Professional Orientation and Ethical Practice (Law and Ethics) Flashcards
1
Q
- *Which group has been most instrumental in opposing counselor**
- *licensure?**
- *a. Social workers.**
- *b. Psychiatrists.**
- *c. Psychologists.**
- *d. AAMFT members**
A
c. Psychologists.
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**
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).
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**
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.
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.**
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
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.**
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
6
Q
- *Most ethical dilemmas are related to**
- *a. confidentiality.**
- *b. testing.**
- *c. diagnosis.**
- *d. research.**
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
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.**
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
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.**
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.
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.**
A
a. accreditation.
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.**
A
d. all of the above.
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.**
A
- *a. a list of the courses the counselor took in graduate**
- *school.**
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.**
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!
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.**
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.
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.**
A
c. exceptions may exist.
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.**
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
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.**
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
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.**
A
d. contact his wife and advise her of possible suicide precautions.
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.**
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.
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..**
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,
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.**
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.**
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.**
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.**
22
Q
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.**
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**
A
b. she has a graduate degree from a psychology department.
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.**
A
- *a. the psychologists are working to eliminate practitioners**
- *with less than a doctorate, while the counselors are not.**
25
* *4. APA is to psychologist as ACA is to:**
* *a. APGA.**
* *b. certified clinical mental health counselor.**
* *c. counselor.**
* *d. NCC**
**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.
26
**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**
**a. revoke your state counseling license.**
27
* *A counselor who is alcoholic and suffering from burnout could**
* *best be described as:**
* *a. a mesomorph.**
* *b. an impaired professional.**
* *c. a paraprofessional.**
## Footnote
**d. a counselor who is wise enough to use his own experiences to help others.**
**b. an impaired professional.**
28
* *Counselor certification:**
* *a. is synonymous with licensure.**
* *b. is synonymous with program certification.**
## Footnote
**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.**
**c. recognizes that you have reached a given level of competence and thus are authorized to use a title.**
29
* *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.**
* *a. refer this client to a colleague who is indeed trained and**
* *experienced with this type of client.**
30
* *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.**
**d. American Counselor Education and Supervision.**
**Known as ACES**. The APGA set up a licensure commission in
1975. 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.
31
* *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.**
**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.
32
**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.**
**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.**
33
* *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.**
**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.
34
* *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.**
* *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.
35
* *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.**
**c. a and b.**
## Footnote
school coun-
selors should be aware that a court of law can still subpoena the
actual counseling notes or request that the counselor testify.
36
**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.**
**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.
37
* *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.**
**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.
38
* *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.**
**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.
39
* *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**
* *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.
40
* *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.**
* *. 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.
41
* *You find yourself sexually attracted to a client. This is known as:**
* *a. counter-transference.**
* *b. ambivalent transference.**
* *c. negative transference.**
* *d. positive transference.**
**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.
42
**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**
* *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.
43
**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.**
**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.
44
* *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.**
**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.
45
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.
**a. CAC.**
46
* *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.**
* *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.
47
* *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.**
* *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.**
48
* *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.**
49
* *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.**
**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.
50
**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.**
**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.
51
* *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.**
**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.
52
* *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.**
* *c. an example of negligence, which is a failure to perform a**
* *duty, which in this instance is an obligation to protect the**
* *client.**
53
* *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.**
* *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.**
54
* *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.”**
**a. a female counselor who repeatedly tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned.**
55
* *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.**
**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.
56
**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.**
* *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.
57
**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.**
* *.**
* *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.”
58
* *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.**
* *d. consider the client’s financial status and the locality and**
* *offer her a reduced rate.**
## Footnote
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.
59
* *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.**
* *b. Dr. X is diverting agency clients to his practice and this is**
* *unethical.**
60
* *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.**
**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.
61
* *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.**
**a. known as bartering and unethical as described here.**
## Footnote
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.
62
* *Ethics state that a counselor should _______ all clients for group**
* *counseling.**
* *a. diagnose.**
* *b. test.**
* *c. screen.**
* *d. a and b.**
**c. screen.**
63
* *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.**
* *d. inform the parents of the student in danger, inform the**
* *principal, and call the police immediately, discussing only material related to the threat.**
## Footnote
An important mini review here: Minimal disclosure means
that if you must break confidentiality you reveal only what is necessary
64
**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.**
**c. inform the client of this before the counseling begins.**
65
* *You have just made a landmark discovery which you feel could**
* *literally change the entire field of counseling and thus you write an article which depicts your findings. The next step would be to:**
**a. submit the article to no more than two journals simultaneously.**
* *b. submit the article to every major APA and ACA journal**
* *published.**
* *c. submit the article to one publication at a time despite**
* *your conviction that the article must get published.**
**d. write NBCC and request permission for multiple submission privileges.**
* *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.
66
**Section F of NBCC’s Code of Ethics is concerned with ethics**
**related to consulting. Consulting or consultation can best be defined as:**
* *a. a brand or paradigm of brief psychotherapy.**
* *b. a brand or paradigm of long-term psychotherapy.**
* *c. a systematic process based on classical conditioning.**
* *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.**
* *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.**
67
* *Section G of NBCC’s Code of Ethics describes ethical issues**
* *related to private practice. Which of these situations is clearly an ethics violation?**
**a. A private practitioner who advertises in the Yellow Pages.**
**b. A private practitioner who advertises in a daily newspaper.**
* *c. A counselor who terminates a professional relationship**
* *with a client because she feels it is no longer productive**
* *for her client.**
* *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.**
**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.**
68
* *Nosology refers to a system of classification. Name the nosologi-**
* *cal system(s) utilized by professional counselors who diagnose**
* *clients.**
* *a. DSM.**
* *b. ICD.**
* *c. a and b.**
* *d. The Rogerian classification system.**
**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”).
69
* *The Diagnostic and Statistical Manual of Mental Disorders**
* *(DSM) was created by the American Psychiatric Association.**
* *The Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD) was created by the World Health Organization (WHO). Which counselor would**
* *most likely be required to utilize one of these guides to diagnose a client?**
* *a. A counselor who wishes to secure insurance (i.e., third**
* *party) payments.**
* *b. A guidance counselor discussing a child with a teacher.**
* *c. A multicultural counselor who is seeing a Black client.**
* *d. counselor leading a T-group.**
* *a. A counselor who wishes to secure insurance (i.e., third**
* *party) payments.**
## Footnote
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).
70
* *Traditionally, _______ counseling has caused the most ethical**
* *concerns.**
* *a. behavioral.**
* *b. person-centered.**
* *c. humanistic.**
* *d. reality therapy.**
**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.
71
* *Insurance payments are also called**
* *a. mandated payments.**
* *b. third-party payments.**
* *c. optional payments.**
* *d. psychometric payments.**
**b. third-party payments.**
72
* *The DSM uses a multi axial classification system with five axes.**
* *Diagnostic codes have _______ digits.**
* *a. five.**
* *b. four.**
* *c. nine (which correspond to the DOT).**
* *d. 12.**
**_a. five._**
i**nclude: _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).**
73
* *Identify the DSM code.**
* *a. 29622.**
* *b. 29.622.**
* *c. 303.90.**
* *d. 2962.2.**
**c. 303.90.**
the decimal point occurs after the third digit regardless of the diagnosis or lack of it.
74
* *As you are reading the DSM you see this code: 296.2X. In this**
* *case the X (i.e., the fifth digit) refers to**
* *a. severity, and thus it will be replaced with a diagnostic**
* *number.**
* *b. an adjustment disorder.**
* *c. developmental disorder.**
* *d. physical disorders and conditions.**
* *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,
75
* *In the DSM the so-called V Codes refer to conditions which are**
* *not attributable to a mental condition. An example of a V Code**
* *would be**
* *a. 6282.V.**
* *b. 62V.82.**
* *c. 628V2.**
* *d. V62.82.**
**d. V62.82.**
The salient feature to remember is that the “V” replaces the first digit in the five-digit code.
76
**An example of a V Code diagnosis would be**
* *a. Major Depression Single Episode Mild.**
* *b. Borderline Personality.**
* *c. Uncomplicated Bereavement.**
* *d. Cocaine Dependence.**
**c. Uncomplicated Bereavement.**
77
* *Formal diagnosis, also known as nosology, is most closely related**
* *to the _______ model.**
* *a. behavioral.**
* *b. medical.**
* *c. cognitive-behavioral.**
* *d. rational-emotive behavior therapy.**
**b. medical.**
## Footnote
The medical model of medicine or psychotherapy begins with a formal label or diagnosis of the problems.
78
**_STUDY THIS_**
Which DSM diagnosis indicates the most serious pathology?
a. 296.21.
b. 296.22.
c. 296.23.
* *d. 296.24.**
**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.
79
* *In the DSM the so-called V Codes refer to conditions which are**
* *not attributable to a mental condition. An example of a V Code**
* *would be**
* *a. 6282.V.**
* *b. 62V.82.**
* *c. 628V2.**
* *d. V62.82.**
**d. V62.82.**
80
**An example of a V Code diagnosis would be**
* *a. Major Depression Single Episode Mild.**
* *b. Borderline Personality.**
* *c. Uncomplicated Bereavement.**
* *d. Cocaine Dependence.**
**c. Uncomplicated Bereavement.**
81
* *Formal diagnosis, also known as nosology, is most closely related**
* *to the _______ model.**
* *a. behavioral.**
* *b. medical.**
* *c. cognitive-behavioral.**
* *d. rational-emotive behavior therapy.**
**b. medical.**
82
**Which DSM diagnosis indicates the most serious pathology?**
* *a. 296.21.**
* *b. 296.22.**
* *c. 296.23.**
* *d. 296.24.**
**d. 296.24.**
83
* *The type of mental health service provided to the client is coded**
* *via _______ and is generally required for insurance payments.**
* *a. DSM (e.g., 296.22).**
* *b. the ICD (e.g., 311).**
* *c. the AMA’s Current Procedural Terminology (e.g., CPT**
* *90844).**
* *d. the Psychiatric Dictionary.**
* *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) .
84
* *You refer a client to Dr. Smith. Ethically, Dr. Smith:**
* *a. may not pay you a referral fee for sending her the client.**
* *b. may pay you a referral fee if you have a written contract**
* *with her.**
## Footnote
**c. may pay you a referral fee if she has expertise in the client’s area of concern and you don’t.**
**d. can pay you a referral fee if and only if she is a psychiatrist.**
**a. may not pay you a referral fee for sending her the client.**
_Save your nickels; counselors cannot ethically accept referral_
_fees._
85
**You have written a very popular book on reality therapy. Now**
**you are teaching a graduate course on counseling at a local university. Ethically, you:**
* *a. may not use the textbook in your class.**
* *b. may not use the textbook in your class but other teachers**
* *at the university may indeed use your book as a textbook.**
* *c. may use the book as a textbook in your class, however, the**
* *royalties you receive must be donated to the institution.**
**d. may use the book as a textbook in your class.**
**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.”
86
* *An elementary school counselor is giving a child a standardized test. On several occasions the child says he does not understand what the counselor has said. The counselor should:**
* *a. refuse to repeat the question.**
* *b. tell the child to answer the question nevertheless.**
* *c. repeat the question, but talk more slowly.**
* *d. ignore the child’s verbalization.**
**c. repeat the question, but talk more slowly.**
## Footnote
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.
87
* *The most popular paradigm of mental health consultation has**
* *been proposed by:**
* *a. Satir and Minuchin.**
* *b. Schein.**
* *c. Caplan.**
* *d. Bandura.**
**c. Caplan. (consultation)**
These four basic types of mental health consultation have been proposed by Gerald Caplan.
88
**The doctor–patient consultation model relies on four distinct**
* *stages: entry, diagnosis, implementation, and evaluation. In order for the doctor–-patient structure to work, the consultee (i.e., the person receiving the consultation) must accurately depict symptomatology, trust the consultant’s diagnosis, and carry out the consultant’s directives. This model is associated most closely with the work of:**
* *a. Caplan.**
* *b. Freud.**
* *c. Adler.**
* *d. Schein.**
**d. Schein.**
Consultants can focus on process (what is happening from a
communications standpoint) or content (knowledge imparted
from the consultant to the consultee).
89
* *\_\_\_\_\_\_\_ is the leading cause of malpractice actions taken against counselors, therapists, and mental health providers.**
* *a. Sexual misconduct.**
* *b. Dual relationships.**
* *c. Failure of the duty to warn.**
* *d. Inferior record keeping.**
**a. Sexual misconduct.**
## Footnote
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.
90
**Your client was seeing Dr. Doyle for counseling for three years.**
**The client has now stopped seeing Dr. Doyle and has an appointment to see you. You should:**
* *a. refuse to see the client unless she will sign a release so**
* *you can secure the information Dr. Doyle compiled.**
* *b. call Dr. Doyle. In this situation no release of information**
* *or consent form is necessary.**
* *c. counsel the client.**
* *d. put something in writing and send it to Dr. Doyle prior to**
* *the second session of counseling.**
**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.
91
* *You are treating a man who suffers from panic disorder. His**
* *panic attacks are so severe he cannot drive to work. After just**
* *three sessions he is not only driving to work but has taken up sky diving to demonstrate his progress over his fear. You would love to put his testimonial on your brochure to show how adept you are at treating this affliction. You should:**
* *a. ask him if he will write you a few sentences to place on the**
* *brochure with his name at the end.**
* *b. ask him if you can write the testimonial for him and place**
* *it on the brochure.**
* *c. not ask him for a testimonial since it would constitute an**
* *ethics violation.**
* *d. ask him if he will write you a few sentences to place on the**
* *brochure but assure him that his name will not appear.**
* *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._
92
* *Ethical dilemmas rarely have clear-cut answers. Thus when a**
* *complex ethical situation manifests itself, it is best to**
* *a. consult only ethical codes and not colleagues.**
* *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.**
* *c. consult ACA but not your colleagues.**
* *d. consult your state licensing bureau but not your col-**
* *leagues.**
* *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.**
93
* *You have attempted to help a client for over two years with little or no success. You should:**
* *a. always refer the client to a board certified psychiatrist.**
**b. terminate the relationship and initiate an appropriate referral.**
* *c. change therapeutic modalities and see the client for an-**
* *other six months.**
* *d. change therapeutic modalities and see the client for at**
* *least another year.**
**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.
94
* *Assume that you have decided to refer a client elsewhere be-**
* *cause you were unable to help her. The client insists upon seeing you. Ethics guidelines would dictate that:**
* *a. you must see her; your duty is to the client.**
* *b. you must refer her to a medical practitioner.**
* *c. you must ask her to consider hospitalization.**
* *d. you are not obligated to continue the relationship.**
**d. you are not obligated to continue the relationship.**
You are acting in the best interest of the client.
95
**Counseling is a relatively new profession. The first counselors in the United States were not called counselors. They were**
* *a. psychoanalysts practicing short-term therapy.**
* *b. behaviorists practicing short-term therapy.**
**c. deans and advisors employed after the Civil War in college settings to watch over young women.**
**d. humanistic psychologists.**
**c. deans and advisors employed after the Civil War in college settings to watch over young women.**
96
**Historically speaking, the first psychology laboratory was set up by:**
* *a. Frank Parsons, who set up community centers to help in-**
* *individuals in search of work.**
* *b. Sigmund Freud, the father of psychoanalysis.**
* *c. Wilhelm Wundt, in 1879 in Leipzig, Germany.**
* *d. E. G. Williamson.**
**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.
97
**Counseling became popular after the 1931 publication of:**
* *a. Workbook in Vocations by Proctor, Benefield, and**
* *Wrenn.**
* *b. The Interpretation of Dreams by Freud.**
* *c. Behaviorism by Watson.**
* *d. Counseling and Psychotherapy by Rogers.**
* *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.
98
* *PL94-142 (The Education Act for All Handicapped Children)**
* *states that:**
**a. all children between 5 and 21 are assured free education.**
* *b. handicapped persons are placed in the least restrictive**
* *environment (LRE).**
* *c. an Individualized Education Plan (IEP) is developed for**
* *each child**
* *d. all of the above.**
**d. all of the above.**
99
* *The major trend that impacted upon the counseling movement**
* *in the 1980s :**
* *a. was reality therapy.**
* *b. was behavior modification.**
* *c. included an emphasis on professionalism, certification,**
* *and licensing.**
* *d. was the group movement.**
* *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.
100
* *The APGA and APA had joint ethics guidelines for counselors**
* *and psychologists. This changed during the 1970s when:**
**a. PsyD programs were introduced.**
* *b. the APA did not wish to credential master’s-level counsel-**
* *ors or psychologists.**
* *c. psychologists were doing more testing.**
* *d. joint ethics became illegal in the United States.**
**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.
101
* *The 1950s was the age of tremendous strides in:**
* *a. analysis.**
* *b. developmental psychology.**
* *c. behavior modification.**
* *d. group work.**
**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.
102
* *The _______ movement began in the late 1960s.**
* *a. testing.**
* *b. Rogerian.**
* *c. group.**
* *d. developmental psychology.**
**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!
103
* *In the 1960s Gilbert Wrenn’s book, The Counselor in a Chang-**
* *ing World, urged counselors to:**
* *a. use biofeedback.**
* *b. rely more heavily on projective testing.**
* *c. emphasize developmental concerns rather than merely**
* *focusing on crises and curing emotional illness.**
* *d. stick to proven nondirective techniques.**
* *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.
104
* *One of the primary problems of counseling in the early 1960s**
* *was that it wrongly emphasized**
* *a. social issues.**
* *b. intrapsychic processes.**
* *c. referrals to secure antidepressant medicine.**
* *d. career counseling.**
**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.
105
* *The significance of the 1958 National Defense Education Act**
* *was that it:**
**a. provided financial aid for graduate education in counseling.**
* *b. expanded school guidance services.**
* *c. improved guidance for gifted children.**
* *d. all of the above.**
**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.
106
* *A man has a rare, highly contagious disease that is fatal. He is**
* *keeping it a secret and insists that he will never tell his wife. You should:**
* *a. break confidentiality and tell his wife.**
**b. honor the man’s decision not to tell his wife for therapeutic reasons.**
* *c. honor the man’s decision not to tell his wife in order to**
* *maintain ethical confidentiality.**
* *d. handle it based on your clinical intuition since ethical**
* *guidelines fail to address this emotionally charged issue.**
**a. break confidentiality and tell his wife.**
