What is the primary responsibility of a supervisor to a supervise?
To serve as a guide and role model appropriate conduct when performing therapy. This includes respecting the relationship between supervisor/supervisee which resembles the therapeutic relationship.
An intern friend shares with you the unethical behavior of his or her supervisor. What wold you counsel him or her to do?
Call CAMFT and ask to speak with staff attorney
What are the duties of a supervisee to a supervisor?
Follow the guidelines estabished by the supervisor. Know the laws and ethics of MFT practicee. Follow Standard of Care. Consult with teh supervisor continuously.
What makes bartering a dangerous issue for therapists?
It can lead to creating a harmful dual relationship. There can be loss of objectivity in pricing below the market value the items exchanaged
Under what conditions can a therapist threat a minor without parental consent?
When they are 12 years or older and are capable of benefitting from therapy, and without treatiment they would be a danger of self or others, or when they have been alleged victim of a crime or incest.
A 16 year old calls a therapist because he wants to quit smoking cigarettes. What does the law say about MFTs treating minors for this issue.
Must obtain parental consent
What makes the age 12 years so important in distinguishing the need for parental consent?
Age 12 appears to be the age of reason in California Law
What are the requirements for marriage in California?
Both parties must be 18 years of age and capable of consenting to and consummating a marriage. If underage, parental consent or court consent must be granted for the underage person.
What elements are required for consent for marriage?
As part of consent, the court requires, for minors, that both parties participate in premarital counseling
What is required to dissolve a marriage?
The willingess to procens with a divorce, irreconcilable differences, insanity, and six month waiting period.
What are the requirements for two underage persons to marry?
Both parties must have parental consent or consent of the court
Who is legally able to carry out a marriage ceremony?
Anyone who is recongized by the state
What is required to obain a confidential marriage license?
Both parties much have lived together for over one year.
Community Property
Property beloning to both parties of the marriage.
Tenants in Common
Both parties have equal ownership with or without marriage,
Joint Tenants
Both parties share ownership without it being equal.
What is separate property in a marriage?
Brought into the marriage before the marriage took place.
What areas of marriage can the court examine when dissolution of marriage takes place?
The status of the marriage; custody of minor children of the marriage, support for the children for whom support may be ordered, including children born after the filing of the initial petition or final decree of dissolution; spport of either party, the s
What are the elements for claiming dissoultion of marriage?
Insanity and Irreconciable Differences
What is the definition of a court appointed guardian?
An individual with court appointed authority to manage the affairs of the marriage
What is a summary dissolution of marriage and what are the conditions for granding it?
A dissolution is granted without a protraced legal process. It takes place when one of the parties does not contest the divorce.
How can a minor become emancipated?
The minor must have the ability to understand what treatment is about.
In CAMFT Ethical Standards 1, what does "advancing the welfare of individuals and families" mean?
...The therapist will do no harm to clients
In CAMFT Ethical Standards 1, what does "make reasonable efforts to ensure that their services aer used apporpriately" mean?
...The therapist will ensure that scope of practice, scope of competence, and therapeutic duty will be applied
In Ethical Standards 1.2, the term "influential position" appears. What is its signifiance in therapy?
...A power differential which exists, by default, in a therapeutic relationship.
What is the difference between a dual relationshp and harmful dual relationships?
...Dual relationship involves two separate relationships with a client, therapist, and another relationship. A harmful dual relationship involves the loss of objectivity or coercion by the part of the therapist.
What makes having sex with a client an egregoius violation?
...This type of violation is the most severe violation that can take place in a therapeutic relationship, besides the possibility of murder.
CAMFT Ethical Standards 1.3 prohibits providing therapy to persons with whom the therapist has had a sexual relationship. How will this affect the therapists objectivity?
A sexual relationship usually involves an emotional attachment between the parties involved. To provide appropriate therapy, objectivity must be clear. A sexual relationship most likely creates a loss of objectivity in the therapist
How are standards of competence in treating different psychotherapeutic issues established?
Scope of Competence is established by experts in the field who publish their expertise in the scientific literature.
What is the responsibility to the profession?
MFT respect the rights and responsibilities of professional colleagues and participate in activities that advance the goals of the profession.
What is accountable to the standards of the profession?
MFT remain accountable to the standards of the profession when acting as members or employees of organizations. Confidentiality of clients and clients issues are respected, harmful dual relationships are avoided, credentials are not misrepresented, state
Internal Reality
A compilation of life experiences, beliefs systems, morality, religious and social values, biases, prejudices, fears, myths, and socioeconomic values. It is everything that make up how you feel and think about your world and how you relate to it.
Blind Spots
Areas in our lives where we lack objectivity for whatever reason.
Therapeutic Safety
Creating a therapeutic environment in which the client and the therapist can generate trust in the process and in each other.
How can you create therapeutic safety?
By knowing and applying the laws and ethics of MFT practice, by obtaining appropriate consultation with a knowledgeable peer, establishing a healthy therapeutic relationship with the client.
Informed Consent
Providing clients with necessary information about the psychotherapeutic process to make an informed decision.
What purpose does obtaining an informed consent to treat serve?
Providing clients with informed consent creates a balance in the power differential inherent to psychotherapy.
Components of Informed Consent
The competency of the client, the disclosure of material information, the clients understanding of the presented material, the voluntary consent of the client.
Advantages and Disadvantages of Using Informed Consent
Creates safety by addressing expectations both therapist and clients may have of each other. In some situations, clients can feel overwhelmed by the information provided.
What are the unique confidentiality problems encountered by MFTS when treating more than one person as part of the treatment unit?
When a MFT treats more than one person as part of the treatment unit, each persons unique confidentiality needs must be taken into consideration. The therapist must provide his or her clients with possible ways of managing the confidentiality needs.
What are the required elements of a legal written release of information document?
Handwritten by the person who signs it or is in a typeface no smaller than 14pt. type, clearly separate from any other language present on the same page and is executed by a signature , signed and dated by patient, legal rep, spouse, beneficiary, states t
What are the dangers of using electronic devises in a psychotherapy practice?
Electronic devices are not conducive to maintaining confidentiality.
What are the differences between privilege and confidentiality?
Privileged deals with the legal system, confidentiality deals with the clinical environment.
What are the similarities between privilege and confidentiality?
Privilege and confidentiality both manage the information given to the therapist in treatment.
When can privilege be violated?
When mandated by law
Who is the holder of privilege?
The client, guardian, executor if dead
How does a licensed therapist assert privilege for the client?
When the therapist receives a subpoena for records and refuses to hand these to the requesting person at the time the subpoena is received.
How does the scope of practice define what kind of issues and clients you will treat?
Scope of practice for MFTs is defined as enhancing relationships.
Example of Intrapersonal Issue in Psychotherapy
Becoming a better reader by learning to overcome an emotional trauma
Example of Interpersonal Issue in Psychotherapy
Addressing depression because it interfered with relationships/
How does a therapist develop scope of competence in new areas?
By taking courses, consulting with more experienced peers, reading books on the subject, and taking clients under an experienced supervisor.
How does therapeutic duty differ from informed consent?
Informed consent is providing information at the beginning of therapy which allows the client to be informed about the process of therapy.
Upon what concept is therapeutic duty is based on?
Contract Law
How can a therapist use the concept of therapeutic duty to create therapeutic safety and protect him or herself?
Therapeutic safety requires objectivity by the therapist, it is created by law and ethics, as these two concepts intertwine, the therapist become moor knowledgeable of law and ethics and allows him/herself to become more objective through his or her own t
Standard of Care
The best care a therapist can give a client and is based on what experts have defined care to be in the field of psychotherapy. It creates a model of what is expected of each other and every therapist to provide his or her clients.
Scientific Standard of Care
Research Findings as they apply to therapy
Clinical Standard of Care
Clinical interventions, theories of psychotherapy, and other clinical elements that apply to therapy.
Legal and Ethical Standards of Care
Laws and Ethics as they apply to psychotherapy
How does standard of care affect therapy?
Enhance it, diminish it, or terminate it, depending on how the client perceives her or she is receiving mental health care from the therapist/
How does case law affect the practice of psychotherapy?
Creates a therapeutic duty on the therapist to apply appropriate legal standards.
How can you stay abreast of case laws as they develop?
Read the official publication of CAMFT to stay abreast of case law in California
What makes an auto accident a challenging situation for clinicians regarding keeping mental health records?
When clients claim emotional injuries in a legal case mental health records can be subpoenaed by the opposing attorney.
What is the scope of practice for MFT
The focus of practice is on enhancing relationships
How the state differentiates MFT from other counselors?
MFT receives remuneration for services
What does BPC expect MFT to provide their clients?
Informed consent
What does BPC define as unprofessional conduct that would require administrative action against the MFT?
Any activity that violates the regulations of marriage and family therapy.
What does BPC state about maintaining confidentiality?
Must be maintained except as permitted or mandated by law.
What does BPC state about disclosing fees?
Fees must be disclosed at the beginning of therapy.
What does BPC state regarding having sexual contact with a client and the impact on the MFTs license?
Sexual contact with any client is prohibited and the therapist can loose the license if he or she engages in such conduct.
A greater professional responsibility?
MFTs will be expected to know the laws and ethics of this profession thoroughly
What is the difference of creating therapeutic safety versus protecting oneself?
Creating safety invites the client to participate and creates partnership. Protecting oneself does not take into consideration the needs of the client and only considers the welfare of the therapist.
What is the importance of the therapeutic relationship in therapy?
It is the vehicle by which all change takes place in therapy.
BBS investigation
An administrative action against the license of the therapist.
Mal practice
a civil legal action against the therapist
What is the current legal position regarding therapist having sex with a client during the therapeutic process?
It is illegal. A therapist can be sued through civil court and criminal court. He or she can loose his or her license.
A therapist who has had sex with a client during the therapeutic process can be prosecuted through civil and criminal courts. What does this mean?
Civil courts means that a mal practice action has taken place and monetary damages can be assessed against the therapist. Criminally the therapist can go to jail an be fines.
Therapists in California have been educated about the dangers of having sex with their clients, yet, some still do. What is the reason behind this?
Some therapists take advantage of the therapeutic relationship and the power differential that takes place in therapy. These therapist use sexual relationship to take advantage of the clients weaknesses.
What aspect of the law do crisis issues have in common?
A breach of confidentiality is mandated or permitted by law.
How do the law and CAMFT ethics interplay with crisis issues?
Sometimes they parallel each other and sometimes they complement each other.
What are the legal duties when managing a suicidal client?
At all time take reasonable steps to protect the life of the client.
How would a reasonable and prudent therapist manage suicidal clients?
Establish a firm therapeutic relationship, follow a sound theoretical approach that works well with suicidal clients, use clinical interventions that are part of the standard of care.
What steps would you take to protect the life of your client per Evidence Code 1024 should he or she be in imminent danger of committing suicide?
Assess the clients mental or emotional state via a mental status exam, determine if the client presents a danger to self or others, if so breach confidentiality only if absolutely needed. Document this decision thoroughly.
When facing a "serious threat to harm" what steps would you take to create safety for yourself and your client.
Assess the client carefully and thoroughly refer as necessary, consult with more experiences peers, document my decisions, breach confidentiality as mandated by law.
What is the difference between Tarasoff and civil code?
Tarasoff is a legally mandated breach of confidentiality when an identifiable victim has been threatened by a client and the therapist hears the serious threat to harm. It places a duty to protect this identifiable victim upon the therapist. Civil code es
What does reasonable suspicion of child about mean?
The context of the statement made to the therapist is evaluated carefully to determine whether it is a reasonable statement.
What are the legal requirement for reporting a reasonable suspicion of child abuse?
Immediately by phone and within 36 hours by written report to Child Welfare Services.
When two or more mandated reporters are involved in a case how is primarily responsible for reporting?
Both of them equally