TCC Texas Counselor Evaluation & Diagnosis 3 — Questions and Answers
Question 1: A school counselor in Texas evaluates a 10-year-old who has shown inattention and hyperactivity across home and school for 8 months. Per DSM-5, which duration criterion must be met for an ADHD diagnosis?
- 3 months
- 6 months (Correct answer)
- 12 months
- 18 months
Correct answer: 6 months
DSM-5 requires that ADHD symptoms persist for at least 6 months across multiple settings.
Question 2: Which standardized instrument is most appropriate for assessing trauma-related symptoms in adults consistent with PTSD criteria?
- PHQ-9
- PCL-5 (Correct answer)
- MMPI-3
- CAGE Questionnaire
Correct answer: PCL-5
The PTSD Checklist for DSM-5 (PCL-5) is specifically designed to assess the severity of PTSD symptoms aligned with DSM-5 criteria.
Question 3: During a clinical interview, a counselor discovers a client's grandiosity, decreased need for sleep, and reckless spending have persisted for 5 days. This symptom cluster best supports a diagnosis of:
- Cyclothymic Disorder
- Persistent Depressive Disorder
- Manic Episode (Correct answer)
- Hypomanic Episode
Correct answer: Manic Episode
A Manic Episode requires elevated or expansive mood with associated symptoms lasting at least 7 days, but hospitalization or marked impairment can qualify at any duration; 5 days with severity suggests mania rather than hypomania.
Question 4: A Texas counselor uses the Columbia Suicide Severity Rating Scale (C-SSRS). What does this tool primarily assess?
- Level of depression over the past two weeks
- The nature and intensity of suicidal ideation and behavior (Correct answer)
- Psychotic symptom frequency
- Substance use patterns and cravings
Correct answer: The nature and intensity of suicidal ideation and behavior
The C-SSRS is a validated scale that assesses the intensity of suicidal ideation and documents suicide-related behaviors.
Question 5: A client reports hearing voices that comment on her actions and believes her thoughts are being broadcast on television. In the mental status exam, these are recorded respectively as:
- Illusion and delusion of reference
- Auditory hallucination and delusion of reference (Correct answer)
- Visual hallucination and persecutory delusion
- Auditory hallucination and somatic delusion
Correct answer: Auditory hallucination and delusion of reference
Commenting voices are auditory hallucinations, and the belief that one's thoughts are broadcast is a delusion of reference.
Question 6: Which reliability concept is most relevant when two Texas counselors independently evaluate the same client and must agree on a diagnosis?
- Test-retest reliability
- Internal consistency
- Inter-rater reliability (Correct answer)
- Construct validity
Correct answer: Inter-rater reliability
Inter-rater reliability measures agreement between two or more independent raters assessing the same subject.
Question 7: A client is evaluated and scores a GAD-7 of 15. Which interpretation is correct?
- Minimal anxiety
- Mild anxiety
- Moderate anxiety
- Severe anxiety (Correct answer)
Correct answer: Severe anxiety
GAD-7 scores of 15–21 indicate severe anxiety, warranting clinical attention and possible referral.
TCC Texas Counselor Evaluation & Diagnosis 3
A school counselor in Texas evaluates a 10-year-old who has shown inattention and hyperactivity across home and school for 8 months.
Per DSM-5, which duration criterion must be met for an ADHD diagnosis?