Pass the NBCC National Certified Counselor NCE-ABE Questions and answers with CertsForce

When assessing intellectual disability, severity is determined primarily by adaptive functioning, particularly in conceptual, social, and practical domains, rather than by etiology or isolated mental status features. For a seven-year-old, the counselor would consider how the child:

Understands and uses concepts (e.g., time, quantity, basic academic skills).

Solves problems and learns new information appropriate to their developmental level.

Option D. Concept formation aligns with this focus on conceptual functioning, which is central to determining the severity of intellectual disability.

A. Pressured speech and B. Agitation are more associated with mood or anxiety disorders (e.g., mania, acute distress) rather than severity of intellectual disability.

C. Genetic factors may help explain the cause of the disability but do not determine its severity.

The NBCC Counselor Work Behavior Areas emphasize accurate use of diagnostic criteria and understanding that severity ratings for intellectual disability are based on everyday functioning in key domains, not just on symptoms or etiology.

The techniques listed come from different theoretical orientations:

Relaxation training – commonly associated with behavioral and cognitive-behavioral approaches.

Covert modeling – a behavioral technique using imagined models.

Mental imagery – used in both cognitive and experiential/affective approaches.

Interpretation – often associated with psychodynamic and insight-oriented therapies.

Empty chair – a hallmark of Gestalt and other affective/experiential approaches.

Because this list spans multiple theoretical orientations, the best match is D. Eclectic, where counselors intentionally draw techniques from different theories and apply them in an integrated manner based on client need rather than allegiance to a single model.

NBCC Counselor Work Behavior Areas describe effective counselors as able to:

Select and apply a variety of interventions.

Match techniques to client goals, problems, and preferences.

Integrate methods from different orientations when appropriate.

This is the essence of an eclectic approach, making D the correct answer.

In the Counseling Skills and Interventions work behavior area, counselors are expected to select interventions that are supported by empirical evidence for the client’s specific concerns, including substance use disorders.

Motivational interviewing (MI) (Option A) is a widely researched, empirically supported treatment modality for individuals with substance use disorders. It is a client-centered, directive approach designed to:

Enhance intrinsic motivation for change,

Resolve ambivalence,

Support clients in moving through stages of change regarding substance use.

Core MI skills often summarized as OARS (open questions, affirmations, reflections, summaries) are used to elicit and strengthen “change talk” and reduce resistance. Research has consistently shown MI’s effectiveness in reducing substance use and increasing treatment engagement across various populations and settings.

Why the other options are less appropriate here:

B. Narrative therapy – While potentially helpful for meaning-making and identity reconstruction, it is not the primary empirically validated front-line modality for substance use disorders.

C. Solution-focused brief therapy – Has some supportive evidence for various problems and can be useful in certain substance-related contexts, but MI has a stronger and more direct evidence base specifically for substance use disorders.

D. Eye movement desensitization and reprocessing (EMDR) – Primarily validated for trauma-related disorders, particularly PTSD, rather than as a core, primary treatment for substance use disorders.

NBCC-aligned counselor work behaviors emphasize that practitioners should match interventions to the problem using approaches with strong empirical support, making motivational interviewing the best choice among the options for treating substance use disorders.

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Within diagnostic work, counselors must distinguish between eating disorders by identifying core diagnostic features. Anorexia nervosa is characterized by restriction of energy intake leading to significantly low body weight, a disturbance in the way one’s body weight or shape is experienced, and, critically, an intense fear of gaining weight or becoming fat, even when underweight. That intense fear is central to both the client’s experience and the clinical diagnosis, making Option B correct.

Option A (repeatedly regurgitating food for at least one month) aligns more with rumination disorder, not anorexia nervosa.

Option C is incorrect: anorexia is more frequently associated with higher-income, industrialized societies, not predominantly low-income countries.

Option D (binge eating) is more characteristic of bulimia nervosa or binge eating disorder; while some people with anorexia (binge-eating/purging type) may binge, it is not the defining feature.

Correctly identifying hallmark symptoms like fear of weight gain reflects the NBCC Intake, Assessment and Diagnosis expectation that counselors accurately recognize and differentiate mental disorders when formulating diagnoses and treatment plans.

Counselors must understand major theories of human development as part of their Areas of Clinical Focus. Carol Gilligan (A) is known for her work on moral development in females, challenging Kohlberg’s male-centered model. She argued that women’s moral reasoning often emphasizes care, relationships, and responsibility, and that this pattern was not adequately captured in earlier theories that relied heavily on male samples.

Her research opened the door for a more nuanced understanding of gender differences in moral reasoning, which is important for counselors when conceptualizing clients’ values, decision-making, and developmental tasks.

The other theorists focus on different areas:

Virginia Satir (B) is associated with family systems and communication patterns in families.

Anne Roe (C) is known for a theory of career development related to early child–parent relationships.

Karen Horney (D) contributed to neo-Freudian psychoanalytic theory and explored personality and feminine psychology but did not specifically develop a major model of moral development in females.

Gilligan’s work supports counselors in recognizing diverse developmental pathways and avoiding gender-biased assumptions when understanding clients’ moral judgments and values.

Within group counseling, counselors are expected to foster participation, interaction, self-exploration, and mutual responsibility. Effective group work typically involves:

Building authentic relationships among members

Encouraging appropriate self-disclosure

Supporting members in exploring personal issues

Promoting responsibility for self and sensitivity to others

Options B, C, and D all reflect desired therapeutic outcomes in groups:

B: Developing positive, natural relationships is a core benefit of group interaction.

C: Exploring personal issues within a supportive group is central to group counseling’s therapeutic power.

D: Learning responsibility to self and others aligns with group norms and interpersonal learning.

In contrast, A describes a client who only listens and stays anonymous, avoiding meaningful participation or self-disclosure. While some initial caution is normal, maintaining anonymity throughout the group undermines the interactive and experiential nature of group counseling and is therefore least desirable.

So the correct answer is A.

The term that encompasses a client’s background, values, morals, traditions, and ways of living within a social context is culture.2 Culture is commonly understood as the shared patterns of beliefs, values, customs, behaviors, and artifacts that a group uses to cope with the world and pass on to future generations. It shapes:

Worldview and meaning-making

Interpersonal expectations and communication styles

Attitudes toward counseling, mental health, and help-seeking

Thus, Option B (culture) is correct.

Why the other options are incorrect:

A. Individualism – Refers to a value orientation emphasizing personal autonomy, independence, and self-reliance. It is one possible cultural value, not the full description of a client’s total human experience.

C. Collectivism – The opposite value orientation to individualism, emphasizing group harmony, interdependence, and group goals. Again, it is one type of cultural value, not the overarching construct.

D. Race – Refers to a category often (problematically) based on physical characteristics and socially constructed groupings. While race can influence experience and oppression, it does not by itself encompass the entirety of background, values, morals, and traditions; those are more fully covered by the broader concept of culture.2

In the Professional Practice and Ethics area, NBCC highlights that ethically competent counselors must understand and respect clients’ cultural contexts, integrating these into assessment, case conceptualization, and intervention.

Career work with clients in midlife and later adulthood must consider actual life circumstances, including financial responsibilities, health, caregiving roles, retirement timing, age discrimination, and existing skills. For this reason, career counseling for this group should be grounded in the realities of clients’ lives—their current roles, constraints, and opportunities—making Option C the best answer.

Option A (focus on career selection) is more appropriate for adolescents or emerging adults choosing an initial field, not individuals who already have extensive work histories.

Option B (abstract self-perception) is too vague and detached from the very concrete life factors often central in midlife/older transitions.

Option D (emphasize training/education) may be appropriate for some clients, but it is not a universal guiding principle and ignores many who may not have the time, resources, or interest for extensive retraining.

NBCC Counselor Work Behavior Areas highlight that, in career development, counselors must integrate developmental stage and real-world context into their clinical focus, particularly for adults navigating later-life work and retirement decisions.

Behavioral counseling focuses on observable behavior, measurable change, and the systematic application of learning principles. When setting up a behavior change program, a behavioral counselor typically:

Establishes a baseline of behavior (Option A) to know the current frequency, intensity, or duration of the target behavior.

Uses contingency management (Option B) — arranging rewards, consequences, or environmental changes to increase or decrease behaviors.

Reviews previous research (Option D) to select interventions that are evidence-based and appropriate for the presenting concern.

Self-actualization (Option C) is associated with humanistic and existential approaches (e.g., Maslow, Rogers), focusing on personal growth and fulfillment rather than directly on observable behavior and contingencies. While a counselor may value growth in a broad sense, a behavioral counselor does not need to directly work from a self-actualization framework when designing a behavior change program.

NBCC Counselor Work Behavior Areas related to interventions highlight that behavioral approaches rely on empirically supported, observable, and measurable strategies, which makes self-actualization the least relevant concern in this specific context.

The presentation described—rapid and significant weight loss (20 lb in one month), restrictive dieting, excessive exercise, possible purging after meals (bathroom use), and functional impairment (missing work due to fatigue)—strongly suggests a severe eating disorder with medical risk (e.g., risk of electrolyte imbalance, cardiac complications, severe malnutrition).

Within treatment planning, counselors are expected to:

Assess risk and severity,

Determine the least restrictive but safe level of care,

Refer to specialized services when problems exceed their scope or when intensive medical and psychological treatment is required.

Given the combination of rapid weight loss, ongoing disordered behaviors, and clear impairment, the safest and most appropriate choice is Option D: referral to an eating disorder inpatient facility, where the client can receive:

Medical monitoring and stabilization,

Nutritional rehabilitation,

Intensive specialized psychotherapy.

Why the other options are not appropriate as the best course:

A. Crisis unit – Typically used for imminent danger such as acute suicidality or psychosis; while eating disorders are serious, the scenario calls for specialized eating-disorder treatment, not just general crisis stabilization.

B. Peer support group – Helpful as an adjunct, but inadequate as the primary level of care for a case with this level of severity and medical risk.

C. Outpatient therapy group – More suitable for mild to moderate cases or for those stabilized medically; the client described likely requires a higher level of care first.

This reflects the Treatment Planning work behavior: using clinical information to select an appropriate level of care, prioritizing client safety, and coordinating referrals to intensive or specialized services when indicated.