CAADE Ethical & Legal Considerations in Substance Abuse Counseling 5 — Questions and Answers
Question 1: A court orders a client to undergo substance abuse treatment. The counselor's primary ethical obligation regarding informed consent in this situation is to:
- Skip the informed consent process since participation is court-mandated
- Inform the client of the voluntary elements of treatment and limits of confidentiality even within the court order (Correct answer)
- Report the client's non-compliance immediately to the court if any resistance is shown
- Obtain written consent from the referring court rather than from the client
Correct answer: Inform the client of the voluntary elements of treatment and limits of confidentiality even within the court order
Even court-ordered clients retain rights to information about treatment; counselors must still obtain informed consent and explain what information may be shared with the court.
Question 2: Under CAADE ethical standards, which situation most clearly constitutes a conflict of interest?
- A counselor treating two unrelated clients with the same diagnosis
- A counselor who owns financial interest in a referral facility and routinely refers clients there (Correct answer)
- A counselor providing services in two different licensed treatment programs
- A counselor who has previously worked in the criminal justice system
Correct answer: A counselor who owns financial interest in a referral facility and routinely refers clients there
A financial interest in a referral destination creates a direct conflict of interest, as personal gain may influence clinical referral decisions rather than client need.
Question 3: A minor client (age 16) voluntarily seeks substance abuse treatment in California without parental consent. Under California law, the counselor should:
- Refuse services until parental consent is obtained
- Provide services and obtain the minor's consent, which is legally sufficient under Health and Safety Code 11987.4 (Correct answer)
- Notify the parents immediately as the minor is not legally capable of consent
- Provide services only if the minor has been emancipated
Correct answer: Provide services and obtain the minor's consent, which is legally sufficient under Health and Safety Code 11987.4
California Health and Safety Code 11987.4 allows minors age 12 and older to consent to substance abuse treatment without parental consent.
Question 4: The ethical concept of 'nonmaleficence' most directly applies when a counselor is considering:
- Whether to share treatment success stories at a community event
- Whether a recommended intervention could harm the client or worsen their condition (Correct answer)
- Whether to accept a new client with a complex dual diagnosis
- Whether to bill a client for a missed session
Correct answer: Whether a recommended intervention could harm the client or worsen their condition
Nonmaleficence—the obligation to do no harm—requires counselors to evaluate whether any intervention they consider could cause harm before proceeding.
Question 5: When terminating services with a client who still needs care, an ethical counselor is obligated to:
- Provide at least 30 days of free services before termination
- Offer a referral and ensure continuity of care is addressed before ending the relationship (Correct answer)
- Terminate immediately if the client has violated program rules
- Require the client to sign a release waiving further care before termination
Correct answer: Offer a referral and ensure continuity of care is addressed before ending the relationship
Ethical termination requires proper notice, clinical discussion, and a referral plan to ensure the client's continuing care needs are not abandoned.
Question 6: A counselor who practices outside the boundaries of their competence is primarily violating the ethical principle of:
- Justice
- Fidelity
- Beneficence
- Nonmaleficence and competence standards (Correct answer)
Correct answer: Nonmaleficence and competence standards
Practicing beyond one's competence violates the duty to do no harm and the professional standard requiring counselors to operate within the limits of their training and credentials.
Question 7: A supervisee discloses to their clinical supervisor that they are developing romantic feelings for a client. The supervisor's most appropriate response is to:
- Reassure the supervisee that such feelings are normal and require no action
- Immediately terminate the supervisee's employment
- Explore the feelings in supervision, arrange client transfer, and ensure the supervisee receives support (Correct answer)
- Report the supervisee to the licensing board without further discussion
Correct answer: Explore the feelings in supervision, arrange client transfer, and ensure the supervisee receives support
Romantic countertransference requires clinical attention in supervision, immediate client protection through reassignment, and support for the supervisee—not automatic punitive action.
CAADE Ethical & Legal Considerations in Substance Abuse Counseling 5
A court orders a client to undergo substance abuse treatment.
The counselor's primary ethical obligation regarding informed consent in this situation is to: