Question 1

When treating Dylan, you were considering Asperger's Disorder, but then realized that he was not able to have complete conversations and therefore did not meet which of the following criteria for Asperger's?

Accepted Answer

Asperger's Disorder requires that the client demonstrate some measurable language development skills. If limited or no language development skills are present, Autism may be a more appropriate diagnosis, since the other aspects would still be present (repetitive activities, rituals, key words).

Question 2

Stuttering is classified as a disorder in the DSM-5:

Accepted Answer

Stuttering is no longer clasified as such in the DSM-5, and has been renamed as Childhood-Onset Fluency Disorder. Additionally, the usage of fillers ("um," "ah," "you know," "like," etc.) is no longer considered a symptom, but anxiety and avoidance have been added as criteria for the disorder.

Question 3

You are evaluating a client who has been coming to you for court-mandated treatment for about four months. He is beginning to show signs and symptoms that have never been present before and is using language that would lead you to believe that he is angling for a lower level of care or to have his sentence or fine reduced. Overall, he fits criteria for:

Accepted Answer

While it may be true, given his circumstances, that he may have relationship issues with others, or potentially a personality disorder, the real issue here is that he is attempting to manipulate someone who is involved in his care to lower his diagnosis or dismiss it all-together to avoid paying a particular penalty, which is the most appropriate category for malingering, or avoiding consequences.

Question 4

Kleptomania, pyromania, and pathological gambling all belong to which grouping of disorders?

Accepted Answer

While certain impulse control disorders are first diagnosed in childhood, many of them resolve themselves as children grow. These three, however, are more adult-level impulse-control disorders. And while some people with personality issues or issues relating to Autism might be a bit on the impulsive side, it is doubtful they would have a long-term issue with these disorders that was caused strictly by impulse control.

Question 5

You are working with a client who seems to present with schizophrenic features. However, when the delusions are more closely examined, they are shown to be non-bizarre, with all other measurements in order. Hallucinations are reported to be intermittent, but certainly not prominent. An appropriate diagnosis would be:

Accepted Answer

If hallucinations are not entirely evident in the presentation, it may immediately rule out many schizo-type disorders. However, before being sure, one would want to test how often the hallucinations appear. Once there is a distinct difference between hallucinations and delusions, particularly with frequency, Delusion disorder is most appropriate.

Question 6

What qualifies a diagnosis of Schizophreniform disorder?

Accepted Answer

While it is true that there may be a recovery period between episodes, it is not always the case. There are also instances where the delusions last between 1 and 6 months without returning again in the same form. Once the six month threshold is crossed, the diagnosis changes to Schizophrenia. While it is possible that hallucinations may happen infrequently, it is mainly the delusions and their frequency that drive this diagnosis.

Question 7

Kevin, a four-year-old foster child, has been referred to you for individual work. His social worker believes that he needs to have someone to talk to because socially, he's very difficult to relate to and had very few figures that he could turn to over the last few years. Given the constant change of primary caregivers and inability to relate, you are able to diagnose Kevin with:

Accepted Answer

While Kevin's situation might cause anyone to be nervous, the important thing to consider is the context of the question. The question is framed in reference to why he was referred, which largely has to do with not having much (if any) of a support system. Reactive Attachment is classified largely in relation to the support system and a lack of appropriate development.

Question 8

You are attempting to make a final diagnosis on whether a particular client's Bipolar Disorder is Bipolar I or Bipolar II. The main differentiating factor between the two is that Bipolar I Disorder is characterized by:

Accepted Answer

Bipolar II never moves into full-blown manic episodes, where clients can become seriously dangerous, a threat to others, or to themselves. Bipolar I on the other hand, begins with manic and depressive episode mood swings. While there may not be an impairment that shows, one likely exists. And both Bipolar I and II could be classified with an early or late onset specifier.

Question 9

Felicia presents in your office after being referred by friends and family. She is recovering from a recent episode of having been away from home and having assumed a new identity for a brief period of time. Diagnostically, Felicia meets the criteria for:

Accepted Answer

Felicia is not someone who appears to have more than one personality who presents in your office, which is the criteria for Dissociative Identity. She does not seem to be hallucinating or delusional right now. That said, since she is intact other than her last episode, which involved travel away from home, Felicia qualifies for Dissociative Fugue.

Question 10

Being so anxious, Hank decided to consult a therapist. He is anxious, experiencing muscle tension, and having fear of not being able to control the anxiety. Hank is most likely experiencing:

Accepted Answer

While all of these are very closely related and it could be mistaken one for the other very easily, a rapid heartbeat (D), fear of leaving one area (C), and panic (A) can all seem closely related. However, with as many physical symptoms as he is demonstrating, GAD would be more appropriate overall.

Question 11

Conversational Connie comes to the assessment appointment with her husband, Mute Michael. From the beginning, you sense that the two of them have difficulty communicating. But as you watch, you begin to notice a pattern between the two that makes conversation difficult. Most often, that pattern will be:

Accepted Answer

Advance/retreat is a common couples issue that makes it difficult to communicate on a regular basis. So many things are opposite, like the other options above, but more than opposites, advance/retreat can become a way of communicating nonverbally with one another that may turn passive-aggressive very quickly. On the other hand, it could teach the couple quite a bit of patience.

Question 12

You are treating a family that has issues with their oldest son. When you ask him about the issue, he answers, "Nothing I do is ever good enough." When you ask his parents about the problem, they answer, "He's not living up to his potential." What can be said about this family?

Accepted Answer

The standards here certainly feel too high, but as a therapist, you must consider when it is your place to say so. Instead, consider that the expectations aren't clear and work on ways that you could help the family clarify what they are and when they're expected to be completed. Then you can work on any unrealistic goals.

Question 13

In strategic therapy, it may be referred to as a "ritual," but in diagnosis and assessment, clinicians are always interested in:

Accepted Answer

For example, if it is alcohol that plays a role in maintaining the problem, alcohol must be addressed before the problem can be resolved. Keep in mind also that not all of these even make sense as reasons for examination (speed and price). Rather, therapists are interested in root problems, even if they are not first apparent.

Question 14

When assessing an individual or family, some things are looked over. One of the most overlooked, but crucial areas of evaluation when it comes to family function is:

Accepted Answer

When thinking about the important diagnostic features, so often we think about what's in the room; we remain unable to focus on what happens outside the room that may be going well for the family. Our nature as therapists is to want to fix things, but if we slow down, we will see some things already working in their favor.

Question 15

When assessing for diagnosis and evaluating certain causes, it is important to remember that ruling out certain causes can almost always be helpful in determining what factors are at play in an individual or family system. Which of the following are always considered separate diagnoses?

Accepted Answer

While paerson could be depressed "due to" medical conditions or drug abuse, medical conditions rand and any drug abuse or addiction are considered contributing factors, not comorbidities. If the diagnosis happens to be present with an anxiety or mood disorder as well, the patient is sometimes referred to as "dual diagnosis."

Question 16

You have diagnosed a 7-year-old client with Attention Deficit Hyperactivity Disorder. Considering he is the third of four children, each of whom has had a similar diagnosis. What can you expect from the parental and sibling units?

Accepted Answer

You might see any of these as you continue to work with them. It is important to continue holding a non-judgmental space for them and reinforce the positive decisions they are making to help their children and family members cope. They may also take up the cause for the disorder with even more passion than before, since they may see a place where they can help as a unit.

Question 17

Your diagnostic impression is that you are dealing with a 12-year-old child who is showing signs of conduct disorder. At school, he is acting out in large, undeniable ways that are characteristic of more severe diagnosis, such as CD. However, at home, the parents deny seeing any of this activity. As a next step, you might examine:

Accepted Answer

Asking a family to visit their home can sometimes be a challenge. After all, you would be considered a guest and even for this 12-year-old, the rule may apply that you treat guests with respect. Still, you would need a picture of what exactly behavior means at home, even if you're not excited about the answers you'll find.

Question 18

This is Janet's first experience with grief and loss. As you work with her, you realize that she needs to build a support network. In order to assist her in doing this and to assess how much she knows about the process, you suggest that she:

Accepted Answer

If this is Janet's first experience with grief, she will be experiencing quite a bit of anxiety and questions that might be addressed by asking her to take on as many conversations as possible, not around grief, but around other topics that could help her build her tolerance to explore.

Question 19

Robert has been referred to you for anger management counseling. As a teenager, he is being confronted with many issues at school. For the first six sessions, Robert has sat with you in silence. Even after your prompting, he does not say anything. What does this nonverbal communication most likely demonstrate?

Accepted Answer

Adolescents always know where to begin, especially if it's about one of their triggering issues. Silence could indicate not knowing where to begin, but the assumption is that as the therapist, you have assisted him with that. He likely feels like he doesn't need help and is managing just fine. Still, he is most likely silent because he hasn't been able to build enough trust with you to share what's really going on.

Question 20

Michael's father has been incarcerated for the past seven years and his mother has been working three jobs to keep the family's situation stable. When Michael begins acting out in the seventh grade, he is referred to you for counseling. What could most likely be said about Michael's support network?

Accepted Answer

We couldn't call the support system nonexistent, since mom works three jobs. Along those same lines, I don't think that we could honestly say that with three jobs she isn't working hard enough; she is. And the last option only takes away the power from Michael's mom. Therefore, Michael must provide a lot for himself right now.

Quiz 1: Assessment