CCE CPCE Exam Questions

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21.

Which of the following best defines self-efficacy?

  • A client's sense of their own ability

  • A client's regard for themselves

  • A client's ability to regulate impulses

  • A client's overall energy level

Correct answer: A client's sense of their own ability 

Self-efficacy is the way in which a client rates their own ability to perform in general. It is a combination of their overall confidence and their sense of control over their environment. A client with high self-efficacy is more likely to be proactive and participatory; one with low self-efficacy will need coaching to take control and express confidence. 

The concept is related to self-regard but has more to do with performance than esteem. Some amount of impulse regulation is implied in a person with high self-efficacy, but this is by no means always the case. Similarly, there are people with both high and low overall energy levels who have a high sense of self-efficacy.

22.

How does the concept of homeostasis apply to family counseling? 

  • Homeostasis is usually more the goal than change is

  • Homeostasis encourages rapid growth and change

  • Homeostasis is usually highly undesirable to families

  • No change is possible in a homeostatic system

Correct answer: Homeostasis is usually more the goal than change is

The concept of homeostasis is an important one to understand in the field of family counseling. Just as it does in considerations of physical homeostasis within the body, system or family homeostasis refers to the way in which a system tries to find stability at any cost. This is evident, for instance, in alcoholic families, which often find an unhealthy homeostasis rather than challenging the dysfunctional status quo. 

Change is possible in such a system, and if properly completed, will establish a new and better homeostasis. 

23.

What can an employer ask about, according to the ADA?

  • How well a candidate can perform a job

  • The nature of a candidate's disability

  • How long a candidate's disability has existed

  • Whether a candidate expects their disability to improve

Correct answer: How well a candidate can perform a job 

The Americans with Disabilities Act (1990) protects disabled persons in various ways. One of these ways is that employers are not allowed to ask about a job candidate's disability, its nature, how long it has existed, or whether it is expected to improve. 

An employer's questions must be related to job performance and qualification as reflected in how well a given candidate can perform a given job.

24.

Which of the following is not a special concern about confidentiality with children?

  • Children cannot understand the concept of confidentiality

  • Children are often unconcerned about confidentiality

  • Children have a limited reasoning capacity

Correct answer: Children cannot understand the concept of confidentiality 

Working with children can be challenging for many reasons for those accustomed to working with adults. One of the special areas of concern about working with children is confidentiality. Children, with certain caveats related to parental rights, are entitled to confidentiality; however, in practice, it is often found that they do not care about the concept due to their limited reasoning ability. 

It is incorrect that they do not understand the concept in all cases; many do.

25.

How might a personal hierarchy be useful in systematic desensitization? 

  • By providing individually-defined stages 

  • By addressing universal sources of anxiety 

  • Personal hierarchies are not used in systematic desensitization 

Correct answer: By providing individually-defined stages 

Systematic desensitization is a process that uses classical conditioning to reduce anxiety around a specific stimulus or situation. Part of the process involves defining a hierarchy of anxiety-provoking items related to the situation, with the end in mind of being able to move past each on a journey to total mitigation. These hierarchies can be universal and more defined by the therapist, or they can be more personally defined by the individual. 

26.

According to the ACA Code of Ethics, what is the minimum required of assessors in terms of explanation?

  • The purpose of the assessment and the intended use of the results

  • The purpose of the assessment alone

  • The intended use of the results alone

Correct answer: The purpose of the assessment and the use of the results 

According to the ACA Code of Ethics (2014), assessors are under an obligation to clearly explain the nature and purpose of any assessment given to a client, as well as the intended use of the results of the assessment. This must be done in language that the client can understand and can be extended to caregivers or other responsible parties around the patient.

27.

Generally speaking, how quickly has the counseling profession responded to multicultural concerns?

  • Slowly, but with eventual clarity

  • Indifferently, with much work still to be done 

  • Rigorously, with a track record of decades

  • There has been little specific attention to multiculturalism

Correct answer: Slowly, but with eventual clarity 

The counseling profession has been slow, historically, to respond to the need to address multiculturalism as a professional initiative. Concern about the lack of such attention in the 1980s led to revision of the ACA Code of Ethics in 2005, which put a central focus on the issue. Subsequent revisions to the Code, particularly in 2014, have added clarity and fullness to the treatment of multicultural issues.

28.

Which of the following is an advantage of qualitative research design?

  • Narrative description

  • Statistical metainference 

  • Replicability 

Correct answer: Narrative description 

Qualitative research design is different from the older, more standard qualitative research design in several ways. Qualitative research design does not, for the most part, deal in statistical metainference, as it is not as concerned with statistical process as is quantitative design. One major advantage of qualitative research design is that participants are much more likely to have their narratives preserved in a meaningful way rather than being reduced to a data point, among many others. 

Replicability can be an issue with qualitative design as, by its nature, qualitative research deals in personal experience and not experiment per se.

29.

Which of the following is true regarding diverse clients and diagnoses? 

  • Minority groups are diagnosed more severely

  • Minority groups are diagnosed with more symptoms

  • Minority groups are underdiagnosed

Correct answer: Minority groups are diagnosed more severely 

According to research, minority groups are diagnosed more severely than non-minority groups, given the same symptoms. African Americans, for instance, are more likely to be diagnosed with schizophrenia and childhood disorders than Americans of European extraction. 

Minority groups are not necessarily diagnosed with more symptoms; the symptomology they present, however, tends to be addressed as more severe. 

30.

Can a personality disorder exist alongside another mental health diagnosis? 

  • Yes, in many circumstances

  • No, in no circumstances

  • Only in cases where the secondary disorder is substance abuse 

  • Only in cases where the secondary disorder is psychotic in character

Correct answer: Yes, in many circumstances 

A personality disorder is a stable orientation of the affective tools of the individual, such that those tools are either ineffective, hostile, or otherwise out of step with affective norms. For instance, antisocial personality disorder is characterized by a pattern of lack of empathy, rule-breaking, exploitation, and manipulation. 

These disorders can and do exist alongside other disorders, including psychotic disorders and substance use disorders, but can co-exist with many others.

31.

What testing privileges do counselors receive upon licensure?

  • Specific privileges vary by state jurisdiction

  • Privileges to administer all but intelligence testing

  • Broad privileges to administer virtually any standardized test

  • No specific testing privileges are granted upon licensure

Correct answer: Specific privileges vary by state jurisdiction 

As with so many other aspects of the counseling profession, there is a high degree of variability in the specifics of which tests, if any, are permissible for licensee counselors to administer. Some states specify, others leave the issue vague, and still others are very strict. It will be up to the individual counselor to know the local statutes and licensee privileges well, in the awareness that such things are open to change.

32.

What is the most striking visual characteristic of a normal distribution?

  • It is symmetrical around the mean

  • It is sloped from right to left

  • It is sloped from left to right

  • It has one large and one small symmetry parallel to the mean

Correct answer: It is symmetrical around the mean 

A normal distribution is one in which there is symmetrical distribution of data around the mean. Thus, it would look like a bell, with a large mass in the middle and rapidly decreasing slopes to both left and right. 

All of the other answer choices describe skewed distributions, technically indicating scores that are either very high or very low for the most part.

33.

How does motivational interviewing function as an assessment strategy?

  • By discovering the client's reasons for change

  • By addressing the client's pathology directly

  • By educating the client about their problem

Correct answer: By discovering the client's reasons for change 

Motivational interviewing began in the substance use treatment arena, where it provided a counterpoint to more counselor-directed, confrontational styles of treatment. As an assessment strategy, motivational interviewing improves on these older methods by forcing the client to come up with their own reasons for change rather than having them dictated by the therapist.

34.

If a person is deemed legally incompetent, is informed consent necessary?

  • No, but assent is necessary

  • Yes, in all circumstances

  • No, in no circumstances

Correct answer: No, but assent is necessary 

The ACA Code of Ethics makes clear that, in cases where a person has been deemed legally incompetent, it is still the responsibility of those dealing with that person to obtain assent for whatever might otherwise involve informed consent, such as treatment or participation in various activities. Consent can be given by a legal representative for such persons, but the ACA stipulates that assent—meaning agreement of the individual—should be obtained as well.

35.

How strong is the association between bullying and suicide?

  • The strength of the association is unclear

  • There is a very clear, demonstrated association

  • There is virtually no statistical association

Correct answer: The strength of the association is unclear 

Though research continues, and it is recognized that bullying and other social pressures can inflect suicide to an undefined degree, the actual association between bullying and suicide remains unclear. There are many factors in play, including the victim's support system, resilience, cultural preparation, general environment, and others. This is also true for the newer phenomenon of cyberbullying.

36.

How should a counselor best deal with transference?

  • By making use of it 

  • By eliminating it 

  • By letting it pass 

  • By discussing it 

Correct answer: By making use of it 

Transference is one of the oldest phenomena known to counseling and psychotherapy, and the guidance on how to deal with it has not substantially changed since Freud first described it. It is best not to ignore it, try to eliminate it, or only bring it up for discussion, but to make therapeutic use of the expressed emotion. 

Transference is the "extra" feelings that a client transfers from other relationships onto the therapist, which can be anything. Many times, this takes the form of romantic feelings or anger, but in all cases, the proper course of action is to acknowledge it openly and attempt to make therapeutic use of it. For instance, a hostility directed toward the therapist may be an issue about another relationship in the person's life that is worth exploration.

37.

Can Dialectical Behavioral Therapy (DBT) be used with family systems?

  • Yes, in many cases

  • No, under no circumstances

  • Yes, if participants are already being treated with DBT

  • No, as DBT is designed for individuals

Correct answer: Yes, in many cases 

Dialectical Behavioral Therapy (DBT) was indeed designed for use with individuals, but many of the skills taught in DBT apply directly to family systems; for instance, communicative and relational skills meant to change the nature of interpersonal interactions. As family therapy is, in many cases, about the nature of interpersonal relationships within the system, DBT skill sets are appropriate for use in family systems.

38.

How does narrative therapy help a client self-define?

  • By creating a personal counter-narrative

  • By exploring unconscious motivations

  • By creating a behavior plan

  • By teaching affective skills

Correct answer: By creating a personal counter-narrative 

Narrative therapy is based on the idea that a person has probably internalized messages throughout their life that may be inaccurate or unhelpful. By examining the "story" a person tells about themselves, and suggesting therapeutic substitutions or amendments to this narrative, the client is able to define their own experience in their own words in an empowering way. 

Narrative therapy does not explicitly address unconscious motivations or deal with behavior plans, nor does it teach affective skills; it concentrates on the story a person tells themselves about themselves.

39.

Which of the following is the main purpose of a genogram?

  • To analyze family structure and relationships

  • To suggest avenues for therapeutic referral

  • To address deep trauma within the family

Correct answer: To analyze family structure and relationships 

A genogram can take many forms, from less elaborate to highly intricate; in all cases, its main function is the analysis of family structure and relationships. 

Through the process of working through a genogram with a client, avenues for possible therapeutic exploration are no doubt identified; however, the purpose is not, strictly speaking, to identify issues or address family trauma.

40.

What is "freedom of choice" legislation with respect to the counseling profession?

  • Legislation that demands counselor equity

  • Legislation that gives counselors rights to practice in neighboring jurisdictions 

  • Legislation that allows counselors equal access to continuing education

  • Legislation that allows counselor reciprocity

Correct answer: Legislation that demands counselor equity 

Historically, counselors have not always been treated with equity by third-party payors in terms of being available as a choice for those seeking mental health treatment. Legislation to put equal access to counselors alongside other mental health professionals as a choice for those seeking mental health treatment is called freedom of choice legislation. 

The issue is not so much jurisdictional as it is an acknowledgment on the part of third-party payors.