Crisis Management
Therapist learns client threatened ex-partner via encrypted messages and deleted them. Ex-partner is identifiable; timing uncertain. MOST appropriate FIRST action?
Your answer: D•Correct: B
Rationale: Deleted digital evidence does not eliminate duty where credible threat indicators remain. Clinical/legal risk assessment and documentation are essential.
Source: Tarasoff v. Regents of the University of California, 17 Cal.3d 425 (1976); Ewing v. Goldstein, 120 Cal.App.4th 807 (2004).
Report IssueClinical Law & Ethics
An 81-year-old dependent adult presents with patterned bruising and reports a caregiver 'gets rough when stressed.' Financial statements also show unusual ATM withdrawals by the caregiver. Client asks therapist to keep this private. The caregiver controls the client’s phone access. What is the MOST appropriate FIRST mandated-reporter action?
Your answer: D•Correct: B
Rationale: Mandated reporting is triggered by reasonable suspicion, not certainty. Prompt reporting and contemporaneous documentation of objective indicators are required.\n\n
Source: California Welfare & Institutions Code §15630; §15610.23; §15610.57.
Report IssueClinical Evaluation
Jisoo (34) and Carlos (36) arrive with their 6-year-old son Roberto, who has severe nightmares and refuses to sleep alone. Roberto was adopted at age 2 from an institution. Jisoo reports he has always been 'attached to her hip' and Carlos feels like an outsider. Roberto is withdrawn at kindergarten and not engaging peers. The therapist recognizes that Roberto's nightmares may reflect early institutional trauma combined with a current family structural problem. What is the MOST appropriate FIRST step?
Your answer: D•Correct: B
Rationale: Roberto's attachment disruption needs to be understood within the current family structure before a specific attachment intervention is chosen. An attachment assessment without structural context could misidentify the primary driver of Roberto's symptoms. The structural map determines whether to realign the marital coalition, clarify parent-child boundaries, or address the early trauma directly.
Source: AAMFT Code of Ethics §1.1 (Informed Consent) and §3.1 (Professional Competence).
Report IssueClinical Law & Ethics
Minors Specialization M-1: In a private practice in Oakland, Aaliyah, a 5-year-old girl, is referred for treatment after one parent signs intake consent. The intake packet includes an old joint-custody order, but a newer minute order may have changed legal decision rights. What is the MOST appropriate FIRST step?
Your answer: D•Correct: C
Rationale: The clinician must verify the active custody order before relying on either parent’s demand. A is wrong because timing of signature does not establish legal authority. B is wrong because some orders permit one authorized parent to consent. D is wrong because disclosure rights and treatment-consent rights are distinct legal questions.
Source: California Family Code §3003; California Family Code §3006.
Report IssueClinical Evaluation
Samantha (41) and David (43) arrive in their fourth session. They have been married 15 years with two children (11, 8). The presenting issue was their older son Jake's behavioral problems at school, but the therapist notices that Samantha and David have not touched each other in three consecutive sessions. When asked about this, Samantha says, 'We've been through this before in couples therapy, and David said he'd work on it and didn't.' David says, 'I don't know what she wants.' What is the FIRST clinical step?
Your answer: D•Correct: B
Rationale: Structural family therapy holds that child behavioral problems are frequently a manifestation of disruptions in the parental subsystem. The couple's physical and emotional distance — combined with David's withdrawal and Samantha's circular complaints — suggests a parental coalition that has collapsed or is near collapse. A structural map will identify whether the children have been drawn into the parental subsystem as pseudo-spouses or pseudo-parents, and whether Jake's symptoms are maintaining a fragile marital equilibrium.
Source: AAMFT Code of Ethics §1.1; §3.1.
Report IssueClinical Law & Ethics
An LMFT receives a subpoena duces tecum for a teen client's chart in a custody dispute. No authorization from the client/holder and no court order are attached. What is the MOST appropriate FIRST response in California?
Your answer: D•Correct: C
Rationale: A subpoena alone typically does not compel privileged psychotherapy disclosures absent proper authorization or court order. Privilege must be timely asserted.
Source: California Evidence Code §1014; California Welfare & Institutions Code §15630; 45 C.F.R. §164.502; 34 C.F.R. Part 99.
Report IssueClinical Law & Ethics
An 81-year-old dependent adult presents with patterned bruising and reports a caregiver 'gets rough when stressed.' Financial statements also show unusual ATM withdrawals by the caregiver. Client asks therapist to keep this private. Home-health staff documented missed medication refills. What is the MOST appropriate FIRST mandated-reporter action?
Your answer: D•Correct: B
Rationale: Mandated reporting is triggered by reasonable suspicion, not certainty. Prompt reporting and contemporaneous documentation of objective indicators are required.\n\n
Source: California Welfare & Institutions Code §15630; §15610.23; §15610.57.
Report IssueClinical Law & Ethics
In a small rural community, an LMFT is asked to treat the business partner of a current client while also serving on the local school advisory board with both families. Both families attend the same weekly faith community. What is the MOST appropriate FIRST ethical approach?
Your answer: D•Correct: C
Rationale: Multiple-relationship decisions should be contextual and documented. In rural settings, unavoidable overlap still requires explicit boundary planning and ongoing risk review.\n\n
Source: AAMFT Code of Ethics §1.3; APA Ethics Code §3.05.
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