MAC Ethical Practice 5 — Questions and Answers
Question 1: Which of the following BEST describes the ethical concept of 'fidelity' in addiction counseling?
- Doing what is best for the client's health outcomes
- Honoring commitments and being trustworthy with clients (Correct answer)
- Distributing services fairly across all client populations
- Avoiding actions that cause harm to clients
Correct answer: Honoring commitments and being trustworthy with clients
Fidelity refers to the counselor's obligation to be honest, keep promises, and honor the trust placed in them by clients.
Question 2: A counselor receives a subpoena for a client's records in a divorce proceeding. The MOST appropriate immediate action is to:
- Release the records immediately to comply with the legal order
- Consult legal counsel and notify the client before releasing any records (Correct answer)
- Refuse to acknowledge that the client is in treatment
- Release only records older than seven years
Correct answer: Consult legal counsel and notify the client before releasing any records
A subpoena is not a court order; the counselor should seek legal advice and notify the client, as 42 CFR Part 2 provides strong protections against such disclosures.
Question 3: An addiction counselor in recovery shares extensive details of their own relapse history during a group session without therapeutic intent. This behavior PRIMARILY raises concerns about:
- Confidentiality of group members
- Inappropriate self-disclosure that may shift focus from clients' needs (Correct answer)
- Violation of 42 CFR Part 2
- Lack of informed consent for group treatment
Correct answer: Inappropriate self-disclosure that may shift focus from clients' needs
Self-disclosure by counselors must be purposeful and client-focused; sharing extensive personal history without therapeutic intent is ethically problematic.
Question 4: A group member discloses information during a group session that another member later shares with the community. The counselor's PRIMARY ethical responsibility was to:
- Record the disclosure in each group member's individual chart
- Establish confidentiality agreements and educate members at group outset (Correct answer)
- Prohibit members from discussing anything personal in group
- Report the breach to the licensing board
Correct answer: Establish confidentiality agreements and educate members at group outset
Counselors must establish and reinforce confidentiality agreements with group members from the start to minimize breaches.
Question 5: A counselor who is also in recovery tells a skeptical client, 'I've been where you are, and I promise treatment works.' This statement is MOST problematic because it:
- Violates the prohibition on counselor self-disclosure
- Constitutes a guarantee of outcomes, which is unethical (Correct answer)
- Violates HIPAA by revealing the counselor's health status
- Is inappropriate only if the client is court-mandated
Correct answer: Constitutes a guarantee of outcomes, which is unethical
Counselors may not promise or guarantee treatment outcomes, as this is both ethically prohibited and clinically inaccurate.
Question 6: Which element is ESSENTIAL when obtaining informed consent from a client who has limited English proficiency?
- Providing consent forms in English with a verbal translation
- Using a qualified interpreter and providing translated written materials (Correct answer)
- Having a bilingual family member translate the consent form
- Recording verbal consent in the client's native language only
Correct answer: Using a qualified interpreter and providing translated written materials
Ethical informed consent requires that clients fully understand the information, necessitating qualified interpreters and translated materials for those with limited English proficiency.
Question 7: A counselor learns that a client lied on their intake form about prior treatment history. The MOST appropriate ethical response is to:
- Discharge the client for dishonesty
- Explore the reasons for the misrepresentation and update the clinical record (Correct answer)
- Report the client to the referring agency immediately
- Ignore the discrepancy to preserve the therapeutic alliance
Correct answer: Explore the reasons for the misrepresentation and update the clinical record
Exploring the reasons behind misrepresentation is therapeutically and ethically appropriate, and the accurate information must be documented in the record.
MAC Ethical Practice 5
Which of the following BEST describes the ethical concept of 'fidelity' in addiction counseling?