NCMHCE Study Question

Multiple Choice

1. Case Study 1 Initial Intake Age: 45 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Asian Relationship Status: Single Counseling Setting: Community outpatient clinic Type of Counseling: Individual Presenting Problem: Li is a self-referral. She walked into the clinic and stated that she had been experiencing feelings of anxiety. Mental Status: During the intake she looked visibly anxious. She appeared jumpy and kept looking at her watch. Although hesitated at times when she was asked a question. The counselor was concerned when Li paused for a long time when asked if she ever thought of hurting herself. Li eventually responded no. The counselor noticed that Li's clothes looked disheveled and soiled. Li was not forthcoming with information about her past. History: Li came into the community outpatient clinic asking to pay a sliding scale fee in cash. When asked for identifying information, Li asked if she had to give that information. She explained that she was undocumented and was weary of leaving any information that may lead government officials to her. Li did not want to give the counselor much of her history and cut the intake session short, stating that she had to get back to work. An appropriate response from the counselor to Li's situation would be:
a. We must use your name for our records.
b. Don't worry, if we use your real name, nothing will happen.
c. We can use a pseudo name if that is what you are most comfortable with.
d. How much can you pay?
2. Li is concerned about her ability to pay. Which of the following is NOT true in regard to counselor code of ethics?
a. In establishing fees for professional counseling services, counselors consider the financial status of clients and locality.
b. Counselors do not have to discuss payment during informed consent since it may change during treatment.
c. If a counselor's usual fees create undue hardship for the client, the counselor may adjust fees or make an appropriate referral.
d. Counselors make a reasonable effort to provide services to the public for which there is little or no financial return.
3. An important area to gain more information on at this point is:
a. Cultural factors
b. Source of anxiety
c. Social support
d. Financial situation
4. Counseling Session 1 , During the first session, Li explained that she came to the United States four months ago after a wealthy US family invited her here to be their nanny. She was told that she would be able to get a stipend for clothes, decent pay, health benefits and even paid time off. However, Li shared that what was described is not currently the life she is living. Li described that for the past few months she has been basically sleeping in a closet with a bed in it, works tremendously long hours and is not allowed to eat the same things as the family. Additionally, the family frequently berates her and addresses her with racial slurs. How should the counselor respond to Li's description of her situation?
a. "That sounds like a tough job."
b. "This happens all the time."
c. "How was it like in your homeland?"
d. "You should not be treated this way."
5. Which of the following steps should the counselor take?
a. Give Li a referral to a shelter.
b. Tell her she needs to find another place to live.
c. Suggest finding another job.
d. Encourage Li to go to the police.
6. By saying, "Tell me about your experience coming into a new culture and going through what you did" The counselor is demonstrating the attribute of:
a. Cultural awareness
b. Curiosity
c. Empathy
d. Inclusion
7. Counseling Session 2 After the initial session, Li was able to report her situation to the authorities and applied to live in a shelter for women. Li reported that since she has been at the shelter, things have been a bit better. Although she has not yet found employment, she feels a better sense of independence. Li did share that something upsetting that happened when she was on the subway. Li stated that she saw someone who looked like her previous employers, and she had an abrupt surge of fear. Li stated that she started sweating and shaking, her heart was pounding, and she felt like she couldn't breathe. A passerby noticed that she was having difficulty and helped her to sit down and get a drink of water. Li's reaction on the subway meets the criteria for:
a. Panic Disorder
b. Panic Attack
c. Hyperventilation
d. Paroxysmal episode
8. Li should be referred to:
a. A group for human trafficking survivors
b. Employment counselor
c. Care manager
d. All of the above
9. An effective treatment for anxiety is:
a. Cardiovascular exercises
b. Cognitive Behavioral Therapy
c. Benzodiazepines
d. Corticosteroids
10. A symptom of Panic Disorder is:
a. Recurrent panic attacks
b. Persistent worry about panic attacks and maladaptive change for 2 weeks
c. Caused by separation from home or attachment figures
d. Symptoms are only precipitated by social situations
11. Case Study 2 Initial Intake Age: 8 Gender: Male Sexual Orientation: N/A Ethnicity: Caucasian Relationship Status: N/A Counseling Setting: Through agency inside school and via telehealth Type of Counseling: Individual Presenting Problem: Attention and concentration deficits Diagnosis: Attention-deficit hyperactivity disorder, combined type (F90.2) Presenting Problem: Avery is an 8-year-old Caucasian male that has been referred to you by his school counselor because of emotional breakdowns, failing grades and falling asleep in class. You set up an initial assessment session with Avery and his parents in person at the school's conference room and learn that he refers to his biological mother as “dad” and her wife as “mom”, and that he has a twin brother with Autism. Mom tells you Avery sees a psychiatrist for medications but frequently has them changed because she feels they are not working. Mom reports Avery has trouble sleeping at night, hits and kicks her and his brother when he's angry and steals food from the kitchen and hides it in his room. She must ask him multiple times to complete a task and he often will not comply or forget each time he is told. Dad adds that Avery is very smart and does well in most subjects in school but struggles with reading comprehension and worded math problems. Avery is already on an IEP (Individualized Educational Plan) in school to better support his unique learning needs. They ask for your help in regulating his affect and behaviors. Mental Status Exam: Avery presents as fair, with some stains on his t-shirt. His mood is euthymic but with anxious affect as evidenced by hyperactivity, some pressured speech and fidgeting of the hands and feet as he cannot sit still. There is no evidence of suicidal or homicidal ideation and no reported hallucinations or delusions. The initial assessment revealed no significant trauma, other than not having his biological father around his entire life. Avery reports feeling tired often but overall happy. Mom reports his appetite is very good, but his diet could be better. He also has headaches at times in school or when he comes home. Family History: Avery is very close with his two mothers and does not seem to notice that he does not have his father present in his life. His mother mentions that he has made several remarks recently about wanting to be a girl. Avery's brother is high functioning on the autism spectrum but has poor communication and coping skills, increasing Avery's stress level at home due to their constant fighting. Both parents work full-time and take shifts in caring for the children, often sleeping at odd hours of the day and therefore have trouble keeping Avery on a regular schedule. Avery has some extended family on both sides and sees them occasionally. Dad reveals she was also diagnosed with ADHD and Dyslexia growing up and had trouble in school. Which of the following is not a behavioral definition of ADHD?
a. Impulsivity as evidenced by frequent intrusions into other's personal business
b. Susceptibility to distraction by extraneous stimuli and internal thoughts
c. Frequent disruptive, aggressive, or negative attention-seeking behaviors
d. Exhibiting a marked impairment or extreme variability in intellectual and cognitive functioning
12. Which instrument is the most appropriate for further screening Avery's diagnosed symptoms?
a. Vineland Adaptive Behavior Scales (VABS)
b. Screen for Childhood Anxiety Related Emotional Disorders (SCARED)
c. Conners Parent and Teacher Rating Scale (CPTRS)
d. Child Behavior Assessment Instrument (CBAI)
13. Regarding Avery's comments about desired gender, which of the following courses of action is the most clinically appropriate?
a. Add diagnosis of gender dysphoria and include gender confusion as part of goals
b. Do nothing because gender dysphoria for children his age is unsubstantiated
c. Do nothing unless Avery or his parents bring it up again as part of a problem
d. Refer parents to a support group for children coping with transgender issues
14. Which of the following is a long-term goal as opposed to a short-term objective?
a. Parents set firm, consistent limits and maintain appropriate parent-child boundaries
b. Consult with school personnel to implement behavioral classroom management interventions
c. Parents and the client demonstrate increased knowledge about ADHD and its treatment
d. Complete psychological testing to measure the nature and extent of ADHD
15. First session, two weeks after the intake session You visit with Avery back in the school's conference room during his math class. He tells you he does not like that class and is happy to be out of it, saying “I am too stupid. It's too hard.” Throughout the session Avery abruptly interrupts you and races off to gather a different activity off the shelf or wants to switch topics of conversation. You call mom afterwards to touch base with how his moods and behaviors have been in the past two weeks. She reports that he is still stealing foods and hiding them, fighting with his brother, and having trouble sleeping. She asks what she should be doing at home to resolve the behaviors. What is the best response for how to guide this parent while building the therapeutic alliance?
a. "Don't worry, you're doing a great job and he will grow out of this phase eventually."
b. "You have to implement stronger boundaries in order for my interventions to be effective."
c. "Use negative reinforcement to deter his behavior and CBT for addressing negative patterns."
d. "I will educate you on the Behavioral Parent Management Training approach and we will explore the benefits of these techniques together."
16. Which of the following interventions support the objective to improve Avery's ability to identify positive traits and talents about himself?
a. Develop with Avery a list of positive affirmations about himself and assign him to read it daily
b. Reinforce verbally Avery's use of confidence and positive affirmations about himself
c. Present Avery with a piece of candy for each positive trait he can identify every session
d. Watch a video with Avery about a character who defeats his struggle with schoolwork
17. Avery has a history of multiple medication switches with his psychiatrist. Which of the following steps would not be necessary to do for your treatment planning?
a. Ask the parents to provide a copy of Avery's Psychiatric records
b. Help the parents identify and explore patterns of behavior and root causes
c. Inquire about which medications he was on and their effectiveness
d. Provide education on stimulants and other prescriptive regimens
18. Second session, two weeks after the first session You decide to meet with Avery's parents again together and in person along with Avery's school counselor briefly before having your next session with Avery. The school counselor reports Avery's emotional responses to difficulties in class have not been as severe as in past weeks, but that he is still falling asleep during morning classes. Dad mentions that Avery is often up late playing video games despite their attempts to get him to sleep. Mom adds they have settled on a medication regimen that has reduced Avery's physical aggression, but that he is less communicative now and “spaces out” more. In meeting with Avery, he presents as more focused on your intervention attempts but when you ask how he has been feeling he reports “I don't feel anything, really.” Which type of therapy encompasses teaching emotion regulation and distress tolerance that would be helpful for Avery in case of future behavioral outbursts?
a. Cognitive Behavioral Therapy
b. Dialectical Behavioral Therapy
c. Applied Behavior Analysis
d. Holistic Therapy
19. In response to Avery's parents telling you how difficult it is to get him to sleep, you reply saying “I completely understand it must be difficult! I am here to help however I can.” This is an example of:
a. Reverse reflection and deflection
b. Non-judgmental stance
c. Development of conflict resolution strategies
d. Empathic responding using validation and therapeutic alliance
20. As you are concluding your conversation with Avery's parents, they ask if you can also treat his twin brother Marc, who has autism spectrum disorder and is non-verbal. You should reply:
a. "I am happy to conduct an assessment, but I also might refer you to an ABA Specialist."
b. "I can't treat him or help you with that, but Google some local autism resources."
c. "It is unethical to provide counseling for a family member of an existing client."
d. "Of course I can treat him! Let me check my calendar and we will get him right in!"

What Are the NBCC Examinations?

The National Counselor Examination (NCE) is the most portable examination in counseling. It is one of the examination options for NBCC’s flagship certification, the National Certified Counselor (NCC), and is required for licensure in some states.
The National Clinical Mental Health Counseling Examination (NCMHCE) is one of the examination options for the NCC and is required for the Certified Clinical Mental Health Counselor, one of NBCC’s national specialty certifications. The NCMHCE is required for licensure in some states.
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NBCC’s examinations are used in national certification and state licensure applications. All 50 states, the District of Columbia, Puerto Rico, and Guam require one or more of NBCC’s examinations for licensure. Each examination is the product of a painstaking research and development process and undergoes regular review and revision by content experts.
NBCC Examinations Are Used:
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NCMHCE Study Question

What Are the NBCC Examinations?

National Certification and State Licensure

NBCC Examinations Are Used:

Learn More About How Our Assessments Are Developed, Including:

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