CASAC Professional Ethics and Regulations 4 — Questions and Answers
Question 1: A CASAC counselor discovers that a colleague is romantically involved with a current client. What is the counselor's primary ethical obligation?
- Ignore it as it is a private matter between colleagues
- Report the situation to a supervisor or ethics board (Correct answer)
- Confront the client directly about the relationship
- Document the observation but take no further action
Correct answer: Report the situation to a supervisor or ethics board
Counselors have an ethical duty to report colleague misconduct that harms clients, including sexual or romantic dual relationships.
Question 2: Under HIPAA, which of the following does NOT qualify as a permissible disclosure of PHI without client authorization?
- Disclosing to public health authorities to prevent disease spread
- Sharing records with a client's employer upon the employer's request (Correct answer)
- Reporting suspected child abuse to state agencies
- Disclosing to law enforcement to prevent imminent serious harm
Correct answer: Sharing records with a client's employer upon the employer's request
HIPAA does not permit disclosure of PHI to employers simply upon their request; client authorization is required for employment-related disclosures.
Question 3: A client discloses they have been driving drunk regularly but denies any intent to harm others. Using the Tarasoff principle, the counselor should:
- Maintain confidentiality since no specific victim is identified
- Immediately call police without notifying the client
- Assess the level of risk and consider warning identifiable potential victims or authorities (Correct answer)
- Terminate the counseling relationship immediately
Correct answer: Assess the level of risk and consider warning identifiable potential victims or authorities
The Tarasoff duty to warn applies when there is foreseeable danger to others; the counselor must assess risk and take reasonable protective action.
Question 4: Which ethical principle is MOST relevant when a counselor adapts treatment goals to align with a client's cultural values and beliefs?
- Nonmaleficence
- Justice
- Autonomy (Correct answer)
- Fidelity
Correct answer: Autonomy
Autonomy respects a client's right to self-determination, including culturally influenced decisions about their own care.
Question 5: A CASAC counselor in private practice wants to offer a discount to clients who refer new clients. This practice is:
- Acceptable if the discount is modest and disclosed
- An ethical violation because it creates a conflict of interest and exploits the therapeutic relationship (Correct answer)
- Standard business practice and fully encouraged in counseling
- Permissible only if the state licensing board approves it first
Correct answer: An ethical violation because it creates a conflict of interest and exploits the therapeutic relationship
Referral incentives exploit the therapeutic relationship and compromise the counselor's objectivity, constituting an ethical violation.
Question 6: When a minor client's parents request full access to all session notes, the counselor should:
- Provide complete records immediately since parents have legal authority
- Refuse all disclosure to protect the minor's privacy absolutely
- Balance parental rights with the minor's therapeutic needs and applicable state law (Correct answer)
- Consult only with the minor before making any decision
Correct answer: Balance parental rights with the minor's therapeutic needs and applicable state law
Counselors must navigate parental legal rights while considering the minor's best interests and applicable state confidentiality statutes.
Question 7: A counselor who accepts a gift of significant monetary value from a grateful client after treatment has concluded is:
- Acting appropriately since the therapeutic relationship has ended
- Still at risk of an ethical violation due to the ongoing influence of the former therapeutic relationship (Correct answer)
- Obligated to report the gift to their licensing board
- Required to donate the gift to charity to remain ethical
Correct answer: Still at risk of an ethical violation due to the ongoing influence of the former therapeutic relationship
Post-termination relationships can still be influenced by the power dynamics of the former therapeutic relationship, making significant gifts ethically problematic.
CASAC Professional Ethics and Regulations 4
A CASAC counselor discovers that a colleague is romantically involved with a current client.
What is the counselor's primary ethical obligation?