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1. All of the following pose a number of potential ethical problems with regard to protecting client privacy EXCEPT:
a. face-to-face interaction.
b. telephone and cellular phone.
c. answering machine and voicemail.
d. fax and e-mail.
2. James is in court facing drug-related charges and his therapist was subpoenaed to testify in court regarding any
discriminating evidence concerning the case. His therapist came to court but refused to answer questions regarding
the case or produce James's records. The therapist used the following legal concept to protect himself from forced
disclosure:
a. confidentiality.
b. privileged communication.
c. client privacy.
d. taking the 5th amendment.
3. As a matter of law, __________ refers to the constitutional right of an individual to be left alone and to control their
personal information.
a. self-disclosure
b. privileged communication
c. privacy
d. confidentiality
Chapter6—Confidentiality:EthicalandLegalIssues
4. It is illegal and unethical for a therapist to disclose confidential information when:
a. the client consents to disclosure.
b. there is a duty to warn or to protect third parties.
c. an emergency exists.
d. an employer requests disclosure to determine the mental status of an employee without their consent.
5. Ethical guidelines regarding confidentiality require that counselors do NOT:
a. allow clerical assistants to handle confidential information.
b. use client records to consult with experts or peers.
c. use client case studies to teach or write books, even when their clients' identities are disguised.
d. disclose client information unless there is clear and imminent danger to the client or others or when legal
requirements demand that confidential information be revealed.
6. Susan is quite distressed after finding out her husband has been unfaithful. She tells her counselor that she is so
angry that she feels like killing him. Upon hearing this, the counselor needs to:
a. question Susan to determine whether she is serious about doing physical harm to her husband.
b. warn the husband that he is in potential danger.
c. commit Susan to a hospital until she can overcome her anger.
d. threaten to terminate services with Susan if she continues to talk about killing her husband.
7. The California court's ruling that requires therapists to breach confidentiality in cases where the general welfare and
safety of others is involved is a result of the:
a. Bradley Center v. Wessner decision.
b. Jablonski v. United States decision.
c. Tarasoff decision.
d. Hedlund v. Superior Court decision.
8. _______________ was passed by Congress to promote standardization and efficiency in the health care industry
and to give patients more rights and control over their health information
a. The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
b. The Family Educational Rights and Privacy Act of 1994 (FERPA)
c. The H1N1 Prevention Act
d. The Confidentiality and Privileged Communication Act
9. In ___________, a Supreme Court decision ruled that communications between licensed psychotherapists and their
clients are privileged and therefore protected from forced disclosure in cases arising under federal law.
a. Bradley Center v. Wessner
b. Jablonski v. United States
c. Jaffee v. Redmond
d. Hedlund v. Superior Court
10. Jolene tells her counselor that she is depressed about the break-up of her relationship and "just wishes she could go
to sleep and never wake up." In this case, the counselor needs to:
a. immediately commit Jolene to a psychiatric facility.
b. assess if Jolene is suicidal and intervene if necessary.
c. recognize that her statement is only a "cry for help" and should not be taken seriously.
d. see if there is any chance for reconciliation.
11. Which of the following would be an ineffective way of managing a client's suicidal ideation?
a. Attempt to secure a promise from the client that he or she will not try to commit suicide.
b. Immediately hospitalize the client.
c. Be willing to communicate your caring without setting limits.
d. Recognize the limits of your competence and know when and how to refer.
12. Two processes that offer safeguards against malpractice liability in suicidal cases are:
a. consultation and documentation.
b. assessment and orientation.
c. individual therapy and group therapy.
d. diagnosis and informed consent.
13. Schools that receive federal funding are generally bound by the provisions of the:
a. Health Insurance Portability and Accountability Act (HIPAA).
b. Family Educational Rights and Privacy Act of 1994 (FERPA).
c. H1N1 Prevention Act.
d. Confidentiality and Privileged Communication Act.
14. Most counseling centers and community mental health agencies now have guidelines regarding the duty to warn and
protect when the welfare of others is at stake. These guidelines generally specify how to deal with:
a. emotionally healthy individuals with non-violent behavior.
b. emotionally disturbed individuals, violent behavior, threats, suicidal possibilities, and other circumstances in
which counselors may be legally and ethically required to breach confidentiality.
c. documentation and assessment of school children.
d. non-suicidal individuals seeking assistance with living arrangements.
15. Privileged communication does NOT apply in cases of:
a. clients' disclosures of personal and sensitive information.
b. child abuse and neglect.
c. unfaithfulness in one or both partners in couple's therapy.
d. legal proceedings where the therapist is asked to produce a client's records in court.
16. An African-American woman was interacting with her child in a domestic abuse shelter when she is over-heard
saying to her child, "Keep touching that and I'm going to whoop you." The social worker that heard this statement
should:
a. immediately report the mother to Child Protective Services.
b. tell the mother that she will be evicted from the shelter if she continues to talk to her child that way.
c. recognize that what constitutes abuse in one culture may not be viewed as abuse in another culture and is not
reportable until it is determined that the child is in danger.
d. remove the child from the mother's care until the mother can learn how to talk to her child with respect.
17. The Georgia Supreme Court ruled that a physician has a duty to take reasonable care to prevent a potentially
dangerous patient from inflicting harm in:
a. Hedlund v. Superior Court.
b. Tarasoff v. University of California Board of Regents.
c. Bradley Center v. Wessner.
d. Jablonski v. United States.
18. A counselor working in an AIDS-related case:
a. has a legal duty to warn according to the Tarasoff decision.
b. is obliged to protect all third parties of the threat of HIV transmission according to ethical codes.
c. must report the case to the Department of Public Health.
d. has few legal guidelines to help determine when or how to inform a potential victim of the threat of HIV
transmission.
19. Theintendedvictim’sknowledgeofathreatdoesNOT relieve therapists of the duty to protect, as can be seen by
the decision in:
a. Bradley Center v. Wessner.
b. Jablonski v. United States.
c. Tarasoff v. University of California Board of Regents.
d. Hedlund v. Superior Court.
20. In the case of disclosing confidential information when working with an HIV-positive client, several writers state that
the therapist has a duty to protect when the following condition exists:
a. the client is engaging in safe-sex with a committed partner.
b. clear and imminent danger must exist.
c. all potential victims must be warned, even if there have been multiple sexual partners over the years.
d. all persons who have exchanged needles with the client must be found and warned of possible danger.
21. _______________ extends the duty to warn in California to a foreseeable, identifiable person who might be near
the intended victim when the threat is carried out and thus might also be in danger.
a. Bradley Center v. Wessner
b. Jablonski v. United States
c. Tarasoff v. University of California Board of Regents
d. Hedlund v. Superior Court
22. Which of the following is NOT identified in the text as a guideline for counselors using the telephone?
a. Exercise caution in discussing confidential or privileged information with anyone over the telephone and
especially
when employing digital and mobile technologies.
b. Set firm boundaries with clients from the beginning and address matters such as avoiding interruptions and
privacy.
c. After addressing the ethical guidelines and ensuring absolute privacy, counselors may speak to their clients as
freely as they desire without fear that their conversations will be used in legal proceedings.
d. Disclose the limits of confidentiality with clients if wireless telephones are used.
23. In Chapter 6, a six-step ethical practice model for protecting confidentiality rights that places legal mandates in an
ethical context is presented. The six steps include all of the following EXCEPT:
a. preparation.
b. tell clients the truth "up front."
c. obtain truly informed consent before making a disclosure.
d. have your attorney respond to legal requests for disclosure.
24. The following are all major types of elder abuse EXCEPT:
a. financial or material exploitation.
b. neglect and abandonment.
c. sexual, physical, and psychological abuse.
d. protection and positive treatment.
25. In_____________,thecourtexpandedthepractitioner’sdutytowarnthoseindangertoincludethecircumstance
in which a family member communicates to a mental health practitioner a belief that the client poses a risk of grave
bodily injury to another person.
a. Tarasoff v. Board of Regents of the University of California
b. Jaffee v. Redmond
c. Ewing v. Goldstein
d. Petersen v. McDonald
26. In most cases, therapists will not have advanced warning that a client is dangerous. Therefore, therapists must be
prepared for such an eventuality. Which of the following is NOT a suggestion from the authors' for preparation?
a. Limit disclosure to all clients until they are deemed safe.
b. Take at least one workshop in the assessment and management of dangerous clients.
c. Know how to contact the legal counsel of your professional organization.
d. Familiarize yourself with professionals who are experienced in dealing with violence and know how to reach
them.
27. The basic standard of care for school counselors is clear; courts have uniformly held that:
a. school personnel should not breach confidentiality at any time.
b. school personnel have a duty to protect students from foreseeable harm.
c. school personnel have a duty to protect students if confidentiality is not at risk.
d. school personnel must release any and all information regarding students to faculty and parents.
28. Even if clients argue that they can do what they want with their own lives, including taking them, therapists with
suicidal clients have a legal:
a. duty to protect.
b. duty to warn.
c. privacy issue.
d. privileged communication issue.
29. Therapists have the responsibility to prevent suicide if they can reasonably anticipate it. Once it is determined that a
client is at risk for serious harm to self, the professional is:
a. released of all legal and ethical requirements to protect the client.
b. legally, but not ethically, required to take appropriate action.
c. legally and ethically required to take appropriate action aimed at protecting the person.
d. ethically, but not legally, required to take appropriate action.
30. The HIPAA Privacy Rule was designed to provide a uniform level of privacy and security on the federal level. This
Privacy Rule, which applies to both paper and electronic transmissions of protected health information by covered
entities, developed out of the concern
that transmission of health care information through electronic means could lead to widespread gaps in the protection
of client confidentiality. Which of the following is NOT a requirement of The Privacy Rule?
a. It requires health plans and other covered entities to establish policies and procedures to protect the
confidentiality of health information about their patients.
b. It provides detailed patient information to individuals outside of the health care agency.
c. It requires technical, administrative, and physical safeguards to protect security of protected health information
in electronic form.
d. It provides patients with rights concerning how their health information is used and disclosed by health care providers
who fall within the domain of HIPAA.
31. _______________isatthecoreofeffectivetherapy;itisthecounselor’sethicaldutytoprotectprivateclient
communication.
a. Privileged communication
b. Privacy
c. Ethics
d. Confidentiality
32. There are three types of ______________: health plans, health care clearinghouses, and health care providers who
transmit health information by electronic means.
a. covered entities
b. computer transactions
c. administrative positions
d. HIPAA rules
33. In this court case, the court found that school counselors have a duty to use reasonable means to attempt to prevent
asuicidewhentheyknowaboutastudent’ssuicidalintentions.Thereasoningofthecourtwasthatanadolescentis
more likely to share thoughts of suicide with friends than with a school counselor, teacher, or parent. The court found
that reasonable care would have included notifying the student's parents that their daughter was at risk for suicide.
a. Tarasoff v. University of California Board of Regents
b. Ewing v. Goldstein
c. Eisel v. Board of Education
d. Jaffee v. Redmond
34. The experts who testified at this trial believed the school board failed to provide adequate training for school
personnel. Without training, school personnel will most likely underestimate the lethality of suicidal thoughts,
statements, and attempts. The conclusion of this expert testimony was that the student would not have committed
suicide if the employees had been adequately trained. Persuaded by this input,
thecourtheldthattheschoolcouldbefoundnegligentforfailingtonotifythedecedent’smother.Thisexplainsthe
court decision in which court case?
a. Eisel v. Board of Education
b. Wyke v. Polk County School Board
c. Hedlund v. Superior Court
d. Ewing v. Goldstein
35. _________________ is designed to encourage reporting of any suspected cases of child, elder, or dependent adult
abuse; thus, therapists are advised to err on the side of reporting in uncertain circumstances.
a. Reportable abuse
b. Dependent abuse
c. Elder abuse
d. Mandatory reporting
