CADC Alcohol and Drug Counselor Professional and Ethical Responsibilities 3 — Questions and Answers
Question 1: A counselor discovers that a colleague is practicing while impaired by alcohol during work hours. The counselor's primary ethical obligation is to:
- Confront the colleague privately and do nothing further
- Report the behavior to a supervisor or licensing board to protect clients (Correct answer)
- Cover for the colleague as a show of professional loyalty
- Ignore the situation since it does not directly affect the counselor's clients
Correct answer: Report the behavior to a supervisor or licensing board to protect clients
Counselors have an ethical obligation to report colleague impairment that poses risk to clients, as client welfare takes precedence over collegial loyalty.
Question 2: Which of the following best describes the ethical principle of 'veracity' in addiction counseling?
- Treating all clients equally regardless of background
- Being honest with clients, even when information may be difficult to hear (Correct answer)
- Maintaining confidentiality about all client disclosures
- Respecting the client's right to make their own decisions
Correct answer: Being honest with clients, even when information may be difficult to hear
Veracity refers to the obligation to be truthful with clients, which builds trust and supports informed decision-making.
Question 3: A counselor who has a personal history of addiction is considering sharing this with a client who is struggling with shame. This practice is best described as:
- Always unethical and should never be done
- Potentially therapeutic self-disclosure if done purposefully and in the client's best interest (Correct answer)
- Mandatory disclosure required by professional ethics codes
- A boundary violation that requires immediate supervision
Correct answer: Potentially therapeutic self-disclosure if done purposefully and in the client's best interest
Purposeful self-disclosure can be therapeutic when done intentionally, sparingly, and with the client's welfare as the primary consideration.
Question 4: Under 42 CFR Part 2, which situation would allow disclosure of a client's substance use disorder records WITHOUT a patient consent form?
- A request from the client's employer for return-to-work clearance
- A medical emergency where disclosure is necessary to protect the client's life (Correct answer)
- A law enforcement investigation into drug trafficking
- A request from the client's insurance company for billing purposes
Correct answer: A medical emergency where disclosure is necessary to protect the client's life
42 CFR Part 2 permits disclosure without consent in a bona fide medical emergency to protect the patient's life.
Question 5: A client asks the counselor to write a letter supporting their disability claim, stating they are unable to work due to addiction. The counselor has not assessed the client's work capacity. The ethical response is to:
- Write the letter because it will benefit the client financially
- Decline to write documentation that goes beyond the counselor's professional assessment (Correct answer)
- Ask the client what they want the letter to say
- Write a vague letter to avoid taking a position
Correct answer: Decline to write documentation that goes beyond the counselor's professional assessment
Counselors must not provide documentation, opinions, or statements outside their area of assessed competence, as this violates professional integrity.
Question 6: When treating a pregnant client with opioid use disorder, which approach best reflects current ethical and evidence-based standards?
- Require immediate abstinence to protect the fetus
- Support medication-assisted treatment such as methadone or buprenorphine as recommended by medical guidelines (Correct answer)
- Prioritize the fetus's welfare over the mother's treatment preferences
- Refuse to treat pregnant clients due to legal liability
Correct answer: Support medication-assisted treatment such as methadone or buprenorphine as recommended by medical guidelines
Current evidence and ethical guidelines support MAT for pregnant women with OUD as safer than withdrawal, reducing risks for both mother and fetus.
Question 7: A counselor learns that a client is HIV-positive and sexually active without disclosing this to partners. The counselor's ethical obligations are primarily governed by:
- Mandatory disclosure requirements to all potentially exposed partners
- A balance between confidentiality and duty to warn, guided by state law and agency policy (Correct answer)
- Immediate breach of confidentiality to protect public health
- No obligation since HIV status is exclusively the client's private matter
Correct answer: A balance between confidentiality and duty to warn, guided by state law and agency policy
Counselors must navigate the tension between confidentiality and duty to warn based on applicable state law and agency policy, as there is no universal mandate.
CADC Alcohol and Drug Counselor Professional and Ethical Responsibilities 3
A counselor discovers that a colleague is practicing while impaired by alcohol during work hours.
The counselor's primary ethical obligation is to: