CADC Alcohol and Drug Counselor Professional and Ethical Responsibilities 2 — Questions and Answers
Question 1: A client discloses during a group session that they have been selling drugs to fund their recovery-related expenses. What is the counselor's primary ethical obligation?
- Immediately report the client to law enforcement
- Address the disclosure within the group and explore treatment implications (Correct answer)
- Ignore the disclosure to protect group confidentiality
- Terminate the client from the program immediately
Correct answer: Address the disclosure within the group and explore treatment implications
The counselor should address the disclosure therapeutically within the group context and explore how this behavior relates to the client's recovery, while also reviewing confidentiality limits.
Question 2: Under HIPAA, which of the following is considered protected health information (PHI) that requires special handling for substance use disorder clients?
- De-identified statistical data used for research
- A client's name combined with their substance use disorder diagnosis (Correct answer)
- Aggregate treatment outcome reports
- Staff training schedules at a treatment facility
Correct answer: A client's name combined with their substance use disorder diagnosis
PHI includes any individually identifiable health information, and for SUD clients, this is further protected under 42 CFR Part 2 regulations.
Question 3: A newly licensed counselor realizes their caseload includes clients with co-occurring disorders beyond their current competency. The most ethical course of action is to:
- Continue treating the clients while secretly learning on the job
- Refer all co-occurring disorder clients to another facility immediately
- Seek supervision, consultation, and additional training while maintaining appropriate client care (Correct answer)
- Inform clients they cannot be treated for co-occurring disorders
Correct answer: Seek supervision, consultation, and additional training while maintaining appropriate client care
Ethical codes require counselors to practice within their scope of competence while actively pursuing training and supervision to expand that competence.
Question 4: When a client who is court-ordered to treatment refuses to sign a release of information to their probation officer, the counselor should:
- Release information anyway because the court order supersedes client consent
- Explain the consequences of non-disclosure and the limits of confidentiality established at intake (Correct answer)
- Immediately discharge the client for non-compliance
- Contact the probation officer without any release to avoid legal trouble
Correct answer: Explain the consequences of non-disclosure and the limits of confidentiality established at intake
Counselors must inform clients about confidentiality limits, including those established by court orders, at the start of treatment.
Question 5: Which ethical principle is most directly violated when a counselor accepts expensive gifts from a client who has just completed treatment?
- Autonomy
- Justice
- Non-maleficence (Correct answer)
- Fidelity
Correct answer: Non-maleficence
Accepting gifts from clients violates non-maleficence by creating potential harm through boundary violations and exploiting the therapeutic relationship.
Question 6: A counselor who works at a faith-based treatment center is asked to counsel a client whose religious beliefs differ significantly from the program's philosophy. The ethical response is to:
- Require the client to adopt the program's religious beliefs as part of treatment
- Refer the client to a more appropriate treatment setting if the philosophical conflict cannot be resolved (Correct answer)
- Ignore the client's religious beliefs and focus solely on substance use
- Report the client's beliefs to program administrators
Correct answer: Refer the client to a more appropriate treatment setting if the philosophical conflict cannot be resolved
When a counselor or program's values conflict irreconcilably with a client's needs, referral to a more appropriate setting is the ethical obligation.
Question 7: The concept of 'duty to warn' in addiction counseling most directly applies when:
- A client relapses and does not tell their family
- A client makes a credible threat of serious harm to an identifiable third party (Correct answer)
- A client discloses past criminal behavior during a session
- A client refuses to attend recommended support group meetings
Correct answer: A client makes a credible threat of serious harm to an identifiable third party
The Tarasoff duty to warn requires counselors to take reasonable steps to protect identifiable third parties when a client makes credible threats of serious harm.
A client discloses during a group session that they have been selling drugs to fund their recovery-related expenses.
What is the counselor's primary ethical obligation?