Solution Manual & Test Bank for Clinical Mental Health Counseling in Community and Agency Settings

i Manual and Test Bank for Clinical Mental Health Counseling in Community and Agency Settings Fifth Edition ii TABLE OF CONTENTS CHAPTER 1: HISTORY OF AND PROFESSIONAL IDENTITY IN CLINICAL MENTAL HEALTH COUNSELING..........................................................................................1 Key Terms..................................................................................................................................1 Questions....................................................................................................................................2 Essay Questions...................................................................................................................7 CHAPTER 2: ETHICAL AND LEGAL ASPECTS OF COUNSELING................................8 Key Terms..................................................................................................................................8 Questions....................................................................................................................................9 Essay Questions.................................................................................................................13 CHAPTER 3: CLINICAL MENTAL HEALTH COUNSELING IN A DIVERSE SOCIETY......................................................................................................................................13 Key Terms................................................................................................................................13 Questions..................................................................................................................................15 Essay Questions.................................................................................................................19 CHAPTER 4: THE COUNSELING PROCESS.......................................................................20 Key Terms................................................................................................................................20 Questions..................................................................................................................................21 Essay Questions.................................................................................................................24 CHAPTER 5: CLIENT ASSESSMENT AND DIAGNOSIS...................................................24 Key Terms................................................................................................................................24 Questions..................................................................................................................................25 Essay Questions.................................................................................................................28 CHAPTER 6: HOLISTIC APPROACHES TO CLINICAL MENTAL HEALTH COUNSELING.............................................................................................................................28 Key Terms................................................................................................................................28 Questions..................................................................................................................................29 Essay Questions.................................................................................................................32 CHAPTER 7: CONSULTATION, ADVOCACY, AND EVALUATION ..............................32 Key Terms................................................................................................................................32 Questions..................................................................................................................................33 Essay Questions.................................................................................................................36 CHAPTER 8: DEALING WITH CRISIS, DISASTERS, AND SUICIDE, WHILE MANAGING STRESS AND AVOIDING BURNOUT............................................................36 Key Terms................................................................................................................................36 Questions..................................................................................................................................38 Essay Questions.................................................................................................................41 iii CHAPTER 9: WORKING WITH GROUPS............................................................................41 Key Terms................................................................................................................................41 Questions..................................................................................................................................42 Essay Questions.................................................................................................................45 CHAPTER 10: COUPLES AND FAMILY COUNSELING...................................................45 Key Terms................................................................................................................................45 Questions..................................................................................................................................47 Essay Questions.................................................................................................................51 CHAPTER 11: COUNSELING CHILDREN AND ADOLESCENTS...................................51 Key Terms................................................................................................................................51 Questions..................................................................................................................................52 Essay Questions.................................................................................................................56 CHAPTER 12: COUNSELING ADULTS.................................................................................56 Key Terms................................................................................................................................56 Questions..................................................................................................................................58 Essay Questions.................................................................................................................61 CHAPTER 13: COLLEGE AND CAREER COUNSELING .................................................61 Key Terms................................................................................................................................61 Questions..................................................................................................................................62 Essay Questions.................................................................................................................66 CHAPTER 14: COMMUNITY AGENCIES, MEDICAL SETTINGS, AND OTHER SPECIALIZED CLINICAL SETTINGS ..................................................................................66 Key Terms................................................................................................................................66 Questions..................................................................................................................................67 Essay Questions.................................................................................................................70 CHAPTER 15: EMPLOYEE ASSISTANCE PROGRAMS, PRIVATE PRACTICE, COACHING, AND MANAGED CARE....................................................................................71 Key Terms................................................................................................................................71 Questions..................................................................................................................................71 Essay Questions.................................................................................................................75 ANSWER KEY ............................................................................................................................75 GLOSSARY................................................................................................................................100 INSTRUCTIONAL ACTIVITIES ...........................................................................................142 1 CHAPTER 1: HISTORY OF AND PROFESSIONAL IDENTITY IN CLINICAL MENTAL HEALTH COUNSELING KEY TERMS Clinical mental health counseling Community counseling Mental health counseling American Mental Health Counselors Association Frank Parsons Jesse B. Davis Clifford Beers Boston’s Vocational Bureau School guidance Council of Guidance and Personnel Association National Vocational Guidance Association American Personnel and Guidance Association American Association for Counseling and Development American Counseling Association Smith-Hughes Act of 1917 Army Alpha, Army Beta intelligence tests Strong Vocational Interest Inventory (SVII) Psychometrics Abraham and Hannah Stone E. G. Williamson Minnesota Point of View Trait-factor Counseling Edward Thorndike John Brewer George-Dean Act Dictionary of Occupational Titles (DOT) Carl Rogers National Mental Health Act U.S. Veterans Administration Society of Counseling Psychology (Division 17) of APA National Defense Education Act (NDEA) Counseling Psychology Gilbert Wren Community Mental Health Centers Act ERIC Clearinghouse on Counseling and Personnel Services (ERIC/CAPS) Association of Counselor Education and Supervision (ACES) Council for Accreditation of Counseling and Related Educational Programs (CACREP) National Board for Certified Counselors (NBCC) National Certified Counselor (NCC) National Academy of Certified Clinical Mental Health Counselors (NACCMHC) Chi Sigma Iota 2 Carol Gilligan Feminist theory Multicultural competencies and standards Managed care organizations Health maintenance organizations (HMOs) Contextualism Evidenced-based interventions 20/20 A Vision for the Future of Counseling Licensure portability Globalization of counseling Patient Protection and Affordable Care Act TRICARE Department of Veterans Affairs’ Choice Program Professional identity Nonprofessional helpers Generalist human services workers Professional helpers Professional counseling Bogust v. Iverson Weldon v. Virginia State Board of Psychologists Examiners Inspection Registration Certification Licensure Social work Psychiatry Biomedical model Biopsychosocial model Psychiatric mental health nurses Psychologists National Fair Access Coalition on Testing (FACT) Secondary service Primary service QUESTIONS Multiple Choice Questions 1. The story of a young man who rescued people from a river illustrates what key component of counseling? a. Counseling emphasizes intervention wherever possible. b. Counseling focuses on prevention wherever possible. c. Counseling avoids altering people’s environments. d. Counseling is a profession for altruists. 3 2. Which of the following terms was devised in the mid- to late-1970s to identify counseling activities that took place outside of educational settings? a. Clinical mental health counseling b. School guidance and counseling c. Mental health counseling d. Community counseling 3. Which of the following divisions of the American Personnel and Guidance Association was established for mental health counselors? a. American Community Counselors Association b. American Clinical Mental Health Counseling Association c. American Mental Health Counselors Association d. American Counseling Association 4. Counseling initially developed from a humanitarian concern to improve people’s lives in communities affected by a. World War I b. World War II c. Sputnik I d. The Industrial Revolution 5. Which of the following individuals founded Boston’s Vocational Bureau and is considered the “founder of guidance?” a. Frank Parsons b. Jesse B. Davis c. Clifford Beers d. Hannah Stone 6. Which of the following individuals was the first to establish a systematized guidance program in the public schools? a. Frank Parsons b. Jesse B. Davis c. Clifford Beers d. Hannah Stone 7. Who wrote the book, A Mind That Found Itself? a. Frank Parsons b. Jesse B. Davis c. Clifford Beers d. Hannah Stone 8. The first national professional organization in the counseling field was called the a. National Vocational Guidance Association b. American Personnel and Guidance Association c. American Counseling Association d. American Mental Health Association 4 9. The flagship journal of the American Counseling Association is the a. Counseling Psychologist b. Journal of Counseling and Development c. Journal of Professional Counseling d. Journal of Mental Health Counseling 10. Which of the following statements reflects the influence of World War I on the development of the profession of counseling? a. As a result of World War I, a greater emphasis in testing emerged, and psychometrics became a popular movement. b. Due to the war efforts, World War I halted the development of counseling for a season. c. World War I had little impact on the development of counseling. d. World War I hastened the need for counselors and psychologists to train and help select specialists for the military and other industry. 11. Which of the following statements reflects the influence of World War II on the development of the profession of counseling? a. As a result of World War II, a greater emphasis in testing emerged, and psychometrics became a popular movement. b. Due to the war efforts, World War II halted the development of counseling for a season. c. World War II had little impact on the development of counseling. d. World War II hastened the need for counselors and psychologists to train and help select specialists for the military and other industry. 12. Which of the following individuals formulated the first theory of counseling? a. Clifford Beers b. Frank Parsons c. Carl Rogers d. E. G. Williamson 13. The first theory of counseling stated that people had aptitudes, interests, and achievements called ______________ that could be combined in a variety of ways to form constellations of individual characteristics called ______________. a. Traits; Factors b. Factors; Traits c. Schemas; Cognitions d. Cognitions; Schemas 14. Which of the following individuals challenged the directive, counselor-centered approach and the major tenets of Freudian psychoanalysis with a non-directive, person-centered approach to counseling? a. Edward Thorndike b. John Brewer 5 c. Albert Ellis d. Carl Rogers 15. The National Defense Education Act (NDEA) was enacted in reaction to what event? a. World War I b. World War II c. The launching of Sputnik I by the Soviet Union d. The Great Depression 16. What did the 1963 Community Mental Health Centers Act authorize? a. The establishment of mental health centers in community colleges. b. The establishment of a nationwide system of community mental health centers. c. Funds for research and training to prevent and treat mental health disorders. d. Stipends and paid internships for students engaged in graduate counseling studies. 17. The first state to adopt a professional counselor licensure law was a. Arkansas b. Alabama c. California d. Virginia 18. Which of the following was formed in the 1980s to standardize counselor training and accredit counseling programs? a. APA b. APGA c. CACREP d. NBCC 19. What occurred as a result of the growth of managed care organizations in the 1990s? a. The number of independent counselors decreased. b. Many counselors became providers for health maintenance organizations (HMOs). c. The number of sessions a counselor could offer under managed health care plans decreased. d. All of the above. 20. Which of the following statements reflect(s) an impetus for forming the taskforce, 20/20: A Vision for the Future of Counseling? a. To address the issue of professional identity. b. To advance the future of counseling. c. To increase unity within the profession. d. All of the above. 21. Which of the following refers to the philosophy, training model, and scope of practice that characterize a particular profession? a. Professional credentialing b. Therapeutic professionalism 6 c. Professional identity d. Professional affiliation 22. _________________ represents a specialty area within the school of medicine? a. Psychiatry b. Social Work c. Clinical Psychology d. Professional Counseling 23. What is the purpose of the National Fair Access Coalition on Testing (FACT)? a. To ensure multicultural sensitivity in test construction and administration b. To advocate for equitable access to testing services for all appropriately trained professionals who have demonstrated competence in administering and interpreting assessment instruments. c. To ensure that all mental health professionals, regardless of training, have access to psychological tests. d. None of the above. 24. Which of the following mental health professions is represented by Division 17 of the APA? a. Professional Counseling b. Clinical Psychology c. Counseling Psychology d. Psychiatry 25. The definition of counseling reached by the task group, 20/20: A Vision for the Future of Counseling, includes all of the following except a. Counseling is a dynamic, lively, and engaging process b. Counselors promote wellness c. Counseling is diverse and multicultural d. All of the above are included in the definition 26. In which court case did a judge rule that a counselor with a doctoral degree could not be held liable for the suicide of one of his clients because counselors were “mere teachers” who received training in a department of education? a. Weldon v Virginia State Board of Psychologists Examiners b. Bogust v. Iverson c. Tarasoff v. University of California - Berkeley d. Iowa Law Review Note 27. All of the following are benefits of national counseling certification except? a. It ensures that counselors, rather than independent state legislators, set the national standards and minimum requirements for being a professional counselor. b. It provides referral sources and networking opportunities across state lines. c. It regulates professional practice. d. All of the above are benefits of national counseling certification. 7 28. _______________ is the international honor society for professional counselors, counselor educators, and students in counselor education programs. a. Psi Chi b. American Mental Health Counseling Student Organization c. Chi Sigma Iota d. Upsilon Psi Sigma 29. Which of the following counseling credentials is offered by NBCC? a. National Certified Counselor (NCC) b. Licensed Professional Counselor (LPC) c. Licensed Clinical Professional Counselor (LCPC) d. National Clinical Mental Health Counselor (NCMHC) 30. Which of the following legally recognized counselors as professionals who provided personal as well as vocational and educational counseling? a. Weldon v. Virginia State Board of Psychologists Examiners b. Iowa Law Review Note c. Bogust v. Iverson d. Tarasoff v. University of California – Berkeley 31. Which court judgment stated that counseling was a profession distinct from psychology? a. Weldon v. Virginia State Board of Psychologists Examiners b. Iowa Law Review Note c. Bogust v. Iverson d. Tarasoff v. University of California – Berkeley 32. _______________ certifies clinical mental health counselors who have met requirements in training, professional counseling experience, and performance on the NCE. a. The American Counseling Association (ACA) b. The National Board for Certified Counselors (NBCC) c. American Mental Health Counseling Association d. Council for Accreditation of Counseling and Related Educational Programs (CACREP) Essay Questions 1. Identify three noteworthy events in the 20th century and describe how each event has influenced the profession of counseling. 2. Identify three noteworthy events in the 21st century and describe how each event has influenced the profession of counseling. 3. In your own words, how has the profession of counseling changed since the early 1900s? What changes, based on future projections by leaders in the profession, do you foresee as most impactful, and why? 4. Give one example of each of the four service components in Lewis et al.’s (2003) clientenvironment interaction model. 8 5. What is the difference between licensure and national certification? 6. Discuss the benefits of national certification. 7. Discuss the importance of professional affiliation for clinical mental health counselors. CHAPTER 2: ETHICAL AND LEGAL ASPECTS OF COUNSELING KEY TERMS Ethics Morality Autonomy Nonmaleficence Beneficence Justice Fidelity Veracity Mandatory ethics Aspirational ethics Law Duty to warn Tarasoff v. Board of Regents of the University of California ACA Code of Ethics (2014)Confidentiality Marginalization Separation Assimilation Integration Guidelines for Acting in Ethically Responsible Ways Statutes Case law Civil law Administrative law Duty to care Privileged communications Practice act counseling statutes Tort Negligence Malpractice Administrative law Health Insurance Portability and Accountability Act (HIPAA) Expert witness Court order Due care Privacy Confidentiality Disclosure Informed consent Free consent 9 Professional competence Bracket Capacity Standards of care Synchronous counseling Asynchronous counseling Multicultural Competencies and Standards Health Information Technology for Economic and Clinical Health Act (HITECH) QUESTIONS Multiple Choice Questions 1. Which of the following, according to Van Hoose & Kottler (1985) is “a philosophical discipline that is concerned with human conduct and moral decision making” (p. 3). a. Morality b. Law c. Ethics d. Autonomy 2. Which of the following involves judgment and evaluation of actions and is associated with words such as good, bad, right, wrong, ought, and should? a. Morality b. Law c. Ethics d. Autonomy 3. All of the following are moral principles described by Kitchener (1984) except a. Nonmaleficence b. Beneficence c. Autonomy d. Capacity e. Fidelity f. Justice 4. A counselor struggles between protecting a client’s welfare and respecting a client’s freedom of choice and action. The counselor is struggling with which two moral principles? a. Fidelity and Autonomy b. Justice and Autonomy c. Capacity and Nonmaleficence d. Beneficence and Autonomy e. Nonmaleficence and Autonomy 5. A counselor who unintentionally harms a client would be breaking which moral principle? 10 a. Beneficence b. Justice c. Capacity d. Nonmaleficence e. Fidelity f. Autonomy 6. Counselors who do not fulfill their obligations to clients are breaking which moral principle? a. Beneficence b. Justice c. Capacity d. Nonmaleficence e. Fidelity f. Autonomy 7. Which of the following ethical practices refers to truthfulness and integrity? a. Autonomy b. Capacity c. Veracity d. None of the above 8. Mandatory ethics are followed when clinical mental health counselors a. Make decisions based on internalized principles and ideals of the profession, not just external considerations. b. Comply with the required minimal standards of the profession. c. Judge or evaluate their professional actions through a spiritual or religious lens. d. All of the above. e. None of the above. 9. Aspirational ethics are followed when clinical mental health counselors a. Make decisions based on internalized principles and ideals of the profession, not just external considerations. b. Comply with the required minimal standards of the profession. c. Judge or evaluate their professional actions through a spiritual or religious lens. d. All of the above. e. None of the above. 10. Which of the following refers to a set of rules that governs particular activities in society? a. Ethics b. Morals c. Law d. Categorical imperative 11. Which of the following is true concerning the relationship between ethical codes and the law? 11 a. Ethical codes are not intended to supersede the law; they typically clarify existing law and policy. b. The law is not intended to supersede professional ethical codes; they typically clarify existing ethical codes and policies. c. Regardless of what the law states, ethical codes, which are defined by the profession and for the profession, should be followed. d. None of the above. 12. Which of the following, according to Welfel (2016) is the key reason for having ethical codes? a. To codify the nature of ethical responsibilities and to justify the mission of an organization b. To establish norms and expectations for practitioners, thereby minimizing the risk of harm to others c. To provide explicit answers to difficult questions d. All of the above 13. All of the following are true regarding ethical codes except a. Ethical codes are necessary and sufficient for promoting ethical behaviors. b. No ethical code can address every situation or potential dilemma. c. Some codes are ambiguous, making them open to interpretation d. Enforcing ethical codes is difficult e. There may be conflicts within the ethical codes as well as among different organizations’ codes. f. Sometimes conflicts arise between ethical and legal codes. 14. According to the 2014 ACA Code of Ethics counselors are restricted from engaging in romantic or sexual relationships with clients for at least how many years after the termination of the counseling relationship? a. 2 years b. 3 years c. 5 years d. Counselors are restricted, in all cases, by the 2014 ACA Code of Ethics from engaging in romantic or sexual relationships with clients. 15. At which step of Wheeler and Bertram’s (2015) Legal and Ethical Decision-Making Model would a counselor consult the 2014 ACA Code of Ethics? a. Step 1 b. Step 2 c. Step 3 d. Step 4 e. Step 5 16. Court cases based on rulings that interpret a law according to a specific case establish what is known as a. Case law 12 b. Civil law c. Criminal law d. Tort 17. Which of the following best represents the ruling in the 1993 Napa County, California case involving Gary Ramona? a. The case was decided on the duty to care legal concept—a legal obligation of health providers to not act negligently. b. The case was decided on the duty to warn legal concept—a legal obligation to protect potential victims from dangerous clients c. The case was decided based on the privileged communication concept—a legal obligation to protect communication between counselor and client. d. None of the above. 18. In which legal case did the court maintain that communications between licensed psychotherapists and their patients are privileged and do not have to be disclosed in cases held in federal court? a. 1993 Napa County, California case b. Jaffee v. Redmond c. Tarasoff v. Board of Regents of the University of California d. None of the above 19. Which of the following is a term that refers to a wrong that legal action is designed to set right? a. Criminal law b. Case law c. Tort d. Administrative law 20. Which of the following refers to situations in which a mental health professional does not carry out his or her responsibilities in accordance with the standards of care outlined by the profession? a. Conscription b. HIPAA c. Negligence d. All of the above. 21. All of the following represent areas of potential malpractice for counseling except a. Failing to take action when someone other than the client is in danger b. Improperly certifying a client in a commitment hearing c. Providing services for which competence has not been established d. Breaching confidentiality e. Promising a “cure” f. All of the above are potential examples of malpractice 13 22. Which of the following terms refers to a client’s legal right to determine what information about himself or herself will be shared with others? a. Beneficence b. Autonomy c. Privacy d. Confidentiality 23. A professional’s promise not to disclose information revealed during the privacy of the counselor-client relationship, except under specific mutually understood conditions, is called a. Privacy b. Privileged communication c. Confidentiality d. Justice 24. In which legal case did the court rule that counselors need to take reasonable action to help protect potential victims from dangerous client? a. 1993 Napa County, California case b. Jaffee v. Redmond c. Tarasoff v. Board of Regents of the University of California d. None of the above 25. Online counseling that occurs during the moment of connection is called a. Synchronous counseling b. Skype counseling c. Asynchronous counseling d. Voice over IP (VolP) Essay questions 1. Discuss the purpose of ethical codes, as well as potential limitations. 2. Describe five changes made to the 2014 ACA Code of Ethics. 3. List and describe the eight steps of Wheeler and Bertram’s (2015) Legal and Ethical Decision-Making Model. CHAPTER 3: CLINICAL MENTAL HEALTH COUNSELING IN A DIVERSE SOCIETY KEY TERMS ADDRESSING model Culture Ethnographic variables Demographic variables Status variables Multicultural 14 Multicultural counseling Etic approach Emic approach Cultural encapsulated Worldview Prejudice Racism Cultural racism Institutionalized racism Western values Acculturation Enculturation Cultural pluralism Triad role-play model Broaching Sexual preference Sexual orientation Affectional orientation Gay Lesbian Bisexual Queer Questioning Sexual attraction Sexual identity Homophobia Homoprejudice Heterosexism Homonegativity Bruff v. North Mississippi Health Services, Inc. (2001) Familism Coming out Internalized homophobia Work discrimination Transgender Genderqueer Transsexual Gender Dysphoria Transphobia Transprejudice Disability Physical disabilities Cognitive disabilities Psychiatric disabilities Ableism Prevention 15 Intervention Postvention or Rehabilitation Counseling Client-aimed interventions Environment-aimed interventions Crisis phase Chronic phase Terminal phase Socioeconomic Status (SES) Social class Classism Privilege Social class privilege Poverty threshold QUESTIONS Multiple Choice Questions 1. The “R” in Hays’ (2016) ADDRESSING model refers to which of the following: a. Race b. Religion (and/or spirituality) c. Race/ethnicity d. Risk factors 2. Which of the following terms describes any group of people who identify with one another on the basis of a common purpose, need, or similarity of background? a. Diversity b. Encapsulation c. Culture d. Ethnicity 3. As defined by Olatunji (2001), which of the following accurately describes multicultural counseling? a. Multicultural counseling refers to multiple perspectives or multiple cultural viewpoints within the counseling relationship in which none are dominant or considered more “normal” than others b. Multicultural counseling refers to binary perspectives or viewpoints within the counseling relationship in which certain viewpoints are healthier than others c. Multicultural counseling refers to multiple perspectives or multiple cultural viewpoints within the counseling relationship in which the viewpoint of the counselor is most accurate due to his or her training and self-awareness. d. None of the above. 4. As defined by CACREP, _______________ takes into account differences in areas such as language, social class, race, ethnicity, gender, sexual orientation, religion, and level of ability 16 a. Culture b. Diversity c. Multiculturalism d. Cultural encapsulation 5. Which counseling perspective emphasizes the universal qualities of counseling that are culturally generalizable? a. Cultural generalizability approach b. Hegemonic approach c. Etic approach d. Emic approach 6. Which counseling perspective focuses on the indigenous characteristics of each cultural group that influence the counseling process and consequently emphasize culturally specific counseling approaches? a. Indigenous approach b. Hegemonic approach c. Etic approach d. Emic approach 7. __________________ refers to the way people perceive their relationship to the world, including nature, other people, objects, and religious experiences. a. Worldview b. Multiculturalism c. Acculturation d. Ethnocentrism 8. ________________, according to Allport (1954) is a negative bias toward a particular group of people. a. Racism b. Transnegativity c. Prejudice d. None of the above 9. _______________ occurs when one cultural group considers another group inferior, and the first group has the power to impose its standards on the other group. a. Institutionalized racism b. Cultural racism c. Acculturation d. None of the above 10. The established use of policies, laws, customs, and norms to perpetuate discrimination and prejudice is called a. Institutionalized racism b. Cultural racism c. Acculturation 17 d. None of the above 11. The retention of one’s culture of identity is called a. Acculturation b. Cultural invariability c. Enculturation d. Cultural pluralism 12. Which of the following terms refers to individuals who are beginning to explore their sexual understanding and orientation? a. Gay b. Questioning c. Bisexual d. All of the above 13. _____________ includes both the affectional and sexual dimensions of self that are evidenced by thoughts, feeling, and behaviors. a. Sexual attraction b. Sexual behavior c. Sexual identity d. All of the above 14. Which of the following refers to an antigay bias, or a fear of individuals who are perceived as lesbian, gay, or bisexual? a. Homophobia b. Racism c. Sexism d. Heterosexism 15. In which court case did a federal appeals court uphold the job termination of a counselor who asked to be excused from counseling a lesbian client on relationship issues because of the client’s sexual orientation conflicted with the counselor’s religious beliefs? a. Jaffee v. Redmond b. Tarasoff v. Board of Regents of the University of California c. Bruff v. North Mississippi Health Services, Inc. d. None of the above 16. Which of the following refers to the primary importance of family in Latino communities? a. Personalism b. Respeto c. Familism d. Marianismo 17. All of the following are accurate regarding the coming out process except a. It’s a key component of minority sexual identity development. 18 b. It is an ongoing process, affected largely by an individual’s life circumstances. c. It is a one-time event, affected largely by an individual’s life circumstances. d. It is generally accepted that coming out is positively associated with mental health and relationship satisfaction. e. Coming out carries with it the risk of abandonment, ridicule, and disapproval and may be psychologically painful. 18. _____________________ is the practice of attempting to change a client’s sexual orientation from lesbian, gay, bisexual, queer, or questioning to that of a heterosexual. a. Cognitive-restructuring therapy b. Reparative therapy c. Exposure therapy d. None of the above 19. Which of the following refers to people whose gender identity and expression conflicts with their biological manifestation of sex? a. Transgender b. Gay c. Bisexual d. All of the above 20. _________________ is a term in the DSM-5 used to describe individuals who experience incongruence between their expressed/experienced gender and their assigned gender. a. Gender Dysphoria b. Sexual Identity Disorder c. Homosexuality d. Gender Identity Disorder 21. ________________ is an example of a cognitive disability. a. Sensory loss b. Learning disability c. Depression d. Congenital disability 22. Which of the following terms refers to a physical or mental impairment that substantially limits a major life activity? a. Heterosexism b. Ethnocentric monoculturalism c. Disability d. None of the above 23. Someone who fears having a group home for adults with mental retardation in his or her neighborhood may espouse which myth about individuals with disabilities? a. The Spread Phenomenon Myth b. The Dehumanization or Damaged Merchandise Myth c. The Feeling No Pain Myth 19 d. The Disabled Menace Myth 24. A client’s sense of coherence is determined by his or her perceptions of which of the following? a. Comprehensibility, manageability, and meaningfulness b. Wellness, cognitive harmony, sense of connection c. Meaningfulness, cognitive complexity, and sense of connection d. None of the above 25. Which phase of adaptation is a family in when members of the family are waiting for a diagnosis or have just received information about a family member’s disability? a. Crisis phase b. Chronic phase c. Terminal phase d. Apprehensive phase 26. _______________ refers to oppression, discrimination, or marginalization experienced by people who are negatively affected by socioeconomic disparity. a. Socioeconomic status b. Social class c. Classism d. Poverty 27. A counselor working with a client whose religion, ethnicity, and sexual orientation are different from his own, decides that he needs to process his thoughts and feelings about these contrastive cultural groups. This counselor is working on what facet of multicultural counseling competency development? a. Cultural skills b. Cultural responsiveness c. Cultural awareness d. Cultural knowledge 28. Jessica, a white female counselor, is working with Richard, a Chinese American male who is struggling with depression. Jessica has worked with many individuals with depression and, although she has not worked with a Chinese male with depression, she believes her existing knowledge base and skill set is sufficient. Which of the following statements, based on this information would be true of Jessica? a. Jessica’s thought process is culturally sensitive because she aims to give the same treatment to Richard that she has given to clients in the past. b. Jessica is exhibiting an etic perspective of counseling. c. Jessica is exhibiting an emic perspective on counseling. d. Jessica is actively contributing to institutionalized racism. Essay Questions 20 1. Discuss ways in which clinical mental health counselors can enhance their multicultural awareness, knowledge, and skills. 2. Describe five ways in which a counselor can convey cultural empathy. 3. Discuss ways in which clinical mental health counselors can establish an environment in which clients feel safe to explore issues related to sexual identity? CHAPTER 4: THE COUNSELING PROCESS KEY WORDS Safety Personalization Softness Role induction Informed consent content checklist Professional disclosure statement Initiative Reluctant clients Resistant clients Noncompliance Avoidance Ambivalence Motivational Interviewing Transtheoretical model of change Precontemplation Contemplation Preparation Action Maintenance Closed questions Open questions Door openers Door closers Culturally sensitive empathy Case conceptualization or case formulation Client records Subpoenas Treatment plan Support factors Learning factors Action factors Cognitive learning Affective experiencing Rehearsal Cognitive distortions Selective abstraction 21 Reframing Catharsis Overt rehearsal Covert rehearsal Duty to warn Termination Fading Referral Recycling QUESTIONS Multiple Choice Questions 1. All of the following are reasons to divide the process of counseling into three stages except a. Conceptually it can be helpful b. Counseling is a linear process c. Various tasks and responsibilities are associated with each stage d. Different client factors, such as motivation to change and responsiveness to treatment, are associated with each stage 2. __________________ refers to counselor-client understanding about the conditions, procedures, and nature of counseling a. Structure b. Role induction c. Fading d. Both “a” and “b” e. All of the above 3. Which of the following provides information to clients about the counselor and about the counseling process a. Action limits b. Professional disclosure statement c. Role induction d. Safety contract 4. ______________ refers to a motivation to change. a. Informed consent b. Rapport c. Initiative d. None of the above 5. Which of the following theoretical frameworks encourages counselors to roll with resistance rather than confront it? a. Cognitive-Behavioral Therapy 22 b. Developmental Counseling and Therapy c. Transtheoretical Counseling d. Motivational Interviewing 6. Maria, a client struggling with alcohol abuse, has taken small steps toward change. In which stage is Maria? a. Precontemplation b. Contemplation c. Preparation d. Action e. Maintenance 7. A counselor is providing continuing support, as well as using reinforcement management and follow-up contracts? In which stage of change might the counselor’s client be? a. Precontemplation b. Contemplation c. Preparation d. Action e. Maintenance 8. Which of the following counseling skills is effective in eliciting a large amount of information in a short time, but does not encourage elaboration? a. Open questions b. Closed questions c. Empathy d. Confrontation 9. All of the following are door openers except a. “What brings you to see me?” b. “What would you like to talk about?” c. “Tell me more.” d. “What if we move on to something different?” 10. ___________________ provides a way for counselors to link clients’ presenting problems to a treatment plan and serves to tailor interventions to specific client needs. a. Case conceptualization b. Rapport c. Empathy d. Clarifying probes 11. ______________ explains why the client is receiving services and what is going to take place in counseling a. Informed consent b. Professional disclosure statement c. Safety contract d. Treatment plan 23 12. Which of the following is an action factor? a. Cognitive learning b. Therapeutic alliance c. Reality testing d. Empathy 13. Which of the following is a term referring to negative, inaccurate biases that can result in unhealthy misperceptions of events? a. Cognitive distortions b. Resistance c. Delusions d. Abreaction 14. ________________ offers the client another probable and positive viewpoint of what a situation is or why an event might have happened. a. Selective abstraction b. Empathy c. Reframing d. Cognitive distortion 15. ________________ involves imagining and reflecting on a desired course of action. a. Overt rehearsal b. Covert rehearsal c. Corrective feedback d. None of the above 16. All of the following are important functions of ending the counseling relationship except a. Signals that something important has been completed b. Gives clients the opportunity to maintain changes already achieved and generalize problem-solving skills to new areas c. Serves as a reminder that the client has matured d. All of the above e. None of the above 17. Which of the following involves arranging other assistance for clients when the initial arrangements are not likely to be helpful? a. Termination b. Abandonment c. Referral d. Recycling 18. Which of the following involves the reexamination of all phases of the therapeutic process? a. Termination b. Abandonment 24 c. Referral d. Recycling 19. A client who is unaware that a problem exists is in which stage of change? a. Precontemplation b. Contemplation c. Preparation d. Action e. Maintenance 20. Which of the following techniques is recommended for use with clients who are in the contemplation stage of change? a. Gestalt techniques b. Behavioral strategies c. Relapse prevention d. Motivational interviewing Essay Questions 1. List and describe the five stages of change of the transtheoretical model of change. 2. List and describe six topics addressed during intake interviews. 3. List and describe the four sections of the SOAP format. 4. Discuss reasons why counselors should engage in careful record keeping. 5. List and describe the five components of a treatment plan. CHAPTER 5: CLIENT ASSESSMENT AND DIAGNOSIS KEY TERMS Assessment Diagnosis Appraisal Psychological testing Checklists Rating scales Minnesota Multiphasic Personality Inventory-2 NEO Personality Inventory-3 Myers-Briggs Type Indicator Structured clinical interview Semistructured interviews Unstructured interviews Mental Status Examination Mental disorder Substance use disorder Behavioral disorders Egosyntonic 25 Biopsychosocial (BPS) Model QUESTIONS Multiple Choice Questions 1. ______________ is an ongoing process in which counselors gather information about clients from several different sources and use the information to make decisions for treatment planning. a. Assessment b. Diagnosis c. Case conceptualization d. None of the above 2. ______________ is an objective, standardized measure of behavior and is usually used for evaluation. a. Assessment b. Appraisal c. Psychological testing d. Diagnosis 3. All of the following are methods of assessment except a. Formal or informal b. Standardized or nonstandardized c. Objective or subjective d. All of the above are methods of assessment. 4. Which of the following describes rating scales? a. Counselors simply mark words or phrases that apply to the client or the client’s situation. b. Counselors indicate the degree or severity of the characteristic being measured. c. Counselors ask questions in an ordered sequence. d. None of the above. 5. Which of the following is an example of a checklist? a. Brief Symptom Inventory b. Conners 3TM c. Myers-Briggs Type Indicator d. NEO Personality Inventory-3 6. Which of the following assessment instruments is based on the work of Carl Jung and Jungian theory, and is the most widely used personality inventory for normal functioning? a. Minnesota Multiphasic Personality Inventory-2 b. NEO Personality Inventory-3 c. Myers-Briggs Type Indicator d. Brief Symptom Inventory 26 7. ______________________ use prescribed items, but also give leeway if a specific issue needs to be addressed. a. Structured interviews b. Semistructured interviews c. Unstructured interviews d. None of the above 8. Which of the following is an example of a qualitative assessment procedure? a. Mental Status Examination b. NEO Personality Inventory-3 c. Card sorts d. None of the above 9. Test trustworthiness includes all of the following except? a. The test is valid b. The test is reliable c. The test is practical d. The test is fair cross-culturally e. All of the above relates to test trustworthiness 10. Approximately what percent, according to the NIMH (2014), of American adults (18- years and older) are affected by mental health disorders in a given year? a. 5% b. 10% c. 18% d. 54% 11. ___________________ according to Hoheshil (1996) is “the process of comparing the symptoms exhibited by the client with the diagnostic criteria of some type of classification system” (p. 66). a. Assessment b. Appraisal c. Psychological testing d. Treatment planning e. Diagnosis 12. According to the DSM-5, which of the following are requirements that must be met for a syndrome to be considered a mental disorder? a. There must be sufficient evidence that the symptoms represent a dysfunction in the processes underlying mental functioning. b. The dysfunction must cause harm to the person in regard to psychological functioning that is clinically significant. c. The syndrome must be behavioral or psychological in nature and culturally sanctioned 27 d. All of the above are requirements that must be met for a syndrome to be considered a mental disorder e. a and c f. a and b 13. Which of the following statements is true regarding the DSM-5? a. It uses a multiaxial system to organize client diagnoses based on mental disorders, personality disorders, medical conditions, psychosocial factors, and global assessment of functioning. b. It uses a nonaxial system of diagnosis, in which mental health disorders, medical conditions, and psychosocial issues are listed on one axis. c. It avoids a dimensional approach to diagnosis to reduce the chance of variability and error in diagnosis. d. It is no longer aligned with the ICD-10, because the APA believed the ICD-10 was over-emphasizing biology in its mental health diagnostic criteria. 14. Which of the following is considered a depressive disorder? a. Substance Use Disorder b. Obsessive-Compulsive Disorder c. Tourette’s d. Disruptive Mood Dysregulation Disorder 15. People with which classification of disorders present with physical symptoms that initially appear to be medical in nature but cannot fully be explained as medical conditions? a. Feeding and Eating disorders b. Somatic Symptom and Related Disorders c. Anxiety disorders d. Depressive disorders 16. Which of the following is an example of a disorder in the category of disruptive, impulsecontrol, and conduct disorders? a. Anorexia Nervosa b. Adjustment Disorder c. Generalized Anxiety Disorder d. Kleptomania 17. Which of the following terms refers to a disorder being an integral part of the self? a. Egosyntonic b. Pica c. Schizotypal d. Histrionic 18. Which of the following is characteristic of someone with a Cluster B personality disorder? a. eccentricity 28 b. anxiety and fear c. emotional dysregulation d. all of the above are characteristics of someone with a Cluster B personality disorder 19. The “I” in the “DO A CLIENT MAP” model refers to a. Individual differences b. Individuation c. Interventions d. Interests 20. Which of the following questions is related to the psychological part of a biopsychosocial assessment? a. What genetic factors may be influencing the client’s wellbeing? b. What medications is the client taking? c. Does the client have a history of addiction or dependency? d. What cultural factors are relevant to the client’s presenting problem? e. Has the client experienced legal difficulties Essay Questions 1. Describe three ways in which assessment facilitates the counseling process. 2. Describe seven of the thirteen principles outlined by Hood and Johnson (2007) to help counselors conduct assessments skillfully. 3. Discuss the potential benefits and risks/limitations of diagnosis. CHAPTER 6: HOLISTIC APPROACHES TO CLINICAL MENTAL HEALTH COUNSELING KEY TERMS Biopsychosocial model Neurotransmitters Limbic system Messenger molecules BATHE Treatment plan Spirituality Religion Mindfulness Intention Attention Attitude 29 Wellness Salutogenic Wheel of Wellness Indivisible Self Prevention Primary prevention Secondary prevention Tertiary prevention Configural equation Incidence formula Stress Vulnerable populations QUESTIONS Multiple Choice Questions 1. Which of the following focuses on multiple, interrelated ways biology, psychology, and social/cultural factors are conducive or detrimental to health and well-being? a. Whole person approach b. Holistic mental health approach c. Biopsychosocial model d. None of the above. 2. Biological components of the BPS model include all of the following except a. Physical factors b. Biochemical factors c. Genetic factors d. Emotional intelligence 3. All of the following describe neurotransmitters except a. Chemicals in the brain that account for the transmission of signals from one neuron to the next across synapses. b. A complex set of structures that lies on both sides and underneath the thalamus, just under the cerebrum. c. Produced by the glands, such as the pituitary gland and adrenal glands d. Messenger molecules released from one neuron to another 4. A decrease in which neurotransmitter is linked to an increase in hyperactivity and irritability? a. Serotonin b. Dopamine c. Norepinephrine d. None of the above 30 5. _____________ is an inhibitory neurotransmitter that is closely associated with emotion and mood. a. Serotonin b. Dopamine c. Norepinephrine d. None of the above 6. Your client, Marcus, shares with you that he often reacts very passionately and aggressively to anyone he believes is taking advantage of him. From a biological perspective, what organ plays a key role in Marcus’s expression of emotions? a. Pituitary gland b. Frontal cortex c. Limbic system d. None of the above 7. According to Nauert (2008), decline in an individual’s immune system after facing chronic stress is due to which stress hormone? a. Cortisol b. Adrenalin c. Neurepinephrine d. GABA 8. In what way(s) do genetics play a key role in the biological component of the BPS model? a. Many psychiatric conditions have a genetic component that puts individuals at a higher risk for developing certain disorders b. They include support systems and work relationships that intersect one’s personal cultural identity. c. They independently determine the activation, severity and duration of mental disorders d. All of the above 9. Which of the following components of the BPS model include patterns of thinking, coping skills, judgment, perceptions, and emotional intelligence? a. Biological b. Psychological c. Social d. Sociocultural 10. You determine that your client is low in emotional intelligence. Which of the following would support this belief? a. Your client shares that he perceives and understands emotions in others really well but struggles to express them herself. b. Your client indicates that she is very logical and regulates her emotions very well. 31 c. Your client shares a history of relationship difficulties, and indicates that she struggles to share how she feels to her partners and rarely perceives or understands their emotions d. Your client shares that her pituitary gland isn’t working properly and she has been feeling really lethargic lately. 11. All of the following are areas of assessment in the BATHE technique except a. Background b. Empathy c. Trouble d. Handling e. Anatomy 12. _____________ has been referred to as the social or organized means by which a person expresses spirituality? a. Spirituality b. Religion c. Existentialism d. Theological counseling 13. _______________ is paying attention to the here and now in a purposeful, nonjudgmental manner. a. Spirituality b. Religion c. Mindfulness d. None of the above 14. All of the following are core building blocks of mindfulness except a. Intention b. Attention c. Attitude d. All of the above are core building blocks of mindfulness 15. All of the following are second-order factors of the IS-Wel except a. Creative self b. Social self c. Physical self d. Essential self e. Spiritual self 16. Which of the following IS-Wel contexts refers to lifespan over time? a. Local b. Institutional c. Global d. Chronometrical 17. Which of the following is a way to use the Indivisible Self Model in counseling? 32 a. As an introduction of the Wellness model b. As an assessment of the wellness components c. To facilitate the development of a personal wellness plan d. For evaluation and follow-up e. All of the above 18. Which of the following is an example of secondary prevention? a. A counselor begins work with a person who is beginning to show signs of anxiety following a traumatic event. b. A counselor is working with a client who is dependent on alcohol. c. A counselor provides workshops to students on stress reduction. d. All of the following represent examples of a secondary prevention 19. Which of the following prevention models emphasizes the need to bolster people’s coping skills, self-esteem, and support systems? a. Configural equation b. Incidence formula c. Primary prevention calculation d. None of the above 20. All of the following are components that McNamara (2000) suggests a stress management program should include except a. General cognitive skills b. Physical ways of coping with stress c. Time management d. Skills for increasing self-control and self-esteem e. All of the above are components suggested by McNamara (2000) Essay Questions 1. Discuss the benefits of primary prevention efforts by counselors. 2. List the five components of the BATHE technique, and give two examples of how a clinical mental health counselor could address each area. 3. List and describe McNamara’s (2000) eight components of a stress management program. CHAPTER 7: CONSULTATION, ADVOCACY, AND EVALUATION KEY TERMS Consultation Client-Centered Case Consultation Consultee-Centered Case Consultation Program-Centered Administrative Consultation Consultee-Centered Administrative Consultation Consultee 33 Third party Advocacy Outreach Social justice Empowerment Social action Client outcome research Evidenced-based treatment (EBT) Evidenced-based practice (EBP) Moderators Treatment integrity Program evaluation Needs assessment Process evaluation or formative evaluation Program outcome evaluation or summative evaluation, or product evaluation Quality assurance Quality of care QUESTIONS Multiple Choice Questions 1. Who, according to Erchul (2009), is known as the father of the modern practice of mental health consultation? a. Frank Parsons b. Carl Rogers c. Viktor Frankl d. Gerald Caplan 2. Which of the following is a definition of mental health consultation? a. A problem solving, interpersonal relationship that develops through periodic faceto-face contacts between consultant and consultee. b. A systematic collection of information about the activities, qualities, and results of clinical mental health counseling programs c. A set of methods or approaches used to determine if there is a need for a certain program or intervention. d. None of the above 3. Which of the following would represent a “third party” in mental health consultation? a. A counselor receiving consultation for work with a client b. A consultant working with a counselor to help a client c. A client being served by a counselor who is receiving consultation d. None of the above 4. Which of the following is true regarding consultation? a. It represents a dyadic relationship between the consultant and consultee(s) 34 b. It is a direct relationship in that the consultant works directly with the client or client system. c. It is an indirect relationship in that the consultant works with the consultee, who works with the client or client system. d. None of the above 5. What is the purpose of consultation? a. To help the consultee with the challenges presented by the consultee’s client b. To increase the consultee’s skills for working independently with similar problems in the future. c. To directly help clients develop the skills necessary to cope with mental health challenges. d. Both a and b e. None of the above 6. In which of Caplan’s four types of mental health consultation is the primary goal to develop a plan to help a specific client? a. Client-centered case consultation b. Consultee-centered case consultation c. Program-centered administrative consultation d. Consultee-centered administrative consultation 7. In which of Caplan’s four types of mental health consultation is the primary goal to assess the consultee and administrative staff to develop more effective professional functioning of an individual, group, or entire organization? a. Client-centered case consultation b. Consultee-centered case consultation c. Program-centered administrative consultation d. Consultee-centered administrative consultation 8. The goal of consultee-centered case consultation is a. To develop a plan to help a specific client b. To improve the consultee’s ability to work effectively with a particular case as well as with similar cases c. To help an individual or group of consultees develop a new program or improve an existing one d. To assess the consultee and administrative staff to develop more effective professional functioning of an individual, group, or entire organization 9. A ______________ is an employee of an organization; whereas, a ________________ is not a regular employee of an organization or agency and is often brought into an organization for a specific purpose. a. supervisor; consultant b. consultant; supervisor c. internal consultant; external consultant d. external consultant; internal consultant 35 10. Which of the following expands the traditional role of individual counseling to a broader focus that addresses injustice, oppression, and environmental conditions that need to improve for the benefit of an individual or group? a. Process consultation b. Supervisory counseling c. Advocacy counseling d. Multicultural consultation 11. _______________ is a process through which clients gain the resources and skills needed to have more control over their environments and their lives. a. Outreach b. Empowerment c. Social Justice d. None of the above 12. ________________ includes contributing to the development of a strong professional identity, lobbying for professional recognition, and demonstrating professional pride and accountability. a. Advocacy counseling b. Social action c. Social justice d. Professional advocacy 13. _______________ are identified based on the outcomes of randomized controlled trials. a. Evidence-based practices b. Needs assessments c. Program evaluations d. Evidence-based treatments 14. _____________, according to Kazdin (2008), “refers to clinical practice that is informed by evidence about interventions, clinical expertise, and client needs, values, and preferences and their integration in decision making about individual care” a. Evidence-based practice b. Needs assessment c. Program evaluation d. Evidence-based treatment 15. Which of the following assessments is used to measure subjective well-being, presenting symptoms, overall life functioning, quality of life, and the therapeutic alliance? a. Outcome Questionnaire-45.2 b. Clinical Outcomes in Routine Evaluation c. Beck Depression Inventory II d. Client Evaluation of Counseling Inventory 36 16. Which of the following is a computerized system designed to measure clients’ subjective well-being, problems and symptoms, life functioning, and risk/harm? a. Outcome Questionnaire-45.2 b. Clinical Outcomes in Routine Evaluation c. Beck Depression Inventory II d. Client Evaluation of Counseling Inventory 17. Which of the following is a definition of a needs assessment? a. A problem solving, interpersonal relationship that develops through periodic faceto-face contacts between consultant and consultee. b. A systematic collection of information about the activities, qualities, and results of clinical mental health counseling programs c. A set of methods or approaches used to determine if there is a need for a certain program or intervention. d. None of the above 18. _________________ provides information about how well a program is being implemented a. Process evaluation, also called formative evaluation b. Program outcome evaluation, also called summative evaluation c. Process evaluation, also called summative evaluation d. Program evaluation, also called product evaluation 19. __________________ is an ongoing process by which an agency and outside groups monitor the quality of services offered a. Consultation b. Needs assessment c. Advocacy counseling d. Quality assurance 20. __________________ connects the costs of implementing a particular program with the benefits achieved by the participants. a. Efficiency evaluation b. Inefficiency evaluation c. Efficacy evaluation d. Sustainability assessment Essay Questions 1. Describe four qualities of a successful consultant. 2. Describe five ways in which counselors might serve as advocates. 3. Describe three issues or challenges of program evaluation. 4. List and describe the 5C’s of empowerment developed by McWhirter (1994) 37 CHAPTER 8: DEALING WITH CRISES, DISASTERS, AND SUICIDE, WHIILE MANAGING STRESS AND AVOIDING BURNOUT KEY TERMS Crisis ABCX model of crisis Double ABCX model of crisis Developmental crises Situational crises Existential crises Nonevents Ecosystemic crises Posttraumatic Stress