CLEE Informed Consent 2 — Questions and Answers
Question 1: For informed consent to be valid in a therapeutic context, the client must have:
- Prior therapy experience to understand the consent fully
- Capacity to understand the information, be given adequate information, and consent voluntarily (Correct answer)
- A third party present to witness the signing
- At least 48 hours to review consent documents
Correct answer: Capacity to understand the information, be given adequate information, and consent voluntarily
Valid informed consent requires three elements: decisional capacity, adequate disclosure of information, and voluntariness (free from coercion).
Question 2: A California therapist is required to inform clients of the limits of confidentiality:
- Only when confidentiality must actually be broken
- At the beginning of the therapeutic relationship (Correct answer)
- Only when mandated reporting is likely
- Once per calendar year in writing
Correct answer: At the beginning of the therapeutic relationship
California law and ethical standards require therapists to disclose confidentiality limits — including mandated reporting, duty to warn, etc. — at the outset of treatment.
Question 3: When treating a minor with parental consent, the therapist should also:
- Obtain the minor's assent when developmentally appropriate (Correct answer)
- Ignore the minor's preferences as the parent is the legal decision-maker
- Require the parent to co-sign every treatment note
- Exclude the minor from all discussions about their own treatment
Correct answer: Obtain the minor's assent when developmentally appropriate
While parents provide legal consent for minors, best practice and ethical standards call for obtaining the minor's assent (agreement) when age and development allow.
Question 4: A therapist plans to use an evidence-based treatment the client is unfamiliar with. Informed consent requires the therapist to:
- Proceed without extensive explanation since it is evidence-based
- Explain the treatment, its rationale, expected benefits, and any known risks (Correct answer)
- Have the client research the treatment independently before consenting
- Obtain written consent only after the first session
Correct answer: Explain the treatment, its rationale, expected benefits, and any known risks
Regardless of whether a treatment is evidence-based, informed consent requires explaining the treatment rationale, expected benefits, risks, and alternatives.
Question 5: Which of the following undermines the voluntariness of informed consent?
- The therapist answers all of the client's questions about treatment
- A client is told their benefits will be cut if they refuse therapy (Correct answer)
- The therapist provides a written copy of the consent form
- The therapist reviews the consent document verbally with the client
Correct answer: A client is told their benefits will be cut if they refuse therapy
Coercion — including threats to cut benefits or face consequences for refusal — violates the voluntariness requirement for valid informed consent.
Question 6: A therapist wishes to video record sessions for training purposes. The therapist must:
- Notify the client in the initial disclosure but no separate consent is needed
- Obtain specific written informed consent for recording, separate from general therapy consent (Correct answer)
- Obtain supervisor approval only — client consent is optional
- Obtain consent only if the recording will be shown outside the agency
Correct answer: Obtain specific written informed consent for recording, separate from general therapy consent
Recording sessions requires separate, specific informed consent beyond the general therapy consent, as recording is not a routine part of treatment.
CLEE Informed Consent 2
For informed consent to be valid in a therapeutic context, the client must have: