ACT Ethics & Professional Standards 2 — Questions and Answers
Question 1: An ACT practitioner is working with a client who has begun dating someone the therapist knows socially. Which ethical principle is most at risk?
- Fidelity
- Autonomy
- Nonmaleficence
- Boundary management (Correct answer)
Correct answer: Boundary management
Multiple relationships that could impair judgment or harm the client represent a boundary management violation under professional ethics codes.
Question 2: When a supervisee discloses they are experiencing psychological fusion with a client's narrative, the supervisor's ethical obligation is to:
- Terminate the supervisory relationship immediately
- Use ACT processes to help the supervisee develop defusion skills (Correct answer)
- Report the supervisee to the licensing board
- Reassign the client without explanation
Correct answer: Use ACT processes to help the supervisee develop defusion skills
Supervision in ACT contexts involves modeling the same psychological flexibility processes to help supervisees work through countertransference fusion.
Question 3: A client's insurance company requests a detailed session-by-session progress report. The therapist's ethical duty is to:
- Provide all requested information without client consultation
- Refuse entirely to protect confidentiality
- Consult the client and release only information necessary for treatment authorization (Correct answer)
- Terminate insurance billing to avoid the issue
Correct answer: Consult the client and release only information necessary for treatment authorization
Therapists must obtain client awareness and release only the minimum necessary information required by third-party payers.
Question 4: In ACT, the ethical stance toward a client's religious values is best described as:
- Challenging values that conflict with evidence-based outcomes
- Treating religious beliefs as cognitive distortions to defuse
- Accepting values as the client's own and integrating them into values clarification work (Correct answer)
- Referring the client to a religiously-oriented therapist
Correct answer: Accepting values as the client's own and integrating them into values clarification work
ACT's values work is explicitly non-prescriptive; the therapist honors the client's chosen values including religious ones without imposing external standards.
Question 5: Which scenario best illustrates an ethical use of self-disclosure by an ACT therapist?
- Sharing detailed personal trauma history to build rapport
- Briefly disclosing a relevant struggle to normalize the client's experience (Correct answer)
- Describing how ACT helped cure the therapist's clinical depression
- Avoiding all self-disclosure to maintain strict professional distance
Correct answer: Briefly disclosing a relevant struggle to normalize the client's experience
Brief, purposeful self-disclosure that normalizes or models psychological flexibility is ethically appropriate; oversharing shifts focus away from the client.
Question 6: A client in crisis texts the ACT therapist at 2 a.m. stating suicidal ideation. The therapist's primary ethical obligation is to:
- Wait until the next scheduled session to avoid dependency
- Respond promptly and follow established safety protocol (Correct answer)
- Block the client's number to enforce boundaries
- Document the text and address it in supervision next week
Correct answer: Respond promptly and follow established safety protocol
Duty to protect requires prompt response to imminent risk, regardless of the communication channel or time of contact.
Question 7: Informed consent in ACT specifically should include disclosure of:
- The therapist's theoretical orientation and how ACT differs from CBT (Correct answer)
- The therapist's personal values that guide treatment
- All previous clients who have undergone ACT successfully
- Detailed neurobiological mechanisms of acceptance
Correct answer: The therapist's theoretical orientation and how ACT differs from CBT
Clients have a right to understand the therapeutic model being used, including how ACT differs from other approaches, so they can make an informed choice.
ACT Ethics & Professional Standards 2
An ACT practitioner is working with a client who has begun dating someone the therapist knows socially.
Which ethical principle is most at risk?