Question 1: D
Rationale: Laws in California related to privilege and confidentiality do not allow you to reveal information about this crime to anyone without the client’s consent. In other words, for most crimes, there is no obligation to report a crime that a client has committed in the past; important exceptions include child, elder, or dependent adult abuse for which specific and separate reporting mandates exist.
Question 2: D
Rationale: Increasing the amount billed to the insurance company to compensate for the lack of copayment from the client is fraudulent and, therefore, illegal and unethical.
Question 3: B
Rationale: Many experts recommend that you adopt a “you first” policy that allows the client to decide if he will acknowledge you outside the service setting. In the situation described in the question, applying this policy is wise since you and the client have yet to discuss what you’ll do if you happen to see each other in a setting outside of your office. Taking the initiative to acknowledge the client first (answers A and C) could reveal to others in the waiting room (including his son) this man’s status as one of your clients, which would violate both his right to confidentiality and his need for self-determination. Refusing to converse with the client (answer D) is not appropriate since he’s likely to misunderstand this behavior and end up feeling rejected, embarrassed, or offended.
Question 4: B
Rationale: A LCSW's license expires no more than two years (24 months) after the date it was issued.
Question 5: D
Rationale: This is a straightforward question that simply requires you to be familiar with the provisions of Evidence Code Section 1013, which defines the "holder of the privilege" as (a) the patient when he has no guardian or conservator, (b) the patient's guardian or conservator, or (c) the personal representative of a patient who is deceased.
Question 6: A
Rationale: Bobby's injuries suggest that he is being physically abused by the other student, and a mandated reporter must make a report of child abuse when, in his or her professional capacity, he or she knows or reasonably suspects that a child has been the victim of abuse.
Question 7: A
Rationale: As defined in EC Section 1013, the "holder of the privilege" is: "(a) The patient when he or she has no guardian or conservator. (b) A guardian or conservator of the patient when the patient has a guardian or conservator. (c) The personal representative of the patient if the patient is dead." In other words, the patient is ordinarily the holder of the privilege unless the patient has a guardian or conservator, in which case the holder of the privilege is the guardian or conservator. Answer C: Case law has confirmed that minors are the holder of the privilege in California, even though they may rely on adults to claim or waive the privilege on their behalf.
Question 8: B
Rationale: Ethical Standard 1.04 states that social workers should provide services only within the bounds of their education, training, license or certification, consultation received, supervised experience, or other relevant professional experience. In this situation, seeking consultation is probably the best course of action since Sasha does have experience and training with behavioral techniques.
Question 9: C
Rationale: Legal requirements for reporting child abuse and neglect are provided in California’s Child Abuse and Neglect Reporting Act (CANRA; PC Sections 11164-11174.3). One form of abuse that mandated reporters must report is “unlawful corporal punishment or injury,” which occurs when “any person willfully inflicts upon any child any cruel or inhuman corporal punishment or injury resulting in a traumatic condition.” This category of abuse does not include “reasonable and age-appropriate spanking to the buttocks where there is no evidence of serious physical injury” (WIC 300).
Question 10: D
Rationale: Before providing information about a client (including the fact that he or she is a client), an LCSW would have to be provided with a search warrant, court order, or signed release from the client. An arrest warrant would not entitle the police to any information about the client.
Question 11: B
Rationale: This issue is addressed in Section 123130 of the California Health and Safety Code. It states that a "health care provider may prepare a summary of the record ... for inspection and copying by a patient. If the health care provider chooses to prepare a summary of the record rather than allowing access to the entire record, he or she shall make the summary of the record available to the patient within 10 working days from the date of the patient's request. However, if more time is needed because the record is of extraordinary length or because the patient was discharged from a licensed health facility within the last 10 days, the health care provider shall notify the patient of this fact and the date that the summary will be completed, but in no case shall more than 30 days elapse between the request by the patient and the delivery of the summary." Note that while California law allows health care providers to provide summaries to clients rather than complete records, HIPAA allows this only when the client agrees to this alternative.
Question 12: D
Rationale: Note that this question is asking about the penalty for failing to report child abuse or neglect when that failure results in death or significant bodily harm. This penalty is described in Penal Code Section 11166.01(b), which states that “any mandated reporter who willfully fails to report abuse or neglect ... where that abuse or neglect results in death or great bodily injury, shall be punished by not more than one year in a county jail, by a fine of not more than five thousand dollars ($5,000), or by both that fine and imprisonment.”
Question 13: 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." Notice that Section 124260 applies to a "professional person": This person may be a licensed clinical social worker, a clinical psychologist, a marriage and family therapist, or 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 14: B
Rationale: You should consult with a supervisor or colleague so that you can evaluate with someone objective whether your thoughts about this client (and likely feelings of sexual attraction) may impair your objectivity or otherwise diminish the effectiveness of your work with him or her.
Question 15: A
Rationale: Although referral (answer D) might be acceptable, it is not necessary as a first course of action in this case given the circumstances. Instead, consultation would be a better action since it would help you determine if your evaluation of the situation is correct. If it turns out that you are correct in thinking that the client isn't benefiting from treatment, then you would terminate therapy and make a referral to another therapist. Ethical guidelines indicate you should terminate your services to a client and your professional relationship with him when your services and the relationship are no longer needed or no longer serve the client's needs or interests.
Question 16: D
Rationale: The Code of Ethics addresses a comparable issue in Standard 3.06 (Client Transfer). It says that if a potential client who is receiving services from another agency or colleague contacts you for services, you should carefully consider the client's needs before agreeing to provide your services. To minimize possible conflict and confusion, you should discuss with the potential client the nature of her current relationship with the other service provider, and the implications, including possible risks or benefits, of entering into a professional relationship with you. In the situation presented here, you'd want to contact the other therapist and discuss whether there is any conflict associated with Kelly seeing both of you. One issue that must be addressed is whether there is a duplication of services. If you and the other therapist are helping Kelly with different problems in therapy, then it is probably acceptable for you to continue working with Kelly while she also sees this other therapist (e.g., perhaps you are working with Kelly on her depression, and she is seeing the other therapist for couples counseling). If this happens, then you'd also need to get Kelly's permission to consult and collaborate with the other therapist so that you can coordinate treatment plans and clearly define your goals and contributions to treatment.
Question 17: D
Rationale: The Code of Ethics requires you to discuss the termination of your services with a client when it is clear that the client is not benefiting from your services. When termination is necessary before the treatment process is completed, as in this situation, you should make appropriate referrals to other helping sources. Test-taking tip: You want to make sure that you've read all of the choices before answering, since, for this item, answer B is appropriate, but answer D is better.
Question 18: D
Rationale: In California, a mandated reporter must make a report of child abuse whenever the reporter "in his or her professional capacity or within the scope of his or her employment, has knowledge of or observes a child whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect." The client is no longer a minor, so you are not required to report his exposure to abuse. However, you have reasonable suspicion that his nephew, who is a minor, is being abused and, therefore, are required to make a report.
Question 19: A
Rationale: EC Section 1027 provides an exception to the psychotherapist-patient privilege when a client under the age of 16 has been the victim of a crime (e.g., stalking) and is also routinely used to justify a breach of confidentiality outside a legal proceeding when it's in the patient's best interests to do so. Answers B and C are not correct because the behavior of the gang members doesn't qualify as child abuse. Maintaining confidentiality (answer D) doesn't seem acceptable since the behavior of the gang members is sufficiently threatening to warrant adult intervention.
Question 20: C
Rationale: This answer is most consistent with Standard 1.13 of the Code of Ethics, which is the standard that addresses payment for services. It states that social workers should ordinarily avoid accepting goods or services from a client as payment for professional services because such bartering arrangements may result in conflicts of interest, exploitation, and inappropriate boundaries in their relationship with a client. The Code of Ethics also states that, in limited circumstances, social workers can explore and may engage in bartering with a client - they may do so when they can demonstrate that the bartering arrangement is an accepted practice among professionals in their community, is viewed as essential for the provision of services, has been negotiated without coercion, and has been entered into at the request of the client and with the client's informed consent. Thus, barter is not completely prohibited by the Code of Ethics; before accepting a bartering arrangement, however, an LCSW should explore alternatives with the client (e.g., offering the client services at low or no cost) as well as the potential consequences of barter. In Jack's case, the exchange of yard work for therapy may be unacceptable because of the potential negative effects on the therapeutic relationship if he doesn't perform the work satisfactorily.