Deck 12: Changing World, Changing Dilemmas

Question 1

Managed care organizations make providing therapy difficult in which of the following ways?

A)Limiting the length of treatment
B)Insistence on certain treatments
C)Denying care
D)A and C

Answer 1

D

Question 2

Evidence-based practice is an approach to care wherein professionals use research to maximize opportunities to help clients and avoid harm.

Answer 2

True

Question 3

Social workers providing services to community groups may find that dual relationships are unavoidable.

Answer 3

True

Question 4

Which of the following is one of the ways in which to dump a client?

A)A worker may tell a client that his problem has been solved successfully (even when it has not)
B)A worker may tell a client that no more can be done for him (when that is not the case)
C)The worker may cancel appointments so frequently that the client loses interest
D)All of the above

Question 5

Discuss how managed care organizations limit therapeutic services for clients.

Question 6

Which of the following is NOT an ethical dilemma that has developed as a result of technology?

A)Questions of beneficence (autonomy verses paternalism)
B)Equity of access to scarce resources
C)Sharing of files with colleagues
D)Ensuring that the maximum number of individuals benefit from the introduction of information technology

Question 7

Discuss the types of ethical dilemmas that are created by managed care organizations.

Question 8

In order to provide a "reimbursable service" for a client, the practitioner may have to consider fudging the diagnosis in some way.

Question 9

Long term therapy is the preferred mode of intervention of the managed care organizations.

Question 10

In the 2008 McBeath and Meezan study comparing the outcomes of children who received fee based services with the outcomes of those who received managed care services, which of the following was found to be true?

A)Performance based managed care is related to suppressed service provision and service disparities.
B)Performance based managed care ensured that foster children received the most clinically effective treatment.
C)Minority children fared better under performance based managed care than fee based services.
D)Both B and C are correct.

Question 11

Which of the following is NOT an expectation placed on social workers?

A)Promote the general welfare of society
B)Support only those politicians which are endorsed by NASW
C)Engage in social and political action
D)Provide services during an emergency

Question 12

Which of the following would be considered to be "dumping a client"?

A)Referring a client out for a specific treatment
B)Referring a client out due to dual-role relationships
C)Referring a client who can no longer pay for services
D)All of the above

Question 13

Social workers employed in governmental agencies can be assured that their electronic messages are safe from being publicly monitored.

Question 14

According to the Code of Ethics, social workers have an ethical responsibility to address the lack of health care available to the poor in this country.

Question 15

Managed care allows the social worker and patient complete autonomy.

Question 16

Native Americans in the United States live an average of 5 years longer any other ethnic group.

Question 17

Which of the following groups is NOT pressuring social workers and human service organizations for evidence that they are accountable and their services are beneficial to those they are serving?

A)Public organizations
B)Private organizations
C)Third party payers
D)Clients

Question 18

"Dumping the client" is one way that some practitioners have responded to clients who can no longer pay for services.

Question 19

A number of factors have combined to escalate health care costs beyond the rate of inflation in the United States.Among these factors are:

A)Growing aged population, costly new treatments, emphasis on acute care rather than preventive care
B)A lack of technology, a shrinking aged population, increased attention to preventive care
C)Modern technology, poor treatment for minorities, more teen pregnancies
D)Better treatment for the upper classes, fewer consumers of mental health treatment, emphasis on preventive care

Question 20

Managed care is one major strategy developed in an attempt to control health and mental health costs by monitoring access to and the type of health care patients receive from health care practitioners or HMOs.

Question 21

George is a private practitioner who has begun to see Elise, a 30-year-old female with a mild anxiety disorder.In order to continue treatment and receive payment by Elise' medical insurance, George deliberately misdiagnoses Elise with a severe panic disorder.

Question 22

As a macro practitioner, to whom do your loyalties belong? (the agency, the community in general, the human service agencies within the community, the community's population, your friends)

Question 23

Divide the class into 3 or 4 groups and provide the groups with one of the following four situations to discuss and share with the class.

Question 24

List and discuss the options that therapists choose when insurance coverage ends.

Question 25

Dr.Smith is on contract with the state mental hospital as a primary care physician.After 12 years of work, a nurse discovers that Dr.Smith billed Medicare for himself and for a physical on a patient.He is paid an annual salary by the hospital.

Question 26

Have the class divide into two groups.Each group chooses a representative who is an agency administrator.Therapists in the agency have collected required outcome data on program effectiveness and found that the results are not positive (there is no evidence that the agency's services are effective).One group argues that it is ethically acceptable to not provide the funding source with that information while the other group argues that it is not ethical to withhold such data.

Question 27

Discuss with the class some important things that a social worker must think about before establishing a private practice.
Class Exercises:

Question 28

Have the class discuss what they believe the role of a macro practitioner is (to engage in agency-wide change efforts, social planning, neighborhood and community organization and development, social action, etc).

Question 29

Mary has been working as a psychotherapist in the local mental health clinic for ten years.She decides it is time to leave and open her own private practice.Her clients are very disappointed and feel connected to Mary.Mary secretly gives her clients at the mental health clinic her new business card.

Question 30

Many funding sources now require that agencies provide outcome data in order to continue receiving funding.Discuss some of the ethical issues that might come up in an agency that is required to prove the effectiveness of its various programs.
Discussion Topics:

Question 31

Discuss the policy implications of managed care, how it effects practice, and relate it back to Chapter 7 where it is discussed that misdiagnosis is often intentional on the part of the practitioner.

Question 32

Discuss the ethical implications of client dumping.

Question 33

Discuss Caputo's (1991), ethical framework for electronic communications.

Question 34

Define what client dumping is, how it occurs, and why it occurs.

Question 35

Research knowledge, clinical expertise, and client values are all integrated in evidence-based practice.Discuss the five steps a practitioner needs to perform in evidence-based practice.

Question 36

Discuss what students feel a therapist should do if a client who needs continued treatment has reached the maximum on his annual or lifetime benefits but is unable to pay for services.

Question 37

Discuss what you believe is the ethical thing to do when a client can no longer pay the therapist's fee.

Question 38

Cameron is a veteran social worker who is two years away from full retirement in a private for-profit agency.She has received a client who is unable to pay due to poverty.After the initial session, Cameron refers the client to the local community mental health clinic, because they offer sliding scale fees.