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What Should I Do? - 39 Ethical Dilemmas Involving Confidentiality - Test
by Gerald P. Koocher, Ph.D., ABPP and Patricia Keith‑Spiegel, Ph.D.

Course content © copyright 2009-2013 by Gerald P. Koocher, Ph.D. and Patricia Keith-Spiegel, Ph.D.. All rights reserved.

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1. What recent development has substantially complicated the ability to maintain confidentiality? Help
Electronic databases
The elimination of client privilege
The legal requirement that therapists disclose information to any family member
All of the above are correct.
2. One way to differentiate between the related concepts of confidentiality, privilege, and privacy, is that: _______ is guaranteed by the Constitution, _______ is chiefly a legal concept, and _______ is chiefly a professional standard. Help
Confidentiality, privacy, privilege
Privacy, confidentiality, privilege
Privacy, privilege, confidentiality
None of the above is in the correct order.
3. Concern about electronic surveillance and a variety of other observational or data-gathering activities fall under the heading of _____ issues. Help
Freedom of speech
4. Confidentiality refers to: Help
A basic right granted to all individuals by the Bill of Rights
A general standard for professional conduct that obliges a professional not to discuss information about a client with anyone
The responsibility of the client to keep information shared with the therapist confidential
All of the above are correct.
5. While there is much debate about the degree to which one should, if ever, violate a client's confidentiality, there is uniform agreement that: Help
The client has the right to know the limits on confidentiality from the outset.
The client's confidentiality must be violated if he/she has admitted to committing a felony.
Therapists should have the final say concerning the rights of confidentiality of their clients.
Total confidentiality should be mandated by the law to avoid confusion.
6. Privileged communication is a right granted by common law or statute to: Help
The psychotherapist.
The client.
Conversations among professional colleagues.
The military.
7. Under the so-called Tarasoff doctrine (Tarasoff v Board of Regents of the University of California) a therapist may have an obligation to: Help
Report potentially violent clients to the police.
Take steps to protect identified third parties when a client threatens to harm them.
Maintain confidentiality without exception.
Refuse services to potentially dangerous clients.
8. The duty of care when clients may be in danger to themselves or others includes which of the following actions? Help
Increase the number of sessions or communications.
Warn possible victims.
Alter medications.
All of the above may be appropriate to uphold a duty of care.
9. If a therapist gets a call from a suicidal client who is at immediate risk, the treating therapist's first response should be to: Help
Discuss the case with a colleague.
Learn the client's location and assure that help will reach the client.
Seek a court order to hospitalize the client.
Try to reach the client's next of kin.
10. Which of the following is not an unethical breach of confidentiality? Help
Telling your spouse identifiable details of a troubling case you encountered at work
Showing a videotape of a client to a class without securing a release, but protecting the client by withholding the last name
Discussing details of a case with your supervisor
Discussing the needs and concerns of an 18 year old client with the child's parents
11. In which of the following situations might breaking confidentiality be appropriate? Help
A client tells you that he hates his teacher and would be happy if she had a heart attack.
A client tells you she is planning to kill herself this evening.
A client tells you that he is thinking about robbing a bank.
None of the above would qualify as a justifiable reason to break confidentiality.
12. A consent to release of information form: Help
Allows a therapist to release information to anyone who requests it.
Designates a specific person to whom any and all information may be released.
Specifies which information may be released and to whom.
Is not necessary when a client has given oral consent to release of confidential information.
13. A release-of-information form should contain: Help
The name of the person to whom the records are to be released.
The purpose for the release of information.
The name of the records to be sent and any limitations on the data to be provided.
All of the above.
14. Opponents of open client access to records make what argument? Help
The therapist must feel free to speculate and jot down any thought or comments, some of which will invariably seem erroneous or misleading if taken out of context.
The records could be unintelligible to a layperson and the revelations may serve no useful purpose.
Harm may follow release of technical professional information to clients who are not equipped to deal with it.
All of the above are correct.
15. You receive a subpoena demanding all records in your files on your client who is charged with a crime. You should immediately: Help
Provide the district attorney with a full copy of your file.
Provide nothing, and notify the client or his attorney.
Remove any hand-written informal jottings from the file and shred them.
Re-type any hand-written notes so they will be easy to read before you turn them over.
16. Which of the following may threaten a therapist's ability to maintain confidentiality? Help
Maintaining progress notes on one's laptop computer
Releasing information to insurance companies
Receiving a subpoena
All of the above are correct.
17. The modern HER (Health Care Records) require: Help
Ready access by any health care provider without special access permission.
The practitioner to sign a waiver of confidentiality.
18. When clients decide to submit a claim for mental health benefits to an insurance company (or authorize a therapist to do so on their behalf), they may not realize that: Help
In so doing, the provider of services will share confidential information.
Their rates will immediately be raised significantly.
The therapist will share this information with colleagues.
The insurance company will decline reimbursement.
19. How long one should keep client records is a function of: Help
The type of record.
The probability of need for future services.
The applicable state or federal regulations.
All of the above are correct.
20. What are the two key factors a therapist should consider in making a decision about retention or disposition of records? Help
Client welfare and therapist welfare
At least two years have passed since the last visit and diagnosis.
Applicable legal obligations and client welfare
Diagnosis and any insurance requirements
21. Which of the following is not true with respect to a therapist's case files? Help
Obsolete materials should be culled from the files.
The IRS may inspect them upon request.
A therapist should specify a means of disposition in the event of his/her death.
Standards on required duration of retention vary from state to state.
22. If a psychotherapist learns information from a client about an impending business merger that is not yet known to the public: Help
The therapist should seek further advice before investing in either company.
The information can readily be shared with others.
The therapist has a duty to alert the Securities and Exchange Commission.
Making an investment that seeks to profit on the information would be unethical.



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