MFT Legal Issues 4 — Questions and Answers
Question 1: A parent involved in a custody dispute asks an MFT who is seeing their child to write a letter supporting their custody claim. The therapist has only seen the child, not both parents. What is the most legally appropriate response?
- Write the letter because the child is the client
- Decline, as offering a custody opinion without evaluating all parties is ethically and legally problematic (Correct answer)
- Write the letter only if the other parent consents
- Write a neutral summary of the child's progress instead
Correct answer: Decline, as offering a custody opinion without evaluating all parties is ethically and legally problematic
A treating therapist should not render custody opinions having only seen one party, as this exceeds their role and can compromise the therapeutic relationship.
Question 2: Under HIPAA's Minimum Necessary Standard, when responding to a records request from another provider, a therapist should:
- Release the complete case file to ensure continuity of care
- Release only the psychotherapy notes as they are the most detailed
- Release only the information reasonably necessary to fulfill the purpose of the request (Correct answer)
- Release no information without a signed authorization
Correct answer: Release only the information reasonably necessary to fulfill the purpose of the request
The Minimum Necessary Standard requires releasing only the amount of PHI reasonably needed to accomplish the intended purpose.
Question 3: A therapist maintains psychotherapy process notes separate from the medical record. Under HIPAA, what is the status of these notes?
- They are subject to the same access rules as the general medical record
- They have additional protections and are generally exempt from patient access requests (Correct answer)
- They must be destroyed after each session
- They must be shared with insurance companies upon request
Correct answer: They have additional protections and are generally exempt from patient access requests
HIPAA grants psychotherapy notes additional protection — they are exempt from the general right of access and require a separate, specific authorization to release.
Question 4: A client asks the therapist to provide records directly to their attorney for a personal injury lawsuit. The attorney sends a subpoena, but no signed HIPAA authorization is included. What should the therapist do?
- Release the records to comply with the subpoena
- Contact the client to obtain a proper HIPAA-compliant authorization before releasing (Correct answer)
- Release only a summary, not the actual records
- Refuse all involvement in legal matters
Correct answer: Contact the client to obtain a proper HIPAA-compliant authorization before releasing
A subpoena alone is generally not sufficient under HIPAA — a compliant authorization or qualified protective order is also required.
Question 5: Which of the following best describes 'negligent supervision' as a legal risk for MFT supervisors?
- Failing to document supervision sessions properly
- Being held liable for a supervisee's clinical errors due to inadequate oversight (Correct answer)
- Providing supervision outside one's area of competence
- Using an inappropriate supervision model
Correct answer: Being held liable for a supervisee's clinical errors due to inadequate oversight
Negligent supervision holds supervisors legally liable when a supervisee causes client harm due to inadequate guidance, oversight, or training.
Question 6: A court appoints an MFT as a guardian ad litem for a child in a dependency case. In this role, the therapist's primary legal obligation is to:
- Advocate for the wishes of the custodial parent
- Represent the best interests of the child (Correct answer)
- Report findings to child protective services only
- Maintain strict therapeutic neutrality
Correct answer: Represent the best interests of the child
A guardian ad litem is appointed by the court to represent the best interests of the child, independent of the parents' positions.
Question 7: An MFT discovers that a former client, now deceased, was involved in an unreported crime against a third party. Does confidentiality survive the client's death?
- No — confidentiality ends automatically at death
- Yes — in most jurisdictions, confidentiality and privilege survive the client's death (Correct answer)
- Yes, but only for 6 months after death
- No — the surviving family can waive privilege on the client's behalf
Correct answer: Yes — in most jurisdictions, confidentiality and privilege survive the client's death
In most jurisdictions, the duty of confidentiality and privilege survive the client's death, though the personal representative may be able to waive privilege.
MFT Legal Issues 4
A parent involved in a custody dispute asks an MFT who is seeing their child to write a letter supporting their custody claim.
The therapist has only seen the child, not both parents.
What is the most legally appropriate response?