Quiz questions

A 55-year-old spa manager is referred to treatment by her colleague. She reports having one failed relationship after another and her most recent break up left her utterly devastated. For the past several months she finds herself with a huge bowl of popcorn every night and feeling disgusted in the morning because she ate too much yet again. During the fourth session the client shares a detailed story of how she was bullied during middle school and her mother refused to believe her. She begins to sob then grows quiet. What would a Gestalt therapist be likely to say to the client at this moment? Score: 1 of 1 A. "What are you experiencing as you tell me this story?" B. "Was you mother there for you in other ways?" C. "Do you think your overeating is a way you bully yourself?" D. "How did you cope?"

A. "What are you experiencing as you tell me this story?"

39-year-old Emilio and 36-year-old Helena are referred by their middle child's teacher. They have 2 sons, ages 11 and 7, and a 9-year-old daughter, Raquel. Both parents disclose being very busy and stressed at work, which means that neither of them is able to be home much. They are both concerned about their daughter Raquel, who appears more and more withdrawn and shut down lately. "I can't get her to do anything", Helena complains. "Plus she used to love going over to her aunt's and uncle's place, but, ever since a couple of months ago, she refuses to set foot in that house. I wonder if it has anything to do with that incident?" How would a therapist assess and clinically manage potential child abuse in this case? Score: 1 of 1 A. Ask Helena what she means by "that incident"; inquire about any other recent changes in Raquel's behavior; process the parents' reactions to a possible child abuse report. B. Review parenting skills modeled by the couple's own parents; file a child abuse report based on the information provided; process the parents' reactions to filing a child abuse report. C. Evaluate current child care arrangements; obtain a release to speak with Raquel's teacher; file a child abuse report based on Helena's concerns. D. Obtain a release to speak with Raquel's teacher; ask Helena what she means by "that incident"; explain the therapist's obligation to report child neglect.

A. Ask Helena what she means by "that incident"; inquire about any other recent changes in Raquel's behavior; process the parents' reactions to a possible child abuse report.

A new client starts off the first session sharing how she feels overwhelmed with her life. She shares that she doesn't like her new job but is uncertain of what career she wants to pursue. She reports feeling like her relationship with her boyfriend is unhealthy and wants to get along better with him. Then she adds that she's been having a lot of conflict with her new roommate and can't decide whether she should move out. When formulating the initial treatment plan, the therapist should: Score: 0 of 1 A. Assist the client to prioritize her treatment goals. B. Determine the most important issue to focus on. C. Assess the client's level of coping. D. Identify her social supports.

A. Assist the client to prioritize her treatment goals.

A 45-year-old woman comes to therapy feeling a lack of meaning in her life. She explains that she is tired of her mundane existence and is feeling depressed. She states, "the only thing I really feel excited about is a martial arts class that I attend two times per week". How would a Depth-oriented therapist proceed? Score: 1 of 1 A. Consider the image and metaphor of martial arts in her life; Metaphorically explore how fighting for/against something could apply to her current situation; Ask the client to say more about her connection to martial arts. B. Explore the soul of the fighter in her that wants to emerge; Ask her to perform some martial arts in the room so that she can experience the feeling it brings her; Ask her about her dreams. C. Consider the metaphor and image of martial arts in her life; Ask her to imagine not being depressed as a way to reduce depression; Explore how she feels when she is doing martial arts. D. Explain to her that the martial arts is compensating for her depressed mood; Ask her about her dreams; Discuss the importance of balance in her relationships.

A. Consider the image and metaphor of martial arts in her life; Metaphorically explore how fighting for/against something could apply to her current situation; Ask the client to say more about her connection to martial arts.

A therapist in private practice meets with a new client who shares that she is also a therapist. The client discloses that she has been practicing for over twenty years and is considering closing her practice. She shares that over the past year she developed feelings for a client and had a brief affair, but ended it because she knew it was wrong. She indicates feelings of guilt and remorse and feels she should no longer practice because of her actions. How should the therapist manage the ethical responsibilities presented in this case? Score: 0 of 1 A. Explore the client's feelings of guilt and remorse, as well as her thoughts about ending her practice. B. Validate her feelings of guilt and remorse and provide her with the brochure "Professional Therapy Never Includes Sex." C. Encourage the client to obtain legal counsel. D. Encourage the client to address the ethical violation directly with her client and provide him with the brochure, "Professional Therapy Never Includes Sex."

A. Explore the client's feelings of guilt and remorse, as well as her thoughts about ending her practice.

A 42-year old woman is in treatment for depression and anxiety that resulted from a severe abuse history she experienced as a child. During the sixth session the client experiences a flashback of a particularly violent exchange with her father when he choked her until she went unconscious. During the session she appears to have difficulty breathing then begins to hyperventilate and appears very scared. How should the therapist proceed with the client? Score: 1 of 1 A. Ground the client by focusing on what is happening in the here and now. B. Offer education about the experience of triggers and flashbacks. C. Normalize her reaction as a common traumatic stress reaction. D. Remain silent until the client calms down.

A. Ground the client by focusing on what is happening in the here and now.

An older couple comes to therapy. The husband reports that since he retired one year ago, he spends much of his time completing his wife's daily chores. He does not understand why she is so upset all the time. "I feel so useless," she says. What intervention would address their dilemma? Score: 1 of 1 A. Help them set more adaptive boundaries so they can shape new roles for themselves. B. Reframe her uselessness as an attempt to distract her husband from his feelings of loss. C. Encourage the wife to involve herself in volunteer activities so she will feel more useful. D. Encourage the husband to obtain part-time employment to divert his attention from his wife.

A. Help them set more adaptive boundaries so they can shape new roles for themselves.

A therapist has been meeting with a 36-year-old client for several months. In one of the sessions, the client discloses that when she was much younger, she had sexual relations with one of her therapists. The therapist provides the client with the brochure "Professional Therapy Never Includes Sex." In addition to providing the brochure, what additional steps should the therapist consider? Score: 1 of 1 A. Process the relationship with the client and encourage the client to file a report with the BBS. B. Process the relationship and file a report with the BBS. C. Inform the client that her previous therapist's behavior was illegal and encourage her to talk to a lawyer. D. Determine how old the client was when she had a sexual relationship and file a child abuse report, if necessary.

A. Process the relationship with the client and encourage the client to file a report with the BBS.

A Korean family is referred by their 12-year-old daughter's teacher. The daughter is complaining of stomach aches, is withdrawn in class and frequently tears up. The family doctor has ruled out a medical issue. The father, mother, and 10-year-old sister attend the first session. The father shares that the daughter started acting like this after her older brother died in a car accident four months ago. The father asks the therapist to explain how she can help the daughter. How should the therapist proceed in this case? Score: 0 of 1 A. Respond directly to the father, explain what they can expect from therapy, provide information about the therapist's background and training. B. Respond directly to the daughter, explain what they can expect from therapy, provide information about the therapist's background and training. C. Ask each member of the family what they expect from therapy. D. Provide the parents with psychoeducation about the grief process and discuss treatment alternatives.

A. Respond directly to the father, explain what they can expect from therapy, provide information about the therapist's background and training.

A 17-year-old is referred by her doctor to a mental health agency for counseling. The client learned several weeks ago that she's pregnant. She reports she is in a relationship with the person who got her pregnant, but they are not getting along, she does not want him to know, and does not think she wants to have the baby. She is conflicted about what to do and tells the therapist she would like support as she decides what to do. The therapist has personal beliefs against abortion and feels strongly the client should not have an abortion. How should the therapist address the conflict presented in this case? Score: 1 of 1 A. Seek immediate consultation to discuss the matter and determine if a referral would be appropriate. B. Seek consultation and refer the client to prenatal services. C. Encourage the client to include her boyfriend in making a decision. D. Share the therapist's personal beliefs and process how it effects the client and therapist's relationship.

A. Seek immediate consultation to discuss the matter and determine if a referral would be appropriate.

Dan, age 46, his girlfriend Nicole, age 34, and her daughter Allison, age 16, are referred to therapy by Allison's school. She has been isolating herself and crying a lot since a cross-country move last month. Dan angrily says, "I'm out of a job and we might lose our house. Allison needs to toughen up and stop complaining about changing schools and missing her friends." Nicole, who has a split lip, timidly explains that she thinks Allison is upset because she and Dan aren't getting along. Allison does not make eye contact and begins to cry softly and says, "Dan drinks too much. I am tired of hearing them fighting. I can't take it anymore." What interventions would a Solution Focused therapist use to treat Allison in the middle phase of treatment? Score: 0 of 1 A. Validate what Allison is doing well to cope with her problems and identify on a scale of 1-10 how Allison feels she has been coping with her situation. B. Encourage Allison to do more of what has been working for her and teach communication skills so she can make new friends at school. C. Find out what would be different if things in Allison's life were better and encourage Allison to do more of what has been working for her. D. Identify on a scale of 1-10 how bad Allison feels her problems are and validate what Allison is doing well to cope with her problems.

A. Validate what Allison is doing well to cope with her problems and identify on a scale of 1-10 how Allison feels she has been coping with her situation.

During an initial assessment interview, a therapist observes that her new client is suspicious of the agency and the therapist. The therapist provides informed consent, including the limits of confidentiality. After receiving informed consent, the client tells the therapist that he wants to share certain information but is concerned it could get his friends in trouble. What is the most appropriate response to address the client's concern in this case? Score: 1 of 1 A. Recognize the client is not ready to talk about the situation and shift the focus to a less threatening subject. B. Acknowledge it could be hard to feel safe in this situation and encourage him to only share information when he feels he is ready. C. Confirm the client understands when a therapist must break confidentiality and show him where the files are locked to ensure his privacy. D. Encourage the client to talk about these things and reassure him that the therapist is not required to report on the behaviors of his friend.

B. Acknowledge it could be hard to feel safe in this situation and encourage him to only share information when he feels he is ready.

A therapist received a phone call from a concerned mother regarding her 15-year old son. She states that he is withdrawn and is exhibiting bizarre symptoms like staying up all night, not eating, and grinding his teeth constantly. What is the most likely diagnosis? Score: 1 of 1 A. Bipolar II Disorder B. Amphetamine Use Disorder C. Schizotypal Personality Disorder D. Cannabis Use Disorder

B. Amphetamine Use Disorder

A 55-year-old woman presents for treatment three months after the death of her husband. Prior to his death she worked full time and enjoyed many hobbies. Since then, she has started missing work and isolating herself, stating that she doesn't enjoy anything, feels guilty about being a "bad wife" and cannot sleep. She reports that she started drinking whiskey every night to help with the pain. What initial diagnoses should the therapist consider? Score: 0 of 1 A. Adjustment Disorder, Alcohol Use Disorder, Major Depressive Disorder B. Bereavement, Substance Induced Depressive Disorder, Major Depressive Disorder C. Adjustment Disorder, Major Depressive Disorder, Substance Induced Depressive Disorder D. Bereavement, Adjustment Disorder, Substance Use Disorder

B. Bereavement, Substance Induced Depressive Disorder, Major Depressive Disorder

A 28-year-old woman seeks therapy for depression. She reports that she recently moved to the city and has had a difficult time making friends. She works as a waitress and a graphic designer. She shares that she was in therapy a few years ago but reports that the other therapist "wasn't very good" so she stopped going to therapy. In addition to a risk assessment, what else should the therapist explore in the initial assessment? Score: 0 of 1 A. Client's thoughts of suicide or self harm. B. Client's expectations of therapy and experience with other therapist. C. Client's motivation for treatment. D. Client's current and past substance use.

B. Client's expectations of therapy and experience with other therapist.

A therapist is planning to expand his practice by offering therapy over the phone and internet to clients residing in rural areas with limited mental health providers. When initiating therapy with a new client, what is the most important issue the therapist should address? Score: 1 of 1 A. How fees will be managed. B. Client's location and emergency contacts. C. Limits of confidentiality. D. Managing dual relationships.

B. Client's location and emergency contacts.

A therapist in private practice has been treating a 54-year-old male client for four months. Over the past two months, the client regularly arrives late to appointments and has also missed several of them. Although the cancellation policy was clearly explained at the onset of therapy, the client continuously fails to call in advance to cancel. When confronted, the client minimizes the problem and accuses the therapist of having unreasonable expectations. How should the therapist initially respond to the client? Score: 0 of 1 A. Remind client of his cancellation policies, have him sign an attendance contract and require he pay for missed appointments. B. Confront the client about his perception of the problem and discuss how to move forward. C. Reframe client's behavior as having difficulty with therapeutic work and collaborate with client to reformulate goals. D. Review cancellation policy and discuss possible termination with client.

B. Confront the client about his perception of the problem and discuss how to move forward.

An 8-year-old client is brought to therapy by her mother, who states that the client has been moody and defiant at home and has been acting aggressively with other children at school since they moved a few months ago. The mother states that "she's at the end of her rope and has no idea how to deal with her daughter." She further states tearfully that the client's father is in rehab for heroin addiction. Which of the following goals should be included in the treatment plan for this case? Score: 1 of 1 A. Decrease aggression at school and defiance at home; Re-establish appropriate relationships between family members; Refer the mother for financial assistance. B. Decrease aggression at school and defiance at home; Improve mother's parenting skills; Refer the mother to Al Anon. C. Enhance impulse-control and attention span; Explore the marital relationship; Refer the mother to Al Anon. D. Enhance impulse-control and attention span; Explore the marital relationship; Refer the mother for anger management.

B. Decrease aggression at school and defiance at home; Improve mother's parenting skills; Refer the mother to Al Anon.

A client seeks therapy for feelings of anxiety and panic that she's had since losing her job three months ago. She reports that she has a second interview at a good company at the end of the week, but she is having a hard time concentrating and is doubting her abilities. She adds that she hasn't been getting along with her boyfriend and wants to lose weight because she can't fit into old work clothes. The immediate focus of treatment with this client should be: Score: 1 of 1 A. Teaching her communications skills to better connect with boyfriend. B. Discuss strategies for her to prepare for her interview. C. Explore her eating habits and exercise routine. D. Refer her to a psychiatrist for a medication evaluation.

B. Discuss strategies for her to prepare for her interview.

A therapist has been working with a 6-year-old boy for one month. The child was brought in by his mother after witnessing his father get hit by a car. The mother reports that the child has been less anxious since starting therapy but continues to have nightmares and doesn't want to go to bed. What intervention should the therapist employ in the middle phase of therapy? Score: 0 of 1 A. Provide psyhoedcuation to mother about trauma in children. B. Engage in art therapy with the child encouraging him to draw his dreams. C. Create a bed in the office and instruct the child to practice lying down. D. Teach the child self-soothing techniques to use when he wakes up from a nightmare.

B. Engage in art therapy with the child encouraging him to draw his dreams.

During the walk between the waiting room and the office, a new client declares a strong affinity for the therapist and a hopeful attitude toward therapy, saying she knows this will be different from previous treatment experiences. After acknowledging the client's positive reactions the therapist should NEXT: Score: 0 of 1 A. Ask what interfered with previous treatment. B. Explore expectations regarding this helping relationship. C. Determine the basis for attraction to the therapist. D. Assess client's reasons for seeking therapy.

B. Explore expectations regarding this helping relationship.

A therapist meets with a client diagnosed with Bipolar I who is brought in for the first session by her father. The father informs the therapist he was recently appointed conservator by the court. The father would like to attend therapy sessions with the client to ensure she is providing the therapist with accurate information and benefiting from treatment. He explains that the client has a history of lying to her therapists. The therapist should: Score: 0 of 1 A. Invite the father to attend the sessions. B. Explore pros and cons of including father and set appropriate boundaries. C. Deny the request and refuse to include the father in treatment. D. Review conservatee's rights to confidentiality with father.

B. Explore pros and cons of including father and set appropriate boundaries

During a group therapy session, one of the group members reports that her sister-in-law has been butting into her life and if she keeps it up the client is "going to make sure she never butts in again." A few of the group members laugh uncomfortably. How should the therapist proceed: A. Validate the client's anger. B. Explore what the client means by "going to make sure she never butts in again." C. Encourage group members to share their reactions. D. Identify healthy ways for client to express her frustration.

B. Explore what the client means by "going to make sure she never butts in again."

Sue, age 70, and Larry, age 69, are referred by their gerontologist. Larry was recently diagnosed with Major Neurocognitive Disorder. Sue shares that Larry has become very irritable since starting a new medication, and that he actually pushed her down on the floor when he became upset. She shows a bruise on her elbow and knee. She states, "I don't think I can handle taking care of him anymore, but I don't want to leave our home." What resources should the therapist utilize initially in this case? Score: 0 of 1 A. Neurologist; Domestic Violence Resources; Psychiatrist B. Gerontologist; Adult Protective Services; Home Care Assistance C. Neurologist; Nursing Home; Care Giver Support Group D. Caregiver Support Group; Adult Protective Services; Home Care Assistance

B. Gerontologist; Adult Protective Services; Home Care Assistance

A 32-year-old client seeks therapy to address relationship issues. She has two young children and recently left an abusive relationship. She was married for 7 years and states that the last 5 years included verbal and emotional abuse. She reports depressive symptoms, trouble in dealing with separation, low self-esteem and difficulty parenting her children. What interventions would a Structural Family therapist utilize in the middle phase of treatment to strengthen the parental hierarchy between the client and her children? Score: 0 of 1 A. Initiate enactments to help client identify specific ways to enact clear boundaries. B. Have client arrange chairs to represent current hierarchy and rearrange chairs to represent her status as a parent. C. Track and match client's interactional style. D. Identify the influence and control her spouse has had on her in the past.

B. Have client arrange chairs to represent current hierarchy and rearrange chairs to represent her status as a parent.

A lesbian couple, Michelle, a 44-year-old African American and Kara, a 38-year-old Caucasian, are referred by a friend. The couple reports that they fight all of the time and can't agree how to parent. They have two adopted children, Josh, 6 and Logan, 4. They report that Josh has been disruptive in class, won't stay seated and is aggressive with other children. Kara starts crying when she says, "I don't know what to do to help him. I am so worried about him. I can't sleep without taking something". Michelle complains angrily, "Well, she pops pills whenever she's stressed and she worries about everything. If she actually disciplined him, we wouldn't have this problem. He listens to me. Now, he's completely out of control like you with that sleep drug". Kara whimpers back, "He listens to you because he's afraid of what you'll do. "What interventions would a Bowenian therapist use in the beginning phase of treatment with Michelle and Kara? Score: 0 of 1 A. Analyze the triangulation of substance abuse in Kara & Michelle's relationship and develop a family history to identify Michelle and Kara's learned parenting styles. B. Identify the role of substance abuse as intrusive in their partnership and assist the couple in understanding the role of parenting in their families of origin. C. Reduce the emotional reactivity of Michelle and Kara's opposing responses to parenting and Interpret the multigenerational parenting styles of Michelle and Kara's families of origin. D. Develop a family history to identify Michelle and Kara's learned parenting styles and analyze substance abuse as Kara's avoidance of relationship responsibility.

B. Identify the role of substance abuse as intrusive in their partnership and assist the couple in understanding the role of parenting in their families of origin.

Brian, age 34, and Kim, age 30, are referred by Kim's co-worker for therapy. Kim shares that she recently caught Brian cheating on her and even though he says it's over, she doesn't know whether she trusts him. Brian says "I know I messed up. It won't happen again. I don't know why we have to keep dwelling on this." How should the therapist proceed with the initial assessment in this case? Score: 0 of 1 A. Explore what conditions would allow Kim to trust Brian again. B. Invite the couple to discuss how they met and what keeps them together. C. Determine what prompted Brian to have an affair. D. Normalize Kim's feelings that she won't be able to trust Brian again.

B. Invite the couple to discuss how they met and what keeps them together.

A 16-year-old client is sent to therapy by his mother who is concerned he is "doing drugs and running with the wrong crowd." The client denies drug use and complains that his mother is overbearing. Four months into therapy, the client confesses to the therapist that he recently broke into one of a neighbor's house with a friend. How should the therapist clinically manage the legal issues in this case? Score: 1 of 1 A. Inform the client that his behavior is illegal and share concerns with his mother. B. Maintain client confidentiality about the incident and document it in the record. C. Obtain a written contract that the client will not commit another break in and document it in his file. D. Inform the client that the police need to be notified of the crime.

B. Maintain client confidentiality about the incident and document it in the record.

A 31-year old woman seeks therapy for relationship issues after losing her job as a bank teller. The client reports a history of suicidal gestures. She shares how much she likes the therapist compared to the horrible therapists she's had in the past. When working with this client the therapist should pay close attention to: Score: 0 of 1 A. Countertransference issues that may arise. B. Maintaining clear boundaries for the therapeutic relationship. C. Limiting self-disclosure. D. Addressing the transference issues that may arise.

B. Maintaining clear boundaries for the therapeutic relationship.

A 45-year old male client who has been unemployed for six months is referred by his wife for therapy. In the initial session, he reports that he wants to sleep all day and he doesn't see his situation getting any better. He says that he can't stand having his wife and children see him like this. As part of a complete assessment, the therapist should FIRST: A. Determine if the client is currently using substances. B. Refer the client to a medical doctor for issues of hypersomnia. C. Ask if the client has thoughts of suicide. D. Explore the client's social supports and coping strategies.

C. Ask if the client has thoughts of suicide.

A 6-year-old, Nate, is referred to therapy by his teacher because he is very disruptive in class, uses obscene language, fights with other students and consistently speaks out of turn. The parents, Steve and Nancy, corroborate that he shows similar behavior at home and does not respond to punishment. The parents add that their son seems unresolved in his grief over his baby sister's recent death. In the initial phase of treatment, how would a Narrative therapist intervene compared to a Solution Focused therapist? Score: 1 of 1 A. Narrative would identify times when Nate's behavior wasn't a problem at school and/or at home and provide psychoeducation on grief in children; Solution Focused would normalize Nate's behavior and identify family strengths. B. Narrative would separate Nate from his bad behavior and explore the effects of the bad behavior at school and home; Solution Focused would ask about times when Nate had behaved well and how the family would know the problem was gone. C. Narrative would provide psychoeducation on grief and explore how the family has attempted to punish Nate in the past; Solution Focused would identify family strengths and unique outcomes when the problem wasn't present. D. Narrative would explore the effects of society's dominant discourse on Nate's problem; Solution Focused would determine the effect the problem was having on the family and provide psychoeducation on grief in children.

B. Narrative would separate Nate from his bad behavior and explore the effects of the bad behavior at school and home; Solution Focused would ask about times when Nate had behaved well and how the family would know the problem was gone.

Dan, age 38, and his wife Mary, age 35, are referred by Dan's oncologist. Dan shares that he was recently diagnosed with a brain tumor that is inoperable and the doctors say he has three months to live. They share that they haven't told their two teenage daughters and are seeking therapy to help them all cope. Mary begins to cry and says, "I know my older daughter is going to be devastated. You can help her right?" What legal obligations does the therapist have initially in the case provided in the vignette? Score: 1 of 1 A. Explore their expectations for treatment; Determine whether Dan has an Advanced Directive; Work within scope of practice. B. Obtain informed consent for treatment; Maintain separate files if family members are seen individually; Obtain a signed release before consulting with Dan's doctor. C. Encourage the family to create an advanced directive for Dan; Work within scope of practice; Obtain a release before consulting with Dan's doctor. D. Obtain informed consent for treatment; Obtain a release before consulting with Mary's doctor; Set fee before onset of therapy.

B. Obtain informed consent for treatment; Maintain separate files if family members are seen individually; Obtain a signed release before consulting with Dan's doctor.

A 19-year-old client seeks treatment for relationship issues. The client shares that he is attracted to both women and men and he doesn't know how to explain it to his parents. Three months into treatment the client is unexpectedly laid off from his job and leaves a message that he can't afford therapy. He declines to attend termination sessions because of concerns about spending money while unemployed. How should the therapist clinically manage the ethical issues in this case? Score: 1 of 1 A. Call the client and explain why the client needs to meet for a final session to gain a sense of closure and provide referral to LGBT services. B. Offer a termination session at a reduced fee to enable the client to process the termination and provide referrals to low fee services. C. Encourage the client to continue therapy in order to determine his sexual identity. D. Send a letter to the client affirming that he terminated against professional advice and is welcome to return.

B. Offer a termination session at a reduced fee to enable the client to process the termination and provide referrals to low fee services.

A therapist is running a therapy group for people going through divorce. The therapist suspects that one member of the group is abusing drugs and determines that his erratic participation is detrimental to the group process. The therapist should FIRST: Score: 1 of 1 A. Confront the client in the group. B. Schedule an individual session with the client. C. Provide the client with a referral for substance abuse treatment. D. Process the group members' feelings about the client's departure.

B. Schedule an individual session with the client.

A therapist is working with a male client who reports occasional impotence and anxiety when having sex with his new girlfriend. The client shares that he has had issues like this in the past but did not have an issue with his previous girlfriend. The therapist has training and experience working with sexual disorders. What therapy intervention should the therapist consider? Score: 1 of 1 A. Desensitization B. Sensate Focus C. Exposure Therapy D. Dialectic Behavioral Therapy

B. Sensate Focus

A 43-year-old woman seeks therapy for anxiety and depression following the death of her sister. Over the course of therapy the client discloses that her husband is emotionally abusive and she is sure he is having an affair. After working with a client for three months, the therapist realizes that the client's husband works at the same company as the therapist's husband. How should the therapist proceed in this case? Score: 1 of 1 A. Review the importance of boundaries with the client. B. Share the information with the client and discuss the impact. C. Seek consultation for countertransference related to information. D. Refer the client to another therapist due to the boundary issue.

B. Share the information with the client and discuss the impact.

A 83-year-old man has been in therapy for six months following the death of his wife. One session he informs the therapist that he recently changed his will, making the therapist the beneficiary of his estate. He states, "You have been so kind to me, you know me better than anyone." How should the therapist clinically manage the ethical issue presented in this vignette? Score: 1 of 1 A. Inform the client that this is a boundary violation. B. Tell the client it is flattering but it is inappropriate due to the nature therapeutic relationship. C. Explain this would be a dual relationship. D. Assist him in finding a charity that could become the beneficiary.

B. Tell the client it is flattering but it is inappropriate due to the nature therapeutic relationship.

A therapist in private practice decides to join two insurance panels in order to build his practice. He invests in an on-line record keeping system that includes electronic billing to insurance. He learns that he must become HIPAA compliant, as he will be a covered entity once he starts billing insurance electronically. Which of the following is required under HIPAA Privacy Rules? Score: 1 of 1 A. The Notice of Privacy Practices must be kept in clients' files. B. The Notice of Privacy Practices must be provided to the clients prior to the onset of therapy. C. The Notice of Privacy Practice must be verbally discussed with the clients prior to the onset of therapy. D. The Notice of Privacy Practices may be displayed in the therapist's office.

B. The Notice of Privacy Practices must be provided to the clients prior to the onset of therapy.

Jim, age 31, and Tina, age 32, seek therapy for intimacy issues. Tina tearfully tells of Jim's lack of affection over the past year. He can't control the amount of time he spends on the Internet at work or at home. Tina says angrily, "I can't keep living like this! He is spending all our money on porn sites. You can fix him right? What will our friends and family think if they knew that we have to come to therapy?" Tim looks out the window as she speaks. What clinical issues should the therapist address with the couple in this initial session? Score: 1 of 1 A. The costs and benefits of internet pornography and when the issue started. ` C. Their reasons for seeking help at this time and the limits of confidentiality. D. Their values and beliefs about intimacy in their relationship and how they've coped with this conflict in the past.

B. Their expectations of therapy and their feelings about seeking help.

Michael, a 25 year-old African-American man, is court-ordered to therapy after being released from prison, where he spent time for selling drugs. Michael states that he is only there because he is required to come. Under his breath he says, "The whole system is rigged against the black man." How should the therapist respond to the client in this case? Score: 1 of 1 A. "Tell me what you mean by 'This whole system is rigged against the black man.'" B. "How have you been adjusting to life outside of prison?" C. "I imagine you've experienced a lot of racism." D. "It is up to you how much you get out of therapy."

C. "I imagine you've experienced a lot of racism."

During a session with a 15-year-old client, she reports that she and her boyfriend have been having sex and she wants to go on birth control. The therapist reminds the client that she is a mandated reporter and will have to file a report if she learns that the boyfriend is what age? Score: 1 of 1 A. 18 or older B. 14 or under C. 21 or older D. 24 or older

C. 21 or older

Karen, a slightly overweight 13-year-old girl, is referred for therapy by her teacher. Parents, Brad and Nina, attend the first session with Karen. Nina shares that her daughter has complained about going to school since they moved to town a month ago. Brad adds that she used to be excited to hang out with the family and now she just wants to be alone in her room. He adds, "You can fix her, right?" Karen glares at her father and says, "Fix me? You're the ones who needs help". How should the therapist clinically manage the ethical responsibilities in this case? Score: 1 of 1 A. Address clients' expectations for treatment; Discuss risks and benefits of being in therapy; Set fees prior to the first session. B. Manage the fee; Determine who the client is and the nature of the therapist's relationship with the parties involved in treatment; Provide referrals if family decides not to continue therapy C. Address clients' expectations for treatment; Inform clients of the limits of confidentiality; Determine who the client is and the nature of the therapist's relationship with the parties involved in treatment. D. Address clients' expectations for treatment; Manage the fee; Obtain a signed release from each of them prior to speaking with Karen's teacher. Question 2

C. Address clients' expectations for treatment; Inform clients of the limits of confidentiality; Determine who the client is and the nature of the therapist's relationship with the parties involved in treatment.

A newly licensed therapist moves next door to a former supervisor. Their supervision relationship terminated four months ago. They have children the same age. The therapist is interested in meeting socially with the former supervisor and her children. How should the former supervisor respond? Score: 1 of 1 A. Discuss the importance of professional boundaries. B. Explain that it would be unprofessional. C. Agree to meet if the supervisor is interested. D. Seek consultation about the issue.

C. Agree to meet if the supervisor is interested.

A long-term client with depression and a history of trauma has recently become unemployed and cannot afford to pay the full fee. The therapist believes that the client is in need of further therapy, especially under the current circumstances. What should the therapist do FIRST? Score: 1 of 1 A. Continue to provide services without fees until the client is able to pay. B. Discuss how the client can budget in order to pay fee. C. Arrange for a reduced fee for the client based on income. D. Provide a referral to a low-fee agency.

C. Arrange for a reduced fee for the client based on income.

Melissa is a 44 year-old single mother of three children, Kristin age 17, Julie age 14, and Brad age 12. Melissa reports that Kristin is highly disruptive at home and at school and she suspects that she is using drugs and alcohol. She notes that Julie and Brad have become more withdrawn in response to Kristin's behavior and they spend most of their time at home in their rooms. How would a Strategic Family therapist intervene in the middle phase of treatment? Score: 0 of 1 A. Request that the children sit together in the session and ask Melissa and Kristin to take turns starting their fights. B. Identify times when Kristin wasn't disruptive and encourage the family not to change. C. Ask Kristin to be extra disruptive every other night and ask Melissa and Kristin to take turns starting their fights. D. Ask each family member to describe what they want from therapy and encourage the family not to change.

C. Ask Kristin to be extra disruptive every other night and ask Melissa and Kristin to take turns starting their fights.

A therapist receives a subpoena from a local law firm regarding a lawsuit in which the therapist's former client is a defendant. The therapist calls the client but is unable to reach him and leaves a voice message to contact the therapist as soon as possible. At this point, what action should the therapist take? Score: 1 of 1 A. Schedule the deposition. B. Call the law firm and discuss the case. C. Assert privilege. D. Contact the court and request that the subpoena be revoked.

C. Assert privilege.

A family of three presents for treatment after being referred by a family friend. Lucas, 42, states that he has recently announced to the family that he is transgender and would like to begin his transition in the near future. His wife, Amelia, 35, tells the therapist that she has been completely numb since receiving her husband's news, unable to imagine what her life is going to be like. Their son Ethan, 14, reveals his latest involvement with oxycodone. "Once kids at school learned about my dad, the ridicule has not stopped. And my parents are so preoccupied with their own problems that nobody even notices that I am high most of the time." What initial interventions should the therapist consider in the case presented in the vignette? Score: 1 of 1 A. Encourage couple to practice active listening; encourage Ethan to seek substance abuse treatment; explore Amelia's reaction towards Lucas' transition. B. Arrange to interview each member separately; encourage Ethan to seek substance abuse treatment; assess Amelia for symptoms of depression. C. Assess Ethan for suicidal ideation and intervene accordingly; provide Lucas with appropriate referrals to support his transition; assess Amelia for symptoms of depression. D. Assess Ethan for suicidal ideation and intervene accordingly; provide Amelia with a referral to a support group for people whose spouses are transitioning; set Lucas up with individual therapy.

C. Assess Ethan for suicidal ideation and intervene accordingly; provide Lucas with appropriate referrals to support his transition; assess Amelia for symptoms of depression.

A 36-year-old client seeks therapy after a recent divorce from his wife of four years. He explains that the main disagreement that pulled him and his wife apart was about having kids. His ex-wife wanted children but he did not. He works in a legal department of a large corporation, but finds his work to be unfulfilling and draining. He noted that it deadens him on the inside. He shares that he doesn't have much of a social life, rarely goes out, and frequently drinks himself to sleep. After establishing a therapeutic alliance with the client, how would an Adlerian therapist proceed? Score: 1 of 1 A. Assess for suicidal ideation; Explore client's expectation of therapy; Identify positive relationships client currently has. B. Explore client's expectation of therapy; Refer client to Alcoholics Anonymous; Encourage client to use alternative coping strategies. C. Assess for suicidal ideation; Explore family dynamics of early childhood; Inquire about client's early memories. D. Explore client's expectation of therapy; Explore family dynamics of early childhood; Inquire about client's early memories.

C. Assess for suicidal ideation; Explore family dynamics of early childhood; Inquire about client's early memories.

A therapist is working at a community center that treats the homeless population. A client and her three-year-old daughter are assigned to the therapist for clinical case management services. The mom reports she has been feeling depressed since she lost her job and was evicted from her apartment. She starts crying when she says that she is not getting along with her family. She asks for help getting childcare. What task should the therapist focus on initially? Score: 0 of 1 A. Finding stable housing. B. Exploring her relationship with her family. C. Developing a comprehensive care plan. D. Validating the client's feelings of depression.

C. Developing a comprehensive care plan.

Parents of a 6-year old are referred to the therapist by the teacher who reports that the child is struggling to complete the coursework and frequently acts out in class. The parents are confused and report that the child is healthy and well behaved at home. The therapist obtains an authorization from the parents to speak to the teacher and the teacher confirms the parents' description. How should the therapist proceed with the parents: Score: 0 of 1 A. Provide psychoeducation about ADHD. B. Refer the child to a psychiatrist for medication evaluation. C. Encourage the parents to get psychological testing. D. Recommend that the parents switch teachers.

C. Encourage the parents to get psychological testing.

A 28-year-old Asian American graduate student seeks treatment for anxiety and depression. She reports that for the past three months she has been unable to concentrate, is unable to sleep and cannot complete her coursework on time. She is worried she will be kicked out of the university and everyone will see she's a failure. What interventions would a Cognitive Behavioral Therapist utilize during the initial session of treatment? Score: 1 of 1 A. Explain how therapy works; Explore client's relationship with parents; Assess for suicide. B. Teach client how thoughts influence behaviors; Assign thought-stopping homework; Assess for suicide. C. Explain how therapy works; Teach client how thoughts influence behaviors; Assess for suicide. D. Explain how therapy works; Teach client how thoughts influence behaviors; Provide client with a journal to track negative thoughts.

C. Explain how therapy works; Teach client how thoughts influence behaviors; Assess for suicide.

A male therapist has been meeting with a recently divorced female client for several months. During a session, the client shares that she is attracted to the therapist. The therapist recently sought consultation because he found himself attracted to the client. How should a psychodynamic therapist respond? Score: 0 of 1 A. Discuss the need to refer the client to a different therapist. B. Identify the client's feelings as a transference from her ex-husband. C. Explore the client's feelings and discuss the limits of therapeutic boundaries. D. Continue to seek consultation from a colleague and refer client out.

C. Explore the client's feelings and discuss the limits of therapeutic boundaries.

A 25-year-old man has been meeting with a theRapist for several months. He has tears in his eyes as he reports to the therapist that his girlfriend of three years broke up with him over the weekend. He tells the therapist that he is beside himself and doesn't think he will ever have a healthy relationship. He explains that he tried to make the relationship work, but his girlfriend was always disappointed in him. He states, "I am such a loser and will be alone the rest of my life. I can't handle this anymore." How would a Cognitive Behavioral therapist intervene in the middle stage of treatment? Score: 1 of 1 A. Identify the types of cognitive distortions the client is using and challenge the client's negative thoughts. B. Teach the client to track his thoughts and develop healthier, alternative thoughts. C. Have the client examine the evidence that supports his negative beliefs as well as the evidence that contradicts these thoughts. D. Have the client identify times in his life when he had healthy relationships and did not feel like a "loser."

C. Have the client examine the evidence that supports his negative beliefs as well as the evidence that contradicts these thoughts.

Helen, a 61-year-old woman referred by her medical doctor, is having difficulties adjusting to a below-the-knee amputation due to complications from diabetes. A note from her doctor indicates that Helen has elevated blood sugars and inconsistently follows her eating plan and medication regimen. Initially, Helen is very animated, speaking rapidly and using expansive gestures. She becomes irritable when asked how she is feeling but admits that she has no appetite and isn't sleeping well at night. Upon further discussion of her medical condition, Helen becomes tearful and states, "I can't keep track of this disease. It's just too much! I'm afraid I am going to get depressed again." What clinical issues require further assessment in the case provided in the vignette? Score: 0 of 1 A. Helen's social isolation; Suicide potential for Helen; Helen's preoccupation with physical challenges and limitations. B. Helen's understanding of her medical issues; Socioeconomic stressors affecting Helen; Helen's mental status. C. Helen's psychiatric history; Suicide potential for Helen; Helen's mental status. D. Helen's substance use; Socioeconomic stressors affecting Helen; Helen's mental status.

C. Helen's psychiatric history; Suicide potential for Helen; Helen's mental status.

A therapist is working with a family with three children, the youngest of whom, age 12, is in a wheelchair because of cerebral palsy. The parents describe the child's withdrawal from outside activities and believe that he is depressed. The child remarks that his mother hovers over him, and that his siblings dislike him because he has no chores at home. He expresses an interest in staying with a cousin over Christmas break and says he wants more responsibility at home. What should the therapist do FIRST? Score: 1 of 1 A. Support the mother's understandable need to be protective. B. Focus on the 12-year-old's need for greater self-esteem. C. Help the family address the 12-year-old's expressed needs. D. Suggest the family explore outside activities for the 12-year-old.

C. Help the family address the 12-year-old's expressed needs.

A therapist, who also works as a real estate agent is working with a couple with relationship issues. The couple is planning to sell their house and the therapist has been giving them advice about various strategies to increase the value of their home and has offered to list the house. The therapist's behavior is: Score: 1 of 1 A. Acceptable because he has the training. B. Acceptable if the therapist terminates current therapeutic relationship. C. Illegal and unethical. D. Illegal.

C. Illegal and unethical.

A private practice group is hiring an intern. An unlicensed MFT applies. Her current therapist would be one of her supervisors. The therapist informs the client that it would create an inappropriate dual relationship. The client claims the dual relationship wouldn't bother her and she really wants to work there. How should the therapist proceed? Score: 1 of 1 A. Discuss termination with client and provide referrals to therapists outside of the practice. B. Discuss possible risks of the dual relationship. C. Inform client that it would be an ethical violation to hire her and process the rejection. D. Consult with a colleague about the dilemma.

C. Inform client that it would be an ethical violation to hire her and process the rejection.

During a family therapy session, the therapist notices that both the 6-year-old and the 4-year-old children have bandages on their hands. The mother discloses tearfully that she can't trust her 15-year-old stepson to stay alone with her young children because he super-glued their hands to his door. The husband shakes his head and says, "We already dealt with this. It won't happen again." What should the therapist do NEXT: A. Find out how they dealt with it. B. Document the incident in your notes. C. Inform the family that you must file a child abuse report. D. Ask if other incidents like this have happened before.

C. Inform the family that you must file a child abuse report.

A 22-year-old client struggling with depression is driven to her third therapy session by her mother. The client reports that her parents are really worried about her and want her to move home. The therapist and the client weigh the pros and cons of moving back in with her parents and the client decides she wants to try living on her own a little longer. At the end of the session, the client's mother enters the office and asks to see the therapist's notes on the session. How should the therapist respond? Score: 0 of 1 A. Schedule a joint meeting with the client to discuss the records. B. Ask the mother to write a request for disclosure of the records. C. Inform the mother of the requirements for disclosure. D. Explain that the records are the property of the client.

C. Inform the mother of the requirements for disclosure.

The mother of a 14-year-old client calls the therapist prior to a session and requests a copy of the client's record. During the session the client starts crying and states that she thought everything she said was confidential and she knows her mom would be really hurt if she knew she talked about her. She adds, "I don't want to keep coming if they are going to be able to see everything we talk about". How should the therapist address the parents' request? Score: 1 of 1 A. Inform the client that her parents have a legal right to see her files. B. Provide the parents with a copy of the records and process client's feelings about it. C. Inform the parents they cannot have access to the records because it would negatively affect the therapeutic relationship. D. Inform the parents they cannot have access to the records because it would put the client in danger.

C. Inform the parents they cannot have access to the records because it would negatively affect the therapeutic relationship.

For the past year, a 21-year-old male college student reports feeling irritable, arguing with his roommates and girlfriend, and having difficulty sleeping and studying. The client reports occasionally drinking a few beers but has not done so in the past month. The client is MOST likely exhibiting: Score: 1 of 1 A. Substance Induced Mood Disorder B. Adjustment Disorder with Depressed Mood C. Major Depressive Disorder D. Persistent Depressive Disorder

C. Major Depressive Disorder

A 23-year-old woman seeks therapy for relationship issues. When she arrives at the first session she is visibly underweight with pale skin and thin hair. During the intake it is clear that the client suffers from Anorexia Nervosa. What resources should be included when formulating the treatment plan? Score: 0 of 1 A. Medical stabilization; Pharmacotherapy; Peer support B. Pharmacotherapy; Nutritional rehabilitation; Cognitive Behavioral Therapy C. Medical stabilization; Nutritional rehabilitation; Cognitive Behavioral Therapy D. Nutritional rehabilitation; Peer support; Psychodynamic psychotherapy

C. Medical stabilization; Nutritional rehabilitation; Cognitive Behavioral Therapy

A mother brings her 15-year-old daughter to therapy after learning that her daughter is pregnant. The mother informs the therapist that an abortion is out of the question because of their religious beliefs, but she does not think the daughter should keep the baby. The mother tells the therapist she wants to place the baby for adoption because she is in ill health and cannot help her daughter raise the baby. How should the therapist initially address the daughter's pregnancy? Score: 1 of 1 A. Meet with mom and daughter separately to explore how they each feel about adoption. B. Educate clients about the process of adoption and provide a referral to a family planning agency. C. Meet with the daughter separately to explore her feelings about the pregnancy and provide clients with appropriate referrals. D. Ask the daughter how she feels about adoption and provide clients with appropriate referrals.

C. Meet with the daughter separately to explore her feelings about the pregnancy and provide clients with appropriate referrals.

A client who has been in therapy for two years for depression has been symptom free for four months. During the final scheduled session, she begins crying and states that she is afraid her depression will come back without therapy. How should the therapist address her concern: Score: 1 of 1 A. Schedule another session in a week. B. Discuss extending treatment until client is more stable. C. Normalize her feelings and make a plan if symptoms return. D. Provide client with referral to support group for depression.

C. Normalize her feelings and make a plan if symptoms return.

A therapist is working with a family with three children, ages, 7, 9 and 15. The parents are concerned that the 15-year-old daughter does not want to participate in family activities and wants to spend time in her room or with her friends. They share that they are concerned she is depressed and are worried she may disengage from school. What should the therapist do FIRST? Score: 0 of 1 A. Obtain a release to speak to the school. B. Refer the 15-year-old for a medication evaluation. C. Provide psychoeducation about normal adolescent development. D. Encourage parents to share their concerns directly with their daughter.

C. Provide psychoeducation about normal adolescent development.

A therapist at a community mental health agency meets with the parents of an 8-year-old boy who has a life threatening illness. The parents are declining appropriate medical treatment for their son because it goes against their religious beliefs. The child is receiving some care within the guidelines of their church's ministry but the child's condition is progressively worsening. How should the therapist respond to this dilemma? Score: 1 of 1 A. Consult with a colleague who has familiarity with the religion and determine if their behavior is in line with the religious doctrines. B. Not report the situation because the family's religious values and right to self-determination restrict the therapist's actions. C. Report the situation to child protective services and process the report with the family. D. Explore the parent's willingness to take actions in the best interest of the child and determine if a report to child protective services is necessary.

C. Report the situation to child protective services and process the report with the family.

A single mother informs the therapist that she was offered a promotion within her company, but the new position would require she move to another state where she doesn't have any friends or family. She asks the therapist to assist her in finding childcare for her 3-year old. She adds that, although she is leaning toward accepting the new position, she thinks it could be easier to remain in her present living arrangement with her parents until the child is older. The therapist feels strongly that the client should stay. Given the client's desire to move, how should the therapist respond? Score: 1 of 1 A. Respect the client's decision and help her identify child-care options. B. Suggest a family session with client's parents to explore the pros and cons of her options. C. Respect the client's right to self-determination, and explore the pros and cons of her options. D. Share therapist's concerns, explore the pros and cons of her options.

C. Respect the client's right to self-determination, and explore the pros and cons of her options.

A therapist is utilizing a brief, six-week crisis intervention model with client who is referred by his Employee Assistance Provider following a break in at his company. The client reports that his girlfriend of seven months recently broke up with him and he was forced to move out of their shared apartment. What treatment goal is most appropriate in this case? Score: 0 of 1 A. Improve the client's coping skills. B. Develop insight into how the client's past is impacting the current situation. C. Restore the client to his previous level of functioning. D. Increase the client's social support system.

C. Restore the client to his previous level of functioning.

During the middle phase of therapy with an adult male client, a therapist finds herself having sexual fantasies about the client. The therapist is married and is disturbed by these fantasies. As a result, the therapist becomes aware of heightened anxiety before seeing the client. How should the therapist ethically manage this situation? Score: 0 of 1 A. Refer the client to another therapist. B. Discuss the situation with the client. C. Seek consultation immediately. D. Begin personal psychotherapy.

C. Seek consultation immediately.

A Chinese-speaking therapist moves to a new city with a relatively large Chinese American population. The therapist would like to market her mental health services to the Chinese population. What factor tends to be the largest barrier to Asian-Americans utilizing mental health services? Score: 1 of 1 A. Lack of insurance B. Language issues C. Shame and stigma D. Reliance on traditional medicine

C. Shame and stigma

After the fourth session of couple's therapy, a woman calls the therapist after finding sexually explicit reading material, which her boyfriend left out in their bedroom. The therapist's best response is to: Score: 1 of 1 A. Ask the woman if she would like an individual appointment to discuss this. B. Suggest that the woman get her boyfriend to call the therapist for an individual appointment. C. Suggest that the woman present her concern at their next appointment. D. Ask the woman how this made her feel.

C. Suggest that the woman present her concern at their next appointment.

A 38-year-old husband and 36-year-old wife seek marital counseling after the birth of their first baby. The wife left her job as a lawyer to stay home with the baby. She shares that she "gets no help from her parents" because her father is deceased and she's been estranged from her mother since her parents got divorced. She adds that her husband's parents are overbearing and always in their business. The husband states that all his wife cares about now is the baby and she never pays attention to him. What interventions would a Bowenian therapist use in the beginning phase of treatment? Score: 0 of 1 A. Facilitate enactments of the common arguments; Interpret the mother's engagement with the baby as avoidance to marital problems. B. Create a multigenerational family map of relationships; Interrupt arguments. C. Teach "I" statements; Encourage reunification of wife with her mother. D. Create a multigenerational family map of relationships; Encourage reunification of wife with her mother.

C. Teach "I" statements; Encourage reunification of wife with her mother.

A 42-year-old female client seeks therapy at the urging of her partner. The client is late to the first session and appears disheveled. The client begins crying and reports that she is distraught about the recent loss of her 82-year-old mother. How would a Client Centered therapist proceed in this case: Score: 1 of 1 A. Express sympathy for the client's loss and assess for danger to self. B. Use body language to communicate empathy and provide psychoeducation about grief reactions. C. Use reflective listening to explore her reaction to her mother's death. D. Relate a personal experience of loss if it is similar to the client's experience.

C. Use reflective listening to explore her reaction to her mother's death.

A pediatrician refers the parents of a 10-year-old boy to therapy shortly after the boy was diagnosed with diabetes. The parents report the family is facing financial problems, and numerous other challenges that are causing them significant stress. The mother begins crying, sharing she is so overwhelmed by the challenges they are facing and feels guilty about her son's diagnosis. Considering the various problems the family is confronting, the therapist should consider which of the following actions? Score: 1 of 1 A. Offer to work individually with the son to address his emotional response to the diagnosis. B. Offer to work with the mother and son to address feelings of guilt and stress related to the recent diagnosis and other stressors. C. Validate the parents' emotional responses to their different stressors and help them prioritize treatment goals. D. Schedule a session to meet with the entire family to determine if family or individual therapy is necessary.

C. Validate the parents' emotional responses to their different stressors and help them prioritize treatment goals.

A family is referred by their minister for family therapy due to conflict between the parents regarding how to discipline their 5 and 7 year-old boys. During the initial assessment the therapist learns that the mother drinks alcohol daily. There is no indication of domestic violence or child abuse. Which of the following interventions should the therapist take FIRST? Score: 1 of 1 A. Involve the family in creating a family map of their problem. B. Obtain a release to speak with their minister. C. Work with the mother regarding her need for an alcohol use assessment. D. Conduct a comprehensive assessment of the family members.

C. Work with the mother regarding her need for an alcohol use assessment.

A 40 year-old accountant is referred by his Employee Assistance Program. He reports irritability, moodiness, and extreme fatigue. He shares that it is affecting his work performance and his relationships with his family. He adds, "I'm tired of not feeling like myself. I want to get better." The therapist should FIRST: Score: 0 of 1 A. Refer him to couples therapy. B. Assess for suicidal ideation. C. Rule out substance use issues. D. Ask when he had his last full physical.

D. Ask when he had his last full physical.

A recently licensed therapist calls a colleague for marketing advice. The therapist wants to know if it is permissible to write the term "psychotherapist" or "psychotherapy" on his business card. How should the colleague respond? Score: 0 of 1 A. It is not legally permissible to write "psychotherapist" or "psychotherapy." B. Yes, if full name, abbreviated license title and license number is included. C. Yes, if full name and complete title and license number is included. D. Both B and C are permissible.

D. Both B and C are permissible.

A therapist is meeting with a 68-year-old man following the death of his spouse. The man has a history of severe depression and is currently being closely monitored by the therapist for risk of suicide. His son has been living with him since the death of his wife and has taken charge of the finances. The client tells the therapist that this will be his last session since the son decides how the money should be spent and no longer feels the man should receive therapy. The man tells the therapist he feels powerless and scared, and expresses a continued need for therapy. The therapist should: Score: 1 of 1 A. Validate client's feelings about termination and explore alternative no-fee therapy options. B. Call APS immediately and file a written report of elder abuse within 24 hrs. C. Offer to meet with the client and son together to discuss the need for ongoing therapy. D. Call APS immediately and file a written report of elder abuse within 2 days.

D. Call APS immediately and file a written report of elder abuse within 2 days.

A 42-year-old African American dentist is referred for therapy by his minister for anger issues. He has been married for 8 years and his wife and him have 2 little kids. He reports that he "blows his top" when his 4-year-old and 6 year-old talk back to him. He cannot stand it when they give him attitude or do not immediately do what he asks of them. He shares that his father was a violent drunk who used to slap the client across his face any time he would misbehave. The client states that he has never physically hurt his kids, but he has thoughts that scare him when he gets really angry. How would a Solution Focused Therapist develop an initial treatment plan? Score: 0 of 1 A. Incorporate cultural issues into focus of treatment; ask when the anger problem began. B. Assist the client in articulating the problem he wants to address; inquire about the client's early recollections of his father's anger. C. Ask the client to describe a recent situation where he got angry in order to understand the problem; ask the client what would be different in his life if he woke up tomorrow and the anger issue has been solved. D. Clarify with the client what he hopes to achieve in therapy; acknowledge the client's desire to be a better dad.

D. Clarify with the client what he hopes to achieve in therapy; acknowledge the client's desire to be a better dad.

A therapist is on a health insurance panel and receives notice that the insurance company is conducting a quality assurance audit on all client files seen in the past six months. They are requesting copies of the records of all clients utilizing their insurance plan. How should the therapist respond to the request? Score: 0 of 1 A. Obtain a release of information from the clients. B. Assert privilege on behalf of the clients. C. Notify all the clients of the content of their notes. D. Comply with the request in a timely manner.

D. Comply with the request in a timely manner.

Alice, age 14, is brought to therapy by her mother, Joan, after she reported having thoughts of killing herself. Joan is a single mother to Alice and Jill, age 16. Alice refuses to go to school, is often irritable and frequently argues with her mom and sister. Joan reports that Alice has cut herself in the past. Joan also shares that she herself is on medication for bipolar disorder. How would a Bowen Family Therapist assess the intergenerational issues related to the crisis issues in this case? Score: 1 of 1 A. Maintain a nonanxious presence; Role model a clear sense of differentiation; Identify triangles with present and/or extended family members B. Construct a genogram related to suicide, defiant behavior and mental health issues; Determine whether family members can distinguish thoughts from feelings; Identify triangles with present and/or extended family members C. Maintain a nonanxious presence; Teach family members how to use "I" statements; Identify each member's sibling position D. Construct a genogram related to suicide, defiant behavior and mental health issues; Explore emotional cutoffs between present and extended family members; Identify multigenerational patterns of parenting and rebellion

D. Construct a genogram related to suicide, defiant behavior and mental health issues; Explore emotional cutoffs between present and extended family members; Identify multigenerational patterns of parenting and rebellion

Jeremy, a 14-year-old Asian-American boy, is referred for therapy by his school counselor. His mother, Sue, attends the initial session with him. She shares that her son has been having hard time adjusting to his new school. He attended a small private school for many years, but since his father lost his job they weren't able to afford it so he had to switch to a large public school. Jeremy states that he "hates going to school because he doesn't have any friends. " His mom replies that "school is about learning, not about friends." The therapist asks to meet with Jeremy alone and completes a risk assessment. How should the therapist handle the legal requirements if Jeremy reports having thoughts of suicide? Score: 1 of 1 A. Ask Jeremy to sign a no harm contract; Inform mother of Jeremy's suicidal thoughts. B. Obtain family history of depression; Initiate a 5150 if Jeremy has a plan to harm himself. C. Ask Jeremy about prior self-harm history; Refer Jeremy to a teen depression group. D. Determine if Jeremy has a plan; If Jeremy has a plan, determine whether he has the means.

D. Determine if Jeremy has a plan; If Jeremy has a plan, determine whether he has the means.

A 54-year-old married client with depression and anxiety has been meeting with a therapist for over a year. Early on in therapy, he brought his wife in for a collateral session. Since they've already met, he asks the therapist to contact his wife to invite her back for an additional collateral session and to discuss his need for additional support from her. The client explains that he feels his wife would listen to the therapist better than she would listen to him. How should the therapist respond to this request? Score: 1 of 1 A. Offer to invite the wife for a collateral session so the client can directly discuss his need for additional support. B. Encourage the client to invite his wife for a collateral session. C. Call the wife and present the client's request for a collateral session and need for additional support. D. Explore client's difficulty communicating his needs and help identify strategies he can use to engage her.

D. Explore client's difficulty communicating his needs and help identify strategies he can use to engage her.

A new client is referred by her minister. The 49 year-old woman shares that she is overwhelmed taking care of her 72 year old mother who is often belligerent due to her dementia. The woman tearfully admits to giving her mother extra medication so that she will sleep longer. She asks for a referral to a support group for caregivers. What should the therapist do initially in this case? A. Provide a referral to a caregiver support group. B. Further assess for Elder Abuse. C. Assist her in developing alternative coping mechanisms. D. File a report with Adult Protective Services and process it with client.

D. File a report with Adult Protective Services and process it with client.

A 38-year-old woman seeks therapy for stress related to parenting and family conflict. In the sixth session the patient complains that she and her husband are upset because the patient's mother-in-law recently disciplined her 2-year child with spankings that left red marks. The patient is very upset and doesn't know how to approach her mother-in-law about the incident. How should a Cognitive Behavioral therapist clinically manage the legal issues in this case? Score: 1 of 1 A. Explore the client's underlying beliefs related to her reluctance to approach her mother-in-law. B. Inform the client that a child abuse report must be filed and explain to her what will happen. C. Assess how client has handled conflicts about discipline with mother-in-law in the past. D. Inform the client that child abuse must be reported and process her reaction.

D. Inform the client that child abuse must be reported and process her reaction.

A recently married couple, Marcus, an Asian American age 31, and John, a Caucasian age 28, are referred by Marcus's health insurance panel. John tearfully tells of Marcus's lack of affection over the past few months and adds that Marcus has been spending a lot of "extra time" at work with a new co-worker. Marcus shakes his head and says, "I'm tired of dealing with his paranoia. He's depressed! I am tired of him calling me at work and telling me he wants to die. I can't take it anymore." What ethical responsibilities does the therapist have based on the case provided in the vignette? Score: 0 of 1 A. Manage the fee; Assess for John's suicide ideation; Review the limits of confidentiality. B. Manage confidentiality with insurance carrier; Inform couple that the therapist does not keep "secrets"; Identify expectations of treatment for both Marcus and John. C. Manage the fee; Assess for John's suicide ideation; Obtain consent to treat from the insurance provider. D. Inform the couple of the "no secrets" policy; Assess for John's suicide ideation; Identify expectations of treatment for both Marcus and John.

D. Inform the couple of the "no secrets" policy; Assess for John's suicide ideation; Identify expectations of treatment for both Marcus and John.

Juan, a 24-year-old Hispanic male, is court-mandated to therapy as part of his conditions of parole. He was recently released after spending three years in prison for a felony assault charge. Juan reports a history of alcohol, crack, and crystal meth use. He shares that he has heard voices in the past and that is why he attacked a lady at the mall. He is currently in a halfway house and taking psychotropic medications. He states "I can't find a job, no one wants to hire a high school dropout. It was easier when I was locked up. All my friends are still in there. I don't want to get out of bed in the morning, there's no point. If my parole officer keeps riding me, I don't know what I'll do." Angrily he adds, "I don't see how therapy is going to help." What adjunctive resources should the therapist consider utilizing initially with Juan in this case? Score: 1 of 1 A. GED program; MD; Substance abuse treatment center. B. Vocational skills center; Depression support group; Psychiatrist. C. MD; Narcotics Anonymous; Depression support group. D. Narcotics Anonymous; Vocational skills center; Psychiatrist.

D. Narcotics Anonymous; Vocational skills center; Psychiatrist.

Kayla, age 15, is brought in for therapy by her Aunt Lynda who was given legal custody following the death of Kayla's mother three years ago. Lynda reports that Kayla is "running with the wrong crowd", has been skipping school and is lying to her about where she goes at night. Lynda states, "She told me that she was at her friend's house, but I went over there and nobody was home. I just can't trust her anymore." Kayla rolls her eyes and responds "Don't pretend like you care. I'm not afraid of you anymore." What legal obligations does the therapist have in the case described in this vignette? Score: 1 of 1 A. File a child abuse report; Request documentation to verify custody; Obtain a release to speak to school counselor. B. Set fee before the onset of therapy; Explore expectations of therapy; Assess for child abuse. C. Obtain signed informed consent to treat a minor; File a child abuse report; Set fee prior to the onset of therapy. D. Obtain signed informed consent to treat a minor; Set fee prior to treatment;Assess for child abuse.

D. Obtain signed informed consent to treat a minor; Set fee prior to treatment;Assess for child abuse.

A married couple in their 30's seeks therapy to improve their communication. The husband reports that he wants to have children but complains that his wife "wants to wait." The wife tears up when she shares that her mother recently died and that her husband expects her to "get over it already." During the initial assessment, they report that their arguments frequently get physical because the wife makes the husband so mad. How should the therapist proceed in this case: A. Discuss the ways in which the wife makes the husband mad. B. Explore the couple's motivation to stay together and their expectations of therapy. C. Require the couple to sign a no violence contract to ensure they won't get violent in the session. D. Refer each of them to individual therapy.

D. Refer each of them to individual therapy.

A therapist has a signed release to speak to a child's teacher about his behavior at school. During the phone call, the teacher asks questions about the parents' relationship and whether the therapist thinks that is affecting the child. The therapist should: Score: 1 of 1 A. Explore why teacher thinks this. B. Provide information about the nature of the parents' relationship. C. Encourage teacher to bring up concerns with parents. D. Remind teacher of the scope of the release of information.

D. Remind teacher of the scope of the release of information.

A mother brings her 11-year-old daughter for therapy following a contentious divorce. The mother explains that she is worried about her daughter because she has been isolating herself and crying a lot. The mother states that the father does not believe in therapy. How should the therapist legally proceed in this case? Score: 1 of 1 A. Obtain signed informed consent to treat from mother. B. Explain that the father must agree to treatment. C. Offer to speak to the father. D. Request a copy of the custody agreement.

D. Request a copy of the custody agreement.

A Caucasian therapist is working in a community agency providing individual therapy to teens struggling with substance abuse. The majority of clients at the clinic are Latino and African American. Over the course of therapy with an African American client, the therapist becomes aware that the client has strong negative beliefs toward Latinos and begins to feel uncomfortable in sessions with him. The therapist should: Score: 1 of 1 A. Explore origin of client's beliefs; determine whether the client has been a victim of racism; and seek consultation. B. Educate the client about the negative effects of racism and seek consultation. C. Confront the client about his beliefs and explore the origins of his beliefs. D. Respect the client's beliefs; focus on the presenting problem; and seek consultation.

D. Respect the client's beliefs; focus on the presenting problem; and seek consultation.

A client is referred to the therapist after being discharged from the psychiatric hospital. The records indicate that he has been hearing voices for the past four months and he believes he is being followed. According to the DSM 5 criteria, the most likely diagnosis for the client is: Score: 0 of 1 A. Brief Psychotic Disorder B. Schizophrenia C. Schizoaffective D. Schizophreniform

D. Schizophreniform

A therapist has been seeing a client intermittently for two years, and they have a strong relationship. The client is often fearful and suspicious of new situations. The focus of interventions has been to promote client's independence and personal decision-making. The client recently learned of an opportunity to move into a group home that offers better social support than the current living arrangement. The client is reluctant to discuss the new housing option and reports being worried about making a change. The therapist asks the client to tour the home and see what it is like before rejecting it. Because he trusts the therapist, the client agrees. What are the ethical implications of the therapist's actions in this case? Score: 1 of 1 A. The therapist is acting unethically by imposing the therapist's values onto the client. B. The therapist is acting ethically by assisting the client to compartmentalize his concerns, making them more manageable. C. The therapist is acting ethically by empowering the client through the process of self-determination. D. The therapist is acting ethically by using the therapist/client relationship as an intervention tool.

D. The therapist is acting ethically by using the therapist/client relationship as an intervention tool.

A therapist specializes in adolescent substance abuse treatment. She creates a website about her practice and solicits testimonials from former clients to include in the brochure. She has the clients sign a release to share their testimonial. The therapist's actions are: Score: 1 of 1 A. Acceptable because she obtained a release. B. Acceptable if she changes the identity of the clients. C. Unethical because the clients are minors. D. Unethical because she solicited testimonials.

D. Unethical because she solicited testimonials.