PTSD Ethical & Legal Considerations Techniques Treatment 3 — Questions and Answers
Question 1: Which legal standard governs involuntary hospitalization of a PTSD client who is acutely suicidal?
- Parens patriae and police power doctrines (Correct answer)
- The Tarasoff standard for third-party protection
- The ADA reasonable accommodation requirement
- Title VII employment non-discrimination provisions
Correct answer: Parens patriae and police power doctrines
Involuntary civil commitment is grounded in parens patriae (state as protector of those unable to protect themselves) and police power (protecting public safety).
Question 2: A clinician practicing EMDR with PTSD clients in a state that requires specific licensure for EMDR is practicing without that credential. This constitutes:
- A minor documentation error correctable by self-disclosure
- Scope of practice violation that could result in license suspension (Correct answer)
- Acceptable practice if the client provides written consent
- A billing issue but not an ethical concern
Correct answer: Scope of practice violation that could result in license suspension
Practicing outside state-defined scope of practice is an ethical and legal violation subject to disciplinary action by the licensing board.
Question 3: A school counselor identifies PTSD symptoms in a 12-year-old student who reports ongoing abuse at home. The FIRST mandatory action is to:
- Consult with parents before contacting authorities
- File a report with child protective services immediately (Correct answer)
- Refer the child to an outside trauma therapist
- Document symptoms for 30 days before reporting
Correct answer: File a report with child protective services immediately
Mandated reporters are legally required to file a report immediately upon reasonable suspicion of child abuse, regardless of parental consent.
Question 4: The ADA requires employers to provide reasonable accommodations for employees with PTSD. Which of the following would typically qualify as a reasonable accommodation?
- Eliminating all performance standards for the employee
- Allowing a modified schedule to attend therapy appointments (Correct answer)
- Transferring the employee's job duties permanently to a colleague
- Excusing the employee from all stressful workplace interactions indefinitely
Correct answer: Allowing a modified schedule to attend therapy appointments
A modified schedule enabling therapy attendance is a commonly recognized reasonable accommodation under the ADA.
Question 5: A PTSD therapist who specializes in trauma is asked to conduct a forensic evaluation of a client's trauma claims for litigation. The MOST significant ethical concern is:
- Billing complexity for dual-role services
- Dual-role conflict that compromises objectivity in both roles (Correct answer)
- Insufficient training in evidence-based trauma treatment
- The requirement to testify in court without client consent
Correct answer: Dual-role conflict that compromises objectivity in both roles
Serving as both treating therapist and forensic evaluator creates a dual-role conflict that impairs clinical and forensic objectivity.
Question 6: In Cognitive Processing Therapy (CPT) for PTSD, when is it ethically appropriate to deviate from the structured protocol?
- Whenever the client expresses any discomfort with assignments
- When clinical judgment indicates a client safety concern overrides protocol adherence (Correct answer)
- When the therapist personally prefers a different approach
- Never — deviations always constitute unethical practice
Correct answer: When clinical judgment indicates a client safety concern overrides protocol adherence
Clinical judgment regarding safety is always paramount and ethically justifies protocol modification when necessary.
Question 7: A PTSD client who is a military veteran requests that their therapy notes never be shared with the VA. The clinician should:
- Agree unconditionally, as all disclosures require client consent
- Explain the limits of confidentiality including mandatory reporting and subpoena exceptions (Correct answer)
- Decline to treat the client if they refuse VA record sharing
- Contact the VA proactively to clarify the client's preferences
Correct answer: Explain the limits of confidentiality including mandatory reporting and subpoena exceptions
Informed consent includes explaining the legal and ethical limits of confidentiality so clients can make autonomous decisions about treatment.
PTSD Ethical & Legal Considerations Techniques Treatment 3
Which legal standard governs involuntary hospitalization of a PTSD client who is acutely suicidal?