CBT-I Ethical Standards & Professional Practice 2

Question 1

A CBT-I practitioner discovers that a client is also receiving sleep coaching from an unlicensed online service. What is the most ethically appropriate first step?

Accepted Answer

Discuss the concurrent services openly with the client and assess potential conflicts

Answer

Immediately terminate the therapeutic relationship

Answer

Report the unlicensed coach to licensing authorities

Answer

Continue treatment without addressing the issue

Question 2

When a CBT-I client discloses that their insomnia is partly due to caring for a terminally ill spouse, the practitioner should:

Accepted Answer

Acknowledge the grief context and consider referral for bereavement support alongside CBT-I

Answer

Focus exclusively on sleep hygiene and restrict discussion to CBT-I protocols

Answer

Defer all CBT-I treatment until the caregiving situation resolves

Answer

Diagnose the client with complicated grief disorder

Question 3

Which action best reflects the ethical principle of fidelity in CBT-I practice?

Accepted Answer

Honoring commitments made to clients about treatment structure and follow-up

Answer

Charging consistent fees regardless of session length

Answer

Maintaining accurate billing records

Answer

Providing equal treatment to all demographic groups

Question 4

A CBT-I practitioner is asked by a client's employer to confirm whether the client is receiving treatment for work-performance-related insomnia. The practitioner should:

Accepted Answer

Refuse to disclose any information without specific written authorization from the client

Answer

Confirm treatment is occurring but withhold the diagnosis

Answer

Provide a general letter stating the client is in good health

Answer

Contact the employer directly to negotiate what can be shared

Question 5

A practitioner realizes mid-treatment that the client's insomnia may stem from undiagnosed sleep apnea. The ethical obligation is to:

Accepted Answer

Refer the client for a sleep study and adjust the treatment plan accordingly

Answer

Continue CBT-I as planned since it is evidence-based regardless of etiology

Answer

Diagnose sleep apnea within the CBT-I scope of practice

Answer

Discontinue treatment immediately and end the therapeutic relationship

Question 6

Which scenario represents a boundary violation rather than a boundary crossing in CBT-I practice?

Accepted Answer

Entering into a business partnership with a current client

Answer

Briefly extending a session by five minutes to complete a sleep diary review

Answer

Accepting a modest gift of homemade cookies at the end of treatment

Answer

Providing a client with an after-hours crisis number

Question 7

Under HIPAA, a CBT-I practitioner in a group practice must ensure that:

Accepted Answer

Client protected health information is accessible only on a minimum necessary basis

Answer

All staff members have unrestricted access to client records for continuity of care

Answer

Paper sleep diaries are stored in the client's personal file without additional protection

Answer

Electronic records are encrypted only when transmitted outside the practice

CBT-I Ethical Standards & Professional Practice 2

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Sources & references