Professional Orientation and Ethics

Question 1

The term “confidentiality”:
Select one:

A.
is an ethical and legal term that has the same meaning in both arenas

B.
refers to the requirements of state laws to limit access to client records to appropriate persons

C.
refers to the ethical obligation to protect the privacy of clients under most circumstances

D.
refers to the ethical responsibility to ensure that a client’s records are not shown to others without the explicit permission of the client

Answer 1

C.
refers to the ethical obligation to protect the privacy of clients under most circumstances

Confidentiality is an ethical issue, not a legal requirement. It refers to a standard of professional conduct in which counselors do not reveal information obtained from persons in the course of their work as counselors. It is distinct from the legal issue of privilege. Privilege is a legal right that prevents information obtained in the therapeutic setting from being disclosed in court or to others. In most situations, the client is the holder of the privilege; that is, the client must sign a waiver for release of information obtained during the course of therapy before the information is released to the court or others. Also, note that under certain circumstances, confidentiality can and should be breached. For instance, most states have mandatory child abuse reporting laws.

Question 2

If an elderly individual who is coherent but physically dependent wants to leave a health care facility, his counselor should:
Select one:

A.
call the man’s family

B.
talk to him

C.
medicate him

D.
call an elder protective service agency

Answer 2

B.
talk to him

This question tested your knowledge, understanding and skill application related to clinical intervention, ethics and the law. Though it did not directly ask for your “first” intervention, you were safe assuming that you should choose it. The best first step in this situation is to talk with the client directly. Since he is coherent, the counselor can discuss with him his dissatisfaction with the health care facility and together, they can explore if he has any other options. If not, the counselor can help the client address his complaints about the facility. A counselor is not qualified to medicate clients or to determine whether they should receive medication. Only a psychiatrist or medical doctor can make this decision. In addition, medication does not seem necessary with a “coherent” client.

Question 3

A major purpose of both certification and licensure is to:
Select one:

A.
allow professional counselors to make diagnoses and receive third party payment

B.
ensure that counselors are perceived by the public to be just as respectable as other health care professionals, such as psychologists and physicians

C.
ensure that individuals who hold themselves to the public as professional counselors meet designated standards of competence

D.
strengthen the profession of counseling by maintaining the existence of individuals who are designated as counselors

Answer 3

C.
ensure that individuals who hold themselves to the public as professional counselors meet designated standards of competence

Certification is the process by which The NBCC grants recognition to an individual who has met the predetermined professional standards it has specified. Licensure is the process by which a state agency or government, upon finding that an individual has met minimal standards of competence, grants permission to an individual to engage in a given occupation. Both processes are designed to protect public safety by ensuring that those designated as professionals meet minimal standards of competence.

Question 4

According to the NBCC Code of Ethics, in which of the following cases should a client be persuaded by a counselor to report knowledge of a crime to the police:
Select one:

A.
when the client knows a crime is about to be committed

B.
when the client knows a crime has been committed

C.
when there is imminent danger to another person or persons

D.
under no circumstances; the counselor himself or herself must determine whether or not the crime should be reported

Answer 4

C.
when there is imminent danger to another person or persons

An ethical counselor should persuade a client to report knowledge of a crime to police or other appropriate law enforcement agencies when there is an imminent danger to other people. Keep in mind that the client is not mandated to report to the police. Also, your ethical obligation to encourage the client to contact the police does not nullify any Tarasoff-related report that you may be mandated to make yourself.

Question 5

You are a counselor in private practice and you lead a therapy group for women who love men who don’t love themselves. One of the participants in the group is a famous movie actress. In the initial stages of the group, the actress’s presence causes some disruption, but the members settle down and you eventually run what you feel is a successful group. Six months after termination, the actress appears on “Geraldo,” where she speaks freely and jokingly about the private lives of the other group members. That night, the other group members show up at your home and angrily accuse you of committing an ethical violation. Are these accusations accurate:
Select one:

A.
no, as long as you had all of the group members sign a written agreement to maintain confidentiality with regard to information disclosed in the group sessions

B.
no, because you are not at all responsible for ensuring that therapy group members keep information about other members confidential

C.
yes, because you are ethically responsible for all breaches of confidentiality committed by group members

D.
yes, because you should have never admitted a famous actress into the group

Answer 5

A.
no, as long as you had all of the group members sign a written agreement to maintain confidentiality with regard to information disclosed in the group sessions

The NBCC Code of Ethics (2012) states that counselors “conducting counseling with more than one client at a time (e.g., group or family counseling) shall discuss with clients the nature, the rights and responsibilities as well as the possible additional limitations of confidentiality. [Counselors] shall also describe the steps that they will take in the event that having multiple clients in session creates issues between or concerning clients.” Thus, if the counselor had explained the importance of confidentiality (e.g., having the members sign a written agreement not to disclose information), she would have met her ethical responsibility in this situation.

Question 6

As a counselor in a small school, you are responsible for providing services to students and teachers. There is another counselor that works part-time, primarily to assist you with students. One day you overhear the part-time counselor revealing confidential information about a student to a teacher. You should:
Select one:

A.
discuss this ethical violation with the counselor

B.
discuss the situation with the principal

C.
contact the teacher to ensure that she does not share the information with anyone else, thus maintaining the students’ confidentiality

D.
formally reprimand the counselor in a letter

Answer 6

A.
discuss this ethical violation with the counselor

In this case, it’s important to discuss the situation with a colleague, making it clear that an ethical violation was committed. Answer C sounds good, but it doesn’t make it clear that what the counselor did was unethical.

Question 7

The difference between professional ethics and professional values is best stated by which of the following:
Select one:

A.
if a counselor is ethical, there should be no difference between ethics and values

B.
ethics are standards for practice set by the profession, while values refer to judgments of right and wrong

C.
ethics can be stated more specifically than values

D.
values specifically define appropriate counseling conduct, while ethics are a more general code of proper professional conduct

Answer 7

B.
ethics are standards for practice set by the profession, while values refer to judgments of right and wrong

Response B distinguishes between ethics and values. Values are concerned with what is good and desirable and ethics refer to correct or appropriate practice. Values and ethics are related in that the latter is usually derived from the former; for example, privacy is a value that is reflected in the ethical standard requiring counselors to obtain clients’ informed consent before taping therapy sessions. Responses (a) and (c) are not necessarily true and answer (a) is not true since values do not specifically define appropriate professional conduct.

Question 8

Mary Linden was recently hired as a counselor by a community mental health center. Shortly after beginning her job, Mary begins therapy with a client whose symptoms suggest a diagnosis of agoraphobia. Although Mary has some experience with phobic disorders, she has never worked with an agoraphobic individual. As an ethical counselor, Mary should:
Select one:

A.
refer the client to another professional who has experience treating agoraphobia

B.
seek supervision but continue to work with the client

C.
review the literature on agoraphobia and enroll in a continuing education course

D.
contact the NBCC for guidance

Answer 8

B.
seek supervision but continue to work with the client

Though Mary should recognize the need for continuing education, in this situation, it would be advisable for her to use other resources and seek supervision from a trained colleague, while still seeing the client.

Question 9

During debriefing at the end of a research study involving deception, a subject becomes very angry and demands that his data be withdrawn from the study. According to ethical guidelines, a counselor should:
Select one:

A.
reassure the subject that the data is confidential but tell him that, once collected, data cannot be removed

B.
inform the subject that he cannot ask for the data to be withdrawn since he signed an informed consent form prior to data collection

C.
agree to withdraw the data, but inform the subject that he must return the compensation he received for participating in the study

D.
agree to withdraw the data

Answer 9

D.
agree to withdraw the data

This is consistent with the NBCC Code of Ethics (2012), which states that counselors “shall provide critical information to potential research subjects that will assist them in reaching a determination about participation. This information shall include the research’s purpose, process, duration, potential consequences, and procedures as well as the participant’s right to refuse or withdraw participation.” This implies that, at all stages of the research (even the data collection stage), participation by subjects must be voluntary.

Question 10

Barbara White, a counselor, sets her clients’ fees according to their ability to pay as determined by their yearly income. This practice is:
Select one:

A.
illegal and unethical

B.
legal, but unethical

C.
both legal and ethical

D.
ethical but illegal

Answer 10

C.
both legal and ethical

Sliding scale fees are legally and ethically acceptable as long as the fee arrangement is made clear from the onset of therapy.

Question 11

What is the difference between supervision and consultation:
Select one:

A.
supervision involves overseeing an intern or employee, while consultation involves obtaining information or assistance from an outside specialist

B.
supervision is always on-site, while consultation occurs in the field

C.
supervision is an educational and supportive function, while consultation is an administrative function

D.
there is no major distinction between supervision and consultation, except as defined by the policies of a given agency

Answer 11

A.
supervision involves overseeing an intern or employee, while consultation involves obtaining information or assistance from an outside specialist

Consultation involves expert help to a consultee with specific job-related problems; similarly, supervision often involves expert help to a supervisee with work-related problems. However, one distinction between the two processes is that a consultant is an outside specialist who works on an as-needed basis, while a supervisor works with a supervisee on a continuing basis. In addition, unlike a supervisor, a consultant has no administrative authority; the consultee is free to ignore a consultant’s suggestions. Choice A describes the differences between consultation and supervision.

Question 12

A counselor who specializes in couples therapy has been referred a young, gay couple, Gary and Bob. This counselor, who is heterosexual, has never dealt with a gay couple before, but has decided that the issues this couple presents are consistent with his experience. Gary and Bob tell the counselor that they have heard terrific things about his abilities, and they do not care that he has not worked with gay couples before. The counselor should be aware that:
Select one:

A.
this case is not within his scope of practice

B.
issues about his own sexuality may arise

C.
the primary focus of therapy must consider the homosexual component more than specific relationship interactions

D.
Gary and Bob would be better served if he referred the case to a homosexual therapist

Answer 12

B.
issues about his own sexuality may arise

This is the best of the four answers, because a heterosexual counselor treating gay clients may experience discomfort which stems from the therapist’s own issues about sexuality. Choice (c) is not true; many homosexuals in therapy are comfortable with, and, therefore, do not require therapy focused on, their sexual orientation. It is also not necessarily true that homosexual clients are better served by homosexual counselors.

Question 13

Certification is best defined as the process by which the NBCC:
Select one:

A.
allows individuals to engage in given occupations after meeting minimal requirements that ensure that the public health and welfare will be reasonably protected

B.
recognizes individuals who have met the predetermined NBCC professional standards

C.
legally sanctions qualified professionals to practice in the counseling field

D.
encourages professional counselors to abide by its code of ethics

Answer 13

B.
recognizes individuals who have met the predetermined NBCC professional standards

Certification involves granting recognition to a person having met predetermined professional standards. Professional organizations such as The NBCC certify individuals. Certification is different from licensure, the process by which a state grants permission for an individual to engage in a given occupation.

Question 14

The sections of the ACA Code of Ethics are:
Select one:

A.
The Counseling Relationship; Private Practice; Confidentiality and Privacy; Professional Responsibility; Relationships With Other Professionals; Evaluation, Assessment, and Interpretation; Supervision, Training, and Teaching; Research and Publication; Resolving Ethical Issues

B.
The Counseling Relationship; Confidentiality and Privacy; Professional Responsibility; Relationships With Other Professionals; Evaluation, Assessment, and Interpretation; Supervision, Training, and Teaching; Research and Publication; Distance Counseling, Technology, and Social Media; Resolving Ethical Issues

C.
General; Confidentiality and Privacy; Professional Responsibility; Relationships With Other Professionals; Evaluation, Assessment, and Interpretation; Supervision, Training, and Teaching; Research and Publication; Distance Counseling, Technology, and Social Media; Individual and Family Counseling

D.
Individual Counseling; Family and Group Counseling; Confidentiality and Privacy; Professional Responsibility; Relationships With Other Professionals; Evaluation, Assessment, and Interpretation; Supervision, Training, and Teaching; Research and Publication; Resolving Ethical Issues

Answer 14

B.
The Counseling Relationship; Confidentiality and Privacy; Professional Responsibility; Relationships With Other Professionals; Evaluation, Assessment, and Interpretation; Supervision, Training, and Teaching; Research and Publication; Distance Counseling, Technology, and Social Media; Resolving Ethical Issues

The nine sections in the ACA Code of Ethics (2014) are: The Counseling Relationship; Confidentiality and Privacy; Professional Responsibility ; Relationships With Other Professionals; Evaluation, Assessment, and Interpretation; Supervision, Training, and Teaching; Research and Publication; Distance Counseling, Technology, and Social Media; Resolving Ethical Issues.

Question 15

A woman is in therapy for bulimia. Her therapist specializes in eating disorders. She comes to you because of anxiety about recurring nightmares. After speaking with her, you should:
Select one:

A.
contact the other counselor if the appropriate release was obtained

B.
limit therapy to dreamwork

C.
refuse to treat her

D.
explain the distinctions between the different schools of therapy

Answer 15

A.
contact the other counselor if the appropriate release was obtained

The NBCC Code of Ethics (2012) states that counselors “who learn that a client is receiving additional mental health services from other professionals shall discuss with the client the importance of developing clear agreements to avoid client confusion and conflict. Following this discussion, [counselors] shall request the client’s written consent to inform the other professional(s) of the counseling relationship and to collaborate on the provision of mental health services. This discussion and the client’s response to the request shall be documented in the client’s record.” You must confer with the other counselor to ascertain how to proceed ethically. It may or may not be appropriate for you to work with this client. The decision must be made in cooperation with the client and the existing therapist.

Question 16

A young male client you’re treating is severely disturbed about a recent breakup with his girlfriend. He blames the failure of the relationship on the girlfriend and says he feels like killing her. He says he knows her daily schedule and could easily “get her” when she is alone in her apartment parking garage. The man has no previous history of violent behavior. You should:
Select one:

A.
maintain confidentiality

B.
refer the client to a physician for medication

C.
hospitalize the young man

D.
warn the intended victim and the police

Answer 16

D.
warn the intended victim and the police

This question was assessing your familiarity with the Tarasoff ruling (duty to warn) and its effects on confidentiality. The duty to warn implies that, when a client threatens violence to an identifiable victim, the therapist has a legal responsibility to warn both the intended victim and the police of the danger. The client’s past history with violence is not relevant to this obligation. In this situation, the client makes a clear threat against an identifiable victim. Although (b) and (c) are actions that might be appropriate, D represents the mandated legal requirement and is therefore the better answer.

Question 17

What does the ACA Code of Ethics say about continuing education?
Select one:

A.
counselors should recognize the need to maintain a reasonable level of knowledge of professional information in their fields of activity

B.
counselors should recognize the need to maintain a reasonable level of knowledge of professional information in their fields of activity; counselors should maintain their competence in their skills, remain open to new procedures, and remain informed regarding the best practices for working with diverse populations

C.
counselors should recognize the need to maintain their competence in their skills after they have practiced in the field for many years

D.
nothing

Answer 17

B.
counselors should recognize the need to maintain a reasonable level of knowledge of professional information in their fields of activity; counselors should maintain their competence in their skills, remain open to new procedures, and remain informed regarding the best practices for working with diverse populations

According to the ACA Code of Ethics (2014), “Counselors recognize the need for continuing education to acquire and maintain a reasonable level of awareness of current scientific and professional information in their fields of activity. Counselors maintain their competence in the skills they use, are open to new procedures, and remain informed regarding best practices for working with diverse populations.” Choice B provides the most complete description of this ethical standard.

Question 18

Which of the following statements is true?
Select one:

A.
confidentiality is an ethical issue, while privilege is a legal right

B.
confidentiality is a legal right, while privilege is an ethical issue

C.
confidentiality and privilege are both ethical and legal issues

D.
confidentiality cannot legally be breached

Answer 18

A.
confidentiality is an ethical issue, while privilege is a legal right

Privilege and confidentiality are both based on the right to “privacy,” which refers to the basic right of individuals to decide how much personal information can be shared with other people. While privilege and confidentiality are generally treated as separate issues, there is a great deal of overlap. For example, the word “confidentiality” appears in many state laws and, in some states, a client has a legal right to sue a counselor for a breach of confidentiality.

Question 19

Which of the following is NOT one of the purposes of Public Law 94-142?
Select one:

A.
to establish a clear and comprehensive prohibition of discrimination on the basis of disability

B.
for all handicapped children have to available to them a free appropriate public education

C.
to assure that the rights of handicapped children and their parents or guardians are protected

D.
to assess and assure the effectiveness of efforts to educate handicapped children

Answer 19

A.
to establish a clear and comprehensive prohibition of discrimination on the basis of disability

The Education for All Handicapped Children Act (Public Law 94-142) was enacted to give handicapped children the right to a free education and to ensure that no single procedure would be used as the sole criterion to place children. It requires that an individualized educational plan be developed for each handicapped child and stipulates that handicapped children should be educated along with nonhandicapped children to the maximum degree possible.

Question 20

Which of the following is most accurate, relative to the ACA Code of Ethics?
Select one:

A.
counselors must refuse requests from others for research data generated in a counselor’s research study, and they must take due care to disguise the identity of respective subjects in all circumstances

B.
counselors must refuse requests from others for research data generated in a counselor’s research study, and they must take due care to disguise the identity of respective subjects in the absence of specific authorization to do otherwise

C.
counselors are not obligated to make research data available to others who may wish to replicate a counselor’s study; also, certified counselors must take due care to disguise the identity of respective subjects in the absence of specific authorization to do otherwise

D.
counselors are obligated to make available sufficient research data to qualified others who may wish to replicate a counselor’s study, but they must take due care to disguise the identity of respective subjects in the absence of specific authorization to do otherwise

Answer 20

D.
counselors are obligated to make available sufficient research data to qualified others who may wish to replicate a counselor’s study, but they must take due care to disguise the identity of respective subjects in the absence of specific authorization to do otherwise

According to the ACA Code of Ethics (2014), “Counselors are obligated to make available sufficient original research information to qualified professionals who may wish to replicate or extend the study.” Furthermore, “Counselors who supply data, aid in the research of another person, report research results, or make original data available take due care to disguise the identity of respective participants in the absence of specific authorization from the participants to do otherwise …”

Question 21

In the context of professional licensure of counselors, reciprocity refers to:
Select one:

A.
a licensing agency accepting the licensing standards of another agency as sufficient for its own professional counselors.

B.
a licensed counselor legally performing the duties of a licensed psychologist

C.
the idea that certification and licensure are synonymous

D.
the idea that graduation from an accredited counselor education program automatically constitutes eligibility for licensure

Answer 21

A.
a licensing agency accepting the licensing standards of another agency as sufficient for its own professional counselors.

Reciprocity refers to a licensing agency (e.g., a state board) accepting the licensing standards of another agency as sufficient for its own professional counselors.

Question 22

You are treating a client who is receiving counseling through his company’s employee assistance program. The employee’s supervisor calls you because he is curious as to how counseling is progressing. In this situation, you can let the employee’s supervisor know how the employee’s treatment is progressing:
Select one:

A.
only if the employee has signed a waiver of confidentiality

B.
as long as no other information about the treatment is given to the supervisor

C.
only if the employee was referred to the program by the supervisor

D.
under no circumstance

Answer 22

A.
only if the employee has signed a waiver of confidentiality

Releasing information about a client - even to a client’s work supervisor in the context of counseling received in an employee assistance program - is unethical unless the client has given consent to release the information. Answer “D” - “under no circumstances” - is too extreme of an answer. You can release the information if consent has been given.

Question 23

A counselor in a social services agency learns that one of her colleagues (who is not a certified counselor) is behaving unethically. The counselor should:
Select one:

A.
respect the confidentiality of the colleague’s professional relationships and not take any action

B.
take action to attempt to rectify the situation

C.
take action only if the colleague is a certified counselor

D.
take action only with the consent of the colleague’s client

Answer 23

B.
take action to attempt to rectify the situation

According to the ACA Code of Ethics (2014), in the Introduction to Section C, it states, in part, “counselors are expected to advocate to promote changes at the individual, group, institutional, and societal levels that improve the quality of life for individuals and groups …” Of course, confidentiality issues are also paramount; however, the counselor can take action without violating the client’s confidentiality.

Question 24

You are a counselor working in private practice. You have been seeing a client weekly for six months and it is apparent that no progress is being made. With regard to seeking consultation from another counseling professional, which of the following statements is true:
Select one:

A.
because you work in private practice, you cannot consult with another professional

B.
you can seek consultation and share any information about the client as long as it is in the best interest of the client

C.
you can seek consultation if you protect the identity of the client

D.
you can seek consultation only if you receive written consent from your client

Answer 24

C.
you can seek consultation if you protect the identity of the client

According to the NBCC Code of Ethics (2012), counselors “who seek consultation (i.e., consultees) shall protect client’s confidentiality and unnecessary invasion of privacy by providing only the information relevant to the consultation and in a manner that protects the client’s identity.” Based on this standard, “C” is correct. Written consent is not required because, unless you reveal personal identifying information about a client, you are not breaking confidentiality.

Question 25

You decide to keep counseling records stored on your personal computer. With regard to counseling records stored on computer, which of the following statements is true according to the NBCC Code of Ethics:
Select one:

A.
it is unethical to store counseling records on a computer

B.
it is ethical to store counseling records as long as you tell the client you’re doing so

C.
it is ethical to store counseling records as long as the records are secure

D.
the NBCC Code of Ethics does not address this situation

Answer 25

C.
it is ethical to store counseling records as long as the records are secure

According to the NBCC Code of Ethics (2012), counselors “shall act in a professional manner by protecting against unauthorized access to confidential information. This includes data contained in electronic formats.” It is not necessary to get the client’s permission - the client understands that counseling records are kept. However, it is your responsibility to make sure the records are secure.

Question 26

You are working in a counseling agency. Prior to a training session, your supervisor asks you to discuss one of your clients in the session with other counselors because he thinks it would be helpful to the other counselors. What should you do:
Select one:

A.
tell your supervisor that you cannot talk about your client in the training session because of confidentiality reasons

B.
tell your supervisor that you cannot talk about your client because it would not be a good idea clinically

C.
tell your supervisor that you’d be happy to discuss your client openly in the training session

D.
tell your supervisor that you can discuss your client in the meeting as long as the client’s identity is protected

Answer 26

D.
tell your supervisor that you can discuss your client in the meeting as long as the client’s identity is protected

According to the ACA Code of Ethics (2014), “The use of client, student, or supervisee information for the purposes of case examples in a lecture or classroom setting is permissible only when (a) the client, student, or supervisee has reviewed the material and agreed to its presentation or (b) the information has been sufficiently modified to obscure identity.” The correct answer is consistent with this principle. The key here is that you are confident that the client’s identity is protected.

Question 27

Which of the following statements is true regarding the use of assessment techniques by counselors:
Select one:

A.
counselors can use any assessment technique that they feel could help the client

B.
counselors can only use assessment techniques for which they have been trained

C.
counselors can only use assessment techniques if they receive an Assessment Technician certification from the NBCC

D.
counselors cannot use assessment techniques

Answer 27

B.
counselors can only use assessment techniques for which they have been trained

According to the NBCC Code of Ethics (2012), counselors “shall use or interpret only the specific tests and assessments for which they have the required education and supervised experience.” There is no such thing as an “Assessment Technician” certification.

Question 28

What does the NBCC Code of Ethics say about the dissemination of research results by counselors:
Select one:

A.
counselors should not be conducting research nor should they be disseminating research results

B.
counselors should only report research results in a manner that is not misleading

C.
counselors should only report research results to other counselors

D.
the NBCC Code of Ethics does not address issues related to research

Answer 28

B.
counselors should only report research results in a manner that is not misleading

The NBCC Code of Ethics (2012) says that counselors “shall accurately report results of research, including limitations and variables that may have impacted the outcomes.”

Question 29

A counselor takes the National Counselor Exam and is so confident that she passed she decides to advertise on her website that she is a “Nationally Certified Counselor” even though it will be weeks before she receives her results. This behavior is:
Select one:

A.
unethical because the counselor is misrepresenting herself

B.
unethical because counselors cannot state their licenses and certifications on websites

C.
ethical because it is likely she will pass and become nationally certified

D.
ethical because the NBCC Code of Ethics does not address advertising on websites

Answer 29

A.
unethical because the counselor is misrepresenting herself

This is clearly unethical behavior because the counselor is misrepresenting herself. The NBCC Code of Ethics discusses advertising in general and this includes advertising in any form, including on a website. Regarding answer “D”, even if the ethics code did not address a particular situation, it does not necessarily make a behavior “ethical.”

Question 30

In a counseling situation, informed consent refers to:
Select one:

A.
a client being informed that information about him or her is being released

B.
a client having the information needed to make a reasonable decision about the services offered

C.
a client being informed about situations in which confidentiality may be breached

D.
a counselor receiving information about a client prior to beginning the counseling relationship

Answer 30

B.
a client having the information needed to make a reasonable decision about the services offered

The goal of an informed consent is to protect the recipient of counseling services by providing the information they need to make an informed decision about whether or not to participate.

Question 31

A counselor writes a magazine article stating that he is not opposed to sexual relationships between counselors and clients, and there should be no restrictions against this type of conduct. According to the NBCC Code of Ethics, this counselor’s behavior is:
Select one:

A.
unethical

B.
ethical

C.
neither ethical nor unethical because the writing of the article is not part of the counseling relationship and thus not covered in the ethics code

D.
neither ethical nor unethical because sexual relationships between counselors and clients are not covered in the ethics code

Answer 31

A.
unethical

The counselor’s behavior is unethical. According to the NBCC Code of Ethics (2012), counselors “providing public presentations by any means, shall ensure that statements are consistent with this Code of Ethics.” Elsewhere in the code, the NBCC writes counselors “shall not engage in any form of sexual or romantic intimacy with clients …”

Question 32

You are considering the use of an intensive short-term counseling approach that is new and innovative with one of your clients. What is your obligation to the client:
Select one:

A.
you have no ethical obligation regarding the use of new and innovative techniques

B.
you should reconsider the use of this technique because this practice is prohibited

C.
you should refer the client to another therapist who can determine whether this technique is viable

D.
you should explain to the client the potential risks and benefits of using this technique

Answer 32

D.
you should explain to the client the potential risks and benefits of using this technique

According to the ACA Code of Ethics (2014), standard C.7.b states “When counselors use developing or innovative techniques/procedures/modalities, they explain the potential risks, benefits, and ethical considerations of using such techniques/procedures/ modalities. Counselors work to minimize any potential risks or harm when using these techniques/procedures/modalities.”

Question 33

A client you have been seeing for six months says he wants to quit therapy. He feels that all of the problems for which he originally requested therapy have all been resolved. You disagree and feel other problems have arisen that must be addressed in therapy. You should:
Select one:

A.
get the client to agree to a specific number of additional sessions and then terminate therapy

B.
discuss his reasons for wanting to terminate

C.
discuss his reasons for wanting to terminate and your reasons for thinking he should continue

D.
terminate therapy but let him know he can come back if he desires

Answer 33

C.
discuss his reasons for wanting to terminate and your reasons for thinking he should continue

This is essentially a “common sense” question. You can’t force a client to continue seeing you. However, you are within your rights to discuss your reservations about his termination. In fact, you are ethically obligated to do so - withholding this information is not in the best interests of the client.

Question 34

According to the NBCC Code of Ethics, which of the following is a primary obligation of a counselor:
Select one:

A.
discussing the appropriateness of counseling with clients

B.
promoting the welfare of clients

C.
curing the disorders of clients

D.
a and “b”

Answer 34

D.
a and “b”

The NBCC Code of Ethics (2012) states that counselors should “promote the welfare of clients, students, supervisees or the recipients of professional services provided.” Furthermore, they shall discuss “with prospective clients the appropriateness of counseling services offered and shall not offer services if there is reasonable cause to believe clients will not benefit.”

Question 35

A client you have been seeing for two months suddenly informs you that this will be his last session. You believe this is not a good time for the client to stop counseling and are concerned about the potential negative consequences of doing so. You should:
Select one:

A.
allow the client to quit since he has the right to do so

B.
provide the client with appropriate referrals

C.
discuss with him the reasons you believe he should continue and recommend that he re-think his decision

D.
inform him that you are not responsible for any negative consequence of terminating prematurely

Answer 35

C.
discuss with him the reasons you believe he should continue and recommend that he re-think his decision

Obviously, a client has a right to discontinue treatment. This creates an ethical dilemma, however, when the therapist believes that termination is ill-advised. Choice C is the best response of those given. In this situation, the counselor would want to discuss the possible risks of terminating therapy at this time and encourage the client to re-think his decision. Although the action described in response (b) would also be important, it should follow a discussion about the possible consequences of leaving.

Question 36

A lesbian client tells you she wants to see a lesbian therapist. You should:
Select one:

A.
tell her you are homosexual, whether you are or not

B.
refer her to a lesbian therapist

C.
explore her reasons for wanting a lesbian therapist

D.
reassure her that therapy can be effective even if you are not gay

Answer 36

C.
explore her reasons for wanting a lesbian therapist

This question can be answered on the basis of clinical judgment and common sense. It is best to explore her reasons for wanting a lesbian therapist, because the client may have some misconceptions about you or about non-lesbian therapists that you would have the chance to correct. Moreover, exploring the reasons why the client wants a lesbian therapist would be revealing about the client and her past experiences.

Question 37

You have been working with a client who is clearly depressed (his diagnosis is Major Depressive Disorder), though not currently a danger to self, for four months. During this time, the client has made no progress and shown no improvement in his depressive symptoms. You have repeatedly recommended that he see a psychiatrist for a medication evaluation and he has refused each time. In this situation you should:
Select one:

A.
emphasize the need for a medication evaluation and discuss the possibility of termination and referral if the client continues to refuse one

B.
respect the client’s right to self-determination and proceed with therapy

C.
refer the client for inpatient treatment

D.
interpret the client’s resistance in psychoanalytic terms, in the hope that your interpretation will engender catharsis and therapy can proceed

Answer 37

A.
emphasize the need for a medication evaluation and discuss the possibility of termination and referral if the client continues to refuse one

The client is making no progress in therapy and refuses to investigate an avenue that could result in amelioration of his depression. It’s possible that he does not want to get better, in which case therapy is not indicated. Moreover, this answer is in line with your ethical obligation to discuss termination and referral when it is clear that a client is not benefitting from therapy. With regard to answer (b), it’s true that you must respect the client’s right to self-determination, so you won’t make any attempt to force him to undergo a medication evaluation. However, you also must respect your obligation to discuss termination and referral when it is clear that a client is no longer benefitting from your services. Also, there’s no indication that inpatient therapy (c) is necessary or would allow you to get past the current impasse in treatment. This is especially true since the question states that the client is not currently a danger to self. Finally, answer (d) is incorrect for two reasons: Not all counselors are psychoanalytically oriented and a catharsis would not likely be evoked by only one interpretation of the client’s resistance.

Question 38

A homosexual client shakes your hand at the end of a session. As a rule, you do not shake hands with your clients. In the next session, the client accuses you of being homophobic because you were reluctant to shake his hand. You should:
Select one:

A.
explain your policy to the client

B.
ask the client why he thinks you’re homophobic

C.
tell the client you are not homophobic

D.
suggest to the client that he has taken your behavior too personally and offer to work on that issue in therapy

Answer 38

A.
explain your policy to the client

Your nonverbal behavior can have a potent effect on your clients, as this case illustrates. The best response offered is to explain your policy. The client misinterpreted your nonverbal behavior in the last session and this has apparently damaged your alliance. You could explain your policy to the client, and then process with him how your behavior made him feel and connect that to other, similar experiences he has had. In this way, the event could be used as an opportunity for the client to grow.

Question 39

You see a client who is court-referred for therapy. The client is late for the first session and states that he does not want to be there. He fails to show up for the second session. In this situation, you should:
Select one:

A.
explain the court order to the client

B.
report what is happening in therapy to the court

C.
call the client on the phone and ask him why he does not want to participate in therapy

D.
maintain the client’s confidentiality under all circumstances

Answer 39

B.
report what is happening in therapy to the court

When a client is referred by the court for therapy, the court usually requires that the client attend a given number of sessions as a condition of probation, parole, or the sentence. Usually, one of the conditions is that the client must sign a release of information so that the court can be informed if the client has lived up to his/her agreement to participate in therapy. You should report what is happening to the court; for whatever reason, the client is not motivated to participate in therapy and the court will want to know this. In this situation, your obligation will be to report to the court, objectively and truthfully, what is happening.

Question 40

During the initial session, a client tells you that she wants to disclose certain information to you, but is reluctant to do so because it involves other people in her family. You should:
Select one:

A.
explain that you are ethically mandated to maintain her confidentiality

B.
explain the ethical standard of confidentiality

C.
reassure the client that she does not have to disclose any information until she is ready to do so

D.
engage the client because she will be more comfortable speaking openly with you after there is therapeutic rapport

Answer 40

B.
explain the ethical standard of confidentiality

The best choice is B because it directly and correctly addresses the client’s concerns. It suggests that you would explain to her that you are required to maintain confidentiality, but that this mandate is limited by certain factors, such as when you suspect child abuse, incur a duty to warn, etc. Choice (a) suggests that you would tell the client that her confidentiality will be maintained under all circumstances, which would, of course, be an inappropriate thing to say (e.g., what if her information is about child abuse?). Answers (c) and (d) are not bad, but they fail to say that you would deal directly with the client’s concerns about confidentiality.