MAC Ethical Practice 3 — Questions and Answers
Question 1: A counselor working in a rural community is the only addiction specialist available. A former client asks to hire them as a personal trainer. The MOST ethical response is to:
- Accept because the therapeutic relationship has ended
- Refuse without offering any explanation
- Consult an ethics committee and document the decision-making process (Correct answer)
- Agree only if one year has passed since termination
Correct answer: Consult an ethics committee and document the decision-making process
In rural settings where dual relationships may be unavoidable, counselors should use a careful decision-making process and document their reasoning.
Question 2: Informed consent in addiction counseling MUST include which of the following?
- The counselor's personal recovery history
- Limits of confidentiality, fees, and treatment alternatives (Correct answer)
- The counselor's theoretical orientation in full clinical detail
- A guarantee of treatment outcomes
Correct answer: Limits of confidentiality, fees, and treatment alternatives
Informed consent must cover the nature of services, fees, limits of confidentiality, and available alternatives so clients can make autonomous decisions.
Question 3: A client who is mandated to treatment by the court asks the counselor to falsify attendance records. The ethical response is to:
- Comply to maintain the therapeutic alliance
- Refuse and explain that falsifying records is unethical and illegal (Correct answer)
- Consult the client's attorney before deciding
- Record attendance as 'unknown' as a compromise
Correct answer: Refuse and explain that falsifying records is unethical and illegal
Falsifying records is both unethical and illegal; the counselor must refuse and explain the reasons clearly to the client.
Question 4: Which practice BEST demonstrates the ethical principle of justice in addiction counseling?
- Charging higher fees to clients with higher incomes
- Providing culturally responsive services equitably to all clients regardless of background (Correct answer)
- Treating court-mandated clients more strictly than voluntary clients
- Reserving evidence-based treatments for clients with the best prognosis
Correct answer: Providing culturally responsive services equitably to all clients regardless of background
Justice requires fair and equitable distribution of services and resources, including culturally responsive care for all populations.
Question 5: A supervisee discloses in clinical supervision that they relapsed on alcohol last weekend but feel fine to practice. The supervisor's FIRST obligation is to:
- Immediately terminate the supervisee's employment
- Assess the impact of the relapse on the supervisee's fitness to practice (Correct answer)
- Report the relapse to the licensing board without further evaluation
- Treat it as confidential and take no action
Correct answer: Assess the impact of the relapse on the supervisee's fitness to practice
The supervisor must first assess whether the supervisee's impairment poses a risk to clients before determining next steps.
Question 6: Which action by a counselor constitutes a violation of the NAADAC Code of Ethics regarding social media?
- Maintaining a professional LinkedIn profile
- Sending a friend request to a current client on Facebook (Correct answer)
- Using a password-protected platform for telehealth sessions
- Educating clients about privacy risks of online support groups
Correct answer: Sending a friend request to a current client on Facebook
Friending a current client on social media blurs professional boundaries and may compromise confidentiality and the therapeutic relationship.
Question 7: A counselor realizes mid-session that they have a strong negative countertransference reaction to a client. The MOST appropriate immediate action is to:
- Terminate the session and refer the client immediately
- Continue the session while suppressing the reaction
- Note the reaction internally and seek supervision promptly (Correct answer)
- Disclose the reaction fully to the client
Correct answer: Note the reaction internally and seek supervision promptly
Counselors should recognize countertransference, manage it professionally in session, and address it through supervision to protect client care.
MAC Ethical Practice 3
A counselor working in a rural community is the only addiction specialist available.
A former client asks to hire them as a personal trainer.
The MOST ethical response is to: