CBT Ethics & Professional Practice 2 — Questions and Answers
Question 1: A CBT client discloses they are having romantic feelings toward their therapist. What is the most ethically appropriate immediate response?
- Terminate the therapeutic relationship immediately
- Explore these feelings therapeutically within the session (Correct answer)
- Refer the client to another therapist without explanation
- Disclose your own feelings to maintain authenticity
Correct answer: Explore these feelings therapeutically within the session
Exploring transference feelings therapeutically is a valuable clinical opportunity that should be addressed within the professional relationship rather than avoided.
Question 2: Under which condition is a CBT therapist ethically permitted to break client confidentiality without consent?
- When a family member requests information about the client's progress
- When the client's employer requests a treatment summary
- When the client presents a credible threat of serious harm to an identifiable third party (Correct answer)
- When the therapist believes disclosure would benefit the client's recovery
Correct answer: When the client presents a credible threat of serious harm to an identifiable third party
The Tarasoff duty-to-warn principle requires therapists to break confidentiality when a client poses a credible, specific threat of harm to an identifiable third party.
Question 3: A CBT therapist realizes midway through treatment that a client's presenting problem is outside their area of competence. What should the therapist do?
- Continue treatment to avoid disrupting the therapeutic alliance
- Consult with a supervisor and arrange appropriate referral (Correct answer)
- Terminate immediately without explanation
- Use trial-and-error to develop competence during the current treatment
Correct answer: Consult with a supervisor and arrange appropriate referral
Ethical practice requires recognizing the limits of competence, seeking supervision, and referring clients to qualified professionals when necessary.
Question 4: Which of the following best describes informed consent in CBT practice?
- A one-time signature obtained before the first session
- An ongoing process ensuring clients understand treatment goals, risks, and alternatives (Correct answer)
- Legal protection for the therapist against malpractice claims
- A requirement only for clients who will receive medication
Correct answer: An ongoing process ensuring clients understand treatment goals, risks, and alternatives
Informed consent is an ongoing process throughout therapy, not a single event, ensuring clients can make autonomous decisions about their care.
Question 5: A therapist uses a validated CBT protocol with a client from a different cultural background. What additional ethical consideration is most critical?
- Obtaining a second opinion from another therapist
- Assessing whether the protocol is culturally appropriate and adapting as needed (Correct answer)
- Charging a lower fee to compensate for cultural differences
- Requiring the client to adopt the cultural norms assumed by the protocol
Correct answer: Assessing whether the protocol is culturally appropriate and adapting as needed
Cultural competence requires therapists to assess the cultural fit of evidence-based protocols and adapt interventions to be relevant and respectful of the client's background.
Question 6: What is the primary ethical concern when a CBT therapist provides therapy to a former close friend?
- Violation of privacy laws
- The presence of a dual relationship that compromises objectivity (Correct answer)
- Inadequate fee structure for familiar clients
- Insufficient session documentation
Correct answer: The presence of a dual relationship that compromises objectivity
Dual relationships with former close friends create conflicts of interest and compromise the therapist's objectivity and the integrity of the therapeutic relationship.
Question 7: A client requests their therapy records to share with a new provider. According to ethical standards, what must the therapist do?
- Deny access to protect the client from potentially distressing material
- Provide records promptly after receiving appropriate written authorization (Correct answer)
- Charge a fee that discourages record requests
- Only allow the new provider to view records without providing copies
Correct answer: Provide records promptly after receiving appropriate written authorization
Clients generally have a right to access and transfer their records, and therapists must facilitate this process upon receiving proper written authorization.
CBT Ethics & Professional Practice 2
A CBT client discloses they are having romantic feelings toward their therapist.
What is the most ethically appropriate immediate response?