ACT Ethical & Professional Considerations 2 — Questions and Answers
Question 1: An ACT therapist notices they are experiencing strong personal distress when a client discusses a topic closely related to the therapist's own unresolved trauma. What is the most ethically appropriate immediate response?
- Disclose the personal connection to build rapport and normalize the client's experience
- Redirect the session topic to avoid further distress for both parties
- Engage in self-care and seek supervision or personal therapy to address the impairment (Correct answer)
- Continue the session while using ACT defusion techniques on their own distress privately
Correct answer: Engage in self-care and seek supervision or personal therapy to address the impairment
Ethical standards require therapists to recognize and address personal impairment that could harm clients, typically through supervision or personal therapy.
Question 2: A client in ACT therapy requests a copy of their session notes to share with a life coach. Under HIPAA and ethical guidelines, the therapist should:
- Decline because notes are the therapist's personal work product and cannot be shared
- Provide a summary rather than raw notes to protect clinical interpretations
- Honor the request with a signed release, providing records within the legally required timeframe (Correct answer)
- Share only the treatment plan but withhold progress notes
Correct answer: Honor the request with a signed release, providing records within the legally required timeframe
Clients have a legal right to their records under HIPAA; a signed authorization allows disclosure to third parties within mandated timeframes.
Question 3: In ACT, the principle of 'psychological flexibility' as a treatment goal most aligns with which ethical obligation?
- Beneficence, by promoting the client's well-being and functional living (Correct answer)
- Non-maleficence, by preventing symptom relapse
- Justice, by ensuring equal access to evidence-based treatments
- Fidelity, by maintaining the therapeutic relationship over time
Correct answer: Beneficence, by promoting the client's well-being and functional living
Beneficence involves actively promoting client welfare, which aligns with ACT's goal of increasing psychological flexibility to improve quality of life.
Question 4: A licensed ACT therapist is asked by a former client (therapy ended 18 months ago) to write a character reference letter for a custody hearing. What is the most appropriate action?
- Agree, since the therapeutic relationship has ended and there is no dual-role conflict
- Decline and offer to provide a clinical summary instead
- Carefully evaluate potential dual-role risks, consult guidelines, and decide based on client welfare (Correct answer)
- Agree only if the client signs a liability waiver
Correct answer: Carefully evaluate potential dual-role risks, consult guidelines, and decide based on client welfare
Post-termination requests require careful evaluation of dual-role conflicts and client welfare; ethical codes do not impose an automatic ban but require thoughtful analysis.
Question 5: Which scenario best illustrates a boundary crossing rather than a boundary violation in ACT therapy?
- A therapist engages in a sexual relationship with a current client
- A therapist accepts a small handmade gift from a client at the end of treatment after culturally sensitive consideration (Correct answer)
- A therapist borrows money from a client to cover a personal expense
- A therapist shares confidential client information at a social gathering
Correct answer: A therapist accepts a small handmade gift from a client at the end of treatment after culturally sensitive consideration
A boundary crossing is a departure from standard practice that may be clinically appropriate in context, whereas a violation causes harm or exploits the client.
Question 6: An ACT-trained consultant working within a correctional facility is asked by administration to provide therapy progress reports to determine inmate housing assignments. This situation primarily raises concerns about:
- Scope of practice, since correctional consulting is outside ACT's competence
- Confidentiality and dual loyalty, as the therapist serves both the institution and the client (Correct answer)
- Informed consent, because clients were not told about treatment approaches
- Cultural competence, as correctional populations are diverse
Correct answer: Confidentiality and dual loyalty, as the therapist serves both the institution and the client
Dual loyalty conflicts arise when a therapist must serve institutional interests (housing decisions) that may conflict with client confidentiality and welfare.
Question 7: When adapting ACT interventions for a client from a collectivist cultural background who prioritizes family harmony over individual values clarification, the ethically and clinically sound approach is to:
- Adhere strictly to standard ACT protocol to maintain treatment fidelity
- Encourage the client to adopt individualist values as part of psychological flexibility
- Adapt values work to encompass relational and collective values meaningful to the client (Correct answer)
- Refer the client to a therapist from the same cultural background
Correct answer: Adapt values work to encompass relational and collective values meaningful to the client
Cultural competence requires adapting evidence-based treatments to honor clients' cultural values rather than imposing Western-centric assumptions.
ACT Ethical & Professional Considerations 2
An ACT therapist notices they are experiencing strong personal distress when a client discusses a topic closely related to the therapist's own unresolved trauma.
What is the most ethically appropriate immediate response?