ACT Ethical & Professional Considerations 3 — Questions and Answers
Question 1: A therapist conducting ACT via telehealth discovers that a client in crisis is located in a state where the therapist is not licensed. The most appropriate immediate action is to:
- Continue providing support since the therapeutic relationship takes precedence over licensure
- Immediately terminate the call and instruct the client to call 911
- Manage the immediate safety need while concurrently clarifying jurisdiction and licensure obligations (Correct answer)
- Document the interstate situation and defer regulatory concerns until after the crisis
Correct answer: Manage the immediate safety need while concurrently clarifying jurisdiction and licensure obligations
Ethical duty to protect overrides procedural concerns in a crisis, but the therapist must simultaneously address licensure and jurisdictional requirements as soon as safely possible.
Question 2: In ACT-informed supervision, a supervisor notices a supervisee is consistently avoiding difficult experiential exercises in session. Ethically, the supervisor should:
- Report the supervisee to the licensing board for incompetent practice
- Explore the supervisee's experiential avoidance as a parallel process and use it as a learning opportunity (Correct answer)
- Reassign the supervisee's clients to more experienced therapists immediately
- Require the supervisee to complete a refresher course before seeing clients again
Correct answer: Explore the supervisee's experiential avoidance as a parallel process and use it as a learning opportunity
ACT supervision uses parallel process to help supervisees identify and address their own experiential avoidance, which mirrors what clients may experience.
Question 3: A client using ACT for anxiety management asks their therapist to testify that they are 'cured' in a legal disability proceeding. The therapist should:
- Provide testimony consistent with the client's request to uphold the therapeutic alliance
- Decline to testify unless subpoenaed, then provide only factual clinical information
- Offer an honest clinical opinion regardless of how it affects the client's legal case (Correct answer)
- Withdraw from treatment to avoid any involvement with legal proceedings
Correct answer: Offer an honest clinical opinion regardless of how it affects the client's legal case
Therapist integrity requires providing honest clinical testimony; misrepresenting a client's status to aid their legal case constitutes professional misconduct.
Question 4: Which documentation practice best supports both ethical accountability and ACT treatment fidelity?
- Recording session transcripts verbatim to capture all therapeutic dialogue
- Noting functional outcomes, values-aligned goals, and client progress on ACT processes such as defusion and acceptance (Correct answer)
- Limiting notes to DSM diagnoses and medication compliance to protect client privacy
- Using a single template note for all clients to ensure consistency
Correct answer: Noting functional outcomes, values-aligned goals, and client progress on ACT processes such as defusion and acceptance
ACT-consistent documentation focuses on functional outcomes and specific ACT processes rather than symptom checklists, fulfilling both clinical and ethical standards.
Question 5: A client discloses that they have been physically abusing their elderly parent who lives with them. The therapist's mandatory reporting obligations in most U.S. states require:
- Reporting only if the elder has formally requested protection
- Reporting to adult protective services, as elder abuse is a mandated reporting category in most states (Correct answer)
- Keeping the information confidential to preserve the therapeutic relationship
- Waiting to report until the abuse is independently verified by a third party
Correct answer: Reporting to adult protective services, as elder abuse is a mandated reporting category in most states
Most U.S. states mandate reporting suspected elder abuse to adult protective services regardless of the client's consent or verification by a third party.
Question 6: An ACT therapist is approached by a pharmaceutical company offering a significant honorarium to present ACT research at a conference they sponsor. The primary ethical concern is:
- Scope of practice, as presenting research may be outside clinical competence
- Conflict of interest, which could bias the presentation or compromise professional integrity (Correct answer)
- Dual relationship, since the company may also employ clients
- Informed consent, because conference attendees have not agreed to hear commercial content
Correct answer: Conflict of interest, which could bias the presentation or compromise professional integrity
Financial relationships with commercial entities create conflicts of interest that can compromise objectivity and professional integrity.
Question 7: When a therapist uses ACT's 'self-as-context' concepts in session, which ethical principle most directly supports this intervention?
- Non-maleficence, by removing harmful thought patterns
- Autonomy, by fostering the client's perspective-taking capacity and self-direction (Correct answer)
- Justice, by equalizing the power differential between therapist and client
- Fidelity, by adhering to the ACT protocol as developed by Hayes et al.
Correct answer: Autonomy, by fostering the client's perspective-taking capacity and self-direction
Self-as-context work supports client autonomy by strengthening their capacity for flexible perspective-taking and self-directed living.
ACT Ethical & Professional Considerations 3
A therapist conducting ACT via telehealth discovers that a client in crisis is located in a state where the therapist is not licensed.
The most appropriate immediate action is to: