CCTC CCTC - Certified Clinical Transplant Coordinator Psychosocial Assessment and Support Questions and Answers 4 — Questions and Answers
Question 1: A transplant candidate reports feeling "numb" and detached since receiving their diagnosis. Which psychosocial concept best describes this response?
- Somatization disorder
- Dissociative reaction as a grief response (Correct answer)
- Conversion disorder
- Malingering
Correct answer: Dissociative reaction as a grief response
Emotional numbing or dissociation is a recognized grief response to a life-threatening diagnosis and is distinct from a psychiatric disorder.
Question 2: When assessing a transplant candidate's social support network, which factor is MOST predictive of post-transplant adherence?
- Number of family members listed as contacts
- Presence of at least one reliable caregiver committed to post-transplant care (Correct answer)
- Geographic proximity of family members
- Whether the patient is married or partnered
Correct answer: Presence of at least one reliable caregiver committed to post-transplant care
Having at least one reliable, committed caregiver is the strongest social-support predictor of post-transplant medication adherence and outcomes.
Question 3: A pediatric transplant patient's parents consistently override the 16-year-old's expressed preferences about treatment. The CCTC's best initial action is to:
- Report the parents to child protective services immediately
- Support the parents since minors cannot consent
- Facilitate a family meeting to explore the adolescent's developing autonomy within the care plan (Correct answer)
- Defer entirely to the legal guardians without further discussion
Correct answer: Facilitate a family meeting to explore the adolescent's developing autonomy within the care plan
Adolescent assent and developing autonomy should be respected; a facilitated family meeting balances parental authority with the patient's emerging decision-making role.
Question 4: Which validated tool is MOST commonly used to screen transplant candidates for alcohol use disorder?
- PHQ-9
- AUDIT (Alcohol Use Disorders Identification Test) (Correct answer)
- GAD-7
- CAGE questionnaire only
Correct answer: AUDIT (Alcohol Use Disorders Identification Test)
The AUDIT is the WHO-endorsed, validated 10-item tool most widely used for alcohol use disorder screening in transplant evaluations.
Question 5: A liver transplant candidate with a history of alcohol use disorder has 18 months of documented sobriety. The ethics committee is debating listing. The CCTC should present:
- Only the sobriety duration, as that is the sole criterion
- A comprehensive psychosocial risk profile including relapse risk factors, support systems, and engagement with treatment (Correct answer)
- Solely the hepatologist's medical opinion
- A recommendation to deny listing until 5 years of sobriety is achieved
Correct answer: A comprehensive psychosocial risk profile including relapse risk factors, support systems, and engagement with treatment
Ethical listing decisions require a holistic psychosocial risk profile rather than sobriety duration alone, as no single factor predicts relapse with certainty.
Question 6: Post-transplant, a patient expresses survivor's guilt after learning a peer on the waitlist died. The CCTC's most therapeutic response is to:
- Reassure the patient that organ allocation is a fair system and they should feel grateful
- Dismiss the feelings as irrational since the patient had no control over allocation
- Acknowledge the patient's feelings as a normal response and explore referral to counseling (Correct answer)
- Tell the patient to focus only on their own recovery
Correct answer: Acknowledge the patient's feelings as a normal response and explore referral to counseling
Survivor's guilt is a recognized psychological response after transplant; acknowledging feelings as valid and offering counseling is the most supportive and therapeutic approach.
Question 7: A transplant coordinator identifies that a listed patient has stopped attending required pre-transplant support group sessions. The MOST appropriate first step is to:
- Remove the patient from the waitlist immediately for non-compliance
- Contact the patient to assess barriers to attendance and problem-solve solutions (Correct answer)
- Document the missed sessions without intervention
- Refer the patient directly to psychiatry without prior contact
Correct answer: Contact the patient to assess barriers to attendance and problem-solve solutions
Proactively reaching out to assess and address barriers maintains the therapeutic relationship and gives the patient an opportunity to re-engage before escalating consequences.
CCTC CCTC - Certified Clinical Transplant Coordinator Psychosocial Assessment and Support Questions and Answers 4
A transplant candidate reports feeling "numb" and detached since receiving their diagnosis.
Which psychosocial concept best describes this response?