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NCMHCE CODE OF ETHICS EXAM 2025/
ACTUAL QUESTIONS AND ANSWERS GRADED
A+
NBCC Code of Ethics
establishes the minimum ethical behaviors and provides an expectation of and assurance for the ethical practice for all who use the professional services of NCCs.
After your work with Jen has ended, she contacts you months later to tell you that she is speaking in front of a group of teens at the local high school to raise awareness about sexual assault. She invites you to attend. How should you respond?
You are so courageous. It would be my pleasure to attend and hear your speech.
This doesn't cross any inappropriate boundaries. You will be attending this event as a professional.
You believe that Mr. and Mrs. Jones are good subjects for a research project, and since you are already seeing them as clients, you conduct the testing during one of your sessions. Is this acceptable?
You believe that the scientific and educational value of your research outweighs the need to inform the Joneses either before or after.
INAPPROPRIATE Counselors shall obtain prior consent from all research participants and shall also inform all research participants that they may withdraw consent at any time and discontinue their participation at any time
You schedule a 90-minute block to complete an intake session with Zach. Zach, however, doesn't arrive at your office until he is already 45 minutes late. He professes that his car broke down, and he had to run to your office. He insists that you see him now. How do you best proceed?
Inform the client of your theoretical orientation
Establish payment plans
Ask Zach if he is comfortable in signing a release for his wife since she is his emergency contact
Also do MSE, sign consent forms, assess suicidality (if indicated- this client said he had just about enough)
Appropriate - It is required of ethical therapists to inform clients of the therapist's theoretical orientation as part the informed consent.
APPROPRIATE Zach will pay out of pocket. Ethical therapists work with clients on an agreed payment plan prior to the start of the therapeutic relationship.
APPROPRIATE Zach agrees. This is a great idea to get this document signed early on.
True or false? Supervisees must explain their professional position with client they sit in with.
True
True or false? Supervisors must set time for bi-weekly feedback with supervisees
HIPAA
Health Insurance Portability and Accountability Act
Health Insurance Portability and Accountability Act (HIPAA)
federal law that requires the creation of national standards to protect sensitive patient health information from being disclosed.
When can you release progress notes?
Therapy notes are protected and may not be released unless court ordered by a judge or requested by the parents of a minor. Even then, caution must be used in releasing this sensitive information, and often, a summary of therapy goals and progress may suffice instead
An adolescent client discloses to you that she drank at a party with her friends last weekend. Break confidentiality?
Alcohol use or substance use is not necessarily cause for breaking confidentiality unless the behavior is accompanied by immediate danger to self or others (e.g., driving while drunk). That said, counselors should work with adolescents to help them to share more openly about their decisions with their parents.
Amelia's (9y.o) father asks for a one-on-one meeting with youWould this pose a potential issue in regard to confidentiality?
NOT INDICATED When one parent signs consent for a child to be in therapy, consent is assumed for the other parent unless they are divorced or separated.
A few years later, a client is still in therapy with you but now is only seen once a month. She enjoys school and life in general. One day in May, she walks in your office for a session and invites you to her graduation. You would like to go. Of the following, what is the best ethical decision?
You have seen Amy for a few years, and I know that our relationship is solid and it won't harm anybody by my attending. I will attend her graduation, but not the party and dinner afterward.
Is this ethical situation handled appropriately?Tad's family is considering a move to another city. The therapist's responsibility to the family's new therapist is to ensure that appropriate clinical processes are completed.
APPROPRIATE This is part of the transfer of services protocol.
Is this ethical situation handled appropriately?Tad and his mother ask you for a referral for Tad's grandmother, who is in end-of-life care. It is acceptable to provide an appropriate referral.
APPROPRIATE Therapists provide appropriate referral information. Assess behaviors and emotions in kids. Mostly for behaviors. Ages range
For a case with a teenager with divorced parents brought in by mom, would this ethical/legal consideration need addressed - The father's right to be informed of treatment
ADMINISTERED It is important to find out about the legal status of custody so that both parents, even if divorced, can be fully informed about their child's treatment.
For a case with a teenager with divorced parents brought in by mom, who presents with conduct disorder - would this ethical/legal consideration need addressed - Obtaining a release of information to talk with the school counselor and teachers
Court-Ordered Services:
If a court orders an evaluation or treatment of the individual the court is the client, not the individual. It is important to clarify this with the individual during the informed consent process.
do you need consent to use testimonials to advertise practice?
yes
Counselors who use testimonials do
not solicit them from current clients,
former clients, or any other persons who may be vulnerable to undue influence.
Counselors discuss with clients the
implications of and obtain permission
for the use of any testimonial.
When completing forensic evaluations...
When possible avoid evaluations about anyone who is a client
They must get written consent from anyone being evaluated and must not counsel individuals they are evaluating.
Recommendations and Resolutions when doing distant/virtual counseling
Counselors in distance counseling must take steps to verify the identity of the client throughout the process.
- Always require proof of the client's legal right to consent (eg., proof that not a minor and can consent)
- Create passwords for confirming identity
- Include an ongoing identity verification process
Ethics and laws issues
- Always try to follow the ACA Code of Ethics even if laws appear to conflict
- If your efforts to reconcile the ACA Code of Ethics with laws fails, you have the option to follow laws
- Counselors may choose not to follow a law when upholding a moral or ethical principle
If HIPAA does not specifically address a privacy issue, what set of laws should therapists follow?
State laws
True or False: If health care providers are asked, the Privacy Rule requires them to give health information to researchers and health plans.
False. The rule allows for such disclosures, but providers can choose not to disclose this information.
Explanation: The Privacy Rule allows providers to give health information to researchers and the police and health plans, but does not require them to do so. In some cases, the client's authorization is required. Even if there is no required authorization from the client, there may be other limitations or requirements on such disclosures.
Paul believes there has been an error made in his provider's billing and would like to access and possibly amend his protected health information (PHI). What access is he afforded under the HIPAA Privacy Rule?
: Paul has the right to access and amend his PHI
Correct answer: No, unless it is crossed out with one line, dated and initialed
Explanation: The short answer is "no." This is a common problem in counseling records, related to missing, incomplete or altered dates. Each entry must list the month, day and year. If it needs to be altered, the legal format is to use one line, write error, initial and date the correction.
If a client requests her/his records be transferred to another counselor, who then becomes the primary provider to the client, then the first provider is:
A counselor is not required to retain the client's records if the client requests that her/his records be transferred to another counselor who then becomes the primary provider to the client.
A therapist is treating 22-year-old Bruce for issues related to abuse by his stepfather. The issue surfaced when he was 21, leading to his mother and stepfather separating and mom filing for divorce. Bruce participated in treatment for about a year, then stopped when he could not decide whether or not to follow through on pressing charges against his stepfather. Shortly thereafter, a man entered treatment with the same therapist. During the first session the therapist realized it was Bruce's stepfather. The therapist should:
Correct answer: Refer the man to another providerExplanation: The therapist has a conflict of interest and must refer the man to another provider. To uphold the confidentiality of Bruce, the therapist should not disclose the conflict. Therapists are under no obligation to take on a client because they engage in assessment. Continuing any contact with Bruce's stepfather could cause difficulty if the case were ever called into court and the therapist is asked to testify on either client's behalf.
A clinical therapist is working with a client who is 22-years-old and has a 12-year-old sister. The client reveals that she has been sexually abused by her father for the past couple of years. After the therapist makes an inquiry as to whether the client's father is also abusing his other daughter, the client clams up and stops talking to the therapist. Faced with this dilemma, the therapist should:
Correct answer: Call the sexual abuse hotline and indicate the probability that the sibling may be experiencing abuse
You supervise an intern who is across the street from your office and who also sees Sharon. You are responsible for her and accountable for her actions, too. True or false?
true You are accountable and liable for the actions of supervisees.
The fundamental principles of professional ethical behavior are
- autonomy,
- nonmaleficence
- beneficence
- justice
- fidelity
- veracity
autonomy
fostering the right to control the direction of one's life;
nonmaleficience
avoiding actions that cause harm;
Beneficience
- safeguarding the integrity of the counselor-client relationship; and
- practicing in a competent and ethical manner.
The fundamental principles of professional ethical behavior are
autonomy
nonmaleficence
beneficence
justice
fidelity,
veracity
