CAADE Ethical & Legal Considerations in Substance Abuse Counseling 4 — Questions and Answers
Question 1: A client who is HIV-positive tells the counselor they are having unprotected sex without disclosing their status to partners. The counselor's ethical dilemma involves a conflict between:
- Confidentiality and the duty to protect identifiable third parties (Correct answer)
- Beneficence and non-maleficence toward the client alone
- The client's autonomy and the counselor's personal values
- Mandatory reporting laws and scope of practice limitations
Correct answer: Confidentiality and the duty to protect identifiable third parties
This scenario creates a classic ethical tension between the client's right to confidentiality and the potential harm to identifiable third parties who may be at risk.
Question 2: Which of the following best describes 'scope of practice' for a CAADE-certified counselor?
- The geographic region in which a counselor may legally operate
- The range of services a counselor is trained, educated, and credentialed to provide (Correct answer)
- The maximum caseload a counselor may carry under state regulations
- The types of substances a counselor may prescribe or recommend
Correct answer: The range of services a counselor is trained, educated, and credentialed to provide
Scope of practice defines the specific services and activities a professional is qualified to perform based on their training, education, and credential requirements.
Question 3: A counselor learns that a client is enrolled in two different substance abuse treatment programs simultaneously to obtain double prescriptions. The most appropriate action is:
- Discharge the client immediately for dishonesty
- Confront the client, explore the behavior clinically, and consult with the supervisor (Correct answer)
- Report the behavior to law enforcement as prescription fraud
- Ignore it because the other program is not the counselor's responsibility
Correct answer: Confront the client, explore the behavior clinically, and consult with the supervisor
The ethical response is to address the behavior therapeutically with the client, explore underlying motivations, and consult a supervisor to determine if further action is warranted.
Question 4: When a recovering counselor who is in their own recovery experience a relapse, they are ethically obligated to:
- Disclose the relapse to all current clients to model honesty
- Continue working and address the relapse privately without informing anyone
- Consult with a supervisor and determine if their ability to practice safely is impaired (Correct answer)
- Voluntarily surrender their certification pending a 90-day sobriety period
Correct answer: Consult with a supervisor and determine if their ability to practice safely is impaired
A counselor's relapse requires immediate self-assessment of impairment and supervisor consultation, as practicing while impaired poses risks to client welfare.
Question 5: Which of the following is an example of appropriate self-disclosure by a substance abuse counselor?
- Sharing detailed personal stories of addiction to build rapport with every client
- Briefly disclosing recovery experience when it may therapeutically benefit a specific client (Correct answer)
- Regularly discussing current personal stressors to model vulnerability
- Telling clients about other clients' recovery stories to inspire hope
Correct answer: Briefly disclosing recovery experience when it may therapeutically benefit a specific client
Ethical self-disclosure is selective, purposeful, and client-focused—used only when it serves the client's therapeutic needs, not the counselor's personal expression.
Question 6: Documentation in substance abuse counseling serves which primary ethical and legal purpose?
- Providing evidence of the counselor's professional credentials
- Creating a record of services that protects the client and demonstrates standard of care (Correct answer)
- Satisfying insurance billing requirements above all other concerns
- Tracking the client's progress for marketing and program evaluation only
Correct answer: Creating a record of services that protects the client and demonstrates standard of care
Documentation creates a contemporaneous record that protects client rights, demonstrates that standard of care was met, and supports continuity of treatment.
Question 7: A counselor suspects they may have made a clinical error that harmed a client. The ethical course of action is to:
- Document the situation favorably to avoid liability
- Consult with a supervisor, acknowledge the error, and take corrective action (Correct answer)
- Transfer the client to another counselor without explanation
- Wait to see if the client notices before taking any action
Correct answer: Consult with a supervisor, acknowledge the error, and take corrective action
Ethical practice requires transparency about errors, supervisor consultation, and remedial action to protect the client and uphold professional accountability.
CAADE Ethical & Legal Considerations in Substance Abuse Counseling 4
A client who is HIV-positive tells the counselor they are having unprotected sex without disclosing their status to partners.
The counselor's ethical dilemma involves a conflict between: