Scenario Exams

Exam Format

If you purchased a NCMHCE package you get access on your Profile page.

You can choose a scenario to get started or choose to review a scenario already begun.

In the Downloads section all three formats of the eBook are available for download.

The 37 Exam Format scenarios are similar to the design utilized by the National Board for Certified Counselors (NBCC) for the NCMHCE. These scenarios follow the standard protocol used to identify a mental health disorder for a simulated client case. Many of the scenarios will provide adequate data to make a diagnosis; however several will provide data that point to multiple diagnoses.

The Exam Format scenarios will be introduced with a Summary of the client's initial statement or chief complaint. Read each summary carefully.

Note that the scenarios become more complex as you advance deeper into the list.

Answering Questions

As the counselor, you must then work through appropriate questions and gather the information necessary to formulate a diagnosis and treatment plan.

As you answer each question, note that most have more than one answer that will provide important information. These answers will positively affect your score, so it is best to select as many positive answers as possible. Other answers will not be helpful, and thus will negatively affect your score. Still other answers will be neutral. You will find out the score associated with each answer at the end of the scenario.

Part of the critical thinking evaluation is for you to determine which answers are important. A response is displayed immediately upon choosing an answer.

Stop Question

Important: each scenario contains a diagnosis Stop question. After initial information gathering questions, sufficient information will have been provided for you to make a correct diagnosis. For the Stop question, you will be instructed not to go forward until a correct diagnosis is made.

For scenarios with two diagnoses, it is suggested that you select the answer with the most prevalent diagnosis first followed by the secondary diagnosis. A few scenarios will instruct you to find three diagnoses before going to the next question. On those scenarios with three correct answers, you may select in any order. A recommended treatment question usually follows the diagnosis question. When multiple diagnoses are identified, the treatment question should be answered with treatments for all identified unless a specified diagnosis is requested.

Page Navigation

At the bottom of the scenario you will find a pagination bar displaying a page for each question. You must complete the current question before before the next becomes available (question number turns blue).

Once you have completed all questions you can select 'Show Score' to see your results.

You can go to another scenario before completing the one in use, then return later to finish. Your progress is remembered.


You score is displayed in two parts "Information Gathering" and "Decision Making". Your 'Information Gathering' and 'Decision Making' points are compared to total possible points.

There is no passing score used for the online scenario simulator.

Once you select the 'Show Score', all questions will be displayed with all answers that include point values for each even if you did not select those choices. It is color coded for easier reading.


Each answer is coded as Not Chosen , Incorrect , Correct , or No Value and includes scoring values. Some questions will show 'Discussions' or 'Recommendations' at the end.