Deck 7: Managing Boundaries and Multiple Relationships

Question 1

_____________ is a serious breach that results in harm to clients and is therefore unethical.

A) A slippery slope
B) A dual relationship
C) A boundary violation
D) A malpractice suit

Answer 1

C

Question 2

Therapists can deal with powerful attractions to clients by:

A) repressing their feelings of attraction.
B) asking the client if the feeling is mutual.
C) terminating the relationship immediately.
D) monitoring boundaries by setting clear limits on physical contact,self-disclosure,and client requests for personal information.

Answer 2

D

Question 3

Which of the following actions would maximize the risks inherent in dual or multiple relationships?

A) Setting healthy boundaries from the outset
B) Securing informed consent of clients and discuss with them both the potential risks and benefits of dual relationships
C) Documenting any dual relationships in clinical case notes
D) Becoming romantically involved with the client

Answer 3

D

Question 4

When a client is unable to afford therapy,it is possible that he or she may:

A) offer a bartering arrangement or exchanging goods in lieu of a fee.
B) offer sexual favors in exchange for services.
C) force the therapist to continue treatment free of charge.
D) report the therapist to his or her license board if he or she refuses to continue treatment and receive payment when the client can afford it at a later date.

Question 5

According to the Canadian Psychological Association,the following is TRUE concerning standards on multiple relationships:

A) There is a clear consensus among practitioners regarding nonsexual relationships in counseling.
B) Due to the fact that there are clinical,ethical,and legal risks,all blending of roles must be avoided.
C) Objectivity in counseling is enhanced with dual relationships.
D) Manage dual or multiple relationships or any other conflict-of-interest situation entered into in such a way that bias,lack of objectivity,and risk of exploitation or harm are minimized.

Question 6

Linda is considering developing a multiple or dual relationship with her client.It's important for Linda to remember:

A) that all multiple relationships should be avoided because they are usually harmful.
B) that absolute answers are available to resolve dual or multiple relationship dilemmas.
C) to be cautious in order to protect herself from censure.
D) to consider whether the potential benefit outweighs the potential for harm.

Question 7

Joe has a counseling practice and is also teaching psychology part-time at a university.He is well-liked and trusted by students and some have asked for private counseling.Joe has decided to wait until semester break before taking them on as clients.Joe would be:

A) exhibiting ethical behavior by telling his students that he will counsel them at the end of the semester.
B) in a dual relationship with his students,which may cause ethical problems.
C) playing favoritism by not counseling all of his students.
D) not qualified to counsel his students because he is a part-time instructor.

Question 8

Bonnie became sexually involved with her therapist soon after therapy began.This action was initiated by the therapist who saw Bonnie's provocative behavior as an invitation to become intimate.Which of the following is NOT a possible ongoing consequence for the client being sexually exploited?

A) Experiencing feelings of freedom and peacefulness
B) Experiencing feelings of shame and guilt and posttraumatic stress disorder
C) Experiencing depression,fear,and anger
D) Experiencing isolation,a stronger distrust,and suicidal tendencies

Question 9

A counselor is likely to adopt stricter social boundaries and will be concerned about polluting the transference relationship if he or she is:

A) psychoanalytically oriented.
B) a behavioral therapist.
C) working with culturally diverse clients.
D) already engaged in an active social life.

Question 10

Clients can file a legal complaint against a therapist for sexual misconduct by all of the following methods EXCEPT:

A) filing a malpractice suit.
B) filing an ethical complaint with the therapist's licensing board.
C) lodging a complaint with the AARP.
D) filing a criminal complaint or a civil suit.

Question 11

Which of the following situations does NOT have the potential to harm or exploit a client?

A) Entering a business venture with a client
B) Developing a sexual relationship with a client
C) Establishing a social relationship with a client
D) Setting healthy boundaries during the initial visit

Question 12

In military settings,multiple relationships are common and can be a healthy part of communal life.These relationships:

A) can improve morale,decrease the stigma attached to seeking psychological assistance,and improve access to care.
B) should be eliminated because they destroy the counseling relationship.
C) have strong boundaries that must be maintained and not crossed in any way in order to avoid malpractice suits.
D) include traits such as rigidity and strict rules discouraging multiple relationships.

Question 13

Boundary management is:

A) not an issue in sparsely populated areas.
B) less challenging in rural areas than in urban areas.
C) equally as challenging in rural and urban areas.
D) more challenging in rural areas than in urban areas.

Question 14

According to professional codes of ethics,sexual relationships between client and counselor are considered to be ethical under which of the following circumstances?

A) If the therapist is really in love with the client.
B) If there is consent by the client.
C) These relationships are not considered to be ethical under any circumstances.
D) If the sexual relationship begins within six months of termination.

Question 15

Nonerotic touching between counselor and client should be:

A) a spontaneous and honest expression of the therapist's feelings.
B) incongruent with what they feel.
C) a therapeutic technique used to extinguish catharsis.
D) considered unethical.

Question 16

A common reaction of therapists who realize that they have sexual feelings toward their clients is to:

A) feel angry at themselves.
B) speak openly about the matter to the client.
C) investigate to see if the client feels the same.
D) feel guilty,anxious,and confused.

Question 17

Ted is a counselor educator and also acts as therapeutic agent for his students' personal development,since personal awareness is considered to be an intrinsic part of developing counselor skills in the program at the university in which he teaches.Ted is:

A) totally unethical in attempting to guide his students toward self-awareness.
B) involved in a situation in which he will become so subjective that he will be unable to teach his students.
C) involved in role blending,which is inevitable in the process of educating and supervising counselor trainees.
D) in a situation that automatically leads to a conflict of interest.

Question 18

Marty is counseling with an Asian client who recently returned from a trip to Japan to visit relatives.His client wants to give him an inexpensive souvenir.It is important for Marty to:

A) refuse the gift on ethical grounds.
B) explain that the gift would change their relationship and create a conflict of interest.
C) be aware that accepting the gift may be culturally appropriate with this client.
D) explain that he cannot accept the gift until the counseling relationship is over.

Question 19

Departures from commonly accepted practices that could potentially benefit clients are referred to as:

A) unethical boundaries.
B) boundary crossings.
C) boundary violations.
D) interpersonal boundaries.

Question 20

Which one of the following is NOT considered a guideline to minimizing the likelihood of sexual transgressions by clinicians?

A) Seek professional support during times of personal loss or crisis.
B) Differentiate between having sexual attraction to clients and acting on this attraction.
C) Avoid terminating the therapeutic relationship,even when sexual feelings obscure objectivity.
D) Make it a practice to examine and monitor feelings and behaviors toward clients.

Question 21

Which of the following is NOT a code of ethics in regards to sexual contact and the therapeutic relationship from various professional organizations?

A) Sexual intimacy with current clients,or their spouses or partners,is prohibited.Engaging in sexual intimacy with individuals who are known to be close relatives,guardians or significant others of current clients is prohibited.
B) Psychologists do not engage in sexual intimacies with current clients/patients; however,if a client/patient has not been treated within two years a relationship may become ethically approved.
C) Sexual or romantic counselorclient interactions or relationships with current clients or their family members are prohibited.
D) Psychologists do not engage in sexual intimacies with individuals they know to be close relatives,guardians,or significant others of current clients/patients.Psychologists do not terminate therapy to circumvent this standard.

Question 22

When in conflict with clinical needs,context,competence,or consent,even the most well-intentioned nonsexual physical contact may be experienced as:

A) appropriate,gentle,and wanted contact.
B) aggressive,frightening,intimidating,demeaning,arrogant,unwanted,insensitive,threatening,or intrusive.
C) passive,soothing,calming,comforting,gentle,and peaceful.
D) completely indifferent for both therapist and client.

Question 23

The notion that certain actions will inevitably lead to a progressive deterioration of ethical behavior is commonly referred to as:

A) the slippery slope phenomenon.
B) therapist decay.
C) the ethical deterioration phenomenon.
D) role erosion.

Question 24

Miguel has been providing couples' counseling to Saundra and Steven for a couple of years and was recently invited to attend their 20th wedding anniversary party.Attending this event is an example of:

A) a boundary violation.
B) a potentially beneficial nonprofessional interaction.
C) an unprofessional interaction.
D) a lapse of judgment.

Question 25

Which of the following is NOT a reason for discouraging the practice of accepting friends as clients or of becoming socially involved with clients?

A) Therapists may not be as challenging as they need to be with clients they know socially because of a need to be liked and accepted by the client.
B) Therapists may be as effective with clients they know socially as they are with clients they have never met previously to the therapeutic relationship.
C) Counselors' own needs may be enmeshed with those of their clients to the point that objectivity is lost.
D) Counselors are at greater risk of exploiting clients because of the power differential in the therapeutic relationship.

Question 26

A __________ application of boundaries can be harmful to clients by creating a sterile relationship that works against establishing a positive therapeutic alliance.

A) rigid risk-avoidance
B) lenient wellbeing
C) easy-going secure
D) slippery slope phenomenon

Question 27

Clinicians who oppose any form of physical contact with their clients (e.g.,nonerotic touching)believe all of the following EXCEPT:

A) it can promote dependency.
B) it can interfere with the transference relationship.
C) it can be misread by clients.
D) it can become a healthy romantic relationship.

Question 28

Mentors often balance a multiplicity of roles.Which of the following would NOT be considered one of these roles?

A) Teacher and counselor
B) Role model
C) Guide and friend
D) Partner

Question 29

Changes in mental health care laws and practice have increased the need for:

A) outreach psychotherapists.
B) higher costs and fewer psychotherapy hours.
C) gift giving.
D) stricter boundaries for outreach psychotherapists.

Question 30

Which of the following is NOT a possible multiple relationship in a small community?

A) A therapist might attend the same church or community activities as the clients they serve.
B) A therapist who is a recovering alcoholic and attends Alcoholics Anonymous meetings may meet a client at one of these meetings.
C) A therapist isolates him or herself in order to limit the possibility of multiple relationships.
D) In an isolated area,a clergy person may seek counseling for a personal crisis from the only counselor in the town-someone who also happens to be a parishioner.

Question 31

All of the following are true about bartering EXCEPT:

A) bartering can be a dignified and honorable form of payment for those who are cash poor but talented in other ways.
B) bartering is a healthy norm in many cultures.
C) bartering is illegal and unethical.
D) bartering can be part of a clearly articulated treatment plan; like other interventions,bartering must be considered in light of the client's needs,desires,situation,and cultural background.

Question 32

Which of the following is NOT a controversy of boundary issues?

A) Age,diagnosis,life experiences such as abuse,and culture are key elements of the therapeutic relationship.
B) An unfortunate reality is that some practitioners have difficulty distinguishing where appropriate boundary lines should be drawn.
C) The goal of ethical decision-making is to take a position where the potential for exploitation is minimized.
D) Failing to establish clear boundaries can be very dangerous to both the client and the therapist.

Question 33

Which of the following statements about giving or receiving gifts is FALSE?

A) Lavish gifts certainly present an ethical problem; yet,we can go too far in the direction of trying to be ethical and actually damage the therapeutic relationship.
B) It is important to recognize when accepting a gift from a client is clinically contraindicated and that you be willing to explore this with your client.
C) In working with culturally diverse client populations,clinicians often discover that they need to engage in boundary crossing to enhance the counseling relationship.
D) It could be more problematic to accept a gift at a later stage of a counseling relationship.

Question 34

Practitioners in rural settings often find themselves involved in multiple relationships.Challenges the deal with include all of the following EXCEPT:

A) professional isolation.
B) high visibility in the community.
C) spending a minimal amount of time traveling between professional engagements.
D) coping with the inevitability of multiple relationships.

Question 35

The ethics codes of most professional organizations provide guidelines for the ethical practice of bartering.Some more recent codes (APA,NASW,AAMFT,and ACA):

A) state the practice of bartering is unethical no matter the circumstances.
B) take a more strict attitude increasing the punishment for practicing bartering.
C) state bartering should take place of payment; therefore,the therapeutic relationship can become more trustworthy.
D) take a more flexible and less punitive attitude toward bartering.