PTSD Ethics & Professional Standards 3 — Questions and Answers
Question 1: A PTSD clinician working with a first responder realizes they share mutual friends. This is best described as:
- An immediate disqualifying conflict
- A potential dual relationship requiring careful management (Correct answer)
- An ethical violation requiring termination
- A non-issue in professional settings
Correct answer: A potential dual relationship requiring careful management
Overlapping social circles constitute a potential dual relationship that requires the clinician to assess the risk of harm and manage boundaries carefully.
Question 2: The concept of 'duty to warn' in PTSD practice most directly obligates the clinician when a client:
- Expresses general anger at society
- Makes a specific, credible threat against an identifiable person (Correct answer)
- Refuses to take prescribed medication
- Reports past violent behavior from years ago
Correct answer: Makes a specific, credible threat against an identifiable person
The Tarasoff duty to warn is triggered by specific, credible threats directed at identifiable third parties, not general expressions of anger.
Question 3: Under HIPAA, which of the following is considered Protected Health Information (PHI)?
- De-identified aggregate treatment outcome data
- A client's diagnosis recorded in their treatment file (Correct answer)
- Published case studies with all identifiers removed
- Anonymous survey responses about PTSD symptoms
Correct answer: A client's diagnosis recorded in their treatment file
A client's diagnosis linked to their identity in a treatment record is PHI and is protected under HIPAA's Privacy Rule.
Question 4: A trauma clinician who personally experienced a traumatic event is working with a PTSD client with a similar history. Ethical practice requires the clinician to:
- Disclose their trauma history to build rapport
- Monitor countertransference and seek supervision if needed (Correct answer)
- Immediately transfer the client to avoid bias
- Document the similarity but take no further action
Correct answer: Monitor countertransference and seek supervision if needed
Clinicians with personal trauma histories must monitor countertransference and use supervision or consultation to ensure the client's needs remain primary.
Question 5: Which ethical standard addresses a clinician's obligation to stay current with research and evolving best practices in PTSD treatment?
- Beneficence
- Justice
- Fidelity
- Lifelong learning and continuing competence (Correct answer)
Correct answer: Lifelong learning and continuing competence
Ethical codes across professions require clinicians to maintain competence through continuing education and staying current with evidence-based practices.
Question 6: A PTSD client requests that their clinician not document certain disclosures. The clinician should:
- Honor the request to preserve the therapeutic alliance
- Explain that accurate documentation is a professional and legal obligation (Correct answer)
- Omit the content but note that the client requested no documentation
- Terminate treatment due to the problematic request
Correct answer: Explain that accurate documentation is a professional and legal obligation
Clinicians have a professional and legal obligation to maintain accurate records and should explain this requirement to the client.
Question 7: When a PTSD client lacks decision-making capacity, the clinician's ethical duty shifts toward:
- Full client autonomy without intervention
- Acting in the client's best interest while involving a surrogate decision-maker (Correct answer)
- Deferring all decisions to the client's insurance company
- Suspending treatment until capacity is restored
Correct answer: Acting in the client's best interest while involving a surrogate decision-maker
When clients lack capacity, clinicians apply beneficence and involve legally authorized surrogates to make decisions in the client's best interest.
PTSD Ethics & Professional Standards 3
A PTSD clinician working with a first responder realizes they share mutual friends.
This is best described as: