California Law and Ethics MFT Exam

What is Standard of Care?

WHAT IMPORTANT TERM is defined as "the usual and customary professional standards".

What four items comprise Standard of Care?

WHAT IMPORTANT TERM is comprised of "Statutes, Licensing Board Regulations, Ethical Codes, and Consensus of your Local Professional Community."

Give an example of a legal standard of care.

Posting your license in your place of practice is an example of WHAT BRANCH of standard of care? Also fulfilling a mandate of reporting child abuse. Or keeping records. Or following the licensing board regulations.

Give an example of an ethical standard of care.

Performing a thorough assessment is an example of WHICH BRANCH of standard of care?

What are California therapists legally required to do to treat suicidality?

California therapists are not legally required to follow any specific treatment protocol when treating a suicidal client, but they are REQUIRED BY WHAT to meet standard of care in their area regarding treating suicidality? This standard of care would be assessed by the consensus of their local professional community.

Who is being kept foremost in mind when setting legal and ethical standards for therapy?

The client's safety is foremost in mind when setting WHAT standards for MFT practice?

Is the standard of care a standard of perfection?

WHAT important term is a minimum standard?

How does a therapist ensure they are always meeting standard of care?

Doing consultation is a great way to know that you're meeting WHAT IMPORTANT TERM, especially if in doubt. Documenting consultation is a great way to show that you're meeting it.

How is standard of care established?

WHAT IMPORTANT TERM is always established by the standards implemented in your local professional community and is based on the resources available in your local professional community.

Describe the test-taking strategy to use when seeing the word "except" in a test question.

Looking for the answer(s) which is (are) definitely not true would be a good test-taking strategy when seeing WHAT WORD as part of a question on the exam?

Is Standard of Care considered to be a legal or ethical concept?

WHAT IMPORTANT TERMis a legal concept and as such is continually changing?

Define Scope of Practice

WHAT IMPORTANT TERM is defined as "the procedures, methods, and processes that are permitted for an individual who is licensed in a given field" or "the activities one can legally do as part of a given profession"?

In order to engage in any activity within your profession that activity must be both WHAT and WHAT?

An activity must fall within both an individual's SCOPE OF PRACTICE and SCOPE OF COMPETENCE if a therapist wants to what?

Is Scope of Practice a legal or ethical concept?

WHAT IMPORTANT TERM is defined by the business and professional code in the State of California?

Give an example of scope of practice.

Psychotherapy is within WHAT IMPORTANT TERM for MFT's in CA.

Give an example of a behavior which does NOT fall within the scope of practice for MFT's in CA.

Prescribing medications, giving advice about medications or side-effects, and suggesting changes to medication dosage is outside WHAT IMPORTANT TERM for MFT's in CA?

Is Scope of Competence a legal or ethical issue?

Name AN IMPORTANT TERM which is solely an ethical issue and is not defined by the California Business and Professional Code.

Is Standard of Care a legal or ethical issue?

WHAT IMPORTANT TERM is both an ethical issue and is also addressed by the California Business and Professional Code?

What is the Scope of Competence?

THIS IMPORTANT TERM is defined as either

1. the area of practice within a professional field in which an individual is proficient to work

2. those activities for which you have the appropriate education, training, and experience to do in your own

Who defines an individual's SCOPE OF COMPETENCE and how?

THIS IMPORTANT TERM is defined by each individual therapist - each therapist defining their capacity due to their own training and experience after a self-assessment of their current skill.

How does one expand one's scope of competence?

THIS IMPORTANT TERM is expanded through Education, Training, and Experience. This could also include obtaining supervision from someone who has expertise in the area you wish to expand into.

What should one do if you receive a case that you'd like to take but that is clearly outside of your scope of competence?

Obtain additional training, education, supervision, or experience are all examples of courses of action one should take if WHAT occurs?

What could a therapist say to a client who is requesting therapy for an issue that is outside the therapist's SCOPE OF COMPETENCE?

A therapist could say "I am sorry. I have a limited background in this issue but I'm willing to seek out additional training and consultation" in order to widen her WHAT and uphold the ethics of her profession?

Is it okay to take cases that would widen your SCOPE OF COMPETENCE?

It's okay and even desirable to take cases (with adequate support which could include training, supervision, or consultation) that would help a therapist to widen their WHAT IMPORTANT TERM?

What additional things would you want to tell a client who is presenting with issues that are outside your scope of competence?

Therapists who are presented with referrals for cases that are outside their WHAT IMPORTANT TERM should always provide clients with referrals and/or help them understand their other treatment options rather than continuing with someone who does not have experience with their presenting issue, even if that therapist agrees to get extra training or supervision.

Define self-determination and/or patient autonomy.

Therapists should always support their clients in WHAT IMPORTANT TERM which means "to act in a way that supports clients to make decisions for themselves".

What would be the best answers on the licensing exam to ensure that you are choosing options that support self-determination and/or patient autonomy.

Choosing answers on the licensing exam that always have the client deciding for themselves what to do would ensure that you are supporting WHAT IMPORTANT TERM for the client?

WHAT IMPORTANT TERM always trumps self-determination and/or patient autonomy?

Choosing a licensing exam answer that prioritizes SAFETY is the one exception to always supporting WHAT IMPORTANT TERM?

Name some therapeutic interventions that support a client in exercising self-determination and autonomy?

Supporting personal insight, examining thought patterns, paying attention to body awareness, are all therapeutic interventions that help a therapist to support WHAT IMPORTANT TERM?

Name two important areas in treatment where it's especially important to support client self-determination and autonomy.

Formulating treatment goals and making decisions around termination are two important areas where a therapist will want to be sure to support WHAT?

What are three important general topics should be included in Informed Consent?

A therapist should ensure that they provide enough information during the WHAT process so that the client knows

1. What exactly therapy entails

2. What the risks and benefits of therapy are

3. What other treatment options may be

...so that the client can make an informed decision about their own treatment.

What important considerations pertaining to SELF-DETERMINATION should therapists make when treating the ELDERLY?

When treating the elderly, often other people in the client's life may have differing ideas about what is needed for client.

WHAT IMPORTANT CONCEPT do therapist need to keep in mind when treating an elderly client in order to ensure that you are supporting whenever possible what the client themselves actually wants.

Question to ask yourself:

What does client actually want?

What kinds of decisions are others making for that person?

What factor will trump SELF-DETERMINATION in the treatment of an elderly client? And in what context is SELF-DETERMINATION not in the hands of an elderly client?

When treating an elderly client, WHAT IMPORTANT TERM is trumped by the following:

1. Always rule out safety issues.

2. If the person was deemed incompetent in a competency hearing, that would be the only time that another person could make decisions for the client.

Name an area where therapists commonly feel compelled to break confidentiality or not support self-determination?

Domestic violence is an area where therapists commonly feel compelled to WHAT and often feel an urge not to support WHAT? But in both instances, they have an ethical and legal obligation not to act in a manner which would betray the client's WHAT (same as above).

What are three rights a client has which are supported when a therapist gives a thorough INFORMED CONSENT?

Clients have a right to the following which is met when a therapist provides a thorough WHAT:

1. Right to know what procedures are going to be used during treatment

2. Right to have all the relevant facts about treatment.

3. Right to know the risks and benefits involved in treatment.

Name four situations in which a person might not be able to give informed consent.

A person might not be capable of WHAT if one of these four situations is present:

1. The client is a minor

2. The client is cognitivly impaired

3. The client is currently impaired due to a mental health crisis

4. The client does not possess all the essential information

Name some circumstances in which the therapist want to review informed consent with a client?

The following are points in treatment a therapist would want to WHAT?

1. At the start of treatment

2. Any time there is a change in treatment

3. Any time there is a change in unit of service

optional:

4. Any time the therapist might need to break the client's confidentiality

Failing to obtain informed consent is a failure to do WHAT?

Providing a client with informed consent is an example of meeting standard of care.

When does informed consent need to be signed?

When treating a minor WHAT has to be signed? For an adult it's fine if the client waives it or if it's given verbally only.

Describe ways to ensure that you show that a client has provided informed consent?

Having a client initial each component within a written document, obtaining a signature, and also making a note in your records are two ways of ensuring that you document that you have provided a client WHAT?

What five components are LEGALLY required to be included within informed consent?

These five components are WHAT TYPE OF REQUIREMENT as part of informed consent?

1. Fees for service

2. License status (license must also be posted in your office)

3. Any technology utilization that may occur (i.e. email, internet submission of insurance forms)

4. Any fictitious business name being used you must list who owns the business

5. If you are a HIPAA covered entity you must provide the Notice of Privacy Practices

What are the STANDARD OF CARE requirements to be included in informed consent? (These akin to legal requirements because a therapist could be sued if she doesn't include these)

These components are required as part of the WHAT TYPE of REQUIREMENT for informed consent? Is this a legal or ethical requirement?

1. Limit of confidentiality - includes what are mandated reports, when else might you have to break their confidentiality?

2. Risks and benefits of treatment - e.g. client might feel worse during treatment, couples might break up, etc.

3. Alternatives to treatment with you - e.g. medication, acupuncture, dietary changes, etc.

4. Cancellation policy - especially if you plan to charge for missed sessions

5. Billing procedures

6. Communication and emergency practices - e.g. how to reach you in an emergency

7. Provide background of therapist - e.g. information about your area of expertise and skill

8. Define who the client is, e.g. is the therapist treating an individual, a couple, a group member, etc.

What conditions must legally be met when a minor is consenting to their own treatment?

The following must be in place when a minor is consenting for their own treatment. Are these legal or ethical requirements?

1. Informed consent must be signed.

2. The minor must be age 12 or older.

Under what conditions is a minor considered legally able to consent for their own treatment?

The following must be in place order for a minor to WHAT?

1. The minor must be 12 or older

2. The minor must be determined mature enough to do so.

3. There is reason not to include the parent(s) or guardian(s).

Describe a condition in which there would be enough reason not to include a parent or guardian in a minor's treatment thereby allowing the minor to consent for their own treatment?

The following are examples of situations which are reason for WHAT?

1. The parents don't believe in therapy.

2. The parents are against therapy.

3. The minor is LGBT, is seeking therapy pertaining to issues related to their LGBT status, and is not comfortable being out with parents.

Who is responsible for payment in therapy?

The person consenting to treatment is responsible for WHAT?

This would be true whether or not the client is a minor (but only for minors who consented to their own treatment without the involvement of their parent or guardian).

Who is allowed to consent for treatment of a minor if the parents ARE MARRIED?

If a minor's parents are married, either parent may WHAT?

Who is allowed to consent for treatment of a minor if the parents were NEVER MARRIED?

If a minor's parents were never married, either parent may WHAT?

Who is allowed to consent for treatment of a minor if the parents are DIVORCED?

If a minor's parents were are divorced, the custody agreement will determine WHAT?

How does a therapist determine who must SIGN CONSENT FOR TREATMENT of a minor when reviewing a custody agreement?

If a minor's parents were are divorced, only a parent who has legal custody* is allowed to WHAT?

*This is especially true if the parent has SOLE LEGAL CUSTODY.

If a therapist determines that a custody agreement gives legal custody to both parents, then what must happen in order for a therapist to obtain CONSENT FOR TREATMENT of a minor?

If the custody agreement gives legal custody to both parents, best practice* is that BOTH SIGN WHAT before a minor can receive treatment with a therapist?

*This would be provided that the custody agreement explicitly states that EITHER PARENT is allowed to sign.

If a therapist determines that a custody agreement gives only physical custody to the parent who has brought a minor for treatment, is that parent allowed to SIGN CONSENT FOR TREATMENT of a minor?

A parent who has only physical custody may not WHAT?

What can a caregiver sign if the caregiver is not a legal guardian but is caring for a minor for whom they are seeking treatment (only in cases where the parents are missing)?

A caregiver can sign a CAREGIVER'S AFFIDAVIT in what context?

Who can CONSENT FOR TREATMENT for a minor in foster care?

The following is a list of those who can WHAT if the minor's parents are not able:

1. Any minor age 12 or over

2. Any legal guardian of the minor

3. A child's lawyer if the child is in foster care

4. A social worker or foster parent if the court has issued a Minute Order

5. Any person whom the court has identified through a Minute Order as the person who should sign for medical treatment of a foster child

6. A foster parent in any instance where a judge has issued an order that a child should receive mental health treatment

What protocol should a therapist do when obtaining consent for treatment for a minor, recommended for every case but especially in cases where a parent brings in a child and the second parent is missing or unavailable?

In what case would a therapist want a parent or caregiver to sign a CAREGIVER'S AFFIDAVIT?

What is one special consideration to include during INFORMED CONSENT with families and couples?

A discussion of "no secrets** policy" is an important component of WHAT when beginning treatment with families and couples?

**Safety issues also trump no secrets policies

What is an important best practice to remember regarding CONFIDENTIALITY when working with groups?

It is important to remember that only a therapist is bound to WHAT* when working with therapy groups?

Best practice is to have each group member sign that they will not share other participants' private information outside the group.

Regarding the fact that only a therapist is legally bound to protect each client's CONFIDENTIALITY, a therapist should remember to do what?

A therapist should inform group members that there is an inherent risk when participating in therapy groups that the client's private information might potentially be shared outside the group. Only the therapist is legally bound to WHAT. Participants cannot sue other participants for breach of WHAT?

Name two situations in which a therapist is allowed to treat without INFORMED CONSENT.

The following are two situations when a therapist can treat without WHAT?

1. Crisis situations which require immediate treatment (e.g. a suicidal or psychotic individual who presents at a psych hospital)

2. If a client refuses WHAT*?

*Be sure to document in records that you made an attempt and the client refused.

Name three special situations in which a therapist wants to be sure to obtain SIGNED INFORMED CONSENT that OUTLINES THE RISKS AND BENEFITS.

The following are two instances when a therapist wants to be sure to obtain WHAT?

1. Anytime a therapist will be using any type of experimental or unusual therapy (e.g. somatic therapy that involves touch)

2. Anytime the therapy may leave a client in an altered state (e.g. hypnosis)

3. Anytime a therapy may include a high risk of increasing a client's discomfort or possible negative ramifications such as exposure to past trauma (e.g. EMDR)

What must a therapist obtain prior to beginning any RESEARCH or making any RECORDINGS?

A therapist must obtain INFORMED CONSENT prior to beginning WHAT or making any WHAT with a client?

What must a therapist do with a MINOR CLIENT prior to starting treatment, even if the client is in crisis?

A therapist may NEVER TREAT WHOM without obtaining WRITTEN INFORMED CONSENT even if the client is in crisis?

Is confidentiality a legal or an ethical requirement?

Name AN IMPORTANT CONCEPT that is BOTH a legal and an ethical concept that restricts the therapist's behavior.

What is one reason that CONFIDENTIALITY is so important in therapy?

WHAT IMPORTANT CONCEPT is an important fact in therapy which helps clients to feel safe?

List all types of MANDATED REPORTS for therapists?

The following are examples of WHAT?

1. Child Abuse and Neglect

2. Elder Abuse and Neglect

3. Danger to Others

List all instances in which a therapist is MANDATED TO BREAK CONFIDENTIALITY but are not a mandated report.

The following are examples of times when a therapist is WHAT?

1. When a client signs a release

2. Court Order

3. Investigation by the Licensing Board (e.g. in an investigation of an ethical violation)

4. Search Warrant for your office

5. Coroner Investigation (requests records for a dead client)

6. Formal Request for records from a client or client's representative - they must submit an authorization for request for records

7. An order via the Patriot Act

List the three ways that COURT ORDERS might be described on the Law and Ethics Exam.

The following are three ways that the L&E exam might describe WHAT?

1. Judge ordered subpoena

2. Supoena by the court

3. Court order

What three sets of rules govern mental health work?

Laws, ethics, and standards of care are each WHAT?

What set of rules trump all other rules governing mental health work?

Laws trump all other WHAT?

When the law trumps all other rules governing MFT practice, best practice is WHAT?

Following the WHAT with the strongest possible adherence to your ethical codes should be done WHEN?

If one set of rules governing MFT practice sets a higher standard than another, an MFT should do WHAT?

One should always follow the set of governing rules that sets the highest standard for behavior when WHAT?

Codes of ethics are developed by WHO to do WHAT?

WHAT is developed by professional associations in order to protect both the public and the professionals providing any psychotherapy service.

Lawmakers are reluctant to add regulations to a profession that is WHAT?

When professionals seems to be adequately governing themselves WHO is reluctant to WHAT?

Name the three basic models for ethical codes.

WHAT can be broken down into these three basic models:

1. Aspirational (provides example of what ideal behavior looks like)

2. Narrow (makes law enforcement easier)

3. Combo (achieve both enforceability and guidance)

In situations where there is no clear legal or ethical guidance, therapists should WHAT?

Therapists are expected to follow the standard of care for their field when WHAT?

Describe one way a therapist can determine if a standard of care exists for a certain situation and how to follow it?

Gathering ideas and feedback from other therapists you trust in your field can help a therapist to determine WHAT?

What are a therapists beat sources of information when seeking a specific, applicable standard of care?

The follow are sources for determining WHAT?

1. Writings in the field

2. Supervisors

3. Colleagues your trust

Where is the best place to refer when seeking information about your ethical obligations as a therapist?

Your professional association's Code of Ethics is the best place for WHAT?

Where is the best place to look when seeking guidance regarding the legal regulations governing your profession as a therapist in California?

Downloading for free the BBS's compilation of Statutes and Regulations Relating to the Practice of Clinical Counseling, Marriage and Family Therapy, Educational Psychology, and Clinical Social Work is the best way to WHAT?

What is the goal or purpose of life coaching?

Helping people to achieve personal and professional goals and to achieve their potential is the purpose of WHAT profession?

What is one notable area which is outside the (non-legal definition of) scope of practice when working as a life coach?

Working to help a client resolve mental illness is outside WHAT when working as a life coach?

In what two contexts are emotional support animals recognized?

WHAT is allowed to do the following:

1. Under federal law they can fly for free with their owner on commercial flights

2. Under federal (and California state) law they can live in housing situations with their owners even if pets are not normally allowed.

What guidelines are necessary in order to become an emotional support animal?

Individuals can have a WHAT if they have obtained a letter of support from their therapist?

What rules or restrictions must be followed in order for a therapist to write a letter of support for an emotional support animal?

There are very few rules or restrictions a therapist can refer to determine whether to issue a letter for WHAT or what the appropriate justification for allowing a WHAT should be.

What do therapists GIVE UP and what do they AGREE TO DO when they become mental health clinicians?

WHO gives up some of their legal rights and agrees to be held to a higher standard of behavior than ordinary people?

WHAT gives the state the authority to discipline the licenses of those who have violated the WHAT?

Unprofessional conduct statutes gives the states authority to WHAT when therapists violate the standards of professional behavior.

Define what is addressed in a civil lawsuit and define the potential outcome.

Awards in a WHAT lawsuit are typically monetary damages awarded when a client alleges that a therapist's actions were outside the standards of the profession and caused them harm.

Define when a therapist might face a criminal case and define the potential outcome.

In a WHAT, a therapist is alleged to have violated the public in some kind of way deserving punishment. Typical punishment would include fines, jail time, or both.

Define what a disciplinary action is and what might be a potential outcome.

In a WHAT the board is focused on the therapist's performance (or fitness for) a professional role, the result of which can be that the therapist's license can be put on probation, suspended, or revoked and the therapist may have to pay the costs incurred during the investigation.

Define the three different types of evidence needed in order to have a civil award, disciplinary action, or criminal case be decided against a therapist.

In a civil award, "a preponderance of evidence" - basically the majority - is needed to WHAT?

In a disciplinary action, "clear and convincing evidence" - higher than the burden of proof for a civil case but lower than what is needed in a criminal case - is needed to WHAT?

In a criminal case evidence is needed "beyond a reasonable doubt" - the highest standard- in order to WHAT?