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Substance Abuse Counselor Ethics, Confidentiality, and Boundaries (Update)

1. Patient autonomy can refer to a patient's right to make his or her own decisions regarding personal health care.

A. True

B. False


2. An addiction professional is asked to review potential health care interventions with a client. How can the addiction professional achieve respect for patient autonomy while reviewing the potential health care interventions with the client?

A. Outline the benefits of the potential health care interventions.

B. Outline the risks of the potential health care interventions.

C. Provide the patient with accurate, unbiased health care information.

D. Outline the benefits and the risks of the potential health care interventions, while providing the patient with accurate, unbiased health care information.


3. An addiction professional is asked to inform a client about a specific health care intervention. In doing so, the addiction professional aggressively instructs the patient to accept the health care intervention as soon as possible. The patient becomes frightened and agrees to accept the health care intervention. Which of the following statements regarding the previous example is most accurate?

A. The addiction professional did not respect patient autonomy.

B. The addiction professional did achieve nonmaleficence, as it relates to health care.

C. The addiction professional upheld justice, as it relates to health care.

D. The addiction professional upheld beneficence.


4. Beneficence, as it relates to health care, refers to the act of doing what is best for a patient, with no consideration for a patient's pain, physical and/or mental suffering.

A. True

B. False


5. Justice, as it relates to health care, can refer to the fair allocation of health care resources to patients.

A. True

B. False


6. Which of the following statements regarding justice is most accurate?

A. Similar patients in similar situations do not have the same right to available health care resources.

B. Similar patients in similar situations have the same right to available health care resources.

C. All patients do not have the same rights to health care once they are administered into a health care setting.

D. Patients in the same health care setting have different rights to different levels of health care.


7. Which of the following statements regarding the NAADAC's code of ethics is most accurate?

A. Addiction professionals considering initiating contact or a relationship with a previous client shall seek documented consultation or supervision prior to its initiation.

B. Addiction professionals considering initiating contact or a relationship with a previous client shall seek documented consultation or supervision after its initiation.

C. Addiction professionals considering initiating contact or a relationship with a previous client shall seek documented consultation or supervision during treatment.

D. An addiction professional may not initiate contact with a previous client.


8. Which of the following statements regarding the NAADAC's code of ethics is most accurate?

A. Addiction professionals shall create treatment plans in collaboration with their client. Treatment plans do not have to be reviewed or revised.

B. Addiction professionals shall create treatment plans in collaboration with their client. Treatment plans shall be reviewed and revised on an ongoing and intentional basis to ensure their viability and validity.

C. Addiction professionals shall create treatment plans in collaboration with their client. Treatment plans shall be reviewed and revised every month to ensure their viability and validity.

D. Addiction professionals shall create treatment plans in collaboration with their client. Treatment plans shall be reviewed and revised every 2 months to ensure their viability and validity.


9. According to the NAADAC's code of ethics, addiction professionals have an obligation to speak out regarding barriers and obstacles that impede access to and/or growth and development of clients.

A. True

B. False


10. Which of the following statements regarding the NAADAC's code of ethics is most accurate?

A. Addiction professionals shall provide a client reasonable access to documentation regarding the client upon his/her verbal request.

B. Addiction professionals should not provide clients with access to documentation regarding their treatment.

C. Addiction professionals shall provide a client reasonable access to documentation regarding the client upon his/her written request.

D. Addiction professionals shall provide a client reasonable access to documentation regarding the client upon his/her verbal and written request.


11. Addiction professionals should work to educate medical professionals about substance use disorders, the need for primary treatment of these disorders, and the need to increase the use of mood altering chemicals for persons in recovery.

A. True

B. False


12. Addiction professionals shall report unethical conduct or unprofessional modes of practice leading to harm which they become aware of to the appropriate certifying or licensing authorities, state or federal regulatory bodies, and/or NAADAC.

A. True

B. False


13. When conducting research, addiction professionals shall provide appropriate explanations regarding the research. However, addiction professionals are not responsible for obtaining consent from a guardian or legally authorized representative prior to working with a research participant who is not capable of giving informed consent.

A. True

B. False


14. Which of the following statements regarding the Iowa state code of ethics for all IBC certified professionals is most accurate?

A. IBC certified professionals should bring personal or professional issues into the counseling relationship.

B. IBC certified professionals should only bring personal or professional issues into the counseling relationship when they have a personal relationship with their client.

C. IBC certified professionals should avoid bringing personal or professional issues into the counseling relationship.

D. IBC certified professionals should avoid bringing personal or professional issues into the counseling relationship when they have a personal relationship with their client.


15. Which of the following statements regarding the Iowa state code of ethics for all IBC certified professionals is most accurate?

A. IBC certified professionals may use their professional relationships with clients to further their own interests when it pertains to research and treatment.

B. IBC certified professionals may use their professional relationships with clients to further their own interests when it pertains to research.

C. IBC certified professionals may use their professional relationships with clients to further their own interests when it pertains to treatment.

D. IBC certified professionals should not use their professional relationships with clients to further their own interests.


16. IBC certified professionals should continue therapeutic relationships only as long as it is reasonably clear that clients are benefiting from the relationship.

A. True

B. False


17. IBC certified professionals are not responsible for assisting persons in obtaining other therapeutic services if they are unable or unwilling to provide professional help.

A. True

B. False


18. Which of the following statements regarding the Iowa state code of ethics for all IBC certified professionals is most accurate?

A. Soliciting and/or engaging in sexual conduct with clients is prohibited; this includes the two years following the termination of services.

B. Soliciting and/or engaging in sexual conduct with clients is prohibited; this includes the three years following the termination of services.

C. Soliciting and/or engaging in sexual conduct with clients is prohibited; this includes the four years following the termination of services.

D. Soliciting and/or engaging in sexual conduct with clients is prohibited; this includes the five years following the termination of services.


19. IBC certified professionals may “friend” their own clients, past or present, or clients of an agency for which they work, on Facebook or other social media sites.

A. True

B. False


20. IBC certified professionals shall embrace, as primary obligation, the duty of protecting the privacy of clients and should not disclose confidential information acquired in teaching, practice or investigation without appropriately executed consent.

A. True

B. False


21. Ideally, prevention specialists (while delivering care in Iowa) should be supervised by competent senior prevention specialists. When this is not possible, prevention specialists should seek peer supervision or mentoring from other competent prevention specialists.

A. True

B. False


22. Which of the following statements regarding the Iowa state code of ethics for prevention specialists is most accurate?

A. Prevention specialists should not use formal or informal structures to receive and incorporate input from service recipients in the development, implementation and evaluation of prevention services.

B. Prevention specialists should use formal and informal structures to receive and incorporate input from service recipients in the development, implementation and evaluation of prevention services.

C. Prevention specialists should only use formal structures to receive and incorporate input from service recipients in the development, implementation and evaluation of prevention services.

D. Prevention specialists should only use informal structures to receive and incorporate input from service recipients in the development, implementation and evaluation of prevention services.


23. The CAADE professional (delivering care in California) who is aware of unethical conduct or unprofessional modes of practice shall report such inappropriate behavior to the appropriate authority.

A. True

B. False


24. The CAADE professional (delivering care in California) shall recognize the ethical responsibility of self-care as being paramount to the delivery of effective service.

A. True

B. False


25. An alcoholism and drug abuse counselor/registrant (delivering care in California) is not responsible for collaborating with other health care professional(s) in providing a supportive environment for the client who is receiving prescribed medications.

A. True

B. False


26. The alcoholism and drug abuse counselor/registrant (delivering care in California)  must not accept a private fee or any other gift or gratuity for professional work with a person who is entitled to such services through an institution or agency.

A. True

B. False


27. HIPAA sets limits and conditions on the uses and disclosures of individuals' personal health care information, while establishing that all patient health care information be properly secured and maintained.

A. True

B. False


28. Which of the following statements is most accurate?

A. The purpose of 42 CFR Part 2 is to impose restrictions upon the disclosure and use of substance use disorder patient records which are maintained in connection with the performance of specific part 2 programs.

B. The purpose of 42 CFR Part 2 is to lift restrictions upon the disclosure and use of substance use disorder patient records which are maintained in connection with the performance of any part 2 program.

C. The purpose of 42 CFR Part 2 is to impose restrictions upon the disclosure and use of substance use disorder patient records which are maintained in connection with the performance of any part 2 program.

D. The purpose of 42 CFR Part 2 is to impose restrictions upon the disclosure of substance use disorder patient records which are maintained in connection with the performance of any hospital program.


29. The regulations of 42 CFR Part 2 cover any information (including information on referral and intake) about patients receiving diagnosis, treatment, or referral for treatment for a substance use disorder created by a part 2 program.

A. True

B. False


30. Which of the following statements is most accurate?

A. If a patient's substance use disorder diagnosis, treatment, or referral for treatment is not provided by a part 2 program, that patient's record is still covered by the regulations in 42 CFR Part 2.

B. If a patient's substance use disorder diagnosis, treatment, or referral for treatment is not provided by a part 2 program, that patient's record is covered by the regulations in 42 CFR Part 2 if the patient has mental illness.

C. If a patient's substance use disorder diagnosis, treatment, or referral for treatment is not provided by a part 2 program, that patient's record is covered by the regulations in 42 CFR Part 2 if the patient is 65 years of age or older.

D. If a patient's substance use disorder diagnosis, treatment, or referral for treatment is not provided by a part 2 program, that patient's record is not covered by the regulations in 42 CFR Part 2.


31. The regulation of 42 CFR Part 2  cover only specific records of a diagnosis identifying a patient as having or having had a substance use disorder which is initially prepared by a part 2 provider in connection with the treatment or referral for treatment of a patient with a substance use disorder.

A. True

B. False


32. Upon request, patients who have consented to disclose their patient identifying information using a general designation must be provided a list of entities to which their information has been disclosed pursuant to the general designation.

A. True

B. False


33. The part 2 program or other lawful holder of patient identifying information must have in place formal policies and procedures to reasonably protect against unauthorized uses and disclosures of patient identifying information and to protect against reasonably anticipated threats or hazards to the security of patient identifying information.

A. True

B. False


34. The statute authorizing the regulations in 42 CFR Part 2 do preempt the field of law which they cover to all state laws in that field.  

A. True

B. False


35. Which of the following statements is most accurate?

A. The 42 CFR Part 2 regulations do prohibit a part 2 program from giving a patient access to their own records.

B. The 42 CFR Part 2 regulations do prohibit a part 2 program from giving a patient access to their own records in special circumstances.

C. The 42 CFR Part 2 regulations do not prohibit a part 2 program from giving a patient access to their own records.

D. The 42 CFR Part 2 regulations do not prohibit a part 2 program from giving a patient access to their own records; however, a patient may not copy his or her record.


36. Patient identifying information may be disclosed to medical personnel to the extent necessary to meet a bona fide medical emergency in which the patient's prior informed consent cannot be obtained.

A. True

B. False


37. 42 CFR Part 2 requires that a notice prohibiting re-disclosure accompany disclosures of 42 CFR Part 2P information.

A. True

B. False


38. The final rule requires a lawful holder, who engages a contractor to carry out payment and or health care operations activities, to have in place a written contract or comparable legal instrument specifically requiring the contractor to comply with 42 CFR Part 2.

A. True

B. False


39. Which of the following statements is most accurate?

A. Under the final rule, a lawful holder may not disclose 42 CFR Part 2 information to its contractors if the disclosure is for “a Medicare, Medicaid or CHIP audit or evaluation, including a civil investigation or administrative remedy.”

B. Under the final rule, a lawful holder may now disclose 42 CFR Part 2 information to its contractors if the disclosure is not for “a Medicare, Medicaid or CHIP audit or evaluation, including a civil investigation or administrative remedy.”

C. Under the final rule, a lawful holder may now disclose 42 CFR Part 2 information to its contractors if the disclosure is for “a Medicare, Medicaid or CHIP audit or evaluation, including a civil investigation or administrative remedy."

D. Under the final rule, a lawful holder may now disclose 42 CFR Part 2 information to its contractors if the disclosure is for “a Medicare, Medicaid or CHIP audit or evaluation, with the exception of a civil investigation or administrative remedy.”


40. Addiction professionals should be aware that patients can revoke consent to one or more parties named in a multi-party consent form while leaving the rest of the consent in effect.

A. True

B. False


41. Which of the following statements is most accurate?

A. 42 CFR Part 2 does not allow the use of a single consent form authorizing the disclosure of 42 CFR Part 2 patient information to different recipients for different purposes.

B. 42 CFR Part 2 requires the use of multiple consent forms authorizing the disclosure of 42 CFR Part 2 patient information to different recipients for different purposes.

C. 42 CFR Part 2 allows the use of a single consent form authorizing the disclosure of 42 CFR Part 2 patient information to different recipients for different purposes.

D. 42 CFR Part 2 does not allow the disclosure of 42 CFR Part 2 patient information to different recipients for different purposes at any time.


42. An addiction professional is presented with an ethical dilemma. The addiction professional decides to use a decision-making model to resolve the dilemma. What should be the addiction professional's first step when using a decision-making model to resolve an ethical dilemma?

A. Gather information

B. Identify the ethical dilemma/issue

C. Develop potential courses of action to resolve the ethical dilemma

D. Select a course of action to resolve the ethical dilemma at hand


43. Redirection, as it pertains to ethical decision-making, can refer to the process of assessing, altering, adjusting and/or changing the course of action selected to resolve an ethical dilemma.

A. True

B. False


44. An addiction professional is faced with an ethical dilemma. The addiction professional is contemplating whether or not to engage in a personal relationship with a client. Which of the following statements regarding the aforementioned addiction professional's ethical dilemma is most accurate?

A. The main ethical issue involved in the ethical dilemma centers around patient confidentiality.

B. The main ethical issue involved in the ethical dilemma centers around patient boundaries.

C. The main ethical issue involved in the ethical dilemma centers around a HIPAA violation.

D. The main ethical issue involved in the ethical dilemma centers around a 42 CFR Part 2 violation.


45. Addiction professionals should document the use of decision-making models in resolving ethical dilemmas.

A. True

B. False


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