Law and Ethics PSY 623

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Do you have patients if you are a therapist trainee?


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Do you have patients if you are a therapist trainee?

NO, your supervisor is the one who has patients

The big gulp patient

having intimidating or dangerous clients. the ethics issue is threshold disclosure, meaning that the last minute urgent topics are said as they are leaving. Discretion, usually rare and odd

Dueling supervisors

presenting patient material to two different supervisors with different theoretical approaches is a big mistake, because they give different treatment plans but get what you can from each supervisor in the best interest of the client

Threshold disclosure

When a patient drops information at the very end of the session as they are “walking out the door” expect the unexpected and handle things properly

in CA what is the age of majority? aka no longer legally a minor?


What is the present status of HIV/AIDS in regards to the og tarasoff and duty to warm? aka try to infect someone (if petient says they are going to harm someone you are required to do something to stop them from harming someone)

There is no duty to warn

how many hours must you accure to take MFT licensing exam in CA?


in intimate partner violence, is it a mandated report situation for CA therapists?

No only if a child is involved

when can a person in CA call themselves a psychologist?

Psy D or Ph. D.

once I pass my exams, can I start practicing independently?


Treatment planning: short term

Crisis intervention, handling the “fires”

Treatment planning: intermediate

Hardest method, need to make yourself unnesisary with the skills taught

Treatment planning: long term

Extended treatment where life skills are taught at a deeper level with the client

What do you base the chunk of therapy on?

Theoretical orientation

Expert witness

Witness that generally enters the scene after it has become a legal issue

Fact or percipient witness

Witness on the case prior to it being a legal issue, generally it is the treating therapist

The five always of ethical intake

CCARQ: clients culture, counter transference, area of competence rule out general medical conditions, and question reported

The five always: client culture

Take into account the background, values, culture, history for ethical consideration

The five always: counter transference

if you cant work with someone because of personal trauma that can be an issue, work through that and remember clients best interest

The five always: area of competence

what are my limitations? In training everything is going to be new. We don't refer, we ask our supervisor for ethical guidance

The five always: rule out general medical conditions or substance use

don't see them unless they have been cleared of medical symptomality

The five always: question reporter

"Is there anything else you would like me to know to help me treat you better?"


Specific rules of conduct


actual law, legislative process codified thereafter

Case law

higher courts ruling that becomes president, just as binding as statute


general professional guidelines you have to follow, and they can touch on the laws

Four mechanisms holding us accountable

Ethics codes, licensing boards, civil suit of malpractice, and criminal allegations

Mechanism #1

Ethics codes- MFT

Mechanism # 2

Licensing boards-BBS, laws and regulations

Mechanism #3

Civil suit of malpractice, with four requirements

Four requirements for a civil suit of malpractice

  • Duty of care

  • standard of care

  • demonstrable harm

  • proximate cause

Civil suit of malpractice requirement: duty of care

(relationships established) you need to make sure the patient is safe, should be established by third session

Civil suit of malpractice requirement: standard of care

In legal terms, the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would have managed the patient's care under the same or similar circumstances​.(what would a reasonably trained therapist do given your circumstances?) includes: ETHICS CODES, STATURE, AND CASE LAW!

Civil suit of malpractice: demonstrable harm

(psychological damage, hard to prove and usually needs witnesses) remedy is money

Civil suit of malpractice: proximate cause

(due to something that the therapist did or failed to do to cause the harm, related to demonstrable harm) only proximate cause before damage. an accident resulted in certain injuries

Mechanism #4

Criminal allegations, involves attorney general action, license gets investigated

Criminal vs. civil law

  • criminal: guilt

  • civil: liable (no one can be guility of a business lawsuit only liable)

Standard of care

In legal terms, the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would have managed the patient's care under the same or similar circumstances​.

O’Conner vs. Donaldson

The landmark decision is that patients have the right to refuse treatment. Mental health systems act (1980) came out of this: THE RULE OF LEAST RESTRICTIVE TREATMENT. if they can be treated outside the hospital they should not be thrown into a hospital, take steps to try and help them be outside of the hospital and avoid being deinstitutionalized.


“Not in my backyard” distinction for where mental health facilities should be in relation to peoples neighborhoods

6 most important words in liability prevention

Consult, consult, consult, document, document, document

Name the four mechanisms holding us accountable for our work as psychotherapists

Ethics Codes and Committees, Licensing Boards​, Civil Suit of Malpractice, AND Criminal Allegations

Name the four elements of a civil suit of malpractice

duty of care, standard of care, demonstrable harm, and proximate cause

Name the four elements of the standard of care

reasonable therapist, ethics codes, statute, and case law


suggested by the 4th amendment of the bill of rights (no illegal search and seizure)


an ethics term, an agreements between client and therapist to keep utterances private


legal term pertains to legal issues such as: going to court, testimony, subpoenas, release of records.

arrangement of the BBS

  • actual members: public members (nurses, lawyers, appointed by governor of legislatures, barrier) AND licensed members (appointed by governor or legislatures) they make rulings, write regulations, disciplinary action, etc

  • clerical staff: analysts (state employees that read the laws and reg document for the practice of MFT and look into that when they get a complaint and decided disciplinary action based on the law) and laws and regulation documents

disciplinary action types

  • disciplinary and public: egregious enough to be made public so that the public can protect themselves, usually on the BBS website or CAMFT (ex. sex with patient, breaches, insurance fraud, failure to keep records)

  • non disciplinary and confidential: smaller action, (ex. failure to put license on public document or on office display.)