assistance and education about how to manage her and her husband's finances. |
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Term
| A therapist offers telehealth services for a slightly reduced fee for clients who cannot afford transportation or do not have a car. At what point during the provision of telehealth with a client would it be ethically required to refer the client for crisis care? |
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Definition
When the therapist recognizes that the client is suicidal.
Although being suicidal all by itself may not yet a crisis, clients who are in potential danger must be referred to services they can access close to where they live |
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Term
| There's something about your client Zohar that reminds you of your brother, and you often find yourself thinking about your brother during sessions and having strong reactions to Zohar because of associations with your brother. Once you accidentally called him by your brother's name. In such a situation, a psychotherapist should: |
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Definition
Talk about this issue with a colleague, in consultation, or with your own psychotherapist.
Journaling, consulting, psychotherapy, or other processes that help a therapist to resolve strong emotional reactions to a client constitute appropriate ethical conduct in such situations. |
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Term
| You just received a referral from a local psychiatrist. The client suffers from a severe psychotic disorder and must take psychotropic medications. You have never treated anyone with a chronic mental illness in your private practice before so you must: |
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Definition
Consider whether you have the appropriate education, training, and experience to accept this case. Also, look at the client's goals for coming to see you.
Before you take on a new case, you want to consider your level of education, training and experience to determine if you are capable of treating this client or if consultation is needed. Also, you need to consider this client's goals. |
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Term
| Your client works for a local newspaper arranging advertising space. You place an ad in the same newspaper for an upcoming therapy group. The client turns out to be the person who does the ad layout. Ethically: |
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Definition
You have every right to place an ad in this newspaper.
A therapist, like anyone else, has a right to advertise in the local paper. You did not directly interact with the client, nor did you intend for your client to work on your ad. This would be an example of an unavoidable dual relationship. |
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Term
| Chong-Wook and Dae-Sup, a Korean-American couple in their mid-thirties who work as computer programmers, come into your office with their six-year-old adopted son, Chin-Hae. Chin-Hae's school counselor referred them to you. During the session, Chin-Hae appears restless and interrupts frequently. Chong-Wook's speech sounds slurred, and he says that he can hardly wait until Chin-Hae is in bed each night, so that he can drink some sho-chu to unwind. Chong-Wook tells you that "the fee won't be a problem, the fee is covered under the overall adoption agreement." What are your ethical obligations? |
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Definition
Determine the family's understanding of the purpose of the therapy; refer for an academic assessment.
Ethically, you would want to clarify the client's purpose. Since the referral was from the school, it could be in the client's best interests to assess the needs there. |
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Term
| You have been seeing Shelly, 54, for two years. During one session, Shelly expresses the wish that the two of you could get together for coffee since she likes you as a person and she has been feeling very lonely lately. You would: |
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Definition
Discuss with Shelly the nature of the therapeutic relationship and explore her feelings and assumptions.
Shelly is beginning to view the therapeutic relationship differently than the therapist views it. It would be your ethical obligation to explore with Shelly her assumptions so that corrective work can be accomplished and at the same time the relationship can be strengthened. |
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Term
| A new client, Susan, comes into your office reporting difficulties making presentations during staff meetings, and has another big presentation in three weeks. Susan says, "I've heard of some technique called EMDR, which is supposed to help with things like this. Can you help me?" Under what circumstances would you be allowed to perform EMDR with a client? |
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Definition
You've taken a practical course on EMDR and have obtained certification.
Taking courses and obtaining certification demonstrates a minimum level of competence to be able to use EMDR in your own practice. Continual education will keep you current on EMDR practices. |
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Term
| You have been seeing a client for 3 months. You learn she has a daughter who attends the same pre-school as your son. How do you ethically handle this dual relationship? |
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Definition
Acknowledge the coincidence, explore your client's reactions, and discuss how you will both act should you see each other at school functions.
This demonstrates proper clinical management for several reasons: this is an unavoidable dual relationship, you are addressing the coincidence, you are being sensitive to your client's reactions, and planning how you will handle seeing one another in a public setting. |
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Term
| Richard, 38, tells you that he is missing more and more work due to back pain. He tells you that he has been to several doctors who prescribe pain medication because he cannot afford to take time off of work. He tells you that he skips work or leaves early because sometimes the "meds make me so tired and fuzzy in my thinking, that I would be fired if I showed up like that." As a therapist who is not experienced with substance abuse, what is your next course of action? |
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Definition
Refer him to an MD
Overuse of pain medications and back pain would require a medical referral. |
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Term
| A client joins a therapist's church congregation. The therapist should: |
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Definition
Review dual relationships and healthy client-therapist boundaries with your client.
Of the answers provided, reviewing dual relationships and healthy client-therapist boundaries with your client, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be uncomfortable for your client, or create any therapeutic problems. It is the most reasonable of the options provided. |
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Term
| A couple whose children have all graduated from high school is considering adopting an elementary school-age child. They believe that a child who has not yet been adopted would do well in their household and they want to give back to society. How should the therapist approach this couple's decision? |
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Definition
Obtain consultation about adoption.
Getting consultation is a potentially useful thing to do when client present a new issue. |
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Term
| During the course of therapy, a very strong emotional bond develops between Rowene and her client, Artie. Three years after the therapy terminates, Rowene and Artie run into each other at a delicatessen and decide to share a pastrami sandwich. One thing leads to another, and several dill pickles later, Rowene and Artie begin a sexual relationship. One year later they break up. Artie, hurt and vengeful, files a complaint with the BBS, claiming Rowene engaged in an unethical dual relationship with Artie by virtue of the relationship they entered into after therapy. Regarding this claim, which of the following responses is true? |
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Definition
Rowene violated neither legal nor ethical standards.
Both the law and ethical standards clearly state that sexual relationships between therapist and client are prohibited during therapy and in the two year period following termination. The sexual relationship started more than two years following termination, so it is neither an ethical nor legal violation. |
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Term
| Which of the following would be the least effective way for a therapist to educate him/herself about a client from another country? |
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Definition
Watch a movie made in that country.
Watching a foreign language movie may not accurately portray the general patterns associated with a particular ethnic group. The intention of the movie may be comedic or dramatic and only inferentially a portrayal of relevant cultural attitudes and values. |
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Term
| A psychiatrist refers you a client with severe anxiety. The day before an intake session, the client calls you to ask if he can see you right away because he is afraid he will take all of the anti-anxiety medication he owns. He tells you that he is actually seeing three different doctors to get as much medication as he can. In collaborating with his doctors, which of the following would be the most ethical approach? |
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Definition
Obtain a consultation from each doctor about his case.
The best answer choice from an ethical point of view would be to speak with each doctor. This is a scope of competence question that tests your knowledge of how to utilize consultation. |
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Term
| You have been treating Mickey, age 19, for six months. He has been dating a 15-year-old girl and they have had sexual intercourse several times. The girl has just told Mickey that she is pregnant. Mickey is very excited and wants to marry the girl right away. Mickey says that the girl would like to see you for individual sessions since she is so impressed by how much help Mickey has gotten from you. How would you respond to this request? |
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Definition
Refer the girl to another therapist.
Referring the girlfriend to another therapist allows her the opportunity to develop a therapeutic relationship that is unbiased and without the complications and potential conflicts that would arise from being Mickey's therapist and Mickey's girlfriend's therapist. |
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Term
| You have attended a yoga class every Saturday morning for the last 5 years. Today when you arrive you notice your client signing in at the counter for the class you attend. What are your ethical responsibilities? |
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Definition
Complete class as usual without acknowledging the client unless he/she acknowledges you, and explore his/her reactions in your next session.
Maintaining confidentiality means not acknowledging clients without their permission when you see them outside of therapy. It would be important to discuss in your next session the client's feelings about seeing you outside the therapeutic setting. |
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Term
| You are seeing a 52-year-old man who is unable to keep a job. He states that he always ends up fighting with his bosses, who then fire him. During a session he makes a derogatory comment about his last boss' homosexuality. You find yourself becoming angry towards this client. What would you do? |
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Definition
Seek consultation.
Of the choices given, seeking consultation is the first step you would take if you are having angry feelings towards this client. It would be important to understand your reaction and to carefully assess how you would proceed. |
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Term
| Recently your mother died and a client comes in grieving the loss of his mother. What would you do FIRST? |
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Definition
Determine if you can deal with this client at this time.
First you would have to assess the client's best interests. Only if you can continue to work with the client would you need to manage your countertransference. |
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Term
| You are given an unwrapped book of inspirational religious poetry by one of your clients as a holiday gift. This book strongly contradicts your personal religious beliefs. You decide to: |
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Definition
Evaluate what would be in the client's best interests and how accepting or rejecting the gift might affect treatment.
Depending on the clinical issues, cost of the gift, length of time you've been seeing the client etc. this answer would allow you to act according to the client's needs. |
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Term
| A therapist chooses a preschool for his daughter and enrolls her. One month after she started school, the therapist discovers that a client's child is in the same class. What would be the therapist's least appropriate action? |
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Definition
Discuss the possibility of trading carpooling in exchange for some of the cost of therapy.
Carpooling in exchange for the cost of therapy is considered a dual relationship and is unethical. |
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Term
| You are seeing a client, Tom, for six months. Tom occasionally mentions his cousin who specializes in installation of landscaped ponds. You've always wanted a landscaped pond with koi. Which of the following represents an ethical course of action? |
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Definition
You find another landscaper to install the pond and do not make any attempt to engage Tom's cousin in a business transaction.
Ethical standards prohibit business ventures or social interactions with a patient, spouse, partner or family member. Hiring Tom's cousin would be considered an unethical dual relationship. |
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Term
| A reality-oriented, high-functioning client tells you she has been following a company's stock for a number of years and the company's stock price is several points below the company's book value. She tells you the company's profits should double in the next two quarters due to a return on recent expansion. You would: |
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Definition
Not buy the stock because of ethical considerations.
Ethically, you would not buy the stock because this information was revealed to you in your professional capacity. Clinically, the potential for powerful countertransference threatens your therapeutic relationship. |
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Term
| After working with a rape survivor for 3 weeks, the therapist determines that the client would benefit from an adjunctive referral to a therapist who specializes in EMDR. All of the following would be clinical considerations in making such a referral, EXCEPT? |
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Definition
The therapist should not make this type of referral yet as the client is still in a vulnerable condition.
Making a referral at any stage of treatment is a relevant ethical concern to get a client the care that may be beneficial. |
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Term
| You receive a phone call from Pat, a former high school sweetheart and first sex partner. You and Pat have not spoken in 20 years, and now Pat asks if you will provide treatment for some life adjustment issues. Pat says you would be perfect because there is already trust between you from the old days. How would you proceed? |
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Definition
Decline to see Pat because professional ethics forbid therapists from treating former sex partners.
Professional ethics forbid therapists from treating former sex partners. |
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Term
| Miriam, a 52-year-old car saleswoman, is referred for therapy by her doctor after Miriam told him that her boyfriend broke up with her. Miriam's boyfriend told her that she has trouble respecting other people's boundaries and is too interpersonally aggressive. From the beginning of treatment, Miriam asks the therapist many questions about the therapist's relationships, family, hobbies and interests, and taste in music and movies. At the fifth session, Miriam asks the therapist where she went to graduate school, how long she has been licensed, and if she has any areas of expertise and training. How should the therapist respond to the questions Miriam is now asking? |
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Definition
Answer Miriam's questions.
Therapists must make a distinction between clinical interventions and ethical responsibilities. Clients have the right to such information as where the therapist went to graduate school, how long the therapist has been licensed, and if there are any areas of expertise and training. Such questions should not be treated as inappropriate or boundary violating and are part of the process of a client determining whether or not the therapist offers the kind of services the client wants or needs. |
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Term
| You have been working for seven months with a young adult who has recently become very involved with a Nazi skinhead group. You have strong feelings about the detrimental effects such an affiliation can have and will need to: |
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Definition
Evaluate whether or not you can continue to work effectively with this client.
The first priority is to determine if you can work effectively with the client. |
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Term
| You have been seeing Terrie and Jennifer, a gay couple. Terrie and Jennifer want at least one child, but they strongly disagree about whether they should adopt a child or have one by artificial insemination. In their next session, they say they need your help to solve this quandary. You should: |
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Definition
Help them problem solve but not give them any personal opinions.
Ethical standards regarding boundaries require that therapists avoid giving opinions and remind the client that they are responsible for their own choices. |
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Term
| After your session with Scott, you decide to buy $10,000 worth of the stock that he was talking about. In a short time, the stock tailspins to 10% of its initial offering price. How would you characterize the therapist's action? |
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Definition
It is unethical.
It is unethical because therapists do not use their professional relationships with patients to further their own interests |
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Term
| A client who is in court-mandated therapy tells the therapist that he is going to leave the state because he doesn't want to be in therapy or go to jail for violating probation. The therapist tries to encourage the client to see the benefits of staying in therapy but the client becomes visibly angry and agitated. If the therapist is concerned about the client's potential for violence, the clinical reason for seeking consultation is NOT: |
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Definition
To discuss any suspicions that would validate terminating the client.
A client's potential violence would not be a reason for terminating the client. It might be a reason, however, for breaking confidentiality. |
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Term
| Joe and Marcie Green and their three children ages 12, 15 and 17 have been in family therapy with you for about 9 months on a regular basis. Joe says that they are getting along much better. Marcie says that the children seem to be willing to spend more time at home and are arguing less with each other. They think that things are so much better that they are ready to end treatment. Which of the following is NOT an ethical obligation? |
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Definition
Adjust your treatment model if it has not been effective.
You don't need to adjust your treatment model if the client is terminating. |
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Term
| Ponciano and Berta are a Guatemalan couple who have been in treatment with you. They are moving back to Guatemala this week. They come to session and present you with some freshly baked sweetbread that Berta says she made especially for you because of all you have done for them. She tells you that it is a custom in her country to make a parting gift when friends are separating. How would you respond? |
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Definition
Based on her explanation regarding the meaning behind the gift, it would be sensible to accept the sweetbread and offer to share it with them at this last session.
Ethical standards are guidelines and there are circumstances in which other considerations, such as cultural issues, would allow for accepting a gift of this nature. |
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Term
| You receive a call from someone seeking treatment for compulsive gambling. The client mentions that he is also depressed, but he believes it is all part of the addiction. How would you proceed? |
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Definition
Speak briefly with the client to determine if the client's depression can be treated in the context of the addiction.
The most ethical management of this issue would be evaluate your own scope of competence before accepting a client. |
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Term
| During a 5th session with a client, Keesterman realizes the client is dating his daughter. How should Keesterman proceed? |
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Definition
Refer the client to another therapist and disclose the reasons.
Treating a client who is dating a member of the therapist's family would constitute a dual relationship and the most ethical way to proceed would be to give the client some referrals. |
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Term
| A therapist becomes attracted to a client. The therapist deals with his/her feelings appropriately and the client feels s/he is ready to terminate. Upon termination, the therapist realizes s/he still has sexual feelings for the client and would like to pursue a relationship. How long should the therapist wait before pursuing such a relationship with this client? |
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Definition
24 months
24 months is the minimum allowable. 24 months (2 years) is the (minimum) prescribed ethical and legal time frame to abstain from engaging in a sexual relationship with a former client (CAMFT Ethical Standard 1.2.2). |
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Term
| In your private practice, you see mostly adults. The one child that you treat was removed from his parents by Social Services after they were reported for child neglect. During your sessions with Mark, you find yourself becoming more and more attached and wanting to take care of Mark yourself. What is the appropriate way to deal with your feelings? |
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Definition
Journal your feelings, and discuss your feelings in peer consultation to regain perspective of what is going on.
The most ethical way to deal with countertransference is through journaling, peer consultation and personal therapy, in an attempt to regain perspective |
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Term
| Cheryl and Bobby are in a joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. Cheryl tells Bobby that she won't make any more referrals to Bobby. If Bobby decides to get some outside support, he is ethically managing his: |
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Definition
Scope of Competence.
Anything that interferes with a therapist's ability to perform to the standard of care would be a scope of competence issue. |
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Term
| A therapist is surprised to learn, in a session, that a client did a "google" search and found out that the therapist has another job in another field. The therapist is also a personal trainer and yoga teacher. The client asks which career the therapist likes better and says that she always wanted to try yoga. The therapist feels like the client is interrogating her and is concerned that the client may show up in a yoga class. How should the therapist proceed? |
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Definition
Talk with the client about the risks of dual relationships.
No matter how a dual relationship emerges, on the internet or in a session, the therapist's ethical obligation is to discuss the risks and avoid it if possible. |
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Term
| When meeting a client for an intake session, a therapist realizes that the client may have needs that exceed the therapist's skills and experience. The client has consented to individual therapy but is asking questions about whether she should really be in family therapy. Since becoming licensed, the therapist has only worked with individuals. Which of the following correctly describes the therapist's ethical obligations? |
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Definition
Clarify the client's expectations of family therapy as distinct from individual therapy.
As part of informed consent, it would be important to discuss the client's expectations about therapy. |
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Term
| You have been participating in the town's bowling league for six months when one of the clients you have been treating joins the league. While speaking to your client about it in the next session, you find out she loves it and plans to stay in the league. First, you would: |
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Definition
Explain the nature of dual relationships to her.
Explaining dual relationships to her would be the best way to start, and the question is asking what you would do FIRST. What you decide from this point depends on the size of your town, and whether you believe this an avoidable dual relationship |
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