Studied by 48 PeopleDo 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?
18
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?
3000
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?
No
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?"
Laws
Specific rules of conduct
Statute
actual law, legislative process codified thereafter
Case law
higher courts ruling that becomes president, just as binding as statute
Ethics
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.
NIMBY
“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
privacy
suggested by the 4th amendment of the bill of rights (no illegal search and seizure)
confidentiality
an ethics term, an agreements between client and therapist to keep utterances private
privilege
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.)