EPPP Part 1 (Examination for Professional Practice in Psychology) — All Questions

A psychologist ended therapy with a client 18 months ago. The former client now proposes a romantic relationship. Under APA Ethics Code Standard 10.08, what applies?

• a.It is permitted after one year with peer consultation
• b.It is permitted because the former client initiated it
• c.It is prohibited because fewer than two years have passed✓
• d.It is permitted because therapy has formally ended

APA Standard 10.08(a) sets a minimum of two years after therapy ends before any sexual intimacy with a former client could even be considered. Formal termination, who initiates the contact, and consultation do not shorten that period.

Three years after ending therapy, a psychologist considers a romantic relationship with a former client. Which statement reflects APA Standard 10.08(b)?

• a.It is permitted only in the most unusual circumstances✓
• b.It is prohibited for life, whatever the circumstances
• c.It is permitted without restriction once two years have passed
• d.It is permitted if the former client signs a written waiver

Under Standard 10.08(b), even after two years such a relationship is ruled out except in the most unusual circumstances, and a psychologist who proceeds must show the absence of exploitation, weighing factors such as how long and intense therapy was, how it ended, and the former client's history and present mental state. The two-year mark does not lift all limits, the Code does not impose a lifetime ban, and a waiver does not shift the burden.

A psychologist notices that a colleague's informed-consent form leaves out the limits of confidentiality. No client has been harmed, and raising it would not breach anyone's confidentiality. Under the APA Ethics Code, what is the appropriate first step?

• a.Report the colleague to the APA Ethics Committee
• b.Raise it with the colleague informally✓
• c.File a complaint with the state licensing board
• d.Take no action because no one has been harmed

Standard 1.04 directs psychologists who believe a colleague may have committed an ethical violation to bring it to that person's attention when informal resolution appears appropriate and does not violate confidentiality rights. Formal reports under Standard 1.05 are for violations that have caused or are likely to cause substantial harm or that are not resolved informally, and ignoring the problem is not what the Code describes.

A client tells her psychologist that a former therapist had sexual contact with her during treatment, but she does not want the psychologist to report it. Assuming no law in the jurisdiction requires a report, what does the APA Ethics Code direct?

• a.Report the former therapist to the licensing board anyway
• b.Report the matter because the harm to her was substantial
• c.Confront the former therapist directly about the allegation
• d.Honor her wish and make no report without her consent✓

Standard 1.05 states that the reporting obligation does not apply when an intervention would violate confidentiality rights, and Standard 4.05(b) limits disclosure without consent to what is mandated or permitted by law for a valid purpose. The psychologist can discuss options with the client, but reporting or confronting the former therapist against her wishes would breach her confidentiality, and the seriousness of the harm does not override that under the Code.

In a small rural town, a psychologist's therapy client is also the town's only pharmacist, whom the psychologist sees occasionally when filling prescriptions. Under APA Standard 3.05, which statement is accurate?

• a.Any multiple relationship is prohibited under the Ethics Code
• b.The psychologist must begin using a pharmacy in another town
• c.The psychologist must terminate therapy as soon as is feasible
• d.It is allowed if no impairment or harm is reasonably expected✓

Standard 3.05(a) asks psychologists to avoid a multiple relationship only when it could reasonably be expected to compromise their objectivity or effectiveness or to risk exploiting or harming the client, and it expressly says relationships without that expected risk are not unethical. The Code does not ban all multiple relationships or require termination or changing pharmacies by default.

A client proposes paying for therapy by doing landscaping work for the psychologist. According to APA Standard 6.05, barter is permitted only if:

• a.It is not contraindicated and not exploitative✓
• b.The client puts the offer in writing first
• c.It involves services rather than goods
• d.The value of the work exactly matches the usual fee

Standard 6.05 treats barter as taking nonmonetary payment, whether goods or services, and permits it on two conditions: it must not be clinically contraindicated, and the resulting arrangement must not exploit the client. The Code does not require exact value matching or a written offer, and it covers goods as well as services.

A former client who still owes a balance is hospitalized in a crisis, and with her authorization the hospital requests her records for emergency treatment. Under APA Standard 6.03, the psychologist:

• a.May send the records only if the hospital pays the balance
• b.May hold the records until the balance is paid
• c.May release the records once a payment plan is signed
• d.Must release them despite the unpaid balance✓

Standard 6.03 states that psychologists may not withhold records under their control that are requested and needed for a client's emergency treatment solely because payment has not been received. Conditioning release on payment, a payment plan or third-party payment would do exactly that.

A psychologist wants peer consultation on a difficult case. Under APA Standard 4.06, what should she do?

• a.Share only necessary, non-identifying information✓
• b.Avoid consultation because it breaches confidentiality
• c.Share the full record so the consultant has complete context
• d.Obtain written consent even if no identifying information is shared

Standard 4.06 says that when consulting, psychologists do not disclose information that could reasonably identify the client unless they have prior consent or disclosure cannot be avoided, and they share information only to the extent necessary for the consultation. Consent is not required for de-identified consultation, sharing the full record exceeds what is necessary, and consultation is permitted and encouraged.

A former client signs a release asking the psychologist to send her test data, including raw scores and her own responses, to her attorney. Under APA Standard 9.04, the psychologist:

• a.Must also send the test manual and full set of test items
• b.Must refuse, because test data may go only to psychologists
• c.May release the data only if ordered by a court
• d.Sends the data unless it risks substantial harm or misuse✓

Standard 9.04(a) states that pursuant to a client/patient release, psychologists provide test data to the client or other persons identified in the release, and may refrain to protect the client or others from substantial harm or misuse or misrepresentation of the data or the test. The Code does not restrict release to psychologists, test manuals and items are test materials protected under Standard 9.11, and a court order is needed only when there is no client release (9.04(b)).

Under the APA Ethics Code, which of the following counts as 'test materials' rather than 'test data'?

• a.Notes on the client's behavior during testing
• b.The protocol pages containing the client's answers
• c.The test manual and test items✓
• d.The client's raw and scaled scores

Standard 9.11 defines test materials as manuals, instruments, protocols and test questions or stimuli, excluding test data. Standard 9.04 defines test data as raw and scaled scores, client responses, and the psychologist's notes on the client's statements and behavior during the examination, and it states that portions of test materials that include client responses count as test data.

A doctoral trainee begins seeing a client, and legal responsibility for the treatment rests with a licensed supervisor. As part of informed consent, what must the client be told?

• a.Nothing more, provided the supervisor co-signs the notes
• b.Only the name of the clinic providing the treatment
• c.Trainee status and the supervisor's name✓
• d.The trainee's grades in relevant graduate coursework

Under Standard 10.01(c), when a trainee provides therapy and the supervisor holds legal responsibility, informed consent must tell the client that the therapist is in training under supervision and must give the supervisor's name. Naming only the clinic or co-signing notes does not satisfy this, and coursework grades are not part of the requirement.

A study uses a cover story that misleads participants about its true purpose; the deception is integral to the design and does not involve pain or severe distress. Under APA Standard 8.07(c), the researcher must:

• a.Explain it by the end of data collection; allow data withdrawal✓
• b.Explain the deception only when the results are published
• c.Skip any explanation because the IRB approved the deception
• d.Explain the deception only to the participants who ask about it

Under Standard 8.07(c), deception built into a study must be disclosed to participants promptly, ideally when each person finishes and in any case by the close of data collection, and participants may then pull their data. Waiting for publication, relying on IRB approval, or explaining only on request do not meet the standard.

Under APA Standard 8.05, which study may proceed without obtaining informed consent from participants (assuming no law requires consent)?

• a.An anonymous questionnaire on study habits posing no risk✓
• b.A laboratory study that records participants' voices
• c.A deception study that induces mild stress in students
• d.An intervention study assigning clients to a new treatment

Standard 8.05 allows research without informed consent in narrow cases, one being studies that use only anonymous questionnaires, carry no reasonable expectation of distress or harm, and would not put participants at risk if responses became known. Voice recording requires consent under 8.03 except for public naturalistic observation, intervention research requires the disclosures of 8.02(b), and deception studies fall under 8.07 rather than 8.05.

An introductory psychology course requires students to participate in department research. Under APA Standard 8.04(b), what must the instructor provide?

• a.A lower grade cap for students who decline
• b.A choice of equitable alternative activities✓
• c.An exemption only for students with a medical excuse
• d.Payment in addition to the course credit

Standard 8.04(b) requires that students offered course credit or extra credit for research participation be able to choose an equitable alternative activity instead. Limiting exemptions to medical excuses or penalizing students who decline would defeat that choice, and payment is not required.

A faculty advisor plans a multiple-authored article substantially based on a student's doctoral dissertation. Under APA Standard 8.12(c), the student:

• a.Is listed after the advisor who supervised the work
• b.Is principal author, barring exceptional circumstances✓
• c.Is acknowledged in a footnote rather than as an author
• d.Is listed last, as the most junior contributor

Standard 8.12(c) states that, except under exceptional circumstances, a student is listed as principal author on any multiple-authored article substantially based on the student's doctoral dissertation, and that advisors discuss publication credit with students early. Placing the advisor first by status, relegating the student to a footnote, or listing the student last contradicts this; Standard 8.12(b) also says institutional position alone does not justify credit.

After a flood, a psychologist with no trauma training is the only mental health professional available to a shelter of distressed residents. Under APA Standard 2.02, the psychologist may:

• a.Provide services and continue as the long-term treating clinician
• b.Not provide services until formal trauma training is completed
• c.Provide services until the emergency ends or others are available✓
• d.Provide services only if residents first sign written consent forms

Standard 2.02 allows psychologists in emergencies to provide services to individuals for whom other mental health services are not available even without the necessary training, and says those services are discontinued as soon as the emergency has ended or appropriate services are available. Refusing help, continuing indefinitely, or making signed forms a precondition are not what the standard describes.

A psychologist begins therapy with a 10-year-old whose parents hold legal authority to consent for him. Under APA Standard 3.10(b), the psychologist should:

• a.Obtain permission from the child's teacher as a neutral party
• b.Obtain the child's own consent in place of the parents' permission
• c.Obtain the parents' permission only, since the child cannot consent
• d.Seek the child's assent and the parents' permission✓

Standard 3.10(b) states that for persons legally incapable of giving informed consent, psychologists provide an appropriate explanation, seek the individual's assent, consider the person's preferences and best interests, and obtain permission from a legally authorized person. The child's assent does not replace the parents' permission, parental permission alone skips assent, and a teacher is not legally authorized.

Under the HIPAA Privacy Rule's definition in 45 CFR 164.501, which item can qualify as part of a mental health professional's 'psychotherapy notes'?

• a.A summary of the diagnosis, symptoms, and treatment plan
• b.The times each counseling session started and stopped
• c.Analysis of session content kept apart from the record✓
• d.Results of the clinical tests that were administered

45 CFR 164.501 defines psychotherapy notes as notes documenting or analyzing the contents of conversation during a counseling session that are separated from the rest of the medical record, and it expressly excludes session start and stop times, clinical test results, medication monitoring, and summaries of diagnosis, functional status, treatment plan, symptoms, prognosis and progress. Under 164.508(a)(2), most uses and disclosures of psychotherapy notes require a specific authorization.

A psychologist is building a practice website. Which action would violate APA Standard 5.05?

• a.Listing her degrees and license accurately
• b.Stating her fees clearly and accurately
• c.Quoting a published review of her book
• d.Asking current clients for testimonials✓

Standard 5.05 states that psychologists do not solicit testimonials from current therapy clients/patients or others who are vulnerable to undue influence. Accurate statements of credentials and fees are consistent with Standard 5.01, and quoting a published review is not soliciting a testimonial from a client.

Which statement accurately describes the General Principles (A through E) of the APA Ethics Code?

• a.They apply only to psychologists who conduct research
• b.They are aspirational and are not meant as a basis for sanctions✓
• c.They are enforceable in the same way as the Ethical Standards
• d.They take precedence over state law whenever the two conflict

The Code states that the General Principles, as opposed to the Ethical Standards, are aspirational, do not represent obligations, and should not form the basis for imposing sanctions. They apply to all psychologists' work, and the Code's conflict provisions (Introduction and Standard 1.02) describe resolving ethics-law conflicts responsibly rather than giving the Principles precedence over law.