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"What Should I Do?" - The Ethics of Marketing, Money, and Managed Care - Test
by Gerald P. Koocher, Ph.D., ABPP and Patricia Keith‑Spiegel, Ph.D.

Course content © copyright 2009-2016 by Gerald P. Koocher, Ph.D. and Patricia Keith-Spiegel, Ph.D.. All rights reserved.

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1. By their very nature, advertisements of mental health services do not easily lend themselves to: Help
Comparisons across vendors such as advertisements of cars, cereals, and other products.
Placement in the Yellow Pages.
Directness or simplicity.
Individual Web pages.
2. Which of the following scenarios illustrates a situation in which direct solicitation of consumers would most likely be acceptable? Help
A psychologist notices the high divorce rate in his community and suggests to couples he meets at parties that they see him for marital therapy.
A school psychologist in the community sends a letter to local school personnel offering herself as an external referral source for consultation.
A marriage and family therapist contacts friends and family members of plane crash victims, as gleaned from newspaper articles, suggesting that they register for his trauma support group.
After giving a talk, a psychiatrist asks members of the audience to come and get his card even if they are already in therapy because he can prescribe drugs that other types of mental health professionals cannot.
3. John Smith is a licensed psychologist with a Ph.D. degree. He has a private practice. Which would be the most appropriate way for him to advertise his services? Help
John Smith, Ph.D.
Dr. John Smith.
John Smith, B.S., M.S., Ph.D.
Dr. John Smith, Ph.D., licensed clinical psychologist and hypnotherapist
4. When the course authors "Googled" the term, "find a therapist" about how many hits came up? Help
About 800
About 7.5 million
Over 50 million
5. Psychotherapists using Facebook and other social media: Help
Tend to advertise their services using appeals to fear.
Should always accept clients as "friends," lest clients feel rejected.
Must maintain professional decorum regarding content and control over who has access to their accounts.
Are immature.
6. What might state licensing boards find as unacceptable advertising? Help
Appeals to client fears
False claims of unique or one of a kind services
Testimonial advertising
All of the above may be unacceptable to some state licensing boards.
7. Which of the following advertisement texts is LEAST appropriate? Help
John Jones, Ph.D., licensed psychologist, specialist in child and adolescent psychotherapy, insurance payments accepted, 555-1234.
Dr. Mary E. Smith, B.A., M.A., Ph.D., licensed psychologist, fluent in Spanish, reduced rates available, 24-hour answering service, 555-9890.
Harrison Williams, Ph.D., licensed psychologist, first session free, call 555-2222. "Boston's best psychologist...he is really helping my family," says Polly Putz of Boston.
Feeling blue? Depression can turn into a serious problem. Call Ralph Upper, Ph.D. for a clinical evaluation, 555-9999.
8. Your course authors and others suggest that psychotherapists often find it uncomfortable to discuss ___ with clients. Help
9. Today and for the foreseeable future, any mental health professional who hopes to build a financially viable practice must prepare to work with ____. Help
Managed care in some form
A partner
A group practice
Seriously disturbed clients
10. A "therapy hour" lasts: Help
60 minutes.
50 minutes.
30 to 40 minutes.
Varying amounts of time, according to surveys.
11. In most cases, the psychotherapist should discuss fee information: Help
At the beginning of a relationship with a new client (i.e., on the original phone contact or first session).
By at least the fourth session.
As soon as the client's insurance runs out.
As soon as the client seems emotionally able to handle such a discussion.
12. The ethical psychotherapist is encouraged to offer some services "pro bono." This means: Help
Charging a higher than usual rate to cover those who cannot afford therapy.
Providing some therapy or other services free of charge or at a very low fee for the good of the public.
That the therapist should charge the lowest possible rates to all clients.
That therapists should get involved in political action.
13. Penny Less was in debt and could no longer afford therapy. Dr. Dollar told Penny that he would be happy to keep seeing her at the regular rate and that she could pay her bill at some later time. Help
This is always a compassionate way to help a client who still needs therapy.
This is not a helpful act if the client cannot reasonably be expected to pay it back.
This makes good sense only if Dr. Dollar includes an interest charge on the unpaid bill.
Dr. Dollar should continue seeing Penny indefinitely and at no charge until she no longer requires therapy.
14. When a client has been in treatment for an extended period of time (e.g., six months to a year), and inflation and other costs of conducting a professional practice have increased, what should the therapist ethically do regarding fees? Help
Fees may be hiked by a maximum of 25%.
Nothing - clients have a right to maintain their fees at the beginning rate for the duration of therapy, even if it extends for years.
Fees may be adjusted upward, but with appropriate notice and due regard for the client's welfare and ability to pay.
Clients must be given a 6 month warning period before raising fees.
15. Generally, it is inappropriate to bill clients for services before they have been rendered. Which of the below might be an exception? Help
When the client is extremely disturbed
When the client has a dissociative disorder ("multiple personality")
When hired to perform a child custody evaluation
If the client is given to flighty behavior
16. It is not unethical to charge a client for an appointment that is not kept or canceled on too short a notice if: Help
The therapist already has a "waiting list."
The client has not cancelled within 48 hours of the appointment.
The client was fully informed in advance of this billing practice.
The insurance company will pay for it.
17. Fee splitting has generally been viewed as unethical among medical and mental health professionals because: Help
Such agreements may preclude a truly appropriate referral in the client's best interests.
Such agreements can result in delivery of unneeded services.
Such agreements may lead to increased costs of services.
All of the above are correct answers.
18. In psychotherapy fee situations, a "third-party" relationship exists whenever: Help
A parent is paying for the minor child's therapy.
An organization or agency other than the client is involved in the payment to the therapist.
There is a duty to warn a third party about a client's threat to harm someone.
The client brings a family member along to the therapy session.
19. Which of the below is not usually defined as a health or mental health problem according to coverage provisions of most health insurance plans? Help
Educational testing
Vocational guidance
Child custody evaluations
All of the above are typically excluded from coverage as health or mental health services.
20. A client is seeing Doinit Myway, L.M.H.C. to try to help the client get along better with his mother, but the client's insurance company does not cover relationship counseling. So, Myway assigns a diagnosis of "adjustment reaction" to assure that the company will pay for the counseling. Myway is: Help
A compassionate therapist who has found a way to help his client.
Doing what needs to be done, given the way insurance companies are.
Flirting with insurance fraud.
Breaking confidentiality.
21. Insurance companies traditionally attempt to reduce the adverse effects of the so-called "moral hazards" by: Help
Devising ways to have policyholders share in the risk.
Hiring only licensed therapists.
Refusing to cover individuals who are diagnosed as "psychopaths."
Covering only those adverse events that result in physical pain.
22. What is the advantage of co-payment insurance benefit contracts? Help
The overall cost to policyholders is lowered because those actually using the benefits pay a significantly greater share of the costs.
Because clients pay some costs from the beginning, the level of motivation to succeed in psychotherapy may be increased.
The sole advantage of co-payment insurance benefit contracts is to enhance company profits.
Both 1 and 2 are advantages.
23. Case review can potentially eliminate unnecessary psychiatric hospital admissions or psychotherapy in the same way second opinions can reduce unnecessary surgeries. However: Help
Review and decision-making in the arena of mental health care are not often as clear-cut as problems in physical medicine.
Most clients require extended stays in psychiatric hospitals.
It takes an extended period of time to review cases and, in the meantime, psychiatric crises have passed.
Seeking case reviews violate clients' rights to confidentiality.
24. Some MCOs have been highly aggressive and heavy handed in contract offers in which of the below ways? Help
Clauses stating that the provider will take no legal action against the MCO under any circumstances
Clauses stating that the provider will be solely responsible in any legal actions undertaken by any party
Clauses stating that the provider must agree to provide services when benefits are exhausted
All of the above have appeared in MCO contract offers.
25. Which of the following is not a basic element of a fraudulent act? Help
One party conspires with another party to commit a crime against a third party.
The misrepresenter's intent is that another will rely on the false representation.
The recipient of the information is unaware of the intended deception.
The recipient of the information is justified in relying on or expecting the truth from the communicator.
26. A new client explains that she has a $200 deductible for mental health coverage on her insurance. She requests that you send her a bill with an extra $200 added in so that she will be able to use her insurance coverage immediately. You should: Help
Decline to do so, because it would constitute fraud.
Agree to do so, if you do not have a contractual relationship with the insurance company.
Tell the client that she is a crook and drop her immediately.
Agree to do so because it helps out the client.
27. A psychotherapist tries to help a client who has limited funds by not collecting the client's insurance co-payment, while leading the insurer to believe the payment was collected. This consideration is: Help
An illustration of the moral principle of compassion.
An illustration of the moral principle of self-sacrifice.
An illustration of the moral principle of "do no harm."
Insurance fraud.
28. Disclosing a non-paying client's name and address for a small claims suit is: Help
Ethical just so long as name, address, and diagnosis are the only facts given to the court.
Unethical because a client's name and address are privileged information.
Ethical because an unpaid bill constitutes a broken contract between the therapist and the client.



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