MAC Ethical Practice 4 — Questions and Answers
Question 1: A client with opioid use disorder requests access to their own treatment records. Under HIPAA, the counselor should:
- Deny access to protect the client from distress
- Grant access within 30 days unless a specific exception applies (Correct answer)
- Require a court order before releasing any records
- Provide only a summary, not the actual records
Correct answer: Grant access within 30 days unless a specific exception applies
HIPAA grants clients the right to access their own protected health information, typically within 30 days of the request.
Question 2: Which situation requires mandatory reporting regardless of client confidentiality protections?
- A client admits to using heroin last week
- A client discloses ongoing physical abuse of their 8-year-old child (Correct answer)
- A client reports a past history of domestic violence
- A client describes suicidal ideation with no plan or intent
Correct answer: A client discloses ongoing physical abuse of their 8-year-old child
Active child abuse is a mandatory reporting situation in all US states and supersedes confidentiality obligations.
Question 3: A counselor is offered a paid referral fee by a residential treatment facility for every client they send. Accepting this fee would violate which ethical standard?
- Nonmaleficence
- Fidelity
- Prohibition on fee-splitting and kickbacks (Correct answer)
- Principle of beneficence
Correct answer: Prohibition on fee-splitting and kickbacks
Fee-splitting and kickbacks are prohibited because they create financial incentives that can compromise client welfare and referral integrity.
Question 4: When terminating services with a client who still has ongoing treatment needs, the counselor's ethical obligation includes:
- Ending services immediately if the counselor is moving away
- Providing referrals and continuity of care planning before termination (Correct answer)
- Allowing the client to decide whether they need a referral
- Documenting that the client refused further services without offering alternatives
Correct answer: Providing referrals and continuity of care planning before termination
Ethical termination requires providing appropriate referrals and ensuring continuity of care so clients are not abandoned.
Question 5: A counselor suspects a client may be suicidal but the client denies any intent. The MOST ethical and clinically appropriate action is to:
- Accept the client's denial and proceed with the session
- Conduct a thorough suicide risk assessment and document the findings (Correct answer)
- Immediately hospitalize the client involuntarily
- Notify the client's family without their consent
Correct answer: Conduct a thorough suicide risk assessment and document the findings
A structured risk assessment with thorough documentation is required when suicidality is suspected, regardless of the client's denial.
Question 6: Which practice MOST clearly violates the ethical standard of professional competence in addiction counseling?
- Seeking supervision when working with an unfamiliar population
- Treating adolescent clients without specialized training in adolescent addiction (Correct answer)
- Referring clients whose needs exceed the counselor's scope of practice
- Pursuing continuing education in co-occurring disorders
Correct answer: Treating adolescent clients without specialized training in adolescent addiction
Practicing outside one's scope of competence—such as treating adolescents without specialized training—violates ethical standards and risks client harm.
Question 7: A client asks their addiction counselor for a hug at the end of each session. The counselor's BEST response is to:
- Agree to maintain rapport and the therapeutic alliance
- Explore the meaning of the request within the therapeutic context (Correct answer)
- Immediately terminate treatment for boundary violations
- Agree only if other clients in the group also request it
Correct answer: Explore the meaning of the request within the therapeutic context
Exploring the meaning of physical contact requests is clinically and ethically appropriate and preserves professional boundaries.
MAC Ethical Practice 4
A client with opioid use disorder requests access to their own treatment records.
Under HIPAA, the counselor should: