First. There's no reason to ever have an empty case. Your initial code sample should be using the not operator. For example:
<<if not $npc.options.includes("attackPC")>>
<<set $npc.options.push("attackPC")>>
<</if>>
As far as a simpler way, you could use a Set instead of an Array. Sets require that all members be unique—i.e. there can only be one such member. For example:
/* Initializing $npc.options as a Set. */
<<set $npc.options to new Set()>>
/* Adding a member to the Set. */
<<run $npc.options.add("attackPC")>>
/* Removing a member from the Set. */
<<run $npc.options.delete("attackPC")>>
/* Checking for the existence of a member. */
<<if $npc.options.has("attackPC")>> ...attackPC exists... <</if>>
/* Checking for the non-existence of a member. */
<<if not $npc.options.has("attackPC")>> ...attackPC does not exist... <</if>>