NCBTMB Professionalism, Ethics, and Law 4 — Questions and Answers
Question 1: A therapist receives a subpoena for a client's records. The correct action is to:
- Immediately release all records to comply with the court
- Consult an attorney and notify the client before releasing records (Correct answer)
- Refuse all legal requests to protect client confidentiality
- Release only records older than one year
Correct answer: Consult an attorney and notify the client before releasing records
A subpoena is a legal order, but therapists should consult legal counsel and follow proper procedures, which may include notifying the client.
Question 2: Which of the following best describes 'informed consent'?
- A verbal agreement made at the start of each session
- A signed waiver releasing the therapist from all liability
- A process ensuring the client understands and agrees to proposed treatment (Correct answer)
- Documentation required only for insurance billing
Correct answer: A process ensuring the client understands and agrees to proposed treatment
Informed consent is an ongoing process of communication ensuring the client understands the nature, risks, and alternatives to proposed treatment.
Question 3: If a client is intoxicated when they arrive for their appointment, the therapist should:
- Proceed with a gentle relaxation massage
- Ask the client to rest briefly, then begin treatment
- Postpone the session and reschedule when the client is sober (Correct answer)
- Reduce session time but complete the appointment
Correct answer: Postpone the session and reschedule when the client is sober
An intoxicated client cannot give valid informed consent and may be more vulnerable to injury, making postponement the appropriate action.
Question 4: When transitioning a client to a different therapist in the same practice, what is the ethical requirement?
- No action is needed because records stay within the practice
- Obtain the client's written consent before transferring records (Correct answer)
- Transfer all records immediately to ensure continuity of care
- Inform the insurance company of the change first
Correct answer: Obtain the client's written consent before transferring records
Even within the same practice, transferring a client's records to a different provider typically requires the client's authorization.
Question 5: A massage therapist diagnoses a client with 'tight hip flexors causing sciatic pain.' This statement is problematic because:
- Tight hip flexors do not affect the sciatic nerve
- Diagnosing a condition is outside the massage therapist's scope of practice (Correct answer)
- The therapist should document findings, not share them with clients
- Sciatic pain is always a medical emergency
Correct answer: Diagnosing a condition is outside the massage therapist's scope of practice
Diagnosis is the exclusive domain of licensed medical practitioners; massage therapists may observe and describe but cannot diagnose.
Question 6: A client who has previously consented to massage now appears reluctant during a session. The most ethical action is to:
- Continue because consent was already given at intake
- Stop and check in with the client verbally (Correct answer)
- Complete the session to avoid disrupting treatment continuity
- Refer the client to a counselor immediately
Correct answer: Stop and check in with the client verbally
Consent is ongoing and can be withdrawn at any time; therapists must be attuned to nonverbal cues and check in when a client seems uncomfortable.
Question 7: Which of the following would be considered sexual misconduct by a massage therapist?
- Asking a client about pain patterns in the gluteal region
- Using clinical terminology when describing treatment areas
- Engaging in sexual discussion at a client's request during a session (Correct answer)
- Draping the client appropriately while working near the hip
Correct answer: Engaging in sexual discussion at a client's request during a session
Sexual discussion or activity during a session constitutes professional misconduct regardless of whether the client initiates it.
NCBTMB Professionalism, Ethics, and Law 4
A therapist receives a subpoena for a client's records.
The correct action is to: