NCMHCE flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Mental status exam

Structured observation of appearance, behavior, speech, mood, affect, thought process, thought content, perception, cognition, insight, and judgment; it forms the observational backbone of a clinical assessment.

PHQ-9 score thresholds

Depression severity bands of 5-9 mild, 10-14 moderate, 15-19 moderately severe, and 20-27 severe; a score of 10 or more usually prompts a full diagnostic evaluation.

Manic episode minimum duration

At least one week of elevated, expansive, or irritable mood with increased energy, unless hospitalization is required, in which case any duration qualifies for the diagnosis.

Substance use disorder severity

Severity is graded by the number of DSM-5 criteria met in the past 12 months: two to three criteria mild, four to five moderate, six or more severe.

PTSD symptom clusters

Four clusters: intrusion symptoms, persistent avoidance, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity, with symptoms lasting more than one month.

Cultural Formulation Interview

A DSM-5 set of 16 core questions used to elicit the client's cultural identity, illness explanations, stressors, and help-seeking expectations during diagnostic assessment.

Panic attack symptom threshold

An abrupt surge of intense fear reaching a peak within minutes with at least four of thirteen physical or cognitive symptoms; it can be coded as a specifier across many DSM-5 disorders.

Four Ps of formulation

Case conceptualization categories: predisposing (vulnerability), precipitating (trigger), perpetuating (maintaining factors), and protective (strengths and supports) that organize the clinical picture.

SMART goals

Treatment goals that are Specific, Measurable, Achievable, Relevant, and Time-bound, so progress can be monitored objectively and reviewed with the client.

Stages of change

Prochaska and DiClemente's sequence of precontemplation, contemplation, preparation, action, and maintenance, with relapse cycling the client back to an earlier stage.

Medical necessity

Documented justification that a DSM-5 diagnosis, functional impairment, and clinically appropriate services make treatment payable, linking reported symptoms to specific interventions.

ADDRESSING framework

Hays's checklist of cultural influences: Age, Developmental disability, Disability acquired, Religion, Ethnicity, Socioeconomic status, Sexual orientation, Indigenous heritage, National origin, Gender.

ASAM six dimensions

Criteria for matching clients to a level of care: withdrawal potential, medical conditions, emotional/behavioral/cognitive conditions, readiness to change, relapse potential, and recovery environment.

OARS skills

Motivational interviewing microskills: Open-ended questions, Affirmations, Reflections, and Summaries, used to build alliance and evoke change talk from the client.

DBT skills modules

Linehan's four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, taught in skills group alongside individual therapy and telephone coaching.

Behavioral activation

A depression intervention that schedules and reinforces valued activities and tracks mood-activity links, countering withdrawal and avoidance rather than targeting cognitions directly.

EMDR eight phases

History-taking, preparation, assessment, desensitization, installation, body scan, closure, and re-evaluation, using bilateral stimulation while the client holds a traumatic memory.

Rogers's core conditions

Unconditional positive regard, accurate empathic understanding, and congruence or genuineness, described as the necessary relational conditions for change in person-centered therapy.

Miracle question

A solution-focused technique asking the client to describe how life would differ if the problem vanished overnight, generating concrete goal descriptions and preferred outcomes.

Systematic desensitization

Wolpe's technique pairing progressive muscle relaxation with a graduated fear hierarchy, so relaxation competes with anxiety at each step until the feared stimulus loses potency.

Tarasoff duty

The 1976 California ruling establishing a therapist's duty to protect or warn an identifiable third party when a client poses a serious threat of violence.

ACA post-termination rule

The ACA Code of Ethics prohibits sexual or romantic relationships with former clients for at least five years after termination and cautions that such relationships carry ongoing risk.

Boundary crossing vs violation

A crossing departs from standard practice and may be harmless or clinically useful; a violation exploits the client or harms the therapeutic relationship and is never acceptable.

42 CFR Part 2

Federal regulation governing substance use disorder treatment records; it is stricter than HIPAA and generally requires specific written consent identifying the recipient before disclosure.

Privilege holder

The legal right to prevent disclosure of confidential communications belongs to the client, who may waive it; a subpoena alone does not override privilege.

Mandated reporting

Legal duty of counselors to report suspected child abuse or neglect and elder or dependent adult abuse to designated authorities, typically within 24 to 48 hours per state law.

SOAP note

A progress note format with four sections: Subjective client report, Objective observable findings, Assessment clinical interpretation, and Plan for the next steps.

DAP note

A condensed progress note with three sections, Data, Assessment, and Plan, often used when agency policy favors brevity over the four-section SOAP structure.

Release of information

Written, signed authorization specifying the client, information to be released, recipient, purpose, and expiration date; it is revocable in writing and should be time-limited.

Discharge summary

Closing document covering reason for referral, presenting problem, diagnosis, course of treatment, progress toward goals, medications, referrals made, and prognosis.

CPT 90837

The billing code for a 60-minute individual psychotherapy session; 90834 covers 45 minutes and 90791 covers the diagnostic intake evaluation.

Treatment plan review interval

Many payers and accreditation bodies require documented review and update of the treatment plan at least every 90 days, or whenever goals are met or changed.