CAADC Professional Ethics and Confidentiality 5 — Questions and Answers
Question 1: Which of the following best describes a 'dual relationship' that is generally considered ethically permissible in addiction counseling?
- Treating a personal friend for their substance use disorder
- Serving as both individual and group counselor for the same client within a program (Correct answer)
- Employing a former client at the counselor's private practice
- Entering a business partnership with a current client
Correct answer: Serving as both individual and group counselor for the same client within a program
Serving as both individual and group counselor within the same program may be unavoidable and can be managed ethically with proper boundaries.
Question 2: A counselor working in a faith-based treatment program has strong religious beliefs that conflict with a client's lifestyle choices. Ethically, the counselor should:
- Refer the client to another counselor who shares the client's values
- Impose the program's religious values to guide the client's recovery
- Provide competent, non-judgmental counseling while managing personal biases (Correct answer)
- Disclose personal beliefs to the client so they can make an informed choice
Correct answer: Provide competent, non-judgmental counseling while managing personal biases
Counselors must set aside personal biases and provide ethical, client-centered care regardless of personal or religious beliefs.
Question 3: Under HIPAA, which of the following entities is primarily regulated?
- All substance use disorder treatment programs
- Covered entities such as health plans and healthcare clearinghouses (Correct answer)
- Any organization that handles any health information
- Only federally funded treatment programs
Correct answer: Covered entities such as health plans and healthcare clearinghouses
HIPAA applies to covered entities—health plans, healthcare clearinghouses, and healthcare providers who transmit health information electronically.
Question 4: A counselor learns during a session that a client is currently driving while intoxicated daily but has not threatened to harm anyone specifically. The counselor's ethical obligation is BEST described as:
- Immediate disclosure to police without client consent
- Making a mandatory report to the DMV in all US states
- Addressing the behavior therapeutically and assessing for duty-to-warn requirements by jurisdiction (Correct answer)
- Maintaining complete confidentiality since no specific victim is identified
Correct answer: Addressing the behavior therapeutically and assessing for duty-to-warn requirements by jurisdiction
Without a specific identifiable victim, duty-to-warn may not be triggered, but the counselor must address the behavior clinically and follow state-specific legal requirements.
Question 5: Informed consent in addiction counseling must include which of the following elements?
- A guarantee of treatment success
- Explanation of confidentiality limits, treatment goals, and client rights (Correct answer)
- Agreement that the client will not sue the counselor
- Confirmation that the client accepts all agency policies without exception
Correct answer: Explanation of confidentiality limits, treatment goals, and client rights
Informed consent requires disclosing confidentiality limits, treatment procedures, risks and benefits, client rights, and alternatives.
Question 6: A former client contacts the counselor three years after treatment to request a social relationship. According to most ethical codes in addiction counseling, the counselor should:
- Freely engage since sufficient time has passed
- Engage if the client's recovery appears stable
- Exercise extreme caution and consider the potential for exploitation, often avoiding the relationship (Correct answer)
- Consult the ethics board only if the client requests a sexual relationship
Correct answer: Exercise extreme caution and consider the potential for exploitation, often avoiding the relationship
Most ethical codes require ongoing caution with former clients regardless of time elapsed, as the power differential from the therapeutic relationship may persist.
Question 7: What is the primary purpose of mandatory supervision requirements for CAACDs?
- To reduce the counselor's workload
- To ensure accountability, professional growth, and client protection (Correct answer)
- To monitor the counselor's personal recovery status
- To satisfy insurance billing requirements
Correct answer: To ensure accountability, professional growth, and client protection
Clinical supervision serves to protect clients, enhance counselor competence, and maintain ethical and professional standards.
CAADC Professional Ethics and Confidentiality 5
Which of the following best describes a 'dual relationship' that is generally considered ethically permissible in addiction counseling?