LCSW Law & Ethics Practice Test

1. Two social workers are dating. They are at dinner and they are talking about their clients. They discover that each of them is seeing a different member of the same couple for individual therapy. What should these social workers do?

Content Area: Law: Confidentiality, Privilege, and Consent

This question is about the legal responsibility of social workers outside of the therapeutic setting discussing a client.

A. No action is necessary since licensed health professionals may consult for purposes of diagnosis and treatment without a release.

B. Stop the discussion and obtain releases so that such discussions in the future do not breach confidentiality.

C. Stop the discussion and do not talk about these clients again.

D. There are no legal or ethical guidelines requiring social workers in such situations to do anything.

C. Stop the discussion and do not talk about these clients again.

The rules of confidentiality would require the social workers to stop the discussion and not talk about these clients.

2. Revocation of a LCSW's license after having been found to have engaged in sexual misconduct with a client would occur after:

Content Area: Ethics: Professional Competence and Preventing Harm

This question tests your knowledge of the penalties for social workers having sex with a client.

A. A social worker filed a complaint with the BBS on behalf of a client.

B. The BBS found that the therapist terminated therapy in order to pursue a sexual relationship.

C. The social worker gives the client the pamphlet "Professional Therapy Never Includes Sex" and discusses it with the client.

D. The BBS cites the offending social worker within 10 years of the statute of limitations.

B. The BBS found that the therapist terminated therapy in order to pursue a sexual relationship.

Terminating therapy in order to pursue a sexual relationship with a client is prohibited.

3. Your client, George, tells you that his mother just got remarried. He tells you that he is worried that the new husband's children are going to go after his inheritance. He tells you that he has very little contact with the new family and wants to keep it that way. What is your legal obligation?

Content Area: Law: Limits to Confidentiality/Mandated Reporting

This question tests your knowledge of how to proceed when you may need to assess for or report elder abuse.

A. You must asses for elder abuse, considering "undue influence" regarding the mother's estate.

B. You should refer the client to an attorney to determine if he has a case.

C. Maintain confidentiality because you do not know the age of the mother.

D. Report elder abuse, considering "abandonment" because he has "very little contact" with his mother.

C. Maintain confidentiality because you do not know the age of the mother.

You would maintain confidentiality because you do not know his mother's age and you do not have "reasonable suspicion" of elder abuse.

4. Ki is a 26-year-old Korean who immigrated to the U.S. with his father 10 years ago. Ki wants to be an artist but his father has saved his money and demands that Ki goes to medical school like his grandfather. Ki says he's depressed and he would rather die than become a doctor. He says he's too stupid to pass the classes in medical school anyway. He doesn't know how to tell his father. The social worker determines that Ki is not suicidal. The most appropriate ethical intervention is to:

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of the ethical obligations that pertain to cultural competence.

A. Recognize the importance of cultural considerations and acknowledge that Ki may have to follow his father's wishes.

B. Ask Ki to bring his father in for a family session because of cultural values that encourage respect for elders.

C. Inform Ki that the risks and benefits o

C. Inform Ki that the risks and benefits of therapy may be that he "finds himself" but may change some of his family values.

Informing a client about the risks and benefits of therapy which includes altering their sense of self and their family, is an ethical obligation.

5. June discloses that she had been molested by a step-brother when she was 15. She is now 28 and was divorced from her husband three years ago. Before seeing you, she saw another therapist and she has just told you that she had sex with him. She wants therapy to focus on the stormy relationship issues that led to her divorce, not on past sexual molestation or exploitation. You would:

Content Area: Law: Legal Standards for Professional Practice, tests your understanding of the legal responsibilities of therapists who learn that a client has had sex with a previous therapist.

A. Respect her wishes and continue to focus on resolving the issues on which she wants to work.

B. Give her the brochure "Professional Therapy Never Includes Sex" and discuss her options.

C. Report the therapist to the BBS to protect the other therapist's present and future clients.

D. Work on the sexual exploitation in therapy.

B. Give her the brochure "Professional Therapy Never Includes Sex" and discuss her options.

Therapist sex with a client is prohibited. When a client reveals that s/he has had sex with a former therapist, the treating mental health professional is required to give her/him the brochure "Professional Therapy Never Includes Sex," as well as discuss it with them.

6. Dr. Sveda has been treating Carliss for seven years during which time the fee has been $50. Carliss finally earns his Ph.D. and gets a job for substantially more money than he had been making. Dr. Sveda tells Carliss he'd like to revisit the fee that Carliss has been paying. Carliss becomes quite upset and tells Dr. Sveda that it would be unethical for him to raise the fee. Dr. Sveda calls for consultation and is given the proper answer which is that social workers are discouraged from increasing a client's fees:

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of ethical considerations in raising client fees.

A. Without providing adequate notice.

B. To avoid exploitation of the client.

C. Unless all client fees are increased.

D. According to strict ethical standards for the mental health profession.

A. Without providing adequate notice.

Ethical standard standards require that clients be given notice of fee increases before they occur.

7. 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. What is your ethical obligation after deciding to terminate family therapy?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of the ethical obligations that pertain to provide clients with information about the therapeutic process, which includes termination.

A. Recommend staying in therapy if there are any regressive symptoms in any individual.

B. Document your agreement with them that they are ready to terminate.

C. Recommend individual therapy if there are any regressive symptoms in any

C. Recommend individual therapy if there are any regressive symptoms in any individual.

If the family wants to terminate but one person might still be in need of individual treatment, it would be ethical to recommend this.

8. Which of the following is true in a court custody case?

Content Area: Law: Confidentiality, Privilege, and Consent

This question examines the parameters of privilege.

A. A minor does not hold his/her own privilege.

B. The court may appoint an attorney to represent the best interests of the child.

C. The parents can waive their child's privilege.

D. The parents' attorney can waive privilege on behalf of the child.

B. The court may appoint an attorney to represent the best interests of the child.

The courts can assign a guardian ad litem, if needed, to represent the best interests of the child.

9. How should physical abuse of a dependent adult be reported by a mental health professional?

Content Area: Law: Limits to Confidentiality/Mandated Reporting

This question tests your understanding of the legal issue of reporting dependent adult abuse.

A. If there is serious bodily harm, within 24 hours.

B. By telephone within two working days and in writing as soon as possible.

C. By telephone as soon as possible and in writing within two working days.

D. By telephone as soon as possible and in writing within 36 hours.

C. By telephone as soon as possible and in writing within two working days.

Mandated reporters must report dependent adult abuse "immediately or as soon as possible by telephone, and shall prepare and send a written report within two working days."

10. Jessica, age 14, comes to see you with her mother. She appears withdrawn and fatigued and refuses to speak with you. Her mother explains that in the last few months Jessica's behavior has changed drastically. How would you manage this family's treatment needs from an ethical perspective?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of the steps to take in starting treatment with a new family unit.

A. Explain the family systems model.

B. If you are unable to make progress with the family, give them three referrals.

C. Evaluate how willing the mother is to reframe the problem as the "family problem" rather than Jessica as the problem.

D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually.

D. Discuss the risks and benefits of seeing them as a unit and of seeing Jessica individually.

You would need to determine the unit of treatment before doing any of the other actions.

11. Your former supervisor refers a client to you and suggests that you split the client fee as you did while under her supervision. You would:

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of how to manage referrals that meets ethical obligations.

A. Report this unethical behavior to the BBS.

B. Negotiate a new split fee arrangement.

C. Inform the supervisor that it is unethical to split fees.

D. Inform the supervisor that since you are now a licensed social worker she can only get 25% of the client's total fee.

C. Inform the supervisor that it is unethical to split fees.

It is not ethical for LCSW's to split fees. NASW's ethical standards state that Licensed Clinical Social Workers do not offer or accept payment for referrals.

*12. 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:

Content Area: Ethics: Professional Competence and Preventing Harm

This question tests your ability to deal with the therapeutic alliance and potential counter-transference in light of gift-giving.

A. Accept the gift in the spirit in which it was given and say nothing about your spiritual beliefs.

B. Evaluate what would be in the client's best interests and how accepting or rejecting the gift might affect treatment.

C. Gently explain to your client that you cannot accept such a personal gift.

D. Thank the client for her thoughtfulness but let her know that your policy is that you don't accept gifts from clients.

B. 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.

13. Which of the following techniques would be considered out of a mental health professional's scope of competence if they did not receive the needed specialized training?

Content Area: Law: Legal Standards for Professional Practice

This question focuses on your knowledge of a mental health professional's scope of competence.

A. Couples therapy

B. Hypnotherapy

C. Psychotherapy

D. Adolescent therapy

B. Hypnotherapy.

Hypnotherapy needs specific additional training beyond the education required to obtain a mental health professional license.

14. You terminated therapy with Margaret after 3 years because she wanted to work with a therapist with her same sexual orientation. You gave her a referral to a new therapist who she has seen a few times. Several weeks later Margaret leaves you a message saying that she is having a conflict at work and wants to speak with you because only you can help her. When documenting this call you would:

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of how to document your care for a client, even a former client.

A. Note that you told her that you cannot ethically treat her because she is already in treatment with another therapist.

B. Indicate that you assessed her risk as "low" and suggested that she call her therapist

C. Confirm that you had a signed termination agreement.

D. Get a release to speak with her other therapist to coordinate care.

B. Indicate that you assessed her risk as "low" and suggested that she call her therapist

Although the client has terminated, you still have an ethical obligation that pertains to crisis management. If her crisis were acute, you would have to do more than simply refer her back to her therapist.

*15. You've been treating a woman who is in the midst of a divorce. You receive a subpoena in the mail from her husband's lawyer asking for your client's records. You:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of how to respond to a subpoena.

A. Contact your client to determine if she wants you to waive or assert privilege.

B. Would contact the husband's lawyer and assert privilege.

C. Ignore the subpoena since there is no one to whom you can assert privilege.

D. Must comply with the subpoena since it is an official court document and you would otherwise be in contempt of court.

A. Contact your client to determine if she wants you to waive or assert privilege.

Clients hold their own privilege and a social worker must consult with the client to determine whether privilege is to be waived or asserted.

16. Mike, your 17-year-old client, has a history of fire-setting. He is in therapy as a result of a court order and his parents know he is in treatment. He tells you that he is angry with his ex-girlfriend and says that he plans to set fire to her house tonight. What should you do?

Content Area: Law: Limits to Confidentiality/Mandated Reporting

This question is assessing your ability to determine a Tarasoff situation.

A. Call his parents so they can be sure that he doesn't go unsupervised.

B. Maintain confidentiality.

C. Call the police immediately and his ex-girlfriend's family.

D. Call the police immediately.

C. Call the police immediately and his ex-girlfriend's family.

In the vignette described there is imminent peril and there is a reasonably identified victim(s). The Duty to Protect includes the mandate to notify the police first and a warning to the identified victim is permitted.

17. A social worker consults with another professional about a particularly challenging case. Has an ethical violation occurred?

Content Area: Ethics: Professional Competence and Preventing Harm

This question assesses your ability to collaborate with other professionals when issues arise outside the social worker's expertise.

A. Yes, if the social worker does not reveal confidential client information to the other professional.

B. No, if the social worker does not reveal identifying information about the client to the other professional.

C. Yes, if the social worker has a signed consent by the client to consult.

D. No, if the other professional agrees to keep the client information confidential.

B. No, if the social worker does not reveal identifying information about the client to the other professional.

According to the National Association of Social Worker's (NASW) Code of Ethics, section (1.07) (q) Privacy and Confidentiality, "Social workers should not disclose identifying information when discussing clients with consultants unless the client has consented to disclosure of confidential information or there is a compelling need for such disclosure." This section implies that the client's direct

consent to consult with another professional is required only if identifying information about the client is revealed. Thus, if general aspects of the case are discussed with another professional, permission from the client is not needed.

*18. When unable to reach a client by phone, a social worker texts the client's mother to tell her that her son is talking seriously about running away from home because of the step-father's abuse. She texts back to tell you that he is home safely but "thanks for the heads-up." What are the social worker's ethical obligations regarding the confidentiality of minors?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of how to handle informed consent about the limits of confidentiality in the treatment of minors.

A. Obtain written informed consent from the minor that allows texts to parents in an emergency.

B. Tell minor clients how you will contact parents if you think there is an emergency.

C. Tell minor clients that you will show them any texts from parents.

D. Obtain informed consent from parents about your mandates to break confidentiality.

B. Tell minor clients how you will contact parents if you think there is an emergency.

Discussing the limits of confidentiality is an element of informed consent.

*19. Maria and Juan have been seeing you for couples' counseling for six weeks. In the 7th session, Maria brings you a batch of fresh, hot, home-baked oatmeal raisin cookies. You would:

Content Area: Ethics: Business Practices and Policies

This ethical question, with a flair of human diversity, reviews ethical policy as it relates to gift giving.

A. Accept the cookies and explore their meaning with Maria and Juan.

B. Refuse the cookies and explore their meaning with Maria and Juan.

C. Accept the cookies and eat one immediately.

D. Refuse the cookies and tell Maria about your "no gift policy."

A. Accept the cookies and explore their meaning with Maria and Juan.

Accepting the cookies and exploring their meaning with Maria and Juan would be the best choice available. The cookies are a small gift which may have a cultural component. It is important, once the decision to accept the gift is made, that the personal meanings behind it are explored.

20. You are conducting a research study on divorce. In the informed consent process, what information do you need to provide your clients?

Content Area: Ethics: Business Practices and Policies

This question assesses your knowledge of procedures when conducting research using human participants.

A. The importance of the client remaining in the study until the very end to maintain the validity of the study.

B. That dual relationships may be inevitable due to the nature of the study.

C. That any information obtained may be used in the study.

D. The client has the right to withdraw from the study at any time.

D. The client has the right to withdraw from the study at any time.

The client has the right to withdraw from the study at any time, and we as therapists, are to respect the client's wishes.

*21. If a social worker digitally recorded a session with a client and then receives a subpoena for records because the client is claiming emotional distress, the recorded session would be provided to the court if:

Content Area: Law: Limits to Confidentiality/Mandated Reporting

This question tests your knowledge of how to respond to a subpoena.

A. The client signed a release to record a session.

B. The client signed a waiver of privilege for the records.

C. The client signed a consent form allowing the session to be videotaped.

D. Digital recording must be disclosed with any records in a subpoena.

B. The client signed a waiver of privilege for the records.

No records would be disclosed until the client or the client's representative waived privilege.

*22. A client is referred to you by his attorney. The client tells you that he is reluctant to talk to you because he doesn't want what he says in therapy coming out in court. Choose the statement that could BEST explain privilege to this client:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of privilege. You must be able to distinguish between confidentiality and privilege as well as between law and ethics.

A. It is an ethical concept involving the right of a social worker to withhold information in a legal proceeding.

B. It is a legal and ethical principle which involves a restriction on the volunteering of information about a client.

C. It is a legal principle that protects client conversations unless there is a court order.

D. Attorney/client privilege extends to the client of a social worker that the attorney uses for referrals.

C. It is a legal principle that protects client conversations unless there is a court order.

Privilege is the legal right of the client not to have confidential information revealed during a legal proceeding. Only a client, judge or court order would challenge privilege.

*23. A client who was referred by his rabbi comes in to see you for issues of grief related to the loss of his mother two weeks ago. Recently your mother died too. What would you do FIRST?

Content Area: Ethics: Professional Competence and Preventing Harm

This question tests your knowledge of how to manage counter-transference.

A. Talk about this situation in your own therapy.

B. Seek professional consultation.

C. Refer the client to another mental health professional who specializes in grief and loss issues.

D. Determine if you can deal with this client at this time.

D. Determine if you can deal with this client at this time.

"A", "B", and "C" are all possibilities once you "Determine if you can deal with this client at this time."

*24. Steven comes to you for help with debilitating anxiety. He says that his anxiety is beginning to interfere with his relationships and his job. He is afraid to drive his car because he thinks that he is going to hit someone. He doesn't know how he will ever take a girl out on a date or get to work if he doesn't get control over this. He thinks he should be able to get over this by himself. The therapist should begin by:

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of ethical obligations when selecting treatment interventions.

A. Teaching him relaxation techniques and pairing those with thoughts and images of driving his car.

B. Explaining the benefits of a behaviorist approach for severe anxiety.

C. Documenting in an initial treatment plan the client's goals for treatment of anxiety.

D. Assessing whether a medication evaluation would be necessary.

D. Assessing whether a medication evaluation would be necessary.

From an ethical point (safety-minded) of view, a therapist would first need to consider all treatment modalities to help a client. In this case, that would include considering whether his anxiety is so severe that medication would help him benefit from therapeutic interventions.

*25. Which of the following is not considered by law to be unprofessional conduct by a social worker?

Content Area: Law: Legal Standards for Professional Practice

This question asks you to identify unlawful unprofessional conduct.

A. A conviction after pleading no contest to a DUI.

B. Thanking a friend for a referral by taking her out to dinner.

C. Being arrested for shoplifting.

D. Poor record keeping.

C. Being arrested for shoplifting.

The law (Business and Professions Code 4982(a) says unprofessional conduct addresses licensees or registrants who have been "convicted" of an offense, not just arrested.

26. A social worker has been working with a client who informs the social worker that he has been living as a woman since he was 35. He is now 45 and wants to begin transitioning into an anatomical woman. The client tells the social worker that he already has confirmed that his insurance will pay for it but he is self-employed so it is going to be very expensive. How should the social worker proceed?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of how to manage diversity from an ethical point of view.

A. Ask if the client would like to be referred to as "he" or "she."

B. Use a the client's signed consent form to determine if he signs it as a woman or as a man.

C. Include a diagnosis of "Gender Dysphoria" on any insurance forms if he signs a release to allow this.

D. If the social worker feels that any counter-transference will impact the therapy, refer the client to

A. Ask if the client would like to be referred to as "he" or "she".

From a diversity perspective, the social worker should directly and respectfully ask the client if s/he would like to be referred to as "he" or "she."

27. You find out that your 14-year-old client's mother is beating her for not making her bed in the mornings. You have determined you need to make a child abuse report. What is your legal responsibility as a mandated reporter?

Content Area: Law: Limits to Confidentiality/Mandated Reporting

This test item addresses your responsibility as a mandated reporter.

A. To contact an agency designated to take a report and follow up with a written report within 36 hours.

B. To contact an agency designated to take a report and follow up with a written report within forty-eight hours.

C. To contact an agency designated to take a report and follow up with a written report within two working days.

D. To contact an agency designated to take a report and follow up with a written report within seventy-two hours

A. To contact an agency designated to take a report and follow up with a written report within 36 hours.

Your responsibility is to contact a designated agency and follow up with a written report within 36 hours.

28. After working with a rape survivor for 3 weeks, the social worker 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?

Content Area: Ethics: Professional Competence and Preventing Harm

This question addresses issues related to using concurrent social workers.

A. It would be necessary to obtain a release in order to work collaboratively with the EMDR therapist.

B. The treatment plan may need to be modified, as the trauma-related symptoms may begin to shift and lead to other issues that need processing.

C. The social worker should not make this type of referral yet as the client is still in a vulnerable condition.

D. There may be an impact on your therapeutic relationship with this client who may compare or feel torn between two therapists.

C. The social worker should not make this type of referral yet as the client is still in a vulnerable condition.

EMDR can be especially effective when a person is suffering from a recent trauma. In addition, you have already determined the client's need for this referral.

29. You are working with a 13-year-old client whose parents are going through a divorce. She texts you one day to tell you that even though she lives full-time with her mother, her dad is now hiring a lawyer for her to come live with him. You receive a subpoena for your records for the purpose of a custody hearing. You would:

Content Area: Law: Confidentiality, Privilege, and Consent

This question evaluates your understanding of how to respond to a subpoena.

A. Assert privilege until a guardian ad litem has been appointed for the client.

B. Contact the parent under whose authorization you are treating the 13-year-old and assert or waive privilege, depending on that person's wishes.

C. Speak to both parents and assert or waive privilege depending on their wishes.

D. Release the records in order to comply with the subpoena and avoid being in contempt of court.

A. Assert privilege until a guardian ad litem has been appointed for the client.

When subpoenas are received for testimony or records involving clients who are minors therapists should assert privilege until the parent(s) or guardians of the child obtain "guardian ad litem" status.

*30. In her first session, Shannon, who is highly anxious, asks you how long therapy will last. You would:

Content Area: Ethics: Therapeutic Relationship/Services

This question is checking your understanding of developing a therapeutic alliance and the importance of explaining the process of therapy at the outset of treatment (informed consent).

A. Interpret her question as an anxiety reaction.

B. Outline the process of treatment.

C. Encourage her to explore the concerns that brought her to therapy.

D. Explore past therapy experiences.

B. Outline the process of treatment.

Engaging in the process of informed consent, for example, explaining the therapeutic process at the beginning of therapy is an ethical obligation.

*31. After being in weekly therapy for 9 months, the client asks if she and the social worker can use telehealth to have sessions on an as-needed basis. If the social worker determines that this is clinically appropriate, what does the social worker need to do to make sure that online sessions are legal?

Content Area: Law: Legal Standards for Professional Practice

This question tests your knowledge about the legalities associated with fee negotiations.

A. Disclose any fees which are different from in-person sessions.

B. Tell the client about confidentiality protections she must have on her computer.

C. Maintain separate files for the different modalities.

D. Get her consent for video recording in writing.

A. Disclose any fees which are different from in-person sessions.

Fee disclosures are legally required before changes to treatment occur.

32. 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:

Content Area: Ethics: Professional Competence and Preventing Harm

This question pertains to issues impacting conjoint therapy.

A. Refuse to see Veronica but counsel Peter.

B. Refuse to counsel either of them until Veronica tells her husband about this affair.

C. Counsel both of them.

D. Counsel Veronica and her husband.

C. Counsel both of them.

As social workers, it is important for us not to impose our values and beliefs on our clients.

33. A couple comes in to see you for therapy. They are referred by the wife's individual therapist. The husband has recently discovered his wife has been cheating on him and he is unsure if he wants to continue the relationship. What is solely an ethical responsibility in treating this couple?

Content Area: Ethics: Therapeutic Relationship/Services

This question addresses your ethical responsibility in treating a couple.

A. Getting a signed release from both the husband and the wife to speak with the wife's therapist.

B. Designating a fee prior to the commencement of therapy.

C. Informing the couple of your "no secrets" policy.

D. Having the wife sign a release to speak with her therapist.

C. Informing the couple of your "no secrets" policy

Informing the couple of your "no secrets" policy is solely an ethical responsibility.

*34. Gladys, age 65, reports she has kicked her 67-year-old husband when it looked like he wasn't listening to her. He tells you that his hearing is poor and most of the time he heard her the first time anyway. What would you do?

Content Area: Law: Limits to Confidentiality/Mandated Reporting

This question addresses the parameters involved in reporting elder abuse.

A. Report immediately to Adult Protective Services and make a written report within 2 working days.

B. Refer him to an MD for possible improvements in his hearing.

C. Since they are spouses, do conjoint work pertaining to anger management.

D. Maintain confidentiality since you are not mandated to report since both spouses are 65 and older.

A. Report immediately to Adult Protective Services and make a written report within 2 working days.

There is a mandated responsibility here since you have knowledge or reasonable suspicion of elder abuse. You would report immediately by phone and follow up with a written report within 2 working days.

*35. Toward the end stages of therapy a client asks his social worker if they can use text or email between sessions to communicate as the final sessions get more spread apart. The social worker suggests that texts and emails won't really get the client used to less contact; they will only be substitutes. The social worker has:

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of how to respond ethically to clients' requests about changing treatment.

A. Provided ethical informed consent.

B. Legally maintained confidentiality.

C. Legally avoided client abandonment.

D. Avoided a dual relationship.

A. Provided ethical informed consent.

The social worker's explanation to the client about the clinical effectiveness of texts and emails is a form of informed consent.

*36. You get a call from the emergency room regarding one of your clients who was brought in by the PET team and is incoherent, delusional, and unstable. While they were going through his belongings they found his driver's license and your card. The psychiatrist on call wants to know if you can give them any information about this person that might be helpful. You would:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of how to protect client safety and confidentiality at the same time.

A. Assist them with information you deem pertinent to the situation at hand.

B. Inform them that you cannot confirm or deny if this person is your client.

C. Tell them that they will have to obtain a release signed by the client and fax it to you before you can disclose any information.

D. Ask to speak with your client before disclosing any information.

A. Assist them with information you deem pertinent to the situation at hand.

In the event of a medical emergency it is permissible to give information to medical professionals that may be treating the client. Social workers are permitted to speak with other health professionals for purposes of treatment and diagnosis in recognition of situations such as these.

*37. 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?

Content Area: Ethics: Professional Competence and Preventing Harm

This question tests your knowledge of ethical responsibilities regarding dual relationships and techniques to manage this responsibility.

A. Complete class as usual without acknowledging the client unless he/she acknowledges you and explore his/her reactions in your next session.

B. Leave immediately before the client sees you.

C. Say to your client, "Don't worry, everything we talk about in therapy is confidential."

D. Say hello to your client, complete the class as usual, and incorporate yoga and body movement in your treatment plan.

A. 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 the client's feelings about seeing you outside the therapeutic setting.

*38. You contract with a family for ten sessions, as that is all their insurance would cover. After the ten sessions they want to continue therapy but can't afford your full fee. What would you do next?

Content Area: Ethics: Therapeutic Relationship/Services

This question addresses your management of insurance clients with limited coverage, your sensitivity to the ethical concerns of client abandonment and ethical standards.

A. Refer them to a low-fee clinic.

B. Accommodate your fee since you've established a bond.

C. Terminate with the family since you have met the terms of the contract.

D. Assess their motivation for continuing therapy.

B. Accommodate your fee since you've established a bond.

Because you've established a bond, accommodating your fee would be in the best interests of the client. If an accommodated fee cannot be agreed upon, then providing three low-cost therapy referrals would be appropriate.

*39. Cheryl and Bobby are in joint private practice. Cheryl is concerned that Bobby is becoming burned out but Bobby won't reduce his caseload. It would be appropriate for Cheryl to:

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of how to assess and address other professionals' competence if it endangers clients.

A. Avoid making any referrals to Bobby.

B. Offer to take some of his caseload.

C. Engage Bobby in a therapeutic conversation.

D. Report Bobby to a regulatory body.

C. Engage Bobby in a therapeutic conversation.

The ethical standard is to speak with the colleague to try to rectify the issue first.

40. A "5150" or involuntary confinement may be invoked by:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question pertains to your knowledge of who can invoke a 5150.

A. Any licensed mental health professional.

B. A peace officer, staff member of an evaluation facility, or other professional person designated by the county.

C. Family members of persons to be confined.

D. All of the above.

B. A peace officer, staff member of an evaluation facility, or other professional person designated by the county.

A peace officer, a staff member of an evaluation facility or other professionals designated by the county, may invoke a 5150.

*41. A client joins a social worker's church congregation. The social worker should:

Content Area: Ethics: Professional Competence and Preventing Harm. This question asks you how you would handle a situation involving a potential dual relationship and boundaries.

A. Leave the congregation.

B. Tell the client s/he needs to join a different congregation.

C. Stay in the congregation but avoid direct social interactions.

D. Review dual relationships with your client and healthy boundaries.

D. Review dual relationships with your client and healthy boundaries.

Of the answers provided, reviewing dual relationships with your client and healthy boundaries, 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.

42. You are working with a family and learn that the father is neglecting the child. After making a report to CPS, you feel anger towards the father. What is/are the best way(s) to deal with your counter-transference?

Content Area: Ethics: Professional Competence and Preventing Harm

This question looks at your knowledge of appropriately handling counter-transference issues.

A. Journaling, peer consultation and individual therapy.

B. Journaling, progressive muscle relaxation, and diaphragmatic breathing.

C. Individual therapy, as you already know your anger won't be resolved through independent measures.

D. Refer the family to another therapist who specializes in victimized children and has her counter-transference issues resolved around these issues

A. Journaling, peer consultation and individual therapy.

Journaling, peer consultation and individual therapy are the appropriate steps in which you would ethically deal with counter-transference.

43. 13-year-old Brianna comes to the clinic where you are doing intakes and asks if she can get a social worker. You assess that Brianna is mature enough to participate intelligently in therapy and Brianna says she can pay for therapy if there is a low fee. In order for Brianna to be seen without parental consent, what other information would you need to know?

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of the legal requirements for treating a minor without parental consent.

A. That Brianna's uncle began to molest her a month ago.

B. That Brianna has daydreams of harming herself and no one in whom to confide.

C. You have sufficient reason to treat Brianna without parental consent.

D. That Brianna is in the process of petitioning the court for emancipation.

C. You have sufficient reason to treat Brianna without parental consent.

This scenario indicates that Brianna meets all the legal requirements for being treated without parental consent: she is mature enough to participate intelligently in therapy, she meets the minimum age requirement of 12-years-old, treatment will occur in an outpatient setting and she is responsible for the fee. The only criterion that remains is to determine if there is a clinical reason to exclude her parents.

*44. Your client, Liz, is a 17-year-old female who is leaving for college out of town at the end of the month. She was molested by her uncle as a young child and is working through these issues with you. She has developed a close working relationship with you and wants to continue to work only with you. You would:

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of the legal issues that pertain to treating clients who are moving.

A. Consult with a colleague about transference/counter-transference issues.

B. Make three referrals out of town.

C. Plan for weekly, hourly phone sessions with you.

D. See her on school breaks.

B. Make three referrals out of town.

Ethically, you need to provide Liz with the containment she needs to work through her early childhood issues. This can best be accomplished by referring her to social workers in her new area rather than concretizing her transference to you, i.e., "you're the only person who can understand and help me."

*45. Your client missed a regularly scheduled appointment. Your policy, made clear to the client in your informed consent document, is that clients will be billed for missed appointments. The client asks you to bill the insurance company. What would you do?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of appropriate billing procedures.

A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.

B. Explain that billing insurance for missed sessions is insurance fraud.

C. Let it go, since by law, insurers cannot be billed for missed sessions and clients with insurance are not required to pay out of pocket.

D. Bill the insurance company for the session.

A. Bill the insurer, indicating that the charge is for a missed session, and tell the client he/she is ultimately responsible for the fee.

It is legal and ethical to bill insurers for missed sessions as long as this is clearly indicated in the billing codes.

*46. At your 12-step meeting you mention that you are a social worker. Some other participants ask if being a social worker makes you a good sponsor. If you tell them that sponsorship is not within your scope of practice you have:

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of how to respond when clients want a service that is beyond your licensure to provide.

A. Failed to provide informed consent.

B. Fulfilled your ethical obligation to restore boundaries.

C. Legally fulfilled your responsibility to provide accurate information about your qualifications.

D. Legally failed to fulfill your responsibility to provide referrals.

C. Legally fulfilled your responsibility to provide accurate information about your qualifications.

You are legally required to provide accurate information about the range of services you can provide, given your license.

*47. 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?

Content Area: Ethics: Professional Competence and Preventing Harm. You must choose which course to pursue in response to your becoming angry at the client.

A. Disclose how you feel.

B. Seek consultation.

C. Refer him out.

D. Put your own feelings on the shelf and deal with the client's issues.

B. 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.

*48. For several sessions, you have been working with a client who insists that he "will not rest" until he makes his son's teacher pay for the false child abuse report that the teacher made. He feels that his family has been shamed and anyone who does an internet search on him will think he is a child abuser. He tells you he would never "put hands on a woman, but I will think of something." The social worker's early intervention plan should include:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This questions tests your knowledge of how to assess for danger and the need to break confidentiality in a potential crisis situation.

A. Notifying the police and the teacher.

B. Creating a therapeutic environment where the client can speak openly.

C. Direct questions about his revenge plans.

D. Educating the client about the law regarding your mandate to over report child abuse.

C. Direct questions about his revenge plans.

The social worker would need to determine if the client has a specific and imminent plan to warrant breaking confidentiality.

49. A social worker has been working with a difficult and resistant client for several months. The social worker might make some referrals to other social workers because:

Content Area: Ethics: Therapeutic Relationship/Services

This question checks your understanding of reasons to refer a client to a different social worker.

A. The social worker is having a counter-transference reaction.

B. The social worker and client both agree that it seems as if no further progress can be made.

C. The client probably needs a more directive and confrontational approach.

D. The client begins to miss sessions.

B. The social worker and client both agree that it seems as if no further progress can be made.

This is the best answer since it takes into account both social worker and client and the very important concern of client progress.

*50. José, a 14-year-old Mexican-American boy, comes to therapy with his mother. He presents with a flat affect and avoids eye contact during the initial assessment session. During the assessment process, José remains quiet as his mother provides a list of José's symptoms and behaviors that she would like you, as the social worker, to address. Before the initial assessment session comes to an end, José requests that you meet with him individually from now on. After deciding that it would be appropriate to schedule individual sessions, what is your legal obligation?

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of the legal obligations that pertain to documentation.

A. Assess whether the absence of Jose's father is having an impact on his behavior or this session.

B. Refer his mother for individual therapy to avoid abandoning her as part of the treatment unit.

C. Do

C. Document your decision to meet individually with José.

An important legal obligation, since you are changing the unit of treatment from a dyad to individual treatment of a minor, is to obtain consent to treat a minor and document it.

51. When writing notes about your client's therapy, which of the following information would not be kept in a client's chart?

Content Area: Ethics: Business Practices and Policies

This question addresses the parameters of record keeping.

A. The client's diagnosis.

B. Notes on any peer consultations regarding counter-transference issues around the case.

C. The informed consent signed by the client.

D. The treatment plan.

B. Notes on any peer consultations regarding counter-transference issues around the case.

Notes dealing with the social worker's personal issues should not be placed into a client's chart.

*52. 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 price offering. How would you characterize the social worker's action?

Content Area: Ethics: Professional Competence and Preventing Harm. This question assesses your sensitivity to the issues of professional boundaries and dual relationships.

A. It is illegal and unethical.

B. As the social worker did not solicit the information, the social worker was free to purchase the stock.

C. It is unethical.

D. It is unethical if it interferes with the nature of the therapeutic relationship.

C. It is unethical.

LCSW's do not use their professional relationships with patients to further their own interests.

*53. What is a social worker legally required to disclose to a client at the beginning of treatment as part of the ethical obligation for informed consent?

Content Area: Ethics: Therapeutic Relationship/Services

This question reviews your knowledge of the legal and ethical aspects of informed consent.

A. The fee, the true name and license of the designated owner of the practice, and the limits of confidentiality.

B. The fee and the type of license held by the social worker and the expiration date of a release authorization.

C. The fee and the true name and license of the designated owner of the practice.

D. The fee, the type of license held by the social worker, and limits of confidentiality.

C. The fee and the true name and license of the designated owner of the practice.

The fee and the name of the owner of the practice, if using a fictitious business name, are legally required disclosures at the onset of therapy.

54. Hank, a 27-year-old stockbroker, is referred by his EAP for 6 sessions. In the 5th session Hank tells you that he has recently acknowledged to himself that he is gay and doesn't know how to tell his fiancee. He wants to bring her to the next session and have you tell her for him. The best course of action would be to:

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of how to manage client expectations and boundaries.

A. Remind him that he only has one more session and that may not be how he wants to use it.

B. Suggest more sessions to clarify his sexual orientation.

C. Ask him how he knows he is gay.

D. Decline his request to tell her for him.

D. Decline his request to tell her for him.

Declining his request is the only ethical answer. You might also say that you will support him while he tells her, if he wishes.

55. A disabled client reports difficulty getting her medications because her son spends her SSI checks on gambling debts. What is your legal responsibility?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of your responsibilities as a mandated reporter.

A. You have no reporting mandate for domestic violence.

B. You are legally mandated to contact Adult Protective Services for dependent adult abuse.

C. You are legally mandated to contact Adult Protective Services for elder abuse.

D. You are ethically responsible to put the client's son on a 5150 for danger to others, as his mother could die without the medications.

B. You are legally mandated to contact Adult Protective Services for dependent adult abuse.

This disabled client says she's on SSI (Supplemental Security Income) which indicates she has a severe disability preventing her from gaining income through employment. Chances are she would be considered a dependent adult and it is important to report financial abuse of dependent adults to APS.

56. A therapist who performs telehealth advertises that the main advantage of internet therapy is that the client can reach a therapist in real-time. "If crises come up or just a quick question, online therapy can meet your needs right away." This advertising is:

Content Area: Law: Legal Standards for Professional Practice. This question pertains to your knowledge of the legal parameters for advertising on the internet.

A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable.

B. Legal if telehealth is within the therapist's scope of practice.

C. Unethical because online therapy cannot be used in a crisis.

D. Unethical because clients will expect a social worker to be available 24/7.

A. Legal if the therapist's informed consent information includes emergency contacts in the case that the therapist is unavailable.

Information about availability between sessions or in emergencies is an element of safety planning which is both a legal and ethical requirement.

57. As you arrive to work in the morning you notice your office has been broken into and your client, Matilda, who has been diagnosed with Borderline Personality Disorder, has pried open your locked file cabinet, has her file under her arm, and is about to leave the premises. She tells you she knows that she has a legal right to her own records. You tell her that this is true but that legally, in order for her to see the records:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of the legal protocols for a client requesting to see her records.

A. She must submit to you a request in writing.

B. She must sign a release authorization because after she leaves the office with her records it is possible that unknown third parties will see the records.

C. You must first inspect the records to make sure that there is nothing in them that would be detrimental to her mental con

A. She must submit to you a request in writing.

Clients must submit in writing any request to see their records.

58. You are a newly licensed social worker. You would like to incorporate EMDR into your practice. Which of the following statements is CORRECT?

Content Area: Ethics: Professional Competence and Preventing Harm. Awareness of when EMDR can be incorporated into your practice is being tested here.

A. EMDR is not within the scope of practice for a mental health professional.

B. You may practice EMDR if you are properly trained.

C. You are legally required to inform a client in the first session that you use EMDR.

D. You may practice EMDR only if you are certified by your state licensing board.

B. 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.

*59. The best time to establish your office policies with a client is:

Content Area: Ethics: Therapeutic Relationship/Services

This question assesses your knowledge of the ethical standards in establishing office policies.

A. At the commencement of treatment.

B. Within the first couple of sessions.

C. On an ongoing need-to-know basis.

D. When your client asks.

A. At the commencement of treatment.

At the beginning of the first session is the best answer. You would want to have an ongoing review of policies, as needed, throughout the course of treatment.

60. In order to tell her clients about how she works with social media, a social worker says that she will only send texts to confirm a cancellation. This agreement between the client and the social worker represents:

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of the contents of informed consent.

A. A Treatment plan.

B. A waiver of privilege.

C. Informed consent.

D. Limits of confidentiality.

C. Informed consent.

This type of statement that refers to boundaries and social worker availability represents informed consent.

61. A potential client was referred to you by a former client. He is specifically requesting "psychoanalysis," is willing to pay cash and wants to see you 2-3 times a week. You work from an Existential theoretical orientation. You know a supervisor who works psychoanalytically and you believe you would receive good supervision from him if you were to see this client. What will you do?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of the ethical responsibility to clarify expectations of therapy and work within your scope of competence.

A. Inform the client of your theoretical orientation and let him decide what he would like to do.

B. Tell the client you would be willing to see him but only one time a week and start educating yourself regarding psychoanalysis.

C. Tell the client you cannot see him because you're not a psychoanalyst and offer three referrals.

D. Explo

D. Explore with the client what he means by "psychoanalysis." Educate him on your theoretical approach and inform him of your limitations regarding psychoanalysis. Let him decide if he would like to continue therapy with you or receive referrals.

It would be important to explore with the client what he means by "psychoanalysis," as he may be referring to psychotherapy in a more general way. As part of informed consent, it is also important to explain to him about your theoretical approach so that he is informed about the service you do offer. This puts him in a position to make an educated decision about continuing therapy with you or receiving referrals for other mental health professionals.

62. Miranda, a medical social worker is going through a painful and conflict-ridden custody battle with her ex-husband. She notices that she has a hard time paying attention in rounds and last week became irritated with a patient and another member of her interdisciplinary team. According to professional ethical standards, how should Miranda proceed?

Content Area: Ethics: Professional Competence and Preventing Harm. This question reviews your knowledge of managing social worker's issues and conflicts that interfere with the ability to deliver professional services.

A. Apologize to the patient and colleague.

B. Take a personal day.

C. Take a leave of absence until the custody situation has been resolved.

D. Speak to her supervisor about making adjustments in her workload.

D. Speak to her supervisor about making adjustments in her workload.

NASW ethical standards say that social workers whose personal problems interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action, including making adjustments in workload.

*63. Eli has relocated his psychotherapy practice from a big city to a small town. In addition to seeing clients in his office, he also takes a job as a supervisor of interns at the town's only community counseling clinic. In his second week at the clinic Eli is given a list of new interns he will be supervising and one of the interns assigned to him is a client in his private practice. This client does not know that Eli supervises at the clinic. What should Eli do?

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge regarding supervision and dual relationships.

A. Decline to supervise the intern.

B. Ask the client to choose between having Eli as a social worker or a supervisor.

C. Terminate the therapy since it conflicts with Eli's role as a supervisor as well as the client's desire for training and career advancement.

D. Proceed as a supervisor since this is a case of an u

A. Decline to supervise the intern.

Declining to supervise the intern is the best ethical choice given here (it is possible that with the proper ongoing consultation and responsible care, this particular dual relationship could be ethically acceptable). Although some dual relationships are considered unavoidable, particularly when there are limited choices, the ethics are less ambiguous in stating that supervisors do not take on current or former therapy clients.

64. You find out that your client Joyce has been living with John for one year. John has a son who has become violent with Joyce on several occasions. She states that she really cares for John but doesn't know what to do about his son. How would you handle this situation?

Content Area: Ethics: Therapeutic Relationship/Services

This question pertains to a social worker's ethical responsibility to provide for a client's safety.

A. Provide Joyce with safety information.

B. Obtain Joyce's informed consent.

C. Refer Joyce to a woman's support group.

D. Refer the son to a high-risk teen group.

A. Provide Joyce with safety information.

As Joyce appears to be the victim of abuse by John's son, it is important that you provide her with safety information.

*65. You are treating a family of four in therapy. The oldest child, age 17, suggested that you do telehealth sessions with him. Legally, in order to do this you must:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of the legal parameters for the use of telemedicine/telehealth.

A. Obtain written consent-to-treat from him because he is age 12 and older, to change the treatment plan.

B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.

C. Legally obtain informed consent with the whole family to change the treatment plan.

D. Determine your fee schedule for a different medium.

B. Obtain consent-to-treat him if he changes from family therapy to individual telehealth therapy.

If he is in family therapy now, but changed to individual therapy, you would need legal consent-to-treat with a minor.

*66. Isaac and Fanny want their son Adam to have his Bar Mitzvah ceremony at the Orthodox synagogue that they belong to. Adam will only agree to study for his Bar Mitzvah at the local youth-oriented Hillel Temple that is less traditional. As a social worker, the most helpful initial step would be to:

Content Area: Ethics: Therapeutic Relationship/Services

This question asks you to clinically evaluate diversity of religious beliefs within a family.

A. Suggest a compromise and see how they respond.

B. Ask permission to speak with both Rabbis for their input.

C. Ask the family members individually to share with you their thoughts about religion.

D. Ask each family member to explain to you from their point of view the meaning this religious ceremony has to them and their family.

D. Ask each family member to explain to you from their point of view the meaning this religious ceremony has to them and their family.

The most inclusive and culturally considerate answer would be to have each family member represent their own views on religion and expand their perspectives by discussing the impact of religion on the family as a whole.

67. According to the Elder/Dependent Adult Abuse Reporting Law, you are mandated to report all of the following EXCEPT:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of the Elder/Dependent Adult Abuse Reporting Law.

A. Mental suffering

B. Self-neglect

C. Financial abuse

D. Physical abuse

A. Mental suffering.

Optional Category. Mental suffering (fear, agitation, confusion, severe depression, serious emotional stress brought on by threats, harassment, or intimidating behavior) are not mandated.

68. A famous rock musician who can pay your top fee is referred to you by a colleague. You send your colleague a bottle of fine wine in gratitude. Which of the following statements is TRUE about this situation? You have:

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal and ethical standards in dealing with referrals.

A. Expressed your gratitude in an appropriate and professional manner.

B. Not acted unethically or illegally since you did not solicit the referral.

C. Not acted unethically or illegally since you did not directly pay the colleague for the referral.

D. Acted unethically and illegally.

D. Acted unethically and illegally.

Although the gift is not substantial in value, social workers are prohibited by law and ethical standards from accepting or providing any kind of remuneration for referrals.

*69. Your 16-year-old client has been working on gender issues since you started treatment when he was 15. He was referred to you by his high school because he was being bullied for wearing women's make-up and shoes. Legally, what would be your first concern?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of legal requirements when treating minors.

A. You would need to get consent from his parents because he is being abused at school.

B. You would need to assess for child abuse.

C. You would need him to sign a release to speak with his school.

D. You would need to assess for possible suicidal ideation.

B. You would need to assess for child abuse.

Under any circumstances in which the safety of a minor is at risk, your first legal obligation is to assess for child abuse.

70. A social worker who works from a Humanistic model tells a few of her clients that she has been sober for 10 years. She finds that clients feel safer with a social worker who is in recovery like themselves. What is a LCSW's ethical obligation to a client if a client wants the social worker to be his sponsor after one year of sobriety and participation in AA?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of how to ethically manage a client's request that you participate in a dual relationship.

A. Tell the client it would be a dual relationship to act as a social worker and sponsor.

B. Wait at least two years to begin any type of relationship concurrent with therapy.

C. Agree to be the sponsor only after the client terminates therapy and if the client initiates the termination.

D. Assess for any counter-transference that would encourage the social worker to become t

A. Tell the client it would be a dual relationship to act as a social worker and sponsor.

Social workers are obligated to tell clients that if a dual relationship is avoidable, that it must be avoided.

*71. A client comes to your office for an initial visit. During your intake the client reveals that she left her previous therapist recently because she became uncomfortable when he invited her to have dinner with him. Your client asks what she should do. You would:

Content Area: Law: Legal Standards for Professional Practice. This question assesses your legal knowledge regarding a therapist's boundaries with a client and requires that you discern between sexual exploitation and an unethical dual relationship.

A. As required by law, provide your client with the brochure describing client options for action against therapists in such situations.

B. Contact the therapist to discuss the legal/ethical consequence of his actions.

C. Assess for further boundary violations.

D. Contact the BBS to report the therapist's inappropriate actions.

C. Assess for further boundary violations.

Assessing for further boundary violations would be important in order to determine the extent of boundary violations and if there had been any sexual contact between the therapist and your client.

72. Patricia, a 12-year-old client, tells you that she hates it when her older sister lets her boyfriend sneak into her room at night. The older sister is 15 and the boyfriend is 18. Patricia says they continue to do "nasty stuff" even though she tells them to stop. What would be your next step?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge of laws that differentiate between reportable sexual abuse and non-reportable consensual sex involving minors.

A. Call Child Protective Services.

B. Tell the parents.

C. Have a session with the sisters.

D. Find out if they are having intercourse.

A. Call Child Protective Services.

It is possible that the consensual sexual activity between the older sister and her boyfriend may be reportable but the exposure of Patricia to it definitely triggers a mandated report.

*73. Audrey, age 32, comes into your office while her father, Carl, and her 4-year-old daughter Brittney stay in your waiting room. Audrey tells you that she recently lost her job after her car broke down. Now she and Brittney live with her father, Carl, and she asks, "Can I pay you when my 'ex' pays his overdue child support?" How would you manage the ethical issue of fees?

Content Area: Ethics: Business Practices and Policies

This questions test your knowledge of the ethics that pertain to fees, fee disclosure and fee management.

A. Review the fee policies outlined in your informed consent document.

B. Disclose your fee prior to providing therapy or as soon as practically possible.

C. If you see Audrey alone and her father is paying, explain that she must collect the fee from him and then pay you.

D. Discuss Audrey's request that you wait to be paid until the 'ex' pays his overdue child support.

A. Review the fee policies outlined in your informed consent document.

Going over relevant fee policies such as the basis on which it is computed, sliding scale polices or fees for late cancellations constitutes sound ethical management.

*74. A social worker wants to speak with a client's nurse practitioner and brings up the subject of signing a release in order to do so. As part of informed consent, a client begins asking the social worker what she will do with the release. The social worker should explain that:

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of how to talk with clients about the impact of their signing a release authorization.

A. The release will expire in one year.

B. The client is entitled to receive a copy of the release.

C. The social worker will speak only with the person on the release.

D. The social worker will tell the client before speaking with the third party.

C. The social worker will speak only with the person on the release.

This answer provides the client with information to the client so that she can consent or refuse to consent to this part of the treatment.

*75. You have been working at your agency for 8 months and you have observed a colleague using EMDR. You are very impressed with the results she is having. You read an article about EMDR in a professional magazine. You also register with an EMDR council on the Internet. You begin using this technique with your clients. In this instance:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to assess your ability to treat a client within your scope of competence.

A. You may use this technique with your clients because you are registered on the Internet with the EMDR site.

B. This would be considered outside of your scope of practice.

C. Since you have studied the technique, it is ethical to practice with your clients.

D. This would be considered outside of your scope of competence.

D. This would be considered outside of your scope of competence.

EMDR in this vignette is outside of your scope of competence. Being in your scope of competence entails that you perform professional services warranted by your "education, training, and experience."

76. John, 15, has lived with his father since his parents divorced. When expelled from school, his father brought him to you for counseling. The following week you get a call from Clara who identifies herself as John's mother. She says that her son needs to live with her if he is ever going to "be a better man than his father." Your initial step would be to:

Content Area: Law: Confidentiality, Privilege, and Consent

This test item addresses procedures to protect client confidentiality.

A. Get a release from John's father to talk to his mother.

B. Get a release signed by both John and his father.

C. Not disclose to John's mother that John is your client.

D. Invite John's mother to the next session.

C. Not disclose to John's mother that John is your client.

Given the choices available, not disclosing to the mother John is your client is the legal course of action because we don't know if the woman on the telephone is actually John's mother. In order to speak to her, a release would be required.; therefore, the social worker's initial obligation is to maintain John's confidentiality.

77. 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? Revocation of a LCSW's license after having been found to have engaged in sexual misconduct with a client would occur after:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of legal and ethical standards involving post therapy sexual relat

D. Rowene violated ethical standards, but not the law.

Both the law and ethical standards clearly state that sexual relationships between social worker 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 the relationship is not illegal. However it violates NASW Ethical code 1.09 (c) which states that social workers do not have sexual relationships with former clients.

78. As a mental health professional, which of the following situations are you mandated to report?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question is asking for the situation that you are mandated to report.

A. Your 30-year-old female client is beating her husband and there are two young children in the home.

B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son.

C. You have suspicions that your 63-year-old client is being beaten by her son-in-law.

D. Your severely depressed client tells you that she wants to die.

B. Your client tells you the elementary school swim instructor is molesting her nine-year-old son.

You must report both known and suspected child abuse to a child protective agency. Since your client tells you that the elementary school swim instructor is molesting her 9-year-old son, you are mandated to report this abuse.

*79. Two years and one day after terminating with your client, Bob, he calls you and says that he has extra tickets to the NBA playoff game tonight and would like to invite you to the game with him and his wife. Under what circumstances might it be ethically appropriate for you to accept?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge regarding dual relationships.

A. Under no circumstances, since a client is always a client and this could constitute a dual relationship.

B. Under all circumstances, since this post-therapeutic relationship would occur more than two years following termination of treatment.

C. If both you and the former client felt comfortable with meeting in this way.

D. If you were to obtain professional consultation to determine the reasonableness of this post-therapeutic relationship.

A. Under no circumstances, since a client is always a client and this could constitute a dual relationship.

Non-sexual, post-therapy relationships may be ethical depending upon the reasonableness of the post-therapeutic relationship and the reasonableness of the time since therapy. However, the highest ethical standard is to avoid relationships with former clients because they may want to return to therapy.

*80. You are treating a client who discloses that she has had sexual relations with all her prior therapists. You:

Content Area: Law: Legal Standards for Professional Practice. This question involves your legal responsibility in treating a client who has had sexual relations with prior therapists.

A. Consider a diagnosis of Borderline Personality Disorder.

B. Provide her with a copy of "Professional Therapy Never Includes Sex" and answer her questions about it.

C. Provide her with a copy of "Professional Therapy Never Includes Sex" and describe the laws prohibiting therapist sex with clients.

D. Contact the BBS and inform them of the client's reports.

B. Provide her with a copy of "Professional Therapy Never Includes Sex" and answer her questions about it.

Your legal responsibility is to provide the pamphlet "Professional Therapy Never Includes Sex" and discuss it with the client if he or she informs you of sexual misconduct between him/herself and a therapist.

*81. Laurel, age 28, a corporate fund-raiser, and Marty, age 30, an electrician, are referred to you by Marty's E.A.P. Three weeks ago Marty witnessed the death by electrocution of a co-worker while they were working on a high-power utility line. Since then, Marty says he can't concentrate, is having nightmares, can't sleep, and finds himself reliving the incident over and over again. Laurel says Marty's problems are due to his drinking, not his co-worker's death. How would you handle the ethical responsibilities pertaining to boundaries?

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of how to manage boundaries.

A. Avoid membership in gyms or country clubs to which either Marty or Laurel belong.

B. Inform Marty how privilege works in case he is subpoenaed regarding the co-worker's death.

C. Have Marty sign a release so that you can speak to his E.A.P.

D. Set the fee bef

D. Set the fee before the first session.

Setting the fee before the first session is both a legal and ethical responsibility. It is one of many things to do when setting boundaries.

*82. 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 NOT tell them if you feel competent to do this kind of therapy?

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of how to ethically change the treatment plan, which requires informed consent from clients.

A. That you will need them to sign an agreement to change the treatment plan.

B. The risks and benefits of this type of therapy.

C. How you will help them determine new treatment goals that fit with EFT.

D. Your skills and experience in working with EFT.

A. That you will need them to sign an agreement to change the treatment plan.

Ethics do not require a signature on a treatment plan.

*83. Who holds the privilege for a 14-year-old client in a custody case?

Content Area: Law: Confidentiality, Privilege, and Consent

This question reviews your knowledge of privilege.

A. The parents of the minor.

B. The lawyer overseeing the client's case.

C. The 14-year-old client.

D. The social worker.

C. The 14-year-old client.

The client is always the holder of his or her own privilege, unless the court assigns a guardian ad litem or conservator.

*84. A family with a 16-year-old daughter and a 15-year-old son comes in to see you. The siblings are of equal height and build. The parents report that they have been referred to you by the school counselor because of the children's frequent squabbles. You discover they both have hit the other hard enough to give each other black eyes. You would:

Content Area: Law: Limits to Confidentiality/Mandated Reporting. The question relates to reporting requirements for sibling abuse.

A. Set up a strict policy of no hitting; teach anger management skills to both siblings; and instruct the parents on recognizing the warning signs that lead to the children's violence.

B. Report the incidents to a children's protective agency.

C. Inform the parents that if they don't contain the violence, you will report the incident to a children's protective agency.

D. Take steps to contain the violence. Since the violence is between sib

B. Report the incidents to a children's protective agency.

This vignette describes sibling abuse that has been occurring for a while. The parents are not in control of the situation, and you are mandated to report.

*85. The juvenile court refers a family to you. The 14-year-old son has been found guilty of vandalism and recently tested positive for using marijuana. The parents say the boy's friends are to blame, and they want your help to convince the court that their son was a victim of these older boys pressuring and threatening him. Ethically you:

Content Area: Ethics: Therapeutic Relationship/Services

This question assesses your knowledge of how to act in an ethical manner with a client who has been referred by the juvenile court.

A. Would explain that you need a release from the parents to communicate to the court.

B. Could tell the court what the parents have told you.

C. Must consult with the boy's attorney so that you remain in your scope of competence.

D. Make a child abuse report concerning the older boys' threats.

A. Would explain that you need a release from the parents to communicate to the court.

Even though the court referred this family, the family is your client, and you cannot break confidentiality without a written release.

86. Your client of six months, Dale, who was referred to you by her wheelchair aerobics instructor, comes to session with her 16-year old daughter Natasha. Dale is worried about abrupt changes in Natasha who has suddenly become argumentative and secretive. Natasha continues, "I'm sick and tired of helping her get to the bathroom. I want to be out with my friends." How would you manage your ethical obligations as they pertain to diversity?

Content Area: Ethics: Business Practices and Policies

This question tests your knowledge of how to incorporate diversity issues into the therapy from an ethical perspective.

A. Educate yourself on the psychosocial impact of being in a wheelchair.

B. Refer Dale to a support group for mothers in wheelchairs.

C. Join with the family by acknowledging similarities between Dale and Natasha.

D. Construct equipment, redesign entrances, or otherwise provide adequate wheelchair accessi

A. Educate yourself on the psychosocial impact of being in a wheelchair.

A better understanding of the issues Dale and Natasha face as a result of Dale's disability would certainly be an important aspect of their treatment and would meet your ETHICAL obligations.

87. 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:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of scope of competence.

A. Only accept referrals within his scope of competence.

B. Accept all referrals and get proper consultation and training as necessary.

C. Not accept any referrals outside of his experience.

D. Not accept any referrals for which he has had no formal training.

A. 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, mental health workers take steps to ensure competence through appropriate education, training, consultation, supervision, etc.

*88. John is a client whom you referred to a psychiatrist for an evaluation. He was reluctant to go because he has a history of steroid abuse that he does not like to talk about. He was given a prescription for SSRIs to alleviate his depression that he has been taking for six months. John comes to session this week and tells you that he has stopped taking the medication. You would:

Content Area: Law: Legal Standards for Professional Practice. This question focuses on the issue of scope of practice.

A. Ensure that John takes the medication.

B. Educate John about the impact of terminating the antidepressant medication.

C. Refer John back to the prescribing psychiatrist.

D. Explore the reasons for John's refusal and suggest that another antidepressant might be more appropriate.

C. Refer John back to the prescribing psychiatrist.

Referring John back to the psychiatrist would be the most appropriate action, as the psychiatrist could explain the benefits of taking the medication and the repercussions of abruptly terminating it.

*89. Michelle, a 52-year-old car saleswoman, has been seeing you for individual counseling. She has a history of stormy relationships and affairs with married men. In one session, after discussing her tendency to avoid intimacy with any one man by juggling too many men at once, she tells you she's been seeing another therapist on the side. Ethically you:

Content Area: Ethics: Therapeutic Relationship/Services

This item reviews the ethics of a client having two separate therapists.

A. Tell her it is unethical to have two therapists and encourage her to pick between you and the other therapist.

B. Tell her it is unethical, and you can't see her again until she terminates with the other therapist.

C. Explore the similarity between what she is doing in her relationships and with her therapy.

D. Ask her what her goals have been with the other therapist and request a release to speak with that therapist.

D. Ask her what her goals have been with the other therapist and request a release to speak with that therapist.

Asking her what her goals have been with the other therapist and requesting a release to speak with that therapist is the best course of action at this time. It is only unethical to have two therapists, if the therapists are working on the same material. It must be clarified what this client is working on in therapy with this other therapist before proceeding.

*90. Cynthia, a 42-year-old, divorced mother of two children, is your client. She has been seeing you to work on overwhelming feelings of anxiety. Her children are being seen in therapy by a well-respected child psychologist to deal with the upset of the divorce. Her husband is suing her for custody of the children. You have been contacted by his lawyer who has subpoenaed your records. You would:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of your legal obligations as they pertain to privilege.

A. Release your records.

B. Tell the lawyer you refuse to release Cynthia's records.

C. Release only a summary of your records.

D. Call your client.

D. Call your client.

You must call Cynthia to proceed. You cannot confirm or deny that Cynthia is your client until she signs a statement allowing you to assert or waive privilege on her behalf.

*91. Your client, Janet, 25 years old, reports being tired all the time, spending less time doing activities that she used to enjoy and crying often for no apparent reason. Janet reports losing weight and spending less time with family and friends. You assess for suicide and judge the risk to be low. You may use all of the following interventions, EXCEPT:

Content Area: Law: Confidentiality, Privilege, and Consent

This question assesses your understanding of interventions used with suicidal clients.

A. Talk with Janet about the problems in her life and her lack of interest.

B. Mobilize external and internal resources.

C. Suggest Janet take anti-depressants.

D. Offer empathy and emotional support and contracting for ongoing contact with you as necessary.

C. Suggest Janet take anti-depressants.

As an LCSW, you would refer the client to a psychiatrist but you would not suggest a client take medication.

92. 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:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of different ethical principles.

A. Scope of competence.

B. Counter-transference.

C. Dual relationship.

D. Scope of practice.

A. Scope of competence.

Anything that interferes with a clinician's ability to perform to the standard of care would be a scope of competence issue.

93. You are a social worker at a private agency funded by a religious charitable organization. You are assigned to work with a couple that initially reported communication problems. You explain the limits of confidentiality and your "no secrets" policy at the first session. After the first session, you receive a message on your voicemail from the wife that says her husband has been physically abusing her. What is the most ethical course of action?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of the ethical management of your "no secrets" policy.

A. Call the wife and remind her of your "no secrets" policy, and that you will disclose her message to the husband at their next session.

B. Call the wife and remind her of your "no secrets" policy, and that you expect her to disclose her message to the husband at their next session.

C. Waive your "no secrets" policy and asses

D. Waive your "no secrets" policy and call the wife to assess whether she is currently in danger.

Ethically, the clinician would be best advised to assess as soon as possible whether the wife is in imminent danger and to plan accordingly. Perhaps the wife needs an immediate referral to a domestic violence shelter and assistance in making a safety plan. Waiting until the next appointment may place the wife in danger.

*94. Karen has been a client of yours for almost six months. One day when you are in church you notice that Karen's name is in the church bulletin welcoming her as a new member of the congregation. You doubt that she knew you went to this church. You should:

Content Area: Ethics: Business Practices and Policies

This question reviews your knowledge of dual relationship protocol.

A. Leave the congregation.

B. Tell the client she needs to join a different congregation.

C. Stay in the congregation but avoid direct social interactions.

D. Review dual relationships with your client, and healthy client-social worker boundaries.

D. Review dual relationships with your client, and healthy client-social worker boundaries.

Of the answers provided, reviewing dual relationships with your client, and healthy client-social worker boundaries, would allow BOTH of you to work to maintain appropriate boundaries. This would allow you to know if this arrangement was going to be too uncomfortable for your client, or create any therapeutic problems. Of the options provided, it is the most reasonable.

95. Your client just found out that her identity has been stolen on the internet and she is worried that whoever stole her identity will also know that she was in therapy from the online bills and emails she paid to you, her social worker. What should you do to fulfill your scope of competence obligations?

Content Area: Ethics: Business Practices and Policies

This question relates to general scope of competence issues-any issue related to your ability to provide treatment in a competent manner.

A. Maintain computer security, i.e. firewalls, passwords, etc.

B. Refer the client to a new mental health professional.

C. Destroy records in a confidential manner.

D. Assure that you are competent to provide internet therapy.

A. Maintain computer security, i.e. firewalls, passwords, etc.

The client is worried about a security breach. Even though you are not responsible, you are ethically obligated to make sure that your practice adheres to privacy measures in the age of digital information transfer.

96. Which of the following people CANNOT initiate a 5150?

Content Area: Law: Limits to Confidentiality/Mandated Reporting. This question tests your knowledge about initiating a 5150 (an involuntary 72-hour-hold). Initiating a 5150 is making the request for a formal 5150 evaluation to take place.

A. A parent.

B. A social worker.

C. A paramedic.

D. A 17-year-old client.

D. A 17-year-old client.

A person who is under age 18 cannot initiate a 5150.

*97. The court sends Sue and Jerry to you for marital counseling after a domestic violence incident. A month after the referral, the court requests a report on the couple's attendance and progress. You:

Content Area: Law: Confidentiality, Privilege, and Consent

This question tests your knowledge of how to respond to a court request.

A. Can inform the court of the couple's attendance, but not progress without a written release signed by Sue or Jerry.

B. Should assert privilege on behalf of the couple.

C. Need a written release signed by both Sue and Jerry before you can communicate with the court.

D. Cannot assert privilege on behalf of the couple.

C. Need a written release signed by both Sue and Jerry before you can communicate with the court.

Since Sue and Jerry are your clients, you must get a written release from both before divulging any information about them.

98. 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:

Content Area: Ethics: Professional Competence and Preventing Harm. This question tests your knowledge of standards for ethical client treatment.

A. 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.

B. Let the doctor know you appreciate the referral, but you are out of your scope of practice in taking on this particular client.

C. Find a supervisor to assist and guide you in working with this client so that you are covered legally.

D. Tell the doctor that you would like to take this case and are prepared to research this diagnosis and work closely with him s

A. 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. If the client wants help with relationship issues, this is within your scope of practice, but if the client's needs are not relationship-oriented, then this case would be out of your scope of practice.

*99. A social worker receives a phone call from a young woman who asks if they can talk before she makes an appointment. In an initial phone call, the woman introduces herself and asks how long you have been a social worker. Missie tells you that she is depressed and that there is no pleasure or joy in anything she does. She doesn't have a lot of time or a lot of money but wants to know if you can help her to feel better. What is the social worker's obligation?

Content Area: Ethics: Therapeutic Relationship/Services

This question tests your knowledge of ethical obligations.

A. Tell her how long you have been licensed and how many clients you have.

B. Ask her how many sessions she can afford and use a therapy model that suits her needs.

C. Before making her a client, perform informed consent about what to expect from therapy.

D. Evaluate the seriousness of her depression to determine if you can treat her.

D. Evaluate the seriousness of her depression to determine if you can treat her.

The social worker's ethical obligation is to determine if the client will benefit from treatment, which requires an assessment of the presenting problem.

100. A client that you treated 3 years ago terminated when her therapy goals had been reached and she was ready. Which of the following would be legally required if this client returned to therapy with you at a new office?

Content Area: Law: Legal Standards for Professional Practice. This question tests your knowledge of legal requirements when starting therapy.

A. Tell her if you have raised your fees.

B. Tell her that you must make referrals if her needs are out of your scope of competence.

C. You must open a separate file.

D. She must sign a new release authorization since they expire after one year.

A. Tell her if you have raised your fees.

You must disclose your fee before beginning therapy with a new or returning client.