CCM Psychosocial Assessment and Intervention 4 — Questions and Answers
Question 1: A case manager is working with a client who has paranoid ideation and refuses to engage with healthcare providers due to distrust. Which approach is MOST effective?
- Insist on compliance and document refusal
- Build trust gradually through consistent, transparent interactions (Correct answer)
- Involve law enforcement to ensure the client attends appointments
- Escalate immediately to psychiatric hospitalization
Correct answer: Build trust gradually through consistent, transparent interactions
Building a trusting therapeutic relationship through consistency and transparency is essential when working with clients who have paranoid ideation.
Question 2: Which of the following is an example of a psychosocial stressor that a case manager should assess as part of a comprehensive evaluation?
- Elevated HbA1c levels
- Recent job loss and financial strain (Correct answer)
- A positive MRI finding
- Abnormal liver function tests
Correct answer: Recent job loss and financial strain
Psychosocial stressors such as job loss, financial difficulties, and relationship problems significantly impact health outcomes and must be assessed comprehensively.
Question 3: A case manager is planning interventions for a client diagnosed with post-traumatic stress disorder (PTSD). Which evidence-based therapy should the case manager coordinate with the treatment team?
- Dialectical Behavior Therapy (DBT) for borderline personality
- Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) (Correct answer)
- Applied Behavior Analysis (ABA)
- Interpersonal Therapy (IPT) for depression
Correct answer: Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE)
Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) are the gold-standard, evidence-based psychotherapies for PTSD endorsed by major clinical guidelines.
Question 4: A case manager observes that a client consistently denies having any problems with daily functioning despite clear evidence to the contrary. This defense mechanism is known as:
- Projection
- Rationalization
- Minimization (Correct answer)
- Displacement
Correct answer: Minimization
Minimization is a defense mechanism where an individual downplays the significance of their problems or symptoms to avoid confronting them.
Question 5: A case manager is assessing a client's readiness to transition from inpatient psychiatric care to community living. Which factor is MOST critical to evaluate?
- The client's insurance coverage limits
- Availability of community support systems and follow-up care (Correct answer)
- The physician's preference for discharge timing
- The number of prior hospitalizations
Correct answer: Availability of community support systems and follow-up care
Adequate community support systems and coordinated follow-up care are the most critical factors in preventing psychiatric rehospitalization after discharge.
Question 6: Which of the following BEST describes secondary traumatic stress as it relates to case managers?
- Stress caused by managing a large client caseload
- Trauma symptoms experienced by helpers as a result of working with traumatized clients (Correct answer)
- A relapse of a case manager's own past trauma
- Physical exhaustion from long work hours
Correct answer: Trauma symptoms experienced by helpers as a result of working with traumatized clients
Secondary traumatic stress (also called compassion fatigue) occurs when case managers develop trauma-like symptoms from indirect exposure to clients' traumatic experiences.
Question 7: A case manager is coordinating care for a client with severe mental illness who has been living on the streets. Which model of care is MOST appropriate to address both housing and psychiatric needs simultaneously?
- The stepped-care model
- Housing First model (Correct answer)
- The medical home model
- Assertive Community Treatment (ACT) without housing prioritization
Correct answer: Housing First model
The Housing First model provides immediate stable housing without prerequisites, recognizing that housing stability is foundational to addressing mental health and other needs.
CCM Psychosocial Assessment and Intervention 4
A case manager is working with a client who has paranoid ideation and refuses to engage with healthcare providers due to distrust.
Which approach is MOST effective?