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COCAS practice questions

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Question 1Clinical Assessment and Diagnosis

Which term describes the consistency of a measurement instrument in producing stable results across repeated administrations?

  1. Validity
  2. Sensitivity
  3. Reliability Correct answer.
  4. Standardization

Explanation

Reliability refers to the consistency and stability of scores produced by an instrument over repeated administrations or across raters. Validity concerns whether the instrument measures what it claims to measure.

Question 2Clinical Assessment and Diagnosis

A clinician wants to know how well a new depression screening tool agrees with a structured diagnostic interview. Which type of validity is being examined?

  1. Face validity
  2. Content validity
  3. Construct validity
  4. Criterion validity Correct answer.

Explanation

Criterion validity assesses how well a measure correlates with an established external standard or criterion, such as a structured diagnostic interview. Content and face validity concern item coverage and surface plausibility rather than agreement with a criterion.

Question 3Clinical Assessment and Diagnosis

In test interpretation, a false negative on a screening instrument means that the instrument:

  1. Yielded an inconsistent result across raters
  2. Identified a disorder that is not present
  3. Produced an invalid raw score
  4. Failed to identify a disorder that is present Correct answer.

Explanation

A false negative occurs when a screening measure fails to detect a condition that is actually present. A false positive, by contrast, flags a condition that is not present.

Question 4Clinical Assessment and Diagnosis

A test has high sensitivity but low specificity. Which interpretation is most accurate?

  1. It is unsuitable for any clinical use
  2. It produces equal rates of false positives and false negatives
  3. It rarely misses true cases but often flags non-cases Correct answer.
  4. It rarely flags non-cases but often misses true cases

Explanation

Sensitivity is the ability to correctly identify those with the condition, so high sensitivity means few false negatives. Low specificity means many people without the condition will still test positive, producing false positives.

Question 5Clinical Assessment and Diagnosis

Which statistic expresses the probability that a person with a positive test result actually has the disorder?

  1. Odds ratio
  2. Positive predictive value Correct answer.
  3. Negative predictive value
  4. Likelihood ratio negative

Explanation

Positive predictive value is the proportion of individuals with a positive test who truly have the condition. It depends on both test characteristics and the prevalence of the disorder in the population tested.

Question 6Clinical Assessment and Diagnosis

As the base rate (prevalence) of a disorder decreases in a population, what happens to the positive predictive value of a fixed screening test?

  1. It increases
  2. It remains unchanged
  3. It decreases Correct answer.
  4. It becomes equal to sensitivity

Explanation

Positive predictive value falls as prevalence declines because a larger share of positive results come from the many non-cases, inflating false positives. Sensitivity and specificity remain stable, but predictive values shift with base rates.

Question 7Clinical Assessment and Diagnosis

Which reliability coefficient is most appropriate when two independent clinicians rate the same clients on a categorical diagnosis?

  1. Split-half reliability
  2. Cohen's kappa Correct answer.
  3. Cronbach's alpha
  4. Pearson correlation of raw scores

Explanation

Cohen's kappa measures agreement between two raters on categorical judgments while correcting for chance agreement. Cronbach's alpha and split-half methods assess internal consistency of scale items rather than interrater agreement.

Question 8Clinical Assessment and Diagnosis

The standard error of measurement is most directly useful for:

  1. Establishing content validity of items
  2. Calculating interrater agreement
  3. Estimating the range of error around an observed score Correct answer.
  4. Determining the base rate of a disorder

Explanation

The standard error of measurement quantifies the expected variability of observed scores around a true score, allowing construction of confidence intervals around a single score. It is derived from reliability and the standard deviation of scores.

Question 9Clinical Assessment and Diagnosis

Which of the following best characterizes a structured diagnostic interview?

  1. It relies entirely on clinician intuition without fixed questions
  2. It uses predetermined questions and scoring rules to standardize diagnosis Correct answer.
  3. It is used only for personality assessment
  4. It eliminates the need for clinical judgment

Explanation

Structured interviews use fixed question sets and explicit scoring rules to improve diagnostic reliability across interviewers. They standardize administration but still require trained clinical judgment in interpretation.

Question 10Clinical Assessment and Diagnosis

A clinician uses the mental status examination to assess a client. Which element is typically included in this examination?

  1. Thought process and content Correct answer.
  2. Intelligence quotient scoring
  3. Projective figure drawings
  4. Neuropsychological test norms

Explanation

The mental status examination systematically assesses domains such as appearance, mood, thought process and content, cognition, and insight. It is a structured observational assessment rather than a standardized psychometric test.

Question 11Clinical Assessment and Diagnosis

During a mental status examination, a client jumps rapidly between loosely connected ideas. This finding is best documented as:

  1. Perseveration
  2. Confabulation
  3. Aphasia
  4. Flight of ideas Correct answer.

Explanation

Flight of ideas describes rapid, loosely connected speech in which the speaker shifts between topics. It is commonly associated with manic episodes and reflects accelerated thought process.

Question 12Clinical Assessment and Diagnosis

Which assessment approach is most consistent with the behavioral tradition?

  1. Measuring observable behaviors and their environmental triggers Correct answer.
  2. Classifying traits through self-report inventories
  3. Analyzing unconscious conflicts
  4. Interpreting ambiguous inkblot responses

Explanation

Behavioral assessment emphasizes observable behavior and the environmental conditions that evoke and maintain it. It favors direct observation, functional analysis, and behavioral recording over inferential methods.

Question 13Clinical Assessment and Diagnosis

A school psychologist records how often a student leaves their seat during class using a tally of each occurrence. This method is best described as:

  1. Interval recording
  2. Time sampling
  3. Event sampling Correct answer.
  4. Situational sampling

Explanation

Event sampling (frequency recording) tallies each occurrence of a target behavior as it happens. Time and interval sampling instead divide observation into periods and note whether the behavior occurs within each period.

Question 14Clinical Assessment and Diagnosis

Which of the following is a defining feature of a projective personality test?

  1. Ambiguous stimuli inviting open interpretation Correct answer.
  2. Direct self-report of symptoms
  3. Norms based on behavioral counts
  4. Fixed-choice response format

Explanation

Projective tests present ambiguous stimuli, such as inkblots or incomplete sentences, and interpret the examinee's responses as reflecting internal processes. Fixed-choice and direct self-report formats characterize objective inventories instead.

Question 15Clinical Assessment and Diagnosis

A clinician administers the same intelligence test to a client twice within one month and compares scores to estimate consistency over time. Which reliability is being assessed?

  1. Interrater reliability
  2. Internal consistency
  3. Test-retest reliability Correct answer.
  4. Parallel-forms reliability

Explanation

Test-retest reliability examines the stability of scores when the same instrument is administered to the same individuals on two occasions. Internal consistency and interrater reliability address different sources of measurement error.

Question 16Clinical Assessment and Diagnosis

Which factor most directly limits the generalizability of a psychological test's norms?

  1. The demographic composition of the normative sample Correct answer.
  2. The test's internal consistency coefficient
  3. The examiner's years of experience
  4. The number of items on the test

Explanation

Norms are interpretable only for populations resembling the standardization sample, so a sample that differs demographically from the client limits generalizability. Item count and examiner experience do not determine whether norms apply to a given individual.

Question 17Clinical Assessment and Diagnosis

In the context of intellectual assessment, a standard score of 100 on a test with a mean of 100 and a standard deviation of 15 corresponds to:

  1. The 84th percentile
  2. One standard deviation above the mean
  3. The 50th percentile Correct answer.
  4. Two standard deviations below the mean

Explanation

A standard score equal to the mean (100) corresponds to the 50th percentile in a normal distribution. Scores of 115 and 85 would correspond to approximately the 84th and 16th percentiles, respectively.

Question 18Clinical Assessment and Diagnosis

Which of the following best describes a T-score distribution?

  1. Mean of 50 and standard deviation of 10 Correct answer.
  2. Mean of 0 and standard deviation of 1
  3. Mean of 100 and standard deviation of 10
  4. Mean of 100 and standard deviation of 15

Explanation

T-scores are standardized scores with a mean of 50 and a standard deviation of 10, often used in personality and symptom inventories. Z-scores use a mean of 0 and standard deviation of 1, while many IQ tests use a mean of 100 and standard deviation of 15.

Question 19Clinical Assessment and Diagnosis

A clinician suspects malingering during a forensic evaluation. Which approach is most appropriate?

  1. Accepting reported symptoms at face value
  2. Administering validated symptom validity and performance validity measures Correct answer.
  3. Relying on a single unstructured interview
  4. Referring the client to projective testing only

Explanation

Symptom validity and performance validity tests are empirically validated tools for detecting feigned or exaggerated deficits. They should be combined with collateral information and clinical judgment rather than relying on a single method.

Question 20Clinical Assessment and Diagnosis

Which of the following is a key limitation of self-report inventories in clinical assessment?

  1. They are vulnerable to response bias and social desirability Correct answer.
  2. They require projective interpretation
  3. They cannot be administered in groups
  4. They cannot be scored objectively

Explanation

Self-report inventories depend on respondents' honesty and insight, making them susceptible to social desirability, underreporting, and other response biases. Many include validity scales to detect such distortions but cannot eliminate them.

Question 21Clinical Assessment and Diagnosis

Which assessment method would best capture the frequency of a target behavior across natural settings over time?

  1. Ecological momentary assessment Correct answer.
  2. Projective storytelling task
  3. One-time clinical interview
  4. Single administration of a self-report scale

Explanation

Ecological momentary assessment collects repeated real-time reports of behavior and context in natural environments, capturing variability over time and settings. Single-occasion methods cannot capture this naturalistic, time-varying information.

Question 22Clinical Assessment and Diagnosis

A test manual reports a specificity of 0.90. This means that:

  1. 90% of positive results are true cases
  2. 90% of negative results are true non-cases
  3. 90% of people without the disorder test negative Correct answer.
  4. 90% of people with the disorder test positive

Explanation

Specificity is the proportion of individuals without the condition who are correctly classified as negative. It is a property of the test itself and does not depend on prevalence, unlike predictive values.

Question 23Clinical Assessment and Diagnosis

Which statement best reflects the relationship between reliability and validity?

  1. A test can be reliable without being valid Correct answer.
  2. A test can be valid without being reliable
  3. Validity guarantees high reliability
  4. Reliability and validity are identical properties

Explanation

Reliability is necessary but not sufficient for validity: a test may consistently measure the wrong construct. Therefore, a reliable test can still lack validity, but an unreliable test cannot be strongly valid.

Question 24Clinical Assessment and Diagnosis

Which of the following is a primary purpose of a clinical case formulation?

  1. Integrating assessment data into an explanatory account guiding treatment Correct answer.
  2. Assigning a billing code
  3. Establishing test-retest reliability
  4. Standardizing normative data

Explanation

Case formulation integrates assessment findings, history, and theory into a coherent explanation of the client's difficulties that guides intervention planning. It is a clinical reasoning process distinct from coding or psychometric standardization.

Question 25Clinical Assessment and Diagnosis

A client's score falls at the 16th percentile on a norm-referenced measure. Approximately how many standard deviations below the mean is this, assuming a normal distribution?

  1. Three standard deviations below the mean
  2. Two standard deviations below the mean
  3. One standard deviation below the mean Correct answer.
  4. Half a standard deviation below the mean

Explanation

In a normal distribution, approximately 16% of scores fall below one standard deviation beneath the mean. Two standard deviations below the mean corresponds to roughly the 2nd percentile.

Question 26Clinical Assessment and Diagnosis

A clinician is evaluating a client and needs to determine whether the client's symptoms meet criteria for major depressive disorder. Which classification system is most commonly used for this purpose in the United States?

  1. DSM-5 Correct answer.
  2. Research Domain Criteria (RDoC)
  3. Psychodynamic Diagnostic Manual (PDM)
  4. ICD-11

Explanation

The DSM-5 is the standard classification system used in the United States for diagnosing mental disorders. It provides explicit criteria for each disorder, facilitating reliable diagnosis.

Question 27Clinical Assessment and Diagnosis

A client reports experiencing persistent sadness, loss of interest, and sleep disturbances for the past three weeks. According to DSM-5 criteria for a major depressive episode, which additional symptom is required to meet the minimum symptom count?

  1. Fatigue or loss of energy Correct answer.
  2. Psychomotor agitation
  3. Hypersomnia
  4. Increased appetite

Explanation

DSM-5 requires at least five symptoms during a two-week period for a major depressive episode. The core symptoms include depressed mood and anhedonia, and additional symptoms such as fatigue, worthlessness, or suicidal ideation must be present to reach the threshold.

Question 28Clinical Assessment and Diagnosis

A 10-year-old child presents with frequent temper outbursts and irritability. The clinician considers disruptive mood dysregulation disorder (DMDD). Which of the following is a core criterion for DMDD?

  1. Severe recurrent temper outbursts occurring at least three times per week Correct answer.
  2. Hallucinations
  3. Grandiose delusions
  4. Pervasive anhedonia

Explanation

DMDD is characterized by severe recurrent temper outbursts that are grossly out of proportion to the situation and occur on average three or more times per week. The outbursts must be present for at least 12 months, with no period of two or more months without symptoms.

Question 29Clinical Assessment and Diagnosis

A client presents with excessive anxiety and worry about multiple events. The clinician suspects generalized anxiety disorder (GAD). Which of the following is a key DSM-5 criterion for GAD?

  1. The worry is solely about having a panic attack
  2. The worry is limited to one specific domain, such as health
  3. The worry is always accompanied by panic attacks
  4. The worry occurs more days than not for at least six months Correct answer.

Explanation

GAD is defined by excessive anxiety and worry occurring more days than not for at least six months about a number of events or activities. The worry is not confined to one domain and is not solely about panic attacks.

Question 30Clinical Assessment and Diagnosis

A clinician is assessing a client for possible bipolar I disorder. Which of the following is required for a diagnosis of a manic episode?

  1. Depressed mood lasting at least two weeks
  2. Hypomanic symptoms lasting at least four days
  3. Mixed features lasting at least one month
  4. Elevated, expansive, or irritable mood lasting at least one week Correct answer.

Explanation

A manic episode requires a distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least one week (or any duration if hospitalization is necessary). This is a core criterion for bipolar I disorder.

Question 31Clinical Assessment and Diagnosis

A client is diagnosed with schizophrenia. Which of the following is considered a negative symptom of schizophrenia?

  1. Delusions
  2. Disorganized speech
  3. Hallucinations
  4. Flat affect Correct answer.

Explanation

Negative symptoms involve a decrease or loss of normal functions, such as flat affect, avolition, and alogia. Positive symptoms include delusions, hallucinations, and disorganized speech.

Question 32Clinical Assessment and Diagnosis

A clinician suspects that a client has obsessive-compulsive disorder (OCD). Which of the following best distinguishes obsessions from compulsions?

  1. Obsessions are always about contamination, while compulsions are always about checking
  2. Obsessions are voluntary, while compulsions are involuntary
  3. Obsessions are intrusive and unwanted thoughts, while compulsions are repetitive behaviors or mental acts Correct answer.
  4. Obsessions are repetitive behaviors, while compulsions are intrusive thoughts

Explanation

Obsessions are defined as recurrent and persistent thoughts, urges, or images that are intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rigid rules.

Question 33Clinical Assessment and Diagnosis

A client experiences recurrent, unexpected panic attacks and worries about having another attack. The clinician diagnoses panic disorder. Which additional criterion is required for panic disorder?

  1. The panic attacks are always triggered by a specific situation
  2. The panic attacks occur only during sleep
  3. The panic attacks are due to a medical condition
  4. The panic attacks are followed by at least one month of persistent concern about additional attacks or their consequences Correct answer.

Explanation

Panic disorder requires recurrent unexpected panic attacks followed by at least one month of persistent concern or worry about additional panic attacks or their consequences, or a significant maladaptive change in behavior related to the attacks.

Question 34Clinical Assessment and Diagnosis

A client reports a history of being easily startled, having nightmares, and avoiding reminders of a traumatic event. The clinician considers posttraumatic stress disorder (PTSD). Which of the following is a DSM-5 criterion for PTSD?

  1. The client must have a comorbid diagnosis of depression
  2. The client must experience delusions
  3. The traumatic event occurred more than 10 years ago
  4. Exposure to actual or threatened death, serious injury, or sexual violence Correct answer.

Explanation

PTSD requires exposure to actual or threatened death, serious injury, or sexual violence in one or more ways, such as direct experience, witnessing, learning that the event occurred to a close family member or friend, or repeated exposure to aversive details.

Question 35Clinical Assessment and Diagnosis

A clinician is assessing a client with a suspected personality disorder. The client displays a pattern of instability in interpersonal relationships, self-image, and affect, along with marked impulsivity. Which personality disorder is most consistent with these features?

  1. Obsessive-compulsive personality disorder
  2. Borderline personality disorder Correct answer.
  3. Antisocial personality disorder
  4. Avoidant personality disorder

Explanation

Borderline personality disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity. These features are core to the diagnosis.

Question 36Clinical Assessment and Diagnosis

A client presents with a lack of interest in social relationships and restricted emotional expression. The clinician suspects schizoid personality disorder. Which of the following best differentiates schizoid personality disorder from avoidant personality disorder?

  1. Individuals with schizoid personality disorder have little desire for social relationships and are indifferent to criticism Correct answer.
  2. Individuals with schizoid personality disorder experience frequent psychotic episodes
  3. Individuals with schizoid personality disorder desire social relationships but fear rejection
  4. Individuals with schizoid personality disorder have a history of impulsive and risky behaviors

Explanation

Schizoid personality disorder is characterized by a lack of desire for social relationships and indifference to praise or criticism. In contrast, avoidant personality disorder involves a desire for relationships but fear of rejection and criticism.

Question 37Clinical Assessment and Diagnosis

A clinician is using the mental status examination to assess a client. Which of the following is typically evaluated under the cognitive domain of the MSE?

  1. Mood and affect
  2. Orientation and memory Correct answer.
  3. Speech rate and volume
  4. Grooming and hygiene

Explanation

The cognitive domain of the MSE includes assessment of orientation, attention, memory, and executive function. Grooming, speech, and mood are assessed in other domains.

Question 38Clinical Assessment and Diagnosis

A clinician is conducting a diagnostic interview and needs to determine the client's current level of functioning. Which tool is specifically designed to assess global functioning?

  1. Wechsler Adult Intelligence Scale (WAIS)
  2. Beck Depression Inventory (BDI)
  3. Minnesota Multiphasic Personality Inventory (MMPI)
  4. Global Assessment of Functioning (GAF) scale Correct answer.

Explanation

The GAF scale is a numeric scale (0 through 100) used to rate the social, occupational, and psychological functioning of adults. It was included in DSM-IV-TR but is no longer in DSM-5; however, it remains a recognized tool for global functioning.

Question 39Clinical Assessment and Diagnosis

A clinician is evaluating a client for possible attention-deficit/hyperactivity disorder (ADHD). Which of the following is a DSM-5 criterion for ADHD?

  1. Symptoms must be accompanied by anxiety
  2. Symptoms must be limited to one setting
  3. Symptoms must be present before age 12 Correct answer.
  4. Symptoms must include motor tics

Explanation

DSM-5 requires that several symptoms of ADHD be present before age 12. Additionally, symptoms must be present in two or more settings and cause impairment.

Question 40Clinical Assessment and Diagnosis

A clinician is using the DSM-5 cultural formulation interview (CFI) to assess a client from a different cultural background. What is the primary purpose of the CFI?

  1. To assess intelligence fairly across cultures
  2. To diagnose culture-bound syndromes
  3. To measure acculturation level
  4. To provide a structured approach to assess cultural factors that may influence diagnosis and treatment Correct answer.

Explanation

The CFI is a set of 16 questions designed to help clinicians assess cultural factors that may affect diagnosis, treatment, and the therapeutic relationship. It is not a diagnostic tool for specific syndromes or a measure of acculturation or intelligence.

Question 41Cognitive-Behavioral Theory and Intervention

In Beck's cognitive model, a client's automatic thought that occurs immediately after an event is best described as which level of cognition?

  1. A conscious appraisal that sits at the surface of awareness Correct answer.
  2. A schema that is fully outside awareness at all times
  3. An intermediate rule or assumption the person lives by
  4. A deeply held belief about the self that is stable across situations

Explanation

Beck's model distinguishes levels of cognition: automatic thoughts are situation-specific and generally accessible to awareness, while intermediate beliefs and core beliefs sit deeper. Automatic thoughts are the most surface-level and are the usual first target in cognitive restructuring.

Question 42Cognitive-Behavioral Theory and Intervention

A therapist helps a client record a situation, the resulting emotion, and the thought that preceded the emotion. This intervention is most accurately called:

  1. Exposure hierarchy
  2. A thought record Correct answer.
  3. Behavioral activation
  4. Cognitive rehearsal

Explanation

A thought record is a core CBT tool for capturing the link between situation, thought, and emotional response. It builds the client's skill at identifying and later evaluating automatic thoughts.

Question 43Cognitive-Behavioral Theory and Intervention

Which statement best captures the behavioral principle of negative reinforcement?

  1. A behavior increases because it produces a rewarding consequence
  2. A response is learned by observing another person being rewarded
  3. A behavior decreases because a consequence is added
  4. A behavior increases because it removes an aversive stimulus Correct answer.

Explanation

Reinforcement always increases behavior; the term negative refers to removal of an aversive stimulus. Positive reinforcement increases behavior by adding a consequence, and punishment decreases behavior.

Question 44Cognitive-Behavioral Theory and Intervention

In cognitive therapy, collaborative empiricism means the therapist and client:

  1. Use only behavioral homework without cognitive work
  2. Avoid discussing the client's distorted beliefs
  3. Have the therapist supply conclusions the client should accept
  4. Treat the client's beliefs as evidence to be examined together Correct answer.

Explanation

Collaborative empiricism frames therapy as a joint investigation in which beliefs are treated as hypotheses to test. The client and therapist gather evidence together rather than the therapist asserting what is true.

Question 45Cognitive-Behavioral Theory and Intervention

A client reports, 'If I make one mistake in my presentation, everyone will think I'm incompetent.' Which cognitive distortion is most prominent?

  1. Catastrophizing Correct answer.
  2. Overgeneralization
  3. Mind reading
  4. Personalization

Explanation

Catastrophizing involves treating a single negative event as an unbearable or disastrous outcome. Predicting total ruin from one mistake fits the leap to the worst-case conclusion.

Question 46Cognitive-Behavioral Theory and Intervention

The primary aim of behavioral activation in depression is to:

  1. Challenge the content of automatic thoughts directly
  2. Reduce rumination through mindfulness alone
  3. Increase engagement in activities that provide reinforcement and mastery Correct answer.
  4. Teach progressive muscle relaxation

Explanation

Behavioral activation targets the withdrawal and inactivity that maintain depression by scheduling activities that yield reinforcement and a sense of accomplishment. It works primarily through behavior change rather than direct cognitive restructuring.

Question 47Cognitive-Behavioral Theory and Intervention

A client's fear of elevators is treated by having the client ride the elevator repeatedly without any relaxation training or distraction. This technique is:

  1. Flooding Correct answer.
  2. Covert sensitization
  3. Systematic desensitization
  4. Graded exposure with coping skills

Explanation

Flooding exposes the person to the feared stimulus at high intensity until anxiety subsides, without pairing it with relaxation or coping strategies. It contrasts with graded exposure that builds in coping and gradual steps.

Question 48Cognitive-Behavioral Theory and Intervention

The Socratic question, 'What is the evidence for and against that belief?' is used in cognitive therapy primarily to:

  1. Replace the client's belief with the therapist's view
  2. Establish the therapist's authority
  3. Guide the client toward evaluating a belief rather than accepting it Correct answer.
  4. Distract the client from painful emotion

Explanation

Socratic questioning guides clients to examine evidence and reach their own conclusions, which supports durable belief change. It is a discovery process, not persuasion or distraction.

Question 49Cognitive-Behavioral Theory and Intervention

A client says, 'I failed one exam, so I'm a total failure as a student and a person.' The therapist helps the client examine the evidence for this global judgment. Which cognitive target is being addressed?

  1. A core belief about the self Correct answer.
  2. A skill acquisition problem
  3. A physiological symptom
  4. A behavioral deficit

Explanation

A global judgment about the self as a total failure reflects a core belief, the deepest level of cognition. Cognitive work at this level aims to modify enduring self-evaluations, not just isolated thoughts.

Question 50Cognitive-Behavioral Theory and Intervention

Which is the best example of a behavioral experiment in CBT?

  1. The therapist lectures the client about why the belief is illogical
  2. The client predicts what will happen in a situation and then tests the prediction in real life Correct answer.
  3. The therapist interprets the client's childhood conflicts
  4. The client completes a relaxation exercise before bed

Explanation

A behavioral experiment involves making a specific prediction from a belief and then gathering real-world data to test it. This produces new learning that can revise the belief more effectively than verbal argument alone.