This quiz takes you beyond the basics and into the kind of real-world knowledge clinicians actually use. Whether you’re brushing up for the NCE, sharpening your clinical instincts, or just testing what you think you know, dive in and see how strong your psychotropics game really is. Let’s get started.
Think you’re ready for a deeper challenge? This DSM-5-TR (Part 2) quiz takes it up a notch, pushing you to apply diagnostic knowledge with sharper distinctions and more advanced clinical nuance. You’ll test your ability to spot subtle differences, identify key specifiers, and recognize patterns that trip people up on the NCE—and in real-world assessments. Stay focused, trust your training, and use this as a chance to strengthen the areas that matter most. Let’s dive in.
For Part 1, see What’s Your DSM-5-TR IQ?
If you’re drawn to bite-sized learning that actually sticks, TED-Ed is a goldmine. Their short, visually engaging lessons spark insight, challenge assumptions, and make complex ideas feel accessible. In this post, I’ve curated 20 of the best TED-Eds for personal growth and learning—handpicked for their clarity, depth, and real-world relevance. Whether you’re a counselor, educator, student, or just someone who loves to learn, these videos can be used for self-reflection, growth, discussion, or as powerful supplements in the classroom or therapy office.
If you’ve made it this far, you’re clearly someone who cares about growing, thinking differently, and leveling up your life. These TED-Ed lessons aren’t just “videos to watch”; they’re quick hits of insight that can change the way you understand yourself and the world. Pick one today and actually apply something from it — even a small shift adds up. Keep exploring, keep questioning, and keep building a life that feels intentional instead of accidental. You deserve that kind of momentum.
Think you’ve got a solid handle on diagnostic criteria and clinical distinctions? This DSM-5-TR (Part 1) quiz will put your knowledge to the test. You’ll review core features, duration requirements, and differentiating symptoms across a variety of disorders—just like you’ll see on the NCE and in real clinical practice. Take your time, trust what you know, and notice where you might want a little more review. Let’s get started.
Once you’re finished with Part 1, move on to Part 2. If you’re studying for the NCE, you may also want to consider taking the free NCE 2025-2026 Practice Exam.
This is Part 6 in a six-part series covering the major content areas on the National Counselor Exam. The questions in this section are drawn from the 2025–2026 Mometrix Test Prep Flashcards, the Encyclopedia of Counseling (3rd Edition), and the DSM-5-TR. You don’t need to buy pricey prep materials—I already did. I’m sharing the information here for free. This is one of the most comprehensive free NCE prep resources available. For best results, watch all the videos in the series and then take the practice exam. There’s also a free tracking sheet you can download to record any questions you miss. It’ll help you see exactly where you need to spend more study time. Feel free to share this series with others who are studying for the exam, and use it with your study group if it’s helpful.
Section 1:
Section 2:
View all the videos in the free NCE study guide series for 2025-2026 and test you knowledge with the free practice exam:
Part 1: Research Design & Professional Ethics
Part 2: Areas of Clinical Focus
Part 3: Counseling Theory & Treatment Planning
Part 4: Counseling Skills & Interventions
Welcome to the fifth post in my free NCE study series. Each post focuses on one major topic area you’ll see on the exam and includes short, guided practice. Start by watching the videos in order—pause after each question to think through your answer, then hit play to check your reasoning. Once you’ve finished all videos, test yourself with the interactive multiple-choice quiz to expand on what you learned.
This post focuses on intake, assessment, and diagnosis and the theories that guide them—domains that show up frequently on the NCE.
View the other free NCE 2025-2026 study guides in this series and take the 175-question practice exam:
Part 1: Research Design & Professional Ethics
Part 2: Areas of Clinical Focus
Part 3: Counseling Theory & Treatment Planning
Part 4: Counseling Skills & Interventions
Stop calling it “being strong.”
Most people don’t break down. They shut down.
They keep working. Keep caretaking. Keep smiling in photos.
They say, “It’s fine, I’m just tired,” because the alternative is having to explain a pain they can barely understand themselves.
The world praises them for being “resilient.”
But it’s not resilience.
It’s the art of falling apart quietly.
Numbness dressed up as strength.
High-functioning.
We’ll call it:
Functional Freeze.
Your body did not fail you. It protected you.
When the world asked you to keep going, your nervous system made sure you could.
There’s a version of you that performs your life without actually feeling your life.
But inside?
It’s quiet. Too quiet.
Flat. Heavy. Far away.
This isn’t laziness.
It isn’t weakness.
It isn’t “not trying hard enough.”
This is your nervous system turning the volume down to protect you because everything was too loud to feel at once. It’s high-functioning depression.
When feelings are too overwhelming to process in real-time, your body turns them down so you can keep going.
Not broken.
Adapted.
Maybe you grew up in a home where your feelings were “too much.”
Maybe you were the caretaker.
The reliable one.
The one who held it all together.
Or maybe life has just been relentless for too long.
When there is no space to fall apart, your system chooses shut down over collapse.
You didn’t choose numbness.
Numbness chose you—to keep you alive.
Read that again.
People who are “high-functioning” almost never get help.
Because:
And so they stay silent.
Invisible.
Hurting in plain sight.
And we’re not jumping to “fix” anything.
We start small. Gentle. Slow.
Try this today (yes, just this):
For 10 seconds, pause and ask your body:
“What am I feeling physically right now?”
Not emotionally.
Not why.
Not how to change it.
Just notice:
If you can notice it,
you’re already coming back to yourself.
That’s the work.
Tiny reconnections.
Without forcing anything to open before it’s ready.
Before you click away, unclench your jaw.
Drop your shoulders.
Exhale slowly.
Notice the space that makes.
You’re still here.
Your body is still on your side.
Your system just let go—just a little.
That’s not weakness. It’s returning.
Pretending you’re fine isn’t required to move toward feeling fine.
You don’t have to fall apart to deserve support.
For more information about the NCE, see The National Counselor Examination (NCE) Content Outline.
This NCE practice exam reflects the types of questions and domains you’ll see on test day.
This NCE practice exam is based on Mometrix Test Preparation NCE Flashcards as well as Encyclopedia of Counseling, 3rd Edition and the DSM-5-TR. It has 175 questions.
To get the most out of this, treat it like the real thing:
Error Categories:
Your goal is not just a score — it’s identifying your weak content areas.
This exam does not measure your ability to help people. It measures recall under stress. Every point you improve is progress. You’re training your brain to think like a test-taker—not a therapist.
You’re building skill.
You’re moving forward.
You’ve got this.
Consider viewing the free NCE Study Guide Series (videos with question and answer slides):
The Modified Angoff Method is the standard-setting process used to determine the passing score on the NCE. It’s how the exam decides what score counts as “passing” for that specific test form.
| CACREP Domain | Approx % on Exam |
|---|---|
| Professional Orientation & Ethics | 10–12% |
| Human Growth & Development | 12–14% |
| Social & Cultural Diversity | 10–12% |
| Helping Relationships | 14–16% |
| Group Work | 9–10% |
| Career Development | 12–14% |
| Assessment | 10–12% |
| Research & Program Evaluation | 5–7% |
When you review missed questions, match them back to these domains.
For this practice NCE, a 70% is required to pass.
1. Don’t spend more than 60–90 seconds on a single question
2. Trust your first instinct unless you misread the question
3. Look for what the question is actually asking—many are about ethics + least restrictive + client safety
4. If stuck, eliminate two answers first, then choose
When two answers are correct, choose the one that is least restrictive and most client-centered.
If safety is involved, stabilize before insight.
On ethics questions, consult + document is almost always there for a reason.
If one answer is judgmental, harsh, or punitive → it’s wrong. Counseling answers prioritize rapport, safety, and dignity.
When in doubt, choose the answer that builds the relationship. Connection first, intervention second.
The “too obvious” answer is usually (but not always) a trap. The correct answer often includes one clarifying detail.
Don’t overthink pharmacology questions. Keep it surface-level: purpose + side effect = enough.
Download and print the free cheat sheet below.
| Look for These (Good) | Avoid These (Often Wrong) |
|---|---|
| Explore | Tell |
| Assess | Advise |
| Support | Direct |
| Collaborate | Persuade |
| Validate | Interpret immediately |
| Client-centered | Counselor-driven |
Disclaimer: This practice exam is an independently created study aid and is not affiliated with, endorsed by, or sponsored by the National Counselor Examination (NCE), NBCC, or any commercial test preparation publisher. All questions have been paraphrased, reworded, and/or newly created based on general counseling knowledge and do not reproduce proprietary test questions. This resource is for educational purposes only and should be used as a supplemental study tool—not as a replacement for official preparation materials.
Did you take the exam recently?
Share your experience or any content areas you’d like a deeper breakdown of.
Your feedback helps me make the next practice exam even better.
Identify your weakest domain.
Download a printable version of the practice exam below:
Print and complete the Incorrect Answer Sheet to guide your studies.
Schedule your next practice session.
Bookmark this page to review later.
**ANSWER KEY (WITH FULL EXPLANATIONS) COMING SOON!**
Ketamine therapy is a medically supervised treatment that uses low doses of ketamine to reduce symptoms of treatment-resistant depression, anxiety, PTSD, and chronic pain. It works by influencing glutamate signaling and promoting neuroplasticity, helping the brain form new, more adaptive pathways.
Let’s start with the facts. Ketamine is “a dissociative anesthetic that has some hallucinogenic effects” (Drug Enforcement Administration, 2020). Originally developed as an anesthetic, ketamine is commonly used in veterinary medicine for short-term sedation and pain relief during surgery and procedures.
Currently, ketamine is the only FDA-approved psychoactive drug available to mental health providers and their patients. It has been shown to improve symptoms of depression in individuals with treatment-resistant depression as well as rapidly reduce suicidal ideations in suicidal patients (Grunebaum et al., 2018). Ketamine may also be a promising treatment for alcohol use disorder (AUD). Individuals with AUD were able to abstain for longer with ketamine-assisted psychotherapy.
Ketamine affects the brain differently than traditional antidepressants. Most standard medications for depression work on the serotonin system and can take several weeks to produce noticeable changes.
Ketamine acts primarily on the glutamate system, the brain’s main excitatory neurotransmitter, by blocking NMDA receptors and increasing the release of BDNF (Brain-Derived Neurotrophic Factor).
This process promotes neuroplasticity, which is the brain’s ability to form new neural connections. In simpler terms, ketamine temporarily shifts the brain out of rigid, depressive thought patterns and opens a window where learning, emotional processing, and therapeutic change may happen more effectively. It’s not just numbing symptoms—it’s helping the brain reconnect, adapt, and respond in new ways.
Ketamine therapy does not work the same way for everyone. Some people experience noticeable relief within the first few sessions, while others notice more gradual changes in mood, perspective, or emotional flexibility. The effects are often strongest when therapy and lifestyle support are included. Most people will need a series of sessions followed by occasional maintenance treatment. The goal is not to “erase” depression or anxiety overnight — it’s to create space for healing and change.
While ketamine therapy can be effective, it is not without risks. Common short-term side effects include dizziness, nausea, elevated blood pressure, blurred vision, fatigue, and dissociation (a temporary sense of disconnection from one’s thoughts, surroundings, or body). These effects typically resolve within one to two hours after a session.
Less commonly, ketamine can cause emotional overstimulation, anxiety during the experience, or headache afterward. Ketamine is not recommended for individuals with uncontrolled hypertension, a history of psychosis, or certain types of bipolar disorder, as it may worsen symptoms.
People who have:
Ketamine therapy may not be appropriate for individuals with:
Screening should always be thorough and individualized.
Because ketamine has misuse potential, it should only be used under medical supervision with structured follow-up and integration support. Screening, careful dosing, and monitoring are essential to ensure the therapy is both safe and effective.
Choosing a ketamine therapy provider should involve more than locating the nearest clinic. Look for a program that offers medical supervision, clear screening procedures, and a treatment plan tailored to your history and needs. Reputable clinics will conduct a comprehensive assessment before beginning treatment, monitor your physical and psychological response during sessions, and provide integration support afterward to help you process insights and maintain progress.
| Method | How It’s Given | Where It Happens | Cost | Pros | Cons |
|---|---|---|---|---|---|
| IV Infusion | Slow, controlled drip | Clinic only | High | Most research support | Expensive; requires time on-site |
| IM Injection | Single injection | Clinic | Moderate | Fast onset; predictable | Less adjustable dose mid-session |
| Spravato (Esketamine) | Nasal spray | Clinic + monitoring | High (but may be covered) | FDA-approved; insurance may help | Must meet specific criteria |
| Lozenge/Troche | Dissolves under tongue | Clinic or at-home protocols | Lower | Flexible + accessible | Greater variation in absorption |
Ask who will be present during the dosing session, how emergencies are handled, and whether psychotherapy is included as part of the program—not just ketamine infusions alone. Be cautious of providers who market ketamine as a “miracle cure” or minimize the need for follow-up care. A trustworthy ketamine program should prioritize safety, transparency, and continuity of care, not just symptom relief.
Ketamine therapy is available in outpatient clinics and specialty mental health centers across the United States. If you’re searching locally, try “ketamine therapy near me” or ask your mental health provider for referrals.
Reflection Prompt: If you are considering ketamine therapy, what are the main symptoms or patterns you are hoping to shift? Writing your intentions down can support clarity in your treatment decisions.
Ketamine therapy varies in cost depending on the type of treatment and setting. IV infusions typically range from $350–$900 per session, while Spravato (esketamine nasal spray) may be covered by insurance when used for treatment-resistant depression. Oral lozenges and at-home protocols are often more affordable but should still be supervised by a trained provider. It’s important to ask providers about pricing, financial policies, and whether they assist with insurance pre-authorization.
Assessment: Your provider reviews medical and mental health history.
Preparation: You may set intentions or talk through emotions beforehand.
Administration: Ketamine is given via IV, IM injection, nasal spray (Spravato), or oral lozenge.
Experience: You will be awake but may feel relaxed, introspective, or detached from your surroundings.
Monitoring: A trained clinician remains present and monitors vital signs.
Integration: After the session, therapy or reflection helps apply insights to daily life.
If you’re considering ketamine therapy, it’s normal to have questions. Understanding what to expect can help you decide whether this approach feels right for you. The following FAQ offers clear, straightforward information about the treatment process, safety, benefits, and practical details. Use it as a starting point — and bring any additional questions to your provider so you can make an informed, confident decision.
This worksheet includes:
Clinician version:
Support for Reflecting and Applying Insights After Ketamine Sessions
After each session, consider:
Ketamine therapy is an emerging treatment option for individuals who have not experienced enough relief from traditional approaches to depression, anxiety, PTSD, or chronic pain. By influencing the brain’s glutamate system and supporting neuroplasticity, ketamine can help reduce symptoms and create an opportunity for meaningful therapeutic change. However, it is not a stand-alone solution or a quick fix.
The most effective outcomes occur when ketamine is provided in a medically supervised setting and paired with integration therapy to support new patterns of thinking and coping.
If you’re considering ketamine therapy, take time to research providers, ask questions, and choose a program that prioritizes safety, transparency, and whole-person care.
Disclaimer: This article is for educational purposes only and is not a substitute for medical or mental health treatment. Always consult with a licensed healthcare provider before beginning ketamine therapy or changing your treatment plan.
Neuroplasticity:
The brain’s ability to form new neural pathways and reorganize existing ones. Increased neuroplasticity can support emotional and cognitive change during treatment.
Glutamate:
The primary excitatory neurotransmitter in the brain. Ketamine acts on glutamate signaling, which plays a central role in mood, learning, and memory.
NMDA Receptor:
A receptor involved in neural communication. Ketamine temporarily blocks this receptor, which can lead to rapid changes in mood and perception.
Dissociation:
A temporary sense of detachment from thoughts, emotions, or surroundings. This is a common and expected part of ketamine’s therapeutic effect and usually fades shortly after treatment.
Integration Therapy:
The therapeutic process of reflecting on and applying insights gained during a ketamine session. Integration helps translate the experience into lasting emotional and behavioral change.
Grabski, M., McAndrew, A., Lawn, W., Marsh, B., Raymen, L., Stevens, T., Hardy, L., Warren, F., Bloomfield, M., Borissova, A., Maschauer, E., Broomby, R., Price, R., Coathup, R., Gilhooly, D., Palmer, E., Gordon-Williams, R., Hill, R., Harris, J.,Mollaahmetoglu, O. M., Curran, H.V., Brandner, B., Lingford-Hughes, A., Morgan. C. J. A. Adjunctive ketamine with relapse prevention–based psychological therapy in the treatment of alcohol use isorder. American Journal of Psychiatry, 2022; DOI: 10.1176/appi.ajp.2021.21030277
Grunebaum, M. F., Galfalvy, H. C., Choo, T.-H., Keilp, J. G., Moitra, V. K., Parris, M. S., Marver, J. E., Burke, A. K., Milak, M. S., Sublette, M. E., Oquendo, M. A., & Mann, J. J. (2018). Ketamine for rapid reduction of suicidal thoughts in major depression: A midazolam-controlled randomized clinical trial. American Journal of Psychiatry, 175(4), 327–335. https://doi.org/10.1176/appi.ajp.2017.17060647
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., … Wolfson, P. (2019). Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy. Journal of Psychoactive Drugs, 51(2), 189–198. https://doi.org/10.1080/02791072.2019.1587556
Drozdz, S. J., Goel, A., McGarr, M. W., Katz, J., Ritvo, P., Mattina, G. F., … Ladha, K. S. (2022). Ketamine assisted psychotherapy: A systematic narrative review of the literature. Journal of Pain Research,15, 1691–1706. https://doi.org/10.2147/JPR.S360733
Drug Enforcement Administration. (2020, June). Ketamine: Drug fact sheet. U.S. Department of Justice. https://www.dea.gov/sites/default/files/2020-06/Ketamine-2020_1.pdf
Cassie Jewell, LPC, LSATP is a licensed clinical therapist and behavioral health clinician specializing in depression, anxiety, trauma recovery, and harm reduction. She has experience supporting individuals with treatment-resistant mental health conditions and approaches care through a trauma-informed, client-centered lens. Cassie is also a stroke survivor and mental health advocate who writes about recovery, resilience, and evidence-based approaches to healing. She created Mind Remake Project to provide accessible, practical mental health resources for individuals and clinicians.
Living with chronic pain can impact every area of life—from your physical health to your emotional wellbeing. Whether you’re managing pain from an injury, illness, or long-term condition, it helps to have pain management tools that empower you to cope and take back a sense of control.
Pain is a complex biopsychosocial experience involving physical, neurological, emotional, and environmental factors. Effective pain management requires acknowledging that pain is not solely a bodily symptom; it is mediated by the nervous system, influenced by psychological stressors, and shaped by personal meaning and context. Treatment is most effective when it addresses the full experience of pain, not just the physical sensation.
When pain becomes chronic, the nervous system can shift into a heightened state of sensitivity, often described as central sensitization. In this state, the body’s pain alarm system becomes hyper-reactive, sending stronger or more frequent pain signals even when there is no new injury or tissue damage. This does not mean the pain is “in someone’s head.” Rather, it reflects real, measurable changes in neural processing.
Movement is central to pain recovery. Contrary to the instinct to rest, prolonged inactivity can worsen pain, decrease function, and increase sensitivity in the nervous system.
Effective strategies include:
Gradual, consistent movement retrains the nervous system to interpret bodily sensations more accurately, improving function over time.
Psychological interventions do not imply that pain is imaginary; rather, they address how pain affects thoughts, mood, and behavior. These strategies can decrease pain-related distress and improve coping.
Evidence-supported approaches include:
These interventions help individuals build a more functional and meaningful life even when pain is present.
Chronic pain is strongly influenced by the body’s stress-response system. Supporting nervous system regulation can reduce pain intensity and improve resilience.
Helpful strategies:
Small, sustainable adjustments are more effective than dramatic short-term changes.
This curated list of free pain management resources includes booklets, workbooks, and practical tools rooted in evidence-based approaches.
Disclaimer: These materials are intended for informational and educational purposes only and should not replace medical advice, diagnosis, or treatment. Please consult a healthcare professional before making changes to your pain management plan. Additionally, while all links were active and publicly available at the time of posting, I am not responsible for the content or maintenance of third-party sites. Readers are responsible for adhering to any applicable copyright laws when accessing or sharing these resources.
