CAADE Ethical & Legal Considerations in Substance Abuse Counseling 2 — Questions and Answers
Question 1: A client discloses they are driving while intoxicated regularly but refuses to stop. Under California law, what is the counselor's primary ethical obligation?
- Immediately report the client to the DMV
- Explore the dangerous behavior thoroughly and document efforts to address it (Correct answer)
- Discharge the client for non-compliance
- Notify local law enforcement of the client's name and address
Correct answer: Explore the dangerous behavior thoroughly and document efforts to address it
Counselors must address dangerous behaviors clinically, document their efforts, and may consult supervisors, but mandatory reporting does not typically apply to drunk driving disclosures.
Question 2: Which California law specifically governs the confidentiality of substance abuse treatment records in state-licensed programs?
- HIPAA
- California Health and Safety Code Section 11845.5 (Correct answer)
- The Lanterman-Petris-Short Act
- California Evidence Code Section 1014
Correct answer: California Health and Safety Code Section 11845.5
California Health and Safety Code Section 11845.5 establishes strict confidentiality protections for records of substance abuse treatment in licensed programs.
Question 3: A counselor discovers that a colleague is romantically involved with a current client. The most appropriate first step is to:
- Confront the colleague directly and give them 24 hours to self-report
- Report the behavior to the supervisor or ethics committee immediately (Correct answer)
- Advise the client to file a complaint
- Document the observation privately and wait to see if it continues
Correct answer: Report the behavior to the supervisor or ethics committee immediately
Professional codes of ethics require counselors to report observed ethical violations to appropriate supervisory or ethics bodies rather than handling them informally.
Question 4: Informed consent in substance abuse counseling must include all of the following EXCEPT:
- The limits of confidentiality
- The counselor's treatment approach and methods
- A guarantee of successful recovery outcomes (Correct answer)
- The client's right to withdraw consent
Correct answer: A guarantee of successful recovery outcomes
Counselors cannot ethically guarantee treatment outcomes; informed consent covers rights, risks, and process but never promised results.
Question 5: Under 42 CFR Part 2, a substance abuse program may disclose client records without consent in which situation?
- When a family member requests information to help the client
- When the client is suspected of relapse
- When a court issues a valid order after following required procedures (Correct answer)
- When a managed care company requests records for billing review
Correct answer: When a court issues a valid order after following required procedures
42 CFR Part 2 permits disclosure without consent only when a court order is obtained through specific legal procedures, not for general billing or family requests.
Question 6: A client in recovery threatens to harm a specific coworker. The counselor's duty under the Tarasoff doctrine requires:
- Maintaining confidentiality because the threat was made in session
- Warning the identifiable potential victim and possibly notifying law enforcement (Correct answer)
- Hospitalizating the client immediately without discussion
- Consulting a supervisor and documenting the session without outside action
Correct answer: Warning the identifiable potential victim and possibly notifying law enforcement
The Tarasoff duty-to-warn requires counselors to take reasonable steps to protect identifiable third parties, which may include warning the potential victim and notifying law enforcement.
Question 7: Cultural competence in substance abuse counseling ethics primarily requires the counselor to:
- Treat all clients with identical intervention strategies regardless of background
- Recognize how culture influences substance use patterns and adapt services accordingly (Correct answer)
- Refer all clients from minority groups to counselors of the same background
- Avoid discussing cultural topics to prevent offending clients
Correct answer: Recognize how culture influences substance use patterns and adapt services accordingly
Ethical practice requires counselors to understand how cultural context shapes substance use and recovery, tailoring their approach to be culturally responsive.
CAADE Ethical & Legal Considerations in Substance Abuse Counseling 2
A client discloses they are driving while intoxicated regularly but refuses to stop.
Under California law, what is the counselor's primary ethical obligation?