Ethical and Legal Standards Flashcards

A counselor is working with a 16-year-old client who reveals they are considering suicide. The client pleads with the counselor not to tell their parents. According to the ACA Code of Ethics, which of the following is the counselor's primary responsibility?

Answer: To breach confidentiality and inform the client's parents or legal guardians.

The ACA Code of Ethics (Standard B.2.a) states that the general requirement to keep information confidential does not apply when disclosure is required to protect clients from serious and foreseeable harm. Suicidal ideation in a minor falls into this category, making it necessary to breach confidentiality and inform the parents or guardians to ensure the client's safety. While exploring the client's reasons is part of the therapeutic process, the immediate duty to protect from harm takes precedence.

During an initial session, a new client signs an informed consent form that outlines the counselor's policies, fees, and the limits of confidentiality. According to ethical standards, when is the process of informed consent complete?

Answer: It is an ongoing process throughout the counseling relationship.

The ACA Code of Ethics (Standard A.2.a) emphasizes that informed consent is an ongoing part of the counseling process. Counselors must appropriately document discussions of informed consent throughout the relationship. This means that as new issues arise or treatment plans change, the counselor should revisit and discuss relevant aspects of the informed consent to ensure the client remains fully aware and in agreement with the therapeutic process.

An LPC in a small, rural town discovers that a new client is a cashier at the only local grocery store. Which of the following best describes this situation and the most appropriate initial action for the counselor to take?

Answer: This is a potentially harmful multiple relationship, and the counselor should discuss the potential challenges and boundaries with the client.

This scenario describes a multiple (or dual) relationship, which occurs when a counselor has another role with a client. The ACA Code of Ethics does not prohibit all nonsexual multiple relationships but requires counselors to manage them with care. In small communities, such relationships can be unavoidable. The most ethical initial step is to discuss the nature of the dual relationship, its potential for impaired judgment or harm, and establish clear professional boundaries with the client as part of the informed consent process.

A client's attorney subpoenas a counselor for the client's complete case file for a legal proceeding. The counselor is concerned that releasing the entire file could be harmful to the client. What is the counselor's most appropriate ethical and legal course of action?

Answer: Consult with their own legal counsel and seek guidance from the court.

While a subpoena is a legal demand, it does not automatically override a counselor's ethical obligations. The ACA Code of Ethics (Standard B.6.e) allows counselors to limit access to records if there is compelling evidence that access would cause harm. The proper course of action is not to ignore the subpoena but to seek legal advice and potentially request that the court review the records in private (in camera) or issue a protective order to limit the disclosure to only what is necessary, thereby protecting the client from foreseeable harm.

The 'duty to warn' established in the Tarasoff v. Regents of the University of California case requires a counselor to take action when a client poses a serious threat of violence. Which of the following conditions is most critical for this duty to be invoked?

Answer: The threat is made against a reasonably identifiable victim.

The Tarasoff ruling and subsequent statutes specify that the duty to warn or protect applies when a patient communicates a threat of serious violence against a reasonably identifiable victim or victims. A vague threat or generalized anger does not typically meet the threshold. The specificity of the threat and the identifiability of the potential victim are key components that trigger this legal and ethical obligation to breach confidentiality.

Which of the following is generally considered outside the scope of practice for a Licensed Professional Counselor (LPC)?

Answer: Prescribing psychotropic medications.

The scope of practice for LPCs is defined by state law but universally excludes the prescription of medication. While LPCs are trained to diagnose mental disorders, use various therapeutic techniques, and conduct assessments, prescribing medication is a medical function reserved for physicians, psychiatrists, or other qualified medical professionals. Some states have different levels of licensure (e.g., LPC vs. LPC/MHSP) that may affect the scope of diagnosis and treatment, but medication management is not within the LPC's scope.