TCC Texas Counselor Evaluation & Diagnosis 2 — Questions and Answers
Question 1: A counselor suspects a client meets criteria for Major Depressive Disorder. Which DSM-5 requirement must be satisfied regarding symptom duration?
- Symptoms present for at least 2 weeks (Correct answer)
- Symptoms present for at least 1 month
- Symptoms present for at least 6 months
- Symptoms present for at least 3 months
Correct answer: Symptoms present for at least 2 weeks
DSM-5 requires that depressive symptoms persist for a minimum of two weeks for a Major Depressive Episode diagnosis.
Question 2: When using the Beck Depression Inventory-II (BDI-II) with a Texas client, a score of 29 indicates which severity level?
- Mild depression
- Moderate depression
- Severe depression (Correct answer)
- Minimal depression
Correct answer: Severe depression
A BDI-II score of 29–63 falls in the severe depression range.
Question 3: A counselor conducting a mental status examination notes that a client's speech is rapid, pressured, and difficult to interrupt. This observation is best documented under which domain?
- Affect
- Thought process
- Speech and language (Correct answer)
- Orientation
Correct answer: Speech and language
Pressure of speech is recorded under the speech and language domain of the mental status exam.
Question 4: Under the Texas Health and Safety Code, a licensed counselor completing an Emergency Detention must document that the person is likely to cause serious harm to themselves or others AND:
- Has a prior psychiatric hospitalization
- Is experiencing imminent danger due to mental illness (Correct answer)
- Has refused voluntary admission
- Has no responsible family member available
Correct answer: Is experiencing imminent danger due to mental illness
Texas law requires documentation of imminent danger resulting from a mental illness as the legal basis for emergency detention.
Question 5: Which assessment tool is specifically designed to screen for alcohol use disorder severity and is frequently used in Texas community mental health settings?
- PHQ-9
- AUDIT (Correct answer)
- GAD-7
- PCL-5
Correct answer: AUDIT
The Alcohol Use Disorders Identification Test (AUDIT) is the WHO-recommended tool for screening alcohol use disorder severity.
Question 6: A client presents with persistent feelings of unreality and detachment from surroundings lasting several weeks. The counselor should consider a differential diagnosis of:
- Schizophrenia spectrum disorder
- Depersonalization/Derealization Disorder (Correct answer)
- Dissociative Amnesia
- Adjustment Disorder
Correct answer: Depersonalization/Derealization Disorder
Persistent derealization (detachment from surroundings) is a hallmark feature of Depersonalization/Derealization Disorder.
Question 7: In the DSM-5 multiaxial framework's replacement, clinicians are encouraged to document medical conditions alongside psychiatric diagnoses because:
- It satisfies Texas Medicaid billing requirements only
- Medical conditions can directly influence mental health presentation and treatment (Correct answer)
- It replaces the need for a physician referral
- Texas law mandates separate Axis III documentation
Correct answer: Medical conditions can directly influence mental health presentation and treatment
Recording medical conditions in DSM-5 reflects the biopsychosocial model, acknowledging that physical health directly impacts mental health symptoms and treatment planning.
TCC Texas Counselor Evaluation & Diagnosis 2
A counselor suspects a client meets criteria for Major Depressive Disorder.
Which DSM-5 requirement must be satisfied regarding symptom duration?