Look, I’m not here to defend the BBS (California’s Board of Behavioral Sciences) or any other licensing board. They’re not your friend. They require deeply flawed exams that even they know don’t work. Their disciplinary guidelines, especially around substance use issues, are unreasonably punitive. They are notoriously unresponsive. There are a lot of problems there. But it’s also true that most complaints about the BBS are based on flat-out falsehoods.
In Part 1, which was an excerpt from my Basics of California Law text, I discussed the subtle ways that even well-meaning therapists can subvert a license exam. Here in Part 2, available only online, I’ll get more specific about what kinds of things I think can be safely shared and what probably can’t.
With so many therapists and clients owning iPhones, some therapists have started experimenting with doing sessions via Apple’s FaceTime videoconferencing. While Apple does not provide a Business Associate Agreement (typically required under HIPAA) for use of FaceTime, there is an interesting legal argument that suggests FaceTime may still be safe for therapists to use.
It is essential to the fairness and validity of any testing process that those who take the test are who they say they are, do not attempt to cheat on the test, and do not reveal any information about test content to those who have not yet taken the exam. This is certainly true with license exams, which are considered high-stakes tests because failing can directly impact one’s professional standing and job opportunities.
Violating exam security or subverting a license exam, one of the forms of unprofessional conduct that can lead to discipline from the Board of Behavioral Sciences, occurs most commonly when someone who has just taken their exam shares its content with others who have not yet taken the exam. “Subverting,” as it is used here, means impacting the integrity of the exam; while sharing content is perhaps the most common way this happens, it certainly is not the only way it could occur.
As mental health clinicians, we all know the importance of setting and maintaining boundaries with clients. We have several posts on this blog about setting boundaries online, specifically in regards to social media use (1 2 3). One boundary that we have not discussed is how to manage situations when you see a client outside of the regular therapy setting.
Therapists generally agree that we do not to approach clients outside of therapy, out of respect for the client’s confidentiality. If someone else knows that you are a therapist, they may make the connection that the person you are interacting with is a client. If a client approaches the therapist first, however, engaging is often considered appropriate. Even so, many therapists agree that it is difficult to maintain professional boundaries while also engaging clients socially.
Legal and technological changes are further complicating the potentially uncomfortable situations where we might encounter clients outside of the office. More specifically, we may see clients in settings that were not previously socially acceptable or accessible. Therapists today are at risk of seeing clients on dating apps, at meet-up groups, and at marijuana dispensaries. The potential for seeing clients in social situations has always been present, but there is added risk that those interactions will reveal private details about your personal life.