NBCC NCE cheat sheet

Autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity are the six foundational ethical principles; when principles conflict, document the reasoning used to resolve the tension.

Informed consent requires competence, voluntariness, disclosure of purpose, risks, benefits, alternatives, and the right to withdraw; it is an ongoing process, not a one-time signature.

Confidentiality has legal limits: imminent danger to self or others, suspected abuse of minors, elders, or dependent adults, court order, and supervisor consultation within the treatment team.

The Tarasoff duty to protect (not merely warn) arises when a client poses serious danger to an identifiable third party; actions include warning, notifying police, or hospitalization depending on state law.

Multiple relationships are not automatically unethical; assess power differential, duration, termination likelihood, and potential harm before entering or continuing the relationship.

Boundary crossings are often benign and context-dependent; boundary violations exploit or harm the client and are always unethical.

Record keeping: keep records sufficient for continuity of care, secure them, and follow state retention laws; release only with written authorization or legal mandate.

Competence is scope-specific; practicing outside training requires supervision, consultation, or referral, and continuing education maintains but does not create competence.

Cultural encapsulation is the tendency to view reality through one's own cultural assumptions; it manifests as stereotyping, insensitivity to variation, and ignoring evidence that contradicts one's beliefs.

Racial/cultural identity development models (e.g., Cross, Helms) describe stage progression from conformity/pre-encounter through dissonance, immersion, internalization, and commitment; stage determines receptivity to cross-racial counseling.

Acculturation strategies (integration, assimilation, separation, marginalization) depend on orientation to heritage culture and host culture; integration is generally associated with best adjustment.

Microaggressions are brief, commonplace verbal, behavioral, or environmental indignities that communicate hostile or derogatory messages; they include microassaults, microinsults, and microinvalidations.

Worldview dimensions relevant to counseling include individualism-collectivism, power distance, uncertainty avoidance, and time orientation; assess rather than assume.

Language access: use qualified interpreters, not family members, and document interpreter use; translated instruments require validation for the population.

Privilege and oppression operate at individual, institutional, and cultural levels; intersectionality (Crenshaw) holds that identities combine to produce unique experiences of advantage and disadvantage.

Multicultural counseling competencies cluster into awareness of own biases, knowledge of client worldview, and culturally appropriate intervention skills.

Piaget's stages: sensorimotor (0-2, object permanence), preoperational (2-7, egocentrism, symbolic thought), concrete operational (7-11, conservation, reversibility), formal operational (11+, abstract, hypothetical reasoning).

Erikson's eight psychosocial stages pair a crisis with a virtue: trust/mistrust, autonomy/shame, initiative/guilt, industry/inferiority, identity/role confusion, intimacy/isolation, generativity/stagnation, integrity/despair.

Kohlberg's moral stages: preconventional (punishment/obedience, instrumental exchange), conventional (interpersonal conformity, law and order), postconventional (social contract, universal principles); Gilligan critiqued the male-oriented justice bias.

Attachment patterns (Ainsworth): secure, avoidant, ambivalent/resistant, and disorganized (Main); early patterns shape internal working models of self and other.

Brain development proceeds bottom-up and back-to-front: sensorimotor and limbic regions mature before prefrontal cortex, which continues developing into the mid-20s.

Vygotsky emphasized social mediation, the zone of proximal development, and scaffolding; learning precedes development in his framework.

Bronfenbrenner's ecological model nests the developing person in microsystem, mesosystem, exosystem, macrosystem, and chronosystem.

Aging: crystallized intelligence holds or grows while fluid intelligence declines; normal aging includes sensory change, slower processing, and preserved wisdom and emotional regulation.

Trait-and-factor (Parsons) matches personal traits to occupational requirements; Holland's RIASEC typology (Realistic, Investigative, Artistic, Social, Enterprising, Conventional) extends it with congruence, consistency, differentiation, and identity.

Super's life-span, life-space theory: self-concept develops through roles (child, student, leisurite, citizen, worker, homemaker) and stages (growth, exploration, establishment, maintenance, decline).

Krumboltz's social learning theory of career decision making identifies genetic endowment, environmental conditions, learning experiences, and task-approach skills; happens chance events are addressed in planned happenstance.

Gottfredson's circumscription and compromise: children eliminate options by sex-role and prestige, then compromise on interests, prestige, or sex type when constraints arise.

Work values and needs inventories (e.g., O*NET, Strong Interest Inventory, Myers-Briggs, DISC) measure interests, values, or personality; interests predict satisfaction, abilities predict performance.

Career decision-making difficulties include indecision (developmental, state-based) versus indecisiveness (pervasive, trait-based); interventions differ accordingly.

Dual-career and work-family issues require role negotiation, boundary management, and consideration of relocation and childcare constraints.

Career transition and job loss reactions follow loss/grief patterns; interventions include information gathering, skills transferability analysis, and supported decision making.

Rogers' core conditions: unconditional positive regard, empathic understanding, congruence/genuineness; these are necessary and sufficient for therapeutic change in person-centered theory.

Psychoanalytic concepts: id/ego/superego, defense mechanisms, transference, countertransference, resistance, free association, interpretation, and working through.

Behavioral interventions: systematic desensitization (counterconditioning), exposure and response prevention, token economies, shaping, and behavioral activation; principles are classical and operant conditioning.

Cognitive interventions: Ellis's ABCDE (activating event, belief, consequence, dispute, effective new belief) and Beck's cognitive triad and cognitive restructuring target irrational or distorted beliefs.

Family systems concepts: boundaries, triangulation, differentiation of self (Bowen), homeostasis, feedback loops, structural hierarchy, and communication patterns (Satir).

Group stages: forming, storming, norming, performing, adjourning; group dynamics include cohesion, universality, altruism, catharsis, and corrective recapitulation of the primary family.

Counseling skills hierarchy: attending, open questioning, paraphrasing, reflecting feeling, summarizing, confrontation, interpretation, and immediacy; confrontation addresses discrepancies, not hostility.

Therapeutic alliance components (Bordin): goals, tasks, and bond; rupture and repair processes are central to outcome.

Group types: psychoeducational, counseling, psychotherapy, task/work, and support groups; each has different leader roles, goals, and member composition.

Group size and duration depend on type: psychoeducational groups can be larger; counseling groups are typically 6-10 members and psychotherapy groups smaller and longer.

Screening and selection reduce risk by assessing fit, readiness, and contraindications (e.g., acute crisis, severe personality pathology, or inability to tolerate feedback).

Stages of group development (Tuckman): forming, storming, norming, performing, adjourning; storming is characterized by conflict and resistance.

Yalom's therapeutic factors include universality, altruism, instillation of hope, cohesiveness, catharsis, interpersonal learning, and corrective recapitulation of the primary family.

Group leader functions: gatekeeping, linking, blocking, modeling, and protecting; leaders balance content and process.

Ethical issues in groups: informed consent about group norms, confidentiality limits (members cannot guarantee confidentiality), dual relationships, and member-to-member confrontation.

Termination in groups involves reviewing gains, consolidating learning, addressing unfinished business, and planning for post-group support.

Reliability refers to consistency: test-retest, parallel forms, internal consistency (Cronbach's alpha, split-half), and inter-rater; reliability limits validity.

Validity types: content (expert judgment, blueprint match), construct (convergent and discriminant), criterion (concurrent and predictive); validity is evidence for a specific use, not a property of the test.

Standard error of measurement (SEM = SD × √(1 − r)) estimates the range around an observed score; confidence intervals use SEM.

Standard scores: z (M=0, SD=1), T (M=50, SD=10), IQ/deviation (M=100, SD=15), stanine (M=5, SD=2); convert via z-score formula.

Norm-referenced versus criterion-referenced tests: norms compare to a group; criteria compare to a standard of performance.

Achievement tests measure learning of content; aptitude tests predict future performance; intelligence tests sample cognitive abilities.

Test fairness: differential item functioning, bias in content, and cultural loading must be evaluated; accommodation does not invalidate standardized interpretation when documented.

Ethical test use: qualified administration, informed consent, secure materials, accurate scoring, and feedback that is understandable to the client.

Internal validity threats: history, maturation, testing, instrumentation, regression to the mean, selection, and attrition; external validity concerns generalizability.

Experimental designs use random assignment and manipulation; quasi-experimental designs lack random assignment; single-subject designs (ABAB) establish functional relations.

Correlation does not imply causation; r ranges from -1 to +1, and r² is the proportion of variance accounted for.

Statistical significance (alpha, typically .05) concerns the probability of a Type I error; Type II error (beta) is failing to detect a real effect; power = 1 − beta.

Effect size measures (Cohen's d, eta squared, r) report magnitude independent of sample size; d of 0.2, 0.5, and 0.8 are small, medium, and large.

Program evaluation models: needs assessment, process/implementation, outcome, and cost analysis; formative evaluation informs improvement, summative judges merit.

Qualitative methods: interviews, focus groups, observation, and case study; trustworthiness criteria include credibility, transferability, dependability, and confirmability.

Informed consent in research requires voluntary participation, disclosure of risks and benefits, and the right to withdraw; IRB approval precedes data collection.

The DSM-5-TR uses a multiaxial-like descriptive approach with diagnostic criteria, specifiers, and severity; it is not a substitute for clinical judgment.

Differential diagnosis requires ruling out medical conditions, substance use, and other mental disorders before assigning a primary diagnosis.

Treatment planning components: presenting problem, diagnosis, goals (measurable and time-bound), objectives, interventions, and evaluation criteria.

Case conceptualization integrates predisposing, precipitating, perpetuating, and protective factors (the 4 Ps) to guide intervention selection.

Level of care decisions consider risk of harm, functional impairment, support system, and treatment history; least restrictive appropriate setting is preferred.

Common co-occurring conditions (e.g., anxiety and depression, substance use and mood disorders) require integrated rather than sequential treatment planning.

Cultural formulation (DSM-5 Cultural Formulation Interview) assesses cultural identity, explanatory models, stressors, and clinician-client relationship.

Documentation of diagnosis and plan should be tied to medical necessity and progress measures to support reimbursement and continuity.

Licensure requirements vary by state and typically include degree, supervised hours, and examination (e.g., NCE, NCMHCE); scope of practice is defined by state law.

Supervision is a distinct competency: supervisee development, evaluation, gatekeeping, and attention to power and multiple roles.

Consultation and referral are ethical obligations when competence or scope is exceeded; document referrals and follow-up.

Business and practice management: fee setting, informed consent, record retention, insurance billing, and telehealth compliance with state and federal rules.

Advocacy: counselors advocate for clients and the profession; social justice advocacy addresses systemic barriers.

Career counseling integrates assessment, occupational information, decision-making, and work adjustment; career development is lifelong and contextual.

Burnout, vicarious trauma, and compassion fatigue require self-monitoring, supervision, and workload management; impairment is an ethical concern.

Professional identity: counselors distinguish their role from psychology and social work, follow the ACA or NBCC code applicable to them, and participate in continuing education.