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1. Our ______________________________ is/are the basis of our worldview and possible biases. a. cultural experiences b. values c. assumptions d. all of the above
2. ___________ counseling is any counseling relationship in which the counselor and the client belong to different cultural groups, may hold different assumptions about social reality, and may subscribe to different world views. a. Culturally encapsulated b. Diversity-sensitive c. Multicultural d. Transcultural
3. The culturally encapsulated counselor is characterized by: a. defining reality according to the client's reality. b. showing sensitivity to cultural variations among individuals. c. evaluating other viewpoints and making attempts to accommodate the behavior of others. d. defining reality according to one set of cultural assumptions.
4. A cross-cultural counselor who perceives reality exclusively through the filters of his or her own life experiences is said to be culturally: a. immersed. b. ignorant. c. encapsulated. d. biased.
5. Statements such as "Minority groups need to take responsibility for their own predicament" and "In order to succeed, people need to stop complaining and start working" do not take into account environmental factors. These are examples of: a. stereotypical beliefs. b. guiding principles for action. c. cultural tolerance. d. challenging culture-bound values.
6. Frank is a Native American college student who is seeking information about his career choice from a male counselor. The counselor notices that he uses very little eye contact and needs to recognize that Frank: a. lacks trust about the information he is receiving. b. is unlikely to follow through with his suggestions. c. is likely to view direct eye contact as a lack of respect. d. would be more likely to have direct eye contact if the counselor were a female.
7. Marie is working with a lesbian client who is in a dysfunctional relationship with another woman. She is seeking counseling to sort out her options regarding leaving her emotionally abusive partner. Marie can assist her client by: a. automatically attributing her client's problems to her sexual orientation. b. attempting to change the sexual orientation of her client. c. supporting her client's attempt to leave the abusive relationship, work on her abuse issues, and eventually enter into a positive lesbian relationship. d. encouraging her client to realize how difficult it is to live in a lesbian relationship.
8. It is the authors' position that counselors would not work well with diverse populations if they: a. are open to being challenged and tested. b. are flexible in applying theories to specific situations. c. believe that they are free from any racist attitudes, beliefs, and or feelings. d. are comfortable with differences that exist between themselves and their clients.
9. Denise is a Euro-American social worker who is a former welfare client. A divorcee and mother of four, she succeeded in completing her degree and getting off the system in four years. She is now working in a welfare-to-work program and sets similar goals for her multicultural clients. Denise's attitude and actions indicate that she: a. believes in her client's ability to achieve and live up to her expectations. b. is well intentioned and willing to challenge her clients. c. can serve as a model of what her clients can accomplish with their lives--if she could do it, so can her clients. d. is operating out of the majority value system and presuming that her clients have the same goals.
10. According to the authors, the first step in the process of acquiring multicultural counseling skills in a training program should be that students: a. take a self-exploratory class to help identity their cultural and ethnic blind spots. b. start a social advocacy campaign and become politically involved on campus. c. free themselves from all racist thoughts, actions and feelings. d. have their value system conform with an "acceptable norm".
11. _______________________________ is a three-stage developmental sequence, from multicultural awareness to knowledge and comprehension to skills and applications. a. Culture-centered counseling b. Multicultural counseling c. Cultural immersion
12. What is/are the reason(s) for the underutilization of mental health services by minority groups? a. biased nature of the services b. child care issues c. transportation challenges d. all of the above e. b and c
13. Which of the following court cases involved an employee assistance program provider who refused to counsel homosexual clients on the basis of religious beliefs and was eventually terminated by her employer? a. Jablonski vs. United States b. Jaffee vs. Redmond c. Bruff vs. North Mississippi Health Services, Inc. d. Tarasoff vs. Board of Regents of the University of California
14. a. b. c. d.
Working effectively with cultural diversity in the therapeutic process is a requirement of good ethical practice. a skill that some clinicians may choose to develop. not related to ethics, but is related to professionalism. is neither related to ethics nor professionalism.
15. Cultural issues affect which of the following aspects of the counseling process? a. Only the initial interactions with clients when counselors need to assess how their clients are similar to and different from them b. All aspects of the counseling process c. No aspects of the counseling process unless one is specifically practicing from a multicultural framework. d. Only the termination phase, since clients may approach endings in ways that are consistent with their culture.
16. Mental health practitioners must ________________ their own group as the standard by which to assess appropriate behavior in others. a. always use b. often use c. avoid using d. be held legally liable for using
17. To the extent that counselors are focused on the values of ______________________ and ______________________ to variations among groups and individuals, they are at risk for practicing unethically. a. the dominant culture; insensitive b. oppressed minority groups; sensitive c. clients living alternative lifestyles; attuned d. people of color; sensitive
18. When the term “culture” is interpreted broadly, it is associated with a. a racial or ethnic group. b. gender. c. religion. d. physical capacity or disability. e. all of the above.
19. ___________________ is a sense of identity that stems from common ancestry, history, nationality, religion, and race. a. Ethnicity b. Multiculturalism c. Pluralism d. Commonality e. None of the above
20. In multicultural counseling, one must balance the importance of______________________ in assessment, diagnosis, and treatment. a. liberal and conservative views b. western approaches and southern approaches c. individualism versus collectivism d. cultural encapsulation and assimilation
21. _____________________ refers to individual differences on a number of variables that place clients at risk for discrimination based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status. a. Diversity b. Multipluralism c. Discriminatory variables d. Oppression 22. _________________________ refers to a practitioner’s level of awareness, knowledge, and interpersonal skill when working with individuals from diverse backgrounds. a. Cultural encapsulation b. Multicultural skill-level c. Cultural diversity competence d. Interpersonal cognizance 23. Which of the following ethics codes mention the practitioner’s responsibility to recognize the special needs of diverse client populations? a. Feminist Therapy Institute’s code of ethics b. Canadian Counselling Association’s code of ethics c. Code of Professional Ethics for Rehabilitation Counselors d. All of the above e. None of the above
24. Oppression has resulted in deep psychological and spiritual pain for persons in diverse groups. This is referred to as a. an identity crisis. b. soul wounding.
an injury to the psyche. a narcissistic injury.
25. The APA has developed a set of specialty guidelines for psychotherapy with lesbian, gay, and bisexual clients that prohibit unfair discrimination based on sexual orientation. Which of the areas stated below are not mentioned in the guidelines? a. Attitudes toward LGB people and sexual orientation issues b. Relationships and family concerns c. The complex diversity within the LGB community d. The training and education needed to work effectively with this client population e. None of the above
Chapter 5—Client Rights and Counselor Responsibilities
1. Informed consent generally implies that the person: a. does not have the capacity to consent. b. verbally gives consent. c. has been persuaded or coerced to sign the consent form. d. has the capacity to consent and has freely, without undue influence expressed consent. 2. ____________ to give informed consent means that the client has the ability to make rational decisions. a. b. c. d. Comprehension of information Voluntariness Capacity Willingness
3. Written consent forms should not include: a. a discussion of how a managed care system will affect the treatment, if applicable. b. a detailed description of what will occur in therapy and a guarantee that the client will resolve their issues. c. a statement describing the counselor's theoretical orientation and how this will affect treatment. d. clarification pertaining to fees and charges and procedures for filing for insurance reimbursement.
4. Which of the statements below is true with regard to clients’ beliefs about the therapeutic process? a. Frequently, clients are not aware of their rights and view the process as mysterious. b. Clients may see their therapist much like they see their doctor and expect the therapist to have the “correct” opinion or answer. c. Clients may not realize that the therapist’s duty is to help clients find their own answers.
All of the above.
5. Most ethical codes specify that therapist should: a. be available to their clients even when they are on vacation. b. inform clients that their records are inaccessible to them. c. inform clients that a diagnosis can become a permanent part of their file and have ramifications in terms of cost of insurance, long-term insurability, and employment. d. alter case notes that are damaging to the client if they are subpoenaed into court.
6. _________ should include a record of client and therapist behavior that is clinically relevant, including interventions used, client responses to treatment strategies, the evolving treatment plan, and any follow-up measures taken. a. Assessments b. Progress notes c. Intakes d. Screenings
7. Concerning counseling via the Internet, which statement is most accurate? a. The codes of the major professional organizations offer detailed guidance regarding ethical practices in the use of technology. b. There are both advantages and disadvantages in using Internet technology to deliver counseling services. c. Most experts agree that what is being currently offered via Internet counseling is a form of traditional psychotherapy. d. This form of counseling is not suited to a problem-solving approach.
8. Regarding counseling with children and adolescents, informed consent of parents or guardians may not be legally required when a minor is seeking counseling for: a. dangerous drugs or narcotics. b. sexually transmitted diseases. c. pregnancy and birth control. d. all of the above
9. The authors have found that when they attend continuing education workshops on ethics in clinical practice, the emphasis is often on a. legal matters and risk management. b. ethical aspects of practice. c. addictions counseling. d. both b and c.
10. The social policy of de-institutionalization, as it applies to mental-health practices, involves the "least restrictive alternative" which requires that: a. voluntary commitment be sought only after less restrictive alternatives have failed. b. professionals commit clients who are delusional.
c. practitioners protect themselves from liability by getting a lawyer. d. treatment be no more harsh, hazardous, or intrusive than necessary to achieve therapeutic aims and protect clients and others from physical harm.
11. The intent of a(n) _____________________ is to define boundaries and clarify the nature of the basic counseling relationship between the counselor and the client. a. supervision contract b. informed consent document c. HIPAA document d. release of information form
12. Of the following, which is an example of a behavior that might leave a mental health practitioner vulnerable to a malpractice suit? a. Used a procedure within the realm of accepted professional practice b. Employed a technique that he or she was not trained to use c. Used a procedure to which the client did not respond favorably d. Explained the possible consequences of treatment and the client still wanted to participate in the process
13. To succeed in a malpractice claim, the plaintiff needs to show that a breach of duty did exist in which: a. the practitioner failed to foresee the client's intention to commit suicide despite warning signs that the client was decompensating. b. the client failed to get better in spite of reasonable care. c. there was no professional relationship between therapist and client. d. the practitioner failed to provide the appropriate standard of care. e. a and d
14. Disclosures should be given in a. plain language in a culturally sensitive manner and must be understandable to clients, including minors and people with impaired cognitive functioning. b. elevated language that will impress consumers and give them confidence in the services they are about to receive. c. writing, which makes it unnecessary to discuss informed consent during sessions. d. several languages since we live in a multicultural society.
15. Joyce was hospitalized as a result of an attempted suicide. She tried to call her therapist before taking an overdose of pills, but he could not be reached because he was on vacation and did not make provisions for a replacement therapist while he was gone. This action constitutes the following type of professional negligence: a. misdiagnosis. b. client abandonment. c. vicarious liability. d. practicing beyond the scope of competency.
16. Inappropriate socialization with clients, burdening clients with a counselor's personal problems, and putting clients in awkward business situations are examples of: a. inappropriate crisis intervention. b. established therapeutic practices. c. inappropriate boundaries. d. seeking balance in the counseling relationship.
17. Which of the following would be least likely to lead to a malpractice suit? a. Failure to obtain or document informed consent b. Practicing beyond the scope of competency c. Unhealthy transference relationships d. Engaging in a bartering arrangement with a client
18. The following is a safeguard against malpractice accusations: a. giving free sessions until the client is able to pay. b. never engaging in bartering under any circumstances. c. avoiding a client's perception of abandonment by not taking time off. d. practicing in specific areas where you are competent.
19. In the event that a practitioner is sued he or she should: a. try to resolve the matter directly with the client. b. destroy or alter files or reports that may be incriminating. c. enter into personal therapy. d. promptly retain an attorney.
20. ______________ can best be viewed as an ongoing process aimed at increasing the range of choices and the responsibility of the client as an active therapeutic partner. a. Diagnosis b. Informed consent c. Documentation d. Case consultations
21. _________________________ are essentially the same as psychotherapy notes. They address the client’s transference reactions and the therapist’s subjective impressions of the client. a. Process notes b. Progress notes c. Diagnostic notes d. Treatment summary
22. Managed care contracts often have a. “gag clauses” that prohibit practitioners from sharing any negative information about managed care policies. b. policies that are inappropriate when applied to health care.
c. d. e.
policies that can be viewed as a restriction of client advocacy and as a measure of intimidation. all of the above none of the above
23. Fran has decided to start an online counseling practice. Which of the following have the potential to result in unethical behavior? a. Accepting psychotic/seriously disturbed individuals as clients b. Charging fees that may not be covered by insurance companies c. Providing inaccurate diagnoses due to lack of behavioral clues d. Promising confidentiality and privacy e. All of the above
24. Elena, your client of two years, has just received the news that she is losing her insurance coverage; however, she recently had a breakthrough in therapy and needs to continue working on her issues. As an ethical therapist, you should a. refer her to a community mental health center where she can get services at a low cost. b. determine new payment terms so that Elena can continue working with you. c. terminate therapy and give Elena some good book references so she can work through her issues on her own. d. terminate therapy and encourage Elena to look in the Yellow Pages for a new therapist who will accept a sliding scale arrangement.
25. Samuel has been planning a two week vacation to Europe for months. He is a private practitioner and has a caseload of clients who have dependency issues. As an ethical practitioner, Samuel should a. not inform his clients until a few days before he leaves. b. not go on vacation so as to not increase his clients’ anxiety levels. c. provide his clients with another therapist in case of need. d. bring back a souvenir for each client to show them how important they are to him.
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