BHP Ethical & Legal Standards in Behavioral Health 3 — Questions and Answers
Question 1: The ethical principle of 'nonmaleficence' in behavioral health practice means:
- Providing the maximum possible benefit to the client
- Treating all clients with equal respect regardless of background
- Avoiding actions that cause harm or risk harm to clients (Correct answer)
- Respecting the client's right to make autonomous decisions
Correct answer: Avoiding actions that cause harm or risk harm to clients
Nonmaleficence means 'do no harm' — the obligation to refrain from actions that inflict unnecessary injury or risk to clients.
Question 2: A BHP learns that a client made a specific threat to kill a named individual. Under the Tarasoff doctrine, the BHP's duty is to:
- Maintain confidentiality because the threat was made in session
- Warn the potential victim and/or law enforcement and take protective steps (Correct answer)
- Document the threat and reassess at the next session
- Transfer the client to a higher level of care without warning the victim
Correct answer: Warn the potential victim and/or law enforcement and take protective steps
The Tarasoff ruling established a 'duty to protect' third parties from credible, identifiable threats, requiring warning the potential victim and/or authorities.
Question 3: Which of the following situations requires mandatory reporting in all U.S. states?
- A client disclosing past substance abuse that is now in remission
- Reasonable suspicion of current child abuse or neglect (Correct answer)
- An adult client admitting to a petty theft years ago
- A client expressing passive suicidal ideation with no plan or intent
Correct answer: Reasonable suspicion of current child abuse or neglect
All 50 states mandate reporting of reasonable suspicion of child abuse or neglect; BHPs do not need proof to report.
Question 4: A client requests a copy of their clinical records. Under HIPAA, the covered entity must generally provide access:
- Only after the treating clinician reviews and approves the request
- Within 30 days of the request (extendable once by 30 days) (Correct answer)
- At the next scheduled appointment
- Only if the client can demonstrate a clinical need for the records
Correct answer: Within 30 days of the request (extendable once by 30 days)
HIPAA requires covered entities to provide clients access to their designated record set within 30 days, with one possible 30-day extension.
Question 5: A BHP supervisor discovers that a supervisee has been practicing outside their scope of competence. The supervisor's FIRST obligation is to:
- Immediately terminate the supervisee's employment
- Take corrective action to protect clients while addressing the supervisee's skill deficits (Correct answer)
- Report the supervisee to the licensing board before any other action
- Document the concern and address it at the next quarterly review
Correct answer: Take corrective action to protect clients while addressing the supervisee's skill deficits
Supervisors have an ethical and legal responsibility to protect clients first, then address the supervisee's competency gaps through training, closer oversight, or reassignment.
Question 6: Which scenario BEST illustrates the ethical concept of 'fidelity' in behavioral health practice?
- A clinician maintains accurate billing records for all services
- A clinician follows through on commitments and keeps promises made to clients (Correct answer)
- A clinician ensures equal access to services for all eligible populations
- A clinician refrains from sharing client information with unauthorized parties
Correct answer: A clinician follows through on commitments and keeps promises made to clients
Fidelity refers to faithfulness and trustworthiness — honoring commitments, keeping promises, and being reliable in the therapeutic relationship.
Question 7: A BHP working in a community mental health center is asked by their agency director to submit documentation that inflates session duration for reimbursement. The BHP should:
- Comply because agency directives take precedence over personal ethics
- Refuse and document the directive, reporting it through appropriate channels (Correct answer)
- Comply only if it is a one-time request from the director
- Ask the client to sign a retroactive consent form covering the discrepancy
Correct answer: Refuse and document the directive, reporting it through appropriate channels
Falsifying documentation for billing purposes is fraud; the BHP must refuse, document the directive, and report it to a compliance officer, licensing board, or law enforcement if necessary.
BHP Ethical & Legal Standards in Behavioral Health 3
The ethical principle of 'nonmaleficence' in behavioral health practice means: