Professional Orientation & Ethical Practice

When counselors state that privileged communication is "qualified," they actually mean that

Exceptions may exist

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

Call the child abuse/neglect hotline, protective services, children's services

When working for a school or a counseling agency do not refer the client to your own private practice. This is known as a

"Self-referral"

A woman comes to your for help with an eating disorder. You have no experience or training in this area. Ethically you should

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

Ethics always describe A) laws B) universal principle which apply to all helpers C) standards of conduct imposed by the ACA and NBCC D) all the above

C Ethics define standards of behavior set forth by organizations and certification bodies. Ethics are not state or federally mandated laws

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

Repeat the question, but talk more slowly. the counselor should always attempt to use the recommended wording. Changing the wording could alter the impact of the test question, possibly confounding the results.

A counselor who sports NCC after her name

will need a specified amount of continuing education contact hours before she can be recertified, or she will need to take the NCE again. *100 hours of professional development are needed during a five-year period

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

you are sexually involved with a client

Exceptions or limitations to maintaining confidentiality include:

-Child or sexual abuse, neglect, or exploitation -Ct is a danger to self or others -Ct requests a release of information -a court orders a release of information -the counselor is engaged in a systematic supervision process -clerical assistants who process ct info and papers -legal and clinical consultation situations -ct raises the issue of the counselor's competence in a malpractice lawsuit -the ct is less than 18 yrs of age (if a ct is a minor, a parent or guardian can demand that information is disclosed that was revealed during a session -elder abuse -and insurance company or managed care company requests a diagnosis and/or relevant clinical information

A statement of disclosure could include (also referred to as informed consent)

-the counselor's qualifications, office hours, and billing policies -emergency procedures and therapy techniques utilized -a statement that confidentiality is desirable, but cannot be guaranteed in a group setting

The ACA code of ethics lists 5 values:

-to enhance human development for the entire lifespan -embrace diversity and multicultural factors since clients are unique -promote social justice -safeguard the integrity of the counselor-client relationship -practice counseling in an ethical/safe manner

You must wait ___ years after the last session before having a sexual or romantic relationship with a client, family member of a client, or the client's romantic partner

5 years After 5 years a written statement should be prepared to explain why the relationship would not hurt or exploit the former clients (Note: NBCC ethics use two years as the line of demarcation)

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 US C) revoke your NCC status D) note in their newsletter that your NCC status has been revoked

A Certification is not the same as licensing. A certification is given to an individual via an organization which is not part of the state or federal gov. A counseling license is granted by the state government

State laws can govern tittle usage and practice, however, they do not govern A) accreditation B) counselor licensure C) psychologist licensure D) involuntary commitment to state psychiatric facilities

A Accreditation is not the law. It is a process whereby an agency or a school meets certain standards and qualifications set forth by an association or accrediting organization. *accreditation applies to programs, not individual counselors

Which choice would most likely violate the counseling ethic or law termed "scope of practice"?

A counselor who is conducting a strict Freudian psychoanalysis with the client *scope of practice suggests that counselors should only practice using techniques for which they have been trained. Most counselors are not trained in classical analysis

The DSM was created by the American Psychiatric Association (APA). The 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 counselor who wishes to secure insurance (third party) payments

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

APA style

A counselor wins the lottery and closes her practice without telling her clients. This counselor's course of action is best described as

Abandonment

Tarasoff warnings/exceptions to confidentiality can apply to

A medical situation if your clients has a contagious life-threatening disease which could harm somebody else. Verification of the medical condition (required in the 2005 ACA code) has been removed based on the fact that the practice just wasn't realistic

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 -American College Personnel Association -American School Counselor Association -Association for Specialists in Group Work -American Counselor Education and Supervision

American Counselor Education and Supervision

A female counselor who tells a male ct how sexy his hairy chest looks when he leaves his shirt unbuttoned. The male ct blushes and appears uncomfortable. This is an example of:

An ethics violation of sexual harassment

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

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

NBCC's Code of Ethics describes ethical issues related to private practice. Which of these is an 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 is out of the country and is engaged in a research project for the next two years.

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

And impaired professional

Conversion and reparative therapies attempting to change the sexual orientation of a client

Are still unethical regardless of the name of the therapy. These techniques, and any others sporting substantial evidence of harm, should not be used.

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.

Six foundational principles for ethical behavior are set forth that are similar to the medical and health professions:

Autonomy: or the notion that a ct has a right to control his or her 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 is equality Veracity: the helper is truthful

You are a counselor relocating to another state. The new state informs you that they will 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

A counselor can refer a client due to a lack of knowledge, but not

Because of his or her personal values

Traditionally, ________ counseling has caused the most ethical concerns.

Behavioral The concern has been that behavior therapists can control, manipulate, and shape behavior

The definition of pro bono has expanded. In the past pro bono occurred when a counselor saw a client for free. The new code includes

Behaviors like free lectures, offering a reduced fee, or providing post-trauma/disaster services

Identify the DSM code. A) 29622 B) 29.622 C) 296.99 D) 2969,2

C

What best describes the counseling profession's reaction to computer-assisted counseling and computer-managed counseling?

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.

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 yr old college student can view his or her own educational record C) a and b D) a and b are both illegal

C) A and B

A registry would be A) a list of licensed psychologists in the state of Illinois B) a list of CRCs in the United States C) a and b D) the registration process for counselor licensure in the state of Missouri

C) a and b A registry is always a list of providers

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 CMC would include tasks such as bookkeeping, client scheduling, printing billing statements, and compiling referral sources. CAC is like having a counseling "assistant" do the counseling for you

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

Caplan. Mental health consultation occurs when a consultant works with a consultee regarding clients or administrative/program issues. When the ultimate goal is to help the client, it is known as a "client-centered" consultation. When your licensing supervisor suggests a plan of action for a given client, then you as a consultee are the recipient of "client-centered" consultation (not to be confused with client-centered therapy). The exam may mention "consultee-centered" consultation. Here, the focus is on helping the consultee develop improved techniques or skills. Thus, when you're licensing supervisor explains a better way for you to implement a hypnotic induction with one of your clients, then you are the recipient of "consultee-centered case consultation." A variation of this is the "consultee- centered administrative consultation" in which your supervisor or consultant's intention is to sharpen up your administrative skills (e.g., making you a better presenter at your agency board meeting). Finally, there is the "program-centered administrative consultation." As the name suggests, the emphasis here is on creating, designing, or evaluating the program in question. These four basic types of mental health consultation have been proposed by Gerald Caplan.

Most ethical dilemmas are related to ______.

Confidentiality

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

Confidentiality and dual relationships

During a session a 42 year old male ct threatens suicide. You should

Contact his wife and advise her of possible suicide precautions.

APA is to psychologist as ACA is to ______

Counselor

One possible negative aspect of counselor licensure is 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

The code sets expectations for all counselors, though to be sure, ACA has no power over

Counselors who are not members (at this time ACA boasts approx. 55,000 members)

Nosology refers to a system of classification. Name the nosological system(s) utilized by professional counselors who diagnose clients.

DSM and ICD

Some states ____________ have a duty to warn/inform

Do not So laws and ethics are not always in agreement.

Dr. X recommends to his clients at the agency where he practices that he would rather counsel them in his private practice. Ethically speaking:

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

Chronic suicidal clients are NOT a good fit for

Electronic counseling intervention

A ct wants his records sent to a psychiatrist he is seeing. You should

First have the ct 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 *if you or your agency didn't collect the info in the record then don't send it even with a release form *exam might refer to a release of information as consent to disclose or transfer records

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

Four or five. Ex: 300.3 Obsessive Compulsive-Disorder or 305.50 Opioid use disorder. Mild.

You are counseling your first cousin for depression. This is

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

In reference to Facebook and other social media sites, do not make clients "friends". Doing so

Goes beyond professional boundaries. Explain social media policies to client and do not follow clients online as this constitutes an invasion of their privacy.

Fee splitting

Has been deemed unethical. This would include using a percentage of the fee for the use of an office. Charging a set office fee is ethical.

Distance counselors should

Have an informed consent statement describing technology failure issues, response time (e.g. you only read your email in the evening), risks, time zones, and emergency protocol.

If a counselor has a social media file, the counselor should

Have separate professional and personal pages. And make sure clients can discern the difference

A counselor who possesses a graduate degree wishes to become a licensed psychologist. Which statement most accurately depicts the current situation?

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.

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

Inform the client of this before the counseling begins

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

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:

Just keep it confidential

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

Laws are unclear and may vary from state to state *privileged comm. is not applicable in cases of child abuse, neglect, or exploitation; suicide or homicide threats; criminal intentions; clients in dire need of hospitalization; or in cases where a counselor is the victim of a malpractice lawsuit

You refer a client to Dr. Smith. Ethically, Dr. Smith

May NOT pay you a referral fee for sending her the client

Formal diagnosis, also known and nosology, is most closely related to the ____________ model.

Medical

You performs a battery of tests on your client. After you complete the testing you discover your ct is 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. -According to NBCC's code of ethics, we are told that normally you would NOT release a ct's test or assessment results without prior written consent. The exception: when there is clear and imminent danger or when legally required to do so by a government agency or a court order

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

NBCC (National Board for Certified Counselors)

By passing the NCE, a counselor can attain _______, given via NBCC.

NCC, a generic certification for counselors *you can only secure specialty certificates such as CCMHC and NCSC after you secure the NCC credential *just bc you are certified does not mean you can call yourself a licensed counselor. Notional certifications can be used on a national basis unlike licenses, which ten to be primarily state specific. Licenses are conferred by the individual state and not the federal government

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 CRC (Certified Rehabilitation Counselor)

Counselor certification

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

All of the following conditions below are V code diagnoses except: - acculturation problem - occupational problem - post-traumatic stress disorder - academic problem

PTSD In addition to the V codes listed above, others include: -malingering (which is avoiding life's work or duties by intentionally exaggerating or feigning physical symptoms or illness) -parent-child problems -occupational problems -noncompliance with medical treatment -other interpersonal problems -a phase of life or circumstances problem

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

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

Which group was most instrumental in opposing counselor licensure?

Psychologists

One impetus of 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 cara companies.

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 consulted 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 ___________

Schein

A woman who is in private practice mentions in her phone book advertisement that she is a licensed counseling psychologist. This generally means that

She has a graduate degree from a a psychology department *the term 'psychology' can only be used if the helper is a licensed psychologist, even if the person specializes in counseling

Counselors only use theories grounded in science and research. If you have a developing, innovative theory, this

Should be shared with the client upfront in an informed consent disclosure statement

Major additions:

Social media, technology, and distance counseling All are infused throughout the entire code as well as occupying their own special sections

A counselor educator gives the students a handout and it lists hoarding disorder and obsessive-compulsive disorder as both having the same 300.3 code. The most likely explanation is:

That his could be correct since two diagnoses can share a single code. Because of the fact that a single code can truly represent multiple conditions it is imperative that you list the name of the condition in the client's chart or medical record.

The landmark 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 can engage in bartering with a client if, and only if,

The practice will not cause harm or exploitation. When bartering is used, a written contract and cultural considerations should be taken into account.

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

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

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

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.

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

You are a well-known cognitive behavioral therapist who heads up a private practice in NJ. For the next two years, you will be in Canada doing research. Your practice has 6 other counselors. The practice is sending brochures to schools, agencies, and hospitals in attempts to boost referrals. Your name appears on the front of the brochure, as if you are available for referrals. This is:

Unethical. Ethics suggest that personas who hold leadership roles not allow their names to be used in professional notices when they are not practicing counseling unless this is clearly stated in the practice's literature.

A fourteen year old male threatens to blow up his parents garage because he has been grounded. You believe his threat is genuine. You should

Warn the parents that their property is in danger

Privileged communication 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. *the client-not the counselor or the court- can choose not to have confidential info revealed during a legal proceeding Simply put- it is the "client's privilege" to reveal

New code removed en-of-life exception rule. This means

You cannot refer a client because he or she is terminally ill or considering a physician's assisted suicide.

You are a counselor in a state that does not legally support privileged communication. You refuse to testify in court. In this situation...

You could be held in contempt of court

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. *in most instances consultation services do not go on as long as supervision services

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

counsel the client. Treat this client in the same manner as you would treat any other client. You may 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.

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

countertransference

Which treatment match up is incorrect? A. Vivitrol for alcoholism B. Lithium for bipolar disorder C. Suboxone for opioid dependence D. Narcan for schizophrenia

d. Narcan for schizophrenia Narcan can block the effects of opioids such as heroin and painkillers such as morphine, codeine, and oxycodone. By impacting the same portions of the brain as opioids, it can stop or reverse overdoses to save lives. Narcan has virtually no serious side effects and will not make the person high.

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

defamation (behavior that can damage ones reputation)

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

explain this to the client and then refer the client to another provider

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

inform the parents of the student in danger, inform the principal, and call the police immediately, discussing only material related to the threat *minimal disclosure means that if you must break confidentiality you reveal only what is necessary and when possible inform the client that you are going to disclose confidential information

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

A counselor is counseling an executive secretary. The counselor notes that he is writing a book and explains to the client that he will see her for free if she types the manuscript. This is

known as bartering and unethical as described here *currently ethics allow the practice of bartering if the client requests it, a written contract is drafted, it does not result in any harm, and the relationship is not exploitative.

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

may use the book as a textbook in your class. Nevertheless, your school could have a policy against it or specify that the royalties you receive must be donated to the institution.

Ethics state that a counselor should _______ all clients for group counseling

screen. Some clients are inappropriate for group work.

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

submit the article to ONE publication at a time despite your conviction that the article must get published In our field, multiple or duplicate submissions are unethical in relation to journal articles. Once your article is published you may not have it republished elsewhere without the express permission of the first publisher.

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 (eg 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. The CPT code will specify the exact nature of the treatment being utilized to help your client (eg psychotherapy, hypnosis, biofeedback, or group psychotherapy)

Insurance payments are also called

third-party payments. Keep in mind that third-party payments do not always cover the entire counseling Fee. An insurance policy, for example, could pay only 50 or 80%. Other third-party systems have a maximum fee for services which could conceivably be less than your normal rate. When a client pay for a portion of the service it is known as a "copayment."

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

unethical as this is misrepresentation