1
Q
Which of the following best reflects a complete and ethical informed consent process?
- A. Provide a handout during intake
- B. Verbally explain only during the first session
- C. Review the consent both verbally and in writing with the client
A
C. Review the consent both verbally and in writing with the client
Informed consent is a process, not a form. Clients must understand and agree, both through verbal explanation and written materials.
2
Q
During group therapy, a member threatens self-harm after the session ends. The counselor should:
- A. Maintain confidentiality as promised
- B. Contact emergency services and follow crisis protocol
- C. Wait until the next meeting to reassess risk
A
B. Contact emergency services and follow crisis protocol
Imminent risk overrides confidentiality; duty to protect requires immediate intervention.
3
Q
A counselor feels personally attracted to a client. The ethically appropriate response is to:
- A. Seek supervision and maintain professional boundaries
- B. End sessions abruptly
- C. Disclose feelings to the client for transparency
A
A. Seek supervision and maintain professional boundaries
Supervision allows reflection and protects objectivity without harming the therapeutic alliance.
4
Q
In a CBT skills group, members are learning thought records. One participant struggles to identify the automatic thought in a situation.
Which leader response MOST supports skill development?
- A. Model identifying an automatic thought from the member’s example
- B. Ask the group to guess what the member might have been thinking
- C. Move on to another member who understands the concept
A
A. Model identifying an automatic thought from the member’s example
CBT groups often use modeling to teach cognitive restructuring techniques.
5
Q
A counselor is offered referral bonuses by a treatment center. The appropriate response is to:
- A. Accept but disclose it to clients
- B. Donate proceeds anonymously
- C. Decline the incentive to avoid conflict of interest
A
C. Decline the incentive to avoid conflict of interest
Ethical integrity forbids monetary gain tied to client referrals.
6
Q
A teacher asks the school counselor for “everything” from sessions to manage classroom behavior. The counselor’s best response is to:
- A. Offer behaviorally relevant summaries aligned with legitimate educational interest
- B. Decline all sharing to protect the relationship
- C. Provide verbatim notes because the teacher has a need to know
A
A. Offer behaviorally relevant summaries aligned with legitimate educational interest
FERPA permits sharing with school officials who have a legitimate educational interest—not wholesale disclosure; share focused, relevant information.
7
Q
A client expresses intent to harm a third party. What takes ethical precedence?
- A. Informed consent
- B. Confidentiality limitations
- C. Nonmaleficence
A
B. Confidentiality limitations
When a threat to others is present, the duty to protect overrides confidentiality. Legal and ethical codes support breaking confidentiality when danger is imminent.
8
Q
You hold a Master’s degree in counseling and a PhD in an unrelated field. On your practice cards, which credentialing format is most ethically accurate?
- A. Dr. Jane Doe, LPC
- B. Jane Doe, MA, LPC
- C. Dr. Jane Doe, PhD, LPC
A
B. Jane Doe, MA, LPC
Counselors should only represent degrees relevant to counseling practice. Listing unrelated doctorates may mislead clients about expertise.
9
Q
A counselor conducts video sessions using an unsecured Wi-Fi connection. This violates:
- A. Client confidentiality and data protection standards
- B. Informed consent procedures
- C. Record-keeping guidelines only
A
A. Client confidentiality and data protection standards
Telehealth ethics require encrypted, secure platforms safeguarding client information.
10
Q
During a cultural consultation, a Native American elder offers a counselor tobacco as a gesture of trust.
What is the most ethically appropriate response?
- A. Decline all gifts to avoid a dual relationship
- B. Accept the gift while explaining it cannot be smoked
- C. Accept the gift, acknowledging its cultural significance
A
C. Accept the gift, acknowledging its cultural significance
Cultural humility and sensitivity require understanding symbolic practices. Accepting culturally symbolic items respectfully upholds the therapeutic alliance.
11
Q
During a group intake, what should you emphasize regarding confidentiality?
- A. It is guaranteed in group work
- B. Participants are expected to maintain it, but it can’t be guaranteed
- C. It can be shared with spouses if no harm is done
A
B. Participants are expected to maintain it, but it can’t be guaranteed
Group confidentiality cannot be guaranteed. Participants must understand this limitation clearly before participating.
12
Q
A counselor accepts a gift card from a long-term client at termination. Ethically, this decision depends on:
- A. Context, value, and potential impact on the therapeutic relationship
- B. Whether the counselor needs the gift
- C. If the gift is handmade
A
A. Context, value, and potential impact on the therapeutic relationship
Gift-giving must be evaluated for motivation, cultural meaning, and power differential.
13
Q
During group therapy, a member begins dating another member. The counselor should:
- A. Address it in session, exploring group impact
- B. End the group immediately
- C. Ignore unless conflict arises
A
A. Address it in session, exploring group impact
Transparency and exploration preserve group safety and cohesion; secrecy undermines process.
14
Q
In a feminist-oriented group, members are discussing salary disparities between genders. The leader notices only men are speaking.
What is the MOST appropriate intervention?
- A. Ask the women directly if they want to respond
- B. Address the group about power dynamics and encourage equitable participation
- C. Change the topic to avoid discomfort
A
B. Address the group about power dynamics and encourage equitable participation.
In feminist-oriented group work, process is as important as content. When only men are speaking during a discussion on gender pay disparities, it reflects the very power imbalance the group seeks to challenge. The counselor’s task is not to silence men, but to openly address unequal participation—naming the dynamic, exploring how socialization and privilege may influence voice, and intentionally creating space for marginalized perspectives.
15
Q
A supervisee reveals personal bias against working with transgender clients. How should the supervisor respond?
- A. Dismiss the supervisee
- B. Refer all such clients elsewhere
- C. Explore the bias and provide training opportunities
A
C. Explore the bias and provide training opportunities
Supervisors have a duty to help supervisees grow ethically and professionally. Addressing bias through supervision and education promotes competence.
16
Q
A research team requests de-identified counseling data from a clinic for outcomes analysis. To proceed ethically and legally, the clinic should first:
- A. Assert fair-use doctrine
- B. Provide raw notes without names
- C. Ensure data are properly de-identified or secure client authorization under applicable law
A
C. Ensure data are properly de-identified or secure client authorization under applicable law
HIPAA defines de-identification standards; otherwise, authorization is needed for disclosures beyond treatment/payment/operations.
17
Q
A 16-year-old seeks counseling for depression at a community clinic in a state allowing minors to consent to mental health treatment. A parent later demands records. The counselor should:
- A. Follow state minor-consent law and privacy rules, which may limit parental access
- B. Deny all parental requests categorically
- C. Release all records to the parent by default
A
A. Follow state minor-consent law and privacy rules, which may limit parental access
State law often governs minor consent and access; when minors can consent, parental access may be limited.
18
Q
A former client reaches out after three years and asks you on a date. Which response is most aligned with the ACA Code of Ethics?
- A. Agree, because the two-year period has passed
- B. Decline, because five years must pass and risk of harm must still be considered
- C. Accept, but avoid physical intimacy
A
B. Decline, because five years must pass and risk of harm must still be considered
ACA guidelines require a five-year buffer before even considering romantic contact with former clients, plus a documented harm-risk assessment.
19
Q
A counselor suspects a colleague of practicing while impaired. The counselor should first:
- A. Report directly to the licensing board
- B. Ignore unless a client files a complaint
- C. Confront the colleague privately and offer support
A
C. Confront the colleague privately and offer support
Ethical protocol begins with informal resolution and peer accountability before formal reporting, unless imminent harm exists.
20
Q
A counselor accidentally meets a current client at church and is invited to join a committee with them. The counselor should:
- A. Accept for community goodwill
- B. Ignore the overlap as harmless
- C. Decline participation and discuss boundary implications in session
A
C. Decline participation and discuss boundary implications in session
Transparent boundary management safeguards objectivity and models professionalism.
21
Q
In a grief-support group, one member begins monopolizing every discussion, while others withdraw and make less eye contact. The leader decides to address the issue indirectly through a structured group activity.
Which leadership approach is this MOST consistent with?
- A. Behavioral shaping through reinforcement
- B. Indirect confrontation to reduce defensiveness
- C. Psychoeducation to increase group knowledge
A
B. Indirect confrontation to reduce defensiveness
An activity that alters group dynamics can gently confront without triggering resistance, a hallmark of skilled group leadership.
22
Q
In a CBT-based relapse prevention group, a member says, “I know I’ll fail again.” Which leader intervention BEST fits CBT principles?
- A. Ask the member to identify the evidence supporting and contradicting that belief
- B. Redirect to a success story from another member
- C. Suggest ignoring the thought and moving on
A
A. Ask the member to identify the evidence supporting and contradicting that belief
CBT targets cognitive distortions through evidence-based evaluation of thoughts.
23
Q
A client begins sending crisis-length messages through the portal at midnight expecting real-time replies. The counselor’s best first step is to:
- A. Clarify response expectations and crisis pathways within informed consent
- B. Disable portal messaging during evenings
- C. Forward messages to emergency services automatically
A
A. Clarify response expectations and crisis pathways within informed consent
Ethical technology use begins with clear limits, expectations, and crisis procedures explained in informed consent and revisited as needed.
24
Q
In a REBT-oriented group, the leader observes that members often reinforce each other’s irrational beliefs (“That’s awful, I couldn’t stand it either”).
What is the BEST leader intervention?
- A. Ignore the reinforcement to maintain rapport
- B. Point out the irrational language and guide the group to reframe it
- C. Allow venting before challenging beliefs
A
B. Point out the irrational language and guide the group to reframe it
REBT leaders actively confront irrational self-talk, even when it’s socially reinforced in the group.
25
To increase **trustworthiness** in qualitative research, the counselor should:
* A. Focus on statistical reliability
* B. Collect more surveys
* C. Use triangulation, member checking, and audit trails
C. Use triangulation, member checking, and audit trails
26
In a multicultural grief group, a member from a collectivist culture remains silent during personal sharing but is active when discussing family rituals.
**Which leader action BEST supports cultural responsiveness?**
* A. Encourage the member to share more personal details for deeper self-disclosure
* B. Recognize and validate their preferred cultural expression of grief within the group
* C. Assign the member a role to present on their cultural traditions
B. Recognize and validate their preferred cultural expression of grief within the group
## Footnote
Option B demonstrates respectful acknowledgment and validation — which is the first act of broaching.
Broaching often begins with validation before moving to exploration.
27
A client who is undocumented fears seeking services because of potential deportation. The counselor is unsure how to proceed ethically.
**What should be the counselor's next action?**
* A. Reassure the client that their immigration status is irrelevant
* B. Decline services to avoid legal risk
* C. Consult with legal and ethical guidelines regarding documentation and duty
C. Consult with legal and ethical guidelines regarding documentation and duty
## Footnote
When unsure, the counselor must seek professional consultation and review legal/ethical guidelines. Avoid assumptions.
28
A 17-year-old girl, Janet, is referred to you by her school counselor. Janet's nose, eyebrow, and tongue are pierced, and her hair is dyed green and yellow. Janet says that recently her twin brother Michael comes into her room at night and tries to "play sleep-over" with her. Janet tells you that a cute boy she met at a rave last week wants her to move in with him. She asks you not to tell her parents that she's seeing you because they're "extremely religious."
**How would you manage your ethical responsibilities if you were working with the entire family?**
* A. Clarify for Janet that, as a victim of abuse, she can consent to her own treatment without her parents' permission.
* B. Clarify for the family how your therapeutic work differs from religious counseling.
* C. Explain the limits of confidentiality to Janet with regard to sexual abuse.
C. Explain the limits of confidentiality to Janet with regard to sexual abuse
## Footnote
When a minor discloses possible abuse, the counselor's duty is to ensure safety. Explaining the limits of confidentiality prepares the client for what will happen next and models professional integrity while protecting her well-being.
29
A counselor **working online with minors** must ensure:
* A. Use of social media for engagement
* B. Parental consent and secure digital platforms
* C. Text-based therapy without documentation
B. Parental consent and secure digital platforms
## Footnote
Telehealth ethics demand legal consent and encryption to maintain confidentiality.
30
The idea that “unfinished business” from past relationships can surface in the here-and-now of group and be resolved through experiential techniques is **MOST associated with which approach?**
* A. Gestalt Therapy
* B. Psychodynamic Therapy
* C. Behavioral Therapy
A. Gestalt Therapy
## Footnote
Gestalt therapy emphasizes the here-and-now and resolving unfinished business, often through experiential group techniques.
31
A counselor records sessions for supervision. **Ethically required step:**
* A. Keep recordings under 24 hours
* B. Obtain written client consent before recording
* C. Record freely if used only for learning
B. Obtain written client consent before recording
## Footnote
Informed consent is mandatory whenever recordings are made for any purpose.
32
A counselor learns during supervision that a colleague has been practicing outside of their scope of competence.
**What should the counselor do first, according to the ACA Code of Ethics?**
* A. Report the colleague to the licensing board
* B. Confront the colleague directly
* C. Consult with a supervisor or appropriate professional colleague
C. Consult with a supervisor or appropriate professional colleague
## Footnote
Ethical practice encourages consultation before taking direct or punitive action. It fosters due process and professional accountability.
33
A supervisee admits to boundary violations with a client. **The supervisor’s duty is to:**
* A. Advise the supervisee to self-report
* B. Intervene to protect the client and provide ethical remediation
* C. Maintain confidentiality of supervision
B. Intervene to protect the client and provide ethical remediation
## Footnote
Supervisors hold a protective duty to clients and must act to prevent further harm.
34
A client with severe depression loses his insurance and can only afford monthly visits. **What should you do FIRST, ethically?**
* A. Refer him to a sliding scale or low-cost provider
* B. Offer free monthly sessions until his insurance resumes
* C. Let him charge weekly visits to his credit card
A. Refer him to a sliding scale or low-cost provider
## Footnote
While it may feel compassionate to continue care, ethical guidelines require helping clients access appropriate care without financial strain.
35
When citing a webpage with a corporate author, **APA requires listing**:
* A. The site’s URL only
* B. The webmaster’s name
* C. The organization name as author
C. The organization name as author
## Footnote
In organizational authorship, the entity itself assumes author position to preserve attribution integrity.
36
The BEST leader intervention for resistance in the **Transition Stage** is:
* A. Ignore it to avoid conflict
* B. Confront respectfully and explore meaning
* C. Remove the resistant member immediately
B. Confront respectfully and explore meaning
## Footnote
Addressing and processing resistance builds trust and models openness.
37
A counselor discloses shared faith with a client to enhance rapport. **Ethically, this is acceptable only when:**
* A. It happens in early sessions to reduce anxiety
* B. The counselor wishes to build connection
* C. It clearly benefits the client and remains clinically relevant
C. It clearly benefits the client and remains clinically relevant
## Footnote
Limited, purposeful self-disclosure is ethical only if it advances client welfare, not counselor comfort.
38
A school threat-assessment team requests counseling information about a student amid credible safety concerns. **Disclosure is guided by:**
* A. FERPA’s legitimate educational interest and health/safety exception
* B. Directory information rules
* C. HIPAA psychotherapy-note standards
A. FERPA’s legitimate educational interest and health/safety exception
## Footnote
FERPA allows limited sharing when there is a legitimate educational interest or an emergency requiring protection of health and safety.
39
A pupil evaluation team considers whether a child with ADHD qualifies for services. The team determines no specialized instruction is required, but classroom access supports are needed. **The appropriate plan is:**
* A. Section 504 accommodation plan
* B. Dismissal because grades are average
* C. IDEA IEP with related services
A. Section 504 accommodation plan
## Footnote
504 addresses access/accommodations without specialized instruction; IDEA (IEP) requires the need for special education.
40
The **Greek-letter** honor society recognizing excellence in counseling scholarship and service is:
* A. Kappa Delta Pi
* B. Chi Sigma Iota
* C. Psi Chi
B. Chi Sigma Iota
## Footnote
Chi Sigma Iota (CSI), founded at Ohio University in 1985, honors academic and professional excellence in counseling.
41
In a K–12 setting, a counselor keeps a private process journal used only as a memory aid and never shared. A parent requests it. **The counselor should respond that:**
* A. It is a sole-possession note and generally not subject to parental inspection
* B. It is an education record and must be disclosed
* C. HIPAA prohibits disclosure
A. It is a sole-possession note and generally not subject to parental inspection
## Footnote
FERPA excludes sole-possession notes from education-record access if truly private and not shared.
42
A supervisor discloses client details during a public workshop. **The ethical breach involves:**
* A. Supervisory prerogative
* B. Appropriate teaching under professional privilege
* C. Violation of confidentiality and informed consent
C. Violation of confidentiality and informed consent
## Footnote
Educational context does not exempt confidentiality; client anonymity must always be maintained.
43
A staff member discovers an unencrypted laptop with client notes was stolen. **The counselor should first:**
* A. Notify all clients immediately
* B. Wait to see if misuse occurs
* C. Contain the incident, assess risk, then follow breach-notification rules
C. Contain the incident, assess risk, then follow breach-notification rules
## Footnote
A breach response follows containment, risk evaluation, and compliant notification procedures under law and ethics.
44
The **CPCE** was originally created by:
* A. The Center for Credentialing & Education (CCE) and NBCC
* B. The American Psychological Association (APA)
* C. The Association for Counselor Education and Supervision (ACES) alone
A. The Center for Credentialing & Education (CCE) and NBCC
## Footnote
The Counselor Preparation Comprehensive Examination (CPCE) evaluates mastery of CACREP’s eight core areas within academic programs.
The CCE, an affiliate of the NBCC, collaborated with universities to standardize graduate-level counselor assessment.
45
A counselor discovers that a client’s partner is secretly attending the same agency under another therapist. **The counselor’s most ethical first step is to:**
* A. Inform both clients immediately to avoid deception
* B. Transfer one client without discussion
* C. Maintain confidentiality while consulting a supervisor
C. Maintain confidentiality while consulting a supervisor
## Footnote
Supervision protects confidentiality while clarifying agency policy before disclosure or transfer.
46
A veteran counselor has strong religious beliefs and refuses to provide premarital counseling to a same-sex couple. **Which ethical principle is most at risk?**
* A. Justice
* B. Fidelity
* C. Nonmaleficence
A. Justice
## Footnote
Justice ensures fair and equitable treatment. Refusing service based on identity risks discrimination and violates ethical standards.
47
During intake, a client asks if the counselor shares their faith tradition. **An ethical response is to:**
* A. Redirect to symptom checklists
* B. Disclose personal beliefs in detail
* C. Acknowledge the question and explore its meaning for the client
C. Acknowledge the question and explore its meaning for the client
## Footnote
Exploring client motives respects spiritual identity without shifting focus to the counselor.
48
A client repeatedly misses payments but denies financial difficulty. **What is your most ethical course of action?**
* A. Reduce the fee and continue treatment
* B. Terminate the relationship with referral until payment is arranged
* C. Continue seeing the client for free
B. Terminate the relationship with referral until payment is arranged
## Footnote
Counselors may ethically terminate treatment for nonpayment but must do so with proper referral and notice.
49
A counselor treating a couple learns that one partner is secretly planning to file for divorce and asks the counselor not to tell. **The counselor’s most ethical response is to:**
* A. Maintain confidentiality but reassess suitability of conjoint sessions
* B. Disclose the secret to promote honesty
* C. End therapy immediately to avoid conflict
A. Maintain confidentiality but reassess suitability of conjoint sessions
## Footnote
Confidentiality must be preserved, yet ongoing joint counseling may be compromised; discussion of structure and consent is warranted.
50
The CPCE ensures **alignment** between counselor education programs and:
* A. APA accreditation guidelines
* B. CACREP’s eight curricular standards
* C. NBCC’s licensing laws exclusively
B. CACREP’s eight curricular standards
## Footnote
The CPCE directly reflects CACREP curriculum standards, ensuring consistent national training benchmarks.
51
A counselor wants to detect subtle differences between two interventions. **To increase statistical power, she should:**
* A. Lower the alpha level
* B. Increase sample size or test reliability
* C. Use fewer participants for efficiency
B. Increase sample size or test reliability
## Footnote
Larger samples and more precise instruments increase the power to detect small effects.
52
A counselor posts anonymous client stories online for “educational inspiration.” **The primary ethical issue is:**
* A. Violation of confidentiality even without identifiers
* B. Appropriate community education
* C. Informed consent obtained retroactively
A. Violation of confidentiality even without identifiers
## Footnote
Any recognizable client material shared publicly breaches confidentiality and trust.
53
Chi Sigma Iota’s emblem contains which **symbol** representing guidance and enlightenment?
* A. The laurel wreath
* B. The owl
* C. The torch
C. The torch
## Footnote
The torch symbolizes enlightenment and the counselor’s role in illuminating pathways toward growth.
54
In a REBT-based anger management group, a member says, “People should never treat me with disrespect, and when they do, I can’t control my anger.”
**Which leader question BEST reflects REBT methods?**
* A. “What’s the evidence that people must always treat you with respect?”
* B. “Have you considered ignoring people who disrespect you?”
* C. “Can you share a time you were respected?”
A. “What’s the evidence that people must always treat you with respect?”
## Footnote
REBT challenges irrational “must” and “should” beliefs that underlie emotional distress.
55
In a women’s empowerment group grounded in feminist therapy, one member says, “I’m not sure I have the right to be angry about what happened at work.”
**Which leader intervention BEST reflects feminist group principles?**
* A. Invite other members to share times when they questioned their right to feel emotions in male-dominated settings
* B. Ask the member to document all workplace incidents before discussing them
* C. Shift focus to conflict resolution strategies in the workplace
A. Invite other members to share times when they questioned their right to feel emotions in male-dominated settings
## Footnote
Feminist therapy emphasizes validation of women’s experiences, consciousness-raising, and connecting personal struggles to broader social and systemic issues (the “personal is political” principle).
56
A counselor at a university health center believes a student poses a serious and imminent threat. **Regarding disclosure:**
* A. Health/safety emergency exceptions permit limited disclosure to those who can mitigate the threat
* B. Only parents may be notified
* C. FERPA forbids any disclosure
A. Health/safety emergency exceptions permit limited disclosure to those who can mitigate the threat
## Footnote
HIPAA and FERPA both allow targeted disclosures during health/safety emergencies to protect the student/others.
57
A counselor posts de-identified success stories online for marketing. **The critical ethical consideration is:**
* A. Use of creative storytelling
* B. Confidentiality and risk of client recognition
* C. Counselor self-promotion rights
B. Confidentiality and risk of client recognition
## Footnote
Even partial details can reveal identity; explicit client consent is required.
58
An employer requests diagnostic labels for a client seeking workplace accommodations. **The counselor should:**
* A. Provide the entire record
* B. Document functional limitations and needed accommodations rather than disclosing more PHI than necessary
* C. Refuse to verify any impairment
B. Document functional limitations and needed accommodations rather than disclosing more PHI than necessary
## Footnote
ADA/§504 processes focus on functional impact and reasonable accommodation; limit PHI to what’s necessary.
59
A school counselor suspects emotional abuse but lacks proof. **The appropriate step is to:**
* A. Wait for confirmation from another professional
* B. Investigate personally before reporting
* C. Report based on reasonable suspicion
C. Report based on reasonable suspicion
## Footnote
Mandated reporters act on reasonable suspicion, not proof, to protect minors.
60
A university counseling center (a HIPAA-covered entity) is asked to provide an accessible telehealth platform for a deaf student. **The governing access duty is best understood as:**
* A. ADA/§504 obligation to provide effective communication and reasonable accommodation
* B. IDEA’s FAPE requirement
* C. FERPA’s parental inspection right
A. ADA/§504 obligation to provide effective communication and reasonable accommodation
## Footnote
ADA/Section 504 require effective communication and reasonable accommodations (e.g., interpreters, captioning). FERPA concerns records; IDEA applies to K-12 special education.
61
The **CPCE’s score report** is often used to:
* A. Replace thesis defense
* B. Rank students for awards
* C. Evaluate program effectiveness and student readiness
C. Evaluate program effectiveness and student readiness
## Footnote
Aggregate results inform both student competency and program-level curriculum evaluation.
62
A refugee client speaks limited English. **To ensure equity, the counselor should:**
* A. Use a qualified interpreter trained in confidentiality
* B. Simplify language and proceed
* C. Ask a bilingual family member to translate
A. Use a qualified interpreter trained in confidentiality
## Footnote
Professional interpreters preserve accuracy and confidentiality within multicultural ethics.
63
Chi Sigma Iota’s **founding paralleled** which movement in counseling history?
* A. The rise of humanistic psychology
* B. The professionalization and accreditation era of the 1980s
* C. The early vocational guidance movement
B. The professionalization and accreditation era of the 1980s
## Footnote
CSI emerged during counseling’s academic consolidation, reflecting ethical unity and scholarly rigor.
64
A client becomes increasingly unstable despite increased session frequency. He declines referral to a higher level of care. **What is your best ethical response?**
* A. Continue seeing him weekly as it’s better than nothing
* B. Discharge him and encourage him to seek help elsewhere
* C. Refer to a higher level of care and discontinue treatment if he declines
C. Refer to a higher level of care and discontinue treatment if he declines
## Footnote
Counselors must refer clients when their condition exceeds the provider’s scope or the treatment’s effectiveness.
65
A counselor **suspects substance use disorder** but the client denies it. The counselor should:
* A. Terminate for lack of honesty
* B. Confront immediately with accusation
* C. Continue assessment using collateral data and observation
C. Continue assessment using collateral data and observation
## Footnote
Diagnostic integrity requires corroborating evidence while maintaining rapport and respect.
66
In a psychoanalytic therapy group, a member persistently directs anger toward the leader after the leader enforces time limits.
**What is the MOST likely explanation from this perspective?**
* A. Displacement toward the leader due to authority-related transference
* B. Cognitive distortion about fairness
* C. A skills deficit in time management
A. Displacement toward the leader due to authority-related transference
## Footnote
Psychoanalytic group work examines transference — transferring feelings from past authority figures onto the leader.
67
When **preparing workplace accommodation letters**, the counselor should prioritize sharing:
* A. Full diagnostic history
* B. Medication details
* C. Functional limitations and requested accommodations
C. Functional limitations and requested accommodations
## Footnote
ADA and Section 504 processes require documentation of functional impact, not unnecessary diagnostic information.
68
Providing telehealth to a client physically located in another state generally requires the counselor to be licensed in the **jurisdiction** of the:
* A. Counselor’s residence
* B. Client’s permanent address
* C. Client’s physical location at the time of service
C. Client’s physical location at the time of service
## Footnote
Most licensing boards define the site of service as the client’s actual location during the session.
69
Which of the following **does NOT need to be part of the informed consent process?**
* A. Emergency contact procedures
* B. Risks and benefits of treatment
* C. Counselor’s personal social media policy
C. Counselor’s personal social media policy
## Footnote
While boundaries around social media may be discussed, they are not core components of informed consent.
70
A clinic stores video sessions in a **third-party cloud**. Before enabling recording, the counselor must ensure:
* A. FERPA directory-information release covers the storage
* B. A compliant business associate arrangement and data-security safeguards are in place
* C. Client consent alone is sufficient
B. A compliant business associate arrangement and data-security safeguards are in place
## Footnote
Under HIPAA, vendors handling PHI are business associates; security agreements and safeguards are required. FERPA “directory information” is unrelated.
71
A private practice counselor treating a college student receives a subpoena (not a court order) demanding complete records. **The ethically sound first action is to:**
* A. Provide only diagnostic codes
* B. Release the entire chart to avoid contempt
* C. Consult legal counsel and seek client authorization or a protective order
C. Consult legal counsel and seek client authorization or a protective order
## Footnote
A subpoena alone does not automatically authorize disclosure; under HIPAA/ethics, consult counsel, notify the client, and limit or protect disclosure.
72
A counselor is asked to participate in a promotional video for a treatment center that guarantees client success.
**What ethical concern should guide their decision?**
* A. Fidelity
* B. Veracity
* C. Avoidance of false or deceptive statements
C. Avoidance of false or deceptive statements
## Footnote
Counselors must not promote false claims or guarantees, as this misleads potential clients and violates professional integrity.
73
A counselor’s client is a prominent local official. **To minimize dual relationship risk**, the counselor should:
* A. Seek public endorsement
* B. Maintain professional neutrality and clear boundaries
* C. Attend civic events together
B. Maintain professional neutrality and clear boundaries
## Footnote
Awareness of power dynamics prevents exploitation or perceived favoritism.
74
A counselor receives a subpoena from an attorney (not a court order). **The correct action is to:**
* A. Refuse and notify the client of the request
* B. Consult legal counsel before releasing any records
* C. Release the records immediately
B. Consult legal counsel before releasing any records
## Footnote
Subpoenas require legal review; only a judge’s court order mandates disclosure.
75
A counselor works with a 9-year-old child. The parents have signed informed consent, but the counselor also explains the process to the child in age-appropriate terms. **What is this practice called?**
* A. Informed assent
* B. Dual consent
* C. Ethical transparency
A. Informed assent
## Footnote
While minors cannot give legal consent, obtaining informed assent respects their autonomy and promotes collaboration.
76
The motto of Chi Sigma Iota, “Virtue, Knowledge, and Service” best captures which **counseling values**?
* A. Academic prestige and exclusivity
* B. Ethical character, lifelong learning, and social responsibility
* C. Autonomy and independence
B. Ethical character, lifelong learning, and social responsibility
## Footnote
The CSI motto parallels the counseling profession’s ethical pillars: integrity, competence, and advocacy.
77
What should a counselor do if **a client cannot afford weekly sessions**?
* A. Refer the client to a low-cost clinic
* B. Charge sessions to his credit card
* C. Tell him to wait until he can afford weekly care again
A. Refer the client to a low-cost clinic
## Footnote
While it may feel compassionate to continue care, ethical guidelines require helping clients access appropriate care without financial strain.
78
A client calls his counselor to discuss an argument he and his wife have had while they have been vacationing in Mexico. The counselor has been seeing the couple together and the wife is unaware of the phone call. **The BEST course of action is to:**
* A. Continue the conversation with the husband
* B. Tell the husband that the discussion will need to wait until the couple returns from their vacation so the wife can also participate in the discussion
* C. Arrange a phone session
B. Tell the husband that the discussion will need to wait until the couple returns from their vacation so the wife can also participate in the discussion
## Footnote
In couples counseling, private communication with one partner compromises neutrality. Upholding transparency is ethically necessary.
79
A parent requests her teenager’s counseling records from a public high school. **The counselor’s first step is to:**
* A. Determine whether the requested materials are “sole-possession notes” vs. education records
* B. Apply HIPAA’s psychotherapy-notes exemption
* C. Deny access due to minor’s privacy rights
A. Determine whether the requested materials are “sole-possession notes” vs. education records
## Footnote
Under FERPA, most records are accessible to parents unless they qualify as sole-possession notes (kept as a memory aid and not shared). HIPAA psychotherapy-note rules typically don’t govern school records.
80
A counselor begins to develop romantic feelings for a client. According to the ACA Code, **what is the best ethical action?**
* A. Self-disclose and process it
* B. Terminate therapy and wait two years
* C. Seek supervision and assess risks before proceeding
C. Seek supervision and assess risks before proceeding
## Footnote
Counselors must manage countertransference ethically. Supervision helps assess risks and determine next steps.
81
Membership in **Chi Sigma Iota** (CSI) reflects commitment to:
* A. Professional development and ethical advocacy in counseling
* B. Educational policy reform
* C. Psychological research and clinical neuroscience
A. Professional development and ethical advocacy in counseling
## Footnote
CSI promotes counselor advocacy, service, and excellence — symbolizing unity within the counseling profession.
82
APA 7th edition recommends what **line spacing** throughout the manuscript?
* A. Single-spacing for body, double for references
* B. Double for text, single for quotations
* C. Double-spacing throughout, including references
C. Double-spacing throughout, including references
## Footnote
Uniform double-spacing ensures readability and scholarly consistency.
83
A client gives their counselor a handmade quilt after completing six months of trauma therapy. The counselor knows this item likely took many hours to make.
**What is the counselor’s most ethical next step?**
* A. Accept the gift as a cultural expression of gratitude
* B. Decline the gift to maintain clear professional boundaries
* C. Consult the ACA Code and explore the meaning of the gift with the client
C. Consult the ACA Code and explore the meaning of the gift with the client
## Footnote
Cultural and therapeutic context matters. Exploring meaning and consulting ethical guidelines supports an informed decision.
84
A counselor begins working with a 16-year-old client whose parents are unaware of her attendance. The client insists on confidentiality and shares suicidal ideation without a current plan.
**What is the counselor's most ethical course of action?**
* A. Inform the parents immediately
* B. Consult with a supervisor and assess for imminent danger
* C. Encourage the client to involve her parents but break confidentiality if she refuses
B. Consult with a supervisor and assess for imminent danger
## Footnote
Assessing risk and consulting ensures responsible action. The counselor must balance confidentiality with duty of care.
85
A counselor receives a social media request from a former client. **The most ethical action is to:**
* A. Decline and discuss professional boundaries if contact occurs
* B. Accept to maintain rapport
* C. Ignore permanently without explanation
A. Decline and discuss professional boundaries if contact occurs
## Footnote
Ethical distance and clarity preserve boundaries and prevent dual relationships.
86
A counselor questions a client’s faith-based healing practice. **An ethical approach would be to:**
* A. Explore its role and effectiveness within the client’s worldview
* B. Recommend evidence-based therapy only
* C. Discourage religious coping as irrational
A. Explore its role and effectiveness within the client’s worldview
## Footnote
Respecting diverse healing traditions honors autonomy and cultural competence.
87
During a long-term analytic group, a member jokingly dismisses feedback about their lateness, saying, “I’ve been like this since I was a kid.”
**Which intervention MOST reflects a Freudian approach?**
* A. Linking the behavior to possible unconscious resistance
* B. Suggesting time management strategies
* C. Ignoring the pattern to avoid confrontation
A. Linking the behavior to possible unconscious resistance
## Footnote
Psychoanalytic group work often interprets recurring behaviors as resistance, potentially rooted in unconscious conflict.
88
The CPCE was designed to mirror which **national licensing exam**?
* A. The EPPP
* B. The NCE
* C. The GRE Psychology Subject Test
B. The NCE
## Footnote
The CPCE parallels the National Counselor Examination (NCE), reinforcing competency across identical CACREP domains.
89
During a Gestalt-oriented interpersonal skills group, the leader notices a member smiling while recounting an incident of rejection.
**Which intervention BEST aligns with Gestalt principles?**
* A. Explore the history of the member’s rejection experiences
* B. Ask the member to exaggerate the smile and notice what emotions arise
* C. Suggest the member focus on future relationships instead
B. Ask the member to exaggerate the smile and notice what emotions arise
## Footnote
Gestalt emphasizes awareness of incongruence between verbal and nonverbal communication, often using exaggeration to deepen insight.
90
The CPCE’s **primary function** within universities is to:
* A. Serve as a comprehensive exit or diagnostic exam
* B. Measure teaching effectiveness
* C. Replace faculty evaluations
A. Serve as a comprehensive exit or diagnostic exam
## Footnote
The CPCE functions as a comprehensive benchmark for counseling students nearing program completion.
91
A high-school team is deciding between an IEP and a 504 Plan for a student with anxiety that limits testing endurance but not core instruction. **The most fitting path is:**
* A. Both IEP and 504 concurrently
* B. 504 Plan accommodations without specialized instruction
* C. IEP under IDEA due to impairment
B. 504 Plan accommodations without specialized instruction
## Footnote
Section 504 covers access/accommodations when no specialized instruction is required (IDEA = IEP + special education services).
92
A counselor encounters a former client at a community event. **The most ethical response is to:**
* A. Greet them publicly as “my client”
* B. Ignore them to avoid awkwardness
* C. Allow the client to initiate interaction
C. Allow the client to initiate interaction
## Footnote
Protecting confidentiality means deferring public acknowledgment to the client’s discretion.
93
The CPCE assesses which of the following **domains**?
* A. Cognitive Neuroscience and Personality
* B. Business Management and Supervision
* C. Research, Helping Relationships, Assessment, and Group Work
C. Research, Helping Relationships, Assessment, and Group Work
## Footnote
The CPCE is grounded in CACREP’s eight core domains — the backbone of counselor education competency.
94
A client describes microaggressions at work. **The counselor’s first step is to:**
* A. Advise immediate resignation
* B. Validate the experience and assess its emotional impact
* C. Suggest ignoring comments to avoid conflict
B. Validate the experience and assess its emotional impact
## Footnote
Validation and emotional exploration precede problem-solving within culturally responsive care.
95
During a group session, a client shares that 7 years ago he set a building on fire, which resulted in the death of a security guard. The counselor may do all of the following **EXCEPT**:
* A. Ask group members how they want to handle the situation
* B. Ignore the statement because the situation happened 7 years ago
* C. Check out members' feelings
B. Ignore the statement because the situation happened 7 years ago
## Footnote
Ignoring significant disclosures, even if historic, risks invalidating the group experience. While it may not be reportable, the counselor has a duty to therapeutically address and assess its impact.
96
A client enthusiastically requests a continuation of a "New Age" intervention you tried once at her request. After researching, you learn that it has been deemed ineffective and potentially harmful for certain individuals.
**What ethical principle best supports your decision to respectfully decline the request?**
* A. Beneficence
* B. Veracity
* C. Nonmaleficence
C. Nonmaleficence
## Footnote
Nonmaleficence requires avoiding harm. Even if the client is excited, you cannot ethically provide treatments that are ineffective or dangerous.
97
A counselor must terminate with a client due to relocation. **Ethically, the counselor should:**
* A. Leave future contact information for emergencies
* B. Provide referrals and discuss transition
* C. End abruptly to avoid attachment
B. Provide referrals and discuss transition
## Footnote
Ethical termination includes preparation and appropriate referrals to protect client continuity.
98
A psychoanalytic group is processing dreams shared by members. One participant describes a dream about being locked out of a house while others are inside laughing.
**Which leader question BEST aligns with Freudian group work?**
* A. “What recent life events might connect to this dream?”
* B. “What feelings do you notice in the group right now as you share this?”
* C. “How could the group help you re-enter the house?”
A. “What recent life events might connect to this dream?”
## Footnote
Freud emphasized exploring latent and manifest dream content, linking imagery to current and past life experiences.
99
In a diversity-focused support group, a member makes a comment based on stereotypes.
**Which leader intervention MOST supports group cohesion while addressing the bias?**
* A. Redirect the conversation without acknowledging the comment
* B. Publicly challenge the member with evidence-based facts
* C. Explore the origins of the comment and invite multiple perspectives from the group
C. Explore the origins of the comment and invite multiple perspectives from the group
## Footnote
This promotes awareness and dialogue without shutting down participation, fostering culturally informed group growth.
100
You lead a successful therapy group and consider using anonymous client testimonials to attract new clients.
**Which ethical stance best aligns with the ACA Code of Ethics?**
* A. Permissible if the testimonial is anonymous and voluntary
* B. Permissible only if clients sign a waiver
* C. Strictly prohibited due to the power imbalance and risk of undue influence
C. Strictly prohibited due to the power imbalance and risk of undue influence
## Footnote
Client testimonials are considered unethical due to potential coercion, even if unintentional. Power dynamics prevent true voluntariness.
101
A client describes tension between personal goals and family expectations rooted in cultural obligation. **The counselor should:**
* A. Explore meaning within the client’s cultural value system
* B. Emphasize autonomy as universal
* C. Recommend separation from family
A. Explore meaning within the client’s cultural value system
## Footnote
Culturally responsive practice honors collectivist values while supporting client self-definition.
102
A counseling center embedded within a university academic division is asked for a student’s mental health file by the registrar. **The controlling law for release**, assuming the records are maintained by the university, is most likely:
* A. FERPA, because the institution maintains the record as part of the educational enterprise
* B. HIPAA only
* C. State psychotherapy-privilege law
A. FERPA, because the institution maintains the record as part of the educational enterprise
## Footnote
At universities, counseling records maintained by the institution typically fall under FERPA rather than HIPAA.
CPCE
flashcards
Decks in class (8)
# Cards
