NCMHCE Study Set, Exam predictor questions and answers, rated A+

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NCMHCE Study Set, Exam predictor questions and answers, rated A+ Always read if loved one put something on assessment - ✔✔-Always read if loved one put/left you a note If there is an injury ... in the case study always look at medical history - ✔✔- Cognitive functioning must be evaluated in order to assess for the possible presence of disturbed cognitive processes associated with psychoses and abnormal content associated with mood or anxiety disorders. - ✔✔-However, there was abnormal cognitive content in the form of thoughts of helplessness, anxiety about her physical condition, and worry about the future. If the case study mentions job, or something happened at the job that lead to symptoms, you must inquire about it - ✔✔- Refer for medical evaluation question-always look to make sure they aren't already involved - ✔✔- Supportive psychotherapy is a type of intervention that emphasizes "ego-building" and is characterized by the use of interventions such as clarification (helping the client articulate something that is difficult to put into words), encouragement ("I want to encourage you to learn to access a computer"), empathic validation ("I can understand why you feel depressed about that"), advice and praise ("I am very pleased that you were able to set limits on those things that are hurtful for you"), and affirmation ("uh-huh" or "yes, I see what you mean"). Education and providing information can also be very supportive ("depression is often caused by inadequate neurotransmission of key chemicals in the brain"). - ✔✔- Only do pharmacotherapy if the symptoms are severe enough - ✔✔- Mindfulness is a group-based therapy is weekly, each of 8 sessions last 2.5-3 hours and consists of exercises designed to raise consciousness and to anchor stressful thoughts in the present experience or moment. Two and a half to three hours might be too long initially but the therapy can be started once the therapist and client have processed the stress reduction benefits. See treatment discussion box after completing the scenario for more information. - ✔✔- at the end when it asks what recommendtaions should the counselor make during termination, be careful of the word "refer" - ✔✔- Do not refer for medication until a diagnosis has been made - ✔✔- After completing initial evaluation, and asks for recommendations, do not give strategies like supportive therapy - ✔✔- Formal testing, including the MMPI-II and Beck's Depression Inventory, may be helpful to ascertain the presence of hidden symptoms and the severity of symptoms. It does seem that a diagnosis can be made without additional costs since finances are a concern stated by Mary Jones. There has been no indication that Mary has personal psychological health benefits (insurance) or that her company has an associated health plan benefit. - ✔✔- Family history is always important, particularly to determine the possibility of a history of mood and anxiety disorders. - ✔✔- Referral for psychological testing with the MMPI-II was not recommended due to cost efficiency and that the diagnosis can be made without an additional expense. - ✔✔-Therapy recommendations are typically made after a diagnosis is confirmed. If like an adjustment disorder can do SFBT - ✔✔- The use of psychotropic drugs such as antidepressants prescribed for adjustment disorder with anxious or depressed mood is not properly founded and should be avoided in less severe forms of this disturbance (van der Klink, Blonk, Schene, & van Dijk, 2003; Cartay, Balestrieri, Murree, & Hardoy, 2009). However, antidepressant medications are typically prescribed for individuals who prefer them and are not candidates for psychotherapy. - ✔✔- Observing the severity of physical symptoms is useful since physical symptoms, particularly pain, tend to improve when depression and anxiety are lessened. - ✔✔- Monitoring her level of engaging in interpersonal and social activities is a subjective measurement and an indication of symptom relief. - ✔✔- The Beck Depression Inventory can be used to monitor however it is recommended that a pre-post measure is taken. Assuming this inventory was used during the initial information gathering process, the Beck Depression Inventory can be an objective and inexpensive self-reporting instrument that could be easily administered as a way of monitoring improvement during treatment. - ✔✔- sleep log as self if there is a sleep diagnosis or if sleep was an important symptom - ✔✔- Predispositions may be discovered in a family history of substance use, mood disorders, tics, and eating disorders. - ✔✔- Relationship evaluation may be good for treatment but not needed for diagnosis - ✔✔- slurred speech/crazy symptoms=get medical history - ✔✔- During provisional diagnosis page=can do beck inventory so that can do it later - ✔✔- With alcohol or drugs mentioned always ask for legal issues - ✔✔- With drugs or alcohol always ask for suicidal ideation/history/etc. - ✔✔- Research with this addiction scale suggests it may be a risk rather than an indicator (Nichols, 2001). A referral for the administration of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; MAC-R [Revised]), a subscale of the MMPI-2-Revised, has been successfully used to screen for alcohol abuse and dependent behaviors (DSM-IV) or alcohol use disorder (DSM-5). The MAST and the CAGE are two instruments that are not cost prohibitive and easy to administer one or more times by counselors who would find them to be within the scope of their practice. - ✔✔- The SCL-90-R is considered a screening tool; however, it is useful in assessment and is intended to pick up on psychological distress and psychopathology. A 'caseness' is determined when The Global Severity Index (GSI) T-score is 63 or greater or any of the nine scales reach that same T-score. The SCL-90-R scales include somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Caseness was not determined for Margaret Alcy on any of the SCL-90-R scales or the GSI. - ✔✔- Psychodrama is a powerful therapeutic tool, particularly to resolve emotional distress related to prior interpersonal conflicts. - ✔✔- The standard treatment for alcohol abuse (dependency) or alcohol use disorder begins with the acute management of withdrawal symptoms in detoxification programs. This is followed by long-term management of dependence and prevention of relapse (Klerman et al., 1994). The client, if she agrees with the 12 step principles, should also be active in an AA 12-Step program. - ✔✔- with AoD to check for improved symptoms look at the following: - ✔✔-nature of relationships, AA attendance with AoD-termination recommendations - ✔✔-discontinue unhealthy relationships ALWAYS START WITH CBT Techniques on test and then move to others - ✔✔- On test after you are given symptoms, think what diagnosis do you think this is, and then choose a test for it - ✔✔- Minimally/plausible required is a right answer - ✔✔- off the symptoms, think what diagnosis, then ask questions based on what you think is right diagnosis - ✔✔- civic organization= community resources - ✔✔- interpersonal reminiescene: personal refelection - ✔✔- cat - ✔✔-feline Provisional diagnosis - ✔✔-Real deal diagnosis-you have enough to make the diagnosis Plausible diagnosis - ✔✔-Broadly describe the client with broad brush strokes- ex. Some anxiety but don't know enough info to make precise. Then ask you which diagnosis would be plausible- think what category, then choose all the fit. Ex. Maybe agoraphobia, panic disorder...LOOK AT specific time frames for this. ex. someone struggled with anxiety for four months and GAD is an option. Do not choose it because must be six months. These are could be diagnosis. Differential diagnosis - ✔✔-What are all of the other diagnosis that goes with bi-polar, PTSD-think categorically...Think mood vs. anxiety. Think which class it falls into. Which diagnosis can you rule out? - ✔✔-Read question carefully!!! When ask what can rule-out (exclude), think which one isn't a match for what chose thus far. LOOK AT TIME FRAMes-if worried for four months then can't be GAD because it takes six months...also, if they have anxiety, then cross of bipolar. On test, you can order test outside of scope of practice. Select any test that makes sense on any plausible diagnosis. ex. minor having problem in school, can order IQ test. - ✔✔- When get unspecified as part of diagnosis option, think of critieria- time duration severity-does it fit? - ✔✔- NEED 71%-get not indicated, relax, say stupid test, and re-read question - ✔✔- Anxiety disorders - ✔✔-Yoga and art therapy can help treat what Consider working and building rapport/trust with client prior to referral-exam favors this-real world should refer - ✔✔-If don't know culture or not familiar with diagnosis used in group or family therapy - ✔✔-Enactment therapy consult, discuss with supervisor, further assessments, review treatment plan-take steps - ✔✔-if don't reach goal in several weeks what do? could have adjustment disorder - ✔✔-pregnant woman who is struggling - ✔✔-If anxiety or mood ask about medical conditions - ✔✔-18 y/o or older, give insurance info to them, not to parents even if parents have the insurance let radar go up for ADHD - ✔✔-see word "impulsivity" Substance Abuse Issues - ✔✔-Mental status exam does not assess for - ✔✔-If client is focused on having a disease, go with illness anxiety disorder. if focused on process like having heart attack, then panic disorder kids. Always integrate family/kids. - ✔✔-Include parents when counseling - ✔✔-flooding, implosion-not indicated for anxiety even though it is favored on exam for even alcoholism - ✔✔-empty chair - ✔✔-Memory is part of mental status exam only share if part of informed consent - ✔✔-working with divorced couples - ✔✔-DONT FALL FOR CIGARETTE DEPENDENCE DISORDER-not in DSMonly refer to what is available in the jail - ✔✔-Working with incarcerated clients If no other kids involved, then give them information about shelters, empower then, educate them, but we don't jump in - ✔✔-pregnant woman abused what do? parents/kids aren't providers - ✔✔-which providers give reports? could be specific phobia, situational - ✔✔-test taking panic you should check for drug and alcohol - ✔✔-With teens, problem behavior indicated - ✔✔-go back and re-read presenting problems to bring in symptoms to track progress - ✔✔-If clients miss appointments don't terminate can be a symptom of panic disorder - ✔✔-Blanking out - ✔✔-Follow up with medical doctor for medical conditions or refer for gyncological exam for sexually active - ✔✔-May send full records to other therapist, clients do not get full access to notes - ✔✔-lots of energy= hypno manic - ✔✔-when requesting for additional sessions form insurance company, identify items on treatment plan not identified and short term/cost effective interventions - ✔✔-Psychasthenia is a psychological disorder characterized by phobias, obsessions, compulsions, or excessive anxiety. The term is no longer in psychiatric diagnostic use, although it still forms one of the ten clinical subscales of the popular self-report personality inventories MMPI and MMPI-2. indicated for phobias and even bulliama- choose if makes sense - ✔✔-Assertiveness training Think roughly five dollars - ✔✔-Accepting gifts think bi-polar 2 - ✔✔-Clt. has history of increased energy and depression consider choosing a maybe if you are in the 50% guideline - ✔✔-informational gathering - ✔✔-Roughly 50% of choices will be correct +/-1..so if 12, roughly 5-7 will be right. Think what would be diagnosis and then try to pick things that will give you insight into symptoms Medical history - ✔✔-Mood or anxiety disorder, must ask about what? - ✔✔-If give an intervention, think what theory- for example, for termination they say give a list of Thougth stopping techniues...This is CBT so will probably be good - ✔✔-Ask about developmental/educational history when working with minors to rule out learning disabilities, pervasive developmental disorders, - ✔✔-Ask about family history of mental history if suspect the following disorders: mood disorders, major depressive disorders, bipolar, schizophrenia, anxiety, adhd, personality disorders, and substance abuse past attempts, plan, depression, AoD, stressors, willingness to contract, plan, hopelessness, behaviors, health status, socialization - ✔✔-Assessing suicide risk threatened violence, name the individual, history of violence, reality testing, personality disorder, AoD usage, plan, means to carry it out, impulsivity, mental health issues - ✔✔-going to harm someone Choose the most risk adverse choices- ex. not okay to email - ✔✔-Legal/ethical issues - ✔✔-Read ethics B&F supervisor, supervisee, and client - ✔✔-triadic relationship - ✔✔-client does not meet supervisor for the exam - ✔✔-Informed consent- supervisee is aware of how being evaluated. Due process-document red flags along the way - ✔✔-Gatekeeper issues: ongoing issues in regards to performance Transitory issues: had a bad a headache and weren't there a hundred percent - ✔✔-mid-teen: treat the teen and the parents as equals in contract for therapy, both sign, everyone signs consents, has a right to copies - ✔✔-Consultant: look at teachers to judge progress. Also, your role is to evaluate the effectiveness of the school-based interventions of the school counselor - ✔✔-Custody mediation: Focus on the objective criteria: how are the kids doing in school, sleeping arrangements, etc. avoid issues such as what are they watching on tv, what is the parent's new partner like? - ✔✔-Stay in your role on the exam: ex. if you are mediator, and kid develops problems, you refer to someone for therapy. You don't do it yourself. - ✔✔-from a young child do not do self-reports EKG - ✔✔-chest pain, palpitatios, panic attacks, are evaluated with sleep laboratories - ✔✔-nightmares, sleep disordes are evaluated in neuroimaging like CT scans, MRI's - ✔✔-changes in cognition are evaluated with PET scans - ✔✔-used for diagnossing brain tumors, stroeks, and neuron damaging with things like dementia Mental Status exam - ✔✔-If there appears to be a major mood disorder, substance use, psychoses, and neurocognive disorder, ask for - ✔✔-If adjustment disorder think brief interventions such as stress inoculation and the miracle question Tourette's Syndrome, Eating disorders, Tics, Alcohol, ADHD, Borderline personality disorder, and social anxiety - ✔✔-Family predispositions screening instrument - ✔✔-SCL-90-R screening instrument - ✔✔-Alcohol Use Disorder Identification Test (AUDIT) screening instrument - ✔✔-Inventory of Interpersonal Problems screening instrument - ✔✔-Screening for avoidant personality inventory measuring low in domincance and affiliation screening instrument - ✔✔-Traumatic Events Screening Inventory screening instrument - ✔✔-Primary Care PTSD Screen Anxiety instrument - ✔✔-PROMIS Anxiety Anxiety instrument - ✔✔-Mood and Anxiety symptom Questionnaire Anxiety instrument - ✔✔-Genralized Anxiety Disorder Scale Anxiety instrument - ✔✔-Positive and Negative Disorder Scale Use an assessment - ✔✔-depression Use an assessment - ✔✔-oppositional defiant disorder Use an assessment - ✔✔-PTSD for children/adults Use an assessment - ✔✔-substance abuse used pre-interview. 23 questions, 13 domains includeing depression, anger, mania, anxiety, somatic symptoms, suicidal ideation, psychosis, sleep problems. If clients score slightly higher in certain domains a level 2 instument may be needed. - ✔✔-DSM-5 Self-Rated Level 1 Cross Cutting Symptom MeasureAdult pre-interveiw, 25 questions, 12 domains including depression, anger, mania, anxiety, somatic symptoms, suicidal ideation, psychosis, sleep problems, inattention, repetite thoughts, and behaviors, irriatiablity, and substance use. - ✔✔-Parent/Guardian-Rated DSM-5 Self-Rated Level 1 Cross Cutting Symptom Measure-Child Age (6-17) assesses neuropsychological development in preschool and school age children (3-8 years old). useful with ADHD and LD. Useful for general assessment, diagnositic assessment, selective assessment, full assessment. Think ADHD, pervasive developmental disorder, language disorder, math disorder, reading disorder. - ✔✔-Neuropsychology II (NEPSY-II) measures visual-motor integration skills in childen and adults ages 4-85. Measures visual motor sckills. Useful in identification of intellectual disabilities, reading difficulties, and personality dynamics. diagnosis of organic brain abnormally, psychotic dysfunction, anxiety states, psychomotac conditions, sexual disturbances, cultural differences, and psychoneurotic conditions: Measures alcoholism, malingering and psychollgical alterations. - ✔✔-Bender Gestalt II 18 years or older, psychopathology and normal/abnormal function-looks for hypcohodrias, depression, hysteria, psychopathic deviate, paranoi, psychoasthenia, schizophrenia, hypoman, social introversionintroversion, masculinity-feminiity, Harris-Lingoes, subscale, MaCandrews addiction scale revise, malinger, etc. - ✔✔-Minnesota Multiphasic Personality Inventory-2 14-18-borderline, depressed mood, eating disorders, homicidal behavior, manfest aggression, victimazation by incest, sleeping problems, phsycial disabilities, schizophrenia. - ✔✔-Minnesoate Multiphasic Personality Inventory Adolescent used for clinical decision making. ranges on age and was a pre-adolescent version (9-12) and the adolescent inventory (13-19). Used for anxiety, bipolar, manci, alcohol, dgrug dependence, ptsd, personality disorders, - ✔✔-Millon Clinical Multiaxal Inventory (MCMII-II) Mood questionnaire. characteristics of positive affect are high energy, ethusiams, and full conctrention, active, and alert. Negative affect charactersitics may be distress, anger, disgust, guilt, fear. - ✔✔-Positive Affect and Negative Affect Scales (PANAS) the Caps is considered one or two instruments most commonly used for assessing PTSD. - ✔✔-Clinican Administered PTSD Scale (CAPS) self-report chiecklist from the past month - ✔✔-PTSD Checklist measures severity of depression in adults and adolescents (13 and older) - ✔✔-BDI-II Beck Depression Inventory diagnose children and adolescents ages 4-18 with behavior problems. think disruptive and emotional scales, social withdrawal, ability deficits, physical deficits [Show More]

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