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MFT Law and Ethics Expanded* (Real Life Scenarios) – Q&A
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MFT Law and Ethics Expanded* (Real Life Scenarios) – Q&A
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MFT Law and Ethics Expanded* (Real Life Scenarios) –Q&A
A therapist meets with a 25-year-old woman who lives at home with her
parents. The client reports feeling extremely depressed, has a history of
self-harm, and after a suicide assessment, the therapist determines she is
at a high risk of serious self-harm. The client reports she does not have
insurance and cannot afford to be hospitalized. How should the therapist
address the ethical and legal issues in this case?
A. Notify client's parents and refer client for a low fee psychiatric
evaluation.
B. Initiate a 5150 because the client may need to be hospitalized.
C. Explore low fee resources to meet client's financial needs.
D. Notify client's parents of her plans and safety plan with client.
✔️Ans -B. Initiate a 5150 because the client may need to be hospitalized.
Rationale: The therapist "determines this is at a high risk for serious self-
harm", this would be the time to initiate a 5150. They may determine she
does not need to be hospitalized, but the therapist would have covered the
standard of care.
A 13-year old boy discloses a history of sexual abuse. He informs the
therapist that his former therapist touched him during several sessions to
demonstrate what is appropriate versus sexually inappropriate touch.
What actions should the therapist take to address the legal issues in this
case?
Response:
A. Maintain confidentiality and provide BBS brochure.
B. Call police and inform his parents.
C. Report to CPS and process it with client.
D. Report misconduct of therapist to BBS and document in file.
✔️Ans -C. Report to CPS and process it with client.
Rationale: The best answer is C. The information shared by the boy points
to sexual abuse, which requires the therapist to make a child abuse report,
answer C. Answer A and D are incorrect because they do not address the
legal mandate to report abuse. While the therapist can contact the police to
make the report, the child is over 12, so processing with client is better
than answer B, informing parents.
,A therapist working in a community agency receives a referral for a child
with severe PTSD from sexual abuse. The therapist has no training or
experience treating children with PTSD from sexual abuse. The therapist
should:
Response:
A. Attend a training on PTSD in children.
B. Conduct an initial assessment and make treatment recommendations.
Should have chosen
C. Refer the child to appropriate services.
D. Treat the child after getting consultation. ✔️Ans -Rationale: C
is the best answer for this particular client because it is outside of the
scope of competence of the therapist. Neither attending a training nor
seeking consultation would be adequate for this type of case, so A and D
are out. B is wrong because the therapist would need training in how to
assess and what to recommend.
After referring a client to an acupuncturist for treatment the acupuncturist
calls the therapist and invites him to lunch to discuss how they can work
together. He tells the therapist that he is willing to pay for referrals. How
should the therapist manage the legal and ethical issues in this situation?
Response:
A. Discuss how much he wants to be paid per client.
B. Decline the lunch invitation because of client's confidentiality.
C. Inform him that he cannot accept payment for referrals.
D. Discuss how the therapist can pay acupuncturist for referrals as well.
✔️Ans -C. Inform him that he cannot accept payment for referrals.
Rationale: C is the best answer because it is illegal to take kick-backs for
referrals. A and D are engaging in unethical and illegal behavior. B is not the
addressing the issue of payment for referrals.
A younger therapist has been treating a 60-year-old Navajo woman for 3
months and has a particularly ground-breaking session. At the next session,
she arrives with a gift, a beautiful handmade blanket. After the therapist
explains that it would be unethical to accept the gift, the woman appears
insulted and quietly mumbles that she wishes to end the session and
discontinue therapy. Ethically, the therapist should have:
A. Accepted the gift, but leave it in the office to use.
B. Accepted the gift and discussed its significance.
,C. Consulted with a supervisor regarding the appropriateness of accepting
the gift.
D. Declined the gift, which was the most appropriate course.
✔️Ans -B. Accepted the gift and discussed its significance.
Rationale: It is not unethical to accept gifts. In this case, B is the better way
to respond to handmade gift.
During the sixth session with a 64-year-old man he breaks down in tears
while discussing his relationship with his estranged 40-year-old son. He
confesses that when his son was younger the client was physically abusive
to his son on a number of occasions, especially when the client had been
drinking. He says that besides his wife, he's never told this to anyone
before. How should the therapist manage the legal obligations in this case?
Response:
A. Explore client's feelings about disclosure and document the session in
his record.
B. Inform the client that child abuse is a mandated report and file a report.
Wrong
C. Review the limits of confidentiality and determine whether the client is
currently abusing any minors.
Should have chosen
D. Maintain confidentiality of the reported abuse and document session in
his record. ✔️Ans -Answer: D.
Rationale: You would not report child abuse if the victim is no longer a
minor. There is no indication that the client is currently abusing any
children. This leaves you with A and D. D is better because it addresses the
legal obligations, where "explore client's feelings" would be a clinical, not
legally required, response.
A therapist has been treating a 42 year-old, single man for five months. The
client is a successful partner at a prestigious law firm. For the past month,
the client has noticed improvements in his mood and his relationships with
others. Around the holidays the client leaves the therapist a bottle of wine
outside the office as an expression of his gratitude. What action should the
therapist take to address the ethical issues in the case?
Response:
A. Accept the gift graciously during the next session.
B. Explain to the client that the therapist is not allowed to accept gifts.
, C. Assist the client in finding someone else in his life he could give the wine
to as an expression of gratitude.
D. Determine the estimated value of the wine. ✔️Ans -Answer:
D
Rationale: D is practicing the standard of care when considering accepting
a gift. Consideration of monetary value of the gift is stated in the ethical
guidelines and the value of wine can vary greatly.
A therapist at a mental health clinic meets with a single mother who
recently moved back in with her mom and step-dad after losing her job. She
reports that her stepdad has been threatening to kick her out of the house
if she does not contribute more to the household needs. The client says that
she is afraid to be around him. What should the therapist do FIRST?
Response:
A. Discuss alternate housing possibilities to empower the client.
B. Encourage the client to call the police.
C. Ask the client why she is afraid.
D. Develop a safety plan and monitor the client's safety. ✔️Ans -
Answer: C.
Rationale: The answer is C because it allows the therapist to assess
potential safety concerns for the client and/or her children. There is not
enough evidence to warrant a call to police or developing of a safety plan at
this time thus B and D are out.
A therapist attends a group consultation. Another therapist begins
presenting a case and based on the information the therapist realizes that
she is friends with the client. How should the therapist deal with the
realization?
A. Disclose to the group that she is friends with client.
B. Keep all information about the client confidential.
C. Excuse herself from the discussion of the client.
D. Not disclose that she knows the client but refrain from participating in
the discussion. ✔️Ans -Rationale: C is the only answer that
doesn't violate or risk violation of confidentiality.
A long-term client comes to therapy and reports that he has been evicted
and is in need of housing immediately. The therapist's brother owns an
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