Au dallas clinical comprehensive exam questions fall 2004

October 2004
CLINICAL COMPREHENSIVE EXAMINATION (CCE) QUESTIONS
PSYD CLINICAL PSYCHOLOGY PROGRAM
ARGOSY UNIVERSITY/DALLAS
FALL 2004
MASTER LIST

October 2004 CEC Domain I
DOMAIN I
PSYCHOTHERAPY THEORY
Please answer three (3) of the following four (4) questions.
1. Please describe in detail the main concepts of psychodynamic and psychoanalytically
oriented psychotherapy and illustrate each concept with examples drawn from one type of
psychodynamic or psychoanalytically oriented psychotherapy. Furthermore, please
discuss critiques of psychodynamic and psychoanalytically oriented psychotherapy
models as articulated by feminists.
2. Please outline Albert Ellis’ theory of cognitive behavior therapy. Describe the evolution
of cognitive behavioral therapy since he introduced his model. How might you alter your
approach using a model of cognitive behavior therapy to treat a conservative Catholic of
Hispanic heritage?
3. Please compare and contrast structural and strategic family therapy theory. How does
Murray Bowen’s approach to family therapy compare to each of them? For each broad
theory, please provide your understanding of how each model either model either works
well or does not work well with an African-American living in an urban environment.
4. Please discuss in detail Carl Rogers’ theory of psychotherapy. Furthermore, please
discuss his theory in light of current research on common factors in psychotherapy.
Please provide an understanding of how to apply this modality to a transgender female
seeking sexual reassignment to become a male.

October 2004 CEC Domain II
DOMAIN II
BEHAVIORAL SCIENCE THEORY
1. Please describe the scientific method in detail. Furthermore, please critique this method
regarding underlying assumptions given a postmodern interpretation of research.
2. Please discuss in detail Margaret Mahler’s theory of development. Specifically, address
her concepts of individuation and separation. Be sure to include the phases an infant
progress through to achieve individuation and separation. Furthermore, how does Jean
Piaget understand infant development and how do his stages of development integrate or
not integrate with Mahler’s theory?
3. Please compare and contrast the theoretical underpinnings of system theory and
constructive psychology theory. Specifically compare and contrast each model’s
understanding of the human condition, human development, motivation, health,
pathology, and treatment. Be sure to use specific examples to illustrate each domain.
4. Define the processes by which one behaves differently in a group versus how one
behaves alone. Be sure to include and discuss concepts such as deindividuation,
alienation, groupthink, and polarization. How might these phenomena potentially impact
one’s “identity” regarding group membership in a nondominant culture?

October 2004 CCE Domain III
DOMAIN III
CLINICAL PRACTICE
1. Please discuss the current research on interventions described as empirically-verified
treatment, empirically-supported treatment, or evidenced-based practice. Specifically,
discuss the pros and cons of each of these types of treatment. Please provide specific
research citations in support of your position(s).
2. Please describe the five (5) axis diagnostic system of the Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Please
discuss each axis and its role in the overall diagnosis of a patient. Please specifically
compare and contrast Axis I and Axis II disorders. Furthermore, please discuss
theoretically and specifically the importance of cultural sensitivity regarding diagnosis.
Provide specific examples from the DSM-IV-TR of potentially “culturally normal”
behavior a culturally-sensitive clinician needs to be wary of to avoid inappropriately
labeling such behavior as pathological.

October 2004 CCE Domain III 2
3. Please read the clinical vignette below and then answer the following questions:
a. What is the best DSM-IV-TR diagnosis given the information you have in the
vignette.
b. Describe in detail how two (2) of the following therapeutic modalities would treat
this man’s problem. Please include a treatment plan and specific techniques for
each modality.
i. Pharmacotherapy
ii. Cognitive-Behavior Therapy
iii. Group Therapy
iv. Client-Centered Psychotherapy
v. Psychodynamic Psychotherapy
vi. Couples Therapy
CLINICAL VIGNETTE FOR CLINICAL PRACTICE QUESTION 3:
A 27-year-old Caucasian married electrician complains of dizziness, sweating palms, heart
palpitations, and ringing of the ears of more than eighteen (18) months’ duration. He has also
experienced dry throat, periods of uncontrollable shaking, and a constant “edgy” and watchful
feeling that often interfered with his ability to concentrate. These feelings have been present
most of the time over the previous two (2) years; they have not been limited to discrete periods.
He admits to consuming approximately two glasses of wine at dinner and heavier consumption
on the weekends.
Because of these symptoms he has seen a family practitioner, a neurologist, a neurosurgeon, a
chiropractor, and an ENT specialist. He had been placed on hypoglycemic diet, received
physiotherapy for a pinched nerve, and told he might have “an inner ear problem.”
For the past two (2) years, he has had few social contacts because of his nervous symptoms.
Although he sometimes had to leave work when the symptoms became intolerable, he continues
to work for the same company for which he has worked since his apprenticeship following high
school graduation. He tends to hide his symptoms from his wife and children, to whom he wants
to appear “perfect,” and reports few problems with them as a result of his nervousness.

October 2004 CCE Domain III 3
4. Using the clinical vignette below, create specific questions and follow-up questions
designed to clarify an ambiguous diagnostic situation. Further, please draw each
diagnostic possibility to a conclusion. Finally, be sure to offer treatment
recommendations that are sensitive to the vignette’s diversity issues.
CLINICAL VIGNETTE FOR CLINICAL PRACTICE QUESTION 4:
Patricia Washington was admitted to the local county hospital’s psychiatric unit because she was
“depressed” and “suicidal.” She is a 41-year-old, female of African-American heritage. She
noted she is divorced and the mother of three (3) adolescents. Ms. Washington noted an
increased use of cocaine in the last six (6) weeks because it makes her “forget about all [her]
problems.” By her account, a chief problem is the removal of her children by Child Protective
Services. Specifically, she noted her eldest daughter made an outcry against Ms. Washington’s
live-in boyfriend. Ms. Washington admitted great consternation over whom to believe because
she has a hard time understanding how her boyfriend could do such a thing.
By all accounts, Ms. Washington has a long-standing history of drug use. She noted her nurse’s
license was suspended four (4) years ago secondary to drug use on the job. She noted she has
been unemployed since that time. Furthermore, she noted attending multiple drug treatment
programs. Ms. Washington described her relationships with boyfriends as “stormy.” She noted
a history of suicide threats and a history of outpatient treatment with multiple therapists.
She noted a variety of symptoms and a variety of diagnoses by her various therapists. She
admitted to frequent episodes of sadness, irritable mood, elevated mood, sleep disturbance,
weight loss, ahedonia, restlessness, feeling guilty, and a sense of free-floating anxiety. She
admits to transient feelings of suspiciousness bordering on paranoia. Furthermore, she noted the
occasional experience of believing her vaginal area was emitting a “foul odor.”

October 2004 CCE Domain VI
DOMAIN IV
ASSESSMENT
Please choose to address the issues in three (3) of the following four (4) cases.
1. Some of the following data was collected from an actual patient. Identifying information
has been modified to protect confidentiality. Remembering that omitting critical
information and including inappropriate information can deduct from your total score,
please provide the following information within the context of any important cultural and
diversity issues:
a. Brief test interpretations for each measure
b. A synthesized summary including major strengths and weaknesses
c. A five-axis DSM-IV-TR diagnosis
d. Recommendations
PSYCHOLOGICAL EVALUATION
This report is intended for professional use only. This material is strictly confidential and only for
persons who have been granted access to this record for their specific purposes. No responsibility
can be accepted if this report is made available to any other person or persons. The duplication,
transmission, disclosure, or transfer of these records may be prohibited. Such action could result in
civil or criminal liability.
Name: Teresa Nighthorse
Date of Birth: March *, 1979
Dates of Evaluation: August * and September *, 2003
Evaluator: Dr. Good Enough
BACKGROUND INFORMATION
Family History
Ms. Nighthorse reported her mother is Ms. Washington. She noted her mother is 47 years old
and unemployed. She noted her mother has a history of untreated “depression.” She also noted
her mother has a distant history of substance abuse. She noted her mother has been married
twice and divorced once. She characterized the relationship with her mother as unsatisfactory
when she was a child and noted that the relationship is currently poor.
Ms. Nighthorse reported her father is Mr. Johnny Nighthorse. She denied any knowledge of her
father.
Ms. Nighthorse noted she was born in Portland, Oregon. She noted limited parenting and
direction as child. She noted she raised herself. She indicated he r brother was helpful in raising
her. She stated, “I was on my own since 13.”

October 2004 CCE Domain IV 2
Ms. Nighthorse noted her she moved frequently as a child. She indicated this instability was
unsettling. She indicated her first memory is of her mother “breaking a doll.” She noted her
brother fixed the toy. She reported her favorite childhood memory was playing with her brother.
When asked about her least favorite memory, she recounted, “I wanted to take piano lessons;
they beat me and locked me in my room for a week. They fed me bread and water.”
She noted two siblings. She indicated Johnny Nighthorse, Jr. was a full sibling who died in a
manner she was unwilling to report. She noted Charlie Nighthorse is a half-sibling with an
unknown father. She said, “I’ve only seen him three times.” She characterized the relationship
with Johnny as satisfactory prior to his death. She noted she has never been close to Charlie.
She noted, “Charlie is sick and perverted. I won’t ever like him; he tried to rape me.”
Relationship History
Ms. Nighthorse reported a history of unstable relationships. She noted does not trust people.
She added, “Friends come and go; I stay to my self. I don’t want no friend.” She characterized
relationships with significant others as historically abusive, intense, and unstable. She indicated
she became sexually active (of her own accord) when she was sixteen years old. She reported
she has had approximately five consensual sexual partners. She noted she has had three serious
relationships and has lived with three men.
Ms. Nighthorse noted she lived with Christopher in 1996. She noted he was a “good man.” She
noted the relationship ended because he was incarcerated on a “rape” charge and she was
incarcerated for “selling drugs.”
Ms. Nighthorse noted she lived with Mr. Anthony Crowder for less than one year. She
characterized him as abusive.
Ms. Nighthorse noted she started cohabitating with Mr. Cory Washington in 1999. She noted
two children from this union. She characterized Mr. Jones as her “husband.” She characterized
the relationship in ambivalent terms. She noted, “We are best friends and had trouble as he has
hit me a couple of times.” She added, “He has changed now. It is great he has changed so
much.” Nevertheless, she noted Mr. Jones is currently incarcerated in state prison.
Abuse History
Ms. Nighthorse noted a long-standing history of abuse. She noted multiple perpetrators have
victimized her sexually on multiple occasions. She noted perpetrators include family friends,
extended family members, and strangers.
Psychiatric History
Ms. Nighthorse noted a history of long-standing marijuana use. She noted she started smoking
marijuana at the age of fourteen years. She stated her heaviest use as one ounce daily. She noted
her last use was “five months ago.” She denied any problems secondary to her marijuana use.

MENTAL STATUS AND BEHAVIORAL OBSERVATION
Teresa Nighthorse is a 24-year-old female of Caucasian and Native-American heritage. Her
height was below average and her build was judged slim. She looked younger than her stated
age. She demonstrated adequate hygiene and was dressed casually for her evaluation. She
utilized corrective lenses to help her read and perform tasks. Her eyes were bloodshot. She
typically demonstrated adequate eye contact and paid adequate attention during the interviews.
Her speech was calm, coherent, and goal-directed. Volume and rate were within normal limits.
She provided spontaneous answers to questions posed. She was right-hand dominant. Gate was
normal; no problems with gross or fine motor skills were noted. She noted she had taken her
morning medications prior to attending the session.
Ms. Nighthorse was oriented to person, place, date, and situation. Her intelligence is estimated
to be in the below average range based on conversational interaction. She demonstrated marked
difficulty with her immediate, short-term, and long-term memory capacities. She noted trouble
paying attention and concentrating. She noted trouble sitting still when not taking her
medication. During the session, her attention and concentration was mildly limited. Her abstract
thinking was generally concrete and commensurate with her cognitive ability. She demonstrated
a limited fund of general information.
Ms. Nighthorse demonstrated an appropriate range of emotional expression. Her mood was
generally depressed during the interviews. She noted frequent mood swings. Her affect was sad.
She noted recent crying spells. She did not demonstrate any psychomotor agitation. In fact, she
was a bit lethargic during the interview. She had no difficulty sitting still in her chair and
focusing on the required tasks. She noted her sleeping patterns are improved secondary to her
medications. She indicated she now has no trouble falling asleep sleeps through the night. She
noted she gets seven hours of sleep a night. She noted she has trouble waking and feeling rested;
she attributed this to medication side effects. She noted her appetite has not changed recently.
She denied any change in her libido. She noted frequency of sexual activity has decreased
secondary to her common-law husband’s incarceration.
Ms. Nighthorse denied a history of self-mutilation. She did note a history of suicidal behavior.
She reported she attempted suicide by cutting her wrists at the age of 16 years. She denied
hospitalization secondary to this attempt. She denied any current suicidal ideation. Moreover,
she denied thoughts of harming others. Ms. Nighthorse denied experiencing auditory and visual
hallucinations. She also denied any delusional beliefs.

ASSESSMENT RESULTS
COGNITIVE ASSESSMENT
With a chronological age of 24 years, * months, and * days, Ms. Nighthorse earned the following
scores on her Wechsler Adult Intelligence Scales, Third Edition (WAIS-III):
Verbal Subtests
Vocabulary 8
Similarities 7
Arithmetic 6
Digit Span 6
Information 8
Comprehension 9
Letter-Number
Sequencing
4
Performance Subtests
Picture Completion 14
Digit Symbol –
Coding
5
Block Design 6
Matrix Reasoning 7
Picture Arrangement 13
Symbol Search 3
Object Assembly N/A
IQ Scores and Indices
Full Scale 84
Verbal 84
Performance 85
VC 88
PO 88
WM 71
PS 69
Please interpret the WAIS-III scores:
PERSONALITY ASSESSMENT
See attachment A
Please interpret Validity Scales:
Please interpret Clinical Scales:
CLINICAL SUMMARY
Please provide an integrated summary addressing strengths and weaknesses.
DIAGNOSIS
Please provide a five-axis diagnosis.
Axis I:
Axis II:
Axis III:
Axis IV:
Axis V:
RECOMMENDATIONS
Please provide recommendations.

please provide the following within the context of any important cultural and diversity
issues:
d. Recommendations
Name: Leena Tokua
Date of Birth: 10/28/92
Dates of Evaluation: 10/23/00; 10/24/00
Date of Report: 11/1/00
Evaluator: Ima Decent Psychologist, PsyD
IDENTIFICATION AND REASON FOR REFERRAL
Leena Tokua is a 7-year-old female of Hispanic and African-American heritage. Apparently,
Leena was the product of a full-term pregnancy and normal delivery. There are no indications
she displayed any delays in her acquisition of developmental milestones.
Family and Social History
There is little known about Leena and her family history. Her foster mother did not provide the
name of either father or mother on Leena’s intake forms. Apparently her mother neglected and
abused her and Child Protective Services removed her and her sister from the home.
By all accounts, she is currently living in Ms Sally Jefferson’s foster home. Ms Jefferson is in
the process of adopting both Leena and her sister.
Educational History
Ms Jefferson indicated Leena has a history of strong academic performance. She added Leena
has been experiencing a recent decline in her school grades. Specifically, Ms Jefferson stated
Leena did not receive a grade above 84 on her last report card. A grade in this range has
traditionally been considered a C.
Psychiatric History
Ms Jefferson indicated Leena is currently in counseling with Jennifer Front. Child protective
services referred Leena for behavior problems including lying and stealing.

Leena Tokua is a 7-year-old, female of Hispanic and African-American heritage. She is of
average height and build. She demonstrated adequate hygiene and was dressed casually for her
evaluation. She did not utilize corrective lenses to help her read or perform tasks. She typically
demonstrated adequate eye contact and seemed able to pay attention during the interview and
testing. Her speech was of a normal rate and volume. A slight lisp was detected.
Leena was oriented to person, place, date, and situation. Prior to testing, her intelligence is
estimated to be at least in the average range. She demonstrated little difficulty with her
immediate, short-term, and long-term memory capacities, although some timeline inconsistencies
were noted. Her attention and concentration were adequate for her to complete tasks requested
of her. Her abstract thinking was commensurate with her cognitive ability. She demonstrated an
adequate fund of general information.
Leena Tokua demonstrated an adequate range of emotional expression. She tended to fidget in
her seat and had a difficult time sitting still. There were no reported problems with sleep or
appetite. She denied suicidal thoughts and intentions. Moreover, she denied thoughts of
harming others. Leena denied experiencing auditory and visual hallucinations. She also denied
any delusional beliefs.
ASSESSMENT RESULTS
Cognitive Functioning
WISC-III Scores
Test Standard Score
Vocabulary 13
Similarities 9
Arithmetic 3
Information 4
Comprehension 10
Verbal IQ 88
Picture Completion 12
Coding 14
Block Design 13
Object Assembly 12
Picture Arrangement 11
Performance IQ 116
Full Scale IQ 101
Please interpret WISC scores.

WRAT-3 Scores
Test Standard Score
Reading 80
Spelling 80
Arithmetic 92
Please interpret WRAT scores.
CLINICAL SUMMARY
DIAGNOSIS
Axis I:
Axis II:
Axis III:
Axis IV:
Axis V:
RECOMMENDATIONS

issues:
d. Recommendations
Name: Samuel Williams
Date of Birth: May **, 1988
Dates of Evaluation: April ** and **, 2003
Evaluator: Better B. Goode, EdD
Samuel Williams is a 13-year-old male of African-American heritage.
Developmental History
By all accounts, Samuel was born to Ms. Wendy Williams. Little is known about her pregnancy
and delivery. By all accounts, Samuel appears to have reached his major developmental
milestones within normal limits.
Family and Social History
As noted above, Samuel was born to Ms. Wendy Williams. By all accounts, Ms. Williams has a
serious and chronic cocaine addiction. Furthermore, there are reports she has been hospitalized
on at least one occasion for a suicide attempt.
By all accounts, Samuel’s father is Mr. Raymond Williams. Samuel’s grandmother noted Mr.
Williams is also a cocaine addict. Samuel noted his father is employed in the fast food industry.
Apparently, Samuel has nine siblings. The grandmother noted eight of the siblings are the
product of the union between Ms. Williams and Mr. Williams. Samuel noted one half-brother
fathered by a man named “Blu”

By all accounts, Samuel and his siblings are living with his maternal grandmother who also cares
for about seven other children for a total of 17 children in the home. The maternal grandmother
noted Samuel has a tendency to loose his temper at the slightest provocation.
Educational History
By all accounts, Samuel has trouble in school. He reported being enrolled in the seventh grade.
He noted repeating the first grade because of excessive absenteeism. He indicated he is in
special behavior classes “because [he] talks too much.” During the second appointment, he
noted he was suspended for allegedly calling a teacher a racially disparaging name. He denied
speaking inappropriately to the teacher.
There is strong evidence that Samuel has trouble with multiple classes and has been referred to
the vice principal’s office on multiple occasions.
Psychiatric History
By all accounts, Samuel has never been hospitalized for psychological problems. He did note
visiting with a school counselor about his behavior in the sixth grade. He noted the treatment
focus was “home and all that.” He indicated he was treated with Ritalin in the sixth grade for
“behavior problems.” He noted the behavior problems included “cursing and all that.” He noted
the medication was discontinued “because [he] changed my behavior.” He said, “I behave
myself more.”
Samuel noted he tried marijuana once.
Samuel Williams is an attractive 13-year-old, male of African-American heritage. His height is
average and age appropriate. His build is slim. He is right-hand dominant. He demonstrated
adequate hygiene and was dressed casually for his evaluation. He did not utilize corrective
lenses to help him perform tasks. He typically demonstrated adequate eye contact and had some
trouble paying attention during the interviews. His speech was colloquial and goal directed.
Volume and rate were within normal limits.
Samuel was oriented to person, place, date, and situation. His intelligence is estimated to be in
the below average range based on observation, interaction, and report. He demonstrated little
difficulty with his immediate and long-term memory capacities. He did have some short-term
memory challenges. His attention was limited. He had trouble focusing. He had some
concentration difficulties. His abstract thinking was commensurate with his cognitive ability.
He demonstrated an adequate fund of general information.
Samuel demonstrated a broad and appropriate range of emotional expression. He presented as
cooperative and engaging. His affect was calm and his mood was euthymic. He was apparently
content to complete the evaluation. He commented that he requires less sleep than the other

children. He demonstrated notable psychomotor agitation. He had notable difficulty sitting still
in his chair and focusing on the required tasks. His right leg bounced as he concentrated on the
required tasks. He did not indicate any trouble with his sleep or appetite. There are no
indications he has any delusions or is experiencing any self-harm thoughts. There are no
indications he experiences any hallucinations.
In sum, Samuel presented as cooperative and polite. He was shy but forthright. He was notably
uncomfortable talking about his mother’s drug addiction and her inappropriate behavior.
ASSESSMENT RESULTS
WISC-III Results
Picture Completion 12 12
Information 12 12
Coding 6 6
Similarities 10 10
Picture
Arrangement 14 14
Arithmetic 6 6
Block Design 12 12
Vocabulary 15 15
Object Assembly 13 13
Comprehension 12 12
Symbol Search 7 7
Digit Symbol 7 7
Sum Scale Score 55 57 49 51 13 13
IQ Scores 106 110 113 117 81 83
V P VC PO FD PS
Sum Scale Score 112
FSIQ 108
Please interpret the WISC scores.
WRAT-3 Results
Instrument Subtest Standard Score Percentile Comment
WRAT-3 Reading 101 53rd
Spelling 95 37th
Arithmetic 86 18th
Please interpret the WRAT scores.

Emotional Functioning
Conners’ Rating Scales T Scores
Conduct Disorder 72
Anxious-Shy 70
Restless-Disorganized 68
Psychosomatic 50
Obsessive Compulsive 56
Antisocial 68
Hyperactive-Immature 74
Please give your impressions of the Conners’ data given your knowledge of the instrument.
CLINICAL SUMMARY
DIAGNOSIS
Axis I:
Axis II:
Axis III:
Axis IV:
Axis V:
RECOMMENDATIONS

issues:
d. Recommendations
Name: Allison Johnson
Date of Birth: 5/**/78
Dates of Evaluation: 11/**/00, 1/**/01, 5/**/01, and 5/**/01
Date of Report: 6/**/01
Evaluator: Fine N. Dandy, PhD.
Allison Johnson is a 22-year-old female of Caucasian heritage.
Family History
Ms. Johnson reported a long-standing unsatisfactory relationship with her family. Ms. Johnson
stated her birth mother is Gerry Smith. She noted her mother has a history of mental illness and
substance abuse. Apparently, her mother suffers from severe narcissistic personality disorder.
Ms. Johnson reported an unsatisfactory relationship with her mother. She stated writes her
mother letters and attempts to telephone her mother. Apparently these efforts are in vain and she
stated her mother is “ashamed of me.”
Ms. Johnson reported her birth Father is Jimmy Dean. She stated she does not believe this
information. She stated she knows nothing about her father’s mental health history or his history
of substance abuse. Apparently he left her mother when she was born.
Ms. Johnson reported she has one child, Sally Johnson. Records indicate Sally was the product
of a union between Ms. Johnson and Mr. Jeremiah Lopez. Ms. Johnson reported at least three
(3) different men could be Sally’s father. Records indicate Sally was born three weeks

prematurely on November **, 2000. Records also indicate Sally was taken into protective
custody because. Apparently, Child Protective Services received several reports about possible
neglectful supervision of Sally by Ms. Johnson. By all accounts, Sally is currently living in a
foster home and Ms. Johnson has regularly scheduled visits with her child.
Abuse History
Ms. Johnson reported a long-standing history of severe abuse. She stated her mother “sold” her
for drugs to various boyfriends. Specifically, she noted the abuse suffered at the hands of these
alleged perpetrators involved fondling, touching, oral sex, and sexual intercourse. She also noted
her mother physically abused her. Specifically, she noted her mother hit her with belts and “cut”
her. Finally, there are indications she was gang-raped when she was 11 years old.
Relationship History
Ms. Johnson reported a long-standing history of unstable relationships. She stated she has a hard
time finding “true friends” who “don’t stab me in the back.” She also noted frequent moves
from group home to group home made keeping satisfactory relationship challenging. Regarding
relationships with lovers and significant others, she noted she became sexually active when she
was 11 years old. She estimated she has had approximately 50 sexual partners and the vast
majority, if not all, of these liaisons were one-night stands or pick-ups. She noted her sexual
promiscuity is the result of previous sexual abuse. She noted she has had one serious
relationship and is currently engaged to a young man she met living in a shelter.
Educational History
Ms. Blanton reported Ms. Johnson began school at the age of 3 because of hearing problems.
She added she has always received special education. Apparently, she has a history of behavior
problems in school and was suspended on at least one occasion. She noted she dropped out of
the 12th
grade when she turned 18 years old. She stated she has attempted and failed the
Graduate Equivalency Diploma test approximately 10 times.
Occupational History
Ms. Johnson noted she has had trouble finding stable employment. She noted she has been
employed “off and on” in temporary employment positions. Apparently, most of these jobs have
been in the custodial arts. Records indicate she has never held any “steady gainful employment”
for any amount of time.
Residential History
By all accounts, Ms. Johnson has a long-standing history of living on the street and in temporary
shelters. She did note she briefly resided with a “godfather” named Cornelius Collins. There are
no indications she has ever been able to rent her own apartment.

Medical History
Early Developmental History
Ms. Johnson noted her mother abuse drugs during her pregnancy with Ms. Johnson. She noted
her mother used, “alcohol and heroine.” Ms. Johnson noted her development was markedly
delayed. She noted she had trouble learning to walk because of “spine and hip” problems. She
also noted her acquisition of language skills was also delayed. She also noted significant hearing
loss in her left ear.
Childhood Medical History
Ms. Johnson noted a history of multiple hospitalizations and operations as a child. She reported
she had tubes placed in her ears approximately 8 times to alleviate chronic ear infections. She
also noted she had her tonsils taken out as a child. She denied any unusual diseases or illness but
did note she has had normal childhood illnesses such as chicken pox.
Adult Medical History
Ms. Johnson noted her adult medical history is positive for spine and hip problems. She also
noted she has a seizure disorder. Apparently, she has a history of grand mal and petit mal
seizures. Moreover, there are indications she has a hard time being compliant with her medical
regimen.
Current Medical Condition
Ms. Johnson stated she currently suffers from chronic bronchitis.
Current Medications
Medication Name Dosage Frequency Reason Taken Helpful?
Dilantin 100 mg TID Seizures Yes
Depakote 250 mg TID Seizures Yes
Legal History
Ms. Johnson noted she has been arrested at least twice. She noted she has been charge with
prostitution and criminal trespassing. She denied any convictions. She noted she received a
warning for the prostitution charge.
Assessment Behavior
Ms. Johnson had a difficult time meeting obligations, following expectations, and being
consistent during the course of the evaluation. She was first seen November **, 2000. She

attended the first interview and was elusive and evasive during the intake interview. When she
arrived for her second appointment (January **, 2001) she stayed for only 30 minutes. She
complained of “throwing up, light headedness, nose bleeds” and a recent visit to the hospital.
She abruptly left the testing session stating she was going to “return to the shelter so my old man
can take me to the hospital.” On May **, 2001, Ms. Johnson was seen again and was given
another initial interview because it had been six months since the first interview. Ms. Johnson
set a follow-up appointment for May **, 2001. She did not attend her May **, 2001
appointment. Ms. Johnson arrived on June **, 2001 to complete her psychological evaluation.
She completed all required tasks on this date. She set an appointment for feedback concerning
her evaluation for June **, 2001.
Mental Status Exam
Allison Johnson is a 22-year-old female of Caucasian heritage. Her height appears to be
average; her build is heavy. She demonstrated adequate hygiene and was dressed casually for
her evaluation. She noted she is right hand dominant. She did not utilized corrective lenses to
help her read or perform tasks. She typically demonstrated adequate eye contact and paid
adequate attention during the interviews. Her speech content was often tangential and impulsive.
She tended to produce spontaneous verbalizations that were irrelevant and off subject. Her rate
of speech was normal and the volume was within normal limits. A slight articulation problem
was noted and is attributed to her reported left ear deafness and possible delays in acquiring
expressive language skills.
Ms. Johnson was oriented to person, place, date, and situation. Her intelligence is estimated to
be in the below average range. She demonstrated some difficulty with her immediate, short-
term, and long-term memory capacities. Her attention and concentration was limited. Her
abstract thinking was concrete but generally commensurate with her estimated cognitive ability.
She demonstrated a limited fund of general information.
Ms. Johnson demonstrated a labile and depressed mood. Her affect was judged to be irritable,
angry, and sad. She did not demonstrate any psychomotor agitation. She had little difficulty
sitting still in her chair and focusing on the required tasks. She reported she has a hard time
falling asleep and often awakes during the night because she is afraid of bad things happening
while living in the shelter. She noted her appetite is “too strong.” She also noted a decrease in
her libido. She denied current suicidal thoughts and intentions. Moreover, she denied thoughts
of harming others. Ms. Johnson denied experiencing auditory and visual hallucinations. She
also denied any delusional beliefs. She did note obsessive thoughts about her daughter.

ASSESSMENT RESULTS
Cognitive Summary
Instrument Subtest Standard
Score
WAIS-III Vocabulary 3
Similarities 6
Arithmetic 5
Digit Span 8
Information 5
Comprehension 4
Verbal IQ 71
Picture
Completion
5
Digit Symbol-
Coding
5
Block Design 4
Matrix Reasoning 11
Picture
Arrangement
5
Performance IQ 76
Full Scale IQ 71
Please interpret WAIS scores.
WRAT-3 Reading 77
Spelling 78
Arithmetic 53
Please interpret WRAT scores.
Emotional Functioning
Please see Attachment B
Please interpret Validity Scores.
Please interpret Clinical Scores.

CLINICAL SUMMARY
DIAGNOSIS
Axis I:
Axis II:
Axis III:
Axis IV:
Axis V:
RECOMMENDATIONS

October 2004 CCE Domain V
DOMAIN V
ETHICS
1. Please read the following ethical dilemma. List the ethical guidelines and state laws you
believe are relevant to the situation. What responsibilities does Dr. Spock face at this
point and what ethical principles should be considered to guide her actions?
Mrs. Smith, a 51-year-old teacher at a private Christian junior high school, has
been in therapy with Dr. Spock for about two years. Initially referred by her
physician for major depression, her treatment progressed well and therapy moved
on to other issues by mutual agreement after the first few months. Ms. Smith has
become increasingly in touch with anger toward her father, finally confiding in
her therapist that she was physically abused by her father during her formative
years.
She has not told anyone except her best friend at the time, whom Mrs. Smith has
not seen since high school. Her 73-year-old father, Mr. Jones, is retired from a
longstanding position as a music director/worship leader in a large
nondenominational Christian church, and still fills in at the church on occasion by
request. He is well-known and highly respected, and Mrs. Smith does not want to
embarrass him in any way. In the process of dealing with her memories in the
office; however, Mrs. Smith decided to talk to her 71-year-old mother
confidentially about the past physical abuse.
In the course of several of those conversations, Mrs. Jones revealed to Mrs. Smith
that she had also been physically abused by Mr. Jones and Mrs. Jones ultimately
decided to come in for therapy herself. Mrs. Jones reported to Dr. Spock in the
third session that she had been physically abused throughout her marriage to Mr.
Jones and had become worse during the past year. Dr. Spock noted several
bruises and some swelling on Mrs. Jones’ arm when she rolled up her long-
sleeved shirt to show her some of the injuries.
When Dr. Spock discussed her reporting responsibilities with Mrs. Jones, she
became visibly upset and suggested she would like Dr. Spock to come to her
house for dinner where she could meet Mrs. Jones’ husband, and they could all
discuss the situation further.

October 2004 CCE Domain V 2
2. Please read the following scenario. List the ethical guidelines and state laws you believe
are relevant to the situation. Where has Dr. Spare made significant mistakes? What are
some of the consequences of his mistakes?
Mr. and Mrs. Jones have been married for 20 years. Mr. Jones found his “true
love” at the office and recently abandoned his wife and two children. He has a
14-year-old daughter and a 9-year-old son. Dr. Spare received a telephone call
from Mrs. Jones’ legal counsel and accepts this case as his first child-custody
evaluation. He warned the attorney he has never done a child-custody evaluation
like this before but is looking to expand his referral sources and broaden his
expertise and thus would be willing to try.
Attorneys representing both parties mutually agree to use Dr. Spare and the
parents arrive together for their first appointment. Dr. Spare informs the couple
he is an expert at conflict resolution (having taken one class in graduate school)
and he would like to mediate and help Mr. and Mrs. Jones conflicts and
differences regarding their relationship, divorce, and custody issues. He
described his fees for the time he will spend on the evaluation and bills their
insurance company using the diagnosis of Adjustment Disorder.
After four sessions of attempted conflict resolution, Dr. Spare made little
headway and determined it was clinically necessary to treat them separately. He
requested each parent to bring one of the children for an interview. At the
conclusion of his time with the Jones family, he drafted a child-custody
evaluation report to the court. In his report he rendered an opinion that the 9-
year-old boy should be in therapy. The parents agreed to let Dr. Spare treat the
child.

October 2004 CCE Domain V 3
3. Please read the following case summary. Given APA Ethics and landmark cases such as
Larry P. vs. Riles (1972/1974/1979/1984), what considerations does the practicum
student need to take into account to ensure she provides a nondiscriminatory assessment?
Amelia, a college freshman came to the University Counseling Center during
Christmas break. She was complaining of marked sadness, edginess, and marked
difficulty with her academic coursework. Although she is attending a university
in the United States, she was born, raised, and educated in Eastern Europe and her
native language is not English. She immigrated to the United States four months
ago to attend university. She is able to communicate effectively in both written
and verbal English. She reported she was an average to above-average student in
high school and is now doing poorly in her courses. She is finding it difficult to
concentrate and focus. The psychology graduate practicum student assigned the
case wants to explore intellectual issues, academic achievement issues, and
personality issues.
4. Please outline the following two studies, the researcher’s hypotheses, the findings, and
any conclusions. Furthermore, please critique each one using the current 2002 APA
Ethics.
i. Zimbardo’s Stanford prison study
ii. Milgram’s original obedience to authority study

October 2004 CCE Domain VI
DOMAIN VI
RESEARCH METHODS AND STATISTICS
1. Please read and critique the Lampropoulos (2000) article.
2. Please read and critique the Baskin, Tierney, Minami, and Wampold (2003) article.
3. Please discuss, describe (including benefits & limitations), and give multiple (at least
four) examples of each type of statistic noted below. Furthermore, please give two
examples of research studies of clinical phenomena that use two of the following.
a. Descriptive Statistics
b. Inferential Statistics
c. Multivariate Statistics
4. Please design an experiment to answer one (1) the following clinical questions. Be sure
to include your hypotheses, null hypotheses, variables, methods, subjects, and statistics.
a. Effects of child temperaments on future relationship satisfaction with significant
others.
b. Effects of early environmental chaos and performance on a standardized measure
of intelligence as a young child.
c. Evaluate how a student learns how to be culturally sensitive and utilize their
cultural competency in the treatment of diverse individuals and groups.

October 2004 CCE
AGREEMENT OF CONFIDENTIALITY
I, _________________________________________, do hereby affirm or avow that I will not
disclose any information contained in this examination with my peers prior to the deadline for
completing the examination. I understand that keeping this material confidential is a matter of
academic integrity. I understand that violation of this agreement will result in my failure of the
CCE Domain(s) disclosed and the failure of the person to whom I disclosed the information.
Furthermore, I understand I will be referred to the Student Conduct Committee and face potential
consequences up to. and including dismissal from Argosy University/Dallas.
__________________________________________ _______________
Student signature Date
__________________________________________ _______________
Witness signature Date

Au dallas clinical comprehensive exam questions fall 2004

Recommended

Recommended

More Related Content

What's hot

What's hot (15)

Similar to Au dallas clinical comprehensive exam questions fall 2004

Similar to Au dallas clinical comprehensive exam questions fall 2004 (19)

Recently uploaded

Recently uploaded (20)

Au dallas clinical comprehensive exam questions fall 2004