CBIS Ethical Standards and Practice 3 — Questions and Answers
Question 1: A CBIS professional receives a subpoena for a client's therapy records. The appropriate first step is to:
- Immediately release all records to comply with the court
- Notify the client and consult legal counsel before releasing records (Correct answer)
- Refuse entirely because therapy records are always privileged
- Destroy the records to protect confidentiality
Correct answer: Notify the client and consult legal counsel before releasing records
Receipt of a subpoena does not automatically require record release; the specialist must notify the client and seek legal guidance.
Question 2: In brain injury rehabilitation, 'scope of practice' means a CBIS professional should:
- Provide any service the client requests regardless of training
- Practice only within the competencies defined by their credential and training (Correct answer)
- Expand services based on client need even without training
- Follow only state licensure rules and ignore national credential standards
Correct answer: Practice only within the competencies defined by their credential and training
Scope of practice requires professionals to limit services to areas where they have demonstrated competence and credential authorization.
Question 3: A CBIS specialist learns that a client is planning to drive despite being assessed as unsafe due to TBI cognitive deficits. After counseling the client, the client still plans to drive. The specialist should:
- Accept the client's autonomy and take no further action
- Immediately notify the police
- Warn identifiable potential victims and consider reporting to the DMV per applicable state law (Correct answer)
- Discharge the client from services
Correct answer: Warn identifiable potential victims and consider reporting to the DMV per applicable state law
The duty to protect third parties may override confidentiality when a client poses a clear danger, consistent with Tarasoff-based obligations.
Question 4: A pharmaceutical company offers a CBIS professional a paid speaking fee to present their TBI medication at a conference. The ethical obligation includes:
- Accepting the fee as standard professional compensation
- Disclosing the financial relationship to the audience (Correct answer)
- Declining only if the medication is ineffective
- Reporting the offer to licensing boards automatically
Correct answer: Disclosing the financial relationship to the audience
Full disclosure of financial conflicts of interest is required so audiences can evaluate potential bias in the presentation.
Question 5: Which of the following best describes 'informed assent' in brain injury practice with clients who have diminished decision-making capacity?
- The legal guardian's signature is sufficient; the client need not be involved
- The client is excluded from all treatment discussions
- The client is provided information in an accessible format and their agreement is sought even when a surrogate has legal authority (Correct answer)
- Assent is identical to informed consent
Correct answer: The client is provided information in an accessible format and their agreement is sought even when a surrogate has legal authority
Even clients with reduced capacity deserve accessible information and should be included in decisions to the greatest extent possible.
Question 6: A CBIS professional is asked to testify as a fact witness about a client's treatment. Before testifying, the professional must:
- Refuse to testify to protect confidentiality
- Obtain a client release or court order authorizing disclosure (Correct answer)
- Summarize records from memory to avoid releasing documents
- Only testify if paid an expert witness fee
Correct answer: Obtain a client release or court order authorizing disclosure
Testifying about a specific client's treatment requires either client authorization or a valid court order to disclose protected information.
Question 7: When a CBIS professional disagrees with an insurance company's denial of a medically necessary brain injury service, the ethical response is to:
- Accept the denial without challenge
- Advocate for the client through appropriate appeals and documentation processes (Correct answer)
- Terminate services immediately to avoid liability
- Bill the client directly without disclosure
Correct answer: Advocate for the client through appropriate appeals and documentation processes
Ethical advocacy requires challenging unjust denials through legitimate appeals processes to protect the client's access to necessary care.
CBIS Ethical Standards and Practice 3
A CBIS professional receives a subpoena for a client's therapy records.
The appropriate first step is to: