Assessing and Managing Risk in Psychological Practice: An Individualized Approach

IMPORTANT - PLEASE NOTE:
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1. All practitioners should realize that they:
• Will make mistakes
• Can not help everyone
• Do not know everything
• All of the above


2. In the risk management formula (Clinical Risk= P * C * D / TF), the “P” refers to:
• Proactive controls
• Payment plans
• Patient risk factors
• Principle-based ethics


3. The risk management formula is a:
• Mathematical formula where fairly precise values can be substituted
• Legal standard commonly used by licensing boards
• Heuristic to help psychologists weigh the benefits and risks of certain actions
• All of the above


4. Which of the following does NOT belong in the category of high risk patients?
• Members of cultural or linguistic minorities
• Patients with complex PTSD
• Wealthy patients
• Patients with Cluster “B” personality disorders


5. The characteristics of passionately committed psychologists include all except that they:
• Are embedded in a social network
• Solicit feedback from others
• Seek out and welcome challenges
• Do not worry about burnout


6. The phrase “Personal Skill Inventory” refers to the:
• Knowledge and ability of the psychologist to apply specific techniques
• Characteristics of the patients being treated
• Context under which treatment occurs
• Inventory of the patient’s personal skills


7. Research shows that the likelihood of malpractice suits against physicians is correlated with:
• The income level of the patient
• The objective degree of harm
• The extent to which the physician deviated from standards of care
• All of the above


8. According to ASPPB data, the most common reason for being disciplined by a licensing board is:
• Patient abandonment
• Boundary violations
• Breach of confidentiality
• Failure to complete continuing education requirements


9. As agencies of the state, licensing boards must afford psychologists the same due process rights that criminals are guaranteed under the 14th Amendment to the US Constitution.
• TRUE
• FALSE


10. Recent data show that there has been an increased risk of disciplinary actions from ________ and a decreased risk of disciplinary actions from ____________ and ________________.
• Licensing boards, malpractice courts, ethics committees
• Malpractice courts, licensing boards, ethics committees
• Criminal courts, malpractice courts, ethics committees
• Ethics committees, criminal courts, malpractice courts


11. Which is NOT true of Ethics Committees?
• They only have jurisdiction over members of their associations
• They make determinations based on the extent to which a patient was harmed
• They make determinations based on whether an ethics code was violated
• They can expel a member from their association if indicated


12. Each of the following is one of the 4 “D’s” of Malpractice EXCEPT:
• Detrimental impact on the profession
• Deviation from standards
• Direct connection between Deviation and Damage
• Damage to the patient


13. The statute of limitations for malpractice suits:
• Varies from state to state, but is usually 2 or 3 years
• May be waived for minors until they reach the age of 18
• In some states may be waived for adults on the basis of the discovery rule
• All of the above


14. According to the APA Ethics Code, the term “reasonable” means the prevailing professional judgment of psychologists engaged in similar activities in similar contexts.
• TRUE
• FALSE


15. You can identify a false risk management principle if it:
• Violates an ethical principle
• Leads to a false memory
• Does not remove all professional risk
• All of the above


16. The APA Ethics Code requires that you:
• Seek to get informed consent from patients who are capable of giving such consent
• Document informed consent
• Try to get the assent from patients who cannot legally give their consent
• All of the above


17. The principles of informed consent suggest that:
• The written materials for informed consent have improved so much in the last 5 years that they alone are usually sufficient to provide adequate informed consent
• It is best to follow the principle of “the doctor knows best”
• You should ask what the average patient would want to know under the circumstances
• If it was covered adequately in the beginning of treatment, there is very seldom any need to revisit it again


18. The research by Pomerantz and Grice suggests that patients may be more accepting of psychologists who:
• Engage in multiple relationships
• Are selective in the patients they choose
• Have firm standards concerning fees
• All of the above


19. The 9th Grade Algebra Teacher standard is a good metaphor for record keeping because psychologists should:
• Keep records with mathematical precision
• Explain their reasoning and thinking processes in solving a problem
• Make their records readily available to all patients
• Increase the detail of their record keeping in geometric proportion to their skill inventory


20. MOST CARE, PAINT, and BASIC ID are acronyms that identify:
• The importance of evidence-based treatment
• Factors that should be considered when doing detailed consultations
• Suicide prevention strategies
• Ways to conceptualize Bloom’s taxonomy


21. Dr. Brown was able to explain the term “informed consent,” demonstrating the _________ level of Bloom’s taxonomy of informed consent.
• Comprehension
• Application
• Synthesis
• Evaluative


22. Dr. Black was able to document a treatment session, adequately demonstrating the _________ level of Bloom’s taxonomy of documentation.
• Understanding
• Application
• Synthesis
• Evaluative


23. Dr. Grey was able to explain why she sought a consultation, evaluate its value, and defend how she used it, demonstrating the _________ level of Bloom’s taxonomy of consultation.
• Comprehension
• Evaluative
• Synthesis
• Knowledge


24. Dr. Black advertises that he is a specialist in five different areas of practice. According to the authors, this is:
• Entirely legitimate if Dr. Black has competence in those areas of practice
• Entirely legitimate if Dr. Black has taken CE courses in those areas of practice
• Possible, but unlikely because being a specialist typically requires that a large portion of your practice is in those areas of practice where you claim to be a specialist
• Acceptable only if Dr. Black has an ABPP in each of those areas of practice


25. Ronnestad and Orlinsky found that demoralization, defensiveness, and therapeutically destructive strategies were characteristics of:
• Stressful involvement
• Skill inventory
• Healing involvement
• Most older psychologists


26. According to Knapp and Keller, the source of information that does the most to develop the skills of psychologists is:
• Newsletters
• Didactic CE presentations
• Interactions with colleagues
• Journal articles


27. The ways to ensure redundant systems of protection include:
• Making patients an active part of the treatment team
• Using brief screening instruments with high risk patients
• Involving families or significant others in the treatment when clinically indicated
• All of the above


28. All psychologists should know basic information about psychopharmacology because they need to:
• Give patients information about treatment options involving medications
• Discontinue their patients medication if medically necessary to do so
• Suggest specific doses and types of medications to their patients
• All of the above


29. Prescribing psychologists who treat patients with serious mental illnesses need to be aware of these treatment issues EXCEPT:
• The capacity of the individual to give informed consent to treatment
• Confidentiality with family member caregivers
• When and how to integrate medications with appropriate psychosocial treatments
• The legal requirement for two sets of records


30. An intern under supervision was able to give a case presentation on a patient she is treating that integrated the components of treatment, their relationship to the presenting problems of the patient, and how the treatment was appropriate for the patient in light of the totality of the patient’s needs and life circumstances. This demonstrates the _____________level of Bloom’s taxonomy of competence.
• Knowledge
• Comprehension
• Synthesis
• Practical


31. The APA Ethics Code states that multiple relationships are inherently unethical.
• TRUE
• FALSE


32. Vulnerable psychologists who have sex with patients may:
• Have rescue fantasies
• Convince themselves that they are in love
• Fail to identify that the patient is using seduction or idealization as an interpersonal coping strategy
• All of the above


33. The private act of sexual misconduct has public implications because it:
• Often occurs in semi-public locations such as the offices of psychologists
• Always get publicized in local papers
• Diminishes the public confidence in psychology as a profession
• All of the above


34. The frequency of sexual contact between psychologists and patients appears to be decreasing in recent years because of:
• Recent laws in some states that criminalize this activity
• Active education and consultation programs, such as those offered by the Trust or SPTAs
• The changing demographics of the profession in which the percentage of women psychologists is increasing
• All of the above


35. Which of the following is TRUE about collateral contacts?
• They facilitate treatment of the identified patient
• They engender the same professional obligations to collateral contact as to the identified patient
• They can evoke the privilege, the same as for the identified patient
• All of the above


36. When treating high conflict families, the:
• Mere fact of treatment may, in and of itself, be harmful
• Stress of the situation may instigate or exaggerate destructive personality traits among the antagonistic parties
• Information that parties present in therapy could be distorted
• All of the above


37. To avoid allegations of misconduct when conducting custody evaluations, psychologists should:
• Avoid conducting evaluations on persons with whom they have conducted therapy
• Release information only with the appropriate authorizations or a court order
• Avoid appearing to be biased in favor of one party over another
• All of the above


38. When a child or parent makes an allegation of child abuse in the context of a child custody evaluation, the psychologist should:
• Investigate the allegation thoroughly before reporting it
• Use considerable discretion in deciding to report since a high percentage of allegations eventually turn out to be unfounded
• Refrain from reporting the abuse unless the evidence of abuse is clear and convincing
• Scrupulously file reports in accordance with state law


39. Psychologists find that attorneys:
• Typically take it up themselves to advise psychologists how to act ethically, even if the attorney is representing another party
• Never encourage their clients to file complaints against psychologists for tactical reasons
• May sometimes pursue the interest of their clients aggressively regardless of the impact of their actions on the child or future family relationships
• All of the above


40. According to the authors, confidentiality is a:
• Constitutional right of individuals to choose what information to reveal
• Duty of psychologists to keep information on patients private
• Legal right to withhold information from courts under certain situations
• All of the above


41. Business associate agreements should be signed by:
• All health care employees
• Any employee who has access to protected health information
• Contracted non-health employees who have access to protected health information
• All of the above


42. Which of the following is true about privileged communication laws?
• The scope of privileged communication laws for psychologists is highly consistent across every state
• The privilege belongs to the patient, not the psychologist
• All states have a psychologist-patient, sexual assault counselor-client, and domestic abuse counselor-client privilege relationship
• Jaffee v. Redmond ensured a psychologist-patient privilege in state and federal courts


43. The HIPAA Privacy Rule applies to all:
• Psychologists
• Psychologists who provide health care services
• Psychologists who provide health care services in covered entities, convert protected health information into an electronic format, and then transmit that information electronically
• Health care providers


44. According to the APA Ethics Code, the term “test data” refers to:
• Test manuals and protocols
• Test questions and stimuli
• Patient responses to test questions
• All of the above


45. Concerning the release of copyrighted test materials, the authors claim that:
• The HIPAA Privacy Rule clearly trumps federal copyright laws
• The APA Ethics Code explicitly instructs psychologists that patient requests for test materials trump federal copyright laws
• It is a reasonable interpretation that psychologists should follow the federal copyright laws
• None of the above


46. According to the HIPAA Security Rule, the addressable specifications:
• Must be implemented by all psychologists
• Permit psychologists to use discretion in whether or not to follow the federal “Policy Standards on Security”
• Allow psychologists discretion in how they address them
• None of the above


47. According to the authors, the role of the judge in a trial is to:
• Act as a referee and ensure that rules are followed
• Consider evidence and assign the value given to it
• Provide a narrative of the events that happened
• All of the above


48. Expert witnesses may draw conclusions related to the issues before the court.
• TRUE
• FALSE


49. When forensic psychologists work with attorneys, it is important that they do all of the following EXCEPT:
• Clarify their roles with attorneys ahead of time
• Vary their opinion according to the needs of the attorney who hires them
• Empower the juries that consider the evidence
• Ensure that they have the skill level necessary to do the work required


50. Consumer focused assessments could increase the legal risks to psychologists if they involved:
• The patient in the discussion of the referral question
• The patient in the phrasing of sensitive or potentially embarrassing information
• Unjustified deviations in the standardized administration of psychological tests
• All of the above


51. When testing for external consequences, the authors recommend that psychologists:
• Never quote from a computer generated report
• Never give a shorter version of a test or a screening instrument
• Always use the latest version of a psychological test
• None of the above


52. The prediction of violence has been compared to weather prediction because:
• The behavior of violent individuals can change as quickly as the weather
• The prediction of violence, like the prediction of weather, is in terms of probability
• The potentially violent individual can “blow hot or cold”
• None of the above


53. According to ADA, during pre-employment testing or interviewing:
• Psychologists may not inquire about personal traits even if they are related to the job
• Employers may not refuse to hire an individual who is disabled even if they present a threat to the safety of the workplace
• Psychologists may not test to diagnose a mental illness
• All of the above


54. Which of the following is true about patient suicides?
• Females attempt suicide more often than males, although males succeed in suicide more than females
• Most of those who attempt suicide have communicated their attempt to others
• Multiple attempters of suicide represent a group with an elevated risk for suicide
• All of the above


55. Kessler et al. found that the diagnosis most associated with suicide is major depression.
• TRUE
• FALSE


56. Coryell and Young found that the single best predictor of a suicide attempt was:
• The diagnosis of the patient
• How the patient rated the intensity of suicidal thoughts in the last week
• Patient demographic data
• None of the above


57. A redundant protection for suicide could include:
• Communication with another treating health care professional
• Communication with an involved family member
• The use of a depression or suicide screening instrument
• All of the above


58. According to the authors, safety agreements or contracts are more effective if they:
• Contain a number of affirmative statements
• Are created in a collaborative effort
• Specify the options to follow when suicidal ideation becomes strong
• All of the above


59. Safety agreements are a good risk management procedure because courts tend to give high deference to the presence of a safety agreement, regardless of how it fits into the overall treatment of the patient.
• TRUE
• FALSE


60. All states have adopted the Tarasoff decision either through statutes or case law.
• TRUE
• FALSE


61. A verbal threat of harm to an identifiable third party always triggers the duty to warn or protect.
• TRUE
• FALSE


62. Which of the following is TRUE about domestic abuse?
• It almost never occurs among patients from middle and upper class backgrounds
• It is virtually non-existent in dating or same sex relationships
• The largest number of victims are female, although the number of male victims is increasing
• All of the above


63. The risk of a complaint increases substantially when a psychologist files an action against a patient with a collection agency.
• TRUE
• FALSE


64. Psychologists may terminate treatment against the wishes of patients if the patients:
• Refuse to pay for treatment and are not in crisis
• Are not benefiting from therapy and are not in crisis
• Or someone close to them threatens the psychologist
• All of the above


65. Which of the following is TRUE about bartering?
• It is inherently unethical according to the APA Ethics Code
• It is acceptable for services, but not for goods
• It may lead to misunderstandings and ill-feelings
• None of the above


66. Concerning loosely organized group practices, the authors believe that:
• They are illegal in many jurisdictions
• Even when they are not illegal, they should be always be avoided because of the substantial increase in legal risks
• Psychologists should be involved with loosely organized groups only after carefully considering the benefits and disadvantages of doing so
• Psychologists should actively attempt to be involved in such groups because they greatly reduce their legal risks


67. Professional risks could occur to retired psychologists who:
• Provide psychological advice, even if it is intended to be done informally
• Do not store records in accordance with the laws of their state
• Assume that volunteer activities are not regulated the same as paid activities
• All of the above


68. A psychologist working for an agency had a complaint of misconduct filed against him because of activities that occurred in his part-time private practice. This psychologist may assume that the agency’s professional liability insurer will:
• Cover his actions
• Cover his actions, unless they included specifically excluded activities, such as sexual contact with patients
• Refuse to cover his actions because they occurred outside of his job description with the agency
• Refuse to cover his actions unless the agency has an “occurrence-based” policy


69. For a claim to be covered under an occurrence policy, the alleged misconduct will be covered if the acts (or failure to act) occurred during the policy period, regardless of when the claim was actually filed.
• TRUE
• FALSE


70. Often a professional liability insurer may refuse to defend a psychologist accused of misconduct if:
• The psychologist did not report the claims to the insurance carrier immediately
• The alleged misconduct involved allegations of an activity (such as the practice of medicine) that was not covered by the insurance
• The alleged misconduct involved allegations of fraud
• All of the above