CRC Exam (Certified Rehabilitation Counselor) — All Questions
6 questions
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.