Test Bank for Substance Use Counseling: Theory and Practice, 6th Edition

Chapter 2: Ethical and Legal Issues in Substance Abuse Counseling Objectives • • • • • • • Highlight the complexity of ethical and legal issues facing substance abuse professionals. Highlight the varied credentialing and licensing requirements for substance abuse counselors. Identify the federal and state laws pertaining to counselors in general and specific to substance abuse counselors. Illustrate the conflicts between and amongst federal laws, state laws, and ethical codes. Emphasize the importance of competently serving diverse populations. Emphasize the increased risk of dual relationships of recovered substance abuse counselors. Provide ethical decision-making models and suggestions. Key Terms and Definitions Autonomy: The therapist’s responsibility to support client independence and freedom of choice. Beneficence: The therapist’s responsibility to do what is in the best interest of the client. Confidentiality: Confidentiality is considered the core value of mental health professionals and is intended to reduce stigma, foster trust, protect privacy, and allow clients to control access of information they have shared. Consent: The client’s permission to release confidential information. Duty to Protect: The therapist’s responsibility to protect or lessen the threat by either contacting authorities or the targeted person, but not necessarily both. Duty to Warn: The therapist’s legal duty to warn a person who may become a victim of a violent act by a client. Fidelity: The therapist’s responsibility to remain loyal to the client. Health Care Providers: Any provider, or third party on behalf of the provider, who electronically transmits health information for the purpose of claims submissions, inquiries about patient eligibility benefits, and authorizing referrals. Health Plans: Health insurance companies, health maintenance organizations (HMO’s), Medicare, Medicaid, and other health carriers. Health Care Clearinghouses: Billing services, community health management information systems, and other processing systems. Informed Consent: The legal and ethical requirement of therapists to inform the client of the potential risks and benefits of counseling. Justice: The therapist’s responsibility to act fairly, avoid bias and stereotypes. Nonmaleficence: The therapist’s responsibility to do no harm. Veracity: habitual observance of truth in speech or statement; truthfulness; correctness or accuracy. Key Websites American Counseling Association, Association for Assessment in Counseling (AAC) American Mental Health Counselors Association (AMHCA) American Rehabilitation Counseling Association American School Counselor Association (ASCA) Association for Spiritual, Ethical & Religious Values in Counseling Council on Accrediting Counseling and Related Educational Programs (CACREP) Counselors for Social Justice (CSJ) International Association of Marriage and Family Counselors NAADAC, the Association for Addiction Professionals National Board for Certified Counselors and Affiliates National Center on Elder Abuse Substance Abuse and Mental Health Administration Services Activities 1. Research the prevalence of drug and alcohol abuse/ dependence and family violence, including child abuse/ neglect and domestic abuse. 2. Interview a substance abuse counselor and ask about ethical dilemmas he or she faced. 3. Interview a school counselor and ask about ethical dilemmas he or she faced. 4. Research national, state, and local organizations in your profession (or future profession) and review the ethical codes. 5. Research your current state laws regarding any of the following: • Mandatory reporting of child abuse/ neglect • Mandatory reporting of elder abuse • Mandatory reporting of domestic abuse • Mandatory duty to warn a potential victim of violence • Minor’s ability to consent to drug and alcohol abuse treatment • Parental access to minor records and confidential information • Certification requirements of substance abuse counselors Essay Questions/ Discussion Starters 1. Describe the diverse avenues for entering the profession of substance abuse counseling. 2. Define confidentiality and privileged communication and describe common ethical limits to confidentiality. 3. Explain the purpose of CFR 42, Part 2, the information that is protected and the information that may be disclosed without client consent. 4. Explain the typical laws that pertain to the confidentiality of minors, both in and out of school settings. Chapter 2 Multiple Choice Questions 1. Which of the following does not contribute to the complexity of ethical and legal issues in substance abuse counseling? (a) Ethical Codes (b) Personal Recovery (c) Standards and Requirements (d) Federal Laws 2. Which of the following is not one of the moral principles on which ethical codes of mental health organizations are based? (a) Fidelity (b) (c) (d) Autonomy Justice Genuineness 3. Who is not bound by confidentiality? (a) The client (b) The substance abuse counselor (c) The supervisor (d) The insurance company 4. Which of the following does not allow for the reporting of child abuse? (a) HIPAA (b) CFR 42, Part 2 (c) ACA Code of Ethics (d) None of the above 5. Which law does not allow for a breach of confidentiality to warn a third party in imminent danger? (a) HIPAA (b) CFR 42, Part 2 (c) State Law (d) None of the above 6. When faced with conflicting laws or ethical codes the substance abuse counselor should always defer to: (a) Federal laws (b) State laws (c) Ethical codes (d) The most restrictive regulation or code 7. According to CFR 42, Part 2, confidential information may be disclosed with client consent: (a) For a third party payment (b) To medical professionals in an emergency situation (c) To family members in an emergency situation (d) None of the above 8. According to CFR 42, Part 2, disclosure of confidential information requires written consent with several elements; which of the following is not one of the required elements? (a) The name of the person or program permitted to make the disclosure (b) The name of the person or program receiving the disclosed information (c) The purpose of the disclosure (d) A statement indicating that the client may revoke consent at any time but only if he or she states that in writing 9. According to HIPAA, client consent is not required for disclosure of confidential information for all the following except: (a) To the client’s employer (b) For the opportunity to agree or object (c) For treatment, payment, and health care operations (d) For public interest and benefit activities 10. Which of the following regulations restricts parental access of their children’s confidential information without the minor’s consent? (a) FERPA (b) IDEA (c) CFR 42, Part 2 (d) PPRA 11. The commonalities between the ethical codes embrace the following common principles: (a) Protecting the client welfare; avoiding harm and the imposition of personal values; and knowledge and adherence to the laws and ethical codes (b) (c) (d) Professional qualifications and competence and knowledge of standards Consultation and counselor supervision with other counseling professionals and competence to administer, use or interpret assessment instruments All of the above 12. One important commonality that exists in all five of the highlighted ethical codes within the text is: (a) The organization and titling of the ethical codes (b) The focus on the counseling relationship competence (c) The emphasis on confidentiality and client rights. (d) None of the above 13. Which of the following is not a characteristic of an ethical dilemma? (a) A choice between two courses of action must be made (b) There are significant consequences for not selecting either of the options (c) Each decision is supported by ethical principles (d) One of the decisions is supported by state regulations 14. The ASCA supports the use of Stone’s (2001) Solutions to Ethical Problems in Schools for ethical decision making. Which of the following is not one of the steps? (a) Define the problem emotionally and intellectually (b) Consider the setting, parental rights and minors’ rights along with the students’ chronological and developmental levels (c) Apply the moral principles and determine your potential courses of action and their consequences (d) Apply the collaboration model. 15. in: Regarding professional conduct, substance abuse counselors need to be aware of requirements delineated (a) (b) (c) (d) Federal and state laws Local laws and regulations Codes of ethics All of these 16. Which of the following groups do not have specific licensure/certification for substance abuse counseling? (a) National Board of Certified Counselors (b) National Association of Alcoholism and Drug Abuse Counselors (c) US Department of Transportation (d) None of these 17. The legal and ethical requirement to inform clients of the potential risks and benefits of counseling is: (a) Informed consent (b) Duty to warn (c) Privileged information (d) Duty to protect 18. In Counseling, the promise of keeping information private is called: (a) Privacy (b) Secrecy (c) Confidentiality (d) Concealment 19. Lipari V. Sears, Roebuck & Co. was a federal case that further extended the duty of counselors to _______________. (a) Warn victims (b) Protect unknown victims (c) Protect identifiable victims (d) All of the above 20. The purpose of HIPAA is _______________. (a) To protect individually identifiable health information (b) (c) (d) To increase the flow of information between health care providers, health plans, or third party on behalf of the party To encourage substance abusers to seek treatment without fear of discrimination, legal ramifications, or fear of losing one’s job. Both a and b 21. HIPPA does not apply to _______________. (a) Health information contained in health care provider records or in health plan records (b) Health information contained in health care clearinghouses. (c) Health information contained in employer records or in educational records (d) None of the above 22. Personal counseling notes are considered a school record ______________. (a) The moment they are created (b) The moment anyone other than the counselor knows of their existence (c) The moment they are placed in the “permanent” school record file (d) None of the above 23. Confidentiality is considered the core value of mental health professionals is intended to: (a) Reduce stigma and foster trust (b) Protect privacy (c) Allow clients to discuss their issues without fear of future repercussions (d) All of the above 24. The right of privilege of confidentiality belongs to: (a) The client, even the deceased clients (b) The counselor (c) The counselor and client (d) The consultant 25. Which law requires the sharing of patient information through encrypted systems, with significant penalties for failing to sufficiently protect client information? (a) Health Insurance Portability Accountability Act (HIPAA) (b) HITECH Act (c) Patient Protection and Affordable Care Act (d) All of the above 26. Counselors may be ethically or legally obligated to break confidentiality, without client consent, in the following limited situations: (a) If the client intends to harm him/herself or an identifiable third party (b) If a client intents to transmit a communicable, life-threatening disease to an identifiable third party (c) If the client is a victim of child or elder abuse/neglect (d) All of the above 27. The purpose of __________ is to protect individually identifiable health information while increasing the flow of information between health care providers, health plans, and health care clearinghouses. (a) HITECH Act (b) Patient Protection and Affordable Care Act (c) HIPAA (d) FERPA 28. The purpose of __________ is to provide affordable health care to uninsured Americans, to better detect mental health issues, and to provide better integration of healthcare. (a) HITECH Act (b) Patient Protection and Affordable Care Act (c) HIPAA (d) FERPA 29. The individually identifiable health information that is protected by HIPAA includes all of the following EXCEPT: (a) (b) condition (c) (d) Health information contained in employer records or in educational records Demographic data regarding an individual’s past, present or future physical or mental health Information related to the provision of health care to the individual Payment for health care to the individual 30. Health care providers must furnish a privacy practices notice to clients no later than the __________ service encounter. (a) First (b) Second (c) Third (d) Fourth 31. According to the _________, the professional school counselor has a primary obligation to the student and is knowledgeable of the laws, regulations, and policies aimed at protecting students’ rights. (a) American Counselor Association (ACA) (b) American School Counselor Association (ASCA) (c) American Mental Health Counselors Association (AMHCA) (d) All of the above 32. __________ refers to an immediate serious threat. (a) Critical peril (b) Significant risk (c) Imminent danger (d) Pending hazard 33. __________ gies parents the right to inspect school records. (a) HITECH Act (b) Patient Protection and Affordable Care Act (c) HIPAA (d) FERPA 34. __________ was intended to ensure that students with disabilities receive a free appropriate education (FAPE) with accommodations in the least restrict environment (LRE). (a) Individuals with Disabilities Education Act of 2004 (IDEA) (b) Protection of Pupil Rights Amendment of 1994 (PPRA) (c) CFR 42, Part 2 in Regard to Minors (d) Hatch Amendment Chapter 2 1. 2. 3. 4. 5. 6. 7. 8. 9. B (p. 26) D (p. 30) A (p. 32) D (pp. 34, 35, 42) B (p. 34) D (p. 43) B (p. 34) D (p. 34) A (pp. 35-36) 10. 11. 12. 13. 14. 15. 16. 17. 18. C (pp. 37, 40) D (p. 30) A (p. 30-32) D (p. 43) D (p. 43-44) D (p. 30) D (p. 27-30) A (p. 38) C (p. 32)27. 19. D (p. 33) 20. D (p. 35) 21. C (p. 35) 22. B (p. 39) 23. D (p. 32) 24. A (p. 32) 25. D (p. 32) 26. D (p. 32-33 C (p. 35) 28. 29. 30. 31. 32. 33. 34. B (p. 36) A (p. 35) A (p. 36) B (p. 38) C (p. 38) D (p. 38) A (p. 39)