NCMHCE - Professional Practice and
Ethics Exam 2025/2026 With 100%
Correct Answers
When should Confidentiality and Informed Consent be
discussed? CORRECT ANSWERS Therapists must explain
confidentiality limits at the start and throughout therapy,
particularly when there is a risk of harm.
T or F: Counselors do not have to discuss payment during
informed consent since it may change during treatment.
CORRECT ANSWERS FALSE! Counselors must discuss
payment during the informed consent process, as well as
payment modalities and inform clients that they may change at
any time, if applicable. When establishing fees, there are many
things for the counselor to consider such as location and
financial status of clients. If the counselor realizes that payment
is causing a hardship, appropriate steps must be taken such as
referring out or lowering fees.
True/False: Duty to warn applies only if a client threatens to
harm themselves. CORRECT ANSWERS False: Duty to warn
applies if a client threatens to harm themselves or others.
Therapists must take action when there is a credible threat.
,A 24-year-old client is seeking therapy after experiencing
anxiety and depression. At the beginning of the first session, the
therapist explains the general nature of the therapeutic process
but does not discuss the limits of confidentiality in detail. The
client agrees to move forward, but later discloses in subsequent
sessions that they are considering self-harm and expresses
feeling hesitant to share further details.
Question: What ethical concern arises here, and what should the
therapist have done differently? CORRECT ANSWERS The
ethical issue here is that the therapist did not provide clear
informed consent, particularly regarding the limits of
confidentiality (e.g., the duty to report when there is risk of harm
to self or others). The therapist should have explained the
potential limitations of confidentiality at the start of treatment,
ensuring that the client understood that information might be
disclosed if there is an imminent risk of harm to themselves or
others.
A therapist has been working with a client for several months
and has developed a positive professional relationship. Outside
of therapy, the therapist learns that the client's sibling is a close
friend from their personal life. The therapist feels conflicted
about how to handle the potential conflict of interest and
wonders if they should continue working with the client.
Question: What is the ethical issue in this scenario, and how
should the therapist respond? CORRECT ANSWERS The
,ethical issue is the dual relationship that could potentially impair
objectivity, professionalism, and the therapeutic process.
According to the ACA Code of Ethics, dual relationships
(especially those that could impair the therapist's judgment)
should be avoided. The therapist should assess whether the
relationship with the client's sibling will create a conflict of
interest, and if it does, the therapist may need to refer the client
to another professional to ensure effective treatment and avoid
boundary violations.
A 35-year-old client tells their therapist during a session that
they are planning to harm their ex-partner. The client is specific
about the time, place, and means of the intended harm. The
therapist feels uncertain about the seriousness of the threat but is
aware of the Tarasoff ruling regarding the duty to warn.
Question: What is the therapist's ethical responsibility in this
situation? CORRECT ANSWERS The therapist has an ethical
duty to warn and protect. Under the Tarasoff ruling, if a client
threatens harm to an identifiable individual, the therapist is
legally obligated to take steps to warn the potential victim and/or
contact appropriate authorities to intervene. In this case, the
therapist should break confidentiality to prevent harm and
ensure the ex-partner's safety, as the threat is specific and
imminent.
A 19-year-old client presents with intense feelings of
hopelessness and admits to having frequent thoughts of suicide.
, They report that they have a plan and the means to carry out the
plan but are unsure if they will follow through. The client is
hesitant to share the specifics of their plan, expressing fear that
the therapist will take extreme action.
Question: How should the therapist ethically respond to this
crisis situation? CORRECT ANSWERS The therapist must first
assess the level of suicide risk (i.e., intent, plan, means, and past
attempts). Based on the severity, the therapist must take
immediate action to ensure the client's safety, which may
include breaching confidentiality if necessary to prevent harm.
This could involve creating a safety plan, involving family or
friends, or referring the client to a crisis intervention team or
emergency services if the risk is high. The therapist should also
address the client's concerns about confidentiality and explain
the necessity of action to ensure their safety.
Duty to Warn and Protect: CORRECT ANSWERS The therapist
must take action if a client presents a serious threat to
themselves or others, in accordance with the Tarasoff ruling.
Culturally Competent Assessments: CORRECT ANSWERS
Ensure that assessment tools are culturally appropriate and adapt
them as needed to respect the client's background.
What was the Tarasoff Ruling? CORRECT ANSWERS Refers
to the legal case Tarasoff v. Regents of the University of
Ethics Exam 2025/2026 With 100%
Correct Answers
When should Confidentiality and Informed Consent be
discussed? CORRECT ANSWERS Therapists must explain
confidentiality limits at the start and throughout therapy,
particularly when there is a risk of harm.
T or F: Counselors do not have to discuss payment during
informed consent since it may change during treatment.
CORRECT ANSWERS FALSE! Counselors must discuss
payment during the informed consent process, as well as
payment modalities and inform clients that they may change at
any time, if applicable. When establishing fees, there are many
things for the counselor to consider such as location and
financial status of clients. If the counselor realizes that payment
is causing a hardship, appropriate steps must be taken such as
referring out or lowering fees.
True/False: Duty to warn applies only if a client threatens to
harm themselves. CORRECT ANSWERS False: Duty to warn
applies if a client threatens to harm themselves or others.
Therapists must take action when there is a credible threat.
,A 24-year-old client is seeking therapy after experiencing
anxiety and depression. At the beginning of the first session, the
therapist explains the general nature of the therapeutic process
but does not discuss the limits of confidentiality in detail. The
client agrees to move forward, but later discloses in subsequent
sessions that they are considering self-harm and expresses
feeling hesitant to share further details.
Question: What ethical concern arises here, and what should the
therapist have done differently? CORRECT ANSWERS The
ethical issue here is that the therapist did not provide clear
informed consent, particularly regarding the limits of
confidentiality (e.g., the duty to report when there is risk of harm
to self or others). The therapist should have explained the
potential limitations of confidentiality at the start of treatment,
ensuring that the client understood that information might be
disclosed if there is an imminent risk of harm to themselves or
others.
A therapist has been working with a client for several months
and has developed a positive professional relationship. Outside
of therapy, the therapist learns that the client's sibling is a close
friend from their personal life. The therapist feels conflicted
about how to handle the potential conflict of interest and
wonders if they should continue working with the client.
Question: What is the ethical issue in this scenario, and how
should the therapist respond? CORRECT ANSWERS The
,ethical issue is the dual relationship that could potentially impair
objectivity, professionalism, and the therapeutic process.
According to the ACA Code of Ethics, dual relationships
(especially those that could impair the therapist's judgment)
should be avoided. The therapist should assess whether the
relationship with the client's sibling will create a conflict of
interest, and if it does, the therapist may need to refer the client
to another professional to ensure effective treatment and avoid
boundary violations.
A 35-year-old client tells their therapist during a session that
they are planning to harm their ex-partner. The client is specific
about the time, place, and means of the intended harm. The
therapist feels uncertain about the seriousness of the threat but is
aware of the Tarasoff ruling regarding the duty to warn.
Question: What is the therapist's ethical responsibility in this
situation? CORRECT ANSWERS The therapist has an ethical
duty to warn and protect. Under the Tarasoff ruling, if a client
threatens harm to an identifiable individual, the therapist is
legally obligated to take steps to warn the potential victim and/or
contact appropriate authorities to intervene. In this case, the
therapist should break confidentiality to prevent harm and
ensure the ex-partner's safety, as the threat is specific and
imminent.
A 19-year-old client presents with intense feelings of
hopelessness and admits to having frequent thoughts of suicide.
, They report that they have a plan and the means to carry out the
plan but are unsure if they will follow through. The client is
hesitant to share the specifics of their plan, expressing fear that
the therapist will take extreme action.
Question: How should the therapist ethically respond to this
crisis situation? CORRECT ANSWERS The therapist must first
assess the level of suicide risk (i.e., intent, plan, means, and past
attempts). Based on the severity, the therapist must take
immediate action to ensure the client's safety, which may
include breaching confidentiality if necessary to prevent harm.
This could involve creating a safety plan, involving family or
friends, or referring the client to a crisis intervention team or
emergency services if the risk is high. The therapist should also
address the client's concerns about confidentiality and explain
the necessity of action to ensure their safety.
Duty to Warn and Protect: CORRECT ANSWERS The therapist
must take action if a client presents a serious threat to
themselves or others, in accordance with the Tarasoff ruling.
Culturally Competent Assessments: CORRECT ANSWERS
Ensure that assessment tools are culturally appropriate and adapt
them as needed to respect the client's background.
What was the Tarasoff Ruling? CORRECT ANSWERS Refers
to the legal case Tarasoff v. Regents of the University of
