ASPD Ethical Standards and Practice 2 — Questions and Answers
Question 1: A therapist treating a client with ASPD notices the client is manipulating session content to avoid discussing criminal behavior. The most ethical response is to:
- Terminate therapy immediately
- Confront the manipulation directly and set clear therapeutic boundaries (Correct answer)
- Report the client to law enforcement
- Ignore it to preserve the therapeutic alliance
Correct answer: Confront the manipulation directly and set clear therapeutic boundaries
Directly addressing manipulation while maintaining boundaries is both clinically and ethically appropriate in ASPD treatment.
Question 2: Which ethical principle is most challenged when a client with ASPD discloses past crimes that have no current victims and are beyond the statute of limitations?
- Justice
- Confidentiality vs. duty to warn (Correct answer)
- Beneficence
- Nonmaleficence
Correct answer: Confidentiality vs. duty to warn
Past crimes with no ongoing victims generally do not trigger mandatory reporting, placing confidentiality in tension with the clinician's values.
Question 3: An individual with ASPD being evaluated for a child custody case presents charming, prosocial behavior. Ethically, the evaluator should:
- Accept the presentation at face value
- Use collateral sources and standardized measures to corroborate self-report (Correct answer)
- Refuse to evaluate individuals with ASPD
- Recommend against custody without further assessment
Correct answer: Use collateral sources and standardized measures to corroborate self-report
Collateral data and objective measures are essential when assessing someone with a pattern of deception.
Question 4: Informed consent for treatment of ASPD should include disclosure that:
- The therapist will report all session content to insurers
- Treatment may have limited effectiveness and involves active confrontation of harmful patterns (Correct answer)
- All criminal history will be reported to authorities
- Progress guarantees are part of the contract
Correct answer: Treatment may have limited effectiveness and involves active confrontation of harmful patterns
Clients deserve honest information about the challenges and nature of ASPD treatment as part of valid informed consent.
Question 5: A forensic psychologist asked to testify about a defendant's ASPD diagnosis is ethically obligated to:
- Advocate for the defense position
- Provide an objective, impartial opinion based on the data (Correct answer)
- Withhold diagnoses that could harm the defendant
- Refuse to testify in criminal cases
Correct answer: Provide an objective, impartial opinion based on the data
Forensic evaluators serve the court and must remain neutral rather than functioning as advocates.
Question 6: When a client with ASPD attempts to form a personal friendship outside sessions, the ethical concern is primarily:
- Cultural insensitivity
- Dual relationship and boundary violation (Correct answer)
- Lack of empathy on the therapist's part
- Violation of confidentiality
Correct answer: Dual relationship and boundary violation
Dual relationships compromise professional objectivity and are an ethical violation regardless of the client's diagnosis.
Question 7: A clinician realizes their personal anger toward a client with ASPD is affecting treatment. The ethical obligation is to:
- Discharge the client immediately
- Seek supervision or personal consultation to address countertransference (Correct answer)
- Conceal the reaction to appear professional
- Increase session frequency to work through it
Correct answer: Seek supervision or personal consultation to address countertransference
Ethical practice requires clinicians to monitor and manage countertransference through supervision to protect client welfare.
ASPD Ethical Standards and Practice 2
A therapist treating a client with ASPD notices the client is manipulating session content to avoid discussing criminal behavior.
The most ethical response is to: