In the Therapy Room
A client talks for 20 minutes without pausing; the most helpful first intervention is this.
What is gently interrupting and structuring the session?
The fastest way to damage rapport in early sessions is doing this too soon.
What is problem-solving before understanding?
A client reports long-standing social detachment, limited emotional expression, and little interest in relationships, but no psychosis, paranoia, or social anxiety.
What is Schizoid Personality Disorder?
When suicidal ideation is present, this must always be assessed—even if the client says they are “just venting.”
What are intent, plan, and means?
A client emails outside session hours; the boundary is determined by this, not urgency.
What is your informed consent and clinic policy?
A client asks, “What would you do if you were me?” The most clinically sound response does this instead of answering directly.
What is redirecting to the client’s values and options?
The most common burnout pattern in associate therapists comes from this behavior.
What is over-functioning and rescuing clients?
A client experiences episodes of depersonalization and derealization without panic attacks, substance use, or psychotic features, and remains fully reality-oriented.
What is Depersonalization/Derealization Disorder?
A client reports passive SI without plan; the minimum standard of care requires this action.
What is risk assessment with documentation and safety planning?
A client asks personal questions about your relationship; the best response balances warmth with this.
What is therapeutic relevance?
A session feels like “catching up” with no movement; the most effective mid-session reset is this.
What is naming the pattern and refocusing on the goal?
You strongly disagree with a client’s beliefs; this skill prevents rupture and ethical drift.
What is therapeutic neutrality with curiosity?
A client presents with sudden neurological-like symptoms (e.g., paralysis, blindness) inconsistent with medical findings and preceded by psychosocial stressors.
What is Functional Neurological Symptom Disorder (Conversion Disorder)?
A client denies SI but gives away belongings and withdraws socially; this is categorized as this type of risk indicator.
What are behavioral warning signs?
Running over session time repeatedly creates this boundary problem.
What is unequal treatment across clients?
A client says something factually untrue but emotionally meaningful; the therapist should respond to this rather than correcting facts.
What is the underlying emotion or meaning?
The most underused supervision skill is not asking questions, but doing this consistently.
What is discussing uncertainty, mistakes, and emotional reactions?
A client demonstrates lifelong patterns of emotional restraint, perfectionism, and excessive devotion to work at the expense of relationships, without ego-dystonic distress.
What is Obsessive-Compulsive Personality Disorder?
The most common documentation error in high-risk cases is not lack of action, but lack of this.
What is documented clinical reasoning for decisions made?
A client wants to connect on social media; the most important step is this.
What is addressing and documenting the boundary conversation?
You realize halfway through session that you are subtly avoiding a difficult topic; the most ethical clinical move is this.
What is naming the avoidance internally and addressing it therapeutically or in supervision?
Feeling dread before a session is ethically important because it represents this type of data.
What is countertransference requiring reflection and consultation?
A client exhibits chronic interpersonal distrust, reads hidden threatening meanings into benign remarks, and persistently holds grudges without psychosis or delusions.
What is Paranoid Personality Disorder?
A client discloses past homicidal thoughts with no current intent; legal and ethical response hinges on this principle.
What is imminence and duty to protect standards?
The hardest boundary to maintain is often not with clients, but with this.
What is your own desire to help or be liked?