Chapter Questions
Chapter 4 Privilege
Privilege
Evidence Code 1010-1027
Exemptions to Privilege
Clinical Example # 1
Questions for Clinical Example # 1
Chapter Questions
Chapter 5 Important Legal Concepts in CADC/CATC Practice. 61
Scope of Practice 61
Scope of Practice for MFT, LCSWs, and Psychologists 62
Scope of Competence 62
CCBADC/CAADE Ethical Standards Related to Scope of Competence 63
Counseling Duty 65
Some Clinical Examples of Counseling Duty 65
Counseling Duty Regarding Assessing Appropriately 66
Counseling Duty Regarding Diagnosing Appropriately 67
Counseling Duty Regarding Treating Appropriately 67
Collaborating With Others 68
Standard of Care 69
Attending to Standard of Care in Clinical Practice 69
The Clinician’s Therapeutic Duty to Assess for Clinically Important Issues Throroughly and
Completely 69
Important Mental Health Case Law 70
Clinical Example # 1 75
Questions for Clinical Example # 1 76
Clinical Example # 2 76
Questions for Clinical Example # 2 76
Chapter Questions 76
Chapter 6 Business and Professions Code as it Applies to Alcoholism and Drug Abuse Counselors SECTIONS 4700. 79
Business and Professions Code 79
Chapter 7 Malpractice and Unprofessional Conduct 81
Malpractice 81
Unprofessional Conduct 82
The 21st Century: Being a Good Counselor Won’t Be Enough to Avoid Malpractice 82
Creating Therapeutic Safety: Learning the Hard Way 84
Mental Health Records and Lawsuits: A Direct Correlation 85
How Small Clinical Issues Become Malpractice Actions 87
A Malpractice Lawsuit Arising From a Child Abuse Report As Well As Not Making The Report 89
Clinical Example # 1 89
Questions for Clinical Example # 1 89
Clinical Example # 2 90
Questions for Clinical Example # 2 90
Chapter Questions 90
Chapter 8 The Counseling Relationship 81
The Counseling Relationship 91
CCBADC/CAADE Ethical Guidelines Related to the Counseling Relationship 92 Creating Safety and the Counseling Relationship 93
Using the Counseling Relationship Appropriately 94
Injuring the Counseling Relationship 94
The Power Differential of the Counseling Relationship 95
Clinical Example # 1 96
Questions for Clinical Example # 1 96
Clinical Example # 2 96
Questions for Clinical Example # 2 96
Chapter Questions 97
Chapter 9 Dual Relationships 99
Dual Relationships 99
Harmful Dual Relationships 99
Friendships With Clients 100
Sexuality and Clients 101
Sexual Harassment: A Work Place Hazard for CADCs 102
Harmful Dual Relationships and Testifying For Clients 102
Clinical Example # 1 104
Questions for Clinical Example # 1 104
Clinical Example # 2 105
Questions for Clinical Example # 2 105
Chapter Questions 105
Chapter 10 Managing Crisis Issues and Creating Counseling Safety 107
The Danger For Clinicians When Facing Crisis Issues 107
The Clinician’s Scope of Competence Regarding Crisis Issues 108
Reasonable and Prudent Steps Required To Manage Crisis Issues 109
Assessing The Client’s Competence 109
Initial Assessment of the Client 109
Consultation With Past and Present Treatment Providers 110
Observable Clinical Behavior 111
Psychosocial Stressors and Environmental Problems 112
Culturally Sensitive Assessments 112
Assessing For Risk Factors 114
Establishing An Appropriate 5-Axis Diagnosis 115
The Presenting Problem 115
The Emergency “Plan of Action” To Manage Crisis Issues 117
Applicable California Laws in Managing Crisis and High Risk Issues 118
Ethical Standards and Crisis Issues 119
Breaching Confidentiality in a Safe Manner 120
Hospitalization as a Clinical Intervention 121
Post-hospitalization Risk Factors 122
Suicide — Specific Laws and Codes: Managing This Issue 122
Serious Threat of Harm to An Identifiable Victim (Tarasoff Situation) — Specific Laws and Codes:
Managing this Issue 124
Spousal Abuse — Specific Laws and Codes: Managing This Issue 125
Child Abuse — Specific Laws and Codes: Managing This Issue 126
Elder/Dependent Abuse — Specific Laws and Codes: Managing This Issue 127
HIV Positive Clients — Specific Laws and Codes: Managing This Issue 128
Eating Disorders — Specific Laws and Codes: Managing This Issue 129
Substance Abuse/Dependence To The Degree Where the Client is a Danger to Self or Others —
Specific Laws and Codes: Managing This Issue 130
Documenting Intake Information 132
Documenting A Mental Status Form 132
Sample Mental Status Form 133
Documenting a Beck Depression Inventory 133
Documenting Consultations 134
Documenting Treatment Plans for Crisis Issues 135
Generic Issues Treatment Plan 135
Documenting a 5-Axis Diagnosis 136
Documenting the Legal Challenges 137
Legal/Ethical Documentation Examples 138
Clinical Example # 1 139
Questions for Clinical Example # 1 140
Chapter Questions 140
Chapter 11 The Suicidal Client and Standard of Care 141
The Suicidal Client 141
Legal, Ethical and Clinical Standard of Care for Treating Suicidal Clients 141
Reasonable and Prudent Steps to Manage Suicidality 142
Ethically-Permitted Breaches of Confidentiality Under Evidence Code 1024 144
Clinical Example # 1 144
Questions for Clinical Example # 1 145
Chapter Questions 145
Chapter 12 The Dangerous Client — Serious Threat to Harm 147
The Dangerous Client 147
The Dangerous Client and Laws Affecting CADCs/CATCs 147
Managing “Serious Threat to Harm” 149
Clinical Example # 1 150
Questions for Clinical Example # 1 150
Chapter Questions 150
Chapter 13 Child Abuse Reporting 151
Child Abuse 151
Managing Child Abuse Reporting 152
Reporting Child Abuse Involving Adults Abused as Children 152
Employees and Child Abuse Law 153
Child Abuse Reporting and Immunity 153
The Use of Anatomically Correct Dolls to Prove Child Abuse 154
Reporting Consensual Sex Between Minors 154
Reporting Consensual Sex Between Minors and Adults 154
The Confidentiality Bind in Child Abuse Reporting 155
The Child Abuse Laws—Penal Code 11164-11174.3 156
Child Abuse Report 176
Clinical Example # 1 179
Questions for Clinical Example # 1 179
Clinical Example # 2 179
Questions for Clinical Example # 2 179
Clinical Example # 3 180
Questions for Clinical Example # 3 180
Chapter Questions 180
Chapter 14 Elder and Dependent Abuse Reporting 181
Management of Elder and Dependent Abuse 181
Elder and Dependent Abuse Reporting and Immunity 182
Recent Changes to the Elder/Dependent Abuse Laws 182
The Elder and Dependent Abuse Laws
Welfare and Institutions Code Section 15600-15755 183
Elder/Dependent Abuse Report 206
Clinical Example # 1 209
Questions for Clinical Example # 1 209
Clinical Example # 2 209
Questions for Clinical Example # 2 209
Chapter Questions 210
Chapter 15 Treatment Records 211
Treatment Records 211
Patient Records: Ethical Standards 212
Health and Safety Code 123130 — Foundation for Content of Treatment Records 212
Patient Access to His/Her Mental Health Records 213
Appropriate Content of Mental Health Records 213
Intake Form 214
Informed Consent Form 214
Additional Informed Consent 214
Ledger Form 215
Psychometric Testing 215
Written Releases of Information 215 Five-Axis Diagnosis, Treatment Plan and Prognosis 215
Consultations and Medical Information 216
Progress Notes 217
Discharge Summary 218
Clinical Charting for Hospital Consultations 218
Sample Clinical Forms 220
Sample Intake Form 221
Sample Informed Consent Form 222
Sample Ledger Form 226
Sample Mental Status Exam Form 227
Sample Release of Information Form 228
Sample Diagnosis, Treatment Plan, and Prognosis Form 229
Sample Consultation Form 230
Sample Progress Form 231
Sample Discharge Summary 232
Chapter Questions 233
Chapter 16 Subpoenas 235
Subpoenas 235
Managing Subpoenas 235
Sample Document 1: Actual Subpoena 237
Sample Document 2: Notice to Consumer 238
Sample Document 3: Proof of Service 239
Sample Document 4: Declaration of Records Released 240
Chapter Questions 241
Chapter 17 Supervision 243
Supervision Issues 243
Scope of Competence 243
Dual Relationships With Supervisees 251
Supervisees as Employees 251
The Supervisee’s Dual Relationship With a Client Cam Impact the Clinical Supervisor 252
Clinical Example # 1 252
Questions for Clinical Example # 1 253
Clinical Example # 2 253
Questions for Clinical Example # 2 253
Chapter Questions 253
Chapter 18 Advertising 255
Advertising 255
Ethical Standards Regarding Advertising 255
Advertising by Supervisees 257
Clinical Example # 1 257
Questions for Clinical Example # 1 257
Chapter Questions 257
Chapter 19 Fees 259
Fees 259
Bartering 261
Disclosure of Fees 261
Collecting Unpaid Balances 261
Maintaining Clinical Objectivity With Third Party Payers 262
Serious Challenges Faced By Clinicians When Third Parties Pay For Services 263
Clinical Example # 1 264
Questions for Clinical Example # 1 264
Clinical Example # 2 263
Questions for Clinical Example # 2 263
Clinical Example # 3 263
Questions for Clinical Example # 3 263
Chapter Questions 263
Chapter 20 Insurance and Managed Care 267
Insurance and Confidentiality 267
Insurance Fraud 267
Appealing Adverse Utilization Review Decisions in Managed Care 268
Confidentiality and the Internet 268
Reasonable and Prudent Actions To Take Before Clients Run Out of Insurance Benefits 269
Clinical Example # 1 271
Questions to Clinical Example # 1 271
Chapter Questions 271
Chapter 21 Forensics, Telephone and Online Counseling 273
Expert Witness 273
Telephone and Online Counseling 273 Witness of Fact Versus Expert Witness 274
Clinical Example # 1 275
Questions to Clinical Example # 1 275
Chapter Questions 275
Chapter 22 Cultural Diversity 277
Counseling Duty and Cultural Diversity Example — The Mexican-American Client 277
Clinical Example # 1 279
Questions to Clinical Example # 1 279
Clinical Example # 2 279
Questions to Clinical Example # 2 279
Chapter Questions 280
Chapter 23 Treatment of Minors 281
Treatment of Minors With Parental Consent 281
Treatment of Minors Without Parental Consent 281
Treatment of Emancipated Minors 282
Treatment of Minors in Divorce Situations 282
Drug and Alcohol Counseling Treatment for Minors 282
Complete Text of the Family Law 283
Clinical Example # 1 283
Questions to Clinical Example # 1 283
Clinical Example # 2 283
Questions to Clinical Example # 2 284
Chapter Questions 284
Chapter 24 A Structure to Process Legal and Ethical Decision 285
The Clinical Structure 285
Practice Vignette 286
Legal Clinical Vignettes 287
Ethical Clinical Vignettes 291
Chapter 25 Accessing California Law Through the Internet 293
Appendix Answer Key 295
Answers to Chapter Questions 295
Answers to Clinical Vignettes 305
Answers to Ethical Vignettes 312
References 315
Index 319