Professional Orientation And Ethical Practice

Question 1

Which group was most instrumental in opposing counselor licensure?

a. Social workers.
b. Psychiatrists.
c. Psychologists.
d. AAMFT members.

Answer 1

Psychologists.

Question 2

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 2

NBCC.

Question 3

By passing the NCE, a counselor can attain the ________, 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 3

NCC, a generic certification for counselors

Question 4

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 4

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

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 the ACA and NBCC.
d. all of the above.

Answer 5

Standards of conduct imposed by the ACA and NBCC.

Question 6

Most ethical dilemmas are related to

a. confidentiality.
b. testing.
c. diagnosis.
d. research.

Answer 6

Confidentiality.

Question 7

The landmark 1969 case, Tarasoff v. the Board of Regents of the University of California illuminated

a. difficulties caused when a counselor has sex with a client.
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 7

The duty to warn a client in imminent danger.

Question 8

A counselor reveals information that is extremely damaging to a client’s reputation. This counselor could
be accused of

a. beneficence.
b. justice.
c. nonmaleficence
d. defamation

Answer 8

Defamation

Question 9

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 9

Accreditation.

Question 10

An exception to confidentiality, or what is termed as relative 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 10

All of the above.

Question 11

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 11

A list of the courses the counselor took in graduate school.

Question 12

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 12

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

By definition privileged communication is a legal term that implies that a therapeutic interaction (verbal or written) will not be available for public inspection.

Question 13

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 13

Laws are unclear and may vary from state to state.

Question 14

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 14

All of the above.

Question 15

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 15

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

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 empathic 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 16

Call the child abuse/neglect hotline.

Question 17

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

Answer 17

Contact his wife and advise her of possible suicide precautions.

Question 18

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 18

Warn the husband.

Question 19

You pass your exam and now have NCC status. You perform a battery of tests on your client. After you complete the testing you discover your client is in imminent danger. You receive a
legal court order to turn over the test scores. You

a. must get a signed release from the client.
b. you must turn over the test records complete with the test
scores.
c. turn over the test records without the scores.
d. should recall that according to “aspirational ethics,” your
client comes first and so you will do nothing.

Answer 19

You must turn over the test records complete with the test
scores.

Question 20

One impetus for counselor licensing was that

a. Academy of Certified Social Workers (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 20

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

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 21

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

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 22

She has a graduate degree from a psychology department.

The trick to answering this question is to remember that the term psychology can only be used if the helper is a licensed psychologist, even if the person specializes in counseling.

Question 23

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 23

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

Question 24

APA is to psychologist as ACA is to

a. APGA.
b. certified clinical mental health counselor.
c. counselor.
d. NCC.

Answer 24

Counselor.

Question 25

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 25

Revoke your state counseling license.

Here is the key point: Certification is not the same as licensing. Thus, a certified reality therapist cannot legally use the title counselor unless he or she is licensed by the state.

Question 26

A counselor who is alcoholic and suffering from burnout could best be described as

a. amesomorph.
b. an impaired professional.
c. a paraprofessional.
d. a counselor who is wise enough to use his own experiences
to help others.

Answer 26

An impaired professional.

Question 27

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 27

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

Question 28

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-esteem.
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 28

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

Question 29

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 29

American Counselor Education and Supervision.

Question 30

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 30

It is difficult to administer them in a fair manner.

Question 31

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 31

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 32

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. first have the client sign a dated release of information
form that stipulates whether the information can be released 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 32

First have the client sign a dated release of information
form that stipulates whether the information can be released once (or for what period of time it can be released) and then you can send the information.

Question 33

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 33

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 credentials of another state or organization.

Question 34

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 record.
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 34

A and B.

Question 35

You are a school counselor who wishes to refer a student with an orthopedic disability 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 35

A CRC.

CRC stands for Certified Rehabilitation Counselor. CRCs will need at least a master’s in rehabilitation counseling from a dually accredited CACREP, CORE (Council on Rehabilitation and Education) program, acceptable experience in the field, and a passing score on a 175-question multiple-choice examination.

Question 36

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 36

A and B.

Question 37

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 37

Abandonment.

Question 38

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 relationship.

Answer 38

Generally unethical as it would constitute a dual or so-called
multiple relationship.

Question 39

A counselor who sports NCC after her name

a. will need not concern herself with continuing education.
b. will need to complete 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
contact hours before she can be recertified, or she will need to take the NCE again.

Answer 39

Will need a specified amount of continuing education
contact hours before she can be recertified, or she will need to take the NCE again.

Question 40

You find yourself sexually attracted to a client. This is known as

a. countertransference.
b. ambivalent transference.
c. negative transference.
d. positive transference.

Answer 40

Countertransference.

Question 41

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 another
provider.
d. continue to see the client but ignore psychosexual topics.

Answer 41

Explain this to the client and then refer the client to another
provider.

Question 42

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 42

You are sexually involved with a client.

Question 43

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 43

CMC.

Question 44

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 a 40-minute session per week. This is an example of

a. CAC.
b. CMC.
c. computer-managedcounseling.
d. b and c.

Answer 44

CAC.

Question 45

A counselor educator has created a research study. He is using students as research subjects. This is commonplace.

a. Student participation can be mandatory as part of a counseling course.
b. Student participation can be mandatory for students who have finished their coursework and are completing a dissertation, thesis, or required scholarly paper.
c. Participation or lack of it cannot impact the student’s academic standing.
d. According to ethics the student cannot participate in the research if he or she is not currently enrolled in the counselor educator’s class.

Answer 45

Participation or lack of it cannot impact the student’s academic standing.

Likewise, NBCC’s code tells us that if you use clients you may not stipulate that they must participate in order to receive counseling services

Question 46

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 technology 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 46

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 47

You secure a state license and NCC status and open a private practice. Your cousin comes to the agency for supervision to get his state license.

a. You would supervise him just like anybody else.
b. You could supervise him if he is your second cousin, but
not your first cousin.
c. Consultation is very important in today’s world. You could
supervise him if you receive a consultation and the
consultant approves of it.
d. It would be unethical to supervise him.

Answer 47

It would be unethical to supervise him.

Question 48

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 48

APA style.

Question 49

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 49

Warn the parents that their property is in danger.

Question 50

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 multiple relationship.
b. an example of informed consent.
c. an example of negligence, which is a failure to perform a
duty, and in this instance is an obligation to protect the
client.
d. multiple submission.

Answer 50

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

Question 51

NBCC has developed a code of ethics to help counselors behave in a professional manner. The Code 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 African Americans 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 nonassertive.
d. Advising a female client to avoid taking a management position because you feel women managers are generally
too aggressive.

Answer 51

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 52

NBCC ethics caution counselors against sexual harassment. An example of an ethics violation in this respect would be

a. a female counselor who tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned. The male client blushes and appears uncomfortable.
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 52

A female counselor who tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned. The male client blushes and appears uncomfortable.

Question 53

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 53

Unethical.

Question 54

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,
and if this fails report it to regulatory organizations.
d. all of the above are considered ethical.

Answer 54

Attempt to rectify the condition via institutional channels,
and if this fails report it to regulatory organizations.

Question 55

A client asks you (and you have NCC status) 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 55

Unethical as this is misrepresentation.

Question 56

In your initial disclosure statement it was clearly explained to the client that she must pay her bill in a timely manner. She did not. According to ACA ethical guidelines you can terminate her.

a. This practice was ethical at one time, but now it is not ethical under any circumstances.
b. This practice was not mentioned, but experts have been very critical of this omission.
c. This practice is ethical whether you revealed this to the client in the initial disclosure statement or not.
d. This practice is ethical if you revealed this to the client in the initial disclosure statement.

Answer 56

This practice is ethical if you revealed this to the client in the initial disclosure statement.

Question 57

Dr. X recommends to his clients at the agency where he practices 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 and ACA actually encourage this method for private
practitioners who wish to increase the number of clients they can assist.

Answer 57

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

Question 58

You wish to use an experimental treatment strategy. According
to NBCC

a. this is a blatant ethics violation.
b. you can do it since you are advancing the profession in a
scientific manner.
c. this could be ethical if you explain this to the client and the
client agrees.
d. it could be ethical, but since it is experimental you must
make an audio or video recording of the interview.

Answer 58

This could be ethical if you explain this to the client and the
client agrees.

Question 59

A counselor is counseling an executive secretary. The counselor is writing a book and mentions this to the client. The counselor suggests that as paying for the counseling might be a hardship for the client so the client could type the counselor’s 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 59

Known as bartering and unethical as described here.

Question 60

Ethics state that a counselor should ________ all clients for group counseling.

a. diagnose
b. test
c. screen
d. a and b

Answer 60

Screen.

Question 61

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 61

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

Question 62

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

a. not take a chance on degrading the therapeutic relationship 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 62

Inform the client of this before the counseling begins.

Question 63

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 your state licensing board and request permission for multiple submission privileges.

Answer 63

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

The NBCC code sets the record straight: “Counselors submit manuscripts for consideration to one journal at a time.” In our field, 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.

Question 64

Consulting is included in ethical guidelines. Consultation can best be defined as

a. a voluntary relationship between a professional helper and a help-needing individual that is generally longer than supervision.
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.

Answer 64

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.

Question 65

NBCC’sCodeofEthicsdescribesethicalissuesrelatedtoprivate 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. She refers the client to another helper.
d. An executive director of a private practice who has his name listed on the practice’s website 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 65

An executive director of a private practice who has his name listed on the practice’s website 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.

Question 66

Nosologyreferstoasystemofclassification.Namethenosological system(s) utilized by professional counselors who diagnose clients.

a. DSM.
b. ICD.
c. a and b.
d. The Rogerian classification system.

Answer 66

A and B.

Question 67

The Diagnostic and Statistical Manual of Mental Disorders (DSM) was created by the American Psychiatric Association (APA). 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 school counselor discussing a child with a teacher.
c. A multicultural counselor who is seeing a client who grew
up in another country.
d. A counselor leading a T-group.

Answer 67

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

Question 68

Traditionally, ________ counseling has caused the most ethical concerns.

a. behavioral
b. person-centered
c. humanistic
d. reality therapy

Answer 68

Behavioral

Question 69

Insurance payments are also called

a. mandated payments.
b. third-party payments.
c. optional payments.
d. psychometric payments.

Answer 69

Third-party payments.

Question 70

The DSM-5 no longer uses a multiaxial classification system or GAF scale. Diagnostic codes have ________ digits.

a. four or five
b. two
c. nine (which correspond to the DOT)
d. 12

Answer 70

Four or Five

Question 71

Identify the DSM code.

a. 29622
b. 29.622
c. 296.99
d. 2962.2

Answer 71

296.99

The decimal point occurs after the third digit.

Question 72

A counselor educator is giving a seminar on the DSM-5. She gives the students a handout and it lists hoarding disorder and obsessive-compulsive disorder as both having the same 300.3 code. This most likely explanation is:

a. that this could be correct since two diagnoses can share a single code.
b. it is a typo on the handout.
c. this is a trick question since the counselor educator must
be quoting an ICD code.
d. she is a researcher and thus does not realize all disorders
have unique codes.

Answer 72

That this could be correct since two diagnoses can share a single code.

Question 73

During a counseling session your client tells you in great detail how he robbed a convenience store six months ago. He got away with a huge sum of money and shot the owner. His descriptions are extremely specific and you believe every word he says. In reality, you are very familiar with the case because the police never solved it and it has been all over the radio and television stations in your town. There is even a huge reward to anybody who can help law enforcement agencies solve the case. Ethically, you should

a. call the police and tell them everything you know.
b. urge the client to call the police and turn himself in.
c. call the anonymous crime tips line since as a counselor you
would not be permitted to reveal your true identity.
d. just keep it confidential.

Answer 73

Just keep it confidential.

Question 74

All of the conditions below are V code diagnoses except:

a. Acculturation problem.
b. Occupational problem.
c. Post-traumatic stress disorder.
d. Academic problem.

Answer 74

Post-traumatic stress disorder.

Question 75

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

Answer 75

Medical.

Question 76

Which treatment match-up is incorrect?

a. Vivitrol for alcoholism.
b. Lithium for bipolar disorder.
c. Suboxone for opiod dependence.
d. Narcan for schizophrenia.

Answer 76

Narcan for schizophrenia.

Narcan or Naloxone is all over the news right now because it can block the effects of opiods such as heroin and painkillers such as morphine, codeine, and oxycodone. By impacting the same portions of the brain as opiods, it can stop or reverse overdoses to save lives. Narcan has virtually no serious side effects and will not make the person high.

Question 77

The type of mental health service provided to the client is coded via ________ and is generally required for insurance payments.
a. the DSM
b. the ICD
c. the AMA’s Current Procedural Terminology (e.g., CPT
90844)
d. the Psychiatric Dictionary

Answer 77

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 ICD code on your billing statement.

Question 78

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.
c. may pay you a referral fee if she has expertise in the client’s
area of concern and you don’t and the client gives you
written permission.
d. can pay you a referral fee if, and only if, she is a psychiatrist.

Answer 78

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

Save your nickels; counselors cannot ethically accept referral fees.

Question 79

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.

Answer 79

May use the book as a textbook in your class.

Question 80

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 verbalizations.

Answer 80

Repeat the question, but talk more slowly.

Question 81

The most popular paradigm of mental health consultation has been proposed by

a. Satir and Minuchin.
b. Schein.
c. Caplan.
d. Bandura.

Answer 81

Caplan.

Question 82

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.

Answer 82

Schein.

Question 83

________ are the leading causes of malpractice actions taken against counselors, therapists, and mental health providers.

a. Confidentiality and dual relationships
b. Termination
c. Failure of the duty to warn
d. Inferior record keeping

Answer 83

Confidentiality and dual relationships

Question 84

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.

Answer 84

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. Moreover, it is possible that the client will not sign for the release.

Question 85

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.

Answer 85

Not ask him for a testimonial since it would constitute an ethics violation.

Question 86

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 colleagues.

Answer 86

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.

Question 87

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
another six months.
d. change therapeutic modalities and see the client for at least
another year.

Answer 87

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.

Question 88

Assume that you have decided to refer a client elsewhere because you were unable to help her. Upon you mentioning this, the client insists that she has seen several other therapists and you are the finest one. 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.

Answer 88

You are not obligated to continue the relationship.

Question 89

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. humanisticpsychologists.

Answer 89

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

Question 90

Historically speaking, the first psychology laboratory was set up by

a. Frank Parsons, who set up community centers to help individuals in search of work.
b. Sigmund Freud, the father of psychoanalysis.
c. Wilhelm Wundt, in 1879 in Leipzig, Germany.
d. E. G. Williamson.

Answer 90

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.

Question 91

Counseling became popular after the 1931 publication of

a. Workbook in Vocations by William Proctor, Glidden Ross Benefield, and Gilbert Wrenn.
b. The Interpretation of Dreams by Sigmund Freud.
c. Behaviorism by John B.Watson.
d. Counseling and Psychotherapy by Carl Ransom Rogers.

Answer 91

Workbook in Vocations by William Proctor, Glidden Ross Benefield, and Gilbert Wrenn.

Prior to 1931, the word guidance was used for educational and vocational guidance. This work, as well as an earlier one by William Proctor in 1925 entitled Educational and Vocational Guidance, began to conceptualize counseling as a psychological process.

Question 92

PL 94-142 (the Education for All Handicapped Children Act) states that

a. all children between ages 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.

Answer 92

All of the above.

Question 93

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.

Answer 93

Included an emphasis on professionalism, certification, and
licensing.

Question 94

The APGA and APA had joint ethics guidelines for counselors and psychologists. This changed during the 1970s when

a. Psy.D. programs were introduced.
b. the APA did not wish to credential master’s level counselors
or psychologists.
c. psychologists were doing more testing.
d. joint ethics became illegal in the United States.

Answer 94

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.

Question 95

The 1950s was the age of tremendous strides in

a. analysis.
b. developmental psychology.
c. behavior modification.
d. groupwork.

Answer 95

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.

Question 96

The ________ movement began in the late 1960s.

a. testing
b. Rogerian
c. group
d. developmental psychology

Answer 96

Group.

Groups would remain popular in the 1970s.

Question 97

In the 1960s C. Gilbert Wrenn’s book, The Counselor in a Changing 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.

Answer 97

Emphasize developmental concerns rather than merely
focusing on crises and curing emotional illness.

Question 98

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.

Answer 98

Intrapsychic processes.

Intrapsychic processes (i.e., processes within one’s mind or psyche). This was not entirely a negative thing; nevertheless, social issues such as Vietnam, civil rights, and women’s issues could have been emphasized to a greater degree.

Question 99

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.

Answer 99

All of the above.

Question 100

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.

Answer 100

Break confidentiality and tell his wife.

Ethics tell us that if a client has a contagious fatal disease the counselor is justified in telling a third party who would be at serious and foreseeable risk. Of course, the counselor must ascertain that the client has not already informed this person or that the client does not intend to inform the third party in a reasonable period of time.