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Christian Counseling Ethics -- A Handbook for Therapists, Pastors and Counselors
edited by Randolph K. Sanders
© 1997.
(InterVarsity Press: Downers Grove, IL). All rights reserved.
[Answer 21 of 30 questions correctly to receive
23 hours of Continuing Education Credit].


Embracing Our Ethical Mandate (p 11-24)
1. Most Christian therapists today
a. give verbal assent to a code of ethics but quietly disobey them.
b. react with anxiety toward a code of ethics, always fearful they will make a mistake.
c. tend to avoid their code of ethics, seldom consulting it for help when questions arise.
d. are trained, service-oriented professionals who honestly try to behave ethically in their daily work.

Psychotherapy and Christian Ethics (p 25-40)
2. A Christian therapist who is helping Brad and follows a Christian ethic would
a. primarily strive to alleviate Brad’s depression.
b. strive to decrease Brad’s suffering and help him achieve his potential.
c. maintain neutrality regarding Brad’s infidelity in order to prevent judgmentalism.
d. weigh the importance of Brad’s happiness against the importance of Brad’s moral obligations
(i.e. fidelity).

Essential Elements for Ethical Counsel (p 43-56)
3. Confidentiality can NOT be broken
a. if the client sues the counselor.
b. after a client dies.
c. when the counselor perceives potential violence toward the client’s
d. when reimbursement requires disclosure.

4. A church member who thinks the pastor’s sermon illustration is referring to their previous counseling session is an example of
a. the power-prestige differential.
b. the divergence of obligations.
c. paranoia.
d. how dual relationships can lead to potential confidentiality problems.

Qualifications of the Christian Mental Health Professional (p 57-74)
5. Professional competency is best understood as
a. advanced academic degrees.
b. clinical expertise.
c. licensures and credentials.
d. a process of character formation.

6. The ultimate task of the Christian mental health professional is
a. to interrelate Christian belief and practice with the best of contemporary scholarship.
b. to study only the Bible as a sufficient means of meeting all human needs.
c. to reject secular theories, paradigms, values and culture in the mental health fields.
d. to seek rigorous mental health training in a Christian academic setting (i.e. seminary).

7. The best way for a Christian mental health professional to
“stay alive” as a person is
a. continuing education.
b. peer review.
c. recredentialing.
d. exposure to diversity.

Pastors Who Counsel (p 75-87)
8. The author limits his pastoral counseling with any church member to no more than 3 sessions because
a. he has many other duties to perform.
b. it protects church members from feeling too exposed.
c. it reduces the likelihood of sexual involvement.
d. all of the above.

Sexual Misconduct and the Abuse of Power (p 86-102)
9. Baylis (1993) argues that sexual misconduct between a therapy patient and her doctor is always
a. non-consensual and harmful, no matter who initiates sexual contact.
b. consensual if the patient initiates sexual contact.
c. intentional if the doctor initiates sexual contact.
d. autonomous no matter who initiates sexual contact.

10. The patient most likely to become sexually involved with her therapist is
a. a woman whose father recently died.
b. a woman who suddenly lost her job.
c. a woman who had been sexually molested by her father.
d. a woman previously diagnosed as “psychotic.”

11. A therapist who establishes clear boundaries to prevent sexual contact with a patient would
a. schedule a favorite patient in between two other appointments.
b. allow for the exchange of gifts so as not to offend the patient.
c. spend extra time on the phone talking with a “needy” patient.
d. engage in extended self-disclosure to affirm the patient’s “human” side.

Christian Responses to the Unethical Healer (p 103-115)
12. If the initial one-on-one confrontation of a therapist’s unethical behavior is unsuccessful (i.e. the therapist acknowledges no wrong-doing), the next step recommended is to
a. take official action and report the therapist to the appropriate regulatory board.
b. do nothing because after an initial confrontation your responsibility as a Christian fellow-professional goes no further.
c. anonymously threaten to report the behavior to the licensing board.
d. use a team approach to confrontation including colleagues, family members or friends.

Ethics in Marital Therapy and Premarital Counseling (p 119-138)

13. If a female client in a miserable marriage (with children) believes that divorce will end all conflict with her husband, the Christian therapist
a. should not challenge such idealism in order to not interfere with client autonomy.
b. should maintain a pro-marriage ethic and factually challenge this idealistic thinking.
c. should maintain a position of neutrality if the client is not a Christian.
d. should adopt a utilitarian ethic of seeking the greatest good for all involved.

14. Ethically, a Christian counselor’s first action after discovering physical abuse in a marriage is to
a. promote better communication as a way of eliminating the abusive behavior.
b. promote conflict resolution as a way of eliminating the abusive behavior.
c. contract with the abuser to immediately end the abusive behavior.
d. protect the abused through temporary separation or legal recourse.

The Homosexual Client (p 139-160)
15. It is the ethical responsibility of every Christian therapist toward each homosexual client to
a. define their professional competency more in light of their Christian orthodoxy than in light of their education, training and supervised experience.
b. help educate and encourage the client with the vast body of research that greatly clarifies the origin and development of sexual orientation.
c. offer extraordinary treatment interventions which, although not grounded in scientific findings, are compatible with Christian orthodoxy.
d. make professional judgments based upon scientifically derived knowledge and be sensitive to the stigma and feelings of self-contempt which often accompany a homosexual orientation.

16. It is the ethical responsibility of every non-Christian therapist toward each homosexual client to
a. conclude that the removal of homosexuality from the Diagnostic and Statistical Manual of Mental Health Disorders (DSM IV) is an endorsement of the healthiness and wholesomeness of homosexual behavior.
b. discourage clients seeking to change their sexual orientation from doing so, arguing that their desire to change is simply a manifestation of internalized homophobia.
c. assist the client in diminishing the influence of their personal moral beliefs in order to achieve a more value-neutral attitude toward their own behavior.
d. maintain concern for the welfare of clients by including the moral beliefs that govern the clients’ lives as part of the total assessment and treatment strategy.

The Child Client (p 161-181)
17. The Christian author Ross Campbell (1992) states that “______ is the first and most important part of good discipline.”
a. establishing parental authority
b. communicating clear boundaries
c. making a child feel loved
d. following through with consequences

Clients with Chronic Conditions (p 182-200)
18. The current prognosis for those diagnosed with schizophrenia is not positive because
a. the majority of schizophrenics live unproductive lives and depend upon others for support.
b. schizophrenia is compounded by the debilitating effects of long-term demon possession.
c. there have been no significant advances in the treatment of schizophrenia with prescription medications.
d. research has found that schizophrenia is primarily caused by specific patterns of family interpersonal relationships that are difficult to change.

Deprogramming (p 201-216)
19. The author believes that a Christian professional counselor can be of great help to the parents of an adolescent who has joined an NRM (New Religious Movement) by
a. arranging for a systematic and forcible deprogramming of the teen’s newly acquired beliefs and practices.
b. explaining the historical tendency of NRMs to quickly wither and disband.
c. reassuring the parents that rather than having been brainwashed, their teen might be freely asserting independence to express spirituality in a different form than the parents’ religion.
d. joining with the parents in seeking to expose the NRM as dangerous, destructive, and manipulative.

Business Ethics in Mental Health Services (p 219-234)
20. For clients of limited financial means but who truly need therapy, the author recommends that the Christian mental health professional
a. bill the client’s insurance company at a higher rate so that the reimbursed amount is equal to the therapist’s full fee.
b. refer all non-paying clients to local social service agencies.
c. perform a portion of their services “pro bono” or on a “sliding scale” to fulfill the biblical mandate for helping the poor.
d. engage in the practice of “cream skimming.”

21. If a managed care company denies further treatment to a client suffering from chronic depression, a Christian therapist’s first step should be to
a. write a forceful letter to the managed care company, reminding them of their “so-called personal commitment” to the client who is “paying their premiums.”
b. appeal the managed care company’s decision even if it means extended paper work re-justifying a treatment plan.
c. change the client’s diagnosis to one that would influence the managed care company toward reauthorization.
d. advise the client to change managed care companies.

Lay Counselor Training (p 235-245)
22. Unlike most therapists in private practice, church lay counselors will often
a. counsel peers and friends.
b. be exempt from adhering to professional ethical guidelines.
c. ask for “donations” for their counseling services.
d. break confidentiality in the case of disciplining a church member.

23. As a mental health professional in a military setting, Dr. Price says that his most significant source of help in dealing with ethical issues has been
a. his senior commander.
b. his written code of ethics.
c. current professional literature.
d. his wife.

Forensic Psychology (p 258-273)
24. The use of “addiction” as an explanation for so many different types of pathological behaviors today is
a. based largely on unproved assumptions.
b. thoroughly grounded in scientific research.
c. a modern breakthrough in explaining difficult behavior.
d. supported by medical research concerning chemical changes in the brain.

Training Programs (p 277-296)
25. In moments of crisis, the therapist’s _______ will largely determine the response he or she will have to a client.
a. clinical technique
b. character
c. theoretical orientation
d. training

A Model for Ethical Decision-Making (p 297-312)
26. In “Case One: Temptation,” what did Dr. Anthony Case do after the fourth session?
a. terminated counseling with the client.
b. told the client about his attraction to her.
c. called his old mentor and brainstormed about several ways to ethically respond.
d. ignored his feelings and scheduled a fifth session.

Christian Codes: Are They Better? (p 313-325)
27. In contrast to Christian ethical codes, the APA Code(1992) anchors its philosophical foundations in
a. faith in God.
b. love for one’s fellow man.
c. concern for the welfare of the individual.
d. a blend of scientism, humanism and pragmatic values.

28. Christian ethical codes sufficiently address the issue of
a. the competency of a therapist.
b. the personal problems of therapists.
c. the inner life of the therapist.
d. the victim of a therapist’s ethical lapse.

The Ethical Behavior of Christian Therapists (p 326-331)
29. Concerning “Dual Relationships with Clients,” the results of a survey of Christian psychologists (Oordt 1990) showed that 90 percent or more rarely or never engaged in
a. accepting or giving gifts over $50 in value.
b. selling goods to clients.
c. asking favors of clients.
d. all of the above.

Ethical Guidelines for the Christian Association for Psychological Studies (CAPS) (p 348-352)
30. In extending grace toward an unethical offender, “the CAPS Pastoral Network Protocol for Giving Service to Troubled Members” recommends the following approach:
a. “If you have violated the CAPS ethical standards, your membership may be terminated.”
b. “How have you thought through for yourself this behavior which seems contrary to our understanding of biblical ethics?”
c. “Make a public statement about the possible or actual ethical misconduct by a member.”
d. “Threaten the member with loss of CAPS membership, media publicity or revelations to that individual’s employer or clients.”