RP Patient Communication Skills 3 — Questions and Answers
Question 1: A client with Borderline Personality Disorder calls the crisis line between sessions saying, 'You're the only one who understands me.' The MOST therapeutically appropriate response is:
- Affirm that the relationship is unique and the client is right
- Validate the client's feelings while gently reinforcing the boundaries of the therapeutic relationship (Correct answer)
- Remind the client that calling between sessions is against the rules
- Transfer the client immediately to a higher level of care
Correct answer: Validate the client's feelings while gently reinforcing the boundaries of the therapeutic relationship
Validating the feeling while reinforcing appropriate limits supports both connection and boundary maintenance in dialectical approaches.
Question 2: In Motivational Interviewing, which communication style is MOST aligned with the 'spirit' of MI?
- Directing the client toward therapist-identified goals
- Collaborating as a partner and evoking the client's own motivation (Correct answer)
- Educating the client about the consequences of their behavior
- Confronting ambivalence to break through denial
Correct answer: Collaborating as a partner and evoking the client's own motivation
The MI spirit is characterized by partnership, acceptance, compassion, and evocation rather than expert-directed advice.
Question 3: A therapist uses the phrase 'You seem to feel overwhelmed when your partner criticizes you.' This is an example of:
- Open-ended questioning
- Empathic reflection of feeling (Correct answer)
- Immediacy
- Cognitive restructuring
Correct answer: Empathic reflection of feeling
Reflecting the client's underlying feeling labels the emotion and conveys empathic understanding.
Question 4: Which of the following is a hallmark of culturally competent communication with clients from collectivist cultures?
- Emphasizing individual autonomy and personal goals above family input
- Recognizing that family and community context may be central to the client's decision-making (Correct answer)
- Discouraging family involvement to protect confidentiality
- Using a standardized Western assessment tool without modification
Correct answer: Recognizing that family and community context may be central to the client's decision-making
Collectivist cultures often prioritize group harmony and family roles, so competent communication incorporates these perspectives.
Question 5: When a therapist says, 'I notice that right now, in this room, you seem angry with me,' this is an example of:
- Transference interpretation
- Immediacy (Correct answer)
- Self-disclosure
- Clarification
Correct answer: Immediacy
Immediacy addresses what is happening in the here-and-now of the therapeutic relationship.
Question 6: A client who is a non-native English speaker struggles to find words during session. The therapist's BEST response is to:
- Complete the client's sentences to save time
- Wait patiently, use simple language, and avoid idioms (Correct answer)
- Recommend the client switch to a therapist who speaks their language
- Speak more loudly and slowly as one would to someone hard of hearing
Correct answer: Wait patiently, use simple language, and avoid idioms
Patience, simple language, and idiom avoidance support comprehension without patronizing the client.
Question 7: Which approach BEST reduces the negative effect of jargon on the therapeutic relationship?
- Using technical terms to establish credibility
- Explaining clinical terms in plain language and inviting questions (Correct answer)
- Avoiding all clinical language entirely
- Assessing vocabulary level before each session
Correct answer: Explaining clinical terms in plain language and inviting questions
Translating clinical language into accessible terms and checking understanding keeps communication collaborative and transparent.
RP Patient Communication Skills 3
A client with Borderline Personality Disorder calls the crisis line between sessions saying, 'You're the only one who understands me.' The MOST therapeutically appropriate response is: