Clinical Vignettes for EPPP: How to Respond
Clinical vignettes on the Examination for Professional Practice in Psychology (EPPP) challenge your ability to apply theoretical knowledge to real-world scenarios. These vignette-based questions simulate realistic situations that psychologists encounter in clinical practice. Responding accurately requires strong clinical judgment and a strategic approach.
How to Approach EPPP Clinical Vignettes
When tackling clinical vignettes, keep these strategies in mind:
- Carefully Read the Scenario: Pay close attention to key details such as the client’s demographics, presenting problems, and any underlying factors that might influence the case.
- Identify the Central Issue: Determine what the vignette is primarily testing. Is it about diagnosis, ethical decision-making, therapeutic interventions, or risk assessment?
- Eliminate Clearly Incorrect Options: Use clinical guidelines, ethical standards, and diagnostic criteria to narrow down your choices by immediately discarding inappropriate or unethical responses.
- Apply Your Clinical Knowledge: Draw from evidence-based practices and established clinical guidelines to select the most appropriate intervention or decision.
- Prioritize Client Welfare and Ethical Standards: Always choose responses that prioritize client safety, confidentiality, informed consent, and adherence to professional ethical guidelines outlined by the American Psychological Association (APA).
- Consider Cultural Competence: Select responses that demonstrate cultural sensitivity and awareness, respecting client diversity and providing culturally informed interventions.
Practice EPPP Clinical Vignettes
Regular practice with EPPP vignette scenarios helps strengthen your clinical judgment. Utilize mock exams and practice questions to familiarize yourself with the format and improve your ability to quickly identify the best responses.
By mastering clinical vignettes, you’ll be better equipped to pass the EPPP and effectively handle real-world clinical challenges in your psychological practice.
3 Practice Clinical Vignettes for the EPPP Exam
EPPP Practice Scenario 1
You have been seeing a 16-year-old girl for therapy for six months. Over that time, you have developed a professional opinion that the girl is depressed and needs supportive, insight-oriented therapy to discover the underlying causes of her depression and the beliefs she has about herself. You think the patient is progressing well in therapy, but are aware that she has continued to have angry outbursts at home. Today, you receive a phone call from the girl’s mother, who says your current therapeutic approach is not working and asks you to begin an “anger management” curriculum with her daughter.
What is the best thing you could do?
A. Refuse to speak with the mother due to confidentiality policies
B. Meet with the mother to explain your approach, as long as you have the client’s permission to share information
C. Agree with the mother and begin an anger management curriculum while continuing to treat the client’s depression
D. Ask the client if she thinks she needs anger management
Correct answer: B. Meet with the mother to explain your approach, as long as you have the client’s permission to share information
Principle E, Respect for People’s Rights and Dignity, ethically requires psychologists to respect clients’ autonomy and self-determination. However, because this client is a minor living at home, it is best to meet regularly with the mother to discuss your observations and conceptualizations of the girl’s anger and depression and explain your approach. You likely discussed confidentiality policies with the client and her mother at the onset of therapy, so talking with the client about sharing information with her mother should not be a surprise to the client. If the mother continues to request a different type of intervention aside from what you know is working, you should gently offer to refer the girl elsewhere. Psychologists have a duty to provide evidence-based interventions.
In general, when meeting with adolescents for the first time, many clinicians explain confidentiality to the parents or caretakers as well. At this time, you can define the limits of confidentiality as well as why you may want to meet regularly with the parents. In subsequent individual sessions with adolescents, you can continue to discuss confidentiality and talk specifically with the client about what she is and is not comfortable with the parents knowing. Based upon these facts, you should not necessarily refuse to speak to the mother.
Agreeing with the mother and providing anger management or talking with the client about anger management isn’t the best option, since the client is making therapeutic progress with your current interventions.
References
EPPP Fundamentals, Step One: Review for the Examination for Professional Practice in Psychology, Second Edition. Pg 332-334.
EPPP Practice Scenario 2
A psychologist has been seeing a middle-aged man for the past month following the death of his wife from cancer. During one therapy session with the psychologist, the man says that he thinks it would be better if he were dead and plans on shooting himself that evening with a gun he has at home. Despite the psychologist’s efforts, by the end of the session, the man continues to be suicidal but refuses to drive himself to the hospital.
What should the psychologist do?
A. Keep the man at the office until he can sign a safety contract
B. Call a family member to pick the man up from the office and stay with him at his house
C. Allow him to leave the office, but send law enforcement to his home for a wellness check
D. Stay with the man until an involuntary commitment can be obtained
Correct answer: D. Stay with the man until an involuntary commitment can be obtained
Although psychologists have an obligation to maintain clients’ confidentiality, there may be situations when psychologists must share certain information, even if it goes against the client’s wishes. In this situation, the man intends to complete suicide and is a clear risk to his own safety. The psychologist should obtain an involuntary commitment according to local procedures and ensure the man is evaluated at an emergency room or crisis center. The other options would not ensure his immediate safety. For example, getting the man to agree to sign a safety contract would be insufficient, as he has a gun at home. He could sign the contract, leave the office, and use the gun to complete suicide.
References
EPPP Fundamentals, Step One: Review for the Examination for Professional Practice in Psychology, Second Edition. Pg 336-337.
EPPP Practice Scenario 3
As a psychologist who regularly provides family therapy, you met with the Smith family for about six months until about three months ago, when you and the family agreed termination was appropriate. You get a call from Mrs. Smith, who informs you that she and Mr. Smith are getting a divorce, and she wants you to testify on her behalf about her parenting abilities as compared to her soon-to-be ex-husband. You contact Mr. Smith, who tells you he does not want you to testify.
What should you do?
A. Refrain from testifying
B. Testify but refuse to share any information about Mr. Smith
C. Only testify about areas in which you are competent
D. Testify but remain objective
Correct answer: A. Refrain from testifying
Standard 10.02(b) states that psychologists who see families and/or couples should withdraw from proceedings if they are called to perform potentially conflicting roles, such as testifying in divorce proceedings. Additionally, Standard 3.04(a) requires psychologists to avoid doing harm to current and former clients when at all possible. In this situation, if you agree to testify, Mr. or Mrs. Smith will potentially be placed at a disadvantage. You also need to have permission from both clients before you can release confidential information.
References
EPPP Fundamentals, Step One: Review for the Examination for Professional Practice in Psychology, Second Edition. Pg 326-327.
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