Professional Orientation and Ethical Practice Flashcards
What are the 5 values of the ACA Code of Ethics?
to enhance human development for the entire life span, embrace diversity and multicultural factors since clients are unique, promote social justice, safeguard the integrity of the counselor-client relationship, and to practice counseling in an ethical/safe manner
What are the 6 foundational principles for ethical behavior?
autonomy, maleficence, beneficence, justice, fidelity, veracity
Autonomy?
the notion that a client has a right to control their own life
Maleficence?
the counselor never uses strategies/interventions or other behavior that could cause harm
Beneficence?
the counselor practices for the good of society as well as the client
Justice?
the idea that all clients are treated fairly and there’s equality
Fidelity?
the counselor keeps promises
Veracity?
the counselor is truthful
T/F: Chronic suicidal clients are a good fit for electronic counseling intervention(s).
false
Should you follow clients online/on social media?
no
What can Tarasoff warning/exceptions to confidentiality be applied to?
medical situations if your client has a contagious life-threatening disease which could harm somebody else
When can you engage in bartering with a client?
if and only if the practice will not cause harm or exploitation; when a written contract between you and the client is considered
According to HIPAA, what’s necessary for/when a client requests unencrypted PHI?
the counselor must explain the risks related to privacy and confidentiality; a statement delineating these issues should be given to the client and the client should sign the document
Is Skype consider HIPAA compliant?
no
How many years must a counselor wait before having a sexual/romantic relationship with a client, family member of a client, or the client’s romantic partner?
5 years
Who should you not evaluate?
former clients, their romantic partners, client’s family members
If you are evaluating someone, are you able to counsel them, too?
no
A counselor should have a plan in each of these situations:
if the counselor becomes incapacitated, dies, closes the practice, or retires
Which group was most instrumental in opposing counselor licensure?
psychologists
In the late 1970s, AACD began to focus heavily on professional credentialing, which led to the formation of?
NBCC
When was the NBCC formed?
1982
When a counselor passes the NCE, they can use which title?
NCC, a generic certification for counselors
If you’re certified as NCC, can you call yourself a licensed counselor?
no
What is an example of a situation that violates the counseling ethic or law termed “scope of practice”?
a counselor who is conducting a strict Freudian psychoanalysis with the client
What does the “scope of practice” concept suggest?
that counselors should only practice using techniques for which they’ve been trained
Ethics always describe…
standards of conduct imposed by the ACA and NBCC
Most ethical dilemmas are related to…
confidentiality
The 1969 case “Tarasoff v. the Board of Regents of the University of California” illuminated:
the duty to warn a client in imminent danger
A counselor reveals information that’s extremely damaging to a client’s reputation. This counselor should be accused of what?
defamation
State laws can govern title usage and practice, however, they do not govern…
accreditation
An exception to confidentiality (aka relative confidentiality) could occur when a client’s suicidal, of which the signs include:
repeatedly joking about killing one’s self
giving away prized possessions after one has been depressed for an extended period of time
a previous suicide attempt and a very detailed suicide plan for the future
What is the 10th leading cause of death in the U.S.?
suicide
Those aged 15-24 have ____ as the 2nd or 3rd leading cause of death
suicide
Older adults are ___ times likely for suicide
2-3
What accounts for suicides more than all other methods put together?
firearms
Where are suicides more likely to occur?
rural areas that aren’t highly populated and in times of economic recession/depression
A statement of disclosure could include all except:
a list of courses the counselor took in graduate school
Privileged communications refers to the fact that anything said to a counselor by a client
will not be divulged outside the counseling setting without the client’s permission
In regard to state law and privileged communication, counselors must be aware that
laws are unclear and may vary from state to state
When is privileged communication not applicable?
cases of child abuse, neglect, or exploitation
suicide/homicide threats
criminal intentions
clients in dire need of hospitalization
counselor is a victim of malpractice lawsuit
When counselors state that privileged communication is qualified, they mean that
exceptions may exist
You’re a counselor in a state that doesn’t legally support privileged communication. You refuse to testify in court. In this situation…
you could be held in contempt of court
An 11 y/o child comes to your office with a black eye and tells you they can’t remember how they got it. You have reason to suspect abuse. You should…
call the child abuse/neglect hotline
What are some exceptions or limitations to maintaining confidentiality?
danger to self or others
requests a release of info
court orders a release of info
counselor’s in a systematic supervision process
clerical assistants who process client info and papers
legal and clinical consultation situations
client raises the issue of the counselor’s competence in a malpractice lawsuit
client’s younger than 18 y/o
elder abuse
insurance or managed care company requests a dx and/or relevant clinical info
During a counseling session, a 42 y/o male client threatens suicide. You should…
contact his wife and advise her of possible suicide precautions
A 39 y/o female secretary you’re seeing in your assertiveness training group reveals that she’s plotting to shoot her husband. Based on the Tarasoff case, you should…
warn the husband
What does the principle of minimal disclosure mean?
reveal only what’s necessary
You pass your exam and now have NCC status. You perform a battery of tests on your client. After testing, you discover your client’s in imminent danger. You receive a legal court order to turn over the test scores. You…
must turn over the test records complete with the test scores
One impetus for counselor licensing was that…
psychology licensure bodies sought to restrict the practice of counselors so counselors could not receive third-party payments from insurance and managed care companies
A counselor who possesses a graduate degree wishes to become a licensed psychologist. What properly depicts their current situation?
in nearly every case, those trained in counseling would not be allowed to sit for the EPPP (examination for professional practice in psychology) and thus could not become a licensed psychologist
A woman who’s in private practice mentions in her phone book ad that she’s a licensed counseling psychologist, which generally means that…
she has a graduate degree from a psychology department
One major difference between the psychology vs. the counseling movement seems to be that…
psychologists are working to eliminate practitioners with less than a doctorate, while counselors are not
APA is to psychologist as ACA is to
counselor
You’ve achieved NCC status. NBCC feels you have violated professional ethics. NBCC can not:
revoke your state counseling license
T/F: Ethical guidelines drafted via your state licensing board may indeed be at odds with your national organization’s standards.
true
A counselor who is alcoholic and suffering from burnout could best be described as
an impaired professional
Counselor certification is…
recognizes that you’ve reached a given level of competence and thus are authorized to use a title
A woman comes to you for help with an eating disorder. You have no experience or training in this area. Ethically, you should:
refer the client to a colleague who is trained and experienced with this type of client
Virginia was the first state to license counselors in 1976. The APGA division that was initially the most instrumental in pushing for licensing was the…
American Counselor Education and Supervision (ACES)
The problem with income-sensitive or sliding fee scales (based on the client’s ability to pay) is that
it is difficult to administer them in a fair manner
One possible negative aspect of counselor licensure if that…
counselors may not be as creative during their graduate work and simply take courses aimed at fulfilling the requirements to take the licensure exam
A client wants his records sent to a psychiatrist he is seeing. You should:
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
What else can a release of information be called?
consent to disclose, transfer records
You’re an LPC in one state but will soon relocate to another. The new state informs you that they’ll grant you reciprocity or so-called endorsement. You will thus…
be permitted to practice in the new state based on your current credentials without taking another exam
When does reciprocity occur?
when one state/organization accepts the license/credentials of another state/organization
According to the Family Educational Rights and Privacy Act (FERPA) of 1974…
a parent can see their child’s middle school record; an 18 y/o college student can view their own educational record
You’re 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 CRC (Certified Rehabilitation Counselor)
A registry would be
a list of licensed psychologists in the state of Illinois and a list of CRCs in the U.S.
A counselor wins the lottery and closes her practice without telling her clients. This counselor’s course of action is best described as
abandonment
You’re counseling your first cousin for depression. This is?
generally unethical as it would constitute a dual/multiple relationship
A counselor who sports NCC after their name…
will need a specified amount of continuing education contact hours before they can be recertified or they will need to take the NCE again
How many hours of professional development are needed within 5 years?
100
You find yourself sexually attracted to a client. This is known as:
countertransference
Your sexual attraction toward your client is hindering the counseling process. You should:
explain this to the client and then refer them to another provider
A malpractice or liability insurance company is least likely to defend you if
you’re sexually involved with a client
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…
CMC
A college student who suffers from panic disorder types their symptoms/concerns onto a PC screen and then waits for the computer program to respond or question further. The student engages in this for a 40-minute session per week. This is an example of:
CAC
A counselor educator has created a research study. They’re using students as research subjects. This is commonplace.
participation or lack of it cannot impact the student’s academic standing
What best described the counseling profession’s reaction to CAC and CMC?
CMC has been well received since it cuts down time on paperwork, scheduling, and record keeping, but there’s a mixed reaction to CAC as some feel it depersonalizes counseling
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.
It would be unethical to supervise him
A counseling journal article should use documentation that’s based on…
APA style
A 14 y/o male threatens to blow up his parents’ garage because he’s been grounded. You believe this threat is genuine so you should:
warn the parents that their property is in danger
A 16 y/o girl threatens to kill herself and you fail to inform her parents. Your behavior as a counselor is best described as…
an example of negligence, which is a failure to perform a duty, and in this instance is an obligation to protect the client
NBCC has developed a code of ethics to help counselors behave in a professional manner. The Code warns against
stereotyping and discrimination
What is discrimination?
the practice of not treating all clients in an equal manner especially due to religious, racial, ethnic, sexual, or cultural prejudice on the part of the therapist
What is stereotyping?
occurs when a counselor views all persons of a given classification or group in a biased manner
NBCC ethics caution counselors against sexual harassment. An example of an ethics violation regarding this would be:
a female counselor who tells a male client how sexy his hair chest looks when he leaves his shirt unbuttoned. the male client blushes and appears uncomfortable
You’re a well-known CBT therapist who heads up a private practice in NJ. For the next 2 years, you’ll be in Canada conducting a research project. Your practice has 6 other counselors and is sending brochures to schools, agencies, and hospitals to boost referrals. Your name appears on the front of the brochure as if you are available for referrals. Is this ethical? Why?
unethical because ethics address private practice and suggest that persons who hold leadership roles not allow their names to be used in professional notices when they’re not practicing counseling unless it’s clearly stated in the practice’s literature
A colleague of yours who is not a certified counselor behaves in an unethical manner. The ethical thing for you to do is
attempt to rectify the condition via institutional channels, and if this fails, report it to regulatory organizations
A client asks you (NCC status) for classical psychoanalysis yet you have no training whatsoever in this area. If you agree to analyze this client, you are…
unethical as this is misrepresentation
In your initial disclosure statement, it was clearly explained to the client that they must pay their bill in a timely manner. They did not. According to ACA guidelines, you can terminate her
This practice is ethical if you revealed this to the client in the initial disclosure statement
A doctor recommends to his clients at his agency that he would rather counsel them in his private practice. Ethically speaking…
he is diverting agency clients to his practice and this act is unethical
You wish to use an experimental treatment strategy. According to NBCC,
this could be ethical if you explain this to the client and the client agrees
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…
bartering and unethical as described in this situation
Ethics state that a counselor should ____ all clients for group counseling
screen
You’re 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…
inform the parents of the student in danger, inform the principal, and call the police immediately, discussing only material related to the threat
Your agency uses a collection agency when clients don’t pay their bills. You should…
inform your client of this before counseling begins
You’ve 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…
submit your article to one publication at a time despite your conviction that the article must get published
What does the NBCC code say about submitting manuscripts?
counselors submit manuscripts for consideration to one journal at a time
T/F: Once your article is published, you can republish it anywhere without expressing the permission from the first publisher.
false
Consulting is included in ethical guidelines. Consultation can best be defined as…
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
NBCC’s Code of Ethics describes ethical issues related to private practice. What’s an example of a clear ethics violation?
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’s out of the country and is engaged in a research project for the next 2 years
Nosology refers to a system of classification. Name the nosological system(s) utilized by professional counselors who diagnose clients.
DSM and ICD
The DSM was created by the APA. The ICD was created by the WHO. Which counselor would most likely be required to utilize one of these guides to diagnose a client?
a counselor who wishes to secure insurance payments (i.e., third party payments)
Traditionally, ____ counseling has caused the most ethical concerns. Why?
behavioral; these therapists can control, manipulate, and shape behavior
Insurance payments are also called
third-party payments
The DSM-5 no longer uses a multiaxial classification system or GAF scale. Diagnostic codes have how many digits?
4 or 5
Give an example of a DSM code.
296.99
A counselor educator is giving a seminar on the DSM-5 and gives the students a handout that lists hoarding disorder and obsessive-compulsive disorder as both having the same 300.3 code. This most likely explanation is:
that this could be correct since 2 diagnoses can share a single code
During a counseling session your client tells you in great detail how he robbed a convenience store 6 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’re very familiar with the case because the police never solved it and it’s been all over the radio and tv stations in town. There’s even a huge reward to anybody who can help law enforcement agencies solve the case. Ethically, you should?
just keep it confidential
What is an example of a V code?
acculturation problem; occupational problem; academic problem
Formal diagnosis (nosology) is most closely related to what model?
medical
Which treatment match-up is incorrect? Why?
narcan for schizophrenia; narcan can block the effects of opioids and painkillers and is meant to stop/reverse overdoses
The type of mental health service provided to the client is coded via ____ and is generally required for insurance payments.
the AMA’s Current Procedural Terminology
What is a CPT code?
specifies the exact nature of the treatment being utilized to help your client as well as the length of the service unit
What does a superbill typically include?
client’s name, date, ICD diagnosis, CPT code, and provider’s name and license
You refer a client to Dr. Smith. Ethically, Dr. Smith…
may not pay you a referral fee for sending her the client
You’ve written a very popular book on reality therapy. Now you’re teaching a graduate course on counseling at a local university. Ethically, you may…
use the book as a textbook in your class
An elementary school counselor is giving a child a standardized test. On several occasions, the child says he doesn’t understand what the counselor has said. The counselor should…
repeat the question but talk more slowly
The most popular paradigm of mental health consultation has been proposed by…
Caplan
When does mental health consultation occur?
when a consultant works with a consultee regarding clients or administrative/program issues
Consultee-centered consultation means?
the focus is on helping the consultee develop improved techniques or skills
Client-centered consultation means?
when the goal is to help a client
Consultee-centered administrative consultation means?
your supervisor’s or consultant’s intention is to sharpen up your administration skills
Program-centered administrative consultation means?
emphasis is on creating, designing, or evaluating the program in question
The doctor-patient consultation model relies on 4 distinct stages: entry, diagnosis, implementation, and evaluation. In order for the doctor-patient structure to work, the consultee 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 who?
Schein
_____ are the leading causes of malpractice actions taken against counselors, therapists, and mental health providers.
confidentiality and dual relationships
T/F: Excessive self-disclosure on the part of the helper is considered malpractice.
true
Your client was seeing Dr. Doyle for counseling for 3 years. The client has now stopped seeing Dr. Doyle and has an appointment to see you. You should…
counsel the client
You’re treating a man who suffers from panic disorder. His panic attacks are so severe he can’t drive to work. After just 3 sessions he’s 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…
not ask him for a testimonial since it would constitute an ethics violation
Ethical dilemmas rarely have clear-cut answers. Thus when a complex ethical situation manifests itself, it’s best to…
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
You’ve attempted to help a client for over 2 years with little or no success. You should…
terminate the relationship and initiate an appropriate referral
Assume you’ve decided to refer a client elsewhere because you were unable to help them. Upon mentioning this, the client insists that they’ve seen several other therapists and you’re the finest one. Ethics guidelines would dictate that…
you are not obligated to continue the relationship
Counseling is a relatively new profession. The first counselors in the U.S. were not called counselors, they were…
deans and advisors employed after the Civil War in college settings to watch over young women
Historically speaking, the first psychology laboratory was set up by?
Wilhelm Wundt, in 1879 in Leipzig, Germany
Counseling became popular after the 1931 publication of…
Workbook in Vocations by William Proctor, Glidden Ross Benefield, and Gilbert Wrenn
PL 94-142 (the Education for All Handicapped Children Act) states that…
all children ages 5-21 are assured free education; handicapped persons are placed in the least restrictive environment (LRE); an individualized education plan (IEP) is developed for each child
The major trend that impacted upon the counseling movement in the 1980s…
included an emphasis on professionalism, certification, and licensing
The APGA and APA had joint ethics guidelines for counselors and psychologists. This changed during the 1970s when…
the APA did not wish to credential master’s level counselors or psychologists
The 1950s was the age of tremendous strides in…
developmental psychology
What movement began in the late 1960s?
group
In the 1960s, C. Gilbert Wrenn’s book “The Counselor in a Changing World” urged counselors to…
emphasize developmental concerns rather than merely focusing on crises and curing emotional illness
One of the primary problems of counseling in the early 1960s was that it wrongly emphasized…
intrapsychic processes
What are intrapsychic processes?
processes within one’s mind or psyche
The significance of the 1958 National Defense Education Act was that it…
provided financial aid for graduate education in counseling; expanded school guidance services; improved guidance for gifted children
A man has a rare, highly contagious disease that’s fatal. He’s keeping it a secret and insists that he’ll never tell his wife. You should…
break confidentiality and tell his wife
A man’s been arrested for a crime. His former counselor is called to perform a forensic evaluation. What’s the counselor’s responsibility in this case?
It’s not considered ethical to perform a forensic evaluation on a current or past client, so the counselor should decline
Is professional liability insurance always required?
required by law in some states but not in others
