COCAS study guide
COCAS · Work through your exam, one topic at a time.
The COCAS credential is intended for clinicians who assess and treat cognitive and behavioral health concerns and who want a formal, exam-based demonstration of that competency. It suits counselors, psychologists, and allied mental health professionals whose work centers on clinical assessment, cognitive-behavioral intervention, and coordinated care. The COCAS study guide has 8 sections and about 1,984 words.
01Clinical Assessment and Diagnosis
Clinical assessment in counseling psychology rests on psychometric literacy: reliability (internal consistency, test-retest, inter-rater), validity (content, criterion, construct), and the standard error of measurement. Candidates should know the DSM-5-TR and ICD-11 organizing logic, including the shift from multiaxial diagnosis to separate notation of psychosocial stressors (Z codes) and disability.
315 words, about 2 min02Cognitive-Behavioral Theory and Intervention
CBT is grounded in the cognitive model: situations are filtered through appraisals, which drive emotion and behavior. Candidates should master the cognitive triad, automatic thoughts, intermediate beliefs (rules and assumptions), and core beliefs, plus behavioral principles (operant and respondent conditioning, exposure, behavioral activation, reinforcement).
255 words, about 1 min03Psychopharmacology and Medical Collaboration
Counseling psychologists need working knowledge of major drug classes, mechanisms, and side effects: SSRIs/SNRIs (serotonin syndrome, discontinuation syndrome), bupropion (lowers seizure threshold), TCAs (anticholinergic and cardiac risk), MAOIs (tyramine and drug interactions), benzodiazepines (tolerance, dependence, falls), antipsychotics (metabolic syndrome, EPS, tardive dyskinesia, NMS), mood stabilizers (lithium toxicity and renal/thyroid monitoring; valproate hepatotoxicity and teratogenicity), and stimulants (cardiovascular effects). Know black-box warnings, especially suicidality in youth on antidepressants.
234 words, about 1 min04Ethics, Legal, and Professional Standards
Ethics codes (APA, and state licensure law) govern competence, informed consent, confidentiality and its limits, multiple relationships, boundaries, fees, and record-keeping. Know the difference between ethical standards and legal requirements, and that when they conflict, the higher standard generally governs.
244 words, about 1 min05Research Methods and Evidence-Based Practice
Candidates should understand study designs (RCTs, quasi-experimental, cohort, case-control, single-case designs), threats to validity (internal, external, statistical conclusion), and bias sources (selection, attrition, detection, publication). Know effect sizes (Cohen's d, r, NNT), confidence intervals, statistical versus clinical significance, and how to read a meta-analysis forest plot.
223 words, about 1 min06Cultural Diversity and Social Justice
Cultural competence and humility require awareness of one's own biases, knowledge of clients' worldviews, and skills for culturally responsive intervention. Know the Multicultural Counseling Competencies, the Cultural Formulation Interview, and the impact of acculturation, enculturation, and acculturative stress.
237 words, about 1 min07Supervision, Consultation, and Training
Supervision is a distinct competency with its own models (developmental, discrimination, integrative) and tasks: gatekeeping, evaluation, and ensuring client welfare. Know the supervisory working alliance, the power differential, and the need for informed consent for supervision, including who sees records and how evaluation occurs.
234 words, about 1 min08Practice Management and Administration
Practice management covers business, legal, and clinical operations: business structures (sole proprietorship, LLC, group practice), credentialing and insurance panels, CPT codes and documentation standards, fee setting and sliding scales, billing and collections, and record retention per state law. Know HIPAA privacy and security requirements, including business associate agreements, risk analysis, and breach notification.
242 words, about 1 min