CASAC - Credentialed Alcoholism and Substance Abuse Counselor Professional Ethics and Regulations Questions and Answers 1 — Questions and Answers
Question 1: A CASAC receives a subpoena from a client's attorney requesting all treatment records for a child custody case. The client has not provided written consent for this release. According to 42 CFR Part 2, what is the CASAC's most appropriate and immediate action?
- Immediately comply with the subpoena to avoid legal penalties.
- Release a treatment summary but withhold detailed session notes.
- Contact the attorney to explain that the records cannot be released without a specific court order or the client's written consent. (Correct answer)
- Provide the records to the client to give to their attorney directly.
Correct answer: Contact the attorney to explain that the records cannot be released without a specific court order or the client's written consent.
Federal regulation 42 CFR Part 2 provides strict confidentiality protections for substance use disorder treatment records. A subpoena alone is insufficient to compel disclosure. A CASAC must have either a specific court order that meets the regulation's requirements or a valid written consent from the client. The correct action is to refuse the request and inform the attorney of the legal requirements, thus protecting client confidentiality as mandated by federal law.
Question 2: A client who has made significant progress and is nearing the end of their treatment offers their CASAC a handmade piece of artwork, valued at approximately $200, as a token of gratitude. According to the CASAC Canon of Ethical Principles, what is the most ethical response?
- Accept the gift to avoid offending the client and damaging the therapeutic relationship.
- Politely decline the gift, explaining the professional boundary against accepting gifts of significant value to avoid a potential dual relationship or exploitation. (Correct answer)
- Accept the gift but donate it to the treatment agency.
- Suggest the client sell the artwork and make a monetary donation to the facility instead.
Correct answer: Politely decline the gift, explaining the professional boundary against accepting gifts of significant value to avoid a potential dual relationship or exploitation.
The CASAC Canon of Ethical Principles requires counselors to avoid dual relationships and exploitation of clients. Accepting a gift of significant monetary value can blur professional boundaries and create a conflict of interest. The most ethical action is to politely decline, reinforcing the professional nature of the relationship while still acknowledging the client's gratitude. This protects both the client's welfare and the counselor's integrity.
Question 3: During a session, a client becomes agitated and discloses a specific, credible plan to seriously harm their former spouse later that day, including the location. In this situation, the CASAC's 'duty to protect' obligations under New York State law would most likely require which of the following actions?
- Maintain absolute confidentiality as required by 42 CFR Part 2.
- Immediately terminate the session and call 911 without informing the client.
- Consult with a supervisor and take reasonable steps to notify law enforcement and the potential victim. (Correct answer)
- Work with the client to create a safety plan and have them sign a no-harm contract.
Correct answer: Consult with a supervisor and take reasonable steps to notify law enforcement and the potential victim.
While confidentiality is paramount, there is an exception for the 'duty to protect' (also known as 'duty to warn' or Tarasoff rule) when a client poses a serious and imminent threat of harm to an identifiable third party. New York law mandates that mental health professionals take reasonable steps to protect the intended victim. This typically involves notifying law enforcement and the potential victim. Consulting a supervisor is a critical step in this process to ensure agency protocol and legal/ethical obligations are met.
Question 4: Which of the following is an essential requirement for maintaining accurate and timely client records, according to the CASAC Canon of Ethical Principles?
- To ensure the counselor is protected in the event of a lawsuit.
- To justify billing to third-party payers.
- To provide a detailed account for law enforcement if requested.
- To ensure the appropriateness and continuity of services provided to the client. (Correct answer)
Correct answer: To ensure the appropriateness and continuity of services provided to the client.
The CASAC Canon of Ethical Principles states that counselors must "take reasonable steps to ensure that documentation in records is accurate, sufficient and timely thereby ensuring appropriateness and continuity of services provided to patients." While records do serve billing and legal functions, their primary clinical and ethical purpose is to support high-quality, continuous care for the client.
Question 5: A CASAC is working with a client who is also involved in a complex child welfare case. The client asks the CASAC for specific advice on how to navigate the family court system and what to say to the judge. The most ethically appropriate action for the CASAC is to:
- Provide the best legal advice they can based on previous cases.
- Advise the client to be completely honest with the judge.
- Coach the client on specific phrases to use in court to regain custody.
- Explain that providing legal advice is outside their scope of practice and refer the client to a qualified legal professional. (Correct answer)
Correct answer: Explain that providing legal advice is outside their scope of practice and refer the client to a qualified legal professional.
The CASAC Canon of Ethical Principles requires counselors to practice within their scope of training and competence. Providing legal advice is not within the scope of practice for a substance abuse counselor. Doing so would be unethical and could potentially harm the client's case. The correct action is to maintain professional boundaries and refer the client to an appropriate resource, such as an attorney or legal aid service.
Question 6: Under the federal regulations of 42 CFR Part 2, which of the following disclosures of client-identifying information is permissible WITHOUT the client's written consent?
- Reporting a client's substance use to their employer who is concerned about their job performance.
- Sharing treatment information with a client's spouse who is participating in family therapy.
- Providing information to qualified personnel for the purpose of a program audit or evaluation. (Correct answer)
- Confirming to a probation officer that a client is enrolled in treatment.
Correct answer: Providing information to qualified personnel for the purpose of a program audit or evaluation.
42 CFR Part 2 allows for a few limited exceptions to the requirement for written consent. One of these exceptions is the disclosure of client-identifying information to qualified personnel for the purpose of conducting a scientific research, audit, or program evaluation. All other choices, including disclosures to employers, family members (without consent), or probation officers, would require specific, written client consent under these stringent federal regulations.
CASAC - Credentialed Alcoholism and Substance Abuse Counselor Professional Ethics and Regulations Questions and Answers 1
A CASAC receives a subpoena from a client's attorney requesting all treatment records for a child custody case.
The client has not provided written consent for this release.
According to 42 CFR Part 2, what is the CASAC's most appropriate and immediate action?