Shhh... It's Confidential
A client asks, "Will everything I say stay confidential?" Name one exception to confidentiality.
Danger to self, danger to others, abuse/neglect reporting, court order (where applicable), or other legal exceptions.
Your client recognizes you at Target and says hello.
Respond naturally if the client initiates contact while protecting confidentiality.
Define competence.
Practicing within one's education, training, supervised experience, and skills.
What's the difference between consent and assent?
Consent is legal permission; assent is the minor's affirmative agreement to participate.
Name one characteristic of a strong progress note.
Objective, accurate, timely, concise, clinically relevant, and tied to treatment goals.
A client's spouse calls asking if their partner attends counseling.
Do not confirm or deny without proper authorization.
A client brings homemade cookies to your final session.
Consider the therapeutic relationship, cultural context, value of the gift, boundaries, and document your decision.
Why is consultation considered an ethical strength rather than a weakness?
It improves decision-making, reduces bias, protects clients, and supports ethical practice.
Parents are divorced. One parent wants counseling; the other objects.
Review custody documents, determine legal decision-making authority, and follow applicable law.
Name at least three components that should be included in a treatment plan.
You receive a phone call from an attorney requesting information about your client. They tell you the client "already gave permission." What is your next move?
Never rely on someone else's word that you have permission. Verify the authorization yourself.
A long-term client tells you they've developed romantic feelings for you.
Explore the feelings therapeutically, maintain clear professional boundaries, seek consultation if appropriate, document the discussion, and avoid acting on the client's feelings.
A client sends you a Facebook friend request.
Maintain professional boundaries and follow your informed consent/social media policy.
A parent says, "I have full custody, so my ex doesn't need to know about counseling."
What should you do?
Do not rely solely on the parent's statement. Request and review the custody or court documents to determine each parent's legal rights regarding treatment and access to information.
A client requests their records. In Texas, how long generally do providers have to respond?
15 days
DAILY DOUBLE
Your 16-year-old client admits to vaping nicotine and drinking alcohol on weekends but is otherwise safe. They beg you not to tell their parents.
What ethical and legal considerations guide your response?
A colleague consistently arrives late, misses notes, and appears impaire
Protect client welfare, consult, document concerns as appropriate, and follow ethical reporting procedures.
You realize burnout is affecting your clinical work.
Seek supervision or consultation, address self-care, adjust workload if needed, and practice within competence.
You reasonably suspect abuse has occurred based on statements made, but have no proof.
Reasonable suspicion, not proof, is generally the threshold for making a report.
Why is documenting consultation important?
It demonstrates sound ethical reasoning, supports continuity of care, and provides legal/ethical protection.
Near the end of session, a client says:
"After I leave here today, I'm going to make my ex pay for what they did."
The client refuses to answer any follow-up questions and quickly leaves your office.
Conduct as much risk assessment as possible before the client leaves. If the client leaves, use the information available to assess whether there is a credible and imminent threat, consult when feasible, follow applicable duty-to-protect/warn laws and agency policy, attempt appropriate follow-up if indicated, and document your assessment, rationale, consultations, and actions thoroughly.
Your cousin asks you to become their therapist because "you're the only one I trust."
Decline and provide appropriate referrals because of the dual relationship.
Name three ethical principles that guide professional counselors.
Examples include autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity.
An older adult appears increasingly confused and vulnerable to financial exploitation.
Assess decision-making capacity, prioritize safety, consider reporting requirements where applicable, involve appropriate supports, and document.
Your note says:
"Client was manipulative and lazy."
What's wrong?
It's judgmental and subjective. Documentation should be objective, behavioral, and clinically relevant.