CBT Assessment & Case Formulation 2 — Questions and Answers
Question 1: In a CBT case formulation, which component explains WHY the client developed their problems based on early experiences?
- Maintaining factors
- Precipitating factors
- Predisposing factors (Correct answer)
- Protective factors
Correct answer: Predisposing factors
Predisposing factors (also called vulnerability factors) include early experiences, core beliefs, and genetic influences that set the stage for developing a disorder.
Question 2: A clinician uses the PHQ-9 during an initial CBT assessment. What does this tool primarily measure?
- Anxiety severity
- Depression severity (Correct answer)
- Cognitive distortion frequency
- Social functioning
Correct answer: Depression severity
The PHQ-9 (Patient Health Questionnaire-9) is a validated self-report measure specifically designed to assess the severity of depressive symptoms.
Question 3: Which term describes the 'here-and-now' factors in a CBT case formulation that keep the problem active?
- Predisposing factors
- Precipitating factors
- Perpetuating factors (Correct answer)
- Protective factors
Correct answer: Perpetuating factors
Perpetuating (or maintaining) factors are current behaviors, thoughts, and environmental conditions that sustain the problem in the present.
Question 4: A client reports that they cannot drive on highways due to fear of losing control. During behavioral assessment, the therapist asks them to rate distress from 0–100 on a hierarchy of driving situations. This technique is called:
- Functional analysis
- Subjective Units of Distress Scale (SUDS) (Correct answer)
- Behavioral Activation Scheduling
- Thought Records
Correct answer: Subjective Units of Distress Scale (SUDS)
The Subjective Units of Distress Scale (SUDS) is a 0–100 self-rating of anxiety used to construct fear hierarchies for exposure-based treatments.
Question 5: In the cognitive model, which level of cognition is MOST accessible to conscious awareness and easiest to identify in early assessment?
- Core beliefs
- Intermediate beliefs
- Automatic thoughts (Correct answer)
- Schema modes
Correct answer: Automatic thoughts
Automatic thoughts are the most surface-level cognitions and are often the first target in CBT assessment because clients can report them with relatively little prompting.
Question 6: During a clinical interview for CBT case formulation, a therapist asks, 'What does this situation mean about you as a person?' This question is designed to elicit:
- Safety behaviors
- Core beliefs (Correct answer)
- Behavioral avoidance
- Mood ratings
Correct answer: Core beliefs
Asking what a situation 'means about you' is a downward arrow technique designed to uncover deeper core beliefs underlying automatic thoughts.
Question 7: A therapist conducting a CBT assessment discovers a client uses alcohol to manage anxiety before social situations. In a functional analysis, the alcohol use is best classified as a:
- Precipitating event
- Safety behavior (Correct answer)
- Predisposing factor
- Cognitive distortion
Correct answer: Safety behavior
Using alcohol to manage anxiety in social situations is a safety behavior — a maladaptive coping response that provides short-term relief but maintains the anxiety long-term.
CBT Assessment & Case Formulation 2
In a CBT case formulation, which component explains WHY the client developed their problems based on early experiences?