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ROC-MC Practice Test study materials
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ROC-MC Practice Test practice questions

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Question 1Clinical Assessment and Diagnosis

In the mental status examination, which element is assessed by asking a client to interpret a common proverb such as "people who live in glass houses should not throw stones"?

  1. Concentration
  2. Orientation
  3. Remote memory
  4. Abstract reasoning Correct answer.

Explanation

Proverb interpretation is a standard probe of abstract reasoning because it requires the client to move from literal wording to a general meaning. Clients who answer only with a concrete restatement suggest impaired abstraction, which can occur in cognitive disorders or thought disorder.

Question 2Clinical Assessment and Diagnosis

A clinician administers the Mini-Mental State Examination and reports a score of 18 out of 30. How should this result be interpreted?

  1. The score suggests cognitive impairment and warrants further evaluation Correct answer.
  2. The score confirms a diagnosis of delirium
  3. The score is within normal limits for all adults
  4. The score is invalid because the instrument is only for children

Explanation

Scores below the conventional cutoff of about 24 on the MMSE generally indicate possible cognitive impairment and call for fuller assessment. A screening score never establishes a diagnosis by itself; it flags the need for further evaluation and clinical correlation.

Question 3Clinical Assessment and Diagnosis

Which criterion is essential to the diagnosis of a major depressive episode?

  1. Symptoms include at least one manic episode
  2. Symptoms occur only in the winter months
  3. Symptoms are present for at least one month
  4. Symptoms persist for at least two weeks and cause clinically significant distress or impairment Correct answer.

Explanation

A major depressive episode requires at least five depressive symptoms present for a minimum of two weeks, with associated distress or functional impairment. The duration and impairment requirements distinguish a diagnosable episode from transient low mood.

Question 4Clinical Assessment and Diagnosis

A client reports recurrent, unexpected episodes of intense fear that peak within minutes and include palpitations and a fear of dying. Which diagnosis is most consistent with this presentation?

  1. Social anxiety disorder
  2. Specific phobia
  3. Generalized anxiety disorder
  4. Panic disorder Correct answer.

Explanation

Recurrent unexpected panic attacks followed by persistent worry about further attacks or their consequences characterize panic disorder. The key features are the spontaneous onset and the subsequent anticipatory concern.

Question 5Clinical Assessment and Diagnosis

Which feature most clearly distinguishes obsessions from delusions?

  1. Obsessions last only seconds, whereas delusions last for years
  2. Obsessions are experienced as intrusive and unwanted, whereas delusions are held as fixed beliefs Correct answer.
  3. Obsessions involve motor behavior, whereas delusions involve perception
  4. Obsessions are always accompanied by hallucinations

Explanation

Obsessions are recurrent intrusive thoughts the person recognizes as ego-dystonic and tries to resist. Delusions are fixed false beliefs held with conviction despite contrary evidence, which separates the two phenomena.

Question 6Clinical Assessment and Diagnosis

A client's speech jumps from topic to topic with loose associations, and the connections between ideas are difficult to follow. This finding is best described as which type of thought disturbance?

  1. Flight of ideas
  2. Obsessive doubt
  3. Formal thought disorder Correct answer.
  4. Delusion of grandeur

Explanation

Formal thought disorder refers to abnormalities in the form or organization of thinking, such as loose associations and derailment. Content disturbances such as delusions are classified separately from the stream and form of thought.

Question 7Clinical Assessment and Diagnosis

Which instrument is a clinician-rated scale specifically designed to rate the severity of depressive symptoms?

  1. Hamilton Depression Rating Scale Correct answer.
  2. Mini-Mental State Examination
  3. Global Assessment of Functioning
  4. Adult Attachment Interview

Explanation

The Hamilton Depression Rating Scale is a clinician-administered measure of depressive symptom severity. It quantifies symptom burden and is commonly used to track treatment response.

Question 8Clinical Assessment and Diagnosis

During an interview a client describes hearing voices commenting on their actions when no one else is present. This experience is best classified as which phenomenon?

  1. Auditory hallucination Correct answer.
  2. Depersonalization
  3. Delusion of reference
  4. Illusion

Explanation

A hallucination is a sensory perception occurring without an external stimulus, and hearing voices in the absence of others is an auditory hallucination. An illusion, by contrast, is a misperception of a real stimulus.

Question 9Clinical Assessment and Diagnosis

A client meets criteria for a manic episode with prominent irritable mood and marked impairment requiring hospitalization. Which diagnosis does this presentation support?

  1. Persistent depressive disorder
  2. Cyclothymic disorder
  3. Schizoaffective disorder, depressive type
  4. Bipolar I disorder Correct answer.

Explanation

A full manic episode, regardless of whether a depressive episode has occurred, is sufficient for a bipolar I diagnosis. Hospitalization and marked impairment underscore the severity typical of mania.

Question 10Clinical Assessment and Diagnosis

Which finding on mental status examination is most characteristic of delirium rather than dementia?

  1. Preserved consciousness throughout
  2. Insidious onset with stable attention
  3. Gradual decline in memory over years
  4. Acute onset with fluctuating level of attention Correct answer.

Explanation

Delirium is marked by an acute onset, fluctuating course, and impaired attention and awareness. Dementia typically has an insidious, progressive course with attention relatively preserved until late stages.

Question 11Clinical Assessment and Diagnosis

A client is preoccupied with a perceived defect in appearance that others cannot see, and this preoccupation causes significant distress. Which diagnosis is most consistent?

  1. Anorexia nervosa
  2. Illness anxiety disorder
  3. Conversion disorder
  4. Body dysmorphic disorder Correct answer.

Explanation

Preoccupation with an imagined or slight appearance flaw that is not observable to others, with resulting distress, defines body dysmorphic disorder. The concern is specifically about appearance rather than health or weight per se.

Question 12Clinical Assessment and Diagnosis

Which assessment approach gathers information from multiple informants and multiple methods to increase diagnostic accuracy?

  1. Multimethod, multi-informant assessment Correct answer.
  2. Single-informant self-report only
  3. Relying on a single screening score
  4. Unstructured clinical impression alone

Explanation

Multimethod, multi-informant assessment combines interviews, rating scales, and reports from different sources to reduce bias and improve accuracy. Converging evidence across sources strengthens diagnostic confidence.

Question 13Clinical Assessment and Diagnosis

A client reports a persistent fear of negative evaluation in social situations, avoided for six months, causing occupational impairment. Which diagnosis best fits?

  1. Agoraphobia
  2. Generalized anxiety disorder
  3. Social anxiety disorder Correct answer.
  4. Panic disorder

Explanation

Marked fear of negative evaluation in social situations, with avoidance and impairment lasting six months or more, meets criteria for social anxiety disorder. The fear is specifically tied to scrutiny by others.

Question 14Clinical Assessment and Diagnosis

Which element of a mental status examination specifically evaluates a client's awareness of the current date, location, and identity?

  1. Insight
  2. Mood
  3. Judgment
  4. Orientation Correct answer.

Explanation

Orientation assesses awareness of time, place, and person and is a core component of cognitive status. Disorientation often signals acute or significant cognitive disturbance.

Question 15Clinical Assessment and Diagnosis

A client describes a fixed belief that government agents are transmitting thoughts into their mind, despite evidence to the contrary. This is best classified as which symptom?

  1. Illusion
  2. Hallucination
  3. Delusion Correct answer.
  4. Obsession

Explanation

A delusion is a fixed false belief held with strong conviction despite contradictory evidence, and thought insertion by external agents fits this definition. Hallucinations are perceptual, whereas delusions are beliefs.

Question 16Clinical Assessment and Diagnosis

Which of the following is a key criterion for diagnosing generalized anxiety disorder?

  1. Fear of gaining weight with restricted intake
  2. Presence of at least one manic episode
  3. Worry limited to one specific situation for two weeks
  4. Excessive worry across multiple domains for at least six months Correct answer.

Explanation

Generalized anxiety disorder requires excessive, difficult-to-control worry about several areas occurring more days than not for at least six months. The worry is diffuse rather than confined to a single situation.

Question 17Clinical Assessment and Diagnosis

A clinician wants to quantify overall psychiatric symptom severity and track change over treatment. Which type of instrument is most appropriate?

  1. A structured diagnostic interview
  2. A projective personality test
  3. A standardized symptom rating scale Correct answer.
  4. A neuroimaging study

Explanation

Standardized symptom rating scales yield quantifiable scores that can be repeated to track change over time. They are designed for measuring severity and treatment response.

Question 18Clinical Assessment and Diagnosis

Which feature best supports a diagnosis of a specific phobia?

  1. Fear of all social situations equally
  2. Fear of contamination with compulsive washing
  3. Fear occurring only during unexpected panic attacks
  4. Marked fear of a circumscribed object or situation, out of proportion to actual danger Correct answer.

Explanation

Specific phobia involves marked, persistent fear of a circumscribed stimulus that is disproportionate to the actual threat and typically leads to avoidance. The fear is focused rather than generalized or spontaneous.

Question 19Clinical Assessment and Diagnosis

A client's speech is rapid and pressured, with leaps between ideas that remain loosely connected, and the client reports decreased need for sleep. These findings most suggest which condition?

  1. Panic attack
  2. Obsessive-compulsive episode
  3. Major depressive episode
  4. Manic episode Correct answer.

Explanation

Pressured speech, flight of ideas, and decreased need for sleep are classic features of mania. The combination reflects elevated energy and accelerated thought and activity.

Question 20Clinical Assessment and Diagnosis

Which statement best reflects the distinction between a screening instrument and a diagnostic assessment?

  1. Screening establishes the disorder, while diagnostic assessment only flags risk
  2. Screening identifies those needing further evaluation, while diagnostic assessment establishes the disorder Correct answer.
  3. Screening is used only for children, and diagnostic assessment only for adults
  4. Screening and diagnostic assessment are interchangeable in clinical practice

Explanation

Screening tools are brief measures that flag individuals who may need fuller evaluation. Diagnostic assessment integrates history, criteria, and clinical judgment to establish whether a disorder is present.

Question 21Clinical Assessment and Diagnosis

Which of the following best describes a structured diagnostic interview?

  1. A standardized set of questions with specified wording and scoring rules to improve reliability Correct answer.
  2. A laboratory test for psychiatric disorders
  3. An open-ended conversation with no fixed questions
  4. A projective drawing task

Explanation

Structured interviews use standardized questions and scoring rules to increase diagnostic reliability across clinicians. Standardization reduces variability in how symptoms are elicited and judged.

Question 22Clinical Assessment and Diagnosis

A client reports low mood, anhedonia, and insomnia for three weeks following a significant loss. Which consideration is most important before assigning a depressive disorder diagnosis?

  1. Whether the client has ever had a manic episode
  2. Whether the symptoms are better explained by bereavement or another medical condition Correct answer.
  3. Whether the client prefers a particular diagnosis
  4. Whether the client has a family history of diabetes

Explanation

Before diagnosing a depressive disorder, clinicians must rule out that symptoms are better explained by another condition, including grief or a medical cause. Differential diagnosis ensures the symptoms are not attributable to a more fitting explanation.

Question 23Clinical Assessment and Diagnosis

Which mental status finding would most strongly suggest impaired insight?

  1. The client denies any problem despite clear evidence of severe impairment Correct answer.
  2. The client reports a sad mood
  3. The client correctly identifies the date and location
  4. The client demonstrates intact attention

Explanation

Insight refers to awareness of one's condition and need for treatment; denying an obvious problem indicates impaired insight. Intact orientation, mood reporting, and attention do not address insight directly.

Question 24Clinical Assessment and Diagnosis

Which pattern of symptoms is most consistent with obsessive-compulsive disorder?

  1. Intrusive contamination thoughts followed by repetitive washing to reduce anxiety Correct answer.
  2. Fixed belief that one is a famous person
  3. Hearing voices when no one is present
  4. Unexpected panic attacks with fear of dying

Explanation

Obsessive-compulsive disorder involves intrusive obsessions and repetitive compulsions performed to reduce distress. The washing ritual is a compulsion linked to contamination obsessions.

Question 25Clinical Assessment and Diagnosis

Which finding on a cognitive screen most specifically suggests a delirium superimposed on dementia?

  1. A consistent score across repeated testing
  2. A previously stable cognitive baseline now showing acute worsening attention and fluctuation Correct answer.
  3. A lifelong history of low mood
  4. A stable mild memory decline over several years

Explanation

Delirium superimposed on dementia is suggested when a person with a stable cognitive baseline develops acute worsening attention and fluctuating course. The change from baseline is the key signal.

Question 26Clinical Assessment and Diagnosis

During a mental status examination, a client is asked to name the current President, recall three words after five minutes, and copy a geometric figure. Which cognitive domain is being assessed by the three-word recall task?

  1. Memory Correct answer.
  2. Executive function
  3. Attention
  4. Language

Explanation

Recall of three words after a delay primarily tests memory, specifically short-term and delayed verbal recall. Attention is typically assessed by digit span or serial sevens, executive function by tasks like alternating sequences, and language by naming or fluency.

Question 27Clinical Assessment and Diagnosis

A clinician is evaluating a client for possible major depressive disorder. Which symptom must be present for at least two weeks to meet the core criterion for a major depressive episode?

  1. Recurrent thoughts of death
  2. Insomnia or hypersomnia
  3. Depressed mood or loss of interest/pleasure Correct answer.
  4. Fatigue or loss of energy

Explanation

The core criterion for a major depressive episode requires either depressed mood or anhedonia (loss of interest or pleasure) nearly every day for at least two weeks. The other symptoms are additional criteria that may support the diagnosis but are not sufficient alone.

Question 28Clinical Assessment and Diagnosis

A client presents with an abrupt onset of inattention, fluctuating level of consciousness, and perceptual disturbances over the past two days. Which diagnosis should be the primary consideration?

  1. Dementia
  2. Major depressive disorder
  3. Delirium Correct answer.
  4. Schizophrenia

Explanation

Acute onset, fluctuating consciousness, and inattention are hallmark features of delirium, which is a medical emergency. Dementia typically has an insidious onset with stable consciousness, while schizophrenia and depression do not typically present with acute fluctuating consciousness.

Question 29Clinical Assessment and Diagnosis

A client reports experiencing recurrent, unexpected panic attacks and worries persistently about having another attack for six months. Which diagnosis is most appropriate?

  1. Panic disorder Correct answer.
  2. Social anxiety disorder
  3. Specific phobia
  4. Generalized anxiety disorder

Explanation

Panic disorder is characterized by recurrent unexpected panic attacks and persistent concern about future attacks or their consequences for at least one month. Generalized anxiety disorder involves excessive worry about multiple domains, while social anxiety and specific phobia involve fear triggered by specific situations or objects.

Question 30Clinical Assessment and Diagnosis

A client describes hearing voices that comment on their actions and sometimes argue with each other. These experiences occur when no one else is present. How should the clinician document this finding?

  1. Auditory hallucinations Correct answer.
  2. Obsessions
  3. Illusions
  4. Delusions

Explanation

Perceptions without external stimuli are hallucinations; hearing voices when alone is a classic auditory hallucination. Illusions are misinterpretations of real stimuli, delusions are fixed false beliefs, and obsessions are intrusive thoughts.

Question 31Clinical Assessment and Diagnosis

A clinician wants to assess a client's ability to understand and follow instructions, which may be impaired in delirium. Which bedside task best evaluates this cognitive domain?

  1. Asking the client to follow a three-step command Correct answer.
  2. Asking the client to recall three objects after five minutes
  3. Asking the client to spell 'world' backwards
  4. Asking the client to name the current season

Explanation

Following a multi-step command assesses comprehension, attention, and execution, which are often impaired in delirium. Naming the season tests orientation, recall tests memory, and spelling backwards tests attention and working memory.

Question 32Clinical Assessment and Diagnosis

A client reports a persistent belief that their spouse is being replaced by an identical imposter, despite clear evidence to the contrary. This belief is not shared by others and causes significant distress. What type of delusion is this?

  1. Persecutory delusion
  2. Somatic delusion
  3. Delusional misidentification Correct answer.
  4. Grandiose delusion

Explanation

Delusional misidentification involves the belief that a familiar person has been replaced by an imposter, known as Capgras syndrome. Persecutory delusions involve beliefs of being harmed, grandiose delusions involve inflated self-worth, and somatic delusions involve bodily functioning.

Question 33Clinical Assessment and Diagnosis

A 70-year-old client with a history of dementia presents with a sudden worsening of confusion, visual hallucinations, and fluctuating alertness over the past 24 hours. Which assessment finding would most strongly suggest that this is a delirium superimposed on dementia?

  1. Acute onset with fluctuating attention Correct answer.
  2. Gradual improvement in memory
  3. Stable cognitive decline over months
  4. Preserved orientation to time and place

Explanation

Delirium is characterized by an acute onset and fluctuating attention, which distinguishes it from the stable, gradual decline of dementia. The other options describe features of dementia or recovery, not acute delirium.

Question 34Clinical Assessment and Diagnosis

A clinician is differentiating between a diagnosis of schizophrenia and schizoaffective disorder. Which feature is essential to the diagnosis of schizoaffective disorder?

  1. Prominent negative symptoms
  2. A major mood episode concurrent with active-phase psychotic symptoms Correct answer.
  3. Psychotic symptoms for at least six months
  4. A history of at least one manic episode

Explanation

Schizoaffective disorder requires that a major mood episode (depressive or manic) be present for the majority of the total duration of the illness, concurrent with psychotic symptoms. Schizophrenia requires psychotic symptoms for at least six months without a predominant mood episode.

Question 35Clinical Assessment and Diagnosis

A client with suspected bipolar disorder is being assessed for a current manic episode. Which symptom is most specific to mania rather than hypomania?

  1. Pressured speech
  2. Increased goal-directed activity
  3. Marked impairment in social or occupational functioning Correct answer.
  4. Decreased need for sleep

Explanation

Mania is distinguished from hypomania by marked impairment in functioning, need for hospitalization, or psychotic features. Increased goal-directed activity, decreased need for sleep, and pressured speech can occur in both mania and hypomania.

Question 36Clinical Assessment and Diagnosis

A clinician is assessing a client who reports hearing voices and believes that neighbors are spying on them. The clinician wants to quantify the severity of these symptoms and track changes over time. Which instrument is most appropriate?

  1. Mini-Mental State Examination (MMSE)
  2. Positive and Negative Syndrome Scale (PANSS) Correct answer.
  3. Hamilton Depression Rating Scale (HAM-D)
  4. Global Assessment of Functioning (GAF)

Explanation

The PANSS is a clinician-rated scale specifically designed to assess the severity of positive and negative symptoms in schizophrenia. The HAM-D measures depression, the MMSE assesses cognition, and the GAF measures overall functioning, not symptom severity.

Question 37Therapeutic Relationships and Counseling Skills

A counselor uses active listening with a client. Which behavior best demonstrates this skill?

  1. The counselor shares a similar personal experience to build rapport.
  2. The counselor summarizes the client's main points and asks a clarifying question. Correct answer.
  3. The counselor advises the client on how to solve the problem quickly.
  4. The counselor changes the subject when the client becomes emotional.

Explanation

Active listening involves fully attending to the client, reflecting content and feelings, and checking understanding through summaries and clarifying questions. It keeps the focus on the client's experience rather than on the counselor's own stories or advice.

Question 38Therapeutic Relationships and Counseling Skills

Which statement is an example of a reflection of feeling?

  1. I think you should talk to your supervisor about the workload.
  2. You sound frustrated that your efforts at home are not being recognized. Correct answer.
  3. Have you considered setting a boundary with your sister?
  4. You have been working at the same company for five years.

Explanation

A reflection of feeling names the emotion the client appears to be experiencing and often links it to the situation, which helps clients feel understood. It differs from paraphrasing content, asking questions, or giving advice.

Question 39Therapeutic Relationships and Counseling Skills

What is the primary purpose of using open-ended questions in a counseling session?

  1. To confirm the counselor's hypothesis about the client.
  2. To keep the session structured and on schedule.
  3. To obtain specific factual details quickly.
  4. To encourage the client to elaborate and explore their thoughts and feelings. Correct answer.

Explanation

Open-ended questions invite clients to expand on their experiences, promoting exploration and self-disclosure. Closed questions are better suited to gathering specific facts or confirming details.

Question 40Therapeutic Relationships and Counseling Skills

A client says, "I don't know why I even bother trying anymore." Which response best demonstrates empathy?

  1. Why do you think you feel that way?
  2. It sounds like you're feeling discouraged and wondering whether your efforts matter. Correct answer.
  3. Everyone feels that way sometimes; it will pass.
  4. You should try to focus on the positive things in your life.

Explanation

Empathy involves perceiving and communicating understanding of the client's feelings and meaning. Reflecting the discouragement and the underlying question about effort conveys that the counselor grasps the client's experience.

Question 41Therapeutic Relationships and Counseling Skills

Which of the following is a characteristic of a therapeutic relationship?

  1. It requires the counselor to remain emotionally detached.
  2. It involves mutual sharing of personal problems.
  3. It is primarily a friendship with professional boundaries.
  4. It is time-limited and focused on the client's goals. Correct answer.

Explanation

A therapeutic relationship is a professional alliance with clear boundaries, a defined purpose, and a focus on the client's goals, often within a time-limited framework. It is not a friendship, and emotional detachment is not required; instead, controlled emotional involvement is used.

Question 42Therapeutic Relationships and Counseling Skills

What is the main function of a counselor's use of immediacy?

  1. To address what is happening in the therapeutic relationship in the present moment. Correct answer.
  2. To provide immediate solutions to the client's presenting problem.
  3. To schedule the next appointment without delay.
  4. To disclose the counselor's personal history right away.

Explanation

Immediacy involves discussing the current interaction between counselor and client, such as tensions, reactions, or patterns in the relationship. It is not about solving problems quickly or sharing personal history.

Question 43Therapeutic Relationships and Counseling Skills

Which of the following best describes the purpose of a treatment plan in counseling?

  1. It lists the fees and payment schedule for services.
  2. It outlines agreed-upon goals, interventions, and methods for evaluating progress. Correct answer.
  3. It documents the counselor's personal notes about the client's appearance.
  4. It serves as a legal contract that cannot be changed.

Explanation

A treatment plan is a collaborative document that specifies goals, objectives, interventions, and evaluation methods to guide and monitor therapy. It is a flexible blueprint rather than an immutable contract or a billing document.

Question 44Therapeutic Relationships and Counseling Skills

A counselor notices a client becoming tearful and says, "Take your time; I'm here with you." Which skill is the counselor primarily using?

  1. Supporting and containing the client's emotional experience. Correct answer.
  2. Challenging the client's emotional response.
  3. Structuring the session agenda.
  4. Interpreting the client's behavior.

Explanation

The counselor is offering support and containment, allowing the client to experience and express emotion safely without judgment or interruption. This fosters trust and emotional regulation.

Question 45Therapeutic Relationships and Counseling Skills

Which of the following is an example of a closed question?

  1. How do you feel about your relationship?
  2. What was that experience like for you?
  3. Did you sleep well last night? Correct answer.
  4. What would you like to focus on today?

Explanation

Closed questions can be answered with a brief yes/no or specific fact and are useful for gathering information. Open-ended questions invite elaboration and exploration.

Question 46Therapeutic Relationships and Counseling Skills

A client repeatedly arrives late and avoids discussing it. The counselor decides to address this pattern directly in the session. Which skill is being used?

  1. Reframing
  2. Paraphrasing
  3. Self-disclosure
  4. Immediacy Correct answer.

Explanation

Immediacy involves discussing the here-and-now interaction between counselor and client, including patterns such as lateness that may reflect relational dynamics. Paraphrasing restates content, reframing offers a new perspective, and self-disclosure shares personal information.

Question 47Therapeutic Relationships and Counseling Skills

During a session, a client says, "My partner never listens to me." Which response best uses paraphrasing?

  1. You should tell your partner how you feel.
  2. My partner doesn't listen to me either.
  3. You feel unheard by your partner. Correct answer.
  4. Why do you think your partner doesn't listen?

Explanation

Paraphrasing restates the essence of the client's message in the counselor's own words, demonstrating understanding without adding advice or interpretation. It keeps the focus on the client's meaning.

Question 48Therapeutic Relationships and Counseling Skills

A counselor is working with a client who has a history of trauma. The client begins to dissociate during the session. What is the counselor's most appropriate initial response?

  1. Ask the client to describe the trauma in detail.
  2. Use grounding techniques to help the client return to the present moment. Correct answer.
  3. End the session immediately without discussion.
  4. Continue exploring the traumatic memory to process it fully.

Explanation

When a client dissociates, the priority is to restore present-moment awareness and safety through grounding techniques. Pushing further into trauma material can worsen dissociation and is contraindicated at that moment.

Question 49Therapeutic Relationships and Counseling Skills

Which of the following best illustrates the use of a scaling question in solution-focused counseling?

  1. Can you tell me more about your childhood?
  2. On a scale of 1 to 10, how confident are you that you can handle this situation? Correct answer.
  3. Why do you think you keep repeating this pattern?
  4. What do you think is causing your anxiety?

Explanation

Scaling questions ask clients to rate their experience or confidence on a numerical scale, helping them visualize progress and identify small steps. They are a hallmark of solution-focused brief therapy.

Question 50Therapeutic Relationships and Counseling Skills

A counselor uses motivational interviewing with a client who is ambivalent about quitting smoking. Which counselor statement best aligns with this approach?

  1. Smoking is harmful; here is a pamphlet on quitting.
  2. You enjoy smoking but also have concerns about your health; how do you see the trade-offs? Correct answer.
  3. You need to quit smoking now for your health.
  4. Why haven't you been able to quit yet?

Explanation

Motivational interviewing explores and resolves ambivalence by eliciting the client's own reasons for change and respecting autonomy. Reflecting both sides of the ambivalence supports this process.