National Certified Counselor NCE-ABE Book

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.

Career construction counseling (Savickas) is a narrative, meaning-based approach to career development. Its central activity is helping clients tell, explore, and organize their life stories in a way that reveals recurring life themes and preferred ways of being in the world. These themes then guide career choices and roles that feel coherent and meaningful.

Thus, option C. Identifying life themes is correct, as it captures the core narrative task of career construction counseling.

A. Analyzing temperament fits more with trait-based or psychometric approaches.

B. Documenting experience may occur, but it is secondary to making sense of those experiences through themes.

D. Practicing interview skills is a useful career skill-building task but is not the central activity of career construction counseling.

NBCC Counselor Work Behavior Areas expect counselors to understand major career theories and approaches, including narrative and constructivist models that emphasize life themes, meaning-making, and storytelling in career development.

Within the Counselor Work Behavior Areas, counselors are expected to understand the core assumptions of major counseling theories, including behavioral approaches. Behavioral theories view psychological issues, including anxiety, primarily in terms of learned behaviors and skills deficits, rather than unconscious conflicts or self-concept discrepancies.

From a behavioral orientation, anxiety is understood as:

A response that has been learned and reinforced in certain situations.

Often maintained because the person does not have effective, adaptive responses or coping skills for those situations.

Reduced in the short term by avoidance, which then reinforces the anxious response in the long term.

Thus, Option B, lack of effective responses to problem situations, best reflects the behavioral view that anxiety develops and persists when individuals have inadequate or maladaptive behavioral repertoires for dealing with stressors.

Why the other options are incorrect:

A. Inappropriate reactions to early childhood behavior – This suggests a more psychodynamic or relational focus on early childhood experiences, not a strictly behavioral explanation.

C. Discrepancies between the real and the ideal self – This reflects humanistic/person-centered theory (Rogers), not behavioral theory.

D. Overt inconsistencies in responding to the environment – While behaviorists pay attention to environmental contingencies, this option does not clearly capture the central behavioral idea that anxiety persists due to reinforced maladaptive responses and lack of effective alternatives.

This matches the Counselor Work Behavior Area requirement that counselors know how different theoretical orientations conceptualize the development and maintenance of client problems, including anxiety, so they can plan appropriate, evidence-based interventions.

Ratio IQs (mental age ÷ chronological age × 100) create interpretation problems, especially for adults, because mental age does not increase steadily across the lifespan. Modern intelligence testing instead uses deviation IQs, which:

Compare an individual’s performance to that of their age-based normative group.

Use a fixed mean (typically 100) and standard deviation (often 15 or 16) to express how far above or below the average a person’s score falls.

Option B best captures this idea: deviation IQs are derived from standardized norms with designated means and standard deviations, which are similar across many commonly used IQ tests, allowing for more meaningful interpretation.

The other options do not describe the purpose of deviation IQs:

A. Lower the standard deviation among test takers – deviation IQs standardize the distribution; they don’t simply “lower” the standard deviation.

C. Place primary emphasis on selecting students in extreme intelligence categories – extremes can be identified, but that is not the primary reason deviation IQs were developed.

D. Reflect that all new IQ tests are being based on a common theory of intelligence – tests differ in their theoretical foundations; deviation scoring is a psychometric method, not a theory of intelligence.

Within the Intake, Assessment and Diagnosis area, counselors are expected to understand basic principles of standardized testing, including the interpretation of IQ scores using norm-referenced, deviation-based metrics.