MC Master of Counseling: Trauma and Crisis Response 5 — Questions and Answers
Question 1: Which DSM-5 PTSD specifier was added to address young children under age 6?
- With delayed expression
- With dissociative symptoms
- PTSD for children 6 years and younger (Correct answer)
- With prominent shame features
Correct answer: PTSD for children 6 years and younger
DSM-5 includes a developmental subtype for PTSD in children 6 years and younger with age-appropriate diagnostic criteria.
Question 2: A counselor learns that a client was raped by their current intimate partner. The client does not want to report. The counselor's MOST appropriate response is to:
- File a mandatory report regardless of the client's wishes
- Respect the client's autonomy, safety plan, and continue supportive counseling (Correct answer)
- Encourage the client to leave the relationship immediately or terminate services
- Contact the partner to warn them of the counselor's awareness
Correct answer: Respect the client's autonomy, safety plan, and continue supportive counseling
Unless imminent danger is present, adult survivors of sexual assault retain autonomy over reporting; counselors support safety planning and client-centered decisions.
Question 3: Which finding from neuroimaging studies is MOST consistently associated with PTSD?
- Enlarged hippocampal volume
- Reduced hippocampal volume and hyperactive amygdala (Correct answer)
- Decreased amygdala activity with normal prefrontal function
- Increased prefrontal cortex volume and reduced amygdala reactivity
Correct answer: Reduced hippocampal volume and hyperactive amygdala
PTSD is associated with reduced hippocampal volume (affecting memory consolidation) and amygdala hyperreactivity to threat cues.
Question 4: A crisis counselor is helping a client create a safety plan. Which element is considered MOST critical to include?
- A list of medications the client should take
- Means restriction and removal of lethal means from the environment (Correct answer)
- A contract promising the client will not attempt suicide
- Daily mood tracking and journaling instructions
Correct answer: Means restriction and removal of lethal means from the environment
Means restriction — removing or limiting access to lethal means — is the single most evidence-based component of suicide safety planning.
Question 5: Trauma-informed care (TIC) organizations emphasize which of the following as foundational to all client interactions?
- Trauma processing before any other therapeutic goals
- Safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity (Correct answer)
- Mandatory trauma screening before intake is completed
- Immediate referral to trauma specialists for all clients disclosing past trauma
Correct answer: Safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity
SAMHSA's TIC framework identifies six key principles: safety, trustworthiness/transparency, peer support, collaboration, empowerment, and cultural/historical/gender issues.
Question 6: Which of the following BEST describes the role of 'pendulation' in Somatic Experiencing (SE)?
- Rapidly alternating bilateral stimulation of the body to process trauma
- Rhythmically moving client attention between distress and a resource or safe sensation (Correct answer)
- Using a pendulum-based relaxation technique to induce a trance state
- Swinging between active exposure and avoidance to build distress tolerance
Correct answer: Rhythmically moving client attention between distress and a resource or safe sensation
Pendulation in SE involves guiding the client's attention between areas of discomfort and areas of relative ease or resource to build nervous system flexibility.
Question 7: A counselor notices persistent fatigue, cynicism, reduced empathy, and a declining sense of personal accomplishment across all clients — not just trauma cases. This presentation MOST suggests:
- Secondary traumatic stress (STS)
- Burnout (Correct answer)
- Compassion fatigue specific to a difficult client
- Countertransference reactions
Correct answer: Burnout
Burnout is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment across the work environment, not linked to specific trauma content.
MC Master of Counseling: Trauma and Crisis Response 5
Which DSM-5 PTSD specifier was added to address young children under age 6?