Learn the ideas behind the questions

Key idea: Lithium toxicity caused by reduced renal clearance

Easy to confuse with: Neuroleptic malignant syndrome · Tardive dyskinesia · Lithium accumulation caused by impaired hepatic metabolism

Why those are wrong: NMS and tardive dyskinesia require exposure to dopamine-blocking (antipsychotic) drugs, which the stem excludes; lithium is cleared by the kidneys, not metabolized by the liver.

Key idea: Negative reinforcement

Easy to confuse with: Positive reinforcement · Positive punishment · Negative punishment

Why those are wrong: Positive reinforcement adds a desirable stimulus; positive and negative punishment both decrease behavior, whereas the behavior in the stem increases.

Key idea: Fundamental attribution error

Easy to confuse with: Self-serving bias · False consensus effect · Cognitive dissonance

Why those are wrong: Self-serving bias concerns explanations of one's own successes and failures; false consensus is overestimating how many people share one's views; cognitive dissonance is discomfort from inconsistent cognitions.

Key idea: Object permanence (sensorimotor stage)

Easy to confuse with: Conservation (concrete operational stage) · Egocentrism (preoperational stage) · Hypothetico-deductive reasoning (formal operational stage)

Why those are wrong: Conservation, egocentrism, and hypothetico-deductive reasoning belong to later Piagetian stages and do not concern searching for hidden objects.

Key idea: A Type I error

Easy to confuse with: A Type II error · A correct rejection of a false null hypothesis · A correct failure to reject a true null hypothesis

Why those are wrong: A Type II error is failing to reject a false null; a correct rejection requires the null to be false; a correct failure to reject is impossible because the null was rejected.

Key idea: The psychologist has a duty to use reasonable care to protect the intended victim, which may include warning the victim or notifying police.

Easy to confuse with: Confidentiality is absolute, so the psychologist may not disclose the threat without the client's written consent. · A duty arises only if the client has already attempted violence against the victim. · The psychologist's only obligation is to document the threat and increase session frequency.

Why those are wrong: Tarasoff held that confidentiality yields when disclosure is essential to avert danger, did not require a prior attempt, and required reasonable protective steps beyond documentation. State statutes now vary (mandatory vs. permissive), so these items test the 1976 holding itself.

Key idea: Raise the concern directly with the colleague to attempt an informal resolution

Easy to confuse with: File a complaint with the state licensing board before speaking to the colleague · Take no action, because the Ethics Code governs only one's own conduct · Alert a local newspaper so that the public is informed

Why those are wrong: Standard 1.05 (formal reporting) applies when substantial harm is likely or informal resolution is inappropriate or fails, which the stem rules out; doing nothing ignores Standard 1.04; publicizing is not a remedy the Code provides.

Key idea: The psychologist may provide the services, discontinuing them once the emergency ends or appropriate services are available

Easy to confuse with: The psychologist must decline, because the Code bars practice outside one's competence even in emergencies · The psychologist may provide the services only after completing formal training in the needed area · The psychologist may provide the services and continue them after appropriate services become available

Why those are wrong: Standard 2.02 is an explicit exception to the competence limits of Standard 2.01, so the Code does not require declining, and requiring formal training first would deny care during the emergency. The services must end once the emergency ends or appropriate services are available, not continue past that point.

Key idea: Take further action, such as referral to a licensing board, ethics committee, or institutional authority

Easy to confuse with: Take no further action, because raising the concern with the colleague satisfied the Code · Take no action, because only the person who was harmed may initiate a complaint · Post a public warning about the colleague on social media to protect future clients

Why those are wrong: When informal resolution under Standard 1.04 fails and substantial harm has occurred or is likely, Standard 1.05 calls for further action, so raising the concern does not end the duty. The Code does not limit action to the harmed person, and a public post is not among the referrals 1.05 describes (ethics committees, licensing boards, institutional authorities).

Key idea: Decline to disclose anything, including whether the individual is receiving services

Easy to confuse with: Confirm only that the individual attends sessions, because attendance is not confidential · Share a brief progress summary, because the requester has a legitimate interest · Share the information if the requester promises to keep it confidential

Why those are wrong: Without consent, Standard 4.05b allows disclosure only as mandated or permitted by law for a valid purpose. Whether someone is in treatment and attends sessions is itself confidential, a requester's interest is not a legal ground, and a recipient's promise of secrecy does not replace the client's consent under 4.05a.

Key idea: It is not clinically contraindicated and the resulting arrangement is not exploitative

Easy to confuse with: The client initiated the offer and the arrangement is documented in the record · The goods or services offered are worth at least the psychologist's usual fee · The client is unable to pay for treatment with money, insurance, or a sliding fee

Why those are wrong: Standard 6.05 sets only two conditions. Who proposed the barter and how it is documented are not among them, the Code sets no minimum value for bartered goods or services, and financial hardship is not a prerequisite (see also Standard 3.05, Multiple Relationships).

Key idea: Provide the test data to the recipient identified in the client's release

Easy to confuse with: Provide the test data only to a psychologist qualified to interpret it · Provide the test data along with copies of the test manuals and stimuli · Withhold the test data unless the psychologist receives a court order

Why those are wrong: Standard 9.04 does not limit release to psychologists. Manuals and test stimuli are test materials protected under Standard 9.11, not test data. A court order or legal requirement governs release only when there is no client release.

Key idea: Prohibited for at least two years, and afterward permitted only in the most unusual circumstances

Easy to confuse with: Permitted after two years, provided the former client is the one who initiates it · Prohibited for one year after termination, after which it is a private matter · Prohibited permanently, regardless of how much time has passed or the circumstances

Why those are wrong: Standard 10.08a sets a minimum of two years, not one. After two years, 10.08b still bars sexual intimacy except in the most unusual circumstances, with the psychologist bearing the burden of showing no exploitation; the standard makes no exception for client-initiated relationships, and it does not impose a permanent ban.

Key idea: Terminate therapy, providing pretermination counseling and suggesting alternative providers as appropriate

Easy to confuse with: Continue therapy for as long as the client wishes to attend and pays the fee · Terminate therapy at once by letter, without further sessions or referrals · Continue therapy but reduce session frequency until the client asks to stop

Why those are wrong: Standard 10.10a requires termination when the client no longer needs the service, is not likely to benefit, or is being harmed, so continuing at any frequency because the client wishes it or can pay is inconsistent with the Code. Ending abruptly by letter skips the pretermination counseling 10.10c requires when nothing precludes it.

Key idea: The requirement violates Title VII unless the employer shows that it is related to job performance.

Easy to confuse with: The requirement is lawful because the employer adopted it without any intent to discriminate. · The requirement is lawful because Title VII permits any professionally developed ability test. · The requirement violates Title VII because employers may not screen applicants with ability tests.

Why those are wrong: Griggs held that good intent does not redeem a practice that is discriminatory in operation, and it read Section 703(h), as the EEOC did, to permit only job-related tests rather than any professionally developed test. It also stated that nothing in the Act precludes testing; what is forbidden is giving tests controlling force unless they are a reasonable measure of job performance (these items test the 1971 holding itself).

Key idea: The therapy communications and session notes are privileged under Federal Rule of Evidence 501 and protected from compelled disclosure.

Easy to confuse with: The therapy communications must be disclosed if the judge finds that the need for the evidence outweighs the client's privacy interest. · The therapy communications must be disclosed because the federal privilege covers psychiatrists and psychologists but not social workers. · The client's statements in therapy are privileged, but the social worker's session notes must be turned over.

Why those are wrong: Jaffee rejected a balancing test because making confidentiality depend on a judge's later weighing would eviscerate the privilege, extended the privilege to licensed social workers providing psychotherapy, and held that both the conversations and the notes taken during counseling sessions are protected. The patient can waive the privilege and the Court noted it must give way when a serious threat of harm can be averted only by disclosure, so every stem rules those out and is set in federal court.

Key idea: The trial judge must determine that the testimony is both relevant and reliable before the jury may hear it.

Easy to confuse with: The testimony is admissible only if the method is generally accepted in the relevant scientific community. · The judge must admit the testimony and leave all questions about its scientific validity to the jury. · The testimony is admissible only if the method has been published in a peer-reviewed journal.

Why those are wrong: Daubert held that Frye's general-acceptance test was superseded by the Federal Rules of Evidence (acceptance remains one factor), that the trial judge must screen proffered scientific testimony rather than leave validity wholly to the jury, and that publication is not a sine qua non of admissibility. The holding governs federal courts and state rules vary, so every stem is set in federal court.

Key idea: Release the notes only if the client signs an authorization specifically for the psychotherapy notes.

Easy to confuse with: Release the notes without authorization, because the request is for the client's treatment or payment. · Release the notes under the general release of medical records the client signed at intake. · Refuse to release the notes under any circumstances, even with the client's written authorization.

Why those are wrong: Under 45 CFR 164.508(a)(2), the only treatment, payment, and operations exceptions for psychotherapy notes are narrow ones such as the note-taker's own use for treatment, so insurers and other clinicians need the client's authorization, and a valid authorization does permit release. A psychotherapy-notes authorization may be combined only with another psychotherapy-notes authorization (164.508(b)(3)(ii)), so a general records release does not reach notes that, per 164.501, are kept separate from the medical record.

Key idea: Early in therapy, explain its nature and anticipated course, fees, third-party involvement, and limits of confidentiality, and answer questions.

Easy to confuse with: Delay the informed consent discussion for a few sessions so that talk of fees and confidentiality does not interfere with building rapport. · Explain the course of therapy and fees now, and raise limits of confidentiality only if a situation requiring disclosure arises. · Explain the course of therapy and limits of confidentiality now, and discuss fees and third-party involvement only if the client asks.

Why those are wrong: Standard 10.01a requires informing clients as early as is feasible, so rapport-building is not a reason to delay. It lists fees, involvement of third parties, and limits of confidentiality among the required topics, so none may be deferred until a problem arises or the client happens to ask.

Key idea: Act on the request within 30 days, providing the designated record set but not the separately kept psychotherapy notes.

Easy to confuse with: Act on the request within 30 days, providing the designated record set and the separately kept psychotherapy notes. · Act on the request within 90 days, providing the designated record set but not the separately kept psychotherapy notes. · Deny the request, because clients have no right of access to their own mental health records.

Why those are wrong: Section 164.524(a)(1) gives individuals a right of access to protected health information in their designated record set and excepts psychotherapy notes (and information compiled for legal proceedings), so the notes are not required but the rest of the record is. Section 164.524(b)(2) requires action within 30 days, with only one extension of no more than 30 days and a written statement of the reasons, so 90 days is never permitted.

Key idea: Give an appropriate explanation, seek assent, consider preferences and best interests, and obtain the legally authorized person's permission.

Easy to confuse with: Obtain the legally authorized person's permission only; an explanation and assent are unnecessary because the person cannot legally consent. · Explain the services and seek the person's assent; if the person agrees, proceed without the legally authorized person's permission. · Postpone services until the person attains or regains legal capacity, because no one else may consent to services on the person's behalf.

Why those are wrong: Standard 3.10b requires psychologists 'nevertheless' to explain and seek assent from persons who cannot legally consent, and also to obtain permission from a legally authorized person when such substitute consent is permitted or required by law, as every stem specifies, so assent alone is not enough. Because the standard provides for that substitute consent, nothing in it calls for withholding services until the person can consent.

Key idea: It is not unethical, because it would not reasonably be expected to cause impairment or risk exploitation or harm

Easy to confuse with: It is unethical, because the Ethics Code prohibits psychologists from having any multiple relationship with a current client · It is permissible only if the client first signs a written waiver acknowledging the multiple relationship · It is permissible only if the psychologist practices in a rural area where no other provider is available

Why those are wrong: Standard 3.05 does not ban all multiple relationships, only those that could reasonably be expected to impair objectivity, competence, or effectiveness or to risk exploitation or harm; neither a signed waiver nor a rural setting is the test of whether one is permissible.

Key idea: Provide the services while making a reasonable effort to obtain the needed competence through relevant research, training, consultation, or study

Easy to confuse with: Decline the case, because psychologists may never provide services outside the boundaries of their existing competence · Provide the services without additional preparation, because the absence of other providers suspends the competence requirement · Provide the services under the emergency provision and discontinue them as soon as the client's condition stabilizes

Why those are wrong: Standard 2.01d lets a psychologist with closely related training serve people who have no appropriate alternative, so declining is not required, but it does not waive the duty to build competence; the emergency provision (Standard 2.02) does not apply because none of these situations is an emergency.

Key idea: Clarify the nature of the conflict, make known a commitment to the Ethics Code, and take reasonable steps to resolve it

Easy to confuse with: Comply with the legal requirement without raising the conflict, because law always takes precedence over the Ethics Code · Refuse to comply with the legal requirement, because the Ethics Code takes precedence over any conflicting law · Comply with the legal requirement while privately recording disagreement in the psychologist's own notes

Why those are wrong: Standard 1.02 says neither that the law automatically prevails nor that the Code does, so silent compliance and outright defiance are both wrong; it requires openly clarifying the conflict, stating a commitment to the Code, and working to resolve it, which a private note does not accomplish.

Key idea: Decline the role, because the interest could reasonably be expected to impair the psychologist's objectivity

Easy to confuse with: Accept the role, provided the interest is disclosed to all parties at the outset · Accept the role, provided the psychologist feels confident of remaining objective · Accept the role, provided a colleague reviews the conclusions before they are released

Why those are wrong: Standard 3.06 directs psychologists to refrain from a role when an interest could reasonably be expected to impair objectivity or expose others to harm or exploitation; it does not offer disclosure, self-confidence, or colleague review as substitutes for refraining.

Key idea: Explain the deception as early as feasible, no later than the end of data collection, and permit participants to withdraw their data

Easy to confuse with: Explain the deception only after the findings are published, so that future participants cannot learn of it · Explain the deception at the end of each session but keep all data, because participants agreed to take part · Omit any explanation of the deception, because the study was judged harmless and scientifically justified

Why those are wrong: Standard 8.07c makes the end of data collection the latest point for explaining deception, so waiting for publication or never explaining is not allowed, and participants must be permitted to withdraw their data even though they agreed to take part. Debriefing under Standard 8.08a also calls for reasonable steps to correct misconceptions the psychologist knows participants hold.

Key idea: Informed consent may be dispensed with, because the study would not reasonably be assumed to cause distress or harm and fits an exempted category

Easy to confuse with: Informed consent is required, because the Ethics Code allows no exceptions for research with human participants · Informed consent may be dispensed with only if participants are later debriefed and offered the chance to withdraw their data · Informed consent may be shortened to a brief verbal agreement but can never be dispensed with entirely

Why those are wrong: Standard 8.05 permits dispensing with consent for research not reasonably assumed to create distress or harm that studies normal educational practices in educational settings, uses only anonymous questionnaires, naturalistic observations, or archival research, or studies organizational effectiveness, as long as the listed safeguards such as protected confidentiality are met, or where law or regulations permit; it does not make debriefing a precondition and does not require even a verbal agreement.

Key idea: List the student as principal author, because the article is substantially based on the student's dissertation

Easy to confuse with: List the faculty advisor as principal author, because the advisor supervised the work and holds the senior position · List the authors alphabetically, so that no contributor's role is ranked above another's · List the student as principal author only if the advisor agrees to give up first authorship

Why those are wrong: Standard 8.12c makes the student principal author of a multiple-authored article substantially based on the dissertation except under exceptional circumstances, and 8.12b ties credit to relative contribution regardless of status, so seniority, alphabetical order, and the advisor's willingness do not decide the order.

Key idea: It is unethical, even though the psychologist has no current evaluative authority over the student or supervisee

Easy to confuse with: It is permissible, because both parties are consenting adults · It is permissible, as long as the psychologist does not teach, supervise, or evaluate the other person · It is permissible if the psychologist discloses the relationship to the program director and recuses from future evaluations

Why those are wrong: Standard 7.07 bars sexual relationships with students or supervisees in the psychologist's own department, agency, or training center, as well as those over whom the psychologist has or is likely to have evaluative authority; adult consent, the lack of a current evaluative role, and disclosure with recusal create no exception.

Key idea: Delegate only those tasks the person can be expected to perform competently, given their training and the supervision provided

Easy to confuse with: Delegate the task, because the psychologist remains responsible for all work performed under their direction · Delegate the task, provided those receiving the service agree to have that person perform it · Perform all such work personally, because the Ethics Code does not permit delegating professional work

Why those are wrong: Retaining responsibility or obtaining agreement does not make it acceptable to assign work beyond a person's training and the supervision available, and Standard 2.05 expressly allows delegation to employees, supervisees, assistants, and interpreters within those limits.

Key idea: Give timely, specific feedback through a process explained to the trainee at the beginning of supervision

Easy to confuse with: Hold the feedback for the formal final evaluation, so that it reflects the full training period · Wait to see whether the problem resolves on its own before raising it, to avoid discouraging the trainee · Report the concern to the training director and let the director decide whether to inform the trainee

Why those are wrong: Standard 7.06a requires a timely and specific feedback process that is explained to the trainee at the beginning of supervision; saving concerns for a final evaluation, waiting for problems to resolve, or leaving it to someone else whether the trainee hears of them all withhold that feedback.