NCMHCE Domain 2: Intake, Assessment, and Diagnosis

A clinician is conducting an intake interview with a client who reports experiencing intense, sudden episodes of fear, palpitations, and fear of losing control or dying that last about 10-20 minutes. Which of the following is the most appropriate initial diagnosis?

During an intake assessment, a client describes symptoms of prolonged periods of sadness, loss of interest in activities, significant weight loss, and trouble sleeping almost every day for the past two weeks. Which of the following diagnoses is most consistent with these symptoms?

A client comes to therapy reporting difficulty concentrating, irritability, muscle tension, and being easily fatigued for more than six months. They mention these issues are causing significant distress in social, occupational, and other important areas of functioning. What is the most likely diagnosis?

During an intake session, a client reveals experiencing flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about a traumatic event that happened a year ago. Which of the following diagnoses best fits this description?

A client seeking counseling presents with episodes of overeating followed by self-induced vomiting, excessive exercise, and misuse of laxatives. They express a preoccupation with body weight and shape. Which of the following diagnoses should the counselor initially consider?

In an assessment interview, a client reports experiencing significant worry about being judged by others in social situations to the point where it interferes with daily functioning. This has been ongoing for over six months. What diagnosis does this suggest?

A client describes experiencing alternating periods of elevated, expansive mood with periods of depression over the past year, with these episodes impacting their ability to work. What is the most appropriate diagnosis?

A new client reports persistent fears and avoidance of places or situations where escape might be difficult or help might not be available in the event of developing panic-like symptoms. Which of the following is the most likely diagnosis?

During an intake session, a client mentions experiencing significant distress in social situations due to a fear of being negatively evaluated by others. This fear specifically revolves around concerns about embarrassing themselves because of visible anxiety symptoms, such as blushing or trembling. Which diagnosis most accurately reflects these concerns?

A client reports a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts. Which of the following diagnoses should be considered?

A clinician is assessing a client who reports periods of excessive energy, risky behaviors, and decreased need for sleep lasting for four days, followed by episodes of significant depression lasting for two weeks. The client has experienced at least three such cycles in the past year. Which diagnosis is most appropriate?

During an intake assessment, a client reports experiencing intrusive, unwanted, and distressing thoughts about harming loved ones, which they find very upsetting and attempt to suppress or neutralize with other thoughts or actions. What diagnosis does this suggest?

A client describes feeling detached from themselves, as if they are an outside observer of their thoughts, feelings, and actions. They report this feeling has been persistent for months and is causing significant distress. Which diagnosis should be considered?

In an intake interview, a client reports a history of difficulty sleeping, irritability, and hypervigilance. They also mention experiencing a traumatic event six months ago. Which diagnosis is most likely?

A client presents with a significant fear of gaining weight, disturbance in the way in which one's body weight or shape is experienced, and has not had a menstrual period for three months. The client's weight is significantly below normal. What is the most appropriate diagnosis?

A client reports experiencing mood swings, irritability, and feelings of emptiness. They describe engaging in impulsive actions, such as binge eating and substance use. These symptoms have been present for more than a year. Which of the following disorders should be considered?

During an intake assessment, a client reveals experiencing intense fear and anxiety when faced with doing something in front of others, fearing they will be embarrassed or judged negatively. This fear is specific to performance situations and has been impacting their professional life. What diagnosis should be considered?

A client describes experiencing persistent sadness, low energy, and a lack of interest in activities once enjoyed. These symptoms have been present for more than two years but have not been severe enough to constitute a major depressive episode. Which diagnosis is most appropriate?

In an assessment, a client reports significant distress over intrusive and repetitive thoughts about contamination, leading to excessive hand washing. Which diagnosis does this most closely align with?

A client comes in for an assessment reporting experiencing a severe loss of motivation, lack of pleasure in all activities, significant weight loss, and feelings of worthlessness over the past month. These symptoms represent a change from their previous functioning. What is the most likely diagnosis?

A client describes feeling a persistent desire to sleep, sleeping up to 14 hours a day, but still feeling fatigued. They report an increase in appetite and weight gain. This pattern has been present during the winter months for the past two years and lifts during the spring and summer. What diagnosis should be considered?

A client reports feeling detached from their emotions and surroundings, experiencing a sensation as if they are dreaming and life isn't real. They have been feeling this way for several months, causing significant distress in their daily functioning. What is the most appropriate diagnosis?

During an intake interview, a client discusses experiencing recurrent, distressing dreams of a traumatic event they witnessed a year ago. They actively avoid reminders of the trauma and have difficulty experiencing positive emotions. What diagnosis should be considered?

A client presents with episodes of sudden terror, chest pain, dizziness, and a fear of dying that occur unpredictably. They worry about the possibility of another attack and its consequences. These episodes have been occurring for over six months. What is the most likely diagnosis?

A client describes having persistent doubts about their partner's fidelity without any objective evidence. They frequently check their partner's phone and email and ask for reassurance. This behavior has been causing significant strain on their relationship. Which diagnosis should be considered?

During an assessment, a client reports excessive worry about a variety of everyday activities, leading to physical symptoms such as restlessness, being easily fatigued, and muscle tension. These symptoms have been present for more than six months. What is the most appropriate diagnosis?

A client reports a history of mood swings from periods of extreme elation, increased energy, and decreased need for sleep, to episodes of significant depression with loss of interest in activities and feelings of worthlessness. These mood changes have been impacting their ability to maintain employment. What is the most likely diagnosis?

In an intake session, a client reveals engaging in repetitive hand washing, driven by a fear of contamination. They recognize these behaviors as excessive, but feel unable to stop. This has been ongoing for over a year and is significantly impairing their daily life. What diagnosis does this suggest?

A client describes feeling a constant sense of dread and fear about future events, to the point where it interferes with their sleep and ability to concentrate. This has been ongoing for the past eight months and they cannot pinpoint any specific cause for their anxiety. Which diagnosis is most appropriate?

A client reports experiencing intense anxiety and physical symptoms when faced with or even thinking about certain social situations where they might be scrutinized by others. These feelings have led them to avoid such situations whenever possible, significantly affecting their work and social life. What is the most likely diagnosis?