NCMHCE Skills and Interventions 2 — Questions and Answers
Question 1: A client with PTSD reports hypervigilance and difficulty sleeping. Which intervention is most evidence-based for this presentation?
- Supportive counseling only
- Prolonged Exposure (PE) therapy (Correct answer)
- Psychoeducation about sleep hygiene only
- Hypnotherapy
Correct answer: Prolonged Exposure (PE) therapy
Prolonged Exposure therapy is an evidence-based treatment for PTSD that directly addresses hyperarousal and avoidance symptoms.
Question 2: During a session, a client becomes dissociative. The most appropriate immediate counselor response is to:
- Continue the session as planned
- Use grounding techniques to reorient the client (Correct answer)
- Terminate the session immediately
- Increase emotional intensity to break through
Correct answer: Use grounding techniques to reorient the client
Grounding techniques (e.g., 5-4-3-2-1 sensory method) help reorient a dissociating client to the present moment.
Question 3: A counselor uses the Socratic questioning technique. This is most associated with which therapeutic approach?
- Person-Centered Therapy
- Cognitive-Behavioral Therapy (Correct answer)
- Psychoanalysis
- Gestalt Therapy
Correct answer: Cognitive-Behavioral Therapy
Socratic questioning is a core CBT technique used to challenge and examine the validity of automatic thoughts.
Question 4: A client describes feeling 'numb' and disconnected from emotions after a traumatic event. The counselor should prioritize:
- Pushing the client to express emotions immediately
- Psychoeducation about emotional numbing as a trauma response (Correct answer)
- Referring to psychiatry without further assessment
- Interpreting unconscious resistance
Correct answer: Psychoeducation about emotional numbing as a trauma response
Emotional numbing is a common trauma response, and normalizing it through psychoeducation reduces shame and builds therapeutic alliance.
Question 5: Which motivational interviewing skill involves the counselor summarizing the client's ambivalence and change talk to reinforce motivation?
- Open-ended questioning
- Affirmations
- Reflective listening
- Summaries (Correct answer)
Correct answer: Summaries
Summaries in MI collect and reinforce change talk, helping clients hear their own arguments for change.
Question 6: A client with depression engages in 'all-or-nothing thinking.' The most appropriate CBT intervention is:
- Free association
- Behavioral activation
- Cognitive restructuring (Correct answer)
- Flooding
Correct answer: Cognitive restructuring
Cognitive restructuring directly targets cognitive distortions like all-or-nothing thinking by challenging and reframing them.
Question 7: When working with a client using a strengths-based approach, the counselor's primary focus is on:
- Diagnosing pathology accurately
- Identifying and amplifying the client's existing resources and competencies (Correct answer)
- Challenging maladaptive defense mechanisms
- Providing direct advice for problem-solving
Correct answer: Identifying and amplifying the client's existing resources and competencies
Strengths-based counseling emphasizes client resilience, resources, and competencies rather than deficits or pathology.
NCMHCE Skills and Interventions 2
A client with PTSD reports hypervigilance and difficulty sleeping.
Which intervention is most evidence-based for this presentation?