CLT Advanced Treatment Methods 2 — Questions and Answers
Question 1: In LEAP therapy, when a client insists their delusion is real, the therapist should:
- Agree with the delusion to build rapport
- Argue using evidence to correct the belief
- Empathize with the emotional content without endorsing the belief (Correct answer)
- Ignore the topic and redirect to another subject
Correct answer: Empathize with the emotional content without endorsing the belief
LEAP therapists empathize with the feelings behind a delusion without validating its factual content.
Question 2: Which motivational interviewing technique is central to the 'Partner' step of LEAP?
- Confrontation to highlight discrepancies
- Collaborative goal-setting around the client's own values (Correct answer)
- Psychoeducation about diagnosis
- Prescribing medication adherence schedules
Correct answer: Collaborative goal-setting around the client's own values
Partnering in LEAP means co-creating goals anchored in what the client already values, not imposing clinician-defined goals.
Question 3: A client with anosognosia refuses medication. The most appropriate advanced LEAP response is to:
- Invoke an involuntary treatment order immediately
- Use reflective listening to explore what the client does want help with (Correct answer)
- Show brain scans to prove the illness exists
- Discharge the client for non-compliance
Correct answer: Use reflective listening to explore what the client does want help with
Reflective listening surfaces the client's own concerns, which can become leverage for partnership without triggering defensiveness.
Question 4: In advanced LEAP practice, 'rolling with resistance' means:
- Surrendering treatment goals when the client pushes back
- Agreeing with the client's every objection
- Avoiding argument by reflecting the client's ambivalence back to them (Correct answer)
- Escalating confrontation to break through denial
Correct answer: Avoiding argument by reflecting the client's ambivalence back to them
Rolling with resistance reframes or reflects the client's own words rather than opposing them, preserving alliance.
Question 5: Which stage of the Stages of Change model is most associated with a client who says, 'I might have a problem, but I'm not sure'?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Maintenance
Correct answer: Contemplation
Contemplation is marked by ambivalence — the client acknowledges possible problems but has not committed to change.
Question 6: When using LEAP's 'Agree' step with a delusional client, the therapist should agree on:
- The factual reality of the delusion
- The client's right to their own opinion and any genuinely shared concerns (Correct answer)
- The clinician's diagnosis and treatment plan
- Nothing, because agreement reinforces delusions
Correct answer: The client's right to their own opinion and any genuinely shared concerns
Agreeing is limited to autonomous rights and genuinely overlapping concerns — never on delusional content.
Question 7: Developing discrepancy in motivational interviewing involves:
- Pointing out inconsistencies harshly to provoke insight
- Helping the client see the gap between current behavior and personal goals (Correct answer)
- Prescribing tasks that feel inconsistent with the client's lifestyle
- Disagreeing with the client to stimulate self-reflection
Correct answer: Helping the client see the gap between current behavior and personal goals
Discrepancy highlights the mismatch between what the client wants for themselves and what their current behavior produces.
CLT Advanced Treatment Methods 2
In LEAP therapy, when a client insists their delusion is real, the therapist should: