RP Clinical Procedures and Protocols 3 — Questions and Answers
Question 1: A therapist suspects a child client is being neglected at home based on clinical observations. Under mandatory reporting laws, the therapist should:
- Consult with a supervisor before deciding whether to report
- Report the suspicion to child protective services without needing certainty of abuse (Correct answer)
- Wait until the child discloses abuse directly before making a report
- Discuss the suspicion with the child's parent first
Correct answer: Report the suspicion to child protective services without needing certainty of abuse
Mandatory reporters are legally required to report reasonable suspicions of child maltreatment; proof or certainty is not required before filing a report.
Question 2: Which psychotherapy approach specifically uses functional analysis (ABC model) to identify antecedents, behaviors, and consequences maintaining a problem?
- Psychodynamic therapy
- Person-centered therapy
- Behavior therapy (Correct answer)
- Narrative therapy
Correct answer: Behavior therapy
Functional analysis is a cornerstone technique in behavior therapy, mapping the environmental triggers and reinforcers that sustain problematic behavior.
Question 3: When a client arrives for their session appearing visibly intoxicated, the MOST appropriate immediate clinical response is to:
- Proceed with the session but document the presentation
- Reschedule the session and address substance use concerns in the next appointment
- End or reschedule the session, address safety, and review substance use policies (Correct answer)
- Call emergency services immediately
Correct answer: End or reschedule the session, address safety, and review substance use policies
An intoxicated client cannot meaningfully engage in therapy, so the session should not proceed; safety must be assessed and clinical substance use policies reviewed.
Question 4: In the stages of change model (Prochaska & DiClemente), a client who acknowledges a problem and intends to take action within the next six months is in which stage?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Contemplation is defined by awareness of the problem and consideration of change within the next six months, without a firm commitment to act immediately.
Question 5: A therapist is treating a client with OCD using exposure and response prevention (ERP). The core mechanism of ERP is:
- Teaching the client to suppress intrusive thoughts through distraction
- Repeated exposure to feared stimuli while preventing the compulsive response to allow habituation (Correct answer)
- Cognitive restructuring of obsessional beliefs before any exposure
- Using relaxation techniques to reduce anxiety during obsessional episodes
Correct answer: Repeated exposure to feared stimuli while preventing the compulsive response to allow habituation
ERP works by exposing the client to feared triggers and blocking the compulsive response, allowing anxiety to naturally decrease through habituation.
Question 6: When a client requests their therapy records, a therapist may withhold psychotherapy notes (process notes) under HIPAA because:
- Process notes belong to the insurance company
- Process notes are held to a separate, higher standard of privacy protection than the general medical record (Correct answer)
- Clients have no right to any mental health records
- Process notes are automatically shared with all treatment providers
Correct answer: Process notes are held to a separate, higher standard of privacy protection than the general medical record
HIPAA grants psychotherapy notes special protected status distinct from the designated record set, allowing clinicians to decline client access requests for these notes.
Question 7: A therapist using solution-focused brief therapy (SFBT) asks: 'On a scale of 0 to 10, where 10 is the problem fully solved, where would you say you are today?' This is an example of which SFBT technique?
- The miracle question
- Scaling question (Correct answer)
- Exception finding
- Coping question
Correct answer: Scaling question
Scaling questions in SFBT help clients quantify their progress and identify small steps toward improvement.
RP Clinical Procedures and Protocols 3
A therapist suspects a child client is being neglected at home based on clinical observations.
Under mandatory reporting laws, the therapist should: