Mixed Deck — All CLEE Topics Flashcards

A therapist receives a friend request from a current client on a social media platform. What is the most ethical course of action?

Answer: Decline the request and explain that it is important to keep professional boundaries.

Accepting a client's social media friend request creates a dual relationship, blurring professional boundaries and potentially exposing the client to personal information about the therapist, or vice versa. This can compromise the therapeutic relationship and client confidentiality. Ethically, therapists must maintain clear professional boundaries, which includes separating personal and professional online interactions to protect the client and the therapeutic process.

Under California law, when is a therapist legally REQUIRED (not merely permitted) to break confidentiality for a suicidal client?

Answer: There is no absolute legal requirement—breaching confidentiality for suicidality is a matter of clinical judgment

California law permits therapists to breach confidentiality for suicidal clients but does not universally mandate it; therapists must exercise clinical judgment based on imminence and severity.

A resident in your care tells you that he does not like his current physician and wishes to be seen by another doctor. Your response to this should be ____.

Answer: to help the resident contact the social worker or RN for assistance in this matter

Residents have the right to choose their physician. If a resident expresses dissatisfaction and wishes to change doctors, the nursing assistant's role is to advocate for them and facilitate their request through appropriate channels. This typically involves contacting the social worker or Registered Nurse (RN), who can then guide the resident through the process of changing physicians, respecting their autonomy.

A client with a serious mental illness lacks capacity to provide informed consent. The therapist should:

Answer: Seek consent from a legally authorized representative and/or pursue appropriate legal processes

When a client lacks decisional capacity, therapists must seek consent from a legally authorized representative (LAR) such as a conservator or authorized family member.

How many hours of the 3,000 required supervision hours for MFT licensure must be direct supervisor contact?

Answer: At least 100 hours

California Business and Professions Code §4980.43 requires at least 104 hours of direct supervisor contact (individual or group) within the 3,000 supervised hours.

Regarding the duty to report under CANRA, a therapist's suspicion of child sexual abuse must be reported:

Answer: Regardless of whether the child has made a direct disclosure

CANRA does not require a direct disclosure or physical evidence; reasonable suspicion from any source — including behavioral observations — is sufficient.

When reporting elder abuse in California, the initial report must be made to:

Answer: Adult Protective Services or local law enforcement

Reports of elder or dependent adult abuse must be made to Adult Protective Services (APS) or, in facilities, the appropriate licensing agency and law enforcement.

In California, the written follow-up report for child abuse must be submitted within how many hours of the initial phone report?

Answer: 36 hours

California Penal Code §11166 requires the written report (Form SS 8572) to be submitted within 36 hours of the initial telephone report.

Under California law, how long must a licensed therapist retain adult client records after the last date of service?

Answer: 7 years

California law requires adult mental health records to be retained for at least 7 years from the date of last service.

Which of the following is required for a California BBS licensee to renew their license?

Answer: Completing continuing education (CE) hours as required by the BBS

California BBS licensees must complete required continuing education hours — typically 36 hours per renewal period for MFTs — to renew their license.

When a mandated reporter suspects that a child is being abused by someone outside the family, who should receive the report?

Answer: Child Protective Services and/or law enforcement

CANRA reports go to Child Protective Services (CPS) or local law enforcement regardless of whether the suspected perpetrator is a family member or someone outside the family.

Which exception allows a therapist to disclose confidential information to prevent a patient from self-harm?

Answer: The imminent danger to self exception under Civil Code §43.92

California Civil Code §43.92 and the duty-to-warn statutes permit disclosure to prevent serious and imminent harm to the patient themselves.

An MFT associate must use which designation when identifying themselves to clients?

Answer: MFT Associate or Associate Marriage and Family Therapist

California updated the title to 'Associate Marriage and Family Therapist' (AMFT) — using the term 'intern' is no longer permitted as it may be misleading to clients.

In California, which board licenses Marriage and Family Therapists (MFTs)?

Answer: Board of Behavioral Sciences (BBS)

The California Board of Behavioral Sciences (BBS) is the regulatory agency responsible for licensing MFTs, LCSWs, LPCCs, and LEPs.

Which California statute governs the confidentiality of mental health records for licensed therapists?

Answer: Civil Code §56.10

California Civil Code §56.10 (part of the Confidentiality of Medical Information Act) governs the disclosure of medical and mental health records.

A patient discloses that they were abused as a child but the abuse ended years ago and the perpetrator is now deceased. The therapist's reporting obligation is:

Answer: No current reporting obligation since the perpetrator is deceased and there is no ongoing risk

CANRA reporting is intended to protect children from ongoing or future harm; historical abuse with no current risk and a deceased perpetrator generally does not create a mandatory reporting obligation.

Mandated reporters of elder abuse in California who report in good faith are protected by:

Answer: Immunity from civil and criminal liability

California Welfare and Institutions Code §15634 grants good-faith reporters immunity from civil and criminal liability, regardless of whether the report is substantiated.

Which of the following is NOT required in the written disclosure statement under California Business and Professions Code §4980.54?

Answer: The therapist's personal religious or spiritual beliefs

While therapists may choose to disclose personal beliefs, California's mandatory disclosure requirements focus on professional credentials, approach, fees, and client rights — not personal religious beliefs.

Which of the following are indicators that you may be having boundary troubles?

Answer: All of the above

Indicators of boundary troubles often involve a shift in the professional's internal experience and behavior towards a client. Difficulty saying 'no,' a desire to 'save' or 'rescue' a client, sharing excessive personal details, or wanting to control or punish a client all signal that professional boundaries may be eroding or have already been crossed. Recognizing these signs is crucial for ethical practice.

Under BBS regulations, an MFT trainee may provide psychotherapy services only when:

Answer: They are enrolled in an approved program and working under qualified supervision

MFT trainees must be enrolled in an approved graduate program and work under the supervision of a qualified supervisor to provide therapy services legally.