CPLEE Practice Exam 1

The correct answer is B.

"Foster parents do not generally have the right to make health care decisions for their foster children, with the exception of ordinary medical and dental treatment." Benitez, Guidelines for the treatment of minors, The California Therapist, September/October, 2000, 15-17.

Answer A: A minor who is a natural parent has the authority to consent to mental health treatment for his or her minor child.

Answer C: Parents who have legally adopted a child have the same authority to consent to mental health treatment as do biological parents.

Answer D: In situations where children are in the care of another family member and their parents are not accessible, affidavits can be drafted to allow other caregivers to consent on behalf of children and avoiding denying services to children whose parents are not accessible.

The correct answer is C.

Per California Board of Psychology Laws and Regulations Section 11166.05, "a mandated reporter shall make a report to an agency specified whenever the mandated reporter, in the mandated reporters professional capacity has knowledge of or reasonably suspects that a child has been the victim of child abuse or neglect; the mandated reporter shall make an initial report by telephone to the agency immediately or as soon as is practically possible, and shall prepare and send, fax, or electronically transmit a written follow up report within 36 hours of receiving information concerning the incident." Given that the psychologist has reasonable suspicion that the child has been the victim of abuse, they should contact child protective services and make a report.

Answers A & B: While the psychologist may wish to send the child appropriate referrals (including the information for child protective services), they should address the clinical emergency. Specifically, the psychologist has been made aware of potential child abuse in a professional capacity (i.e., the child emailed their therapy office for help) and thus they should make a report to child protective services.

Answer D: The psychologist may wish to start treatment with this child; however, this answer does not address the most pressing clinical issue, which is reporting a reasonable suspicion of child abuse.

The correct answer is B.

Educational is not one of the categories approved by the board for Continuing Professional Development (CPD).

Answers A, C, & D: The four categories stated by the BOP for CPD are professional activity, academic, sponsored continuing education, and board certification.

The correct answer is D.

The relevant issues are that both clients hold the privilege in this situation, and that waiver of the privilege by one of the clients does not affect the right of the other client to claim the privilege, even when it relates to the same confidential information. When a psychologist treats a couple and is called to testify, they must secure consent to disclose from both clients.

Answers A, B, and C: The psychologist must obtain consent from both the husband and wife to testify.

The correct answer is D.

HIPAA requires health providers to provide patients with copies of their records (PHI) when the provider receives a written request for the records and there is no lawful reason for withholding the records and the 15-day requirement for providing the records is established by Health and Safety Code Section 123110(b). Note, that HIPAA's requirements with regard to the release of a copy (rather than a summary) of records take precedence over state law (H&SC 123110) since HIPAA is more stringent in terms of providing patients with access to their records. Note that the requirement to provide a copy of the records (versus a summary) does not apply to psychotherapy notes since HIPAA does not require a release of psychotherapy notes to patients. Therefore, H&SC 123110 applies to psychotherapy notes, and it permits providing a copy or a summary of the records.

Answer A: This response provides an incorrect length of time.

Answer B: This suggests a summary can be sent instead when a copy of the records is most appropriate.

Answer C: This response provides an incorrect length of time.

The correct answer is D.

According to Section 11166.01 (b) of the code, "any mandated reporter who willfully fails to report abuse or neglect, or any person who impedes or inhibits a report of abuse or neglect, in violation of this article, 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, or by both that fine and imprisonment."

Answer A: This provides incorrect information.

Answer B: This is the punishment for failing to make a required report of child abuse. However, in the example above, as a result of failing to make a child abuse report the client has suffered great bodily injury. The penalty in this situation is higher than just failing to report child abuse.

Answer C: This is similar to the correct answer. However, the duration of jail time makes it an incorrect answer. Up to one year in county jail is the correct duration.

The correct answer is C.

While it should become an area of clinical focus to address the violence in the client's safety, there is no legal mandate to disclose violence between adults in romantic relationships. The psychologist is ethically obligated to maintain the information about the violence confidential.

Answer A: A referral would not address the question of reporting and it may be inappropriate to treat them as a couple.

Answer B: This would violate the client's confidentiality.

Answer D: Adult Protective Services refers to the protections surrounding elder or dependent adults, which is not indicated in this example.

The correct answer is D.

This issue is covered by California Penal Code 11172(a), which states that: "No mandated reporter shall be civilly or criminally liable for any report required or authorized by this article. Any other person reporting a known or suspected instance of child abuse or neglect shall not incur civil or criminal liability as a result of any report authorized by this article unless it can be proven that a false report was made and the person knew that the report was false or was made with reckless disregard of the truth or falsity of the report, and any person who makes a report of child abuse or neglect known to be false or with reckless disregard of the truth or falsity of the report is liable for any damages caused."

Answers A, B, and C: The psychologist cannot be held liable for civil or criminal penalties when acting in good faith to report a reasonable suspicion of child abuse.

The correct answer is B.

The Board of Psychology states several items that mandate a standard of care regarding telehealth, one of which is the practitioner should have a valid and active license in California but not that they must reside in California.

Answers A, C, and D: The standard of care for telehealth includes a practitioner to be licensed in California, clarity on fees for services (how to charge and when), ensuring confidentiality of all communications between client and therapist, covering the risks and benefits of obtaining services over the internet so the client can make an informed decision, and obtaining verbal or written informed consent from the client or their legal representative prior to starting services.

The correct answer is C.

Legal requirements for detaining an individual beyond the initial 72-hour hold are described in Sections 5250 to 5259.3 of the Welfare and Institutions Code. Section 5250 states that, after a 72-hour hold, an individual may be held for an additional 14 days if it is determined that they are still a danger to self or others or is gravely disabled. However, Section 5254 also requires that the individual be notified that they "are entitled to a certification review hearing, to be held within four days of the date on which the person is certified for a period of intensive treatment."

Answer A, B, and D: These do not meet the time requirement for a certification hearing.

The correct answer is A.

The Ethics Code Standard 3.10 states, "When psychological services are court ordered or otherwise mandated, psychologists inform the individual of the nature of the anticipated services, including whether the services are court ordered or mandated and any limits of confidentiality, before proceeding."

Answer B: Patient consent is not waived simply because treatment is court-ordered. The patient still needs to be informed about treatment.

Answer C: While the psychologist does need to discuss limits of confidentiality, this response fails to mention that the psychologist still requires consent to treat.

Answer D: The patient must consent to treatment, although it can be verbal or written.

The correct answer is D.

Business and Professions Code Section 2960 identifies a number of activities that constitute unprofessional conduct and may result in disciplinary action by the Board of Psychology. Answer D best reflects the actual language of Section 2960(p), which states that unprofessional conduct by a psychologist includes "functioning outside of his or her field or fields of competence as established by his or her education, training, and experience."

Answer A: Psychologists' peers are not involved in reviewing unprofessional conduct.

Answer B: Receiving a degree in psychology would not necessarily account for the appropriate education, training, and experience depending on the scope of the psychologist's unprofessional act.

Answer C: One can hold a license as a psychologist, but not be competent to practice within each and every scope of the field of psychology.

The correct answer is C.

In the state of California, the rape of a minor should always be reported as child abuse. However, while consensual sex between minors and young adults (18 years or older) is statutory rape, consensual sex does not always indicate child abuse. 

Answer A: Consensual sex between a 16-year-old and a 21-year old does not indicate a mandated child abuse report.

Answer B:  Consensual sex between a 15-year-old and an 18-year old does not indicate a mandated child abuse report.

Answer D: Consensual sexual relations between a 14-year-old and a 15-year-old does not indicate a mandated child abuse report.

The correct answer is B.

Per APA Ethics Code 6.03, "psychologists may not withhold records under their control that are requested and needed for a client's/patient's emergency treatment solely because payment has not been received." However, according to HIPAA, psychologists may not under any circumstances withhold records for nonpayment. Thus, it is technically ethical but actually illegal to withhold the records for nonpayment in non-emergency situations. Therefore, the psychologist should release the records to the client.

Answers A & C: The psychologist cannot withhold treatment records for nonpayment regardless of whether or not it is an emergency or non-emergency.

Answer D: Given that the request is coming from the former client, the psychologist should release the records directly to the client rather than the treating therapist.

The correct answer is A.

Standard 1.04 of the Ethics Code states that when psychologists believe another psychologist has committed an ethical violation, they should first attempt informal resolution.

Answer B: There is not enough information to warrant immediate reporting to the licensing board.

Answer C: There is no directive in the ethics code to document the ethical violations of others.

Answer D: While this may be a good idea, it is not the guidance stated in the ethical code.

The correct answer is B.

The information provided in the question does not indicate that the client has given permission to provide the requested information. When a psychologist receives a subpoena, they must appear as requested, but they should assert the privilege on the client's behalf.

Answer A: A psychologist is not permitted to provide information unless the client has given permission to do so or is ordered to do so by the court.

Answer C: A psychologist must appear as requested by the subpoena and does not require permission from the client to do so.

Answer D: A psychologist should appear when they receive subpoenas or court orders.

The correct answer is C.

This is not a specific requirement by the Board of Psychology for telehealth informed consent.

Answers A, B, and D: The Board of Psychology requires psychologists providing telehealth to give specific informed consent to clients including risks, data storage policies and procedures, possibility of technical failure, insurance coverage considerations, and explaining how telehealth services and in-person services differ.

The correct answer is D.

H&SC Sections 123110(a) states that when a client requests a copy of their record "the health care provider shall ensure that the copies are transmitted within 15 days after receiving the written request."

Answers A, B, and C: These responses provide the incorrect length of time when a client submits a written request for a copy of their therapy records.

The correct answer is C.

This answer is the best one because it reflects the actual language of the Introduction and Application section, Standard 1.02, and Standard 1.03 of the APA's Ethics Code. For example, the Introduction and Applicability section states: "If psychologists' ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to this Ethics Code and take steps to resolve the conflict in a responsible manner in keeping with basic principles of human rights."

Answers A, B, and D: None of these responses are mentioned in this section of the Ethics code.

The correct answer is B.

This issue is addressed in the Board of Psychology's Disciplinary Guidelines. It states that, when probation includes practice and/or billing monitoring, the psychologist "shall notify all current and potential patients of any term or condition of probation that will affect their therapy or the confidentiality of their records (such as this condition, which requires a practice monitor/billing monitor). Such notifications shall be signed by each patient prior to continuing or commencing treatment."

Answer A: The psychologist is not required to contact past patients.

Answer C: Patients are not expected to inquire, rather the psychologist is expected to disclose the information and document that the patient was informed.

Answer D: The psychologist does need to inform current and new patients.

The correct answer is C.

According to CA law, "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 patients health service records shall be retained for a minimum of seven years from the date the patient reaches 18 years of age." In this question, the client turns 18 on Jan 4, 2023. Thus, 7 years later would be January 4, 2030. Of note, APAs Record Keeping Guidelines adds, "psychologists may consider retaining full records until 3 years after a minor reaches the age of majority." (The age of majority is 18). Sometimes there is confusion about these different guidelines. When guidelines conflict, unless one source trumps the other (e.g. federal law vs. state law), the correct answer is this most conservative one. Keeping records until the client is 25 is more conservative than keeping records until the client is 21, thus C is the correct answer as opposed to D. If the question stated, "According to APA, how long should Dr. Jones retain the client's record?" then D would be the correct answer.

Answer A: This answer would be correct if the client was an adult. However, because this client was a minor at the time of termination, records need to be kept for 7 years after the client turns 18.

Answer B: This answer is incorrect for two reasons. First, because the client is a minor. (See rationale for answer A). Second, because of the word "only". The law states that records must be kept for a "minimum" of 7 years after the clients termination date. It is within the law to maintain records beyond that point, although it is not necessary. Therefore, "at least until" in the other examples is a better answer choice than "only until".

Answer D: This date fits the guidelines put forth by APA: 3 years after the client turns 18. However, because the question did not specifically ask what Dr. Jones should do according to APA guidelines but rather, according to California guidelines, keeping records for 7 years after the client turns 18 is the correct answer. If the question did not indicate which source to adhere to, the most conservative guidelines should be chosen. In this instance, that would be California law.

The correct answer is A.

The question suggests that the psychologist may not be qualified to treat this family. According to Ethical Standard 2.01(b), "Where scientific or professional knowledge in the discipline of psychology establishes that an understanding of factors associated with age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status is essential for effective implementation of their services or research, psychologists have or obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals."

Answer B: It is not discriminatory to help clients access the most competent care. 

Answer C: While consultation may be helpful, the question suggests the family is already discontented with their treatment. Referring out is the better option. 

Answer D: There is no such obligation.

The correct answer is C.

Ethics Code Standard 9.04(a) allows psychologists to "refrain from releasing test data to protect a client/patient or others from substantial harm or misuse or misrepresentation of the data or the test," but it also states that psychologists must recognize "that in many instances release of confidential information under these circumstances is regulated by law." Because HIPAA's privacy rule does not identify reasons to treat test data differently than any other medical information, psychologists are required to treat test results in the same way that they treat other PHI. In other words, psychologists are required to release test data except in certain legally defined situations that permit them to deny a client or the parents of minor client access to the client's record. With regard to minor clients, under H&SC Section 123115(a)(2), psychologists may refuse to provide parents or legal guardians access to a minor's records (including test scores) when they determine "that access to the patient records requested by the representative [parent or legal guardian] would have a detrimental effect on the provider's professional relationship with the minor patient or the minor's physical safety or psychological well-being."

Answers A, B, and D: Unless the psychologist has determined that doing so is not likely to have a detrimental effect on Daryl's well-being, she should provide the mother with Daryl's scores and an interpretation of those scores.

FeedbackThe correct answer is C.

Per California law, it is illegal to possess, produce, or distribute "obscene matter" depicting children under 18 years old. For example, if an adult receives a sexting message from someone under the age of eighteen and keeps the photo or shares the photo with others, it is considered illegal. In this situation, the client is attempting to show the psychologist a picture of them wearing a bra. Ideally, the psychologist should say that they do not feel comfortable looking at the photo and redirect the conversation. However, this option is not given. Thus, the next best available answer is C.

Answer A: Abruptly terminating the therapy may be considered client abandonment and thus this is not the best option listed. Moreover, terminating the therapy because a client attempted to show their psychologist a picture of them wearing a new bra seems a bit drastic and unreasonable with the information given.

Answer B: If the client sent the psychologist the picture, and the psychologist saved the image or shared the image with others, it may be considered possessing and distributing child pornography. However, in this case, the client did not send the photo. Moreover, viewing the photo is not considered possessing or distributing child pornography. Again, the best option would be to not view the photo and bring the conversation back to the treatment or review the nature of their professional therapeutic relationship.

Answer D: A psychologist who is receiving, saving, and/or distributing pictures of a client (child or adult) is acting unethically and illegally, and this would be considered a serious offense and sexual misconduct between a patient and a psychologist.

The correct answer is A.

Every renewal cycle, a psychologist is expected to receive 4 hours of training in laws and ethics and 4 hours of training in cultural diversity/social justice.

Answer B: The law and ethics requirement for continuing professional development is 4 hours.

Answers C and D: These are both one-time requirements for an initial application for licensure but they are not required for each renewal cycle.

The correct answer is D.

California 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."

Answer A: The court cannot be appointed as someone's representative.

Answer B: Privilege does not end when the patient dies.

Answer C: Though a patient's next of kin may be their representative, this isn't necessarily always the case.

The correct answer is D.

Barter is addressed in Standard 6.05 (Barter with Clients/Patients), which states: "Barter is the acceptance of goods, services, or other nonmonetary remuneration from clients/patients in return for psychological services. Psychologists may barter only if it is not clinically contraindicated, and the resulting arrangement is not exploitative. "The prohibition against barter is not absolute but applies when a psychologist believes it may be clinically contraindicated or exploitative. For example, barter should be avoided when it is likely to impair a psychologist's objectivity or otherwise adversely affect the therapist-client relationship or when it is not possible to determine the extent to which a bartered service or good is equivalent in monetary value to the psychologist's fee (Fisher, 2003). The APA Ethics code states, multiple relationships "occur when a psychologist is in a professional role with a person and at the same time is in another role with the same person," in this case, the psychologist would be acting as the patient's therapist and their client. Multiple relationships should be avoided when they can be reasonably expected to impact 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."

Answers A, B, and C: Each response listed should be considered in helping to make the decision to accept bartering as payment.  Contraindication in treatment, exploitation, and multiple relationships are all reasons you would not accept bartering as payment.

The correct answer is D.

Confidentiality refers to the obligation of psychologists to protect clients from unauthorized disclosure of information revealed in the context of the professional relationship. Privilege is also known as "testimonial privilege" and is a legal term that refers to a person's right not to have confidential information revealed in a legal proceeding.

Answers A, B, and C: These statements are inaccurate or incomplete descriptions of confidentiality and privilege.

The correct answer is C.

B&PC Section 2966 specifies that "a psychologist's license shall be suspended automatically during any time that the holder of the license is incarcerated after conviction of a felony, regardless of whether the conviction has been appealed." When this occurs, the Board notifies the psychologist of the suspension and of their "right to have the issue of penalty heard."

Answers A, B, and D: None of these options can be taken without a prior hearing.

The correct answer is B.

As noted in WIC Section 5270.55(c), "the maximum involuntary detention period for gravely disabled persons pursuant to Sections 5150, 5250 and 5270.15 shall be limited to 47 days" - i.e., three days under Section 5150, 14 days under Section 5250, and 30 days under Section 5270.15.

Answers A, C, and D: These responses do not provide the correct maximum length of time for involuntary detention for individuals who have been determined to be "gravely disabled"

The correct answer is D.

Per the Guidelines for Psychotherapy With Lesbian, Gay, and Bisexual Clients published by the APA, "Psychologists are encouraged to recognize how their attitudes and knowledge about lesbian, gay, and bisexual issues may be relevant to assessment and treatment and seek consultation or make appropriate referrals when indicated."

Answers A, B, and C: Although consultation or referral might be necessary for the situations described in these responses, answer D most clearly describes a situation in which referring out would be the best course of action.

The correct answer is C.

California Code of Regulations Section 1397.61(b) requires that a person renewing or reactivating their license must have completed at least four credits in "law and ethics as they apply to the practice of psychology in California."

Answers A, B, and D: These responses do not satisfy the requirement for a psychologist renewing their license.

The correct answer is C.

State laws are preempted by HIPAA regulations except when the state law provides the client with greater privacy protection or privacy rights or control over individually identifiable health information.

Answer A: State law does not automatically preempt HIPAA privacy law.

Answer B: HIPAA regulations do not always preempt state laws.

Answer D: The client relationship is not a factor when conflicts arise between HIPAA and state law.

The correct answer is C.

Through the process of elimination, this is the best option. This patient is clearly distressed and potentially paranoid, but these symptoms do not always signal the need for law enforcement involvement or hospitalization.

Answer A: There is insufficient information to indicate the need for any breach of confidentiality at this point. However, this may be a clinical decision in which you seek her consent to speak to her husband. For the purposes of these questions, it's important to think of the legal and ethical mandates.

Answer B: It would not be appropriate to contact the police. In considering this answer, you might follow that train of thought. What would you report to the police? If there is nothing objective to report, you likely wouldn't choose this option.

Answer D: A 5150 order is put in place when an individual is at risk to themselves or others. In this scenario, Inga appears frightened of her coworkers but has no ideation, plan, or intent to hurt them or herself, rendering this plan of action inappropriate.

The correct answer is D.

If an adult patient reports a history of child abuse, the psychologist should determine if there are any children currently at risk. For example, if the perpetrator has access to children and may be abusing children. If so, the psychologist should file an abuse report. If not, the psychologist should maintain confidentiality. In contrast, if a minor reports a history of child abuse, the psychologist is required to make a report. For this question, given the information provided, the psychologist is not required to report this history of abuse.

Answers A & B: If a minor was reporting the abuse, then the psychologist should report the abuse regardless of whether or not it was a single event or frequent occurrence. In addition, if a minor is reporting an incident or physical injury involving an object on bare skin, a report should be made.

Answer C: Again, child abuse is reported when it is reported by a minor or if there is a risk of this abuse is occurring now. Although the adult patient may decide to report this incident, the psychologist is not obligated to report the abuse. Moreover, it may not be clinically indicated for the psychologist to encourage the client to report their history of child abuse.

The correct answer is D.

Section 1387.1 of the California Code of Regulations states several requirements, one of which is that supervision must be provided in-person or through synchronous audiovisual means, in compliance with patient health confidentiality.

Answers A, B, and C: All of these requirements are included in Section 1287.1 as requirements for primary supervisors of associates.

The correct answer is C.

California Code of Regulations Section 1380.6 requires licensed psychologists to include their license number in any advertising, public directory or solicitation, and HIPAA's Privacy Rule requires psychologists to provide clients with a written Notice of Privacy Practices (NPP) on or before the onset of treatment and to post the NPP in a prominent place. In addition, the Business and Professions Code (which this question is asking about) requires psychologists to post the following notice in a conspicuous location in their place of business: "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 by email at bopmail@dca.ca.gov, on the Internet at www.psychology.ca.gov, by calling 1-866-503-3221, or by writing to the following address: Board of Psychology, 1625 North Market Boulevard, Suite N-215, Sacramento, California 95834."

Answers A, B, and D: A psychologist's license, diploma, and a notice of privacy policies are not required to be displayed by the Board of Psychology in California, though it is common practice.

The correct answer is C.

HIPAA's Security Rule provides regulations related to the creation, storage, and transmission of PHI in any electronic form (e.g., Internet, e-mail, CDs, computer drives) and lists several administrative, physical, and technical safeguards for protecting electronic PHI from unauthorized release. These safeguards are categorized as either "required implementation specifications" or "addressable implementation specifications." Required specifications are mandatory, but addressable specifications allow covered entity flexibility when (a) it is determined that the specification is not reasonable or appropriate for the covered entity's environment and (b) the covered entity documents why the specification is not reasonable or appropriate and implements an equivalent alternative measure as appropriate. Implementing "security measures to reduce risks and vulnerabilities to a reasonable and appropriate level" is a required specification [45 CFR Section 164.308(a)(1)(ii)(B)], while encryption of electronic PHI is an addressable specification [45 CFR Sections 164.312(a)(2)(iv) and 164.312(e)(2)(ii)].

Answers A, B, and D: These responses are not listed within HIPAA's security rule as guidelines for encryption.

The correct answer is D.

"Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience" (Ethical Standard 2.01(a) [Boundaries of Competence]). The psychologist has no training in treating clients with DID, therefore a referral is indicated.

Answer A: The client is not qualified to make this decision.

Answer B: Merely seeking information is not an adequate way to compensate for lack of training.

Answer C: Seeking supervision or consultation is an appropriate option if the psychologist has the general skill to treat a case, but there is a particular aspect of the case that they have not dealt with extensively, or at all.

The correct answer is C.

All of the following requirements need to be met to provide documentation for an emotional support dog: a) a valid and active license in the jurisdiction where the documentation is to be provided, b) have an established client-provider relationship for at least 30 days prior to the documentation, c) complete a clinical evaluation of the individual for the need of an emotional support dog, d) provide notice to the client in writing or verbally that fraudulently reporting oneself as an owner or trainer of any dog licensed, qualified, or identified as a service, guide, or signal dog is a misdemeanor violation of Penal Code Section 365.7, and include the psychologists effective license date and number and jurisdiction in the documentation.

Answers A, B, & D: See rationale for answer C.

The correct answer is B.

The need to maintain client confidentiality when seeking consultation is addressed in Standard 4.06 of the Ethics Code. It states that psychologists "do not disclose confidential information that reasonably could lead to the identification of a client/patient ... unless they have obtained the prior consent of the person ... or the disclosure cannot be avoided." This answer is most consistent with this requirement.

Answer A: In most cases, a psychologist could deidentify the client's information and proceed ethically.

Answer C: The issue is the identification of the client, not the credentials of the consultant.

Answer D: Standard 4.06 also requires psychologists to disclose only information that is relevant to the purpose of the consultation. However, discussing only relevant information does not eliminate the need to obtain permission when the client's identity cannot be disguised.

The correct answer is A.

Per WIC Section 15630(b)(1), "any mandated reporter who in their professional capacity or scope of employment... has knowledge of an incident... constituting physical abuse... or reasonably suspects that abuse, shall report the known or suspected instance of abuse..." Answer A is the best answer because when a psychologist becomes aware of elder abuse, they are required to report it to the authorities.

Answer B: Although anger management may be a good clinical response, it does not speak to the psychologist's status as a mandated reporter.

Answer C: Even if the past therapist did corroborate that the abuse was previously reported, the psychologist should ensure the report took place with Adult Protective Services.

Answer D: Incidences of elder abuse are reportable regardless of the passage of time as long as the victim of the abuse was older than 60 years old or otherwise a dependent adult (18-59 years old) at the time of the incident.

he correct answer is C.

Nondisciplinary actions are usually confidential (i.e., not made available to the public). An exception is a citation and fine, which is considered a nondisciplinary action but is also public information.

Answer A: Probation is a disciplinary action.

Answer B: Educational review is a nondisciplinary action that is not considered a matter of public information.

Answer D: A letter of warning is a nondisciplinary action that is not considered a matter of public information.

The correct answer is D.

Though either parent who has legal custody may consent to treatment, it is best practice to encourage parents to come to a mutual decision about treatment. If no such decision can be reached, their next recourse can be to submit to court proceedings. Depending on the level of risk of the patient's presentation, the psychologist can help parents make a decision.

Answer A: Only one parent is required to consent legally speaking, although this wouldn't be the best standard of care.

Answer B: Although a custodial parent may have insight into the patient's difficulties, custodial parenting doesn't supersede legal custody.

Answer C: A guardian ad litem is typically appointed by the courts in family court proceedings.

The correct answer is A.

Privilege refers to the right to keep confidential communications from being disclosed in a legal proceeding. The patient, when they do not have a legal guardian or conservator, holds privilege.

Answers B & D: The psychologist may assert privilege on their clients behalf; however, only the patient holds privilege.

Answer C: The patient's personal representative only holds privilege when the patient is deceased.

The correct answer is C.

Although California law states a health care provider can determine whether to provide a patient with a record summary or an entire record, HIPAA's privacy rule states this is applicable only if the patient agrees in advance to receive a summary. The HIPAA privacy rule preempts California law. In addition, HIPAA and California law both state that a patient should request their records in writing.

Answer A: An explanation after the fact would not change HIPAA requirements which states the patient must agree in advance to receive a summary.

Answer B: Although requests must be made in writing not verbally, this wouldn't impact whether or not you write a summary or give the entire record.

Answer D: Although the psychologist can make the decision not to release records if that disclosure could reasonably lead to the client or others being harmed, there is nothing to suggest that the patient's safety is at risk in this question.

The correct answer is A.

The Ethics Code (2.06) states "When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties."

Answers B, C, and D: While these may be options the psychologist could take, professional consultation will help the psychologist make a decision based on what's best for the therapy group.

The correct answer is C.

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."

Answers A, B, and D: These responses do not provide the correct information regarding the sharing of information with members of a multidisciplinary team involved in the prevention, identification, and treatment of child abuse.

The correct answer is D.

WIC Section 15630(b)(3)(A) states that a psychotherapist is not required to file a report of elder or dependent adult abuse when all of the following conditions are met: "(i) The ... [psychotherapist] has been told by an elder or dependent adult that they have experienced behavior constituting physical abuse ..., abandonment, abduction, isolation, financial abuse, or neglect. (ii) The ... [psychotherapist] is not aware of any independent evidence that corroborates the statement that the abuse has occurred. (iii) The elder or dependent adult has been diagnosed with a mental illness or dementia or is the subject of a court-ordered conservatorship because of a mental illness or dementia. (iv) In the exercise of clinical judgment, ... [the psychotherapist] reasonably believes that the abuse did not occur."

Answers A, B, and C: These are examples of conditions that must be present in order for psychologists to decide not to report a potential elder abuse incident.

The correct answer is C.

In conservator court proceedings, the court will waive privilege as the information from the psychological evaluation is needed to determine the patient's ability to care for himself.

Answer A: It is not necessary for the son to have his own attorney.

Answer B: The patient is an adult, not a minor.

Answer D: The patient's privilege is waived by the court.

The correct answer is D.

A psychologist has no legal obligation to take any particular action when the wife of a client is dangerous. If, on the other hand, the client was threatening to shoot the nanny, this would trigger a duty to protect if the client communicated this threat to the psychologist or his wife reached out in good faith and informed the psychologist. In this case, you would have to make "reasonable efforts to communicate the threat to the victim or victims and to a law enforcement agency (California Civil Code 43.92). The family members of clients acting in good faith can also trigger this requirement, by the precedent set by Ewing v. Goldstein.

Answers A, B, and C: The psychologist has no legal obligation to take a specific action when the wife of a client is dangerous.

The correct answer is D.

Per the APA Ethics Code, Section 10.10 Terminating Therapy, "psychologists may terminate therapy when threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship." As the psychologist is feeling "highly uncomfortable" and likely threatened, they are fully within their rights to terminate the therapy. Of note, the psychologist could break confidentiality and seek a protective order against a client/patient if they suspect that they will threaten or harm them.

Answer A: When a psychologist becomes aware through a patient that they had a sexual relationship with a psychologist during the course of treatment, they should review this pamphlet with their patient. Although the psychologist could review this pamphlet with their patient, this answer does not address the underlying issue of the psychologist's safety.

Answer B: It would be helpful to address this behavior with the client. However, the behaviors described in the vignette make it difficult to continue with the treatment.

Answer C: Per the APA Ethics Code, "except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists should provide pretermination counseling and suggest alternative services providers as appropriate." Thus, while psychologists are encouraged to provide pretermination counseling, this is not required by the ethics code and depends on the specific circumstances. As it is likely that this behavior will continue in a future session and possibly even escalate, the psychologist should terminate the therapy and provide appropriate referrals.

The correct answer is A.

Per APA Ethics Code 6.07, payments or fee-splitting between psychologists and other professionals must be based on services provided (clinical, administrative, etc.). Psychologists cannot pay another professional for a referral, as this may lead to a conflict of interest. In addition, per CA Laws and Regulations, Article 6, "any rebate, refund, commission, preference, patronage dividend, discount, or other consideration, whether in the form of money or otherwise, as compensation or inducement for referring patient, clients, or customers to any person is unlawful." Thus, sending gifts for referrals, particularly when they are of significant monetary value and/or are sent on a regular basis, is unethical and illegal.

Answer B: This behavior is generally frowned upon and considered unethical.

Answer C: Sending small gifts (under $50) to referral sources during the holidays may be seen as acceptable behavior. However, in this question the psychologist is regularly sending a gift card as a thank you for a referral, which is considered unethical.

Answer D: Regardless of whether or not the therapist also gave the client other referrals, the therapist may have been influenced by the history of gift giving to refer to this psychologist, which is considered unethical.

The correct answer is C.

This situation is addressed in Ethics Code Standard 10.10(b), which states that: "Psychologists may terminate therapy when threatened or otherwise endangered by the client/patient or another person with whom the client/patient has a relationship. Except where precluded by the actions of clients/patients or third-party payors, prior to termination psychologists provide pre-termination counseling and suggest alternative service providers as appropriate." In other words, the Ethics Code permits psychologists to terminate therapy with a patient when the patient or a person the client has a relationship with (e.g., the patient's ex-husband) poses a threat to the psychologist, but in most cases, they should also provide pre-termination counseling or suggest alternate providers. This question captures two issues; confidentiality and abandonment. While a psychologist has the right to break confidentiality by calling the police and terminating treatment, they also cannot stop treatment for the patient without appropriate referrals. In this situation, the psychologist is not required to provide advanced notification of termination or pre-termination counseling to the patient but should provide referrals within a reasonable amount of time. Moreover, prohibitions against breaching confidentiality do not apply if the psychologist needs to contact the police or others to obtain protection (see, e.g., C. B. Fisher, Decoding the ethics code: A practical guide for psychologists, Thousand Oaks, CA: Sage Publications, 2003).

Answer A: A psychologist can terminate treatment with appropriate referrals, thus not abandoning the patient.

Answer B: A psychologist can break confidentiality and contact the police if they feel they are at risk of harm.

Answer D: The psychologist does not need the patient's consent to break confidentiality if they feel they are at risk of harm.

The correct answer is B.

This issue is addressed in the BOP's Spectrum of Administrative Actions Available to the Board of Psychology (http://www.psychboard.ca.gov/enforce/spectrum.htm), which states, "Those whose licenses are revoked must wait three years before petitioning the BOP for reinstatement of licensure."

Answers A, C, and D: The psychologist must wait at least 3 years before petitioning for reinstatement.

The correct answer is D.

This issue is addressed in PC Section 11172(a) which states: "No mandated reporter shall be civilly or criminally liable for any report required or authorized by... [the California Abuse and Neglect Reporting Act], and this immunity shall apply even if the mandated reporter acquired the knowledge or reasonable suspicion of child abuse or neglect outside of their professional capacity or outside the scope of their employment."

Answers A, B, and C: These responses are incomplete in meeting the requirement for mandated reporters.

The correct answer is A.

The Ethical Code for Psychologists states that it is unprofessional conduct for a psychologist to practice outside of their field of competence as established by their education, training, and experience. Answer A is the best answer because reading an article would not qualify as neither education, training, or experience.

Answer B: No one article could prepare a psychologist to ethically apply a new treatment technique. Further education and/or training is needed.

Answer C: Even if the patient agreed to the psychologist in experimenting with a technique outside of their scope, the psychologist is still responsible for practicing within their scope of competence. It should also not be up to the patient to make that determination.

Answer D: This statement overstates reading an article as replacing the need for training, education, or experience.

The correct answer is A.

Mandated reporters have immunity from criminal and civil liability for any report required or authorized under the Child Abuse Reporting Law. This immunity applies even though the knowledge or reasonable suspicion of abuse was acquired outside his or her professional capacity or outside the scope of his or her employment [P.C. 11172 (a)]. If a mandated reporter is sued for making a report, he or she may be able to receive compensation for legal fees incurred in defending against the action [P.C. 11172 (c)].

Answers B, C, and D: Incorrect as both civil and criminal liability are covered in the California Penal Code [P.C. 11172 (c)].

The correct answer is B.

The term custodial parent refers to the parent that the child lives with and is cared for by. However, being the non-custodial parent does not remove a parent's right to the child's treatment record. Therefore, the best course of action is to comply with the request.

Answer A: An authorization to release information is not needed for parents of a child client.

Answer C: An authorization to release information is not needed for parents of a child client. 

Answer D: A parent has a legal right to know if their child is in treatment unless consent was provided by the minor.

The correct answer is A.

Gottlieb recommends considering 3 factors when determining whether a multiple relationship is unethical; power differential, duration of the relationship, and clarity of termination. The frequency of past contact is not a factor in this decision making model.

Answer B: The power differential refers to how much power the psychologist has over the individual.

Answer C: The duration of the relationship refers to how long the relationship has lasted, i.e. longer relationships are more likely to be unethical.

Answer D: This response refers to how likely it will be that the student will require the psychologist's professional services in the future.

The correct answer is C.

Domestic violence when witnessed by minors may constitute child abuse. Though the abuse is historical, the psychologist is required to report the abuse to the authorities. Since the family is already engaged in treatment, it also makes sense that the psychologist assess and better understand the role of domestic violence in the patient's treatment.

Answer A: Though a report addresses the legal obligation, the ethical obligation is also to help the family in treatment, making answer choice C a better response.

Answer B: The psychologist should gather information about the role of domestic violence within the family, but this response doesn't address the legal obligation to report child abuse.

Answer D: The psychologist does not know enough to know if this is warranted at this point in time, and again this answer does not address the legal obligation to report child abuse.

The correct answer is C.

Per the California Board of Psychology Laws and Regulations - Article 1024., "There is no privilege... if the psychotherapist has reasonable cause to believe that the patient is in such mental or emotional condition as to be dangerous to himself or to the person or property of another and that disclosure of the communication is necessary to prevent the threatened danger." Answer C is the best answer because the psychologist would need to assess if the patient is at risk of harming others in the future, as the Article 1024 refers to the duty to warn others about potential harm.

Answer A: The Laws and Regulations governing psychologists do not require that psychologists report assaults (unless they occur to a protected class of individuals).

Answer B: Without first assessing, it isn't clear from the example that hospitalization is warranted.

Answer D: While this may be a good clinical strategy, it doesn't address that psychologists have a duty to protect the public from harm when they become aware of threats.

The correct answer is D.

Many options are available to the psychologist for follow-up.  Given that the client is in hospice care, it would not be recommended to initiate hospitalization outside of the facility, therefore documenting, assessing, and developing a plan with the hospice team is the most feasible plan of action to ensure the client's safety.

Answers A, B, and C: All of these options are appropriate strategies for follow-up and therefore incorrect in answering the question.

The correct answer is D.

If a minor is legally authorized to get treatment by himself or herself, their parent or guardian may be denied access to the treatment records. Also, per California law, when a minor participates in therapy with their parent's consent, the minor's parent or guardian may be denied access to the treatment record if the provider determines that this would have a detrimental impact on the therapeutic relationship or the minor's physical or emotional wellbeing.

Answer A: Although psychologists often offer to write a treatment summary in lieu of the treatment records, this psychologist should not release anything (treatment summary or records) to the minor's parent, as the client was legally authorized to obtain treatment on their own.

Answer B: The psychologist may decide to discuss this request with the client; however, they should not release the records without the client's consent.

Answer C: Similarly, in this situation, the psychologist should not review any confidential information during a phone call with the client's mother.

The correct answer is C.



According to BPC section 2988.7,  allows the Board, in its discretion, to accept the offer of a surrender of a license. The Board’s acceptance of the offer of a surrender shall be in writing. A person whose license has been surrendered may petition the Board for reinstatement after a period of not less than one year after the effective date of the acceptance. 

Answers A, B, and D: The psychologist can petition the board for reinstatement of their voluntary surrendered license after a period of not less than one year after the effective date of acceptance.

The correct answer is C.

"Parents have a right to access their minor child's records. This access is restricted, however, by three broad exceptions. Parents cannot access their child's records if: (1) the minor has access to the records, (2) the release would have a detrimental effect on the provider's professional relationship with the minor, or (3) the release would have a detrimental effect on the minor's safety or psychological well-being" (Z. Pelchat, Request for records: How to respond, The California Therapist, May/June, 2001, 14-15).

Answer A: A request to the child's treatment records does not have bearing on a psychologist's decision that disclosure would be psychologically harmful.

Answer B: Psychological and physical danger are both potential reasons to deny disclosure.

Answer D: It wouldn't be recommended for the psychologist to bring the issue to a minor to resolve.

The correct answer is B.

It's very likely you'll encounter a question on Section 5150 on the exam, and you want to know that it permits a 72-hour hold of any person who, as the result of a mental disorder, is a danger to self or others or is gravely disabled.

Answers A: Provides an incorrect length of time one can be held involuntarily. 

Answer C: Provides an incorrect length of time one be held involuntarily.

Answer D: Refers to the length of time a person can be held after the initial 72-hour hold.

The correct answer is B.

Caregivers, who are at least 18 years old, and have signed a caregiver affidavit may consent to treatment on behalf of a minor.

Answer A: As the child was left with his grandmother and care was provided for them, they are not considered abandoned.

Answer C: The grandmother is not required to attempt every solution to find the child's mother prior to consenting to treatment.

Answer D: The grandmother may consent to treatment.

The correct answer is D.

Section 5150 of the California Welfare and Institutions Code identifies the individuals who can institute an involuntary 72-hour hold. A peace officer, attending staff at a designated evaluation facility, designated member of a mobile crisis team, or person designated by the county most accurately identifies the individuals who can initiate a 72-hour hold.

Answers A, B, and C: These responses do include the individuals who most accurately can initiate a 5150 in the state of California.

The correct answer is D.

The appropriate recipient of a report of elder or dependent adult abuse depends on the type of abuse and where it occurred. For all types of physical abuse, when the abuse "occurred in a long-term care facility, except a state mental health hospital or a state developmental center, a telephone and a written report shall be made to the local ombudsperson and the local law enforcement agency" [WIC Section 15630(b)(1)]. Physical abuse includes sexual assault (which includes rape, spousal abuse, incest, sodomy, oral copulation, sexual penetration, and lewd or lascivious acts).

Answers A, B, and C: The appropriate authority to report the abuse is to the local ombudsperson and local law enforcement agency.

The correct answer is A.

Even though the client was not sober, the issue is the impact on the person's capacity, not necessarily sobriety. Capacity refers to the patient's capacity to make rational decisions about therapy. Being under the influence of alcohol and not remembering the intake, signaling the patient was black out drunk, would suggest they did not have the capacity or comprehension at the time of the intake to consent to treatment.

Answers B, C, and D: Legally speaking, the three conditions of informed consent are comprehension, capacity, and voluntariness.

The correct answer is D.

Unresolvable conflicts between law and ethics create a difficult dilemma, and the best response is to seek consultation to determine the most appropriate course of action. In a discussion of this issue, the APA's Committee on Professional Practice and Standards recommends seeking legal advice or consulting with the state licensing board [Legal Issues in the professional practice of psychology, Professional Psychology: Research and Practice, 34(6), 595-600, 2003]. Another alternative is to contact the California Psychology Association which offers a free confidential phone consultation on ethical issues ("Ethics on Call") to its members.

Answer A: This refers to the language within the Ethical Code which offers guidance when resolving conflicts between the law and the ethical code, however, irresolvable conflicts would signal the need for legal consultation.

Answer B: This refers to this same guidance, but again doesn't apply when the conflict is irresolvable.

Answer C: Consulting with a client presents multiple issues and should be avoided.

The correct answer is D.

As defined in California Welfare and Institutions Code Section 5008(h)(1), a grave disability is a condition that occurs as the result of a mental disorder and involves an inability to provide for one's "basic personal needs for food, clothing, or shelter." Of the people described in the answers to this question, only the individual described in answer D clearly meets these criteria.

Answer A: The man has access to shelter through the homeless shelter.

Answer B: The woman has a home and someone responsible for ensuring her needs are met.

Answer C: The man technically has shelter and there is no indication his addiction impairs his ability to access food or clothing.

The correct answer is A.

The Ethical Code states (9.09), "Psychologists who delegate work to employees, supervisees, or research or teaching assistants or who use the services of others, such as interpreters, take reasonable steps to (1) avoid delegating such work to persons who have multiple relationships with those being served that would likely lead to exploitation or loss of objectivity; (2) authorize only those responsibilities that such persons can be expected to perform competently on the basis of their education, training, or experience, either independently or with the level of supervision being provided; and (3) see that such persons perform these services competently." Therefore the psychologist is responsible for choosing an interpreter that does not have multiple relationships with the patient as this would impact objectivity and are competent in their ability to translate. Answer A is the best answer because the patient's son constitutes multiple relationships and thus cannot be objective in his mother's assessment.

Answer B: The ethical code states this situation should be avoided, not compensated for.

Answer C: While the interpreter is competent, they are not objective. Both are required.

Answer D: Acknowledging the limitations of the translation services does not adequately avoid the potential harm to the patient.

The correct answer is C.

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."

Answers A, B, and D: The question states that the psychologist has not yet published their results; consequently, they are not required by the Ethics Code to share the data with their colleague.

The correct answer is B.

Though HIPAA protects psychologists from releasing their psychotherapy notes to patients, California preempts HIPAA and allows for such requests. Though a psychologist is not obligated to release their psychotherapy notes, they can release a copy or a summary if they so choose, and if they determine that the release would not present a substantial risk of significant adverse or detrimental consequences to the patient.

Answers A, C, and D: The psychologist is not compelled to release the psychotherapy notes as copies or in a summary format. Also, California law does in fact preempt HIPAA law.

The correct answer is D.

B&PC 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."

Answer A: A minor's record would not be destroyed immediately when they turn 18.

Answer B: This does not meet the B&PC code requirement. 

Answer C: This does not meet the B&PC code requirement.

The correct answer is C.

WIC Section 5150 states that when a person is held involuntarily for treatment for 72 hours, a certification review hearing is not required until the individual has been certified for an additional 14-day hold after the initial 72-hour hold.

Answers A, B, and D:  These do not meet the criteria for Section 5150.

The correct answer is A.

Effective January 1, 2021, the BOP is required to provide flexibility in processing the initial applications and to expedite the licensure process for refugees, those granted asylum by the Secretary of Homeland Security or the Attorney General of the United States, and individuals with a special immigrant visa.

Answers B, C, and D: See rationale A.

The correct answer is B.

Psychologists should be wary of treating a patient who is putting excessive limitations upon their duty to provide competent and comprehensive care. Thus, it is in the psychologist's best interest to state their practice policies related to communicating with other health care providers about the patient's mental health. If the patient is uncomfortable with this policy, the psychologist should provide appropriate referrals.

Answer A: Failure to coordinate the care and consult with other current providers may open the psychologist up to claims of negligence. Thus, it is in the psychologist's best interest to refer this client out if they are unable to follow the standard of care for their practice.

Answer C: The psychologist should be upfront about their practice policies and should not begin treatment with a patient that is placing limitations on their duty of care as this opens them up to possible risks and claims.

Answer D: The psychologist should be upfront about their practice policies and should not begin treatment with a patient that is placing limitations on their duty of care as this opens them up to possible risks and claims.

The correct answer is D.

Test integrity refers to the usefulness and accuracy (validity) of test results and depends on several factors including the appropriateness of the test content, the availability of current and appropriate norms, and the use of standardized testing procedures. Test integrity is likely to be compromised when the test contains outdated content or when test norms are not current.

Answer A: Test accommodation refers to providing supports for someone to access test material, such as having someone read test questions to a test taker.

Answer B: Test sophistication refers to the familiarity a subject may have with a test and its impact on the score attained.

Answer C: Test security refers to limiting unauthorized access to test items and other test materials.

The correct answer is C.

Legal requirements for the retention of health records by licensed psychologists after a patient's discharge are provided in B&PC Section 2919. It states that "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."

Answers A, B, and D: A psychologist is legally required to maintain a minor client's records for a minimum of 7 years from the date they turn 18.

The correct answer is B.

When the court orders a client to receive assessment or therapy services, signed consent for treatment is not required of the client. This circumstance does not relieve the psychologist of the ethical responsibility to explain the limits that may be imposed on confidence. Even when services are court ordered or otherwise mandated, psychologists should inform the client about the nature of the anticipated services, including that the services are court ordered or mandated and any limits on confidentiality.

Answer A: Signing a consent form is different from building informed consent.

Answer C: The client may still choose to not consent to treatment, but there will likely be consequences from the court. 

Answer D: When treatment is court-ordered, the psychologist is required to report attendance to the court.

The correct answer is C.

 Psychologists are legally and ethically obligated to take appropriate actions when personal problems, such as physical or mental illness, might interfere with their ability to provide services. CCR section 1396 states, "if a psychologist is already engaged in such activity when becoming aware of such personal problems, he or she shall seek competent professional assistance to determine whether services to the patient or patient should be continued or terminated." 

Answer A: The psychologist should seek consultation, not necessarily refer the patient or terminate treatment.

Answer B: This statement doesn't address the ethical concern.

Answer D: It may do more harm to abruptly end the patient's treatment without referrals and can be considered patient abandonment. Also, if the language in the question was harsher (e.g. the psychologist feels unsafe when alone with the patient), answer D may have made more sense, but even so, the psychologist should provide referrals instead of simply terminating treatment.

The correct answer is B.

Statutory rape has occurred since the patient is a minor. However, according to the Board of Psychology, "Reportable Conduct (effective January 1, 2021): For the purposes of the Child Abuse Neglect Reporting Act (CANRA), AB 1145 revised the definition of sexual assault to no longer include any acts under the Penal Code Sections 286 (sodomy), 287 or former Section 288a (oral copulation), and Section 289 (sexual penetration), if committed voluntarily and if there are no indicators of abuse unless the conduct is between a person 21 years of age or older and a minor who is under 16 years of age." Thus, this situation does not constitute a mandated report.

Answer A: The psychologist is not required to report the statutory rape.

Answer C: The psychologist is not required to breach confidentiality and contact the patient's parents.

Answer D: Child sexual abuse has not occurred, and neither the police nor Child Protective Services are required to be contacted.

The correct answer is D.

HIPAA details in which circumstances a patient's request for records can be denied, and lose the right to request a review of the denial. One of these circumstances is when the patient agreed to the denial of access during a research study.

Answer A: This is one instance in which denying a patient their records does not break HIPAA.

Answer B: The patient's age has no bearing.

Answer C: The length of time has no impact if the patient agreed to give up the right to their record.

The correct answer is A.

The HIPAA privacy rule identifies situations in which a patient can request a review if their request for records is denied. Denying records request due to the reasonable likelihood of physical harm or life of the patient is one of these situations.

Answer B: The patient has the right to have the denial reviewed.

Answer C: It does nothing to serve the patient to request it again.

Answer D: There is no mention of an ongoing court case.

The correct answer is D.

"In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential patient's welfare. Psychologists discuss these issues with the patient or another legally authorized person on behalf of the patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues" (Ethical Standard 10.04). The psychologist should contact the other therapist, and discuss whether there is any conflict associated with the client seeing two therapists. One issue that the two therapists should address is whether there is a duplication of services. If the two therapists are addressing different problems in therapy (for example, individual therapy for obsessive-compulsive disorder and family therapy for parent-child conflicts), it is not inappropriate or unethical for the client to receive treatment from two therapists. The therapists, on the other hand, should not duplicate services.

Answer A: This relies on the patient rather than a consultation with the other therapist to assess whether treatment is being duplicated. This also does not address the question of conflicts in duplicate services.

Answer B: The patient may not be aware of all factors impacting their welfare in treatment.

Answer C: Even though consultation may be beneficial, it does not address the larger issue that the psychologist should evaluate the appropriateness of the two treatments running concurrently, identify conflicts, and avoid duplication.

The correct answer is C.

Ethics Standard 6.04(a) requires psychologists to work out agreements about fees and other financial matters with clients "as early as feasible." For example, as part of the informed consent process during the initial therapy session, a psychologist should make sure the client is aware of and agrees to pay his or her fee (or the copayment) and discuss the policy regarding missed appointments, arrangements with the insurance company or other third party payor, and procedures for collecting unpaid bills.

Answers A, B, and D: These do not meet the legal requirement regarding when and how a psychologist should discuss fees.

The correct answer is C.

The psychologist's client is an adult, therefore disclosing missed appointments without his consent is not appropriate, nor is seeking payment from his parents.

Answers A, B, and D: These options include disclosing information to the client's parents without their consent.

The correct answer is B.

Several sections of the California Evidence Code specify exceptions to the psychotherapist-patient privilege. The exception addressed in this question is provided in Section 912(a) which states that "the right of any person to claim ... [the psychotherapist-patient privilege] is waived with respect to a communication protected by the privilege if any holder of the privilege, without coercion, has disclosed a significant part of the communication or has consented to a disclosure made by anyone. Consent to disclosure is manifested by any statement or other conduct of the holder of the privilege indicating consent to the disclosure, including failure to claim the privilege in any proceeding in which the holder has the legal standing and opportunity to claim the privilege."

Answer A: You can eliminate this response as it does not specify a "significant part of the communication."

Answer C: You can eliminate this response as it does not indicate that the disclosure must be done without coercion (voluntarily).

Answer D: You can eliminate this response as it does not indicate that the disclosure must be done without coercion (voluntarily).

The correct answer is C.

The psychologist is a mandated reporter and must report potential neglect and child endangerment to child protectives services.

Answers A, B, and D: While these are all good problem-solving strategies, they don't account for the fact that the psychologist is a mandated reporter and must report potential neglect and child endangerment.

The correct answer is C.

HIPAA's Privacy Rule does not require a psychotherapist or other health care provider to obtain an authorization or consent from a patient prior to disclosing PHI for the purposes of treatment, payment, or health care operations (TPO). While it is usually a good idea to obtain consent from a patient prior to disclosure in order to best protect their rights and welfare, this question is asking specifically about HIPAA requirements, so answer C is the best answer.

Answers A: Signed authorization is not needed to use PHI to complete billing.  

Answer B: Verbal or written authorization is not needed to use PHI to complete billing.  

Answer D: While a clinical emergency is an appropriate time to breach confidentiality, it is not the only time that one may do so.

The correct answer is A.

Dual relationships are not in and of themselves unethical. What makes dual relationships unethical is if the relationship causes harm to the patient and/or impairs the therapist's objectivity. The appropriate steps are to determine to what extent this dual relationship would be harmful to the client and/or impair the supervisee's objectivity or competency. It is unclear from the prompt how close the step-sister and supervisee are to one another, how long the supervisee dated her ex-boyfriend, and how close the ex-boyfriend and step-sister are to one another. Thus, the next step is to discuss the matter with the client further to determine the appropriate steps.

Answer B: Although this may not be a wrong answer, the better answer is A. More information is needed to determine if a referral would be in the best interest of the client.

Answer C: There is no ethical mandate or law that a supervisor has to take on a supervisee's case if there is a dual relationship. Additionally, a dual relationship is not automatically unethical. If it is determined that the dual relationship qualifies as unethical, a referral would be appropriate.

Answer D: The two-year rule may seem familiar. There is a standard that states psychologists cannot engage in sexual intimacies with former clients for a t least two years after cessation of therapy and only in the most unusual of circumstances. Additionally, psychologists are not allowed to become sexually intimate with relatives of current clients. However, neither of these two standards is applicable in this situation since it is the stepsibling of a previous boyfriend that is a potential client. The duration of the supervisee's breakup is not a relevant factor in determining what is ethical. The question is asking about the ethical standards for a dual relationship.

The correct answer is D.

This situation is addressed in B&PC Section 2946: It states: "A psychologist certified or licensed in another state or province and who has made application to the board for a license in this state may perform activities and services of a psychological nature without a valid license for a period not to exceed 180 calendar days from the time of submitting his or her application or from the commencement of residency in this state, whichever first occurs."

Answers A, B, and C: These answers address periods of time less than the required 180 days.

The correct answer is B.

This is a direct quote taken from California laws requirements for recordkeeping. Of note, these requirements do not apply if hard copy records are kept instead of electronic records.

Answer A: The guidelines for electronic recordkeeping do not specify that the back-up storage system must be non-computerized. The back up could be stored in a hard drive, for example. Similarly, the requirements state that having a mechanism to "copy" signature documents is necessary rather than being able to "print" them.

Answer C: This answer is spoiled for two reasons: 1) the back up system does not have to be non-electronic and 2) although having the records stored securely is important, there is no requirement for a double layer of security access such as two passwords.

Answer D: The first two statements in this answer are correct, however the third is incorrect. If a comprehensive electronic record system is used, the hard copies can be destroyed once the electronic record has been stored.

The correct answer is B.

When the court hires you to evaluate a defendant, the court is your "client," and there is no privilege (E.C. 1017, Court-Appointed Psychotherapist).

Answer A: Paying for an adult's treatment does not give a parent legal access to their records.

Answer C: Emancipated minor's parents do not have legal rights to their child's records.

Answer D: Only a deceased patient's representative may request their records, not necessarily their next of kin.

The correct answer is A.

Per the APA Ethics Code, Advertising and Other Public Statements, 5.01, "psychologists do not make false, deceptive, or fraudulent statements concerning (1) their training, experience, or competence." Although the psychologist was "practicing in the field for ten years" while she was in graduate school, this statement may be misleading to the public. Specifically, the public may assume that she has been licensed for 10 years. Therefore, the psychologist should remove this statement.

Answer B: Psychologists must include their license number in any advertising, public directory, or solicitation of business. However, this suggestion does not address the underlying issue of making a misleading statement to the public and thus removing that statement.

Answer C: Although providing the date of licensure may help elucidate the number of years the psychologist has been licensed, it is possible that the public may not know how to interpret this date and thus defer to the misleading statement made by the psychologist.

Answer D: As mentioned previously, the psychologist should remove this statement to ensure that she is not making any deceptive statements to the public regarding her training, experience, or competence.

The correct answer is D.

This answer is most consistent with the requirements of Standard 2.02 of the Ethics Code, which states that, "in emergencies, when psychologists provide services to individuals for whom other mental health services are not available and for which psychologists have not obtained the necessary training, psychologists may provide such services in order to ensure that services are not denied. The services are discontinued as soon as the emergency has ended or appropriate services are available."

Answer A: A psychologist should treat someone in crisis when there are no other available referrals. 

Answer B: Consumers cannot make decisions about the psychologists' competence, rather its the psychologist's responsibility to protect their clients.

Answer C: Given that this is well beyond the psychologist's competence, it would be better to connect them to appropriate services after the crisis has passed.

B.not privileged.