Mock 3 Sample Question Review

A 46-year-old single woman seeks therapy for relationship issues and low self-esteem. She works as a clerk at a law firm and reports that her boss was initially nice, then "something switched and now he's just a slave driver." She shares that she's been dating a guy who is pretty distant and she worries, "he's too laid back." She reports that she finds herself second-guessing herself and criticizing her interactions with others. In formulating a treatment plan, what would the primary goal of an Object Relations therapist be in the case provided? A. Helping her to develop the capacity for a more balanced, integrated view of self and others. B. Helping client to understand the role of her family-of-origin in her current functioning. C. Helping client to understand her transference to the therapist and applying that to relationships in the world. D. Helping client to learn how to challenge her underlying beliefs of the world that she introjected from her family of origin.

A

A therapist works at a community agency that provides therapy services for foster youth. An eighteen-year-old girl who is transitioning out of foster care requests therapy. According to the Mental Health Services Act (MHSA), what conditions would be necessary in order to provide her treatment? A. The client plans to attend community college and needs help with study skills. B. The client needs help with vocational skills. C. The client needs help with social skills. D. The client just completed a 30-day inpatient alcohol and drug treatment program and needs outpatient help.

D

A therapist has been working with a client for four months and has noticed that the client often corrects the therapist when the therapist paraphrases back to him what he heard him say. He seems to be unaware of this pattern. Using a psychodynamic approach how might the therapist address this in a future session? A. Directly tell the client your observation; Ask your client if he felt unheard or misunderstood in his family of origin, Process client's reaction to the intervention. B. Ask the client how he feels when you paraphrase what he is saying; Explore the clients beliefs about the intervention; Ask the client to notice and chart this defense throughout the week. C. Directly tell the client your observation; Ask how he feels in the present moment; Educate your client on defense mechanisms. D. Ask the client if he feels misunderstood by you; Directly tell him your observation; Ask him if he would prefer you didn't paraphrase his ideas in the future.

A

A therapist sees a 60-year-old man who reports feeling irritable and unhappy in his 35-year marriage. The man also describes loss of interest in his longtime hobbies, and trouble sleeping. Six months ago he had a serious heart attack and is currently on disability after working all his adult life. The therapist should first: A. Determine when the client's problems first began. B. Refer the client for psychiatric evaluation. C. Obtain a signed release to consult with client's doctor. D. Determine if the client is open to couples therapy.

A

An 36-year-old Ethiopian woman seeks therapy for marital issues. She is a professor at a local university. She reports that she and her husband have been fighting about having children and her career. She states that he doesn't understand her history and why working is so important to her. She mentions that she misses her family but cannot afford to fly to visit them. In order to ensure a culturally competent evaluation, what should the therapist explore? A. Client's immigration status; Immigration story; Connections with her country of origin B. Client's professional goals; Immigration story; Connections with her country of origin C. Client's social support network; Client's professional goals; Connections with her country of origin D. Client's expectations of treatment; Immigration story; Connections with her country of origin

A

Chad, an 18-year-old male diagnosed with Bipolar Disorder II has been attending therapy since he was 15, when his parents consented to his treatment. The therapist received a distressed message from the client's parents requesting to speak with the therapist about recent details discussed in therapy. His parents are frantic because they have been unable to reach him for three days. The therapist shares in the parents' concerns for his safety because of his behavior during the last session. Chad presented as depressed and spoke of "drinking until he passed out." The therapist also recalls Chad mentioning a desire to get on a bus to go visit a friend to "get away from the drama." Legally, what actions should the therapist take to respond to the parents' request for information? A. Contact the parents to express shared concerns for client's safety and share knowledge of his plan to visit a friend. B. Inform the parents that information disclosed in session can only be shared if client signs a release. C. Attempt to reach client's emergency contacts to determine the whereabouts of the client and ensure his safety. D. Maintain the client's confidentiality since he is now considered an adult.

A

Kevin a recently divorced African American man with limited custody of his 5-year-old daughter, seeks treatment. Kevin reports that his wife Tammy "kicked him out" several months ago out of the blue. Kevin states that he has few friends, is in a "dead-end" career and worries about how to rebuild his life. He states that he attempts to contact Tammy daily but she hangs up on him. He reports not wanting to initiate contact with his daughter after he notes that the quality of their relationship has diminished. What interventions would a Strategic therapist use in the middle phase of treatment? A. Instruct Kevin to take a walk around the block before calling Tammy and instruct Kevin to worry for 10 minutes every morning and evening. B. Exaggerate hopelessness of the situation and direct Kevin to stop worrying. C. Keep a log of the times Kevin calls Tammy and instruct Kevin to worry for 10 minutes every morning and evening. D. Instruct Kevin to take a walk around the block before calling Tammy and identify the role Kevin is playing in his relationships.

A

A therapist working in a group practice is increasingly forgetful of client names, their basic information, and is often losing things. His colleagues have noticed as well, and encourage him to seek medical attention. The therapist meets with his doctor and is diagnosed with early onset Alzheimer's disease. Ethically, what actions should the therapist take in his group practice? A. Continue providing therapy to existing clients while monitoring symptoms and consulting with doctor to determine when he should stop working. B. No longer accept any new clients, but continue working with current clients and discuss diagnosis with business partners. C. Begin termination with current clients and provide referrals to clients that need ongoing therapy. D. Accept new clients and continue working with medical doctor to decide when working is no longer appropriate.

C

A 5-year-old kindergartner who throws tantrums when mom "attempts" to leave her at school is referred to therapy by the school. During the initial assessment with the parents, the mother denies any recent stressors. She reports that the problematic behavior is mainly happening at school. The dad states that they don't know how to deal with this new behavior. Which of the following interventions should be included in a treatment plan? A. Use a transitional object and instruct mom leave child for longer periods of time/intervals. B. Implement a behavioral modification program with parents and school. C. Refer to a psychiatrist for a medication evaluation. D. Initiate play therapy to assess for past trauma.

B

A family is referred for therapy by their minister. The parents report that their 5-year-old and 8-year-old are out of control. The mother complains that the husband spends too much time at the office and she is left raising the kids. The father replies that she is too lenient with the children and gets upset when he disciplines the kids. In the session, the children frequently interrupt their parents. How should a therapist proceed using Bowen Family therapy interventions? A. Rearrange the family seating in the room; Teach the parents active listening; Instruct the children to interrupt more often. B. Meet with parents alone; Create a family diagram to identify influence of families of origin; Identify work as a way the husband avoids their issues. C. Assign active listening homework; Direct the parents to address the interruptions of the kids; Strengthen the parental subsystem. D. Explore how family roles are defined; Direct the parents to talk directly to one another; Ask what their family would look like if there weren't any problems.

B

A married mother of two young children is referred to a therapist by her employer for an inability to maintain expected standards at work. The initial assessment reveals that the client has recently experienced the sudden death of her younger sister who was a single mother of two young children. The children are now in the client's care. The client's mother and one brother are in prison. The client's husband is employed, but they need her paycheck to make ends meet. How would a Strategic Family therapist approach this case? A. Explore her coping skills and social supports. B. Provide clear directives to help change symptomatic behaviors. C. Invite the whole family for the next session and to assess attachment dynamics. D. Collaborate in problem solving around her most pressing needs.

B

A therapist has been working with a 17-year-old boy with a history of depression, anxiety, and self-harming behaviors. The therapist and the client have worked to identify triggers and collaboratively developed a safety plan. The client's mother contacts the therapist distraught, explaining her son received a rejection letter from the college of his choice, locked himself in his room, and she fears he might be seriously hurt. What actions should the therapist take to address the crisis situation? A. Determine who consented to treatment prior to speaking with client's mother to avoid breaking client's confidentiality. B. Direct the client's mother to immediately call for emergency support. C. Direct the mother to get client on phone with therapist in order to evaluate client's current safety. D. Review client's safety plan with mother to ensure client receives appropriate support.

B

A therapist meets with an adolescent who frequently misses school and is having academic problems. Psychological testing found the client is above average in intelligence, but has poor impulse control and is at high risk for antisocial behaviors. The therapist completes the social history to: A. Explain the client's developmental progress. B. Understand factors that affect the client's behavior. C. Identify client's social support system. D. Assess current coping mechanisms.

B

Luisa is a 24-year-old, Native American college graduate who seeks therapy for feelings of intense sadness and loneliness since her girlfriend ended their 2-year relationship a few months ago. Luisa shares that she had been unfaithful and doesn't understand why she cheated and then lied about the affair. She shares she feels confused and uncertain about how to move forward with her life. How would a Solution-Focused therapist determine appropriate treatment goals in this case? A. Allow Luisa to tell her story while listening for strengths and ask about times when she didn't feel sad or lonely. B. Ask her how she would know then she was "better." C. Identify current strengths and explore the severity of her symptoms. D. Explore how her Native American heritage impacts her problem.

B

An older couple, Kelly and Sam, have been attending therapy for two months following a car accident that resulted in significant injuries and the totaling of their car. During the session, Kelly begins sobbing while discussing the details of the car accident. The therapist begins to feel sweaty and notices an increase in heart rate causing the therapist distress. Only one month ago, the therapist had also been in a serious car accident, which resulted in increased anxiety both in and out of the car. What actions should the therapist take to maintain ethical boundaries in this situation? A. Tell the couple it would be inappropriate to continue with them and provide referrals at the end of the session. B. Consult with a colleague to discuss the therapist's experience during session and to manage countertransference. C. Seek personal therapy to work on any unresolved distress as a result of the recent car accident. D. Continue providing therapy to the couple but monitor personal reactions in session.

C

The therapist is meeting with a family of four: Jim, 45, Shannon, 43, Parker, 13, and Grace, 10. During the first session, Shannon is discussing how devastated she feels about the recent loss of their youngest child, Sam, five months ago. "Sam drowned in our family pool when the nanny looked away for just a few seconds. The fence around the pool was accidentally left open and Sam crawled right to the edge. By the time our nanny realized that he was not inside, Sam was gone." While Shannon is talking, the therapist begins to feel very uncomfortable and unable to focus due to the therapist's own recent loss of younger sister. What action should the Satir Family Therapist therapist take in this case? A. Seek consultation and help members of the family understand how their experiences have shaped their present views of themselves. B. Acknowledge every family member as an important member of the group and set up personal therapy to work through grief of losing a younger sister. C. Attempt to create an atmosphere of trust and hope and continue seeing the family weekly while monitoring personal emotions and reactions. D. Remain authentic and tell the family about unresolved grief issues and refer them out.

B

Tobias, age 32, and Vince, age 29, have been dating for nine months. Tobias refuses to accept Vince's drinking habits. "He drinks most nights of the week" he says. "Tobias is overreacting! That's all," Vince exclaims, "I was drunk the first time we met. That didn't seem to bother you." After several sessions of them constantly arguing over Vince's drinking the couple remains at an impasse. How should the therapist clinically manage the situation presented in the vignette? Score: 0 of 1 A. Arrange for a complete alcohol use evaluation for Vince and ask him to discuss the pattern of his substance use. B. Ask the couple how their relationship would change if the drinking stopped. C. Provide a comprehensive list of local Al-Anon meetings for Tobias. D. Suggest that the couple work on other relationship issues that are not related to Vince's substance use in order to regain trust with each other.

B

Tony, a 29-year-old male, seeks treatment regarding his social anxiety. In the process of therapy, the client discloses his love for gambling. He vividly describes the smells and noises of the casino, free drinks that flow endlessly, and "the thrill of winning and walking away with a wad of cash in your hands." In addition, the client shares that his social anxiety is almost non existent at the gambling table because the adrenaline rush takes care of it. The therapist had had a problem with gambling in the past, but has been in recovery for the past seven years. After meeting with the client for four months, the therapist is so drawn in by the vivid descriptions the client provides, that the therapist finds himself in a casino almost weekly. The therapist begins to dread upcoming sessions with Tony. Which of the following actions should the therapist take? A. Inform the client that they can continue therapy only if the client begins attending gamblers' anonymous meetings. B. Seek therapy for personal issues of gambling addiction since this issue has the potential to negatively impact the therapeutic relationship. C. Seek immediate consultation to resolve gambling addiction issues before therapist's bad habits negatively impact the therapeutic relationship. D. Share the thrill of gambling that the therapist experiences with the client as way of connecting and validating the client.

B

A 24 year-old woman is being seen for depression following the end of a relationship with a man who she had hoped to marry. She has been paying for her sessions out-of-pocket, but after 10 sessions she tells the therapist that she can no longer afford the therapist's fee because she has lost her job. She has applied for MediCal coverage, but the therapist is not an approved provider for MediCal. The therapist could take any of the following actions EXCEPT: A. Offer the client a reduced fee. B. Give the client a list of referrals to therapists who take MediCal. C. Apply to become a MediCal approved therapist and ask the client to wait until the therapist gets approval to continue sessions. D Process with the client how she sees her progress after these sessions and suggest she move to a low-fee support group if appropriate.

C

A 32 year-old single mother of two comes to therapy complaining of depression. She reports difficulty sleeping, performance problems at her work, a contentious relationship with her former husband, and frequent fights with both of her children, Jane, aged 9 and William, aged 5. The therapist has worked with the client for three sessions and in each session the client focuses on a new pressing issue. In the third session her children take center stage and the client asks if the therapist will see her and her children together as a family instead of continuing with individual sessions. What actions would a Client Centered therapist take in response to this request? A. Accept the client's decision as a way to empower her; Begin seeing the family as the new treatment unit. B. Ask the client to draw a diagram representing her family of origin; Suggest that she continue with individual therapy and refer her to another therapist for family sessions. C. Reflect on how the client seems to have many topics that are all very important to her and express empathy for how challenging this is for her; Suggest focusing on individual therapy for a few more sessions. D. Suggest to the client that she is avoiding her own issues by making family relations the focus of treatment; Refer the children to another therapist experienced in working with children of divorce.

C

A 54-year-old woman seeks therapy for anger and depression. She shares that her 82-year-old mother with dementia moved in with her three months ago and she feels overwhelmed taking care of her. The woman reports, "Sometimes I just leave the house all day, because I can't deal with all her neediness. She's like a whiney baby." The client adds that as the only child, it is all on her to deal with her mother. How should the therapist proceed in this session? A. Normalize her reactions toward her mother and refer her to a psychiatrist for medication evaluation. B. File an elder abuse report and process it with the client. C. Determine who is caring for mother when client is gone all day and explore her experience of being overwhelmed. D. Identify other family support and refer client to respite care services.

C

A couple in their 70's seek therapy for family problems. They report that their daughter and son-in-law moved in with them recently and they are afraid of the son-in-law, who expects money from them and has been using their credit cards. They add, "We are afraid of him but don't know what to do." How should the therapist clinically manage the legal issue of elder abuse in this case: A. File an elder abuse report and document it in the notes. B. Assess for elder abuse and create a safety plan. C. Inform them that an elder abuse report needs to be filed and create a safety plan. D. File an elder abuse report and process their reaction.

C

A couple in their early 40s, Eva and Briella, present for treatment due to an ongoing conflict. After several years of unsuccessful pregnancies, Briella was finally able to get pregnant. As a result, they had their only child, a son named Magnus. When the couple got pregnant they decided that Briella would stay at home until the baby turned one. Their son is now almost two and Eva has been getting impatient. "Our savings are running out and Briella doesn't want to go back to work," she states. " I refuse to be the sole provider any more. It is time to put Magnus in daycare." In response Briella tearfully says, "Do you remember everything we had to go through for us to even have him? I want to spend as much time with him as I possibly can. I do not care if we have go in debt. These precious years will never return." What interventions would a Strategic therapist use in the middle stage of therapy? A. State that their situation is hopeless and teach the clients the use of I-statements. B. Point out ways in which the clients control the therapist and each other and collaborate with clients on strengthening the boundaries. C. Instruct the clients to write each other a love letter each time they have and urge to argue about Magnus and request that the clients stop trying to get better. D. Create a new problem for clients to solve and identify dysfunctional communication patterns in their families of origin.

C

A couple is referred to therapy by their MD. During the first appointment the couples shares that at the wife's annual physical exam the doctor noted some suspicious bruises. The wife told the doctor that her husband drinks too much, becomes angry, and hits her and their children. The husband angrily reports that the doctor made a child abuse report and suggested they go to therapy. How should the therapist proceed? A. File a child abuse report; Refer the couple to AA and Alanon; Refer the husband to a batterer's program; Consult with wife's physician B. Refer the couple to AA and Alanon; Refer the couple to domestic violence intervention program; Document that child abuse report has been made; Consult with wife's physician C. File a child abuse report; Refer each person to individual therapy; Provide wife with information on domestic violence resources; Provide husband with referral for substance abuse treatment D. Refer the couple to AA and Alanon; Refer the husband to a batterer's program; Document that child abuse report has been made; Provide wife with information on domestic violence resources

C

A couple seeks treatment for communication issues and on-going conflict. If a therapist was using a cognitive approach, what would be one focus of treatment? A. Identifying how their pasts influence their understanding of each other. B. Exploring how their patterns of engagement stem from their family of origin. C. Identifying their underlying assumptions about each other and their relationship. D. Setting clear boundaries with their extended families.

C

A single mother of two young children is referred by a friend. The client reports feeling overwhelmed with all her responsibilities and shares that she has been experiencing episodes where she is unable to breathe, has a tingling in her body, feels disconnected from the world, and thinks she is going to die. What initial interventions should be considered in this case? A. Identify triggers for the episodes; Refer her to a medical doctor; Assess child neglect; Explore coping skills. B. Complete a mental status exam; Refer to psychiatrist for medication; Refer to parenting classes; Identify coping skills C. Identify triggers for the episodes; Refer her to a medical doctor; Explore her current stressors; Identify coping skills. D. Complete a mental status exam; Refer to psychiatrist for medication; Encourage exercise; Teach coping skills.

C

A therapist sees a family for family therapy. The parents are distraught about their 4-year-olds tantrums. They say they can't agree how to respond and the preschool is threatening to have him kicked out. What is an example of circular questioning that the therapist can ask the parents in this case? A. "When did you two notice this was a problem?" B. "If you each had it your way, how would you like your spouse to respond?" C. "When your son has a tantrum, how do you each respond?" D. "How have each of you been coping with the stress of this?"

C

Larry, a 42-year-old stockbroker, came to therapy after his marriage fell apart. He found out that his partner was cheating on him over the period of the last 5 years. Larry spent a good amount of time healing his pain and taking a close look at his relational dynamic in hopes of understanding various ways in which he might have contributed to such outcome. Nearing termination, Larry tells the therapist: "I am really grateful for all the work we have done together. And I would love for you to benefit from our relationship as well. I have a tip about the stock market that will have a 20% return on your investment. I am happy to share it with you." How should the therapist respond to the client's offer? A. Refuse the tip as an inappropriate boundary crossing. B. Refuse the tip as an illegal barter for services. C. Refuse the tip as a conflict of interest. D. Refuse the tip as a boundary violation.

C

Sheri, age 14, is brought in for therapy by her half-sister Kelly, age 28, who was given legal custody following the death of Sheri's biological parents 7 months ago. Sheri has been getting into trouble at school for cheating on exams, skipping class, and threatening classmates. Kelly caught her sneaking a boy into her room over the weekend and caught her smoking marijuana. Kelly states, "I just don't know what's wrong with her. I'll pay for as many sessions as you need. My toddler keeps me busy enough, I don't have time to deal with this!" Sheri angrily responds, "I wish I would have died in the accident too." What crisis issues are presented in the case described in the vignette? A. Loss of parents; Substance use; Academic problems. B. Academic problems; Sheri's possible suicidality; Family restructure. C. Substance use; Sheri's potential for self-harm; Sheri's at-risk behavior. D. Substance use; Lack of social support; Child neglect.

C

Tracy, a 38-year-old corporate lawyer, and her 28-year-old wife, Jill, a musician, self-refer for couples therapy. Tracy recently gave birth to a son with special needs. Tracy states, "Jill doesn't understand my stress. I have to bill a certain number of hours or there is no way I am going to make partner." She complains that Jill drinks and smokes pot nightly and doesn't get out of bed all day. I can't trust her with our baby." Jill responds, "You're the one who wanted the baby. Don't blame me for your child care problems while you keep working 15 hours a day." How should the therapist assess and clinically manage potential child abuse based on the case described in the vignette? A. Determine whether the couple can adequately care for the baby; Review parenting skills modeled by their parents; Obtain a release to consult with the pediatrician. B. Evaluate the current child care arrangements; Explore why Tracy can't trust Jill with the baby; Refer them to a support group for parents of children with special needs. C. Evaluate the current child care arrangements; Explore why Tracy can't trust Jill with the baby; Process reactions to a possible child abuse report. D. File a child abuse report based on Jill's neglect of the baby; Obtain a release to consult with the child's pediatrician; Refer couple to a support group for parents of children with special needs.

C

A 15- year-old girl, Jill, is brought to therapy by her parents. They are concerned that she is withdrawing from her usual activities, spending less time with the family and choosing instead to do things on her computer in her room. After six weeks of therapy the client asks that the therapist use the name JD, not Jill, and male-gender pronouns when talking about "him." JD pleads that the therapist not tell his parents about this because they are strictly religious and he has heard them reacting with disgust to items in the news about transgender people. What actions should therapist take in this case? A. Tell the client that his parents must be informed because this change may affect him medically and process his reaction. B. Tell the client that his parents must be informed only if the client is considering any medical changes to support his new gender and explore his discomfort at telling parents. C. Respect the client's request for confidentiality and encourage the client to work toward telling parents. D. Explain client's rights to confidentiality and assess for danger to self.

D

A 28-year-old client who has been coming to therapy for two months for depression shares with the therapist that her husband thinks that her therapy is making their relationship worse and that she should stop. The therapist suspects there is domestic violence going on at home. How should the therapist respond? A. Provide psychoeducation on domestic violence and refer to a domestic violence shelter. B. Explore the client's feelings about her husband's views and make a termination plan. C. Provide psychoeducation on domestic violence and confront client's denial about her problems. D. Explore the client's feelings about her husband's views and share concerns about possible domestic violence.

D

A 29-year old female client with a history of suicide attempts seeks therapy for emotional difficulties and relationship problems. She comes to the third session and declares that she doesn't see things getting any better in her life. After further assessment, the therapist learns that the client has a plan to take pills she has hidden at home. What should the therapist do NEXT? A. Initiate an involuntary hospitalization and have the client dispose of the pills. B. Contact the client's emergency contact and have them dispose of the pills. C. Require that client to sign a no harm contract and agree to dispose of the pills. D. Discuss voluntary hospitalization and identify a plan to dispose of the pills.

D

A 32-year-old woman seeks therapy after the recent death of her infant son. She shares that she has struggled with alcoholism and it has gotten worse since her son passed away. What initial adjunctive resource should the therapist consider initially in this case? A. Alcoholics Anonymous B. Grief Support Group C. MD D. Substance Use Treatment Center

D

A 36-year-old woman is referred to the therapist by her OB/GYN for excessive worry and feeling down. During the initial session, she tearfully shares that her husband is extremely controlling. She is not allowed to work or have access to any money. When she stands up to him, he becomes enraged and emotionally abusive. How would a Solution-Focused therapist proceed in the initial session? A. Teach her assertiveness skills and create a safety plan. B. Explore her goals for therapy and refer her to a domestic violence support group. Incorrect C. Explore her goals for therapy and find out how she's been coping. D. Assess her current safety and find out how she's been coping.

D

A client is court mandated to see a therapist for help with anger control. The client denies having a problem and blames others for initiating fights. The client also states that attending therapy sessions is not necessary. In order to engage the client in the process, the therapist should: A. agree with the client's denial of problems with anger. B. reflect back the client's resistance. C. note that the client's probation officer must be informed of his resistance. D. express understanding of the client's position regarding therapy.

D

A mother and father seek assistance at a community agency because they are concerned that their 6-year-old son has an Autism Spectrum Disorder. The treating therapist schedules a session to meet with the parents alone. At the initial session both parents are distraught. They report being overwhelmed by having to juggle between running the household and working full-time. The parents note that they "just can't handle one more thing." They talk over one another and argue about how to explain their concerns to the therapist. In addition, they express concern over their son's life potentially being "horrible" and that the extra pressure on their family will be "unbearable." How should the therapist clinically manage the situation presented in the vignette? A. Express empathy for the parents' concerns; make appointments for individual sessions with mother and father; ask parents to have their child assessed by the school psychologist. B). Tell the parents that they are being premature in getting so upset; make appointments for individual sessions with mother and father; ask parents to have their child assessed by the school psychologist. C. Tell the parents that they are being premature in getting so upset; get more details about the specific behaviors that they find concerning; arrange to see the minor client at the next session. D. Express empathy for the parents' concerns; get more details about the specific behaviors that they find concerning; arrange to see the minor client at the next session.

D

A school therapist is facilitating a meeting with students at a high school after a classmate committed suicide over the weekend. The therapist should FIRST: S A. normalize the grief process. B. provide referrals to mental health counseling. C. find out if there were any signs that were missed. D. encourage the students to express their reactions.

D

Barbara, age 43, and Bill, age 48, seek therapy for marital issues. The couple shares that they had separated but that Bill had moved back in when he agreed to go to therapy and stop drinking. Barbara states, "After he lost his job a year ago he started to drink again. And when he's drunk he loses his temper with the kids and becomes violent." Bill nods and adds, "I was sober for 10 years but losing my job just pushed me over the edge." How should the therapist clinically manage the legal and ethical obligations presented in this vignette? A. Identify Bill's prior history of violence; File a report to child protective services; Refer Bill to Alcoholics Anonymous. B. File a child abuse report; Provide Barbara with a safety plan for the children; Document interventions in their record. C. Assess whether Bill is currently sober; Provide Barbara with a safety plan for the children; Document interventions in their record. D. Review the limits of confidentiality; Process with Barbara and Bill the possible need to make a child abuse report; Further assess for child abuse.

D

Desiree, a 23-year-old African American female, seeks therapy because she is struggling with depression and anxiety. Desiree is a junior in college and has been living with her boyfriend for approximately 4 months. During the initial session she makes minimal eye contact, and the therapist notices bruises on her arms and a deep gash on her cheek. What actions should a CBT therapist take to assess the potential safety issues in the initial session? A. Ask client how she received the injuries and explore her thoughts about the relationship with her boyfriend. B. Ask client about her depression and anxiety and wait until the therapeutic relationship is stronger to ask about the cause of injuries. C. Ask client about the relationship with her boyfriend and explore possible cognitive distortions about their relationship. D. Ask client how she received the injuries and explore whether client has thoughts of self harm.

D

Dolly, age 44, and Gonzalo, age 46, are referred to therapy by Dolly's individual therapist. They express a deep commitment to stay together. During the initial session they both continually interrupt the other one and become defensive. Why should the therapist utilize role reversal as part of this couples' course of treatment? A. To reinforce autonomy of the two partners. B. To reinforce the established roles of each partner. C. To increase lighthearted interplay between partners. D. To increase empathy and understanding between partners.

D

Tom, age 25, and Kathy, age 24, come for couple's therapy because they have been arguing a lot. They have lived together for several years. Tom returned three months ago from a 9-month deployment in Iraq. He shares that he "feels very out of place, like he doesn't belong anywhere." Kathy is concerned because Tom wakes up screaming, has been drinking more, and has angry, unprovoked outbursts. She has caught him crying twice and says he stays in bed all day. Kathy adds that she recently lost her job. They want help because they are committed to each other. What areas should the therapist assess to evaluate risk in this case? A. Severity of Tom's alcohol use; Socioeconomic stress affecting couple; Tom's feelings of not belonging B. Tom's possible suicidality; Severity of domestic violence affecting couple; Severity of Tom's alcohol use C. Tom's level of suicidality; Socioeconomic stress affecting couple; Tom's mental status D. Tom's possible suicidality; Severity of Tom's alcohol use; Tom's mental status

D

Trish, a 23-year-old graduate student comes for treatment complaining of irritability and tiredness. She has lost her appetite, her academic performance is deteriorating, she finds that she cannot concentrate and she has very low energy. The therapist decides to use a Cognitive therapy approach. Which of the following interventions should be used in this situation? A. Facilitate exploration of client's underlying beliefs to increase self-esteem; Assess client's level of self-understanding about self-defeating behaviors learned in childhood; Probe present aspects of the client's life that contribute to the sadness B. Identify thoughts that lead to positive feelings; Reframe symptoms as client's need to connect with others; Assist client to correct negative automatic thoughts C. Assist client to suppress depressive thoughts; Utilize activity scheduling and incentives; Teach the client thought stopping techniques D. Assist client in identifying negative automatic thoughts; Utilize activity scheduling and incentives; Teach the client how to use activity chart and rate the pleasure that she derives from each activity

D