A law and ethics question. My answer and explanation are in comments. On the exam (or at least on practice questions I’ve seen), questions may ask exclusively about law or ethics. Different answers, so heads up.
In your first meeting with Kevin, 47, he tells you that he’s been “feeling funny” lately, having trouble getting up in the morning, sleeping “too much.” Kevin says he has “occasionally” used crack cocaine in the past, but says “I haven’t hit the pipe in a week.” Kevin has been homeless in the past. He currently lives in a sober living house downtown. Kevin tells you he sometimes thinks people are talking about him and laughing about him, “but it doesn’t bother me much.” Kevin says he has not worked since being laid off two years ago.
3. What are the legal and ethical considerations in this case?
1. Get client’s informed consent before beginning treatment
Terminate with Kevin if countertransference feelings emerge during treatment
Base your fee on client’s ability to pay
Take steps to have client hospitalized if he is a danger to himself or others
2. Get client’s written consent before making referrals
Work cooperatively with other professionals involved with this case
Bill more to client’s insurance in order to reduce his co-pay
Take steps to have client hospitalized if he is a danger to himself or others
3. Get client’s written consent before making referrals
Work cooperatively with other professionals involved with this case
Base your fee on client’s ability to pay
Refer client to a specialist–case is out of LCSW’s scope of practice
4. Seek consultation if countertransference emerges during course of treatment
Get client’s written consent before making referrals
Work cooperatively with other professionals involved with this case
Base your fee on client’s ability to pay
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Well done. My comments are that Social Workers are ethically bound to consider client't ability to pay. At the same time the code is clear that you do not have to reduce your fee based on ability to pay.
The responder did a great job pointing out that at least two elements allow you to eliminate entire answer groups leaving you with A or D. Since every SW has some countertransference in every case we would be unable to see clients if we were forced to terminate with each client about whom we have a feeling. You are obliged to terminate if those feelings interfere with treatment.
MY ANSWER: #4 – THE ONLY SET THAT DOESN'T HAVE A FLAT-OUT WRONG ANSWER IN IT.
3. What are the legal and ethical considerations in this case?
1. Get client's informed consent before beginning treatment (YES)
Terminate with Kevin if countertransference feelings emerge during treatment (NO, SEEK CONSULTATION.)
Base your fee on client's ability to pay (YES)
Take steps to have client hospitalized if he is a danger to himself or others (YES)
2. Get client's written consent before making referrals (YES)
Work cooperatively with other professionals involved with this case (YES)
Bill more to client's insurance in order to reduce his co-pay (UNETHICAL!)
Take steps to have client hospitalized if he is a danger to himself or others (YES)
3. Get client's written consent before making referrals (YES)
Work cooperatively with other professionals involved with this case (YES)
Base your fee on client's ability to pay (YES)
Refer client to a specialist–case is out of LCSW's scope of practice (NOPE – EXHIBIT IS WITHIN LCSW SCOPE)
4. Seek consultation if countertransference emerges during course of treatment (YES)
Get client's written consent before making referrals (YES)
Work cooperatively with other professionals involved with this case (YES)
Base your fee on client's ability to pay (YES)