NCMHCE COUNSELING CONCEPTS EXAM
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES 2026
1. Which assessment tool is most appropriate for routinely screening
for depression severity in adult outpatient settings?
A. Minnesota Multiphasic Personality Inventory (MMPI)
B. Patient Health Questionnaire-9 (PHQ-9)
C. Thematic Apperception Test (TAT)
D. Beck Hopelessness Scale
The PHQ-9 is a brief, validated self-report measure designed
specifically to screen and monitor depression severity in outpatient
settings.
2. The primary goal of a biopsychosocial formulation is to:
A. Assign a single diagnosis to the client
B. Identify psychodynamic conflicts only
C. Integrate biological, psychological, and social factors to explain
current functioning
D. Replace the treatment plan with a medication regimen
A biopsychosocial formulation synthesizes multiple domains to
guide individualized case conceptualization and treatment
planning.
3. In motivational interviewing, the clinician's response to sustain
talk should be to:
, A. Challenge the client’s reasons for staying the same
B. Provide education immediately
C. Use reflective listening to explore ambivalence
D. Confront the client about resistance
Reflective listening validates feelings and helps clients resolve
ambivalence, which is central to motivational interviewing.
4. A client reports current passive suicidal ideation without a plan or
intent. The clinician’s immediate action should be to:
A. Discharge the client for noncompliance
B. Conduct a more thorough risk assessment and safety planning
C. Assume low risk and schedule routine follow-up in one month
D. Call law enforcement to involuntarily commit immediately
Passive ideation warrants comprehensive risk assessment and
development of a safety plan tailored to identified risks and
protective factors.
5. The stage of change characterized by no intention to change
behavior in the foreseeable future is:
A. Preparation
B. Action
C. Precontemplation
D. Maintenance
In the transtheoretical model, precontemplation indicates a lack of
readiness or intention to change within the next six months.
6. Which therapeutic technique is most directly designed to help a
client re-evaluate and modify automatic negative thoughts?
A. Flooding
B. Cognitive restructuring
, C. Systematic desensitization
D. Family sculpting
Cognitive restructuring (a core CBT technique) targets automatic
thoughts to change mood and behavior.
7. A counselor is aware of strong personal feelings toward a client
that may affect objectivity. The best ethical step is to:
A. Ignore feelings and continue therapy
B. Terminate treatment immediately without referral
C. Seek supervision or consultation and manage boundaries
appropriately
D. Share personal problems with the client to build rapport
Supervision helps the clinician process countertransference and
ensures client welfare through appropriate boundary
management.
8. For an adult with generalized anxiety disorder, which medication
class is commonly considered first-line in collaboration with a
prescribing provider?
A. Tricyclic antidepressants only
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Typical antipsychotics
D. Barbiturates
SSRIs are commonly recommended as first-line pharmacotherapy
for GAD, often combined with psychotherapy.
9. When documenting informed consent, the clinician should
include:
A. Only the risks of therapy
B. Billing codes and clinical notes verbatim
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES 2026
1. Which assessment tool is most appropriate for routinely screening
for depression severity in adult outpatient settings?
A. Minnesota Multiphasic Personality Inventory (MMPI)
B. Patient Health Questionnaire-9 (PHQ-9)
C. Thematic Apperception Test (TAT)
D. Beck Hopelessness Scale
The PHQ-9 is a brief, validated self-report measure designed
specifically to screen and monitor depression severity in outpatient
settings.
2. The primary goal of a biopsychosocial formulation is to:
A. Assign a single diagnosis to the client
B. Identify psychodynamic conflicts only
C. Integrate biological, psychological, and social factors to explain
current functioning
D. Replace the treatment plan with a medication regimen
A biopsychosocial formulation synthesizes multiple domains to
guide individualized case conceptualization and treatment
planning.
3. In motivational interviewing, the clinician's response to sustain
talk should be to:
, A. Challenge the client’s reasons for staying the same
B. Provide education immediately
C. Use reflective listening to explore ambivalence
D. Confront the client about resistance
Reflective listening validates feelings and helps clients resolve
ambivalence, which is central to motivational interviewing.
4. A client reports current passive suicidal ideation without a plan or
intent. The clinician’s immediate action should be to:
A. Discharge the client for noncompliance
B. Conduct a more thorough risk assessment and safety planning
C. Assume low risk and schedule routine follow-up in one month
D. Call law enforcement to involuntarily commit immediately
Passive ideation warrants comprehensive risk assessment and
development of a safety plan tailored to identified risks and
protective factors.
5. The stage of change characterized by no intention to change
behavior in the foreseeable future is:
A. Preparation
B. Action
C. Precontemplation
D. Maintenance
In the transtheoretical model, precontemplation indicates a lack of
readiness or intention to change within the next six months.
6. Which therapeutic technique is most directly designed to help a
client re-evaluate and modify automatic negative thoughts?
A. Flooding
B. Cognitive restructuring
, C. Systematic desensitization
D. Family sculpting
Cognitive restructuring (a core CBT technique) targets automatic
thoughts to change mood and behavior.
7. A counselor is aware of strong personal feelings toward a client
that may affect objectivity. The best ethical step is to:
A. Ignore feelings and continue therapy
B. Terminate treatment immediately without referral
C. Seek supervision or consultation and manage boundaries
appropriately
D. Share personal problems with the client to build rapport
Supervision helps the clinician process countertransference and
ensures client welfare through appropriate boundary
management.
8. For an adult with generalized anxiety disorder, which medication
class is commonly considered first-line in collaboration with a
prescribing provider?
A. Tricyclic antidepressants only
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Typical antipsychotics
D. Barbiturates
SSRIs are commonly recommended as first-line pharmacotherapy
for GAD, often combined with psychotherapy.
9. When documenting informed consent, the clinician should
include:
A. Only the risks of therapy
B. Billing codes and clinical notes verbatim
