March

Question 1

1 of 20.
A psychologist working in a community mental health clinic has been asked to manage the caseload of a colleague who is on leave. When reviewing a client’s file the psychologist notices that there is variability in the amount of documentation for each session. For example, some progress notes are detailed and others have only the date and time the client attended an appointment.
What is the most important reason for maintaining adequate progress notes of a client’s treatment?
A.To be able to produce adequate records of treatment in case of litigation
B.To ensure protection if someone complains to the Psychology Board of Australia
C.To have a record of treatment if the client returns for treatment at a later date
D.To be able to monitor a client’s progress in treatment over time
E.To have a record of therapy if the client requests a copy of the progress notes

Answer 1

Answer D
A is not the most important reason as maintaining adequate records to prevent litigation does not benefit the client. B is not the most important reason as maintaining adequate records would not prevent a client making a complaint. C is not the most important reason, as while it is important to have a record of sessions if a client returns for treatment, there is no guarantee that the client will see you again when they seek treatment. D is the most important reason as monitoring progress in treatment through maintaining adequate records helps maintain continuity of care and therefore benefits the client. E is not the most important reason as while a client has a right to a copy of the session notes, it is more important to maintain adequate records to provide for continuity of care.

Question 2

A psychologist has been receiving supervision from a senior and highly-experienced colleague. The psychologist attends a supervisory session and discovers that, for the third successive session, the supervisor is intoxicated. The psychologist raises concerns with the supervisor about his alcohol use, but he denies that there is any problem.

What is the best way for the psychologist to proceed?
A.Offer to meet the psychologist at a local hotel to assess his drinking
B.Cease supervision with the psychologist and look for another supervisor
C.Contact the Board to report the psychologist as an impaired practitioner
D.Offer to help the psychologist seek assistance for his uncontrolled drinking
E.Continue to monitor and document the sychologist’s episodes of intoxication

Answer 2

Answer C
A is not the best option as it is not your role as a supervisee to complete an assessment of your supervisor’s behaviour, and in doing so you would be entering into a dual relationship. B is not the Answer C A is not the best option as it is not your role as a supervisee to complete an assessment of your supervisor’s behaviour, and in doing so you would be entering into a dual relationship. B is not the

Question 3

A psychologist working as an employee assistance program provider for a large employer has been seeing a 23-year-old Aboriginal woman who has reported experiencing harassment from her work unit supervisor. The woman’s supervisor contacts the psychologist requesting a meeting to discuss important information.
In this situation what is the most important initial thing to do?
A.Agree to see the supervisor and discuss the issues concerning the client
B.Refuse to discuss with the supervisor any issues concerning the client
C.Inform the client of the request and seek her consent for the meeting
D.Arrange a meeting with the supervisor and the client to discuss the alleged harassment
E.Arrange a meeting with the supervisor to discuss the role of the psychologist

Answer 3

Answer C
A is not the most important thing to do as you do not have the consent of your client to discuss these issues. B is not the most important thing to do, as while you cannot discuss this information initially with the supervisor, it may be appropriate but only if you are able to obtain relevant informed consent from your client. C is the most important thing to do as it is critical to obtain consent from your client before you proceed further, and she needs to be informed as the client that her supervisor has contacted you. D is not the most important thing to do as this option would not be the most important initial thing to do. E is not the most important thing to do as it is critical to gain consent with your client, the woman. At the outset of the employee assistance program the nature of your role and relationship with people within the organisation should have been defined.

Question 4

A psychologist has been seeing a client for a driving phobia following a traffic accident where he was the driver. During the course of therapy the client discloses that he was a victim of bullying in the workplace and that he has submitted a Workcover claim. The psychologist receives a valid subpoena to provide all the records for this client. The subpoena was initiated by legal representatives of the alleged perpetrator of the bullying.
What is the most appropriate response to the subpoena?
A.The psychologist is not obliged to release the records as client records are subject to professional privilege
B.Release only information about the client that the psychologist judges to be in the client’s best interests
C.Release a summary of the client records but retain a more detailed set of notes collected during therapy sessions
D.Release all information that is requested as there is no professional privilege in this situation
E.Refuse to release the client records because to do so would constitute a breach of confidentiality

Answer 4

Answer D
A is not the most appropriate response as psychologists are obliged to provide access to records if required by a valid subpoena. Professional privilege does not apply to Psychologists. B is not the most appropriate response as you must release all your client records as stipulated in the a valid subpoena. C is not the most appropriate response as you must release all your client records as required by subpoena. D is the most appropriate response as information gathered in the course of a psychological service is not subject to professional privilege. You are required to release all information specified in a valid subpoena. This is one of the cases where a legal obligation overrides the normal protection of confidentiality of client records. E is not the most appropriate response as legal obligations such as a valid subpoena override normal confidentiality requirements.

Question 5

5 of 20.
A psychologist works in a multidisciplinary practice where all practitioners frequently refer clients to each other. One of the practitioners tells the psychologist that she is having increasing problems which are impacting on her work performance. She asks if the psychologist would take her on as a client.
What is the psychologist’s most appropriate response to this request?
A.Advise the practitioner of the contact details of other local psychologists
B.Accept the practitioner as a client and develop a treatment plan together
C.Advise the practitioner to take time off work to lessen her anxiety
D.Accept the practitioner as a client but find another venue for treatment
E.Advise the practitioner to obtain consent from her manager first

Answer 5

Answer A
A is the best course of action because by suggesting other local psychologists you are able to maintain appropriate professional boundaries and refrain from creating a dual relationship. B is not the best course of action because you should refrain from developing dual relationships where it may be difficult to maintain professional boundaries. C is not the best course of action because by providing such advice you may risk putting yourself in a psychologist-client relationship with your colleague and risk blurring boundaries by entering into a dual relationship. D is not the best course of action because you should avoid dual relationships with a potential client irrespective of the venue for treatment. E is not the best course of action as her manager’s consent is not required in assisting the practitioner to seek appropriate help.

Question 6

6 of 20.
A psychologist delivering employee assistance programs is treating an accountant for work-related stress. Over the course of therapy, the client informs the psychologist that he is aware that another psychologist from the same practice is under investigation for inappropriate financial dealings. This information is not public knowledge.
What is the most appropriate course of action for the treating psychologist?
A.The psychologist should not act on this information or disclose it to anyone
B.The psychologist should act on this information to protect the financial interests of other clients
C.The psychologist should seek permission to disclose the information to the colleague under investigation
D.The psychologist should terminate treatment and refer the client to a psychologist outside the practice
E.The psychologist should disclose this information to the colleague and request an explanation

Answer 6

Answer A
A is the most appropriate course of action because the information is bound by confidentiality which you are obliged to maintain. B is not the most appropriate course of action because you only have obligations to disclose information in exceptional circumstances, such as imminent threat of significant harm or serious malpractice. C is not the most appropriate course of action because it is not clear how disclosing it to your colleague is in the best interests of the client. D is not the most appropriate course of action because it is not in the best interests of the client to refer on. E is not the most appropriate course of action because it is unethical to disclose information that is bound by confidentiality.

Question 7

7 of 20.
A distressed 16-year-old youth is referred to a psychologist by his general practitioner (GP). The young man is concerned that he has a serious physical illness that has not yet been identified, despite extensive medical testing. The psychologist decides to conduct a Mental State Examination to assist with developing an initial formulation of the client’s presenting problem.
What is the main type of information gathered in a Mental State Examination?
A.Subjective information from the client
B.Collateral information from his parents
C.Collateral information from his school teachers
D.The GP’s opinion about the client’s presentation
E.Behavioural observations of the client’s presentation

Answer 7

Answer E
A is not the best option as self-report measures would be a more typical subjective evaluation of what is happening, and the Mental State Exam (MSE) relies more on the examiner’s observation of behaviour and performance B is not the best option as collateral information is a not the main information gathered in the MSE. C is not the best option as collateral information is a not the main information gathered in the MSE. D is not the best option as collateral information is a not the main information gathered in the MSE. E is the best option as a Mental State Examination is based on the therapist’s objective observation of a client’s presentation at time of interview.

Question 8

8 of 20.
A psychologist has been asked by the owner of a local meat-processing plant to help reduce the number of injuries that have been occurring. The owner reports that the plant is struggling to meet customer orders and that absenteeism rates have been increasing. Interviews with worker-based focus groups reveal that turnover is high and workers perceive that management is not concerned with their well-being.
Which of the following tests would best assist in a general survey of employee well-being?
A.Wechsler Adult Intelligence Scale
B.NEO Five-Factor Inventory
C.Depression Anxiety and Stress Scales
D.Strong Interest Inventory
E.State-Trait Anxiety Inventory

Answer 8

Answer C
A is not the most appropriate option as the WAIS would yield valuable information about intelligence but would not assess the referral question. B is not the most appropriate option as the NEO-FI would not assess the problems being reported by the workers. C is the most appropriate option as the Depression Anxiety and Stress scales (DASS) will provide helpful information about the psychological health of the employees. Stress, in particular, is known to be associated with errors and absenteeism and it is a reasonable assumption that stress levels are a problem in this organization. D is not the most appropriate option as the Strong Interest Inventory assesses career preferences which would not answer the referral question about well-being. E is not the most appropriate option as the State-Trait Anxiety Inventory would not provide as much relevant information as the DASS.

Question 9

9 of 20.
A 17-year-old girl is referred to a psychologist by her GP. In the referral the GP reports that the client is completing Year 12 and having difficulties achieving the grades she needs to get into her preferred course at University. At her first session the client presents as sad and tearful and reports increasing social withdrawal. During the last two months she has lost 10 kgs in weight and reports little interest in eating. The client is missing school frequently, is not sleeping well, and is finding it increasingly difficult to concentrate on her schoolwork. She feels hopeless about her future and occasionally stabs her wrists in despair with a pen.
Given the client’s presentation, what is the most likely diagnosis?
A.Major depressive disorder
B.Anorexia nervosa
C.Social anxiety disorder
D.Personality disorder
E.Normal functioning given her situation

Answer 9

Answer A
A is the most likely diagnosis because symptoms reported meet criteria for a Major Depressive Disorder. B is not the most likely diagnosis because the main symptoms the client reports are not relating to food or body image. C is not the most likely diagnosis because the main presenting symptoms do not occur within the context of social relationships. D is not the most likely diagnosis because a diagnosis of Personality Disorder is made in the context of an enduring pattern of inner experiences and behaviours that deviate markedly from the expectations of the individual’s culture. The self-harming behaviour is associated with despair, as opposed to occurring within a context of instability of interpersonal relationships or affective instability due to marked reactivity of mood as would be more typical in personality disorder. E is not the most likely diagnosis because the client’s level of expressed distress and behaviour together with the duration of her difficulties is inconsistent with normal behaviour.

Question 10

10 of 20.
A general practitioner (GP) refers an 84-year-old man to a psychologist for assessment. He attends the first appointment with his wife. The man’s wife reports changes in his behaviour over the last year including pacing the house at night, irritability, and misplacing objects. He has also become concerned that the neighbours have been spying on him.
What is the most likely diagnosis?
A.Generalised anxiety disorder
B.A form of dementia
C.Major depressive disorder
D.Delusional disorder
E.Late onset psychosis

Answer 10

Answer B
A is not the most likely diagnosis as the man has not reported uncontrolled and excessive worries. B is the most likely diagnosis given the man’s age and age of onset. C is not the most likely diagnosis as the there are not enough symptoms to suggest the presence of depression. D is not the most likely diagnosis, as given the man’s age and commencement of symptoms, it is more likely attributable to dementia. E is not the most likely diagnosis, as given the man’s age and commencement of symptoms, it is more likely attributable to dementia.

Question 11

11 of 20.
A 43-year-old man is referred to a psychologist working for a local workers’ compensation authority. The psychologist has been asked to conduct a vocational assessment to determine recommendations for retraining. The psychologist administers the WAIS and discovers that the VCI score is 25 points lower than the PRI.
What is the most appropriate interpretation of this difference in scores?
A.The client’s visuospatial skills are better developed than his verbal skills
B.The client’s visuospatial skills are less developed than his verbal skills
C.The client’s verbal and visuospatial skills are comparable
D.The two scores are not comparable given the broad range of scores
E.The difference score cannot be interpreted without knowing the FS IQ

Answer 11

Answer A
A is the most appropriate interpretation as a difference of 25 points is clinically significant and are unlikely to be due to error. B is not the most appropriate interpretation, as the client’s verbal skills are not higher than his visuo-spatial skills. C is not the most appropriate interpretation, as there is a clinically significant difference in scores. D is not the most appropriate interpretation as the scores can be interpreted, as they are measuring different skills. E is not the most appropriate interpretation as the scores can be interpreted without knowing the FSIQ. In addition, the FSIQ is not interpretable in this situation due to the clinically significant difference in scores.

Question 12

12 of 20.
A psychologist receives a referral from a general practitioner (GP) for a 25-year-old woman with depression and anxiety symptoms. The referral also states that the client is very motivated to see a psychologist to help improve her psychological functioning. The GP reports having administered the K10 and that the score is extremely high.
How should the psychologist interpret the client’s K10 score?
A.The K10 score is a specific measure of the client’s severe depressive symptoms
B.The K10 score is a specific measure of the client’s severe stress symptoms
C.The K10 score is a specific measure of the client’s high anxiety symptoms
D.The K10 score is a specific measure of the client’s high psychological distress
E.The K10 score is a specific measure of the client’s high motivation to change

Answer 12

Answer D
A is not the best option as the K-10 is not a specific measure of depression but rather is a broad measure of psychological distress. It is designed and validated to detect the presence of a range of psychiatric disorders including major depression and generalised anxiety disorder. B is not the best option as the K-10 is not a specific measure of stress but rather is a broad measure of psychological distress. C is not the best option as the K-10 is not a specific measure of generalised anxiety disorder, but rather a broad measure of psychological distress. D is the best option as the K-10 is a brief screening instrument of broad psychological or psychiatric distress. E is not the best option as the K-10 is not a measure of motivation to change.

Question 13

13 of 20.
A psychologist is seeing a client with a psychological disorder that she has never treated before. Following the initial interview and gathering of collateral information, the psychologist decides to review the literature covering the various treatments.
Which of the following publications should the psychologist prioritise to determine the appropriate treatment for this client?
A.Publications that review the psychotherapeutic process factors in the treatment of the disorder
B.Publications that report individual experiments that randomly assign clients to treatment groups to compare efficacy
C.Publications that examine long-term and sustained results for treatment progress of individual clients
D.Publications that review literature on the most popular treatment for clients with this disorder
E.Publications that report meta-analyses of the efficacy of the different treatments for this disorder

Answer 13

Answer E
A is not the best option because these studies may provide a non-representative summary of the scientific status of the literature. B is not the best option because these studies may provide a non-representative summary of the scientific status of the literature. C is not the best option because these studies may provide a non-representative summary of the scientific status of the literature. D is not the best option because these studies may provide a non-representative summary of the scientific status of the literature. E is the best option as meta-analytic studies provide a comprehensive and cumulative overview of the scientific evidence from a range of studies using specific criteria, and is accepted as the gold standard method for evaluating the literature.

Question 14

14 of 20.
A 56-year-old man is referred to you by his general practitioner (GP.) He has been unemployed for eight months after being retrenched from work. His GP has recently prescribed a selective serotonic reuptake inhibitor (SSRI) medication.
What is the most likely initial diagnosis?
A.Major depressive disorder
B.Schizophrenia
C.Adjustment disorder
D.Social anxiety disorder
E.Bipolar affective disorder

Answer 14

Answer A
A is the most likely reason as SSRI is a type of antidepressant. Antidepressants are most commonly used to treat depression. B is not the most likely reason as SSRIs are not commonly prescribed for Schizophrenia. C is not the most likely reason as it is not common for medication to be prescribed for someone with an adjustment disorder. If the symptoms reported were severe, they would most likely fulfil criteria for another disorder. D is not the most likely reason as while antidepressants can be prescribed in some cases of anxiety; it is more likely that the client is experiencing a major depressive episode based on the limited presenting information. E is not the most likely reason as mood stabilisers are usually prescribed for Bipolar Affective Disorder and there is not sufficient information to suggest that the client has this diagnosis.

Question 15

15 of 20.
A psychologist is running a program for supervisors in an organization. The goal of the program is to better equip the supervisors to manage staff and thereby enhance the organisation’s performance. The psychologist receives positive feedback from supervisors but decides to conduct research to determine the effectiveness of the program.
Which of the following designs would be most useful for evaluating the program?

A.Compare measures of the profitability of the organisation before and after the program
B.Compare staff turnover and absenteeism rates before and after the program with those in equivalent organisations
C.Ask supervisors to rate their own performance before and after the program on the skills targetted by the program
D.Ask employees to rate the performance of their supervisors before and after the program on skills targetted by the program
E.Randomly assign supervisors to treatment and control groups and compare performance before and after the program

Answer 15

Answer E
A is not the most appropriate option as many factors would contribute to the organisation’s profitability. B is not the most appropriate option because you cannot control other things that have happened in the organisation (e.g., a pay rise). C is not the most appropriate option because the program may have created an expectation among the supervisors that they would improve. D is not the most appropriate option because it does not control for other things that may be happening in the organisation (e.g., a change from a busy to a quieter period). E is the most appropriate option because it contains pre- and post-measures and because it allows for comparison with a control group, which would share other experiences with the experimental group.

Question 16

16 of 20.
A 45-year-old woman is referred to a psychologist for treatment of spider phobia. The psychologist decides to use a form of exposure therapy.
Which of the following exposure methods is likely to be most effective?
A.Graduated exposure and habituation to live spiders
B.Graduated exposure and habituation to plastic spiders
C.Exposure and habituation using pictures of spiders
D.Exposure and habituation of the response to live and plastic spiders
E.Graduated exposure and habituation using spiders and other insects

Answer 16

Answer A
A is the most effective strategy as it describes in vivo exposure, which is defined by graduated exposure to real situations that provoke anxiety. This method is the most effective method in producing habituation. B is not the most effective strategy as there is good evidence that exposure to actual stimuli where possible more effectively facilitates habituation. C is not the most effective strategy as there is good evidence that exposure to actual stimuli where possible more effectively facilitates habituation. D is not the most effective strategy as it does not specify graduated exposure which is the most effective method in producing habituation to the feared stimuli. E is not the most effective strategy as using relevant feared stimuli has been shown to be more effective in producing habituation.

Question 17

17 of 20.
A 26-year-old classical violinist is referred to a psychologist for assistance with performance anxiety. The client reports that he has been invited to join the London Philharmonic Orchestra, an achievement that means a lot to him. However, since receiving the invitation he has been making uncharacteristic mistakes and is no longer wanting to practise as frequently. He is afraid that he will make a mess of his chance for international recognition.

What is the most likely cause of the client’s performance anxiety?
A.Ambivalence about moving up to the international stage
B.Cognitive distortions about evaluations of his own expertise
C.Lack of skills in setting and achieving appropriate goals
D.Increased autonomic hyperarousal
E.Feelings of isolation and lack of support by others

Answer 17

Answer B
A is not the most appropriate formulation as the client reports being motivated about the opportunity. B is the most appropriate formulation as the client’s description of his thoughts and fears around his performance indicate that cognitive distortions are the main problem. C is not the most appropriate formulation as there is no indication that the client lacks skills in goal setting. D is not the most appropriate formulation because the arousal might be a result of the client’s anxiety but it is not the likely reason that anxiety is occurring. E is not the most appropriate formulation because there is no evidence that he is isolated socially.

Question 18

18 of 20.
An 18-year-old male is referred for treatment of depression and insomnia. The psychologist completes the initial interview and negotiates a treatment plan targeting depression as the primary presenting problem. The client attends the next session stating that he is ambivalent about addressing his depression and instead wants to focus on work stress.
What is the most appropriate way to manage the client’s ambivalence regarding the treatment goal?
A.Use narrative deconstruction to address the client’s ambivalence regarding the initial treatment goal
B.Acknowledge the client’s ambivalence but continue with the treatment plan for depression
C.Refer the client to another psychologist because of the client’s ambivalence about the treatment
D.Explore the reasons for the client’s ambivalence in order to maintain a good therapeutic alliance
E.Accept that stress is the problem uppermost in the client’s mind and start a treatment plan for stress

Answer 18

Answer D
A is not the most appropriate way to manage the client’s ambivalence because narrative deconstruction encourages the client to tell their story to allow the therapist to fully understand the client’s perception of their problem. It may not facilitate addressing why the client wants to change his treatment goal. B is not the most appropriate way to manage the client’s ambivalence as this option ignores the reasons for the client’s wanting to change treatment goal and fails to acknowledge that this risks client engagement in therapy. C is not the most appropriate way to manage the client’s ambivalence. This option has the potential to invalidate the client’s reasons for changing the treatment goal by assuming it is something to do with the current therapy. D is the best response as exploring the ambivalence will help assess the specific issues. Maintaining a strong therapeutic alliance is critical to strengthening client engagement, and even more critical when a client is ambivalent or resistant. E is not the most appropriate way to manage the client’s ambivalence. You and the client have not assessed the reasons behind their desire to change, nor have you assessed if stress is the appropriate treatment target at this time. This option may simply facilitate the client’s avoidance of their depression which may be counter-productive to good treatment.

Question 19

A psychologist is preparing to provide feedback to a 76-year-old client regarding the results of a recent memory assessment. The psychologist has noticed that the client is anxious about the results of the assessment and has repeatedly asked for feedback about his performance. The assessment indicates that the client has significant memory deficits.
How can the psychologist deliver the feedback in a way that increases the likelihood of understanding and retention?
A.Emphasise visual forms of feedback and avoid the use of numbers as much as possible
B.Emphasise the validity of the assessment by referring to research and age-appropriate norms
C.Emphasise eye contact during the feedback session and limit extended questioning by the client
D.Emphasise multiple modes of feedback and encourage the presence of a support person
E.Emphasise overall performance by highlighting relative strengths as well as weaknesses

Answer 19

Answer D
A is not the best option as it is unknown whether this client prefers visual and non-numeric information. B is not the best option because although referring to research to support the findings of your assessment may be appropriate, the question is about the process of providing feedback, not what to include in the feedback. C is not the best option in reducing distress because while eye contact is important to ensuring your feedback is received, it is not a critical factor in increasing understanding of your feedback. It is also appropriate to encourage questions by the client to improve understanding. D is the best option as providing information in multiple forms is likely to improve the chances of comprehension and retention of information. The presence of a support person can reduce stress and also provide another source of information for the client. E is not the best option as while highlighting relative strengths and weaknesses is good practice and may be a helpful strategy to assist with understanding, the question is about the process of providing feedback, not what to include in the feedback.

Question 20

20 of 20.A psychologist working in a private practice has been seeing a 17-year-old elite athlete for treatment of adjustment difficulties following a career-ending injury. The client’s mother attends the next session with her son to discuss her concerns about his mood. The client discloses that he has been having more frequent and intense thoughts about suicide. He also reports that he has started giving away belongings and has written a letter to his family. The psychologist assesses the client’s risk of suicide as imminent but by this stage it is 6pm so he asks the client’s mother to take him to the local Emergency Department (ED).
What is the best way for the psychologist to transfer responsibility for the client’s care to the Emergency Department (ED)?
A.The psychologist should phone ahead to inform ED of his concerns and fax a written referral
B.The psychologist should instruct his mother to inform ED staff of their mutual concerns
C.The psychologist should phone ED to inform the staff that the client is on his way for a review
D.The psychologist should ask the client provide the relevant information when he attends ED
E.The psychologist should phone ED and provide the relevant referral information over the phone

Answer 20

Answer A
A is the most appropriate response as it would be important to let ED know to expect the client and to also provide written information that you have to assist ED in determining the risk in case they are unable to contact you. B is not the most appropriate response as it is your responsibility to hand over relevant clinical information and to ensure that it is received. C is not the most appropriate response as while it is important to let the ED know that the client is coming you have not provided any information about why you are concerned. D is not the most appropriate response as it is your responsibility to ensure that relevant information is provided and received as you have decided there is a high risk of suicide. E is not the most appropriate response as while it would be important to let ED know the client is coming, there is a possibility of information being lost if you only provide it over the phone.