NCMHCE Treatment Planning Process 2 — Questions and Answers
Question 1: A client with major depressive disorder refuses pharmacotherapy but agrees to therapy. When writing the treatment plan, the counselor should:
- Discharge the client for non-compliance
- Document the refusal and incorporate the client's preferences into the plan (Correct answer)
- Refer exclusively to psychiatry
- Delay treatment until the client accepts medication
Correct answer: Document the refusal and incorporate the client's preferences into the plan
Client autonomy and informed refusal must be documented and respected while still crafting an evidence-based plan within the client's stated preferences.
Question 2: Which element of a SMART goal addresses whether the goal can realistically be achieved given the client's current resources?
- Specific
- Measurable
- Attainable (Correct answer)
- Time-bound
Correct answer: Attainable
The 'Attainable' (or Achievable) component ensures the goal is realistic given the client's strengths, resources, and circumstances.
Question 3: During a treatment planning session, a client with PTSD discloses ongoing domestic violence. The counselor's first priority should be:
- Continue developing long-term trauma processing goals
- Conduct a safety assessment and revise the plan to address immediate safety (Correct answer)
- Refer the client to a support group
- Maintain the existing plan and address safety in a future session
Correct answer: Conduct a safety assessment and revise the plan to address immediate safety
Immediate safety supersedes all other treatment planning priorities; the plan must be revised to address the acute safety concern first.
Question 4: A counselor is writing objectives for a client's treatment plan. Objectives differ from goals in that objectives are:
- Broader and more aspirational
- Specific, measurable steps toward achieving the broader goal (Correct answer)
- Written by the insurance company
- Identical to clinical interventions
Correct answer: Specific, measurable steps toward achieving the broader goal
Objectives are the concrete, measurable steps that serve as the pathway toward achieving the overarching treatment goal.
Question 5: A managed care organization requests a treatment plan update after 8 sessions. What information is most critical to include?
- The counselor's theoretical orientation
- Client's progress toward measurable objectives and medical necessity justification (Correct answer)
- A list of all topics discussed in session
- The client's DSM-5 history only
Correct answer: Client's progress toward measurable objectives and medical necessity justification
Utilization review requires evidence of medical necessity and demonstrated progress toward measurable objectives to authorize continued services.
Question 6: Which approach to treatment planning involves collaboratively identifying problems, strengths, and goals with the client actively participating in each step?
- Prescriptive planning
- Clinician-directed planning
- Collaborative or client-centered planning (Correct answer)
- Diagnosis-driven planning
Correct answer: Collaborative or client-centered planning
Collaborative treatment planning treats the client as an active partner, which improves therapeutic alliance and goal commitment.
Question 7: A counselor notes that a client's presenting problem has shifted significantly since the initial treatment plan was written. The appropriate action is to:
- Complete treatment using the original plan only
- Update the treatment plan to reflect current presenting concerns (Correct answer)
- Write an entirely new intake assessment
- Refer the client to a new provider
Correct answer: Update the treatment plan to reflect current presenting concerns
Treatment plans are living documents that must be revised whenever there are significant changes in the client's presenting concerns or clinical status.
NCMHCE Treatment Planning Process 2
A client with major depressive disorder refuses pharmacotherapy but agrees to therapy.
When writing the treatment plan, the counselor should: