NCMHCE - National Clinical Mental Health Counseling Examination Professional Practice and Ethics Questions and Answers

Question 1

A counselor is beginning therapy with a 15-year-old client who was brought in by her parents.
The parents provide written consent for treatment.
During the initial session, the adolescent is defiant and states, 'I don't want to be here and you can't make me talk.' What is the counselor's primary ethical responsibility in this situation?

Accepted Answer

Explain the counseling process, confidentiality limits, and potential benefits to the adolescent in an attempt to gain her assent.

Answer

Ignore the adolescent's protests and proceed with the session since the parents have provided legal consent.

Answer

Refuse to provide services until the adolescent verbally agrees to fully cooperate with the treatment plan.

Answer

Inform the parents that counseling is impossible without the client's willing participation and suggest they seek family therapy instead.

Question 2

A counselor in a small, rural town accepts a new client. After the first session, the counselor realizes the client is the owner of the only auto repair shop in town, where the counselor's car is currently being serviced. Which of the following actions is the MOST ethically sound initial step for the counselor to take?

Accepted Answer

Disclose the dual relationship to the client, discuss potential conflicts of interest, establish clear boundaries, and document the conversation.

Answer

Immediately refer the client to a counselor in another town to eliminate the dual relationship.

Answer

Continue the counseling relationship but find a different mechanic in another town for all future car repairs.

Answer

Say nothing to the client to avoid making the situation awkward, as the business relationship is minor and unlikely to cause a conflict.

Question 3

During a session, a client discloses a clear and specific plan to cause serious physical harm to their former supervisor, naming the individual and the time and place they intend to act. The counselor assesses the threat as credible and imminent. According to the Tarasoff ruling and its subsequent interpretations, the counselor's primary duty is to:

Accepted Answer

Take reasonable steps to protect the intended victim, which may include warning the victim and notifying law enforcement.

Answer

Maintain strict confidentiality as the disclosure was made within a therapeutic context.

Answer

Work with the client to create a safety plan and contract for safety, but take no outside action at this time.

Answer

Immediately arrange for the client's involuntary hospitalization without notifying any third parties.

Question 4

A counselor with expertise in treating generalized anxiety disorder has been seeing a client for several months. The client begins to reveal complex symptoms and history consistent with an eating disorder, an area in which the counselor has no specialized training or supervised experience. What is the counselor's most ethical course of action?

Accepted Answer

Inform the client of the counselor's competency limitations and collaborate with the client to refer them to a qualified eating disorder specialist, while offering to coordinate care.

Answer

Continue treating the client for anxiety while reading books and articles about eating disorders to become more competent.

Answer

Refer the client to a specialist for the eating disorder and terminate the current counseling relationship to avoid fragmentation of care.

Answer

Seek supervision from a colleague experienced in eating disorders, but do not inform the client about the counselor's lack of experience.

Question 5

Which of the following is NOT an ethical requirement for maintaining clinical records?

Accepted Answer

Including verbatim personal notes and unfiltered emotional reactions the counselor has about the client.

Answer

Ensuring documentation is timely and accurately reflects the services rendered.

Answer

Storing records securely to protect client confidentiality in accordance with state and federal laws.

Answer

Documenting the informed consent process and the collaboratively developed treatment plan.

Question 6

A counselor is providing telemental health services to a client who lives in a different part of the state. To meet ethical obligations for this modality, what is MOST critical for the counselor to establish during the informed consent process?

Accepted Answer

A clear and documented emergency plan, including the client's physical location and local crisis resources.

Answer

The client's preferred social media platforms for communication.

Answer

A detailed plan for how the client will submit payment electronically.

Answer

An agreement that the client will not record any of the counseling sessions.