Professional Orientation and Ethical Practice (Law and Ethics) Flashcards

Question 1

Q

*Which group has been most instrumental in opposing counselor**
*licensure?**
*a. Social workers.**
*b. Psychiatrists.**
*c. Psychologists.**
*d. AAMFT members**

Answer

A

c. Psychologists.

Question 2

Q

*In the late 1970s, AACD ( known as ACA since 1992) began to**
*focus very heavily on professional credentialing. This led to the**
*formation of the**
*a. CCMHC.**
*b. NBCC.**
*c. CACREP, formed in 1981.**
*d. APGA, formed in 1952**

Answer

A

b. NBCC.

In 1982, the American Association for Counseling and Development (AACD), now the American Counseling Association, formed the National Board for Certifi ed Counselors (NBCC).

Question 3

Q

*By passing the NCE, a counselor can attain _______, given via**
*NBCC.**
*a. NCC, a generic certification for counselors.**
*b. NCC, a specialty mental health certification for counselors.**
*c. NCC, national certification for school counselors.**
*d. MAC, master addictions counselor**

Answer

A

a. NCC, a generic certification for counselors.

National certifications can (as the name suggests) be used on a national basis unlike licenses which tend to be state specific. Licenses are conferred by the individual state and not the federal government.

Question 4

Q

*Which choice would most likely violate the counseling ethic or**
*law termed “scope of practice”?**
*a. A counselor who is using good accurate empathy with a**
*client, but fails to confront her about her excessive drinking.**
*b. A licensed counselor who gives the client a DSM diagnostic code for insurance.**
*c. A counselor who is too active-directive with a client.**
*d. A counselor who is conducting a strict Freudian psychoanalysis with the client.**

Answer

A

d. A counselor who is conducting a strict Freudian psychoanalysis with the client.

The “scope of practice” concept suggests that counselors should
only practice using techniques for which they have been trained.
Most counselors are not trained in classical analysis. This concept also implies that a counselor should not attempt to treat
clients for which he or she has no training. Your state counseling
law could stipulate that you disclose your “scope of practice” to
all potential clients

Question 5

Q

*Ethical guidelines were first created for the helping professions in 1953 when the American Psychological Association (APA) published their first code of ethics. The National Association of Social Workers (NASW) created their code in 1960, and in 1961, the organization that is now ACA adopted ethics for counselors.Ethics always describe**
*a. laws.**
*b. universal principles which apply to all helpers.**
*c. standards of conduct imposed by ACA and NBCC.**
*d. all of the above.**

Answer

A

c. standards of conduct imposed by ACA and NBCC.

Ethics define standards of behavior set forth by organizations and certification bodies. Ethics are not state- or federally mandated laws. Unlike many laws, ethical guidelines generally do not spell out penalties for violations. Hence, the aforementioned counselor who is dating a client might lose his or her license but will not be serving time in a city jail or a federal penitentiary

Question 6

Q

*Most ethical dilemmas are related to**
*a. confidentiality.**
*b. testing.**
*c. diagnosis.**
*d. research.**

Answer

A

a. confidentiality.

What goes on in the counseling relationship remains private rather than public. Helpers must, nevertheless, be aware that there are exceptions to this principle. The exceptions illuminate the fact that confi dentiality is relative to the situation

Question 7

Q

*The landmark 1969 case, Tarasoff versus the Board of Regents of the University of California illuminated:**
*a. difficulties involved in client/counselor sexual behavior.**
*b. ethical issues in relation to research.**
*c. the duty to warn a client in imminent danger.**
*d. the impact of an impaired professional.**

Answer

A

c. the duty to warn a client in imminent danger.

This case is often cited as an example of a professional helper’s “duty to warn” a person of serious and foreseeable harm to him- or herself or to others. ACA chose to replace the phrase “clear and imminent danger” which appeared in the previous version of their ethical code with “serious and foreseeable harm.” The newer terminology is seen as indicating that there is a broader scope of circumstances where confi dentiality may need to be broken such as a client with a terminal illness who has no medical options and wishes to end his or her own life. Nevertheless, no matter what terminology is used, if another party needs to be contacted to prevent a dangerous situation then the counselor should ethically take this action even if it means violating confi dentiality

Question 8

Q

*A counselor reveals information that is extremely damaging to a client’s reputation. This counselor could be accused of:**
*a. beneficence.**
*b. justice.**
*c. maleficence**
*d. defamation.**

Answer

A

d. defamation.

The correct answer—defamation—describes behavior that can damage one’s reputation. It is known as libel if it is written and slander if the defamation refers to verbal remarks.

Question 9

Q

*State laws can govern title usage and practice, however, they do not govern:**
*a. accreditation.**
*b. counselor licensure.**
*c. psychologist licensure.**
*d. involuntary commitment to state psychiatric facilities.**

Answer

A

a. accreditation.

Question 10

Q

*An exception to confidentiality could occur when a client is suicidal. Suicidal warning signs include:**
*a. repeatedly joking about killing one’s self.**
*b. giving away prized possessions after one has been depressed for an extended period of time.**
*c. a previous suicide attempt and a very detailed suicide**
*plan for the future.**
*d. all of the above.**

Answer

A

d. all of the above.

Question 11

Q

*A statement of disclosure could include all except:**
*a. a list of the courses the counselor took in graduate**
*school.**
*b. the counselor’s qualifications, office hours, and billing**
*policies.**
*c. emergency procedures and therapy techniques utilized.**
*d. a statement that confidentiality is desirable, but cannot be**
*guaranteed in a group setting.**

Answer

A

*a. a list of the courses the counselor took in graduate**
*school.**

Question 12

Q

Privileged communication refers to the fact that anything said to a counselor by a client:

*a. can be revealed in a court of law if the counselor decides**
*it is beneficial.**
*b. can be revealed only if a counselor testifies in court.**
*c. is protected by laws in every state.**
*d. will not be divulged outside the counseling setting without the client’s permission.**

Answer

A

d. will not be divulged outside the counseling setting without the client’s permission.

the client—not the counselor—can choose not to have confidential information revealed during a legal proceeding (generally on the witness stand). Repeat after me out loud: the client is the holder of the privilege. Say it again!

Question 13

Q

In regard to state law and privileged communication, counselors must be aware that:

*a. privileged communication exists in every state in the**
*union for LPCs.**
*b. laws are unclear and may vary from state to state.**
*c. there are no laws which govern this issue.**
*d. state psychology laws are applicable in this respect.**

Answer

A

b. laws are unclear and may vary from state to state.

privileged communication for the licensed counselor/client relationship. Privileged communication is not applicable in cases of child abuse, neglect, or exploitation; suicide or homicide threats; criminal intentions; clients in dire need of hospitalization; or in cases where a counselor is the victim of a malpractice lawsuit. In addition, privileged communication does not apply to minors (although their legal guardians generally hold the privilege) or those who are mentally incompetent.

Question 14

Q

*When counselors state that privileged communication is “qualified,” they actually mean that:**
*a. the counselor must have certification before privileged**
*communication applies.**
*b. privileged communication applies only to doctoral level**
*counselors.**
*c. exceptions may exist.**
*d. all of the above.**

Answer

A

c. exceptions may exist.

Question 15

Q

*You are a counselor in a state that does not legally support privileged communication. You refuse to testify in court. In this situation**
*a. ACA will back you for doing the ethical thing.**
*b. NBCC will back you if and only if you have attained NCC**
*status.**
*c. you need not testify if your case was supervised by a licensed psychologist and/or psychiatrist.**
*d. you could be held in contempt of court.**

Answer

A

d. you could be held in contempt of court.

Your client in this situation would not have the “privilege” to say no if you are asked to testify

Question 16

Q

*An 11-year-old child comes to your office with a black eye and**
*tells you she can’t remember how she received it. You have reason to suspect abuse. You should:**
*a. be emphatic and discuss her feelings regarding the matter.**
*b. drop the matter as it could embarrass her.**
*c. refer her to a medical doctor of your choice.**
*d. call the child abuse/neglect hotline.**

Answer

A

d. call the child abuse/neglect hotline.

Counselors are mandated reporters for child abuse. It is
legal and ethical to break confi dentiality in such cases.
You must report child abuse, it’s the law! The word mandated means that a counselor does not have a choice in
the matter.

Is a counselor always on duty? I mean, what about the old “I saw
a child being abused in the grocery store” dilemma? As of this
writing counselors are only mandated reporters while they are
performing professional duties. If you are in the grocery store
tapping on watermelons and you spy a parent abusing his child,
you can make the decision to report it, or not report it

Question 17

Q

*During a counseling session a 42-year-old male client threatens suicide. You should:**
*a. keep it a secret as the client is not a minor.**
*b. call the state child abuse/neglect hotline even though he**
*is an adult.**
*c. call his wife and mention that a serious problem exists but**
*be very careful not to discuss the issue of suicide since to**
*do so would violate the client’s confi dentiality.**
*d. contact his wife and advise her of possible suicide precautions.**

Answer

A

d. contact his wife and advise her of possible suicide precautions.

Question 18

Q

*A 39-year-old female secretary you are seeing in your assertiveness training group reveals that she is plotting to shoot her husband. Based on the Tarasoff case you should:**
*a. warn the husband.**
*b. keep it confidential because an assertiveness training**
*group is decidedly not the same as one-to-one counseling.**
*c. make a police report in the city in which the husband resides.**
*d. tell a supervisor, administrator, or board member if one**
*exists, but do not contact her husband.**

Answer

A

a. warn the husband.

Professionals generally adhere to the principle of
minimal disclosure, which suggests that you reveal only
what is necessary.

Tarasoff is controversial and based on a California court decision that may or may not apply to your state.

Question 19

Q

*You pass your exam and now have NCC status. During a staff**
*meeting a clinical director explains to you that, from an ethical**
*standpoint, your primary duty is to the agency. Most experts in**
*the field of counselor education would:**
*a. agree with this position with very few reservations.**
*b. disagree inasmuch ( to the extend ) as professional ethics emphasize that your primary responsibility is to your clients.**
*c. disagree inasmuch as professional ethics emphasize that**
*your primary responsibility is to the ACA.**
*d. say that, according to “aspirational ethics,” your agency**
*comes first..**

Answer

A

b. disagree inasmuch ( to the extend ) as professional ethics emphasize that your primary responsibility is to your clients.

“If the certified counselor and the employer do not agree and cannot reach agreement
on policies that are consistent with appropriate counselor ethical practice that is conducive to client growth and development,

Question 20

Q

One impetus (motive) for counselor licensing was that:

*a. ACSW wanted to restrict counselors.**
*b. politicians demanded that counselors be licensed.**
*c. psychology licensure bodies sought to restrict the practice**
*of counselors so counselors could not receive third party**
*payments from insurance and managed care companies.**
*d. insurance companies pushed strongly for it.**

Answer

A

*c. psychology licensure bodies sought to restrict the practice**
*of counselors so counselors could not receive third party**
*payments from insurance and managed care companies.**

Question 21

Q

*A counselor who possesses a graduate degree wishes to become a licensed psychologist. Which statement most accurately depicts the current situation?**
*a. Any counselor can easily become a psychologist if he or**
*she can pass the EPPP.**
*b. A counselor can become a licensed psychologist by taking**
*three graduate credit hours in physiological psychology**
*and then passing the EPPP.**
*c. In nearly every case individuals trained in counseling departments would not be allowed to sit for the EPPP and**
*thus could not become licensed psychologists.**
*d. A counselor with a doctorate in counseling could be licensed as a counseling psychologist if he or she has a degree from a recognized department of counseling.**

Answer

A

*c. In nearly every case individuals trained in counseling departments would not be allowed to sit for the EPPP and**
*thus could not become licensed psychologists.**

Question 22

Q

Answer

A

*c. In nearly every case individuals trained in counseling departments would not be allowed to sit for the EPPP and**
*thus could not become licensed psychologists.**

Question 23

Q

*A woman who is in private practice mentions in her phone book advertisement that she is a licensed counseling psychologist. This generally means that:**
*a. she has a doctorate from a counselor education program.**
*b. she has a graduate degree from a psychology department.**
*c. she has a degree from a CACREP program.**
*d. she has a degree in counseling but is trained in projective**
*testing**

Answer

A

b. she has a graduate degree from a psychology department.

Question 24

Q

One major difference between the psychology versus the counseling movement seems to be that:

*a. the psychologists are working to eliminate practitioners**
*with less than a doctorate, while the counselors are not.**
*b. counselors are working to give up tests for licensure.**
*c. psychology boards are made up primarily of psychiatrists.**
*d. in most states psychologists do not need to take an exam.**

Answer

A

*a. the psychologists are working to eliminate practitioners**
*with less than a doctorate, while the counselors are not.**

Question 25

Q

*4. APA is to psychologist as ACA is to:**
*a. APGA.**
*b. certified clinical mental health counselor.**
*c. counselor.**
*d. NCC**

Answer

A

c. counselor.

Here is a straightforward example of an analogy item. First, recall that the APA (in context of this question) refers to the
American Psychological Association, which is the major professional body for psychologists. ACA plays the same role for counselors.

Question 26

Q

You have achieved the status of NCC. NBCC, nevertheless, feels you have violated professional ethics. NBCC can do any of the following except:

*a. revoke your state counseling license.**
*b. remove your name from the list of NCCs in the U.S.**
*c. revoke your NCC status.**
*d. note in their newsletter that your NCC status has been**
*revoked**

Answer

A

a. revoke your state counseling license.

Question 27

Q

*A counselor who is alcoholic and suffering from burnout could**
*best be described as:**
*a. a mesomorph.**
*b. an impaired professional.**
*c. a paraprofessional.**

d. a counselor who is wise enough to use his own experiences to help others.

Answer

A

b. an impaired professional.

Question 28

Q

*Counselor certification:**
*a. is synonymous with licensure.**
*b. is synonymous with program certification.**

c. recognizes that you have reached a given level of competence and thus are authorized to use a title.

d. is primarily a legal process.

Answer

A

c. recognizes that you have reached a given level of competence and thus are authorized to use a title.

Question 29

Q

*A woman comes to you for help with an eating disorder. You**
*have no experience or training in this area. Ethically you should:**
*a. refer this client to a colleague who is indeed trained and**
*experienced with this type of client.**
*b. keep the client and work on her general lack of self-es-**
*teem.**
*c. tell the client you will do a comprehensive Internet search**
*on the topic and then begin seeing her.**
*d. explain to the client that a symptom such as eating or not**
*eating is not the real problem and that counseling focuses**
*on real underlying issues.**

Answer

A

*a. refer this client to a colleague who is indeed trained and**
*experienced with this type of client.**

Question 30

Q

*Virginia was the first state to license counselors in 1976. The**
*APGA (later AACD and now ACA) division that was initially the**
*most instrumental in pushing for licensing was the**
*a. American College Personnel Association.**
*b. American School Counselor Association.**
*c. Association for Specialists in Group Work.**
*d. American Counselor Education and Supervision.**

Answer

A

d. American Counselor Education and Supervision.

Known as ACES. The APGA set up a licensure commission in

What’s in a name? Why in the world did the Ameri-
can Personnel and Guidance Association (APGA) founded

in July of 1952, change the organization’s name to AACD,

or the American Association for Counseling and Develop-
ment, in 1983? Well, the story goes that during the late

seventies and early eighties members expressed a dislike
for the words personnel and guidance, as these terms did
not accurately depict the work of counselors. The current
nameplate, the American Counseling Association (ACA),
was adopted in July 1992, after the members voted by
mail. The new name was intended once again, to clarify
what members really did.

Question 31

Q

*The problem with income sensitive or sliding fee scales (based**
*on the client’s ability to pay) is that:**
*a. scales of this kind are unethical.**
*b. scales of this nature are illegal.**
*c. it is difficult to administer them in a fair manner.**
*d. scales like this are used frequently; however, they are**
*unethical and illegal.**

Answer

A

c. it is difficult to administer them in a fair manner.

Sliding fee scales, which are ethical and legal, quite popular with
not-for-profi t agencies, are often confused with the term amount
waived,which refers to the amount a third party payer did not
cover.

Question 32

Q

One possible negative aspect of counselor licensure is that:

*a. counselors would receive more third-party payments.**
*b. counselors might be accepted as providers by insurance**
*companies.**
*c. counselors may not be as creative during their graduate**

work and simply take courses aimed at fulfilling the requirements to take the licensure exam.

d. it will take business away from psychologists.

Answer

A

c. counselors may not be as creative during their graduate

work and simply take courses aimed at fulfilling the requirements to take the licensure exam.

Question 33

Q

*A client wants his records sent to a psychiatrist he is seeing. You should:**
*a. advise against it based on current research.**
*b. refuse to do so based on ethical guidelines.**
*c. fi rst have the client sign a dated release of information**
*form that stipulates whether the information can be re-**
*leased once (or for what period of time it can be released)**
*and then you can send the information.**
*d. call the psychiatrist to discuss the case but explain that**
*state law prohibits a counselor from sending anything in**
*writing about the client.**

Answer

A

c. fi rst have the client sign a dated release of information

*form that stipulates whether the information can be re-**
*leased once (or for what period of time it can be released)**

and then you can send the information.

Exam hint: Your exam might refer to a
release of information as consent to disclose or transfer

records. Also note that you may not record or observe ses-
sions without permission of the client. Lastly, ethics dic-
tate that you should keep the client’s record for at least

fi ve years after your last contact with the client even in
cases where the client is deceased.

Question 34

Q

*You are a licensed professional counselor in one state but will**
*soon relocate to another state. The new state informs you that**
*they will grant you reciprocity or so-called endorsement. You**
*will thus:**
*a. simply need to take the licensing test in the new state.**
*b. be permitted to practice in the new state based on your**
*current credentials without taking another exam.**
*c. need to take numerous graduate courses.**
*d. not be allowed to practice until you serve an internship.**

Answer

A

*b. be permitted to practice in the new state based on your**
*current credentials without taking another exam.**

Reciprocity occurs when one state or organization accepts the license or credential of another state or organization. The profession is working diligently to enhance portability (the ease that something can be transferred) so that one state would accept another’s credentials.

Question 35

Q

*According to the Family Educational Rights and Privacy Act**
*(FERPA) of 1974 (also known as the Buckley Amendment)**
*a. a parent can see his or her daughter’s middle school re-**
*cord.**
*b. an 18-year-old college student can view his or her own**
*educational record.**
*c. a and b.**
*d. a and b are both illegal.**

Answer

A

c. a and b.

school coun-
selors should be aware that a court of law can still subpoena the

actual counseling notes or request that the counselor testify.

Question 36

Q

You are a school counselor who wishes to refer an orthopedically disabled student to a private therapist. In general, the best referral would be to:

*a. a CRC.**
*b. a MAC.**
*c. a licensed clinical psychologist.**
*d. a licensed social worker.**

Answer

A

a. a CRC.

CRC stands for Certifi ed Rehabilitation Counselor. CRCs will
need at least a master’s in rehabilitation counseling, acceptable
experience in the fi eld, and a passing score on a 400-question

multiple choice examination.

Question 37

Q

*A registry would be:**
*a. a list of licensed psychologists in the state of Illinois.**
*b. a list of CRCs in the United States.**
*c. a and b.**
*d. the registration process for counselor licensure in the**
*state of Missouri.**

Answer

A

c. a and b.

A registry is always a list of providers. A person whose name is
included in a state counseling registry can sometimes use the
title “registered professional counselor” or RPC.

Question 38

Q

*A counselor wins the lottery and closes her practice without telling her clients. This counselor’s course of action is best described as:**
*a. a multiple relationship.**
*b. defamation.**
*c. abandonment.**
*d. nonmaleficence.**

Answer

A

c. abandonment.

The client in this ques-
tion is the victim of abandonment which occurs when a

counselor stops providing services and does not refer the
client to another helper.

Question 39

Q

*You are counseling your first cousin for depression. This is:**
*a. ethical.**
*b. not actually an ethical issue.**
*c. ethical if you continue to counsel her and refer her to a**
*psychiatrist for an antidepressant.**
*d. generally unethical as it would constitute a dual or so-**
*called multiple**

Answer

A

*d. generally unethical as it would constitute a dual or so-**
*called multiple**

A dual relationship results when a counselor has another sig-
nifi cant relationship with the client that hinders objectivity. A

dual relationship is also said to exist when a supervisor accepts a
subordinate or administrator as a client.

Question 40

Q

*A counselor who sports NCC after her name:**
*a. will need not concern herself with continuing education.**
*b. will need three graduate courses every 10 years.**
*c. will never receive credit for workshops but should attend**
*for her own personal growth nevertheless.**
*d. will need a specified amount of continuing education con-**
*tact hours before she can be recertified, or she will need**

to take the NCE again.

Answer

A

*. will need a specified amount of continuing education con-**
*tact hours before she can be recertified, or she will need**

to take the NCE again.

One hundred hours of professional development are needed
during a fi ve-year period. Recently, Home Study Programs have
made this process more convenient.

Question 41

Q

*You find yourself sexually attracted to a client. This is known as:**
*a. counter-transference.**
*b. ambivalent transference.**
*c. negative transference.**
*d. positive transference.**

Answer

A

a. counter-transference.

A typical manifestation of counter- transference would be roman-
tic or sexual feelings toward a client. Counter-transference is an

indication of unresolved problems on the part of the helper.

Question 42

Q

Your sexual attraction toward your client is hindering the counseling process. You should:

*a. continue treatment but be honest and empathic with the**
*client.**
*b. ignore your feelings; after all you are a professional.**
*c. explain this to the client and then refer the client to an-**
*other provider.**

d. continue to see

Answer

A

*c. explain this to the client and then refer the client to an-**
*other provider.**

The word hindering is critical to answering the question correct-
ly. If the counselor felt a sexual attraction which had “not” as yet

hindered the treatment process, then personal therapy/profes-
sional supervision for the counselor would be the most desirable

plan of action.

Question 43

Q

A malpractice or liability insurance company is least likely to defend you if:

*a. you are sexually involved with a client.**
*b. you violate confidentiality.**
*c. you do not have a client sign a release of information and**
*send a record to another agency or provider.**
*d. you call a state child abuse hotline and a client takes legal**

action since the child was actually the victim of an accident.

Answer

A

a. you are sexually involved with a client.

NBCC ethics

stipulate that you should not engage in sexual intimacies
with a former client within a minimum of two years after
terminating the counseling relationship. If you engage in
such a relationship after the two-year period you must

be able to document that the relationship was not exploi-
tive in nature. ACA ethics indicate that a minimum of fi ve

years must pass before the counselor can have a roman-
tic relationship with the client.

Question 44

Q

*Computers are now being used in various counseling settings.**
*Counselors speak of Computer Assisted Counseling (CAC) and**
*Computer Managed Counseling (CMC). An office that employs a computer to schedule clients would be an example of:**
*a. CMC.**
*b. CAC.**
*c. an ethical violation.**
*d. the misuse of computers, though the practice is ethical.**

Answer

A

a. CMC.

When a computer helps manage your practice (yes, just like a
manager) then it is known as CMC. CMC would include tasks

such as bookkeeping, client scheduling, printing billing state-
ments, and compiling referral sources. CAC is like having a

counseling “assistant” do the counseling for you. A computer
software program that attempts to counsel clients is an example
of CAC in action. CAC is controversial and most experts agree
computers can never provide the compassion of a human doing
counseling.

Question 45

Q

A college student who suffers from panic disorder types his
symptoms and concerns onto a PC screen and then waits for
the computer program to respond or question him further. The
student engages in this practice for one 40-minute session per
week. This is an example of::
a. CAC.
b. CMC.
c. Computer Managed Counseling.
d. b and c.

Answer

A

a. CAC.

Question 46

Q

*As a professional counselor you develop a self-help software**
*package for use by the general public. Ethics indicate that**
*a. the package must be designed to use with counseling.**
*b. the package must be designed to use with counseling and**
*then modified for stand-alone usage.**
*c. the package must be initially designed for stand-alone us-**
*age as opposed to modifying a package requiring counselor support.**

d. this is an unethical practice.

Answer

A

*c. the package must be initially designed for stand-alone us-**
*age as opposed to modifying a package requiring counselor support.**

Ethics also dictate that the certifi ed counselor must provide descrip-tions of appropriate and inappropriate applications, suggestionsfor using the software, statements regarding the intended out-comes, and how and when counseling services are benefi cial. Lastly, the manual must delineate the counselor’s qualifi cations,the process of development, validation data, and operating pro-cedures.

Question 47

Q

*Which statement best describes the counseling profession’s reaction to computer assisted counseling and computer managed counseling?**
*a. Counselors are very humanistic and seem to dislike CMC**
*and CAC technology.**
*b. Counselors have welcomed both forms of computer tech-**
*nology with open arms.**
*c. CMC has been well received since it cuts down time on**
*paperwork, scheduling, and record keeping, but there is**
*a mixed reaction to CAC as some feel it depersonalizes**
*counseling.**
*d. Counselors dislike CMC but praise CAC highly.**

Answer

A

*c. CMC has been well received since it cuts down time on**
*paperwork, scheduling, and record keeping, but there is**
*a mixed reaction to CAC as some feel it depersonalizes**
*counseling.**

Question 48

Q

Answer

A

*c. CMC has been well received since it cuts down time on**
*paperwork, scheduling, and record keeping, but there is**
*a mixed reaction to CAC as some feel it depersonalizes**
*counseling.**

Question 49

Q

*You are a supervisor at a sexual abuse treatment agency. Sally is one of your counselors and you give her a performance rating on a yearly basis. Sally has been having panic attacks on a daily basis at home for almost a month and her physician feels that counseling rather than medicine is indicated. Now—for the first time—she has a terrible panic attack at work. If you don’t see her the nearest counselor is 150 miles away. You should:**
*a. refer her to the counselor who is 150 miles away.**
*b. absolutely refuse to see her as dual relationships violate**
*ethical guidelines.**
*c. teach her relaxation but refuse to counsel her.**
*d. attempt to counsel her.**

Answer

A

d. attempt to counsel her.

Also remember that ACA ethics now state that not all dual relationships are bad and that very fact helped remove the term from the current guidelines.

Question 50

Q

A counseling journal article should use documentation (i.e., references) that is based on

*a. APA style.**
*b. MLA style taught in most English composition classes.**
*c. a or b.**
*d. none of the above.**

Answer

A

a. APA style.

Counseling journals conform to the standards of the Publica-
tion Manual of the American Psychological Association.

The reality is, however, that many of us took only English com-
position courses that taught MLA, rather than APA style.

Question 51

Q

*A 14-year-old male threatens to blow up his parents’ garage because he has been grounded. You believe his threat is genuine. You should:**
*a. ask the child if he will sign a release of information so you**
*can talk to his parents.**
*b. not talk to the parents since this would weaken the bond**
*of trust you have with the client.**
*c. have the child sign a contract stating he will not blow up**
*the garage but mention nothing to the parents.**
*d. warn the parents that their property is in danger.**

Answer

A

d. warn the parents that their property is in danger.

a case tried in the Supreme Court

of Vermont suggested that a mental health agency was negligent for not warning parents that their son, who was in therapy,threatened to burn down their barn—which he did. So until further notice a warning is in order.

Question 52

Q

*A 16-year-old girl threatens to kill herself and you fail to inform**
*her parents. Your behavior as a counselor is best described as:**
*a. an example of a dual relationship.**
*b. an example of informed consent.**
*c. an example of negligence, which is a failure to perform a**
*duty, which in this instance is an obligation to protect the**
*client.**
*d. multiple submission.**

Answer

A

*c. an example of negligence, which is a failure to perform a**
*duty, which in this instance is an obligation to protect the**
*client.**

Question 53

Q

*NBCC has developed a Code of Ethics to help counselors be-**
*have in a professional manner. The code is divided into a preamble and seven sections. The first section (i.e., Section A) warns against stereotyping and discrimination. All of the following would be examples of stereotyping and discrimination except**
*a. advising an African-American client to avoid graduate**
*school because you believe the Jensen research regarding**
*Blacks and IQ scores.**
*b. advising a client to consider switching his college major**
*based on your clinical judgment as well as the results**
*from an extensive test battery.**
*c. advising a female client to avoid taking a management**

position because you feel women are generally non assertive.

*d. advising a female client to avoid taking a management**
*position because you feel women managers are generally**
*too aggressive.**

Answer

A

*b. advising a client to consider switching his college major**
*based on your clinical judgment as well as the results**
*from an extensive test battery.**

Question 54

Q

*Section A, which is the general section of NBCC’s Code of Ethics, cautions counselors against sexual harassment defined as“unwelcome comments, gestures, or physical contacts of a nature.” An example of an ethics violation in this respect would be:**
*a. a female counselor who repeatedly tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned.**
*b. a male counselor who smiles to reinforce a female client**
*(who is overly critical of her looks) who has just said that**
*she is beginning to accept her feminine qualities.**
*c. a female career counselor who tells a male client that she**
*feels his gray flannel suit would be the most appropriate**
*for a given job interview.**

d. when a client who has been very depressed and neglecting her looks comes into the therapy session looking much better and the counselor comments, “You certainly look nice today.”

Answer

A

a. a female counselor who repeatedly tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned.

Question 55

Q

*You are a well-known cognitive behavior therapist who heads**
*up a private practice in New Jersey. For the next two years you**
*will be in Canada conducting a research project. Your practice**
*has six other counselors. The practice is sending brochures to**
*schools, agencies, and hospitals in an attempt to boost referrals. Your name appears on the front of the brochure as if you are available for referrals. This is:**
*a. totally ethical.**
*b. unethical.**

c. possibly ethical and possibly unethical. Not enough information is given to answer this question.

*d. irrelevant since ACA and NBCC ethics do not address**
*private practice.**

Answer

A

b. unethical.

The verdict: unethical. Ethics do address private practice and
suggest that persons who hold leadership roles not allow their

names to be used in professional notices when they are not practicing counseling unless this is clearly stated in the practice’s literature.

Question 56

Q

A colleague of yours who is not a certified counselor behaves in an unethical manner. The ethical thing for you to do is:

a. ignore it; unfortunately you have no rights in this situation.

*b. consult the school the person graduated from.**
*c. attempt to rectify the condition via institutional channels,**
*turning to NBCC procedures if this fails.**
*d. all of the above are considered ethical.**

Answer

A

*c. attempt to rectify the condition via institutional channels,**
*turning to NBCC procedures if this fails.**

Professional behavior of associates is expected of “both

certifi ed and noncertifi ed counselors.” Read Section A: Gen-
eral, paragraph 3, of, NBCC’s Code of Ethics. Try to amelio-
rate the diffi culty via the institution’s channels before contacting

NBCC.

Question 57

Q

A client asks you for classical psychoanalysis yet you have no

training whatsoever in this area. If you agree to analyze the client, you are

*a. violating the duty to warn.**
*b. still ethical if you possess LPC or NCC.**
*c. unethical as this is misrepresentation.**
*d. still ethical if and only if you have a doctorate.**

Answer

A

*.**
*c. unethical as this is misrepresentation.**

Code of Ethics states in Section A paragraph 7 that “certified
counselors recognize their limitations and provide services or
only use techniques for which they are qualified by training and/
or experience.”

Question 58

Q

*A client needs counseling but can afford only $5 per session. As a private practitioner you charge $75 per hour. You should:**
*a. still charge the client $75 per hour, but let her pay you**
*$5 per week indefinitely until she has actually paid your**
*normal rate.**
*b. be firm and tell her the fee is $75 per hour regardless of**
*her income.**
*c. immediately refer her to a state funded agency.**
*d. consider the client’s financial status and the locality and**
*offer her a reduced rate.**

Answer

A

*d. consider the client’s financial status and the locality and**
*offer her a reduced rate.**

cost.” Incidentally, ACA ethics state that counselors devote a portion of their work making a contribution to society by providing services with little financialreturn or “pro bono” (i.e., free) services.

Question 59

Q

*Dr. X recommends to his agency clients that he would rather**
*counsel them in his private practice. Ethically speaking**
*a. Dr. X has every right to do this.**
*b. Dr. X is diverting agency clients to his practice and this is**
*unethical.**
*c. guidelines do not address this practice.**
*d. NBCC encourages this method for private practitioners.**

Answer

A

*b. Dr. X is diverting agency clients to his practice and this is**
*unethical.**

Question 60

Q

*Section B of NBCC’s Code of Ethics deals with the counseling**
*relationship. Thus a counselor who uses a paradoxical strategy:**
*a. has committed a blatant ethics violation.**
*b. does not need to explain the purpose of the paradox to the**
*client.**

c. should explain the purpose of this technique to the client.

d. must tape record the interview.

Answer

A

c. should explain the purpose of this technique to the client.

Certified counselors will clearly inform clients of the purposes,
goals, and techniques utilized. Some textbooks in the fi eld may
have inadvertently given counselors the false notion that it is best
to mystify the counseling process. Paradoxical interventions—in

which a client is told to exaggerate a symptom—are contraindi-
cated in cases with homicidal or suicidal clients.

Question 61

Q

*A counselor is counseling an executive secretary. The counselor notes that he is writing a book and explains to the client that he will see her for free if she types the manuscript. This is:**
*a. known as bartering and unethical as described here.**
*b. known as bartering and ethical.**
*c. known as bartering and is highly recommended for clients with limited income.**
*d. is known as bartering and ethics encourage this practice**
*whenever possible.**

Answer

A

a. known as bartering and unethical as described here.

And what happens to the counselor’s objectivity if his secretary
is doing a poor job or worse yet not completing the manuscript?
The practice of “bartering” is discouraged. Bartering occurs

when a client exchanges a good or service for treatment or test-
ing (e.g., I’ll paint your car if you provide me with six sessions

of therapy). Currently, ethics allow the practice if the client re-
quests it, a written contract is drafted, and the relationship is not

exploitative. Choice “c” would be correct if the client had sug-
gested the bartering in lieu of the fact that she could not afford

the sessions.

Question 62

Q

*Ethics state that a counselor should _______ all clients for group**
*counseling.**
*a. diagnose.**
*b. test.**
*c. screen.**
*d. a and b.**

Answer

A

c. screen.

Question 63

Q

*You are a middle school counselor at a public school. A child is**
*threatening to kill another student and admonishes you to keep it a secret. According to the ethical principle of minimal disclosure the best course of action would be to:**
*a. try to talk the client out of his plan of action but do not**
*violate his confidentiality by telling anyone else.**
*b. call the major radio and television stations as research**
*clearly indicates that publicity can stop school tragedies.**
*c. call the police and give them a complete blow by blow**
*description of the counseling session.**
*d. inform the parents of the student in danger, inform the**
*principal, and call the police immediately, discussing only material related to the threat.**

Answer

A

*d. inform the parents of the student in danger, inform the**
*principal, and call the police immediately, discussing only material related to the threat.**

An important mini review here: Minimal disclosure means
that if you must break confidentiality you reveal only what is necessary

Question 64

Q

Your agency uses a collection agency when clients don’t pay their bills. You should:

*a. not take a chance on degrading the therapeutic relation-**
*ship by mentioning it.**

b. Explain to the client that ethically the agency can do this;

*however, a private practitioner is not allowed to use a collection agency and thus a private counselor might be a wiser choice.**
*c. inform the client of this before the counseling begins.**
*d. never do this as it is unethical in our field.**

Answer

A

c. inform the client of this before the counseling begins.

Answer 65

A

*c. submit the article to one publication at a time despite**
*your conviction that the article must get published.**

certified counselors must not submit the same manuscript, or one essentially the same in content, for simultaneous publication consideration by two or more journals.” Multiple or duplicate submissions are unethical in relation to journal articles. Exam hint: Once your article is published you may not have it republished elsewhere without the express permission of the first publisher.

Answer 66

A

*d. a voluntary relationship between a professional helper and**
*a help-needing individual, group, or social unit in which**
*the consultant helps define or solve problems related to**
*clients, the client system, or work-related issues.**

Answer 67

A

d. An executive director of a private practice who has his

name listed in a Yellow Pages advertisement as a counseling provider despite the fact that he is out of the country and is engaged in a research project for the next two years.

Answer 68

A

c. a and b.

Did you mark choice “a”? Well give yourself an A– because that’s
not really a bad answer. In fact, it is not even an incorrect answer.
The answer I wanted you to mark, nevertheless, was choice “c”

since some third-party payers have begun asking for ICD (In-
ternational Classifi cation of Disease) codes (choice “b”).

Answer 69

A

*a. A counselor who wishes to secure insurance (i.e., third**
*party) payments.**

cure. Despite all the aforementioned diffi culties, insur-
ance companies/managed care organizations ask for a diagnosis

before paying for a service; this is a remnant of the so-called
medical model. Remember: The DSM is produced by a medical

organization, the American Psychiatric Association (yes unfortu-
nately, there’s another APA to commit to memory).

Answer 70

A

a. behavioral.

The concern has been that behavior therapists can control, ma-
nipulate, and shape behavior. Is it ethical, for example, to use

aversive conditioning such as electrical shocks, drugs, or paraly-
sis to eliminate smoking, alcoholism, gambling, or homosexual

tendencies? Some clients in token economy behavior modifi ca-
tion systems have questioned the legality of using contingencies

in the form of reinforcement to get them to talk, work, behave,
dress, or interact in a certain way.

Answer 71

A

b. third-party payments.

Answer 72

A

a. five.

include: Axis I—Clinical Syndromes: Other Condi-tions That May Be a Focus of Clinical Attention; (except

*personality disorders and mental retardation) this could include**
*most V Codes; Axis II— Personality Disorders and Mental**
*Retardation; _Axis III—_General Medical Conditions (i.e.,**
*that might be relevant to diagnosis or treatment of the disor-**
*der); Axis IV—Psychosocial and Environmental Problems,**

and Axis V—Global Assessment of Functioning (GAF).

Answer 73

A

c. 303.90.

the decimal point occurs after the third digit regardless of the diagnosis or lack of it.

Answer 74

A

*a. severity, and thus it will be replaced with a diagnostic**
*number.**

The fifth digit can also indicate a condition in a state of remission while a fifth digit of 0 means “unspecified.” In this actual

example the 296.2X indicates the condition of major depression,

Answer 75

A

d. V62.82.

The salient feature to remember is that the “V” replaces the first digit in the five-digit code.

Answer 76

A

c. Uncomplicated Bereavement.

Answer 77

A

b. medical.

The medical model of medicine or psychotherapy begins with a formal label or diagnosis of the problems.

Answer 78

A

d. 296.24.

The fi fth digit can also indicate a condition in a state of remis-
sion while a fi fth digit of 0 means “unspecifi ed.” In this actual

example the 296.2X indicates the condition of major depression,

single episode. In the form of 296.20 the condition is “unspeci-
fi ed.” Written 296.21 the condition is “mild.” 296.22 is moderate,

while 296.23 is “severe without psychotic features”; and fi nally
296.24 signifi es the most serious state of “severe with psychotic
features”; 296.25 is “in partial remission,” whereas 296.26 is “in full remission.” This is an example of a mood disorder. For or-
ganic mental disorders and schizophrenia, the fi ve-digit code

will take on a different meaning. Five-digit codes for organic
impairment include: 1=with delirium (i.e., mental confusion);

2=with delusions (a false belief unaltered by facts to the con-
trary); 3=with depression; and 0=uncomplicated. For schizo-
phrenia, 1=subchronic; 2=chronic; 3=subchronic with acute

exacerbation; 4=chronic with acute exacerbation; 5=remission;

and 6=unspecifi ed. Also take note of the fact that the DSM rou-
tinely uses the abbreviation NOS, which means “not otherwise

specifi ed,” while NEC (“not elsewhere classifi ed”) appears in
the ICD. The DSM does not speculate about causation of the
condition.

Answer 79

A

d. V62.82.

Answer 80

A

c. Uncomplicated Bereavement.

Answer 81

A

b. medical.

Answer 82

A

d. 296.24.

Answer 83

A

*c. the AMA’s Current Procedural Terminology (e.g., CPT**
*90844).**

If you want to accept insurance payments you will generally
need to specify a CPT code in addition to the DSM or ICD
code on your billing statement. The CPT code will specify the
exact nature of the treatment being utilized to help your client

(e. g., psychotherapy, hypnosis, biofeedback, or group psycho-
therapy) .

Answer 84

A

a. may not pay you a referral fee for sending her the client.

Save your nickels; counselors cannot ethically accept referral
fees.

Answer 85

A

d. may use the book as a textbook in your class.

It’s ethical! Nevertheless, your school could have a policy against it or a policy similar to choice “c.”

Answer 86

A

c. repeat the question, but talk more slowly.

The counselor should al-
ways attempt to use the recommended wording. Changing the

wording could alter the impact of the test question, possibly con-
founding the results.

Answer 87

A

c. Caplan. (consultation)

These four basic types of mental health consultation have been proposed by Gerald Caplan.

Answer 88

A

d. Schein.

Consultants can focus on process (what is happening from a
communications standpoint) or content (knowledge imparted
from the consultant to the consultee).

Answer 89

A

a. Sexual misconduct.

It has been estimated that over 95% of those clients who were
sexually involved with their therapists have been harmed, and
that in about one third of the cases, treatment literally ended as
soon as sexual intimacy began.

Answer 90

A

c. counsel the client.

Treat this client in the same manner as you would treat any other
client! To be sure, you might decide that information amassed
via Dr. Doyle would be helpful and then you would secure the
client’s written permission to contact him. Nevertheless, this

certainly isn’t required to begin the counseling process. More-
over, it is possible that the client will not sign for the release.

Answer 91

A

*c. not ask him for a testimonial since it would constitute an**
*ethics violation.**

Ethics guidelines clearly state that the counselor should not so-
licit testimonials from clients.

Answer 92

A

*b. consult with colleagues as well as ethical codes inasmuch**
*as legal standards are very often based on the methods of**
*fellow professionals in analogous situations.**

Answer 93

A

b. terminate the relationship and initiate an appropriate referral.

Ethics guidelines suggest that when a counselor feels he or she is unable to help a potential or existing client, then the relationship should not be initiated, or the existing one should be terminated. In either case, the counselor is responsible for providing alternative referral sources to the client.

Answer 94

A

d. you are not obligated to continue the relationship.

You are acting in the best interest of the client.

Answer 95

A

c. deans and advisors employed after the Civil War in college settings to watch over young women.

Answer 96

A

c. Wilhelm Wundt, in 1879 in Leipzig, Germany.

Wundt was convinced that psychology could be accepted as a
science if consciousness could be measured. Wundt’s school of
thought is termed structuralism because his interest was in the
“structure” of consciousness.

Answer 97

A

*a. Workbook in Vocations by Proctor, Benefield, and**
*Wrenn.**

This work, as well as an earlier one by Proctor in 1925 entitled Educational and Vocational Guidance, began to conceptualize counseling as a psychological process.

Answer 98

A

d. all of the above.

Answer 99

A

*c. included an emphasis on professionalism, certification,**
*and licensing.**

Credentialing helped counseling become a specific and separate profession such as psychology or psychiatry. Although group work is still very popular, it emerged as a driving force in the 1970s.

Answer 100

A

b. the APA did not wish to credential master’s-level counselors or psychologists.

Separate ethics were thus developed, which helped discern
counseling from psychology as a profession.

Answer 101

A

b. developmental psychology.

Piaget, Erikson, and Havinghurst were very influential. In addition, thanks primarily to the work of Carl R. Rogers, counseling rather than testing became the major task for professionals.

Answer 102

A

c. group.

Groups would remain popular in the 1970s. Some of the litera-
ture in the fi eld refers to the 1960s and 1970s as the “decades of

variation,” in which we became “therapy of the month consum-
ers”! Jerome Frank hypothesized at the time that the sudden

fl ood of new therapies was due to the current upheaval in soci-
ety. Gestalt, Transactional Analysis (TA), Primal Scream Thera-
py, Encounter Groups, Marathon Groups, and yes, even Naked

Encounter Groups became popular!

Answer 103

A

*c. emphasize developmental concerns rather than merely**
*focusing on crises and curing emotional illness.**

This 1962 APGA publication was an attempt to steer counseling
away from merely providing remedial services to students.

Answer 104

A

b. intrapsychic processes.

was not entirely a negative thing; nevertheless, social is-
sues such as Vietnam, civil rights, and women’s issues could have been emphasized to a greater degree.

Answer 105

A

d. all of the above.

Many pilot programs developed as a result of the funding. Grad-
ually, the funding found its way into helping counselors prepare

to work with economically disadvantaged youth. Thus, the act

eventually helped all types of young people secure better coun-
seling and guidance services. Some exams may use the abbrevia-
tion NDEA when referring to this act.

Answer 106

A

a. break confidentiality and tell his wife.

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