NCMHCE Professional Practice and Ethics 3 — Questions and Answers
Question 1: Which situation MOST clearly represents a conflict of interest that requires a counselor to decline or withdraw from a case?
- Counseling a client who shares the same religion as the counselor
- Counseling the adult child of a close personal friend (Correct answer)
- Counseling a client in a different city than the counselor's practice
- Counseling a client who previously worked in mental health
Correct answer: Counseling the adult child of a close personal friend
Counseling the adult child of a close personal friend creates a dual relationship that compromises objectivity and professional judgment.
Question 2: Under HIPAA, a 'covered entity' in mental health practice is BEST described as:
- Any licensed counselor who accepts insurance payments
- A health care provider who transmits health information electronically in connection with standard transactions (Correct answer)
- Any practice with more than 10 employees
- A counselor who stores records in electronic health record software
Correct answer: A health care provider who transmits health information electronically in connection with standard transactions
HIPAA defines covered entities as health care providers who transmit protected health information electronically for standard transactions such as billing.
Question 3: A client in a rural community is the only person who fits a very specific demographic. When writing a case study, the counselor must:
- Obtain written consent and still alter identifying details sufficiently to prevent recognition (Correct answer)
- Simply change the client's name before publication
- Not publish the case study under any circumstances
- Only publish in academic journals not accessible to the general public
Correct answer: Obtain written consent and still alter identifying details sufficiently to prevent recognition
Even with consent, counselors must disguise identifying information thoroughly enough that clients cannot be recognized, especially in small communities.
Question 4: A counselor working in a school setting learns a 16-year-old student is sexually active with a 17-year-old peer. Both parties appear to consent. The counselor should:
- Report immediately as statutory rape in all states
- Assess whether state law requires reporting and then follow applicable mandates (Correct answer)
- Inform the student's parents without hesitation
- Take no action because both parties are minors and consented
Correct answer: Assess whether state law requires reporting and then follow applicable mandates
Age of consent and mandatory reporting thresholds vary by state, so the counselor must know applicable state law before determining what action is required.
Question 5: Which of the following is an example of 'beneficence' in clinical practice?
- Explaining the limits of confidentiality before starting treatment
- Using evidence-based interventions most likely to produce positive client outcomes (Correct answer)
- Charging sliding-scale fees to low-income clients
- Referring clients to specialists when outside one's competence
Correct answer: Using evidence-based interventions most likely to produce positive client outcomes
Beneficence means actively promoting client well-being, most concretely expressed by selecting interventions with demonstrated effectiveness.
Question 6: A counselor disagrees with a managed care organization's decision to deny further sessions for a client who remains at risk. The ethically appropriate action is to:
- Immediately terminate the client because services are not covered
- Continue sessions for free indefinitely
- Formally appeal the denial, document the client's risk, and discuss options with the client (Correct answer)
- Contact the client's employer to request the insurer extend benefits
Correct answer: Formally appeal the denial, document the client's risk, and discuss options with the client
Counselors have an ethical duty to advocate for clients through proper appeals processes while keeping clients informed of their options and ongoing risk.
Question 7: When providing telehealth services, a counselor MUST verify a client's physical location at each session primarily to:
- Ensure the counselor holds a license in the state where the client is physically present (Correct answer)
- Bill insurance correctly based on geographic rates
- Comply with HIPAA data storage requirements
- Confirm the client is not in a public location
Correct answer: Ensure the counselor holds a license in the state where the client is physically present
Licensure is state-specific, so a counselor must practice within the jurisdiction where the client is physically located during the session.
NCMHCE Professional Practice and Ethics 3
Which situation MOST clearly represents a conflict of interest that requires a counselor to decline or withdraw from a case?