PTSD Ethical & Legal Considerations Techniques Treatment 2 — Questions and Answers
Question 1: A PTSD client discloses during therapy that they plan to harm a coworker tomorrow. Under Tarasoff duty-to-warn obligations, what is the clinician's FIRST required action?
- Notify the intended victim and relevant authorities (Correct answer)
- Continue therapy and document the statement only
- Immediately terminate treatment and refer elsewhere
- Obtain written consent from the client before warning anyone
Correct answer: Notify the intended victim and relevant authorities
Tarasoff v. Regents requires clinicians to warn identifiable intended victims and notify law enforcement when a credible threat exists.
Question 2: Which ethical principle is MOST directly violated when a trauma therapist begins a romantic relationship with a former PTSD client six months after termination?
- Beneficence
- Autonomy
- Non-maleficence (Correct answer)
- Justice
Correct answer: Non-maleficence
Non-maleficence (do no harm) is violated because the power imbalance from the therapeutic relationship persists and poses risk of harm to the former client.
Question 3: A PTSD treatment program receives a subpoena for a client's therapy records. The client has NOT signed a release. What is the appropriate response?
- Comply immediately to avoid contempt of court
- Notify the client and consult legal counsel before releasing records (Correct answer)
- Refuse the subpoena outright as legally invalid
- Release only session dates, not content
Correct answer: Notify the client and consult legal counsel before releasing records
A subpoena does not automatically override HIPAA; the clinician should notify the client and seek legal guidance to determine if a court order compels disclosure.
Question 4: When obtaining informed consent for Prolonged Exposure (PE) therapy with a PTSD client, which element is ethically REQUIRED?
- Guaranteeing symptom remission within 12 sessions
- Disclosing that symptoms may temporarily worsen during exposure (Correct answer)
- Withholding information about alternatives to reduce dropout
- Obtaining family member co-signature on the consent form
Correct answer: Disclosing that symptoms may temporarily worsen during exposure
Informed consent must include potential risks such as temporary symptom exacerbation, which is common during exposure-based treatments.
Question 5: A clinician treating a combat veteran with PTSD discovers the client is also being treated by another mental health provider without prior disclosure. The BEST ethical action is to:
- Immediately terminate the therapeutic relationship
- Discuss the situation with the client and coordinate care with the other provider (Correct answer)
- Report the client to their insurance company for fraud
- Continue treatment without addressing the dual-provider situation
Correct answer: Discuss the situation with the client and coordinate care with the other provider
Coordinated care serves the client's best interest, and open discussion prevents conflicting treatment approaches.
Question 6: Under HIPAA, which situation would constitute a permissible disclosure of a PTSD client's protected health information WITHOUT client authorization?
- Sharing records with the client's employer for workplace accommodation
- Disclosing to a researcher with an IRB waiver of authorization (Correct answer)
- Releasing information to the client's spouse upon request
- Providing records to law enforcement for a routine drug investigation
Correct answer: Disclosing to a researcher with an IRB waiver of authorization
HIPAA permits disclosure to researchers when an IRB has approved a waiver of authorization under appropriate safeguards.
Question 7: A trauma therapist feels strong countertransference reactions when treating a sexual assault survivor. The MOST ethical course of action is to:
- Immediately transfer the client to another provider without explanation
- Seek personal supervision or consultation to manage the countertransference (Correct answer)
- Disclose all personal feelings to the client to model transparency
- Avoid trauma-focused interventions for this specific client
Correct answer: Seek personal supervision or consultation to manage the countertransference
Supervision and consultation allow clinicians to process countertransference ethically without burdening the client or compromising care.
PTSD Ethical & Legal Considerations Techniques Treatment 2
A PTSD client discloses during therapy that they plan to harm a coworker tomorrow.
Under Tarasoff duty-to-warn obligations, what is the clinician's FIRST required action?