Confidentiality & Boundaries
A client recognizes you in a public setting and starts sharing personal information.
What is Politely redirecting the conversation to protect confidentiality?
ACA Code B.1.c (Confidentiality of Records & Interactions)
A bilingual client prefers to speak their native language, but no interpreter is available.
What is seek professional interpretation services instead of relying on family? (APA 2.01)
A 14-year-old discloses occasional drinking at parties.
What is likely not report unless harm or endangerment is present? (State laws on child welfare)
A client asks to text instead of using a telehealth platform.
What is require the client to use HIPAA-compliant platforms only? (ACA H.4.a)
A client asks their therapist if they are married.
What is maintain neutrality and redirect focus to therapy?
A client invites you to their wedding, raising ethical considerations.
What is maintain professional boundaries and consider potential dual relationships? (ACA Code A.5.d)
A client's religious beliefs strongly influence their mental health decisions.
What is respect and integrate beliefs while upholding ethical guidelines? (ACA A.4.b)
A minor reports sneaking out at night but insists it's harmless.
What is assess safety and risk factors before making a decision? (ACA B.2.a)
A client emails sensitive details outside of a session.
What is encourage the client to discuss sensitive matters during sessions and not via email? (APA 4.02)
A client shares that they are seeing another therapist but asks their therapist not to tell them.
What is encourage transparency between treatment providers? (ACA A.3.b)
A client requests to follow their therapist on social media.
What is politely decline and maintain professional ethics? (APA 6.04)
In a collectivist culture, the client insists on family joining every session despite potential harm.
What is balance family inclusion with client autonomy and safety? (NASW 1.05.a)
A 16-year-old reports vaping marijuana in a state where it’s legal and begs the therapist not to tell their parents.
What is follow HIPAA and state laws on minor confidentiality?
A therapist conducts teletherapy, and the client appears intoxicated.
What is address immediate safety concerns and reschedule if necessary? (ACA A.1.a)
A new client requests therapy for a "friend," but it becomes clear they are talking about themselves.
What is gently explore their needs and offer direct therapy?
A former client requests therapy again after three years.
What is evaluate potential conflicts of interest before agreeing? (NASW Code 1.06.d)
A therapist feels uncertain about working with a client from an unfamiliar cultural background.
What is seek supervision, training, or consultation on cultural competence? (ACA C.2.a
A client experiencing domestic violence begs the therapist not to report it.
What is report if imminent harm exists, otherwise provide resources and safety planning? (Mandatory Reporting Laws)
A client messages their therapist at 10 PM through a telehealth platform, saying they feel suicidal.
What is follow crisis protocols and direct the client to emergency services if needed? (APA 3.04)
A therapist runs into a client at a social event where alcohol is being served.
What is acknowledge the client only if they initiate contact?
A client brings a valuable gift, and the agency has no clear policy.
What is assess cultural significance and agency policies before accepting? (ACA A.10.e)
A client describes symptoms using culturally specific terms that do not align with DSM-5 diagnoses.
What is use the DSM-5 Cultural Formulation Interview to assess the symptoms? (APA 3.01)
A client threatens to harm someone but refuses to give their name.
What is assess duty to warn and consult with a supervisor if necessary? (Tarasoff v. Regents of the University of California)
A social media influencer client asks if they can tag their therapist in a post about their therapy progress.
What is maintain professional boundaries and decline public social media interactions? (ACA H.6.b)
A client offers a business discount in exchange for therapy.
What is decline due to the risks of dual relationships? (ACA A.5.a)