Chapter 1 of 515% of exam

Professional Practice and Ethics

This domain covers the rules that frame every counseling relationship: informed consent, confidentiality and its limits, boundaries, competence, records, and technology. On the exam these questions sit inside case narratives, so you apply the ACA and NBCC codes to a specific client rather than recite them.

Informed consent and client rights

Informed consent is an ongoing process, not a single signature. Clients need to understand the purposes, risks, benefits, and limits of services, fees and billing, and how confidentiality works before they decide to take part. Special cases, such as mandated clients, minors, and people who cannot consent, change how consent is obtained but do not remove it.

Consent is ongoing
Counselors review client and counselor rights and responsibilities both in writing and verbally, and document informed-consent discussions throughout the relationship.
ACA Code of Ethics (2014) A.2.a
What clients must be told
Purposes, goals, techniques, risks and benefits, the counselor's qualifications, fees and nonpayment procedures, limits of confidentiality, and the right to refuse services.
ACA Code of Ethics (2014) A.2.b; NBCC Code of Ethics (2023) standard 32
Mandated clients
Before counseling begins, explain what information will be shared, with whom, and the consequences if the client refuses services.
ACA Code of Ethics (2014) A.2.e
Minors and others unable to consent
Seek the client's assent and include them in decisions, while respecting the legal rights of parents or guardians.
ACA Code of Ethics (2014) A.2.d; NBCC Code of Ethics (2023) standards 38-39
Language access
When a client has difficulty understanding the counselor's language, arrange a qualified interpreter or translator.
ACA Code of Ethics (2014) A.2.c

Confidentiality and its limits

Confidentiality is the default, and every exception is narrow. Disclosure without consent is justified to keep a client or an identified person safe from serious, foreseeable harm, or when the law requires it, and even then only essential information is released. Couples, families, and groups need explicit agreements, because the counselor cannot control what other members repeat.

Serious and foreseeable harm
The duty of confidentiality gives way when disclosure is needed to keep a client or an identified person safe from serious, foreseeable harm; consult when unsure and follow state law.
ACA Code of Ethics (2014) B.2.a; NBCC Code of Ethics (2023) standard 19
Court orders
Inform the client before a court-ordered release where possible, and release only what the order requires.
NBCC Code of Ethics (2023) standard 31; ACA Code of Ethics (2014) B.2.d
Minimal disclosure
When disclosure is required, reveal only essential information and involve the client in the decision when possible.
ACA Code of Ethics (2014) B.2.e
Couples and families
Define who the client is and put the agreement on how shared information is handled in writing; do not reveal one member's confidences without that person's written permission.
ACA Code of Ethics (2014) B.4.b; NBCC Code of Ethics (2023) standard 37
Groups
Explain the importance and limits of confidentiality in the specific group; members can agree to privacy, but the counselor cannot guarantee it.
ACA Code of Ethics (2014) B.4.a

Boundaries, competence, and professional conduct

Many ethics items turn on what a counselor may not do: romantic relationships with current or recent clients, personal social-media connections with clients, practice outside one's competence, or referral based only on the counselor's values. Others turn on what a counselor must do when their own functioning slips.

Former clients
Sexual or romantic relationships with former clients are prohibited for 5 years after the last professional contact.
ACA Code of Ethics (2014) A.5.c; NBCC Code of Ethics (2023) standard 24
Social media
No personal virtual relationships with current clients; the social media policy is part of informed consent.
ACA Code of Ethics (2014) A.5.e, H.6.b; NBCC Code of Ethics (2023) standards 109, 114
Gifts and bartering
Gifts are weighed by relationship, value, and motive, and documented when accepted; bartering requires the client's request, no exploitation, community acceptance, and a written contract.
ACA Code of Ethics (2014) A.10.e-f; NBCC Code of Ethics (2023) standards 20-21
Competence and values
Practice within the limits of your training; do not refer a client solely because of your personal values, and seek training where you risk imposing them.
ACA Code of Ethics (2014) C.2.a-b, A.11.b
Impairment and self-care
Monitor for impairment and limit, suspend, or end professional duties until you can safely resume.
ACA Code of Ethics (2014) C.2.g; NBCC Code of Ethics (2023) standard 4

Records, technology, and research literacy

Documentation, telehealth, and basic research literacy are also in the outline. Telehealth adds legal and safety duties tied to the client's location. Research tasks call for recognizing what a study design can and cannot show.

Records
Create and maintain documentation needed for services; obtain written permission before transferring records to third parties.
ACA Code of Ethics (2014) A.1.b, B.6.a, B.6.g
Telehealth law
Counselors must follow the law where they practice and where the client is located.
ACA Code of Ethics (2014) H.1.b; NBCC Code of Ethics (2023) standard 92
Telehealth safety
Provide written crisis steps listing emergency services local to the client, and confirm identity and location at every contact.
NBCC Code of Ethics (2023) standards 105-106
Recording and observation
Obtain client permission before recording sessions or allowing anyone to observe or review them.
ACA Code of Ethics (2014) B.6.c-d
Study designs
Random assignment (experimental design) supports cause-and-effect conclusions; comparing groups that were not randomly assigned (quasi-experimental design) leaves pre-existing differences as a possible explanation.
CDC, Introduction to Program Evaluation for Public Health Programs (2011)

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