CRC Exam (Certified Rehabilitation Counselor) — All Questions

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.