NCE Exam - Professional Orientation and Ethics
From the Rosenthal study materials and various notes for the National Counselor Exam.
Terms in this set (125)
Which group has been most instrumental in opposing counselor licensure?
National Board for Certified Counselors, formed in 1982,
awards the NCC generic credential.
National Certified Counselor
Good for 5 years with 100 hours of professional development.
(Passing the NCE will get a counselor this certification.)
American Counseling Association
(used to be the American Personnel and Guidance Association [AACD])
Certified Clinical Mental Health Counselor
(Must get NCC credential first.)
National Certified School Counselor
(Must get NCC credential first.)
Scope of practice
Counselors should only practice using techniques for which they have been trained.
First created in 1953 by the American Psychological Association (APA),
National Assoc. of Social Workers (NASW) created theirs in 1960,
ACA created theirs in 1961.
Ethics always describe standards of conduct imposed by ____ and ______.
ACA and NBCC.
Ethics define standards of behavior set forth by organizations and certification bodies, they are not usually
state or federally mandated laws.
Most ethical dilemmas are related to ______.
implies the counselor will not reveal anything about a client unless he is given specific authorization to do so.
(Confidentiality is relative to the situation as far as counselors go [legally].)
Most ethical dilemmas are related to _________.
ACA indicates counselors have an obligation to protect the confidentiality of the deceased and this should be stated clearly in your ______ ______ document given to the client at the beginning of treatment.
Should counselors attend a funeral of a client?
Ask self if whether beneficial (same as attending a wedding), and if attending, document date, time, basis for decision.
Tarasoff v. Board of Regents of the Univ. of California
'Duty to Warn' someone in imminent danger.
(Case where client threatened in session, later killed her - her family sued, state court denied [Tarasoff I] but appealed and won in Supreme Court [Tarasoff II].)
Duty to warn
Counselors have a responsibility to warn those who appear in serious and foreseeable harm due to statements made during a session.
revealing information that is damaging to a client's reputation.
Counselor is working for the good of the client or group.
Justice (in a group situation)
Counselor treats all members fairly.
Counselor will do no harm.
Defamatory information that is written.
Defamatory information that is written but references verbal remarks.
State laws govern title usage and practice, however, they do not govern ______.
(applies to programs, not counselors)
- Accreditation is NOT the law, only a process whereby an agency/school meets certain standards and qualifications set forth by an association/organization.
Programs in Psychology boast accreditation by the APA, while counseling programs are accredited by ______.
(Council for Accreditation of Counseling and Related Educational Programs)
Downside of accreditation
Accreditation organization sets the curriculum to gain it, not the school.
Exceptions to confidentiality when dealing with suicide include
joking about killing one's self,
giving away possessions after a depressed period,
previous suicide attempts,
detailed suicide plan
Suicide checks in as the ___ or ___ leading cause of death in the US (higher than homicide).
11th or 12th
(Guns account for more than all other methods put together.)
Suicide is the 2nd/3rd leading cause of death for those ages ____ to ____.
15 to 24.
Suicide is more likely to occur in rural areas and in times of economic recession/depression.
Most suicides occur in the spring at the end of April or May.
____ to ____ of clients will give warning signs of suicide.
75 to 80%
The process of giving the client a document stating counselor qualifications, office hours, billing policies, emergency procedures, therapy techniques, and confidentiality rules so they can acknowledge and sign to signify understanding.
Privileged communication (client's privilege)
Legal term implying that a therapeutic interaction (verbal or written) will not be available for public inspection (without client consent).
The client can choose whether to reveal confidential info (usually on witness stand) - they are the holder of the privilege.
Privileged communication is a _____ concept which protects _____, not counselors.
Privileged communication laws are not applicable in cases of
child abuse, neglect, exploitation, suicide, homicidal threats, criminal intentions, clients in dire need of hospitalization, malpractice suits, where client is a minor or mentally incompetent.
Privileged communication that is 'qualified' means
exceptions may exist.
(Privileged comm. based on licensure status, not degree of certification credetials, because it is a LEGAL concept.)
Counselors are mandated reporters for child abuse, making it legal and ethical to break confidentiality in such instances.
When a client's condition indicates there is a clear and imminent danger or serious/foreseeable harm to the client and others, the counselor must take reasonable personal action or inform responsible authorities.
Exceptions to confidentiality
Client is danger to self or others, Client requests release of info, Court orders a release of info, Counselor engaged in supervision, Clerical assistant processes client info,
Legal/clinical consultations, Malpractice suit, Client less than 18 yrs old, Elderly abuse, Insurance co. requests diagnosis
Tarasoff implies a responsible helper will warn an ____ ______.
Professionals generally adhere to the ______ of _______ _______, which suggests you reveal only what is necessary.
principle of minimal disclosure
a practitioner adheres to the highest possible ethical standards.
A 39 yr old female you are seeing in an assertiveness training group reveals she is plotting to shoot her husband. Based on Tarasoff, you should
warn the husband.
One impetus for counselor licensing was that psychology licensure bodies sought to _______ the practice of counselors so counselors could not receive 3rd party payments from insurance and managed care company.
(Licensing for counselors was needed as psychologist attained licensing [and had a monopoly on nonmedical treatment services] in every state in the U.S.)
Examination for Professional Practice in Psychology
(EPPP is to psychologists what the NCE is to counselors)
The term 'psychology' can only be used if the helper in question is a licensed ________.
CACREP accredits masters' degree programs in
career, college, community, gerontological, marital, couple, family, mental health, school counseling, student affairs, counselor education, counselor supervision, and doctoral degrees.
(largest # is in school counseling, community counseling is 2nd)
One major difference between the psychology v. counseling movement is
psychologists are working to eliminate practitioners with less than a doctorate while counselors are not.
APA is to psychologist as ACA is to
Certification is not the same as _______.
(A counseling license is granted by the state government. It is a title mastered by living up to certain standards.)
an impaired professional
A counselor who is alcoholic and suffering from burnout.
(defined here as the deterioration in the ability to function as a counselor)
a helper who does not possess the education and experience necessary to secure professional credentials.
recognizes you have reached a given level of competence and thus are authorized to use a title.
A woman comes to you for help with an eating disorder. You have no experience or training in this area. Ethically, you should
refer this client to a colleague who is trained and experienced with this type of client.
________ was the first state to license counselors in 1976.
The problem with _____ ____ _____ is that it is difficult to administer them in a fair manner.
sliding fee scales (or income sensitive scales)
They are ethical and legal, and popular with nonprofit agencies.
Amount waived fees
The amount a 3rd party payer does not cover.
One potential negative of counseling licensure is that
counselors may not be as creative during graduate work and only take courses aimed at fulfilling the requirements to take the licensure exam.
Licensing generally adds prestige to a profession and can serve to protect ____ ______.
Privacy issue: If you or your agency didn't collect the information in the record, you cannot ethically send it to someone else requesting it even if a release form has been signed. (only send info you have collected)
Release of information (aka 'consent to disclose')
Ethics dictate client records should be kept at least 5 years after your last contact with the client even if the client is deceased.
occurs when one state or organization accepts the license/credential of another state.
FERPA (aka, Buckley Amendment)
Family Educational Rights and Privacy Act (1974)
-says parents can see their children's school records, and college students can see their own once they are 18.
Certified Rehabilitation Counselor
(need at least a master's in rehabilitative counseling, acceptable experience in the field, and passing score on 400 question multiple choice examination)
Master Addictions Counselor
A list of licensed providers.
(counselors on the list sometimes called 'registered professional counselor')
_____ or _____ activity with any CURRENT client is unethical under new and old sets of ethics.
Sexual or romantic
(Counselor should NEVER have a sexual relationship with a current client.)
occurs when a counselor stops providing services and does not refer the client to another helper.
results when a counselor has another significant relationship with the client that hinders objectivity.
(can also exist if a supervisor accepts a subordinate as a client.)
NCC credential requirements over 5 year period
100 hours of professional development (CEUs)
Countertransference in reference to attraction
Counselor being sexually attracted to the client.
(typical manifestation of countertransference - purported to indicate unresolved problems on the part of the helper.)
A malpractice/liability insurance company is least likely to defend you if
you are sexually involved with a client.
(Your license may be revoked even if the client is not damaged or harmed by the experience.)
According to NBCC, a counselor should not engage in sexual intimacies with a FORMER client within a minimum of ____ years after terminating the counseling relationship.
(If engaging in sex after 2 year period, you must document that relationship was not exploitative in nature.)
According to the ACA, a counselor should not engage in sexual intimacies with a FORMER client within a minimum of ____ years after terminating the counseling relationship.
Computer Assisted Counseling (CAC)
Controversial software that attempts to counsel clients.
(A humanistic counselor's worst nightmare!)
Computer Managed Counseling (CMC)
Software that helps manage counseling practice through bookkeeping, appointment setting, billing, etc.
(Cuts down on time, paperwork, and money.)
Exceptions to dual relationships by the NBCC include
an exception in instances where "an individual's situation warrants counseling intervention and another alternative is unavailable."
A counseling journal article should use documentation that is based on _____ style.
(from the Publication Manual of the American Psychological Association)
A 16-yr old girl threatens to kill herself and you fail to inform her parents. Your behavior as a counselor is
negligence, failing to perform a duty (obligation to protect the client)
Informed consent (as it applies to research)
Fair explanation of benefits, discomfort, freedom to withdraw from study at any time
The practice of not treating all clients in an equal manner, especially due to religious, racial, ethnic, sexual, or cultural prejudice.
occurs when a counselor views all persons of a given classification or group in a biased manner.
Sexual harassment (per the NBCC)
unwelcome comments, gestures, or physical contact of a sexual nature.
Persons holding leadership roles must not allow their names to be used in professional notices when they are not practicing unless this is clearly stated in the literature.
Certified counselors recognize their limitations and provide services or only use techniques for which they are qualified by training and/or experience.
According to the ACA, counselors consider the _____ status of clients.
(ACA also states that counselors devote a portion of their work making a contribution to society by providing services with little financial return or even pro bono.)
occurs when a client is told to exaggerate a symptom
(not ok in cases with homicidal/suicidal clients)
occurs when a client exchanges a good or service for treatment or testing.
(ethics allow if client requests, written contract is drafted, and relationship is not exploitative)
Ethics state a counselor should _____ all clients for group counseling.
if a counselor must break confidentiality, they must reveal only what is necessary, and when possible, inform the client that they are going to disclose confidential info.
NBCC code dictates for article submissions, that
certified counselors must not submit the same manuscript (or one of same initial content) for simultaneous publication consideration by 2 or more journals.
(Once article is published, may not have it republished elsewhere without express permission of 1st publisher)
voluntary relationship between professional helper and help-needing individual, group, or social unit in which the consultant helps define or solve problems related to clients, client system, or work-related issues.
(encourages growth and self-direction for consultee)
a system of classification or formal diagnosis (using the DSM-IV or ICD).
International Classification of Disease
(created by World Health Organization [WHO])
Diagnostic and Statistical Manual of Mental Disorders
(created by American Psychiatric Association)
Traditionally, _____ counseloing has caused the most ethical concerns.
(Concern is that behavior therapists can control, manipulate, and shape behavior.)
Another word for 'insurance payments' is
The DSM uses a multiaxial classification system with ___ axes.
Published in 1952.
First 3 axes - 'official diagnostic assessment'
last 2 axes - used for research and special clinical settings to predict outcome and help treatment planning.
5 axes of a DSM diagnosis
Axis 1 - Clinical syndromes: other conditions that may need clinical attention
Axis 2 - Personality disorder and mental retardation
Axis 3 - General medical condition
Axis 4 - Psychosocial/Environmental problems
Axis 5 - Global Assessment of Functioning (GAF)
Global assessment of functioning (GAF)
rates psychological, social, and occupational functioning on a continuum of mental health/mental illness.
(taken 2 times - once for present level and once for level during past year which lasted a few months)
5 digits total, 3 digits split by a decimal point, then 2 digits
Fifth digit of DSM code
Can indicate severity or condition in a state of remission.
(if '0', indicates 'unspecified', which is also shown as 'NOS' for 'not otherwise specified')
refers to conditions which are not attributable to a mental condition (although may be a focus of treatment such as 'academic problem', 'uncomplicated bereavement' or 'antisocial behavior'.)
CPT (by the American Medical Assoc.)
Current Procedural Terminology
(insurance billing codes that specify the exact treatment being utilized [i.e., family therapy, individual, etc.])
Mental health consultation
Occurs when a consultant works with consultee regarding clients or administrative program issues.
Counselors cannot ethically accept referral fees.
Proposed the most popular paradigm of mental health CONSULTATION, consisting of 4 basic types.
Goal is to help client.
(When supervisor suggests plan of action for one of your clients.)
Goal is on helping the consultee develop improved techniques or skills.
(Supervisor suggests better way for you to implement a technique.)
Consultee-centered administrative consultation
Goal is to help sharpen administrative skills.
(i.e., making you a better presenter at your board meeting.)
Program-centered administrative consultation
Emphasis on creating, designing, or evaluating the program in question.
Shein's doctor-patient consultation model
Relies of 4 stages: entry, diagnosis, implementation, and evaluation
In order for the doctor-patient consultation to work, the consultee must accurately depict ______, trust the consultant's ______, and carry out consultant's ________.
symptomatology, diagnosis, directives
_____ ______ is the leading cause of malpractice actions taken against counselors, therapists, and mental health providers.
(estimates over 95% of those involved with therapist have been harmed)
Ethical dilemmas seldom have clear-cut answers, therefore, when faced with one
consult with fellow colleagues as well as ethical codes and legal requirements.
(In malpractice cases, you are often judged by what your peers would do in the same situation.)
Termination and referral of a client you have been unable to help is ethical because you are
acting in the best interest of the client.
The first counselors in the US were called ____ and _____ employed after the Civil War in college settings to watch over young women.
deans and advisors
Set up the first psychology laboratory
(in Leipzig, Germany, in 1879)
Convinced consciousness could be measured - termed 'structuralism' because of this interest.
Counseling became popular after the 1931 publication of
Workbook in Vocations, by Proctor, Benefield, and Wrenn.
(Coined the term 'counseling')
The Education Act for All Handicapped Children
-passed in 1975 and assured children would get free education, least restrictive environment (LRE), get Individualized Education Plan (IEP)
Americans with Disabilities Act (ADA)
Formed in 1990 and states business with 15+ employees cannot discriminate against disabled.
Group therapy became popular in the _____, but began in the late ____.
The ____ was the age of tremendous strides in development psychology.
(Piaget, Erikson, and Havinghurst)
Gilbert Wrenn's 1960 book, The Counselor in a Changing World' urged counselors to
emphasize developmental concerns rather than focusing merely on crises/emotional illness.
One primary problem with counseling in the early 60s was that it emphasized _____ _______.
(When social issues were huge at the time...)
National Defense Education Act of 1958 (NDEA)
provided financial aid for grad ed counseling, expanded school guidance services, and improved guidance for gifted children
Ethics tell us if a client has a contagious and fatal disease, we are justified in telling a 3rd party who would be at risk. (The counselor must ask if the client has not already informed this 3rd party or if they intend to.)
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