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69 Cards in this Set
- Front
- Back
What kinds of matters does Criminal Law cover? What is the standard of proof?
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-things that ppl do wrong that require moral action by society; moral blame
- "Beyond a reasonable doubt" or a standard of 99% certainty |
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What kinds of matters does Civil Law cover?
What is the standard of proof? |
-assigns responsibility for harm & determining proper amends; liability
-"by clear & convincing evidence" 70% certainty |
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Who has the burden of proof?
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1. Criminal – prosecutor (govt or state) to show the defendant is guilty beyond a reasonable doubt
2. Malpractice – complaining party and their attorney |
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– “a preponderance of the evidence”
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- Lowest standard of proof
- only about 51% so jury has to be a little more sure that something happened than it didn’t (this is where malpractice is) |
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Standard of proof
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amount of proof needed to support one’s case in the legal system
-Criminal "beyond a reasonable doubt" -Civil "by clear & convincing evidence" |
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What is "Discovery" ??
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a process by which one party in a lawsuit discovers facts from another party in the law suit
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What are the 3 important purposes of Discovery?
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-helps focus the issues to be addressed in trial
-helps save facts that might otherwise have been forgotten or misplaced -might lead to a settlement outside of court |
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Depositions
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used to discover facts that are unknown; consist of oral questions & responses and attorneys can ask questions from a wide range of topics; most will occur at an attorney’s office
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Interrogatory
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written portion of discovery
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i. Writ of habeas corpus:
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originally used for a judge to review the legality of putting someone in jail; in CA used in mental health laws to review an individual’s involuntary hospitalization. Allows someone to go in front of judge and make case that they were hospitalized illegaly
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Statute of Limitations
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law limits amount of time that can pass before a person brings a law suit
BECAUSE -Even if a person has harmed someone, they have right after a certain amount of time to know they can continue with life -Evidence can get old; stale |
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Subpoena
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legal process granted to lawyers in order to conduct discovery (part of fishing expedition) & to have a witness appear at legal proceeding
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Subpoena duces tecum
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requires you to bring docu with you to legal proceedings
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What are the steps you should take after receiving a subpoena for client records?
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1. Contact client & ask to waive or invoke privilege
2. If unsure – ask to be released from subpoena but if not, have to comply. Once there say client has invoked privilege and can’t release info (or documents if that is the case); if judge says you still need to comply, follow rules to a “T” |
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If you received a subpoena what must you do regardless of a client's decision to invoke privilege?
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APPEAR; this is mandatory & you don't need the client's release in order to do this. Privilege is a different matter & must be determined by judge & your client
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Who grants a subpoena?
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The judge
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Who issues a court order? What does it contain?
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Issued by the judge
Specifies what material is to be released |
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After receiving a subpoena, how many days do you have to respond?
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30 days to notify insurance & file a response in court or else the court will file a default judgment in favor of the opposition
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What are you supposed to do after receiving a subpoena? What are the steps?
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1. Contact insurance– will provide counsel
2. Start gathering docus, reports, journals you have on patient’s case (client record) 3. Provide everything to attorney 4. Meet w/attorney appointed to case & be truthful & omit nothing 5. Duty of Confidentiality COMPLETE – give everything to lawyer (they can't breach confidentiality) 6. Do not contact patient/patient’s family |
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What are some examples of false, misleading, or deceptive statements that are prohibited by the ad/marketing rule?
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-misrep of fact
-failure to disclose material facts -false/unproven expectations of + results -unclear fee statements -anything misleading to an ord prudent person |
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What should be included in ads/marketing?
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-the purpose
-degrees, license #, school -statements of fact -intern status, licensure status, ID-ing info |
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Are there specific standards written in the Ethical Principles... regarding website content?
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NO
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What do consumers look for on psychologists' websites?
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-office address, insurance, hrs, experience, work #, kind of therapy, area of specialty, fees, etc
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What do you have to do before offering services to someone who is already receiving services from another therapist?
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-confer w/other therapist & get approval
or -wait until they terminate other therapy |
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What does the Health Insurance Portability & Accountability Act cover?
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-rules regarding security of records
-privacy policies that must be dvlpd & notice given to clients -assures consumer access to records -uniform electronic records -"scale-able" compliance |
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What are the 3 major rules under HIPAA?
Who enforces them? |
1. Privacy Rule
2. Transaction Rule 3. Security Rule Enforced by DHHS by relying on complaints & imposing fines; currently emphasize voluntary compliance |
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What are the requirements covered in HIPAA's Privacy Rule?
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-written acknowledgment obtained of privacy practices notice
-obtain authorization to release things such as therapy notes -have privacy policies/procedures -disclose info about client's privacy & access rights to them -adopt & be able to demonstrate safeguards -train employees -in place procedures for if records/confidentiality gets broken -in place complaint procedures |
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Duty to Mitigate
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covered in HIPAA Privacy rule
example: if records are mistakenly disclosed, retrieve & notify client |
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Who does the HIPAA Privacy Rule pertain to?
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-hospitals, clinics
-managed care orgs -group practices - solo practitioners who use electronic transactions |
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Issue: Necessity of License
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Rule: In order to provide psychotherapy services for $, one needs a valid license
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Issue: Scope of Practice
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A psych may provide individuals, gps, orgs, or the public any psychological service, including, but not restricted to: Dx, prevention, treatment, & amelioration of psychological problems & emotional & mental disorders of individuals & gps
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Issue: Competence
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A psych must demonstrate appropriate edu, training, & (supervised) experience to provide services. If not, the edu, training, & (supervised) experience must be gained as quickly as possible or a thoughtful & appropriate referral must be made.
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Issue: Informed Consent
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Rule: A client must be informed of anything that would affect his/her decision to enter/continue treatment, including but not limited to, fees, cancellation policy, intern or trainee status, & limits of confidentiality
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Issue: Client Welfare
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Rule: A psych must do what is in the best interest of the client &, if the client fails to benefit from treatment, the psych should get consultation or make a thoughtful & appropriate referral
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Issue: Confidentiality
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Rule: A psych has a legal & ethical responsibility to safeguard his/her clients from unauthorized disclosure of info revealed during treatment, except when there is a danger to self/others, child abuse, dependent adult abuse, or elder abuse
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Issue: Treatment of Minors
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Rule: In order to treat a minor (<18yrs old), the consent of a parent w/legal custody or a guardian is req'd unless:
-the minor is emancipated or -12 yrs old & mature enough to consent to treatment & -----in danger of severe phys/mental harm or -----the victim of incest or child abuse |
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Issue: Advertising & Marketing
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Rule: Psychologists should not use any false, misleading, or deceptive statements in their advertising/marketing materials/claims
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Issue: Inter-professional Relations
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Rule: A psychologist may NOT receive commissions/rebates for referrals & should not offer services to a person already receiving services from another therapist *EXCEPT*
-by agreement w/other therapist OR -after the person terminates other therapy |
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Issue: Psychotherapist Conduct
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Rule: A psychotherapist should do nothing that negatively impacts the client's welfare
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HIPAA: Privacy Rule
Electronic Transactions - definition |
The transmission of info between 2 parties to carry out financial or admin activities related to healthcare via electronic technology
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What are the types of electronic transactions that HIPAA's Privacy Rule covers?
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-the internet
-the extranet (internet tech linking a biz w/collaborating parties only) -leased lines -dial-up lines -private networks -using magnetic tape, disk, or cd media -computer faxes |
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HIPAA: Transaction Rule
What kind of format must you submit claims for services in? Who must comply? |
-requires that you use the standard format
-any one who submits claims electronically -who provides MediCal or MediCare services |
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HIPAA: Security Rule
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Assures secure & private communication maintenance of confidential info
-Covers how you put together your systems (physical infrastructure, access to offices, files, computers, hard drives, software) |
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HIPAA: Health Care Record
includes... |
-dates & times of services provided
-meds - test results - Dx - Treatment Plan - Prognosis & progress notes |
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HIPAA: Psychotherapy Notes
include... |
-Contents of sessions
-Impressions regarding client -details of conversations -process note entries |
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What is the difference between a Health Care Record and Psychotherapy Notes
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- HIPAA mandates you maintain a health care record (objective data) but the psychotherapist has a choice as to whether or not to keep psychotherapy notes (subjective/"soft" data, such as impressions, conversations, session content)
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What would SOAP notes fall under? Psychotherapy Notes or the Health Care Record?
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The health care record
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Do you have to inform your client that you may keep psychotherapy notes?
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YES
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What is the Client Record?
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-All paperwork associated w/treatment, including
- Intake forms -Informed Consent -Treatment Plan -Assessments, test results, measures -Progress notes (NOT PROCESS NOTES!) -Financial records -Correspondence |
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What should you take caution to do when adding to your Client Record?
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-Avoid being emotional, judgmental, etc b/c it can be used against you
-write & store as though a lawyer were looking over your shoulder |
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Who owns the client records?
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The content is owned by the client but the therapist owns the physical documents
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Who has the right to access the client record?
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-The client (complete access)
-authorized client reps Either way, records are reviewed together in your office; originals can't be changed so don't leave your client alone w/them! - Summaries can be written instead, but the client then has the option of going to court & having entire record reviewed |
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Before you can allow access to the client record, what must be done?
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- a written request specifying which documents they want to be reviewed
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What is the time line for responding to written requests to see the client record?
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-w/in 5 WORKING days, records must be made available during REGULAR biz hours
-w/in 15 DAYS after request is received, copies must be transmitted to requester |
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What happens if you deny the client access to their client record?
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(only do if you believe that sharing would be set back their progress in therapy or otherwise hurt them)
-provides grounds for a lawsuit -you MUST have a very sound rationale |
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In order to deny the client access to their client record, what must the therapist do?
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-Note date, reason for referral, description of adverse consequences
-inform client of the decision & of their right to have another therapist review the records -permit another clinician (chosen by client) to access records - note whether or not another therapist was directed to do so by the client |
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For how long does HIPAA require us to retain a client's records?
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-at least 7 yrs post discharge (hospitals) though 10 years is best
- Minors: at least 1 yr after minor turns 18 yrs old |
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What shouldn't you keep in the client record?
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-personal opinions
-discussions about a 3rd party -sensitive info -past criminal behavior (only important for your record if pertains to current activity) |
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What are the minimal requirements of Record-keeping?
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-ID-ing data
-Background/historical data -Dx/prognosis -Treatment plan -Informed consent -Progress notes -Termination summary |
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In addition to the minimum reqs of info to be included in your record-keeping, what might be helpful to include?
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-current psychological/psychiatric evaluations
-risk management/incident notes -consultations/supervisions -correspondence & phone calls -suggestions/directives ("failure to comply" documentation) -failed/ canceled appointment data -releases of info |
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Which principle applies to the issue of psychotherapist conduct?
What are some examples of conduct rules? |
Principle - Nonmaleficence
Examples of conduct rules: -Do not breach confidentiality -Do not have sexual relations w/clients |
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What is Malpractice?
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The failure to render professional services/to exercise the degree of skill ordinarily expect of other professionals in a similar situation AND which involves negligence that results in injury/loss to the client
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Who has the burden of proof in regards to claims of malpractice?
What must they prove? |
-Plaintiff has the burden of proof
-4 Ds (Duty, breach of duty, damage, direct causation) |
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What are the 2 major sources of malpractice suits?
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1. Sexual misconduct (Client Welfare - Dual Relationships)
2. Breaches of confidentiality outside the legitimate exceptions (confidentiality) |
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What is an assessment?
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An opinion based upon information and techniques sufficient to support findings
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If the case review doesn't support need for an assessment, what must you do?
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-Provide an explanation & sources of info that influenced your conclusion
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What does informed consent look like in regards to performing an assessment?
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-nature/purpose of the assessment
-related fees -3rd parties -opportunity for Q & A -time involved -confidentiality issues - given using reasonable language |
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What are the components of an assessment?
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Test data
--scores (raw & scaled) --test taker's responses --notes/recordings of statements & Bx Release of test data (very confidential) Obsolete tests/outdated test results Security of test materials (manuals, forms, test data, etc) |
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What does Sect 8 of the Ethics Code, Research & Publication, contain?
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-informed consent to participants
-deception in research -debriefing participants -reporting results (be specific; no generalizations) -Plagiarism -Publication |