NCMHCE - National Clinical Mental Health Counseling Examination Professional Practice and Ethics 3 — Questions and Answers
Question 1: A counselor working in a community mental health center learns that a colleague is billing Medicaid for sessions that were never provided. The most appropriate first step is to:
- Confront the colleague privately and give them a chance to self-report
- Report the fraud to the state licensing board and Medicaid immediately
- Consult with a supervisor or ethics committee before taking action (Correct answer)
- Document the observations and wait to see if the behavior continues
Correct answer: Consult with a supervisor or ethics committee before taking action
Consulting with a supervisor or ethics committee first ensures the counselor responds appropriately and within proper channels before formal reporting.
Question 2: Under the ACA Code of Ethics, when a counselor terminates services with a client who still has ongoing needs, the counselor MUST:
- Provide the client with a list of alternative referrals (Correct answer)
- Continue seeing the client until they find a new provider
- Obtain written consent from the client agreeing to termination
- Notify the client's insurance company of the termination
Correct answer: Provide the client with a list of alternative referrals
The ACA Code requires counselors to provide appropriate referrals and resources to ensure continuity of care when terminating services.
Question 3: A school counselor is subpoenaed to testify about a student's counseling records. The MOST appropriate initial action is to:
- Provide all records to the court as required by the subpoena
- Contact the student's parents to obtain consent before complying
- Consult with an attorney before releasing any information (Correct answer)
- Refuse to comply citing privileged communication
Correct answer: Consult with an attorney before releasing any information
A subpoena is not a court order; consulting with legal counsel first helps the counselor understand their obligations and options regarding privilege.
Question 4: According to HIPAA, a mental health counselor in private practice must provide clients with a Notice of Privacy Practices:
- Only upon written request from the client
- At the time of first service delivery or upon request (Correct answer)
- Annually regardless of when services began
- Only when treatment involves insurance billing
Correct answer: At the time of first service delivery or upon request
HIPAA requires covered entities to provide the Notice of Privacy Practices no later than the first date of service delivery.
Question 5: A counselor has an unexpected romantic attraction to a current client. The most ethical course of action is to:
- Immediately terminate services and pursue the relationship after a 5-year waiting period
- Continue counseling while managing the feelings through personal therapy
- Consult with a supervisor or trusted colleague and seek personal therapy (Correct answer)
- Disclose the attraction to the client to maintain transparency
Correct answer: Consult with a supervisor or trusted colleague and seek personal therapy
The ACA Code recommends that counselors experiencing attraction seek consultation and personal therapy to manage countertransference without acting on it.
Question 6: A counselor who uses social media for professional purposes should primarily be concerned with:
- Maximizing follower count to expand their professional reach
- Maintaining clear boundaries between personal and professional online identities (Correct answer)
- Obtaining written consent from all clients before posting any mental health content
- Avoiding social media entirely to prevent ethical complications
Correct answer: Maintaining clear boundaries between personal and professional online identities
The ACA Code addresses social media use by emphasizing that counselors must maintain clear professional boundaries and protect client confidentiality online.
Question 7: When providing telehealth counseling services across state lines, a licensed counselor must FIRST ensure:
- The client's insurance covers out-of-state telehealth services
- They are licensed in the state where the client is physically located (Correct answer)
- The platform used is HIPAA-compliant and end-to-end encrypted
- Written informed consent for telehealth has been obtained from the client
Correct answer: They are licensed in the state where the client is physically located
Licensure is governed by the state where the client is physically located during the session, making jurisdictional licensure the primary legal requirement.
NCMHCE - National Clinical Mental Health Counseling Examination Professional Practice and Ethics 3
A counselor working in a community mental health center learns that a colleague is billing Medicaid for sessions that were never provided.
The most appropriate first step is to: