ACT Patient Safety & Risk Management 3 — Questions and Answers
Question 1: A client with a history of domestic violence discloses that their partner has threatened them. What is the therapist's primary obligation?
- Maintain confidentiality and continue therapy as planned
- Assess immediate safety, assist with safety planning, and provide crisis resources (Correct answer)
- Report the partner to law enforcement immediately without client input
- Transfer the client to a domestic violence specialist immediately
Correct answer: Assess immediate safety, assist with safety planning, and provide crisis resources
The therapist must assess the client's immediate safety, collaboratively develop a safety plan, and provide appropriate crisis resources while respecting client autonomy.
Question 2: In ACT, how is 'committed action' related to risk management for clients with chronic suicidality?
- Committed action replaces the need for safety planning
- Committed action toward valued living provides a reason-to-live framework that supports safety (Correct answer)
- Committed action is postponed until suicidal ideation resolves
- Committed action focuses solely on eliminating suicidal thoughts
Correct answer: Committed action toward valued living provides a reason-to-live framework that supports safety
Building committed action toward a values-driven life creates intrinsic reasons for living that complement formal safety planning in ACT.
Question 3: What ethical principle is most directly implicated when an ACT therapist decides to consult a colleague about a high-risk client?
- Justice
- Beneficence and nonmaleficence (Correct answer)
- Fidelity
- Autonomy
Correct answer: Beneficence and nonmaleficence
Seeking consultation to ensure the best and safest care reflects the ethical principles of beneficence (doing good) and nonmaleficence (avoiding harm).
Question 4: A client discloses child abuse that occurred 20 years ago with no current children involved. What is the therapist's reporting obligation?
- Mandatory report is required regardless of when the abuse occurred
- No mandatory report is required if there is no current child at risk (Correct answer)
- Report only if the perpetrator is still alive
- Report only with the client's written consent
Correct answer: No mandatory report is required if there is no current child at risk
Mandatory reporting laws are triggered by current risk to children; historical abuse with no ongoing risk or current child victims typically does not require a report.
Question 5: Which ACT process is most directly associated with reducing experiential avoidance that might otherwise escalate self-harm risk?
- Cognitive restructuring
- Acceptance (Correct answer)
- Behavioral activation
- Exposure hierarchy
Correct answer: Acceptance
Acceptance in ACT involves willingness to experience difficult emotions without avoidance, which reduces the need to escape internal distress through self-harm.
Question 6: What is the recommended approach when an ACT therapist has reason to believe a client is not honest about their level of suicidal risk?
- Accept what the client reports and continue with ACT protocols
- Increase assessment rigor, consult a colleague, and consider collateral information (Correct answer)
- Terminate the therapeutic relationship due to dishonesty
- Immediately hospitalize the client as a precaution
Correct answer: Increase assessment rigor, consult a colleague, and consider collateral information
When deception about suicidal risk is suspected, clinicians should use structured assessment tools, seek consultation, and gather collateral information to inform their clinical decision.
Question 7: Under HIPAA, which situation permits a therapist to share protected health information with a client's family member without consent?
- When the family member requests the information
- When the client poses an imminent danger and disclosure may prevent harm (Correct answer)
- When the therapist believes it would benefit the client's treatment
- When the client has missed multiple sessions
Correct answer: When the client poses an imminent danger and disclosure may prevent harm
HIPAA permits disclosure without consent to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
ACT Patient Safety & Risk Management 3
A client with a history of domestic violence discloses that their partner has threatened them.
What is the therapist's primary obligation?