A licensed counselor whose specialty is anxiety disorders is assigned a new client who presents with a primary diagnosis of anorexia nervosa. The counselor has no training or supervised experience treating eating disorders. Which action best reflects the ethical standard regarding competence?

A counselor who recently completed a two-day introductory workshop on a specialized trauma processing technique wants to begin offering it independently to trauma clients. According to ethical guidelines on competence, what is the most appropriate next step?

A counselor who has not completed any specific training in affirmative counseling for sexual minority clients is asked to work with a gay male client struggling with internalized stigma about his sexual orientation. The counselor believes that treating all clients equally regardless of background satisfies any competency obligation. Which response best reflects ethical competency standards?

During a biopsychosocial intake interview, a counselor asks a new client about their current living situation, employment status, and quality of relationships with friends and family. Which component of the biopsychosocial model does this line of questioning primarily address?

A counselor is completing an intake with a 35-year-old client who reports chronic back pain, insomnia, and depressed mood following a recent job loss. To conduct a thorough biopsychosocial assessment, which area should the counselor explore in addition to the client’s psychological symptoms and social stressors?

A client presents for an intake session and discloses a history of childhood abuse, a current partner who is controlling, limited social support, and recent termination from her job. She reports anxiety and difficulty sleeping. The counselor wants to identify the precipitating factor for her current presentation. Which intake question would best capture this?

A 42-year-old client reports persistent sadness for the past eight months, sleeping 10 to 11 hours per night, significant weight gain, difficulty concentrating at work, and feeling that nothing will ever get better. Which of the following best characterizes the physical symptom pattern this client is experiencing?

A counselor is conducting an intake with a 55-year-old client who endorses depressed mood, anhedonia, fatigue, and feelings of worthlessness for six weeks following a job loss. The client states, I know things will never improve for me. According to the cognitive model of depression, this statement most directly reflects which cognitive distortion?

A 67-year-old client with a recent diagnosis of major depressive disorder, single episode, severe, also reports a two-week history of believing her internal organs have stopped functioning and that she is already dead. She has no prior psychiatric history. Which specifier most accurately applies to her presentation?

A counselor is meeting with a 34-year-old client diagnosed with Major Depressive Disorder, single episode, moderate severity. When developing treatment goals, which approach best reflects collaborative goal-setting practice?

A counselor and a 28-year-old client with Generalized Anxiety Disorder are trying to write a measurable objective. The client says, ‘I just want to feel less stressed.’ Which response by the counselor best moves toward a measurable objective?

A counselor reviews a treatment plan with a client after four sessions. The client states, ‘I don’t really care about goal number two. That was more your idea than mine.’ What is the most appropriate next step?

A client arrives late to the third session and says, ‘I almost didn’t come today. I don’t think talking about this stuff is helping.’ Which counselor response BEST preserves the therapeutic alliance?

A counselor notices that a client from a collectivist cultural background consistently frames problems in terms of family obligations rather than individual distress. The counselor is working from a person-centered model. Which adjustment BEST strengthens the therapeutic alliance?

During session five, a client says, ‘You always take my wife’s side whenever I talk about our arguments.’ The counselor has not met the client’s wife. Which response BEST addresses this rupture in the alliance?

A counselor notices she feels unusually protective of a client who recently disclosed childhood abuse similar to the counselor’s own history. The counselor begins scheduling extra session time for this client and subtly discouraging termination. Which concept BEST describes what is occurring?

A counselor-in-training frequently checks her watch, crosses her arms, and gives brief responses when clients discuss relationship conflict. Her supervisor points out that these behaviors may communicate discomfort. This feedback is an example of developing awareness in which area?

A male counselor working with a female client who experienced intimate partner violence notices he frequently minimizes risk disclosures and pivots quickly to problem-solving. In supervision, he realizes he feels uncomfortable sitting with her fear. The MOST clinically appropriate first response is for the counselor to: