CAADE Ethical Practice 2 — Questions and Answers
Question 1: A client discloses they are currently driving under the influence on their way home from sessions. What is the counselor's primary ethical obligation?
- Maintain confidentiality since it is self-harm only
- Warn potential victims and notify authorities as required by duty-to-protect (Correct answer)
- Terminate services immediately without further discussion
- Document the disclosure and take no immediate action
Correct answer: Warn potential victims and notify authorities as required by duty-to-protect
When a client poses imminent danger to others, the counselor's duty to protect overrides standard confidentiality obligations.
Question 2: Which scenario best illustrates a dual relationship that must be avoided in alcohol/drug counseling?
- Referring a client to a peer support group
- Accepting a client's invitation to attend their family's sober celebration as a personal guest (Correct answer)
- Co-facilitating a group with a licensed counselor
- Providing psychoeducation in a community setting
Correct answer: Accepting a client's invitation to attend their family's sober celebration as a personal guest
Attending a client's personal event as a guest blurs professional boundaries and creates a dual relationship.
Question 3: Under HIPAA and 42 CFR Part 2, what distinguishes substance use disorder records from general medical records?
- SUD records require written consent for nearly all disclosures, including to other treating providers without a court order (Correct answer)
- SUD records can be shared freely among all treating healthcare providers
- HIPAA alone governs all SUD record disclosures
- SUD records have a shorter retention requirement than general medical records
Correct answer: SUD records require written consent for nearly all disclosures, including to other treating providers without a court order
42 CFR Part 2 imposes stricter confidentiality protections on SUD records, requiring specific written patient consent for most disclosures.
Question 4: A counselor realizes mid-treatment that a client's needs exceed their competence level. The most ethical response is to:
- Continue treatment while self-studying the relevant area
- Consult with a supervisor and facilitate an appropriate referral (Correct answer)
- Discharge the client without explanation
- Ask the client to seek help elsewhere without providing resources
Correct answer: Consult with a supervisor and facilitate an appropriate referral
Ethical practice requires counselors to recognize scope-of-competence limits and ensure continuity of care through proper referral.
Question 5: When documenting a client's progress note, which approach best reflects ethical record-keeping standards?
- Record only positive progress to encourage the client
- Write objective, factual, and timely entries that reflect the client's actual status (Correct answer)
- Avoid documenting sensitive disclosures to protect the client
- Use informal language so the client can easily understand the record
Correct answer: Write objective, factual, and timely entries that reflect the client's actual status
Ethical documentation must be objective, accurate, and timely to support quality care and legal accountability.
Question 6: A client requests a copy of their treatment records. Under ethical and legal standards, the counselor should:
- Deny the request to protect program confidentiality
- Provide the records promptly after the client signs an appropriate release (Correct answer)
- Redact all clinical observations before releasing the file
- Require the client to obtain a court order first
Correct answer: Provide the records promptly after the client signs an appropriate release
Clients generally have the right to access their own records; a signed release is the appropriate mechanism for release.
Question 7: An alcohol/drug educator working in a school notices a colleague appears intoxicated at work. The educator's ethical duty is to:
- Ignore the situation to avoid conflict
- Report the observation to a supervisor or the appropriate professional body (Correct answer)
- Confront the colleague publicly in front of students
- Cover for the colleague until the situation resolves itself
Correct answer: Report the observation to a supervisor or the appropriate professional body
Impaired colleague conduct that endangers clients or students must be reported through proper channels per professional ethics codes.
CAADE Ethical Practice 2
A client discloses they are currently driving under the influence on their way home from sessions.
What is the counselor's primary ethical obligation?