- National Clinical Mental Health Counseling Examination Intake, Assessment, and Diagnosis Flashcards

A client presents with persistent sadness, anhedonia, sleep disturbances, and reports that symptoms have been present for 3 weeks. Which diagnosis is MOST appropriate at this time?

Answer: Unspecified Depressive Disorder

MDD requires symptoms for at least 2 weeks, but since a full diagnostic picture cannot be confirmed without ruling out other conditions, Unspecified Depressive Disorder is used when criteria are nearly but not fully met or information is insufficient.

During a clinical intake, a counselor notices a client uses vague language, avoids eye contact, and provides minimal responses. The BEST next step is to:

Answer: Use open-ended questions and reflective listening to build rapport

Building rapport through open-ended questions and reflective listening encourages a reluctant client to engage more openly during intake.

Which DSM-5 criterion differentiates Bipolar I Disorder from Bipolar II Disorder?

Answer: Presence of at least one full manic episode in Bipolar I

Bipolar I requires at least one full manic episode (lasting ≥7 days or requiring hospitalization), while Bipolar II involves hypomanic but not full manic episodes.

A counselor is completing a biopsychosocial assessment. Which of the following best represents the 'social' component?

Answer: Client's current employment status and family support system

The social component of a biopsychosocial assessment covers environmental factors such as relationships, employment, housing, and support systems.

A client reports hearing voices that comment on their behavior and expresses the belief that a TV news anchor is sending them secret messages. These symptoms are MOST consistent with:

Answer: Schizophrenia

Third-person auditory hallucinations and ideas of reference are hallmark positive symptoms of Schizophrenia, especially when persistent.

When assessing a client for Posttraumatic Stress Disorder (PTSD), the counselor must confirm that the traumatic event meets which DSM-5 Criterion A requirement?

Answer: Exposure must involve actual or threatened death, serious injury, or sexual violence

DSM-5 Criterion A for PTSD specifies exposure to actual or threatened death, serious injury, or sexual violence through direct experience, witnessing, indirect learning, or repeated exposure.

A client scores 22 on the PHQ-9 during intake. What does this score indicate, and what is the counselor's PRIORITY action?

Answer: Severe depression; conduct a suicide risk assessment

A PHQ-9 score of 20–27 indicates severe depression, and the counselor's priority is to assess for suicidality given the elevated risk.