2023 CA Law & Ethics Exam (LPCC)

Professional clinical counseling - ANSWER-- application of counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems - conducting assessments for the purpose of establishing counseling goals and objectives to empower individuals to deal adequately with life situations, reduce stress, experience growth, change behavior, and make well-informed rational decisions - focused exclusively on the application of counseling interventions and psychotherapeutic techniques for the purposes of improving mental health, and is not intended to capture other, nonclinical forms of counseling for the purposes of licensure. Scope of Practice for LPCC - ANSWER-- does not include the assessment or treatment of couples or families unless the counselor has completed additional training and education, beyond the minimum training and education required for licensure - not include the provision of clinical social workservices - can use of assessments within counselors' scope of practice. - no restriction for LPCCs or PCCIs to assess and treat children What are the requirements for LPCC who would like to work with families, couples, and children? - ANSWER-- LPCCs and PCCIs can work with children, families, and couples as long as they are supervised LMFT, LCSW, licensed psychologist, licensed physician (board-certified in psychiatry) or a LPCC (completed 500hrs and 6 MFT graduate hrs w/ written confirmation from BBS). - take 6 sem units/9 qtr hrs of MFT theory - 500 hrs supervised work with children, family, couples - 6 CEU MFT specific course each renewal cycle Counselor impairment - ANSWER-Being alert to early signs of personal problems (fatigue, burnout, depression, substance abuse) that may prevent one from fulfilling professional obligations. How should a counselor deal with impairment? - ANSWER-- maintain consultation and supervision - seek treatment - provide appropriate referrals if necessary If a client will benefit from being referred to another provider, what should a therapist do? - ANSWER-- have a termination session focusing on transitioning them to a new provider - appropriate referrals - clt sign ROI authorizing new and old therapist to communicate for continuity of care - f/up with new therapist to transfer records and coordination of care What could potentially happen if therapist is unaware of his/her personal values, attitudes, and beliefs? - ANSWER-- incorrect diagnoses and poor tx decisions - bias toward one or more family members (if qualified to work with couples and family) - may become overly friendly/hostile with a clt - likely to miss or misinterpret impt clinical info How to manage impact of therapist's attitudes? - ANSWER-- consider how attitudes are impacting tx - seek supervision or consultation to ensure quality of care - personal therapy to identify source of attitudes/beliefs/values - refer if it continues to interfere, be careful not to abandon and referral is not discriminatory in nature T/F: If therapist refers clt out based on personal attitudes about race, gender, or other protected characteristics, the therapist is not engaging in discrimnation. - ANSWER-False, it is discrimination Autonomy - ANSWER-CLT has fundamental right to choose for themselves what kinds of mental health they will participate in, except for those who present an imminent danger to selves or others (involuntary hospitalization) - clt can discontinue/change provider any time What is the primary reason for the existence of legal and ethical obligations? - ANSWER-to protect the best interests of clients When there is a direct conflict between the code of ethics and the law, what should a therapist do? - ANSWER-follow what the law dictates T/F: The agency policies trumps the code of ethics for counselors. - ANSWER-False, agency policies does not excuse a counselor from following ethical obligations. informed consent for counseling - ANSWER-an ethical principle that research participants be told enough to enable them to choose whether they wish to participate ___________ is the cornerstone of the counseling relationship according to ACA Code of Ethics. - ANSWER-Trust respect the dignity and promote the welfare of clients - ANSWER-primary responsibilities of counselors In developing a treatment plan, who is in charge? - ANSWER-counselor and clt collaborating T:/F Counselors can engage in a personal virtual relationship with individuals with whom they have a current counseling relationship (e.g., through social and other media) to establish rapport. - ANSWER-False, counselors are pohibited What are the core professional values of the counseling profession? - ANSWER-1. enhancing human development throughout the life span; 2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts; 3. promoting social justice; 4. safeguarding the integrity of the counselor-client relationship; and 5. practicing in a competent and ethical manner. What are the fundamental principles of professional ethical behavior? - ANSWER-AUTONOMY NONMALEFICENCE BENEFICENCE JUSTICE FIDELITY VERACITY Autonomy - ANSWER-fostering the right to control the direction of one's life Nonmaleficence - ANSWER-do no harm Beneficence - ANSWER-working for the good of the individual and society by promoting mental health and wellbeing Justice - ANSWER-treating individuals equitably and fostering fairness and equality Fidelity - ANSWER-honoring commitments and keeping promises, including fulfilling one's responsibilities of trust in professional relationship Veracity - ANSWER-dealing truthfully with individuals with whom counselors come in contact with Counseling interventions and psychotherapeutic techniques - ANSWER-application of cognitive, affective, verbal or nonverbal, systemic or holistic counseling strategies that include principles of development, wellness, and maladjustment that reflect a pluralistic society. These interventions and techniques are specifically implemented in the context of a professional clinical counseling relationship and use of a variety of counseling theories and approaches Assessment - ANSWER-- selecting, administering, scoring, and interpreting tests, instruments, and other tools and methods designed to measure an individual's attitudes, abilities, aptitudes, achievements interests, personal characteristics, disabilities, and mental, emotional, and behavioral concerns and development and the use of methods and techniques for understanding human behavior in relation to coping with, adapting to, or ameliorating changing life situations, as part of the counseling process - not include the use of projective techniques in the assessment of personality, individually administered intelligence tests, neuropsychological testing, or utilization of a battery of three or more tests to determine the presence of psychosis, dementia, amnesia, cognitive impairment, or criminal behavior What is the consequence for unprofessional conduct? - ANSWER--punishable by revocation or suspension of a license or an intern's registration - a misdemeanor punishable by imprisonment in the county jail up to six months, by a fine not exceeding $2,500, or both. - BBS citations w/ fine under $1500 posted on the BBS website for 5 yrs, above $1500 posted indefinitely Unprofessional conduct - ANSWER-- negligence or incompetence in the performance of marriage and family therapy - misrepresentation involving type of license held, educational credentials, professional qualification or professional affiliations - performing, or holding oneself out as being able to perform services outside the scope of the license - failing to maintain confidentiality, except as otherwise permitted or required by law - soliciting or paying remuneration for referrals - the failure to keep records consistent with sound clinical judgment, the standards of the profession, and the nature of the services being rendered - engaging in sexual relations with a client, soliciting sexual relations with a client, or committing an act of sexual abuse, or sexual misconduct with a client, or committing an act punishable as a sexually related crime, - false advertising Individual Supervision - ANSWER-In CA one supervisor and one person being supervised is allowed. Group Supervision - ANSWER-In CA no more than 8 persons can be supervised by one supervisor Required Supervision Hours for CA - ANSWER-at least 1 hr individual supervision or 2 hrs of group supervision each work setting * 3hrs max/week - minimum of 52 wks Therapist sex with a client which is defined as a ____________ - ANSWER-felony, punished by up to six months in jail and/or a fine of up to $2,500. Have an injunction or restraining order placed against them - license placed on probationary status - license is suspended or revoked What's a therapist's duty upon learning of unprofessional conduct on the part of another therapist? - ANSWER-- are encouraged, but not required, to report unprofessional, incompetent, or unethical conduct on the part of other therapists - encouraged by ethical standards, to assist colleagues who are impaired due to substance abuse, emotional problems, or mental illness and may report such conduct to their professional organization What are the things should be included in informed consent? - ANSWER-- fee disclosure before tx starts - name and license designation (req'd as well when using fictitious business name - must file "fictitious business name statement with county registrar) - conspicuously display counselors license in her primary place of business - interns/associate shall disclose this status before tx BELOW ARE NOT REQUIRED BY LAW: - tx process - limits of confidentialtiy - potential risk, drawbacks, and benefits of therapy - clt access to records - length o time therapist retains records - tx alt, w/c can be no tx - clt/therapist relationship - length of therapist in practice - expected length of sessions and tx - mutual right to terminate therapy - procedures for collecting/rasing fees - cancellation policy - tp availability between session or in crisis Standard of care - ANSWER-- the degree of prudence and caution required of an individual who is under a duty of care - the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful therapists would possess and use in similar circumstances What is a legal principle used to prosecute or defend therapists accused of negligence or incompetence? - ANSWER-Standard of care Privilege - ANSWER-- client's right not to have confidential information revealed during a legal proceeding without their prior authorization - protects clients from confidences being revealed publicly without prior authorization Who is the holder of privilege? - ANSWER-- patient (regardless of age) when there is no guardian/conservator - guardian ad litem - personal representative of the pt if pt is dead - all members of t tx unit (individual, couple, family) Who can assert privilege - ANSWER-- person who holds it - therapist on behalf of clt until directed by clt or court - therapist required to assert privilege on behalf of their clients whenever a client's confidential information is sought pursuant to a legal proceeding - mental health professions who are subpoenaed about a clt on probation, parole, or incarcerated. As it relates to subpoena, if the clt decided to assert privileges, what does he/she must do? - ANSWER-- client's attorney files a motion to quash the subpoena. - therapist should obtain a signed document by the clt or drafted by clt's attorney of his/her decision to assert/waive privilege T/F: The holder of the privilege retains the right to read all information in his or her file with the exception of therapist's notes. - ANSWER-True, therapist's notes belong solely to the therapist as the provider * advisable for therapists keep separate files in order to ensure that their personal notes do not become integrated into the patient's legal record Exceptions to confidentiality - ANSWER-Child Abuse Dependent Adult and Elder Abuse Tarasoff Danger to Self and/or Others Grave disability What is a 5150? - ANSWER-Involuntary psychiatric hold in which the patient poses an immediate risk of harm either to themselves, others, or gravely disabled they can be held for up to 72 hours against their will for treatment and evaluation Who may rescind the 5150 and allow the person to either remain voluntarily or be discharged? - ANSWER-psychiatrist If after 72hrs or involuntary confinement and the pt evaluated to be appropriate for continued hospitalization, what is the next step? - ANSWER-The person may be offered a voluntary admission. * If it is refused, then another hold for up to 14 days, the 5250 (WIC-5250), must be written to continue the involuntary confinement of the person. A Certification Review Hearing (W&I 5256) must occur within 4days before a judge or hearing officer to determine whether probable cause exists to support the 5250. * the pt can demand a writ of habeas corpus to be filed for their release after they are certified for a 5250, and once filed, by law, the person must be in front of a judge in two (2) days, which, is two days sooner than the Certification Review Hearing T/F: 5150 hold written by a peace officer is valid in any county in CA wherein the ones written by a designated clinician is only valid in that county. - ANSWER-True, the clinician is only able to write the 5150 hold while present at the facility where they work, unless they work as part of the psychiatric response team gravely disabled - ANSWER-18 y/o and older: The person's mental condition prevents him/her from being able to provide for food, clothing, and/or shelter, and there is no indication that anyone is willing or able to assist him/her in procuring these needs Under 18 y/o: The person is unable to provide for his/her food, clothing, and/or shelter or to make appropriate use of them even if these are supplied directly--for example, a psychotic adolescent who refuses to eat because he/she believes their parents are poisoning them Under WIC what are two mandatory legal documents? - ANSWER-the 5150 application itself and the patient advisement (may be issued in the form of Form MH 303, Involuntary Patient Advisement) form as required by WIC 5157(c) Tarasoff v. Regents of the University of California - ANSWER-Supreme Court of California held that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient - 1976 re-hearing included "duty to protect" the intended victim - therapist has legal obligation (mandated) to protect potential victim(s); notify of local law enforcement of clt's identity w/in 24 hrs Child Abuse Mandated Reporting - ANSWER-therapists are legally obligated to report what he or she knows of the situation to the proper authorities (Child Protective Services, police, county probation offices or county welfare office) by telephone as soon as possible, with a written follow-up required within 36 hours * Mandated reporters may not make an anonymous report but are not legally required to tell involved individuals that a report is about to be made * It can be very beneficial to give clients the opportunity to make the reports themselves in the therapist's presence. * self-report, however, does not negate the therapist's mandate to report What are the types of child abuse that must be reported by a mandated reporter? - ANSWER-physical abuse sexual abuse child molestation Physical abuse of a child - ANSWER-- Any nonaccidental injury - An physical injury: punching, beating, kicking, biting, burning, shaking, throwing, stabbing, choking, hitting, or otherwise hurting a child Sexual abuse of children - ANSWER-- includes sexual assault and sexual exploitation. - Sexual assault includes rape and rape in concert, oral copulation and sodomy, lewd and lascivious acts upon a child under the age of 14, penetration of a genital or anal opening by a foreign object and child molestation - Unlawful sexual intercourse with a child under the age of 16 when the perpetrator is over the age of 21 - lewd and lascivious acts with a child of 14 or 15 years of age when the perpetrator is more that 10 years older than the victim Sexual exploitation of children - ANSWER-includes conduct involving matter depicting minors engaged in obscene acts; promoting, aiding or assisting a minor to engage in prostitution, a live performance involving obscene sexual conduct or posing for a pictorial depiction involving obscene conduct for commercial purposes; and depicting a child in or knowingly developing a pictorial depiction in which a child engages in obscene sexual conduct T/F: Consensual, non-abusive sex between two 13-year-olds is not reportable, but would become reportable when one partner reaches the age of 14. - ANSWER-True Sexual assault of children - ANSWER-as rape and rape in concert: This includes any forced sexual activity with anyone under age 18, or helping someone else rape a minor Incest - ANSWER-any sexual activity between parents and children, ancestors and descendants, siblings and between uncles or nieces and aunts or nephews T/F: If "lewd and lascivious" behavior occurred between minors, when each is under the age of 14 years, is reportable, even though minors are of roughly the same age and there is no coercion involved. - ANSWER-- False, it is not reportable as long as the minors are of roughly the same age and no coercion involved Is it reportable if "lewd and lascivious" behavior occurred between minors, when each is under the age of 14 years? - ANSWER-No , it is not reportable, as long as the minors are of roughly the same age and there is no coercion involved. T/F: It is reportable when lewd and lascivious acts with a child of 14 or 15 years of age if perpetrator is more than 10 years old than the victim. - ANSWER-True, it is reportable Severe Neglect - ANSWER-- the negligent failure of a person having the care or custody of a child to protect the child from severe malnutrition or medically diagnosed nonorganic failure to thrive - "any person having the care or custody of a child willfully causes or permits the person or health of the child such that his or her person or health is endangered including the intentional failure to provide adequate food, clothing, shelter or medical care. General Neglect - ANSWER-the negligent failure of a person having the care or custody of a child to provide adequate, food, clothing, shelter, medical care or supervision where no physical injury has occurred." T/F: If a therapist learns about suspected child abuse from a third party (hearsay), and reasonable suspicion exists, the therapist does not need to make a report if the information was revealed to the therapist within their professional capacity. - ANSWER-False, the therapist need to make a report T/F: Mandated reporters have immunity from criminal and civil liability for reporting as required. Any other person who reports a known or suspected case of child abuse is also protected from civil and criminal liability, unless it can be proven that the person deliberately made a false report. - ANSWER-True What happens if you fail to report known or suspected child abuse/neglect? - ANSWER-misdemeanor and punishable by a term in jail not to exceed 6 mos or by a fine not to exceed $1000 or both Elder and Dependent Adult Abuse Reporting - ANSWER-mandated reporter must report a known or suspected instance of elder or dependent adult abuse when, in his or her professional capacity, or within the scope of his or her employment, he or she (1) has observed or has knowledge of an incident that reasonably appears to be physical abuse, neglect, financial abuse, abandonment, abduction, or isolation; (2) is told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse, neglect, financial abuse, abandonment, abduction, or isolation; (3) reasonably suspects abuse Dependent Adult - ANSWER-Any person who is between the ages of 18 and 64 who has physical or mental limitations which restrict their ability to carry out normal activities Elder or Dependent Adult Abuse Categories - ANSWER-Physical abuse, neglect, financial abuse, abandonment, abduction, isolation, and any other form of treatment that results in physical harm, pain, or mental suffering Mental suffering - ANSWER-may consist of fear, confusion, severe depression, agitation, or other serious emotional distress caused by threats, harassment, or other forms of intimidating behavior Physical abuse - ANSWER-includes assault, assault with a deadly weapon or with force likely to cause great bodily injury; battery; sexual assault, unreasonable physical restraint; prolonged or continual deprivation of water or food; and the use of physical or chemical restraint for punishment, for a period of time beyond that for which the medication was ordered through instructions from a licensed physician or surgeon caring for the elder or dependent adult, and/or for any purpose not authorized by the elder or dependent adult's physician or surgeon Neglect - ANSWER-- refers to the negligent failure of any person having the care or custody of an elder or dependent adult to exercise that degree of care that a reasonable person in a similar position would provide. - includes self-neglect, the negligent failure of an elder or dependent adult to provide a reasonable degree of care to himself or herself