his exam is modeled in the National Clinical Mental Health Counseling Exam (NCMHCE) format that is used in many states as their licensure exam and for the Certified Clinical Mental Health Counselor (CCMHC) national certification.
This week, you will be assessed on the use of diagnosis, assessment, and intervention in a multiple-choice final exam. This exam is modeled in the National Clinical Mental Health Counseling Exam (NCMHCE) format that is used in many states as their licensure exam and for the Certified Clinical Mental Health Counselor (CCMHC) national certification. As opposed to other exams where you are asked to recall specific facts, this exam is based on case scenarios where you will apply your clinical problem-solving ability to assess, diagnose, and treat crisis and trauma situations. You will focus on identifying “the best answer”—as opposed to the “correct” answer. This means that each question contains more than one correct answer, but only one answer is the best. As “best answer” exams require a great deal of discernment, be sure to read each question carefully, look for the correct answers, and then discern the “best” answer. Taking a comprehensive exam in this format will pay off in the end when you sit for the NCMHCE in the future. I need this completed by 11/02/18 at 7pm. .
QUESTION 1
1. Case #1 – Jenna
Jenna is a six-year-old Caucasian female who currently resides with her foster parents, her older biological sister, and two foster brothers. Jenna and her siblings were taken from her biological parents because of suspected sexual abuse and neglect. It is reported that Jenna lived in a home without food, water, and utilities. Jenna’s foster parents report that her biological mother “may have some disabilities and has never had the financial means to take care of her children.” Jenna’s biological brother is in a separate foster home. He is suspected of sexually abusing both Jenna and her older sister. It has been reported that he sexually abused Jenna, while her sister was helplessly told to watch. Jenna has expressed this trauma with agitated behavior. The traumatic event is re-experienced by repetitive play where she stimulates herself on furniture. Jenna avoids the stimuli associated with the trauma by avoiding conversations associated with sexual abuse. Jenna avoids activities, places, and people associated with the trauma except for her sister who was also a victim. Jenna also has a sense of a foreshortened future. She frequently brings up death with her foster parents. Jenna has persistent symptoms of increased arousal that were not present before the trauma as indicated by irritability and outbursts of anger nearly every day with her biological sister and her foster father. Jenna is also hyper vigilant and does not want her foster father around. The disturbances have lasted for over a month and have caused clinically significant social impairment to the point she is unable to attend a full day of school due to emotional breakdowns.
1) What intake information should be obtained and assessed to formulate a provisional DSM-5 diagnosis? Select AS MANY as you consider essential.
a.
History of learning disabilities.
b.
Length of time problematic behaviors have persisted.
c.
Changes in sleeping patterns.
d.
Substance use.
e.
Attention problems.
f.
Details of sexual trauma.
g.
Hypervigilance or increased arousal.
2 points
QUESTION 2
1. What assessment tools might offer meaningful information on this client? Select the ONE most appropriate option. (Refer to Case #1)
a.
Beck Anxiety Inventory
b.
Attachment Questionnaire for Children (AQC)
c.
Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA)
d.
Child and Adolescent Needs and Strengths (CANS)
2 points
QUESTION 3
1. Based on the available information, what would appear to be the most appropriate provisional DSM-5 diagnosis? Select the ONEmost appropriate primary diagnosis. (Refer to Case #1)
a.
Disruptive Mood Dysregulation Disorder (296.99)
b.
Postttraumatic Stress Disorder (309.81)
c.
Acute Stress Disorder (308.3)
d.
Adjustment Disorder with Mixed Disturbance of Emotions and Conduct (309.4)
2 points
QUESTION 4
1. Based on the provisional diagnosis, what interventions might work best as you begin to work with this client? Select AS MANY as you consider indicated. (Refer to Case #1)
a.
Group Therapy
b.
Behavioral Rehearsal
c.
Grounding Techniques
d.
Play Therapy
e.
Flooding Techniques
f.
Medical Referral for Anxiety Medication
g.
Assertiveness Training
2 points
QUESTION 5
1. In developing a collaborative treatment plan with the client, identify immediate goals to be addressed. Select AS MANY as you consider correct and necessary. (Refer to Case #1)
a.
Reunification with Biological Family
b.
Addressing Sexualized Behaviors
c.
Increasing Emotional Regulation
d.
Preventing Revictimization
e.
Reenactment of Traumatic Events
2 points
QUESTION 6
1. Case #2 – Morgan
Morgan is staying at a local shelter after she experienced a natural disaster that destroyed her home three days ago. She is a 25-year-old lesbian female who was living with her partner. She has a flat affect and makes no eye contact as she talks about having to vacate her home in the middle of the night as the waters were filling her condo. Her partner did not make it out and drowned in the storm. She has not made contact with any of her other relatives who she says she has been distant from for “many years.” She mentions that before the storm she was taking “some meds to help with my moods” but is not sure of the medication name. Since she arrived at the shelter, she has laid in her cot, not taken any showers, eaten very little food, and avoided any contact with shelter workers or other families. She has a significant startle response when approached and has difficulty remembering basic information. She cries herself to sleep and has moments where she screams out at night after having “nightmares about drowning.”
What intake information should be obtained and assessed to formulate a provisional DSM-5 diagnosis? Select AS MANY as you consider important.
a.
