CRC Exam (Certified Rehabilitation Counselor) — All Questions

Eight years after termination, a CRC is asked on a date by a former client whom the CRC treated for PTSD following an assault. What does the CRCC Code require?

• a.Proceed, because more than five years have passed since the last contact
• b.Decline, because the prohibition applies regardless of elapsed time✓
• c.Proceed after documenting that the relationship would not be coercive
• d.Proceed after obtaining approval from the CRCC Ethics Committee

Standard A.4.c prohibits romantic or sexual relationships with former clients who have a history of physical, emotional, or sexual trauma, regardless of how much time has passed. The five-year period in A.4.b does not apply to these vulnerable former clients, documentation of non-coercion is the A.4.b safeguard for other former clients, and the Code provides no Ethics Committee approval route.

At the final session, a client from a culture in which small gifts express gratitude offers her rehabilitation counselor a handmade scarf. Which approach is consistent with the CRCC Code?

• a.Refuse the gift, since the Code prohibits accepting any gift from a client
• b.Accept the gift only if it is worth less than twenty-five dollars
• c.Accept the gift and report it to the client's funding source
• d.Weigh the cultural practice, the gift's value, and each party's motives✓

Standard A.4.j says CRCs do not accept gifts except when culturally appropriate or therapeutically relevant, and directs them to consider cultural or community practice, the therapeutic relationship, the gift's monetary value, and both parties' motives, while following employer policy. The Code does not impose a blanket ban, sets no dollar threshold, and does not call for reporting gifts to a funding source.

A CRC is coordinating a job accommodation for a client who has bipolar disorder. The client's new manager asks the CRC for the client's diagnosis and medication list. What should the CRC do?

• a.Share only job-relevant information the client consented in writing to share✓
• b.Give the diagnosis but keep the medication list confidential from the manager
• c.Share the full clinical file, because the employer is paying for the placement
• d.Refuse to discuss the client with the manager in any way at all

Standard B.1.f requires written client consent before disclosing information to employers and, in placement and retention work such as coordinating accommodations, limits disclosure to necessary job-relevant information for those with a need to know. Volunteering the diagnosis or the whole file exceeds that limit regardless of who pays, and refusing all contact would block the accommodation the client asked the CRC to coordinate.

A CRC in private practice receives a subpoena for a client's records issued by the opposing party's attorney, not signed by a judge. What is the CRC's first appropriate step under the CRCC Code?

• a.Send the complete file before the response deadline stated on the subpoena
• b.Disregard the subpoena, since only a judge can compel the release of records
• c.Shred the session notes that the subpoena happens to cover
• d.Inform the client and assess the potential harm before releasing anything✓

Standard B.2.c says that when a subpoena comes from someone other than a judge, such as an attorney, the CRC informs the client and assesses potential harm to the client or the counseling relationship before releasing information, and ensures properly signed releases are in place. Releasing the full file skips those steps, ignoring a subpoena is not what the Code directs, and destroying requested records is never an acceptable response.

After a thorough discussion of the risks, a client insists on pursuing a sales job that her rehabilitation counselor considers a poor fit. The counselor supports her decision. Which ethical principle does this most directly reflect?

• a.Fidelity
• b.Autonomy✓
• c.Justice
• d.Nonmaleficence

The CRCC Code defines autonomy as respecting the right of clients to be self-governing within their social and cultural framework, and Standard A.1.e directs CRCs to respect clients' decisions on their own behalf. Fidelity concerns keeping promises and honoring trust, justice concerns fair treatment and appropriate services for all clients, and nonmaleficence is the duty to do no harm.

The publisher of a vocational aptitude battery released a revised edition 18 months ago. A CRC still uses the earlier edition with a new client. Under the CRCC Code, what must the CRC do?

• a.Nothing, because tests remain current for five years after publication
• b.Document a valid reason the earlier edition better fits this client✓
• c.Obtain written permission from the publisher to keep the earlier edition
• d.Have a second evaluator co-sign every report that uses the older edition

Standard H.4.b states that new or revised tests are generally used within one year of publication unless the CRC documents a valid reason why the previous version is more applicable to the client. The Code sets no five-year currency window, and neither publisher permission nor co-signed reports substitute for that documented rationale.

An attorney who is not a psychologist or counselor asks a CRC for the client's raw test answer sheets. The client has signed a general release. What does the CRCC Code allow?

• a.Release the raw data to the attorney because the client signed a release
• b.Release the raw data only after removing the client's name and scores
• c.Release the raw data after the attorney signs a confidentiality pledge
• d.Release raw data only to a professional qualified to interpret it✓

Standard H.2.b allows raw data identifying a client to be released, when copyright law allows, only with client consent or court order and only to professionals recognized as qualified to interpret it. A general release does not make an unqualified recipient eligible, removing identifiers would strip the data of its use rather than satisfy the rule, and a confidentiality pledge does not add interpretive qualifications.

A plaintiff's attorney offers a CRC who provides forensic vocational opinions a bonus equal to a share of any damages awarded. How should the CRC respond?

• a.Accept, as long as the fee arrangement is written into the retainer
• b.Decline, because forensic payment can never depend on the outcome✓
• c.Accept, provided the bonus is disclosed to the trier of fact at trial
• d.Accept only if the CRC's opinion is finished before the offer is made

Standards G.4.a and L.3.d state that in a forensic setting payment for services is never contingent on the outcome of a case or award, and the Glossary defines a contingency fee as one payable if the case is won or settled. Writing the arrangement into a retainer, disclosing it at trial, or timing the opinion before the offer does not cure the conflict the Code forbids.

A CRC is revising her professional disclosure statement. Regarding social media, what does the CRCC Code specifically require her to include?

• a.A list of every social media platform on which she keeps a personal account
• b.Her consent for clients to tag her in public posts about their progress in services
• c.A promise to review each client's public social media profiles before the intake session
• d.A statement that she declines client friend or follow requests on personal accounts✓

Standard K.4.c requires CRCs to explain the benefits, limitations, and boundaries of social media as part of informed consent and to include an explicit statement about non-acceptance of friend or follow requests from clients on personal accounts. The Code does not require listing personal accounts, and K.4.d directs CRCs to avoid searching a client's online presence unless it is relevant and disclosed in advance.

A CRC is starting telehealth counseling with a client who lives two hours away. Which step does the CRCC Code require at the beginning of virtual counseling?

• a.Confirm that the client's internet connection passes a formal speed test
• b.Require that the client's family attend the first video session
• c.Collect local emergency numbers and an emergency contact near the client✓
• d.Schedule at least one in-person meeting before any video sessions

Standard K.5.d requires CRCs, at the beginning of virtual counseling, to develop an emergency procedure that includes contact information for local emergency services and a personal emergency contact in the client's physical location. The Code does not require a speed test, family attendance, or an in-person session before virtual work begins, though K.5.a lists technology failure as an informed-consent topic.

An employer's manager tells an applicant that the company will not hire him because he once received treatment for cancer, which is now in remission. Which prong of the ADA definition of disability most directly covers him?

• a.An actual disability that is currently active
• b.A record of such an impairment✓
• c.An impairment that is transitory and minor
• d.A disability established by a physician's letter

Under 29 CFR 1630.2(g) and (k), an individual is covered under the 'record of' prong if he has a history of an impairment that substantially limited a major life activity, and ada.gov gives cancer in remission as an example. The cancer is not currently active, 'transitory and minor' describes an exception to the 'regarded as' prong rather than a basis for coverage, and the ADA definition does not turn on a physician's letter.

A client has worked for a 40-person employer for 14 months, averaging 30 hours a week, and needs time off after surgery. All 40 employees work at one site. Is he eligible for FMLA leave?

• a.Yes, because he has worked for this employer for more than 12 months
• b.Yes, because he has worked more than 1,250 hours in the past year
• c.No, because the employer has fewer than 50 employees within 75 miles✓
• d.No, because he has not worked full time for the full 12 months

Under 29 CFR 825.110(a), an eligible employee must have 12 months of employment, at least 1,250 hours of service in the prior 12 months, and work at a site where the employer has 50 or more employees within 75 miles. He meets the months and hours tests (about 1,560 hours), but the 40-employee worksite fails the 50-within-75-miles test; nothing in the rule requires full-time status.

A rehabilitation counselor works to be genuine, to accept the client without conditions, and to accurately sense the client's inner world. Which approach emphasizes these as the conditions for change?

• a.Rational emotive behavior therapy
• b.Reality therapy
• c.Person-centered therapy✓
• d.Psychoanalytic therapy

Carl Rogers proposed that congruence (genuineness), unconditional positive regard, and empathic understanding are the conditions that facilitate therapeutic change, which is the core of person-centered therapy. REBT centers on disputing irrational beliefs, reality therapy on present choices and behavior, and psychoanalytic therapy on unconscious conflict and insight.

After a job rejection, a client says, "I must get every job I apply for, or I am worthless." The counselor asks, "Where is the evidence that one rejection makes you worthless?" This technique is most characteristic of which approach?

• a.Person-centered therapy
• b.Acceptance and commitment therapy
• c.Solution-focused brief therapy
• d.Rational emotive behavior therapy✓

Albert Ellis's REBT uses the A-B-C framework, in which beliefs rather than events drive emotional consequences, and the counselor actively disputes irrational beliefs such as absolutist 'musts'. Person-centered work does not challenge beliefs directly, acceptance and commitment therapy helps clients relate differently to thoughts rather than disputing their content, and solution-focused therapy builds on exceptions and goals rather than examining evidence for beliefs.

A counselor asks a client who keeps missing work: "What do you want? What are you doing now to get it? Is it working? What is your plan?" This sequence comes from which approach?

• a.Adlerian therapy
• b.Reality therapy✓
• c.Existential therapy
• d.Solution-focused brief therapy

Reality therapy, grounded in William Glasser's choice theory, uses the WDEP system (Wants, Doing, Evaluation, Planning) described by Robert Wubbolding to help clients evaluate current behavior and make plans. Adlerian work explores lifestyle and social interest, existential therapy explores meaning and freedom, and solution-focused therapy uses exceptions, scaling, and the miracle question rather than WDEP.

A counselor asks, "Suppose tonight a miracle happened and the problem was solved. What would be the first thing you would notice tomorrow?" Which approach uses this question?

• a.Rational emotive behavior therapy
• b.Solution-focused brief therapy✓
• c.Psychoanalytic therapy
• d.Behavior therapy

The miracle question is a signature technique of solution-focused brief therapy developed by Steve de Shazer and Insoo Kim Berg, alongside exception-finding and scaling questions. REBT disputes irrational beliefs, psychoanalytic therapy explores unconscious material, and behavior therapy modifies behavior through learning principles such as reinforcement.

A counselor encourages a client to speak about "the Depression" as something that visits and tries to talk him out of job searching, rather than as part of who he is. This technique is called:

• a.Reflecting feelings
• b.Systematic desensitization
• c.Externalizing the problem✓
• d.Paradoxical intention

Externalizing the problem, developed by Michael White and David Epston, is a central narrative therapy technique that separates the person from the problem so the client can re-author a preferred story. Reflecting feelings is a basic listening skill, systematic desensitization pairs relaxation with a graded fear hierarchy, and paradoxical intention (associated with Frankl) asks clients to intend the very thing they fear.

A counselor explores a client's early recollections, family constellation, and sense of belonging to understand the client's lifestyle and level of social interest. This reflects which theory?

• a.Adlerian therapy✓
• b.Gestalt therapy
• c.Trait-factor theory
• d.Behavior therapy

Alfred Adler's individual psychology examines a person's lifestyle (style of life) through early recollections and family constellation and treats social interest as a key index of psychological health. Gestalt therapy emphasizes present-moment awareness, trait-factor theory matches individual traits to job requirements, and behavior therapy focuses on observable behavior and learning.

A counselor asks a client to imagine his former employer sitting in an empty chair and to speak to him directly, focusing on what the client feels right now. Which approach does this reflect?

• a.Reality therapy
• b.Adlerian therapy
• c.Gestalt therapy✓
• d.Solution-focused brief therapy

The empty-chair technique and emphasis on here-and-now awareness and unfinished business are hallmarks of Gestalt therapy as developed by Fritz Perls. Reality therapy evaluates current choices using WDEP, Adlerian therapy explores lifestyle and social interest, and solution-focused therapy builds on exceptions and future goals rather than enactment.

A client with severe anxiety about riding the bus to work learns progressive muscle relaxation and then imagines a ranked series of bus-related scenes, from least to most anxiety-provoking, while staying relaxed. This technique is:

• a.Implosive therapy
• b.Aversive conditioning
• c.Cognitive restructuring
• d.Systematic desensitization✓

Joseph Wolpe's systematic desensitization pairs a relaxation response with a graduated anxiety hierarchy so relaxation inhibits anxiety step by step (reciprocal inhibition). Implosive therapy has the person imagine intensely feared scenes at full strength without a graded hierarchy or relaxation, aversive conditioning pairs an unwanted behavior with an unpleasant stimulus, and cognitive restructuring targets thoughts rather than a relaxation-paired hierarchy.

In a motivational interviewing session, a client says, "I know drinking is why I keep missing shifts, and I don't want to lose this job." How is this statement best classified?

• a.Sustain talk
• b.Change talk✓
• c.Discord
• d.Resistance to the counselor

MINT's summary of motivational interviewing distinguishes change talk (language in favor of change) from sustain talk (language against change) and asks practitioners to attend to and strengthen change talk. The client's reasons for change are change talk; sustain talk would argue for the status quo, and discord describes friction in the working relationship rather than the client's view of the behavior.

A counselor using motivational interviewing wants to share information about how a new medication could affect a client's work schedule. Which approach is most consistent with MI?

• a.Ask what the client knows, offer information with permission, then ask her view✓
• b.Give a clear warning about what will happen if the client does not follow the advice
• c.Present research findings on the medication before the client has a chance to respond
• d.Point out contradictions between the client's statements to reduce the client's denial

MINT describes information exchange in MI through Elicit-Provide-Elicit: explore what the person knows, offer information with permission, then explore the response. MINT also states that MI requires refraining from unsolicited advice, confronting, instructing, directing, or warning, which rules out warnings, lecturing before listening, and confronting denial.

A client says she has been thinking seriously about quitting smoking in the next few months but has not yet made any plans or taken any steps. In the transtheoretical model, she is in which stage?

• a.Precontemplation
• b.Preparation
• c.Action
• d.Contemplation✓

In Prochaska and DiClemente's transtheoretical model, contemplation is the stage in which a person is aware of the problem and seriously considering change in the foreseeable future (operationalized as the next six months) but has not committed to act. Precontemplation involves no intention to change, preparation involves intending to act soon with some small steps already taken, and action involves modifying the behavior.

A rehabilitation client has both an opioid use disorder and major depressive disorder. According to current federal guidance on co-occurring disorders, what treatment approach is preferred?

• a.Treating the substance use disorder until abstinence, then depression
• b.Treating the depression first, since it is the underlying cause
• c.Integrated treatment that addresses both disorders together✓
• d.Referring each disorder to a separate program with no coordination

SAMHSA's TIP 42 on co-occurring disorders recommends integrated care in which both the substance use disorder and the mental disorder are addressed together, and NIDA notes that co-occurring conditions should ideally be treated in tandem. Sequential models that make one disorder wait for the other, or parallel programs without coordination, are the approaches the integrated model was developed to replace.

A 16-year-old client with a learning disability is trying out different roles, values, and career ideas while figuring out who he is. According to Erikson, which psychosocial stage is he working through?

• a.Industry versus inferiority
• b.Intimacy versus isolation
• c.Initiative versus guilt
• d.Identity versus role confusion✓

In Erik Erikson's psychosocial theory, adolescence is the stage of identity versus role confusion, in which young people explore roles and values to form a coherent identity. Industry versus inferiority belongs to the school-age years, intimacy versus isolation to young adulthood, and initiative versus guilt to the preschool years.

In Bernard's discrimination model of clinical supervision, a supervisor who helps a supervisee explore how her own anxiety affects her work with clients is focusing on which skill area?

• a.Intervention
• b.Conceptualization
• c.Evaluation
• d.Personalization✓

Janine Bernard's discrimination model crosses three supervisor roles (teacher, counselor, consultant) with three focus areas: intervention skills, conceptualization skills, and personalization skills. Personalization concerns how the supervisee's personal reactions and style affect counseling; intervention covers observable counseling behavior, conceptualization covers understanding the case, and evaluation is not one of the model's three foci.

A CRC is forming a job-seeking skills group. Before it begins, what does the CRCC Code require regarding prospective members?

• a.Admit every referred client so that no one is excluded from services
• b.Obtain each member's signed promise to keep all disclosures secret
• c.Screen them so members' needs and goals fit the group's goals✓
• d.Limit membership to clients who share the same type of disability

Standard A.6.a of the CRCC Code requires CRCs to screen prospective group members and, to the extent possible, select those whose needs and goals are compatible with the group's goals, who will not impede the group process, and whose well-being will not be jeopardized. Open admission ignores screening, a signed secrecy promise cannot guarantee confidentiality (B.4.a), and nothing requires grouping by disability type.

At the first session of a group, the CRC reviews ground rules about confidentiality. Which statement is consistent with the CRCC Code?

• a."I expect everyone to keep what is shared here private, but I can't guarantee it."✓
• b."Everything said in this room is legally privileged, so none of it can leave here."
• c."Because this is a group, the usual confidentiality rules do not apply."
• d."Any member who breaks confidentiality will be reported to the state licensing board."

Standard B.4.a directs CRCs to state their expectation that all members maintain confidentiality while advising members of its limits and that confidentiality by other members cannot be guaranteed. Promising legal privilege overstates protection, saying confidentiality does not apply misstates the expectation, and group members are not licensees subject to a board.

A substance use treatment program runs a group in which a counselor teaches members how alcohol affects the brain and how to recognize relapse warning signs, with little member-to-member processing. According to SAMHSA TIP 41, this is which group model?

• a.Interpersonal process group
• b.Psychoeducational group✓
• c.Support group
• d.Cognitive-behavioral group

SAMHSA TIP 41 describes psychoeducational groups as leader-focused groups that educate clients about substance use and its consequences. Interpersonal process groups work through relational issues in the here-and-now, support groups provide a forum for members to share practical help, and cognitive-behavioral groups work to change the thoughts and actions that lead to substance use.

In the third session of a new vocational support group, members begin challenging the leader's agenda and arguing with one another about how the group should run. In Tuckman's model, this is which stage?

• a.Forming
• b.Storming✓
• c.Norming
• d.Performing

Bruce Tuckman's developmental sequence names forming (orientation and dependence), storming (conflict and resistance to the task and leader), norming (cohesion and shared norms), and performing (functional work), with adjourning added in 1977. Challenging the leader and arguing about how to run the group is characteristic of storming.

A family counselor observes that a mother and her adult son with a brain injury are so closely involved that the son cannot make any decision without her, and she speaks for him. In structural family therapy, this pattern is described as:

• a.An enmeshed boundary✓
• b.A disengaged boundary
• c.A clear boundary
• d.Differentiation of self

Salvador Minuchin's structural family therapy describes boundaries along a continuum from disengaged (rigid, distant) to enmeshed (diffuse, overinvolved), with clear boundaries in between; the therapist works to restructure enmeshed subsystems. A disengaged boundary is the opposite pattern, a clear boundary is the healthy middle, and differentiation of self is a Bowen concept rather than a structural boundary type.

A husband and wife who are in conflict repeatedly pull their teenage daughter into their arguments to relieve the tension between them. Bowen family systems theory calls this:

• a.Scapegoating
• b.Triangulation✓
• c.Double-bind communication
• d.Enmeshment

In Murray Bowen's family systems theory, a triangle forms when anxiety between two people is managed by drawing in a third, and triangles are considered the basic building block of emotional systems. A double bind is a communications-theory concept of contradictory messages, enmeshment is a structural (Minuchin) term for diffuse boundaries, and scapegoating describes blaming one member rather than detouring tension through them.

A client tells her CRC that she has been thinking about ending her life and describes a specific plan. Under the CRCC Code, how does the CRC approach confidentiality?

• a.Keep it confidential, because she has not yet taken any action to harm herself
• b.Notify her employer, since the job may be contributing to her distress
• c.Assess the risk and disclose what is needed if harm is serious and foreseeable✓
• d.End services and refer her elsewhere, since crisis work is out of scope

Standard B.2.a states that confidentiality does not apply when disclosure is required to protect clients or identified third parties from serious and foreseeable harm, and directs CRCs to assess the risk (e.g., suicidal ideation, intent, plan) before breaking confidentiality and to use consultation when in doubt. Waiting for an act ignores the exception, notifying an employer is not a protective disclosure, and abrupt termination would conflict with A.7.f on abandonment.

A CRC and a client with recurrent suicidal thoughts collaboratively write a Stanley-Brown safety plan. Which step specifically addresses reducing access to lethal means?

• a.Identifying personal warning signs
• b.Listing internal coping strategies
• c.Making the environment safe✓
• d.Naming people who provide distraction

The Stanley-Brown Safety Planning Intervention has six steps: warning signs, internal coping strategies, people and social settings that provide distraction, people who can help, professionals and agencies to contact (including 988), and making the environment safe through lethal means counseling. The other steps are part of the plan but do not address access to lethal means.

A rehabilitation agency revises its intake so that clients choose the order of assessments, help set their own goals, and can decline to discuss trauma history. Which SAMHSA trauma-informed principle does this most directly apply?

• a.Empowerment, voice, and choice✓
• b.Peer support
• c.Trustworthiness and transparency
• d.Cultural, historical, and gender issues

SAMHSA's six key principles of a trauma-informed approach are safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues. Giving clients choices over sequence, goals, and disclosure applies empowerment, voice, and choice; the other principles concern peers with lived experience, open and trustworthy operations, and responsiveness to culture and history.

Six weeks after a warehouse explosion, a client has flashbacks, avoids the neighborhood, is easily startled, and has persistent guilt that interferes with work. According to NIMH, what is the minimum symptom duration for an adult PTSD diagnosis?

• a.At least 2 weeks
• b.At least 1 month✓
• c.At least 6 months
• d.At least 1 year

NIMH states that to be diagnosed with PTSD an adult must have, for at least 1 month, at least one re-experiencing symptom, at least one avoidance symptom, at least two arousal and reactivity symptoms, and at least two cognition and mood symptoms. Two weeks is the NIMH duration for major depression, and six months or a year are not the PTSD threshold.

A veteran injured in a blast has a traumatic brain injury, a below-knee amputation, hearing loss, and PTSD. In the VA system of care, this combination of injuries is best described as:

• a.Polytrauma✓
• b.Comorbid psychosis
• c.Secondary disability
• d.Chronic pain syndrome

The VA defines polytrauma as two or more injuries, one of which may be life-threatening, sustained in the same incident that affect multiple body parts or organ systems and result in physical, cognitive, psychological, or psychosocial impairments and functional disability, often including TBI. Psychosis is not part of the presentation, 'secondary disability' and 'chronic pain syndrome' do not describe multiple concurrent injuries from one incident.

A CRC's office is in a region prone to hurricanes. Which action does the CRCC Code require regarding possible disaster-related interruptions?

• a.Plan for continued client services if a disaster interrupts them✓
• b.Suspend all services until the regional emergency has fully ended
• c.Transfer every client to a telehealth provider located in another state
• d.Refer clients only to shelters run by the local emergency agency

Standard E.2.b requires CRCs to plan for continued client services in the event that services are interrupted by disaster such as violence, terrorism, natural disaster, or public health crises, and B.6.f adds reasonable precautions to protect confidentiality in a disaster. Suspending services, blanket out-of-state transfers, or limiting referrals to shelters do not meet the planning duty.

A client sustained a spinal cord injury at the cervical level and has paralysis affecting all four limbs. This condition is called:

• a.Paraplegia
• b.Hemiplegia
• c.Monoplegia
• d.Tetraplegia✓

NINDS explains that injury to the upper part of the spinal cord can cause paralysis affecting all limbs (tetraplegia, also called quadriplegia), while injury lower on the cord may affect only the lower body and legs (paraplegia). Hemiplegia is paralysis of one side of the body, typical after stroke, and monoplegia affects a single limb.

A client with a high thoracic spinal cord injury suddenly develops a pounding headache, flushing, sweating, and a sharp rise in blood pressure at work. Which condition should the counselor recognize as a medical emergency?

• a.Orthostatic hypotension
• b.Spasticity
• c.A pressure injury
• d.Autonomic dysreflexia✓

NINDS describes autonomic dysreflexia as a life-threatening reflex reaction, mainly in people with injuries to the neck or upper back, with symptoms such as flushing or sweating, pounding headache, anxiety, and a sudden increase in blood pressure. Orthostatic hypotension is a drop in blood pressure, spasticity is increased muscle tone, and pressure injuries are skin breakdown without this acute blood-pressure surge.