Question 1: B
Rationale: According to Business and Professions Code 2936, "[t]o facilitate consumers in receiving appropriate psychological services, all licensees and registrants shall be required to post, in a conspicuous location in their principal psychological business office a notice which reads as follows: NOTICE TO CONSUMERS: The Department of Consumer Affair's Board of Psychology receives and responds to questions and complaints regarding the practice of psychology. If you have questions or complaints, you may contact the board on the Internet at www.psychboard.ca.gov, by calling 1-866-503-3221, or by writing to the following address: Board of Psychology, 1625 North Market Blvd., Suite N-215, Sacramento, California 95834." Note, too, that under HIPAA, you must also post the Notice of Privacy Practices in a prominent place in your office where clients can read it.
Question 2: B
Rationale: When the parents are divorced but share joint legal custody, either parent alone may consent to therapy for their child. Legal custody refers to a parent's right and responsibility to make decisions that concern a child's physical and mental health, education, and welfare (FC Section 3003); while physical custody refers only to living arrangements and supervision of the child (FC Sections 3004 and 3007). Only a parent with legal custody may consent to a child's treatment. If the legal custody of a minor child is disputed or unclear, a psychologist should consider the best interests of the child and the rights of parents and consult an attorney and or or relevant state laws.
Question 3: C
Rationale: Photocopying standardized tests is unethical and illegal. Using only tests that have not been photocopied (answer A) would not resolve the company's misuse of the tests. Reporting the director might be an option (answer B), but the best initial action would be to attempt to resolve the matter informally by talking to the program director. (The psychologist would also want to obtain more information about which tests are being photocopied and whether or not permission from the publisher to do so has been obtained.) Administering the tests (answer D) is not an acceptable course of action since doing so would be unethical and illegal.
Question 4: D
Rationale: A 14-day certification for intensive treatment requires that, after the initial 72-hour hold, the person is a danger to self or others or is gravely disabled. Additional holds may follow the 14-day certification, with the duration of the hold depending on the individual’s circumstances.
Question 5: B
Rationale: The qualifications and responsibilities of primary supervisors are specified in CCR Section 1387.1. It states that "all primary supervisors shall be licensed psychologists, except that board certified psychiatrists may be primary supervisors of their own registered psychological assistants. In this regard, a maximum of 750 hours of experience out of the required 3000, can be supervised by a board certified psychiatrist and can be counted toward meeting the SPE licensing requirements."
Question 6: C
Rationale: Section 830(a) of the Welfare and Institutions Code applies to this situation. It states: "Notwithstanding any other provision of law, members of a multidisciplinary personnel team engaged in the prevention, identification, management, or treatment of child abuse or neglect may disclose and exchange information and writings to and with one another relating to any incidents of child abuse that may also be a part of a juvenile court record or otherwise designated as confidential under state law if the member of the team having that information or writing reasonably believes it is generally relevant to the prevention, identification, management, or treatment of child abuse, or the provision of child welfare services. All discussions relative to the disclosure or exchange of any such information or writings during team meetings are confidential unless disclosure is required by law."
Question 7: D
Rationale: This situation is covered by Standard 10.07 of the Ethics Code, which prohibits psychologists from providing therapy to former sexual partners. In addition, providing therapy to the wife only would violate Standard 3.06, which states that psychologists refrain from engaging in professional activities when "personal, scientific, professional, legal, financial, or other interests or relationships could reasonably be expected to (1) impair their objectivity, competence, or effectiveness in performing their functions as psychologists." Therefore, answer d is the best response of those given.
Question 8: B
Rationale: When you perform a court-ordered evaluation, the court would make decisions regarding the evaluation. Consequently, you should seek the court's guidance when you receive a request from the defendant's lawyer.
Question 9: B
Rationale: C Section 2919 states: "A licensed psychologist shall retain a patient's health service records for a minimum of seven years from the patient's discharge date. If the patient is a minor, the patient's health service records shall be retained for a minimum of seven years from the date the patient reaches 18 years of age."
Question 10: A
Rationale: FC Section 3025 addresses access by parents who are divorced. It states that, "notwithstanding any other provision of law, access to records and information pertaining to a minor child, including but not limited to, medical, dental, and school records, shall not be denied to a parent because such a parent is not the child's custodial parent."
Question 11: B
Rationale: With regard to conflicts or inconsistencies between the requirements of HIPAA and state laws, the general rule is to follow the law that provides the patient with greater privacy, access, or autonomy.
Question 12: C
Rationale: Note that this question is asking about the requirements of HIPAA's privacy rule and not about other legal or ethical requirements. Therefore, answer c is the correct response because it most accurately describes HIPAA's requirements with regard to consent for disclosure of PHI.
Question 13: C
Rationale: Section 15630(b)(1)(A) of the California Welfare and Institutions Code applies to this situation. It states: "If the abuse has occurred in a long-term care facility, except a state mental health hospital or a state developmental center, the report shall be made to the local ombudsperson or the local law enforcement agency."
Question 14: B
Rationale: Spousal abuse is not identified as a reportable type of abuse in California. However, psychologists must report known and suspected cases of the abuse of a minor and the physical abuse, abandonment, abduction, isolation, financial abuse, or neglect of an elder or dependent adult. >Answer C: A report must be made whether or not the individual wants the psychologist to do so.
Question 15: D
Rationale: Ethical Standard 3.05(a) (Multiple Relationships) states, "A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists." While not all multiple relationships are prohibited, the one described in this question appears to pose a high risk of harming the potential client. In their analysis of the Ethics Code, Keith-Spiegel and Koocher offer the following recommendation: "We advise that accepting those with close preexisting relationships into a professional relationship should be avoided altogether, with the possible exception of short-term emergency support until a suitable referral can be located" (in P. Keith-Spiegel and G.P. Koocher, 1998. Ethics in Psychology: Professional Standards and Cases. New York: Random House).
Question 16: A
Rationale: Legal requirements regarding minor consent to treatment are provided in H&SC Section 124260. Section 124260(b) permits a minor who is at least 12 years of age to consent to outpatient "mental health treatment or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services." Note that Section 124260 applies to a "professional person," which includes a clinical psychologist, a marriage and family therapist, a licensed clinical social worker, and a licensed educational psychologist. As defined in WIC Section 14029.8, Section 123260 does "not apply to the receipt of benefits under the Medi-Cal program."
Question 17: B
Rationale: When records do not pertain to health care for which the minor has legally consented or could have consented, the parents or legal guardians of a minor ordinarily have the right to have access to the minor's records which makes answer D incorrect. It is helpful to remember that biological parents have the right to records. While you may have to have the legal guardian sign your consent for treatment for the minor, the same is not true for the minor's records, which makes answers A and C incorrect.
Question 18: C
Rationale: Standard 8.14 of the Ethics Code applies to this situation. It states that: "After research results are published, psychologists do not withhold the data on which their conclusions are based from other competent professionals who seek to verify the substantive claims through reanalysis and who intend to use such data only for that purpose, provided that the confidentiality of the participants can be protected and unless legal rights concerning proprietary data preclude their release." The question states that you have not yet published your results; and, consequently, you are not required by the Ethics Code to share the data with your colleague. After publishing the results, however, you would be required to comply with a request for the data by a "competent professional" as long as the request is for the purpose of re-analyzing the data and the confidentiality of the participants can be protected.
Question 19: B
Rationale: Your client appears to meet the requirements for a grave disability as defined in WIC Section 5008 - i.e., as the result of a mental disorder, the client is unable to provide for his or her basic personal needs for food, clothing, or shelter. (A useful strategy for determining whether a person's behavior meets the legal requirements for a grave disability is to consider whether the behavior is due to a mental disorder and, if so, whether the behavior threatens his or her survival.) When a person meets the criteria for a grave disability, WIC Section 5150 applies. It states: "When any person, as a result of a mental disorder, is a danger to others, or to himself or herself, or gravely disabled, a peace officer, a member of the attending staff of an evaluation facility designated by the county, designated members of a mobile crisis team, or other professional person designated by a county, may upon probable cause, take, or cause to be taken, the person into custody and place him or her in a facility designated by the county and approved by the State Department of Mental Health as a facility for 72-hour treatment and evaluation."
Question 20: B
Rationale: A subpoena legally requires a psychologist to appear at a designated time at a deposition or trial. When the client invokes the privilege (does not give permission for the release of confidential information), the subpoena is still valid. A psychologist's options in this situation are addressed by S. H. Behnke and J. T. Hilliard in The Essentials of Massachusetts Mental Health Law (W. W. Norton, New York, 1998). They note that, when the client invokes the privilege, the psychologist should contact the client's attorney or his or her own attorney to discuss the matter. In addition, the psychologist can contact the attorney who issued the subpoena to request to be released from it. Unless the psychologist receives the requested release, he or she must appear as requested but should invoke the privilege on the client's behalf.