CLT Ethics & Professional Boundaries 3 — Questions and Answers
Question 1: A LEAP therapist learns that a client who has anosognosia is being coerced into treatment by family members against their will. The therapist's ethical obligation is to:
- Support the family's approach to ensure the client receives care
- Advocate for the client's right to self-determination while assessing safety risks (Correct answer)
- Immediately discharge the client until they consent voluntarily
- Report the family to adult protective services automatically
Correct answer: Advocate for the client's right to self-determination while assessing safety risks
LEAP ethics balance client autonomy with safety concerns, requiring the therapist to advocate for the client's rights while carefully assessing risk.
Question 2: Which of the following best illustrates 'informed consent' in LEAP therapy?
- Explaining LEAP techniques only after the client has agreed to treatment
- Providing the client with a written description of LEAP methods, risks, and alternatives before beginning (Correct answer)
- Asking the family to consent on behalf of the client with anosognosia
- Obtaining verbal agreement from the client at each session
Correct answer: Providing the client with a written description of LEAP methods, risks, and alternatives before beginning
Informed consent requires written disclosure of the nature of the treatment, its risks, benefits, and alternatives before therapy begins.
Question 3: A LEAP therapist's client makes a vague comment about 'not wanting to be around anymore.' According to ethical duty-to-protect standards, the therapist should FIRST:
- Contact 911 immediately
- Conduct a thorough risk assessment to determine the level of intent and plan (Correct answer)
- Reassure the client and move on to the session agenda
- Notify the client's family without assessing further
Correct answer: Conduct a thorough risk assessment to determine the level of intent and plan
Ethical practice requires a structured risk assessment before determining which intervention level is appropriate for a vague suicidal statement.
Question 4: When practicing LEAP, therapists are ethically required to use evidence-based methods. This obligation is grounded in the principle of:
- Fidelity
- Non-maleficence
- Beneficence (Correct answer)
- Justice
Correct answer: Beneficence
Beneficence requires that therapists actively promote client welfare, which includes using methods with proven effectiveness.
Question 5: A LEAP therapist is asked to testify in a legal case involving their client. The most ethical course of action is to:
- Refuse all court involvement to protect the therapeutic relationship
- Obtain the client's written consent or await a valid court order before disclosing (Correct answer)
- Testify freely since court proceedings are confidential
- Notify the client's insurance company before testifying
Correct answer: Obtain the client's written consent or await a valid court order before disclosing
Therapist disclosures in legal settings require either client-signed authorization or a legally valid subpoena or court order.
Question 6: Which action by a LEAP therapist would represent a boundary crossing rather than a boundary violation?
- Accepting a large cash gift from a grateful client
- Entering into a business partnership with a current client
- Attending a client's graduation ceremony when specifically invited and clinically appropriate (Correct answer)
- Providing personal contact details so clients can reach the therapist at home
Correct answer: Attending a client's graduation ceremony when specifically invited and clinically appropriate
Attending a culturally or clinically appropriate event when invited by the client is a boundary crossing that may be justified, not a violation.
Question 7: A LEAP therapist discovers that a colleague is routinely sharing client stories (without names) at social gatherings. This is ethically problematic because:
- Colleagues should not discuss cases outside of formal supervision
- Even de-identified stories can compromise confidentiality if details allow identification (Correct answer)
- Social settings are appropriate for informal peer consultation
- It violates the LEAP therapist's duty to report only
Correct answer: Even de-identified stories can compromise confidentiality if details allow identification
De-identification does not always prevent re-identification, and sharing clinical material in non-professional settings violates confidentiality norms.
CLT Ethics & Professional Boundaries 3
A LEAP therapist learns that a client who has anosognosia is being coerced into treatment by family members against their will.
The therapist's ethical obligation is to: