What if?
In cases of high parental conflict post-divorce, which therapeutic goal is particularly important when working with children of divorced parents?
A) Aligning with one parent for clarity
B) Supporting the child’s emotional wellbeing and stability
C) Preventing the child from discussing the divorce
D) Encouraging the child to spend equal time with both parents
B) Supporting the child’s emotional wellbeing and stability
Double it and give it to the next person
The team next to you gets not 100 but 200 points!!
What key factor should the clinician consider when handling therapy for a minor in a situation with divorced parents and conflicting allegations?
A) The non-custodial parent’s requests for session information
B) The emotional and mental wellbeing of the minor
C) The therapist’s relationship with each parent
D) Only the custodial parent's statements
B) The emotional and mental wellbeing of the minor
What ethical considerations arise from Emily’s desire to distance herself from both parents?
a) Ethically, the clinician should respect Emily’s autonomy and explore her feelings toward her parents without judgment.
b) Pressuring Emily to reconcile with her parents to reduce family conflict.
c) Sharing Emily’s feelings with both parents to keep them informed of her emotional state.
d) Balancing confidentiality with legal reporting requirements if there is a risk of harm.
a) Ethically, the clinician should respect Emily’s autonomy and explore her feelings toward her parents without judgment.
After Emily says her parents are divorced and her father does not have primary custody, what should the clinician do immediately?
a) Obtain visitation/custody agreements forms to find out who can give consent.
b) Try to get in touch with Emily’s mother to get her involved with the therapy and get her consent.
c) Rely on the fact that good faith assumptions of parental custody means the clinician is within the law.
d) Tell Emily it is against the law to accept consent outside of visitation times and refer her out.
a) Obtain visitation/custody agreements forms to find out who can give consent.
What actions should the clinician consider if Emily’s safety is at risk during her visitation with her father?
A. Ignore the safety concerns and assume everything will work out.
B. Encourage Emily to handle the situation herself if she feels unsafe.
C. Wait until the next scheduled session to address any concerns.
D. Instruct Emily to keep any safety issues private and not tell others.
E. The clinician should conduct a risk assessment to determine the level of threat
E) Clinician should determine level of risk before proceeding or letting Emily off on her own
DAILY DOUBLE
As a team come up with a brief response to the following question, the team with the closest answer will receive double the points! (600)
Question: Let's say Emily actually wanted therapy, and consented to it herself. Her mother, Rosa, did not approve of this. Her dad Luis thinks it would be a good idea and encourages Emily. Emily cannot afford therapy on her own and uses her dad's money to pay for the treatment. Rosa's mom has found out about this and is furious with both Luis and Emily. She refuses to give consent and allow Emily to go back. Can Emily proceed with treatment without her mother's approval?
Well in basic terms it's messy, as we know. So, in California, minors 12 and older can generally consent to therapy, but the specifics of confidentiality and treatment depend on the circumstances and the minor's ability to understand the process. All of this is based on the principle that the minor is mature in nature, consents to therapy and what that entails which includes the rights that parents have to be informed of the treatment. If Rosa refuses to give consent and is actively preventing Emily from attending therapy, Emily’s ability to continue therapy may be at risk, especially if the therapist believes that parental consent is needed for continuation of treatment. If Emily is experiencing significant emotional distress, and therapy is critical to her well-being, the clinician may need to explore legal and ethical avenues to proceed, potentially involving child protective services or other legal guidance to ensure Emily's safety and access to necessary care.
The clinician finds out that legally Rosa has Sole Custody. The clinician attempts to reach out to her but is unable to get in touch. What should the clinician do?
a) Note the exact times in which they attempted to contact the mother, continue reaching out, and continue working with Emily.
b) Inform Luis his consent is not legally sufficient to start therapy for Emily, and discontinue working with Emily.
c) Spend at least one more full session with Emily to obtain information about parental relationships to possibly see if any reportable abuse has occurred before making another decision.
d) Reach out to Emily directly to inform her about her options moving forward before booking another full session.
a) Note the exact times in which they attempted to contact the mother, continue reaching out, and continue working with Emily.
If the clinician finds out Luis does have legal custody at the time of consent, should the clinician provide him all the records he requested?
a) Yes, immediately, because legally he has client privilege.
b) Yes, but only after asking Emily for written permission.
c) No, or at least not immediately, because the motives for his request are suspicious and Emily expressed her fear of him.
d) No, because only the parent with primary custody can access records.
c) No, or at least not immediately, because the motives for his request are suspicious and Emily expressed her fear of him.
What confidentiality limits should the clinician discuss with Emily, given the safety concerns?
a) The clinician says, “I might have to tell someone if I think it’s necessary, but don’t worry about it too much.” This statement is unhelpful because it doesn’t clearly outline the specific circumstances under which confidentiality would be broken. Without this clarity, Emily may feel uncertain about what she can safely discuss, affecting her trust in the therapeutic process.
b) The clinician says, “Emily, I want you to feel comfortable sharing openly with me, However, there are some situations where I’m legally required to reach out to others” This statement gives clear explanation to Emily the limits of confidentiality, especially around any disclosures of harm to herself or others.
c) The clinician says, “I would only report something if it’s extremely serious, so most of what you say won’t go anywhere.” This response is misleading, as it downplays the situations where reporting is legally mandated, such as any disclosure of abuse, self-harm, or harm to others. Emily might misunderstand what qualifies as “serious” and withhold important information.
d) The clinician says, “I may share some of what we discuss with your family, as they have a right to know what’s going on.” This response is incorrect because family members do not automatically have the right to know everything shared in therapy, especially if there are safety concerns. This could cause Emily to feel unsafe sharing sensitive information about her home life.
b) The clinician says, “Emily, I want you to feel comfortable sharing openly with me, However, there are some situations where I’m legally required to reach out to others” This statement gives clear explanation to Emily the limits of confidentiality, especially around any disclosures of harm to herself or others.
How should the clinician respond to Emily’s disclosure about using drugs as a coping mechanism?
a) When Emily reveals that drug use has become her main way of coping with emotional difficulties, the clinician’s best response would be to share personal stories about substance use to make Emily feel less alone and suggest that she could limit her drug use to weekends only to better manage her habit.
b) Upon learning that Emily is using drugs as a way to manage her emotional struggles, the clinician should suggest that Emily could try legal substances, like energy drinks, as a safer alternative. Also keep the disclosure confidential, not considering referrals or additional support unless Emily asks.
c) The clinician should address Emily’s drug use sensitively, prioritizing her safety and exploring her reasons for using substances. They may need to assess whether mandatory reporting applies due to potential harm
c) The clinician should address Emily’s drug use sensitively, prioritizing her safety and exploring her reasons for using substances. They may need to assess whether mandatory reporting applies due to potential harm
What mandatory reporting considerations should the clinician evaluate based on Emily’s statements about drug use and her fear of her father?
a) Decide if Emily’s drug use is recreational and, therefore, not subject to mandatory reporting.
b) The clinician should consider whether Emily’s drug use and fear of her father or mother indicate abuse, neglect, or emotional harm that meets mandatory reporting criteria.
c) Delay considering reporting until further sessions to gather more information about Emily’s family situation.
d) None of the above
b) The clinician should consider whether Emily’s drug use and fear of her father or mother indicate abuse, neglect, or emotional harm that meets mandatory reporting criteria.