Deck 11: Diagnosis and Treatment Planning

Question 1

Disadvantages associated with structured diagnostic interviews include all of the following EXCEPT:

A) They are not very suitable for scientific research.
B) They require a lot of time to administer.
C) They de-emphasize rapport building.
D) They exclude important information about client personal history and personality.
E) There are no disadvantages.

Answer 1

A

Question 2

The SCID-I is a good example of a:

A) Circumscribed structured and semi-structured diagnostic interview protocols
B) A core values assessment protocol
C) A broad or comprehensive semi-structured diagnostic interview
D) A depression scale that actually is more effective in identifying anxiety
E) An unreliable interview protocol

Answer 2

C

Question 3

Which of the following factors do(es) NOT present a problem when trying to establish an accurate diagnosis for clients?

A) Clients may not be honest.
B) Diagnostic comorbidity.
C) Confounding cultural factors.
D) Interviewer countertransference.
E) All of the above factors present a problem

Answer 3

E

Question 4

Which statement(s) is/are true of the Diagnostic and Statistical Manual of Mental Disorders?

A) It's the authoritative guide for all mental health professionals throughout the United States.
B) It has been phased out; the DSM-IV-TR was the final edition
C) The new edition provides detailed treatment plans for most major mental disorders.
D) Both A and C are true of the DSM.
E) None of the above are true

Question 5

Practical advantages of diagnosis include which of the following?

A) It can be a relief for clients to have their problems named and defined.
B) It allows practitioners to communicate efficiently with other professionals and insurance companies.
C) It is a working hypothesis that can be tested with appropriate use of theories, techniques, and interventions.
D) All of the above are correct.
E) Both B and C are correct.

Question 6

Which of the following is true about the SCID-I?

A) There are separate research and clinical versions available
B) It is a good example of a loosely structured or unstructured interview
C) It's not used much among practitioners
D) Only A and B
E) Only A and C

Question 7

Caitlin is one of Maxine's clients. After Maxine worked collaboratively with her to identify an appropriate diagnosis of Panic Disorder, which positive outcome was Caitlin most likely to feel?

A) Relieved that what she was experiencing had a name or label
B) Happy to be hospitalized
C) Pleasantly surprised by an immediate recovery
D) Happy to have a label that would stay with her for a long time
E) There are no positive outcomes associated with diagnosis

Question 8

The central focus of structured or semi-structured diagnostic interviews is on:

A) Establishing rapport with new clients
B) Gathering reliable and valid data to support accurate mental disorder diagnoses
C) Identifying the client's core conflictual relationship theme
D) Exploring the BASIC I.D.
E) None of the above

Question 9

Which of the following is/are NOT part of the formal DSM definition of mental disorder?

A) Subjective distress
B) Nonconforming social behavior
C) Disability or impairment in functioning
D) All of the above are part of the DSM definition of mental disorder.
E) Both B and C are not part of the DSM definition of mental disorder.

Question 10

Which statement(s) is/are true of the relationship between the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases-10-CM?

A) These are equivalent manuals and either can be used.
B) The DSM-5 is the standard in the U.S.
C) The ICD-10-CM codes should be used and both manuals can be used to aid in diagnosis
D) The ICD-11 is now the appropriate manual to use for mental disorder diagnosis
E) Both A and C are true

Question 11

Which of the following is/are true regarding the science of diagnostic interviewing?

A) The current DSM diagnostic criteria are marginally more reliable and valid than the original DSM previously published criteria.
B) If you stick closely with the DSM criteria, you have a better chance of producing a reliable diagnosis.
C) Formal training in diagnostic procedures increases your chances of producing reliable diagnoses.
D) All of the above are true.
E) Only A and C are true

Question 12

What is true regarding the use of the terminology mental illness and mental disorder in the DSM and ICD systems?

A) The DSM and ICD authors view mental illness as more problematic terminology.
B) Both terms are used interchangeably
C) Mental illness is the preferred terminology
D) Mental disorder isn't used because it's too vague
E) Both C and D are true

Question 13

When a client is presenting with confusing symptom clusters, therapists must tease out possible __________ in order to establish an accurate diagnostic label.

A) Client misinformation
B) Interviewer countertransference
C) Differential diagnoses
D) Confounding cultural factors
E) All of the above

Question 14

Miguel's client, Thomas, has been arrested many times for protesting political and religious freedoms. Assuming that his social deviance is NOT caused by a personal dysfunction, what is his appropriate diagnosis?

A) Oppositional defiant disorder
B) Conduct disorder
C) Adjustment disorder with a disturbance in conduct
D) No diagnosis is appropriate
E) Either A or B would fit

Question 15

Advantages of structured diagnostic interviewing include which of the following?

A) Generally higher inter-rater reliability
B) Being well suited for scientific research
C) Fast administration
D) A and B are correct.
E) All of the above are true.

Question 16

Which of the following is NOT a symptom of Generalized Anxiety Disorder?

A) Apprehension
B) Motor tension
C) Auditory hallucinations
D) Blank mind or problems with concentration
E) These are all symptoms of Generalized Anxiety Disorder

Question 17

Which of the following are the two main systems for diagnosing mental disorders in the U.S.?

A) The PDM and ICD
B) The ICD and DSM
C) The DSM and RDoc
D) The RDoc and ICD
E) The DSM is the sole authoritative guide

Question 18

Maxine is a mental health provider. She hates diagnosis, but she uses it anyway because of some of the benefits of using diagnostic systems:

A) It helps her predict her clients' prognosis
B) She finds it helps her and her clients to closely monitor specific symptoms and diagnostic indicators
C) She uses it to communicate with other professionals
D) All of the above
E) Only B and C are benefits of using diagnosis

Question 19

The Hamilton Rating Scale for Depression (HSRD) is an example of:

A) A circumscribed structured or semi-structured diagnostic interview protocol
B) A core values assessment protocol
C) A broad or comprehensive interview protocol
D) A depression scale that actually is more effective in identifying anxiety
E) An unreliable interview protocol

Question 20

A semi-structured interview is best described as:
F) A predetermined series of questions, followed by unplanned questioning or an exploration period

A) A tight protocol wherein clinicians ask a series of predetermined questions
B) A loosely structured interview where the clinician asks only a few pre-determined questions
C) Could be A or C
D) None of the above

Question 21

Charlie has a new client who behaves in ways that appear "resistant." Based on his knowledge of Beutler, Harwood, Michelson, Song, and Holman's (2011) meta-analysis, Charlie should probably:

A) Use tasks that "bolster patient control and self-direction"
B) Use "rigid and graded homework assignments"
C) Present homework assignments as mandates
D) Provide more education to his client
E) Provide more and repeated instructions

Question 22

Research on positive expectations in therapy yielded which of the following recommendations?

A) Assess client outcome expectations at the beginning of therapy
B) Use gentle, empathic, but positive statements about likely outcomes
C) Notice and comment on previous or in-session client accomplishments
D) All of the above
E) Only A and C

Question 23

Which of the following might arise as a problem or complicating factor in matching ESTs to client diagnosis in your clinical work?

A) There are comorbid conditions that complicate treatment selection
B) Your client is opposed to using an EST
C) You're not trained in an EST connected to your client's diagnosis
D) Culture or ethnicity complicates the straightforward application of an EST
E) All of the above may complicate the application of an EST

Question 24

Sam told his therapist that he experiences extreme panic every time he goes to the grocery store. Sam's therapist asks him to imagine that he is going grocery shopping while he is in the interview room, so that he can observe Sam's behavior. What is the therapist trying to assess by doing this?

A) Sam's current anxiety level
B) Sam's social skills
C) Sam's coping skills
D) Sam's personal strengths
E) All of the above

Question 25

Internalizing clients tend to respond best to which approach?

A) A religious or spiritual approach
B) A skill-building therapy
C) An approach that focuses on symptom reduction
D) All of the above are equal
E) None of the above is a good match

Question 26

Overall, research has shown that when clients are more resistant or opposed to therapy, clinicians should:

A) Become more directive
B) Consider using motivational interviewing techniques
C) Avoid rigid homework assignments
D) Both A and B
E) Both B and C

Question 27

Which of the following can be used for gathering diagnostic-relevant information?

A) Diagnostic interviewing
B) Physical examinations
C) Projective techniques
D) All of the above can be used for gathering diagnostically relevant information.
E) Only A and C can be used for gathering diagnostically relevant information.

Question 28

To be labeled an empirically supported treatment (EST), the treatment must:

A) Be manualized
B) Have client testimonials based on qualitative research
C) Be cognitive-behavioral
D) Show itself superior to placebo controls or another treatment in one well-controlled study
E) Both A and C

Question 29

Which matching variables are likely to improve treatment outcomes?

A) Matching religious clients with secular-only therapy
B) Matching resistant clients with directive therapy
C) Matching religious clients with religious or spiritually-oriented therapy
D) Both A and B
E) Both B and C

Question 30

When it comes to culture and therapy, research has shown that the most effective treatments tend to be:

A) Spiritually oriented
B) Those with greater numbers of cultural adaptations
C) Those that emphasize a medical or biomedical approach
D) Offered by older therapists
E) A and D in combination is the best answer

Question 31

Research has shown that client preferences for treatment type and therapist type are:

A) Unrelated to therapy outcomes
B) Inconsistent and immeasurable
C) Significantly associated with improved outcomes and decreased drop-out rates
D) Ironically related to poorer outcomes
E) There's no research on this topic

Question 32

Becca comes for therapy and has several symptoms of Moderate Depressive Disorder. Which of the following would be a reasonable treatment goal?

A) Elevate or improve Becca's mood
B) Increase Becca's interest and enjoyment in recreational activities
C) Reduce Becca's initial insomnia
D) All of the above
E) The only reasonable goal is to eliminate Moderate Depressive Disorder

Question 33

The authors note that one consistent problem with the biopsychosocial model is that:

A) Medication treatments are downplayed
B) Biomedical case formulations and treatments dominate
C) There's an overemphasis on the psychological domain
D) There's an overemphasis on the social domain
E) No one uses the biopsychosocial model

Question 34

Concerning reliability and validity of interview procedures, which of the following statements is true?

A) If an interview procedure is reliable, it's unlikely to be valid.
B) A valid interview procedure will consistently produce the same results.
C) It is possible for an interview procedure to be very reliable but invalid.
D) A highly reliable interview procedure will produce more accurate results than a highly valid interview procedure.
F) Both B and C are true

Question 35

Whether to integrate spiritual or religious content into therapy should be done based on:

A) The desires and needs of the therapist
B) The desires and needs of the client
C) The reactance level of the client
D) The client's coping style
E) None of the above

Question 36

Phillip complains to his therapist, Angelique that he's been depressed lately. Which of the following is a reasonable next step for Angelique in her assessment of Phillip?

A) Clients are usually correct in their self-diagnoses, so it's safe for her to conclude that Phillip suffers from depression
B) She could administer the Hamilton Rating Scale as a method for gathering additional information.
C) She should consider Phillip's input, but also continue gathering information about Phillip's various symptoms, including his depressive symptoms
D) All of the above
E) Only B and C are reasonable options

Question 37

When assessing a client's current functioning as part of a diagnostic interview, clinicians are LEAST likely to inquire about which of the following areas?

A) Coping skills
B) Differential activation
C) Social support network
D) The client's typical day
E) Personal strengths

Question 38

Which of the following components is LEAST likely to be included in a diagnostic interview?

A) An introduction characterized by warmth and active listening.
B) An analysis of the client's problem.
C) A review of the client's symptom history.
D) A discussion of potential intervention strategies.
E) All of the above must be included.

Question 39

Larry is a new client. He is an "externalizer." Which therapy approach is the best fit for him?

A) A religious or spiritual approach
B) A skill-building therapy
C) An approach that focuses on symptom reduction
D) Both A and B
E) Both B and C

Question 40

Many people believe that diagnosing individuals is dehumanizing because it attaches labels to individuals, ignoring their unique characteristics. This is sometimes referred to as:

A) Derealization.
B) Depersonalization.
C) Pigeonholing.
D) Diagnostic proliferation.
E) None of the above.

Question 41

The Cultural Formulation Interview (CFI) is a:

A) Semi-structured interviewing protocol to aid in diagnostic assessments.
B) Method for assigning clinical diagnoses
C) A depression-oriented interview designed to aid in diagnosis
D) Both A and B
E) Both B and C

Question 42

Which of the following do the authors claim is the "bridge" between client diagnosis and specific treatments?

A) Collaboration
B) Therapeutic alliance
C) Case formulation
D) A and B
E) None of the above

Question 43

Which of the following is/are a step(s) identified by Person for determining mechanisms underlying specific problems?

A) Select a symptom to focus on
B) Select a theory to explain the symptom
C) Use your theory to extrapolate to the individual case
D) All of the above
E) Only B and C

Question 44

In the "Case of Michael," which of the following is an example of an intervention?

A) Michael's distorted, maladaptive beliefs.
B) Designing a hierarchy of Michael's feared situations.
C) Normalizing social anxiety
D) Both A and B
E) Both B and C

Question 45

In the "Case of Michael," which of the following is an example of a problem?

A) Michael's distorted, maladaptive beliefs.
B) Designing a hierarchy of Michael's feared situations.
C) Normalizing social anxiety
D) Both A and B
E) Both B and C

Question 46

Based on a meta-analysis, which recommendations for cultural adaptation were provided:

A) Align treatment with clients' cultural background
B) Conduct therapy in the client's native or preferred language
C) Make efforts to align therapy with client culture along multiple dimensions
D) All of the above
E) Empirically supported treatments are consistently the treatment of choice with clients from diverse cultures

Question 47

Person identified four case formulation steps from the CBT perspective. Which of the following is NOT one of those steps?

A) Create a problem list
B) Identify possible mechanisms causing the problems
C) Consider how much current distress the client is experiencing
D) Identify triggers that currently activate the problem
E) Consider historical origins of the client's problem