CACREP AREA: Professional Counseling Orientation and Ethical Practice

Question 1

Which group was most instrumental in opposing counselor licensure?

Answer 1

Psychologists

Question 2

In the late 1970s, AACD (known as ACA since 1992) began to focus very heavily on professional credentialing.

This led to the formation of what organization?

Answer 2

NBCC (National Board for Certified Counselors)

Question 3

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

Answer 3

NCC, a generic certification for counselors

HINT: the NCC crednetial constitutes a generic ceritification

Question 4

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

Answer 4

A counselor who is conducting a strict Freudian psychoanalysis with the client

HINT:

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

Question 5

Ethical guidelines were first created for the helping professions in 1953 when the American Psychological Association (APA) published their first code of ethics. The National Association of Social Workers (NASW) created their code in 1960, and in 1961, the organization that is now ACA adopted ethics for counselors.

Ethics always describe what?

Answer 5

standards of conduct imposed by the ACA and NBCC.

Question 6

Most ethical dilemmas are related to…?

Answer 6

Confidentiality

Question 6

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

Answer 6

the duty to warn a client in imminent danger.

HINT: This case is cited as an example of a professional helpers duty to warn a person of serious and foreseeable harm

Question 7

A counselor reveals information that is extremely damaging to a client’s reputation.

This counselor could be accused of…?

Answer 7

defamation

Question 8

State laws can govern title usage and practice, however, they do not govern what?

Answer 8

Accreditation

HINT: Informed consent is another way of referring to a statement of disclosure

Accreditation does NOT equal law

Accreditation applies to programs, NOT individual counselors

Question 8

An exception to confidentiality, or what is termed as “relative confidentiality”, could occur when a client is suicidal.

Suicidal warning signs include…?

HINT: Multiple answers

Answer 8

1) repeatedly joking about killing one’s self.

2) giving away prized possessions after one has been depressed for an extended period of time.

3) a previous suicide attempt and a very detailed suicide plan for the future.

Question 9

A statement of disclosure could include all except:

Answer 9

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

Question 10

Privileged communication refers to the fact that anything said to a counselor by a client…?

Answer 10

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

HINT:

Priviliged communication = a legal term that implies that a theraputic interaction (verbal or written) will not be available for public inspection

The client (not the counselor) can choose not to have confidential info revealed during a legal proceeding

THE CLIENT IS THE HOLDER OF THE PRIVILEGE

Question 11

In regard to state law and privileged communication, counselors
must be aware about what?

Answer 11

That laws are unclear and may vary from state to state.

HINT: Privileged communication legislation varies from state to state

Question 12

When counselors state that privileged communication is “qualified,” they actually mean that…?

Answer 12

exceptions may exist

Question 13

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

In this situation, what is true?

Answer 13

you could be held in contempt of court.

HINT: Client in this situation would not have the “privilege” to say no if you are asked to testify

Question 14

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…?

Answer 14

call the child abuse/neglect hotline.

HINT:

Counselors are MANDATED REPORTERS for child abuse; it is legal and ethical to break confidentiality

Question 14

During a counseling session a 42-year-old male client threatens suicide.

You should do what?

Answer 14

contact his wife and advise her of possible suicide precautions.

Question 14

A 39-year-old female secretary you are seeing in your assertiveness training group reveals that she is plotting to shoot her husband.

Based on the Tarasoff case you should do what?

Answer 14

warn the husband

HINT:

Tarasoff = the responsible helper will warn an intded vicitim

Here is where professionals adhere to the principle of minimal disclosure, which suggests revealing only what is neccesary

Question 15

You pass your exam and now have NCC status. You perform a battery of tests on your client.

After you complete the testing you discover your client is in imminent danger. You receive a legal court order to turn over the test scores.

In this scenario, what should you do?

Answer 15

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

HINT:

A counselor MUST turn over client record IF
1) there is clear imminent danger

2) there is legal requirement/mandate by a government agency or court order

Question 16

One impetus for counselor licensing was that…?

Answer 16

psychology licensure bodies sought to restrict the practice of counselors so counselors could not receive third-party

Question 16

A counselor who possesses a graduate degree wishes to become a licensed psychologist.

Which statement most accurately depicts the current situation?

Answer 16

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.

HINT:

EPPP = Examination for Professional Practice in Psychology.

EPPP is to psychologists as the NCE is to counselors.

Question 17

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…?

Answer 17

She has a graduate degree from a psychology department.

HINT:

The term “psychology” can only be used if the helper is a licensed psychologist, even if the person specializes in counseling.

Question 17

One major difference between the psychology versus the counseling movement seems to be what?

Answer 17

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

Question 18

APA is to psychologist as ACA is to…?

Answer 18

counselor

Question 19

You have achieved the status of NCC. NBCC, nevertheless, feels you have violated professional ethics. NBCC can do any of the following except:

Answer 19

Revoke your state counseling license. ## Footnote **HINT:** A certificaiton board cannot revoke your license ***BUT*** they reserve the right to contact your state licensing board in which your state board may decide to take your license.

Question 20

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

Answer 20

an impaired professional.

Question 21

What is true of counselor certification?

Answer 21

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

Question 22

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

Answer 22

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

Question 23

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…?

Answer 23

American Counselor Education and Supervision (ACES)

Question 24

The problem with income-sensitive or sliding fee scales (based on the client's ability to pay) is that…?

Answer 24

it is difficult to administer them in a fair manner

Question 25

One possible negative aspect of counselor licensure is that counselors…?

Answer 25

counselors may not be as creative during their graduate work and simply take courses aimed at fulfiling the requirements to take the licensure exam.

Question 26

A client wants his records sent to a psychiatrist he is seeing. You should…?

Answer 26

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

Question 27

You are a licensed professional counselor in one state but vill thon relocate to another state. The new state informs you that they will grant you reciprocity or so-called endorsement. You will thus…?

Answer 27

be permitted to practice in the new state based on your current credentials without taking another exam. ## Footnote **HINT:** Reciprocity occurs when one state or organization accepts the license or credentials of another state or organization.

Question 28

According to the Family Educational Rights and Privacy Act (FERPA) of 1974 (also known as the Buckley Amendment) ## Footnote **HINT:** Multiple answers

Answer 28

1) a parent can see his or her daughter's middle school record. 2) an 18-year-old college student can view his or her own educational record.

Question 29

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…?

Answer 29

CRC (certified rehabilitation counselor)

Question 30

A registry would be a…? ## Footnote **HINT:** Multiple answers

Answer 30

1) list of licensed psychologists in the state of Illinois. 2) a list of CRCs in the United States. ## Footnote **HINT:** A registry is ***always*** a list of providers

Question 31

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

Answer 31

abandonment

Question 32

You are counseling your first cousin for depression. This is what?

Answer 32

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

Question 33

A counselor who sports NCC after her name will…?

Answer 33

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

Question 34

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

Answer 34

countertransference.

Question 35

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

Answer 35

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

Question 36

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

Answer 36

you are sexually involved with a client.

Question 37

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 what?

Answer 37

CMC (computer-managed counseling) ## Footnote **HINT:** **CMC tasks include:** bookkeeping client scheduling printing billing statements compiling referral sources.

Question 38

A college student who suffers from panic disorder types his symptoms and concerns onto a PC screen and then waits for the computer program to respond or question him further. The student engages in this practice for a 40-minute session per week. This is an example of…?

Answer 38

CAC (computer assisted counseling) ## Footnote **HINT:** CAC is like having a counseling "assistant" do the counseling for you. A computer software program that attempts to counsel clients is an example of CAC in action. CAC is controversial and most experts agree computers can never provide the compassion of a human doing counseling

Question 39

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

Answer 39

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

Question 40

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

Answer 40

CMC has been well received since it cuts down time on paperwork, scheduling, and record keeping, but there is a mixed reaction to CAC as some feel it depersonalizes counseling.

Question 41

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. What is true in this case?

Answer 41

It would be unethical to supervise him.

Question 42

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

Answer 42

APA style

Question 43

A 14-year-old male threatens to blow up his parents garage because he has been grounded. You believe his threat is genuine. You should do what in this case?

Answer 43

warn the parents that their property is in danger

Question 44

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…?

Answer 44

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

Question 45

NBCC has developed a code of ethics to help counselors behave in a professional manner. The Code warns against stereotyping and discrimination. All of the following would be examples of stereotyping and discrimination except…?

Answer 45

Advising a client to consider switching his college major based on your clinical judgment as well as the results from an extensive test battery.

Question 45

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

Answer 45

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

Question 46

You are a well-known cognitive behavior therapist who heads up a private practice in New Jersey. For the next two years you will be in Canada conducting a research project. Your practice has six other counselors. The practice is sending brochures to schools, agencies, and hospitals in an attempt to boost referrals. Your name appears on the front of the brochure as if you are available for referrals. With regards to ethics, this is…?

Answer 46

unethical ## Footnote **HINT:** Ethics ***DO*** address private practice and suggests that persons who hold leadership roles ***NOT*** allow their names to be used in professional notices when they are not practicing counseling (unless clearly stated in the practice's literature)

Question 47

A colleague of yours who is not a certified counselor behaves in an unethical manner. The ethical thing for you to do is…?

Answer 47

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

Question 47

A client asks you (and you have NCC status) for classical psychoanalysis yet you have no training whatsoever in this area. With regards to ethics, if you agree to analyze the client, you are…?

Answer 47

unethical as this is misrepresentation.

Question 48

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. With regards to ethics/ethical practice, what is true of this case?

Answer 48

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

Question 49

Dr. X recommends to his clients at the agency where he practices that he would rather counsel them in his private practice. Ethically speaking, what is true in this case?

Answer 49

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

Question 49

You wish to use an experimental treatment strategy. According to NBCC, what is true?

Answer 49

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

Question 50

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 known as…?

Answer 50

known as bartering and unethical as described here. ## Footnote **HINT:** Bartering = occurs when a client exchanges goods/services for treatment or testing Currently, *ethics allows this practice* **IF** 1) the client requests it 2) a written contract is drafted 3) does not result in any harm 4) the relationship is exploitative

Question 51

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

Answer 51

Screen

Question 52

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…?

Answer 52

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

Question 53

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

Answer 53

inform the client of this before the counseling begins.

Question 54

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…?

Answer 54

submit the article to one publication at a time despite your conviction that the article must get published. ## Footnote **HINT:** NBCC code states counselors should submit manuscripts for consideration to ONE journal at a time * multiple submission is ***unethical*** in relation to journal articles

Question 55

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

Answer 55

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. ## Footnote **HINT:** A consulting relaitonship encourages growth and self-direction for the consultee

Question 56

NBCC's Code of lEthics describes ethical issues related to private practice. Which of these situations is clearly an ethics violation?

Answer 56

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. ## Footnote **HINT:** Counselor who are in executive leadership roles should ***NOT*** allow their names to be used in professional notices at times when they are not performing counseling

Question 57

Nosology refers to a system of classification. What is the name of the nosological system(s) utilized by professional counselors who diagnose clients? ## Footnote **HINT:** Multiple answers

Answer 57

DSM ICD

Question 58

The Diagnostic and Statistical Manual of Mental Disorders (DSM) was created by the American Psychiatric Association (APA). The Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD) was created by the World Health Organization (WHO). Which counselor would most likely be required to utilize one of these guides to diagnose a client?

Answer 58

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

Question 59

Traditionally, ___?___ counseling has caused the most ethical concerns

Answer 59

behavioral ## Footnote **HINT:** The concern is that behavior therapists can control, manipulate, and shape the behavior

Question 60

Insurance payments are also called…?

Answer 60

third-party payments.

Question 61

The DSM-5 no longer uses a multiaxial classification system or GAF scale. Diagnostic codes have ___?___ (number) digits.

Answer 61

Four (4) to five (5)

Question 62

Identify an example of a DSM code.

Answer 62

296.99

Question 63

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

Answer 63

that this could be correct since two diagnoses can share a single code. ## Footnote **HINT:** A single code can represent multiple conditions, so one must list the name of the condition in the client's chart/medical record

Question 64

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 do what?

Answer 64

just keep it confidential. ## Footnote **HINT:** In this case, Tarasoff duty to warn or protect is ***NOT*** applicable since there is no reason to believe the client is going to harm themself or anybody else in the future

Question 65

All of the conditions below are V code diagnoses except…?

Answer 65

Post-traumatic stress disorder. ## Footnote **HINT:** V codes essentially are what the average person might consider day-to-day probelms rather than a psychiatric or psychological difficulty

Question 66

Formal diagnosis, also known as nosology, is most closely related to the ___?___ model

Answer 66

Medical

Question 67

Which treatment match-up is incorrect?

Answer 67

Narcan for schizophrenia. ## Footnote **HINT:** Narcan/naxolone blocks the effects of opiods such as heroin and painkillers (morphine, cocaine, oxycodone) * it impacts the same portions of the brain as opiods, and can stop/reverse overdoses to save lives

Question 68

The type of menta health service provided to the client is coded ___?___ and is generally required for insurance payments.

Answer 68

the AMA's Current Procedural Terminology (e.g., CPT 90844) ## Footnote **HINT:** A CPT code and ICD code needs to be specified in a billing statement in order for insurance to accept payments ***CPT (Current Procedural Terminology):*** Codes used to describe medical procedures and services performed by healthcare providers. ***ICD (International Classification of Diseases):*** Codes used to describe diagnoses and medical conditions.

Question 69

You refer a client to Dr. Smith. Ethically, what can or cannot Dr. Smith do?

Answer 69

may not pay you a referral fee for sending her the client. ## Footnote **HINT:** Counselor CANNOT ethically accept referral fees

Question 70

You have written a very popular book on reality therapy. Now you are teaching a graduate course on counseling at a local university. Ethically, what is true?

Answer 70

royalties you receive must be donated to the institution; you may use the book as a textbook in your class.

Question 71

An elementary school counselor is giving a child a standardica test. On several occasions the child says he does not understand what the counselor has said. The counselor should do what?

Answer 71

repeat the question, but talk more slowly.

Question 71

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

Answer 71

Caplan ## Footnote **HINT:** ***Client centered consultation =*** ultimate goal to help a client ***Consultee centered case consultation =*** when your supervisor explains a better way for you to implement a hypnotic induction with one of your clients ***Consultee centered administrative consultation =*** when you supervisor or consultant's intention is to sharpen up your administrative skills ***Program centered administrative consultation =*** creating, designing, or evaluating the program in question

Question 71

The doctor-patient consultation model relies on four distinct stages: entry, diagnosis, implementation, and evaluation. In order for the doctor-patient structure to work, the consultee (i.e., the person receiving the consultation) must accurately depict symptomatology, trust the consultant's diagnosis, and carry out the consultant's directives. This model is associated most closely with the work of who?

Answer 71

Schein

Question 72

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

Answer 72

Confidentiality and dual relationships

Question 73

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 do what?

Answer 73

counsel the client. ## Footnote **HINT:** always treat the client in the same manner you would treat any other client

Question 74

You are treating a man who suffers from panic disorder. His panic attacks are so severe he cannot drive to work. After just three sessions he is not only driving to work but has taken up sky diving to demonstrate his progress over his fear. You would love to put his testimonial on your brochure to show how adept you are at treating this affliction. You should do what in this case?

Answer 74

not ask him for a testimonial since it would constitute an ethics violation. ## Footnote **HINT**: the counselor should NOT solicit/retrieve testimonials from clients

Question 75

Ethical dilemmas Talley have clear cut answers. This, when a complex ethical situation manifests itself, it is best to consult…?

Answer 75

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. ## Footnote **HINT:** Legal standards/cases regarding malpractice suits are often decided by the behavior of your fellow professionals

Question 76

You have attempted to help a client for over two years with little or no success. You should do what?

Answer 76

terminate the relationship and initiate an appropriate referral. ## Footnote **HINT:** Ethics guidelines suggests that when a counselor feels they are unable to help a potential or existing client, then ***the relationship should not be initiated*** or the ***exisiting one should be terminated***

Question 77

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

Answer 77

you are not obligated to continue the relationship.

Question 78

Counseling is a relatively new profession. The first counselors in the United States were not called counselors. They were called what?

Answer 78

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

Question 79

Historically speaking, the first psychology laboratory was set up by who?

Answer 79

Wilhelm Wundt, in 1879 in Leipzig, Germany. ## Footnote **HINT:** Wundt was convinced that psychology could be accepted as a science consciousness could be measured Wundt's school of thought is termed "structuralism" due to his interest in strucutre of consciousness

Question 80

Counseling became popular after the 1931 publication of what book?

Answer 80

Workbook in Vocations by William Proctor, Glidden Ross Benefield, and Gilbert Wrenn. ## Footnote **HINT:** Groups remained popular in the 1970's

Question 81

PL, 94-142 (the Education for All Handicapped Children Act) states that…? ## Footnote **HINT:** Multiple answers

Answer 81

1) all children between ages 5 and 21 are assured free education. 2) handicapped persons are placed in the least-restrictive environment (LRE). 3) an Individualized Education Plan (IEP) is developed for each child ## Footnote **HINT:** This set the stage for the popularization of the word "counseling" ; prior to 1931, the word "guidance" was used for educational and vocational guidance

Question 81

The major trend that impacted upon the counseling movement in the 1980s…?

Answer 81

included an emphasis on professionalism, certification, and licensing.

Question 82

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

Answer 82

the APA did not wish to credential master's level counselors or psychologists.

Question 83

The 1950s was the age of tremendous strides in what?

Answer 83

developmental psychology

Question 84

The ___?___ movement began in the late 1960s.

Answer 84

Group

Question 85

In the 1960s C. Gilbert Wrenn's book, The Counselor in a Changing World, urged counselors to

Answer 85

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

Question 86

One of the primary problems of counseling in the early 1960s was that it wrongly emphasized…?

Answer 86

intrapsychic processes. ## Footnote **HINT:** Intrapsychic processes = processes within one's mind or psyche

Question 87

The significance of the 1958 National Defense Education Act was that it…? ## Footnote **HINT:** Multiple answers

Answer 87

1) provided financial aid for graduate education in counseling. 2) expanded school guidance services. 3) improved guidance for gifted children. ## Footnote **HINT:** This act helped all types of young people secure better counseling and guidance services

Question 88

A man has a rare, highly contagious disease that is fatal. He is keeping it a secret and insists that he will never tell his wife. You should do what in this scenario?

Answer 88

break confidentiality and tell his wite.