CBC Behavioral Modification Techniques — Questions and Answers

Question 1: A bariatric client says, "I want to lose weight, but I love eating out with friends." According to motivational interviewing, what is this an example of?

Denial
Resistance
Precontemplation
Ambivalence (Correct answer)

Correct answer: Ambivalence

Holding two conflicting motivations at once is ambivalence, the central target of motivational interviewing.

Question 2: Which self-monitoring practice is most strongly associated with sustained weight loss after bariatric surgery?

Annual lab work review
Monthly photo comparisons
Consistent food journaling (Correct answer)
Weekly body measurements

Correct answer: Consistent food journaling

Regular food logging increases awareness of intake and is one of the strongest behavioral predictors of long-term weight maintenance.

Question 3: A client repeatedly eats when bored in the evening. Which behavioral technique directly targets the environmental trigger?

Cognitive restructuring
Flooding
Contingency contracting
Stimulus control (Correct answer)

Correct answer: Stimulus control

Stimulus control modifies cues in the environment, such as removing snacks from view, to reduce triggered eating.

Question 4: In the Transtheoretical Model, a client who scheduled bariatric surgery and started attending nutrition classes is in which stage of change?

Contemplation
Maintenance
Preparation (Correct answer)
Precontemplation

Correct answer: Preparation

Taking concrete steps toward change within the next month, like scheduling surgery, defines the preparation stage.

Question 5: Which counselor response best exemplifies a reflective listening statement to a client who says, "I blew my diet again this weekend"?

"Why did you let that happen?"
"You need to try harder next weekend."
"Everyone slips up; don't worry about it."
"It sounds like you're frustrated with how the weekend went." (Correct answer)

Correct answer: "It sounds like you're frustrated with how the weekend went."

Reflective listening mirrors the client's feeling or meaning without judgment, advice, or reassurance.

Question 6: A client rewards herself with a manicure after each week of meeting her exercise goal. This is an example of which behavioral principle?

Negative reinforcement
Extinction
Punishment
Positive reinforcement (Correct answer)

Correct answer: Positive reinforcement

Adding a pleasant consequence to increase a desired behavior is positive reinforcement.

Question 7: Which goal statement best follows SMART goal criteria for a post-bariatric client?

"Exercise a lot more than before."
"Get healthier soon."
"Walk 20 minutes after dinner, five days a week, for the next month." (Correct answer)
"Try to move whenever possible."

Correct answer: "Walk 20 minutes after dinner, five days a week, for the next month."

The goal is specific, measurable, achievable, relevant, and time-bound, meeting all SMART criteria.

Question 8: A client believes, "If I eat one cookie, the whole day is ruined." Which cognitive distortion is this?

Catastrophizing about health
Personalization
All-or-nothing thinking (Correct answer)
Mind reading

Correct answer: All-or-nothing thinking

Viewing a single lapse as total failure reflects all-or-nothing (dichotomous) thinking.

Question 9: Which technique asks clients to delay eating for 10 minutes when a craving strikes and observe the urge without acting on it?

Urge surfing (Correct answer)
Systematic desensitization
Thought stopping
Aversion therapy

Correct answer: Urge surfing

Urge surfing is a mindfulness-based technique of riding out a craving until it naturally subsides.

Question 10: In relapse prevention counseling, a single episode of overeating that does not return the client to old patterns is best labeled a:

Collapse
Failure
Lapse (Correct answer)
Relapse

Correct answer: Lapse

A lapse is a brief, single slip, distinguished from a relapse, which is a full return to prior behavior.

Question 11: A counselor asks a client, "On a scale of 0 to 10, how confident are you that you can follow your meal plan this week?" This tool primarily assesses:

Body image
Nutritional knowledge
Hunger level
Self-efficacy (Correct answer)

Correct answer: Self-efficacy

Confidence rulers measure self-efficacy, the client's belief in their ability to perform the behavior.

Question 12: Which strategy best addresses mindless eating in front of the television?

Eating faster to finish before the show starts
Skipping dinner on TV nights
Buying smaller televisions
Restricting all meals and snacks to the kitchen table (Correct answer)

Correct answer: Restricting all meals and snacks to the kitchen table

Limiting eating to one designated location is a stimulus-control strategy that breaks the TV-eating association.

Question 13: A client agrees in writing to attend all support group meetings for a month, with a specified consequence if she misses. This technique is called:

Shaping
Token economy
Behavioral contracting (Correct answer)
Modeling

Correct answer: Behavioral contracting

A behavioral contract is a written agreement specifying target behaviors and consequences.

Question 14: Which approach is most consistent with motivational interviewing when a client resists tracking meals?

Assigning tracking as mandatory homework
Referring the client to a stricter program
Warning the client about weight regain statistics
Exploring the client's own reasons for and against tracking (Correct answer)

Correct answer: Exploring the client's own reasons for and against tracking

Motivational interviewing evokes the client's own motivations rather than imposing directives or warnings.

Question 15: A post-surgical client eats rapidly and experiences dumping syndrome. Which behavioral strategy directly targets eating pace?

Putting utensils down between bites (Correct answer)
Drinking fluids with every bite
Choosing softer foods exclusively
Eating only twice daily

Correct answer: Putting utensils down between bites

Setting utensils down between bites slows eating pace, reducing overload of the small pouch.

Question 16: Which of the following is an example of covert antecedent to problem eating that a counselor should help a client identify?

A coworker offering donuts
Feeling lonely on weekend evenings (Correct answer)
Passing a bakery on the commute
A candy dish on the office desk

Correct answer: Feeling lonely on weekend evenings

Covert antecedents are internal states like emotions, unlike visible environmental cues such as food displays.

Question 17: A counselor teaches a client to replace "I'm a failure at dieting" with "I had a difficult day and can restart at my next meal." This technique is:

Stimulus generalization
Paradoxical intention
Negative reinforcement
Cognitive restructuring (Correct answer)

Correct answer: Cognitive restructuring

Identifying and replacing maladaptive thoughts with balanced alternatives is cognitive restructuring.

Question 18: Breaking the goal of "exercise regularly" into first walking 5 minutes daily, then 10, then 20, illustrates which behavioral principle?

Chaining
Discrimination training
Shaping (Correct answer)
Extinction

Correct answer: Shaping

Shaping reinforces successive approximations toward a target behavior.

Question 19: Which counselor action best supports a client experiencing weight-loss plateau frustration six months after surgery?

Advising daily weigh-ins to increase pressure
Suggesting the surgery may have failed
Recommending a 500-calorie diet
Reviewing non-scale victories and reinforcing adherence behaviors (Correct answer)

Correct answer: Reviewing non-scale victories and reinforcing adherence behaviors

Shifting focus to behavior-based and non-scale successes maintains motivation during expected plateaus.

Question 20: A client who night-eats keeps a log revealing the behavior follows evening arguments with her spouse. Identifying this pattern is part of which process?

Functional analysis of behavior (Correct answer)
Aversive conditioning
Progressive muscle relaxation
Biofeedback

Correct answer: Functional analysis of behavior

Functional analysis identifies the antecedents, behaviors, and consequences that maintain a habit.

Question 21: Which statement by a client represents "change talk" that the counselor should reinforce?

"I could probably prep my lunches on Sundays." (Correct answer)
"Diets have never worked for me."
"My spouse should stop buying junk food."
"My schedule makes healthy eating impossible."

Correct answer: "I could probably prep my lunches on Sundays."

Statements expressing ability or intention to change are change talk, which counselors selectively reinforce.

CBC Behavioral Modification Techniques

A bariatric client says, "I want to lose weight, but I love eating out with friends." According to motivational interviewing, what is this an example of?

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