Nce: Professional Orientation & Ethics

Front 1

Which group has been most instrumental in opposing counselor licensure?

a. Social workers.
b. Psychiatrists.
c. Psychologists.
d. AAMFT members

Back 1

c). psychologist

Others point out that at one time psychologists were debased and called “Junior psychiatrists,” and now the psychologists are doing to counselors what psychiatrists did to them. In any case, the tide appears to be changing as “mental health coalitions” are popping up in which psychiatrists, psychologists, counselors, social workers, and related specialists

Front 2

In the late 1970s, AACD ( known as ACA since 1992) began to focus very heavily on professional credentialing. This led to the formation of the

a. CCMHC.
b. NBCC.
c. CACREP, formed in 1981.
d. APGA, formed in 1952.

Back 2

b). NBCC

In 1982, the American Association for Counseling and Devel- opment (AACD), now the American Counseling Associationformed the National Board for Certified Counselors (NBCC). If you meet the educational/skill requirements and pass an exam (come on now you remember, probably the exam you are study- ing for this very minute!) you can use the title NCC —National Certified Counselor. This is a generic certification. The designa- tion lasts for five years at which time the counselor must have 100 approved hours of continued professional development (e.g., workshops) or sit for the test again.

Front 3

By passing the NCE, a counselor can attain _______, given via NBCC.

a. NCC, a generic certification for counselors.
b. NCC, a specialty mental health certification for counselors.
c. NCC, national certification for school counselors.
d. MAC, master addictions counselor.

Back 3

a). generic certification for counselors

The NCC credential constitutes a “generic” certification. The word generic literally means.“general” or “referring to all types of counselors. ”National certifications can (as the name suggests) be used on a national basis unlike licenses which tend to be state specific. Licenses are con- ferred by the individual state and not the federal government

Front 4

Which choice would most likely violate the counseling ethic or law termed “scope of practice”?

a. A counselor who is using good accurate empathy with a client, but fails to confront her about her excessive drinking.
b. A licensed counselor who gives the client a DSM diagnostic code for insurance.
c. A counselor who is too active directive with a client.
d. A counselor who is conducting a strict Freudian psychoanalysis with the client.

Back 4

d). a counselor who is conducting a strict Freudian psychoanalysis with the client

The “scope of practice” concept suggests that counselors should only practice using techniques for which they have been trained. Most counselors are not trained in classical analysis. This concept also implies that a counselor should not attempt to treat clients for which he or she has no training.

Front 5

Ethical guidelines were first created for the helping professions in 1953 when the American Psychological Association (APA) published their first code of ethics. The National Association of Social Workers (NASW) created their code in 1960, and in 1961, the organization that is now ACA adopted ethics for counselors. Ethics always describe

a. laws.
b. universal principles which apply to all helpers.
c. standards of conduct imposed by ACA and NBCC.
d. all of the above.

Back 5

c). standards of conduct imposed by ACA and NBCC

Ethics define standards of behavior set forth by organizations and certification bodies. Ethics are not state or federally mandated laws. Unlike many laws, ethical guidelines generally do not spell out penalties for violations. Hence, the aforementioned counselor who is dating a client might lose his or her license but will not be serving time in a city jail or a federal penitentiary.

Front 6

Most ethical dilemmas are related to

a. confidentiality.
b. testing.
c. diagnosis.
d. research.

Back 6

a). confidentiality

Some of the literature in the field refers to confidential material as “entrusted secrets.” What goes on in the counseling relationship remains private rather than public. Helpers must, nevertheless, be aware that there are exceptions to this principle. The exceptions illuminate the fact that confidentiality is relative to the situation.

Front 7

The landmark 1969 case, Tarasoff versus the Board of Regents of the University of California illuminated

a. difficulties involved in client/counselor sexual behavior.
b. ethical issues in relation to research.
c. the duty to warn a client in imminent danger.
d. the impact of an impaired professional.

Back 7

c). the duty to warn a client in imminent danger

This case is often cited as an example of a professional helper’s “duty to warn” a person of serious and foreseeable harm to him or herself or to others. ACA chose to replace the phrase “clear and imminent danger” which appeared in the previous version of their ethical code with “serious and foreseeable harm.” The newer terminology is seen as indicating that there is a broader scope of circumstances where confidentiality may need to be broken such as a client with a terminal illness who has no medical options and wishes to end his or her own life.

Front 8

A counselor reveals information that is extremely damaging to a client’s reputation. This counselor could be accused of

a. beneficence.
b. justice.
c. nonmaleficence
d. defamation

Back 8

d). defamation

Beneficence means the counselor is working for the good of the client or the group. Justice (usually applied to group situations) means that the counselor treats all members fairly. Nonmaleficence means that the counselor will do no harm. The cor- rect answer—defamation—describes behavior that can damage one’s reputation. It is known as libel if it is written and slander if the defamation refers to verbal remarks.

Front 9

State laws can govern title usage and practice, however, they do not govern

a. accreditation.
b. counselor licensure.
c. psychologist licensure.
d. involuntary commitment to state psychiatric facilities.

Back 9

a). accreditation

Accreditation, however, is not the law. In fact, you need to be aware of the fact that many counselor preparation programs are not accredited. Accreditation is a process whereby an agency or school (not an individual) meets certain standards and qualifications set forth by an association or accrediting organization. The organization that grants the ac- creditation usually requires site visits for the purpose of evaluating the institution initially and on an ongoing basis. Thus, programs in psychology will boast accreditation via the APA (American Psychological Association) while counseling programs can be accredited by CACREP, mentioned earlier.

Front 10

An exception to confidentiality could occur when a client is suicidal. Suicidal warning signs include

a. repeatedly joking about killing one’s self.
b. giving away prized possessions after one has been depressed for an extended period of time.
c. a previous suicide attempt and a very detailed suicide plan for the future.
d. all of the above.

Back 10

d). all of the above

Most suicides occur in the spring at the end of April or May and about 75 to 80% of your clients will give warning signs.

Front 11

A statement of disclosure could include all except

a. a list of the courses the counselor took in graduate school.
b. the counselor’s qualifications, office hours, and billing policies.
c. emergency procedures and therapy techniques utilized.
d. a statement that confidentiality is desirable, but cannot be guaranteed in a group setting.

Back 11

a). a list of the courses the counselor took in graduate school

Front 12

Privileged communication refers to the fact that anything said to a counselor by a client

a. can be revealed in a court of law if the counselor decides it is beneficial.
b. can be revealed only if a counselor testifies in court.
c. is protected by laws in every state.
d. will not be divulged outside the counseling setting without the client’s permission.

Back 12

d). will not be divulged outside the counseling setting without the client's permission

privileged communication is a legal term that implies that a therapeutic interaction (verbal or written) will not be available for public inspection. A counselor/client relationship protected by privileged communication is one in which the client—not the counselor—can choose not to have confidential information revealed during a legal proceeding (generally on the witness stand).

Front 13

In regard to state law and privileged communication, counselors must be aware that

a. privileged communication exists in every state in the union for LPCs.
b. laws are unclear and may vary from state to state.
c. there are no laws which govern this issue.
d. state psychology laws are applicable in this respect.

Back 13

b). laws are unclear and may vary from state to state

Privileged communication is a legal concept that protects clients, not counselors. If a client decides to waive his or her right to privileged communication, then the counselor must reveal the information. Privileged communication legislation varies from state to state

Front 14

When counselors state that privileged communication is “qualified,” they actually mean that

a. the counselor must have certification before privileged communication applies.
b. privileged communication applies only to doctoral level counselors.
c. exceptions may exist.
d. all of the above.

Back 14

c). exceptions may exist

Front 15

You are a counselor in a state that does not legally support privileged communication. You refuse to testify in court. In this situation

a. ACA will back you for doing the ethical thing.
b. NBCC will back you if and only if you have attained NCC status.
c. you need not testify if your case was supervised by a licensed psychologist and/or psychiatrist.
d. you could be held in contempt of court.

Back 15

d). you could be held in contempt of court

Your client in this situation would not have the “privilege” to say no if you are asked to testify.

Front 16

An 11-year-old child comes to your office with a black eye and tells you she can’t remember how she received it. You have reason to suspect abuse. You should

a. be empathic and discuss her feelings regarding the matter.
b. drop the matter as it could embarrass her.
c. refer her to a medical doctor of your choice.
d. call the child abuse/neglect hotline.

Back 16

d). call the child abuse/neglect hotline

Counselors are mandated reporters for child abuse. It is legal and ethical to break confidentiality in such cases. You must report child abuse, it’s the law! The word mandated means that a counselor does not have a choice in the matter.

Front 17

During a counseling session a 42-year-old male client threatens suicide. You should

a. keep it a secret as the client is not a minor.
b. call the state child abuse/neglect hotline even though he is an adult.
c. call his wife and mention that a serious problem exists but be very careful not to discuss the issue of suicide since to do so would violate the client’s confidentiality.
d. contact his wife and advise her of possible suicide precautions.

Back 17

d). contact his wife and advise her of possible suicide precautions

Ethics guidelines will usually say something like this: When a client’s condition indicates that there is a clear and imminent danger or serious and foreseeable harm to the client and others, the counselor must take reasonable personal action or inform responsible authorities.

Front 18

A 39-year-old female secretary you are seeing in your assertiveness training group reveals that she is plotting to shoot her husband. Based on the Tarasoff case you should

a. warn the husband.
b. keep it confidential because an assertiveness training group is decidedly not the same as one-to-one counseling.
c. make a police report in the city in which the husband resides.
d. tell a supervisor, administrator, or board member if one exists, but do not contact her husband.

Back 18

a). warn the husband

Tarasoff implies that a responsible helper will warn an intended victim. Professionals generally adhere to the principle of minimal disclosure, which suggests that you reveal only what is necessary.

Front 19

You pass your exam and now have NCC status. During a staff meeting a clinical director explains to you that, from an ethical standpoint, your primary duty is to the agency. Most experts in the field of counselor education would

a. agree with this position with very few reservations.
b. disagree inasmuch as professional ethics emphasize that your primary responsibility is to your clients.
c. disagree inasmuch as professional ethics emphasize that your primary responsibility is to the ACA.
d. say that, according to “aspirational ethics,” your agency comes first.

Back 19

b). disagree inasmuch as professional ethics emphasize that your primary responsibility is to your clients

Number 2 of the first section (i.e., Section A: General) states that “If the certified counselor and the employer do not agree and cannot reach agreement on policies that are consistent with appropriate counselor ethical practice that is conducive to client growth and development, the employment should be terminated.

Front 20

One impetus for counselor licensing was that

a. ACSW wanted to restrict counselors.
b. politicians demanded that counselors be licensed.
c. psychology licensure bodies sought to restrict the practice of counselors so counselors could not receive third party payments from insurance and managed care companies.
d. insurance companies pushed strongly for it.

Back 20

c). psychology licensure bodies sought to restrict the practice of counselors so counselors could not receive third party payments from insurance and managed care companies.

Many—if not most—counselors were not able to be licensed as psychologists because one popular requirement was that the graduate program had to be “primarily psychological in nature,” which basically meant that persons who attended counseling programs were considered inappropriate. Licensing for counselors was needed as psychologists attained licensing (and had somewhat of a monopoly on nonmedical treatment services) in every state in the United States.

Front 21

A counselor who possesses a graduate degree wishes to become a licensed psychologist. Which statement most accurately depicts the current situation?

a. Any counselor can easily become a psychologist if he or she can pass the EPPP.
b. A counselor can become a licensed psychologist by taking three graduate credit hours in physiological psychology and then passing the EPPP.
c. In nearly every case individuals trained in counseling departments would not be allowed to sit for the EPPP and thus could not become licensed psychologists.
d. A counselor with a doctorate in counseling could be licensed as a counseling psychologist if he or she has a degree from a recognized department of counseling.

Back 21

c). In nearly every case individuals trained in counseling departments would not be allowed to sit for the EPPP and thus could not become licensed psychologist

EPPP stands for Examination for Professional Practice in Psychology. Roughly speaking, the EPPP is to psychologists, as the NCE is to counselors.

Front 22

A woman who is in private practice mentions in her phone book advertisement that she is a licensed counseling psychologist. This generally means that

a. she has a doctorate from a counselor education program.
b. she has a graduate degree from a psychology department.
c. she has a degree from a CACREP program.
d. she has a degree in counseling but is trained in projective testing.

Back 22

b). she has a degree from a psychology department

The trick to answering this question is to remember that the term psychology can only be used if the helper is a licensed psychologist, even if the person specializes in counseling. Hence, the degree would need to be from a program which is primarily psychological, a psychology rather than a counseling department

Front 23

One major difference between the psychology versus the counseling movement seems to be that

a. the psychologists are working to eliminate practitioners with less than a doctorate, while the counselors are not.
b. counselors are working to give up tests for licensure.
c. psychology boards are made up primarily of psychiatrists.
d. in most states psychologists do not need to take an exam.

Back 23

a). the psychologists are working to eliminate practitioners with less than a doctorate, while the counselors are not

Counselors and social workers seem comfortable with master’s level practitioners. In an early study in which ACES members were asked to comment on the minimum level of education nec- essary for licensure, over 45% of the respondents felt comfortable with master’s level practitioners. A little over 41% insisted that a doctorate was necessary.

Front 24

APA is to psychologist as ACA is to

a. APGA.
b. certified clinical mental health counselor.
c. counselor.
d. NCC.

Back 24

c). counselors

First, recall that the APA (in the context of this question) refers to the American Psychological Association, which is the major professional body for psychologists. ACA plays the same role for counselors.

Front 25

You have achieved the status of NCC. NBCC, nevertheless, feels you have violated professional ethics. NBCC can do any of the following except

a. revoke your state counseling license.
b. remove your name from the list of NCCs in the U.S.
c. revoke your NCC status.
d. note in their newsletter that your NCC status has been revoked.

Back 25

a). revoke your state counseling license

Certification is not the same as licensing. Thus, a certified reality therapist cannot legally use the title counselor (assuming the state has licensing) unless he or she is licensed by the state. A certification is given to an individual via an organization which is not part of the state or federal government. A counseling license is granted by the state government. Nevertheless, you must (yes must) be certified to call yourself a certified counselor. You could, however, call yourself a professional counselor if you are not certified.

Front 26

A counselor who is alcoholic and suffering from burnout could best be described as

a. a mesomorph.
b. an impaired professional.
c. a paraprofessional.
d. a counselor who is wise enough to use his own experiences to help others.

Back 26

b). an impaired professional

The term impaired is used here to mean a deterioration in the ability to function as a counselor. The counselor described in this question definitely meets the criteria.

Front 27

Counselor certification

a. is synonymous with licensure.
b. is synonymous with program certification.
c. recognizes that you have reached a given level of competence and thus are authorized to use a title.
d. is primarily a legal process.

Back 27

a). recognizes that you have reached a given level of competence and thus are authorized to use a title

Front 28

A woman comes to you for help with an eating disorder. You have no experience or training in this area. Ethically you should

a. refer this client to a colleague who is indeed trained and experienced with this type of client.
b. keep the client and work on her general lack of self-esteem.
c. tell the client you will do a comprehensive Internet search on the topic and then begin seeing her.
d. explain to the client that a symptom such as eating or not eating is not the real problem and that counseling focuses on real underlying issues.

Back 28

a). refer this client to a colleague who is indeed trained and experienced with this type of client

Front 29

Virginia was the first state to license counselors in 1976. The APGA (later AACD and now ACA) division that was initially the most instrumental in pushing for licensing was the

a. American College Personnel Association.
b. American School Counselor Association.
c. Association for Specialists in Group Work.
d. American Counselor Education and Supervision.

Back 29

d). American Counselor Education and Supervision

Front 30

The problem with income sensitive or sliding fee scales (based on the client’s ability to pay) is that

a. scales of this kind are unethical.
b. scales of this nature are illegal.
c. it is difficult to administer them in a fair manner.
d. scales like this are used frequently; however, they are unethical and illegal.

Back 30

c). it is difficult to administer them in a fair manner

Sliding fee scales, which are ethical and legal, quite popular with not-for-profit agencies, are often confused with the term amount waived,which refers to the amount a third party payer did not cover.

Front 31

One possible negative aspect of counselor licensure is that

a. counselors would receive more third-party payments.
b. counselors might be accepted as providers by insurance companies.
c. counselors may not be as creative during their graduate work and simply take courses aimed at fulfilling the requirements to take the licensure exam.
d. it will take business away from psychologists.

Back 31

c). counselors may not be as creative during their graduate work and simply take courses aimed at fulfilling the requirements to take the licensure exam

Licensing generally adds prestige to a profession and can serve to protect the public; nevertheless, students often take precisely what is required for licensing or certification.

Front 32

A client wants his records sent to a psychiatrist he is seeing. You should

a. advise against it based on current research.
b. refuse to do so based on ethical guidelines.
c. first have the client sign a dated release of information form that stipulates whether the information can be released once (or for what period of time it can be released) and then you can send the information.
d. call the psychiatrist to discuss the case but explain that state law prohibits a counselor from sending anything in writing about the client.

Back 32

c. first have the client sign a dated release of information form that stipulates whether the information can be released once (or for what period of time it can be released) and then you can send the information.

Front 33

You are a licensed professional counselor in one state but will soon relocate to another state. The new state informs you that they will grant you reciprocity or so-called endorsement. You will thus

a. simply need to take the licensing test in the new state.
b. be permitted to practice in the new state based on your current credentials without taking another exam.
c. need to take numerous graduate courses.
d. not be allowed to practice until you serve an internship.

Back 33

b). be permitted to practice in the new state based on your current credentials without taking another exam.

Reciprocity occurs when one state or organization accepts the license or credential of another state or organization. State requirements for licensure differ and thus one state does not always accept credentials snared in another state. When that occurs we merely say that the state the counselor is moving to will not grant the counselor reciprocity.

Front 34

According to the Family Educational Rights and Privacy Act (FERPA) of 1974 (also known as the Buckley Amendment)

a. a parent can see his or her daughter’s middle school record.
b. an 18-year-old college student can view his or her own educational record.
c. a and b.
d. a and b are both illegal.

Back 34

c). a parent can see his or her daughter's middle school record and an 18-year-old college student can view his or her own educational record

In order to abide by FERPA, school counselors are urged to keep their counseling notes separate from the rest of the student’s file and to make certain other teachers do not have access to the files. However, school counselors should be aware that a court of law can still subpoena the actual counseling notes or request that the counselor testify.

Front 35

You are a school counselor who wishes to refer an orthopedically disabled student to a private therapist. In general, the best referral would be to

a. a CRC.
b. a MAC.
c. a licensed clinical psychologist.
d. a licensed social worker.

Back 35

a). a CRC (Certified Rehabilitation Counselor)

CRCs will need at least a master’s in rehabilitation counseling, acceptable experience in the field, and a passing score on a 400-question multiple choice examination.

Front 36

A registry would be

a. a list of licensed psychologists in the state of Illinois.
b. a list of CRCs in the United States.
c. a and b.
d. the registration process for counselor licensure in the state of Missouri.

Back 36

c). a list of licensed psychologists in the state of Illinois and a list of CRCs in the United States

A registry is always a list of providers. A person whose name is included in a state counseling registry can sometimes use the title “registered professional counselor” or RPC.

Front 37

A counselor wins the lottery and closes her practice without telling her clients. This counselor’s course of action is best described as

a. a multiple relationship.
b. defamation.
c. abandonment.
d. nonmaleficence.

Back 37

c). abandonment

The client in this question is the victim of abandonment which occurs when a counselor stops providing services and does not refer the client to another helper.

Front 38

You are counseling your first cousin for depression. This is

a. ethical.
b. not actually an ethical issue.
c. ethical if you continue to counsel her and refer her to psychiatrist for an antidepressant.
d. generally unethical as it would constitute a dual or so called multiple relationship.

Back 38

d). generally unethical as it would constitute a dual or so called multiple relationship

Front 39

A counselor who sports NCC after her name

a. will need not concern herself with continuing education.
b. will need three graduate courses every 10 years.
c. will never receive credit for workshops but should attend for her own personal growth nevertheless.
d. will need a specified amount of continuing education contact hours before she can be recertified, or she will need to take the NCE again.

Back 39

d). will need a specified amount of continuing education contact hours before she can be recertified, or she will need to take the NCE again

One hundred hours of professional development are needed during a five-year period. Recently, Home Study Programs have made this process more convenient.

Front 40

You find yourself sexually attracted to a client. This is known as

a. counter transference.
b. ambivalent transference.
c. negative transference.
d. positive transference.

Back 40

a). counter transference

A typical manifestation of countertransference would be romantic or sexual feelings toward a client. Countertransference is an indication of unresolved problems on the part of the helper.

Front 41

Your sexual attraction toward your client is hindering the counseling process. You should

a. continue treatment but be honest and empathic with the client.
b. ignore your feelings; after all you are a professional.
c. explain this to the client and then refer the client to another provider.
d. continue to see the client but ignore psychosexual topics.

Back 41

c). explain this to the client and then refer the client to another provider

If the counselor felt a sexual attraction which had “not” as yet hindered the treatment process, then personal therapy/profes- sional supervision for the counselor would be the most desirable plan of action. Moreover, prior to the point where the counselor’s attraction interfered with the treatment, most experts would advise against discussing the attraction with the client.

Front 42

A malpractice or liability insurance company is least likely to defend you if

a. you are sexually involved with a client.
b. you violate confidentiality.
c. you do not have a client sign a release of information and send a record to another agency or provider.
d. you call a state child abuse hotline and a client takes legal action since the child was actually the victim of an accident.

Back 42

a). you are sexually involved with a client

Front 43

Computers are now being used in various counseling settings. Counselors speak of Computer Assisted Counseling (CAC) and Computer Managed Counseling (CMC). An office that employs a computer to schedule clients would be an example of

a. CMC.
b. CAC.
c. an ethical violation.
d. the misuse of computers, though the practice is ethical.

Back 43

a). Computer Managed Counseling

When a computer helps manage your practice (yes, just like a manager) then it is known as CMC. CMC would include tasks such as bookkeeping, client scheduling, printing billing state- ments, and compiling referral sources. CAC is like having a counseling “assistant” do the counseling for you. A computer software program that attempts to counsel clients is an example of CAC in action. CAC is controversial and most experts agree computers can never provide the compassion of a human doing counseling.

Front 44

A college student who suffers from panic disorder types his symptoms and concerns onto a PC screen and then waits for the computer program to respond or question him further. The student engages in this practice for one 40-minute session per week. This is an example of

a. CAC.
b. CMC.
c. Computer Managed Counseling.
d. b and c.

Back 44

a). Computer Assisted Counseling

Front 45

As a professional counselor you develop a self-help software package for use by the general public. Ethics indicate that

a. the package must be designed to use with counseling.
b. the package must be designed to use with counseling and then modified for stand-alone usage.
c. the package must be initially designed for stand-alone usage as opposed to modifying a package requiring counselor support.
d. this is an unethical practice.

Back 45

c). the package must be initially designed for stand-alone usage as opposed to modifying a package requiring counselor support

Ethics also dictate that the certified counselor must provide descrip- tions of appropriate and inappropriate applications, suggestions for using the software, statements regarding the intended out- comes, and how and when counseling services are beneficial.

Front 46

Which statement best describes the counseling profession’s reaction to computer assisted counseling and computer managed counseling?

a. Counselors are very humanistic and seem to dislike CMC and CAC technology.
b. Counselors have welcomed both forms of computer technology with open arms.
c. CMC has been well received since it cuts down time on paperwork, scheduling, and record keeping, but there is a mixed reaction to CAC as some feel it depersonalizes counseling.
d. Counselors dislike CMC but praise CAC highly.

Back 46

c. CMC has been well received since it cuts down time on paperwork, scheduling, and record keeping, but there is a mixed reaction to CAC as some feel it depersonalizes counseling.

Front 47

You are a supervisor at a sexual abuse treatment agency. Sally is one of your counselors and you give her a performance rating on a yearly basis. Sally has been having panic attacks on a daily basis at home for almost a month and her physician feels that counseling rather than medicine is indicated. Now—for the first time—she has a terrible panic attack at work. If you don’t see her the nearest counselor is 150 miles away. You should

a. refer her to the counselor who is 150 miles away.
b. absolutely refuse to see her as dual relationships violate ethical guidelines.
c. teach her relaxation but refuse to counsel her.
d. attempt to counsel her.

Back 47

d). attempt to counsel her

NBCC ethics that address dual relationships state that: “Exceptions are made only in in- stances where an individual’s situation warrants counseling intervention and another alternative is unavailable.” Also remember that ACA ethics now state that not all dual relationships are bad and that very fact helped remove the term from the current guidelines.

Front 48

A counseling journal article should use documentation (i.e., references) that is based on

a. APA style.
b. MLA style taught in most English composition classes.
c. a or b.
d. none of the above.

Back 48

a). APA style

Front 49

A 14-year-old male threatens to blow up his parents’ garage because he has been grounded. You believe his threat is genuine. You should

a. ask the child if he will sign a release of information so you can talk to his parents.
b. not talk to the parents since this would weaken the bond of trust you have with the client.
c. have the child sign a contract stating he will not blow up the garage but mention nothing to the parents.
d. warn the parents that their property is in danger.

Back 49

d). warn the parents that their property is in danger

Front 50

A 16-year-old girl threatens to kill herself and you fail to inform her parents. Your behavior as a counselor is best described as

a. an example of a dual relationship.
b. an example of informed consent.
c. an example of negligence, which is a failure to perform a duty, which in this instance is an obligation to protect the client.
d. multiple submission.

Back 50

c). an example of negligence, which is a failure to perform a duty, which in this instance is an obligation to protect the client.

Front 51

NBCC has developed a Code of Ethics to help counselors behave in a professional manner. The code is divided into a preamble and seven sections. The first section (i.e., Section A) warns against stereotyping and discrimination. All of the following would be examples of stereotyping and discrimination except

a. advising an African-American client to avoid graduate school because you believe the Jensen research regarding Blacks and IQ scores.
b. advising a client to consider switching his college major based on your clinical judgment as well as the results from an extensive test battery.
c. advising a female client to avoid taking a management position because you feel women are generally nonassertive.
d. advising a female client to avoid taking a management position because you feel women managers are generally too aggressive.

Back 51

b). advising a client to consider switching his college major based on your clinical judgment as well as the results from an extensive test battery.

Front 52

Section A, which is the general section of NBCC’s Code of Ethics, cautions counselors against sexual harassment defined as “unwelcome comments, gestures, or physical contacts of a sexual nature.” An example of an ethics violation in this respect would be

a. a female counselor who repeatedly tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned.
b. a male counselor who smiles to reinforce a female client (who is overly critical of her looks) who has just said that she is beginning to accept her feminine qualities.
c. a female career counselor who tells a male client that she feels his gray flannel suit would be the most appropriate for a given job interview.
d. when a client who has been very depressed and neglecting her looks comes into the therapy session looking much better and the counselor comments, “You certainly look nice today.”

Back 52

a). a female counselor who repeatedly tells a male client how sexy his hairy chest looks when he leaves his shirt unbuttoned.

Front 53

You are a well-known cognitive behavior therapist who heads up a private practice in New Jersey. For the next two years you will be in Canada conducting a research project. Your practice has six other counselors. The practice is sending brochures to schools, agencies, and hospitals in an attempt to boost referrals. Your name appears on the front of the brochure as if you are available for referrals. This is

a. totally ethical.
b. unethical.
c. possibly ethical and possibly unethical. Not enough information is given to answer this question.
d. irrelevant since ACA and NBCC ethics do not address private practice.

Back 53

b). unethical

The verdict: unethical. Ethics do address private practice and suggest that persons who hold leadership roles not allow their names to be used in professional notices when they are not practicing counseling unless this is clearly stated in the practice’s lit- erature.

Front 54

A colleague of yours who is not a certified counselor behaves in an unethical manner. The ethical thing for you to do is

a. ignore it; unfortunately you have no rights in this situation.
b. consult the school the person graduated from.
c. attempt to rectify the condition via institutional channels, turning to NBCC procedures if this fails.
d. all of the above are considered ethical.

Back 54

c). attempt to rectify the condition via institutional channels, turning to NBCC procedures if this fails

NBCC does not beat around the bush in regard to this critical issue. Professional behavior of associates is expected of “both certified and noncertified counselors.” Read Section A: General, paragraph 3, of, NBCC’s Code of Ethics. Try to ameliorate the difficulty via the institution’s channels before contacting
NBCC.

Front 55

A client asks you for classical psychoanalysis yet you have no training whatsoever in this area. If you agree to analyze the client, you are

a. violating the duty to warn.
b. still ethical if you possess LPC or NCC.
c. unethical as this is misrepresentation.
d. still ethical if and only if you have a doctorate.

Back 55

c). unethical as this is misrepresentation

Front 56

A client needs counseling but can afford only $5 per session. As a private practitioner you charge $75 per hour. You should

a. still charge the client $75 per hour, but let her pay you $5 per week indefinitely until she has actually paid your normal rate.
b. be firm and tell her the fee is $75 per hour regardless of her income.
c. immediately refer her to a state funded agency.
d. consider the client’s financial status and the locality and offer her a reduced rate.

Back 56

d). consider the client's financial status and the locality and offer her a reduced rate

ACA ethics tell the story: “Counselors consider the financial status of clients.” If the fee is inappropriate, you must assist the client in “finding comparable services of acceptable cost.”

Front 57

Dr. X recommends to his agency clients that he would rather counsel them in his private practice. Ethically speaking

a. Dr. X has every right to do this.
b. Dr. X is diverting agency clients to his practice and this is unethical.
c. guidelines do not address this practice.
d. NBCC encourages this method for private practitioners.

Back 57

b). Dr. X is diverting agency clients to his practice and this is unethical

Front 58

Section B of NBCC’s Code of Ethics deals with the counseling relationship. Thus a counselor who uses a paradoxical strategy

a. has committed a blatant ethics violation.
b. does not need to explain the purpose of the paradox to the client.
c. should explain the purpose of this technique to the client.
d. must tape record the interview.

Back 58

c). must explain the purpose of this technique to the client

Front 59

A counselor is counseling an executive secretary. The counselor notes that he is writing a book and explains to the client that he will see her for free if she types the manuscript. This is

a. known as bartering and unethical as described here.
b. known as bartering and ethical.
c. known as bartering and is highly recommended for clients with limited income.
d. is known as bartering and ethics encourage this practice whenever possible.

Back 59

a). known as bartering and unethical as described here

Front 60

Ethics state that a counselor should _______ all clients for group counseling.

a. diagnose.
b. test.
c. screen.
d. a and b.

Back 60

c). screen

Front 61

You are a middle school counselor at a public school. A child is threatening to kill another student and admonishes you to keep it a secret. According to the ethical principle of minimal disclosure the best course of action would be to

a. try to talk the client out of his plan of action but do not violate his confidentiality by telling anyone else.
b. call the major radio and television stations as research clearly indicates that publicity can stop school tragedies.
c. call the police and give them a complete blow by blow description of the counseling session.
d. inform the parents of the student in danger, inform the principal, and call the police immediately, discussing only material related to the threat.

Back 61

d. inform the parents of the student in danger, inform the principal, and call the police immediately, discussing only material related to the threat.

Minimal disclosure means that if you must break confidentiality you reveal only what is necessary (i.e., a minimal amount) and when possible inform the client that you are going to disclose confidential information.

Front 62

Your agency uses a collection agency when clients don’t pay their bills. You should

a. not take a chance on degrading the therapeutic relationship by mentioning it.
b. Explain to the client that ethically the agency can do this; however, a private practitioner is not allowed to use a collection agency and thus a private counselor might be a wiser choice.
c. inform the client of this before the counseling begins.
d. never do this as it is unethical in our field.

Back 62

c). inform the client of this before the counseling begins

Front 63

You have just made a landmark discovery which you feel could literally change the entire field of counseling and thus you write an article which depicts your findings. The next step would be to

a. submit the article to no more than two journals simultaneously.
b. submit the article to every major APA and ACA journal published.
c. submit the article to one publication at a time despite your conviction that the article must get published.
d. write NBCC and request permission for multiple submission privileges.

Back 63

c). submit the article to one publication at a time despite your conviction that the article must get published

Here is a concept I mentioned earlier and Section D of the NBCC code sets the record straight: “certified counselors must not submit the same manuscript, or one essentially the same in content, for simultaneous publication consideration by two or more journals.” Multiple or duplicate submissions are unethical in relation to journal articles.

Front 64

Section F of NBCC’s Code of Ethics is concerned with ethics related to consulting. Consulting or consultation can best be defined as

a. a brand or paradigm of brief psychotherapy.
b. a brand or paradigm of long-term psychotherapy.
c. a systematic process based on classical conditioning.
d. a voluntary relationship between a professional helper and a help-needing individual, group, or social unit in which the consultant helps define or solve problems related to clients, the client system, or work-related issues.

Back 64

d. a voluntary relationship between a professional helper and a help-needing individual, group, or social unit in which the consultant helps define or solve problems related to clients, the client system, or work-related issues

Front 65

Section G of NBCC’s Code of Ethics describes ethical issues related to private practice. Which of these situations is clearly an ethics violation?

a. A private practitioner who advertises in the Yellow Pages.
b. A private practitioner who advertises in a daily newspaper.
c. A counselor who terminates a professional relationship with a client because she feels it is no longer productive for her client.
d. An executive director of a private practice who has his name listed in a Yellow Pages advertisement as a counseling provider despite the fact that he is out of the country and is engaged in a research project for the next two years.

Back 65

d. An executive director of a private practice who has his name listed in a Yellow Pages advertisement as a counseling provider despite the fact that he is out of the country and is engaged in a research project for the next two years.

NBCC’s Section G states, however, that certified counselors in executive leadership roles should not allow their names to be used in professional notices at times when they are not perform- ing counseling.

Front 66

Nosology refers to a system of classification. Name the nosological system(s) utilized by professional counselors who diagnose clients.

a. DSM.
b. ICD.
c. a and b.
d. The Rogerian classification system

Back 66

c). DSM and ICD

Front 67

The Diagnostic and Statistical Manual of Mental Disorders (DSM) was created by the American Psychiatric Association. The Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD) was created by the World Health Organization (WHO). Which counselor would most likely be required to utilize one of these guides to diagnose a client?

a. A counselor who wishes to secure insurance (i.e., third party) payments.
b. A guidance counselor discussing a child with a teacher.
c. A multicultural counselor who is seeing a Black client.
d. counselor leading a T-group.

Back 67

a). a counselor who wishes to secure insurance

Diagnosis has been seen as dehumanizing, and a given diagnosis does not imply a given cure. Despite all the aforementioned difficulties, insurance companies/managed care organizations ask for a diagnosis before paying for a service; this is a remnant of the so-called medical model.

Front 68

Traditionally, _______ counseling has caused the most ethical concerns.

a. behavioral.
b. person-centered.
c. humanistic.
d. reality therapy.

Back 68

a). behavioral

The concern has been that behavior therapists can control, manipulate, and shape behavior. Is it ethical, for example, to use aversive conditioning such as electrical shocks, drugs, or paralysis to eliminate smoking, alcoholism, gambling, or homosexual tendencies?

Front 69

Insurance payments are also called

a. mandated payments.
b. third-party payments.
c. optional payments.
d. psychometric payments.

Back 69

b). third party payments

Keep in mind that third-party payments do not always cover the entire counseling fee. An insurance policy, for example, could pay only 50 or 80%. Other third-party systems have a maximum fee for services which could conceivably be less than your normal rate. When a client pays for a portion of the service it is known as a “copayment.”

Front 70

The DSM uses a multiaxial classification system with five axes. Diagnostic codes have _______ digits.

a. five.
b. four.
c. nine (which correspond to the DOT). d. 12.

Back 70

a). five

Front 71

Identify the DSM code.

a. 29622.
b. 29.622.
c. 303.90.
d. 2962.2.

Back 71

c). 303.90

Choice “c” is correct. As mentioned in the answer to the last question, the decimal point occurs after the third digit regardless of the diagnosis or lack of it.

Front 72

As you are reading the DSM you see this code: 296.2X. In this case the X (i.e., the fifth digit) refers to

a. severity, and thus it will be replaced with a diagnostic number.
b. an adjustment disorder.
c. developmental disorder.
d. physical disorders and conditions.

Back 72

a). severity and thus will be replaced with a diagnostic number

In this actual example the 296.2X indicates the condition of major depression, single episode. In the form of 296.20 the condition is “unspecified.” Written 296.21 the condition is “mild.” 296.22 is moderate, while 296.23 is “severe without psychotic features”; and finally 296.24 signifies the most serious state of “severe with psychotic features”; 296.25 is “in partial remission,” whereas 296.26 is “in full remission.” This is an example of a mood disorder.

Front 73

In the DSM the so-called V Codes refer to conditions which are not attributable to a mental condition. An example of a V Code would be

a. 6282.V.
b. 62V.82.
c. 628V2.
d. V62.82.

Back 73

d). V62.82

Please do not memorize this code. The salient feature to remember is that the “V” replaces the first digit in the five-digit code.

Front 74

An example of a V Code diagnosis would be

a. Major Depression Single Episode Mild.
b. Borderline Personality.
c. Uncomplicated Bereavement.
d. Cocaine Dependence.

Back 74

c). uncomplicated bereavement

Certainly bereavement in response to a death of a loved one, for example, might not be attributed to any other “mental disorder” listed in the DSM. It might surprise you to discover that in addition to the aforementioned conditions, V Codes include marital problems, borderline intellectual functioning (an IQ of 71 to 84; 70 or below is considered retarded), malingering (which is avoiding life’s work or duties by exaggerating or feigning physical symptoms or illness), parent–child problems, occupational problems, noncompliance with medical treatment, other inter- personal problems, and a phase of life or circumstances problem (such as enduring a divorce).

Front 75

Formal diagnosis, also known as nosology, is most closely related to the _______ model.

a. behavioral.
b. medical.
c. cognitive-behavioral.
d. rational-emotivebehaviortherapy.

Back 75

b). medical

Front 76

Which DSM diagnosis indicates the most serious pathology?

a. 296.21.
b. 296.22.
c. 296.23.
d. 296.24.

Back 76

d)296.24

Front 77

The type of mental health service provided to the client is coded via _______ and is generally required for insurance payments.

a. DSM (e.g., 296.22).
b. the ICD (e.g., 311).
c. the AMA’s Current Procedural Terminology (e.g., CPT
90844).
d. the Psychiatric Dictionary.

Back 77

c). the AMA's Current Procedural Terminology (CPT)

If you want to accept insurance payments you will generally need to specify a CPT code in addition to the DSM or ICD code on your billing statement. The CPT code will specify the exact nature of the treatment being utilized to help your client (e.g., psychotherapy, hypnosis, biofeedback, or group psychotherapy). A CPT code also can specify the length of the service unit, such as “psychotherapy over 30 minutes.”

Front 78

You refer a client to Dr. Smith. Ethically, Dr. Smith

a. may not pay you a referral fee for sending her the client.
b. may pay you a referral fee if you have a written contract with her.
c. may pay you a referral fee if she has expertise in the client’s area of concern and you don’t.
d. can pay you a referral fee if and only if she is a psychiatrist.

Back 78

a). may not pay you a referral fee for sending her the client

counselors cannot ethically accept referral fees.

Front 79

You have written a very popular book on reality therapy. Now you are teaching a graduate course on counseling at a local university. Ethically, you

a. may not use the textbook in your class.
b. may not use the textbook in your class but other teachers at the university may indeed use your book as a textbook.
c. may use the book as a textbook in your class, however, the royalties you receive must be donated to the institution.
d. may use the book as a textbook in your class.

Back 79

d). may use the book as a textbook in your class

It’s ethical! Nevertheless, your school could have a policy against it or a policy similar to choice “c.”

Front 80

An elementary school counselor is giving a child a standardized test. On several occasions the child says he does not understand what the counselor has said. The counselor should

a. refuse to repeat the question.
b. tell the child to answer the question nevertheless.
c. repeat the question, but talk more slowly.
d. ignore the child’s verbalizations.

Back 80

c). repeat the question, but talk more slowly

A word of caution is in order here. The counselor should always attempt to use the recommended wording. Changing the wording could alter the impact of the test question, possibly confounding the results.

Front 81

The most popular paradigm of mental health consultation has been proposed by

a. Satir and Minuchin.
b. Schein.
c. Caplan.
d. Bandura.

Back 81

When the ultimate goal is to help a client, it is known as a “client-centered” consultation.These four basic types of mental health consultation have been proposed by Gerald Caplan.

Front 82

The doctor–patient consultation model relies on four distinct stages: entry, diagnosis, implementation, and evaluation. In order for the doctor–-patient structure to work, the consultee (i.e., the person receiving the consultation) must accurately depict symptomatology, trust the consultant’s diagnosis, and carry out the consultant’s directives. This model is associated most closely with the work of

a. Caplan.
b. Freud.
c. Adler.
d. Schein.

Back 82

d). Schein

Consultants can focus on process (what is happening from a communications standpoint) or content (knowledge imparted from the consultant to the consultee).

Front 83

______ is the leading cause of malpractice actions taken against counselors, therapists, and mental health providers.

a. Sexual misconduct.
b. Dual relationships.
c. Failure of the duty to warn.
d. Inferior record keeping.

Back 83

a). sexual misconduct

It has been estimated that over 95% of those clients who were sexually involved with their therapists have been harmed, and that in about one third of the cases, treatment literally ended as soon as sexual intimacy began.

Front 84

Your client was seeing Dr. Doyle for counseling for three years. The client has now stopped seeing Dr. Doyle and has an appointment to see you. You should

a. refuse to see the client unless she will sign a release so you can secure the information Dr. Doyle compiled.
b. call Dr. Doyle. In this situation no release of information or consent form is necessary.
c. counsel the client.
d. put something in writing and send it to Dr. Doyle prior to the second session of counseling.

Back 84

c). counsel the client

Treat this client in the same manner as you would treat any other client! To be sure, you might decide that information amassed via Dr. Doyle would be helpful and then you would secure the client’s written permission to contact him. Nevertheless, this certainly isn’t required to begin the counseling process.

Front 85

You are treating a man who suffers from panic disorder. His panic attacks are so severe he cannot drive to work. After just three sessions he is not only driving to work but has taken up sky diving to demonstrate his progress over his fear. You would love to put his testimonial on your brochure to show how adept you are at treating this affliction. You should

a. ask him if he will write you a few sentences to place on the brochure with his name at the end.
b. ask him if you can write the testimonial for him and place it on the brochure.
c. not ask him for a testimonial since it would constitute an ethics violation.
d. ask him if he will write you a few sentences to place on the brochure but assure him that his name will not appear.

Back 85

c). not ask him for a testimonial since it would constitute an ethics violation

Ethics guidelines clearly state that the counselor should not so- licit testimonials from clients.

Front 86

Ethical dilemmas rarely have clear-cut answers. Thus when a complex ethical situation manifests itself, it is best to

a. consult only ethical codes and not colleagues.
b. consult with colleagues as well as ethical codes inasmuch as legal standards are very often based on the methods of fellow professionals in analogous situations.
c. consult ACA but not your colleagues.
d. consult your state licensing bureau but not your colleagues.

Back 86

b. consult with colleagues as well as ethical codes inasmuch as legal standards are very often based on the methods of fellow professionals in analogous situations.

Front 87

You have attempted to help a client for over two years with little or no success. You should

a. always refer the client to a board certified psychiatrist.
b. terminate the relationship and initiate an appropriate referral.
c. change therapeutic modalities and see the client for another six months.
d. change therapeutic modalities and see the client for at least another year.

Back 87

b). terminate the relationship and initiate an appropriate referral

Front 88

Assume that you have decided to refer a client elsewhere because you were unable to help her. The client insists upon seeing you. Ethics guidelines would dictate that

a. you must see her; your duty is to the client.
b. you must refer her to a medical practitioner.
c. you must ask her to consider hospitalization.
d. you are not obligated to continue the relationship.

Back 88

d). you are not obligated to see her

You are acting in the best interest of the client.

Front 89

Counseling is a relatively new profession. The first counselors in the United States were not called counselors. They were

a. psychoanalysts practicing short-term therapy.
b. behaviorists practicing short-term therapy.
c. deans and advisors employed after the Civil War in college settings to watch over young women.
d. humanistic psychologists.

Back 89

c). deans and advisors employed after the Civil War in college settings to watch over young women

Front 90

Historically speaking, the first psychology laboratory was set up by

a. Frank Parsons, who set up community centers to help individuals in search of work.
b. Sigmund Freud, the father of psychoanalysis.
c. Wilhelm Wundt, in 1879 in Leipzig, Germany.
d. E. G. Williamson.

Back 90

c). Wilhelm Wundt, in 1879 in Leipzig, Germany

Wundt was convinced that psychology could be accepted as a science if consciousness could be measured. Wundt’s school of thought is termed structuralism because his interest was in the “structure” of consciousness.

Front 91

Counseling became popular after the 1931 publication of

a. Workbook in Vocations by Proctor, Benefield, and Wrenn.
b. The Interpretation of Dreams by Freud.
c. Behaviorism by Watson.
d. Counseling and Psychotherapy by Rogers.

Back 91

a). Workbook in Vocations by Proctor, Benefield and Wrenn

it set the stage for the popularization of the word counseling. Prior to 1931, the word guidance was used for educational and vocational guidance. This work, as well as an earlier one by Proctor in 1925 entitled Educational and Vocational Guidance, began to conceptualize counseling as a psychological process.

Front 92

PL94-142 (The Education Act for All Handicapped Children) states that

a. all children between 5 and 21 are assured free education.
b. handicapped persons are placed in the least restrictive environment (LRE).
c. an Individualized Education Plan (IEP) is developed for each child
d. all of the above.

Back 92

d). all of the above

This act was passed in 1975—the same year Virginia passed the first counselor licensure law—after a congressional finding that the United States had over 8 million handicapped children. Over half were not receiving appropriate education while one million were excluded from public education. Enforcement relied on funding.

Front 93

The major trend that impacted upon the counseling movement in the 1980s

a. was reality therapy.
b. was behavior modification.
c. included an emphasis on professionalism, certification, and licensing.
d. was the group movement.

Back 93

c). included an emphasis on professionalism, certification and licensing

Credentialing helped counseling become a specific and separate profession such as psychology or psychiatry. Although group work is still very popular, it emerged as a driving force in the 1970s.

Front 94

The APGA and APA had joint ethics guidelines for counselors and psychologists. This changed during the 1970s when

a. PsyD programs were introduced.
b. the APA did not wish to credential master’s-level counselors or psychologists.
c. psychologists were doing more testing.
d. joint ethics became illegal in the United States.

Back 94

b). APA did not wish to credential master's level counselors or psychologists

Separate ethics were thus developed, which helped discern counseling from psychology as a profession.

Front 95

The 1950s was the age of tremendous strides in

a. analysis.
b. developmental psychology.
c. behavior modification.
d. groupwork.

Back 95

b). developmental psychology

Piaget, Erikson, and Havinghurst were very influential. In addition, thanks primarily to the work of Carl R. Rogers, counseling rather than testing became the major task for professionals.

Front 96

The _______ movement began in the late 1960s.

a. testing.
b. Rogerian.
c. group.
d. developmental psychology.

Back 96

c). group

Groups would remain popular in the 1970s. Some of the literature in the field refers to the 1960s and 1970s as the “decades of variation,” in which we became “therapy of the month consumers”! Jerome Frank hypothesized at the time that the sudden flood of new therapies was due to the current upheaval in soci- ety. Gestalt, Transactional Analysis (TA), Primal Scream Therapy, Encounter Groups, Marathon Groups, and yes, even Naked Encounter Groups became popular!

Front 97

In the 1960s Gilbert Wrenn’s book, The Counselor in a Changing World, urged counselors to

a. use biofeedback.
b. rely more heavily on projective testing.
c. emphasize developmental concerns rather than merely focusing on crises and curing emotional illness.
d. stick to proven nondirective techniques.

Back 97

c. emphasize developmental concerns rather than merely focusing on crises and curing emotional illness.

Front 98

One of the primary problems of counseling in the early 1960s was that it wrongly emphasized

a. social issues.
b. intrapsychic processes.
c. referrals to secure antidepressant medicine.
d. career counseling.

Back 98

b). intrapsychic processes

This was not entirely a negative thing; nevertheless, social issues such as Vietnam, civil rights, and women’s issues could have been emphasized to a greater degree.

Front 99

The significance of the 1958 National Defense Education Act was that it

a. provided financial aid for graduate education in counseling.
b. expanded school guidance services.
c. improved guidance for gifted children.
d. all of the above.

Back 99

d). all of the above

Many pilot programs developed as a result of the funding. Gradually, the funding found its way into helping counselors prepare to work with economically disadvantaged youth. Thus, the act eventually helped all types of young people secure better counseling and guidance services. Some exams may use the abbreviation NDEA when referring to this act.

Front 100

A man has a rare, highly contagious disease that is fatal. He is keeping it a secret and insists that he will never tell his wife. You should

a. break confidentiality and tell his wife.
b. honor the man’s decision not to tell his wife for therapeutic reasons.
c. honor the man’s decision not to tell his wife in order to maintain ethical confidentiality.
d. handle it based on your clinical intuition since ethical guidelines fail to address this emotionally charged issue.

Back 100

a). break confidentiality and tell his wife