CBT Assessment & Case Formulation 3 — Questions and Answers
Question 1: Which assessment tool is most commonly used in CBT to measure the severity of generalized anxiety?
- Beck Depression Inventory (BDI-II)
- GAD-7 (Correct answer)
- Yale-Brown Obsessive Compulsive Scale
- Social Phobia Inventory (SPIN)
Correct answer: GAD-7
The GAD-7 is a validated 7-item self-report questionnaire used to measure the severity of generalized anxiety disorder symptoms.
Question 2: A CBT case formulation uses a 'longitudinal cross-section.' What does the cross-sectional component specifically capture?
- Early life experiences and core belief development
- Current triggers and maintaining cycles (Correct answer)
- Diagnostic history and prior treatments
- Family history and genetic risk
Correct answer: Current triggers and maintaining cycles
The cross-sectional component of the formulation captures the current situation: triggers, thoughts, emotions, behaviors, and physiological responses in the present.
Question 3: In a CBT assessment, a client endorses: checking the stove 20 times before leaving home. The MOST appropriate disorder-specific measure to administer next would be:
- PHQ-9
- Y-BOCS (Correct answer)
- GAD-7
- PCL-5
Correct answer: Y-BOCS
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the gold-standard clinician-administered tool for measuring OCD symptom severity, including obsessions and compulsions.
Question 4: Which of the following BEST describes the role of a 'thought record' in CBT assessment?
- It tracks medication adherence over time
- It identifies the functional relationship between situations, cognitions, emotions, and behaviors (Correct answer)
- It measures the frequency of safety behaviors
- It records interpersonal conflicts for schema therapy
Correct answer: It identifies the functional relationship between situations, cognitions, emotions, and behaviors
Thought records are structured tools used to identify and examine the links between triggering situations, automatic thoughts, emotions, and behavioral responses.
Question 5: A therapist conducting a suicide risk assessment within a CBT framework would MOST focus on which cognition as a key risk factor?
- Overgeneralization
- Hopelessness (Correct answer)
- Mind reading
- Catastrophizing
Correct answer: Hopelessness
Hopelessness (the belief that the future will remain negative and unchangeable) is the cognitive variable most strongly associated with suicidal ideation and intent in CBT research.
Question 6: A CBT case formulation identifies that a client's panic attacks are maintained by hyperventilation, body scanning, and reassurance-seeking. These are examples of:
- Predisposing vulnerabilities
- Precipitating stressors
- Maintenance cycles (Correct answer)
- Protective factors
Correct answer: Maintenance cycles
Hyperventilation, body scanning, and reassurance-seeking are all behavioral responses that perpetuate the panic cycle by preventing disconfirmation of feared outcomes.
Question 7: When assessing a client's problem list in CBT, why is it important to establish the ORDER in which problems will be addressed?
- Insurance requires prioritized problem lists for billing
- Targeting the most severe or functionally impairing problem first maximizes engagement and progress (Correct answer)
- DSM order must be followed for ethical compliance
- The least distressing problem should always be treated first to build rapport
Correct answer: Targeting the most severe or functionally impairing problem first maximizes engagement and progress
Establishing priority order ensures therapy targets the problem causing the most distress or functional impairment, which maximizes engagement and demonstrates early treatment effectiveness.
CBT Assessment & Case Formulation 3
Which assessment tool is most commonly used in CBT to measure the severity of generalized anxiety?