EPPP Test Ethical and Legal Standards Questions and Answers — Questions and Answers
Question 1: A psychologist receives a subpoena from an attorney to produce a client's therapy records. The psychologist has not received consent from the client to release the information. What is the psychologist's most appropriate first step?
- Release a summary of the records but withhold sensitive details.
- Immediately comply with the subpoena to avoid legal penalties.
- Contact the client, inform them of the subpoena, and seek their consent to release the records. (Correct answer)
- Ignore the subpoena because it is not a court order.
Correct answer: Contact the client, inform them of the subpoena, and seek their consent to release the records.
The psychologist's primary ethical and legal obligation is to protect client confidentiality. The first step upon receiving a subpoena is to contact the client, discuss the situation and the potential implications of releasing or not releasing the records, and determine the client's wishes. A subpoena is a legal demand, but it does not override the psychologist's duty of confidentiality without the client's consent or a court order. Simply releasing records (even a summary) without consent is a breach of confidentiality. Ignoring the subpoena is not advisable as it can lead to legal consequences.
Question 2: The APA Ethics Code is divided into General Principles and Ethical Standards. Which of the following best describes the primary difference between these two sections?
- General Principles are enforceable rules for specific situations, while Ethical Standards are aspirational goals.
- General Principles are aspirational goals that guide psychologists, while Ethical Standards are specific, enforceable rules of conduct. (Correct answer)
- General Principles apply only to research activities, while Ethical Standards apply to all professional activities.
- General Principles are updated annually, while Ethical Standards are revised only once per decade.
Correct answer: General Principles are aspirational goals that guide psychologists, while Ethical Standards are specific, enforceable rules of conduct.
The General Principles (e.g., Beneficence and Nonmaleficence, Integrity) are aspirational and intended to guide psychologists toward the highest ideals of the profession. They are not enforceable rules themselves. The Ethical Standards, in contrast, set forth specific, enforceable rules for conduct. Violations of the Ethical Standards can lead to sanctions by the APA or other bodies.
Question 3: A psychologist practices in a small, isolated rural community. The psychologist's client is a baker who has just opened the only bakery in town. The psychologist's child has a severe gluten allergy, and the baker is the only person in the community who can prepare a custom, gluten-free birthday cake for the child's upcoming party. Which of the following actions is most consistent with ethical guidelines regarding multiple relationships?
- Refuse to do business with the client to avoid any possible multiple relationship.
- Order the cake but keep the transaction anonymous by having a friend pick it up.
- Terminate the therapeutic relationship with the client before ordering the cake.
- Discuss the potential for a multiple relationship with the client, assess for any risk of harm or exploitation, document the discussion, and then proceed with the business transaction. (Correct answer)
Correct answer: Discuss the potential for a multiple relationship with the client, assess for any risk of harm or exploitation, document the discussion, and then proceed with the business transaction.
The APA Ethics Code recognizes that some multiple relationships are unavoidable, particularly in settings like small rural communities. The ethical focus is on avoiding exploitation or harm. The most appropriate course of action is to address the situation openly with the client, evaluate any potential negative impacts on the therapeutic relationship, ensure the business transaction does not create a power imbalance or harm, and document the decision-making process. Avoiding the relationship entirely may not be practical or necessary and could even harm the client if therapeutic services are limited.
Question 4: The landmark legal case of Tarasoff v. Regents of the University of California established the "duty to protect." This duty requires a therapist to take reasonable steps when a client communicates a serious threat of physical violence against an identifiable victim. Which of the following actions is a primary way a psychologist can discharge this duty?
- Having the client sign a no-harm contract.
- Warning the potential victim and/or notifying law enforcement. (Correct answer)
- Immediately terminating the therapeutic relationship with the client.
- Documenting the threat thoroughly in the client's file.
Correct answer: Warning the potential victim and/or notifying law enforcement.
The Tarasoff ruling established that a therapist's duty to protect may require them to breach confidentiality to protect a third party from harm. The primary and most direct ways to discharge this duty involve taking protective actions, such as warning the intended victim, notifying the police, or initiating involuntary commitment. While documenting the threat is crucial, it is not sufficient on its own. A no-harm contract can be a therapeutic tool but does not legally fulfill the duty to protect. Terminating the client would be considered abandonment and fails to address the danger.
Question 5: Dr. Lee is asked by a television news program to provide commentary on the psychological state of a defendant in a high-profile murder trial. Dr. Lee has not evaluated the defendant but has reviewed publicly available news reports and court documents. According to the APA Ethics Code, what is required for Dr. Lee to ethically provide commentary?
- She must first obtain written consent from the defendant to discuss the case.
- She must avoid giving any opinion and only state facts from the public record.
- She must clearly state that she has not conducted an evaluation and clarify the basis and limitations of her opinions. (Correct answer)
- She must decline to comment, as it is unethical to discuss an individual one has not formally evaluated.
Correct answer: She must clearly state that she has not conducted an evaluation and clarify the basis and limitations of her opinions.
APA Ethical Standard 5.04 (Media Presentations) allows psychologists to provide public advice or comment. However, they must take precautions to ensure their statements are based on their professional knowledge and are consistent with the Ethics Code. Crucially, they must clarify that no professional relationship has been established and state the limitations of their opinions, especially when they have not personally evaluated the individual. It is a violation to present opinions as if they are based on a formal evaluation when one has not occurred.
Question 6: Under the Health Insurance Portability and Accountability Act (HIPAA), which of the following is an example of Protected Health Information (PHI)?
- An individual's name and address listed in a public phone directory.
- A client's diagnosis written on a billing statement sent to their insurance company. (Correct answer)
- A statistical report on mental health trends where all individual data has been de-identified.
- A pamphlet on stress management techniques handed out in a psychologist's waiting room.
Correct answer: A client's diagnosis written on a billing statement sent to their insurance company.
Protected Health Information (PHI) is any individually identifiable health information transmitted or maintained by a covered entity. A billing statement that includes a client's name, diagnosis, and insurance information is a clear example of PHI because it links a specific person to their health information and payment for care. Publicly available information, de-identified data, and general health pamphlets are not considered PHI.
EPPP Test Ethical and Legal Standards Questions and Answers
A psychologist receives a subpoena from an attorney to produce a client's therapy records.
The psychologist has not received consent from the client to release the information.
What is the psychologist's most appropriate first step?