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NCMHCE
Questions and answers for the test
| Question | Answer |
|---|---|
| "Affective" | Mood + psychosis, with 2 weeks psychosis alone |
| "Brief" | Less than 1 month |
| "Delusional" | Greater than or equal to 1 month delusions only |
| "Form" | Less than 6 months |
| "Phrenia" | Greater than or equal to 6 months |
| Example of advanced empathyReflecting deeper meaning | feelings beyond what client states (e.g., “It sounds like underneath your anger, there’s hurt and fear of being rejected”). |
| What are the two types of schizoaffective disorder? | Bipolar type: if a manic episode has ever occurred (depressive episodes may also occur). Depressive type: only major depressive episodes are present. |
| 16-year-old withdrawn, failing grades, irritability, no mania. Possible diagnosis? | Major Depressive Disorder (adolescent presentation: irritability instead of sadness). Rule out substance use, Adjustment Disorder. |
| What is "splitting" in Object Relations Theory? | Defense mechanism where self/others are seen as "all good" or "all bad." Healthy development integrates both. |
| Which describes the difference between a hallucination and a delusion? | Hallucinations are false sensory perceptions, whereas delusions are beliefs held with strong conviction even though there is strong evidence against them |
| History of neglect or attachment issues at a young age Overly loose boundaries | Disinhibited Social Engagement d/o |
| Disorganized speech, hallucinations, and delusions lasting at least one day, but less than one month | Brief Psychotic Disorder |
| Grossly disorganized or catatonic behavior, disorganized speech, and hallucination for at least 6 months | Schizophrenia |
| One month or longer and criteria A for Schizophrenia have not been met. | Delusional d/o |
| Symptoms of delusions, hallucinations, and disorganized speech for less than 6 months. Her symptoms are consistent with: | Schizophreniform |
| Which is NOT a symptom of Schizotypal Personality Disorder? | Manic episode |
| Which treatment is best suited for Schizophrenia? | Medication and therapy |
| ACT | Acceptance, Mindfulness, Values Driven Behavior |
| ADHD in adults often co-occurs with which disorders? | Substance Use Disorders Mood Disorders (esp. Depression) Anxiety Disorders. |
| AUDIT: Alcohol Use Disorder Identification Test | Alcohol use screen |
| Acute Stress d/o | 3 days - 1 month |
| Acute Stress d/o | Less than 1 month |
| Adjustment d/o | 1 - 6 months |
| Adjustment d/o | Within 3 months onset, 6 months duration after stressor ends |
| Adlerian | Social interest, inferiority, birth order, encouragement, lifestyle assessment |
| Anxiety | -Big uncontrollable worry -Restlessness -Muscle tension -Can't concentrate -Fear of the future -Fear of losing self control -Irritability |
| Autism Spectrum Disorder (ASD) often co-occurs with which psychiatric conditions? | ADHD, Anxiety Disorders, Depression, and sometimes Intellectual Disability. |
| BAI: Beck Anxiety Inventory | Anxiety severity |
| BDI-2: Beck Depression Inventory 2 | Depression severity |
| BPD | Bipolar I or II, PTSD - Since both may involve emotional instability and impulsivity or Depressive Disorders |
| Behavior Therapy | Conditioning, Reinforcement, Exposure, Desensitization |
| Bipolar Disorder frequently co-occurs with which disorders? | Substance Use Disorders (esp. alcohol), Anxiety Disorders, and ADHD. |
| Bowen Family Systems | Differentiation, Triangles, Multigenerational Transmission, Genograms |
| Brief Psychotic Disorder | At least 1 but no more than 1 month... at least one of the following: - Delusions - Hallucinations - Disorganized Speech - Disorganized behavior (catatonia) |
| Brief Psychotic d/o | 1 day - less than 1 month |
| Brief psychotic d/o symptoms do not typically include.... | Diminished Emotional Expression |
| Somatic Symptom d/o | One or more distressing physical (somatic) symptoms (e.g., pain, fatigue, GI issues) that are disproportionately distressing or disruptive to daily life. |
| What is Depersonalization? | Feeling detached from one’s own self. Self feels unreal, robotic, or as if watching from outside. Examples: “I feel like I’m in a movie,” “My body parts don’t belong to me.” |
| What is Derealization? | Feeling detached from the external world. Surroundings seem dreamlike, foggy, distorted, or unreal. Examples: “The world looks fake,” “Everything feels dreamlike.” |
| Key difference between depersonalization and derealization? | Depersonalization = self is unreal Derealization = world is unreal |
| What disorder involves depersonalization and derealization? | Depersonalization/Derealization Disorder May include one or both experiences. Reality testing is intact (unlike psychosis). |
| How do depersonalization/derealization differ from psychosis? | In Depersonalization/Derealization Disorder: Reality testing is intact (the person knows their experience is unreal/strange). Symptoms involve detachment (self or environment). |
| How do depersonalization/derealization differ from psychosis? | In Psychosis: Reality testing is impaired (beliefs/hallucinations are accepted as real). Symptoms include delusions, hallucinations, and disorganized thinking. |
| Brief psychotic disorder | 1 day - 1 month |
| C-SSRS: Columbia Suicide Severity Rating Scale | Suicidal ideation/behavior |
| CAGE/CAGE AID: Cut down, annoyed, guilty, eye-opener AID: Alcohol and Drugs version | Alcohol and drug misuse (brief) |
| CAPS-5: Clinician Administered PTSD Scale for DSM 5 | Gold standard PTSD interview |
| CBCL: Child Behavior Checklist | Child behavioral/emotional problems |
| CBT (Beck/Ellis) | Thoughts, Feelings, Behavior, Cognitive Distortions, Homework |
| CDI-2: Children's Depression Inventory - 2 | Childhood depression |
| Conners CBRS/Conners 3 | Conners Comprehensive Behavior Rating Scale (including Conners 3 for ADHD behavior) / ADHD behavior |
| Core feature of Paranoid Personality Disorder? | Distrust and suspiciousness of others; interprets motives as malevolent. |
| Core feature of Schizoid Personality Disorder? | Detachment from social relationships and restricted emotional expression. |
| Core feature of Schizotypal Personality Disorder? | Acute discomfort in close relationships + cognitive/perceptual distortions + eccentric behavior |
| Covi Anxiety Scale | Brief clinician rated scale for anxiety severity |
| Criteria for Major Depressive d/o (MDD) | Greater than or equal to 5 symptoms in 2 weeks; at least depressed mood OR loss of interest. Symptoms: SIGECAPS (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidality, Mood). |
| Criteria for Major Depressive d/o (MDD) continued.... | Must cause distress/impairment. Not due to substances/medical. No history of mania/hypomania. |
| Cyclothymic d/o | At least 2 years adults, 1 year youth |
| DAST: Drug abuse screening test | Drug misuse (severity) |
| DBT (Linehan) | Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness |
| DSM-5 criteria for Adjustment Disorder | Emotional/behavioral symptoms in response to identifiable stressor Onset: within 3 months of stressor Distress out of proportion, impairment present Does not persist beyond 6 months after stressor ends |
| DSM-5 criteria for Generalized Anxiety Disorder (GAD) | Excessive worry, difficult to control Greater than or equal to 6 months, more days than not Greater than or equal to 3 symptoms (1 for kids): restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance |
| DSM-5 criteria for Generalized Anxiety Disorder (GAD) continued | Clinically significant distress/impairment Not due to substance/medical condition |
| DSM-5 criteria for PTSD (core features) | Exposure to trauma Greater than or equal to 1 intrusion symptom (memories, nightmares, flashbacks) Greater than or equal to 1 avoidance symptom Greater than or equal to 2 negative mood/cognition changes Greater than or equal to 2 |
| DSM-5 criteria for PTSD (core features) continued | arousal/reactivity symptoms (irritability, hypervigilance, sleep issues, startle response) Duration: Greater than 1 month Distress/impairment required |
| Delusional Disorder | 1+ month ... at least 1 delusion |
| Delusional disorder | Greater than or equal to 1 month |
| Dependent vs. BPD | Dependent - Very clingy, foregoing their own opinion to get a long and gain acceptance |
| Dependent vs. BPD | BPD - Somewhere between mid-level neurosis and mid-level psychosis, very reactive, very intense, opinions can go from favorable one minute to very negative the next and low-level paranoia. |
| Depression | -Hopelessness -Low mood -Low energy -Changes in sleep and appetite -Loss of interest -Low self esteem -Irritability |
| Difference between AUDIT and CAGE? | AUDIT = broader, covers hazardous drinking patterns; quantitative. CAGE = 4 items, rapid screen for alcohol dependence. |
| Difference between Paranoid PD and Delusional Disorder? | Paranoid PD has pervasive suspiciousness but is reality-based (no fixed psychotic delusions). |
| Difference between paraphrasing and summarizing | Paraphrasing = restating client’s idea in your own words (short). Summarizing = pulling together multiple points/themes over longer span. |
| Different types of Adjustment d/o | - with depressed mood - with anxiety - with mixed anxiety and depressed mood - with disturbance of conduct - with mixed disturbance of emotions & conduct - unspecified |
| Distressing Emotional or Behavioral Symptoms in Response to a Stressor | Adjustment d/o |
| SASSI-4 (Adult Substance Abuse Subtle Screening Inventory) | This survey/interview is designed to assess substance use disorders and includes a prescription drug scale that identifies individuals likely to be abusing prescription medications. |
| Persistent Depressive Disorder in an adult? | 2 Years |
| EDE-Q: Eating Disorder Examination Questionnaire | Eating disorder symptoms |
| EMDR (Shapiro) | Trauma reprocessing with bilateral stimulation |
| Example of SMART treatment objective for depression | Client will identify 3 positive coping strategies and practice them at least 3x per week for 4 weeks. |
| Existential | Meaning, freedom/responsibility, anxiety as part of life |
| Exposed to Life Threatening Trauma -Intrusive symptoms -Avoidant behavior -Negative changes in cognition/mood -Exaggerated reactive responses 3 DAYS to 1 MONTH | ACUTE STRESS d/o |
| Exposed to Life Threatening Trauma -Intrusive symptoms -Avoidant behavior -Negative changes in cognition/mood -Exaggerated reactive responses LONGER THAN 1 MONTH | PTSD |
| Exposed to severe. life threatening trama History of neglect or attachment issues at a young age Withdrawn behavior | Reactive Attachment d/o |
| Feminist Therapy | Empowerment, social context, egalitarian relationship |
| First step in treatment planning for a client with alcohol dependence | Assess severity & medical risk; ensure safety (detox if needed); establish client’s readiness for change. |
| First step in treatment planning for substance abuse? | Assessment of severity & readiness; safety concerns (detox, medical stabilization) goals → objectives → interventions |
| GAD - Generalized Anxiety d/o | At least 6 months |
| GAD-7: Generalized Anxiety Disorder 7 | Generalized Anxiety |
| Gestalt (Perls) | Here and now, unfinished business, empty chair, role play |
| Gottman | Couples Therapy - Strengthening friendships/intimacy - Managing conflict - Four Horseman |
| HAM-D | Hamilton Depression Rating Scale |
| HAM-D: Hamilton Depression Rating Scale | Clinician rated for depression |
| How does Object Relations Theory explain pathology? | Psychological problems stem from maladaptive internalized object relations and difficulty integrating split self/other images. |
| How does Paranoid PD present? | Hypervigilant, suspects others of exploitation, holds grudges, reads hidden meanings into neutral remarks, quick to feel attacked. |
| How does Schizoid PD present? | Prefers solitude, little interest in relationships (even family), indifferent to praise or criticism, emotionally cold/flat affect. |
| How does Schizotypal PD present? | Odd beliefs or magical thinking, unusual perceptual experiences, eccentric dress/speech, suspiciousness, persistent social anxiety. |
| How is transference used in Object Relations therapy? | The therapist becomes a "new object," allowing exploration and repair of dysfunctional relational patterns. |
| How long must psychotic symptoms (delusions or hallucinations) occur without mood symptoms in schizoaffective disorder? | At least 2 weeks at some point during the illness. |
| How much of the total illness duration must mood episodes be present in schizoaffective disorder? | Mood episodes must be present for the majority of the illness duration (active and residual phases). |
| Hypomanic Episode | At least 4 days |
| In Object Relations Theory, what is an "object"? | An internalized mental image of a person (often a caregiver), not a physical object. |
| Interpersonal Therapy (IPT) | Relationships, grief, role disputes, transitions |
| Key interventions in DBT | Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness; hierarchy of targets (life-threatening → therapy-interfering → quality-of-life). |
| MAST: Michigan Alcohol Screening Test | Alcohol misuse (severity) |
| MDD | At least 2 weeks |
| MDD | Bipolar d/o - since both involve depressive episodes GAD - since both can present with restlessness and difficulty concentrating |
| MDQ: Mood Disorder Questionaire | Bipolar Spectrum Screen |
| MMSE: Mini-Mental State Exam | Cognitive impairment |
| Manic Episode | At least 1 week (or any duration if hospitalized) |
| MoCA: Montreal Cognitive Assessment | Mild cognitive impairment/dementia |
| Motivational Interviewing (MI) | Roll with resistance, develop discrepancy, autonomy |
| Multicultural Counseling | Cultural humility, worldview, addressing bias/oppression |
| What does “decompensating” mean in clinical practice? | Mental Health Context: When a client who has been coping with stressors or symptoms experiences worsening functioning (e.g., relapse, regression, crisis). |
| What does compensating mean? | Definition: The ability to adjust, cope, or adapt so that functioning remains stable despite stressors, illness, or symptoms Mental Health Example: A client with depression uses therapy and coping skills to manage daily life effectively. |
| What does decompensating mean? | Mental Health Example: A client with schizophrenia stops medication, leading to hallucinations, paranoia, and decline in daily functioning. |
| Key Differences between Compensating & Decompensating | Compensating: Coping mechanisms are working. Decompensating: Coping mechanisms fail. |
| What is the primary responsibility of counselors? | To respect the dignity and promote the welfare of clients. |
| What should counselors do if personal values conflict with client values? | Avoid imposing values and seek supervision or referral if needed. |
| What does informed consent include? | Purpose, goals, techniques, procedures, limitations, risks, benefits, and client rights. |
| What is the general rule about confidentiality? | Counselors protect the confidential information of prospective and current clients. |
| When can confidentiality be broken? | When disclosure is required to protect clients or others from serious and foreseeable harm, or when legal requirements demand it. |
| What should counselors do before disclosing information? | Make reasonable efforts to inform the client and involve them in the decision. |
| What is competence? | Counselors practice only within their boundaries of competence based on education, training, supervised experience, or credentials. |
| What is the rule on continuing education? | Counselors must engage in continuing education to maintain competence. |
| How should counselors handle conflicts between ethics and law? | Make known their commitment to the ACA Code of Ethics and take steps to resolve conflicts. |
| What is expected in interdisciplinary teamwork? | Communicate and collaborate respectfully while clarifying professional roles. |
| How should counselors handle unethical colleagues? | Attempt informal resolution first; if unresolved, report to appropriate authorities. |
| What must be explained before assessment? | The nature and purposes of assessment and use of results. |
| How should assessments be used? | Only for purposes consistent with established validity and reliability. |
| What is the supervisor’s primary obligation? | To monitor client welfare and supervisee development. |
| What is gatekeeping? | The responsibility to evaluate trainees and protect future clients by addressing supervisees’ limitations. |
| What is the primary obligation of researchers? | To conduct research that contributes to knowledge while protecting participants’ rights. |
| What must informed consent for research include? | Purpose, procedures, risks, benefits, confidentiality, and voluntary nature. |
| What must counselors ensure when using technology? | Security and confidentiality of client information. |
| What should be included in informed consent for distance counseling? | Explanation of risks/benefits, limits to confidentiality, and secure communication methods. |
| What is the first step when facing an ethical dilemma? | Use ethical decision-making models and consider principles such as autonomy, beneficence, nonmaleficence, justice, and fidelity. |
| What should counselors do when unsure about an ethical decision? | Consult with colleagues, supervisors, or professional organizations. |
| Adlerian | Acting "as if: the transition has already ocurred |
| OARS | Open questions, Affirmations, Reflective listening, and Summaries |
| Intermittent Explosive Disorder | one of several impulse control disorders characterized by problems controlling emotions and behaviors that result in behaviors that violate social norms and the rights of others. |
| Intermittent Explosive Disorder | A client with Intermittent Explosive Disorder cannot restrain impulses that result in verbal or physical aggression. |
| Treatment for Intermittent Explosive d/o | Individual and group therapy |
| DSM 5 TR Criteria for "Intermittent Explosive Disorder" | Verbal..or physical aggression.. occurring twice weekly, on average, for a period of three months. |
| Development and course of Intermittent Explosive Disorder? | Common onset during the Identity vs. Role Confusion stage of development following a chronic and persistent course over many years |
| The most common onset of Intermittent Explosive Disorder | during late childhood or adolescence. The symptoms are often chronic and follow a persistent course over many years. |
| Motivational Interview (MI) | A counseling approach designed to help people find the motivation to make a positive behavior change |
| Contextual Family Therapy | Genogram |
| Best treatment for Anti-Social Personality Disorder | Psychodynamic Therapy |
| Body Awareness | Gestalt |
| Body Awareness | Body awareness is a Gestalt technique in which awareness is raised where feelings may be associated in the body through breathing or reflecting inconsistencies between verbal reports and body language. |
| Family Sculpting | This is a technique in family therapy developed by Virginia Satir in which the therapist asks one or more members of the family to arrange the other members (and lastly themselves) |
| Family Sculpting | Arranging one another in terms of posture, space, and attitude to portray the arranger's perception of the family, either in general or concerning a particular concern in mind. |
| Person Centered Therapy | Fostering the client's self-exploration and gain insight into her feelings, beliefs, and behaviors |
| Person Centered Therapy | Encouraging the client to engage in self-exploration can help her gain insights into her feelings, beliefs, and behaviors. |
| Using CBT to develop a sense of agency | CBT places emphasis on helping individuals learn to be their own therapists. Through exercises in session and as homework, clients are helped to develop coping skills. |
| Rogerian | Person Centered Therapy |
| Person Centered and/or Rogerian therapist conduct | The person-centered therapist defaults to asking the client to share and then listening quietly, or with small encouragement, without offering advice or opinions. |
| CBT is best for... | Anxiety, depression, PTSD, Panic d/o, Mood/Anxiety Related d/o, Individual, Chronic Pain, Substance Abuse & Addiction, Eating d/o and Adolescents |
| Gestalt is best for ... | Anxiety, Depression, Self Awareness, Emotional distress/regulation, Couples, Personal Growth, Individual, Group and Trauma |
| Adlerian is best for ... | Anxiety, Depression, Couples, Personal Growth, Individual, Self-Esteem, Families, Goal Setting, Early Family Influences, Adolescents, Children and Children Under 6 |
| Psychodynamic is best for .... | Anxiety, Depression, Couples, Personal Growth, Individual, Self-Esteem, Unresolved Past Conflicts, BPD, Severe Personality d/o, Trauma, |
| Humanistic is best for ... | Anxiety, Depression, Couples, Personal Growth, Individual, and Existential Crises |
| DBT is best for .... | PTSD, Couples, Individual, Unresolved Past Conflicts, BPD, Severe Personality d/o, Chronic Pain, Trauma, Substance Abuse/Addiction, Eating d/o, Suicidal and Dual Diagnosis |
| Solution Focused is best for .... | Personal Growth, Couples, Individual, Adolescents, Children and Children Under 6 |
| Narrative is best for .... | Anxiety, Depression Couples , Personal Growth, Individual, Families, Trauma, Substance Abuse/Addiction, |
| Family Systems is best for ..... | Couples, Families, Adolescents, Children and Children Under 6 |
| ACT is best for .... | Anxiety, Depression, PTSD, Individual, BPD, Severe Personality d/o, Chronic Pain, Substance Abuse/Addiction, Adolescents and Major Life Transitions |
| EMDR is best for .... | Anxiety, PTSD, Panic d/o, Phobias, Individual, BPD, Trauma and Grief |
| Reality Therapy is best for .... | Anxiety, Depression, Couples, Individual, Substance Abuse/Addiction and Adolescents |
| MI is best for .... | Individual, Substance Abuse/Addiction and Adolescents |
| Existential is best for ... | Anxiety, Depression, Individual, Grief and Adolescents |
| Logo Therapy | Anxiety, Depression, Individual, BPD, Severe Personality d/o, Grief, Adolescents, |
| IPSRT (Interpersonal and Social Rhythm Therapy) is best for .... | Anxiety, Depression, Mood/Anxiety Related Issues, Couples, Individual, Substance Abuse/Addiction, Bipolar and Sleep Disturbance |
| Columbia Suicide Severity Rating Scale: C-SSRS is best for ... | Suicide assessment |
| Clinician Administered PTSD Scale DSM 5 TR: CAPS - 5 is best for ... | PTSD |
| Biopsychosocial is best for ... | Family History |
| Michigan Alcohol Screening Test (MAST) is best for .... | Alcohol Abuse |
| Penn State Worry Questionaire (PSWQ) is best for ... | Anxiety |
| Beck Hopelessness Scale (BHS) is best for .... | Hopelessness |
| Level 1 Cross-Cutting Symptom Measure is best for ... | Clinical Snapshot |
| Young Mania Rating Scale is best for ... | Bipolar (depressive) |
| REBT | a type of therapy that helps people identify and change irrational beliefs that lead to emotional distress and negative behaviors. |
| Sublimation | a mature defense mechanism where socially unacceptable impulses, like aggression or sexual desires, are transformed into socially acceptable and often productive behaviors |
| Congruent | refers to the harmony between a person's real self (their actual thoughts, feelings, and behaviors) and their ideal self (the person they aspire to be) |
| Solution-Focused Therapy | a brief, goal-oriented approach that concentrates on creating solutions rather than dwelling on problems |
| Mindfulness Based Cognitive Therapy | combines mindfulness meditation with cognitive behavioral therapy (CBT) techniques to help individuals manage recurring depression, anxiety, and other emotional distress |
| Stereotypic Movements | repetitive, rhythmic, and non-goal-directed actions like hand flapping, body rocking, or head nodding |
| Filial Therapy | where parents are trained to conduct play therapy sessions with their children to address behavioral and emotional difficulties |
| Reaction Formation | a psychological defense mechanism where a person unconsciously adopts beliefs or behaviors that are the opposite of their true feelings to protect themselves from anxiety or socially unacceptable impulses |
| Open-ended questions | a question that cannot be answered with a simple "yes," "no," |
| Open-ended questions example | "What would you do differently next time?" |
| ODD Timeframe | 6 months |
| Reattribution Therap | a cognitive-behavioral technique used to help people reframe negative events by reassessing the causes and taking less self-blame |
| Difference between MDD and PDD | MDD = 2 weeks while PDD - 2 years (1 year in children) |
| Person-Centered Therapy "Be With" | Be empathetic Be non-directive Be authentic Be accepting |
| SFBT "Do Different" | Be empathetic Be non-directive Be authentic Be accepting |
| Use CBT for | Depression/Anxiety |
| USE DBT for | BPD/Self harm |
| Use MI for | Substance use/ambivalence |
| Use exposure therapy for | phobias |
| Use trauma focused CBT for | trauma in youth |
| Use supportive therapy for | crisis |
| Use safety planning for | suicidality |
Created by:
PsychMama3
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