Intro to Clinical Mental Health Counseling (Fall 2025)

With Dr. Lien Nguyen :)

Which of the following terms was devised in the mid- to late-1970s to identify counseling activities that took place outside of educational settings? (Chapter 1)

A. Mental health counseling

B. Community counseling 

C. School guidance and counseling

D. Clinical mental health counseling

B. Community counseling

Which of the following divisions of the American Personnel and Guidance Association was established for mental health counselors? (Chapter 1)

A. American Community Counselors Association

B. American Clinical Mental Health Counseling Association

C. American Mental Health Counselors Association

D. American Counseling Association

C. American Mental Health Counselors Association

The first state to adopt a professional counselor licensure law was: (Chapter 1)

A. Alabama

B. Virginia

C. Arkansas

D. California

B. Virginia

Which of the following was formed in the 1980s to standardize counselor training and accredit counseling programs? (Chapter 1)

A. CACREP

B. APGA

C. APA

D. NBCC

A. CACREP

What occurred as a result of the growth of managed care organizations in the 1990s? (Chapter 1)

A. Many counselors became providers for health maintenance organizations (HMOs).

B. The number of sessions a counselor could offer under managed health care plans decreased.

C. The number of independent counselors decreased

D. All of the above

D. All of the above

Which of the following statements reflect(s) an impetus for forming the taskforce, 20/20: A Vision for the Future of Counseling? (Chapter 1)

A. To advance the future of counseling.

B. To address the issue of professional identity

C. To increase unity within the profession

D. All of the above

D. All of the above

Which of the following mental health professions is represented by Division 17 of the APA? (Chapter 1)

A. Counseling Psychology

B. Clinical Psychology

C. Professional Counseling

D. Psychiatry

A. Counseling Psychology

The definition of counseling reached by the task group, 20/20: A Vision for the Future of Counseling, includes all of the following except: (Chapter 1)

A. Counselors promote wellness

B. Counseling is diverse and multicultural

C. Counseling is a dynamic, lively, and engaging process

D. All of the above are included in the definition

D. All of the above are included in the definition

All of the following are benefits of national counseling certification except? (Chapter 1)

A. It ensures that counselors, rather than independent state legislators, set the national standards and minimum requirements for being a professional counselor

B. It regulates professional practice.

C. It provides referral sources and networking opportunities across state lines

D. All of the above are benefits of national counseling certification.

B. It regulates professional practice.

Which court judgment stated that counseling was a profession distinct from psychology? (Chapter 1)

A. Bogust v. Iverson

B. Iowa Law Review Note

C. Weldon v. Virginia State Board of Psychologists Examiners

D. Tarasoff v. University of California – Berkeley

C. Weldon v. Virginia State Board of Psychologists Examiners

Which of the following, according to Van Hoose & Kottler (1985) is “a philosophical discipline that is concerned with human conduct and moral decision making” (p. 3). (Chapter 2)

A. Morality

B. Law

C. Ethics

D. Autonomy

C. Ethics

All of the following are moral principles described by Kitchener (1984) except: (Chapter 2)

A. Autonomy

B. Justice

C. Nonmaleficence

D. Fidelity

E. Beneficence

F. Capacity

F. Capacity

A counselor struggles between protecting a client’s welfare and respecting a client’s freedom of choice and action. The counselor is struggling with which two moral principles? (Chapter 2)

A. Nonmaleficence and Autonomy

B. Capacity and Nonmaleficence

C. Justice and Autonomy

D. Fidelity and Autonomy

E. Beneficence and Autonomy

E. Beneficence and Autonomy

Mandatory ethics are followed when clinical mental health counselors: (Chapter 2)

A. Make decisions based on internalized principles and ideals of the profession, not just external considerations.

B. Judge or evaluate their professional actions through a spiritual or religious lens.

C. Comply with the required minimal standards of the profession.

D. None of the above.

E. All of the above.

C. Comply with the required minimal standards of the profession.

All of the following are true regarding ethical codes except: (Chapter 2)

A. No ethical code can address every situation or potential dilemma.

B. Enforcing ethical codes is difficult

C. Sometimes conflicts arise between ethical and legal codes.

D. There may be conflicts within the ethical codes as well as among different organizations’ codes.

E. Ethical codes are necessary and sufficient for promoting ethical behaviors.

F. Some codes are ambiguous, making them open to interpretation

E. Ethical codes are necessary and sufficient for promoting ethical behaviors.

According to the 2014 ACA Code of Ethics counselors are restricted from engaging in romantic or sexual relationships with clients for at least how many years after the termination of the counseling relationship? (Chapter 2)

A. 2 years

B. 3 years

C. Counselors are restricted, in all cases, by the 2014 ACA Code of Ethics from engaging in romantic or sexual relationships with clients.

D. 5 years

D. 5 years

All of the following represent areas of potential malpractice for counseling except: (Chapter 2)

A. Providing services for which competence has not been established

B. Improperly certifying a client in a commitment hearing

C. Promising a “cure”

D. Breaching confidentiality

E. Failing to take action when someone other than the client is in danger

F. All of the above are potential examples of malpractice

F. All of the above are potential examples of malpractice

Which of the following terms refers to a client’s legal right to determine what information about himself or herself will be shared with others? (Chapter 2)

A. Autonomy

B. Beneficence

C. Privacy

D. Confidentiality

C. Privacy

In which legal case did the court rule that counselors need to take reasonable action to help protect potential victims from dangerous client? (Chapter 2)

A. Tarasoff v. Board of Regents of the University of California

B. Jaffee v. Redmond

C. 1993 Napa County, California case
D. None of the above

A. Tarasoff v. Board of Regents of the University of California

Online counseling that occurs during the moment of connection is called: (Chapter 2)

A. Skype counseling

B. Asynchronous counseling

C. Voice over IP (VolP)

D. Synchronous counseling

D. Synchronous counseling

As defined by Olatunji (2001), which of the following accurately describes multicultural counseling? (Chapter 3)

A. Multicultural counseling refers to multiple perspectives or multiple cultural viewpoints within the counseling relationship in which the viewpoint of the counselor is most accurate due to his or her training and self-awareness.

B. Multicultural counseling refers to multiple perspectives or multiple cultural viewpoints within the counseling relationship in which none are dominant or considered more “normal” than others

C. Multicultural counseling refers to binary perspectives or viewpoints within the counseling relationship in which certain viewpoints are healthier than others

D. None of the above.

B. Multicultural counseling refers to multiple perspectives or multiple cultural viewpoints within the counseling relationship in which none are dominant or considered more “normal” than others

Which counseling perspective emphasizes the universal qualities of counseling that are culturally generalizable? (Chapter 3)

A. Cultural generalizability approach

B. Etic approach

C. Hegemonic approach

D. Emic approach

B. Etic approach

__________________ refers to the way people perceive their relationship to the world, including nature, other people, objects, and religious experiences. (Chapter 3)

A. Multiculturalism

B. Ethnocentrism

C. Worldview

D. Acculturation

C. Worldview

_____________ includes both the affectional and sexual dimensions of self that are evidenced by thoughts, feeling, and behaviors. (Chapter 3)

A. Sexual behavior

B. Sexual attraction

C. Sexual identity

D. All of the above

C. Sexual identity

In which court case did a federal appeals court uphold the job termination of a counselor who asked to be excused from counseling a lesbian client on relationship issues because of the client’s sexual orientation conflicted with the counselor’s religious beliefs? (Chapter 3)

A. Tarasoff v. Board of Regents of the University of California

B. Bruff v. North Mississippi Health Services, Inc.

C. Jaffee v. Redmond

D. None of the above

B. Bruff v. North Mississippi Health Services, Inc.

Which of the following refers to the primary importance of family in Latino communities? (Chapter 3)

A. Respeto

B. Familism

C. Personalism

D. Marianismo

B. Familism

_________________ is a term in the DSM-5 used to describe individuals who experience incongruence between their expressed/experienced gender and their assigned gender. (Chapter 3)

A. Homosexuality

B. Sexual Identity Disorder

C. Gender Dysphoria

D. Gender Identity Disorder

C. Gender Dysphoria

_______________ refers to oppression, discrimination, or marginalization experienced by people who are negatively affected by socioeconomic disparity. (Chapter 3)

A. Social class

B. Socioeconomic status

C. Classism

D. Poverty

C. Classism

A counselor working with a client whose religion, ethnicity, and sexual orientation are different from his own, decides that he needs to process his thoughts and feelings about these contrastive cultural groups. This counselor is working on what facet of multicultural counseling competency development? (Chapter 3)

A. Cultural skills

B. Cultural knowledge

C. Cultural awareness

D. Cultural responsiveness

C. Cultural awareness

Jessica, a white female counselor, is working with Richard, a Chinese American male who is struggling with depression. Jessica has worked with many individuals with depression and, although she has not worked with a Chinese male with depression, she believes her existing knowledge base and skill set is sufficient. Which of the following statements, based on this information would be true of Jessica? (Chapter 3)

A. Jessica is actively contributing to institutionalized racism.

B. Jessica’s thought process is culturally sensitive because she aims to give the same treatment to Richard that she has given to clients in the past.

C. Jessica is exhibiting an emic perspective on counseling.

D. Jessica is exhibiting an etic perspective of counseling

D. Jessica is exhibiting an etic perspective of counseling

______________ refers to a motivation to change. (Chapter 4)

A. Initiative

B. Rapport

C. Informed consent

D. None of the above

A. Initiative

Which of the following theoretical frameworks encourages counselors to roll with resistance rather than confront it? (Chapter 4)

A. Cognitive-Behavioral Therapy

B. Motivational Interviewing

C. Transtheoretical Counseling

D. Developmental Counseling and Therapy

B. Motivational Interviewing

Which of the following counseling skills is effective in eliciting a large amount of information in a short time, but does not encourage elaboration? (Chapter 4)

A. Open questions

B. Empathy

C. Confrontation

D. Closed questions

D. Closed questions

All of the following are door openers except: (Chapter 4)

A. “What brings you to see me?”

B. “What if we move on to something different?”

C. “Tell me more.”

D. “What would you like to talk about?”

B. “What if we move on to something different?”

___________________ provides a way for counselors to link clients’ presenting problems to a treatment plan and serves to tailor interventions to specific client needs. (Chapter 4)

A. Case conceptualization

B. Empathy

C. Rapport

D. Clarifying probes

A. Case conceptualization

Which of the following is a term referring to negative, inaccurate biases that can result in unhealthy misperceptions of events? (Chapter 4)

A. Delusions

B. Resistance

C. Abreaction

D. Cognitive distortions

D. Cognitive distortions

________________ offers the client another probable and positive viewpoint of what a situation is or why an event might have happened. (Chapter 4)

A. Reframing

B. Selective abstraction

C. Empathy

D. Cognitive distortion

A. Reframing

Which of the following is best option describing the important function of ending the counseling relationship? (Chapter 4)

A. Gives clients the opportunity to maintain changes already achieved and generalize problem-solving skills to new areas

B. Serves as a reminder that the client has matured

C. Signals that something important has been completed

D. None of the above are important functions of ending the counseling relationship.

E. All the above are important functions of ending the counseling relationship.

E. All the above are important functions of ending the counseling relationship.

Which of the following involves arranging other assistance for clients when the initial arrangements are not likely to be helpful? (Chapter 4)

A. Recycling

B. Referral

C. Abandonment

D. Termination

B. Referral

A client who is unaware that a problem exists is in which stage of change? (Chapter 4)

A. Contemplation

B. Precontemplation

C. Maintenance

D. Action

E. Preparation

B. Precontemplation

______________ is an ongoing process in which counselors gather information about clients from several different sources and use the information to make decisions for treatment planning. (Chapter 5)

A. Assessment

B. Diagnosis

C. Case conceptualization

D. None of the above

A. Assessment

Which of the following assessment instruments is based on the work of Carl Jung and Jungian theory, and is the most widely used personality inventory for normal functioning? (Chapter 5)

A. Minnesota Multiphasic Personality Inventory-2

B. NEO Personality Inventory-3

C. Myers-Briggs Type Indicator

D. Brief Symptom Inventory

C. Myers-Briggs Type Indicator

Test trustworthiness includes all of the following except? (Chapter 5)

A. The test is valid

B. The test is reliable

C. The test is practical

D. The test is fair cross-culturally

E. All of the above relates to test trustworthiness

E. All of the above relates to test trustworthiness

___________________ according to Hoheshil (1996) is “the process of comparing the symptoms exhibited by the client with the diagnostic criteria of some type of classification system” (p. 66). (Chapter 5)

A. Assessment

B. Appraisal

C. Psychological testing

D. Treatment planning

E. Diagnosis

E. Diagnosis

According to the DSM-5, which of the following are requirements that must be met for a syndrome to be considered a mental disorder? (Chapter 5)

A. There must be sufficient evidence that the symptoms represent a dysfunction in the processes underlying mental functioning.

B. The dysfunction must cause harm to the person in regard to psychological functioning that is clinically significant.

C. The syndrome must be behavioral or psychological in nature and culturally sanctioned

D. All of the above are requirements that must be met for a syndrome to be considered a mental disorder

E. a and c

F. a and b

F. a and b

Which of the following is considered a depressive disorder? (Chapter 5)

A. Substance Use Disorder

B. Obsessive-Compulsive Disorder

C. Tourette’s

D. Disruptive Mood Dysregulation Disorder

D. Disruptive Mood Dysregulation Disorder

People with which classification of disorders present with physical symptoms that initially appear to be medical in nature but cannot fully be explained as medical conditions? (Chapter 5)

A. Feeding and Eating disorders

B. Somatic Symptom and Related Disorders

C. Anxiety disorders

D. Depressive disorders

B. Somatic Symptom and Related Disorders

Which of the following is an example of a disorder in the category of disruptive, impulse-control, and conduct disorders? (Chapter 5)

A. Anorexia Nervosa

B. Adjustment Disorder

C. Generalized Anxiety Disorder

D. Kleptomania

D. Kleptomania

Which of the following is characteristic of someone with a Cluster B personality disorder? (Chapter 5)

A. eccentricity

B. anxiety and fear

C. emotional dysregulation

D. all of the options are characteristics of someone with a Cluster B personality disorder

C. emotional dysregulation

Which of the following questions is related to the psychological part of a biopsychosocial assessment? (Chapter 5)

A. What genetic factors may be influencing the client’s wellbeing?

B. What medications is the client taking?

C. Does the client have a history of addiction or dependency?

D. What cultural factors are relevant to the client’s presenting problem?

E. Has the client experienced legal difficulties

C. Does the client have a history of addiction or dependency?

___________ are 3.5 times more likely to die by suicide; whereas, ______________ attempt suicide more. (Chapter 8)

A. Men; men

B. Women; men

C. Men; women

D. Women; women

C. Men; women

When assessing for the presence of a suicide plan, all of the following are recommended except: (Chapter 8)

A. That the counselor be indirect by using euphemisms

B. That the counselor be direct

C. Ask open questions to invite discussion and gain information to help with risk assessment

D. That the counselor be calm

A. That the counselor be indirect by using euphemisms

Which of the following is the strongest single predictor of future suicide? (Chapter 8)

A. Substance use

B. Age

C. Prior suicide attempt

D. Military status

E. Posttraumatic stress disorder

C. Prior suicide attempt

All of the following are protective factors that reduce the likelihood of suicide except: (Chapter 8)

A. Investment in effective clinical care

B. Restricted access to highly lethal means of suicide

C. Interpersonal support

D. Cultural/religious beliefs which encourage self-preservation

E. Healthy problem-solving and coping skills

F. All of the above are protective factors

F. All of the above are protective factors

________________ have been replaced with a much more effective and ethical intervention called ___________________. (Chapter 8)

A. Safety Plans; No-Suicide Contracts

B. Involuntary Commitments; Safety Plans

C. No-Suicide Contracts; Involuntary Commitment

D. No-Suicide Contracts; Safety Plans

D. No-Suicide Contracts; Safety Plans

_______________ is an example of a developmental crisis. (Chapter 8)

A. War

B. Death of a loved one

C. Retirement

D. Realizing one cannot have children

C. Retirement

_______________ is an example of an existential crisis. (Chapter 8)

A. Retirement

B. Realizing one can never have children

C. War

D. Death of a loved one

B. Realizing one can never have children

Which of the following represents an affective reaction to a crisis situation? (Chapter 8)

A. Intense emotional expressiveness, such as screaming and sobbing uncontrollably

B. Perceptions of threat, loss, or transgression

C. Denying or escaping the crisis event

D. Immobility

A. Intense emotional expressiveness, such as screaming and sobbing uncontrollably

In which step of the six-step model of crisis intervention does a counselor encourage the client to identify available support sources and coping mechanisms? (Chapter 8)

A. Step 3 – Providing Support

B. Step 5 – Making Plans

C. Step 4 – Examining Alternatives

D. None of the above

C. Step 4 – Examining Alternatives

______________________ refers to changes that alter mental health professionals’ views of themselves, others, and the world and is associated with disruption in helpers’ views of safety, trust, esteem, intimacy, and control. (Chapter 8)

A. Crisis response

B. Vicarious traumatization

C. Posttraumatic stress disorders

D. All of the above

B. Vicarious traumatization

Which of the following focuses on multiple, interrelated ways biology, psychology, and social/cultural factors are conducive or detrimental to health and well-being? (Chapter 6)

A. Holistic mental health approach

B. Whole person approach

C. Biopsychosocial model

D. None of the above.

C. Biopsychosocial model

All of the following describe neurotransmitters except: (Chapter 6)

A. Messenger molecules released from one neuron to another

B. Produced by the glands, such as the pituitary gland and adrenal glands

C. Chemicals in the brain that account for the transmission of signals from one neuron to the next across synapses.

D. A complex set of structures that lies on both sides and underneath the thalamus, just under the cerebrum.

D. A complex set of structures that lies on both sides and underneath the thalamus, just under the cerebrum.

A decrease in which neurotransmitter is linked to an increase in hyperactivity and irritability? (Chapter 6)

A. Norepinephrine

B. Serotonin

C. Dopamine

D. None of the above

C. Dopamine

_____________ is an inhibitory neurotransmitter that is closely associated with emotion and mood. (Chapter 6)

A. Dopamine

B. Norepinephrine

C. Serotonin

D. None of the above

C. Serotonin

Your client, Marcus, shares with you that he often reacts very passionately and aggressively to anyone he believes is taking advantage of him.

From a biological perspective, what organ plays a key role in Marcus’s expression of emotions? (Chapter 6)

A. Pituitary gland

B. Limbic system

C. Frontal cortex

D. None of the above

B. Limbic system

According to Nauert (2008), decline in an individual’s immune system after facing chronic stress is due to which stress hormone? (Chapter 6)

A. Adrenalin

B. GABA

C. Cortisol

D. Norepinephrine

C. Cortisol

In what way(s) do genetics play a key role in the biological component of the BPS model? (Chapter 6)

A. Many psychiatric conditions have a genetic component that puts individuals at a higher risk for developing certain disorders

B. They independently determine the activation, severity and duration of mental disorders

C. They include support systems and work relationships that intersect one’s personal cultural identity.

D. All of the above

A. Many psychiatric conditions have a genetic component that puts individuals at a higher risk for developing certain disorders

You determine that your client is low in emotional intelligence.

Which of the following would support this belief? (Chapter 6)

A. Your client shares that her pituitary gland isn’t working properly and she has been feeling really lethargic lately.

B. Your client indicates that she is very logical and regulates her emotions very well.

C. Your client shares a history of relationship difficulties, and indicates that she struggles to share how she feels to her partners and rarely perceives or understands their emotions

D. Your client shares that he perceives and understands emotions in others really well but struggles to express them herself

C. Your client shares a history of relationship difficulties, and indicates that she struggles to share how she feels to her partners and rarely perceives or understands their emotions

_______________ is paying attention to the here and now in a purposeful, nonjudgmental manner. (Chapter 6)

A. Religion

B. Mindfulness

C. Spirituality

D. None of the above

B. Mindfulness

All of the following are components that McNamara (2000) suggests a stress management program should include except: (Chapter 6)

A. General cognitive skills

B. Time management

C. Skills for increasing self-control and self-esteem

D. Physical ways of coping with stress

E. All of the above are components suggested by McNamara (2000)

E. All of the above are components suggested by McNamara (2000)

_____________, according to Gladding (2016), refers to a “collection of two or more individuals who meet in face-to-face interaction, interdependently, with the awareness that each belongs to the group and for the purpose of achieving individual and/or mutually agreed upon goals” (p. 4). (Chapter 9 & 10)

A. Group

B. Congregation

C. Collective

D. None of the above

A. Group

Which of the following describes the function of counseling groups? (Chapter 9 & 10)

A. To help group participants resolve the usual, yet often difficult, situations connected with living in an ever changing world as well as to help participants develop their existing interpersonal problem-solving competencies to better handle future problems

B. To improve work practices and to accomplish identified work goals

C. The prevention of personal or societal disorder through conveying information and/or the examining of values.

D. To help individual group members resolve their in-depth and sometimes serious psychological problems

A. To help group participants resolve the usual, yet often difficult, situations connected with living in an ever changing world as well as to help participants develop their existing interpersonal problem-solving competencies to better handle future problems

In which stage of group development are feelings of tension and testing of the group environment prevalent? (Chapter 9 & 10)

A. Norming

B. Performing

C. Storming

D. Adjourning

E. Forming

C. Storming

All of the following are qualities of an effective group leader except: (Chapter 9 & 10)

A. caring

B. executive function

C. meaning attribution

D. person-centered theoretical orientation

E. emotional stimulation

D. person-centered theoretical orientation

_____________ concentrates on making changes in systems, whereas _______________ and __________________ primarily focus on intrapersonal and interpersonal changes. (Chapter 9 & 10)

A. individual counseling; family counseling; group counseling

B. group counseling; individual counseling; family counseling

C. family counseling; individual counseling; group counseling

D. none of the above

C. family counseling; individual counseling; group counseling

__________________ is the name given to the stages a family goes through as it evolves over the years. (Chapter 9 & 10)

A. Family Feedback Cycle

B. Individual life cycle

C. Family life cycle

D. All of the above

C. Family life cycle

_______________ refers to family environments in which members are overly dependent on each other or are undifferentiated. (Chapter 9 & 10)

A. Enmeshment

B. Close-knit

C. Role-disjointed

D. Triangulation

A. Enmeshment

All of the following are ways in which counselors can be effective when working with gay or lesbian couples and families except: (Chapter 9 & 10)

A. being knowledgeable about political, social, and legal implications of being a lesbian or gay family

B. Being able to refer clients to places of support in the community

C. assuming that the underlying reason for therapy is sexual orientation

D. not assuming that the reason for therapy has to do with sexual orientation

C. assuming that the underlying reason for therapy is sexual orientation

Which of the following is an accurate statement concerning couples counseling? (Chapter 9 & 10)

A. Treating one spouse for one or two sessions before seeing the couple together is an appropriate practice that leads to greater rapport and commitment.

B. It is crucial, in almost all cases, that clinical mental health counselors see both members of the couple from the beginning

C. Treating one spouse for one or two sessions initially doesn’t affect couples counseling.

D. None of the above is accurate

B. It is crucial, in almost all cases, that clinical mental health counselors see both members of the couple from the beginning

A counselor working with a family believes that the second child in the family is largely responsible for the dysfunction occurring in the family system. Therefore, the counselor focuses much of his attention in family counseling on confronting the second child and trying to change his “maladaptive behaviors.”

Based on this information, it appears the counselor is going against which concept? (Chapter 9 & 10)

A. Homeostasis

B. Nonsummativity

C. Morphogenesis

D. None of the above

B. Nonsummativity